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Mitotic cell division of monoplastidic sporogones was investigated in the moss Timmiella barbuloides (Brid.) Moenk. (Pottiales, Bryophyta) by TEM. Division polarity of sporogones is established by the interphase position of the single oblong cup-shaped plastid, which is orientated with its long axis parallel to one of the cell walls. In preprophase the plastid elongates and its extremities bend at right angles. Plastid growth is directed by microtubules and accompanied by plastid tubules. The plastid begins the process of duplication by constricting centrally in the plane of the future cytokinetic septum. There is no preprophase band of microtubules at the division site. The large central nucleus becomes fusiform and aligned parallel to the main plastid axis. By the end of prophase the daughter plastids are positioned at the opposite poles of the nucleus where they probably function as nucleating or organizing centres for the spindle microtubules. Metaphase and anaphase spindles contain long sheets of ER. Cytokinesis involves the formation of a well developed phragmoplast. [ABSTRACT FROM AUTHOR]

Competing Interests: None.

Introduction: Bacterial prostatitis (BP) is a common prostatic infection characterized by a bimodal distribution in young and older men, with a prevalence between 5-10% among all cases of prostatitis and a high impact on quality of life. Although the management of bacterial prostatitis involves the use of appropriate spectrum antibiotics, which represent the first choice of treatment, a multimodal approach encompassing antibiotics and nutraceutical products in order to improve the efficacy of chosen antimicrobial regimen is often required., Objective: To evaluate the efficacy of Flogofilm ® in association with fluoroquinolones in patients with chronic bacterial prostatitis (CBP)., Methods: Patients diagnosed with prostatitis (positivity to Meares-Stamey Test and symptoms duration > 3 months) at the University of Naples "Federico II", Italy, from July 2021 to December 2021, were included in this study. All patients underwent bacterial cultures and trans-rectal ultrasounds. Patients were randomized into two groups (A and B) receiving antibiotic alone or an association of antibiotics plus Flogofilm ® tablets containing Flogomicina ® for one month, respectively. The NIH-CPSI and IPSS questionnaires were administered at baseline, four weeks, twelve and twenty-four weeks., Results: A total of 96 (Group A = 47, Group B = 49) patients concluded the study protocol. The mean age was comparable, with a mean age of 34.62 ± 9.04 years for Group A and 35.29 ± 10.32 years for Group B ( p = 0.755), and IPSS at the baseline was 8.28 ± 6.33 and 9.88 ± 6.89 ( p = 0.256), respectively, while NIH-CPSI at baseline was 21.70 ± 4.38 and 21.67 ± 6.06 ( p = 0.959), respectively. At 1, 3 and 6 months, the IPSS score was 6.45 ± 4.8 versus 4.31 ± 4.35 ( p = 0.020), 5.32 ± 4.63 versus 3.20 ± 3.05 ( p = 0.042) and 4.91 ± 4.47 versus 2.63 ± 3.28 ( p = 0.005) for Groups A and B, respectively. Similarly, the NIH-CPSI total score at 1, 3 and 6 months was 16.15 ± 3.31 versus 13.10 ± 5.03 ( p < 0.0001), 13.47 ± 3.07 versus 9.65 ± 4.23 ( p < 0.0001) and 9.83 ± 2.53 versus 5.51 ± 2.84 ( p < 0.0001), respectively., Conclusions: Flogofilm ® , associated with fluoroquinolones, demonstrate a significant improvement in pain, urinary symptoms and quality of life in patients affected by chronic bacterial prostatitis in both IPSS and NIH-CPSI scores compared with fluoroquinolones alone.

