Early results of a modified technique of cryosurgery

The objective of this study was to present a simple, convenient, and reliable technique for the application of liquid nitrogen and to evaluate the effectiveness of curettage and cryosurgery. Between 1992 and 2002, 24 patients who had benign aggressive and low-grade malignant bone tumors were treated by curettage and cryosurgery. While cryosurgery was applied by the "direct pour" technique in the first seven patients, it was applied by the "pressurized spraying" technique in the others. Functional results were graded according to Enneking. The mean follow-up was 47 (range 9-131) months. There were no local recurrences. Three patients who underwent the direct pour technique developed partial skin necrosis. The functional results were excellent in 14 patients, good in six, and fair in four. When compared with previous reports on cryosurgery and its application techniques, we detected no tumor recurrence or complications, including soft-tissue injury, infection, and late fracture with liquid nitrogen applied by the pressurized spraying technique.     

Transplantation Using Renal Grafts With Multiple Renal Arteries: A Putative Study on the Impact of Arterial Reconstruction Technique and Site of Implantation on Outcomes

BackgroundIn the present retrospective study, we analyzed the outcomes of patients transplanted with grafts with multiple renal arteries (MRAs).Patients and MethodsIn total, 89 patients were transplanted with renal grafts with MRAs from 2003 to 2018. Demographic characteristics; type of donor; warm and cold ischemia times; arterial anastomosis technique; complications; graft function at first month, first year, and last outpatient clinic visit; and patient and graft survival were all retrospectively evaluated.ResultsThe mean age of the patients was 40.4 ± 13.3 years. Fifty-six patients (62.9%) were male. In total, 42 patients (47.2%) received renal grafts from living related donors. In group A (n = 24; 27%), anastomosis was performed separately to the recipient external or internal iliac arteries; in group B (n = 38; 42.7%), the secondary artery was anastomosed to the main artery in a side-to-side fashion to form a single common orifice; in group C (n = 27; 30.3%), secondary arteries were anastomosed to the main renal artery in an end-to-side fashion. Creatinine clearance at the first month was significantly lower for deceased-donor grafts compared to living-donor renal grafts (P < .05). Creatinine clearance in the first postoperative month was significantly lower in group A and creatinine clearance in the first year was significantly lower in group C (P < .05). The best survival was found for anastomosis to the internal iliac artery (P < .05).ConclusionMRAs can be safely used and the reconstruction technique does not matter if the graft kidney’s arterial supply is preserved and the internal iliac artery is chosen for anastomosis.     

Should Interventional Radiology or Open Surgery Be the First Choice for the Management of Ureteric Stenosis After Transplantation? Dual-Center Study

Background

Ureteric stenosis (US) is the most common urologic complication after kidney transplantation. In this dual-center retrospective study we compared the efficacy and safety of open surgery versus interventional radiology for the management of US.

Blood plasma proteins on polyurethane and alkylsiloxane plasma-treated polyurethane surfaces. Dynamic approach by stimulus-response technique

In this study, interactions of blood proteins (i.e. albumin and fibrinogen) with polyurethane biomaterial surfaces were investigated in an in vitro bead column test circuit using a stimulus-response technique. The dynamic sorption process of radiolabelled proteins on the surfaces was followed by detecting the radioactivity at the exit stream of the column, which was the response of a pulse stimulus at the inlet. The mathematical model was described and solved using ‘parameter estimation by cybernetic moment technique’, and the adsorption rate constants of plasma proteins on different biomaterial surfaces were calculated. By evaluation of the response curves with standard and cybernetic moment techniques, the following results were obtained. Albumin and fibrinogen adsorption is competitive, and the competition is strongly dependent upon the surface characteristics of the biomaterial. Preadsorption or preferential adsorption of albumin decreases the fibrinogen adsorption, and there-fore increases the biocompatibility of material surface. Adsorption of blood plasma proteins are irreversible. The moment technique can also be used for the evaluation of stimulus-response data of biological systems, to determine the process parameters.     

