The Role of Suprapubic Superficial Fascial System Reconstruction During Repair of Adult-Acquired Buried Penis.

BACKGROUND: Adult-Acquired Buried Penis is a disorder associated with systemic obesity that confers increased risks of malignancy, sexual dysfunction, urinary abnormalities, and psychological distress. Surgical correction improves patient-reported functional and psychological outcomes and often requires collaboration between plastic and urologic surgeons. To improve postoperative cosmetic outcomes and decrease wound complications following adult-acquired buried penis repair, we performed an anatomic and histologic study of the superficial fascial layers providing support to the external male genitalia and describe our approach for fascial reconstruction. METHODS: We characterized the superficial fascial anatomy in three patients undergoing adult-acquired buried penis repair, including two patients with Wisconsin Type II disease and one patient with Wisconsin Type IV disease. Gross specimens were sent from two patients histologic analysis using H&E and elastin-specific stains to characterize the identity of the superficial fibrofatty tissue. RESULTS: In all three patients, the fundiform ligament overlying the suspensory ligament was identified, isolated, and transected for removal with the suprapubic specimen. We found that reapproximation of this ligament following transection at the time of escutcheonectomy provided significant lift to the penis and genitals via improved support of dartos fascia. Histologic analysis of the superficial fibrofatty tissue located beneath the dermis revealed histologic similarities with the superficial fascial system described previously in abdominal and breast tissue. CONCLUSIONS: Reapproximation of the fundiform ligament and superficial fascial tissue following suprapubic/lower abdominal fat pad removal during adult-acquired buried penis may improve postoperative cosmesis by reducing strain on the dermal closure. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Phage-induced efflux down-regulation boosts antibiotic efficacy.

The interactions between a virus and its host vary in space and time and are affected by the presence of molecules that alter the physiology of either the host or the virus. Determining the molecular mechanisms at the basis of these interactions is paramount for predicting the fate of bacterial and phage populations and for designing rational phage-antibiotic therapies. We study the interactions between stationary phase Burkholderia thailandensis and the phage ΦBp-AMP1. Although heterogeneous genetic resistance to phage rapidly emerges in B. thailandensis, the presence of phage enhances the efficacy of three major antibiotic classes, the quinolones, the beta-lactams and the tetracyclines, but antagonizes tetrahydrofolate synthesis inhibitors. We discovered that enhanced antibiotic efficacy is facilitated by reduced antibiotic efflux in the presence of phage. This new phage-antibiotic therapy allows for eradication of stationary phase bacteria, whilst requiring reduced antibiotic concentrations, which is crucial for treating infections in sites where it is difficult to achieve high antibiotic concentrations.

MHD surrogate model for convection in electromagnetically levitated molten metal droplets processed using the ISS-EML facility.

Electromagnetic levitation experiments in space are an essential tool for thermophysical property measurement and solidification studies. In light of the need for material properties as inputs to industrial process modeling, investigators need new tools for efficient experiment planning. MHD surrogate modeling is a parametric method for prediction of flow conditions during processing using the ISS-EML facility. Flow conditions in model Au, Zr, and Ti39.5Zr39.5Ni21 samples are predicted using the surrogate model. For Au, flow is shown be turbulent in nearly all experimental conditions, making property measurement difficult. For Zr, the flow is turbulent with the heater on and laminar with the heater off, allowing for property measurement during free-cooling experiments only. For TiZrNi, the flow is laminar under all experimental conditions, indicating that TiZrNi is an excellent candidate for EML experiments. This surrogate modeling approach can be easily applied to other materials of interest, enabling investigators to choose materials that will perform well in levitation and to tailor experiment parameters to achieve desirable flow conditions.

Hysteresis analysis of nitrate dynamics in the Neuse River, NC.

