A microsurgical approach to post-traumatic penile amputation: Towards standardizing the technique - A case report.

INTRODUCTION: Penile amputation is an unusual situation reported globally as isolated cases and small series. It constitutes a urological emergency which requires microsurgical skills for the repair of the penis. We present a case of a penile amputation and discuss the management of this challenging condition. CASE PRESENTATION: A 47-year-old patient presented to the emergency room with total amputation of corpora cavernosa of the penis resulting from knife aggression. The patient underwent successful microsurgical replantation, demonstrating positive progression and satisfactory results. CLINICAL DISCUSSION: Microneurovascular repair of penile amputation is the gold standard. Recommendations include a meticulous anastomosis, and a focus on vein anastomoses for optimal outcomes as well as associating a psychiatric approach. The PENIS score classifies the severity of lesion and predict postoperative complications and main outcomes. CONCLUSION: Penile amputation presents a distinctive challenge, necessitating microsurgical anastomosis, meticulous tissue management, and adherence to established protocols are imperative for effectively managing such intricate cases. Even in cases of posttraumatic partial penile amputation after a long period, can yield satisfactory morphofunctional outcomes.

Low-Intensity Resistance Training and Compression Garment in the Management of Breast Cancer-Related Lymphedema: Single-Blinded Randomized Controlled Trial.

There is limited evidence regarding the combined effect of exercise and compression garment on breast cancer-related lymphedema (BCRL). Therefore, we investigate the effect of low-intensity resistance training alone or in combination with a compression garment on lymphedema volume, self-reported lymphedema symptoms, and shoulder mobility and function. A total of 60 women with unilateral BCRL were randomly assigned to low-intensity resistance exercises (Rex group, n = 30) or exercises and compression garment (Rex-Com-group, n = 30). Both groups take part in exercises program consisted of 10-12 repetitions at 50 to 60% of one repetition maximum (IRM), three times weekly, for 8 weeks. The primary outcome was lymphedema volume determined by percentage reduction of excess limb volume (ELV). Secondary outcomes were lymphedema symptoms (pain, heaviness, and tightness) and shoulder mobility and function using the disabilities of the arm, shoulder, and hand (DASH) questionnaire. All measurements were standardized and performed before (week 0, W0), after the intervention (week 8, W8), and at follow-up (week 12, W12). A significant reduction in percentage of ELV (p < 0.01), pain severity (p < 0.05), a sensation of heaviness (p < 0.05) and tightness (p < 0.001), and improvement in shoulder range of motion (p < 0.05) and function on DASH scores (p < 0.05) were observed at W8 and W12 in both groups. However, no between-group differences were observed over time. These findings suggest that low-intensity resistance training, irrespective of garment use, can effectively reduce limb volume and lymphedema symptoms, and increase shoulder mobility and function.

Infrared dynamics study of thermally treated perfluoroimide acid proton exchange membranes.

The temperature induced dehydration process of the 3M Brand perfluoroimide acid (PFIA), an advanced proton exchange membrane for fuel cells, was studied by in situ infrared spectroscopy to understand proton transport processes under conditions of low hydration levels. A comprehensive assignment of the vibrational bands of PFIA in the mid infrared region is provided. Investigation of the kinetics in conjunction with 2D correlation spectroscopy methods revealed the sequential process of the hydration and dehydration in a conclusive model. The results indicate that at a lower water content the sulfonate group of the PFIA side chain is preferentially ionised and involved in a hydrogen bonding structure with the sulfonyl imide acid group, until a sufficient amount of water is present to ionise the second ionic site. Comparison to the well-understood NAFION™ membrane revealed that under low humidity conditions a higher amount of water is retained in PFIA in a state most similar to liquid water. The results contribute to a better understanding of water retention capability and thus proton conductivity under high-temperature and low-humidity conditions.

Self-association of organic solutes in solution: a NEXAFS study of aqueous imidazole.

