Search

This case report summarises the case of a 56-year-old man with low-flow, ischaemic priapism requiring urgent insertion of a penile prosthesis following prophylactic anticoagulation with tinzaparin. Low-molecular-weight heparin (LMWH) has been proposed as a cause of ischaemic priapism, although reported cases of this are rare. This particular side effect of tinzaparin has been reported once in a case report in 2018, and there are scant other reports of LMWH-induced priapism. This case was refractory to the full treatment algorithm, including multiple aspirations, phenylephrine injection, cavernosal shunt and required transfer for implantation of a penile prosthesis. Only one other case of such a severe case of priapism has been documented, involving LMWH and warfarin. Documented evidence of possible causes of priapism are vital, given the rarity of this condition, the frequency of LMWH and the potentially devastating complications.

Delayed cerebral ischemia (DCI) is a poorly predictable complication occurring after aneurysmal subarachnoid hemorrhage (SAH) that can have dramatic functional consequences. Identifying the patients with the highest risk of DCI may help to institute more suitable monitoring and therapy. Early brain injuries and aneurysm-securing procedure complications could be regarded as confounding factors leading to severity misjudgment. After an early resuscitation phase, a subacute assessment may be more relevant to integrate the intrinsic SAH severity. A retrospective analysis was performed upon patients prospectively included in the registry of SAH patients between July 2015 to April 2020. The amount of cisternal and intraventricular blood were assessed semi-quantitatively on acute and subacute CT scans performed after early resuscitation. A clot clearance rate was calculated from their comparison. The primary endpoint was the occurrence of a DCI. A total of 349 patients were included in the study; 80 (22.9%) experienced DCI. In those patients, higher Fisher grades were observed on acute (p = 0.026) and subacute (p = 0.003) CT scans. On the subacute CT scan, patients who experienced DCI had a higher amount of blood, either at the cisternal (median Hijdra sum score: 11 vs 5, p 0.001) or intraventricular (median Graeb score: 4 vs 2, p 0.001) level. There was a negative linear relationship between the cisternal clot clearance rate and the risk of DCI. The assessment of the amount of subarachnoid blood and clot clearance following resuscitation after aneurysmal SAH can be useful for the prediction of neurological outcome.

Purpose: Diagnostic radiation is an important part of patient care in the Intensive Care Unit; however, there is little data on the acute effects of exposure to these doses. We investigated...

Ticks are involved in the transmission of various pathogens and some tick-borne diseases cause significant problems for the health of humans and livestock. Despite their obvious importance, the composition of viral communities in ticks, and their interactions with pathogens, is poorly understood, particularly in Eastern Europe that constitutes (via bird migrations for example) a major hub for animal-arthropod vectors exchanges. The aim of this study was first to describe the virome of Dermacentor sp., Rhipicephalus sp. and Haemaphysalis sp. ticks collected from poorly investigated regions of Romania (Iasi and Tulcea counties) located at the intersection of various biotopes, countries and routes of migrations. We then focused the study on viruses that could have potential relevance for human and animal health. More than 500 ticks were collected in 2019 from the environment and from small ruminants and analyzed by high-throughput transcriptome sequencing. Among the viral communities infecting Romanian ticks, viruses belonging to the Flaviviridae, Phenuiviridae and Nairoviridae families were identified and full genomes were derivedPhylogenetic analyses placed them in clades where mammalian isolates are found, suggesting that these viruses could constitute novel arboviruses. We also assessed the bacterial microbiome of the collected ticks. The characterization of these microbial communities increases the knowledge of the diversity of viruses in Eastern Europe and provide a basis for further studies on the relationship between ticks and tick-borne viruses.

