Minimizing complications in a porcine survival craniotomy model

2021 ◽  
pp. 002367722110094
Author(s):  
Ahmet Kinaci ◽  
Koen Vaessen ◽  
Saskia Redegeld ◽  
Albert van der Zwan ◽  
Tristan P.C. van Doormaal
Keyword(s):  
Blood Pressure ◽  
Tranexamic Acid ◽  
Epidural Hematoma ◽  
Porcine Model ◽  
Postoperative Recovery ◽  
Surgical Approaches ◽  
Sagittal Sinus ◽  
The Right ◽  
Drill Holes ◽  
Acid Administration

A large craniotomy survival porcine model is useful for scientific research. The surgical approaches and complications of craniotomies in pigs have not been published before. This study describes how large craniotomies were performed in 46 pigs and how the risk of complications was minimized. The major complications were direct postoperative epidural hematomas ( n = 3) and sagittal sinus rupture ( n = 4). The measures taken to prevent postoperative epidural hematomas consisted of optimizing anesthesia, using bone wax to stop trabecular bleeding, increasing blood pressure before bone flap replacement, tranexamic acid administration, and postoperative recovery of the pigs in the prone position in a dedicated hammock. After these measures, no pig died from a postoperative epidural hematoma. Iatrogenic sagittal sinus rupture occurred in cases where the dura shifted into the craniotome during craniotomy. The dura was detached from the skull through drill holes with custom elevators before craniotomy to minimize the risk of a sagittal sinus rupture. In conclusion, pigs can undergo craniotomy and survive if the right measures are put in place.

scholarly journals Incidental diagnosis of nonfunctional bladder paraganglioma: a case report and literature review

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xi Tu ◽  
Neng Zhang ◽  
Xiyao Zhuang ◽  
Shulian Chen ◽  
Xu Luo
Keyword(s):  
Blood Pressure ◽  
Bladder Cancer ◽  
Postoperative Recovery ◽  
Partial Resection ◽  
Outpatient Department ◽  
Neuroendocrine Neoplasm ◽  
Pathological Features ◽  
Clinical Radiology ◽  
The Right ◽  
The Masses

Abstract Background Nonfunctional bladder paragangliomas is a rare urological disease. It may present clinical, radiology and pathological features similar to bladder cancer, Only scarce reports have been reported. Urologist must identify this generally benign neuroendocrine neoplasm to avoid misdiagnosis. Case presentation A 62-year-old female presented the outpatient department of our hospital with the symptoms of stomachache, frequent micturition, and urination pain for 20 days. Diagnosed with high blood pressure 1 year ago, administered Amlodipine besylate tablets 5 mg po qd occasionally, did not check blood pressure; denied any tumor observation in the family history. Color ultrasound of the urinary system showed a 38 mm × 34 mm hypoechoic mass on the right side of the bladder, CDFI: in the masses, blood supply was sufficient. Cystoscope showed bladder occupying lesion. Biopsy diagnosis: papillary polypoid cystitis was suspected as a malignant change (Fig. 3a). Then, the patient was admitted to our urological department. Further, computer tomography urography considered bladder cancer. Cystoscopy and biopsy failed to define the nature of the lesions in our outpatient department, which prompted a transurethral resection of the bladder tumor. histopathological and immunohistochemical results were diagnosed as bladder paragangliomas. For the reason, the tumor was removed by partial resection of the bladder. The postoperative recovery and follow-up were uneventful. Conclusions Nonfunctional bladder paragangliomas are occasionally found on imaging studies with the symptoms of urinary tract infection or/and intermittent painless hematuria. It may present clinical, radiology and pathological features similar to bladder cancer, so knowledge of this generally benign neuroendocrine neoplasm is of great importance to avoid misdiagnosis. It should be accompanied by the clinical and pathological characteristics of the patient and image changes. Partial resection of the bladder can effectively treat this disease.

scholarly journals Large Vertex Epidural Hematoma: Case Report and Review of Surgical Approaches

2019 ◽  
Vol 38 (04) ◽  
pp. 324-327
Author(s):  
Angelo R. Silva Neto ◽  
Luana Medeiros ◽  
Fábio B. Silva ◽  
Renata N. Velloso
Keyword(s):  
Surgical Planning ◽  
Epidural Hematoma ◽  
Clinical Presentation ◽  
Technical Note ◽  
Surgical Approaches ◽  
Sagittal Suture ◽  
Sagittal Sinus ◽  
Central Brain ◽  
Burr Holes ◽  
Left Pupil

