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1.
World J Urol ; 42(1): 348, 2024 May 24.
Article in English | MEDLINE | ID: mdl-38789804

ABSTRACT

PURPOSE: To determine the prevalence of concomitant squamous metaplasia (SM), the initial histological change from normal urethra to urethral stricture, in bulbar urethral strictures and to investigate the associated clinical factors. METHODS: A retrospective review was conducted on 165 male patients with bulbar urethral strictures who underwent excision and primary anastomosis (EPA) between 2010 and 2020, for whom complete clinical data and excised urethral specimens were available. An experienced pathologist histologically evaluated concomitant SM in paraffin sections of the proximal end of the excised urethra blinded to the clinical data. Disease duration was calculated as the period from the initial diagnosis of urethral stricture to the date of EPA. The association between concomitant SM and clinical background was investigated. RESULTS: SM was identified in 86 (52.1%) patients. The median disease duration in patients with SM (38 months) was significantly longer than that in patients without SM (9 months, p < 0.0001). In multivariate analysis, the longer disease duration, non-traumatic stricture etiology, and failure to maintain urethral rest with urinary diversion via a suprapubic tube for more than 90 days were independent factors predicting concomitant SM. No significant difference was observed in success rates of EPA between patients with SM (93.2%) and those without SM (97.5%, p = 0.18). CONCLUSIONS: Reconstructive urologists need to be aware that concomitant SM is frequent in patients with bulbar urethral stricture, especially in those with long disease duration and those who were voiding volitionally during the period of urethral rest.


Subject(s)
Metaplasia , Urethra , Urethral Stricture , Urologic Surgical Procedures, Male , Humans , Urethral Stricture/epidemiology , Urethral Stricture/pathology , Urethral Stricture/surgery , Male , Retrospective Studies , Middle Aged , Aged , Urethra/pathology , Adult , Urologic Surgical Procedures, Male/methods , Time-to-Treatment
2.
J Bone Joint Surg Am ; 2024 Apr 16.
Article in English | MEDLINE | ID: mdl-38626018

ABSTRACT

BACKGROUND: The incidence of developmental dysplasia of the hip (DDH) in Japanese newborns has reduced drastically following a primary prevention campaign initiated around 1972 to 1973; this perinatal education campaign promoted maintaining the hips of newborns in the naturally flexed-leg position. The purpose of the present study was to describe the life course epidemiology of hip osteoarthritis (OA) in adolescent and adult patients and to assess its association with exposure to the primary prevention campaign for DDH. METHODS: We included new patients with hip OA diagnosed from January 1, 2022, to December 31, 2022, at 12 core hospitals (8 special-function hospitals and 4 regional medical care support hospitals). The trend in the percentage of hips with a history of DDH treatment in childhood was estimated with use of a centered moving average using the birth year of the patient. We compared the prevalence of severe subluxation (Crowe type II, III, or IV) between patients with secondary hip OA due to hip dysplasia who were born in or before 1972 and those who were born in or after 1973. RESULTS: Overall, 1,095 patients (1,381 hips) were included. The mean age at the time of the survey was 63.5 years (range, 15 to 95 years). A total of 795 patients (1,019 hips; 73.8% of hips) were diagnosed with secondary OA due to hip dysplasia. Approximately 13% to 15% of hips among patients born from 1963 to 1972 had a history of DDH treatment in childhood; however, the percentage decreased among patients born in or after 1973. The prevalence of severe subluxation (Crowe type II, III, or IV) among patients born in or after 1973 was 2.4%, which was significantly less than that among patients born in or before 1972 (11.1%; odds ratio, 0.20; p < 0.001). CONCLUSIONS: As of 2022, secondary hip OA due to hip dysplasia is still responsible for most new cases of adolescent and adult hip OA seen in core hospitals in Japan. However, the perinatal education campaign initiated 50 years ago, which utilized a population approach and advocated for maintaining the hips of newborns in the naturally flexed-leg position, may have improved the environmental factors of DDH, as indicated by the apparently reduced need for treatment of DDH in childhood and the associated severe subluxation. This may result in a reduced need for challenging hip surgery later in life. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