Recently, buffered salt solutions and 20% albumin (small volume resuscitation) have been advocated as an alternative fluid for intravenous resuscitation. The relative comparative efficacy and potential adverse effects of these solutions have not been evaluated. In a randomized, double blind, cross-over study of six healthy male subjects we compared the pulmonary and hemodynamic effects of intravenous administration of 30 ml/kg of 0.9% saline, Hartmann's solution and 4% albumin, and 6 ml/kg of 20% albumin (albumin dose equivalent). Lung tests (spirometry, ultrasound, impulse oscillometry, diffusion capacity, and plethysmography), two- to three-dimensional Doppler echocardiography, carotid applanation tonometry, blood gases, serum/urine markers of endothelial, and kidney injury were measured before and after each fluid bolus. Data were analyzed with repeated measures ANOVA with effect of fluid type examined as an interaction. Crystalloids caused lung edema [increase in ultrasound B line ( P = 0.006) and airway resistance ( P = 0.009)], but evidence of lung injury [increased angiopoietin-2 ( P = 0.019)] and glycocalyx injury [increased syndecan ( P = 0.026)] was only observed with 0.9% saline. The colloids caused greater left atrial stretch, decrease in lung volumes, and increase in diffusion capacity than the crystalloids, but without pulmonary edema. Stroke work increased proportionally to increase in preload with all four fluids ( R2 = 0.71). There was a greater increase in cardiac output and stroke volume after colloid administration, associated with a reduction in afterload. Hartmann’s solution did not significantly alter ventricular performance. Markers of kidney injury were not affected by any of the fluids administrated. Bolus administration of 20% albumin is both effective and safe in healthy subjects.NEW & NOTEWORTHY Bolus administration of 20% albumin is both effective and safe in healthy subjects when compared with other commonly available crystalloids and colloidal solution.

Background and Objectives: The cushioning effect of large, healthy arteries reduces pulsatile afterload to the heart, reduces pulsatility in the microvasculature of target organs, and promotes coronary/cerebral perfusion [1]. With age, large arteries become stiffer, which increases both pulse wave velocity (PWV) and pulse pressure (PP). This results in isolated systolic hypertension [2], which is characterized by increased systolic blood pressure (SBP) with normal or low diastolic blood pressure (DBP) leading to left ventricular afterload. This study aims to replicate, experimentally, arterial stiffness of hypertensive patients, and proposes a novel thoracic endograft for restoring the arterial cushioning function. Methods: The experimental setup comprised of two stiff descending aorta silicone replicas (DASR 1&2), pulse duplicator, heated blood mimicking fluid, pressure and flow sensors. An internal annular viscoelastic cushion, referred to as the ‘WaveGraft’, was deployed in DASR2. Firstly, pulsatile flow was directed through DASR1, (stiff vessel only), then it was diverted through DASR2 (vessel including WaveGraft). Results: When compared to the stiff vessel replica (DASR1), the WaveGraft (DASR2) data showed significant reduction in PWV(−60%), SBP(−9%) and PP(−35%), while DBP increased by 10%. An increase in diastolic perfusion by up to 150%, was observed from the recorded data. Conclusion: This work successfully replicated, key features of aortic hemodynamics in hypertension, linked to the increase in arterial stiffness. The WaveGraft concept showed great potential in altering blood pressure, flowrates and PWV, which may become an important clinical tool in the management of isolated systolic hypertension, heart failure, chronic kidney disease and other chronic conditions.

Levetiracetam is an anti-epileptic drug commonly used in intensive care when seizure is suspected as a possible cause of coma. We propose to question the cofounding effect of Levetiracetam during the prognostication process in a case of anoxic coma. We report the story of a young woman presenting a comatose state following a hypoxic cardiac arrest. After a first EEG presenting an intermediate EEG pattern, a seizure suspicion led to prescribe Levetiracetam. The EEG showed then the appearance of burst suppression, which was compatible with a very severe pattern of post-anoxic coma. This aggravation was in fact related to an overdose of Levetiracetam (the only medication introduced recently) and was reversible after Levetiracetam cessation. The increased plasmatic dosages of Levetiracetam confirming this overdose could have been favoured by a moderate reduction of renal clearance, previously underestimated because of a low body-weight. This EEG dynamic was unexpected under Levetiracetam and could sign a functional instability after anoxia. Burst suppression is classically observed with high doses of anaesthetics, but is not expected after a minor anti-epileptic drug. This report proposes that Levetiracetam tolerance might not be straightforward after brain lesions and engages us to avoid confounding factors during the awakening prognostication, which is mainly based on the severity of the EEG. Hence, prognosis should not be decided on an isolated parameter, especially if the dynamic is atypical after a new prescription, even for well-known drugs. For any suspicion, the drug's dosage and replacement should be managed before any premature care's withdrawal.

