6 vs. 1.3 vs. 0.12 lymphangiectases per square millimeter and 54 vs. 23 vs. 1 mm, respectively; P = 0.0001). Warts exhibited mild fibrosis significantly more frequently than peritumor skin
(57% vs. 5%; P = 0.0001). For peritumor (normal) skin, age, solar elastosis, and adjacent malignancy correlated with greater dilation of lymphatics. Solar elastosis also correlated with increased number of lymphangiectases.
Conclusions: Minor trauma and solar elastosis from chronic ultraviolet radiation exposure are likely the etiologic factors in the development of lymphostasis. By decreasing immune surveillance, latent lymphedema ostensibly facilitates human papillomavirus infection and carcinogenesis.”
“Background: The optimal fluid strategy for the early treatment of trauma ON-01910 patients remains highly debated. Our objective was to determine the efficacy of an initial bolus of resuscitative
Adriamycin fluids used in military and civilian settings on the physiologic response to uncontrolled hemorrhagic shock in a prospective, randomized, blinded animal study.
Methods: Fifty anesthetized swine underwent central venous and arterial catheterization followed by celiotomy. Grade V liver injury was performed, followed by 30 minutes of uncontrolled hemorrhage. Then, liver packing was completed, and fluid resuscitation was initiated over 12 minutes with 2 L normal saline (NS), 2 L Lactated Ringer’s (LR), 250 mL 7.5% hypertonic saline with 3% Dextran (HTS), 500 mL Hextend (HEX), or no fluid (NF). Animals were monitored for 2 hours postinjury. Blood loss after initial hemorrhage, mean arterial pressure (MAP), tissue oxygen saturation (StO(2)), hematocrit, pH, base excess,
and lactate were measured at baseline, 1 hour, and 2 hours.
Results: NF group had less post-treatment blood loss compared with other groups. MAP and StO(2) for HEX, HTS, and LR at 1 hour and 2 hours were similar and higher than NF. MAP and StO(2) did not differ between NS and NF, but NS resulted in decreased pH and base excess.
Conclusions: Cl-amidine Withholding resuscitative fluid results in the least amount of posttreatment blood loss. In clinically used volumes, HEX and HTS are equivalent to LR with regard to physiologic outcomes and superior to NF. NS did not provide a measurable improvement in outcome compared with NF and resulted in increased acidosis.”
“Purpose: We report a simple figure-of-eight tension adjustable suture to ligate the vascular pedicle (VP) during robot-assisted radical prostatectomy (RARP).
Materials and Methods: During nerve-sparing RARP, after the rectum has been mobilized, the VP is isolated and prepared for transection. Previous reports describe placing of hemostatic clips (metallic or Hem-o-lok (TM)) or laparoscopic bulldog clamps (30 mm) to control and oversew the VP; both techniques are quite assistant dependent.