Urinary bladder auto augmentation using INTEGRA® and SURGISIS®: an experimental model

Objective

We present our experience with an experimental urinary bladder auto augmentation model using SURGISIS^® and INTEGRA^® (collagen layer) in comparison with seromuscular enterocystoplasty. The aim of the study was to evaluate the change in compliance and elasticity of the urinary bladder.

Materials and methods

Eighteen lambs were divided into three different groups. Auto augmentation was performed using the seromuscular layer of small bowel, SURGISIS^® or the collagen layer of INTEGRA^®. After 3 months of the initial procedure, the lambs were re-operated, the bladder compliance was measured and the urinary bladder was submitted for histological examination and assessment of elasticity. The lambs were euthanized.

Results

The postoperative period was uneventful in 17 lambs except for intestinal obstruction in one lamb from the seromuscular enterocystoplasty group. A statistically significant difference in compliance was observed with SURGISIS^® and the INTEGRA^®. Histologically, there was neovascularization in all the specimens from the SURGISIS^® and INTEGRA^® groups with the presence of fibrosis in the SURGISIS^® group. The INTEGRA^® group showed better elastic properties than the SURGISIS^®.

Conclusions

Urinary bladder auto augmentation using the collagen layer of INTEGRA^® showed better functional and histological results when compared with SURGISIS^® and demucosalized enterocystoplasty in the present model.     

Factors determining the clinical outcome of acute variceal bleed in cirrhotic patients

Variceal bleed is a severe complication of portal hypertension. We studied the predictors of failure to control variceal bleed and re-bleed in patients with cirrhosis. We reviewed the case records of 382 consecutive patients admitted with variceal bleed from January 2001 to December 2005. Diagnosis of cirrhosis was made on clinical, laboratory, and radiological parameters. Acute variceal bleeding, failure to control bleed, and re-bleeding were defined according to Baveno III consensus report. Failure to control bleed was observed in 39 (10.2%) patients while in hospital re-bleed occurred in 49 (12.8%) patients. Thirty-four patients died. Diabetes was present in 148 (39%) patients. On multivariate logistic regression analysis, predictors of failure to control bleed were presence of diabetes mellitus and active bleeding at the time of endoscopy; predictors of in-hospital re-bleed were diabetes mellitus and serum bilirubin >3 mg/dL. Diabetes mellitus, active bleeding at endoscopy and bilirubin >3 mg/dL are bad prognostic factors for initial control of variceal bleed, and recurrent bleed in patients with cirrhosis.     

Acquired immune deficiency syndrome (AIDS) presenting as a nasal septal perforation.

Patients infected with the Human Immunodeficiency Virus (HIV) and those with AIDS may present with many head and neck manifestations. We report a case of an undiagnosed HIV positive male who presented with symptoms due to a nasal septal perforation, and rapidly developed AIDS. The histopathology of the perforation margins revealed active chronic inflammation with no evidence of neoplasia or granuloma. No viral or fungal infection was demonstrable on immunological testing and fungal stain. This is the first reported case of a patient developing AIDS presenting with a nasal septal perforation.     

Mechanism of formation of concentrically laminated spherules: implication to Randall’s plaque and stone formation

We report on the formation of calcium phosphate multi-laminated spherules via a polymer-induced liquid-like precursor (PILP) process. In this non-classical crystallization route, the precipitation of liquid-like amorphous calcium phosphate (ACP) particles is promoted using anionic polypeptide additives, and these droplets coalesce to form globules that later crystallize into spherulites. During crystallization of the amorphous globules, the polymer additive, as well as the waters of hydration, is excluded ahead of the crystallization front, but some polymer becomes entrapped within diffusion-limited zones. This results in the formation of concentric laminations with layers of variable density from organic-rich inclusions. The striking resemblance of these spherules with the crystals of the Randall’s plaque and other laminated stones suggests that such biological structures may form via an amorphous precursor process as well. Given the organic-rich environment present in the urinary tract, one might expect a large amount of organic materials to become entrapped within the stratified zones of a forming stone during this type of solidification and transformation process. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users. 11th International Symposium on Urolithiasis, Nice, France, 2–5 September 2008. Urological Research (2008) 36:157–232. doi: .     

