Biomedical subjects

Paul Whelan

Publications and source records attributed to Paul Whelan.

3 recordsLinked to original sources

PubMed2004

Comparison of laparoscopic radical renal surgery in morbidly obese and non-obese patients.

BACKGROUND AND PURPOSE: Laparoscopic radical nephrectomy is rapidly becoming accepted as the preferred management of low-stage renal masses not amenable to partial nephrectomy. Minimally invasive surgery is advantageous to decrease perioperative and postoperative morbidity and allows patients to return to normal activities faster. Obesity has been a relative contraindication to this technique, and these patients have traditionally undergone open surgery. We present a review of 23 morbidly obese patients in comparison with patients who were not morbidly obese who underwent radical laparoscopic nephrectomy and nephroureterectomy at our institution. PATIENTS AND METHODS: Hospital charts between April 2001 and October 2003 were reviewed for morbidly obese patients undergoing transperitoneal laparoscopic renal surgery who were compared with age- and sex-matched control patients who underwent laparoscopic renal surgery in the same institution for similar indications. The data were collected at the time of the surgery. RESULTS: Twenty-three patients with a mean BMI of 42.2 kg/m2 underwent successful transperitoneal laparoscopic surgery. The mean specimen mass was 865 g, which was significantly larger than in the control group. The mean operative time was 200 minutes, which was around half an hour longer than in the matched group. The mean estimated blood loss was 243 mL, which was comparable to that of the controls. There were two perioperative complications, and the mean hospital stay was 4.5 days, 1 day longer than in the control group. CONCLUSIONS: Laparoscopic transperitoneal renal surgery is technically more difficult in morbidly obese patients but is a feasible, effective, minimally invasive method of removing renal malignancies. It offers decreased respiratory and cardiac morbidity in this higher-risk population. This study showed a complication profile similar to that in non-obese patients.

Aged↗

PubMed2004

McMaster experience with laparoscopic pyeloplasty.

PURPOSE: Laparoscopic pyeloplasty has been developed as a minimally invasive alternative to open pyeloplasty for the treatment of ureteropelvic junction obstruction (UPJO). Several series have been published with similar success rates for the two procedures. We present our initial experience with laparoscopic pyeloplasty. MATERIAL AND METHODS: A retrospective review of 29 consecutive patients (mean age 37 years) who underwent Laparoscopic dismembered Hynes-Anderson pyeloplasty in our institution between January 2001 to April 2003 was performed. All patients had flank pain with radiologic findings consistent with ureteropelvic junction obstruction and impaired drainage on diuretic renal scan. Patients were assessed at 6 weeks with an ultrasound and assessment of pain, then an intravenous pyelogram (i.v.p.) and diuretic renogram were completed at 6 months along with a repeat clinical assessment. RESULTS: Twenty-nine patients underwent the procedure with one patient converted to an open procedure due to difficulties with the anastomosis. Mean operating time was 225 minutes, which decreased with experience. Mean blood loss was 50 cc and no patient required transfusion. Mean hospital stay was 2.5 days. Mean follow-up was 12 months. Twenty-six patients had complete resolution of their pain and an improvement on ultrasound was demonstrated, but only six patients showed improvement in function on i.v.p. or renogram at 6 months. In five patients with 25% or less differential renal function preoperatively, the function was worse or negligible despite complete resolution of symptoms. One patient developed stent migration requiring repositioning and another developed calcification on the distal end of the stent requiring cystolithalopaxy prior to stent removal. CONCLUSIONS: In our experience, laparoscopic pyeloplasty offers excellent symptomatic relief in a minimally invasive fashion with low morbidity for adult patients with ureteropelvic junction obstruction. In patients with borderline function (25% or less) preoperatively and with a normal functioning contralateral kidney, nephrectomy should be a consideration.

Adolescent↗

PubMed2003

Functionalization of single-walled carbon nanotubes with (R-)oxycarbonyl nitrenes.

Sidewall functionalization of single-walled carbon nanotubes (SWCNTs) via the addition of (R-)oxycarbonyl nitrenes allows for the covalent binding of a variety of different groups such as alkyl chains, aromatic groups, dendrimers, crown ethers, and oligoethylene glycol units. Such additions lead to a considerable increase in the solubility in organic solvents such as 1,1,2,2-tetrachloroethane (TCE), dimethyl sulfoxide (DMSO), and 1,2-dichlorobenzene (ODCB). The highest solubilities of 1.2 mg/mL were found for SWCNT adducts with nitrenes containing crown ether of oligoethylene glycol moieties in DMSO and TCE, respectively. The presence of chelating donor groups within the addends allowed for the complexation of Cu(2+) and Cd(2+). Atomic force microscopy (AFM) and transmission electron microscopy (TEM) revealed that the functionalized tubes form thin bundles with typical diameters of 10 nm. The presence of thin bundles in solution is supported by (1)H NMR spectroscopy. The elemental composition of the functionalized SWCNT was determined by X-ray photoelectron spectroscopy (XPS). The use of Raman and electron absorption spectroscopy (UV/Vis-nIR) showed that the electronic properties of the SWCNTs are mostly retained after functionalization, indicating a low degree of addition within this series of SWCNT derivatives.

Journal Article↗