Showing 26 results for Graft
Karimiyazdi A, Sazgar Aa, Aghayan Hr, Sadrhoseini Sm, Arjmand B, Tavasoli A, Imamirazavi Sh,
Volume 66, Issue 9 (12-2008)
Abstract
Background: Several therapeutic modalities have been cited for patients with microtia. Recently there are several reports about using cadaveric homograft cartilage for some other purposes. The aim of this study was to assess the results of auricular reconstruct-tion in 10 patients (12 ears) with congenital atresia using homograft rib cartilage from the Iranian Tissue Bank.
Methods: We enrolled 10 patients with microtia who were referred to the Imam Khomeini Hospital from September 2006 to July 2007 for auricular reconstruction. The reconstruction was performed using a pre-shaped homograft(s) of each patient's ear(s) made by the Iranian Tissue Bank from the 6th, 7th and 8th costal cartilage according to the method of Marquette. In six patients, the second stage of reconstructive surgery was performed three months after the first stage. The patients were followed regarding the ear appearance, the dimensions of cartilage and tissue reaction.
Results: The mean age of the patients was 11.08 (SD=5.57) years and the average duration of follow-up was 6.29 (SD=3.12) months. Eight cases had unilateral involvement (six right and two left), in addition to two cases of bilateral involvement. During the follow-up period, the appearance of the helix was satisfactory in 11 ears and the lobule in 10 ears. The height and width of the reconstructed auricles was an average of 1-2 millimeters different from the opposite ear. Erythema was the most common early complication. Late complications, including cartilage exposure and infection, were observed in one patient.
Conclusion: Auricular reconstruction using homograft costal cartilage in patients with microtia has promising results. The short term resorption can be ignored and significant early or late complications are infrequent.
Radmehr H, Tatari H, Salehi M, Bakhshande A,
Volume 66, Issue 12 (3-2009)
Abstract
Background: The usage of pericardium of patient himself, for support of anastomosis lines may carry benefits in patients undergoing aortic valve replacement with pulmonary autograft (Ross). The aim of the present study was to compare the short term results of aortic valve replacement with pulmonary autograft with routine and offered methods.
Methods: In a non-randomized clinical trial, 64 patients who referred to cardiac surgery ward of Imam Khomeini hospital Tehran Iran from December 2002 to December 2006 for aortic valve replacement with pulmonary autograft with two different methods. In the first two years of this study all of the patients were operated with routine procedure (group A, n=28) and during the next two years, all of them were operated with authors' offered method in which the patient`s pericardium was used for support of anastomosis lines (group B, n=36). Some of clinical parameters and outcome were compared between two groups.
Results: There were no significant differences between mean of age, sex, pathology, preoperative and postoperative EF in two groups. In group B, the mean pump time was significantly lower than group A (144.09±26 vs. 179.64±25 min). The mean Cross-clamp time was significantly lower in group B (118.5±22 vs. 136.93±19 min) Need for blood transfusion in ICU was significantly lower in group B (35.71% vs. 68.57%). Mean ICU Stay and Postoperative Hospital Stay were significantly lower in group B (1.3±0.3 vs. 1.9±0.7 and 5.2±0.9 vs. 5.9±1.5 days respectively). Overall mortality was four death (6.25%) which was not significant between two groups.
Conclusions: The usage of patient's pericardium for support of anastomosis lines in patients undergoing aortic root replacement with pulmonary autograft carry advantages to routine procedure and its utilization is advocated in other centers.
Farahvash Mr, Yegane Ra, Farahvash B, Sheidaeian M, Masoomi M,
Volume 67, Issue 3 (6-2009)
Abstract
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Background: Trauma is the 2nd cause of mortality in Iran, after cardiovascular
diseases. In traumatic patients, head and neck and face skeletal fracture is
common. The most common facial fracture is mandible fracture and the least
common is frontal fracture. Complications due to orbital fracture are more
devasting than the other fractures in face.
Methods: These descriptive cross sectional studies are designed on 92 patients with
orbital fractures in a referral educational trauma center, Imam Khomeini
hospital, Tehran, Iran. Sample size was the patients
who referred to this hospital with orbital fracture during the ten years period
(1986-2000).
