Penile traumatic testicular dislocation: a case report.

Traumatic testicular dislocation is rare and usually occurs in patients after a traumatic motor accident. Manual reduction or surgical exploration is the main treatment for this condition. We report a rare case of unilateral traumatic testicular dislocation in a man with an ectopic testis in the middle of the penis after a motorcycle crash injury. On the sixth day of hospitalization, the patient found a lump in the middle of his penis. Doppler ultrasound showed an ectopic testicle in the middle of the penis with good blood flow. After consultation, a manual reduction was successfully performed. A careful physical examination should be performed in patients with multiple injuries from the first medical exam. Early detection and timely reduction are critical to protect testicular function.

Nanoparticle-Assisted Pool Boiling Heat Transfer on Micro-Pin-Fin Surfaces.

Boiling heat transfer intensification is of significant relevance to energy conversion and various cooling processes. This study aimed to enhance the saturated pool boiling of FC-72 (a dielectric liquid) by surface modifications and explore mechanisms of the enhancement. Specifically, circular and square micro pin fins were fabricated on silicon surfaces by dry etching and then copper nanoparticles were deposited on the micro-pin-fin surfaces by electrostatic deposition. Experimental results indicated that compared with a smooth surface, the micro pin fins increased the heat transfer coefficient and the critical heat flux by more than 200 and 65-83%, respectively, which were further enhanced by the nanoparticles up to 24% and more than 20%, respectively. Correspondingly, the enhancement mechanism was carefully explored by high-speed bubble visualizations, surface wickability measurements, and model analysis. It was quantitatively found that small bubble departure diameters with high bubble departure frequencies promoted high heat transfer coefficients. The wickability, which characterizes the ability of a liquid to rewet a surface, played an important role in determining the critical heat flux, but further analyses indicated that evaporation beneath bubbles was also essential and competition between the wicking and the evaporation finally triggered the critical heat flux.

Characteristics of Renal Function in Patients Diagnosed With COVID-19: An Observational Study.

Objective: The aim of the study was to analyze the characteristics of renal function in patients diagnosed with COVID-19. Methods: In this retrospective, single-center study, we included all confirmed cases of COVID-19 in a tertiary hospital in Guangdong, China from January 20, 2020 to March 20, 2020. Blood and urine laboratory findings related to renal function were summarized, and the estimated glomerular filtration rate (eGFR) and endogenous creatinine clearance (Ccr) were also calculated to assess the renal function. Results: A total of 12 admitted hospital patients were diagnosed with COVID-19, included 3 severe cases, and 9 common cases. Serum creatinine (Scr) was not abnormally elevated in all of the patients, and blood urea nitrogen (BUN) was abnormally elevated in only 25.0% of the patients. However, compared with the recovery period, the patient's Scr and BUN increased significantly in peak of disease (p-scr = 0.002 & p-bun < 0.001). By observing the fluctuations in Scr and BUN from admission to recovery, it was found that the peak of Scr and BUN appeared within the first 14 day of the course of the disease. Urinary microprotein detection indicated that the abnormally elevated rates of urine microalbumin (UMA), α1-microglobulin (A1M), urine immunoglobulin-G (IGU), and urine transferring (TRU) standardized by urinary creatinine in peak of disease were 41.7, 41.7, 50.0, and 16.7%, respectively. The abnormal rates of the calculated eGFR and Ccr were 66.7 and 41.7%. Conclusion: Scr and BUN were generally increased during the course of COVID-19. Detection of urinary microproteins and application of multiple indicators assessment could be helpful for discovering abnormal renal function in patients with COVID-19. However, the evidence is limited due to the small sample size and observational nature. Additional studies, especially large prospective cohort studies, are required to confirm these findings.

The Handling of Oxalate in the Body and the Origin of Oxalate in Calcium Oxalate Stones.

Urolithiasis is one of the most common urologic diseases in industrialized societies. More than 80% of renal stones are composed of calcium oxalate, and small changes in urinary oxalate concentrations affect the risk of stone formation. Elucidation of the source of oxalate and its mechanism of transport is crucial for understanding the etiology of urolithiasis. Sources of oxalate can be both endogenous and exogenous. With regard to oxalate transport, tests were carried out to prove the function of solute-linked carrier 4 (SLC4) and SLC26. The molecular mechanism of urolithiasis caused by SLC4 and SLC26 is still unclear. The growing number of studies on the molecular physiology of SLC4 and SLC26, together with knockout genetic mouse model experiments, suggest that SLC4 and SLC26 may be a contributing element to urolithiasis. This review summarizes recent research on the sources of oxalate and characterization of the oxalate transport ionic exchangers SLC4 and SLC26, with an emphasis on different physiological defects in knockout mouse models including kidney stone formation. Furthermore, SLC4 and SLC26 exchangers provide new insight into urolithiasis and may be a novel therapeutic target for modification of urinary oxalate excretion.

Frequency-specific plasticity of the auditory cortex elicited by thalamic stimulation in the rat.

