Surgical aspects of autonomic dysreflexia

Autonomic dysreflexia (AD) is a characteristic syndrome that occurs in spinal cord injury (SCI) patients with lesions above the sympathetic outflow at T6 and rarely in those with lesions below T10. Symptoms are initiated by noxious stimuli below the level of injury which result in massive sympathetic discharges from the isolated cord. These produce what may be called a sympathetic storm manifest by severe life threatening hypertension. Anesthesiologists and surgeons dealing with SCI patients must know how to recognize this syndrome, how to prevent its occurrence and how to manage it aggressively. Choice of anesthesia is frequently difficult and, in particular, it may be difficult to decide which type of anesthesia is best for patients susceptible to the syndrome. Therefore, we have conducted a retrospective study of SCI patients in the Department of Veterans Affairs Medical Center, Long Beach, California, where the Spinal Cord Injury Service is one of the largest in the country.     

Relationship between ABO blood group and levels of Gal alpha,3Galactose-reactive human immunoglobulin G

BACKGROUND: The terminal Gal alpha1,3Galactose (alphaGal) determinant is present on all porcine glycoproteins and glycolipids, but is not expressed by human cells. Consequently human sera contain anti-alphaGal natural antibodies. The human blood group B antigen [Gal alpha1,3(Fuc1,2)Galactose] is differentiated from the alphaGal epitope by the presence of a fucosyl group. METHODS: To determine whether the expression of the B antigen has any effect on the level of alphaGal-reactive natural antibodies, equal numbers (n=12) of A, B, AB, and O serum samples were evaluated by ELISA and flow cytometry. RESULTS: A significant reduction in IgG alphaGal reactivity was observed with serum samples from B antigen-expressing donors (B, AB) relative to non-B antigen-expressing donors (A, O). CONCLUSIONS: These results are consistent with the possibility that anti-alphaGal antibodies in non-B antigen-expressing individuals include a subset that is reactive with the structurally related B antigen and that this subset is absent in B and AB individuals.     

Micromechanics-Based Predictions on the Overall Stress-Strain Relations of Cement-Matrix Composites

A micromechanics-based model is proposed to determine the nonlinear stress-strain relations of cement-matrix composites at different concentrations of inclusions (aggregates). We first conducted some experiments to uncover the stress-strain behavior of the cement paste with a water-to-cement ratio of 0.45, and those of the mortar with the same cement paste but at three different volume concentrations of aggregates. The behavior of the cement paste is then simulated by Burgers’ rheological model. In the development of the composite model, we extend the linear elastic response to the nonlinear one through the replacement of elastic moduli by the corresponding secant moduli. The nonlinear stress-strain curves of the cement-matrix composite are then determined from those of the cement paste and inclusions. It is shown that the predicted stress-strain curves of the mortar are in close agreement with the experimental curves up to an aggregate volume fraction of 49% or 60?wt?%.     

Laparoscopic resection of posterior gastric leiomyoma

BACKGROUND: A variety of laparoscopic procedures for the repair of abdominal wall hernias have been described. The repair described in this paper represents a modification and improvement of one approach. METHODS: Our technique employs an Origin Tacker (Origin Medsystems, Inc, Menlo Park, CA) and a Gore suture passer (W. L. Gore, Flagstaff, AZ) to secure an expanded polytetrafluoroethylene (ePTFE) patch, (DualMesh, W. L. Gore, Flagstaff, AZ) to the anterior abdominal wall. RESULTS: This approach simplifies the repair by minimizing the number of steps required to secure the ePTFE graft to the anterior abdominal. CONCLUSIONS: We have found this to be a safe and reliable technique that may be used in the laparoscopic repair of ventral, umbilical, or inguinal hernias.     

Modified version of dissolving suture material on the basis of glycol cellulose ethers: a histological study

Investigation of manufacturing of home-produced dissolving suture material was conducted. Influence of the material on tissues in the region of threads location and on the organism as a whole was studied up. The material resolved actively, did not cause pathological changes in surrounding tissues and in general pathological processes in the organism of animals. During 180 days the majority of the suture material quantity have resolved.