Complex urethral disruptions: In pursuit of a successful reconstruction

OBJECTIVES: We analyzed the methods and outcomes of urethroplasty in men with complex urethral disruptions. METHODS: The medical records of 40 men with complex urethral disruptions were analyzed. Surgical methods were individualized according to stricture location, severity and length of the stricture, bladder neck characteristics and presence of complicating factors. Patients were divided into four groups based on the above characteristics. RESULTS: End-to-end urethroplasty performed in six patients with short bulbar strictures (<3 cm) was successful in all. Elaborated perineal repair was performed in 10 patients with intermediate (3-6 cm) strictures with or without complicating factors. Elaborated perineal repair with urethral substitution was performed in nine patients with long segment stricture (>6 cm). Abdominal transpubic repair was successfully applied to patients with rectourethral fistula or lacerated bladder neck. Success rate of anastomotic urethroplasty was 95% while over all success rate was 85%. CONCLUSION: Guidelines for urethral reconstruction of complex urethral disruptions are predicated on stricture length, location, bladder neck characteristics and associated complicating factors. End-to-end urethroplasty with stricture excision is highly reliable for short strictures for which previous operative repair have failed. Elaborated perineal repair is extremely versatile for intermediate and longer strictures with associated complicating factors. Abdominal transpubic urethroplasty is effective for patients with rectourethral fistula or lacerated bladder neck.     

Absorption of Propranolol in Humans Following Oral,Jejunal, and Heal Administration

Pharmaceutical Research -     

Reduplication cyst of appendix with mucinous carcinoma and Müllerian metaplasia: a case report

This report describes a case of mucinous carcinoma and Müllerian metaplasia arising within an appendiceal duplication cyst found incidentally during an emergency Caesarian section. Intestinal duplication cysts are rare and although there are occasional reports of malignant transformation, this is the first case where Müllerian metaplasia was found concurrently with a malignancy. There was no previous history of endometriosis and no other abnormalities were found at surgery. Treatment included surgical excision. The patient is alive and well two years after removal of the cyst.     

Sexual Agreements and Intimate Partner Violence Among Male Couples in the U.S.: An Analysis of Dyadic Data

Prior research with male couples has focused on how sexual agreements can influence relationship dynamics, sexual risk taking, and health promoting behaviors. Little is known about the association between sexual agreements and the experience or perpetration of intimate partner violence (IPV) in this population. Our study sought to evaluate these associations using dyadic data from a sample of 386 male couples residing in the U.S. Both partners independently reported on their relationship characteristics, sexual agreements, and specific acts reflecting physical, emotional, controlling, and monitoring IPV in separate surveys. Participants were more likely to have experienced IPV in the past year if they were in a relationship for?≥?3 years versus?<?3 years (aOR?=?1.62, 95% CI?=?1.03–2.53). Among 278 couples who had formulated sexual agreements, men who concurred with their partners on being in an “open” relationship were less likely to have experienced IPV versus those in a “closed” relationship (aOR?=?0.47, 95% CI?=?0.25–0.89). However, participants were more likely to have experienced IPV if their partners believed they had previously broken their sexual agreement (aOR?=?2.79, 95% CI?=?1.03–7.52). The verbal explicitness and duration of sexual agreements were not associated with either experiencing or perpetrating IPV in the past year. However, increasing levels of depressive symptomatology were associated with a greater likelihood of both experiencing and perpetrating IPV. Our findings highlight the need to prioritize dyadic interventions for male couples that focus on skills building around enhancing mutual communication and negotiating sexual agreements to reduce IPV.

     

Specific cerebellar reductions in children with chromosome 22q11.2 deletion syndrome

Children with chromosome 22q11.2 deletion syndrome commonly are found to have morphological brain changes, cognitive impairments, and elevated rates of psychopathology. One of the most commonly and consistently reported brain changes is reduced cerebellar volume. Here, we demonstrate that, in addition to the global cerebellum reductions previously reported, volumetric reductions of the anterior lobule and the vermal region of the neo-cerebellum in the mid-sagittal plane best differentiate children with the deletion from typically developing children. These results suggest that the morphological changes of specific portions of the cerebellum may be an important underlying substrate of cognitive impairments and increased incidence of psychopathology in this group.     

Inhibin/Activin信号对卵巢癌生长调控的初步研究

目的 :分析抑制素 (Inhibin)和激活素 (Activin)在卵巢癌上皮和间质中的表达 ,评估两种多肽信号对卵巢癌生长的调控作用 ,探讨卵巢癌发病机制。方法 :采用免疫组化法检测 10 2例卵巢癌上皮及间质中抑制素和激活素的表达。结果 :( 1)激活素在卵巢癌组织上皮和间质中的总阳性表达率显著高于抑制素 ( 79/ 2 0 4vs 5 2 / 2 0 4 ,P <0 .0 0 5 ) ;( 2 )卵巢癌上皮中激活素阳性表达率显著高于抑制素 ( 61/ 10 2vs 2 2 / 10 2 ,P <0 .0 0 5 ) ,而间质中抑制素阳性表达率显著高于激活素 ( 30 / 10 2vs 18/ 10 2 ,P <0 .0 5 ) ;( 3)高分化癌组织(G1、G2 )上皮中激活素阳性表达率显著低于低分化癌组织 (G3、G4 )上皮中激活素阳性表达率 ( 4 5 / 66vs 16/ 36,P <0 .0 0 5 )。结论 :抑制素和激活素在卵巢癌组织中的不平衡表达可能是卵巢癌发生、发展的原因之一 ;低分化癌组织较高分化癌组织合成更多的激活素 ,通过与受体结合 ,激活信号放大 ,刺激细胞生长更趋恶性     

Infections in the gynaecological tract

In the context of infections in the body, those that occur in the gynaecological tract are less common and perhaps less clinically significant compared with other body sites. However, a few infections are important in view of their association with pathological sequelae such as tumour formation or pelvic inflammatory disease complex.This review will discuss some of the most relevant infections, first under histology, which will be further subdivided into locations in the genital tract and then under cytology, which focuses mainly on the infections seen in cervical cytology samples. There will be only brief mention of the less common infections or those that do not produce diagnostic challenges or lead to significant complications.     

Ocular myasthenia gravis: A review

Myasthenia gravis (MG) is a disease that affects the neuro-muscular junction resulting in classical symptoms of variable muscle weakness and fatigability. It is called the great masquerader owing to its varied clinical presentations. Very often, a patient of MG may present to the ophthalmologist given that a large proportion of patients with systemic myasthenia have ocular involvement either at presentation or during the later course of the disease. The treatment of ocular MG involves both the neurologist and ophthalmologist. Thus, the aim of this review was to highlight the current diagnosis, investigations, and treatment of ocular MG.