3.
Sci Rep ; 14(1): 3813, 2024 02 15.
Article in English | MEDLINE | ID: mdl-38361017

ABSTRACT

This study is designed to compare the extent of sacroiliac joint (SIJ) degeneration at total hip arthroplasty (THA) for two pathologies: osteoarthritis of the hip (OA) and osteonecrosis of the femoral head (ON). We also assessed the prevalence of SIJ degeneration in patients with lumbar spondylolisthesis or degenerative scoliosis. A total of 138 hips from 138 patients (69 OA and 69 ON) were assessed in this study, including 66 hips affected by OA secondary to developmental dysplasia of the hip. The degenerative changes in the SIJ and lumbar spine were evaluated prior to THA using radiographs and computed tomography (CT) scans, showing 9 instances of spondylolisthesis and 38 of degenerative scoliosis. The OA group exhibited longer duration from onset to surgery than the ON group. The OA group also included more cases with significant pelvic obliquity (3 degrees or more) and with significant increases in SIJ sclerosis and irregularities. Patients with lumbar spondylolisthesis or degenerative scoliosis were significantly more likely to have SIJ irregularities. The prevalence of SIJ degeneration was higher in cases of THA for OA than for ON. This study also suggests the possibility of Hip-SIJ-Spine syndrome in THA patients with OA.


Subject(s)
Arthroplasty, Replacement, Hip , Osteoarthritis, Hip , Scoliosis , Spondylolisthesis , Humans , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Hip/methods , Sacroiliac Joint/surgery , Spondylolisthesis/surgery , Scoliosis/complications , Scoliosis/diagnostic imaging , Scoliosis/epidemiology , Hip Joint/surgery , Osteoarthritis, Hip/diagnostic imaging , Osteoarthritis, Hip/epidemiology , Osteoarthritis, Hip/surgery , Retrospective Studies
4.
BMC Musculoskelet Disord ; 25(1): 117, 2024 Feb 09.
Article in English | MEDLINE | ID: mdl-38336666

ABSTRACT

BACKGROUND: Hip dysplasia is a condition where the acetabulum is too shallow to support the femoral head and is commonly considered a risk factor for hip osteoarthritis. The objective of this study was to develop a deep learning model to diagnose hip dysplasia from plain radiographs and classify dysplastic hips based on their severity. METHODS: We collected pelvic radiographs of 571 patients from two single-center cohorts and one multicenter cohort. The radiographs were split in half to create hip radiographs (n = 1022). One orthopaedic surgeon and one resident assessed the radiographs for hip dysplasia on either side. We used the center edge (CE) angle as the primary diagnostic criteria. Hips with a CE angle < 20°, 20° to 25°, and > 25° were labeled as dysplastic, borderline, and normal, respectively. The dysplastic hips were also classified with both Crowe and Hartofilakidis classification of dysplasia. The dataset was divided into train, validation, and test subsets using 80:10:10 split-ratio that were used to train two deep learning models to classify images into normal, borderline and (1) Crowe grade 1-4 or (2) Hartofilakidis grade 1-3. A pre-trained on Imagenet VGG16 convolutional neural network (CNN) was utilized by performing layer-wise fine-turning. RESULTS: Both models struggled with distinguishing between normal and borderline hips. However, achieved high accuracy (Model 1: 92.2% and Model 2: 83.3%) in distinguishing between normal/borderline vs. dysplastic hips. The overall accuracy of Model 1 was 68% and for Model 2 73.5%. Most misclassifications for the Crowe and Hartofilakidis classifications were +/- 1 class from the correct class. CONCLUSIONS: This pilot study shows promising results that a deep learning model distinguish between normal and dysplastic hips with high accuracy. Future research and external validation are warranted regarding the ability of deep learning models to perform complex tasks such as identifying and classifying disorders using plain radiographs. LEVEL OF EVIDENCE: Diagnostic level IV.


