Fistulogram after Arteriovenous Dialysis Graft Thrombectomy Should be Mandatory

2008 ◽  
Vol 74 (12) ◽  
pp. 1154-1158
Author(s):  
Shakthi D. Kumar ◽  
Krishna M. Jain ◽  
Shikha Jain ◽  
John S. Munn ◽  
Mark C. Rummel
Keyword(s):  
Graft Patency ◽  
Clinical Findings ◽  
Primary Patency ◽  
Surgical Exploration ◽  
Significant Stenosis ◽  
Group I ◽  
Dialysis Graft ◽  
Group Ii ◽  
Significant Lesion

The purpose of this study was to determine if fistulogram after prosthetic arteriovenous dialysis graft thrombectomy would reveal underlying lesions, which need correction, and if revision would improve graft patency. One hundred and ninety-two open thrombectomy procedures in 61 patients from January 1, 2000 to July 31, 2005 were reviewed retrospectively. All of the study patients were divided into two groups: In Group I fistulogram was carried out and in Group II no fistulogram was performed. Based on the fistulogram or clinical findings, appropriate intervention was carried out. In Group I, of 99 thrombectomy procedures, a significant lesion was identified and revision was carried out in 77 cases (78%). In Group II, of 93 thrombectomy procedures, a significant lesion was identified and revised in 53 cases (57%). A significant abnormality was more likely to be encountered by routine fistulogram than surgical exploration alone, 78 per cent versus 57 per cent (P < 0.05). Assisted primary patency is significantly increased in Group I and II when revision was performed (4.84 months) compared with when no fistulogram and no revision was performed (2.9 months), P < 0.05. Routine fistulogram after thrombectomy of an arteriovenous dialysis graft increases the likelihood of identifying a significant stenosis. Revision of the graft increases the longevity. We recommend routine use of fistulogram during thrombectomy.

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Variable Extent ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals Fabrication of aortic bioprosthesis by decellularization, fibrin glue coating and re-endothelization: a cell scaffold approach

2019 ◽  
Vol 8 (3) ◽  
pp. 197-210 ◽  
Author(s):  
Sonal Walawalkar ◽  
Shahdab Almelkar
Keyword(s):  
Endothelial Cells ◽  
Fibrin Glue ◽  
Cellular Proliferation ◽  
Graft Patency ◽  
Cell Viability Assay ◽  
Ethanol Group ◽  
Viability Assay ◽  
Group I ◽  
Group Ii ◽  
Cellular Dna

Abstract Aortic dysfunctions (aneurysm, aortitis) lead to the most serious conditions related to aortic wall with life-threatening complications. The most common modality of management for such conditions is replacement (diseased part) of aorta by a larger diameter stent (reconstructive vascular surgery) which in itself is a big trial. The most natural way is to use a re-endothelized scaffold. Developing a scaffold with biomimetic properties is an experimental aim for most of the scientists and surgeons. We aim to structure a strategy to overcome the well-known problems associated with aorta. In this study, we plan to remold a larger diameter blood vessel such as aorta from xenogeneic origin using different protocols to decellularize and comparing them with normal aorta. The chemicals and enzymes used for bovine aorta decellularization are 1% SDS (group II), 70% ethanol + 0.25% trypsin (group III), 70% ethanol (group IV), and 0.25% trypsin (group V). Group I served as control (without decellularization). Histology and SEM study were conducted for cellular presence/absence in all scaffolds. Later, the scaffolds were coated with the fibrin glue (FG) and endothelial cells were proliferated over them. 3D images were taken showing the remolding of the endothelial cells on FG-coated surfaces. The re-endothelization was confirmed by lectin and vWF+/+ expression. Graft elasticity and burst pressure were confirmed by biomechanical tensile testing. Further, the absence of host tissue DNA and presence of cellular DNA after re-endothelialization were confirmed by PicoGreen assay. The acceptability for metabolically active cellular proliferation on scaffolds and its non-toxicity were proved by cell viability assay. Current findings accomplish that larger diameter aorta extracellular matrix scaffold (group II) can be fabricated and re-endothelialized to develop non-thrombotic surfaces with improved graft patency with promising results compared to other fabricated scaffold groups.

