or anastomotic procedures (range 0 to 8). There were 35 patients with bulbar strictures (53.8%), 15 with penobulbar (23.1%), 10 with penile (15.4%), 4 with membranous (6,2%) and 1 had simultaneously a bulbar and a penile stricture (1.5%) respectively. Prior to the operation a small buccal mucosa biopsy of 0.5cm³ was harvested in local anesthesia. Cells were isolated therefrom and cultivated in an external laboratory through tissue engineering, manufacturing within three weeks to a 3x4 cm large mucous membrane with autologous patient's cells. The operative technique was performed in 56 cases in ventral onlay technique (86.2%), in 5 cases in dorsal inlay technique (7.7%) and in 4 cases combined (6.1%).RESULTS: Mean stricture length was 5.3 cm (range 2-16). Mean operative time was 92 minutes (range 70 to 210). None perioperative hemorrhage occurred in all patients. Mean post-operative uroflow rate was 20.1 ml/s (range 10.6 to 35.5). Mean reduction of post-void residual was 73,6 ml (range 0 to 230). Mean follow up was 12.1 months (range 2 to 28). 12 patients (18.5%) developed a recurrence of the stricture (7 with bulbar, 2 penobulbar, 2 penile and 1 membranous localization and mean 2.3 previous endoscopic operations) after mean 5.2 months (range 2 to 12). No local (oralurethral) or general adverse events related to the use of MukoCellÒ were observed.CONCLUSIONS: The effectiveness of different methods of onestage urethroplasty using MukoCellÒ was 81.5% and was not significantly inferior to the conventional methods with native oral mucosa. The advantages of tissue-engineered oral mucosa grafting were avoiding excision of larger segments of the patient's oral mucosa and preventing associated complications, shortening the operating time, and simplifying the surgical technique. Larger patient series and long-term results of the therapy are following.
CnLcitr~ plays a dominant role in many biochemical processes that are critical to body homeostasis. 1 Blood clotting and muscle contraction are two mechanisms in which ionic calcium is essential. In the myofibril, calcium ions entering the cell on depolarization, and those freed from an intracellular bound form act to cause sarcomere shortening? The other electrolytes, sodium, potassium, magnesium, and inorganic phosphate are also necessary in proper concentrations for balanced biological systems3How much of what kinds of intravenous solution to give during operation is an everyday consideration for anaesthetists. Does giving dextrose in water alter the pattern of plasma electrolytes, particularly calcium, compared to giving Ringer's lactate solution? Seeking an answer, we studied 13 patients during anaesthesia for abdominal operations who received one or other of these two intravenous solutions.
PATIENTS STUDIEDThe six females and seven males averaged 55 years of age (range 39--76), and 77 kg weight (range 50-92). All were intra-abdominal operations, except for one herniorraphy. Their A.S.A. physical status categories were Class 1-8 and Class II-5.All patients were induced with thiopentone, given succinylcholine for intubation and maintained with nitrous oxide and tubocurare. In addition, halothane was given to all but two patients, who had Innovar| Nine patients, with a mean anaesthetic time of 123 minutes, received a mean volume of dextrose/water of 816 ml during operation and for one hour in the recovery room. The group who received a mean volume of 707 ml of 5 per cent dextrose/Ringer's lactate, averaged 116 minutes of anaesthesia. The intended flow rate was 250 ml per hour over the three hours. No blood was transfused.
STuDY PRoTOCOLSerial samples of venous blood were drawn in heparinized syringes, without tourniquet, before induction, at mid-operation and end-operation and one hour afterwards. Samples were iced and biochemical determinations began within 15 minutes. Blood-gas analyses were done by electrodes ( Instrumentation Laboratory, Inc.) without correction for body temperature. Concentrations of several con-*From the
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