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Objective To evaluate the feasibility and clinical efficacy of intraperitoneal laparoscopic partial nephrectomy for T1a peripheral renal neoplasms. Methods Intraperitoneal laparoscopic partial nephrectomy was performed without renal artery occlusion for T1a peripheral peripheral renal neoplasms. The operative time, bleeding volume and complications were observed and the clinical experience was summarized. Results From October 2014 to January 2017 ,there were 10 patients:7 males and 3 females. All patients had T1a peripheral renal tumors. 10 patients underwent operation successfully ,of which 1 case developed temporarily blocked renal artery in the surgery due to hemorrhage. There was no referral during surgeries. The operative duration was 108 to 210 min,with a median of 135 min. The estimated blood loss was 100 to 750 mL,with a median of 320 mL. Followed up duration was 2 to 24 months (median 12 months),there were not postoperative renal secondary bleeding , leakage and other complications. No recurrence of tumor was found. Conclusion It is feasible and safe to exercise intraperitoneal laparoscopic partial nephrectomy without renal artery occlusion in the treatment of T 1a peripheral renal tumors,which can protect renal function to the greatest extent.
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Objective To evaluate the efficacy and safety of intradetrusor injection of botulinum toxin type A in the treatment of ketamine-related cystitis.Methods A retrospective analysis of clinical data of 36 ketamine-related cystitis patients with intradetrusor injection of botulinum toxin type A treatment in our hospital during August 2010 to December 2015 was conducted, including 31 males and 5 females with a mean age of 25.5 years.All patients had failed to conventional treatment options including cessation of ketamine, antibiotics, M-blockers.At the time of the first injection, patients were injected with 200 U botulinum toxin type A diluted in 15 ml of 0.9％ saline into the detrusor muscle at 30 sites, sparing the trigone, under cystoscopic guidance.3-d voiding diary, interstitial cystitis symptom index (ICSI),interstitial cystitis problem index (ICPI), pelvic pain and urinary frequency/urgency symptom score (PUF) were recorded to evaluate the efficacy.The treatment-related complications were recorded.When the efficacy of botulinum toxin type A decreased and the patient's symptoms returned to baseline before treatment, the patient received repeated injections of botulinum toxin type A with the same dose and method as the first injection.Results Thirty-six patients with ketamine-related cystitis were treated with intradetrusor injection of botulinum toxin type A.Sixteen patients received two injection treatments and two patients received three injection treatments.During the follow-up, 3-d urinary diaries, ICSI, ICPI, and PUF showed a significant improvement in outcome at 4 weeks after the first injection.The efficacy of the second and third injection treatment was also remarkable.Three patients developed urinary tract infection after the first injection, and two patients developed urinary tract infection after the second injection.Mild hematuria occurred in 15 patients after the first injection, and mild hematuria occurred in 7 patients after the second injection, which was improved in 1 to 2 days.All patients did not appear acute urinary retention and other adverse drug reactions.Conclusions Intradetrusor injection of botulinum toxin type A could be a safe and effective method for the treatment of ketamine-related cystitis.Repeated injection therapy is still safe and effective.
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Objective To develop a clinical nomogram for predicting the probability of bladder outlet obstruction (BOO) in male LUTS/BPH using the most common and noninvasive parameters in clinical practice , with the hope of detecting BOO individually and precisely. Methods Retrospectively analyze the outpatients and inpatients of male LUTS/BPH from November 2003 to November 2015 in Guangzhou First People′s Hospital. Collect the Pressure-flow study parameters and other clinical parameters including Qmax , PV, TZV, TZI, PSA, and PVR. Find out the best independent predictors on the diagnosis of BOO and develop the nomogram for pre-dicting BOO. Results The data from 1 599 patients were analyzed. The areas under the ROC curve (AUCs)of PV, TZV, TZI, PSA, Qmax, and PVR were 0.803, 0.807, 0.698, 0.775, 0.742, and 0.641, respectively. Qmax, PV, and PSA were selected as the best clinical parameters to predict BOO. The Logistic regression equa-tion is Log(p)=0.332 4 - 0.201 8*Qmax + 0.026 6*PV + 1.135 1*PSA. Finally, a nomogram model was developed by R statistical software. This nomogram showed a concordance index of 0.854 according to the inter-nal validation of the model. Conclusions The clinical nomogram presented a high accuracy (85.4%) in de-tecting BOO, which would help predicting BOO in male LUTS/BPH noninvasively, individually, accurately, and providing valuable reference and guidance in clinical decision.
