Prenatal Diagnosis of congenital diaphragmatic hernia improves the postoperative outcome: a local experience

To date, uniform standards for congenital diaphragmatic [CDH] management have not existed. This study was to compare infants with congenital diaphragmatic hernia [CHD] who had undergone a prenatal diagnosis to those who had not undergone such diagnosis. Sixteen infants with CDH who were admitted to the neonatal intensive care unit [NICU] of Suez canal university hospital from December 2000 to August 2004 were prospectively studied. They were classified into two groups; group I including 7 infants who were prenatally diagnosed as CDH by serial ultrasound scans. In group II: 9 infants were diagnosed as having CDH after birth with no prenatal diagnosis. Special care for respiration and resuscitation was performed for all patients in the two group according to a special resuscitation protocol. After stabilization and resuscitation, surgical intervention was done under special anesthetic care. The outcome of the morbidity and mortality in both groups were studied and statistically evaluated. The mean gestational age was 37. +/- 1.05 weeds in group I in contrast to 35.18 +/- 2.7 weeks in group II. [P=0.04] and the mean birth weight was 2.5 +/- 0.8 kg in group I in contrast to 2.1 +/- 1.3 in group II. All infants required mechanical ventilation. In group I, the mean gestational age at prenatal diagnosis was 26.5 weeks. The lung area head circumference ratio [LHR] ranged from 0.36 to 0.23. associated abnormalities in group I included ventricular septal defect, atrial septal defect, polyhydramnios, premature rupture of membrane and preterm labor. In group I, the overall survival rate was 4 patients out of 7 [57.1%] in group II, 2 infants out of 9 survived with a survival rate of 22.2% with a statistically significant difference. Prenatally diagnosed infants with CDH have a better survival rate and a less morbidity compared with those who have not undergone this diagnosis

Ultrastructural study of the autonomic innervation of the detrusor muscle in the wall of the urinary bladder of mice

Fifteen adult mice were used to study the fine structure of the intermuscular axon profiles in the urinary bladder of mice. Tissue samples were taken from the dorsal wall of the bladder and processed for examination in a transmission electron microscope. The muscle coat possessed an extensive plexus of nerve fibers, which were mostly motor in nature. Most of such motor nerves occurred as non-myelinated vesicle-packed axonal varicosities with a neurilemmal cell covering. Single axons were not infrequent. The vesicles were of two types, small agranular type and large with a dense central core one. The latter type occurred in relatively high numbers as the small clear vesicles. Such large granulated vesicles could be considered as the storage sites of neuropeptides in cholinergic nerve terminals

Ultrastructural identification of the basal-granulated cells in the duodenum of golden hamsters

The fine structure of the crypt epithelium of the duodenal mucosa in hamsters was studied to represent the types and distribution of the basal-granulated or endocrine cells. Fifteen male animals were used. Perfusion-fixation was made and samples of duodenal mucosa were taken and processed to prepare epon-embedded specimens for examination by a transmission electron microscope. Cells containing membrane-bound granules were seen in the crypt epithelium. They were identified to be basal-granulated cells. Six different types of such cells were demonstrated. All of the cells were of the closed type. The possible functional significance of these closed cell types was discussed. Correlation between the distributions of such cells in the intestine of hamsters might enable the physiologists, internists and other researchers to study several biologically active peptides with well established functions other than those which have long been investigated

Split thickness skin grafting plus dural closure in management of myelomeningocele

This study was designed to evaluate post operative and long term follow up wound healing after using two methods of repair [direct closure or covering by split thickness skin grafts. Long term follow up revealed a higher incidence of chronic skin ulceration the split-thickness skin graft group as compared with the primary closure group. All skin breakdowns appeared in the presence of C.S.F. leakage and or the presence of Gibbus deformity. A thoracic or thoracolumbar myelomeningocele repair with split thickness skin graft was more likely to be complicated by skin problems than the defects in the lumbar lumbosacral or sacral region. This relationship was secondary to the frequency of gibbus deformity in the more cephalad defects than caudal defects

Pathological study of clinically diagnosed benign breast masses

120 female patients presented to Al Azhar University Hospital with a lump in the breast which was diagnosed as a benign mass on clinical examination. All masses were sent for histopathological examination, the incidence of malignancy in the clinically diagnosed benign masses was 12.5%. Fibroadenomas were the commonest masses encountered in the study and forms 47.5%, fibrocystic disease was the second infrequency and from 30% of the cases. Malignant lesions were the third infrequency and form 12.5% of cases followed by non specific mastitis which forms 5% of cases, there was 2 cases of glactocele and 2 cases of duct ectasia, 2 cases cytsoarcompaphylloids. and one case of intraduct papilloma