Subject(s)
Deep Learning , Hip Dislocation, Congenital , Hip Dislocation , Humans , Hip Dislocation/diagnostic imaging , Hip Dislocation/surgery , Pilot Projects , Hip Dislocation, Congenital/diagnostic imaging , Hip Dislocation, Congenital/surgery , Radiography , Acetabulum/diagnostic imaging , Acetabulum/surgery , Retrospective Studies
5.
J Arthroplasty ; 38(12): 2655-2660, 2023 12.
Article in English | MEDLINE | ID: mdl-37279849

ABSTRACT

BACKGROUND: The literature has reported that supero-lateralization of the femoral head increases the rates of aseptic loosening and prosthesis revision. However, there are few reports on the influence of different hip center positions on liner wear with more than a 15-year follow-up period. METHODS: From April 2000 to August 2003, 91 patients underwent 108 total hip arthroplasties using a highly cross-linked polyethylene liner combined with zirconia femoral head and cup components. Pelvic radiographs were used to assess the vertical and horizontal distances to the center of the hip and the amount of liner wear. Mean patient age at the time of surgery was 54 years (range, 33 to 73), and mean follow-up duration was 19 years (range, 18 to 21). RESULTS: Average liner wear was 0.221 mm, with average annual wear of 0.012 mm/year. Mean vertical and horizontal distances for the hip center were 24.9 and 31.8 mm, respectively. There was no difference in linear wear between patients who had different hip center heights (<20, 20 to 30, and >30 mm), and quadrant partitioning showed no differences across the 4 quadrant zones. CONCLUSION: At a minimum of 18 years of follow-up in patients having developmental dysplasia of the hip who had different Crowe subtypes and different hip centers, elevated hip center and uncemented fixation techniques using a highly cross-linked polyethylene on ceramic components were associated with very low wear rates and excellent functional scores.


Subject(s)
Arthroplasty, Replacement, Hip , Hip Dislocation, Congenital , Hip Dislocation , Hip Prosthesis , Humans , Adult , Middle Aged , Aged , Polyethylene , Follow-Up Studies , Hip Dislocation/surgery , Prosthesis Failure , Arthroplasty, Replacement, Hip/methods , Hip Dislocation, Congenital/surgery , Prosthesis Design
6.
J Funct Biomater ; 14(5)2023 May 09.
Article in English | MEDLINE | ID: mdl-37233372

ABSTRACT

Cemented polished tapered femoral stems (PTS) made of cobalt-chrome alloy (CoCr) are a known risk factor for periprosthetic fracture (PPF). The mechanical differences between CoCr-PTS and stainless-steel (SUS) PTS were investigated. CoCr stems having the same shape and surface roughness as the SUS Exeter® stem were manufactured and dynamic loading tests were performed on three each. Stem subsidence and the compressive force at the bone-cement interface were recorded. Tantalum balls were injected into the cement, and their movement was tracked to indicate cement movement. Stem motions in the cement were greater for the CoCr stems than for the SUS stems. In addition, although we found a significant positive correlation between stem subsidence and compressive force in all stems, CoCr stems generated a compressive force over three times higher than SUS stems at the bone-cement interface with the same stem subsidence (p < 0.01). The final stem subsidence amount and final force were greater in the CoCr group (p < 0.01), and the ratio of tantalum ball vertical distance to stem subsidence was significantly smaller for CoCr than for SUS (p < 0.01). CoCr stems appear to move more easily in cement than SUS stems, which might contribute to the increased occurrence of PPF with the use of CoCr-PTS.