In a process known as frequency-specific plasticity, electrical stimulation of the ventral division of the medial geniculate body (MGBv) in the thalamus evokes a shift in the frequency-tuning curves of auditory cortical (AC) neurons toward the best frequency (BF) of stimulated MGBv neurons. However, the underlying synaptic mechanisms of this process are uncharacterized. To investigate whether this dynamic change depends on thalamocortical (TC) synaptic plasticity, we studied frequency-specific changes in synaptic transmission efficacy in TC pathways evoked by thalamic stimulation. Specifically, we induced cortical plasticity by repetitive focal electrical stimulation of the MGBv in rats and measured receptive field shifts and local field potentials in AC neurons. Our data show that focal electrical stimulation of the MGBv induced receptive field shifts as well as long-term potentiation or depression of the local field potentials in AC neurons. The evoked potentiation and depression depended on the frequency of the electrical stimulation of the MGBv synchronized with the BF of MGBv and AC neurons. Receptive field shifts were produced by inhibition of responses at the BF of the recorded AC neurons and facilitation of responses at the BF of the stimulated MGBv neurons. These results suggest that MGBv neurons play a decisive role in the expression of AC synaptic plasticity and that activation of different frequency-specific TC pathways may be the synaptic mechanism underlying this plasticity.

[DAZL gene polymorphisms and astheno-teratozoospermia].

OBJECTIVE: To investigate the association between single nucleotide polymorphism (SNP) of the DZAL gene in infertile Han Chinese males with astheno-teratozoospermia. METHODS: We collected semen samples from 173 infertile Han Chinese men with astheno-teratozoospermia (case group) and 175 age-matched normal male volunteers (control group) for semen routine and morphological analyses. We obtained genomic DNA, genotyped the polymorphisms of the DAZL gene A260G and A386G via the Sequenom MassARRAY system, and compared the frequencies of the genotypes between the case and control groups. RESULTS: The AA nucleotide variant was found in the A260G and A386G polymorphisms of the DZAL gene in both the cases and controls, but the heterozygous AG variant in neither. CONCLUSION: The A260G and A386G polymorphisms of the DAZL gene are not correlated with astheno-teratozoospermia-induced male infertility in the Han Chinese population, and therefore could not be considered as molecular markers of male infertility.

Changes of synaptic ultrastructure in the guinea pig interpositus nuclei associate with response magnitude and timing after trace eyeblink conditioning.

Learning-induced changes of synaptic ultrastructure have long been proposed as a mechanism that may contribute to support memory formation. Although recent studies have demonstrated that the interpositus nuclei (IN) play critical role in acquisition and retention of trace conditioned eyeblink responses (CRs), there is now limited evidence associating trace eyeblink conditioning with changes of synaptic ultrastructure in the IN. Here, we investigated this issue using a transmission electron microscope. Adult guinea pigs were randomly allocated to either a trace-paired, delay-paired, unpaired or exposure-only condition. The IN tissue was taken for morphological analysis 1h after the completion of the tenth training session. Serial section analysis of synaptic ultrastructure revealed that trace eyeblink conditioning induced increases in the thickness of excitatory PSD. Classification of the synapses into shape subtypes indicated that the increased thickness of excitatory PSD was mainly attributable to increase in the concave- and convex-shaped synapses. On the contrary, trace eyeblink conditioning resulted in decreases in the thickness of inhibitory PSD. Specifically, these significant changes of PSD thickness were limited to occur in the animals with good behavioral performance. Further analysis of correlations between the trace CR performance and synaptic ultrastructural modifications showed that the thickness of excitatory PSD within the IN correlated with the peak amplitude of trace CRs, whereas the thickness of inhibitory PSD correlated with the onset latency. The present findings suggest that trace eyeblink conditioning induces structural plasticity in the IN, which may play a crucial role in acquiring and executing adaptive eyeblink movements.

Comparison of hand-assisted laparoscopic and open radical cystectomy for bladder cancer.

PURPOSE: To present our experience of hand-assisted laparoscopic radical cystectomy (HALRC) and compare it with open radical cystectomy (ORC). PATIENTS AND METHODS: During the period between May 2004 and November 2007, 31 patients underwent HALRC and 39 patients underwent ORC for bladder cancer. The patient demographics, intraoperative variables and postoperative outcomes were compared retrospectively. RESULTS: There was no statistically significant difference with regard to age, sex, body mass index, and urinary diversion in the 2 groups. In the HALRC group, 20 patients had stage pT2 or less, 7 had pT3 disease, and 4 had stage pT4 disease. In the ORC group, 29 patients had stage pT2 or less, 5 had pT3 disease, and 5 had stage pT4 disease. All margins in both groups were negative. The HALRC group had decreased blood loss (250.9 vs. 812.8 ml, p < 0.001) and a lower rate of transfusion (9.7 vs. 76.9%, p < 0.001), but similar mean operative time (365.7 vs. 362.6 min, p = 0.862). Time to liquid diet was significantly less in the HALRC group versus the ORC group (4.3 vs. 6.3 days, p < 0.001). The median number of lymph nodes were similar between the HALRC and ORC groups (14 vs. 15, p = 0.377). Six patients developed perioperative complications in the HALRC group and 12 patients had complications in the ORC group (19.4 vs. 30.8%, p = 0.278). Late complications occurred in 3 patients (2 parastomal hernias and 1 ureteroenteral stricture) in the HALRC group. CONCLUSIONS: Compared with ORC, HALRC patients had decreased blood loss, less transfusion requirements, and quicker intestinal recovery. Long-term follow-up in a larger cohort of patients is needed to assess the long-term oncological and functional outcomes.