AbstractVertex epidural hematomas (VEHs) are a special clinical entity due to their clinical presentation, vascular etiology and options of surgical approach. The clinical suspicion involves recognizing the mechanism of the injury and the correct visualization of the hematoma in computed tomography (CT) coronal sequences. In the present article, we describe a case of a very large (146 mL) VEH with central brain herniation, and provide a technical note on the surgical planning and treatment. A 34-year-old male patient was admitted to the hospital after an injury on the left superior parietal region. The Glasgow coma scale score was 6, and the left pupil of the patient was dilated. The CT scan showed a large epidural hematoma on the vertex between the coronal e lambdoid sutures, and a fracture over the sagittal suture. During the surgery, multiple burr holes were made laterally to the sagittal suture, and after inspection and no visualization of bleeding in the superior sagittal sinus (SSS), we performed a standard biparietal craniotomy. The patient was discharged three days after the surgery without any deficits. Currently, with the improvement in imaging modalities, more cases of VEH are being identified. Identifying the etiology prior to the craniotomy is challenging in severe cases. Tears in the SSS can bleed profusely, and they demand strategies during the craniotomy. With multiple burr holes parallel to the sagittal suture, we can visualize whether there is bleeding in the SSS and design a craniotomy with or without a central osseous bridge to anchor the dura. Neurosurgeons must be prepared to plan a surgical strategy in cases of large VEHs. Due to its rare frequency and bleeding risks, VEHs are considered challenging.

Anatomical and Morphological study of the Heart's Chambers and valves in Iraqi ducks Anser platyrhuncha

2019 ◽  
Vol 43 (1) ◽  
pp. 21-25
Author(s):  
Mohammed Senna Hassan
Keyword(s):  
Blood Pressure ◽  
Anterior Chamber ◽  
High Blood Pressure ◽  
Pulse Rate ◽  
Morphological Study ◽  
Heart Valves ◽  
Simple Manner ◽  
High Pulse ◽  
The Right ◽  
High Pulse Rate

   Twenty Iraqi ducks hearts ( 10 male and 10 female ) have been  used for   demonstration  and illustration of heart's valves  and chambers  as well as  anatomical   and morphological site of view to explain what modifications had been take place for ducks heart  to perform  his normal life at the  circumstances  of  high  blood  pressure  and  pulse  rate. The heart  which has distinctly pointed  apex  was  built   in simple  manner located  in a transparent  taught  heart  pericardial  sac. It   was pyramidal in shape  externally  and  has a longitudinal  salcus  passing  to the  right  side, the  anterior of  the   heart  is  divided  into two  unequal  anterior  chamber  similar  to  those of mammalian  hear  .The heart valves are modified  in  order to  minimize  the  fraction  that occur as a result of  high  blood  pressure  and  pulse  rate  of  the  duck  heart , also  the  muscular  trabeculae   replace  the  chordate  tendineae  , which  were  present in the  mammalian    heart  in order to  minimize  the  fraction  resulting  from high  pulse  rate..    

scholarly journals A tissue-engineered urinary conduit in a porcine urinary diversion model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arkadiusz Jundziłł ◽  
Piotr Kwieciński ◽  
Daria Balcerczyk ◽  
Tomasz Kloskowski ◽  
Dariusz Grzanka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Diversion ◽  
Porcine Model ◽  
Histological Evaluation ◽  
Metabolic Complications ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Group 1

AbstractThe use of an ileal segment is a standard method for urinary diversion after radical cystectomy. Unfortunately, utilization of this method can lead to numerous surgical and metabolic complications. This study aimed to assess the tissue-engineered artificial conduit for urinary diversion in a porcine model. Tissue-engineered tubular polypropylene mesh scaffolds were used for the right ureter incontinent urostomy model. Eighteen male pigs were divided into three equal groups: Group 1 (control ureterocutaneostomy), Group 2 (the right ureter-artificial conduit-skin anastomoses), and Group 3 (4 weeks before urostomy reconstruction, the artificial conduit was implanted between abdomen muscles). Follow-up was 6 months. Computed tomography, ultrasound examination, and pyelogram were used to confirm the patency of created diversions. Morphological and histological analyses were used to evaluate the tissue-engineered urinary diversion. All animals survived the experimental procedures and follow-up. The longest average patency was observed in the 3rd Group (15.8 weeks) compared to the 2nd Group (10 weeks) and the 1st Group (5.8 weeks). The implant’s remnants created a retroperitoneal post-inflammation tunnel confirmed by computed tomography and histological evaluation, which constitutes urostomy. The simultaneous urinary diversion using a tissue-engineered scaffold connected directly with the skin is inappropriate for clinical application.

Early tranexamic acid administration

2015 ◽  
Vol 79 (6) ◽  
pp. 1015-1022 ◽  
Author(s):  
Mark E. Diebel ◽  
Lawrence N. Diebel ◽  
Charles W. Manke ◽  
David M. Liberati ◽  
John R. Whittaker
Keyword(s):  
Tranexamic Acid ◽  
Acid Administration
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