scholarly journals Serum Adenosine Deaminase Activity in Monitoring Disease Activity and Response to Therapy in Severe Psoriasis

2006 ◽  
Vol 49 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Zülal Erbagci ◽  
A. Binnur Erbagci ◽  
Oya Köylüoglu ◽  
A. Almila Tuncel
Keyword(s):  
Disease Activity ◽  
Adenosine Deaminase ◽  
T Cell Activation ◽  
Cell Activation ◽  
Clinical Findings ◽  
Severe Psoriasis ◽  
Response To Therapy ◽  
Group I ◽  
Adenosine Deaminase Activity ◽  
Group Ii

Objectives: Activity of Serum Adenosine Deaminase (ADA), a main enzyme in purine degradation and considered as a marker for non-specific T cell activation, in psoriasis has been investigated in a few studies with conflicting results. Design and Methods: To evaluate the significance of serum ADA activity in psoriasis, and analyze whether ADA activity may be related to disease activity, we performed a prospective study with 38 cases of psoriasis and 24 healthy volunteers. Patients were divided into two groups as cases with local and stable lesions (Group i, n: 20) and severe cases with extensive involvement (Group ii, n: 18). Serum ADA activity was determined by modified Guisti procedure. Results: When taken into consideration of all patients -regardless of the severity of the disease- the mean serum ADA activity of psoriatics did not differ significantly from that of controls (p>0.05). However, it was higher in Group ii than in Group i and healthy controls (respectively p<0.001 and p<0.05). A significant decrease was observed also after therapy only in Group ii (p<0.001). Conclusion: Serum ADA activity may be correlated to the disease activity of severe psoriasis. We suggest that it might be a serologic marker for follow-up of in such cases. It could be used in predicting relapses before clinical findings as well as in deciding to stop or decrease systemic therapies at the right time, which have potential to cause severe systemic side effects when given for a long period. Further studies with larger case populations are required to support our findings.

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Chi Square ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 toNovember 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying student Chi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

Immune system-mediated endothelial damage is associated with NO and antioxidant system disorders

2004 ◽  
Vol 42 (10) ◽  
Author(s):  
Vidosava B. Djordjević ◽  
Tatjana Stanković ◽  
Vladan Ćosić ◽  
Lilika Zvezdanović ◽  
Borisav Kamenov ◽  
...  
Keyword(s):  
Immune System ◽  
Endothelial Damage ◽  
Clinical Findings ◽  
Control Group ◽  
Antioxidant Enzyme Activities ◽  
Sod Activity ◽  
Immunological Parameters ◽  
Immune System Dysfunction ◽  
Group I ◽  
Group Ii

AbstractTwo distinct systems of different origin are involved in the pathogenesis of both infectious and immunological vasculitis syndrome: nitric oxide (NO) from endothelial cells and granulocyte NADPH oxidase. In this study, in 31 children with immune system dysfunction, NO, NO synthase (NOS) and antioxidant enzyme activities [catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx)], as well as immunological parameters, were investigated. On the basis of the clinical findings, all children were divided into three groups: group I, 8 children clinically showing macular skin manifestations; group II, 11 children with maculo-papulous changes; and group III, 12 children with clinical findings of papulous changes. Plasma NO values in groups II and III were significantly elevated (79.14 ± 30.13 and 65.32 ± 6.70 µmol/l), compared to the control group (41.24 ± 3.65 µmol/l), while group I showed statistically lower values (32.38 ± 3.37 µmol/l). In children with the highest level of NO (group II) NOS activity was two-fold higher (1.77 ± 0.59 nmol/ml/min; p < 0.01) than in controls (0.98 ± 0.23 nmol/ml/min). Catalase activity showed a significant increase and SOD activity a significant decrease in all experimental groups, while GPx was not significantly changed. The results show that immune system dysfunction manifested as vasculitis is associated with significant disturbances in the NO system and free radicals scavengers.