7.
J Vet Med Sci ; 85(5): 551-556, 2023 May 03.
Article in English | MEDLINE | ID: mdl-36927961

ABSTRACT

Cryptorchid bulls have low economic value owing to the effects of masculinization. Moreover, surgical removal of an ectopic testis is difficult in certain clinical cases. Recently, immunocastration has garnered popularity as a nonsurgical castration method in pig farming; however, the effects of immunocastration on cryptorchid bulls are yet to be yet. Herein, we investigated endocrine changes due to immunocastration in cryptorchid bulls and studied its effectiveness. This study included 13 Holstein bulls diagnosed with cryptorchidism and classified into two groups based on pubertal period: <8 months of age (pregroup) and ≥8 months of age (postgroup). Antigonadotropin-releasing hormone (GnRH) vaccine was used for immunocastration, and two vaccine doses were administered. Blood testosterone and anti-Müllerian hormone (AMH) levels were measured and analyzed for endocrine evaluation. The testosterone levels significantly decreased following the start of immunocastration in both groups, thereby confirming the efficacy of antiGnRH vaccination in cryptorchid bulls. The AMH levels significantly increased in the pregroup with two antiGnRH vaccination, suggesting a compensatory response via the neutralization of GnRH antibodies. The AMH levels did not significantly change in the postgroup, indicating the partial suppression of AMH secretion in Sertoli cells during sexual maturation and failure of Sertoli cell maturation. Thus, we successfully restrained the serum testosterone levels in cryptorchid bulls using antiGnRH vaccine. The testosterone levels are a useful indicator of the immunocastration effect on cryptorchid bulls. Hereafter, a vaccine program that can sustain the castration effect on cryptorchid bulls is necessary.


Subject(s)
Cattle Diseases , Cryptorchidism , Swine Diseases , Vaccines , Male , Animals , Cattle , Swine , Gonadotropin-Releasing Hormone/pharmacology , Cryptorchidism/surgery , Cryptorchidism/veterinary , Testis , Testosterone , Cattle Diseases/prevention & control
8.
J Orthop Sci ; 28(3): 683-692, 2023 May.
Article in English | MEDLINE | ID: mdl-36775784

ABSTRACT

The Japanese Orthopaedic Association National Registry (JOANR) is Japan's first national registry of orthopaedic surgery, which has been developed after having been selected for the Project for Developing a Database of Clinical Outcome approved by the Health Policy Bureau of the Ministry of Health, Labour and Welfare. Its architecture has two levels of registration, one being the basic items of surgical procedure, disease, information on surgeons, surgery-related information, and outcome, and the other being detailed items in the affiliated registries of partner medical associations. It has a number of features, including the facts that, because it handles medical data, which constitute special care-required personal information, data processing is conducted entirely in a cloud environment with the imposition of high-level data security measures; registration of the implant data required to assess implant performance has been automated via a bar code reader app; and the system structure enables flexible collaboration with the registries of partner associations. JOANR registration is a requirement for accreditation as a core institution or partner institution under the board certification system, and the total number of cases registered during the first year of operation (2020) was 899,421 registered by 2,247 institutions, providing real-world evidence concerning orthopaedic surgery.


Subject(s)
Orthopedic Procedures , Orthopedics , Humans , Japan , Registries
9.
Int Orthop ; 47(1): 75-81, 2023 01.
Article in English | MEDLINE | ID: mdl-36323872

ABSTRACT

BACKGROUND: Changes in pelvic tilt angle (PTA) and cup orientation have been reported in patients after total hip arthroplasty, but the current literature generally has a brief follow-up period. This study will be the first to report PTA and cup orientation changes in the supine position for a minimum 18 years after total hip arthroplasty (THA) and investigate the factors associated with pelvic tilt and cup orientation changes. METHODS: In this study, 101 patients (120 hips) who underwent THA were retrospectively analyzed. The aims of our study were to evaluate the PTA and cup orientation change over 18 years after THA to assess differential PTA, cup inclination, and anteversion. We also investigated whether factors such as gender, body mass index, and age have any influence on PTA and cup orientation after THA. RESULTS: Patients showed a significant incremental change in PTA pre-operatively, immediately post-operatively, and at final follow-up. Cup orientation increased significantly at the final follow-up compared to the immediate post-operative period. Gender subgroup analysis showed that PTA was significantly greater in females than in males at the final follow-up (p = 0.025). Age subgroup analysis showed that PTA was significantly greater in the over 60 years group than in the other groups. CONCLUSION: Our patients showed significant changes in PTA and cup orientation at a minimum 18 years after surgery, especially in females over 60 years. Female patients over 60 are a risk factor after THA.


