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Objective: To investigate if treatment with transurethral enucleation of the prostate (TUEP) during the learning curve is as efficient and safe in the short term as transvesical open prostate enucleation (OPE), in patients with benign prostatic obstruction (BPO) > 80 ml in a population in Sweden.  Methods: 54 patients with ultrasound verified BPO > 80 ml and indication for surgery underwent TUEP or OPE between 2013 and 2019. Peri- and postoperative outcome variables regarding voiding efficiency and morbidity from 20 OPE at Skåne University Hospital (SUS) and from the first 34 TUEP performed at SUS and Ystad Hospital were retrospectively assembled. Follow-up data from the first 6 postoperative months were collected by chart review., Results: Intraoperative bleeding during TUEP was less than in OPE (225 ml vs. 1,000 ml). TUEP took longer surgery time than OPE (210 vs. 150 min.). Within 30 days postoperatively, bleeding occurred less often after TUEP (23% vs. 40%), requiring one fourth of the blood transfusions given after OPE. After TUEP, patients had shorter hospitalisation (3 days vs. 7 days) and catheterisation time (3 days vs. 12 days). During the 6-month follow-up period, incontinence and UTI defined as symtomatic significant bacteriuria (urinary culture) were observed as main complications after TUEP and OPE. Functional outcome data availability (International Prostate Symptom Score [IPSS] questionnaire, uroflowmetry, residual urine) were limited., Conclusions: Treatment with TUEP during the learning curve led to less bleeding, shorter hospitalisation- and catheterisation time than treatment with OPE. However, surgery time was shorter with OPE. There were no major differences between the groups concerning mid-term functional outcomes, with the reservation of an inconsistent follow-up.

Cysticercosis and Trichinella spp. infection are parasitic zoonoses prevalent among pigs in Southeast Asia, where pork is the most important source of meat. In rural Cambodia, many pigs are raised extensively in family backyards, and information regarding the prevalence in rural small-scale pig production is very limited. This study was conducted in four provinces in north-eastern Cambodia to determine the seroprevalence of porcine cysticercosis and Trichinella spp. infection in rural villages, and to identify possible risk factors. Only households with less than 10 pigs above three months old were eligible. In total, 139 households participated, and 242 blood samples were collected. Farmers were interviewed about food and hygiene habits, disease knowledge and practices. The serum samples were analysed by ELISA to determine antigens to Taenia spp. cysticerci or antibodies to Trichinella spp. muscle larvae. Positivity among the pigs was 11.2% (95% CI 7.5-15.8) for Taenia spp. cysts and 2.5% (95% CI 0.9-5.4) for Trichinella spp. Cysticerci were more common in the province Preah Vihear ( p < 0.001) than in the other provinces. Risk factors associated with porcine cysticercosis were management systems for the pigs and access to human faeces ( p < 0.001). Trichinella spp. infection in pigs was more common in the province Ratanakiri ( p = 0.001). The main risk factor associated with Trichinella spp. transmission was feeding pigs with food waste ( p = 0.048). More men had heard about cysticercosis than women ( p = 0.002), and men also consumed undercooked pork meat to a greater extent ( p = 0.004). Although the present study is relatively small, several risk factors could be identified for porcine infection with Taenia spp. and Trichinella spp., which can be used to guide future interventions to improve both porcine and human health in these provinces.

