Varicocelectomy with primary gubernaculum veins closure: A randomised clinical trial.

To evaluate the effect of microsurgical inguinal varicocelectomy with testicular delivery on semen parameters. A total of 416 patients, diagnosed with grade III varicocele, were randomised into two groups. One group underwent microsurgical inguinal varicocelectomy without testicular delivery. For the other group, testicular delivery and ligation of gubernacular and all collateral veins were performed. A semen analysis was performed before and 6 months after the procedure. Mean age of the patients in the case and control groups was 27.3 ± 6.1 years and 25.9 ± 4.6 years respectively (p = .1). The total number of recurrence after 6 months in the conventional and testicular delivery groups was 13 (6.5%) and 3 (1.5%) (p < .05). No case of hydrocele formation was observed in any of the groups. All sperm parameters were improved 6 months after the surgery in both groups. But comparing the mean improved difference between the two groups revealed a significant difference in improvement in sperm motility for patients who had undergone varicocelectomy with testicular delivery (p = .05). Microsurgical inguinal varicocelectomy is a safe and efficient technique with a minimum chance of post-operative complications and recurrence and also may have role in improvement of sperm motility compared with conventional techniques.

Functional ultrasound imaging of the human spinal cord.

Utilizing the first in-human functional ultrasound imaging (fUSI) of the spinal cord, we demonstrate the integration of spinal functional responses to electrical stimulation. We record and characterize the hemodynamic responses of the spinal cord to a neuromodulatory intervention commonly used for treating pain and increasingly used for the restoration of sensorimotor and autonomic function. We found that the hemodynamic response to stimulation reflects a spatiotemporal modulation of the spinal cord circuitry not previously recognized. Our analytical capability offers a mechanism to assess blood flow changes with a new level of spatial and temporal precision in vivo and demonstrates that fUSI can decode the functional state of spinal networks in a single trial, which is of fundamental importance for developing real-time closed-loop neuromodulation systems. This work is a critical step toward developing a vital technique to study spinal cord function and effects of clinical neuromodulation.

Comparison of surgical outcomes and cosmetic results between standard and mini laparoscopic pyeloplasty in children younger than 1 year of age.

OBJECTIVE: To evaluate safety, efficacy, and cosmetic results after mini laparoscopic (mL) pyeloplasty and standard (sL) pyeloplasty in children younger than 1 year of age with ureteropelvic junction obstruction (UPJO). MATERIALS AND METHODS: From August 2009 to March 2011, 20 sL pyeloplasties were performed in pediatric patients younger than 1 year of age; afterwards, 20 patients younger than 1 year of age underwent mini laparoscopic (mL) pyeloplasty from June 2011 to August 2012. The patients were followed by urine culture and ultrasonography at 3 and 6 months after surgery. Cosmetic appearance was assessed in all patients in both groups group 3 months after surgery using the Patient Scar Assessment Questionnaire. RESULTS: Peri and postoperative results revealed that operative time (total and anastomosis of ureteropelvic junction), hospital stay, and overall complication rate were significantly lower in mL than in sL. Persistent hydronephrosis in follow-up imaging and recurrence of obstruction was not observed in any cases. Mean appearance score and consciousness score showed significantly better results in the mL group. CONCLUSION: We believe that mL pyeloplasty in infant cases with UPJO is more cosmetically pleasing and less invasive than sL pyeloplasty and has similar functional outcomes.

Long-term outcome of renal transplantation in patients with familial Mediterranean fever amyloidosis: a single-center experience.

INTRODUCTION: Familial Mediterranean fever (FMF) is an autosomal-recessive disorder, affecting multiple organs. The AA type of amyloidosis is most common and serious complication cause nephropathy and end-stage renal disease (ESRD). Renal transplantation (RTX) remains treatment of choice for ESRD. We aimed to investigate long-term results of RTX in patients with FMF amyloidosis. PATIENTS AND METHODS: We compared the outcomes of 18 patients (12 men and 6 women) with FMF amyloidosis among 601 (2.9%) transplants with 200 control patients. Demographic data and gene analysis were evaluated. RESULTS: In our study the 1-year graft and patient survivals were 94.44% and 100%, respectively. At 5 years after RTX, they were 94.73% and 88.88%, respectively, in the FMF group without difference from controls. Mean creatinine level at 1 and 5 years were 1.43 ± 0.54 and 1.73 ± 0.89, respectively. The results of MEFV mutation analyses were: M694V/M694V homozygote in 1 patient, M694V/EQ148 in 3, M694V/V726A in 2, 680M-I/E148Q in 3, M694V/M680I in 5, R202Q/M680I in 2, and M694V/R202Q in 2. Recurrence was noticed in 1 patient with M694V/M680I. One patient died because of graft loss and cardiac complications with M694V/M680I gene analysis. Colchicine was reduced in 4 patients owing to side effects. CONCLUSION: Long-term outcomes of transplantation in patients with amyloidosis secondary to FMF is similar to that in the general transplant population and maintenance colchicine, even after decreasing its dose, effectively prevents recurrence of amyloidosis in the allograft.

Effects of Papaver rhoeas (L.) extract on formalin-induced pain and inflammation in mice.