Clinical Findings and Neurologic Outcome in Neonatal Encephalopathy With White Matter Injury Accompanied by Rotavirus

2018 ◽  
Vol 33 (4) ◽  
pp. 297-305 ◽  
Author(s):  
Jae Kyun Ku ◽  
Young Jin Heo ◽  
Keun Soo Lee ◽  
Bo Lyun Lee
Keyword(s):  
White Matter ◽  
Neurodevelopmental Outcome ◽  
Clinical Findings ◽  
White Matter Injury ◽  
Periventricular White Matter ◽  
Neonatal Encephalopathy ◽  
Neurodevelopmental Outcomes ◽  
Laboratory Findings ◽  
Group I ◽  
Group Ii

Our objective was to elucidate the clinical characteristics and neurodevelopmental outcomes in neonatal encephalopathy with characteristic white matter injury as compared with other injury patterns on magnetic resonance diffusion-weighted imaging. We conducted a retrospective study comparing clinical and laboratory findings, and neurologic outcomes between 17 newborns with diffuse lesions in the periventricular white matter and white matter tract (group I) and 22 newborns with other patterns (group II). Stool samples indicated that 16 neonates (94.1%) in group I were rotavirus-positive, whereas none in group II had rotavirus infection. Significantly lower calcium levels were found in group I than in group II ( P < .001). Moreover, a more favorable neurodevelopmental outcome was observed in group I than in group II. This study suggests that characteristic white matter injury in neonatal encephalopathy may be related to decreased calcium levels induced by rotavirus, and may have a better neurodevelopmental prognosis than other causes.

scholarly journals Paclitaxel coated-balloon (PCB) versus standard plain old balloon (POB) fistuloplasty for failing dialysis access

2020 ◽  
Vol 102 (8) ◽  
pp. 601-605
Author(s):  
AG Karmota
Keyword(s):  
Vascular Access ◽  
Target Lesion ◽  
Primary Patency ◽  
Secondary Patency ◽  
Dialysis Access ◽  
Technical Success ◽  
Major Complications ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Introduction This study aimed to evaluate the safety and efficacy of paclitaxel-coated balloon compared with conventional plain balloon for the treatment of failing native dialysis access. Materials and methods This prospective study included 60 patients presenting to the Kasr Alainy Hospitals and Aseer Central Hospital in the period from September 2015 to December 2017 with failing native vascular access. Dilatation with a plain balloon was done in 30 patients (group I) and with a paclitaxel-coated balloon in 30 patients (group II) with either stenosis or occlusion. The majority were outflow lesions, with 20 (66.7 %) patients in group I and 21 (70%) patients in group II. Mean balloon diameter was 7.1mm (± 1.5mm) compared with 6.5mm (± 1.2mm) and length 66mm (± 19.1mm) compared with 54.6mm (± 15.7mm), respectively. Safety endpoint was reported as 30 day’s freedom from procedure-related major complications and mortality. Procedural technical success was defined as a residual diameter 30% or less for treated lesions. Target lesion primary patency, circuit primary patency and secondary patency were reported at 3, 6 and 12 months. Results There were no 30-day procedure-related major complications or mortality in either group. Procedural technical success of 100% was achieved in both groups. Target lesion primary patency, circuit primary patency and secondary patency in group II were better than in group I, especially at 12 months (90% vs 66.7%, 83.3% vs 60% and 96.7% vs 93.3%, respectively). There was a statistically significant difference in target lesion primary patency (p = 0.029) in patients who were treated with paclitaxel-coated balloon angioplasties. Conclusion The paclitaxel-coated balloon proved to be safe and effective, and improved the patency of failing vascular access. Results are comparable with previous studies.

scholarly journals Drug-coated balloons versus 1ry stenting for TASC C and D femoropopliteal lesions

2019 ◽  
Vol 6 (2) ◽  
pp. 492
Author(s):  
Baker Ghoneim ◽  
Ahmed Shaker ◽  
Ahmed Karmoota ◽  
Hany Abdelmola
Keyword(s):  
Target Lesion ◽  
Primary Patency ◽  
Smoking History ◽  
Limb Amputation ◽  
Lesion Length ◽  
Technical Success Rate ◽  
Group I ◽  
Safety Endpoint ◽  
Primary Stenting ◽  
Group Ii

