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OBJECTIVE To evaluate the long-term outcome of bladder papillary urothelial neoplasms of low malignant potential (PUNLMP). PATIENTS AND METHODS Of 475 consecutive patients with newly diagnosed bladder tumours between 1976 and 1993, 330 (69%) had superficial (Ta and T1) tumours and 53 (11%) were diagnosed as having PUNLMP. Fifty patients (mean age at presentation 57.2 years, range 26–83; male-to-female ratio 6 : 1) who were followed for> 5 years or until they died, were included in the present study. All histological slides were reviewed, and fulfilled the diagnostic criteria of the 1998 World Health Organization/International Society of Urological Pathology classification system. RESULTS The mean (median, range) follow-up was 11.7 (10.8, 1.3–24.4) years. During the follow-up, 30 patients (60%) had local recurrences. The 2, 5 and 10-year recurrence-free rates were 66%, 51% and 36%, respectively. No patients developed high-grade or muscle-invasive (≥ T2) carcinomas, or upper urinary tract tumours, or died from the disease. At the last follow-up, 34 patients (68%) had been disease-free for> 5 years. CONCLUSIONS Despite a high recurrence rate, PUNLMP carries a very low malignant potential. We agree with the use of the term ‘papillary urothelial neoplasms of low malignant potential’ instead of ‘superficial bladder carcinoma (cancer)’ for these tumours. [ABSTRACT FROM AUTHOR]

OBJECTIVES To explore the spontaneous regeneration, over a long period, of the seriously injured sympathetic pathway controlling the prostate. MATERIALS AND METHODS The hypogastric nerve (HGN), which is part of the sympathetic pathway from the spinal cord to the prostate, was partly removed over half of its length on both sides in six dogs. Four years after surgery the responses of the prostate to electrical stimulation of the lumbar splanchnic nerve (LSN) or the HGN proximal to the site removed, were assessed. RESULTS In six dogs, 10 of the 17 LSNs (second to fourth) and four of the 10 HGNs stimulated elicited prostatic contraction. The pathways via the ipsilateral HGN and/or the contralateral HGN from the LSNs to the prostate were identified as having regenerated in four of six dogs. CONCLUSION These results indicate that the sympathetic pathways via the HGN to the canine prostate can regenerate spontaneously over a long period after serious injury, and that their cross-innervation system can also be repaired. [ABSTRACT FROM AUTHOR]

Summary. The numbers of Sertoli and pre-meiotic germ cells in the developing rabbit testis were investigated as an initial step in determining the physiological meaning of the control of cell number in the testis by apoptosis. Sections were stained immunohistochemically for the detection of apoptotic cells and counterstained with haematoxylin. The number resulting from subtraction of the number of apoptotic cells from the total cell number was defined as the viable cell number. The number of viable pre-meiotic germ cells in the adluminal compartment of seminiferous tubules decreased during the pre-natal period, although neither apoptotic nor necrotic figures were detected. After birth, the numbers of total and apoptotic Sertoli and pre-meiotic germ cells increased, maintaining a stable ratio of their viable cell populations until the induction of meiosis. During induction of meiosis, the increase in the number of viable Sertoli cells was significantly accelerated because of the rapid decrease in the number of apoptotic Sertoli cells. Just after spermatids were formed the number of viable spermatogonia increased, reflecting an active supply of differentiated spermatogonia entering meiosis. In conclusion, apoptosis of Sertoli and pre-meiotic germ cells plays an important role in the acquisition of a suitable ratio of both cell types, and in providing intratubular environments for further progression of spermatogenesis, by controlling numbers of both cell types during the post-natal period. [ABSTRACT FROM AUTHOR]

Summary. Aquaporin (AQP) is a molecule that facilitates water permeability through cell membranes and is widely distributed in the mammalian body. Among members of the AQP family, AQP7 and AQP8 are predominantly expressed in the testis. This paper examined the expression of these two AQPs in the developing rat testis, using northern blot and immunohistochemistry to visualize their roles during the progression of spermatogenesis in the developing testis. In adult rats, expression of AQP7 was localized to spermatids, whereas AQP8 protein was observed in spermatocytes. In the developing testis, transcripts of AQP7 became detectable between 23 and 25 days post-partum, when round spermatids have been reported to appear. On the other hand, AQP8 mRNA was first detected between 13 and 16 days post-partum, consistent with the reported first appearance of spermatocytes (13–14 days). AQP7 and AQP8 proteins were detectable at 28 days post-partum. The results suggest that AQP7 and AQP8 appear in the testis in accordance with the maturation of germ cells, and are involved in spermatogenesis. [ABSTRACT FROM AUTHOR]

This article focuses on the use of prostatic stenting as an alternative to urinary retention caused by BOO, especially for high-risk patients unfit for surgery. Two major issues influencing successful stenting are the choice of stent length and the precise placement of the stent. Prostatic stenting stenting does not require lumbar anaesthesia, endoscopy or X-ray fluoroscopy equipment, making stent insertion simpler and less invasive than the conventional method using endoscopy or fluoroscopy.