Social media is the interaction among people in which they create, share or exchange information and ideas in virtual communities and web-based networks. This year, the Irish Society of Urology (ISU) expanded its involvement in social media with a preregistered Twitter hashtag (#ISU14) for the annual meeting. The aim of this study was to highlight the use of Twitter at an annual national meeting held in 2014. The Symplur healthcare analytics website was used to prospectively examine traffic related to the 2014 ISU Annual Meeting. This feature was used to generate statistics for the number of impressions, unique tweets (excluding retweets) and distinct contributors who used the indexing hashtag #ISU14. Individual tweets were assessed using the conference hashtag on the Twitter website. The total number of attendees at the conference was 119, and 99 individuals participated in Twitter using the conference hashtag (#ISU14). 31 % of attendees participated in tweeting at the conference. Over the course of the conference, a total of 798 unique tweets were generated, creating over 665,000 impressions in cyberspace. 590 (73.9 %) tweets were generated from attendees at the conference, while 26.1 % of tweets were from virtual followers. 702 (87.9 %) tweets were from urologists and 439 (55 %) tweets were of scientific nature. Tweet activity peaked during the guest lectures on both days. Twitter use at the ISU has been shown to facilitate interaction between delegates and allows users to follow as well as participate from afar.

As the audiovisual industry has globalized, it has developed a complicated pattern of national and international marketing strategies. Some nation-states rely on trade barriers and quotas to protect national cultural industries from foreign competition, while elsewhere once-national corporations have evolved into international audiovisual giants, whose products are fine-tuned to the needs and tastes of different national markets. In addition, innovative technologies and alternate outlets present new opportunities for product positioning. It is here argued that one result of these and other strategies is the increased domination of a neoliberal model of global commercialization, with products that don’t fit the model needing to develop alternative strategies.

cited By 0; International audience; In this study, GaAs crystals were grown by chemical beam epitaxy on nominal (001) Si substrate over Ge nano-seeds placed within nano-holes opened through a 0.6 nm silica layer. GaAs crystal morphology and atomic organization at the interface between Ge and GaAs were studied by using complementary Scanning Transmission Electron Microscopy, energy dispersive X-ray spectrometry and dark-field electron holography. Fourfold symmetry GaAs crystals were obtained and found to be completely relaxed and twin free. Thus, the use of Ge nano-seeds to initiate the growth of GaAs results in the suppression of twins previously observed for direct GaAs growth on nominal (001) Si. Nevertheless, anti-phase domains were detected. A simple atomistic model is proposed which explains how Anti-Phase Boundaries develop at the junctions between Ge {113} facets, and {113} and {111} facets for As-stabilized GaAs growth.

We present a highly coherent semiconductor laser device formed by a ½-VCSEL structure and an external concave mirror in a millimetre high finesse stable cavity. The quantum well structure is diode-pumped by a commercial single mode GaAs laser diode system. This free running low noise tunable single-frequency laser exhibits >50mW output power in a low divergent circular TEM00 beam with a spectral linewidth below 1kHz and a relative intensity noise close to the quantum limit. This approach ensures, with a compact design, homogeneous gain behaviour and a sufficiently long photon lifetime to reach the oscillation-relaxation-free class-A regime, with a cut off frequency around 10MHz.

Esophageal varices are a significant complication of portal hypertension. Endoscopic variceal ligation (EVL) is one of the clinical standards for treating these varices and preventing their hemorrhage. Limitations of EVL include the risk of stricture formation and postband ulcer bleeding due to the damage caused to the esophageal mucosa, as well as the need for multiple endoscopic treatment sessions to eradicate the varices. The goal of this study is to develop a device and evaluate the technical feasibility of microwave ablation to seal esophageal varices, while preventing thermal damage to the surface mucosal tissue. A microwave applicator with a directional radiation pattern was developed for endoscopic ablation of esophageal varices. Electromagnetic and bioheat transfer computational models were employed to optimize the design of the microwave applicator and evaluate energy delivery strategies for this application. Experiments in ex vivo and in vivo tissue were employed to verify simulation results. Simulations predicted enhanced heating performance of the antenna using an angled monopole radiating element. Further, simulations indicate that while the endoscopic cap attenuated electric fields in tissue, it also enhanced surface cooling of tissue, increasing the likelihood of preserving mucosal tissue. Experiments in ex vivo tissue indicated the feasibility of sealing veins with 77 W microwave power delivered for 30 s. In vivo experiments demonstrated the ability to seal veins, while preserving surface tissue. This study demonstrated the technical feasibility of microwave thermal ablation for treating esophageal varices using a 2.45 GHz water-cooled directional microwave applicator.