Japanese encephalitis (JE) is endemic in Cambodia, but circulation of JE virus (JEV) among domestic pigs has previously only been studied in the southern part of the country. The main purpose of this study was to determine the seroprevalence of JEV antibodies in smallholder pigs held in rural areas of Kampong Thom, Preah Vihear, Ratanakiri, and Stung Treng provinces, northeastern Cambodia. Another purpose was to identify possible associations between serologic status and other factors, such as reproductive disorders, and to investigate the farmers' knowledge of mosquito-borne diseases and use of preventive measures. In October 2019, 139 households were visited throughout the study area, and 242 pigs were sampled for blood. The sera were analysed with ELISA for JEV antibodies. Household representatives were interviewed, and data were recorded for each sampled pig. The apparent seroprevalence was 89.1% in pigs between 3 and 6 months of age, and 100% in pigs over 6 months of age. In total, 93.0% of the pigs tested positive. Province appeared to be the only factor significantly associated with serologic status ( p < 0.001). Almost all (97.8%) respondents knew that mosquitos could transmit diseases, and 70.5% had heard of JE. However, only one respondent knew that JEV is transmitted to people through mosquito bites. Very few respondents knew that pigs can become infected with JEV, and no one knew that mosquitos transmit the virus. All families used some sort of mosquito protection for themselves, but only 15.1% protected their pigs from mosquito bites. The children were vaccinated against JE in 93 households, while adults only were vaccinated in eight households. The results suggest that JEV transmission is intense in northeastern Cambodia, and that people's knowledge about the transmission route of JEV and the role of pigs in the transmission cycle is low. Fortunately, people are well aware of mosquito-borne diseases in general and use mosquito protection, and many children are vaccinated against JE. Nonetheless, it is important that national vaccination is continued, and that people-especially in rural areas where pigs are commonly kept-are educated on the ecology and transmission of JEV.

Statement of Problem: Studies of guided implant surgery have identified various methods that could influence accuracy. The present investigation was designed to limit the factors contributing to accuracy and to compare the results for 5 different surgeons., Purpose: The purpose of this study was to evaluate any deviation between virtually planned and actually placed implants by 5 surgeons performing computer-aided design/computer-aided manufacturing (CAD/CAM)-guided implant surgery on duplicate plastic models., Material and Methods: Five surgeons participated in the study, and each received 5 plastic maxillary jaw models. Thus, 25 models were used for implant placement with CAD/CAM-fabricated surgical templates. Each model contained 6 implants; therefore, a total of 150 implants were placed. The virtually planned and actually placed implant positions were compared for the apex, hexagon, depth, and angle with 2 computed tomography scans that were matched with voxel-based registration software. In addition, any differences in the 4 parameters among the surgeons were statistically tested. The data were analyzed with the t test, ANOVA, and Scheffé test (α=.05)., Results: A statistically significant difference between the virtually planned and actually placed implant positions was observed for 3 of the 4 outcome variables (the apex, hexagon, and depth; P<.05). A statistically significant difference was also noted among all surgeons regarding the positions of the apex, depth, and angle., Conclusions: The results of this study provide a better understanding of the differences in accuracy between surgeons when using a CAD/CAM surgical technique. There was a significant difference between the virtually planned and actually placed implant positions and between the surgeons for some of the variable parameters analyzed. The null hypothesis was thus rejected., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: CAD/CAM template-guided surgery has gained attention as a method of improving the predictability of dental implant placement. However, due to possible variations during the manufacturing process and in the robustness of the template design, a virtual prediction of the potential positioning of the implants is needed., Purpose: The purpose of this study was to perform virtual variation simulations on virtually planned implant placements and to compare them with corresponding results from actual surgeries performed on human cadavers in a previous study., Material and Methods: Seventeen computer-aided plans were used for virtual variation simulation of surgeries conducted on 17 human cadavers and 145 implants placed in the cadavers. For each surgery, 10,000 virtual surgeries were performed, resulting in 1,450,000 implant placements. The results from the virtual variation simulations were statistically compared with the results from the actual surgeries. The Mann-Whitney U test was used to compare the implant distributions (alpha=.05)., Results: In the maxillae, the difference between the simulated average mean of the mean and the compared surgical average of the median was 0.22 mm (apex) and -0.35 mm (hex), and for the mandible, the corresponding values were -0.19 mm (apex) and -0.69 mm (hex). The simulated average mean of the range compared to the mean range of the maximum deviation results from the surgeries of the maxillae was 2.96 mm (apex) and 0.44 mm (hex), and 2.3 mm (apex) and 0.26 mm (hex) for the mandible. The implant distributions between the simulations and the surgeries were significantly different at both the hex (P<.001) and apex (P<.001)., Conclusions: The implant distributions were neither static nor normally distributed. Thus, within the limitations of this study, the definitive geometrical variations of the implants were not static, as they depend on the individual anatomy of the jaws and the ability to place the CAD/CAM-guided surgical template in the proper position., (Copyright 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.)