Evaluation of Dentinal Tubule Penetration after the Use of Dentin Bonding Agent as a Root Canal Sealer

IntroductionThe purpose of this study was to compare the effectiveness of Excite DSC (Ivoclar Vivadent, Schaan, Liechtenstein), a dentin bonding agent, with AH-26 (Dentsply, Detrey, Germany) as a root canal sealer by evaluating the penetration depth into the dentinal tubules and the tag density of the two compounds.MethodsForty-two extracted, single-rooted premolars were prepared and randomly obturated with either Excite DSC (n = 20) or AH-26 (n = 20). Two teeth were filled without sealer and used as controls. Randomly, one half of the specimens in each group (n = 10) was sectioned 3 days after obturation (short-term), and the other half (n = 10) was sectioned after 3 months (long-term). The specimens were sectioned perpendicular to the long axis in two regions and prepared for observation using scanning electron microscopy.ResultsIn the short-term evaluation, the mean penetration depth of AH-26 in the apical sections (520.48 μmol/L) was significantly higher than that of Excite DSC (0.00 μmol/L). In the long-term evaluation, AH-26 exhibited a significantly greater depth of penetration in both the apical (797.74 μmol/L) and middle sections (1162.11 μmol/L) than Excite DSC (321.43 μmol/L and 657.72 μmol/L, respectively).ConclusionAH-26 showed more dentinal tubule penetration depth than Excite DSC in both evaluation periods.     

A prospective study of different test targets for the near point of convergence

Purpose: To determine whether different test targets including an accommodative target (AT), a transilluminator (TR), and a transilluminator with a red lens (RL), affect the near point of convergence (NPC) value; and to determine which test target is most sensitive to identify convergence insufficiency (CI) in young adults. Methods: Subjects were 36 optometry students from the Illinois College of Optometry, including 18 subjects with normal binocular vision (control group) and 18 subjects with CI. None of the subjects had accommodative insufficiency. The NPC break and recovery were measured by three methods: AT, TR, and RL. Each test method was administered by a different examiner and the test sequence was randomized. Results: The mean NPC break values for AT, TR, and RL in the control group were 4.31, 3.76, and 4.08 cm respectively, compared to 10.05, 11.37 and 13.04 cm in the CI group. The mean recovery values were 6.23, 5.56, and 5.95 cm for AT, TR, and RL respectively in the control group, vs 12.21, 14.37, 16.40 cm in the CI group. Significant differences in NPC break and recovery values were detected in the CI group between RL and AT, but not between AT and TR, or TR and RL. There was no significant difference in NPC values using the three targets in the control group. For an NPC cut point of 6 cm (break) and 9 cm (recovery), RL had higher sensitivity (100%) and specificity (88.9%) as well as lower false positive (10%) and false negative (0%) values compared to AT. Conclusion: NPC with RL is a more sensitive method to identify abnormal findings and assist in diagnosing CI compared to using AT or TR. We recommend that NPC with RL be routinely used to evaluate patients suspected of having CI.     

Comparison of electrocardiographic parameters and serum electrolytes and microelements between single infection of rotavirus and coronavirus and concurrent infection of Cryptosporidium parvum with rotavirus and coronavirus in diarrheic dairy calves

To study the effects of concurrent infection of Cryptosporidium parvum with rotavirus and coronavirus in comparison to single infection of rotavirus and coronavirus, electrocardiographic parameters and serum electrolytes and microelements are compared between eight calves with concurrent infection and ten calves with single infection. Calves with single infections had higher serum concentrations of sodium and calcium, and less potassium, copper, and iron, which was not statistically significant. They also had significantly shorter P and QRS wave amplitudes and longer T wave duration in electrocardiogram patterns.