Technological improvements for the treatment of obstructed defecation syndrome.

Background/aim: Standard stapled transanal rectal resection (STARR) with two PPH-01™ poses some questions regarding the completeness of prolapse resection in patients with obstructed defecation syndrome (ODS) since 20% to 30% of patients have persistent rectocele or rectal intussusception that may impair the physiological recovery of rectal sensitivity. New high-volume (HV) devices, such as CPH34 HV™ and CPH36 SMS™, allow for wider prolapsectomy to be performed and we herein assessed the possibility and safety of a STARR mono-stapler.

Materials And Methods: On May 30th-31st 2011, 13 pigs were selected to undergo standard STARR with two PPH-01™ (n=2) or STARR mono-stapler with one CPH34 HV™ (n=11) at the Experimental Center of Vila do Conde (Portugal); another set of 13 pigs was selected on January 14th-17th 2014 to undergo standard STARR (n=2) or STARR mono-stapler by means of one CPH36 SMS™ (n=11).

Maternal weight as an alternative determinant of the gestational day of Wistar rats housed in individually-ventilated cages.

One of the commonly used animal models in fertility, developmental and neurobiological studies is the laboratory rat. The early recognition of rat pregnancy and confirmation of the exact embryonic day are vital. The aim of this study was to investigate the correlation of maternal weight at the time of conception to its increase throughout gestation, aiming to develop a mathematical model, which can be used for the determination of the exact day of pregnancy, set the threshold, and monitor pregnancy from the onset.

Ischemia-reperfusion rat model of acute pancreatitis: protein carbonyl as a putative early biomarker of pancreatic injury.

Acute pancreatitis (AP) is an inflammatory disorder that can affect adjacent and/or remote organs. Some evidence indicates that the production of reactive oxygen species is able to induce AP. Protein carbonyl (PC) derivatives, which can also be generated through oxidative cleavage mechanisms, have been implicated in several diseases, but there is little or no information on this biomarker in AP.

The impact of type 2 diabetes and atorvastatin treatment on serum levels of MMP-7 and MMP-8.

Aim: Novel members of matrix metalloproteinases (MMPs), MMP-7 and MMP-8, have emerged as predictors of cardiovascular events. Our study aimed to evaluate serum MMP-7 and MMP-8 concentrations in patients with type 2 diabetes mellitus (T2DM) and the effects of atorvastatin on them.

Methods: We enrolled 85 statin-free subjects with concomitant T2DM and hypercholesterolemia, but without overt micro-/macro-vascular complications (diabetic group - DG).

High-density lipoproteins inhibit urate crystal-induced inflammation in mice.

Objectives: To investigate the effects and mechanisms of action of high-density lipoproteins (HDL) in monosodium urate (MSU) crystal-induced inflammation -that is, gouty inflammation, in vivo.

Methods: Air pouches raised on the backs of mice were injected with MSU crystals or tumour necrosis factor (TNF) in the presence or absence of HDL and/or interleukin (IL)-1 receptor antagonist (IL-1Ra) for 3 h. Leucocyte count and neutrophil percentage in pouch fluids were measured using a haemocytometer and May-Grünwald-Giemsa staining.

The beneficial effects of a direct thrombin inhibitor, dabigatran etexilate, on the development and stability of atherosclerotic lesions in apolipoprotein E-deficient mice : dabigatran etexilate and atherosclerosis.

Purpose: Dabigatran etexilate (DE) constitutes a novel, direct thrombin inhibitor. Regarding the association of thrombin with atherogenesis, we assessed the effects of DE on the development and stability of atherosclerotic lesions in apolipoprotein-E deficient (ApoE-/-) mice.

Materials-methods: Fifty male ApoE-/- mice were randomized to receive western-type diet either supplemented with DE 7.

Effect of layer heterogeneity on the biomechanical properties of ascending thoracic aortic aneurysms.

This study addressed layer-specific differences in the biomechanical response of ascending aortic aneusysms, obtained from patients during graft replacement. Tensile tests were conducted on pairs of (orthogonally directed) intimal, medial, and adventitial strips from the anterior, posterior, and two lateral quadrants. The experimental data were reduced by the Fung-type model, affording appropriate characterization of the material properties.

