ABSTRACT
PURPOSE: We report a multicenter experience using double dartos flap to protect the neourethra in TIP urethroplasty for distal and midpenile hypospadias. METHODS: A total of 394 patients underwent tubularized incised plate urethroplasty for primary distal and midpenile hypospadias using double dartos flap protection by ten pediatric surgeons and urologists at five different institutions. RESULTS: Tubularized incised plate urethroplasty protected by a double dartos flap was simple to perform and flaps were easy to obtain. Complications occurred in 23 patients (5.83%): fistulas 1.01% (4 cases), stenosis 0.25% (1 case), mild stenosis 2.53% (10 cases), dehiscence of ventral cutis 0.50% (2 cases) and penile torsion 1.26% (5 cases). All fistulae had a spontaneous resolution. CONCLUSION: Double dartos flap to protect tubularized incised plate urethroplasty is safe with a low complication rate. The neourethra is covered entirely with a double layer of vascularized tissue and the double coverage appears a good choice for preventing urethrocutaneous fistula formation.
Subject(s)
Hypospadias/surgery , Penis/surgery , Plastic Surgery Procedures/methods , Surgical Flaps , Urethra/surgery , Urologic Surgical Procedures, Male/methods , Adolescent , Child , Child, Preschool , Follow-Up Studies , Humans , Hypospadias/diagnosis , Infant , Male , Prospective Studies , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
Intestinal perforation, intussusception, and infarction constitute the major surgical complications in Henoch-Schonlein purpura. Early corticosteroid treatment for intestinal complications is recommended. Here the authors describe the case of a 13-year-old boy with Henoch-Schonlein purpura who had multiple and recurrent perforations that occurred under corticosteroid treatment.
Subject(s)
IgA Vasculitis/complications , Intestinal Perforation/etiology , Adolescent , Adrenal Cortex Hormones/therapeutic use , Digestive System Surgical Procedures/methods , Humans , IgA Vasculitis/drug therapy , Intestinal Perforation/surgery , Male , RecurrenceABSTRACT
Beta-adrenergic antagonist L-alprenolol was labelled for radioactivity and UV fluorescence, and the binding to intact cultured chicken brain cells under equilibrium conditions, as the model of the experiments in vivo, was probed. The application of fluorescent label did not explore any cell type or cell particle with enhanced binding. The analysis of the radiolabelled alprenolol-binding revealed a non-specific accumulation on the surface of these cells, which was inhibited by unlabelled alprenolol excess, however, this is the peculiarity of the specific binding. Our results emphasize that for the characterization of membrane receptors of intact cells, the accurate separation of specific and non-specific binding is required. The application of a ligand concentration as low as possible and a very effective washing procedure for the removal of the unbound (and the bulk of the nonspecifically bound) label is recommended.
