The application of tissue-engineered preputial matrix and fibrin sealant for urethral reconstruction in rabbit model

Background

To introduce the role of fibrin sealant and preputial acellular matrix (PAM) as a new source of inert collagen matrix for urethral reconstruction.

Methods

A ventral urethral segmental defect was created in 24 male rabbits divided into four groups. In group 1 (G1), urethrotomy was closed in layers. In group 2 (G2), closure was followed by applying fibrin sealant. In groups 3 (G3) and 4 (G4), urethroplasty was performed with a patch graft of PAM, and in G4, fibrin sealant was also applied. Serial urethrography was performed before and after the operation. Then, the animals were euthanized, and their urethra was excised 1, 3, and 9 months postoperatively for further electron microscopic examination, terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) technique, and immunohistochemical (IHC) staining with CD34, CD31, desmin, SMA, and α-actin.

Results

In G1 and G2, the fistula repair failed in all the time points. In G3 and G4, serial urethrography confirmed the maintenance of a wide urethral caliber without signs of strictures or extravasations. Satisfactory vascularity was observed in G3 and G4 during the whole study, which was more significant in G4 after 9 months of follow-up. The presence of a complete transitional cell layer was confirmed over the graft in G3 and G4 in all time points. IHC staining confirmed the effectiveness of fistula repair in G3 and G4, 3 months postoperatively.

Conclusion

This rabbit model showed that PAM combined with fibrin sealant may herald a reliable option for repairing segmental urethral defects.     

Secondary Hemorrhage After Total Laparoscopic Hysterectomy

Background and Objectives:

The purpose of this study is to estimate the cumulative incidence, patient characteristics, and potential risk factors for secondary hemorrhage after total laparoscopic hysterectomy.

Methods:

All women who underwent total laparoscopic hysterectomy at Paul''s Hospital between January 2004 and April 2012 were included in the study. Patients who had bleeding per vaginam between 24 hours and 6 weeks after primary surgery were included in the analysis.

Results:

A total of 1613 patients underwent total laparoscopic hysterectomy during the study period, and 21 patients had secondary hemorrhage after hysterectomy. The overall cumulative incidence of secondary hemorrhage after total laparoscopic hysterectomy was 1.3%. The mean size of the uterus was 541.4 g in the secondary hemorrhage group and 318.9 g in patients without hemorrhage, which was statistically significant. The median time interval between hysterectomy and secondary hemorrhage was 13 days. Packing was sufficient to control the bleeding in 13 patients, and 6 patients required vault suturing. Laparoscopic coagulation of the uterine artery was performed in 1 patient. Uterine artery embolization was performed twice in 1 patient to control the bleeding.

Conclusions:

Our data suggest that secondary hemorrhage is rare but may occur more often after total laparoscopic hysterectomy than after other hysterectomy approaches. Whether it is related to the application of thermal energy to tissues, which causes more tissue necrosis and devascularization than sharp culdotomy in abdominal and vaginal hysterectomies, is not clear. A large uterus size, excessive use of an energy source for the uterine artery, and culdotomy may play a role.     

Synthesis of Zn3(VO4)2/BiVO4 heterojunction composite for the photocatalytic degradation of methylene blue organic dye and electrochemical detection of H2O2

In this study, a Zn₃(VO₄)₂/BiVO₄ heterojunction nanocomposite photocatalyst was prepared using a hydrothermal route with different molar concentration ratios. The as-synthesized nanophotocatalyst was characterized using XRD, SEM, EDS, XPS, FT-IR, Raman, BET, UV-vis DRS, EPR and PL. The effect of molar ratio on composition and morphology was studied. The as-prepared nanocomposite exhibited excellent photocatalytic response by completely degrading the model pollutant methylene blue (MB) dye in 60 min at molar concentration ratio of 2 : 1. In basic medium at pH 12, the Zn₃(VO₄)₂/BiVO₄ nanocomposite degrades MB completely within 45 min. The nanocomposite was also successfully used for the electrochemical detection of an important analyte hydrogen peroxide (H₂O₂). This study opens up a new horizon for the potential applications of Zn₃(VO₄)₂/BiVO₄ nanocomposite in environmental wastewater remediation as well as biosensing sciences.

In this study, a Zn₃(VO₄)₂/BiVO₄ heterojunction nanocomposite photocatalyst was prepared using a hydrothermal route with different molar concentration ratios.     

Radiofrequency catheter ablation of septal accessory atrioventricular pathways.

