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The study aimed to quantify polycyclic aromatic hydrocarbons (PAHs) in the sediments and to assess their impact on the ovary of the catfish (Clarias gariepinus) obtained from two Delta Nile Canals, Bahr Shebeen (Site 1), and El-Bahr El-Pharaouny (Site 2) Canals in Al-Minufiya Governorate, Egypt. Eight female catfish specimens were collected from various localities at two examined sites during July 2023. Furthermore, Σ16 PAHs were quantified in sediments. Some female sex hormones were evaluated. Morphology, maturation and histopathological changes in the ovary were elucidated. The results indicate that the mean values of PAHs including, naphthalene, phenanthrene, chrysene, benzo(b)fluoranthene, benzo(k)fluoranthene, benzo(a)Pyrene, dibenzo(a,h)anthracene and benzo(g,h,i)Perylene were higher in sediment from site 2 compared to site 1. In contrast, the mean values of pyrene, benz(a)anthracene, and indo(1,2,3-cd) pyrene were higher in sediment from site 1 than site 2. Fluorene value (1.006±1.743) was exclusively detected in sediment at site 2. Acenaphthylene, acenaphthene, anthracene and fluoranthene were completely absent in the sediments of the two investigated sites. The mean value of progesterone (ng/ml) was higher in serum of fish collected from site 1 in comparison with site 2. On the other hand, the estradiol (E2) (pg/ml) was greater in serum of fish obtained at site 2 than site 1. The ovarian morphology of fishes from site 1 exhibited a normal structure, while slight abnormalities were observed at site 2. The ovary of the catfish from site 1 exhibited the lowest incidence of atretic oocytes, whereas site 2 displayed the lowest percentage of mature oocytes alongside the highest occurrence of atresia. Microscopic examinations revealed degenerative alterations (atresia) in certain oocytes leading to the adherence of their cellular covering. This study revealed that elevated levels of PAHs result in heightened histopathological changes in the ovaries of the catfish, therefore serving as effective biomarkers for assessing PAHs in freshwater ecosystems. [ABSTRACT FROM AUTHOR]

Ovarian cells of animals undergo atresia to regulate egg numbers and their release. However, unrestrained atretic activity decreases the chances of oocyte maturity and further process, ultimately resulting in a reduced population. Edible fishes are a critical source of nutrition and it is required to regulate their population. The application of herbicides at fish production sites is a threat to their population by altering female reproductive activity. In concern to this, here, this 60-day study investigates herbicide paraquat dichloride (PD)-induced atresia in ovarian cells of Channa punctatus (C. punctatus). Further, 96-h LC50 of PD for C. punctatus was calculated as 58.40 mg/L. At the end of each exposure period, an increase in intracellular ROS in blood cells and activities of SOD and CAT in ovary tissue were observed in PD-treated fish with increasing concentration. The frequency of micronuclei in blood cells subsequently increased with the highest PD concentration. A significant (p < 0.05) increase in the relative expression of target genes was observed at the 30th and 60th day of the sampling periods in the fish treated with the highest concentration of PD. The histological study confirmed the occurrence of atretic ovary cells in PD-exposed fish. From the results it can be concluded that PD enhances the uncontrolled death of ovarian cells and has consequences of impairing the ovary health and reproductive potential of fish, hence reducing the fish population. [ABSTRACT FROM AUTHOR]

Background and Objectives Congenital choanal atresia is a rare condition that occurs in approximately 1 in 7,000 to 8,000 live births and involves the obstruction of the posterior nasal airway. It may present as either unilateral or bilateral, with bilateral cases being more severe due to the risk of immediate neonatal respiratory distress. Bilateral congenital choanal atresia (BCCA) necessitates prompt medical intervention to prevent cyanosis and significant breathing difficulties. This study focuses on the timing of surgery, the duration of stent use, and postoperative care in patients with bilateral congenital choanal atresia who underwent endoscopic transnasal surgery. Unlike previous studies, this research emphasizes the efficacy of an extended stenting period and introduces novel stenting techniques aimed at reducing restenosis. Methods From 2018 to 2021, three patients with BCCA underwent transnasal surgery that included the placement of stents. We retrospectively analyzed their medical records, focusing on the surgical outcomes in relation to the duration of stent placement and postoperative care. A novel approach was adopted, involving the use of customized stent sizes tailored to the specific anatomical factors of each patient, which facilitated improved neochoana maintenance. Results The average interval from diagnosis to surgery was 3.6 weeks. Surgery was successful in all cases, and the stent was removed after 6 months. In all patients, stable neochoanae were maintained without significant restenosis. Additionally, we observed that maintaining a stent for a period longer than previously recommended significantly reduced the risk of restenosis compared to the shorter durations used in earlier studies. Conclusion Our study suggests that an extended stenting period of 6 months or more is crucial for maintaining long-term patency in patients with BCCA. This approach could lead to a more reliable stenting protocol and improved postoperative care, potentially establishing a new standard for managing BCCA.