Stress amelioration can improve its metabolic as well as other side effects. In the present study, the effects of hydro-alcoholic extract of Papver rhoeas (L.) on formalin-induced pain and inflammation were investigated in male Swiss-Webster mice (20-25 g). Formalin injects in the plantar portion of mice hind paw and pain was studied for 60 min. The plant extract and other drugs were administered intraperitoneally 30 min before formalin. Experiments showed that administration of extract (25, 50 and 100 mg kg(-1)) could induced analgesia in a dose-response manner in both phases of formalin test. More over, the extract inhibits inflammation induced by formalin injection. Naloxone (4 mg kg(-1)), dextromethorphan (20 mg kg(-1)) and NG-nitro-L-arginine-methylester (L-NAME; 10 mg kg(-1)) reduced the extract analgesia in first but not late phase. Extract administration also increased plasma corticosterone level in dose-dependent manner. It could be concluded that Papaver rhoeas (L.) extract could inhibits acute phase of formalin test in mice by opioidergic, glutamatergic and nitricergic mechanisms. In addition, the extract can induce corticosterone plasma level which may be responsible for inhibition of inflammation and chronic phase of pain induced by formalin.

Determination of lead and cadmium content in sausages from Iran.

The contents of lead and cadmium in five major brands of six types of cooked beef sausages consumed in Iran were determined by a graphite furnace atomic absorption spectrometer (GFAAS) after hydrogen peroxide/nitric acid digestion. The metal content in the samples, expressed in µg kg(-1) wet weight, varied from 24.0 to 158.7 with an average of 53.5 for lead and from 2.2 to 13.5 with an average of 5.7 for cadmium. The highest lead and cadmium concentrations were obtained from a German sausage (158.7 µg kg(-1); brand B) and hot dog (13.5 µg kg(-1); brand D), respectively. The results indicate that the sausages from Iran have concentrations below the permitted levels for these heavy metals. The daily dietary intakes and the percentage contribution of the two considered metals to the provisional tolerable weekly intake (PTWI) were calculated for sausages.

Dissociative electron attachment to gas-phase glycine.

By using a high-resolution electron energy monochromator low-energy electron attachment to gas-phase glycine (H2NCH2COOH, or G) has been studied by means of mass spectrometric detection of the product anions. In the same way as for several other biologically relevant molecules no stable parent anion was formed by free electron attachment. The largest dissociative electron attachment (DEA) cross-section, approximately 5x10(-20) m2, was observed for (G-H)-+H at an electron energy of 1.25 eV. Glycine and formic acid (HCOOH) have several common features, because a precursor ion can be characterized by electron attachment to the unoccupied pi* orbital of the -COOH group. At higher incident electron energies several smaller fragment anions are formed. Except for H-, which could not be observed in this study, there was good agreement with an earlier investigation by Gohlke et al.

Racial differences in ischemic cerebrovascular disease.

PURPOSE: To evaluate racial differences in extracranial carotid atherosclerosis and vascular risk factors in patients with symptomatic cerebrovascular disease. BACKGROUND: There are conflicting data on racial differences in certain vascular risk factors and prevalence of large-vessel versus small-vessel disease in patients with stroke. METHODS: We prospectively studied 211 consecutive patients admitted to our stroke service. There were 71 African-American, 114 Caucasian, 20 Hispanic, and 6 other patients. Extracranial vascular stenosis was assessed with a carotid duplex (CD) scan. Risk factors monitored included race, age, history of hypertension (HTN), diabetes mellitus (DM), prior stroke, hyperlipidemia, smoking, cardiac disease (congestive heart failure, atrial fibrillation), and family history of stroke. Cholesterol and triglyceride blood levels, and computed tomography/magnetic resonance imaging results were obtained in most cases. RESULTS: Significant differences were found between Caucasians and African-Americans in several variables. Caucasians had more frequent hypertriglyceridemia and a higher rate of cardiac disease. African-Americans had more frequent lacunar infarcts. There was a trend toward decreased risk of CD scan abnormality, and more HTN and prior stroke in African-Americans. There were no differences in the presence of DM, both HTN and DM, abnormal cholesterol (including high- and low-density lipoprotein) values, and smoking history. Except for the difference in lacunar infarction, there were no differences in the type of stroke. CONCLUSIONS: Our data indicate a greater risk of cardiac disease and hypertriglyceridemia in Caucasians with cerebrovascular disease. There was a trend for Caucasians to have more extracranial carotid disease, and a trend for African-Americans to have more hypertension and prior stroke, although the difference did not reach significance. Consistent with prior racial studies, we found African-Americans to have more lacunar strokes than Caucasians.

Acyclovir in the treatment of recurrent respiratory papillomatosis: a preliminary report.

INTRODUCTION: In this study, we evaluate the effect of acyclovir in the treatment of recurrent respiratory papillomatosis (RRP), in addition to CO2 surgery. MATERIALS AND METHODS: We include 12 patients who had aggressive RRP and required at least three prior endoscopic surgeries in this study. Acyclovir treatment started the day after the surgery. During the planned treatment period of 6 months, patients older than 5 years were asked to take the daily dose of 800 mg, and those younger than 5 years were asked to take 400 mg. RESULTS: Nine of 12 patients were disease free during the follow-up periods, which ranged from 14 to 25 months with a mean of 18 months. Only 3 patients who used the drug inadequately required reoperation. CONCLUSION: Because of the specific viral origin of RRP, we hope that addition of acyclovir to surgery will preclude or at least decrease the number of recurrences in this potentially fatal disease.