OBJECTIVE--Septal accessory atrioventricular pathways are recognised as being more difficult to ablate than pathways in other locations. This paper describes an experience of 48 consecutive patients with septal accessory pathways who had catheter ablation with radiofrequency current. PATIENTS AND METHODS--There were 28 male and 20 female patients, mean (SD) age 35 (17). 43 patients had a single accessory pathway and 5 patients had multiple accessory pathways. Pre-excitation was present in 37 patients, and 11 patients had concealed accessory pathways. 21 patients had had a previous electrophysiological study. Catheter ablation was undertaken with radiofrequency current delivered by a standard unipolar technique or by delivery of current across the septum (the bipolar technique). RESULTS--The median total procedure time was 167 (83) minutes including a 30-40 minute observation period after the abolition of conduction by the accessory pathway. The median total fluoroscopic time was 56 (30) minutes. 42 (88%) out of 48 patients had successful ablation of the pathway during the first session. In the six patients in whom the procedure failed, five had a midseptal pathway and one had a right anteroseptal pathway. A second attempt at ablation was made in two patients and succeeded in both. In total, 49 accessory pathways were successfully ablated in 44 (92%) out of 48 patients. The bipolar technique was used in 11 patients and succeeded in 10 patients. Standard unipolar current delivery had previously failed in seven of the 11 patients. Complications developed in two patients with a mid septal pathway (one with complete atrioventricular block and the other with a small pericardial effusion). CONCLUSION--Radiofrequency catheter ablation of septal accessory pathways is efficacious and safe. The procedure time can be shortened and success rate can be increased after improvement of the technique--that is, consideration of a bipolar approach for energy delivery in difficult cases.     

Efficacy of agnique (mmf) monomolecular surface film against immature stages of Anopheles arabiensis patton and Culex spp (diptera: culicidae) in Khartoum, Sudan

The efficacy of the larvicidal and pupicidal agent (Agnique) MMF was evaluated against larvae of An. arabiensis and Culex (Diptera: Culicidae) under field conditions in Bahary Locality, Khartoum, Sudan. At an applied dosage of 0.25 ml/m2, MMF resulted in 89.4, 79.8 and 88.2% reductions in L3-L4 instars An. arabiensis and 63.5% in Culex larvae (all stages) 24 to 72 hours post-treatment. Pupae were completely eliminated (100%) within 24 hours posttreatment. The earlier instars (L1-L2) of An. arabiensis were more tolerant with a 62.5% reduction at 72 hours post-treatment compared to (L3-L4) instars and pupae. At 7-days post-treatment Agnique gave a 57.5% reduction in L1-L2 and 92.6% in L3-L4 instar larvae of An. arabiensis and 57.3% and 86.4% in Culex larvae and pupae, respectively. We conclude that Agnique can perform effectively against L3-L4 instars and pupae of An. arabiensis for only 1 week, and 3 to 4 days against L1-L2 instars of Culex spp.     

FLT3 ligand and not TSLP is the key regulator of IL-7-independent B-1 and B-2 B lymphopoiesis

Phenotypically and functionally distinct progenitors and developmental pathways have been proposed to exist for fetally derived B-1 and conventional B-2 cells. Although IL-7 appears to be the primary cytokine regulator of fetal and adult B lymphopoiesis in mice, considerable fetal B lymphopoiesis and postnatal B cells are sustained in the absence of IL-7; in humans, B-cell generation is suggested to be largely IL-7-independent, as severe combined immune-deficient patients with IL-7 deficiency appear to have normal B-cell numbers. However, the role of other cytokines in IL-7-independent B lymphopoiesis remains to be established. Although thymic stromal lymphopoietin (TSLP) has been proposed to be the main factor driving IL-7-independent B lymphopoiesis and to distinguish fetal from adult B-cell progenitor development in mice, recent studies failed to support a primary role of TSLP in IL-7-independent fetal B-cell development. However, the role of TSLP in IL-7-independent adult B lymphopoiesis and in particular in regulation of B-1 cells remains to be established. Here we demonstrate that, rather than TSLP, IL-7 and FLT3 ligand are combined responsible for all B-cell generation in mice, including recently identified B-1-specified cell progenitors. Thus, the same IL-7- and FLT3 ligand-mediated signal-ing regulates alternative pathways of fetal and adult B-1 and B-2 lymphopoiesis.     

Expression analysis of microRNA-155 in type 2 diabetes in Kashmiri population

International Journal of Diabetes in Developing Countries - The present study aimed to evaluate the expression of microRNA-155 (miR-155) in type 2 diabetes mellitus (T2DM) and assess its...     

Hysterectomy in a male? A rare case report

INTRODUCTION

Persistent Mullerian duct syndrome is a rare form of male pseudo-hermaphroditism characterized by the presence of Mullerian duct structures in an otherwise phenotypically, as well as genotypically, normal man; only a few cases have been reported in the worldwide literature. A great variety of organs have been found in indirect inguinal hernial sacs.

PRESENTATION OF CASE

We report a case of 70 year old man, father of 4 children with unilateral cryptorchidism on the right side and left-sided obstructed inguinal hernia containing uterus and fallopian tube (that is, hernia uteri inguinalis; type I male form of persistent Mullerian duct syndrome) coincidentally detected during an operation for an obstructed left inguinal hernia.

DISCUSSION

PMDS is usually coincidently detected during surgical operation, as was in our case. However pre-operative ultrasonography, computerized tomography and MRI allow possible pre-operative diagnosis.³

CONCLUSION

In cases of unilateral or bilateral cryptorchidism associated with hernia, as in our patient''s case, the possibility of PMDS should be kept in mind.