Radiographic calibration for pubic diastasis assessment in bladder exstrophy-epispadias complex: a phantom study.

BACKGROUND: The assessment of pubic diastasis is important for the surgical planning of patients with bladder exstrophy-epispadias complex. Understanding how the diastasis changes during surgical follow-up may help predict patient morbidity. Radiography can follow diastasis but may be affected by patient and technical imaging factors including body size, imaging protocol, and equipment. Using imaging calibration and anatomic ratios may mitigate differences due to these aspects. OBJECTIVE: Use imaging phantoms to assess the effect of radiographic calibration on measurements of pubic diastasis and an internal anatomic ratio as a child grows. MATERIALS AND METHODS: Radiographic images were obtained of three different sizes of computed tomography phantoms (older child, child, and infant) using three imaging techniques that include the osseous pelvis in children. All phantoms were imaged with abdomen and pelvis techniques. The infant phantom was additionally imaged using a thoracoabdominal technique. These exposures were all repeated with systems from three manufacturers. Linear measurements were made between radiographic markers placed to simulate pubic diastasis and sacral width. A ratio was also created between these distances. Measurements with and without image calibration were made by two pediatric radiologists using rulers placed at the time of image acquisition. RESULTS: There was excellent interrater agreement for measurements, ICC >0.99. Anterior distances were more affected by magnification than posterior ones with a significant difference between uncalibrated versus calibrated anterior distances (p=0.04) and not for posterior ones (p=0.65). There was no difference between radiographic equipment manufacturers without or with calibration (p values 0.66 to 0.99). There was a significant difference in simulated pubic distance between thoracoabdominal and abdomen (p=0.04) as well as pelvic (p=0.04) techniques which resolved with calibration, each p=0.6. The ratio between the simulated pubic diastasis and sacral width differed by phantom size (all p<0.01) and imaging technique (p values 0.01 to 0.03) with or without calibration. However, the numerical differences may not be clinically significant. CONCLUSION: Image calibration results in more uniform measurements that are more accurate than uncalibrated ones across patient size, imaging techniques, and equipment. Image calibration is necessary for accurate measurement of inter-pubic distances on all projection imaging. Small differences in the pelvic ratio likely are not clinically significant, but until there is a better understanding, image calibration may be prudent.

Remyelination after Lysophosphatidyl Choline-Induced Demyelination Is Stimulated by Bone Marrow Stromal Cell-Derived Oligoprogenitor Cell Transplantation.

Bone marrow stromal cells (BMSCs) are a desirable cell source that may be useful for the treatment of neurodegenerative diseases given their capacity to differentiate into various types of cells. The current study aimed to investigate whether oligoprogenitor cell (OPC)-derived BMSCs have therapeutic benefits in an animal model of local demyelination. BMSCs were transdifferentiated into OPCs using a defined culture medium supplemented with a combination of inducers. The differentiation capacity of the BMSCs was evaluated at the end of the induction phase by assessing the expression levels of the glial-specific markers oligodendrocyte transcription factor 2 and O4 surface antigen. Local demyelination was induced in the corpus callosum of adult female rats via direct injection of lysophosphatidylcholine (LPC) followed by engraftment of BMSC-generated OPCs. The rats were divided into sham control, vehicle control, and cell-transplanted groups. The changes in the extent of demyelination and the robustness of the remyelination event were assessed using Luxol Fast Blue staining and immunohistochemical analysis 1 week after LPC injection and 2 weeks after cell transplantation. Consequently, transplantation of OPCs into the demyelinated corpus callosum model resulted in differentiation of the cells into mature oligodendrocytes that were immunopositive for myelin basic protein. Furthermore, OPC transplantation mitigated demyelination and augmented remyelination relative to controls. These findings suggest that BMSC-derived OPCs can be utilized in therapeutic approaches for the management of demyelination-associated diseases such as multiple sclerosis.

The Modulatory Role of Orexin 1 Receptor in Nucleus Accumbens (NAc) on Spatial Memory in Rats.

