Usefulness of sonourethrography for penile abscess as a result of xanthogranulomatous granuloma in the corpus cavernosum of an adult: A case report

A 75‐year‐old man presented with a 4‐month history of a swollen and painful penis. Computed tomography showed a round‐shaped mass measuring 3 × 2 cm in the corpus cavernosum. Percutaneous drainage of the penile mass was carried out and a course of antibiotics was prescribed. Viral, fungal and selective bacterial cultures were negative. Total penectomy and urethroperineal fistula formation were carried out because of penile pain. Histopathological diagnosis was xanthogranulomatous granuloma of the corpus cavernosum. Before surgery, sonourethrography was carried out under general anesthesia. Sonourethrography is an infrequently used modality to observe the male urethra under urinary micturition or injection of saline. We previously reported modified sonourethrography with retrograde jelly injection. In the present case, sonourethrography successfully showed the damaged and deformed urethra including the abscess cavity and fistula. Although xanthogranulomatous granuloma is rare, the findings reported here showed the usefulness of sonourethrography for morphological evaluation of the male urethra.     

Analysis of antioxidant prenylflavonoids in different parts of Macaranga tanarius,the plant origin of Okinawan propolis

Objective:To analyze the antioxidant prenylilavonoids in different parts of Macaranga tanarius(M.tanarius)(Euphorbiaceae)including the leaf,petiole,stem,leaflet,flower and fruit(only in female plant),and to evaluate their antioxidant properties.Methods:Methanol extracts of each part of M.tanarius were prepared and five prenylilavonoids in them were quantitatively analyzed using HPLC.The fruits from female plant were further separated into seed,pericarp,and glandular trichome.After the quantitative analyses of prenylflavonoids in each part of M.tanarius,antioxidant activity of the extracts was evaluated by 2,2-diphenyl-l-picryI-hydrazyl(DPPH)radical scavenging assay.Results:The leaf of M.tanarius contained two prenylflavonoids as main components in both male and female plants.Both flowers(male and female)contained five kinds of prenylflavonoids.In the petiole,stem and leaflet of both male and female plants,the prenylflavonoids were not delected or their amounts were very low.Five kinds of prenylflavonoids were detected in the seed,pericarp and glandular trichome of female M.tanarius.In particular,the glandular trichome had the highest level of total prenylflavonoids(235 mg/g of fresh plant).DPPH radical scavenging activity of all parts was more than 30%.Conclusions:We found that different parts of M.tanarius contained antioxidant prenylflavonoids.In particular,not only the glandular trichome but also the leaf contained prenylflavonoids,which indicated that M.tanarius may be developed as a functional plant,because the leaves of this plant can be easily collected.     

The involvement of neurofilament heavy chain phosphorylation in the maturation and degeneration of rat oocytes

Neurofilaments (NF) are intermediate filament proteins that were originally found to be expressed in neurons and are involved in the maintenance of axonal structure. However, there has not been much research on the expression and physiological significance of NF in other organs. In the present study, we examined the expression of NF in rat ovaries and found that NF heavy chain (NF-H) was expressed in oocytes of follicles from the primary to mature stages, ovulated oocytes, fertilized zygotes, and degenerative oocytes of atretic follicles. Cytoplasmic NF-H disappeared at the two-cell stage of embryonic development, whereas degenerative oocytes of atretic follicles continued to express NF-H even after fragmentation. An antibody that specifically recognizes phosphorylated NF-H (pNF-H) was used to examine the pattern of NF-H phosphorylation in oocytes. pNF-H was detected in the cytoplasm and nuclei of oocytes of mature and atretic follicles, ovulated oocytes, and one-cell zygotes. Treatment with 3,3'-iminodipropionitrile, which induces aberrant phosphorylation of NF in the perikarya of neurons and causes neuropathy, induced oocyte degeneration with follicular atresia, phosphorylation of NF-H in oocytes, and ovarian gene expression of cyclin-dependent kinase 5, a candidate kinase of NF-H. However, an indicator of neuron degeneration, Fluoro-Jade C, failed to stain the pNF-H-immunopositive oocytes. Our results indicate that NF-H expressed in oocytes may be involved in the maintenance of oocyte structure during follicular growth and that the phosphorylation of NF-H in ephemeral oocytes may contribute to the degeneration process of oocytes.     

