Glans reconfiguration for management of glanular mutilation

IntroductionThe glans penis is prone to mutilation in a handful of conditions, some accidental and others iatrogenic. Deformed functioning remnants of the glans challenge the surgeon's decision. Neither is the glans totally amputated, justifying a neoglansplasty, nor are the remnants cosmetically acceptable, though retaining sensibility and engorgement.AimIn this work, we described the “reconfiguration of the glans penis” whereby deformed glanular tissue remnants can be made into a functional and cosmetically acceptable glans.MethodsFive patients with separate mutilated lumps of functioning glanular tissue were operated upon. The lumps were mobilized and flattened into sheets and configured to redrape the summit of the penis, minding their vascular and nerve supply.Main Outcome MeasuresCosmetic and functional outcome.ResultsThe outcome was cosmetically acceptable for all patients in comparison to the preoperative state.ConclusionGlans reconfiguration may possibly confer an acceptable cosmetic outlook to a mutilated glans without compromising valuable functional characteristics. Shaeer O, El-Sebaie A, Sherif A, El-Sadat A, and Shaeer A. Glans reconfiguration for management of glanular mutilation.     

Dental arch changes after anterior open bite treatment in the mixed dentition produced by miniscrew-supported palatal crib vs conventional fixed palatal crib:: A randomized clinical trial

ObjectivesTo evaluate the dental arch changes produced by the miniscrew-supported palatal crib (MSPC) and the conventional fixed palatal crib (CFPC) after the treatment of patients with anterior open bite (AOB) attributed to the tongue-thrusting habit in the mixed dentition stage.Materials and MethodsA total of 26 children aged 8 to 11 years with an AOB were randomly distributed into two equal groups; the MSPC group was treated using a palatal crib supported by two miniscrews inserted paramedially, whereas the CFPC group was treated using a conventional fixed palatal crib soldered to bands. Digital models were obtained pretreatment and after a follow-up duration of 9 months.ResultsThe MSPC group included 12 participants (9 girls and 3 boys; mean age, 9.4 ± 0.75 years), and the CFPC group included 12 participants (10 girls and 2 boys; mean age, 9.0 ± 0.73 years). The amount of AOB closure was similar in both groups: 3.97 ± 1.44 mm in the MSPC group and 3.97 ± 0.89 mm in the CFPC group. There was significant mesial movement of the maxillary first molar in the CFPC (−1.42 ± 0.99 mm) compared with the MSPC group (−0.53 ± 0.32 mm).ConclusionsBoth appliances resulted in similar improvement in the amount of AOB closure. There was significantly more mesial movement of the maxillary first molars in the CFPC group compared with the MSPC group.     

In Vitro and In Vivo Evaluations of Dihydroquinoline- and Dihydroisoquinoline-based Targetor Moieties for Brain-specific Chemical Delivery Systems

Brain-targeted delivery of various drugs can be successfully achieved by chemical delivery systems (CDS) that contain a 1,4-dihydropyridine-based redox targetor moiety and undergo a sequential metabolism. However, the susceptibility of this moiety toward hydration in acidic media may limit the shelf-life of such compounds in aqueous formulation. Here, a systematic investigation of the chemical stability toward oxidation and hydration of ester and amide derivatives of 3-substituted 1,4-dihydropyridine, 1,4-dihydroquinoline, and 4-substituted 1,2-dihydroisoquinoline is reported, together with the in vitro stability and in vivo (rat) distribution of isoquinoline-based testosterone and hydrocortisone chemical delivery systems, which were selected as having the most suitable acid-resistant targetor moieties.     

CXC ligand 13 in rheumatoid arthritis and its relation to secondary Sjögren’s syndrome

Aim of the workThe aim of the present study was to measure the level of the chemokine CXC ligand 13 protein (CXCL13) in the plasma and unstimulated saliva of rheumatoid arthritis (RA) patients in order to find out its role in the disease activity and its relation to secondary Sjögren’s syndrome (sSS).Patients and methodsThe study was conducted on thirty rheumatoid arthritis patients attending the Outpatient Clinic of Rheumatology and Rehabilitation department of Ain shams University Hospitals. The patients’ group had been classified into group (1) which included fifteen RA patients associated with sSS diagnosed according to the American–European Consensus Group Classification Criteria and group (2) which included fifteen RA patients not associated with sSS. Ten healthy subjects were included as a control group. Patients were subjected to full history taking, clinical examination, and laboratory detection of CXCL13 level in the plasma and saliva of patients as well as the control groups using ELISA technique. Assessment of disease activity in RA patients was done using the disease activity score (DAS28).ResultsPlasma levels of CXCL13 were significantly higher in RA patients than control group (p < 0.001). Plasma levels of CXCL13 were significantly correlated with the RA disease activity (r = 0.677, p < 0.001) and disease duration (r = 0.406, p < 0.05), while the salivary levels were higher in those with sSS and correlated with sSS disease duration (r = 0.536, p < 0.05). A highly significant correlation was found between salivary CXCL13 and severity of sSS (r = 0.816, p < 0.001). Salivary levels of CXCL13 above 110 pg/ml may diagnose sSS with sensitivity 80% and specificity 84%.ConclusionThe results of this preliminary study point out the importance of CXCL13 as a marker for RA disease activity, its role in diagnosing sSS, and estimation of sSS severity.     

Difficulties in Differentiating Coronaviruses from Subcellular Structures in Human Tissues by Electron Microscopy

Efforts to combat the coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have placed a renewed focus on the use of transmission electron microscopy for identifying coronavirus in tissues. In attempts to attribute pathology of COVID-19 patients directly to tissue damage caused by SARS-CoV-2, investigators have inaccurately reported subcellular structures, including coated vesicles, multivesicular bodies, and vesiculating rough endoplasmic reticulum, as coronavirus particles. We describe morphologic features of coronavirus that distinguish it from subcellular structures, including particle size range (60–140 nm), intracellular particle location within membrane-bound vacuoles, and a nucleocapsid appearing in cross section as dense dots (6–12 nm) within the particles. In addition, although the characteristic spikes of coronaviruses may be visible on the virus surface, especially on extracellular particles, they are less evident in thin sections than in negative stain preparations.     

Congestive heart failure as a rare cause of unilateral breast edema: A case report & review of the literature

Reported cases encountered difficulty in differentiating between inflammatory carcinoma and breast edema caused by congestive heart failure especially if the breast edema is unilateral. Our presented case is an elderly woman with unilateral breast edema due to congestive heart failure that was initially suspected to have breast cancer based on clinical findings. However imaging studies showed breast edema pattern with no definite underlying mass. This edema was resolved with standard treatment of heart failure. Congestive heart failure may be a possible cause of unilateral breast edema especially in a patient with background of congestive heart failure.