Apraxia of lid opening (ALO) is a syndrome characterized by a non-paralytic inability to open the eyes at will in the absence of visible contraction of the orbicularis oculi muscle. Here we report that globus pallidus internus deep brain stimulation on the right side markedly alleviates ALO as well as gait freezing in a patient with Parkinson’s disease. [ABSTRACT FROM AUTHOR]

Although de-airing procedures are commonly performed during cardiac surgery, use of these procedures is not necessarily based on evidence. Uncertainly remains around the size of bubbles that can be detected by echocardiography, whether embolized air or carbon dioxide can be absorbed, and the reasons for embolic events occurring despite extensive de-airing. Since air bubbles are invisible in the blood, we used simple experimental models employing water and 10% dextran solution to determine the correlation between actual bubble size and the depicted size on echocardiography, bubble size, and floatation velocity and the absorption of carbon dioxide under embolization and irrigation conditions. Bubbles depicted as larger than 1 mm were overestimated by echocardiography: the actual size was larger than 0.4 mm in diameter. While bubbles of 0.5 mm had a floatation velocity of 2 to 3 cm/s, the buoyancy of bubbles smaller than 0.3 mm was negligible. Thus, bubbles that are depicted as larger than 1 mm on echocardiography or that present with apparent buoyancy should be visible and need to be meticulously removed. However, echocardiography cannot distinguish bubbles of around 0.1 mm in diameter from those of capillary size (<10 μm). Thus, we advise continuous venting of dense bubbles until they become sparse. While carbon dioxide was rapidly absorbed when circulating, the absorption of embolized carbon dioxide was negligible. These results suggest that detected intracardiac air represents residual "air," with carbon dioxide already absorbed. Therefore, the use of conventional de-airing procedures needs reconsideration: air and buoyant bubbles should be removed from the heart before they are expelled into the aorta; this requires timely and precise assessment with transesophageal echocardiography and effective collaboration between surgeons, anesthesiologists, and perfusionists., (© 2021 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Background: Surgical ring annuloplasty is generally performed in patients with symptomatic atrial functional mitral regurgitation (MR) caused by long-standing atrial fibrillation (AF). However, its clinical results have not been well reported., Methods: Twenty consecutive patients with atrial functional MR (mean age of 68 ± 9 years) and a left ventricular (LV) ejection fraction (EF) greater than 50% underwent mitral annuloplasty. Concomitant procedures included tricuspid valve surgery in 16 patients, AF ablation in 13 patients, and coronary artery bypass grafting in 2 patients. We reviewed the clinical outcomes of those patients and investigated the specific preoperative echocardiographic findings related to MR recurrence., Results: At discharge, the mean left atrial (LA) volume index and mean tricuspid regurgitation peak gradient had significantly decreased from 94 ± 59 mL/m 2 to 58 ± 30 mL/m 2 and from 34 ± 11mm Hg to 23 ± 5mm Hg, respectively. During the follow-up period of 28 ± 17 months, the New York Heart Association functional class significantly improved from 2.3 ± 0.6 to 1.3 ± 0.6. Four patients developed recurrent MR, and of those, two required reoperation. Those with recurrent MR had a significantly larger preoperative LV dimension than those without recurrent MR. Preoperative three-dimensional transesophageal echocardiography was performed in 12 patients, revealing a greater degree of leaflet tethering in patients with recurrent MR than that in patients without recurrent MR., Conclusions: In patients with the combination of atrial functional MR, left ventricular dilatation and excessive leaflet tethering, mitral annuloplasty alone may not be sufficient to achieve long-term correction of MR., (© 2019 Wiley Periodicals, Inc.)

Continuous monitoring of serum solute concentrations throughout a dialysis session could be beneficial for the prevention of intradialytic morbidity such as hypotension and for the confirmation of dialysis adequacy. In this paper, we introduce a new on-line monitoring system for use during hemodialysis sessions, a system developed for the continuous observation of serum biochemical data. Using this system, we also show the possibility of clinical applications. Intradialytic hypotension could be prevented by the observation of filtrate sodium concentration and the control of dialysate sodium concentration. The termination of a dialysis session could be decided by the observation of the filtrate urea nitrogen, on the basis of the Kt/V urea ratio. Because monitoring for other solutes such as calcium and creatinine is theoretically available, clinical applications will continue to increase in the future.

The process of attachment of Mycoplasma hominis and M. orale to HAIN-55 cells, derived from normal embryonic human lung, was investigated quantitatively. The attachment reached its maximum within about 2-4 hr at 37 degrees C and increased linearly as a function of the number of organisms present in the system. The relative attachment efficiency of M. hominis was approximately 1% under our experimental conditions. Trypsin and EDTA were effective in detaching particles of M. hominis and M. orale from the surfaces of HAIN-55 cells. Therefore it was suggested that some proteinaceous substance and salt bridges might be involved in the attachment of these mycoplasmas to HAIN-55 cells.

The behavior of Mycoplasma hominis in normal human embryonic lung fibroblast (HAIN-55) cell cultures was investigated. Multiplication patterns of cell-associated mycoplasmas and of extracellular mycoplasmas in the HAIN-55 cultures depended upon the size of the inoculum. This relationship did not vary with the number of days the cells had been cultured, nor with the number of HAIN-55 cell passages. The maximum mycoplasmal growth was obtained with inoculum sizes of 10(5) to 10(6) colony-forming units (CFU)/ml. The recovery of mycoplasmas decreased rapidly with inoculum size beyond 10(7) CFU/ml, and growth of the HAIN-55 cells was inhibited. Growth of the cells was also inhibited by the addition of the cytoplasmic fraction of Mycoplasma hominis.

The usefulness of chicken egg yolk extract as a substitute for horse serum in culture media for Mycoplasma pneumoniae was investigated. As a growth-supporting factor in the growth medium for M. pneumoniae and some other mycoplasmal species, the primary isolation medium for M. pneumoniae, and the metabolism-inhibition test medium for diagnosis of M. pneumoniae infection, egg yolk extract may be an excellent substitute for horse serum. The particular superiority of egg yolk extract to horse serum is that egg yolk extract, unlike horse serum, did not show any inhibitory effect on the growth of M. pneumoniae.