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Aim Congenital monorchism is considered a condition in which an initially normal testis has existed but subsequently atrophied and disappeared due to a third trimester catastrophe (presumably torsion). Since inhibin B concentrations appear related to Sertoli and germ cells number, we evaluated pre- and postoperative inhibin B of boys with congenital monorchism to determine whether the well-known hypertrophy of the contralateral testis was reflected in inhibin B concentrations. Materials and Methods Twenty-seven boys consecutively diagnosed with congenital monorchism (median age 12 months) underwent follow-up with reproductive hormones 1 year postoperatively (median age 25 months). The results were compared with inhibin B of 225 boys with congenital nonsyndromic unilateral cryptorchidism, by converting values to multiple of the median (MoM) for age in normal boys. Results Ten boys (37%) had blind-ending vessels and ductus deferens (vanished testis) and the remaining (63%) had testicular remnants. At the time of diagnostic procedure, monorchid boys did not have significantly lower inhibin B (median 114, range 20–208) than unilateral cryptorchid boys (136, 47–393) (p = 0.27). During follow-up, MoM values of inhibin B increased in monorchid boys (median 0.59 to 0.98) and in unilateral cryptorchid boys (0.69 to 0.89) (both p Conclusion Generally, inhibin B MoM values were normalized during follow-up in boys with congenital monorchism, reflecting compensatory hypertrophy within the first 2.5 years of life. The compensatory capacity to increase was better in monorchism than in unilateral cryptorchidism.

Take Home Message Compensatory hypertrophy is present in most children with unilateral ureteropelvic junction obstruction after sufficient follow-up time. Contralateral kidney length provided no clear prognostic value for developing kidney injury. Studies with more patients and additional biomarkers of kidney injury are needed to personalise care further., Background Compensatory hypertrophy is common in children with solitary functioning kidney, but it is unknown whether it also develops in children with unilateral partial reduction of kidney function. Objective The aim of this study was to assess whether children with a unilateral ureteropelvic junction obstruction (UPJO) show compensatory growth of the unaffected kidney. Furthermore, we investigated whether the length of the unaffected kidney was related to the degree of split kidney function lost and other possible risk factors. Lastly, we studied a possible relationship with signs of kidney injury. Design, setting, and participants We retrospectively analysed clinical information from 194 children with a unilateral UPJO who participated in the Aetiologic research into Genetic and Occupational/environmental Risk factors for Anomalies in children (AGORA) data- and biobank. Data on kidney length, split kidney function, and other factors possibly associated with kidney length were extracted from electronic patient records. Outcome measurements and statistical analysis Pearson’s correlation coefficients between the split kidney function and unaffected kidney length were calculated. Multivariable logistic regression analyses were performed to identify factors associated with kidney length and signs of kidney injury. Results and limitations Most children with a UPJO had an unaffected kidney length above the reference for age at the end of follow-up (median age 6.5 yr). A correlation with split kidney function was present only in children with a split kidney function of ≥60% in the unaffected kidney (r = 0.41). Aside from split kidney function, UPJO side was the only determinant of kidney length, while no associations between kidney length and kidney injury were identified. Conclusions Compensatory growth was visible in most children with a UPJO after sufficient follow-up time and was correlated with split kidney function in children with a severe UPJO. Contralateral kidney length provided no clear prognostic value for developing kidney injury. Studies with more patients and additional biomarkers of kidney injury are needed to further personalise care. Patient summary Children with obstruction of urine outflow in one kidney often had a larger contralateral kidney. However, the size of this kidney could not be used to predict which children would develop kidney injury.

Synergistic ablation (SA) is widely used to induce muscle hypertrophy in rodent studies. However, it has been demonstrated that SA-induced compensatory hypertrophy induces increases in maximum isometric force that are smaller in magnitude than the increase in muscle cross-sectional area, suggesting a reduction in the specific force production due to intrinsic contractile dysfunction in the hypertrophied fibers. Here, by using the mechanical skinned fibers, we investigated the mechanisms behind the reduction in specific force in the compensatory hypertrophied muscles. Rats had unilateral surgical ablation of the gastrocnemius and soleus muscles to induce the compensatory hypertrophy in the plantaris muscles. Two wk after surgery, the mean fiber diameter was increased by 19% in the SA group compared with the contralateral control (CNT) group. In contrast, compared with the CNT group, both the depolarization-induced force (−51%) and the Ca2+-activated maximum specific force (−32%) were markedly reduced in skinned fibers from the SA group. These deleterious functional alterations were accompanied by decreases in the amount of DHPRα1, RYR, junctophilin 1, and SH3 and cysteine-rich domain 3 (STAC3) in SA muscles. Thus, these data clearly show that SA induces not only an increase in skeletal muscle fiber hypertrophy but also leads to a reduction in the intrinsic contractile dysfunction due to the excitation–contraction uncoupling and impaired force-generating capacity.

Deviated nasal septum after some time in most of the patients is associated with compensatory hypertrophy of the contra lateral inferior nasal turbinate. This is a compensatory mechanism to prevent excessive air entry in contra lateral nose. Till now the treatment of the condition was septoplasty but majority of the patients were not relieved of nasal obstruction caused by hypertrophy of the inferior nasal turbinate; hence treating the condition became necessary. Aim of chapter: Was to establish the reason of hypertrophy; causes of the hypertrophy not reverting after the correction of the Nasal septum which was the cause of hypertrophy along with finding the indications and best possible treatment option for the condition. We concluded that Compensatory Hypertrophy can easily be established by endoscopy and radiological methods; it involves both the mucosa (predominantly medial side of Inferior turbinate mucosa) as well as the turbinate bone; treating this Compensatory Hypertrophy at the time of septal correction is advisable as this Compensatory Hypertrophy is irreversible; depending upon the radiological evaluation of the predominant area of hypertrophy surgery can be planned.