Purpose: The purpose of this study was to compare the efficacy, accuracy, and safety of in-office diagnostic arthroscopy with magnetic resonance imaging (MRI) and surgical diagnostic arthroscopy., Methods: A prospective, blinded, multicenter, clinical trial was performed on 110 patients, ages 18 to 75 years, who presented with knee pain. The study period was April 2012 to April 2013. Each patient underwent a physical examination, an MRI, in-office diagnostic imaging, and a diagnostic arthroscopic examination in the operating room. The attending physician completed clinical report forms comparing the in-office arthroscopic examination and surgical diagnostic arthroscopy findings on each patient. Two blinded experts, unaffiliated with the clinical care of the study's subjects, reviewed the in-office arthroscopic images and MRI images using the surgical diagnostic arthroscopy images as the "control" group comparison. Patients were consecutive, and no patients were excluded from the study., Results: In this study, the accuracy, sensitivity, and specificity of in-office arthroscopy was equivalent to surgical diagnostic arthroscopy and more accurate than MRI. When comparing in-office arthroscopy with surgical diagnostic arthroscopy, all kappa statistics were between 0.766 and 0.902. For MRI compared with surgical diagnostic arthroscopy, kappa values ranged from a low of 0.130 (considered "slight" agreement) to a high of 0.535 (considered "moderate" agreement). The comparison of MRI to in-office arthroscopy showed very similar results as the comparison of MRI with surgical diagnostic arthroscopy, ranging from a low kappa of 0.112 (slight agreement) to a high of 0.546 (moderate agreement). There were no patient-related or device-related complications related to the use of in-office arthroscopy., Conclusions: Needle-based diagnostic imaging that can be used in the office setting is statistically equivalent to surgical diagnostic arthroscopy with regard to the diagnosis of intra-articular, nonligamentous knee joint pathology. In-office diagnostic imaging can provide a more detailed and accurate diagnostic assessment of intra-articular knee pathology than MRI. Based on the study results, in-office diagnostic imaging provides a safe, accurate, real-time, minimally invasive diagnostic modality to evaluate intra-articular pathology without the need for surgical diagnostic arthroscopy or high-cost imaging., Level of Evidence: Level II, comparative prospective trial., (Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

Chondral defects of the knee are quite common, affecting an estimated 10% to 12% of the population. Symptomatic chondral defects are thought to be persistent and possibly progressive. Less is known about the natural history of asymptomatic chondral lesions. Traditional treatment of chondral lesions has involved arthroscopic debridement with a mechanical shaver. Radiofrequency chondroplasty has been explored as a possible alternative or adjuvant to mechanical chondroplasty. The role of chondroplasty in the setting of knee osteoarthritis is more controversial. Early studies demonstrated promising results of arthroscopic debridement in the context of knee arthritis. However, publications in the last 10 to 15 years have brought into question the role of arthroscopic debridement in the setting of knee osteoarthritis. The purpose of this chapter is to explore the role of arthroscopic debridement in the treatment of chondral defects.

Background: Preoperative patient education is an important part of the informed consent process, and a perceived lack of information can lower patient satisfaction. We sought to evaluate the effect of a web-based multimedia patient education tool on the perioperative experience of patients undergoing first-time knee arthroscopy for a meniscal tear., Methods: Adult patients undergoing knee arthroscopy for the first time for a primary diagnosis of a meniscal tear were consecutively enrolled into the study from January 2014 through June 2014. Patients were equally randomized to a control group, who received standard preoperative counseling, or the intervention group, who completed a twenty-minute web-based multimedia tutorial in addition to standard counseling. The web-based tutorial covered relevant anatomy, pathology, and general perioperative instructions, and it was completed prior to the preoperative visit. Patients completed surveys that evaluated their preparedness for surgery and knowledge recall at the preoperative visit, on the day of surgery, and after the first postoperative visit., Results: Sixty-four patients were enrolled, and fifty-five patients (86%; twenty-nine in the control group and twenty-six in the intervention group) with complete data sets were included in the analysis. Preoperatively, the intervention group felt significantly more informed about the surgery and more clearly understood the risks and benefits of, and alternatives to, the surgery (all p < 0.001). Postoperatively, the intervention group reported being significantly more satisfied with the perioperative education that they had received and felt more informed about their surgery and rehabilitation (p ≤ 0.05). Patients in the intervention group were significantly more likely to correctly answer questions regarding their surgical details at the first postoperative visit (p ≤ 0.03)., Conclusions: Patients who completed the web-based tutorial had improved preoperative knowledge and preparedness as well as enhanced postoperative knowledge recall regarding their surgical procedure. The tutorial received high user satisfaction scores with low user burden scores and was an effective tool for enhancing the patients' perioperative experience., (Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.)