Results: In this study 74 patients were male and 18 patients were female. Mean age
of patients was 30 years. The most common cause of orbital fracture was motor
vehicle accident which was seen in 38 patients.46 patients had fracture in left
orbit and 44 patients in right. Isolated orbital fracture was seen in 38
patients and 54 patients had concomitant trauma and fracture in the other
organs. Management of orbital fracture was reduction of displaced bone fragment
and fixation for osteosynthesis. The most common methods for osteosynthesis was
fixation with miniplate which used in 53 patients and then reconstruction of
orbital floor and roof with autologus bone graft. The most common complications
due to orbital fracture was related to eyes that were seen in 20 patients.
Conclusion: Face
fractures are a piece of all problems in multiple trauma patients as the tip of
iceberg. Concomitant injuries are the concealed part of this iceberg. Early
detection of orbital fracture and immediate treatment that prevent the future
complications and deformities due to orbital fractures.
Ashrafi M, Hamidi Beheshti Mt, Shahidi Sh, Ashrafi F,
Volume 67, Issue 5 (8-2009)
Abstract
Background: Kidney transplantation had been evaluated in some
researches in Iran mainly with clinical approach. In this research we
evaluated graft survival in kidney recipients and factors impacting on
survival rate. Artificial neural networks have a good ability in
modeling complex relationships, so we used this ability to demonstrate
a model for prediction of 5yr graft survival after kidney
transplantation.
Methods: This retrospective study was done on 316 kidney
transplants from 1984 through 2006 in Isfahan. Graft survival was
calculated by Kaplan-meire method. Cox regression and artificial neural
networks were used for constructing a model for prediction of graft
survival.
Results: Body mass index (BMI) and type of transplantation
(living/cadaver) had significant effects on graft survival in cox
regression model. Effective variables in neural network model were
recipient age, recipient BMI, type of transplantation and donor age.
One year, 3 year and 5 year graft survival was 96%, 93% and 90%
respectively. Suggested artificial neural network model had good
accuracy (72%) with the area under the Receiver-Operating
Characteristic (ROC) curve 0.736 and appropriate results in goodness of
fit test (κ2=33.924). Sensitivity of model in identification of true
positive situations was more than false negative situations (72% Vs
61%).
Conclusion: Graft survival in living donors was
more than cadaver donors. Graft survival decreased when the BMI
increased at transplantation time. In traditional statistical approach
Cox regression analysis is used in survival analysis, this research
shows that artificial neural networks also can be used in constructing
models to predict graft survival in kidney transplantation.
Tanaray B, Eslami M, Salehi M, Jahanzad I, Emami M,
Volume 68, Issue 7 (10-2010)
Abstract
Background: Studies of the association between post operative AF and Plasma level of NT- Pro BNP have reported conflicting findings. The aim of the present study was evaluation of the association between post coronary bypass graft- Atrial Fibrillation (AF) and Plasma level of NT- ProBNP as an independent risk factor of AF development in patients undergoing coronary artery bypass graft.
Methods: In a cohort study, 79 patients with sinus rhythm who admitted in Imam Khomeini Hospital in Tehran, Iran, during February 2009 and February 2010 for CABG are included the study and followed for developing post operative AF rhythm.
Results: Post operative AF was found in 17.7% of patients. The peak time from the operation to the first AF episode was in second post op day in ten patients (71.4%). The serum level of ProBNP in patients with AF was significantly higher (1624± 647 versus 221± 238 pg/ml, p< 0/0001). Increased age, Increased LA size and high plasma level of ProBNP were associated with increased risk for post op AF. After adjustment of risk factors, plasma level of ProBNP was the most important risk factor with odds ratio of 15.34 with CI 95% 1.77-132.95 and then LA diameter with odds ratio of 6.11 with CI 95% 0.99-37.42 was independently correlated with post op AF. Correlation between plasma level of ProBNP with age and LA size was seen too (LA size r = 0.0281, p= 0.012). Between age and ProBNP (r= 0.337, p= 0.002). The best cut off point for plasma ProBNP as a predictor of post op AF was 854 pg/ml.
Conclusion: Increased level of preoperative ProBNP levels could be an independent predictor of post operative Atrial Fibrillation.
Bolourian Aa, Beheshti Monfared M, Gachkar L, Ghomeisi M, Shahzamani M, Foroughi M, Kazem Arabnia Mk, Ghods K, Dabbagh A,
Volume 69, Issue 1 (4-2011)
Abstract
Background: Atrial fibrillation is the most common but benign arrhythmia following cardiac surgery. Although this arrhythmia is often self-limited and vanishes in about 24 hours upon surgery a number of arrhythmias might ensue among which some might be really life-threatening. A multitude of therapeutic modalities have been proposed for the prevention of this arrhythmia and one of them is posterior pericardiotomy. This method has not been fully accepted by the peers yet and more studies are needed to prove its efficacy and benefits to the patients.