Asymmetric dimethylarginine (ADMA) is a methylated form of arginine and an endogenous nitric oxide synthase inhibitor. Renal function decline is associated with increase of plasma ADMA in chronic kidney disease populations. It is yet unknown how isolated renal function impairment affects ADMA homeostasis in healthy humans. Here, we measured plasma concentrations and urinary excretion of ADMA using GC-MS/MS in 130 living kidney donors before and at 1.6 (1.6-1.9) months after donation. We additionally analyzed 201 stable renal transplant recipients (RTR) that were included > 1 year after transplantation, as a model for kidney disease in the context of single kidney state. We measured true glomerular filtration rate (mGFR) using 125I-iothalamate. To study enzymatic metabolism of ADMA, we also measured L-citrulline as primary metabolite. Mean age was 52 ± 10 years in donors and 54 ± 12 years in RTR. Renal function was significantly reduced from pre- to post-donation (mGFR: 104 ± 17 vs. 66 ± 10 ml/min per 1.73 m2 BSA, - 36 ± 7%, P

Liver resection still represent the treatment of choice for liver malignancies, but in some cases inadequate future remnant liver (FRL) can lead to post hepatectomy liver failure (PHLF) that still represents the most common cause of death after hepatectomy. Several strategies in recent era have been developed in order to generate a compensatory hypertrophy of the FRL, reducing the risk of post hepatectomy liver failure. Portal vein embolization, portal vein ligation, and ALLPS are the most popular techniques historically adopted up to now. The liver venous deprivation and the radio-embolization are the most recent promising techniques. Despite even more precise tools to calculate the relationship among volume and function, such as scintigraphy with (99m)Tc-mebrofenin (HBS), no consensus is still available to define which of the above mentioned augmentation strategy is more adequate in terms of kind of surgery, complexity of the pathology and quality of liver parenchyma. The aim of this article is to analyse these different strategies to achieve sufficient FRL.

Background/aim The criteria for surgical management of ureteropelvic junction obstruction are not well-defined, and there is a risk for loss of renal function before the operation. In this context, certain changes in contralateral kidney had been investigated in order to increase the sensitivity of diagnosis. In this study, we aimed to investigate whether contralateral transient minimal hydronephrosis (CTMH) can be considered as an “early alarm” sign for worsening of the affected kidney in infants with hydronephrosis. Materials and methods A total of 182 infants (92 surgically treated and 90 conservatively followed-up) with unilateral hydronephrosis were retrospectively analyzed. Ultrasonography and renal scan findings were evaluated. Correlation between the appearance of CTMH, contralateral compensatory hypertrophy (CCH) on ultrasonography, and prognosis of the affected kidney were evaluated. Results Among the surgically treated patients, 18 (19.6%) patients developed CTMH on average 7 months (0–13 months) before surgery. Among these 18 patients with CTMH, 12 patients (66.6%) had loss of renal function preoperatively, while this ratio was 29.7% on their counterparts (p = 0049). CCH was observed in 31 (33.7%) individuals in surgically treated patient group including all 18 patients with CTMH, while none of the conservatively followed-up patients developed CCH and/or CTMH. In the multiple logistic regression analysis, among the variables investigated, CTMH was found as an independent predictor of the deterioration in the affected kidney and of the poor prognosis (p = 0.011 and p = 0.0004, respectively). Conclusion In our study, among the variables investigated, CTMH was found as an independent predictor of the deterioration in the affected kidney and poor prognosis in infants followed-up with isolated unilateral hydronephrosis. Additionally, CTMH can be considered as an “early alarm” sign for worsening of the affected kidney and the need for surgical intervention.

Background: Deviation of nasal septum towards one side is often associated with over growth of inferior turbinate, which occupies expansive space of contralateral nasal cavity. The enlargement of inferior turbinate can be due to mucosal elements or bony expansion. Many surgeons are of the belief if septoplasty is done, compensatory hypertrophy regresses on its own. There are others who argue that these changes are not spontaneously reversible and should be corrected in conjunction with nasal septal surgery. Otherwise surgery may relieve the obstruction on one side of nose but leave other side of obstructed because of relocation of septum towards hypertrophied turbinate.Methods: A prospective interventional randomized comparative study is carried out from 1st November 2017 to 31th March 2019, with a sample size of 40 patients. Patients were divided in two surgical groups; group A, with conventional septoplasty done and group B, with reduction of inferior turbinate along with conventional septoplasty done. Post operatively patients’ symptoms will be evaluated using nasal obstructions evaluation scale (NOSE) and nasal airway with nasal endoscopy at 1, 3 and 6 months, and compared with preoperative findings.Results: Data is analyzed using percentage graph and tables. The comparisons of NOSE score at 1, 3- and 6-months interval showed the p value of 0.001 which was significant. Also comparison of two groups with NOSE score showed significant improvement in group B.Conclusions: The study shows that hypertrophied turbinate need reduction along with septoplasty in cases of long standing nasal obstruction.

Inferior turbinate compensatory hypertrophy is a common condition found in post-traumatic septal deviation. In literature several approaches are described for treating turbinates enlargment. We conduct a retrospective study on two group of 43 and 48 patients mached for age and sex that underwent to rino-septo-turbinoplasty from January 2011 to January 2013. First group was treated by inferior turbinates submucous unipolar coblation and the second by submucous unipolar coblation plus lateral outfracture. Inclusion criteria were: isolated nasal occlusion non-sensitive to medical treatment with compensatory enlarged inferior turbinate/s and marked nasal pyramid-septal deviation evaluated by pre-operative nasal endoscopy; turbinates hypertrophic grade from I –III according to Friedman.