Summary We designed a PyQt graphical user interface—Sequanix—aimed at democratizing the use of Snakemake pipelines in the NGS space and beyond. By default, Sequanix includes Sequana NGS pipelines (Snakemake format) (http://sequana.readthedocs.io), and is also capable of loading any external Snakemake pipeline. New users can easily, visually, edit configuration files of expert-validated pipelines and can interactively execute these production-ready workflows. Sequanix will be useful to both Snakemake developers in exposing their pipelines and to a wide audience of users. Availability and implementation Source on http://github.com/sequana/sequana, bio-containers on http://bioconda.github.io and Singularity hub (http://singularity-hub.org). Supplementary information Supplementary data are available at Bioinformatics online.

High Power Impulse Magnetron Sputtering (HiPIMS) with pre-ionization was successfully used for metal deposition at very low-pressures by feeding one cathode of a conventional dual magnetron deposition system, the other one being radio frequency (RF) supplied. By adjusting the pulse length and RF power, this hybrid RF/HiPIMS co-deposition process improved the deposition rate of niobium in a-NbSi films as well as the film homogeneity on 4 in. Si substrates. Moreover, the films obtained by hybrid RF/HiPIMS showed good response for both superconducting critical temperature transition (T c ) and normal resistivity (R), which compared favorably to films obtained by Electron Beam Physical Vapor Deposition (EB PVD) and standard DC/RF MS-PVD co-sputtering deposition currently used in the micro-fabrication of cryogenic detector.

Objectives. This study determines the risk of ipsilateral ischaemic neurological events in relation to the degree of asymptomatic carotid stenosis and other risk factors. Methods. Patients (n = 1115) with asymptomatic internal carotid artery (ICA) stenosis greater than 50% in relation to the bulb diameter were followed up for a period of 6-84 (mean 37.1) months. Stenosis was graded using duplex, and clinical and biochemical risk factors were recorded. Results. The relationship between ICA stenosis and event rate is linear when stenosis is expressed by the ECST method, but S-shaped if expressed by the NASCET method. In addition to the ECST grade of stenosis (RR 1.6; 95% CI 1.21-2.15), history of contralateral TIAs (RR 3.0; 95% CI 1.90-4.73) and creatinine in excess of 85 μmol/L (RR 2.1; 95% CI 1.23-3.65) were independent risk predictors. The combination of these three risk factors can identify a high-risk group (7.3% annual event rate and 4.3% annual stroke rate) and a low risk group (2.3% annual event rate and 0.7% annual stroke rate). Conclusions. Linearity between ECST percent stenosis and risk makes this method for grading stenosis more amenable to risk prediction without any transformation not only in clinical practice but also when multivariable analysis is to be used. Identification of additional risk factors provides a new approach to risk stratification and should help refine the indications for carotid endarterectomy. © 2005 Elsevier Ltd. All rights reserved.

Single junction Si solar cells dominate photovoltaics but are close to their efficiency limits. This paper presents ideal limiting efficiencies for tandem and triple junction multijunction solar cells subject only to the constraint of the Si bandgap and therefore recommending optimum cell structures departing from the single junction ideal. The use of III-V materials is considered, using a novel growth method capable of yielding low defect density III-V layers on Si. In order to evaluate the real potential of these proposed multijunction designs, a quantitative model is presented, the strength of which is the joint modelling of external quantum efficiency and current-voltage characteristics using the same parameters. The method yields a single parameter fit in terms of the Shockley-Read-Hall lifetime. This model is validated by fitting experimental data of external quantum efficiency, dark current, and conversion efficiency of world record tandem and triple junction cells under terrestrial solar spectra without concentration. We apply this quantitative model to the design of tandem and triple junction solar cells, yielding cell designs capable of reaching efficiencies without concentration of 32% for the best tandem cell and 36% for the best triple junction cell. This demonstrates that efficiencies within a few percent of world records are realistically achievable without the use of concentrating optics, with growth methods being developed for multijunction cells combining III-V and Si materials.