Methods: In this single-blind randomized clinical trial, done over a 2-year period from February 2009 to January 2011, the effects of posterior pericardiotomy were evaluated in 174 patients (87 the case and 87 the control groups) undergoing elective coronary artery bypass grafting (CABG). The case group underwent CABG with posterior pericardiotomy while the control group underwent CABG-only operation. The postoperative incidence of arrhythmia, especially atrial fibrillation, was assessed for a week using statistical methods.
Results: The prevalence of postoperative atrial fibrillations were fewer in the group undergoing CABG with posterior pericardiotomy compared with the CABG-only group (P<0.004).
Conclusion: Posterior pericardiotomy seems to reduce the incidence of atrial fibrillation following elective CABG therefore, its application is suggested for elective
CABGs
Tahmasebi Mn, Ayati Firoozabadi M, Panjavi B, Kaseb Mh,
Volume 69, Issue 2 (5-2011)
Abstract
Background: One of the most common orthopedic complaints is direct or indirect trauma to the knee with torn anterior cruciate ligament (ACL). Reconstruction of the torn ACL is emphatically offered in active individuals as by this operation, we prevent osteoarthritis, knee instability and injury to the meniscus. There are numerous methods for graft fixation in the femoral tunnel in ACL reconstruction. If the graft proves to be stable after the operation, patients would not complain of giving way knee joints. In this clinical trial, we compared transfemoral pinning with endobutton fixation of hamstring graft in arthroscopic ACL reconstruction by examining knee stability and use of other relevant functional tests.
Methods: Fourteen Patients who had undergone arthroscopic ACL reconstruction in Shariati Hospital during the years 2008-2009 and were being followed up were evaluated at least 15 months post-operatively by physical examination and the use of an
arthrometer made by the Faculty of Mechanics of Sharif Technical University.
Results: The results showed that two out of seven patients in which their ACL had been reconstructed by hamstring graft fixation by endobutton technique, and in one out of seven patients who had undergone ACL reconstruction by hamstring graft fixation through transfemoral pinning, Lachmann test (in 25 position) was greater than 5 mm but there were not any complaints of giving way knee joints.
Conclusion: The clinical results of ACL reconstruction by transfemoral pinning technique seems to be superior to the reconstruction by endobutton technique.
Amanpour S, Muhammadnejad S, Muhammadnejad A, Mazaheri Z, Kazem-Haghighi M, Oghabian M, Khoshnevisan A,
Volume 69, Issue 3 (6-2011)
Abstract
Background: Despite advances in cancer diagnosis and treatment, survival rate of
patients suffering from glioblastoma multiform (GBM) has not been significantly improved. Therefore, novel therapeutic adjuncts to routine therapies have been suggested over time. Inhibition of angiogenesis by antiangiogenic drugs is one of the new approaches to inhibit the growth of malignant cells. Microvessel density (MVD) assay is a technique performed by counting immunohistochemically-stained blood vessels. Nowadays, athymic nude mice are widely used for the establishment of xenograft tumor models in cancer research. The aim of this study was to evaluate the MVD of autochthonous xenograft models of GBM isolated from Iranian patients for use in pharmaceutical research on antiangiogenic drugs.Methods: Fresh tumor samples of GBM were obtained from three patients in Cancer Institute of Tehran University of Medical Sciences in Fall of 2010 and Winter of 2011. After preliminary processing, minced tumor samples were implanted heterotopically on flanks of athymic nude mice. Two months later, the animals were sacrificed and the xenograft tumor samples were sent to the pathology laboratory. After establishing the proof of the xenograft tumor type, MVD-CD34, an endothelial cell marker, was assessed by counting hot spot areas in 22 samples.Results: The mean number of microvessels in these xenograft tumor models was 30±2.1.
Conclusion: These autochthonous xenograft models of GBM can be used in preclinical settings for research on antiangiogenic drugs regarding a pharmacogenomics-based treatment regimen for the Iranian population. Moreover, such models can be used in future studies for determining the sensitivity or resistance to antiangiogenic drugs in individualized cancer therapy.