Aortic valve disease imposes significant challenges upon the circulatory system during exercise. However, during the pediatric years, left ventricular dilation and the decline in systemic vascular resistance that accompanies exercise tend to effectively mitigate the effects of aortic regurgitation. Similarly, in pediatric patients with less than severe aortic stenosis, compensatory hypertrophy often mitigates the hemodynamic impact of the stenosis. Hence the exercise function of most pediatric patients with aortic valve disease is usually remarkably well preserved. Exercise testing can help identify the subset of patients in whom the compensatory mechanisms are no longer effective.

Congenital myasthenic syndromes (CMS) result from reduced cholinergic transmission at neuromuscular junctions (NMJs). While the etiology of CMS varies, the disease is characterized by muscle weakness. To date, it remains unknown if CMS causes long-term and irreversible changes to skeletal muscles. In this study, we examined skeletal muscles in a mouse line with reduced expression of Vesicular Acetylcholine Transporter (VAChT, mouse line herein called VAChT-KD(HOM)). We examined this mouse line for several reasons. First, VAChT plays a central function in loading acetylcholine (ACh) into synaptic vesicles and releasing it at NMJs, in addition to other cholinergic nerve endings. Second, loss of function mutations in VAChT causes myasthenia in humans. Importantly, VAChT-KD(HOM) present with reduced ACh and muscle weakness, resembling CMS. We evaluated the morphology, fiber type (myosin heavy chain isoforms), and expression of muscle-related genes in the extensor digitorum longus (EDL) and soleus muscles. This analysis revealed that while muscle fibers atrophy in the EDL, they hypertrophy in the soleus muscle of VAChT-KD(HOM) mice. Along with these cellular changes, skeletal muscles exhibit altered levels of markers for myogenesis (Pax-7, Myogenin, and MyoD), oxidative metabolism (PGC1-α and MTND1), and protein degradation (Atrogin1 and MuRF1) in VAChT-KD(HOM) mice. Importantly, we demonstrate that deleterious changes in skeletal muscles and motor deficits can be partially reversed following the administration of the cholinesterase inhibitor, pyridostigmine in VAChT-KD(HOM) mice. These findings reveal that fast and slow type muscles differentially respond to cholinergic deficits. Additionally, this study shows that the adverse effects of cholinergic transmission, as in the case of CMS, on fast and slow type skeletal muscles are reversible.

Scoring of myocardial infarction (MI) disease extent in cardiac magnetic resonance (CMR) images has been generally presented in terms of area-based infarct size. However, gradual thinning of the infarcted wall and compensatory hypertrophy of the noninfarcted remote wall during left ventricular (LV) remodeling after MI complicate the accuracy of infarct size measurement. In this study, we measured and compared infarct sizes in mice on late gadolinium enhancement (LGE) images using area-, length-, and radial sector-based methods.MI was induced by permanent ligation of the left coronary artery (n = 6). LGE images were acquired 30 minutes after intravenous injection of Gd-DTPA-BMA. Percentages of infarct size (%Area, %Length, and %Sector) on the LGE images were calculated and compared with histological findings.Infarct sizes obtained by an area-based approach were smaller than those obtained by other measurements. The area-based approach underestimated infarct size compared with the length-based approach. Most infarct sizes measured by each method demonstrated a similar trend, with maximum values determined by sector-based measurements using a mean + SD threshold. Spearman's rank correlation coefficients indicated that the 3 measurements were strongly correlated (P < 0.05) to each other. Significant differences and trends were observed between sector-based infarct sizes with different thresholds when 16 or more sectors were used.In conclusion, our study demonstrated that methods used for the histological calculation of infarct size could be applied to CMR analysis. Moreover, our results showed a similar trend to histological assessment. Sector-based CMR approaches can be useful for infarct size measurement.

Measurement of fetal kidney size can assist in the diagnosis when a renal abnormality is suspected. Fetal kidney size increases with gestational age. Nomograms are available for kidney length, anterior-posterior diameter, and transverse diameter. This chapter reviews the normal embryologic development of the fetal kidney and includes a systematic approach to the evaluation of a suspected enlarged or small fetal kidney.

Aplasia of the major salivary glands are very rare, and commonly occurs at the parotid gland. Patients are usually asymptomatic and diagnosed incidentally. But dry mouth, difficulty in swallowing, dental problems may be seen. Also mass complaints may occur due to compensatory hypertrophy of the other major salivary glands. Herein, we presented the magnetic resonance imaging findings of a very rare case of bilateral submandibular gland aplasia with compensatory hypertrophy of sublingual glands.

