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Purpose To explore the ultrasonic characteristics of idiopathic retroperitoneal fibrosis (IRPF) and assess the diagnostic value of ultrasound. Materials and Methods Ultrasonic images of 11 cases of IRPF were retrospectively analyzed.Results The hypoechogenic masses encasing the abdominal aorta were detected in all cases, among which the encasement of inferior vena cava was found in 4 cases, the involvement of iliac artery in 3 cases and hydronephrosis in 9 cases.Conclusion IRPF demonstrated ultrasonic characteristics that would facilitate its detection and diagnosis.
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BACKGROUND: In order to conserve blood and keep the operating field clean, cell saver is often used with electrocautery in hip arthroplasty. When applying the principle of thermal coagulation, electrocautery produces tissue self-burning with noxious gas byproducts, including carbon monoxide(CO). However the existing blood salvage systems do not have any reoxygenation or filtration function for CO.OBJECTIVE: To evaluate the effects of simultaneous use of electrocautery and a cell saver system on the blood levels of CO in patients undergoing hip arthroplasty.DESIGN: A comparative observation.SETTING: Department of Orthopedics, Duisburg-Essen University.PARTICIPANTS: From August 2002 to August 2003, patients undergoing hip arthroplasty including the use of electrocautery as well as intended use of a cell saver system were selected from the Department of Orthopedics, Duisburg-Essen University. Exclusive criteria: ① smoking history; ② history of anemia, hemoglobinopathy or coagulopathy; ③history of organ dysfunction, including lung, liver and kidney; ④ preoperative abnormal electrocardiogram (ECG), including cardiac ischemia and/or arrhythmia.Among all the enrolled patients, those who ultimately received the retransfusion of processed salvaged blood were counted as the observed group,whereas the others who did not receive any retransfusion for inadequate salvaged volume or possible contamination within salvaging were added as the control group, and no allogenic blood was transfused. All the patients agreed to participate in the study.METHODS: ① All the operations were performed under combined intravenous and inhalation general anesthesia. ② Electrocautery was used for coaluation during the incision of subcutaneous tissues, fascias, muscles as well as capsules. ③ A cell saver system (Haemonetics Cell Saver #5 System, manufactured by Haemonetics Corporation, U.S.A.) was applied during the operation. Salvaged blood were retransfused into the patients after the procedure of filtration and wash. ④ Blood CO-Oximetry: Blood CO levels were measured by carboxyhemoglobin (CO-Hb) concentration with a spectrophotometric blood gas analyzer (ABL 700 series, manufactured by Radiometer, Copenhagen, Denmark). In both groups, systemic blood samples were collected from a radial arterial catheter at 3 time points, including preoperatively, postoperatively and merely before the retransfusion of salvaged blood and at 6 hours postoperatively. In the observed group, additionally samples were collected instantly after skin incision from the aspirator connected to the cell saver reservoir, directly after femoral stem implantation also from the aspirator and immediately before retransfusion from the collecting sac, to reveal the trend of CO-Hb levels in salvaged blood.MAIN OUTCOMEMEASURES: CO-Hb levels in the systemic blood and salvaged blood at different time points were mainly observed.RESULTS: Totally 49 patients were involved in the analysis of results. ① General data: Forty-nine ASA Ⅰ -Ⅱ patients were enrolled in this study.There were 35 and 14 patients in the observed and control group, respectively, with 7 and 3 had a history of coronary heart diseases (heart function of class Ⅰ - Ⅱ ) correspondingly. There were no obvious differences in the sex, age, mean operative time and mean estimated blood loss between the two groups (P ＞ 0.05). The vital signs were stable in all the patients. ② CO-Hb concentration: In the observed group, the CO-Hb concentration in systemic blood at 6 hours postoperatively was significantly increased as compared with the preoperative and postoperative ones [(2.2±0.54)%,(1.6±0.34)%, (1.7±0.19)%, P ＜ 0.05]; the CO-Hb concentration in salvaged blood was (2.6±0.62)%, which was significantly higher than that in systemic blood preoperatively and postoperatively (P ＜ 0.01). In the control group, the CO-Hb concentration in systemic blood at 6 hours postoperatively had no obvious differences as compared with the preoperative and postoperative ones (P ＞ 0.05). ③ Postoperative conditions: In the observed group, sinus tachycardia and inferior myocardial ischemia were detected by ECG monitoring in 2 patients with pre-existing coronary heart disease,which complained of precardial discomfort at 4-6 hours postoperatively.Higher levels of CO-Hb were detected in salvaged blood before retransfusion (39% and 4.5%) and in systemic blood at 6 hours postoperatively(3.5% and 4.2%). No patient in the control group demonstrated symptoms of CO intoxication or cardiovascular compromise, also no abnormal changes were revealed by ECG monitoring.CONCLUSION: Retransfusion of salvaged blood in hip arthroplasty with simultaneous use of electrocautery and a cell saver system leads to a significant increase of systemic CO-Hb concentration, which can provoke the cardiovascular compromise. Therefore, it is suggested to measure CO-Hb level in salvaged blood, the retransfusion of which should be cautious, especially to patients with pre-existing heart diseases.