Subject(s)
Arthroplasty, Replacement, Hip , Hip Prosthesis , Male , Humans , Female , Middle Aged , Arthroplasty, Replacement, Hip/adverse effects , Hip Prosthesis/adverse effects , Retrospective Studies , Posture , Pelvis/surgery , Acetabulum/diagnostic imaging , Acetabulum/surgery
10.
Orthop Surg ; 15(2): 496-501, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36479825

ABSTRACT

OBJECTIVE: The dual mobility cup (DMC) is designed to extend the longevity of the prosthesis by improving stability, enhancing the range of motion, and decreasing impingement without increasing wear. We hypothesized that DMC would reduce the risk of dislocation in elderly patients. This study aimed to investigate the clinical and radiographic outcomes of DMC-total hip arthroplasty (THA) in elderly patients at high risk of dislocation. METHODS: From June 2016 to March 2020, 94 patients with a mean age of 77.7 years (97 hips) who underwent a posterolateral approach for DMC-THA in our department were followed up for at least one year. Preoperative and postoperative pelvic tilt angles (PTA) and DMC orientation were prospectively collected for all patients. Intraoperative and postoperative complications were recorded. A parametric test was used for normal distribution, and a non-parametric test was used for non-normal distribution. RESULTS: Abduction and anteversion angles of the cup were 42.4 and 18.0° in the supine position immediately postoperative. The average PTA for patients in the supine and standing positions were 26.5 and 34.5°, respectively. When moving from the supine to the standing position, patients experienced a mean posterior pelvic tilt of 9°. No intraoperative acetabular-related complications were recorded. Postoperative complications included early infection in one patient (1.0%) and dislocation in one patient (1.0%). CONCLUSION: Our study demonstrates that DMC-THA provides satisfactory short-term outcomes in elderly patients at a high risk of dislocation, regardless of the change in PTA resulting from postural transition.


Subject(s)
Arthroplasty, Replacement, Hip , Hip Dislocation , Hip Prosthesis , Joint Dislocations , Humans , Aged , Arthroplasty, Replacement, Hip/methods , Hip Prosthesis/adverse effects , Acetabulum/surgery , Posture , Joint Dislocations/prevention & control , Joint Dislocations/surgery , Hip Dislocation/etiology , Hip Dislocation/prevention & control , Hip Dislocation/surgery , Postoperative Complications/etiology
11.
Adv Exp Med Biol ; 1395: 367-372, 2022.
Article in English | MEDLINE | ID: mdl-36527664

ABSTRACT

In intact mitochondria, the transport of electrons, respiration and generation of proton gradients across the inner membrane (proton motive force) are mutually coupled, according to Peter Mitchell's hypothesis on oxidative phosphorylation. Thus, the inhibition of electron transport at either respiratory complex III or IV in the electron transport chain leads to failure in producing proton motive force along with the abolition of respiration. Here, we determined the mitochondrial membrane potential (MMP), as a measure of proton motive force, and cellular respiration in various cultured cells and demonstrated that inhibition of complex IV by KCN abolished mitochondrial respiration while MMP was sustained. These results are unexpected and appear incompatible with Mitchell's chemiosmotic hypothesis.


Subject(s)
Electron Transport Complex IV , Proton-Motive Force , Membrane Potential, Mitochondrial , Electron Transport Complex IV/metabolism , Oxidative Phosphorylation , Mitochondrial Membranes/metabolism , Adenosine Triphosphate/metabolism
12.
Adv Exp Med Biol ; 1395: 373-378, 2022.
Article in English | MEDLINE | ID: mdl-36527665

ABSTRACT

We hypothesised that concentration gradients of O2/H+ within tissue guide migration of primary cancer cells toward intra-tumour microvessels, thus promoting intravasation and eventual haematogenous metastasis of cancer cells. Previously, we demonstrated in vitro that MDA-MB-231 cells under pH and O2 gradients (0.2-0.3 units/mm and ~ 6%/mm, respectively) migrate toward higher pH/O2 regions. The present study was designed to address questions yet unanswered in the previous one, i.e., (1) whether extracellular O2 gradients could be a cue for directional cell migration in physiologically relevant O2 environments, and (2) whether average pH level in the bulk extracellular medium affects directional cell migration. In the absence of pH gradients, directional cell migration was not demonstrated at a physiological O2 level (<5%). We demonstrated that both the migration velocity and directionality are significantly affected by the average extracellular pH level. This result is consistent with our model for directional cell migration that does not necessitate sensing of pH gradient at a single cell level. Thus, in this study, we demonstrated further evidence that gradients of extracellular pH direct migration of MDA-MB-231 cells in vitro.