Tahmasebi Mn, Enayati B, Enayati B,
Volume 69, Issue 9 (12-2011)
Abstract
Background: Anterior cruciate ligament (ACL) reconstruction is a first choice treatment for ACL-deficient knees, and arthroscopic single-bundle reconstruction has been widely accepted around the world in this regard. Although, such single-bundle reconstructions result in sufficient knee stability in most cases, but some patients have not been satisfied with postsurgical results in both short-term and long term clinical studies. One of the reasons for these unsatisfactory results could be related to the fact that normal function of the native ACL has not been restored by the traditional ACL reconstruction which uses only a single-bundle graft. The natural ACL consists of a 3-dimensional structure with multibundle fascicles, which can be anatomically divided into 2 main bundles, the anteromedial (AM) and the posterolateral (PL) bundles named for the orientation of their tibial insertions. The purpose of the present study was to compare double-bundle and single-bundle ACL reconstruction.
Methods: Twenty-two patients with anterior cruciate ligament tear who were candidates for ACL reconstruction were enrolled in the study undertaken in Shariati Hospital from 2009 to 2010. Fourteen patients underwent single-bundle and 8 patients double-bundle ACL reconstruction. The patients were evaluated by arthrometer and physical examination in postoperation follow up visit at least 9 months after the operations.
Results: Four out of 14 patients with single-bundle reconstruction had knee joint translation greater than 5 mm but nobody had knee translation more than 5 mm in the double-bundle reconstruction group.
Conclusion: Double-bundle ACL reconstruction seems to be more stable than single-bundle ACL reconstruction.
Hassani Ebrahim, Mahoori Alireza, Mehdizadeh Hamid, Noroozinia Heydar, Aghdashi Mir Mousa, Saeidi Mohammad,
Volume 70, Issue 3 (6-2012)
Abstract
Background: Perioperative administration of tranexamic acid (TA), decreases bleeding and the need for transfusion after cardiac procedures. Hence, the results may vary in different clinical settings and the most appropriate timing to get the best results is unclear. The primary objectives of the present study were to determine the efficacy of TA in decreasing chest tube drainage, the need for perioperative allogeneic transfusions and the best timing for TA administration following primary, elective, coronary artery bypass grafting (CABG) in patients with a low baseline risk of postoperative bleeding.
Methods: In this double-blind, prospective, placebo-controlled clinical trial in Seiedoshohada Hospital during 2011-2012, we evaluated 150 patients scheduled for elective, primary coronary revascularization. They were randomly divided into three groups. Group B received tranexamic 10 mg/kg prior to, Group A received tranexamic acid 10 mg/kg after cardiopulmonary bypass and group C received an equivalent volume of saline solution. Blood requirement and postoperative chest tube drainage were recorded.
Results: The placebo group (group C) had a greater postoperative blood loss 12 h after surgery (501±288 vs. 395±184 in group B and 353±181 mL in group A, P=0.004). The placebo group also had greater postoperative total blood loss (800±347 vs. 614±276 in group B and 577±228 mL in group A, P=0.001). There was a significant increase in allogeneic blood requirement in the placebo group (P=0.001).
Conclusion: For elective, first time coronary artery bypass surgery, a single dose of tranexamic acid before or after cardiopulmonary bypass is equally effective.
Akbari H, Fatemi Mj, Shakour Z, Mousavi Sj, Madani P, Pedram Ms,
Volume 70, Issue 10 (1-2013)
Abstract
Background: Autograft is the best option in nerve defects when end-to-end repair can not sufficiently preserve nerve continuity. Theoretically, if the severed nerve is reversely grafted, it may prevent axonal growth into nerve branches, and larger amounts of axons will reach the target organ and more satisfactory results will be obtained. In this study we aimed to compare conventional versus reverse nerve grafting.
Methods: This study was performed in Animal laboratory of Hazrat Fatemeh Hospital from April till August 2011. We randomly divided 40 Wistar rats into two groups. We excised 1.5 cm of the right sciatic nerve and anastomosed it conventionally between the proximal and distal ends of the nerve in rats in group A and in a reverse manner in rats in group B. The rats’ footprints were recorded in the first and 16th weeks after surgery. In week 16, the grafted nerves were removed under anesthesia for pathological examination and axon count. Subsequently, the results were compared clinically by sciatic functional index (SFI) through footprint analysis and paraclinically by axon count. A p-value smaller than 0.05 was considered statistically significant.