Electron beam (e-beam) exposure of insulating material gives rise to charge accumulation which degrades pattern resolution and position during lithography and observation. In this paper we propose a process which reduces significantly the artifacts due to charging effects by using a charge dissipater based on a bi-layer deposited on top of the insulating substrate. The first layer is an inorganic thin film and soluble in water at room temperature, while the second layer is a metallic thin film. We reported the results of this process during e-beam lithography and observation of insulating samples.

Gallbladder stones form the majority of biliary disease, and are conveniently detected by ultrasonography (US).

The importance of the rectal examination cannot be over-stressed: it should ideally form part of every complete bowel examination. A measure of the importance of the rectal examination is gauged by the fact that about 15% of all large bowel cancers can be felt digitally. It is usually possible to reach further with a finger than can be seen with an anoscope.

The anatomy of the liver and spleen and the physiology of the portal circulation can be investigated in numerous ways. Some of the techniques are too specialized for general use, but many have found a place in routine diagnosis.

Background: The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis. Methods: This was a prospective, multicenter, cohort study of patients undergoing medical intervention for vascular disease. Hazard ratios for ICA stenosis, clinical features, and plaque texture features associated with ipsilateral cerebrovascular or retinal ischemic (CORI) events were calculated using proportional hazards models. Results: A total of 1121 patients with 50% to 99% asymptomatic ICA stenosis in relation to the bulb (European Carotid Surgery Trial [ECST] method) were followed-up for 6 to 96 months (mean, 48). A total of 130 ipsilateral CORI events occurred. Severity of stenosis, age, systolic blood pressure, increased serum creatinine, smoking history of more than 10 pack-years, history of contralateral transient ischemic attacks (TIAs) or stroke, low grayscale median (GSM), increased plaque area, plaque types 1, 2, and 3, and the presence of discrete white areas (DWAs) without acoustic shadowing were associated with increased risk. Receiver operating characteristic (ROC) curves were constructed for predicted risk versus observed CORI events as a measure of model validity. The areas under the ROC curves for a model of stenosis alone, a model of stenosis combined with clinical features and a model of stenosis combined with clinical, and plaque features were 0.59 (95% confidence interval [CI] 0.54-0.64), 0.66 (0.62-0.72), and 0.82 (0.78-0.86), respectively. In the last model, stenosis, history of contralateral TIAs or stroke, GSM, plaque area, and DWAs were independent predictors of ipsilateral CORI events. Combinations of these could stratify patients into different levels of risk for ipsilateral CORI and stroke, with predicted risk close to observed risk. Of the 923 patients with

Ultra-low temperature sensors provide unprecedented performances in X-ray and far infrared astronomy by taking advantage of physical properties of matter close to absolute zero. CESAR is an FP7 funded project started in December 2010, that gathers six European laboratories around the development of high performances cryogenic electronics. The goal of the project is to provide far-IR, X-ray and magnetic sensors with signal-processing capabilities at the heart of the detectors. We present the major steps that constitute the CESAR work, and the main results achieved so far.

Si nanowires were grown on (111) substrates by ultra high vacuum chemical vapor deposition using the Au-catalyzed vapor–liquid–solid (VLS) technique. Depending on the growth temperature, the nanowires can be straight in the direction or kinked towards . We present a transmission electron microscopy investigation of the Si nanowires. Results exhibit the relationship between the morphology of nanowires and the distribution of gold on sidewalls bounding the nanowires. The distribution of Au nanoclusters is used as a probe to investigate the growth mechanisms of the VLS process. Our observations are consistent with the model of nucleation and step flow related to the oscillatory behavior of the catalyst droplet.