Statement of Problem: An optimal method for approaching the clinical surgical situation, when using preoperatively, virtually planned implant positioning, is to transfer data to a CAD/CAM-guided surgical template with the definitive position of the implant placed after surgery. The accuracy of CAD/CAM-guided surgeries must be determined to provide safe treatment., Purpose: The purpose of this study was to compare the deviation between the position of virtually planned implants and the position of implants placed with a CAD/CAM-guided surgical template in the mandible and the maxilla in human cadavers., Material and Methods: Ten maxillae and 7 mandibles, from completely edentulous cadavers, were scanned with CT, and 145 implants (Brånemark RP Groovy) were planned with software and placed with the aid of a CAD/CAM-guided surgical template. The preoperative CT scan was matched with the postoperative CT scan using voxel-based registration. The positions of the virtually planned implants were compared with the actual positions of the implants. Data were analyzed with a t test (alpha=.05)., Results: The mean measurement differences between the computer-planned implants and implants placed after surgery for all implants placed were 1.25 mm (95% CI: 1.13-1.36) for the apex, 1.06 mm (95% CI: 0.97-1.16) for the hex, 0.28 mm (95% CI: 0.18-0.38) for the depth deviation, 2.64 degrees (95% CI: 2.41-2.87) for the angular deviation, and 0.71 mm (95% CI: 0.61-0.81 mm) for the translation deviation., Conclusions: The results demonstrated a statistically significant difference between mandibles and maxillae for the hex, apex, and depth measurements in the variation between the virtually planned implant positions and the positions of the implants placed after surgery with a CAD/CAM-guided surgical template., (Copyright 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.)

Aim: To compare irritable bowel syndrome (IBS) patients with apparently healthy persons and to evaluate body awareness therapy, which is a physiotherapeutic remedy focusing on normalising tensions in the body, for the treatment of IBS with the hypothesis that altered body tension is associated with the syndrome., Methods: Twenty-one IBS patients received body awareness therapy two hours weekly for 24 wk. At baseline as well as after 12 and 24 wk, they underwent examinations including resource oriented body examination in combination with body awareness scale evaluation and filled in gastrointestinal and psychological symptom questionnaires. Saliva cortisol was analysed. A group of 21 apparently healthy persons underwent the same examinations once., Results: Compared to the apparently healthy group, IBS patients scored higher at baseline for gastrointestinal and psychological symptoms. They showed more often alterations in normal body tension patterns, as well as deviating cortisol slopes in saliva. After 24 wk of body awareness therapy, their gastrointestinal and psychological symptoms were reduced overall. Somatic symptoms decreased in parallel with depressive symptoms. Whole body pain score decreased, coping ability as well as biochemical stress markers improved., Conclusion: IBS patients scored higher for gastrointestinal and psychological symptoms, and presented with altered biochemical stress markers. Their body tension deviated compared to healthy controls. Furthermore, body awareness therapy gave relief of both somatic complaints, psychological symptoms and normalised body tension. These findings indicate that distorted tension constitutes an important part of the symptoms in IBS.

Morphology and compliance of tissue-engineered blood vessels (TEBV) are dependent on the culture period and production of extracellular matrix (ECM) components in order to increase the strength of the developing tissue. The aim of the present study was to evaluate the potential of TEBVs to produce an ECM similar to native arteries and veins. Human smooth muscle cells (SMC) were seeded onto the poly(glycolic acid) (PGA) scaffold and placed in bioreactors filled with DMEM supplemented with growth factors. After 6 weeks, the vessels were harvested from the bioreactors and seeded with human endothelial cells at the lumen for another 3 days. Then, the TEBVs were harvested for RNA and protein isolation for further RT-PCR and Western blot. TEBVs had a similar macroscopic appearance to that of native vessels with no visible evidence of the original PGA. Histological and immunohistochemical analyses indicated the presence of high cell density and development of a highly organized structure of ECM. After 6 weeks of culture, there were significantly lower gene expression of SMC-specific markers, such as alpha-actin, caldesmon, and vimentin, and proteoglycans, such as biglycan, decorin, and versican, and other ECM components, such as collagen I and elastin, in TEBVs, with and without pulsatile conditions, compared to that of native arteries. Gene expression of fibronectin was significantly lower in TEBVs grown during pulsatile conditions compared to that of native arteries. No difference was observed in TEBVs grown during non-pulsatile conditions. The presence of alpha-actin, collagen I, decorin, and fibronectin at protein level was demonstrated in TEBVs with and without pulsatile conditions after 6 weeks and in native veins and arteries as well. How this deviation translates into mechanical properties remains to be explored.