Neuropeptide orexin mainly exists in neurons within and around the lateral hypothalamus and exhibits high affinity to orexin 1 and 2 receptors (OX1R and OX2R, respectively). Orexinergic neurons send their axons to the nucleus accumbens (NAc), which expresses OX1Rs. Previous studies have shown the involvement of orexins and their role in learning and memory processes in the dorsal raphe nucleus and hippocampus. However, no study has examined the effects of orexins in the NAc on memory. The present study examined the effect of the post-training and pre-probe trial intra-NAc administration of SB-33486-A (OX1R antagonist, 12 µg/0.5µl) and TCS-OX2-29 (OX2R antagonist, 10 µg/0.5 µl) on the consolidation and retrieval of memory in the Morris Water Maze (MWM) task. In experiment 1, rats were trained in the MWM and, immediately after every training, received bilateral injections of dimethyl sulfoxide (DMSO) (control group), SB-334867-A (SB), and TCS-OX2-29 (TCS) into the NAc. Experiment 2 was similar to experiment 1, except that the rats received DMSO, SB, and TCS 15 min before the probe test. Probe and visible tests were performed after the last training, and the distance moved, escape latency, and velocity were recorded. In experiment 3, rats trained in experiments 1 and 2, immediately after the probe test, were given the trials for visuomotor coordination assessment on the visible platform. According to the results, the injection of SB increased the distance moved and escape latency in the treated groups, compared to the control group, in the consolidation phase of spatial memory (P<0.05) but not in its retrieval phase (P>0.05). However, TCS-OX2-29 had no effect. These results suggest that the inactivation of the NAc OX1Rs, but not OX2Rs, impairs the consolidation but not the retrieval of spatial memory in rats.

A double-blind randomised controlled trial of gloved versus ungloved merocel middle meatal spacers for endoscopic sinus surgery.

BACKGROUND: Middle meatal spacers are commonly used following endoscopic sinus surgery to prevent post-operative bleeding and lateralization of the middle turbinates. The effects of nasal packing on post-operative sinonasal mucosal healing remain unknown in humans. OBJECTIVE: This study aims to compare the histopathalogical effects of Merocel and Merocel covered with a finger glove on mucosal healing, and patients` discomfort immediately post-operatively after endoscopic sinus surgery and at removal of the nasal packing. METHODS: Thirty-seven patients with chronic rhinosinusitis undergoing bilateral endoscopic sinus surgery were enrolled in a prospective study. Patients were randomized and blinded to receive Merocel middle meatal spacer (MMMS) in one nostril and finger glove Merocel middle meatal spacer (FGMMS) in the contra lateral side. Patients were seen on post-operative day 6, and completed a visual analogue score reporting the post-operative discomfort from nasal packing on each side. Following the removal of nasal packing, patients indicated which side caused more discomfort on removal. Biopsies were taken from the middle turbinates and sent to a blinded pathologist who scored the level of mucosal inflammation from 0 - 4. RESULTS: There was no statistically significant difference between MMMS and FGMMS in regards to their effect on sinonasal mucosal inflammation and discomfort post-operatively. A statistically significant difference was noted with respect to discomfort at removal with the uncovered Merocel more likely to cause discomfort when compared to the Merocel covered in a glove finger. CONCLUSION: MMMS and FGMMS are equivalent in the amount of sinonasal mucosal inflammation and discomfort post endoscopic sinus surgery. However, the main advantage of the FGMMS was a significant reduction in pain on removal when compared with the MMMS.

Subcision-suction method: a new successful combination therapy in treatment of atrophic acne scars and other depressed scars.

BACKGROUND: Among therapeutic modalities of acne scars, subcision is a simple, safe procedure with a different and basic mechanism for correcting atrophic and depressed scars. Subcision releases scar surfaces from underlying attachments and induces connective tissue formation beneath the scar directly, without injury to the skin surface. Therefore, subcision is a valuable method, but due to high recurrence rate, its efficacy is mild to moderate. OBJECTIVES: To increase the efficacy of subcision, a new complementary treatment of repeated suction sessions was added at the recurrence period of subcised scars. METHODS: In this before and after trail, 58 patients with mild to severe acne scars of various types (rolling, superficial and deep boxcar, pitted), chicken pox, traumatic and surgical depressed scars were treated by superficial dermal undermining, with mainly 23-guage needles. The protocol for suctioning was: start of suction on third day after subcision for flat and depressing subcised scars and its continuation at least every other day for 2 weeks. RESULTS: Forty-six patients followed the protocol completely, had 60-90% improvement in depth and size of scars (significant improvement) with mean: 71.73%. 28.2% of them had '80% improvement or more' (excellent improvement). Twelve patients started suction late and/or had long interval suction-sessions, had 30-60% improvement (moderate improvement) with mean: 43.75%. CONCLUSION: Frequent suctioning at the recurrence period of subcision increases subcision efficacy remarkably and causes significant and persistent improvement in short time, without considerable complication, in depressed scars of the face. Therefore, subcision-suction method is introduced as a new effective treatment.