Background: To compare the effectiveness and outcome of Drug-Coated Balloon (DCB) versus primary nitinol stenting for the treatment of long femoropopliteal lesions (TASC II C and D).Methods: This was retrospective study along 3 years included all the cases of femeropopliteal disease TASC C and D that was treated with DEB or primary stenting. The safety endpoint was 30-day free from major limb amputation and mortality. The primary end point was primary patency and freedom from clinically driven target lesion revascularization at 6 and 12 months, patient genders, demographics, co-morbidities, smoking history, indications for intervention were recorded.Results: PTA and post-dilation with paclitaxel-eluting balloons was done in 32 patients (group I) and 1ry stenting was done in 30 patients (group II) with either stenosis or occlusion. The mean lesion length was 18.43±2cm in group 1 and 18.8±2.32cm in group. The technical success rate was 100% in group II and 93.7% in group I. 6 months and 12-month patency rate for group I and II were 93.3% vs. 93.3% and 83.3% vs. 86.6%, respectively. There were no 30 days related major amputations or mortalities in either group.Conclusions: DCB for long femoropopliteal lesions showed a comparable result to primary stenting and provide durable results and lower incidence of target revascularization in patients with TASC C and D lesions.

scholarly journals A COMPARATIVE STUDY BETWEEN EARLY EXPLORATIONS VERSUS CONSERVATIVE MANAGEMENT IN MANAGEMENT OF APPENDICULAR LUMP

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Sanjay Patidar ◽  
Kritika Kamal ◽  
Jaydip Sinh Kathota ◽  
Sudhanshu Tiwari ◽  
Prashant Nakrani
Keyword(s):  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Conservative Management ◽  
Research Centre ◽  
Age Group ◽  
Surgical Exploration ◽  
Hospitalization Time ◽  
Group I ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction

Background: Acute Appendicitis is one of the most common acute surgical conditions of the abdomen and appendicular lump is formed if treatment is delayed. Appendicular mass is one of its early complications developing in   2-6% cases within48 hours of attack. The traditional treatment of appendicular lump is conservative followed by delayed appendectomy. During conservative treatment 10-20% is not resolved and leads to gangrene or perforation followed by localized abscess or generalized peritonitis requiring early surgical intervention. Aim and Objective: To evaluate the outcome of early surgical exploration and its complications in respect to conservative management of appendicular lump. Material and Methods: Total of 48 patients admitted with diagnosis of appendicular lump were included in our study. This prospective study was conducted in Department of General Surgery of Index Medical College, Hospital and Research Centre, Indore, M.P over period of 2 years [August 2019 to July 2021] in all age group and both sexes. All cases were divided randomly into two groups. Group I, early surgical exploration and Group II, conservative approach with OCHSNER SHERREN REGIME followed by interval appendectomy after 6 weeks. Results: Total 471 patients admitted to hospital with diagnosis of acute appendicitis, out of which total 48 patients were having Appendicular lump suggestive of incidence of 9.81%. Maximum patients were found in age group 21-30 years. Average duration of symptoms was 2 days. Two methods were adopted for the management of appendicular lump. The first group included 24 patients who were operated immediately after investigations and second group of 24 patients were managed conservatively followed by delayed appendectomy. In the first group mean hospitalization time was 4 days. Residual abscess, adhesive intestinal obstruction, failure of treatment and readmission were not found. In the group II, mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted. Conclusion: In our study, it can be concluded that early surgical exploration confirms diagnosis and cures the problem, reduce the cost of management, shortens the convalescence and hospital stay with reasonably satisfactory outcome. Key-Words: Appendicular Lump, Ochsner-Sherren Regime Appendectomy.

Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

1970 ◽  
Vol 28 ◽  
pp. 208-209
Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA
Keyword(s):  
Osmium Tetroxide ◽  
Male Mice ◽  
Alcohol Group ◽  
Group Iii ◽  
Group I ◽  
C57bl Mice ◽  
Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

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