RESUMO
PURPOSE: The impact of a capnoperitoneum on the known blood pressure (BP) difference of the upper and lower limb was studied in piglets. METHODS: Eleven German Landrace piglets (body weight, 4.3-7.4 kg; mean body weight, 6.2 kg) were studied. Arterial lines were placed in the right carotid and right femoral artery for pressure monitoring. Intraabdominal pressure levels were increased in steps of 6 mm Hg up to 24 mm Hg. RESULTS: We found that elevated intraabdominal pressures up to 24 mm Hg did not change the preexisting systolic BP difference between the carotid and femoral arteries. Systolic femoral artery pressure constantly remained 5% higher than its carotid counterpart. In addition, mean and diastolic values were not affected. CONCLUSIONS: Arterial BP measurements recorded at the legs of piglets when abdominal pressure is increased by up to 24 mm Hg can be used for intraoperative assessment of systemic arterial BP.
Assuntos
Artérias Carótidas/fisiologia , Artéria Femoral/fisiologia , Laparoscopia , Monitorização Intraoperatória/métodos , Pneumoperitônio Artificial , Animais , Pressão Sanguínea , Determinação da Pressão Arterial , SuínosRESUMO
We report the case of an isolated non-displaced fracture of the capitate in an 11-year-old boy. On the basis of the relevant literature we present a survey of the diagnostic and treatment options. To the best of our knowledge this is the first description of a paediatric capitate fracture in the German-speaking area.
Assuntos
Capitato/lesões , Moldes Cirúrgicos , Fraturas Ósseas/terapia , Capitato/diagnóstico por imagem , Criança , Consolidação da Fratura/fisiologia , Fraturas Ósseas/diagnóstico por imagem , Força da Mão/fisiologia , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Radiografia , Amplitude de Movimento Articular/fisiologiaRESUMO
The purpose of the study was to compare the biomechanical properties of five different palmar fixation plate designs in a distal radius osteotomy cadaver model. A 1cm metaphyseal osteotomy gap was made to simulate a corrective osteotomy and the osteotomy plated. Axial load was applied to the distal end of each construct by a material testing machine under control of a motion analysis video system. The specimens were arranged into five implant groups of eight specimens each. No test group developed deformity and movement of the fracture gap greater than 2mm with a load of 100N. Increasing the load to 250N revealed statistically significant differences in stiffness and failure load between the different plates. Axial failure strength and stiffness were greater for the radial correction plates than for the other implants. The former may provide enough stability for corrective osteotomy of dorsally angulated distal radial malunions, even when the osteotomy gap is only filled with cancellous bone graft instead of cortical bone graft.
Assuntos
Placas Ósseas , Fixação Interna de Fraturas/instrumentação , Teste de Materiais , Osteotomia , Fraturas do Rádio/cirurgia , Idoso , Cadáver , Análise de Falha de Equipamento , Feminino , Humanos , Masculino , Desenho de Prótese , Gravação em Vídeo , Suporte de CargaRESUMO
Hypothenar hammer syndrome (HHS) is ischemia of the distal ulnar artery caused by injury to the ulnar part of the palmar arch. This disease often involves workers who frequently use the hypothenar part of the hand as a hammer. The aneurysmatic form of HHS represents an indication for operative treatment; the thrombotic form is treated mainly conservatively. In our opinion, the symptomatic thrombotic form represents an indication for operation if symptoms persist during conservative therapy, particularly if symptoms progress. In fresh embolic occlusions, regional thrombolysis is usually successful. We present here the symptomatic treatment and course in two patients with complaints increasing during conservative therapy. The patients reported progressive Raynaud's phenomenon of the fingers. Angiography confirmed corkscrew-like aneurysmatic configuration of the distal ulnar artery and subsequent embolization of digital arteries. In both cases, we removed the source of the embolism with resection of the involved arterial segment and anastomosis with autologous vein grafts.
