Use of chorioamniotic membrane instead of bogota bag in open abdomen: How I Do It?

It is one of the most important problems for general surgeons to decide which operation should be undertaken on patients with intra-abdominal infection, especially those with concomitant abdominal hypertension. Recentlly, closure techniques using prosthetic meshes in order to retain abdominal tension and to control sepsis have become very popular for patients with abdominal sepsis and hypertension. We used chorioamniotic membrane instead of plastic material to cover the open abdomen. We conclude that human chorioamniotic membrane prepared under sterile conditions may be an alternative to conventional plastic bags in daily practice, for preventing serosal erosion and fistulas in patients undergoing open abdominal surgery

The effect of extracoporeal schock waves on intestinal anastomosis

Background and Objectives: To investigate the effect of extracorporeal shock waves on the healing of intestinal anastomosis. Materials and Methods: Thirty Wistar rats were randomly divided into three groups of ten each comprising of Group I (only laparotomy), Group II (right colon segment resection and end to end anastomosis) and Group III (right colon segment resection and end to end anastomosis). Group III animals a total of 1200 impulse 0.12 mj/mm 2 shock waves on the post-operative 3 rd , 5 th and 7 th days in three session each of which included 400 impulse with 14KV. On the 10 th post operative day, the rats were sacrificed and postmortem examination was done. The explosion pressures were measured using a sphygmomanometer specially designed for this purpose. In the study groups 4 cm intestine segments which include anastomose line was taken out. The segments which include anastomosis of the study group and the control group pieces were histopathologically examined. The fibroblast, collagen, angiogenesis and inflammatory cells were studied. Results: The mean anastomoses explosion pressure for group III was 272 ± 7.895 and the average anastomose explosion pressure was 220 ± 6.831. The difference between the pressure means was significant ( P < 0.05). Histological fibroblast/collagen ratio were 14.50 ± 5.66, 274 ± 66.21 and 416 ± 52.44 for Group I, Group II and Group III, respectively. The vein amount was 5.80 ±3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II ( 3.19, 51.20 ± 10.76 and 75.10 ± 13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II ( P < 0.05). Conclusion: From the results of our study, extracorporeal shock waves treatment (ESWT) increase the intestinal tensile strength and may be useful to enhance the mechanical strength of anastomosis of the colon during healing

The effect of extracoporeal schock waves on intestinal anastomosis

Background and Objectives: To investigate the effect of extracorporeal shock waves on the healing of intestinal anastomosis. Materials and Methods: Thirty Wistar rats were randomly divided into three groups of ten each comprising of Group I (only laparotomy), Group II (right colon segment resection and end to end anastomosis) and Group III (right colon segment resection and end to end anastomosis). Group III animals a total of 1200 impulse 0.12 mj/mm 2 shock waves on the post-operative 3 rd , 5 th and 7 th days in three session each of which included 400 impulse with 14KV. On the 10 th post operative day, the rats were sacrificed and postmortem examination was done. The explosion pressures were measured using a sphygmomanometer specially designed for this purpose. In the study groups 4 cm intestine segments which include anastomose line was taken out. The segments which include anastomosis of the study group and the control group pieces were histopathologically examined. The fibroblast, collagen, angiogenesis and inflammatory cells were studied. Results: The mean anastomoses explosion pressure for group III was 272 \ub1 7.895 and the average anastomose explosion pressure was 220 \ub1 6.831. The difference between the pressure means was significant ( P &lt; 0.05). Histological fibroblast/collagen ratio were 14.50 \ub1 5.66, 274 \ub1 66.21 and 416 \ub1 52.44 for Group I, Group II and Group III, respectively. The vein amount was 5.80 \ub13.19, 51.20\ub110.76 and 75.10\ub113.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II ( 3.19, 51.20 \ub1 10.76 and 75.10 \ub1 13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II ( P &lt; 0.05). Conclusion: From the results of our study, extracorporeal shock waves treatment (ESWT) increase the intestinal tensile strength and may be useful to enhance the mechanical strength of anastomosis of the colon during healing

Full Thickness Retinal Hole Formation after Nd:YAG Laser Hyaloidotomy in a Case with Valsalva Retinopathy

A 27-year-old male was presented with a sudden onset of visual loss in his right eye. A secondary care center referred the patient with fundus photographs which were screened 4 days before and after the Nd: YAG laser hyaloidotomy treatment. Snellen acuity was 10/10 in both eyes. Fundus examinations revealed a retinal pigment epithelium (RPE) alteration at the margin of the inferior temporal arterial vascular arcade in the right eye and resolved preretinal and subretinal hemorrhages were seen in the macula. A diagnosis of Valsalva retinopathy was made based on the history and the treatment photographs of Nd:YAG laser hyaloidotomy. At 1st month examination all hemorrhages were resolved but RPE alterations were still at the margin of the inferior temporal arterial vascular arcade. The optical coherence tomography angiography (OCTA) images revealed 2 lesions. On en face OCT angiogram of OCTA full thickness retinal hole formation and ellipsoid zone damage at the superior and inferior margin of the inferior temporal arterial vascular arcade were seen. Superficial vascular plexus was also damaged at that region. The projection of the evacuation of blood from subhyaloid space and the full thickness retinal hole formation were the same, indicating that the partial and full thickness retinal holes were created by the laser treatment

Investigation the Relationship of Lower Urinary Tract Symptoms whit Vascular Risk Factors; Our Preliminary Results

Our aim was to investigate the relationship between lower urinary tract symptoms (LUTS) in terms of vascular risk factors include diabetes. In a prospective study, a total of 116 men aged 40 years or more who presented to the outpatient clinics of urology or endocrinology between January 2012 and April 2013 were included. After receiving a detailed medical history, fasting blood glucose, serum lipids including total cholesterol, HDL and triglyceride, HbA1c, creatinine, total testosterone and total prostate-specific antigen were measured. Urinalysis and uroflowmetry were done. Postvoiding residual urine and prostate volume were measured by suprapubic ultrasonography. International Prostate Symptom Score (IPSS) of the patients were determined. Existence of vascular risk factors including hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease and obesity as well as age, body mass index (BMI), weight, waist circumference and body fat percentage values were recorded. Of the patients, 41 (35.3%) had hypertension, 54 (46.6%) dyslipidemia, 68 (58.6%) diabetes mellitus, 34 (29.3%) coronary artery disease and 39 (33.6%) obesity. When the patients were grouped according to the presence of the risk factors (no risk [14 patients], mild to moderate [1-2 risk factor] [65 patients] and severe [3 or more risk factors] [37 patients]), there was no a significant difference among the groups in terms of IPSS (p = 0.76) The results of this prospective study show that vascular risk factors and diabetes may not be related to LUTS [Med-Science 2015; 4(1.000): 1826-35