Hand-assisted laparoscopic radical cystectomy and extracorporeal urinary diversion: experience with 31 cases.

OBJECTIVES: To report our techniques and experience with hand-assisted laparoscopic radical cystectomy and extracorporeal urinary diversion for bladder cancer. METHODS: Between May 2004 and November 2007, 31 patients (mean age 61.3 years, range 40-79) underwent hand-assisted laparoscopic radical cystectomy with extracorporeal urinary diversion for bladder cancer. Five patients had previously undergone abdominal surgeries. Data were collected with respect to patient demographics, perioperative outcomes and short-term oncological follow up. RESULTS: Twenty-four patients underwent an ileal conduit and seven patients underwent an orthotopic neobladder. Mean operative time was 365.7 min (range 245 to 530). Estimated blood loss was 250.9 cc (range 100 to 500), with a transfusion rate of 9.7%. Oral liquids were resumed at 4.3 days and the mean hospital stay was 19.7 days. There were no intraoperative complications. Postoperative early complications (within 30 days of surgery) occurred in six patients (19.4%). Two wound infections, one urinary leak, one wound dehiscence, one bowel obstruction and one alimentary tract hemorrhage were all treated conservatively. Late complications occurred in three patients (two parastomal hernias and one ureteroenteric stricture). With a mean follow up of 18 months, 27 patients had no evidence of disease. One patient died because of cancer and one died for unrelated causes. One was alive with local recurrences and one with lung metastasis. CONCLUSIONS: Hand-assisted laparoscopic radical cystectomy is a safe, reproducible and minimally invasive option for bladder cancer patients.

[The clinico-pathological significance of protein expression of PAK1 in bladder transitional cell carcinoma].

OBJECTIVE: To investigate the protein expression of p21-activated kinase 1 gene (PAK1) in bladder transitional cell carcinoma (BTCC) and its clinico-pathological significance. METHODS: Immunohistochemistry and TUNEL were used, in combination with tissue microarray technique, to examine the protein expression of PAK1 and status of cell apoptosis in 100 BTCC tissue specimens obtained during operation and 30 specimens of adjacent normal bladder mucosa. RESULTS: All adjacent normal bladder mucosa specimens were negative in PAK1 protein expression or only with a low-level expression of PAK1 protein, while 58% of the BTCC specimens showed over-expression of PAK1. PAK1 expression was significantly associated with tumor pathological grade and tumor size (both P < 0.05). The PAK1 overexpression rate of the poorly-differentiated BTCC specimens (at the G3 stage) was 78%, significantly higher than that of the well-differentiated specimens (at the stage G1/G2, 47%, P = 0.05). The PAK1 overexpression rate of the large-sized BTCC specimens (>or= 3 cm in diameter) was 73%, significantly higher than that of the small-sized BTCC specimens (< 3 cm in diameter, P = 0.034). The PAK1 protein expression was negatively correlated with the apoptotic index of the cells (P < 0.05). CONCLUSION: Overexpression of PAK1 protein may via its anti-apoptotic function to play an important role in the development and progression of BTCC. Overexpression of PAK1 in BTCC is associated closely with tumor malignant histological phenotype and it may be used as a molecular marker to predicate the malignant potential of BTCC.

[The clinical significance of expression and amplification of FGF3 in bladder transitional cell carcinoma].

OBJECTIVE: To investigate the amplification and expression of FGF3 in bladder transitional cell carcinoma (BTCC) and its clinical significance. METHODS: Immunohistochemistry (IHC) and Fluorescence In Situ Hybridization (FISH) methods were used to examine the protein expression and amplification of FGF3 in a tissue microarray (TMA) of 100 BTCCs and 30 adjacent normal bladder mucosas, so as to analyze their correlation and association with patient's clinico-pathological features. RESULTS: In this study, none of the normal bladder mucosas were detected FGF3 positivity, while in 89 informative BTCCs, 20 (22%) cases were observed positive expression of FGF3 protein, and it was significantly more frequently to occur in BTCCs of poor-differentiation (Grade 3), later clinical stage (T2-4) and tumor in >or= 3 cm in diameter (P < 0.05). In FISH study, 10 of the 63 (16%) informative BTCCs were observed amplification of FGF3 and it was significantly associated with BTCC's tumor size and clinical stage (P < 0.05). In addition, 10 BTCCs with amplification of FGF3 in this study were all detected positive expression of FGF3 protein, while in the remaining 53 BTCCs without amplification of FGF3, only 3 (6%) cases were observed FGF3 protein positivity. CONCLUSION: The up-regulated expression of FGF3 in BTCC was associated closely with tumor's malignant clinical phenotypes, and it might be involved in the malignant progression of parts of BTCC. The amplification of FGF3 gene might be a predominant mechanism of increased expression of FGF3 protein in BTCC.