A rare case of adult intussusception.

SUMMARY: Adult intussusception is rare, and its non-specific symptoms make the diagnosis particularly difficult. Imaging modalities such as X-ray, abdominal ultrasound and multidetector computed tomography (MDCT) may improve preoperative detection. In this report, we present a 53-year-old male with an ileocaecal intussusception. The patient underwent an extended right hemicolectomy and double barrel ileocolostomy. Histopathological review of the specimen identified the lead point as an intramural caecal lymph node which, as far as we are aware, is the first time this type of lead point has been reported.

The spectrum of male breast disease at Charlotte Maxeke Johannesburg Academic Hospital - a 3-year retrospective review.

BACKGROUND: The spectrum of male breast disease (MBD) and its relative proportions is not well documented. This study aims to describe the demographics, clinical, radiological and histopathological characteristics of the spectrum of MBD managed at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). METHODS: This is a retrospective, descriptive study of all male patients diagnosed with MBD at CMJAH between 1 January 2016 and 31 December 2018. Patients' data were extracted from the Breast Imaging Department, CMJAH Breast Clinic and the National Health Laboratory Services patients' records. Data collected included patients' demographics, clinical presentation, radiological findings and histopathological diagnosis, where available. The collected data were captured using REDCap™ and were analysed using Statistica 13 and SAS version 9.2. P-value of 0.05 was used for statistical significance. RESULTS: Of the 269 males imaged, 244 (91%) had a diagnosed breast condition, 90% of which were benign. Gynaecomastia accounted for 85% of all breast disease diagnosed. Patients who presented with benign breast disease were significantly younger than those with malignant breast disease, with a mean age of 45.59 years vs 58.29 years (p = 0.0007). Seventyone per cent of patients had a known HIV status with 39% being HIV positive. There was a significant association between patients with HIV and benign breast disease (p = 0.0129). CONCLUSION: Gynaecomastia is the most common MBD seen at CMJAH. There was a significant association between HIV and benign breast disease. This association should be explored further with respect to the direct effects of the virus and to those of the antiretroviral medication.

Development of a glial cell-derived neurotrophic factor-releasing artificial dura for neural tissue engineering applications.

Encapsulated electrospun nanofibers can serve as an artificial dura mater, the membrane that surrounds the brain and spinal cord, due to their desirable drug delivery properties. Such nanofiber scaffolds can be used to deliver drugs such as glial cell-derived neurotrophic factor (GDNF). GDNF promotes the survival of both dopaminergic and motor neurons, making it an important target for treatment of central nervous system injuries and disorders. This work focuses on designing a novel class of encapsulated poly(ε-caprolactone) (PCL) nanofiber scaffolds with different topographies (random and aligned) that generate controlled release of GDNF to potentially serve as a suitable substitute for the dura mater during neurosurgical procedures. Random and aligned scaffolds fabricated using solution electrospinning were characterized for their physical properties and their ability to release GDNF over one month. GDNF bioactivity was confirmed using a PC12 cell assay with the highest concentrations of released GDNF (∼341 ng mL-1 GDNF) inducing the highest levels of neurite extension (∼556 µm). To test the cytocompatibility of aligned GDNF encapsulated PCL nanofibers, we successfully seeded neural progenitors derived from human induced pluripotent stem cells (hiPSCs) onto the scaffolds where they survived and differentiated into neurons. Overall, this research demonstrates the potential of such substrates to act as artificial dura while delivering bioactive GDNF in a controlled fashion. These scaffolds also support the culture and differentiation of hiPSC-derived neural progenitors, suggesting their biocompatibility with the cells of the central nervous system.

Modelling catchment management impact on in-stream phosphorus loads in northern Victoria.

Phosphorus pollution severely impairs the water quality of rivers in Australia and worldwide. Conceptual models have proved useful to assess management impact on phosphorus loads, particularly in data-sparse environments. This paper develops and evaluates the coupling of a point-scale model (HowLeaky2008) to a catchment scale model (CatchMODS) to enhance modelling of farm management impacts on in-stream phosphorus loads. The model was tested in two adjacent catchments in northern Victoria (Avon-Richardson and Avoca), Australia. After calibration of the in-stream attenuation parameter against measurements at gauging stations, the model simulated specific annual phosphorus loads across the catchments well (Nash-Sutcliffe model efficiency of 0.52 in the Avon-Richardson and 0.83 for the Avoca catchment). Phosphorus loads at both catchment outlets under current conditions were estimated at 7 t y(-1) and were dominated by field exports. Changes to farm management practices, i.e. the use of perennial pastures in grazing systems and zero-tillage in cropping systems were estimated to reduce phosphorus load by 31% in the Avon-Richardson catchment and 19% in the Avoca catchment, relative to current practices (annual pasture and minimum tillage). The model afforded a major improvement in conceptual modelling by explicit simulation of the impacts of soil and climatic conditions on field-scale exports and by placing them in the context of landscape processes.

Growth hormone and its receptor in projection neurons of the chick visual system: retinofugal and tectobulbar tracts.

Recent studies have shown the presence of growth hormone (GH) in the retinal ganglion cells (RGCs) of the neural retina in chick embryos at the end of the first trimester [embryonic day (E) 7] of the 21 day incubation period. In this study the presence of GH in fascicles of the optic fiber layer (OFL), formed by axons derived from the underlying RGCs, is shown. Immunoreactivity for GH is also traced through the optic nerve head, at the back of the eye, into the optic nerve, through the optic chiasm, into the optic tract and into the stratum opticum and the retinorecipient layer of the optic tectum, where the RGC axons synapse. The presence of GH immunoreactivity in the tectum occurs prior to synaptogenesis with RGC axons and thus reflects the local expression of the GH gene, especially as GH mRNA is also distributed within this tissue. The distribution of GH-immunoreactivity in the visual system of the E7 embryo is consistent with the distribution of the GH receptor (GHR), which is also expressed in the neural retina and tectum. The presence of a GH-responsive gene (GHRG-1) in these tissues also suggests that the visual system is not just a site of GH production but a site of GH action. These results support the possibility that GH acts as a local growth factor during early embryonic development of the visual system.

Effects of dental local anaesthetics in cardiac transplant recipients.

OBJECTIVE: To investigate the cardiovascular responses of cardiac transplant recipients to dental local anaesthetic solutions with and without epinephrine (adrenaline). MATERIALS AND METHODS: A clinical study employing 30 patients (20 cardiac transplant recipients and ten healthy) awaiting gingival or minor oral surgery under local anaesthesia receiving either 4.4 ml lidocaine (lignocaine) with 1:80,000 epinephrine or 4.4 ml 3% prilocaine with 0.031 U/ml felypressin. RESULTS: Cardiac transplant patients experienced a significant tachycardia 10 minutes after injection of the epinephrine-containing solution. No significant change in heart rate was detected after the injection of an epinephrine-free solution. Blood pressure was not affected. Periodontal surgery did not affect the responses to the local anaesthetics in the transplant recipients. CONCLUSIONS: The cardiovascular response to dental local anaesthesia in cardiac transplant recipients is governed by the solution injected.