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Journal of Pediatric Urology Feb 2018Tubularized urethroplasty is commonly performed in clinical practice using genital skin flaps, bladder mucosa, and buccal mucosa. However, the long-term effects are not...
INTRODUCTION
Tubularized urethroplasty is commonly performed in clinical practice using genital skin flaps, bladder mucosa, and buccal mucosa. However, the long-term effects are not satisfying, and donor site morbidities remain a problem. Besides, those grafts are unavailable with malignant conditions of the urinary tract, a history of lichen sclerosis, or oral disease.
OBJECTIVE
An autologous granulation tissue tube of any required length and diameter can be produced by implanting foreign objects subcutaneously (Summary Fig.). The current study aimed to investigate to what extent of length this fully autologous tissue could be used for tubularized urethroplasty, satisfying urethral patency and tissue regeneration, in male rabbits.
STUDY DESIGN
Twenty-seven New Zealand male rabbits were randomly divided into three groups. Silastic tubes were implanted subcutaneously in Group 1 and Group 2. By 2 weeks the granulation tissue encapsulating the tubes was harvested. In Group 1, pendulous urethral segments of 1 cm were excised, and urethroplasty was performed with the granulation tissue tube in an end-to-end fashion. In Group 2, a pendulous urethral segment of 1.5 cm was replaced with the tissue tube. In Group 3, a pendulous urethral defect of 1 cm was repaired by re-anastomosis as control. Serial urethrograms were performed at 1, 2 and 6 months postoperatively. Meanwhile, the neo-urethra were harvested and analyzed grossly and histologically.
RESULTS
The urethrograms showed that all animals in Group 1 maintained a wide urethral caliber. In contrast, animals in Group 2 and Group 3 developed progressive strictures. Histologically, an intact urothelium with one to two cell layers lined the graft by 1 month, which was surrounded by increasing organized smooth muscle in Group 1. By 6 months, the grafts were completely integrated into native urethra. Nevertheless, extensive fibrosis occurred in Group 2 and Group 3.
DISCUSSION
The tissue successfully maintained patency and guided urethral regeneration across a distance of 1 cm. As an epithelium-free graft, the tissue showed better results than acellular matrix for tubularized urethroplasty compared with previous studies. Nevertheless, several limitations existed: (1) the urethral defect was created in healthy urethra, which could not fully simulate the clinical situation; (2) as a small animal model, rabbit was less informative for clinical problems; (3) the tissue was inadequate for long segmental urethral replacement. Further study is needed before the procedure is used clinically.
CONCLUSION
An autologous granulation tissue tube grown subcutaneously could be successfully used to repair urethral defects of 1 cm in male rabbits.
Topics: Animals; Biopsy, Needle; Disease Models, Animal; Graft Rejection; Graft Survival; Granulation Tissue; Immunohistochemistry; Male; Rabbits; Random Allocation; Recovery of Function; Risk Assessment; Tissue Engineering; Tissue and Organ Harvesting; Transplantation, Autologous; Treatment Outcome; Urethra; Urologic Surgical Procedures
PubMed: 29133168
DOI: 10.1016/j.jpurol.2017.07.019 -
Plant Disease Jan 2015Ribes lobbii (Gray) is a native, deciduous shrub from British Columbia, California, Oregon, and Washington that is grown for its pendulous red and white flowers, bristly...
