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Vessel Disposition Technique in Kidney Transplantation: Long-term Follow-up at Cho Ray Hospital, Vietnam
Thu Thi Ngoc Du,
Sinh Ngoc Tran
Issue:
Volume 3, Issue 2, December 2019
Pages:
27-35
Received:
29 August 2019
Accepted:
23 September 2019
Published:
9 October 2019
Abstract: In this clinical serial, we would like to introduce a surgical technique for kidney transplantation (KTx) from living donor (LD); we call the vessel disposition technique (VDT), with long-term follow-up results. A prospective study at Cho Ray Hospital. The patients underwent the KTx from 1998-2011 and following-up until 2016. There were 201pts., 130 males (64.7%) and 71 females (35.3%). Average age is 33.56 ± 8.62 year old (yo), [15 to 61yo]. We divided it into two groups (at the back table and recipient surgical table): Group A: The Kidney graft (KG) with short vein (≤20 mm) was transplanted on right iliac fossa: 63/201pts. (31.34%), 13/63 from the left (20.63%) and 50/63 from the right (79.37%): the renal vein was dissected, liberated and prolonged; for the right KG, a renal VDT would be done. On the pts., right Gibson incision, made an iliac VDT: dissection of the right iliac vessels (RIV), moved the external iliac vein (IV) to the right side of the external iliac artery; and a termino-lateral venous anastomosis. The renal artery anastomosis would be done as usual. Group B: The KG with the long vein enough (>20 mm) was also transplanted on RIF: 138/201pts (68.66%). Usually, the KG is the left, the KTx was performing as usual, vascular postoperative follow-up by Doppler ultrasound. There wasn’t any surgical vascular complication during the average FU of: 8.0±3.44 years (group A) and 8.79±4.07 years (group B). During the long time follow-up on the serial, the VDT was satisfactory. The KTx from LD was safety for the short KG vein and we could perform on the right side of the pts for the left and the right KG. We could avoid other risky venous reconstructive techniques.
Abstract: In this clinical serial, we would like to introduce a surgical technique for kidney transplantation (KTx) from living donor (LD); we call the vessel disposition technique (VDT), with long-term follow-up results. A prospective study at Cho Ray Hospital. The patients underwent the KTx from 1998-2011 and following-up until 2016. There were 201pts., 13...
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Penile Fracture, Surgical Success and Complication Rate in 26 Cases
Naser Alfgi,
Saliem Abuaniza,
Abdulghany Hussien
Issue:
Volume 3, Issue 2, December 2019
Pages:
36-39
Received:
19 September 2019
Accepted:
29 September 2019
Published:
20 October 2019
Abstract: A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place in the Urology Department of the Tripoli Medical Center on 26 patients in the form of a retrospective study between August 2003 and July 2018. The ages of the patients were between 19 and 61 years old (mean 34.23 years). The diagnosis was based on history and clinical examination. A circumferential sub coronal incision was made followed by degloving the penis to its base. The hematoma was evacuated and the tear was repaired using absorbable, interrupted stitches and the skin was closed with 3/0 undyed vicryl. Cefotriaxon 1 gm IV was given pre-operatively and continued for 5 days post-operative and diazepam 5 mg tab was given twice daily. The cause of penile fracture was masturbation in 11 patients. Intercourse was the cause in 9 cases and 6 were caused by rolling over the erect penis during sleep. All of the patients presented with swelling and ecchymosis and 18 patients underwent surgery within the first 24 hrs while 8 patients were operated on in the 2nd day. After six months of follow up, 19 patients (73.1%) were without complaint, of which 17 (89.47%) of them were operated on within the first 24 hrs and 2 patients (10.53%) were operated on in the 2nd day. Within the group, 7 patients (26.9%) had complications of which 6 patients were operated on after 24 hrs from the time of trauma and one patient who was operated on in the first 24 hrs and complained of painless penile deviation. Three patients had complications with penile deviation and with painful erection while 3 patients had complications of penile deviation. This experience showed that penile fracture is a rare urological emergency. Early surgical correction of penile fractures can be successful in preserving normal erections without significant complications whilst delayed operative management is associated with complications such as penile deviation and painful erection.
Abstract: A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place...
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Torsion of the Testicular Appendages in Adult Acute Scrotum
Issue:
Volume 3, Issue 2, December 2019
Pages:
40-45
Received:
28 August 2019
Accepted:
15 October 2019
Published:
26 October 2019
Abstract: Adult patients with acute scrotum sometimes tend to be treated for epididymitis without undergoing ultrasonographic examination, although precise ultrasonography reveals that there are some patients with torsion of the testicular appendages. In this report, I investigate the incidence of patients with torsion of the testicular appendages among patients with adult acute scrotum, who mainly used to be treated for epididymitis. In the last 5 years, 46 patients (23~62, average age 43.5 years) with scrotal pain and swelling visited our clinic for diagnosis and treatment. On an outpatient basis, their symptoms were evaluated, and blood tests, urinalysis, and grey scale and color Doppler ultrasonography with a 5-12 MHz linear scan were performed. Five (10.9%) of the 46 patients were diagnosed as having torsion of the testicular appendages. Although none of them had a high fever, 4 of the 5 (80%) had nausea and abdominal pain. Leukocytosis and pyuria were not found in any case. Typical ultrasound appearances were reactive hydrocele and a hyperechoic swollen mass or enlarged hyperechoic, spherical mass of the appendage. On color Doppler ultrasonography, there was no blood flow within the torsed appendage testis, and an increase in periappendiceal blood flow was seen in all of the cases. They were treated conservatively with anti-inflammatory agents and cooling, and their symptoms disappeared within 2 weeks. It is suggested that as many as 10.9% of adult patients with scrotal pain and swelling may suffer from torsion of the testicular appendages. We should conduct ultrasonography for adult patients with acute scrotum.
