The epoxy group of the epoxy compounds has an oxygen arm that can work as a flexible joint in a cross‐linking bridge and can block not only the amino group but also the carboxy group of collagen peptide. The purpose of this study is to evaluate the anticalcification efficacy of the epoxy compounds as a cross‐linking agent for xenograft bioprostheses.
Porcine aortic leaflets were treated with 2% epoxy compounds and implanted in subcutaneous layer of 4‐week‐old rats. Measurement of calcium content showed that epoxy‐treated implants received a minimal calcification: mean 0.64μg/mg dry weight leaflet tissue (range 0.5–0.8;N=7) at 1 month; mean 0.94μg/mg (range 0.3–1.3;N=9) at 2 months; and mean 1.2μg/mg (range 0.5–2.1;N=10) at 3 months. Natural leaflets contained calcium of mean 0.43μg/mg. By contrast, glutaraldehyde‐preserved implants were severely calcified: mean 91μg/mg (range 41–130;N=11) at 1 month; mean 136μg/mg (range 73–205;N=16) at 2 months; and mean 170μg/mg (range 90–214;N=21) at 3 months.
The epoxy compounds provide more pronounced anticalcification effects than the glutaraldehyde under pressure load‐free subcutaneous circumstances.
Prognosis of patients with diabetes mellitus or liver cirrhosis can be worsened by the development of a variety of infectious diseases. We describe a case of psoas abscess and bacterial peritonitis in a 58-year-old woman with type C liver cirrhosis and diabetes mellitus hospitalized after having an elevated temperature caused by urinary tract infection for 2 months. The cirrhosis had not been treated and daily self-administration of insulin had been discontinued for the previous 5 months. On day 2 of hospitalization, vomiting and decreased blood pressure developed. Abdominal computed tomography scan revealed ascites, pneumoperitoneum, and psoas abscess. Laparotomy revealed psoas abscess and bacterial peritonitis without gastrointestinal perforation and psoas abscess perforation. Surgical drainage of the abscess and peritoneal cavity was performed. Immediately after the operation, upper gastrointestinal bleeding, shock, hypoglycemia, and metabolic acidosis developed, followed by hepatic failure, renal insufficiency, and cerebral dysfunction. Death occurred on postoperative day 19. Upon autopsy, bacterial peritonitis residue of psoas abscess, and urinary tract infection were confirmed. We surmise that untreated liver cirrhosis and diabetes mellitus is a risk for urinary tract infection that may spread in iliopsoas and free peritoneal space.
The effects of an ultrasonic surgical aspirator on the vascular system was evaluated in 12 mongrel dogs. The pathologic effects of the device were investigated in femoral vessels by light and electron scanning microscopies and the physiologic effects by measuring the internal mammary arterial and femoral venous blood flow.Changes in the intimal surface of arteries (platelet aggregation and fibrin network formation) were more frequent at higher vibration amplitudes, while such changes were less common in the vein. Disintegration and loss of the vascular wall did not extend beyond the adventitia. There was no obvious change in the blood flow pattern or flow rate after administration of ultrasonic vibrations.The results showed that by keeping the output below 110 microns and using the aspirator together with other conventional surgical devices for dissection, damages to the vascular wall may be held to a minimum. This device can be a very useful supplementary tool in cardiovascular surgery.
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