Unrelieved postoperative pain may impair rehabilitation, compromise functional outcomes, and lead to patient dissatisfaction. Preemptive multimodal analgesic techniques may improve outcomes after surgery. We hypothesized that patients using preoperative cryotherapy plus a standardized postoperative treatment plan will have lower pain scores and require less pain medication compared with patients receiving a standardized postoperative treatment plan alone after arthroscopically assisted anterior cruciate ligament reconstruction (ACLR). A total of 53 consecutive patients undergoing arthroscopically assisted ACLR performed by one of seven surgeons were randomly assigned to one of two groups. Group 1 received no preoperative cryotherapy and group 2 received 30 to 90 minutes of preoperative cryotherapy to the operative leg using a commercial noncompressive cryotherapy unit. Visual analog scale pain scores and narcotic use were recorded for the first 4 days postoperatively. Total hours of cold therapy and continuous passive motion (CPM) use and highest degree of flexion achieved were recorded as well. Group 1 consisted of 26 patients (15 allograft Achilles tendon and 11 autograft bone patellar tendon bone [BPTB]), and group 2 consisted of 27 patients (16 allograft Achilles tendon and 11 autograft BPTB). Group 2 patients reported less pain (average 1.3 units, p < 0.02) and used less narcotic use (average 1.7 tablets, p < 0.02) for the first 36 hours compared with group 1. No statistically significant differences were identified between the two groups with regard to demographics, hours of postoperative cryotherapy, hours of CPM use, or maximum knee flexion achieved. Complications did not occur in either group. This is the first report we are aware of showing the postoperative effects of preoperative cryotherapy. Our results support the safety and efficacy of preoperative cryotherapy in a multimodal pain regimen for patients undergoing ACL reconstruction., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Medial elbow pain is reported in 18% to 69% of baseball players aged of 9 and 19 years. This is due to the large valgus stresses focused on the medial side of the elbow during overhead activities. In overhead throwers and pitchers, pain can be attributed to valgus extension overload with resultant posteromedial impingement, overuse of the flexor-pronator musculature resulting in medial epicondylitis, or occasional muscle tears or ruptures. The anconeus epitrochlearis is a known cause of cubital tunnel syndrome and has been postulated as a source of medial elbow pain in overhead athletes. This article describes the cases of 3 right-handed baseball pitchers with persistent right-sided medial elbow pain during throwing despite a prolonged period of rest, physical therapy, and nonsteroidal anti-inflammatory drugs. Two patients had symptoms of cubital tunnel syndrome as diagnosed by electromyogram and nerve conduction studies and the presence of the anconeus epitrochlearis muscle per magnetic resonance imaging. All patients underwent isolated release of the anconeus muscle without ulnar nerve transposition and returned to their previous levels of activity. The diagnosis and treatment of pitchers who present with medial-sided elbow pain can be complex. The differential should include an enlarged or inflamed anconeus epitrochlearis muscle as a possible cause. Conservative management should be the first modality. However, surgical excision with isolated release of the muscle can be successful in returning patients with persistent pain despite a trial of conservative management to their previous levels of function., (Copyright 2012, SLACK Incorporated.)

Revision anterior cruciate ligament (ACL) reconstruction surgery has become increasingly common. The number of primary ACL reconstructions increases each year, and athletes are often able to return to cutting and pivoting sports. Most failed ACL reconstructions result from technical errors, commonly malpositioned tunnels. Correcting such tunnels in revision surgery requires understanding anatomy, preoperative planning, and often multiple methods of addressing bony defects. Multiple options have been described for handling these bony deficiencies, many of which are technically difficult and time-consuming to correct. We describe a simple technique for addressing a bony defect during revision ACL reconstruction using a unique bioabsorbable interference screw comprised of an osteoconductive bioceramic beta-tricalcium phosphate and poly(lactide-co-glycolide). Unique properties of this screw provide significant structural support for drilling revision tunnels through a portion of the screw or next to the screw, which allows for uncompromised tunnel placement.

