Hemodynamic and hemolytic features of the St. Jude Medical valve prostheses

We performed valvular replacement in 86 cases (108 valves, 43 males, 43 females) from July 1978 to July 1981 with St. Jude Medical valves which utilize two discs made of pyrolytic carbon and employ a bileaflet central opening system. Ages ranged from 13 to 68 years (average 42.3). For all cases in this study, we performed anti-coagulant therapy. The incidence of thromboembolic complication was zero. With regard to postoperative clinical evaluation on valve function and chronic hemolysis, we compared the cases of St. Jude Medical valves with those of Starr-Edwards (S.E.) valves (aortic: Model 2320, mitral: Model 6400), Carpentier-Edwards (C.E.) valves and cases of open mitral commissurotomy. As for valve function such as left atrioventricular diastolic pressure gradient, mitral effective orifice area both at rest and on exercise, the St. Jude Medical valve yielded best results. Next was the C.E. and third was the S.E. The results of the St. Jude Medical valve group and those of the open mitral commissurotomy group were equivalent. In comparison with ball type cardiac valve prostheses and bioprostheses, the St. Jude Medical valve has excellent hemodynamic characteristic. Concerning hemolysis, the St. Jude Medical was below only the C.E., however the degree of hemolysis was so low that the St. Jude Medical valve holds great promise as central flow mechanical valve prostheses.     

Use of resurfaced temporoparietalis flap in total ear reconstruction with less-than-favorable skin coverage

Use of a vascular pedicled temporoparietalis muscle flap resurfaced with a full-thickness skin graft from the opposite ear, instead of less-than-favorable skin coverage, is advocated to achieve more satisfactory aesthetic results in total ear reconstruction handicapped by the presence of scarred local skin. The technical feasibility of the procedure and the authors' experiences in the past 9 years are described.Presented at the 8th International Congress of Plastic and Reconstructive Surgery, Montreal, Canada, June, 1983     

Use of vacuum-assisted closure (VAC™) in high-energy complicated perineal injuries: analysis of nine cases

Our study reviewed nine patients who were treated with the VAC? Abdominal Dressing System after suffering pelvic fractures and soft tissue loss after high‐energy pelvic trauma. Between March 2008 and August 2009, our clinic treated nine patients with complicated perineal injuries from high‐energy pelvic trauma with multiple irrigation and debridement procedures and broad‐spectrum antibiotics. Protective ostomies were created for all nine patients. Required interventions were made for associated injuries, and VAC? application was started. All patients were male, with an average age of 24·3 (range 21–32) years, and a mean injury severity score of 36·4 (range 16–59). Wound diameters ranged from 15 to 30 cm, and wound depths ranged from 5 to 25 cm. The injuries included one traumatic bilateral hemipelvectomy, and three unilateral and two bilateral lower extremity amputations. Intensive care unit length of stay averaged 12 (6–19) days, and average hospital length of stay was 44·12 (31–64) days. Beginning at an average of day 17 (±5·9 days) post‐injury, wound cultures detected no bacterial colonisation. One patient died on the sixth day after injury from septic complications. Two patients' wounds were closed by primary closure, and six patients' wounds were closed by split thickness grafts after an average of 31·4 (17–50) days. Optimal treatment of high‐energy perineal injuries requires early and extensive debridement and rich irrigation. The application of the VAC? system as temporary coverage of large complex wounds in the pelvic region enhances wound healing and facilitates an early grafting process.     

Surgical outcome of simultaneous carotid and cardiac surgery

Purpose  

The surgical outcome of a simultaneous carotid endarterectomy and cardiac surgery has not been clarified. This study retrospectively reviewed short- and mid-term outcomes after a carotid endarterectomy combined with valvular surgery or coronary artery bypass grafting (CABG).     

Resveratrol, a Red Wine Constituent Polyphenol, Protects Gastric Tissue Against the Oxidative Stress in Cholestatic Rats

This experimental study was designed to determine the effects of resveratrol on the level of malondialdehyde (MDA), reduced glutathione (GSH), and nitric oxide (NO) in gastric tissue after bile duct ligation (BDL). Swiss albino rats were divided into three groups: Group 1, sham (n = 7); Group 2, BDL (BDL only group; n = 7); and Group 3, BDL plus resveratrol (n = 7). Animals in the resveratrol group were treated with 10 mg/kg resveratrol (i.p.) once a day throughout 28 days. In the resveratrol group, levels of MDA and NO in gastric tissue were significantly lower than in the BDL-only group (P < 0.001). The level of GSH in the resveratrol group was significantly higher than in the BDL-only group (P < 0.001). The present study demonstrates that intraperitoneal administration of resveratrol maintains antioxidant defenses and reduces oxidative gastric damage. This effect of resveratrol may be useful to preserve gastric tissue under oxidative stress due to cholestasis.     

The role of systemic hypermobility and condylar hypermobility in temporomandibular joint dysfunction syndrome

Objective: To evaluate the risk of temporomandibular joint dysfunction (TMD), when both systemic joint hypermobility (SJH) and localized condylar hypermobility (LCH) exist. Materials and methods: Sixty-four consecutive outpatients with temporomandibular joint clicking or pain, and 77 sex- and age-matched control subjects, were recruited in the study. LCH was diagnosed when condylar subluxation was present, and SJL was diagnosed by using Beightons method. The frequency of symptoms, mean mouth opening, and the frequency of subjects with SJL and LCH were the main outcome measures. Results: Out of the 64 patients, 16 patients were suffering from pain, 20 patients from joint-clicking and 28 patients from both. Both SJH and LCH were more frequently observed in those patients with TMD than in control subjects. The risk of TMD was higher if LCH and SJH existed jointly. Conclusion: Both systemic and localized hypermobility may have a role in the etiology of TMD.