Purpose. Using the classical Ankaferd Blood Stopper (ABS) solution to create active hemostasis during partial nephrectomy (PN) may not be so effective due to insufficient contact surface between the ABS hemostatic liquid agent and the bleeding area. In order to broaden the contact surface, we generated a chimeric hemostatic agent, ABS nanohemostat, via combining a self-assembling peptide amphiphile molecule with the traditional Ankaferd hemostat. Materials and Methods. In order to generate ABS nanohemostat, a positively charged Peptide Amphiphile (PA) molecule was synthesized by using solid phase peptide synthesis. For animal experiments, 24 Wistar rats were divided into the following 4 groups: Group 1: control; Group 2: conventional PN with only 0.5 ml Ankaferd hemostat; Group 3: conventional PN with ABS + peptide gel; Group 4: conventional PN with only 0.5 ml peptide solution. Results. Mean warm ischemia times (WITs) were 232.8 ± 56.3, 65.6 ± 11.4, 75.5 ± 17.2, and 58.1 ± 17.6 seconds in Group 1 to Group 4, respectively. Fibrosis was not different among the groups, while inflammation was detected to be significantly different in G3 and G4. Conclusions. ABS nanohemostat has comparable hemostatic efficacy to the traditional Ankaferd hemostat in the partial nephrectomy experimental model. Elucidation of the cellular and tissue effects of this chimeric compound may establish a catalytic spark and open new avenues for novel experimental and clinical studies in the battlefield of hemostasis.
Uterovesical fistulas are rare genitourinary fistulas developing secondary to iatrogenic etiologies. In this article, we report a a post-cesarean vesicouteri fistula with review of the literature.
Although renal cystic formations are seen frequently and arise with diverse symptoms, epidermal cyst is a very unusual cause of renal masses. A50-year-old woman was admitted to our clinic because of lumbar pain, hematuria and dysuria that lasted for 2 months. An atrophic and dysfunctional right kidney was identified. Transperitoneal laparoscopic simple nephrectomy was performed. Microscopic examination revealed typical findings of epidermoid cyst. According to the literature, intrarenal epidermal cysts are usually treated by nephrectomy because they cannot be differentiated from renal masses. To the best of our knowledge, this case report of an epidermoid cyst located in the renal parenchyma of a female patient is the first in the English-language literature.
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