We investigated whether external beam radiotherapy (EBRT) could induce compensatory liver hypertrophy in liver cancers and assessed related clinical factors. A total of 82 consecutive patients receiving EBRT for hepatocellular carcinoma (n = 77) or cholangiocarcinoma (n = 5) from April 2012 to June 2014 were recruited and divided into two subgroups according to tumor location in the right or left lobe. The left lateral and right lobes were considered as unirradiated volumes accordingly. Total liver volume (TLV), nontumor liver volume (NLV), left and right lobe whole volume (LLWV and RLWV, respectively), volume of liver irradiated

To investigate the usefulness of the ellipsoid formula for assessing compensatory hypertrophy of the contralateral kidney on pre-operative and post-operative CT in renal cell carcinoma (RCC) patients.We retrospectively identified 389 patients who had radical nephrectomy for RCC between 2011 and 2015. Contrast-enhanced CT was performed within 3 months pre-operative and at 1 year post-operative. The kidney volumes were calculated from CT using the ellipsoid formula. We subdivided patients into three groups based on tumour size (I: ≤4 cm, II: 4-7 cm, III: 7 cm). Volumetric renal parameters were compared and multivariate analyses were performed to determine predictors associated with pre-operative and post-operative compensatory hypertrophy.Kidney volume calculation using the ellipsoid method took a median of 51 s. Group III had a significantly larger median pre-operative contralateral renal volume than Groups I and II (I: 140.4, II: 141.6, III: 166.7 ml, p0.05). However, the median ratio of post-operative contralateral renal volume change was significantly higher in Groups I and II than Group III (I: 0.36, II: 0.23, III: 0.12, p0.001). On multivariate analysis, tumour size revealed the strongest positive association with pre-operative contralateral kidney volume (partial regression coefficient: β = 30.8, 7 cm) and ratio of post-operative contralateral kidney volume change (β = 0.214, I vs III; β = 0.168, II vs III).Kidney volume calculation for assessing pre- and post-operative compensatory hypertrophy of the contralateral kidney in RCC patients can be easily and rapidly performed from CT images using the ellipsoid formula. Advances in knowledge: The ellipsoid formula allows reliable method for assessing pre-operative and post-operative compensatory hypertrophy of the contralateral kidney in RCC.

Summary Objective: The aim was to evaluate the effectiveness of the experimental synergists muscle ablation model to promote muscle hypertrophy, determine the period of greatest hypertrophy and its influence on muscle fiber types and determine differences in bilateral and unilateral removal to reduce the number of animals used in this model. Method: Following the application of the eligibility criteria for the mechanical overload of the plantar muscle in rats, nineteen papers were included in the review. Results: The results reveal a greatest hypertrophy occurring between days 12 and 15, and based on the findings, synergist muscle ablation is an efficient model for achieving rapid hypertrophy and the contralateral limb can be used as there was no difference between unilateral and bilateral surgery, which reduces the number of animals used in this model. Conclusion: This model differs from other overload models (exercise and training) regarding the characteristics involved in the hypertrophy process (acute) and result in a chronic muscle adaptation with selective regulation and modification of fast-twitch fibers in skeletal muscle. This is an efficient and rapid model for compensatory hypertrophy. Resumo Objetivo: Avaliar a eficácia do modelo experimental de ablação dos sinergistas para promover a hipertrofia muscular, determinar o período de maior hipertrofia, sua influência sobre os tipos de fibras musculares e determinar diferenças na remoção unilateral ou bilateral para reduzir o número de animais utilizados nesse modelo. Método: Após a aplicação dos critérios de elegibilidade para sobrecarga mecânica do músculo plantar em ratos, 19 artigos foram incluídos na revisão. Resultados: Ocorre maior hipertrofia entre os dias 12 e 15, o que torna o modelo eficiente para alcançar a hipertrofia rapidamente. O membro contralateral também pode ser usado, pois não houve diferença entre a cirurgia unilateral e bilateral, o que reduz o número de animais usados no experimento. Conclusão: O modelo difere de outros modelos de sobrecarga (exercício e treinamento) em razão das características envolvidas no processo de sobrecarga imposta (aguda), resultando em uma adaptação crônica muscular com modificação de fibras de contração rápida do músculo esquelético. É um modelo rápido e eficiente para se estudar hipertrofia compensatória.

Salivary glands repair and regenerate following various types of injuries and surgical procedures. However, the tissue responses induced in the contralateral glands have yet to be elucidated in detail. Hsp27, a member of the heat-shock protein (Hsp) family, is strongly expressed in physiological environments, particularly during development. Hsp27 was previously shown to play a role in the regulation of acinar cell proliferation and differentiation in the rat submandibular gland. The present study performed the following surgical treatments on the right submandibular glands of adult rats: 1) duct ligation followed by unligation after one week; 2) partial sialoadenectomy; and 3) total sialoadenectomy. Immunohistochemistry for Hsp27 and Ki67 was performed in the experimental and normal contralateral glands, and localization was histologically and morphometrically analyzed. The results obtained revealed the localization of Hsp27 to the intercalated duct in the submandibular glands of non-treated rats. The expression of Hsp27 was strongly induced in both the uninjured contralateral control glands as well as treated glands of experimental rats regardless of the surgical procedure performed. The number of Hsp27-immunopositive cells increased rapidly following surgery, and subsequently returned to the same level as that in non-treated rats after 4 weeks. However, no marked changes were observed in the number of Ki67-immunopositive proliferating cells. Therefore, the change in the number of Hsp27-immunopositive cells may have contributed to compensatory hypertrophy. The results of the present study indicate that the expression of Hsp27 in the intercalated duct in the submandibular gland may play a role in the differentiation of acinar cells.