N K-edge near-edge X-ray absorption fine-structure (NEXAFS) spectra of imidazole in concentrated aqueous solutions have been acquired. The NEXAFS spectra of the solution species differ significantly from those of imidazole monomers in the gas phase and in the solid state of imidazole, demonstrating the strong sensitivity of NEXAFS to the local chemical and structural environment. In a concentration range from 0.5 to 8.2 mol L(-1) the NEXAFS spectrum of aqueous imidazole does not change strongly, confirming previous suggestions that imidazole self-associates are already present at concentrations more dilute than the range investigated here. We show that various types of electronic structure calculations (Gaussian, StoBe, CASTEP) provide a consistent and complete interpretation of all features in the gas phase and solid state spectra based on ground state electronic structure. This suggests that such computational modelling of experimental NEXAFS will permit an incisive analysis of the molecular interactions of organic solutes in solutions. It is confirmed that microhydrated clusters with a single imidazole molecule are poor models of imidazole in aqueous solution. Our analysis indicates that models including both a hydrogen-bonded network of hydrate molecules, and imidazole-imidazole interactions, are necessary to explain the electronic structure evident in the NEXAFS spectra.

Analysis of genomic mutation and immunohistochemistry of platelet-derived growth factor receptors in canine vascular tumours.

We examined whether mutation of the platelet-derived growth factor receptor protein tyrosine kinase (PDGFR)-α and PDGFR-ß genes contributes to their overexpression in canine vascular tumours. Genomic sequences of trans- or juxtamembrane regions of PDGFR-α and PDGFR-ß were analysed with immunohistochemical staining and polymerase chain reaction-direct sequencing using DNA from paraffin-embedded neoplastic tissues of 27 hemangiosarcomas (HSAs) and 20 hemangiomas (HAs). Immunohistochemically, 75% of the HA cases were positive for PDGFR-α and almost most of the HA cases were negative for PDGFR-ß. Of the HSA cases, 55.6% were negative for PDGFR-α and 63% were strongly positive for PDGFR-ß. Among the HA cases, 1 missense mutation was detected in PDGFR-α exon 18 and 1 in PDGFR-ß exon 17. Two HSA cases had missense mutations in exon 14 and 1 in exon 17 of PDGFR-ß. Thus, genomic mutation of trans- or juxtamembrane regions of PDGFRs was not the main mechanism driving the activation of receptors in HSA and HA.

The electronic structure of perfluorodecalin studied by soft X-ray spectroscopy and electronic structure calculations.

Fluorine and carbon K absorption and emission spectra of liquid perfluorodecalin are presented and analyzed in terms of density functional calculations-configuration interaction. A comprehensive view of the electronic structure is given, and site-specific intramolecular interactions are investigated in detail. It is found that, while the outer fluorine atoms have excess charge in the ground state, the lowest excitations must be associated with charge transfer towards the inner carbon atoms.

Functionalization of linen/cotton pigment prints using inorganic nano structure materials.

The present work opens up a novel strategy for the development of new multifunctional cellulosic pigment prints. The developed process aims at modifying the solvent-free pigment printing formulations via inclusion of certain inorganic nano materials namely silver (Ag-NPs), zinc oxide (ZnO-NPs), zirconium oxide (ZrO2-NPs) or titanium dioxide (TiO2-NPs) at 20 g/kg paste followed by screen printing and microwave fixation. The imparted functional properties together with the depth of the obtained prints are governed by the type of nano additives, type of binder and the pigment colorant. The imparted antibacterial and/or UV protection properties to the pigment prints were retained with an acceptable level (>70%) of durability even after 20 washing cycles. The presence of nano materials on the surface of the obtained pigment prints was confirmed using SEM images and EDX spectra.

A smart approach to add antibacterial functionality to cellulosic pigment prints.

This study was devoted to enhancing the antibacterial functionality of pigment printed cotton, linen and viscose fabrics. Ag-NP's/PVP colloid, triclosan derivatives, chitosan or choline chloride was successfully incorporated into the pigment paste followed by printing and microwave curing to impart antibacterial activity to the cellulosic prints. Results obtained demonstrate that the modified pigment prints exhibit a remarkable antibacterial activity against the G+ve (Staphylococcus aureus) and G-ve (Escherichia coli) bacteria with a noticeable durability after 20 washing cycles without adversely affecting the printing and softness properties. The extent of printability and functionality of the nominated substrates are significantly governed by the type of: bio-active ingredient, binder, pigment and substrate. TEM, SEM and EDX analysis confirmed the formation of Ag-NP's/PVP colloid, of particle size range 7-14 nm, deposition of cross-linked-binder film onto the modified pigment prints, and the existence of elementary Ag and Si loaded onto fabrics surface, respectively.