Subject(s)
MDA-MB-231 Cells , Microvessels , Cell Line, Tumor , Cell Movement/physiology , Hydrogen-Ion Concentration
13.
Clin Orthop Surg ; 14(4): 477-485, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36518923

ABSTRACT

Subchondral insufficiency fracture (SIF) of the femoral head is one of the predominant etiologies of rapidly progressive osteoarthritis of the hip (RPOH). SIF is a rare disease that causes acute pain in the hip joint. It is most frequently found in elderly women with osteoporosis. It is often underdiagnosed or misdiagnosed as osteonecrosis of the femoral head. SIF is currently a well-established cause of RPOH; however, the deeper etiology of SIF is not clear. Good clinical outcomes have been reported for hip preservation therapy and hip replacement. SIF is not obvious radiologically in the early stage, and a T1-weighted magnetic resonance imaging shows a discontinuous low-intensity band under the articular cartilage convex to the articular surface as its characteristic manifestation. Some patients will lose the opportunity to preserve the hip joint due to symptoms such as progressive joint space narrowing and subchondral collapse within a very short period. Patients with progressive hip space narrowing and subchondral collapse on X-ray should be converted to total hip arthroplasty. Based on the characteristics of the disease, surgeons need to master the clinical and radiological characteristics of SIF and strive for early diagnosis and treatment.


Subject(s)
Fractures, Stress , Joint Diseases , Osteonecrosis , Humans , Female , Aged , Femur Head/diagnostic imaging , Fractures, Stress/diagnostic imaging , Fractures, Stress/therapy , Magnetic Resonance Imaging
14.
IJU Case Rep ; 5(5): 366-368, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36090942

ABSTRACT

Introduction: We report a case of bulbar urethral injury complicated by periurethral abscess due to inappropriate suprapubic catheter management. Case presentation: A 58-year-old man with bulbar urethral injury due to perineal trauma was referred to our hospital, and a suprapubic catheter was inserted for initial management. Although he was instructed to connect the catheter to the urine collection bag, he connected a plug to the catheter. As a result, he developed periurethral abscesses due to extravasated urine from the injured urethra, requiring percutaneous drainage and prolonging the time to definitive urethroplasty for the urethral stricture. Conclusion: It is essential that the suprapubic catheter be connected to a urine collection bag rather than a plug to keep the bladder as empty as possible and to minimize extravasation of the urine from the injured urethra.

15.
Int J Urol ; 29(12): 1470-1475, 2022 12.
Article in English | MEDLINE | ID: mdl-36001651

ABSTRACT

OBJECTIVES: We report our experience with urethral reconstruction for hypospadias surgery-related urethral stricture in terms of surgical and patient-reported outcomes. METHODS: Twenty-nine adult males who underwent urethral reconstruction for hypospadias surgery-related urethral stricture between August 2008 and January 2022 were retrospectively reviewed. Uroflowmetry and patient-reported outcomes were evaluated at 3, 6, and 12 months, and annually thereafter. Surgical success was defined as the absence of additional procedures. Patients were asked to rate their satisfaction with urethral reconstruction as "very satisfied", "satisfied", "unsatisfied", or "very unsatisfied". RESULTS: The median patient age at referral was 43 years. The median number of previously performed hypospadias surgeries was three, and 18 patients (62.8%) had been treated with repeated transurethral procedures. The median stricture length was 54 mm (interquartile range 36-81). Performed urethral reconstruction included staged urethroplasty in 22 (75.9%), one-stage onlay augmentation in 3 (10.2%), and perineal urethrostomy in 4 (13.8%) cases. Urethral reconstruction was successful in 26 patients (89.7%) over a median postoperative period of 31 months. Patient-reported outcomes were assessed in 25 (86.2%) patients. The mean maximum flow rate, international prostate symptom score total score, international prostate symptom score quality of life score, and EuroQol-5 dimensions index significantly improved postoperatively. Twenty-three patients (92%) were "very satisfied" or "satisfied" with the outcome of their urethral reconstruction. CONCLUSIONS: Urethral reconstruction is a highly successful and patient-satisfying treatment for hypospadias surgery-related urethral stricture in adult patients. Perineal urethrostomy is a reasonable alternative for elderly patients and for patients with complicated hypospadias surgery-related urethral strictures.


