Trophically and topographically functionalized silk fibroin nerve conduits for guided peripheral nerve regeneration.

Artificial nerve conduits (NC) can be used as an alternative to autologous nerve grafts to enhance the repair of small nerve gaps. Current NC lack adequate molecular and structural functionalities. Thus, we developed silk fibroin NC (SF NC) that were loaded with glial cell line-derived neurotrophic factor (GDNF) and nerve growth factor (NGF) and topographically functionalized with aligned and non-aligned SF nanofibers. The SF NC were produced from fully functionalized SF membranes on which initial experiments were performed. DRG (dorsal root ganglions) sensory neurons and spinal cord (SpC) motor neurons, both from chicken embryos, exhibited an augmented length and rate of axonal outgrowth parallel to the aligned nanofibers. In addition, glial cells from DRG proliferated and migrated in close association and even slightly ahead of the outgrowing axons. On the contrary, axonal and glial growth was slower and randomly oriented on non-aligned nanofibers. The DRG and SpC explants were also inserted into the lumen of the finished SF NC. The unidirectional orientation of axo-glial outgrowth from the explants evidenced the preservation of the trophic and topographical functionalities in the SF NC. Bioactive GDNF and NGF were released in vitro from SF NC over 4 weeks. Thus, the developed functionalized SF NC hold promise to enhance functional recovery of injured peripheral nerves.

After two years, did Viagra live up to its expectations?

Sildenafil (Viagra) is the first on-demand oral medication approved for treatment of male erectile dysfunction (ED). Since the unprecedented release of sildenafil, the initial surge of 'Viagra craze' has subsided and there is a considerable decline in world-wide prescriptions. We did a long-term efficacy study of sildenafil in our community practice to assess the discontinuation rate and the etiologic factors causing discontinuation.

Plasma androgens and estrogens in paraplegic men.

The plasma testosterone, estrone (E1), and estradiol (E2) levels were measured in paraplegic men and age-matched controls. Sephadex LH-20 columns and the celite technique were used to extract the sex steroids and a radioimmunoassay was used to measure them. Leydig cell stimulation was achieved with human chorionic gonadotropin administration.

Familial occurrence of testicular neoplasms (in cousins).

Testicular malignancies in closely related family members rarely occur. Only 18 cases have been reported in the literature. Our cases concern two families with testicular tumors occurring in cousins. This is the first such incidence reported. The need for a thorough checkup of other family members is reiterated.

Anti-arcing loop and resectoscope.

A new modified cutting loop assembly and a modification of the resectoscope to prevent arcing between the bare wire loop and the distal end of the telescope are described.

[Hydraulic haemostasis in transurethral resection of the prostate (author's transl)]. / L'hémostase hydraulique dans la résection transurétrale de la prostate

The method described for T.U.R. of the prostate merits the name of hydraulic haemostasis. Its principle consists of placing the irrigation recipient at a height of 90 cm, using it in combination with the Iglesias continuous irrigation-suction resector with a low intravesical pressure. Per- and postoperative bleeding is minimised and the "T.U.R.", syndrome is absent, despite reports in the world literature. Two modifications to the Iglesias resector are presented: the optic protector and a new system of suction orifices.

The importance of continuous pump suction in TUR hydraulic hemostasis.

An intravesicoprostatic hydrostatic pressure below 10 mm Hg maintains normal anatomy and physiology of the muscular and vascular prostatic structures by continuous pump suction. An increase of the hydrostatic intravesicoprostatic pressure above 10 mm Hg produces a distortion in the musculature of the prostate, especially at the true capsule, opening the cut vessels, making possible the absorption of the irrigant free of electrolytes (TUR syndrome). A low hydrostatic intravesicoprostatic pressure permits the compression of cut vessels by the inflow hydraulic pressure of 90 cm H2O achieving hydraulic hemostasis during TURP reducing the bleeding and operative time by more than 50% and making hemostasis easier. In our last 400 TURs, blood transfusions have been unnecessary. Less electrocoagulation is required, resulting in a more rapid recovery.

Serratia marcescens and the urologist.

Serratia marcescens, long considered a non-pathogen, is now found to be responsible for outbreaks of nosocomial infections. An outbreak of Serratia infection at 2 institutions is reported, in which 253 cultures of Serratia were grown and 115 patients were involved. The 3 most important conditions that preceded isolation of Serratia were the use of indwelling urethral catheters, antibiotic therapy and operation. All infections were acquired in the hospital. An epidemiological survey showed that the organism is present in the environment, even in the absence of active infection.