Combined antimicrobial finishing and pigment printing of cotton/polyester blends.

This study demonstrates the possibility of enhancing the antibacterial functionality and pigment printing properties of cotton/polyester blends (50/50 and 35/65) in one step. Inclusion of chitosan (10 g/kg), choline chloride (15 g/kg), triclosan derivative (20 g/kg), hyperbranched poly amide-amine/silver or zinc oxide nanoparticles (HBPAA/Ag-NP's hybrid or HBPAA/ZnO-NP's hybrid - 20 g/kg) into a pigment print formulation followed by printing and microwave curing at 386 W for 5 min results in an improvement in antibacterial activity and pigment printability. It was further noted that, in all cases, the G+ve (S. aureus) bacteria is more susceptible to the action of the immobilized antibacterial agents than the G-ve bacteria (E. coli). The functionalized pigment prints exhibited very sufficient antibacterial activity even after 20 washing cycles. Modes of interactions were proposed, and surface modification was also confirmed by SEM and EDX analysis.

Spectrophotometric and TLC-densitometric methods for the simultaneous determination of Ezetimibe and Atorvastatin calcium.

Three sensitive methods were developed for simultaneous determination of Ezetimibe (EZB) and Atorvastatin calcium (ATVC) in binary mixtures. First derivative (D(1)) spectrophotometry was employed for simultaneous determination of EZB (223.8 nm) and ATVC (233.0 nm) with a mean percentage recovery of 100.23 ± 1.62 and 99.58 ± 0.84, respectively. Linearity ranges were 10.00-30.00 µg mL(-1) and 10.00-35.00 µg mL(-1), respectively. Isosbestic point (IS) spectrophotometry, in conjunction with second derivative (D(2)) spectrophotometry was employed for analysis of the same mixture. Total concentration was determined at IS, 224.6 nm and 238.6 nm over a concentration range of 10.00-35.00 µg mL(-1) and 5.00-30.00 µg mL(-1), respectively. ATVC concentration was determined using D(2) at 313.0 nm (10.00-35.00 µg mL(-1)) with a mean recovery percentage of 99.72 ± 1.36, while EZB was determined mathematically at 224.6 nm (99.75 ± 1.43) and 238.6 nm (99.80 ± 0.95). TLC-densitometry was employed for the determination of the same mixture; 0.10-0.60 µg band(-1) for both drugs. Separation was carried out on silica gel plates using diethyl ether-ethyl acetate (7:3 v/v). EZB and ATVC were resolved with Rf values of 0.78 and 0.13. Determination was carried out at 254.0 nm with a mean percentage recovery of 99.77 ± 1.30 and 99.86 ± 0.97, respectively. Methods were validated according to ICH guidelines and successfully applied for analysis of bulk powder and pharmaceutical formulations. Results were statistically compared to a reported method and no significant difference was noticed regarding accuracy and precision.

Expression of platelet-derived growth factor and its receptors in spontaneous canine hemangiosarcoma and cutaneous hemangioma.

Hemangiosarcoma (HSA) is a malignant neoplasia of vascular endothelial cells (ECs). Our previous report on the expression of vascular endothelial growth factor, basic fibroblast growth factor, and their receptors in canine HSA suggested an autocrine/ paracrine mechanism of tumor growth. However, the influence of other angiogenic growth factors in canine HSA was not elucidated; therefore, the expression of platelet-derived growth factor (PDGF) and its receptors was investigated by immunohistochemical analysis. Forty-six canine HSAs and 21 canine cutaneous hemangiomas (HAs) were analyzed. For immunohistochemistry, anti-PDGF-BB, anti-PDGFR-α, and anti-PDGFR-ß antibodies were utilized as primary antibodies. Immunoreactivities were scored as strongly positive (>25% positive neoplastic cells), weakly positive (1-25% positive neoplastic cells), and negative if not staining at all. In cutaneous HA, 33.3% and 57.1% of cases were strongly and weakly positive, respectively, and 43.5% and 13.0% of HSAs were strongly and weakly positive for PDGF-BB, respectively. Moreover, 38.1% and 28.6% of cutaneous HAs cases were strongly and weakly positive, respectively, and 23.9% and 4.3% of HSAs cases were strongly and weakly positive, respectively, for PDGFR-α. Thirty-five HSAs cases (76.1%) were strongly positive, and the remaining 11 (23.9%) were weakly positive for PDGFR-ß. In contrast, 18 (72.0%) cutaneous HAs were negative, and only 3 cases (12.0%) were weakly positive, for PDGFR-ß. The proportion of strongly positive cases of HSAs was significantly higher than that of cutaneous HA for PDGFR-ß (P<0.01), while PDGFR-α was highly expressed in cutaneous HA and may be related to pathogenesis of cutaneous HA. Therefore, PDGFR-ß may be associated with the malignant nature of canine HSA.

