Neurologic Complications in Percutaneous Nephrolithotomy

PURPOSE: Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. RESULTS: The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. CONCLUSIONS: It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection.

Effect of modified starch used alone or in combination with wheat flour on the sensory characteristics of beef sausage

The effects of modified waxy maize starch [MWMS] [1-3.25%] on the sensory characteristics of 60% beef sausages were investigated by replacing the varying levels of sunflower oil or both sunflower oil and wheat flour [WF]. The addition of MWMS improved the red color, the palatability, and the overall acceptability compared to the control sausages. The Color was medially and positively correlated with firmness. The correlations between color and taste and between taste with juiciness and firmness were weak and positive. The significant correlations were not observed between palatability and overall acceptability and with the other sensory characteristics. Juiciness was negatively correlated with firmness but was not significantly different. As a result, MWMS offset the effects of lowering the fat content

influence of freezing conditions on the organoleptic attributes of Iranian leafy vegetable foods

The edible leafy vegetables contain nutritional ingredients that are necessary for human health and it is important that nutrients protection be monitored during processing and storage. The aim of this study was to study some organoleptic attributes of a very popular Iranian meal named Coco-Sabzi, which was prepared with a mixture of edible grinded leafy vegetable pre-stored at different frozen conditions. So, by sensorial evaluation we can conclude about nutritional loss of products. The mixture of five edible grinded leafy vegetables including Allium ampeloprasum var. porrum, Lepidium sativum, M. spicata [M. sativa], Ocimum basilicum and Allium porrum were stored at -9, -12 and -18 C for 120, 150 and 180 days. The organoleptic attribute of the prepared Coco-Sabzi was compared with the above three different time-temperature combinations during the frozen storage period. Results indicated that the best colors were observed at -18, -12 and -9 C, respectively. Taste and overall acceptability at -18oC after 120 and 150 days and also at -12 C after 180 days ranked 1st [P< 0.05]. Data analysis showed that the color, taste and overall acceptability of samples were not statistically different at three different time-temperature combinations during the frozen storage period. As a result, organoleptic attribute during six months of frozen storage was affected by freezing temperature, not by frozen storage period

Effect of shortening type on the rheological characteristics of cookie dough

The effect of four types of shortening including a commercially vegetable oil [as control], palm olein [PO], palm stearin [PS], and a blend of the latter two oils with rapeseed oil [BF] on the rheological properties of cookie dough was determined by using dynamic oscillatory measurement testing. All of the obtained dough treatments showed weak liquid viscoelastic behavior. Their storage [G] and loss [G] moduli were almost the same with a loss tangent [tan ?] value of about 1. G was greater than G in most of the measured frequency range. Both G and G were frequency dependent and decreased with increasing of frequency. Differing oil compositions were found to differently affect on the overall strength of the doughs. The control dough showed the lowest frequency dependence. At lower frequencies, PO dough had the same consistency as the control, but at higher frequencies, its interaction was reduced leading to a weaker system. PS and BF doughs had stronger systems with higher values of G and G at low frequencies; both showed a dramatic drop in the values of G and G at about 1 Hz. After this frequency, they showed similar rheological profile to the control. Baking test showed that the final quality of the baked products was significantly different in both appearance and internal texture

Suprome percutaneous nephrolithotomy, is it really effective? A systematic review of literature

This systematic review was performed to determine the clinical value of percutaneous nephrolithotomy in the supine position in comparison with the convention of performing the procedure in the prone position. A systematic review of the medical literature was conducted searching for studies on percutaneous nephrolithotomy in the supine position, limited to publications appeared in the PubMed between 1980 and July 2008. Non-English articles were considered if deemed relevant by providing additional data. In the retrieved articles, reference lists were hand-searched to identify additional relevant articles. There were 9 original articles on percutaneous nephrolithotomy in the supine position. Five studies were retrospective and 4 were prospective, of which only 1 was a well-designed randomized controlled trial published in 2008. The success rate of the procedure was reported between 69.6% and 95%. The risk of requiring blood transfusion was between zero and 8%. Duration of hospital stay was variable, but generally less than that in the prone position. No colon perforation was reported. In carefully selected patients with uncomplicated urinary calculi, percutaneous calculus removal in the supine position can yield similar outcomes to that in the prone position