Assuntos
Aneurisma/cirurgia , Transtornos Traumáticos Cumulativos , Embolia , Mãos/irrigação sanguínea , Trombose , Artéria Ulnar/cirurgia , Adulto , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Aneurisma/patologia , Angiografia , Transtornos Traumáticos Cumulativos/diagnóstico , Diagnóstico Diferencial , Progressão da Doença , Embolia/diagnóstico , Embolia/etiologia , Embolia/cirurgia , Fibrinolíticos/uso terapêutico , Dedos/irrigação sanguínea , Golfe/lesões , Humanos , Masculino , Cuidados Pós-Operatórios , Doença de Raynaud/etiologia , Síndrome , Trombose/diagnóstico , Trombose/tratamento farmacológico , Trombose/etiologia , Trombose/cirurgia , Transplante Autólogo , Artéria Ulnar/diagnóstico por imagem , Artéria Ulnar/lesões , Artéria Ulnar/patologia , Veias/transplanteRESUMO
Skin burns to patients with tattoos during MRI procedures are reported but rare complications. MRI scans are being used more often also as diagnostic procedures in trauma patients. In this article we present the case of a patient after trauma of the vertebral column who experienced burning pain at the site of a tattoo on the distal femur during the MRI examination, necessitating cessation of this procedure. Based on this example we discuss possible pathomechanisms of MRI-induced skin burns to patients with tattoos. It becomes clear that patients have to be asked about possible tattoos before MRI scans and should be informed about possible pain development.
Assuntos
Queimaduras por Corrente Elétrica/diagnóstico , Queimaduras por Corrente Elétrica/etiologia , Queimaduras por Corrente Elétrica/prevenção & controle , Imageamento por Ressonância Magnética/efeitos adversos , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Pele/lesões , Tatuagem , Queimaduras por Corrente Elétrica/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/complicações , Lesões por Radiação/prevenção & controle , Traumatismos da Medula Espinal/diagnósticoAssuntos
Diabetes Mellitus Experimental/cirurgia , Transplante das Ilhotas Pancreáticas/métodos , Transplante Heterotópico/métodos , Animais , Glicemia/metabolismo , Separação Celular , Centrifugação com Gradiente de Concentração , Diabetes Mellitus Experimental/sangue , Teste de Tolerância a Glucose , Ilhotas Pancreáticas/citologia , Transplante das Ilhotas Pancreáticas/fisiologia , Rim , Veia Porta , Suínos , Transplante Autólogo , Transplante Heterotópico/fisiologiaRESUMO
The clinical course of a 37-year old female patient with chronic pancreatitis undergoing total duodenopancreatectomy and subsequent autotransplantation of purified pancreatic islets into the portal vein is described. The indication, technical aspects and the metabolic outcome of the procedure are discussed along with the current literature.
Assuntos
Transplante das Ilhotas Pancreáticas/métodos , Pancreaticoduodenectomia/métodos , Pancreatite/cirurgia , Transplante Heterotópico , Adulto , Glicemia/metabolismo , Doença Crônica , Feminino , Humanos , Insulina/sangue , Transplante das Ilhotas Pancreáticas/fisiologia , Pancreatite/sangue , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/cirurgiaRESUMO
This study reports the cryopreservation of purified fetal pig proislets (FPP) which were isolated by a culture technique. The FPP were equilibrated with 2 M dimethyl sulfoxide (Me2SO), cooled at a rate of 0.25 degrees C/min to -40 degrees C, transferred to liquid nitrogen (-196 degrees C), stored for 2 h to 2 months at -196 degrees C, and thawed in a 37 degrees C water bath. The morphology of frozen-thawed FPP was similar to that of noncryopreserved FPP. One hundred percent recovery of response capacity was achieved when tested with 16.7 mM glucose plus 10 mM theophylline. We have recently shown that streptozotocin is not toxic to FPP. Accordingly, we transplanted a standardized dose (10-15 mg/mouse) of either cultured of frozen-thawed FPP beneath the renal capsule of nude mice. Three to four weeks later the recipients of the FPP were rendered diabetic by iv streptozotocin. All of the mice transplanted with cultured FPP and seven of eight mice receiving cryopreserved FPP achieved normoglycemia, 74.8 +/- 32.9 and 54.7 +/- 8.1 days (P > 0.05) after transplantation. An intraperitoneal glucose tolerance test in the mice of both groups showed a flatter response to glucose compared to those of normal controls. Grafts removed from the mice with normoglycemia for > 3 weeks, in both groups, had the capacity to secrete insulin in response to 16.7 mM glucose alone and 16.7 mM glucose plus 10 mM theophylline during in vitro perifusion. Histological examination revealed that the extent of differentiation and development, in vivo of cryopreserved FPP was comparable with that of cultured FPP. These data indicate that cryopreservation, with the protocol used here, is successful in maintaining functional viability of frozen-thawed FPP. This study is valuable for clinical islet transplantation research.