The optimal number of core biopsies of the prostate that are needed for the detection of prostate cancer is unknown. A retrospective review of protocols and charts concerning 1149 transrectal ultrasound examinations with biopsy performed in 1013 patients was undertaken. Cancer detection rate was correlated to findings on digital rectal examination (DRE), serum levels of prostate-specific antigen (PSA) and number of biopsies taken. The cancer detection rate was significantly higher in patients who had five or more cores taken compared to those who had four or less (49% versus 35%, p < 0.05) in patients with serum PSA less than 10 ng/ml and a DRE suspicious of malignancy. The same trend was seen in patients with normal DRE and PSA less than 10 ng/ml (14% versus 8%, p = 0.057), while the detection rate for prostate cancer was unaffected by the number of cores taken if serum PSA was above 10 ng/ml.

The blood flow in an experimental adenocarcinoma in the rat liver was determined with the 133Xe-washout technique before and after hepatic artery ligation (HAL). There was an initial reduction of the washout of 50%. This was further reduced after 1 day by 50%, which was maintained for 7 days. Seven days after HAL or sham procedures the 133Xe-washout was of similar magnitude in the liver tumours, although after the sham procedure the tumours were larger (3.4 g vs. 1.5 g). The estimated tumour blood flow was then approximately 0.04 ml x min-1 x g-1. The influence on normal liver parenchyma of HAL was a reduction at 30 minutes, which was maintained for 7 days. Postacton--a synthetic vasopressin--did not influence the 133Xe-washout in normal liver parenchyma in non-tumour, as well as in tumour-bearing animals. There was no influence of Postacton on the 133Xe-washout in the liver tumours. Thirty minutes after HAL Postacton gave a reduction of blood flow in normal liver parenchyma of tumour-bearing animals, which is thus only from the portal vein. In tumours Postacton did not significantly reduce the tumour blood flow immediately after HAL.

These studies were undertaken to evaluate the optimal effects of corticosteroids in an experimental septic shock model, with regard to time of therapy institution and the dose of corticosteroids (dexamethasone and methylprednisolone). Septic shock was induced by intraperitoneal injection of 5 x 10(8) live E coli bacteria/100 g body weight. Hematocrit was measured before and 4 h after injection of bacteria. Survival time was recorded continuously for 24 h and then daily for 7 days. Mortality rate correlated with hematocrit increase at 4 h in untreated control animals. Surviving rats did not increase their hematocrit, but nonsurvivors did. Survival time in untreated rats was 9.2 +/- 0.2 h (SEM). Corticosteroids significantly increased survival time when given prophylactically. This effect, however, decreased linearly with time when dexamethasone was given up to 8 h after bacteria injection. Dexamethasone (3-96 mg/kg) and methylprednisolone (19-225 mg/kg) significantly prolonged survival time. Twenty-two percent (73/329) of corticosteroid-treated animals lived longer than 24 h compared to 14% (19/135) of the controls. This difference was of borderline significance (P = 0.05).

The rabbit ear containing a mature Lucite chamber was subjected to ischemia in 25 rabbits. The ischemic insult lasted in one group for 2 hours, in the second group for 5 hours, and in a third group for 5 hours with the addition of systemic prednisolone therapy. The gross edema of the ear, restoration of flow within the microvasculature in the rabbit ear chamber, and the occurrence and resolution of the cellular inflammatory response were documented by daily in vivo observations of the chamber. The 2-hour ischemic period resulted in a relatively insignificant injury, but the 5-hour ischemic period resulted in edema of the ear, changes in the flow within the microvasculature, and a cellular inflammatory response that increased in intensity for the first 24 hours following ischemia. Ultimate resolution of these changes was noted in all the animals. Systemic administration of prednisolone dramatically reduced the occurrence of edema and reduced the intensity of the inflammatory response, which resolved in a shorter period of time than in untreated animals. These studies demonstrate that ischemia evokes a classic inflammatory response that is inhibited by the administration of systemic steroids.