Combined use of Mathieu and incised plate technique (Snodgrass technique) for repair of distal hypospadias in older children

ObjectivesTo evaluate the results and complications after combined use of Mathieu and incised plate technique for management of distal hypospadias in older children.Patients and methodsA total of 33 patients with primary distal penile hypospadias were operated upon using the Mathieu technique combined with deep urethral plate incision (Snodgrass technique). Each patient was evaluated according to the site of original urethral opening, original urethral stenosis, the presence and degree of chordee. The operative and postoperative results and complications were reported. Follow up of the patients was done weekly for 3 weeks postoperatively and then every month for at least 1 year.ResultsThe mean age was 6.5 ± 2.5 years (range 6–9 years). Bleeding was reported in one case. Wound infection was reported in two cases. Forcible slippage of stent occurred in one case. Meatal stenosis occurred in two cases and urethrocutaneous fistula occurred in one case. No urethral stenosis was reported in any of the patients.ConclusionCombined use of Mathieu and incised plate technique is suitable for primary distal hypospadias in older children with original meatal stenosis.     

Interleukin-1 stimulates proliferation of acute myeloblastic leukemia cells by induction of granulocyte-macrophage colony-stimulating factor release

In this study, we further established the role of interleukin-1 (IL-1) alpha and IL-1 beta as regulators of proliferation of acute myeloid leukemia (AML) cells. IL-1 stimulated tritiated thymidine (3H-TdR) uptake of AML cells in 13 of 28 cases. Cytogenetic analysis confirmed the leukemic clonality of the IL-1-stimulated cells. Most likely, IL-1 exerted these stimulative effects directly on AML blast cells because IL-1 effectively induced 3H-TdR uptake of CD34-positive AML blasts (separated following cell sorting). Furthermore, adherent cell-depleted AML samples of three patients were more effectively stimulated than nondepleted AML fractions. Cluster and colony formation from adherent cell depleted AML samples could also be stimulated with IL-1, ie, in seven of ten cases analyzed. Subsequent experiments indicated that IL-1 stimulation depended on the release of GM-CSF because (1) induction of DNA synthesis of AML cells by IL-1 could be abrogated with antigranulocyte-macrophage colony-stimulating factor (GM-CSF) antibody, (2) conditioned media (CM) prepared from IL-1 stimulated AML blasts (adherent cell depleted) could stimulate the proliferation of purified normal bone marrow progenitors whereas supernatants from nonstimulated AML blasts did not, and (3) GM-CSF was demonstrated in IL-1/AML-CM with a specific radioimmunoassay, while GM-CSF was not detectable in nonstimulated supernatants. In one case of AML showing significant 3H- TdR uptake in the absence of CSFs, this spontaneous DNA synthesis was found to depend on autocrine IL-1 beta release as it could be suppressed with anti-IL-1 beta antibody or anti-GM-CSF. The blockade by anti-IL-1 beta could be overcome by the addition of high concentrations of IL-1 beta as well as GM-CSF. Thus, in this particular case, endogenously produced IL-1 beta had stimulated the release of GM-CSF which resulted in GM-CSF-dependent proliferation. The results indicate that GM-CSF production by AML blasts is often regulated by IL-1 rather than being constitutive.     

The evaluation of gastrointestinal function in diabetic patients

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