Experimental investigation and constitutive modeling of the 3D histomechanical properties of vein tissue.

Numerous studies have provided material models of arterial walls, but limited information is available on the pseudo-elastic response of vein walls and their underlying microstructure, and only few constitutive formulations have been proposed heretofore. Accordingly, we identified the histomechanics of healthy porcine jugular veins by applying an integrated approach of inflation/extension tests and histomorphometric evaluation. Several alternate phenomenological and microstructure-based strain-energy functions (SEF) were attempted to mimic the material response.

Laparoscopic vs. open abdominal surgery in male pigs: marked differences in cortisol and catecholamine response depending on the size of surgical incision.

Objective: Minimally invasive operations, such as laparoscopic cholecystectomy and adrenalectomy, result in a more rapid recovery of normal function, less physiological disturbances and less stress to the organism than similar open operations. The purpose of this study was to determine the stress response associated with minimally invasive abdominal surgery compared to conventional small or large incision laparotomy.

Methods: We compared the responses of the stress hormones cortisol and the catecholamines adrenaline and noradrenaline to elective conventional and laparoscopic cholecystectomy and unilateral adrenalectomy in male pigs.

Expanded polytetrafluoroethylene in canine bile duct injury: a critical analysis.

Purpose: Analyze the morphological and structural outcomes of a patch of expanded polytetrafluoroethylene in the treatment of an iatrogenic injury of the common bile duct.

Methods: In Group 1 (Sham), 7 dogs underwent 3 laparotomies with intervals of 30 days between them. In Group 2, 10 dogs underwent transient common bile duct obstruction.

Effects of exercise training on the severity and composition of atherosclerotic plaque in apoE-deficient mice.

Aim: To investigate the effects of exercise on atherosclerotic plaque composition, the concentration of matrix metalloproteinases (MMPs) in the atherosclerotic plaque and the systemic circulation.

Methods: Ninety apolipoprotein E-deficient (apoE(-/-)) mice (45 male) were randomized to the following groups (n=15 each): control male/female; sedentary male/female; exercise male/female. Mice were kept on a 16-week high-fat diet.

The efficacy of imiquimod on dysplastic lesions of the oral mucosa: an experimental model.

Aim: To study the potent efficacy of the immunomodulatory agent imiquimod when applied on dysplastic lesions of the oral mucosa.

Materials And Methods: Carcinogen (DMBA) was applied to the mucosa of the left buccal pouch of 26 male Wistar rats for 8 weeks, until dysplastic lesions were observed and histologically diagnosed. At the second phase of the experiment, 5% imiquimod cream was applied to these dysplastic lesions for 16 weeks.

The role of ex-vivo gene therapy of vein grafts with Egr-1 decoy in the suppression of intimal hyperplasia.

Objectives: To test the hypothesis that vein graft intimal hyperplasia can be significantly suppressed by a single intra-operative transfection of the graft with a decoy oligonucleotide (ODN) binding the transcription factor Egr-1.

Design: Experimental study.

Materials And Methods: Jugular vein to carotid artery interposition grafts in rabbits were treated with Egr-1 decoy, mutant decoy ODN, vehicle alone, using a non-distending pressure of 300 mm Hg for 20 min, or were left untreated.

Protective effect of simvastatin in the cyclophosphamide-induced hemorrhagic cystitis in rats.

Purpose: Cyclophosphamide (CYP) is an antineoplastic agent used for the treatment of many neoplastic and inflammatory diseases. Hemorrhagic cystitis is a frequent side effect of CYP. Several studies show that simvastatin has important pleiotropic (anti-inflammatory and immunomodulatory) effects.

Conservative management of an extensive renal graft subcapsular hematoma arising during living donor nephrectomy. Role of Doppler sonographic posttransplant follow-up.

We report a case of subcapsular hematoma (SH) of a kidney graft arising during minimal-incision living-donor nephrectomy. SH covered at least two-thirds of the cortical surface. Capsulotomy was not done because it was deemed too risky.

Subcutaneous transposition of the superficial femoral artery for arterioarterial hemodialysis: technique and results.