The association of the Friesinger score and estimated glomerular filtration rate in an urban South Asian patient population.

AIM: The correlation between kidney function and coronary artery disease (CAD) severity as assessed by an angiographic score has not yet been studied in the South Asian population. We sought to estimate the association by performing a single-center, cross-sectional study. PATIENTS AND METHODS: The estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation and the Friesinger score to quantify the severity of CAD were the primary endpoints in patients undergoing coronary angiograms. RESULTS: The mean eGFR was significantly lower in participants with a Friesinger score of > 5 compared to participants with a score of < 5 (73 vs. 86 ml/min/1.73 m(2) by MDRD). In univariate analysis, an eGFR of < 55 ml/min/1.73 m(2) was associated with a 9.5-fold increased odds of a higher Friesinger score compared to an eGFR >= 55 ml/min/1.73 m2 (p = 0.043), which was unchanged in multivariate analysis. In multivariate analysis, a 10 ml/min/1.73 m(2) decrease in eGFR was associated with a 1.63-fold increased odds of a higher score (95% CI 1·10 - 2.37, p = 0.042). Traditional risk factors such as a history of previous CAD, hypertension, and dyslipidemia remained predictors of a higher Friesinger score. CONCLUSION: Our study demonstrates that kidney function as assessed by eGFR is a significant independent predictor of severity of CAD as determined by the Friesinger score.

Femtosecond modification of electron localization and transfer of angular momentum in nickel.

The rapidly increasing information density required of modern magnetic data storage devices raises the question of the fundamental limits in bit size and writing speed. At present, the magnetization reversal of a bit can occur as quickly as 200 ps (ref. 1). A fundamental limit has been explored by using intense magnetic-field pulses of 2 ps duration leading to a non-deterministic magnetization reversal. For this process, dissipation of spin angular momentum to other degrees of freedom on an ultrafast timescale is crucial. An even faster regime down to 100 fs or below might be reached by non-thermal control of magnetization with femtosecond laser radiation. Here, we show that an efficient novel channel for angular momentum dissipation to the lattice can be opened by femtosecond laser excitation of a ferromagnet. For the first time, the quenching of spin angular momentum and its transfer to the lattice with a time constant of 120+/-70 fs is determined unambiguously with X-ray magnetic circular dichroism. We report the first femtosecond time-resolved X-ray absorption spectroscopy data over an entire absorption edge, which are consistent with an unexpected increase in valence-electron localization during the first 120+/-50 fs, possibly providing the driving force behind femtosecond spin-lattice relaxation.

Modulation of peristalsis by NK3 receptor antagonism in guinea-pig isolated ileum is revealed as intraluminal pressure is raised.

1. NK(3) tachykinin receptors mediate slow excitatory transmission in the enteric nervous system and play a role in reflexes induced by the intestinal stretch or mucosal compression. However, there is little evidence to suggest that these receptors are important in peristalsis. We have examined the effects of the NK(3) receptor antagonist, talnetant, on peristalsis in guinea-pig isolated ileum induced by optimal and by supra-maximal distension pressures. 2. At the guinea-pig NK(3) receptor, talnetant was shown to have high affinity (pK(B) 8.8) and selectivity over the guinea-pig NK(1) and NK(2) receptors. 3. Peristaltic waves in the ileum elicited by optimal distension pressures (1-3 cmH(2)O) were unaffected by talnetant at a supra-maximal concentration (250 nm). 4. Distension at a higher pressure (4 cmH(2)O) induced peristalsis in which there was incomplete closure of the lumen during each peristaltic wave and an increase in the periods of inactivity observed between bursts of peristaltic activity. The addition of talnetant (250 nm) increased the number of peristaltic events by reducing these periods of inactivity and thus, increased the productivity of the peristaltic reflex. 5. The data suggest that NK(3) receptors are not involved in the modulation of peristaltic movements by physiological stimuli, but they may have a role in modulation of reflexes in extreme or pathological conditions.

