Vascular endothelial growth factor and endothelin-1 levels in normal pregnant women and pregnant women with pre-eclampsia.

The aim of the study was to estimate the levels of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) in maternal serum from normal pregnant women and women with pre-eclampsia. Serum concentrations of VEGF and ET-1 were measured in maternal blood in control group (n = 40) and in pregnancies complicated by pre-eclampsia (n = 40). Results showed that maternal VEGF levels were significantly raised in women with pre-eclampsia (p < 0.001). ET-1 concentration was not significantly different among women with pre-eclampsia compared with that in the control group. It was concluded that an increase in serum VEGF level was demonstrated in pre-eclampsia, suggesting that VEGF is involved in pathogenesis of pre-eclampsia. Further studies are needed to determine the serum concentrations of VEGF in pregnant women before the development of pre-eclampsia.

Buried and trapped penis: a case report.

While buried penis cases are characterised by congenital normal attachments to penis, trapped penis cases are characterised by insufficiency of penile skin occurring as a complication after surgical operations such as circumcision. Unless diagnosed, circumcision procedures should be avoided in congenital concealed penis cases. Here we present a case of congenital buried penis with deteriorated clinical findings after two circumcision procedures at 1.5 years of age. The surgical treatment applied in this case is discussed.

Low flow desflurane and sevoflurane anaesthesia in children.

BACKGROUND AND OBJECTIVE: Low flow desflurane and sevoflurane anaesthesia were administered to children and compared for haemodynamic response, renal and hepatic function, recovery time and postoperative nausea and vomiting. METHODS: Eighty ASA I-II patients aged 5-15 yr were included in the study. Midazolam was given for premedication. Anaesthesia induction was performed with fentanyl, propofol and atracurium. After intubation, the first group received desflurane, oxygen and nitrous oxide at 6 L min(-1) and the second sevoflurane, oxygen and nitrous oxide at 6L min(-1). Ten minutes after induction the flow was decreased to 1 L min(-1) in both groups. Haemodynamic parameters, preoperative and postoperative renal and hepatic function, the times of operation and anaesthesia, and early recovery data were recorded. Modified Aldrete scores were noted at the 10th and 30th minutes postoperatively and postoperative nausea, and vomiting were assessed. RESULTS: There were no significant differences in haemodynamic parameters, renal and hepatic functions, postoperative recovery and postoperative nausea and vomiting between groups. The recovery time was shorter in the desflurane group compared to the sevoflurane group. CONCLUSION: Low flow desflurane and sevoflurane anaesthesia do not adversely affect haemodynamic parameters, hepatic and renal function in children. Desflurane may be preferred when early recovery from anaesthesia is warranted.

Proteus syndrome associated with liver involvement: case report.

We report a patient with proteus syndrome who has epidermal nevus, right-sided asymmetric growth of extremities, pelvis, vertebrae and hemimegalencephaly. This patient also had enlargement of the liver which is not reported before in the proteus syndrome.

Epidemiology, morbidity, mortality and treatment of lightning injuries in a Turkish burns units.

Deaths from lightning injuries are infrequent--0.2-0.8 per million per year. The victims are mostly young, active people who are struck during various outdoor activities in the summer months. From November 1975 to October 1998; 22 lightning burns were treated in Ankara Numune Teaching and Research Hospital. The mean age of the patients was 32.9 (12-65) years, the female/male ratio 9/13 and the mean duration of hospital stay 15.4 (1-62) days. The commonest clinical symptoms were confusion, amnesia (5 patients), neurological dysfunction (2 patients), cystitis (4 patients), and cardiac arrhythmias (1 patient). There were no deaths. Sixteen surgical procedures were carried out on 14 patients; this was significantly fewer than from any other cause of burns. The commonest long-term complication was chronic pain. Because complications are frequently seen in lightning injuries, our results revealed that patients should be hospitalised and treated as soon as possible after the accident with fluid resuscitation, cardiac resuscitation, tetanus prophylaxis and antibiotics where necessary.

Pneumoperitoneum-assisted harvesting of split-thickness skin grafts from the abdomen.

Harvesting split-thickness skin grafts from the abdomen is difficult when using a conventional hand dermatome. In this study, pneumoperitoneum was created in 10 patients before skin grafts were taken. No complications arose from the insufflation, and the conventional dermatome was then easy to use. Pneumoperitoneum provides more abdominal surface area, allowing the surgeon to harvest a greater number of larger, more uniform grafts during a single procedure, even when working near an anatomical protuberance.