Subject(s)
Hypospadias , Urethral Stricture , Male , Adult , Humans , Aged , Urethral Stricture/etiology , Urethral Stricture/surgery , Hypospadias/surgery , Urologic Surgical Procedures, Male/adverse effects , Urologic Surgical Procedures, Male/methods , Retrospective Studies , Quality of Life , Treatment Outcome , Urethra/surgery
16.
Opt Lett ; 47(13): 3371-3374, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-35776627

ABSTRACT

Based on dual-chirped optical parametric amplification (DC-OPA) and type-I BiB3O6 (BiBO) crystals, the generation of >100 mJ, 10.4 fs, 10 Hz, carrier-envelope phase (CEP)-stable laser pulses, which are centered at 1.7 µm, was demonstrated producing a peak power of 10 TW. CEP-dependent high harmonic generation (HHG) was implemented to confirm the sub-two-cycle pulse duration and CEP stabilization of infrared (IR) laser pulses. As far as we know, the obtained pulse energy and peak power represented the highest values for sub-two-cycle CEP-stable IR optical parametric amplification. Additionally, the prospects of achieving high-energy water window isolated attosecond pulses (IAPs) via our developed laser source were discussed.

17.
Int J Urol ; 29(9): 995-1001, 2022 09.
Article in English | MEDLINE | ID: mdl-35574632

ABSTRACT

OBJECTIVES: We investigated the efficacy of urethral reconstruction in male patients with iatrogenic urethral stricture after transurethral prostate surgery. METHODS: We retrospectively reviewed the cases of 82 patients who underwent urethral reconstruction for iatrogenic urethral stricture caused by transurethral prostate surgery between August 2011 and July 2021. Patients were followed up postoperatively with uroflowmetry, postvoid residual urine measurement, and questionnaires using Peeling's picture score, International Prostate Symptom Score, International Consultation on Incontinence Questionnaire Short Form, Sexual Health Inventory for Men, EuroQol-5 dimensions, and EuroQol-5 dimensions visual analog scores. Successful urethral reconstruction was defined as the absence of a postoperative decrease in urinary force and any additional treatment. RESULTS: The median patient age was 72 years, and the stricture site was the urethral meatus in eight (9.8%) patients, penoscrotal junction in 42 (51.2%), and proximal bulbar urethra in 26 (31.7%). Six patients (7.3%) had synchronous urethral strictures. Urethral reconstruction was successful in 78 patients (95.1%), with a median follow-up of 43 months. The mean maximum flow rate (P < 0.0001), postvoid residual urine (P = 0.004), Peeling's picture score (P < 0.0001), the score for each question and total International Prostate Symptom Score and International Prostate Symptom Score-quality of life scores (P < 0.0001 for all comparisons), and EuroQol-5 dimensions and EuroQol-5 dimensions visual analog scores (P < 0.0001 for both) significantly improved postoperatively. However, the Sexual Health Inventory for Men and International Consultation on Incontinence Questionnaire Short Form scores remained unchanged (P = 0.09 and 0.70, respectively). CONCLUSIONS: Urethral reconstruction was effective for urethral stricture due to transurethral prostate surgery in both subjective and objective aspects.