Ribes lobbii (Gray) is a native, deciduous shrub from British Columbia, California, Oregon, and Washington that is grown for its pendulous red and white flowers, bristly fruit, and attractive, aromatic foliage. It is uncommon in nature and has only recently begun being propagated for sale in ornamental and native nurseries. In April 2013, 2-year-old containerized plants (15/50 plants) were found with severe wilt and chlorosis symptoms at a nursery production facility in western Oregon. Most fine roots were completely rotted and larger roots exhibited numerous black lesions. By the end of August, 50% of the plants were affected and most died within a few weeks of initial symptom development. At least three initially asymptomatic plants developed symptoms after being sold and planted. Isolation was attempted from 10 plants by plating pieces of necrotic root tissue (3 mm) that had been surface disinfested for 1 min in 10% bleach and 1 min in 70% ethanol onto PARP medium (2). Eight Phytophthora isolates were recovered and identified as P. cactorum (seven isolates, GenBank Accession No. KM085441) and P. citrophthora (one isolate, KM085442) on the basis of morphology and 99 to 100% internal transcribed spacer (ITS) sequence similarity to published sequence data (1). One isolate of each species was used to prepare vermiculite inoculum (3) and subsequently to infest potting media (Sunshine Professional Growing Mix) at 100 propagules per gram. Due to the scarcity of R. lobbii in nature and the nursery trade, only a limited number of plants were available for pathogenicity tests. Three 1-year-old rooted cuttings of R. lobbii (~15 to 30 cm tall) were transplanted into individual 10-cm pots containing 175 g of the respective infested media for each pathogen. Three plants transplanted into individual pots of noninfested media served as negative controls. Plants were then watered to pot capacity and incubated in a greenhouse at 28/24°C day/night. The entire experiment was repeated 2 weeks later. Within 1 week after inoculation, all inoculated plants in both trials wilted and died, regardless of the Phytophthora species used; negative control plants remained healthy. Each pathogen (with identity confirmed by ITS sequence analysis) was re-isolated from the roots and stem of each respective inoculated plant, but was not isolated from negative controls, thus fulfilling Koch's postulates. Therefore, to my knowledge, this is the first report of P. cactorum and P. citrophthora as root rot pathogens of R. lobbii. The use of infected, but asymptomatic native plants in habitat restoration efforts will likely compromise success and there is considerable risk to nearby plant species given the broad host range of both pathogens. References: (1) D. E. L. Cooke et al. Fungal Genet. Biol. 30:17, 2000. (2) M. E. Kannwischer and D. J. Mitchell. Phytopathology 68:1760, 1978. (3) J. E. Weiland et al. Plant Dis. 97:744, 2013.
PubMed: 30699777
DOI: 10.1094/PDIS-07-14-0691-PDN -
Canadian Urological Association Journal... 2015We describe the combined use of the Orandi flap and the scrotal skin advancement flap to reduce complications for pendulous urethral stricture in men >40 years old.
INTRODUCTION
We describe the combined use of the Orandi flap and the scrotal skin advancement flap to reduce complications for pendulous urethral stricture in men >40 years old.
METHODS
Over the last 40 months, 10 men underwent urethroplasty for pendulous stricture by the modified Orandi urethroplasty. In this, additionally, a midline hairless scrotal skin flap of the size of the ventral skin defect on the pendulous portion was raised based on the dartos fascia. This flap was mobilized so that it reached the pendulous portion without tension and covered the penile defect. The catheter was removed after 4 weeks. Patients were followed every 3 months using uroflowmetry and the American Urological Association (AUA) symptom score.
RESULTS
The mean age was 55.5. Of the 10 patients, the etiology was post-catheterization in 5 and idiopathic in the remaining 5. Three men also had stricture extending into the bulbous urethra (repaired using buccal graft). The mean additional time needed for the flap coverage was 36.2 minutes (range: 30-45). The median follow-up was 12 months (range: 3-40). The mean postoperative symptom score was 5.2 and the mean flow rate was 20.1 mL/sec. In 2 men, the meatus got retracted to the distal penile part (probably due to downward traction by scrotal skin). No patient complained of disfigurement. Two men reported recurrence (1 each in bulbous and penile urethra). The limitations are small number of patients and the observational nature of this study.
CONCLUSIONS
The intermediate-term results show that the modified Orandi urethroplasty is an acceptable treatment option with acceptable cosmetic results.
PubMed: 26085873
DOI: 10.5489/cuaj.2455 -
Journal of the American Animal Hospital... 2020
Topics: Animals; Cat Diseases; Cats; Female; Kidney Neoplasms; Myxosarcoma
PubMed: 31961219
DOI: 10.5326/JAAHA-MS-6863 -
Journal of Experimental & Clinical... Oct 2015In women with macromastia, a type IV skin sparing mastectomy is often required to achieve an aesthetically pleasing reconstruction. The introduction of "skin-reducing...
INTRODUCTION
In women with macromastia, a type IV skin sparing mastectomy is often required to achieve an aesthetically pleasing reconstruction. The introduction of "skin-reducing mastectomy", which inserts a permanent prosthetic device into a large pouch made by the pectoralis major muscle and an inferior pedicle dermal flap, allows the surgeon to achieve a safe oncologic result plus a cosmetically satisfying reconstruction.
OBJECTIVE
We report here our experience with the skin-reducing mastectomy with the aim of emphasizing the problems associated with the technique.
MATERIALS AND METHOD
A study was conduced from April 2009 to November 2012, 74 patients with breast cancer were selected then received a skin-reducing mastectomy. The enrolled women satisfied the criteria of Nava. Statistical analysis was conduced to estimate the significance of the outcome results and complication rate.
RESULT
A total of 88 SRMs were performed and the outcomes were as follows: excellent in 34 patients, good in 21, and poor in 8. We recorded 25 % of adverse events and statistic helped us to identify patient related factors whose can increase the complications onset.