Results: Conventional and reverse nerve grafting no had statistically significant differences in clinical assessment in the first and 16th weeks (P=0.87) post-surgically and also no difference in paraclinical assessment in week 16 (P=0.68).
Conclusion: We had no significant clinically or para clinically differences between two approaches. It should be considered that the diameter and length of nerves and muscles in human is larger than rats, so the results of nerve repair may differ in human. We suggest a study in animal model which is anatomically more similar to human.
Roghayyeh Borji , Mohammad Reza Khatami, Mohammad Reza Abbasi , Alipasha Meysamie , Khosro Barkhordari , Farah Ayatollah Esfahani, Mina Pashang, Laleh Ghadirian ,
Volume 71, Issue 12 (3-2014)
Abstract
Background: The mortality due to Coronary Artery Bypass Graft (CABG) in patients with chronic renal failure is more common than normal population. This study evalu-ates the impacts of prophylactic dialysis on decreasing mortality and morbidity of non- dialysis-dependent patients with renal failure after CABG surgery.
Methods: In this study, fifty non-dialysis-dependent patients who were suffering from renal failure and needed to CABG, were selected by convenience sampling method. Se-quentially, they were allocated to prophylactic dialysis (n=20) and no prophylactic dialysis (n=30) groups, using a randomized block design. Exclusion criteria were under 18 year old patients and doing CABG for second time. Mortality rate and some complications such as acute renal failure, brain accident and atrial arrhythmias were compared between two groups after CABG. All cardiac surgeries were performed in a single centre and through a median sternotomy. P value less than 0.05 was considered as significant.
Results: The mean age of patients was (65.3±9.9). The patients included %16 (n.8) of women and %84 (n.42) of men. There were 20 patients in intervention and 30 patients in control groups. Baseline characteristics were similar in two groups. Comparison be-tween intervention and control groups after surgery did not show any difference in mortality (P=0.14), acute renal failure (P=0.4), cerebrovascular accidents (P=1) and atrial arrhythmias (P=0.3), need to second surgery due to bleeding (P=1), need to dialysis (P=0.14), need to rehospitalization (P=1), duration of ventilator use (P=0.4), duration of need to hospitalization (P=0.11), duration of a patients stay in the Intensive Care Unit (P=0.4) and deep sternal infection (P=0.7) rates.
Conclusion: According the results of this study, prophylactic dialysis, before conduct-ing CABG, does not have any significant effect on mortality and other complications. The only exception is lung complications in non-dialysis-dependent patients with renal failure.
Sudabeh Alatab , Gholamreza Pourmand ,
Volume 73, Issue 8 (11-2015)
Abstract
Thymoglobulin is a purified polyclonal immunoglobulin that has been used widely over the last decades in the prevention and treatment of rejection following renal transplantation. This immunoglobulin works against human thymocytes. Since thymoglobulin does not contain the nephrotoxic properties therefore it can be used in induction therapy especially in patients with higher risk of graft rejection such as patients who receive graft from cadavers. Recent research showed also its beneficial role in cross-match-positive transplantation, a role that is mediated through conjunction with inhibitors of terminal complement activation. This immunoglobulin has also been used for treatment of rejection following renal transplantation. Thymoglobulin can have various effects on various Immune system cells including T cells, B cells and also plasma cells. Thymoglobulin also affects the Tcell surface antigens, natural killer-cell antigens, B cell antigens, plasma cell antigens, adhesion molecules and chemokine receptors. Diverse effects of thymoglobulin on the immune system includes: T cell depletion, induce apoptosis in B cell lineage and interference with dendritic cell functional properties. Thymoglobulin can cause acute complications, delayed complications as well as infectious complications. Acute reaction events includes: anaphylaxis, fever, chills, dyspnea, nausea, vomiting and diarrhea. Thymoglobulin also induces cytokine release syndrome manifested by high grade fevers and chills and treated by steroid therapy. Delayed reactions events usually present as serum sickness and infections. Infectious complications are more important and include cytomegalovirus (CMV) infection, sepsis, candidiasis, herpes simplex and urinary infections. Thymoglobulin can also induce cytokine release syndrome. It has been thought that thymoglobulin increases the risk of post-transplant lymphoproliferative disorder (PTLD), however, debate still exists whether such an association is present when lower dosing regimens are used. In this review, we aimed to present first a brief history of thymoglobulin development and its mechanism of action and then assess the most recent published data regarding the role of thymoglobulin in following issues: immunological tolerance, ischemia-reperfusion injury, delayed graft function, prevention and treatment of acute allograft rejection, live donor transplantation, graft and patient survival and posttrans-plant lymphoproliferative disorder. This review can help specialist in transplant domain to appropriately used thymoglobulin in transplant patients.
