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Bilateral laparoscopic gonadectomy is reported as an operative procedure of removing the intraabdominal gonads in individuals with complete androgen insensitivity syndrome (CAIS). We present a case of 18 year old patient who had history of primary amenorrhea. The clinical evaluation shows a female phenotype, excellent breast development, absence of hair in the groins and axillary areas and short blind vagina. In ultrasonographic examination uterus was absent. Hormonal assay showed elevated serum testosterone levels of 1,037 ng/dL. A karyotype was also performed which revealed a 46 XY. Laparoscopy diagnostic revealed absence of internal genitalia except bilateral gonads appearing as testes. The testes were removed to avoid the risk of malignancy. Histopathological examination revealed that both the masses were composed of testicular tissue. Laparoscopy allows to clearly identify, locate as well as gonadectomy in the same time. This approach results in rapid recovery with minimal blood loss and should be considered for all patient with intraabdominal gonads.

This study investigates mosquito proboscis-inspired (MPI) insertion applied to the clinically used biopsy needle to reduce tissue deformation and organ displacement. Advanced medical imagining has enabled early-stage identification of cancerous lesions that require needle biopsy for minimally invasive tissue sampling and pathological analysis. Accurate cancer diagnosis depends on the accuracy of needle deployment to the targeted cancerous lesion site. However, currently available needle delivery systems deform and move soft tissue and organs, leading to a non-diagnostic biopsy or undersampling of the target. Two features inspired by the mosquito proboscis were adopted for MPI insertion in prostate biopsy: (1) the harpoon-shape notches at the needle tip and (2) reciprocating needle-cannula motions for incremental insertion. The local tissue deformation and global prostate displacement during the MPI vs. traditional direct insertions were quantified by optically tracking the displacement of particle-embedded tissue-mimicking phantoms. Results show that the MPI needle insertion reduced both local tissue deformation and global prostate displacement because of the opposite needle-cannula motions and notches which stabilized and reduced the tissue deformation during insertion. Findings provide proof of concept for MPI insertion in the clinical biopsy procedures as well as insights of needle–tissue interaction for future biopsy technology development.

Biaxial tensile testing of the silicone elastomer fabricated by additive manufacturing (AM) for wearable biomedical devices is presented. Silicone elastomer has unique mechanical properties ideal for stretchable parts in wearable biomedical devices. Biaxial tensile testing, in comparison to the uniaxial tensile and compression tests, is more representative for materials with large, multidirectional stretch. This study investigates the experimental setup and methods to measure and characterize mechanical properties of AM solid and porous silicone elastomer sheets on equi-biaxial stretch (with the stretch ratio up to 2). Four hyperelastic material models were applied to characterize the AM silicone sheet and evaluated through the finite element analysis (FEA) to quantify the fit to biaxial tensile test results. The Yeoh model with C10 = 80.7 kPa, C20 = –2.11 kPa, and C30 = 0.22 kPa has the best match to the experimentally measured stress-strain curve as well as the force and strain in FEA. This study demonstrates that the effects of raster angle and thickness are insignificant in the stress-strain curve of an AM silicone elastomer with solid cross-section. This study also demonstrates that AM can fabricate anisotropic porous silicone elastomer parts with different stiffness in x- and y-directions.

Climate change can have a direct effect (e.g. changes in air temperature, increased ultraviolet radiation, and pollution) and indirect effect (such as increased incidence infectious diseases). Infectious diseases are the main cause of high human mortality, especially in developing countries like Indonesia. Andong plant (Cordyline terminalis) is one of Bali’s local plants, which is widely used as a drug for infections due to microbes resulting from climate change. This study aimed to observe the effect of Andong leaf extract as an antioxidant and antibacterial and to identify the compounds. This research design was carried out with sample preparation including cleaning, cutting, drying, grinding and sifting to powder. Extraction was done by maceration method. Phytochemical tests were then performed with color reagents. Antioxidant test was carried out using diphenyl picryl hydrazil hydrate (DPPH) method and antibacterial activity was determined by well diffusion method. Measurement of antioxidant compounds’ levels was determined spectrophotometrically and analysis of antioxidant compounds was carried out by the LC-MS/MS method. The result showed that the Andong leaf extract contained saponins, polyphenols, flavonoids, steroids, triterpenoids, phytosterols, amino acids and alkaloids. In the testing of antioxidant compounds, Andong leaf extract contained tannins was 3324.550±0.821 mg/100 g TAE, phenol was 1398.905±0.812 mg/100 g GAE and flavonoids was 1373.065±1.288 mg/100 g QE. Andong leaf extract reduced free radicals from DPPH with IC50 88.26±0.015 ppm and inhibited the three bacterial test results with significant differences compared to controls (p

Cerebral Abscess in Adult with Atrial Septal Defect and Pulmonary Stenosis

The testis was composed by the cells of Leydig, Sertoli, and Spermatogenic. The cells formation itself was able to be disrupted by exposure to an endocrine disrupting chemical (EDC) since the prenatal period. The research was intended to prove that Genistein could obstruct the formation of Leydig cells, Sertoli cells, Spermatogenic of rats. The randomized post-test only control group design method was conducted towards white female Wistar rats, 12-13 weeks old, has been had one child, could normally eat and drink. The analysis unit was the child of mother rat treatment group that given Genistein of 10 mg/kg/day and the control group that received distilled water, each of them were 15. The research was done in the Laboratory of Faculty of Veterinary Medical, Udayana University, from January to July 2016. The computer was used for analyzing the data using, with α of 0.05. The result was the Genistein child had an average of 5.464 Sertoli cell, 11.120 Leydig cell, and 48.427 spermatogonia, whereas, the control group had an average of 8.173 Leydig cells, 12.987 Sertoli cells, and 69.547 spermatogonia. There were significant differences between the two groups (p 0.000). The conclusion was that an average of Leydig cells, Sertoli cells, and Spermatogonia lower in children whose their parent rats given Genistein during Periconception period.

Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART) in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources in terms of the number and distribution of infertility clinics would reduce the substantial travel required to access infertility care. Thirdly, improvements in the financial accessibility of infertility care would have promoted ease of access to care in this sample. Finally, the expansion of poorly developed referral systems would also have enhanced the efficiency with which this group of patients were able to access appropriate care.