Assuntos
Criopreservação/métodos , Transplante das Ilhotas Pancreáticas/fisiologia , Ilhotas Pancreáticas , Animais , Glicemia/metabolismo , Células Cultivadas , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/cirurgia , Feminino , Transplante de Tecido Fetal/patologia , Transplante de Tecido Fetal/fisiologia , Feto , Idade Gestacional , Glucose/farmacologia , Teste de Tolerância a Glucose , Insulina/farmacologia , Ilhotas Pancreáticas/efeitos dos fármacos , Ilhotas Pancreáticas/metabolismo , Transplante das Ilhotas Pancreáticas/patologia , Camundongos , Camundongos Nus , Gravidez , Suínos , Teofilina/farmacologia , Transplante HeterólogoAssuntos
Transplante das Ilhotas Pancreáticas/métodos , Animais , Glicemia/metabolismo , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/cirurgia , Feminino , Transplante das Ilhotas Pancreáticas/fisiologia , Rim , Masculino , Pancreatectomia , Veia Porta , Suínos , Fatores de Tempo , Transplante Autólogo , Transplante Heterotópico , Transplante HomólogoAssuntos
Sobrevivência de Enxerto/imunologia , Transplante das Ilhotas Pancreáticas/imunologia , Macrófagos/fisiologia , Transplante Heterotópico/métodos , Animais , Glicemia/metabolismo , Carragenina/farmacologia , Sobrevivência de Enxerto/efeitos dos fármacos , Guanidinas/farmacologia , Imunossupressores/farmacologia , Veia Porta , SuínosAssuntos
Azatioprina/uso terapêutico , Ciclosporina/uso terapêutico , Transplante das Ilhotas Pancreáticas/imunologia , Prednisolona/uso terapêutico , Animais , Glicemia/metabolismo , Quimioterapia Combinada , Terapia de Imunossupressão/métodos , Transplante das Ilhotas Pancreáticas/patologia , Transplante das Ilhotas Pancreáticas/fisiologia , Fígado/patologia , Pancreatectomia , Suínos , Transplante Heterotópico/imunologia , Transplante Heterotópico/patologia , Transplante Heterotópico/fisiologia , Transplante Homólogo/imunologia , Transplante Homólogo/patologia , Transplante Homólogo/fisiologiaAssuntos
Transplante das Ilhotas Pancreáticas , Ilhotas Pancreáticas , Pâncreas , Animais , Glicemia/metabolismo , Peptídeo C/metabolismo , Insulina/metabolismo , Secreção de Insulina , Ilhotas Pancreáticas/citologia , Transplante das Ilhotas Pancreáticas/fisiologia , Pancreatectomia , Suínos , Tolbutamida/farmacologia , Transplante AutólogoRESUMO
Canine and porcine islets were either cultured for 10 days at 37 degrees C or cryopreserved. The effect of these treatments on MHC class II antigen expression was examined by indirect immunofluorescence test using the class II monoclonal antibody 2MC3. Within untreated canine islets exclusively round shaped cells as leukocytes and monocyte/macrophage like cells with dendritic branches were positive with 2MC3. Porcine islets additionally exhibited strong immunofluorescence of the vascular endothelium. Tissue culture significantly reduced the class II antigen expression in both species. The majority of the untreated canine islets had between 5 and 19 2MC3 positive cells. Cell culture reduced the number of class II positive cells to a maximum of 3 and even 84.9% of the islets were completely negative for class II antigens. Porcine islets showed a total class II antigen loss of the vascular endothelium, whereas leukocytes and monocytes/macrophages remained class II antigen positive. Cryopreservation did not have clear-cut effects on the MHC expression in both species.