Growth, morphogenesis, and differentiation during mouse prostate development in situ, in renal grafts, and in vitro

BACKGROUND: In vitro organ culture and renal grafting of the urogenital sinus (UGS) have both been used as models of prostate development. However, neither has been rigorously examined for its fidelity to replicate the canonical process of prostate differentiation in situ. METHODS: We assessed size, morphology, histology, and the mRNA expression of differentiation marker genes of the E14 male mouse UGS grown for 0-28 days as sub-renal capsule allografts in nude mice or in culture containing androgen and compared these to UGS development in situ. RESULTS: Development of grafted tissues was morphologically and histologically similar to development in situ but differentiation occurred more rapidly. UGS growth in organ culture resulted in bud formation, but did not trigger cellular differentiation. However, the potential for differentiation was maintained and could be rescued by grafting tissues into nude mice. CONCLUSIONS: In vitro organ culture and renal grafting of UGS tissues may be appropriate models for studying prostatic bud formation, but only grafting is an appropriate model for prostatic differentiation.     

Functions,responsibilities, dedication,payment, organization,and profile of the hospital transplant coordination in Spain in 2002

In Spain, the number of donors per million of population and the activity of transplantation is a direct consequence of the continued work of the hospital transplant coordinators. There are 146 procurement hospitals with approximately 534 transplant coordinators (13.6 coordinators per hospital and 12.7 per million of population). A voluntary survey of 74 Spanish transplant coordinators revealed 67.6% to be men and 32.4% women of average age 43 years with specialization of 75.7%, Intensive Care Medicine; 8.1%, Anesthesiology; 6.7%, Nephrologists; and the rest, General Surgery or without any specialization. Among the group who responded to the injury, 86.5% were doctors and 13.5%, nurses. The overall team is composed of 52% doctors, 27.7% nurses and others with 70.3% working part-time and 27%, full-time. Previous experience was noted to be less than 5 years among 51.4%, and more in the rest of the cases. The 85% work under medical direction by management. Their payment includes salary plus activity in 48.7% of the cases; 21.6%, only salary, and 18.9%, only activity. Each coordinator generates between 3 and 7 organ as well as 3 and 11 of tissue donors. In conclusion, comparing this data with the practice in the United States demonstrates the unique aspects of the Spanish system.     

Mentoring in Surgery—Mentor,Parshuram, Dronacharya,Krishan

Success in any profession has no well-defined predictors. Knowledge, skills, training, and talent come in plenty but fail at times to achieve the universal goal of success. Some attribute it to luck. Apart from the tangible ingredients of a successful career, the intangibles like luck or something ill-defined is a real challenge. The intangibles seem like a chasm, an abyss, or a phantom obstacle. Presence of a guiding spirit who can handhold you to overcome these is essential for success. The aim of a professional is to learn, earn, and yearn for creativity. Practice of surgery is an ideal career to pursue the learning, earning, and yearning. More than any other profession, the guiding handholding spirit is required in surgical profession, the concept of mentoring. Originating from the Greco-Roman times when kind Odysseus left his son Telemachus under the care of his friend, mentor, it has become a universal defining necessity for a successful career in surgery. Indian history replete with such examples of mentorship, good as in the case of Dronacharya to Kaurvas but bad as denied by an able, competent, aspiring student like Eklavya. In the medical profession, there are very few Indian role models of mentorship. One name that comes to our mind is Dr. Krishan Mahajan. The more said is less revealed about him. “Knife before wife” was his commonly spoken advice to all who sought his mentorship. “Hard work is not easy but it is fair” so said a famous boxer, Larry Holmes. It is more than true for our profession as it is better to prepare and prevent, rather than repair and repent.     

Massive, solitary, intrahepatic, extramedullary hematopoietic tumor in thalassemia

Diffuse compensatory extramedullary hematopoiesis is well known to involve the spleen and liver in certain hematologic disorders. Hematopoietic tumor masses occasionally form and usually occur paraspinally in the posterior mediastinum. A 31-year-old patient with thalassemia is described with a massive, solitary, intrahepatic hematopoietic tumor and a smaller one in the posterior mediastinum. Review of the literature indicates that presentation as a large, focal liver lesion is unique. The implications and differential diagnosis are discussed.     

Distribution, elimination, and action of d-tubocurarine in neonates, infants, children, and adults

The relation of plasma concentration of d-tubocurarine (dTc) to neuromuscular blockade, and the distribution and urinary excretion of dTc was determined in neonates (n = 4), infants (n = 6), children (n = 8), and adults (n = 8). The plasma concentration-time course curves to 24 hr are best described for all groups by three-compartment models. Both neonates and infants exhibit decreased plasma clearance (CLP), 1.1 +/- 0.08 and 1.0 +/- 0.06 ml X kg-1 X min-1, and in addition a prolonged t1/2 terminal phase, 311 +/- 44 and 306 +/- 35 (mean +/- SEM, min). The neonates' 24-hr urinary excretion, 27 +/- 2 (mean +/- SEM, % total dose) is significantly less than the adult value, 45 +/- 4% total dose. There was no significant difference seen in the log plasma concentration-evoked compound electromyogram (ECEMG) response between 20-80% paralysis for adults, children, infants, and five of the seven neonates studied. Two of the neonates had a significant shift of their log concentration-response curve to the right. There was also no significant difference between any of the groups in the time for 50% return of ECEMG stimulus height or the time required for recovery of the ECEMG from 25 to 75% of control value. for recovery of the ECEMG from 25 to 75% of control value.     