Subject(s)
Urethral Stricture , Aged , Humans , Iatrogenic Disease , Male , Patient Reported Outcome Measures , Prostate , Quality of Life , Retrospective Studies , Treatment Outcome , Urethra/surgery , Urethral Stricture/etiology , Urethral Stricture/surgery , Urologic Surgical Procedures, Male/methods
18.
J Comp Pathol ; 193: 20-24, 2022 May.
Article in English | MEDLINE | ID: mdl-35487619

ABSTRACT

We investigated the pathological characteristics of renal dysplasia with hydronephrosis and congenital ureteral stricture in two calves. Macroscopically, the affected kidneys were enlarged and the renal calyces were dilated and associated with ureteral strictures. Histopathologically, multifocal regions of mesenchyme were observed in the renal medulla. This mesenchyme was weakly eosinophilic with haematoxylin and eosin, blue with Alcian blue and pale blue with Masson's trichrome, and was immunopositive for vimentin and smooth muscle actin, consistent with persistent mesenchyme. There was asynchronous differentiation of the renal cortex characterized by immature glomeruli, immature tubules and arteriolar proliferation. Similar persistent mesenchyme was observed in the ureteral walls with ureteral stricture, and the ureteral musculature or smooth muscle bundles had a disorganized arrangement. Congenital ureteral stricture appeared to have caused ureteral obstruction and hydronephrosis. The lesions may represent a new phenotype of renal dysplasia with concomitant congenital ureteral stricture in Holstein-Friesian calves.


Subject(s)
Cattle Diseases , Hydronephrosis , Ureteral Obstruction , Animals , Cattle , Cattle Diseases/pathology , Constriction, Pathologic/pathology , Constriction, Pathologic/veterinary , Female , Hydronephrosis/complications , Hydronephrosis/congenital , Hydronephrosis/veterinary , Kidney/pathology , Male , Muscle, Smooth/pathology , Ureteral Obstruction/veterinary
19.
Int J Mol Sci ; 23(5)2022 Mar 01.
Article in English | MEDLINE | ID: mdl-35269885

ABSTRACT

Cartilage lesions are difficult to repair due to low vascular distribution and may progress into osteoarthritis. Despite numerous attempts in the past, there is no proven method to regenerate hyaline cartilage. The purpose of this study was to investigate the ability to use a 3D printed biomatrix to repair a critical size femoral chondral defect using a canine weight-bearing model. The biomatrix was comprised of human costal-derived cartilage powder, micronized adipose tissue, and fibrin glue. Bilateral femoral condyle defects were treated on 12 mature beagles staged 12 weeks apart. Four groups, one control and three experimental, were used. Animals were euthanized at 32 weeks to collect samples. Significant differences between control and experimental groups were found in both regeneration pattern and tissue composition. In results, we observed that the experimental group with the treatment with cartilage powder and adipose tissue alleviated the inflammatory response. Moreover, it was found that the MOCART score was higher, and cartilage repair was more organized than in the other groups, suggesting that a combination of cartilage powder and adipose tissue has the potential to repair cartilage with a similarity to normal cartilage. Microscopically, there was a well-defined cartilage-like structure in which the mid junction below the surface layer was surrounded by a matrix composed of collagen type I, II, and proteoglycans. MRI examination revealed significant reduction of the inflammation level and progression of a cartilage-like growth in the experimental group. This canine study suggests a promising new surgical treatment for cartilage lesions.


Subject(s)
Cartilage, Articular , Animals , Cartilage, Articular/surgery , Dogs , Femur/surgery , Humans , Hyaline Cartilage , Knee Joint/surgery , Powders
20.
Opt Express ; 30(2): 2933-2948, 2022 Jan 17.
Article in English | MEDLINE | ID: mdl-35209424

ABSTRACT

Maintaining a high spatial resolution in photoacoustic microscopy (PAM) of deep tissues is difficult due to large aberration in an objective lens with high numerical aperture and photoacoustic wave attenuation. To address the issue, we integrate transmission-type adaptive optics (AO) in high-resolution PAM with a low-frequency ultrasound transducer (UT), which increases the photoacoustic wave detection efficiency. AO improves lateral resolution and depth discrimination in PAM, even for low-frequency ultrasound waves by focusing a beam spot in deep tissues. Using the proposed PAM, we increased the lateral resolution and depth discrimination for blood vessels in mouse ears.


Subject(s)
Blood Vessels/diagnostic imaging , Ear/blood supply , Microscopy, Acoustic/instrumentation , Optics and Photonics , Photoacoustic Techniques/instrumentation , Transducers , Animals , Equipment Design , Mice
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