Giant prostatic urethral calculus associated with urethrocutaneous fistula

Urethral stones in men are rare clinical entity and most of them migrate from the urinary bladder. Urethral stones are rarely formed primarily in the urethra and are usually associated with urethral strictures or diverticula. We report a 41-year-old man with giant prostatic urethral stone (5.9x3.2x2.8 cm) associated with a urethrocutaneous fistula. The etiological factors, pathogenesis, clinical presentation, complications and management of giant urethral calculi are reviewed.     

JOINT MOBILITY AND MITRAL VALVE PROLAPSE IN AN ARAB POPULATION

The association of joint laxity and mitral valve prolapse (MVP)has been disputed. In this study of an Arab population, thejoint mobility scores of 29 subjects with MVP, 10 of whom wereasymptomatic, were compared to 60 normal controls. It was found that the joint mobility score was significantlyhigher in both the asymptomatic and the symptomatic subjectswith MVP when compared to the controls. This suggests that bothmitral valve prolapse and joint laxity may be due to the sameabnormality of connective tissue structure. KEY WORDS: Joint laxity, Heart valve, Echocardiograph, Age, Race     

Transesophageal Echocardiographic Features of Unieuspid Aortic Valve

The usefulness of transesophageal echocardiography in the diagnosis of congenital unieuspid aortic valve is described.     

2005-2010年新疆内脏利什曼病流行的回顾分析

目的分析2005～2010年新疆维吾尔自治区内脏利什曼病（黑热病）的流行趋势,为制定和采取相应的防治对策提供依据。方法汇总2005～2010年新疆内脏利什曼病的报告数据（包括兵团垦区）,采用Microsoft Excel2010和EpiIn．fo2002对资料进行分析。结果2005—2010年报告内脏利什曼病1208例,其中新疆地方报告1108例,占91．72％（1108／1208）,发病率为5．08／10万（1108／2181万）;1108例患者分布在新疆南部27个县（市）的5个城镇与128个乡（镇）和新疆北部7个县（市）的4个城镇与5个乡（镇）;新疆兵团垦区报告100例,占8．28％（100／1208）,发病率为3．90／10万（100／256万）;100例患者分布在塔里木盆地北缘12个农垦团场和新疆北部6个农垦团场。1208例患者中,人源型内脏利什曼病占43．46％（525／1208）,自然疫源型内脏利什曼病占54．88％（663／1208）,未确定类型的占1．66％（20／1208）。2005年报告175例,2008年和2009年高于其他年份,分别报告309例和301例,男女性别之比为1．47：1（718／490）;人源型内脏利什曼病集中在5-20岁年龄组,占59．42％（312／525）;自然疫源型内脏利什曼病以0-2岁年龄组婴幼儿为主,占92．43％（613／663）;此后,随年龄的增大发病数降低。结论新疆内脏利什曼病自1996年起逐年增多,预示如果不能有效地控制其传染源和传播媒介,将会有更多的新疫区出现。     

新发现的内脏利什曼病流行区新疆民丰县Ⅰ. 流行病学调查

目的 对新疆民丰县一个新发现的内脏利什曼病（黑热病）流行区进行现场流行病学调查。 方法 2007年6月采用回顾性调查和现况调查相结合,对民丰县安迪尔乡所有居民进行逐户入户调查。内容包括家庭成员中20年来的健康状况、既往有无疑似内脏利什曼病史（包括已过世者）,并对15岁以下儿童进行体查（触诊肝、脾）;对部分居民进行利什曼素皮内试验和rk39免疫层析试条检测。 结果 共调查居民313人,未见现症病例。既往有疑似内脏利什曼病史者60例,其中13例已过世。171人进行利什曼素皮内试验检测,阳性率为99.4%（170/171）,其中有疑似内脏利什曼病病史者的阳性率为96.6%（28/29）。197人进行rk39免疫层析试条检测,阳性率为10.2%（20/197）,其中有疑似内脏利什曼病史者的阳性率为19.4%（6/31）,追溯诊断为既往内脏利什曼病病例。 结论 新疆民丰县为内脏利什曼病流行区。     

Application of Tissue Engineering to Pelvic Organ Prolapse and Stress Urinary Incontinence

Synthetic or biological materials can be used for the surgical repair of pelvic organ prolapse (POP) or stress urinary incontinence (SUI). While non‐degradable synthetic mesh has a low failure rate, it is prone to complications such as infection and erosion, particularly in the urological/gynecological setting when subject to chronic influences of gravity and intermittent, repetitive strain. Biological materials have lower complication rates, although allografts and xenografts have a high risk of failure and the theoretical risk of infection. Autografts are used successfully for the treatment of SUI and are not associated with erosion; however, can lead to morbidity at the donor site. Tissue engineering has thus become the focus of interest in recent years as researchers seek an ideal tissue remodeling material for urogynecological repair. Herein, we review the directions of current and future research in this exciting field. Electrospun poly‐L‐lactic acid (PLA) and porcine small intestine submucosa (SIS) are two promising scaffold material candidates. Adipose‐derived stem cells (ADSCs) appear to be a suitable cell type for scaffold seeding, and cells grown on scaffolds when subjected to repetitive biaxial strain show more appropriate biomechanical properties for clinical implantation. After implantation, an appropriate level of acute inflammation is important to precipitate moderate fibrosis and encourage tissue strength. New research directions include the use of bioactive materials containing compounds that may help facilitate integration of the new tissue. More research with longer follow‐up is needed to ascertain the most successful and safe methods and materials for pelvic organ repair and SUI treatment.     

Protective effects of trapidil in ischemia–reperfusion injury due to testicular torsion and detorsion: An experimental study

OBJECTIVE: We aimed to detect the preventive effects of trapidil in ischemia-reperfusion (IR) injury due to testicular torsion and detorsion. METHODS: Forty prepubertal albino rats were used. In the IR group, torsion was created by rotating the left testis over 2 h, and detorsion was done by untwisting the testis. Bilateral orchiectomies were performed after 4 h. In study group, 2-h torsion was performed and trapidil was administered as a single dose 1 h before detorsion. Bilateral orchiectomies were performed after 4 h. In the sham group, a sham operation was done. In the sham plus trapidil group, a sham operation was done and trapidil was administered as a single dose. Testicular tissue malondialdehyde (MDA), nitric oxide (NO) and total sulfhydryl (T-SH) levels were determined for each group. The grades of interstitial injury were determined in histopathologic examination. RESULTS: The NO and MDA levels in the IR group were significantly higher than the study, sham and sham plus trapidil groups in the left testis (P<0.05, P<0.001 and P<0.001, respectively). A statistical difference was not found among study, sham and sham plus trapidil groups in the left testis in NO and MDA levels (P>0.05). The T-SH level in the study group was significantly higher than in the IR, sham and sham plus trapidil groups in left testis P<0.05). In the IR group (left testis), grade 1 interstitial injury was 30% (3/10), grade 2 injury was 60% (6/10) and grade 3 injury was 10% (1/10). In the study group (left testis), grade 1 interstitial injury was 30% (3/10) and there was no injury in 70% (7/10). CONCLUSION: Trapidil decreased free oxygen radical formation in testicular torsion and detorsion, and attenuated histopathological damage in the ipsilateral twisted testis.