BACKGROUND: The most frequent genetic disease of the kidneys occurring in 1 of 1000 inhabitants is autosomal-dominant polycystic kidney disease (ADPKD). Growing renal cysts compress the kidney resulting in damage to parenchyma and functional disorders. Around 10% of these patients are dialyzed due to terminal renal insufficiency. With the advent of laparoscopic techniques, the idea of laparoscopic excision of cysts seemed a tempting alternative to nephrectomy. We assessed the preliminary results of laparoscopic treatment of polycystic kidneys compared with open nephrectomy for patients with ADPKD. MATERIALS AND METHODS: Thirty ADPKD patients were treated between 2000 and 2004. Eleven procedures in five men and six women of mean age 51 years included laparoscopic cyst excisions. In the remaining 19 patients (six men and 13 women) of mean age 54 years, nephrectomy was done. Indications for surgery included pain due to compression by large cysts and cyst contamination. Patients after nephrectomy were prepared for renal transplantation when necessary. RESULTS: Laparoscopic polycyst removal produced better effects than nephrectomy. Mean operative time was significantly shorter (86 minutes for cyst removal vs 108 minutes for nephrectomy; P < .05). Postoperative pain measured with the VAS scale was reduced in patients after laparoscopy. Hospital stay was shorter (5 vs 9 days), as well as time to recovery. Other benefits of laparoscopic cyst removal included maintained urination in the patient and no need for erythropoietin substitution, as well as reduced risk of cyst contamination. When eligible for renal transplantation, patients after laparoscopic polycyst removal have smaller kidneys that do not interfere with the graft and the risk of infection during immunosuppression seems lower. CONCLUSION: Although larger series of patients are required in patients with ADPKD, laparoscopic polycyst removal seemed superior to early nephrectomy.

Female↗

PubMedDate not supplied

Viral inactivation of human bone tissue using supercritical fluid extraction.

A new bone tissue process using supercritical carbon dioxide fluid extraction (SFE) has been evaluated for its ability to inactivate or eliminate viruses. Four viruses, human immunodeficiency virus type 1 (HIV-1), Sindbis virus, polio Sabin type I virus, and pseudorabies virus (PRV), were exposed to four different processing steps. In addition to supercritical CO2, hydrogen peroxide, sodium hydroxide, and ethanol treatments were evaluated. The mean cumulated reduction factors (log10) for the four viruses exposed to these four steps were > 14.2 for HIV-1, > 18.2 for Sindbis virus, > 24.4 for poliovirus, and > 17.6 for PRV. The mean reduction factors obtained by the supercritical fluid extraction alone were > 4.0, > 4.3, > 6.6, and > 4.0, respectively. These results demonstrate that the SFE process is effective in inactivating viruses on human femoral heads, and provides a level of inactivation similar to that obtained by traditional cleaning methods. It is proposed that CO2 SFE be incorporated as a routine step in the processing of bone allografts for transplantation either to replace or supplement existing procedures.

Carbon Dioxide↗

PubMedDate not supplied

The activity of cholesterol esterase and ceruloplasmin are inversely related in the serum of men with atherosclerosis obliterans.

BACKGROUND: Ceruloplasmin is a copper-containing (2-glycoprotein and a member of the acute phase reactant family. Parallel changes in ceruloplasmin and copper concentration have been observed in diseases accompanied by severe inflammation, indicating a closely related process. Cholesterol esterase participates in lipoprotein degradation by the hydrolysis of cholesteryl esters in low density lipoproteins (LDL-CE). LDL-CEs are substrates for cholesterol esterase, but can also undergo oxidation by metal ions. The reduction of lipid hydroperoxides has been claimed to play a key role in the control of lipid peroxidation in living systems. MATERIAL AND METHODS: The experimental group consisted of 16 men with atherosclerosis obliterans of the lower limbs, with 12 healthy male volunteers as a control group. The activity of cholesterol esterase (CEase), ceruloplasmin (Cp), and glutathione peroxidase (GPx), and the concentrations of malonyldialdehyde (MDA) and copper were determined in serum samples. RESULTS: CEase and Cp activity and copper concentrations were found to be greater in the AO group than in the controls. In addition, CEase and Cp were negatively correlated (r=(0.65, p< or = 0.05) in the serum of men with AO, but not in the controls. Moreover, copper concentration was significantly correlated with the activity of Cp and GPx (r=0.81 and r=0.58, respectively). The reduced GPx activity and the higher MDA concentration found in the AO group indicate a decline in the antioxidative barrier of plasma. CONCLUSIONS: The results reported here show an inverse relationship between the activities of CEase and Cp in chronic arterial occlusion of the lower limbs, which may reveal the interaction between the antioxidant and lipolytic enzymes.

Aged↗

PubMedDate not supplied

[Evaluation of surgical results in lower limb atherosclerotic ischemia comparing men and women].

Multicenter studies involved 1449 male and 131 female patients operated for the atherosclerotic ischemia of the lower limbs. About 50% of all limbs were in the III or IV stage of ischemia (according to Fontaine's classification) before surgery. Atherosclerotic lesions involved mainly aortoiliac segment in the majority of patients. Early results of surgery were similar in both men and women. An improvement during a 5-year follow up period was noted more frequently in women than in men--86% and 68.5% of limbs respectively. Late result of lumbar sympathectomy was similar in both groups. Limb amputation and mortality rates were similar in both groups in the early postoperative period and during a 5-year follow up as well.

Aged↗