Sodium, renin, aldosterone, catecholamines, and blood pressure in diabetes mellitus

Interrelations among plasma renin activity (PRA), aldosterone and cortisole levels, 0lood volume, exchangeable sodium, urinary catecholamines, and blood pressure were studied in 35 normal subjects and 60 age-matched non-azotemic patients with diabetes mellitus (60% with hypertension, 15% with orthostatic hypotension). Basal PRA, plasma aldosterone, cortisol, blood volume, plasma potassium, and urinary electrolytes were comparable in diabetic and normal subjects. Diabetic patients, however, had a 10% increase in body sodium (P less than 0.01), and 8% of them showed normal postural PRA responses and subnormal aldosterone responses; 22% had subnormal PRA and normal aldosterone responses, and 17% had subnormal responses of PRA and aldosterone. Non-PRA-related aldosterone responses could not be explained by ACTH or electrolytes. Orthostatic decreases in blood pressure correlated (P less than 0.01) with both catecholamine excretion and basal PRA. This suggests that in diabetes mellitus, body sodium is increased. Basal PRA and plasma aldosterone are usually normal, but their postural responses are frequently impaired. Absent aldosterone responses, despite normal PRA responsiveness, may reflect an adrenal abnormality or an ineffective form of renin. Marked postural aldosterone stimulation, unrelated to PRA, ACTH, or electrolytes, points to a potent unknown factor in aldosterone control. Low levels of free peripheral catecholamines and PRA may be complementary factors contributing to postural hypotension.     

Congenital,multiple, bilateral,trigger digits in a child

Summary Congenital triggering of a digit other than the thumb is a rare. A nine year old boy has been treated for congenital, multiple trigger digits in addition to the thumb. The operative findings were only slight thickening of the flexor pulley and noticeable fusiform swelling of the flexor tendons.

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Résumé Un garçon de 9 ans présentait des doigts à ressaut congénitaux. Ceux-ci ont été traités chirurgicalement. Cette anomalie est rare, sauf en ce qui concerne le pouce. Le ressaut semble être la conséquence d'un renflement fusiforme des tendons fléchisseurs.

     

不同烧伤面积血清、尿、水泡液中Zn、Cu、Fe、Ca、Mg的动态比较

为探讨烧协病人伤后血清、尿和水泡液中 Zn、Cu、Fe、Ca、Mg 的含量,观察了106例烧伤病人(L 组烧伤≥30%,TBSA,57例;S 组烧伤<30%TBSA,49例)伤后1,2,3,7,14,21,28天血清、尿和水泡液中 Zn、Cu、Fe、Ca、Mg 的动态变化。发现除血清 Fe 第1天高于正常值外,其它各元素都减低,L 组比 S 组减低明显。尿 Zn、Cu、Fe 排出明显增多,尿 Ca、Mg 排出减少。水泡液 Zn、Fe、Ca 与血清正常值近似,Cu、Mg 略低于血清正常值。说明烧伤后血 Zn、Cu、Fe、Ca、Mg 的降低与从尿液及创面丢失有关。     

不同烧伤面积血清、尿、水泡液中Zn、Cu、Fe、Ca、Mg的动态比较

为探讨烧伤病人伤后血清、尿和水泡液中Ｚｎ、Ｃｕ、Ｆｅ、Ｃａ、Ｍｇ的含量，观察了１０６例烧伤病人（Ｌ组烧伤≥３０％ＴＢＳＡ，５７例；Ｓ组烧伤＜３０％ＴＢＳＡ，４９例）伤后１，２，３，７，１４，２１，２８天血清、尿和水泡液中Ｚｎ、Ｃｕ、Ｆｅ、Ｃａ、Ｍｇ的动态变化。发现除血清Ｆｅ第１天高于正常值外，其它各元素都减低，Ｌ组比Ｓ组减低明显。尿Ｚｎ、Ｃｕ、Ｆｅ排出明显增多，尿Ｃａ、Ｍｇ排出减少。水泡液Ｚｎ、Ｆｅ、Ｃａ与血清正常值近似，Ｃｕ、Ｍｇ略低于血清正常值。说明烧伤后血Ｚｎ、Ｃｕ、Ｆｅ、Ｃａ、Ｍｇ的降低与从尿液及创面丢失有关。     

Vincristine,bleomycin, methotrexate, 5-fluorouracil,and prednisone in metastatic,hormonally unresponsive prostatic adenocarcinoma

Patients with hormonally unresponsive prostatic adenocarcinoma were subjected to a five-drug chemotherapy program using bleomycin, 5-fluorouracil, methotrexate, vincristine, and prednisone. Analysis of survival curves indicated that deletion of an alkylating agent from this five-drug program reduced survival when patients with equal risk factors were compared. Bleomycin was poorly tolerated by this aged population.