Noorahmad Latifi , Navid Rezvani , Mohammad Javad Fatemi , Majid Nourian , Shirin Araghi , Tooran Bagheri,
Volume 73, Issue 11 (2-2016)
Abstract
Background: Graft survival has been considered the major problem in reconstructive surgery. Clinical studies have helped us to understand the role of PRP in increasing skin survival. Our goal in this study was to examine the treatment effects of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) on autologous full thickness skin graft survival in male rats.
Methods: This experimental study was performed on 36 rats of Sprague-Dawley race with weighing approximately 250 to 300 gr on May 2015 in animal laboratory of Hazrat Fatima Hospital. After anesthesia, rats were divided into 3 groups. We injected platelet-rich plasma (PRP) in the first group, platelet-rich fibrin (PRF) in the second and saline in the third group after removing the skin. Microscopic analysis was performed with camera (Canon powershot SX200, Tokyo, Japan) on days 7, 14, 21 and 28 after surgery. We used image analysis system (ImageJ, ver. 1.45) to examine necrosis and survival rate. Samples were studied with H&E staining on day 28 microscopically for histological analysis of vascular density and angiogenesis.
Results: Our findings showed the area of necrosis in animals injected with PRP on days 7 and 14, was meaningfully less than control group (P= 0.0001). There was no meaningful difference between control and PRP groups (P> 0.05). The area of necrosis in animals injected with PRF did not have any significant difference with control group from beginning to 21st day (P< 0.0001). there was no meaningful difference in vascular density between control and PRP group, whereas in animals injected with PRF the vascular density was significantly less than control group (P= 0.002).
Conclusion: According to our results in this study, we can conclude that using autologous PRP can enhance the process of healing soft tissue injury and be affective at increasing graft survival. This method is suggested to be conducted for patients highly at risk of graft loss and also for those who are in need of early treatments.
Ghasemali Khorasani , Siamak Rakei , Amirhosein Tavakoli ,
Volume 74, Issue 2 (5-2016)
Abstract
Background: Cartilage grafting is used in rhinoplasty and reconstructive surgeries. Autologous rib and nasal septum cartilage (auto graft) is the preferred source of graft material in rhinoplasty, however, homologous cartilage (allograft) has been extensively used to correct the nasal framework in nasal deformities. Autologous cartilage graft usage is restricted with complication of operation and limiting availability of tissue for extensive deformities. Alternatively, preserved costal cartilage allograft represents a readily available and easily contoured material. The current study was a formal systematic review of complications associated with autologous versus homologous cartilage grafting in rhinoplasty patients.
Methods: In this cohort retrospective study, a total of 124 patients undergone primary or revision rhinoplasty using homologous or autologus grafts with postoperative follow-up ranging from 6 to 60 months were studied. The types of grafts and complications related to the grafts were evaluated. This included evaluation for warping, infection, resorption, mobility and fracture.
Results: The total complications related to the cartilage grafts were 7 cases, which included 1 warped in auto graft group, three cases of graft displacement (two in allograft group and one in auto graft group) and three fractures in allograft group. No infection and resorption was recorded. Complication rate (confidence interval 0.95) in autologous and homologous group were 1.25(0.4-3.88) and 2.08(0.78-5.55) in 1000 months follow up. There was no statistically significant difference between autologous and homologous group complications. Onset of complication in autologous and homologous group were 51.23(49.27-53.19) and 58.7(54.51-62.91) month respectively (P=0.81).
Conclusion: The allograft cartilage has the advantage of avoiding donor-site scar. Moreover, it provides the same benefits as autologous costal cartilage with comparable complication rate. Therefore, it can be a reliable alternative material for rhinoplasty surgeries. A longer follow-up may be necessary to confirm the structural stability of the allograft cartilage grafts.
