Fournier's gangrene in a patient after third-degree burns: a case report

<p>Abstract</p> <p>Introduction</p> <p>Fournier's gangrene is characterized by tissue ischemia leading to rapidly progressing necrotizing fasciitis.</p> <p>Case presentation</p> <p>We present the case of a patient with Fournier's gangrene after third-degree burns. Clinical manifestations, laboratory results and treatment options are discussed.</p> <p>Conclusion</p> <p>Fournier's gangrene is a surgical emergency. Although it can be lethal, it is still a challenging situation in the field of surgical infections.</p

Sex differences in the impact of ozone on survival and alveolar macrophage function of mice after Klebsiella pneumoniae infection

<p>Abstract</p> <p>Background</p> <p>Sex differences have been described in a number of pulmonary diseases. However, the impact of ozone exposure followed by pneumonia infection on sex-related survival and macrophage function have not been reported. The purpose of this study was to determine whether ozone exposure differentially affects: 1) survival of male and female mice infected with <it>Klebsiella pneumoniae</it>, and 2) the phagocytic ability of macrophages from these mice.</p> <p>Methods</p> <p>Male and female C57BL/6 mice were exposed to O₃or to filtered air (FA) (control) and then infected intratracheally with <it>K. pneumoniae </it>bacteria. Survival was monitored over a 14-day period, and the ability of alveolar macrophages to phagocytize the pathogen <it>in vivo </it>was investigated after 1 h.</p> <p>Results</p> <p>1) Both male and female mice exposed to O₃are significantly more susceptible to <it>K. pneumoniae </it>infection than mice treated with FA; 2) although females appeared to be more resistant to <it>K. pneumoniae </it>than males, O₃exposure significantly increased the susceptibility of females to <it>K. pneumoniae </it>infection to a greater degree than males; 3) alveolar macrophages from O₃-exposed male and female mice have impaired phagocytic ability compared to macrophages from FA-exposed mice; and 4) the O₃-dependent reduction in phagocytic ability is greater in female mice.</p> <p>Conclusion</p> <p>O₃exposure reduces the ability of mice to survive <it>K. pneumoniae </it>infection and the reduced phagocytic ability of alveolar macrophages may be one of the contributing factors. Both events are significantly more pronounced in female mice following exposure to the environmental pollutant, ozone.</p

Peritoneal changes due to laparoscopic surgery

Item does not contain fulltextBACKGROUND: Laparoscopic surgery has been incorporated into common surgical practice. The peritoneum is an organ with various biologic functions that may be affected in different ways by laparoscopic and open techniques. Clinically, these alterations may be important in issues such as peritoneal metastasis and adhesion formation. METHODS: A literature search using the Pubmed and Cochrane databases identified articles focusing on the key issues of laparoscopy, peritoneum, inflammation, morphology, immunology, and fibrinolysis. Results : Laparoscopic surgery induces alterations in the peritoneal integrity and causes local acidosis, probably due to peritoneal hypoxia. The local immune system and inflammation are modulated by a pneumoperitoneum. Additionally, the peritoneal plasmin system is inhibited, leading to peritoneal hypofibrinolysis. CONCLUSION: Similar to open surgery, laparoscopic surgery affects both the integrity and biology of the peritoneum. These observations may have implications for various clinical conditions.1 januari 201

Effects of low intraperitoneal pressure and a warmed, humidified carbon dioxide gas in laparoscopic surgery: a randomized clinical trial.

Laparoscopic surgery technology continues to advance. However, much less attention has been focused on how alteration of the laparoscopic surgical environment might improve clinical outcomes. We conducted a randomized, 2 × 2 factorial trial to evaluate whether low intraperitoneal pressure (IPP) (8 mmHg) and/or warmed, humidified CO2 (WH) gas are better for minimizing the adverse impact of a CO2 pneumoperitoneum on the peritoneal environment during laparoscopic surgery and for improving clinical outcomes compared to the standard IPP (12 mmHg) and/or cool and dry CO2 (CD) gas. Herein we show that low IPP and WH gas may decrease inflammation in the laparoscopic surgical environment, resulting in better clinical outcomes. Low IPP and/or WH gas significantly lowered expression of inflammation-related genes in peritoneal tissues compared to the standard IPP and/or CD gas. The odds ratios of a visual analogue scale (VAS) pain score >30 in the ward was 0.18 (95% CI: 0.06, 0.52) at 12 hours and 0.06 (95% CI: 0.01, 0.26) at 24 hours in the low IPP group versus the standard IPP group, and 0.16 (95% CI: 0.05, 0.49) at 0 hours and 0.29 (95% CI: 0.10, 0.79) at 12 hours in the WH gas group versus the CD gas group

Fournier's gangrene after renal transplantation

[Abstract not Available

The relationship between HLA antigens and blood groups [HLA-A, B ve Dr antijenleri ile kan gruplar?n?n İlişkisi]

