Transition to adulthood with a bladder augmentation: histopathologic concerns.

AIM: To investigate the histopathologic changes in native bladder and gastrointestinal segment, the relation between histopathologic changes, type of operation and the period passed over operation in patients with bladder augmentation. MATERIALS AND METHODS: Twenty consecutive patients were enrolled in this study. Histopathologic evaluation of the cystoscopic mucosal biopsies from native bladder and enteric augment was performed in all patients. RESULTS: Active or chronic non-specific inflammation of various degrees was found in all specimens except two. Metaplastic changes were detected in 3 patients. Two patients had squamous metaplasia (one focal, one extensive) and one patient had intestinal metaplasia. All metaplastic changes were found in native bladder specimens. The type of augmentation in patients with metaplastic changes were ileocystoplasty and sigmoidocystoplasty. No signs of malignancy were detected in any patient. CONCLUSION: The complexity of the disorders requiring bladder augmentation does not let the surgeons to draw a clear line between different groups of complications including malignancy formation. However, due to challenging course of the augmentation procedure itself, surgeons should be well aware of the possibility of malignancy development.

Antibacterial activity of ciprofloxacin-impregnated 3D-printed polylactic acid discs: an in vitro study.

INTRODUCTION: Three-dimensional (3D) printing technology allows incorporation of various substances including antibiotics into different structures. This study aimed to evaluate the antibacterial activity of ciprofloxacin-impregnated 3D discs against Escherichia coli. METHODOLOGY: Polylactic acid pellets were coated with ciprofloxacin at 1% and 2% concentrations, then filaments were produced from these pellets, and antibiotic-containing discs were obtained using fused deposition modeling 3D printers. The working temperatures during filament extrusion and 3D printing processes were 200 °C and 215 °C, respectively. Therefore, in order to test the thermal stability of ciprofloxacin during these processes, the antibiotic was exposed to 200 °C and 215 °C in an oven, and then tested against E. coli. Following this, efficiencies of antibiotic-coated pellets, filaments and discs against E. coli were determined by diffusion tests. RESULTS: Ciprofloxacin heated at 200 °C and 215 °C was stable and retained its antibacterial activity. Pellets, filaments and discs coated with 1% or 2% concentration of ciprofloxacin produced inhibition zones in the culture plates. Increasing ciprofloxacin concentration did not significantly affect the diameter of inhibition zones (p > 0.05). Ciprofloxacin-containing polylactic acid pellets produced significantly larger inhibition zones than those of filaments and discs (p < 0.0001). The difference in zone diameters around ciprofloxacin-containing filaments and discs was not statistically significant (p > 0.05). CONCLUSIONS: Ciprofloxacin-coated polylactic acid-based 3D discs displayed antibacterial activity against E. coli. This suggests that, various polylactic acid-based ciprofloxacin-containing 3D products can be obtained and evaluated for antibacterial activity in future studies.

Obtaining Stem Cell Spheroids from Foreskin Tissue and the Effect of Corchorus olitorius L. on Spheroid Proliferation.

OBJECTIVES: Mesenchymal stem cells are self-renewing stem cells. The human foreskin has potential to be used as a source of stem cells. The aim of the study was to obtain spheroid formation of human foreskin cells (hnFSSCs) isolated from newborn human foreskin tissue. In addition, the apoptotic and proliferative effects of a traditional plant, Corchorus olitorius L. (C. olitorius), on hnFSSC spheroids were investigated. MATERIALS AND METHODS: After a routine circumcision procedure the cells were isolated and cultured in suitable medium. The plant leaves was extracted with ethanol and their composition was analyzed by liquid chromatography coupled with mass spectrometry (LC-MS/MS). The foreskin stem cells were characterized immunocytochemically by CD45, CD34, and CD90 antibodies. hnFSSC spheroids were formed using the hanging drop technique. Immunofluorescence staining was used on the obtained spheroids to determine the distribution of caspase-3 and Ki-67 after being treated with C. olitorius extract for 48 h. RESULTS: Immunostaining analysis showed that hnFSSCs were positive for CD45 and CD34 and negative for CD90. According to LC-MS/MS C. olitorius was rich in flavanols and hydrocinnamic acid derivatives. Although the spheroids obtained were loose and floating, the cells interacted with each other. Caspase-3 activity was higher in the control group than in the extract-treated group and Ki-67 was higher in the extract-treated group than in the control group, suggesting that the plant might have the capacity to increase stem cell proliferation due to its rich polyphenolic content. CONCLUSION: The results suggest that hnFSSCs and spheroids might be used in stem cell generation, tissue repair and renewal as human foreskin tissue has potential to be used as a stem cell source. C. olitorius also increased proliferation of hnFSSCs, showing that polyphenols might increase proliferation of stem cells.

High Prenatal Exposure to Bisphenol A Reduces Anogenital Distance in Healthy Male Newborns.