We report the use of subcutaneous transposition of the femoral artery (STFA) for placement of both inflow and outflow needles in 14 hemodialysis (HD) adult patients with difficult access. Follow-up time was 318 months during which a total of 3215 arterioarterial HD sessions were done. Kt/V values ranged between 0.

Angiotomographically-proven left innominate vein occlusion in dialysis patients with prior left internal jugular vein catheterization presenting with arm swelling after ipsilateral access creation: report of four cases.

Central vein occlusion (CVO) is not uncommonly observed after hemodialysis (HD) catheter placement and it may prevent subsequent ipsilateral arteriovenous (AV) access creation. Right internal jugular vein catheterization (RJVC) appears to be the insertion site with the lowest incidence of CVO, but little is known about the incidence of CVO following left internal jugular vein catheterization (LJVC). We report on four patients with left innominate vein occlusion after LJVC who developed severe arm swelling after ipsilateral AV access creation.

Vein wall dissection: a rare puncture-related complication of brachiocephalic fistula. Gray-scale and color Doppler sonographic findings.

We describe a case of brachiocephalic fistula vein wall dissection (VWD) occurring in a 36-year-old female hemodialysis patient. Unlike subcutaneous or subfascial infiltrations for which the mechanism is blood extravasation, VWD seems to be due to disruption of the fistula vein layers caused by misplacement of the outflow (venous) needle bevel. In this setting, the pressure of the dialysis blood pump acts as the driving force of the dissecting column, extending it proximally.

Reversible leukoencephalopathy syndrome associated to leukopenia in a chronic hemodialysis patient.

Reversible leukoencephalopathy syndrome (RLS) is a rare brain disorder, characterized by diffuse attenuation of cerebral white matter, which has been most commonly observed in transplant patients receiving calcineurin inhibitors or in patients with severe hypertension. We report an episode of RLS in a 22-year-old male patient on chronic hemodialysis with well-controlled moderate hypertension who presented with de novo headache and generalized seizures. Cranial magnetic resonance image (MRI) revealed multiple areas of increased signal intensity in the white matter on T2-weighed images which resolved spontaneously at subsequent MRIs.

Use of the Monti principle for constructing a continent gastrostomy.

Objective: To research technical alternatives for permanent gastrostomy that minimizes the drawbacks and complications reported by several authors.

Materials And Methods: An experimental model was developed where the material was divided into 2 groups: the study group (SG) composed of 12 half-breed dogs where the proposed technique was applied, and the control group (CG) composed of 10 animals where a gastrostomy as proposed by Webster in 1974 was applied. On the 90th postoperative day, both groups underwent tests for assessing competence concerning leakage.

Right versus left internal jugular vein catheterization for hemodialysis: complications and impact on ipsilateral access creation.

This study investigated whether the anatomical differences between right and left internal jugular vein catheterization (RJVC and LJVC) would lead to differences in the frequency of complications, in particular, central vein occlusion (CVO). A group of 479 jugular vein catheterizations, 403 RJVC and 77 LJVC done in 294 prevalent hemodialysis patients were analyzed. A right-sided carotid pseudoaneurysm was the only major puncture-related complication.

Ulnar-basilic fistula: indications, surgical aspects, puncture technique, and results.

Ulnar-basilic fistula (UBF) is an autogenic vascular access option for hemodialysis (HD) first reported in 1967. However, only a few reports dealing with its complications and survival rates have been published in the literature. In the present work the results of 61 UBFs done in 60 adult patients on chronic HD are reported.

Severely elevated intrarenal arterial impedance and abnormal venous flow pattern in a normal functioning kidney graft.

Serial Doppler sonographic impedance measurements represent the most common diagnostic method for noninvasive monitoring of kidney grafts. Severely elevated arterial impedance is almost always associated with graft dysfunction. However, we describe in the present work a renal transplant recipient with optimal graft function despite permanently elevated arterial impedance (pulsatility index (PI) ranging from 2.

Basic steps for increasing the rate of autogenic vascular accesses for hemodialysis.

The number of patients on chronic hemodialysis (HD) is steadily increasing worldwide. The creation of a well-functioning vascular access represents a critical aspect in their management. Autogenous arteriovenous fistulas (AVF) are considered the first choice vascular access in terms of lower morbidity and costs, and higher survival rates when compared with grafts.