Aim: Recently, organ transplant is the most common treatment of organ deficiency. Although there has been some discussion about the necessity of HLA in recent times, in kidney transplant HLA still keeps on being important. Our aim in this study is to search whether there is a relationship between the HLA antigens and blood type of 362 patients who are registered to the waiting list from cadaver in Selçuk University Transplant Unit. Method: In this study, the tissue groups of the patients in the waiting list from-cadaver have been determined with Class I microlenfocitotoxicity technique (HLA-A/B/C), Class II (HLA-DR) PCR-SSP (Polymerase Chain Reaction-Single Strand Polymorphism) technique and their blood type with micro plate agglutination. Result: Of 362 patients on the waiting-list, 206 were male (57%) and 156 female (43%). When the patients were observed according to their blood type, 165 (45%) were A type, 118 (33%) O type, 54 (15%) B type, and 25 (7%) AB type. The most common tissue groups in all blood types, has been detected as in HLA group HLA A2 antigens (48%), in HLA-B group HLA B35 (33%), in HLA-DR group DRB11 antigens (48%). When the commonly seen HLA groups and their blood types were compared, there was found no statistical correlation (p> 0.01). Conclusion: In this study which we searched about the correlation between HLA antigens and blood types, there could not found any correlation as statistically

Intraoperative determination of intestinal viability: A comparison with transserosal pulse oximetry and histopathological examination

Background. In this study, we aimed to measure the O-2 saturation of ischemic intestinal segments and the relationship between these measures and concomitant pathological gradings. Materials and methods. We used 14 New Zealand White rabbits, anesthetized with a combination of 80 mg/kg (i.m.) Ketamine hydrochloride and 10 mg/kg Acepromazine (i.m.). The superior mesenteric artery (SMA) was explored, and O-2 saturation was measured by pulse oximetry 5 cm proximal to the ileocecal valve at the 0th hour. At the same time a 0.5-cm. full-thickness wedge biopsy was taken from the same region. Thereafter, the SMA was ligated and the abdomen was closed. All rabbits were undertaken relaparotomy at the 4th hour; O-2 saturation was measured by pulse oximetry at 5 cm away from the region of the first biopsy and a 0.5-cm. full-thickness wedge biopsy was taken. The abdomen was then closed. The same procedure was performed at the 8th and the 12th hour. Mucosal hemorrhage, transmural congestion, mucosal necrosis, and transmural necrosis were examined in the specimens. Results. Pathologically, transmural necrosis was concomitant with 64% O-2 saturation (sensitivity: 100%; specificity: 86%). Mucosal necrosis was concomitant with 76% O-2 saturation values (sensitivity: 100%; specificity: 75%). Transmural congestion was concomitant with 81% O-2 saturation values (sensitivity: 89%; specificity: 58%). Mucosal hemorrhage was concomitant with 91% O-2 saturation (sensitivity: 100%; specificity: 31%). Conclusion. O-2 saturation measures > 76% may indicate reversible changes as mucosal necrosis, transmural congestion, or mucosal hemorrhage, and O-2 saturation measures < 64% may indicate permanent transmural necrosis. As a result, intraoperative evaluation of intestinal viability by pulse oximetry may give us an idea about the degree of pathological changes and subsequently might reduce the number of second-look operations. (c) 2005 Elsevier Inc. All rights reserved

Determination of operation time in colorectal diseases: Preoperative chemotherapy application

Background. Our aim was to determine the time it takes for wound healing to return to normal in cases where patients have undergone preoperative chemotherapy. Materials and methods. Eighty-four Wistar-albino rats were included in the study. Twelve of them were placed in the control group (Group 1), with no further drug administration. Another 12 rats were placed in a sham group (Group 11) and were peritoneally injected with 1 cc of isotonic saline solution 5 days a month, for a period of 6 months. The remaining 60 rats were placed in five chemotherapy groups (Groups III-VII) and were administered 20 mg/kg 5-fluorouracil through peritoneal injection, 5 days a month for a period of 6 months. At the end of the sixth cure, 12 rats from the control (Group 1), sham (Group II), and chemotherapy groups (Group III) were operated on, and an intestinal transsection. was applied to the rectosigmoid junction, followed by one-by-one anastomosis using 5/0 vicryl. Other groups (Groups IV-VI) with chemotherapy treatment were operated on at 1-week intervals and subjected to the same procedure. The subjects were reoperated on on the eleventh day. A full-layer 4 x 4 cm piece was removed from the abdominal wall containing the previous incision line at the middle, for tensile strength pressure measurements. In addition, a 4 cm colon segment was removed for bursting pressure measurements. Plasma albumin and tissue hydroxyproline levels were measured, and fibroblast numbers were counted in the sections prepared from the abdominal wall. Results. The control and sham groups were found to be similar to each other with respect to all parameters measured (P > 0.05). Significant reductions were observed in all parameters in the early chemotherapy groups compared with the control and sham groups (P <0.05). All parameters measured in Groups V, VI, and VII were found to be similar to those in the control and sham groups (P <0.05). Conclusion. Wound healing is impaired in rats with chemotherapy, but following the second week after the chemotherapy, disrupted parameters return to their normal levels. (C) 2005 Elsevier Inc. All rights reserved