CONCLUSION
Skin-reducing mastectomy is an indispensable procedure to treat cancer in large and pendulous breasts. The correct patient selection is mandatory to reduce the not negligible complication risk. Skin reducing mastectomy when is well conduced allow to obtain good results with patient satisfaction but, like other breast-conserving surgeries, in some case is not the ultimate solution, because it may require some revisions to maintain the optimum results. To day it be consider relatively safe in selected patient and the gold standard in macormastia immediate reconstruction.
Topics: Adult; Aged; Breast; Breast Neoplasms; Female; Humans; Hypertrophy; Mammaplasty; Mastectomy, Segmental; Middle Aged; Organ Sparing Treatments; Patient Satisfaction; Retrospective Studies; Surgical Flaps
PubMed: 26467095
DOI: 10.1186/s13046-015-0227-5 -
Clinics in Dermatology 2021New and emerging types of cutaneous vascular (capillary) proliferations have been described or better categorized in the last few years. They include reactive...
New and emerging types of cutaneous vascular (capillary) proliferations have been described or better categorized in the last few years. They include reactive angioendotheliomatosis, acroangiodermatitis (pseudo-Kaposi sarcoma), diffuse dermal angiomatosis, intravascular histiocytosis, glomeruloid angioendotheliomatosis, and angiopericytomatosis (angiomatosis with cryoproteins). Clinically, they are characterized by multiple, red violaceous, and purpuric patches and plaques, sometimes evolving toward necrosis and ulceration with a wide distribution but a propensity to involve the extremities. Histologically, they are characterized by different patterns of intravascular or extravascular lobular or diffuse hyperplasia of endothelial cells, pericytes, and sometimes histiocytes. Although these angioproliferations can histologically have a pseudoangiosarcomatous pattern, they are reactive in that they originate from the (sub)occlusion of vascular lumina by different localized or systemic disorders. The vascular proliferation stops after the inducing hypoxic stimulus has been withdrawn. Among them, diffuse dermal angiomatosis of the breast is a variant of diffuse dermal angiomatosis involving middle-aged women with macromastia, obesity, smoking, and vasculopathic disorders, considered a distinct disorder in the spectrum of cutaneous reactive angiomatoses. It presents with reticulated erythematous to purple patches with sometimes a tendency to ulcerate and bleeding, appearing on large, pendulous breasts. The pathogenesis is related to tissue hypoxemia resulting from subclinical torsion, compression, and increased venous hydrostatic pressure due to the macromastia, aggravated by the associated ischemic conditions such as hypertension and diabetes. There is no evidence-based therapy, but reduction mammoplasty is a viable treatment option. This should be evaluated in all patients who fail conservative therapy.
Topics: Angiomatosis; Breast; Endothelial Cells; Female; Humans; Middle Aged; Skin; Skin Diseases, Vascular
PubMed: 34272021
DOI: 10.1016/j.clindermatol.2020.10.004 -
BMC Gastroenterology Sep 2020We investigated whether duodenal major papilla morphology could be a risk factor for failure of selective biliary cannulation (SBC) and post endoscopic retrograde... (Observational Study)
Observational Study
BACKGROUND
We investigated whether duodenal major papilla morphology could be a risk factor for failure of selective biliary cannulation (SBC) and post endoscopic retrograde cholangiography and pancreatography (ERCP) complications.
METHODS
A prospectively recorded database was reviewed retrospectively. Patients were included if they received therapeutic ERCP and had naïve major duodenal papilla. We used Haraldsson's classification for papilla morphology, as follows: Regular (Type 1), Small (Type 2), Protruding or Pendulous (Type 3) and Creased or Ridged (Type 4). Risk factors for failing SBC and post-ERCP complications were analyzed by multivariate analysis.
RESULTS
A total of 286 cases were included. Age, gender, indications and therapeutic procedures were not different among the four types of papillae. The failure rates of SBC with Type 3 papilla and Type 4 papilla were 11.11% and 6.25%, respectively. In the multivariate analysis, Type 2 papilla (odd ratio 7.18, p = 0.045) and Type 3 papilla (odd ratio 7.44, p = 0.016) were associated with greater SBC failure compared with Type 1 papilla. Malignant obstruction compared to stone (odds ratio 4.45, p = 0.014) and age (odd ratio = 1.06, p = 0.010) were also risk factors for cannulation failure. Type 2 papilla was correlated with a higher rate of post-ERCP pancreatitis (20%, p = 0.020) compared to the other types of papilla However, papilla morphology was not a significant risk factor for any complications in the multivariate analysis.