This comment letter report on a critical reading of an article published in Journal of Materials Science [1]. As stated in the acknowledgements, the silicon-based solar cells described in the article under question were contractually fabricated at the Institut d’Electronique Fondamentale, by using the technological facilities of the University Technology Center (CTU IEF-Minerve) of the University Paris Sud, France. The fabrication of prototype devices on request of external research institutions is part of the current assignments of this Center. The corresponding invoice was received from the author of Ref [1] in April, 2009. Using our previous know-how in epitaxial growth, a number of structures have been fabricated, consisting of a stack of Ge quantum dots, a Si layer and a highly doped Si layer, as described in Fig. 1 of ref. [1]. The solar cell devices based on these structures were completed with back and front contacts, as seen in Fig. 8 of Ref [1]. In addition, structural and optical routine characterizations were done in order to calibrate the areal quantum dot density and check the quality of the grown material, consisting in scanning electron microscopy imaging, and photoluminescence (PL) measurements made at room temperature. In collaboration with Prof. O. Aboelfotoh, we also checked the current voltage characteristics of the whole devices in the dark and under AM 1.5 standard illumination by using the dedicated facility of the Laboratoire de Genie Electrique de Paris, France. These devices and attached data were finally provided in 2010 to the King Fahd University of Petroleum & Minerals, Saudi Arabia. At this step, Dr H.M. Tawancy was of course free to act in his own way, like publishing results obtained from these devices. The corresponding article, entitled ‘‘Enhancing the photovoltaic effect in the infrared region by germanium

Diabetes mellitus is a leading cause of impaired wound healing. The aim of this study was to establish a glucose-controlled diabetic wound healing model. Sprague–Dawley rats were divided into three groups: Control group (C), Diabetic Non-glucose Controlled group (DNC) and Diabetic glucose Controlled group (DC). Glucose control was achieved using Insulman Rapid (average daily glucose level

Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta. We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters. Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively. Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated. These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.

Introduction Hypoperfusion of the bowel is a risk factor for anastomotic failure. Electrical field stimulation has been shown to improve repair in ischemic tissue, but its influence in hypoperfused colon has not been investigated. The hypothesis of this experimental animal study was that electrical field stimulation improves anastomotic healing in ischemic bowel. Materials and methods Thirty rats were divided evenly into three groups: control, ischemia/placebo, and ischemia/test group. Ischemia was induced by ligation of the arterial supply to the proximal colon. The watershed area was identified and transected. Field stimulation was achieved by application of negatively charged diethylaminoethyl Sephadex beads in methylcellulose gel to the colonic epithelium prior to anastomosis. The placebo group had methylcellulose gel only applied and control animals had anastomosis only. Anastomotic strength was measured using anastomotic bursting pressure and hydroxyproline content. Systemic effect was investigated via interleukin-6 and vascular endothelial growth factor assay. Results The ischemia/electrical field stimulation (EFS) group had significantly increased bursting pressure and hydroxyproline content in comparison with the placebo group (P

Type 1 diabetics have a well-recognised risk of accelerated cardiovascular disease. Even in the absence of clinical signs there are detectable abnormalities of conduit vessel function. Our group has previously reported reversal of endothelial dysfunction in diabetics with pravastatin. In young asymptomatic smokers, taurine supplementation has a beneficial impact on macrovascular function, assessed by FMD, and shows an up-regulation of nitric oxide from monocyte—endothelial cell interactions. We hypothesise that taurine supplementation reverses early endothelial abnormalities in young male type 1 diabetics, as assessed by applanation tonometry, brachial artery ultrasound and laser Doppler fluximetry. Asymptomatic, male diabetics ( n=9) were scanned prior to treatment and then randomised in a double-blind cross-over fashion to receive either 2 weeks placebo or taurine. Control patients ( n=10) underwent a baseline scan. Assessed diabetics had detectable, statistically significant abnormalities when compared with controls, in both arterial stiffness (augmentation index) and brachial artery reactivity (FMD). Both of these parameters were returned to control levels with 2 weeks taurine supplementation. In conclusion, 2 weeks taurine supplementation reverses early, detectable conduit vessel abnormalities in young male diabetics. This may have important implications in the long-term treatment of diabetic patients and their subsequent progression towards atherosclerotic disease.