The purpose of work was the assessment of influence of a palliative resection of a liver with application of cryodestruction and without cryodestruction application on the remote results of treatment of the patients who have been repeatedly operated for alveococcosis.The analysis of surgical treatment of 14 patients operated repeatedly for alveococcosis of a liver is carried out. Patients were operated in the complicated stage of a disease in the presence of germination of a parasite in caval and/or portal gate of organ. Primary interventions were various – a diagnostic laparotomy, a cytoreduction and a marsupialization of a parasite, a liver resection. All patient at repetition intervention executed palliative resections of a liver. Resections were carried out by a clinic technique with imposing the ginglymoid of ligatures on remaining tissue of a liver at distance of 2–3 cm from the deleted parasitic knot taking into account a segmentary structure of organ. At all patients on "dangerous zones" (a zones of gate of a liver, a hepatoduodenal ligament) plates of parasitic fabric of various sizes from 1  2 cm to 2  4 cm were left. At 10 patients they were exposed to cryodestruction. The exposition in one point made from 1 to 2 minutes at a temperature –196 С. Postoperatively, patients received a dose of 10 mg/kg albendazole.Development of hepatic insufficiency after palliative resections of a liver is noted in one case. Lethal outcomes weren't.All patients for convenience of the analysis were divided into two groups: group of patients without application of cryotechnologies (n = 4) and group of the patients operated with application of cryodestruction (n = 10). Efficiency of palliative resections estimated on a median of survival of patients. Calculation of survival carried out Kaplan–Meier's method. The survival median in groups made 12 and 17 years respectively.When comparing survival of patients by Gehan's test with Yates's correction distinction of survival in two selections are statistically significant (z = 2,94; p < 0,005).Among patients repeatedly operated for alveococcosis when involving in parasitic process of gate of a liver, lack of possibility of prosthetics of vascular structures and developments of a compensatory hypertrophy of not struck departments of body the palliative resection allows to achieve survival of 50% of patients more than 16,8 years.Cryodestruction is the effective and safe method, allowing to increase survival of patients after a p alliative resection of a liver, through the destruction left in the area of the liver gate parasitic tissue sections.

Complete absence of Inferior Vena Cava (IVC) is a rare anomaly with a reported incidence of 0.0005% to 1%. This is often asymptomatic with incidental detection during cross-sectional imaging. It may also present with deep venous thrombosis, pulmonary thromboembolism or compressive symptoms in form of nerve root compression. Pelvic Congestion Syndrome (PCS) is an increasingly recognized entity with well laid out diagnostic criteria and evolving management protocols. Complete absence of IVC is a rare cause of pelvic congestion syndrome. We present a case of young female presenting with symptoms typical of pelvic venous congestion who was found to have complete absence of IVC as the underlying cause. She also had associated small left kidney with compensatory hypertrophy of the right kidney which is another rare association.

Intramedullary reaming and nailing of long bones impairs the endosteal circulation, often causing necrosis of the inner region of the bone cortex. We hypothesized that compensatory hypertrophy of the periosteal microcirculation may develop in response to mechanical destruction of the endosteum, and that this may affect bone survival in these circumstances. In these studies, nailing was performed with materials that affect regeneration of the endosteum differently, and the effects on the tibial periosteal microvasculatory organization were examined.In male Wistar rats, the right tibia was reamed and implanted with an inert titanium nail or a less osseointegrative polyethylene nail; the contralateral tibial endosteum was destroyed by reaming. Reaming without nailing or sham operation was performed on both extremities in two other groups of rats. Twelve weeks later, the anteromedial and anterolateral surfaces of the tibias were exposed by a microsurgical technique. The structural characteristics of the periosteal microcirculation (vessel density and distribution of vessel diameters) were determined by intravital videomicroscopy and computer-assisted analysis. The stability of the implants was assessed on the basis of grades 0-2 on a qualitative scale.Tibial reaming alone caused significant increases in overall blood vessel and capillary densities in the periosteum compared with those of the intact tibias. Implantation with a titanium nail resulted in firm embedding of the nail and caused changes in the periosteal vasculature similar to those after reaming alone. In contrast, implantation of a polyethylene nail was followed by the development of marked instability of the endomedullary implant and significant increases in the percentage of capillaries and the vessel density in the periosteum.Destruction of the endosteal microcirculation per se brings about an increase in periosteal vascular density, which is further augmented if implantation is performed with a material which delays regeneration of the endosteal circulation.

Congenital aplasia of the major salivary glands is very rare. Some authors have reported that most congenital aplasia of a major salivary gland is assosiated with multiple other developmental anomalies, especially in the case of craniofacial lesions. Other authors have reported on some cases of aplasia of the partial major salivary glands involved only the parotid glands or submandibular glands without other malformations. Here we report on a very case of aplasia of the bilateral submandibular glands and compensatory hypertrophy of the bilateral lingual glands.

Heat shock proteins (HSPs) are important factors in the response of skeletal muscles to chronic increases or decreases in activation and loading. The purpose of this study was to compare species-, time- and muscle-dependent changes in protein expression of Hsp20, Hsp25, αB-crystallin, Hsp72 and Hsp90 in response to functional overload (FO) in rats and mice. We compared protein levels of Hsp20, Hsp25, αB-crystallin, Hsp72 and Hsp90 in soleus and plantaris in baseline conditions and following 0.5, 1, 2, 3 and 7 days (rats) or 3 and 7 days (mice) of FO. Baseline levels of all HSPs were higher in rat soleus than plantaris, whereas only baseline expression of Hsp20 was higher in mouse soleus than plantaris. Levels of Hsp72 and Hsp90 were higher in plantaris and soleus of FO than control mice and rats after 3 and 7 days of FO. Protein levels and phosphorylation of Hsp25 in mouse plantaris and soleus were higher than control levels after 3 and 7 days of FO, except for soleus at 3 days. αB-crystallin levels were higher in plantaris of FO than control mice after 3 and 7 days of FO and in FO than control rats after 7 days of FO. Heat shock protein 20 was the least responsive, increasing only in 7 day FO rat plantaris compared with control rats. Overall, the results demonstrate that levels of both large and small HSPs increase with FO, suggesting a contributory role during the compensatory hypertrophy response.