CONCLUSION
Small papilla and protruding or pendulous papilla are more difficult to cannulate compared to regular papilla. Small papilla is associated with a higher rate of post-ERCP pancreatitis.
Topics: Ampulla of Vater; Catheterization; Cholangiopancreatography, Endoscopic Retrograde; Humans; Pancreatitis; Retrospective Studies; Sphincterotomy, Endoscopic
PubMed: 32988368
DOI: 10.1186/s12876-020-01455-0 -
Dermatology Online Journal Mar 2016Cutis laxa, clinically characterized by loose and pendulous skin related to loss of elastic tissue, is a rare heterogeneous condition. It is classified into congenital... (Review)
Review
Cutis laxa, clinically characterized by loose and pendulous skin related to loss of elastic tissue, is a rare heterogeneous condition. It is classified into congenital and acquired types. We report a case of generalized acquired cutis laxa type 1 in a young man following pruritic urticarial plaques. We have done a brief review of literature.
Topics: Adult; Cutis Laxa; Facial Dermatoses; Humans; Male; Skin; Thorax
PubMed: 27136630
DOI: No ID Found -
Poultry Science May 2016The impact of graded levels of day-length on the productivity of hens and toms was studied in two trials. Daylength treatments (trts) were 14 (14L), 17 (17L), 20 (20L),...
The impact of graded levels of day-length on the productivity of hens and toms was studied in two trials. Daylength treatments (trts) were 14 (14L), 17 (17L), 20 (20L), and 23 (23L) h and were started at 10 d of age. Turkeys (720 hens and 480 toms) were randomly allocated to 8 rooms (2 rooms per lighting trt) with six pens (3 hen--30 per pen and 3 tom--20 per pen) per room in each trial. Body weight (BW) was assessed at 0, 10, 21, 42, 63, 84, and 126 d of age; feed consumption (FC) was measured for the time periods between body weight determinations and feed efficiency (G:F; g of gain/g of feed) was calculated from BW and FC values. Birds were checked daily for mortality and culls, and affected birds were sent for necropsy. Data were analyzed according to a completely randomized block design with trial as the block and rooms nested within lighting trts. Regression analysis was used to study the relationship between dependent variables and daylength. Significance was declared at P≤ 0.05 and trends at P≤ 0.10. At both 21 and 42 d, body weight increased linearly with increasing daylength. At 84 d weights of toms decreased in a quadratic fashion and hen weights were unaffected. At 126 d, both tom and hen weights decreased linearly as daylength increased, with the magnitude of response gender dependent. Feed consumption corresponded with body weight changes, increasing for d 10 to 21, and 21 to 42 and decreasing for d 63 to 84, 84 to 105, and 105 to 126 with increasing daylength. Feed efficiency (G:F) was not affected by daylength for 10 to 84, 10 to 105 and 10 to 126 d periods. The incidence of mortality and culling was not affected by daylength for the 10 to 84 d period, but increased in a quadratic manner with increasing daylength for the 10 to 105 and 10 to 126 d periods. To conclude, daylength affects the growth and feed intake of turkeys in an age and gender-specific manner, and mortality and culling increase with longer daylength.
Topics: Aging; Animal Feed; Animals; Eating; Female; Male; Photoperiod; Turkeys
PubMed: 26976908
DOI: 10.3382/ps/pew060 -
PloS One 2018Zuojiangia jingxiensis, both a new genus and species, is described from the Pearl River in China. It is distinguished from all other genera and species of Labeonini by...
Zuojiangia jingxiensis, both a new genus and species, is described from the Pearl River in China. It is distinguished from all other genera and species of Labeonini by the unique combination of modified oromandibular structures and head skeleton: a well-developed, pendulous, and conspicuously arched rostral fold, with an entirely crenulated margin; prominent papillae densely covering the margin of the rostral fold and anterior part of the lower lip; long postlabial grooves, partitioning the lower lip into three parts; transverse branch of dentary longer than half the length of the longitudinal branch; stubby lateral process present at the anterolateral margin of the longitudinal branch of the dentary, close to the corner; in the upper jaw, the premaxilla bears a triangular ascending process tapering to a point; maxilla exhibits a pair of articular heads at the anterodorsal margin, and a distinct fingerlike descending process posterior to the medial articular head embracing the ascending process of the premaxilla.
Topics: Animal Distribution; Animals; China; Cyprinidae; Ecosystem; Pigmentation; Rivers
PubMed: 29979725
DOI: 10.1371/journal.pone.0199973