Background: It is important that serological assays detect antibodies to human immunodeficiency virus (HIV) in all infected individuals, including those infected with less prevalent, more diverse subtypes., Methods: Performance of the ADVIA Centaur HIV 1/O/2 Enhanced (EHIV) Assay was tested on 1344 samples from HIV-positive subjects, 6061 samples from groups at low-risk for HIV infection, and 1042 samples from groups at high-risk for HIV-1 and HIV-2 infection. Results were compared with those of an FDA-approved predicate assay., Results: The ADVIA Centaur EHIV Assay showed good precision with a diagnostic specificity of 99.9% and diagnostic sensitivity of 100%. HIV seroconversion was detected earlier in 6 panels, at the same time in 13 panels and later in only 1 of the panels when compared to the predicate assay, thereby narrowing the window period between infection and antibody detection. Of clinical significance, a blood donor sample that was indeterminate by HIV-1 Western blot and non-reactive by the predicate assay was repeatedly reactive in the ADVIA Centaur Assay and confirmed as positive by HIV-2 immunoblot., Conclusions: The ADVIA Centaur EHIV Assay is useful as an aid in the diagnosis of individuals infected with HIV-1 and/or HIV-2.

The major technical pitfalls in the performance of patellofemoral surgery stem from improper patient selection, unrealistic patient expectations, and inappropriate rehabilitation. Proper patient selection requires the physician to spend additional time in communicating with patients obtaining a comprehensive history, and performing a thorough physical examination. Patients' expectations can be realistic if appropriate time is devoted to patient education. A commitment on behalf of patients to undertake a comprehensive postoperative rehabilitation program before proceeding with any surgical procedure helps to enhance patients' success.

The present retrospective study reviews our clinical experience with Subcutaneous immunotherapy (SIT) over a 10 year period (1981-1991), in order to assess both incidence and clinical features of nonfatal systemic reactions due to this treatment. 192,505 injections were globally administered to 2,206 outpatients, following the suggested precautionary guidelines. We observed 115 systemic reactions (5.2% of patients and 0.06% of injections) and no fatalities. The association asthma + urticaria was the most frequent reaction (67%), followed by asthma alone (22%). No risk factor related to age, gender, pollen season or manufacturer was observed. The occurrence of systemic reactions was highly frequent in asthmatic patients, but approximately 1/3 of the patients who presented reactions had never previously suffered from asthma. The largest part of the observed reactions occurred during the maintenance phase of treatment. Almost all adverse events occurred within 30 minutes after the injection and they were promptly controlled by routine therapy. We conclude that subcutaneous immunotherapy, if performed with careful compliance to good clinical practice rules, is a safe treatment for respiratory allergy.

Reconstruction for symptomatic anterior cruciate deficient knees has yielded varying success rates. Prosthetic cruciate replacement has recently become a potentially attractive alternative. The results of the Gore-Tex polytetrafluoroethylene ligament, which is intended as a permanent replacement, are reported. Eighty-two patients were followed prospectively, mean age was 28 years (range, 16 to 51 years) and mean followup was 18 months (range, 12 to 30 months). Subjective scores improved in all categories, including pain, swelling, giving way, locking, and stair climbing. All patients without complications had no episodes of actual giving way, considered themselves improved, and returned to activities of daily living at 3 weeks and athletics at 8 months. Range of motion lacking at 3 months was 2 degrees of extension and 10 degrees of flexion, and at 12 months was 0 degrees of extension and 4 degrees of flexion. All mean objective data, including the anterior drawer, Lachman, and pivot shift, demonstrated improvement at final followup. Cybex testing revealed improvement in relative quadriceps strength from 88% to 99%. The KT-1000 Arthrometer showed improvement in the injured-normal knee difference score throughout the follow-up period. Of importance is that while final objective data was improved over initial data, an early nonprogressive shift toward loosening was indicated by worsening of the drawer, Lachman, pivot shift, and KT-1000 scores. This shift may be attributed to resorption of interposed soft tissue, creep, or loosening of the graft. Subjective scores remained stable after improving. Complications included four ruptures, four chronic sterile effusions with partial attenuation, one infection, and one symptomatic loose body.(ABSTRACT TRUNCATED AT 250 WORDS)