Oxidative stress on the renal tubules has been implicated as a mechanism of injury in both stress hyperglycemia and contrast-induced nephrotoxicity. The purpose of this study was to determine whether the combination of these effects has a synergistic effect on accentuating renal tubular apoptosis and therefore increasing the risk of contrast-induced nephrotoxicity.Dog kidney cells were incubated with 5- and 30-mmol/L glucose solutions and no glucose and then exposed for 2 hours to three types of contrast media-high osmolar (370 mg I/mL), low osmolar (300 mg I/mL), and isoosmolar (320 mg I/mL)-and a mannitol control solution. In an identical experiment, each group of cells was pretreated with an antioxidant-N-acetylcysteine or taurine-to evaluate the protective effect, if any. Apoptosis was assessed with fluorescence-activated cell sorter flow cytometry.The high-osmolar contrast medium was associated with significantly elevated levels of apoptosis compared with the mannitol control (percentage apoptosis, 27.98 +/- 1.08 vs 6.19 +/- 0.771; p0.001). This effect was less pronounced after incubation with the low-osmolar agent but was still significant (percentage apoptosis, 20.19 +/- 0.3665 vs 6.19 +/- 0.771; p0.001). The isosmolar agent did not have a significant effect. Both the high- and low-osmolar contrast media coupled with hyperglycemia (30-mmol/L glucose) were associated with a significantly increased level of apoptosis. In all contrast medium groups, taurine had a greater protective effect on attenuation of cell apoptosis than did N-acetylcysteine.The combination of contrast medium and an elevated glucose level has a synergistic effect on apoptosis. Taurine may be a more effective prophylactic antioxidant than the currently advocated antioxidant, N-acetylcysteine.

Study Type – Therapy (RCT) Level of Evidence 2b OBJECTIVE To compare the potassium-titanyl-phosphate GreenlightTM 80-W laser ablation system for photovaporization of the prostate (PVP; Laserscope, San Jose, CA, USA) with transurethral resection of the prostate (TURP), as many technologies have been proposed as equivalent or superior to TURP without gaining widespread acceptance, due to lack of data from randomized trials. PATIENTS AND METHODS In all, 120 patients were randomized to undergo either TURP or PVP after a full urological evaluation, which was repeated at 1, 3, 6 and 12 months after surgery. Irrigation use, duration of catheterization (DOC), length of hospital stay (LOS), blood loss, cost and operative time were also assessed. RESULTS Both groups showed a significant increase in mean (sd) maximum urinary flow rate from baseline (P

We present a 19-year-old man with a diagnosis of Ehlers-Danlos syndrome (EDS) and a delayed presentation of testicular torsion. EDS is a rare and heterogeneous condition affecting collagen synthesis and presents multiple difficulties in a surgical setting. Management of this case of testicular torsion was complicated by impaired cognition of the patient, difficulty with intubation, a contralateral undescended testis and postoperative bleeding. We discuss the specific challenges faced in this case of testicular torsion with longstanding ischaemia and perioperative considerations of EDS.

Pulsed laser induced epitaxy (PLIE), based on melting/solidification processes induced by nanosecond laser pulses, is used to synthesize pseudomorphic Si1 − xGex epilayers from 20 to 80 nm thick Ge layers evaporated on a Si(100) wafer. Ge concentration and strain are characterized by transient reflectivity, energy dispersive X-ray analysis and X-ray diffraction from symmetric (004) and asymmetric (224) reflections. For a low Ge thickness or a high laser fluence, PLIE builds up only a pseudomorphic strained Si1 − xGex layer with a graded Ge composition reaching x ≈ 19% near the surface. When the Ge amount is in excess to achieve this situation, PLIE forms additionally a relaxed Si1 − xGex layer with x values up to ≈40% over the previous pseudomorphic layer.

Background Major aortic surgery results in significant haemodynamic and oxidative stress to the myocardium. Cytokine release is a major factor in causing cardiac injury during aortic surgery. Endovascular aortic aneurysm repair (EVAR) has the potential to reduce the severity of the ischaemia reperfusion syndrome and its systemic consequences. Aim The aim of this study was to investigate the occurrence of myocardial injury during conventional and endovascular abdominal aortic aneurysm repair using measurement of the myocardial-specific protein, cardiac troponin T. Interleukin-6 was also measured in both groups and haemodynamic responses to surgery assessed. Methods Nine consecutive patients undergoing conventional infra-renal aortic aneurysm surgery were compared with 13 patients who underwent EVAR. Patients were allocated on the basis of aneurysm morphology and suitability for endovascular repair. Results Patients undergoing open repair had significantly more haemodynamic disturbance than those having endovascular repair (mean arterial pressure at 5 min following unclamping or balloon deflation: open (69.6 + 3.3 mmHg); endovascular (86 + 4.4 mmHg), P0.1 ng/l when compared with the endovascular group (P