Endovascular treatment of vertebral arteriovenous fistula using an occlude

The search for the optimal approach in the treatment of brachiocephalic arteriovenous fistulas is one of the current problems of neurosurgery and vascular surgery. It is important to note that the best prognosis requires timely diagnosis and the earliest possible dissection of the fistula. Also, the method of treatment should have the least negative consequences and a good clinical effect. Previously, surgeons used open surgical vessel ligation with great technical difficulties due to anatomical difficulties of access as well as bleeding. In recent decades, the endovascular approach to treatment has demonstrated advantages over open interventions. Despite the low traumaticity, there is a risk of complications such as untargeted vascular embolization, perioperative stroke, etc. In this article we demonstrate the experience of arterio-venous vertebral artery fistula dissection using an occluder.

Laparoscopic Fowler-Stephens orchidopexy for intra-abdominal cryptorchid testis: a single institution experience

Fowler-Stephens Laparoscopic Orchiopexy (FSLO) permits the mobilization of Intra-Abdominal Testis (IAT) to the scrotal position after spermatic vessel ligation. We reported our experience of FSLO for IAT. The charts of all boys who underwent a FSLO were retrospectively reviewed. Data were analysed for demographic data, procedure, complications and follow-up results. From January 2008 to June 2016, 160 laparoscopies for Non Palpable Testis (NPT) were performed at a mean age of 3,2 years. 61% of patients had a right NPT, while 6% were bilateral. In 64 cases, an IAT was found: 20 were managed by FSLO with a two-stage procedure in 11 patients. There were no differences in hospitalisations; one patient had a prolonged ileus. Follow-up ranged from 1 to 8 years. Of the 20 patients who underwent FSLO, testicular atrophy developed in three; the remaining testes were in the scrotal position, with normal consistency. FSLO was applied in 31% of IAT. The overall success rate of the technique was 85 %. The percentage of atrophy associated after spermatic vessels interruption appears to provide a good chance of testicular survival.

The Effect of Hesperidin on BDNF/TrkB Signaling Pathway and Oxidative Stress Parameters in the Cerebral Cortex of the Utero-placental Insufficiency Fetal Rat Model

Introduction: Uteroplacental insufficiency (UPI) produces critical neurodevelopmental problems affecting the intrauterine growth restricted (IUGR) in offspring. In this study, it was aimed to investigate the possible neuroprotective roles of hesperidin (Hes) on the fetal cerebral cortex of the UPI rat model. Methods: In this experimental study, 40 pregnant Wistar rats (age:~40-day old, weight: 180±10g) were randomly divided into 5 groups (n=8), includeing control (normal saline, orally), UPI+NS (uterine vessel ligation+normal saline, orally), UPI+HES25, UPI+HES50 and UPI+HES100 (uterine vessel ligation+25, 50 and 100 mg/kg hesperidin, orally). After being anesthetized by ketamine and xylazine, UPI was induced by permanent bilateral closure of the uterine vessels on gestation day (GD) 18. From GD15, the Hes/NS- treated groups received Hesperidin/normal saline until GD21. On GD21, uterus, placenta and fetus were dissected out and weighed. The oxidative stress parameters, including catalase (CAT) activity, malondialdehyde (MDA), and total antioxidant capacity (TAC) in the fetal cerebral cortex were measured. The expression of brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrkB) was assessed by RT qPCR methods. Data were analyzed by ANOVA and Tukey’s post hoc test. Results: Findings showed a significant difference in the uterine and fetus weight in Hes-treated mothers (p< 0.05). In fetus, Hes reduced MDA, and increased CAT activity and TAC (p ˂ 0.001 in the UPI+Hes100 group compared to the UPI+NS group). UPI reduced BDNF and TrkB mRNA expression compared to the control group (p< 0.05). Also, Significant increases in BDNF and TrkB mRNA expression were observed after administration of Hes in the fetal cerebral cortex of the UPI rat model, in a dose dependent manner (p< 0.05). Conclusion: Hesperidin; as a neuroprotective and antioxidant agent; accelerates BDNF-TrkB signaling pathway and suppresses oxidative stress parameters in the cerebral cortex of the UPI rat model.

Unusual intraoperative finding of abnormal retroperitoneal ileum: a case report

A 52-year-old female patient diagnosed with an adenocarcinoma of the sigmoid colon underwent anterior resection with direct anastomosis. Intraoperatively, we found the ileum completely retroperitonealized. Previously, the patient was asymptomatic and no congenital syndromes were diagnosed. The intraoperative finding of abnormal anatomy made the mobilization of the left hemicolon and the vessel ligation more challenging. This anatomical situation is a rare variation due to an embryonic malrotation, which occurs in about 1:500 newborns.