Transurethral drainage of prostatic abscess: points of technique

The incidence of prostatic abscess [PA] has markedly declined with the widespread use of antibiotics and the decreasing incidence of urethral gonococcal infections. To evaluate different treatment methods for prostatic abscess and to describe technical points that will improve the outcome of transurethral [TUR] drainage of pro-static abscess. We performed a retrospective study of a series of 11 patients diagnosed with prostatic abscess, who were admitted and treated in Farwaniya Hospital, Kuwait, between February 2008 and November 2010. Drainage was indicated when antibiotic therapy did not cause clinical improvement and after prostatic abscess was confirmed by TRUS [Transrectal ultrasonography] and/or CT computed Tomographyscan. TUR drainage was indicated in 7 cases, ultrasound-guided transrectal drainage was performed in 2 cases, and ultrasound-guided perineal drainage was performed in 2 cases. All patients that underwent TUR-drainage had successful outcomes, without the need of secondary treatment or further surgery. TUR drainage of a prostatic abscess increases the likelihood of a successful outcome and lowers the incidence of treatment failure or repeated surgery. Less invasive treatment, with perineal or transrectal aspiration, may be preferred as a primary treatment in relatively young patients with localized abscess cavities

Effect of major burn on immunophenotype of peripheral blood T lymphocytes

The immunosuppressive effect of a major burn has been known for many years. However, a complete understanding of the effects of a burn on the immune system remains elusive. Lymphocytes immunophenotype is a reflection of the functional level of immune system. There is little knowledge concerning the expression of HLA-DR on peripheral blood [Pb] T lymphocytes. T lymphocytes of 26 major burn [25-40%] patients were analyzed in 24 hours, 1 week and 2 weeks after burn, using, monoclonal antibodies of CD3, CD4, CD8, CD25 [IL2R,] and HLA-DR by flow cytometry and comparing them with those of26 apparently healthy donors. There was statistically significant reduction in absolute number of CD3 [p<0.0001], CD4/CD8 ratio [p=0.01] in the first 24 h in comparison with controls. CD25 [IL2R] shows insignificant upregulation on T lymphocytes after burn with significant upregulation of HLA-DR. The absolute number of CD3[+] cells began to increase after 2 weeks [p=0.03]. but still reduced than controls [p=0. 08,]. CD4/CD8 ratio was more or less as healthy control after 2 weeks. Upregulation of CD25 was insignificantly increased and that of HLA-DR were marked increased after 2 weeks. The absolute number CD25 and HLA-DR[+] T lymphocyte subsets all over the time of the study are low than controls except that of HLA-DR[+] T lymphocytes after 2 weeks [p=0.009]. The data obtained suggest persistent activation of T lymphocytes 2 weeks post major burns. HLA-DR expression can reflect post burn lymphocyte activation

Clinical and pathological assessment of different suture techniques for microvascular anastomosis in rat femoral artery

This study examined the clinical and pathologicalfeatures after a microvascular anastomosis of a ratfemoral artery using four different suture techniques.Sixty Sprage-Dawely rats were divided randomly into 4groups. Fifteen bisected arteries (one from each animal) inGroup I, II, III and IV were sutured with the simpleinterrupted suture, continuous suture, sleeve suture andcuff suture, respectively. The anastomosis times in GroupI, II, III and IV were 28.67, 14.67, 15.47 and 15.93 min,respectively. Immediate bleeding that stopped withoutintervention (grade I) was observed in 67%, 73% and60% of the anastomosed vessels in Groups II, III and IV,respectively, while 60% of the vessels in Group I showedlight bleeding that was inhibited by gentile pressure(grade II). All vessels examined appeared to be patent at 5and 15min after the anastomosis. On the 7th daypostoperatively, the vessels of Group I showed the highestpatency rate (93%) compared with Groups II (67%), III(73%) and IV (87%). Moreover, there were morepronounced pathological changes in Group I than in theother groups. These changes included endothelial loss,endothelial proliferation, degeneration and necrosis of thetunica media. Suture materials surrounded by aninflammatory reaction were also observed. In conclusion,the simple interrupted suture is preferable formicrovascular anastomosis due to its highest patency rate.The other techniques investigated can be good alternativesbecause of their short anastomotic time and moderatepathological changes.

Diagnostic value of endoscopy and radiology in chronic maxillary sinusitis

The article aimed at demonstrating the diagnostic significance of the endoscopy of the maxillary sinus. It correlates the radiographic with the endoscopic findings in case of chronic maxillary sinusitis. For this purpose 30 patients with frank chronic maxillary sinusitis clinically were picked up. Another 5 normal cases were taken as a control group. Both were examined radiologically and endoscopically. False negative and positive results were found

Schistosomal colonic polyposis and ulcerative colitis with variable thickening of the subepithelial collagen layer: a possible resemblance to collagenous colitis

The clinical and histopathological features of schistosomal colonic polyposis and ulcerative colitis were studied in 32 and 7 patients, respectively. Schistosomal patients presented with bleeding per rectum in 100% of dysentery in 75%, liver enlargement in 100%, splenic enlargement in 80%, schistosomal mass in 42% and nail clubbing in 31%. While ulcerative colitis patients presented with abdominal cramp in 71% and recurrent bleeding per rectum in all of the cases. Sigmoidoscopy and barium enema detected schistosomal colonic polyposis in the rectum in 31% of cases, rectosigmoid in 43% and in descending colon in 20% of patients. The same procedures done for ulcerative colitis patients showed mucosal changes and superficial ulceration in all cases; loss of haustrations in 70% of patients. From the histopathological point of view, schistosomiasis simulated collagenous colitis in many of its features as increase in the mean thickness of subepithelial collagen layer, absence of generalized crypt damage, mild lymphocytic infiltration of crypt epithelium and the presence of some autoimmune manifestations in schistosomiasis. Cases showing no schistosomal egg in the stools showed on electron microscopy remnants of schistosomal egg shells and shreds of teguments inside the lysosomes of macrophages lying in the lamina propria. Thus, electron microscopy served as an augmented diagnostic tool