Neuromedin U can exert colon-specific, enteric nerve-mediated prokinetic activity, via a pathway involving NMU1 receptor activation.

BACKGROUND AND PURPOSE: The neuromedin U (NMU) receptors, NMU1 and NMU2, are expressed in the gut but their functions are unclear. This study explores the role of NMU in gastrointestinal motility. EXPERIMENTAL APPROACH: The effects of NMU were examined in the forestomach and colon isolated from NMU2R wild-type and NMU2R-/- (knockout) mice, looking for changes in muscle tension and in nerve-mediated responses evoked by electrical field stimulation (EFS), and in models of peristalsis in mouse colon and faecal pellet transit in guinea-pig colon. KEY RESULTS: In the mouse forestomach, NMU (1 nM-10 microM) concentration-dependently induced muscle contraction, in the presence of tetrodotoxin and atropine, in preparations from both wild-type and NMU2R-/- mice (pEC50: 7.9, 7.6, Emax: 0.26, 0.20g tension, respectively, n=8 each concentration). The same concentrations of NMU had no consistent effects on the responses to EFS (n=8). In the mouse colon, NMU (0.1 nM-1 microM) had no significant effect on baseline muscle tension (n=8), but concentration-dependently potentiated EFS-evoked contractions in preparations from both wild-type and NMU2R-/- mice, pEC50: 8.1, 7.8, Emax: 24%, 21%, respectively, n=6-11. NMU (0.01 nM-0.1 microM, n=5-7) concentration-dependently decreased the interval between waves of peristalsis in the mouse colon (pEC50: 8.8) and increased the rate at which a faecal pellet moved along the guinea-pig colon. CONCLUSIONS AND IMPLICATIONS: These results demonstrate that NMU exerts colon-specific, nerve-mediated, prokinetic activity, via a pathway involving activation of NMU1 receptors. This suggests that this receptor may represent a molecular target for the treatment of intestinal motility disorders.

Comparison between subjective and objective assessments of the cervix before induction of labour.

The aim of the study was to compare the pre-induction cervical assessment by Bishop's score with the transvaginal ultrasound cervical length as predictors of the induction-delivery interval (IDI) and the success of induction. This prospective study included 104 women with singleton pregnancies who were booked for induction of labour at term over a period of 3 years. Transvaginal ultrasound measurement of the cervical length and Bishop's Score were performed by different operators. Data were collected on parity, gestational age, methods of induction, Bishop's score, ultrasound cervical length measurements, IDI and mode of delivery. A total of 87 women (83.7%) delivered vaginally and 17 (16.3%) delivered by caesarean section. Linear regression models demonstrated that ultrasound cervical length was a better indicator of IDI than Bishop's score. The adjusted R2 for the regression including ultrasound cervical length was 0.87 compared with a value of 0.67 for the model including Bishop's score. Although logistic regression analysis confirmed that cervical effacement was the best component of Bishop's score to predict the mode of delivery, ultrasound cervical length assessment provided better prediction. Receiver operating characteristic curve showed that the optimised cut-off value for prediction of vaginal delivery was < or =3.4 cm for the cervical length and >5 for the Bishop's score. At those optimised cut-off values the cervical length predicted vaginal delivery with sensitivity of 62.1% (95% CI [51%, 72.3%]) and specificity of 100% (95% CI [80.5%, 100%]) while the Bishop's score predicted vaginal delivery with a sensitivity of 23% (95% CI [14.6%, 33.2%]) and specificity of 88.2% (95% CI [63.5%, 98.5%]). Further analysis showed that ultrasound cervical length has a higher sensitivity in prediction of vaginal delivery in multiparous than nulliparous women (85.1% compared with 35%) at a cut-off value of < or =3.4 cm. On the other hand, it has a higher sensitivity in nulliparous comparable with multiparous women (85.3% compared with 30%) in prediction of IDI at a cut-off value of >3.5 cm. In conclusion, transvaginal ultrasound cervical length assessment is better than Bishop's score in predicting the IDI and the success of induction of labour.