Anthropogenic activities have caused N saturation in many terrestrial ecosystems. The transfer of nutrients and sediments to freshwater environments has resulted in water quality impairments including eutrophication, increased turbidity, ecosystem acidification, and loss of biodiversity. Storm events account for the transport of a large proportion of nutrients and sediments found in watersheds on an annual basis. To implement effective water-quality management strategies, the importance of surface and subsurface flow paths during storm events and low flow conditions need to be quantified. The increased availability of optical in-situ sensors makes high-frequency monitoring of catchment fluxes practical. In this study, we present a high-resolution nitrate monitoring record over a 10-year period in the Neuse River Basin near Clayton, North Carolina. The relationship between discharge and nitrate concentration for 365 storm events are categorized into hysteresis classes that indicate different transport mechanisms into the river. Storm events over the entire period of this study are divided between clockwise, counter-clockwise, and complex hysteresis patterns, indicating multiple nitrate flow paths during different seasons and years. Logistic regression of a suite of environmental variables demonstrates that antecedent soil moisture is a significant factor in determining the storm hysteresis class, with the odds of counter-clockwise hysteresis increasing by 10.3% for every 1 percentage point increase in the soil moisture. There is also an overlying seasonal effect, which indicates that dry soil conditions and frequent small storms during summer leads to greater nitrate transport on the rising limb, in contrast to slower, groundwater-driven inputs during the rest of the year.

Numerical and experimental investigation of light trapping effect of nanostructured diatom frustules.

Recent advances in nanophotonic light-trapping technologies offer promising solutions in developing high-efficiency thin-film solar cells. However, the cost-effective scalable manufacturing of those rationally designed nanophotonic structures remains a critical challenge. In contrast, diatoms, the most common type of phytoplankton found in nature, may offer a very attractive solution. Diatoms exhibit high solar energy harvesting efficiency due to their frustules (i.e., hard porous cell wall made of silica) possessing remarkable hierarchical micro-/nano-scaled features optimized for the photosynthetic process through millions of years of evolution. Here we report numerical and experimental studies to investigate the light-trapping characteristic of diatom frustule. Rigorous coupled wave analysis (RCWA) and finite-difference time-domain (FDTD) methods are employed to investigate the light-trapping characteristics of the diatom frustules. In simulation, placing the diatom frustules on the surface of the light-absorption materials is found to strongly enhance the optical absorption over the visible spectrum. The absorption spectra are also measured experimentally and the results are in good agreement with numerical simulations.

Proliferative Activity in Pancreatic Endocrine Tumors: Association with Function, Metastases, and Survival.

Endocrine tumors of the pancreas are slow-growing lesions, yet one-third to one-half will metastasize. It is generally accepted that histopathologic features do not reliably predict metastatic potential or outcome. We investigated whether proliferative activity, as determined by MIB-l labeling, correlated with tumor type, metastasis, or patient survival. Formalin-fixed sections of pancreatic endocrine tumors were immunohistochemically stained for the MIB-l antibody against Ki-67 using the avidin-biotin complex technique. Labeling index (LI) was determined by counting 1000 consecutive tumor cells in an area of greatest staining intensity at x400 and expressed as a percentage. The study group included 37 patients, including 10 gastrinomas, 9 insulinomas, 4 glucagonomas, 2 VlPomas, and 12 nonfunctioning tumors. Twenty-one patients had metastases, primarily to regional lymph nodes and the liver. Five patients had MEN I. MIB-1 LI was significantly greater in the nonfunctioning tumors (mean 20S%) than in the functioning tumors (mean 51%) (p = 0.01). LI for functional tumors (insulinomas 64%, glucagonoma 44%, gastrinomas 32%, VlPomas 32%) were similar to each other, MIB-1 was significantly higher in those tumors that metastasized (mean 15.6%) compared to those that did not (mean 31%), (p = 0.04). All tumors with MIB-1 LI >10% developed metastases. Logistic regression showed that MIB-1 was a significant predictor of metastases (p = 0.003) after adjusting for functional status. MIB-1 LI also correlated with outcome in that those patients with MIB-1 LI >/=10% had a mean survival of 19 mo compared to 72 mo for those with levels <10% (p = 0.0001). Results of the proportional hazards model showed that MIR-1 remained a significant (p = 0.03) and independent predictor of survival times after adjustment for tumor size and functional status. Higher MIB-1 LI values were significantly associated with shorter survival times. In conclusion, MIB-1 LI appears to be a useful indicator of metastatic potential and is predictive of outcome in PET.