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Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.
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Objective: To investigate the ultrastructural pathogenesis of retina injury by observing the ultrastructural changes under the transmission electron microscope(TEM) after ocular blast injury in rabbits.Methods: Ocular blast injury models were set up in 20 rabbits by the bow wave produced with a bioshock tube.The rabbits were sacrificed at scheduled times after injury,their retinas obtained and their ultrastructural changes observed by TEM.Results: The axonal ultrastructural changes of the retina induced by blast were summarized as follows.The microfilaments and microtubules were swollen and distorted in the early stage,followed by reactive swelling of the ganglion cells.The swollen mitochondria and endoplasmic reticula focally accumulated and the cytoskeleton was destroyed.Finally the intraaxonal cellular structure disappeared and the axon disconnected.Conclusion: Ocular blast injury may cause retinal ultrastructural changes.The pathological changes of ganglion cells in the optic nerve may be associated with the direct effect of the blast and/or ischemia and are possibly important factors in the pathogenesis of vision disturbance.
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Objectives: To reveal the morphological features of the stratum corneum lipids in hairless mouse epidermis. Methods: Ruthenium tetroxide and osmium tetroxide were compared as post fixative in the preparation of hairless epidermis for transmission electron microscopic examination. Results: Both reagents reveled characteristic membrane coating granules within the granular layer. Whereas, the transformation of the membrane coating granule contents into multiple lamellae at the interface between the granular and cornified layers and the persistence of these lamellae through all levels of the stratum corneum were demonstrated only by ruthenium tetroxide fixation. Conclusions: The distinctive patterning of the intercellular lamellae reflects the nonrandom organization of the stratum corneum lipids. In addition, the ruthenium tetroxide postfixation technique is a useful method in the investigation of the morphological features of the stratum corneum lipids.
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Stratum corneum,the outermost layer of the mammalian skin, has its unique structural,biophysical and biochemical characteristics.The form of stratum corneum is a continuous sheath of protein-enriched corneocytes embedded in an intercellular matrix enriched in nonpolar specialized lipids.It provides an impermeable barrier from exogenous noxious substances and prevents the body from transdermal water loss.Recent researches suggest that its morphological and functional abnormalities can be induced by various environmental effects such as ultraviolet radiation,mechanical friction,organic solvents,etc.However,the mechanism of the injury-repair process remains unclear.Several cytokines and ceramide may be involved in the regulation.
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50%) in the objective findings and/or subjective symptoms in both patients.In case 1 and case 2,the frequency of daily urination decreased by 7.3% and 34.3%,the volume of urination increased by 118.2% and 65.7%,the degree of urgent urination declined by 72.0% and 68.1%,respectively.Then they received permanent electrode and neurostimulator implantation and the improvement remained significant.They were followed up for 26 and 17 months,respectively,and no significant complications were found. Conclusions SNN is a micro-invasive,effective,and safe therapy for chronic voiding dysfunction.It may also be effective for some neurogenic dysfunctions of the bladder and urethra.
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BACKGROUND: Stratum corneum lipids are arranged as intercellular membrane bilayers presumed to mediate the epidermal permeability barrier. Acute disruption in barrier function will initiate epidermal lipid synthesis, which can be prevented by occlusive membrane. Whereas, occlusion of the skin is known to cause an increased transepidermal water loss(TEWL) and enhanced percutaneous absorption of a variety of compounds. OBJECTIVE: Previous reports with electron microscopy showed varying sizes of lacunae and disorganized intercorneocyte lipids after tape stripping and occlusion with a water impermeable membrane on the murine skin. Hence we studied the effects on stratum corneum lipids and changes in barrier function after occlusion with a water-impermeable membrane. METHODS: Male hairless mice were occluded with one finger of a Latex glove for 24, 48 and 60 hours. After occlusion, TEWL was measured and biopsy specimens were taken from skin. For electron microscopic examination the samples were treated with osmium tetroxide, ruthenitum tetroxide, and tracer (lanthanum) and infrared spectroscopy were also applied. RESULTS: Occlusion with a water-impermeable membrane on the skin induced higher TEWL Values and greater penetration of the tracer than normal. Alterations of the lipid bilayer membrane and lacunae forwation in the stratum corneum interstices were also induced after 24 hours of occlusion. However, the orderness of the lipid alkyl chain in the stratum corneum was not changed until 60 hours of occlusion. CONCLUSION: These studies indicate that the increased epidermal permeability after occlusion may be due to the abnormal lipid membrane structures and volume expansion of existing lacunar domains in the stratum corneum interstices.