Summary: The effect of unilateral or bilateral vasectomy on testicular weight and basal testosterone production in vitro was studied in neonatal intact and hemicastrated rats. Five days after right-side vasectomy ipsilateral to vasectomy testicular weight increased, and basal testosterone production decreased. Ten days postvasectomy the changes were opposite, and affected both testes. In hemicastrated animals hemivasectomy did not interfere with compensatory hypertrophy but induced a significant decrease in basal testosterone production. The data of the present study suggest that in neonatal animals intact ductus deferens bundle(s) is also required for the full control of testicular weight and basal testosterone secretion. Zusammenfassung: In einer experimentellen Studie wird an Ratten der Einflus einer einseitigen bzw. doppelseitigen Vasektomie auf die Hodenfunktion (Hodengewicht und basale Testosteronproduktion in vitro) studiert; es handelte sich um neonatale intakte und um hemikastrierte Tiere. Funf Tage nach der rechtsseitigen Vasektomie stieg das Hodengewicht der gleichen Seite an, wahrend Testosteron abfiel. Zehn Tage nach Vasektomie waren die Veranderungen gegenlaufig und betrafen beide Hoden. Bei hemikastrierten Ratten beeintrachtigte die Hemivasektomie nicht die kompensatorische Hypertrophic, induzierte jedoch einen signifikanten Abfall der basalen Testosteronproduktion. Diese Da-ten legen nahe, das bei neonatalen Tieren die intakten Samenleiter Bundel fur die voll-standige Kontrolle des Hodengewichtes und der basalen Testosteronproduktion benotigt werden.

Objective:To measure the dimensions of compensatory hypertrophy of the middle turbinate in patients with nasal septal deviation, before and after septoplasty.Methods:The mucosal and bony structures of the middle turbinate and the angle of the septum were measured using radiological analysis before septoplasty and at least one year after septoplasty. All pre- and post-operative measurements of the middle turbinate were compared using the paired samplet-test and Wilcoxon rank sum test.Results:The dimensions of bony and mucosal components of the middle turbinate on concave and convex sides of the septum were not significantly changed by septoplasty. There was a significant negative correlation after septoplasty between the angle of the septum and the middle turbinate total area on the deviated side (p= 0.033).Conclusion:The present study findings suggest that compensatory hypertrophy of the middle turbinate is not affected by septoplasty, even after one year.

The aim of this study is to acquire useful information of lower urinary tract symptom (LUTS) diagnosis through urophonography signal as a noninvasive method. The hardware and software which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and urophonography signal during urination. The PSD (power spectrum density) and the log-log plot gradient analysis were accomplished in frequency domain. For evaluation of the system and analysis method, a model system for the lower urinary system of men was used. From the evaluation of the model system, the PDS and the log-log plot gradient were dependent on the occlusion degree significantly. In a pilot study on normal and abnormal male subjects, the PSD and the log-log plot gradient were highly correlated with the artificial urethral obstruction.

SummaryThe right ventricle (RV) has to face major changes in loading conditions due to cardiovascular diseases and pulmonary vascular disorders. Clinical experience supports evidence that the RV better compensates for volume than for pressure overload, and for chronic than for acute changes. For a long time, right ventricular (RV) pathophysiology has been restricted to patterns extrapolated from left heart studies. However, the two ventricles are anatomically, haemodynamically and functionally distinct. RV metabolic properties may also result in a different behaviour in response to pathological conditions compared with the left ventricle. In this review, current knowledge of RV pathophysiology is reported in the setting of chronic pressure overload, including recent experimental findings and emerging concepts. After a time-varying compensated period with preserved cardiac output despite overload conditions, RV failure finally occurs, leading to death. The underlying mechanisms involved in the transition from compensatory hypertrophy to maladaptive remodelling are not completely understood.

Purpose We evaluated the association between tumor size and preoperative volumetric kidney parameters measured with CT in patients with renal cell carcinoma (RCC).

The purpose of urodynamic investigation is to obtain the information on the function of the urinary system. The aim of this study is to acquire the useful information of lower urinary tract symptom (LUTS) diagnosis through void force signal as noninvasive method. The system which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and void force during urination. The implemented system composes of the sensor parts, signal conditioning parts and PC monitoring program. For the evaluation of the implemented system, the simulation of control part of the system was performed and the model system for the lower urinary system was designed. The superiority of a measuring characteristic of the implemented system was verified using the model system. From the evaluation of the model system, we have found out that the void force was dependent on the occlusion degree and compensatory hypertrophy significantly.

Growth of the lung involves unique structure-function interactions not seen in solid organs. Mechanical feedback between the lung and thorax constitutes a major signal that sustains developmental as well as compensatory lung growth. After the loss of lung units as by pneumonectomy (PNX), increased mechanical stress and strain on the remaining units induce adaptive responses to augment oxygen transport, including 1) recruitment of alveolar-capillary reserves, 2) remodeling of existing tissue, and 3) regenerative growth of acinar tissue when strain exceeds a critical threshold. Alveolar hypoxia, hormones, and growth factors may feed into the mechanical feedback system to modify an existing growth response but are unlikely to initiate compensatory growth in the absence of sufficient mechanical signals. Whereas endogenous post-PNX alveolar growth preserves normal structure-function relationships, experimental manipulation of selected metabolic pathways can distort these relationships. Finally, PNX widens the disparity between the rapidly adapting acini and slowly adapting conducting airways and blood vessels, leading to disproportionate airflow and hemodynamic dysfunction and secondary hypertrophy of the right ventricle and respiratory muscles that limits overall organ function despite regeneration of gas exchange tissue. These are key concepts to consider when formulating approaches to stimulate or augment compensatory growth in chronic lung disease.

