Interleukin-10 Levels and Clinical Outcome : Comparison of Retroperitoneal versus Transperitoneal Approaches in Infra-Renal Abdominal Aorta Reconstruction

BACKGROUND

To compare retroperitoneal (RP) vs. transperitoneal (TP) approaches in abdominal aorta reconstruction in terms of operative characteristics, plasma interleukin-10 levels and postoperative complications.

METHODS

A total of 100 patients scheduled for elective abdominal aortic surgery for occlusive disease under general anesthesia from May 2005 to January 2010 were included in this prospective study with allocation of patients randomly to TP approach (n = 50 ; mean (SD) age : 64.3 (4.0) years ; 76.0% were males) or RP approach (n = 50 ; mean (SD) age : 63.8 (5.6) years ; 75.0% were males) for aortic surgery. Demographic data, risk factors, perioperative and postoperative data and IL-10 levels were analyzed in two groups.

RESULTS

TP approach was associated with higher levels for IL-10 measured at the time of T1 (before unclamping of aorta) [(8.4 (5.1) vs. 6.5 (4.9) pg/mL, p < 0.05)] and T2 (sixty minutes after declamping) [(11.7 (6.0) vs. 8.3 (6.2) pg/mL, p < 0.01)] compared with RP approach. Postoperative evaluation revealed a higher percentage of patients with postoperative ileus (10.0 vs. 0.0%, p < 0.001) and pulmonary complications (18.0 vs. 4.0%, p < 0.001) in the TP rather than RP groups. The TP and RP groups were similar in terms of mortality rates whereas TP approach was associated with longer mean (SD) length of hospital stay (6.2 (1.0) vs. 3.8 (1.0) days, p < 0.001) compared with the RP approach.

CONCLUSIONS

Our findings revealed that the RP approach has significant advantages over the TP approach in aortic reconstruction surgery leading better pulmonary function and low ileus rate in the postoperative period as well as shorter length of hospital stay. While an increase in IL-10 levels was reported in both approaches, probably in relation to higher degree of tissue trauma, the increase was more profound in the TP approach.

The relationship between deep vein thrombosis and erythema nodosum in male patients with Behçet's disease

OBJECTIVE

The pathogenesis of thrombosis in Behçet's Disease (BD) is unknown, however, multiple factors leading to the disease may include hypercoagulability, hypofibrinolysis and endothelial injury. We sought to evaluate the frequency of erythema nodosum-like lesions (ENLL) due to the presence of vasculitis in ENLL observed in BD in male patients with BD with and without deep vein thrombosis. To our knowledge this is the first study to investigate the association of ENLL between the groups with or without thrombosis in only male patients with BD.

PATIENTS AND METHODS

The study included 92 patients, 41 of whom had deep vein thrombosis (DVT) and 51 had no thrombosis that met the international diagnosis criteria for BD. Vascular involvement was diagnosed based on clinical signs; radiological findings from Doppler, ultrasonography and/or angiography computed tomographic or magnetic resonance. ENLL were diagnosed by means of biopsy in suspected cases.

RESULTS

Since both groups were age-matched, there were no statistically significant differences in regard to age (p > 0.05). Twenty-four patients (66%) of the DVT group, had ENLL, while18 patients (35%) of the group without DVT had ENLL. In male patients with vascular involvement, the frequency of ENLL was significantly higher than that of male patients without vascular involvement (p < 0.05).

CONCLUSIONS

The male Behçet's patients with ENLL compose high-risk patient group in terms of complications, such as DVT. We therefore recommend that male patients with ENLL be monitored more carefully for DVT.

Three mode Er3+ ring-doped fiber amplifier for mode-division multiplexed transmission

We successfully fabricate three-mode erbium doped fiber with a confined Er(3+) doped ring structure and experimentally characterize the amplifier performance with a view to mode-division multiplexed (MDM) transmission. The differential modal gain was effectively mitigated by controlling the relative thickness of the ring-doped layer in the active fiber and pump launch conditions. A detailed study of the modal gain properties, amplifier performance in a MDM transmission system and inter-modal cross-gain modulation and associated transient effects is presented.

73.7 Tb/s (96 x 3 x 256-Gb/s) mode-division-multiplexed DP-16QAM transmission with inline MM-EDFA

Transmission of a 73.7 Tb/s (96 x 3 x 256-Gb/s) DP-16QAM mode-division-multiplexed signal over 119 km of few-mode fiber transmission line incorporating an inline multi mode EDFA and a phase plate based mode (de-)multiplexer is demonstrated. Data-aided 6 x 6 MIMO digital signal processing was used to demodulate the signal. The total demonstrated net capacity, taking into account 20% of FEC-overhead and 7.5% additional overhead (Ethernet and training sequences), is 57.6 Tb/s, corresponding to a spectral efficiency of 12 bits/s/Hz.