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Background: During laparoscopy, insufflation of an inert gas in the peritoneal cavity creates a working space to facilitate surgery. The space should be large enough to facilitate surgery without increasing intra-abdominal pressure (IAP) over a threshold limit (usually 15 mm Hg)., Objectives: This experimental study was performed to evaluate the effects of increasing in intra-abdominal pressure on internal organs., Materials and Methods: Twenty female mixed breed dogs (20 ± 3 kg, 18 ± 1.2 months) were selected. They were randomly divided to two groups (n = 10). The intra-abdominal pressure was maintained 12 mm Hg and 20 mm Hg during the operation in control group and in test group respectively., Results: Histopathologic evaluations revealed more pathological changes at the kidney of all the dogs in test group in comparison to control group., Conclusions: Our findings revealed that organs that their blood supplies are related to one single or two arteries and their blood drainage are related to one or two veins are more sensitive to increased intra-abdominal pressure.

Iran, a developing country with a population of approximately 71,000,000, is the most populous country in the Middle East and the 16th most populous in the world. Gross domestic product (GDP) per capita is US$8900 and total health expenditure is approximately 6% of GDP. The total number of end-stage renal disease (ESRD) patients reported by the Management Center for Transplantation and Special Diseases (MCTSD) was 32,686 in 2007, which denotes a prevalence of 466 per million population (pmp) in Iran. Considering the growth rate of 12%, the expected number of ESRD patients in 2010 is 40,000; incidence of ESRD is expected to be 63.8 pmp. These numbers are lower compared to developed countries, which may suggest poor referral and under-diagnosis of ESRD. In Iran at present, hemodialysis (HD) and renal transplantation are the most common renal replacement therapy (RRT) modalities, accounting for 47.7% and 48.8% of prevalent RRT patients respectively. Based on the Iran Dialysis Center report of 2001, approximately 1% of ESRD patients were being treated with continuous ambulatory peritoneal dialysis (CAPD); this number increased to approximately 3.5% (6.8% of total dialysis patients) in 2006. In the present article, reasons for underutilization of peritoneal dialysis (PD) and improvements in PD within the past 5 years will be reviewed.

Background: Gastroesophageal reflux, by exposing the pharynx to Helicobacter pylori (H. pylori), is a potential risk factor for laryngo-hypopharyngeal carcinoma. Its possible association has been inconsistent. In this case-control study, we investigated the relationship between H. pylori seropositivity and laryngo-hypopharyngeal carcinoma in Iran., Methods: We had 105 healthy controls (group A), 70 cases of laryngeal carcinoma (group B), and 28 cases of hypopharyngeal carcinoma group (group C). Age, sex, smoking habit, alcohol use, and H. pylori serology were determined for all subjects., Results: Groups were matched in age and alcohol use. Smoking and H. pylori seropositivity were more common in groups B and C, and male sex was more common in group B (compared with group A). In multivariate regression, the effect of smoking (p <.01, odds ratio [OR] = 2.92) and H. pylori seropositivity (p <.01, OR = 11.49) remained highly significant., Conclusion: H. pylori is an independent risk factor for laryngo-hypopharyngeal carcinoma., ((c) 2008 Wiley Periodicals, Inc.)

Background: Laparoscopic techniques for placement of peritoneal dialysis catheters are becoming increasingly popular. In this paper, we report the results of one-port laparoscopic placement of Tenckhoff catheters in 79 patients in our center., Method: Videoscopic monitoring was performed via a port inserted in the left upper quadrant and the catheter was placed via a pull-apart sheath through an incision near the umbilicus. The tip and the deep cuff of the catheter were placed into the true pelvis (on the urinary bladder) and into the rectus sheath respectively. A subcutaneous tunnel was created and a point midway on the umbilico-crestal line was selected as the exit site of the catheter. Catheters were capped for 2 weeks before initiation of peritoneal dialysis. Mean duration of the operation was 25 minutes., Results: Four patients died during the follow-up period, all due to other medical problems, and 4 patients underwent renal transplantation. During a 48-month follow-up, catheter-related complications were catheter migration (1.3%; month 1), dialysate leakage (1.3%; month 1), portsite hernia (3.8%; after 6 months), exit-site infection (2.5%; months 1 and 9), and bacterial peritonitis (2.5%; after 6 months). Catheter survival was 97.2% in our series., Conclusion: We obtained a low complication rate and a high catheter survival rate with this one-port laparoscopic technique.