Introduction: the compensatory hypertrophy of the inferior turbinate in patients with septal deviation to one of the nostrils is considered to protect the airways from the excess of air that could enter through the nostril and its potential negative effects such as dryness, alteration of air filtration, mucociliary flow, or lung involvement. Materials and methods: A prospective, longitudinal, non-randomized study. Patients were divided in two groups: 10 consecutive patients, with nasal septal deviation and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity (10 non-hypertrophied turbinates as control and 10 contralateral hypertrophied turbinates as study cases), and the second group with 5 patients without any nasal pathology (10 turbinates without any obvious pathology). In both groups CT scans of the nasal region were performed. A comparison of patients with nasal septal deviation with compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity and with nonpathological inferior turbinate was carried out. Results: When analyzing the groups of patients with septal deviation, the contralateral hypertrophied turbinate and the non-hypertrophied turbinate side, we found a significant hypertrophy in the anterior portion of the inferior tur binate, at the level of the medial mucosa (P = 0.002) and bone (P = 0.001) in the group of patients with contralateral hypertrophied turbinate. However, when we compared the contralateral hypertrophic turbinate with the turbinate of patients without septal deviation, we found a significant difference in all volumes of the medial and lateral mucosa and the bone portion (P = 0.001, P = 0.005). Conclusion: Surgical correction of the nasal septum and lateralization or reduction of the volume of the inferior turbinate (which may include the medial mucosa, head or part of the bone) is necessary in order to improve air passage into the nasal valve.

We assessed compensatory hypertrophy in the contralateral kidney after partial and radical nephrectomy in adults. We also examined predictive factors to facilitate more accurate estimation of global renal function after surgery.We analyzed the records of 172 patients who underwent partial or radical nephrectomy with appropriate studies to determine function and parenchymal mass specifically in the operated and contralateral kidneys. All patients required renal scans to provide split renal function preoperatively and postoperatively. Parenchymal volume was measured by computerized tomography. All studies were done less than 2 months preoperatively and 4 to 12 months postoperatively.A total of 113 and 59 patients underwent partial and radical nephrectomy, and median tumor size was 3.5 and 7.0 cm, respectively (p0.0001). Of patients treated with partial nephrectomy 19% had high complexity tumor compared to 80% of those treated with radical nephrectomy (p0.0001). Median ipsilateral parenchymal volume was reduced 18% after partial nephrectomy and the median glomerular filtration rate in this kidney decreased 24.4%. The median contralateral kidney function increase after partial nephrectomy was 2.3% vs 21.1% after radical nephrectomy (p0.0001). Median global function decreased 9.6% after partial nephrectomy vs 32.2% after radical nephrectomy (p 0.0001). A larger percent parenchymal volume loss (p = 0.0001) and fewer comorbidities (p = 0.0072) significantly correlated with greater compensatory hypertrophy in the contralateral kidney on multivariable analysis.Compensatory hypertrophy in adults was limited after partial nephrectomy and it correlated significantly with the amount of parenchymal volume excised. Healthier patients also appeared to respond better. These results may allow for more accurate estimation of global renal function after partial and radical nephrectomy.

A 54-year-old woman with a symptomatic giant hepatic hemangioma underwent an extended left hepatic trisegmentectomy complicated by 250–350 mL/d postoperative bilious drainage. After 5 months of therapy, drainage was unabated, and the patient was no longer a surgical candidate. Sinography revealed three distinct isolated bile duct leaks involving segments 6, 7, and 8. Endobiliary segmentectomy was achieved by obliterating the isolated systems with ethylene-vinyl alcohol copolymer (Onyx; ev3, Plymouth, Minnesota) during three fluoroscopic procedures. Bilious leaks were successfully eliminated, and compensatory hypertrophy of noninvolved liver occurred. At 2 years from the last embolization procedure, the patient remained asymptomatic with no bilious leak.

Resume Objectifs – Decrire les modifications de la fonction ventriculaire gauche, sur un groupe de judokas camerounais, comparativement a un groupe temoin apparie. Methodes – Trente judokas et 30 sedentaires âges de 19 ans en moyenne ont ete examines. La fonction ventriculaire gauche systolique et diastolique a ete evaluee par l'echocardiographie-Doppler. Resultats – L'epaisseur des parois septale et posterieure ainsi que la masse ventriculaire gauche etaient significativement plus eleves chez les athletes. Il en etait de meme des diametres telediastoliques de l'oreillette gauche, du ventricule gauche et du ventricule droit. La fraction de raccourcissement etait plus reduite chez les athletes ainsi que le temps d'ejection. Sur le flux mitral au Doppler pulse, l'onde ‘A’ de contraction auriculaire, l'onde ‘E’ de remplissage protodiastolique, le temps de decroissance de cette derniere et le rapport E/A etaient superposables dans les deux groupes. Le temps de relaxation isovolumetrique etait plus court chez les judokas. Conclusion – Cette etude montre que le judo est responsable du developpement aussi bien d'une hypertrophie parietale que d'une dilatation des cavites cardiaques, mais surtout de la normalite des parametres fonctionnels etudies. Ces modifications morphologiques donc sont adaptees, chez ce type de sportif soumis a la fois aux efforts isotoniques, qu'isometriques.