Electrospun matrices made of poly(alpha-hydroxy acids) for medical use

Biomaterials are widely used in diverse applications as substances, materials or important elements of biomedical devices. Biodegradable polymers, both natural and synthetic, have been utilized in applications in which they act as temporary substitutes. Poly(alpha-hydroxy acids), especially lactic acids and glycolic acid and their copolymers with epsilon-caprolactone, are the most widely known and used among all biodegradable polymers. They degrade in vivo into safe end products mainly by hydrolysis in a few weeks to several months, depending on several factors, including molecular structure/morphology, average molecular weight, size and shape. They are processed into tailor-made materials for diverse applications, although mainly for soft and hard tissue repair. Electrospinning is a method of producing nanofibers and nonwoven matrices from their solutions and melts. Several factors affect fiber diameter and resulting nonwoven structures/morphologies. Recently, electrospun matrices made of lactic acids, glycolic acid and epsilon-caprolactone homo- and co-polymers have been attracting increasing attention for fabrication of novel materials for medical use. This review briefly describes poly(alpha-hydroxy acids) and the elecrospinning process, and gives some selected recent applications of electrospun matrices made from these polymers.     

Evaluation of allergic sensitization and gastroesophageal reflux disease in children with recurrent croup

Background:  Croup, which is seen commonly in childhood, is a disorder that can be recurrent and progress to bronchial asthma. In the present study the prevalence of gastroesophageal reflux (GER) and atopy and the response to therapy were investigated in children with recurrent croup.
Methods:  Between October 2003 and June 2004, 57 patients with acute stridor were admitted to the emergency room. The patients who had at least three croup episodes and patients with first croup episode were compared.
Results:  Thirty-two children had recurrent croup history, GER was found in of 62.5%, and atopy in 17.2%. Atopy was not found in any children with first croup episode. The difference was significant. In addition it was found that atopic dermatitis, previous history of wheezing and established atopy increased the risk of croup recurrence. Alone or combined inhaled corticosteroids and GER therapy were administered, and 77.7% of the patients responded very well.
Conclusion:  GER and atopy should be investigated in patients with recurrent spasmodic croup. Recurrent croup is a non-specific manifestation of atopy. Patients with atopy should be followed closely for developing bronchial asthma.     

COMPARISON OF THE UROPROTECTIVE EFFICACY OF MESNA AND HBO TREATMENTS IN CYCLOPHOSPHAMIDE-INDUCED HEMORRHAGIC CYSTITIS

The aim of this research was to compare the protective effects of mesna, hyperbaric oxygenation (HBO), and their combination in cyclophosphamide-induced hemorrhagic cystitis in guinea pigs. Following one dose of i.p. 21.5 mg./kg. mesna administration 20 minutes before i.p. 68.1 mg./kg. cyclophosphamide, 3 additional doses of mesna were given every three hours. A total of 8 HBO exposures, 5 of which were applied prophylactically before cyclophosphamide, were performed at 2.8 ATA for 90 minutes 2 times a day. Although mesna or HBO provided significant protection for cyclophosphamide-cystitis in animal bladders, there was also significant damage compared with controls. The combination of mesna and HBO, which act through independent mechanisms, resulted in complete protection, since mean histological scores and hematuria levels in this group were not different from controls (p >0.05). Therefore, this combination may be a useful tool in the prophylaxis and treatment of cyclophosphamide-induced hemorrhagic cystitis.     

Platelet and mean platelet volume kinetics in adult patients with sepsis

Abstract

The aims of this study were to evaluate the kinetics of platelet counts and mean platelet volume (MPV) in adults with sepsis and to determine whether the responses are infection-specific. This retrospective cohort study included patients admitted to a tertiary-care teaching hospital with microbiologically proven nosocomial sepsis between January 2006 and January 2011. Platelet counts and MPV measurements were examined daily for 5 days after the onset of sepsis. During the study period, 151 of the 214 sepsis episodes were associated with thrombocytopenia. Gram-positive microorganisms were the most frequently isolated. The decrease in platelet counts was statistically significant for the first 3 days of sepsis in Gram-positive septic patients, for 4 days in Gram-negative septic patients and for all 5 days in fungal septic patients (p?<?0.001). The increase in MPV values was statistically significant for the first 3 days of sepsis in Gram-positive septic patients and for all 5 days in the other groups (p?<?0.001). We conclude that fungal sepsis has a stronger association with thrombocytopenia and increased MPV.