OBJECTIVE: To estimate the relationship between cord blood bisphenol A (BPA) levels and anogenital measurements in healthy newborns. METHODS: Pregnancy and birth history, together with body mass and length data, anogenital measurements, penile measurements and cord blood samples were obtained from healthy newborns. Cord blood concentration of BPA was analyzed by sandwich enzyme-linked immunosorbent assays kit. RESULTS: Among 130 healthy newborns (72 boys, 58 girls), mean anopenile distance was 45.2±6 mm and anoscrotal distance was 21.9±5.4 mm in boys; mean anoclitoral distance was 33.8±6.6 mm and mean anofourchette distance was 12.2±4.9 mm in girls. Mean cord blood BPA level was 4.75±2.18 ng/mL. 90th percentile value for cord blood BPA was 8.26 ng/mL and the analysis showed a statistically significant correlation between anoscrotal distance and cord blood BPA levels above the 90th percentile (p=0.047) in boys. The changes in anogenital distance in girls were not statistically significant. CONCLUSION: We showed a significant association between high cord blood BPA levels and shortened anoscrotal distance in male newborns. However, this result should be interpreted with caution since there were no significant external genital abnormalities in our study group.

Transvesicoscopic cross-trigonal ureteroneocystostomy in children: a single-center experience.

PURPOSE: To evaluate the safety and efficacy of transvesicoscopic ureteric reimplantation in children. PATIENTS AND METHODS: Seventeen ureteric units in 11 patients underwent a transvesicoscopic 'Cohen' ureteroneocystostomy in 2003-2007 and the results were retrospectively analyzed. There were four boys and seven girls. All patients had vesicoureteric reflux (VUR), except for one with paraostial diverticula. Six patients underwent bilateral and five unilateral transvesicoscopic reimplantation (a total of 17 units). RESULTS: The procedure was successfully completed in all patients. Mean operation time was 217 min in unilateral cases and 306 min in bilateral cases without perioperative complications, except for pneumoperitoneum development in two cases. In the early postoperative period, two patients developed macroscopic hematuria. Mean hospital stay was 3.8 days (3-5 days), except for one patient who suffered from urinary tract infection and needed longer hospitalization. Mean follow-up period was 4.5 years (3-7 years). One patient with bilateral VUR had passive unilateral grade I VUR on postoperative cystogram, giving a success rate of 91% (94% of ureters). This patient was followed conservatively. One patient had recurrent urinary tract infections without reflux. CONCLUSION: Transvesicoscopic cross-trigonal ureteroneocystostomy can be safely performed with a high success rate in children.

Transition to adulthood with a bladder augmentation: histopathologic concerns

ABSTRACT Aim: To investigate the histopathologic changes in native bladder and gastrointestinal segment, the relation between histopathologic changes, type of operation and the period passed over operation in patients with bladder augmentation. Materials and methods: Twenty consecutive patients were enrolled in this study. Histopathologic evaluation of the cystoscopic mucosal biopsies from native bladder and enteric augment was performed in all patients. Results: Active or chronic non-specific inflammation of various degrees was found in all specimens except two. Metaplastic changes were detected in 3 patients. Two patients had squamous metaplasia (one focal, one extensive) and one patient had intestinal metaplasia. All metaplastic changes were found in native bladder specimens. The type of augmentation in patients with metaplastic changes were ileocystoplasty and sigmoidocystoplasty. No signs of malignancy were detected in any patient. Conclusion: The complexity of the disorders requiring bladder augmentation does not let the surgeons to draw a clear line between different groups of complications including malignancy formation. However, due to challenging course of the augmentation procedure itself, surgeons should be well aware of the possibility of malignancy development.

Actinomycosis presenting as an abdominal mass in a child.

Abdominal actinomycosis in childhood period is very rare and a relation to trauma is not well established. Herein we report a case that appeared subsequent to abdominal trauma. A 17 years old boy presented with left lower quadrant abdominal mass and signs of acute abdomen. The symptoms of abdominal discomfort began after a fall from height 3 months before admission. There were signs of acute abdomen at physical examination. Ultrasound of abdomen demonstrated a mass; CT scan findings pointed to a suspicious "internal hernia". An emergency laparotomy was performed. During surgery, a mass located over sigmoid colon and infiltrating the lateral abdominal wall was found. It was removed en bloc with the adjacent omentum. Except for the thickened sigmoid colon, no other pathologies were present at laparotomy. The pathology specimen revealed the actinomyces infection. The patient was treated with oral penicillin after discharge and the follow-up was uneventful. We advocate, keeping the actinomyces infection in mind in cases presenting with abdominal mass of unknown origin in childhood period.

Intestinal volvulus and perforation caused by multiple magnet ingestion: report of a case.

Ingested magnets can cause intestinal fistulas, perforation, and obstruction. There have been reports of magnet ingestion causing intestinal volvulus, but multiple magnet ingestion causing perforation and intestinal volvulus in a child is very unusual. We report the case of a 4-year-old girl, who ingested four magnets she acquired as toys, which caused intestinal volvulus and perforation as a result of pressure necrosis, several days after ingestion. At surgery we repaired two perforations, but additional bowel resection was not required. The patient was discharged on postoperative day 10. If multiple magnet ingestion is suspected in a child, the child must be monitored carefully. If there are signs of obstruction, emergency surgery is mandatory.