Abstract: Adult patients with acute scrotum sometimes tend to be treated for epididymitis without undergoing ultrasonographic examination, although precise ultrasonography reveals that there are some patients with torsion of the testicular appendages. In this report, I investigate the incidence of patients with torsion of the testicular appendages among pati...
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Nano-realgar Inhibits the Proliferation of Bladder Cancer Cell and Induces the Expression of Apoptosis-related Proteins
Issue:
Volume 3, Issue 2, December 2019
Pages:
46-49
Received:
15 October 2019
Accepted:
6 November 2019
Published:
12 November 2019
Abstract: Background The main component of realgar is arsenic disulfide (As2S2). Modern medical research shows that realgar can inhibit tumorigenesis and development of tumor by regulating cell proliferation and apoptosis. However, the lack of the traditional realgar preparations present with lower bioavailability, which further affects the therapeutic effect. With the improvement of new drug preparation processes, nano-androgen is increasingly used for anti-tumor drugs. Objective In order to investigate the effect of nano-realgar on proliferation of bladder cancer cell line RT4, we performed the research. Methods Nano-realgar was prepared by mechanical milling method. RT4 cell was used as target cell. MTT assay was used to detect the proliferation of RT4 cell treated with nano-realgar. And western blot was used to detect the expression of apoptosis-related proteins (Bax, Caspase-3) in the RT4 cell treated with nano-realgar. Results Nano-realgar could significantly inhibit the proliferation of RT4 cell. After treated with 10 ug/ml, 20 ug/ml and 40 ug/ml nano-realgar for 24 h and 48 h, the proliferation inhibition rate of RT4 cell increased significantly compared with the negative control group (P<0.05), and the expression of apoptosis-related proteins, Bad and Caspase-3, increased significantly after treated with 20 ug/ml and 40 ug/ml nano-realgar for 48 h (P<0.05). Conclusion Nano-realgar can inhibit the proliferation of RT4 cell, and induces the expression of Bax and Caspase-3.
Abstract: Background The main component of realgar is arsenic disulfide (As2S2). Modern medical research shows that realgar can inhibit tumorigenesis and development of tumor by regulating cell proliferation and apoptosis. However, the lack of the traditional realgar preparations present with lower bioavailability, which further affects the therapeutic effec...
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The Experience and Outcome of Renal Transplantation in Yemen
Nagib Wazea Abuasba,
Ibrahim Al Nono,
Tawfiq Al Badani,
Abd Al Ilah Ghailan,
Abdo Zekri
Issue:
Volume 3, Issue 2, December 2019
Pages:
50-55
Received:
9 November 2019
Accepted:
28 November 2019
Published:
10 December 2019
Abstract: Access to renal transplantation in the developing world remains limited It remains the treatment of choice for end-stage kidney disease. This procedure not only improves quality of life, but also markedly increases patients’ survival rates. Therefore, this study aimed to evaluate clinical outcomes of renal transplants in our center and to compare the outcomes between the patients who received induction therapy and those patients without such induction. It was a retrospective study conducted at Al Thawra General Hospital, Sana’a on 154 patients. Data were collected on all patients who underwent a renal transplant from 2004 to t 2015. Analyses were performed to assess baseline characteristics, graft and patient survival, as well as the outcomes of patients who given induction therapy. A total of 154 renal transplants were carried out at Al Thawra center. The mean age of patients was 32.42 ± 10.4 years (rang 14 – 66) and the male sex was predominant accounting for 72.7%. There were 93.5% of patients on dialysis and the dialysis time was ≥ 3 years in 72%. The major causes of end-stage kidney disease (ESKD) were chronic pyelonephritis (77.9%), hypertension (13%), glomerulonephritis (3.9%) and diabetes mellitus (2.4%). During the first year following renal transplants, 6 patients (3.9%) complicated by acute rejection episodes that did not reach statistical significance (P > 0.05). It is found that the mortality rate during the 1st, 5th, and 10th years was 1.9%, 9% and 14.9%respectively and the infectious conditions were the most frequent cause of death (13%) followed by cardiovascular events (3.9%) and others (2.5%). Although, the process of renal transplants in Yemen started slowly with the initial support and cooperation of the Egyptians’ transplant surgeons, the overall outcomes are satisfactory and comparable to the universal reports.
Abstract: Access to renal transplantation in the developing world remains limited It remains the treatment of choice for end-stage kidney disease. This procedure not only improves quality of life, but also markedly increases patients’ survival rates. Therefore, this study aimed to evaluate clinical outcomes of renal transplants in our center and to compare t...
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