Soraya Shahrokh , Seyed Abolhasan Emami , Mohammad Javad Fatemi , Mir Sepehr Pedram , Saeid Farzad Mohajeri , Seyed Jaber Mousavi , Seyed Aboozar Hoseini , Tooran Bagheri , Shirin Araghi ,
Volume 75, Issue 1 (4-2017)
Abstract
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Background: Cartilage grafts is one integral component in the various fields of plastic surgery particular rhinoplasty. Surgeons usually use from various sources, including the septum of the nose, ears and rib. Complications such deformity and reabsorbtion may be created with use of the cartilage. Area of the removal of cartilage can prevent these complications. The aim of this study was to compare the absorption rate and viability of cartilage autograft between two common donor site, the rib and the concha.
Methods: This experimental study was performed on October 2014 in animal laboratory of Hazrat Fatima Hospital, Tehran, Iran. In this study, 15 New Zealand white male rabbits, weighing 2000-2500 g, approximately 12 to 16 weeks of age were used. In each rabbit, a piece of one ear and one cartilage was excised. After careful weighting of grafts, we implanted the rib cartilage graft into the left pocket and the conchal cartilage graft into the right one. After 8 weeks, the grafts were removed and weighed precisely and photography was carried out. The specimens were fixed in 10% formalin solution for histologic examination was. An example of hematoxylin and eosin staining and cut (H&E) were performed and samples of live chondrocytes and fibrosis were examined by a pathologist.
Results: We lost 3 rabbits during our study. The results showed that the average weight of a graft from the ear within 2 months, but this increase was not statistically significant (P= 0.152). In the rib graft weight loss over 2 months, and this reduction was statistically significant (P= 0.009). The resorption between two group was not significant but the amount of fibrosis was more in conchal cartilage graft.
Conclusion: According to the study it can be concluded that absorption rib cartilage is somewhat better results than the cartilage of the ear. More studies, in addition to cartilage implants longer human studies can contribute to more accurate conclusions.
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Mohadeseh Mozafari , Seyyed Abolghasem Mehri Nejad , Jamshid Bagheri , Mehrangiz Peyvstegar , Masoud Saghafinia ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Previous researches have provided contradictory results about on working memory performance after the coronary artery bypass graft (CABG). In addition, studies have focused on the elderly community. For this reason and with regard to the importance and direct effects of working memory on the quality of life human. This study was designed to compare working memory of young CABG patients with age range of 30-55 years one year postoperatively with healthy subjects.
Methods: In this Case-control study, which was conducted from February 2017 to October 2018, two groups of people, 40 patient men with coronary artery bypass graft that admitted to the heart center of Tehran in last year and 64 healthy males were selected with using available sampling method. Both groups were tested with Wechsler's working memory scale.
Results: The results of the study showed that the mean and standard deviation of the age of coronary artery bypass graft patients were 52.65 and 5.559, respectively, and the mean and standard deviation of healthy subjects were 41.81 and 8.619, respectively. The results showed that The two group had significantly difference (P<0.01), in the sub scales of the working memory including of the forward auditory memory and reverse auditory memory, total score of auditory memory, reverse visual memory and auditory memory span and the two groups had significantly difference (P<0.05), in the total score of visual memory. But the two group had not significantly difference (P>0.05) in the forward visual memory (CABG [mean=5.40 & standard deviation=1.41] Healty people [mean=6.13 & standard deviation=3]) and visual memory span (CABG [mean=5.35 & standard deviation=1.12] Healty people [mean=5.56 & standard deviation=1.97]). The results showed that Patients with CABG than healthy people have overall poorer results for all sub scales the of working memory test.
Conclusion: The results of this study confirm the prevalence of relatively high cognitive decline, especially in working memory after CABG, and provide a pattern of persistence of cognitive decline after one year of coronary artery bypass surgery in young patients aged 30 to 55 years.
Vahid Hatami, Hamed Tavan, Sajad Hatami , Ali Delpisheh, Mina Mamizadeh,
Volume 79, Issue 10 (1-2022)
Abstract
Background: Healing involves complex processes that are not yet fully known. The wound healing process consists of three stages. In all these stages, normal wound healing requires platelet activation, release of cytokines and growth hormones, and chemotaxis and cell differentiation. Platelets play a key role in homeostasis and wound healing and growth factor production of more than 30 carried out by them. Platelets regulate the healing process with their chemotactic effect. Antilogous PRP platelet count in about 3 to 5 times increase and consequently also increases the number of growth factors, for this reason, they are being used in surgical procedures and clinical therapy.