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Animals , Humans , Male , Mice , Biopsy , Fingers , Lanthanum , Latex , Lipid Bilayers , Membranes , Mice, Hairless , Microscopy, Electron , Osmium Tetroxide , Permeability , Skin , Skin Absorption , Spectrum Analysis , WaterABSTRACT
BACKGROUND: The stratum corneum(SC) has a permeability barrier function which regulates percutaneous absorption by the inhibition of transepidermal water loss(TEWL). Acute mechanical or chemical disruption of the SC induces the impairment of the permeability barrier and so increases the TEWL. The calciumtion has been recognized as an important ion in the recovery of the skin barrier. Recently the main delivery pathway of iontophoretic drugs have been suggested by SC interstices. However the morphologic changes in the SC interstices and calcium after iontophoresis have not been reported. OBJECTIVE: The aim of our study is to confirm that iontophoresis may induce changes in the SC interstices and delay the recovery of the barrier after disruption. MATERIALS AND METHODS: After tape stripping the hairless mouse flank skin, the iontophoresis power supply (6V, 0.6mA) was connected to the patch atiached for 2.5 hours to the stripped site. We checked the THWL 0, 2.5, 6, 12, 18, 24 hours after the tape stripping and obtained specimens and performed osmium tetroxide, ruthenium tetroxide postfixation and calcium ion-capture cytochemical stains for electron microscopic study. RESULTS: The recovery rate of the TEWL in iontophoresis was lower than in the control. This was especially so in the anouse which had received anode iontophoresis for 6 hours. It showed statistically lower TEWL than in the control(p<0.05). Anode iontophoresis induced low calcium in stratum granulosum (SG), but cathode iontophoresis induced high calcium in SC. After iontophoresis there were changes in the SC interstices structures. CONCLUSION: Iontophoresis can induce changes in the SC interstices and calcium distribution and so may help the topical drug delivery system.
Subject(s)
Animals , Mice , Calcium , Coloring Agents , Drug Delivery Systems , Electric Power Supplies , Electrodes , Iontophoresis , Mice, Hairless , Osmium Tetroxide , Permeability , Ruthenium , Skin , Skin AbsorptionABSTRACT
Objective To investigate the effect of all-trans retinoic acid on the change in intracellular glycogen in ovarian epithelioma cell line in vitro and ovarian epithelial carcinoma in nude mice in vivo. Methods COC2 cells were treated with all-trans retinoic acid in 1, 5, 10 and 30?mol/L drug concentrations for different length of time, and then intracellular glycogen and LDH were determined by biochemistry assay. Morphologic changes were observed with light and electron microscopy. CAOV3 tumor-bearing nude mice were treated with intragastric injection of the same drug in a dose of 2mg/(kg?d) for four weeks. The tumor samples were harvested thereafter for pathological study with histochemical and immunohistochemical staining, and also with electron microscopy. Results Intracellular glycogen was significantly increased, while LDH level was lowered after the cell line was treated with 5~10?mol/L of all-trans retinoic acid, and apoptosis of cancer cell occurred after using 30?mol/L of the drug. These changes were also observed in CAOV3 cells of tumor-bearing nude mice. Conclusion Our results suggest that treatment with all-trans retinoic acid resultin an increase in intracellular glycogen and decrease in LDH level both in COC2 cells in vitro and in CAOV3 tumor-bearing nude mice in vivo, and the suppression of tumor cell proliferation may be attributed to retarded intracellular metabolism.
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Objective To delineate the epidermal calcium ions distribution in normal and acetone-treated nude mouse skin. Methods acetone was applied on the nude mouse skin for 20*!min with cotton balls. The ion capture cytochemistry, i.e., the potassium oxalate-pyroantimonate method was employed to localize calcium ions in nude mouse epidermis for ultrastructural examination. Results Ultrastructural examinations demonstrate that abundant calcium ions displayed within the epidermis, with a low content of calcium in the basal and spinous layers, followed by a progressive increase with calcium content and reaching its maximal density within the outer stratum granulosum. Whereas, application of acetone to the nude mouse skin caused the loss of the epidermal calcium gradient.Conclusion The present results suggest that a calcium gradient exists within normal murine epidermis. Moreover, the ion capture cytochemistry is a potentially powerful investigative tool for the demonstration of epidermal ionic environment.