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<p><b>OBJECTIVE</b>To observe whether olfactory ensheathing cells could be used to promote axonal regeneration in a spontaneously nonregenerating system.</p><p><b>METHODS</b>After laminectomy at the lower thoracic level, the spinal cords of adult rats were exposed and completely transected at T10. A suspension of ensheathing cells was injected into the lesion site in 12 adult rats, and control D/F-12 (1:1 mixture of DMEM and Ham's F-12) was injected in 12 adult rats. Six weeks and ten weeks after cell transplantation, the rats were evaluated by climbing test and motor evoked potentials (MEPs) monitoring. The samples were procured and studied with histologicl and immunohistochemical methods.</p><p><b>RESULTS</b>At the 6th week after cell transplantation, all the rats in both the transplanted and control groups were paraplegic and the MEPs could not be recorded. At the 10th week after cell transplantation, of 7 rats in the control group, 2 rats had muscles' contraction of the lower extremities, 2 rats had hips and/or knees' active movement; and 5 rats' MEPs could be recorded in the hind limbs in the transplanted group (n=7). None of the rats in the control group had functional improvement and no MEPs recorded (n=7). Numerous regenerating axons were observed through the transplantation and continued to regenerate into the denervated host tract. Cell labelling using anti-Myelin Basic Protein (MBP) and anti-Nerve Growth Factor Receptor (anti-NGFR) indicated that the regenerated axons were derived from the appropriate neuronal source and that donor cells migrated into the denervated host tract. But axonal degeneration existed and regenerating axons were not observed within the spinal cords of the adult rats with only D/F-12 injection.</p><p><b>CONCLUSIONS</b>The axonal regeneration in the transected adult rat spinal cord is possible after ensheathing cells transplantation.</p>
Subject(s)
Animals , Male , Rats , Axons , Physiology , Brain Tissue Transplantation , Cell Transplantation , Nerve Regeneration , Olfactory Bulb , Cell Biology , Transplantation , Rats, Sprague-Dawley , Spinal Cord , Physiology , Spinal Cord Injuries , General SurgeryABSTRACT
Objective To observe the ingrowth characteristics of the interface between hydroxyapatite coated intervertebral implants and vertebral cortex loaded with physiological compressive stress. Methods Twelve titanium alloy intervertebral implants special for macaque were prepared, 4 of which were coated with corundum (control group) and 8 of which were coated with hydroxyapatite (HA, observed group). One control and two observed implants were randomly inserted into the intervertebral spaces of L2,3, L3,4 and L4,5 in each of 4 healthy homogenous adult macaques (2 males and 2 females). Roentgenology was performed at 3, 6, 12, 24 and 40 weeks postoperatively. Histomorphometry as well as histology were also evaluated at 40 weeks postoperatively. Results All the animals recovered well from the operation. Three days after operation all the animals began to stand and walk with normal gait. Gross anatomy showed excellent healing in the annulus fibrous involved, and no implant loosening or migration was found. On 40 weeks postoperatively, the interface of the observed group were filled with calcified mature bone and partly-mineralized osteoid tissue, the content of calcified bone as well as the amount of osteoblasts and osteocytes were significantly higher in observed group, and the differences were of statistical significance (t=5.001, P=0.000 and t=16.983, P=0.000). A tight connection was observed between the vertebral bones and HA coating. The thickness of coating decreased form 130-150 ?m to 100-130 ?m. And no evident breakage or debris was found on the implant coating. Conclusion HA coating was stable in vivo and had favorable biocompatibility with vertebral bone. It was more effective than corundum coating in inducing intervertebral cortical bone ingrowth under physical compressive loading.