[14C]Oxalate was found in the urine of fasted male Wistar rats fed L-[14C3]-serine, DL-[14C1]serine, [14C1]ethanolamine, [14C1]hydroxypyruvate, [14C3]-hydroxypyruvate, [14C1]glycolate or [14C2]glyoxylate. [14C1]Hydroxypyruvate and [14C1]ethanolamine were the least effective precursors of [14C]oxalate. 20% of the [14C1]serine and [14C3]serine administered was recovered as 14CO2, while less than 4% was metabolized by pathways known to contribute to oxalate synthesis. Oxalate synthesis from serine involved both the transamination to hydroxypyruvate and the conversion to glycine, but not decarboxylation to ethanolamine. The oxidation of [14C2]glyoxylate to [14C]oxalate in the rat was inhibited by hydroxypyruvate, but the oxidation of [14C1]glycolate to [14C]-oxalate was not significantly altered. [14C]Glycolaldehyde, [14C]glycolate, [14C]glyoxylate and [14C]oxalate were recovered in the urine of rats administered [14C3]hydroxypyruvate. This is consistent with the oxidation of hydroxypyruvate via glycolaldehyde leads to glycolate leads to glyoxylate leads to oxalate and is identical to the metabolic pathway for the oxidation of ethylene glycol to oxalate. However, the major metabolic intermediate recovered from [14C3]hydroxypyruvate was [14C]glyoxylate rather than [14C]glycolate, suggesting that an alternate pathway is contributing to the oxidation of hydroxypyruvate to oxalate in the rat.

The development of the placental complex including the gametophyte vaginula and the bulbous foot of the sporophyte in the liverwort Targionia hypophylla L. (Marchantiales) was studied by transmission electron microscopy. The vaginula and foot are separated by an intervening space and each consist of parenchymatous cells without intercellular spaces. Transfer cells begin to differentiate at the gametophyte-sporophyte interface just prior the onset of meiosis. While a single epidermal transfer-cell layer has developed in the foot by the end of meiosis, a multilayered pattern of transfer cells is formed in the vaginula. Gametophyte transfer cells have wall labyrinths which decrease in complexity with distance from the foot, lack plasmodesmata, and show signs of degeneration in the proximity of the foot. During meiosis, amyloplasts of both vaginula and foot lack starch and develop some thylakoid grana. In the subsequent stage of spore maturation, obliteration of the wall labyrinth occurs in both gametophyte and sporophyte transfer cells. The developmental pattern of the placental complex in Targionia is discussed in relation to that of mosses.

The development of the placenta in the anthocerote Phaeoceros laevis (L.) Prosk. was studied by transmission electron microscopy. By the time the sporophyte emerges from the involucre, a conspicuous placental region is formed by the intrusive growth of sporophyte foot haustorial cells into the adjacent gametophyte vaginula tissue. The separation of gametophyte cells by haustorial cells and their incorporation into the placenta are preceded by the loosening and swelling of their walls and the formation of a periplasmic space. This process causes the disruption of the plasmodesmata, and may eventually result in the complete isolation and consequent degeneration of the cells. Crystals are commonly observed in the vacuoles of gametophyte placental cells. Crystals become more abundant during cytoplasmic degeneration, and are released in the placental lacunae that result from the complete dissolution of gametophyte cells. During the subsequent phase of capsule elongation, the gametophyte placental cells that retain the symplastic connection with the adjoining gametophyte parenchyma develop a wall labyrinth typical of transfer cells. Obliteration of the wall labyrinth by deposition of lightly staining wall material is observed later in sporophyte development, in concomitance with capsule dehiscence. Crystals are negative to the periodic acid/thiocarbohydrazide/silver proteinate test for carbohydrates whilst they are completely digested by pepsin or protease, denoting protein composition.