The effects of early isolation on sexual behavior and c-fos expression in naïve male Long-Evans rats.

Previous findings have demonstrated that the maternal environment is important for the development of male sexual behavior. The present study examined the effects of complete early life isolation and replacement 'stroking' stimulation on male sexual behavior and neural activation as seen by Fos immunoreactivity (Fos-IR). Animals were either artificially reared (AR) with minimal (AR-MIN) or maximal (AR-MAX) body simulation, or maternally reared (MR). In adulthood, animals were either given an exposure to an estrous female (EXP) or left undisturbed (NoEXP). No significant effects of early development were found in sexual behavior; however differences in activation in response to this exposure were observed. AR-MIN animals showed lower Fos-IR in the medial preoptic area and the ventromedial hypothalamus compared to MR animals. AR-MAX animals were not significantly different from either condition. These findings demonstrate that although there are no differences in the quality of the first copulatory exposure between AR and MR animals, the brain's response to this exposure differs in sites within the brain that subserve sexual behavior.

Monte Carlo Simulation of Electron Beams produced by LIAC Intraoperative Radiation Therapy Accelerator.

Background: One of the main problems of dedicated IORT accelerators is to determine dosimetric characteristics of the electron beams. Monte Carlo simulation of IORT accelerator head and produced beam will be useful to improve the accuracy of beam dosimetry. Materials and Methods: Liac accelerator head was modeled using the BEAMnrcMonte Carlo simulation system. Phase-space files were generated at the bottom of the applicators. These phase-space files were used as an input source in DOSXYZnrc and BEAMDP codes for dose calculation and analysis of the characteristic of the electron beams in all applicators and energies. Results: The results of Monte Carlo calculations are in very close agreement with the measurements. There is a decrease in the peak of the initial spectrum when electrons come from the end of accelerator wave guide to the end of applicator. By decreasing the applicator diameter, the mean energy of electron beam decreased. Using applicators and increasing their size, X-ray contamination will increase. The percentage of X-ray contamination increases by applicator diameter. This is related to the increase of the mean energy of electron beams. Conclusion: Application of PMMA collimator leads to, although well below accepted level, the production of bremsstrahlung. The results of this study showed that special design of LIAC head accompanying by PMMA collimator system cause to produce an electron beam with an individual dosimetric characteristic making it a useful tool for intraoperative radiotherapy purposes.

Fabrication of biodegradable Zn-Al-Mg alloy: Mechanical properties, corrosion behavior, cytotoxicity and antibacterial activities.

In this work, binary Zn-0.5Al and ternary Zn-0.5Al-xMg alloys with various Mg contents were investigated as biodegradable materials for implant applications. Compared with Zn-0.5Al (single phase), Zn-0.5Al-xMg alloys consisted of the α-Zn and Mg2(Zn, Al)11 with a fine lamellar structure. The results also revealed that ternary Zn-Al-Mg alloys presented higher micro-hardness value, tensile strength and corrosion resistance compared to the binary Zn-Al alloy. In addition, the tensile strength and corrosion resistance increased with increasing the Mg content in ternary alloys. The immersion tests also indicated that the corrosion rates in the following order Zn-0.5Al-0.5Mg

Quetiapine-associated cholestasis causing lipoprotein-X and pseudohyponatraemia.

A case of intrahepatic cholestasis secondary to treatment with quetiapine in combination with lamotrigine and zopiclone, resulting in severe hypercholesterolaemia without overt lactescence of the plasma, is presented. Abundant lipoprotein-X was seen on lipoprotein electrophoresis. The patient was diagnosed and treated for hyponatraemia which was likely factitious and caused by hypercholesterolaemia. Cholestasis and hypercholesterolaemia resolved over a period of several months after the discontinuation of quetiapine.