Population pharmacokinetics of olprinone in patients undergoing cardiac surgery with cardiopulmonary bypass

Purpose

Olprinone, a phosphodiesterase type III inhibitor, is a strong inotrope and vasodilator that does not increase oxygen consumption and is often used during weaning from cardiopulmonary bypass (CPB). To control the pharmacological effects of olprinone, pharmacokinetic information is essential; however, there is little published information on the pharmacokinetics of olprinone in a large population. Therefore, the purpose of this study was to determine olprinone pharmacokinetic parameters in a large population undergoing cardiac surgery with CPB.

Methods

Olprinone was infused at a rate of 0.2 μg/kg/min when weaning from CPB was started. Whole blood samples were periodically obtained to determine the olprinone concentrations using high-performance liquid chromatography. Measured olprinone concentrations were analyzed with a one-compartment model via a population approach.

Results

A total of 86 blood samples from 26 patients were used for pharmacokinetic analysis. The calculated clearance, volume of distribution (V _d), and elimination half-life were 378 ml/min, 40.7 l, and 97.1 min, respectively. Olprinone clearance depended on weight and creatinine clearance, whereas V _d depended only on weight.

Conclusion

We investigated the pharmacokinetic parameters of olprinone in patients undergoing cardiac surgery with CPB. Olprinone clearance depended on weight and creatinine clearance, whereas V _d depended only on weight. When olprinone is infused according to the recommended dosing regimen, it takes more than 60 min to reach the target concentration (20 ng/ml). However, there is a possibility that a lower concentration is sufficient for weaning from CPB in combination with a continuous infusion of dopamine.     

Usefulness of an Inflammation-Based Prognostic Score (mGPS) for Predicting Survival in Patients with Unresectable Malignant Biliary Obstruction

Background

An inflammation-based prognostic score, the modified Glasgow Prognostic Score (mGPS), has been established as a useful tool for predicting postoperative outcome in patients with cancer. However, no studies have investigated the usefulness of the mGPS for prognostication in patients undergoing palliative surgery for unresectable malignant biliary obstruction (UMBO). The present study was conducted to investigate whether the mGPS is useful for predicting the postoperative survival of patients undergoing intraoperative placement of an expandable metal stent for UMBO, or not.

Methods

The mGPS was calculated as follows: patients with both an elevated level of C-reactive protein (CRP) (>1.0 mg/dL) and hypoalbuminemia (<3.5 g/dL) were allocated a score of 2. Patients with only an elevated CRP level were allocated a score of 1, and patients without an elevated CRP level (≤1.0 mg/dL) were allocated a score of 0. Postoperative survival was evaluated by Kaplan–Meier analysis and log rank test. The significance of risk factors for postoperative survival was evaluated with the Cox proportional hazards model.

Results

Kaplan–Meier analysis revealed that patients with mGPS 0 (n = 36) and 1 (n = 7) had better postoperative survival (p = 0.017) than patients with mGPS 2 (n = 17). The 6-month and 1-year survival rates of patients with mGPS 0 and 1 were 58.1 and 27.3 %, and those for patients with mGPS 2 were 25.0 and 6.2 %, respectively. Multivariate analysis revealed that mGPS (0, 1/2) was a significant risk factor for postoperative survival (hazard ratio 3.271; 95 % CI 1.109–9.649; p = 0.032).

Conclusion

The mGPS is not only one of the most significant predictors of postoperative survival for UMBO patients receiving intraoperative biliary stenting but also a useful indicator capable of dividing such patients into two independent groups before surgery.