The effects of 10 wk of functional overload (FO), with and without daily treadmill endurance training, on the cross-sectional area, myonuclear number, and myonuclear domain size of mechanically isolated single fiber segments of the adult rat plantaris were determined. The fibers were typed on the basis of high-resolution gel electrophoresis for separation of specific myosin heavy chain (MHC) isoforms and grouped as type I+(containing some type I MHC with or without any combination of fast MHCs), type IIa+(containing some type IIa with or without some type IIx and/or IIb but no type I MHC), and type IIx/b (containing only type IIx and/or IIb MHCs). Type I+fibers had a higher myonuclear number than did both fast types of fibers in the control and FO, but not in the FO and treadmill trained, rats. All fiber types in both FO groups had a significantly larger (36–90%) cross-sectional area and a significantly higher (61–109%) myonuclear number than did control. The average myonuclear domain size of each fiber type was similar among the three groups, except for a smaller domain size in the type IIx/b fibers of the FO compared with control. In general, these data indicate that during hypertrophy the number of myonuclei increase proportionally to the increase in fiber volume. The maintenance of myonuclear domain size near control values suggests that regulatory mechanisms exist that ensure a tight coupling between the quantity of genetic machinery and the protein requirements of a fiber.

Ultrasonography has been shown to be a reliable technique for measurement of kidney length in pediatric patients. Ultrasound was used in this study to evaluate normal variation in kidney size in healthy pediatric patients. The data also were used for comparison of kidney size in solitary kidneys to evaluate compensatory hypertrophy in pediatric patients. The authors also compared renal size in pediatric patients with chronic liver disease against those with healthy kidneys. A correlation was found in younger pediatric patients.

L'hypertrophie renale compensatrice apres nephrectomie est bien connue cliniquement et experimentalement. Cependant, on connait mal les possibilites de developpement renal compensateur in utero. Dans ce cadre, nous avons pratique des nephrectomies unilaterales chez le fœtus de lapin et avons etudie la croissance du rein controlateral. Trente fœtus de plapins ont subi une nephrectomie unilaterale au 25eme jour de gestation. Au 28eme jour de gestation, tous les fœtus ont ete extraits par cesarienne et les rapports poids du rein/poids du corps du fœtus opere compares a ceux de fœtus temoins de la portee. Les reins ont ete examines par un histologiste. Nous avons constate une augmentation statistiquement significative du poids de rein restant. L'etude histologique des reins restant a mis en evidence une augmentation statistiquement significative de la surface glomerulaire confirmant l'hypertrophie renale. Cette experimentation demontre la possibilite chez le lapin de developper une hypertrophie renale compensatrice in utero.

The hypertrophy of the remaining kidney following uninephrectomy (UNx) has been related to an increase in renal insulin growth factor-I (IGF-I) content. However, while the increase in renal IGF-I lasts for only days after UNx, renal hypertrophy continues for months. In the present study we investigated whether IGF-I also plays a role in the late post uninephrectomy growth of the remaining kidney. Renal IGF-I in the remnant kidney was greater than that of control kidneys (78.3 +/- 17.3 vs 56.0 +/- 14.0 pmol g-1; p0.05) 3 days after UNx, tended to remain higher 30 days after UNx (83.8 +/- 23.6 vs 57.3 +/- 14.5 pmol g-1; p = 0.07), but was similar to that of the control kidney when examined 60 days after UNx (66.6 +/- 15.6 vs. 70.4 +/- 6.7 pmol g-1). Serum IGF-I in uninephrectomized rats was similar to that of controls 3 days after UNx, started to increase above the control level at day 10 after UNx and remained higher 30 and 60 days after UNx (75.9 +/- 6.9 vs. 48.7 +/- 7.3 nmol l-1 at 30 days, and 81.2 +/- 13.7 vs 52.9 +/- 11.0 nmol l-1 at day 60, p0.05 for both). The kidney weight of uninephrectomized rats was higher by 21% than that of controls 3 days after UNx, by 45% 30 days after UNx and by 63% 60 days after UNx (p0.05 for all three observations). At the end of the study, the glomerular volume of uninephrectomized rats was higher by 36% than that of the controls (p0.05) We suggest that in the rat, while the initial post uninephrectomy hypertrophy of the remnant kidney is associated with and most probably mediated by an increase in renal IGF-I, the hypertrophy that persists in later post UNx periods is associated with and may be mediated by an increase in serum IGF-I.

White matter hyperintensities are associated with an increased risk of Alzheimer's disease (AD). White matter hyperintensities are believed to disconnect brain areas. We examined the topographical association between white matter hyperintensities and cortical thickness in controls, mild cognitive impairment (MCI), and AD patients. We examined associations between white matter hyperintensities and cortical thickness among 18 older cognitively healthy participants, 18 amnestic MCI, and 17 mild AD patients. These associations were cluster-size corrected for multiple comparisons. In controls, a positive association between white matter hyperintensities and cortical thickness was found in lateral temporal gyri. In MCI patients, white matter hyperintensities were positively related to cortical thickness in frontal, temporal, and parietal areas. Positive associations between white matter hyperintensities and cortical thickness in AD patients were confined to parietal areas. The results of the interaction group by white matter hyperintensities on cortical thickness were consistent with the findings of positive associations in the parietal lobe for MCI and AD patients separately. In the frontal areas, controls and AD patients showed inverse associations between white matter hyperintensities and cortical thickness, while MCI patients still showed a positive association. These results suggest that a paradoxical relationship between white matter hyperintensities and cortical thickness could be a consequence of neuroinflammatory processes induced by AD-pathology and white matter hyperintensities. Alternatively, it might reflect a region-specific and disease-stage dependent compensatory hypertrophy in response to a compromised network.