Methods: At Ilam Medical Center in Imam Khomeini Hospital, 20 patients with two similar donor graft sites were gradually selected to participate in a clinical trial from January to March 2017. The two regions have the same skin graft patients, an area of Honor conventional and other areas with the topical administration of platelet-rich plasma That immediately after surgery and in the days after the fifth and eleventh, eightieth and after washing the wound with a topical serum Physiology rubbed on the wound and thus treated The rate of wound healing clinically and using X-ray photo-checked and compared.
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Results: Seven are male and thirteen are female and the age range of patients is between 17 and 67 years. After collecting wound healing times in two groups, we used the means comparison method to evaluate the effect of PRP on wound healing rate and analyzed the results (T-Test). Because the data followed a normal distribution, we used the Independent T-test method, which resulted in 0.416, which was higher than the alpha level equal to 0.05.
Conclusion: In this study, we found that PRP had a positive effect on wound healing time and increased the speed of wound healing. It is suggested that the effect of the PRP method on various organs that have not been tested before, be discussed in future studies.
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Mohammad Parsa Mahjoub , Naser Kechuian, Mohammad Haji Aghajani , Hossein Aghamiri , Ainaz Samadi, Fateme Omidi ,
Volume 82, Issue 7 (10-2024)
Abstract
Background: Cardiovascular surgery is sometimes associated with brain consequences such as cognitive disorders. Diagnosis of cognitive disorders risk factors in cardiovascular patients is important for increasing patient satisfaction and success after (CABG). In the present study, the frequency of cognitive disorders in cardiovascular patients and its effective factors were investigated.
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Methods: In the current cross-sectional study that was conducted from September 2019 to the February 2022, 60 cardiovascular patients undergoing CABG surgery were selected by convenience sampling method. Demographic, clinical, and intraoperative information was recorded for participants in the data collection form. Mini–Mental State Examination quesionary.
Results: The results showed that 15% of participants had cognitive impairment. Gender and age were the actual variables on the incidence of cognitive disorders after CABG surgery. The frequency of cognitive disorders in women was 14 times higher than men and 6.5 times higher in the elderly. Elderely population was considered as 65 years old or above. The clinical variables such as blood transfusion under surgery and ejection fraction<40% were effective factor for incidence of cognitive disorders in cardiovascular patients.
Conclusion: The CABG surgery may be associated with cognitive disorders in cardiovascular patients, which is more common in women and the elderly. Further studies are recommended to confirm the results of the present study and identify the related risk factors.
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Ali Yavari, Hojjat Molaie, Hesam Amini ,
Volume 82, Issue 9 (12-2024)
Abstract
Background: Macromastia can have a significant impact on patients’ quality of life by causing physical discomfort and psychological distress. Reduction mammoplasty can provide both aesthetic and therapeutic benefits. In cases of gigantomastia, where extreme breast hypertrophy prevents the use of traditional pedicled techniques, breast amputation with a free nipple graft is always a considered surgical option. There are different presented methods and designs for this procedure. This surgery is highly beneficial for patients, and most of them report significant improvements in their quality of life and overall satisfaction with the final results.
Case Presentation: In this study, we employed reduction mammoplasty and a free nipple graft with a vertical design and superior pedicle preservation in patients with gigantomastia who were referred to Tehran Imam Khomeini Hospital Clinic during a period of five years (February 2020–February 2025). The patients were out of the range of fertility and were in the range of obesity (most of them had a BMI of over 35(kg/m2)). Then, patient satisfaction and quality of life improvement were evaluated with a standard questionnaire. Finally, complications during and after surgery were recorded. The surgery was performed on 17 patients. The distance from the sternal notch to the nipple was more than 40 cm, and the distance from the nipple to the inframammary fold (IMF) was more than 20 cm in all patients (confirming gigantomastia). Therefore, they were not candidates for pedicled mammoplasty. All the patients were satisfied with the results. Their quality of life, posture, back pain, neck pain, and other symptoms improved significantly. We recorded no cardiovascular complications during or after surgery.
Conclusion: Breast amputation with a free nipple graft is an efficient method for treating gigantomastia and is very safe for patients with diabetes mellitus, cardiovascular diseases, high BMI, and those at infertile ages. A vertical design with superior pedicle preservation can provide both aesthetic and therapeutic benefits, leading to high patient satisfaction and improved quality of life.