In domestic hens, the atresia of large white follicles (LWFs) directly affects the number of follicles that enter the hierarchical development and ovulation. Figuring out factors responsible for LWFs atresia is helpful to improve egg production of hens. At the LWF stage, yellow yolk begins to be deposited into the follicles via receptor mediated endocytosis, which requires large amounts of ATP. Mitochondrial oxidative phosphorylation (OXPHOS) is the primary source of ATP for follicular development. However, it is not clear whether the OXPHOS is changed along LWFs atresia. In this study, firstly, differences in morphological appearance, histology, cell proliferation, apoptosis, OXPHOS and mitochondrial dynamics between LWFs and atretic large white follicles (ALWFs) in hens at the peak laying stage (35W) were determined to elucidate whether OXPHOS changes in ALWFs. Then, these differences of LWFs between the peak laying hens (35W-LWFs) and the late laying hens (70W-LWFs) were detected to confirm whether OXPHOS changes during LWFs atresia. The results showed that ALWFs exhibited a wrinkled surface with several hemorrhage spots, and numerous intercellular vacuoles, as well as severe nuclear pyknosis. Compared to LWFs, a higher cell apoptosis rate and a lower proliferation rate were observed in ALWFs. In ALWFs, OXPHOS declined as manifested by reductions in ATP levels, ATP synthetase abundance, NAD+, NADH and NAD+/NADH ratio, and mRNA levels of genes associated with OXPHOS complexes I-V. Meanwhile, mitochondrial dynamics disequilibrium was detected in ALWFs as the expression levels of proteins and genes related to mitochondrial fusion (MFN1, MFN2, and OPA1) decreased, while the expression levels of proteins and genes related to mitochondrial fission (DRP1 and FIS1) increased. Further, compared to 35W-LWFs, 70W-LWFs showed a histology resembling to ALWFs, manifested as a slightly loosen structure of granulosa layers, and a lower cell proliferation rate. Moreover, both lower OXPHOS and impaired mitochondrial dynamics were detected in 70W-LWFs. In conclusion, our results indicated that OXPHOS decline and mitochondrial dynamics disequilibrium are involved in LWFs atresia in laying hens. • OXPHOS and mitochondrial dynamics in LWFs and ALWFs of peak laying hens, and in LWFs of late laying hens were determined. • Compared to LWFs, OXPHOS declined and mitochondrial dynamics disequilibrium occurred in ALWFs. • LWFs in late laying hens are more prone to atresia than those in young hens, which may be attributed to age-related OXPHOS decline. [ABSTRACT FROM AUTHOR]

Pulmonary vein atresia is a rare congenital abnormality that could manifest in isolation or in association with other congenital abnormalities in the cardiovascular system such as pulmonary vein hypoplasia. Pulmonary vein atresia leads to changes in cardiovascular functioning. This abnormality is often diagnosed in children with recurrent pneumonia and hemoptysis. In adulthood, pulmonary vein atresia is much less common, with clinical symptoms such as dyspnea during physical exercises and hemoptysis. However, some patients are asymptomatic. Owing to the nonspecific imaging findings, lung parenchymal changes are often misdiagnosed as another lung disease, including inflammatory genesis disease. In this article, a case of a young man with asymptomatic unilateral pulmonary vein atresia combined with pulmonary artery hypoplasia and interstitial lung changes in a lung with hypoplasia was presented. These pathologies were first identified in a 21-year-old patient by contrast-enhanced computed tomography.

The present study focuses on the detailed description of postovulatory follicles (POFs) resorption and atresia in horse mackerel from Algerian waters. From February 2013 to February 2014, 155 female horse mackerel were randomly collected. Histological sections of ovaries were analyzed. Few POFs (7.28% of early POFs and 2.91% of old POFs of the total observed oocytes) were detected. Morphological changes of POF resorption were discussed in the current study. No particular shape was observed. Four types of atretic oocytes were determined: α = 34.38%, β = 5.28%, δ = 2.37% and γ = 0.94%, which was reported for the first time in horse mackerel. The incidence of α atresia was higher in the yolked (21.48%) than in the unyolked oocytes (12.89%). α atretic oocytes can be classified into two main types: non-bursting (capsulated, lipoidal and cystic atresia) and bursting (multiple bursts, single bursts, phagocytic bursts and liquified bursts). Further studies are required to better understand the reproductive strategies of fish in relation to postovulatory follicle resorption and atresia.

In mammalian ovaries, most follicles do not ovulate and are eliminated by atresia, which primarily depends on granulosa cell (GC) apoptosis. Autophagy is an alternative mechanism involved in follicle depletion in mammals through independent or tandem action with apoptosis. However, follicular autophagy has not yet been investigated in sheep; therefore, the present study aimed to investigate the involvement of autophagy in atresia among a pool of growing antral follicles in ewe ovaries. The abundance of the autophagic marker LC3B-II was determined using western blotting in GCs collected from ewe antral follicles. The antral follicles were classified as healthy or atretic based on morphological criteria and steroid measurements in follicular fluid (FF). Immunofluorescence and confocal microscopy analyses were performed on GCs to evaluate the presence of autophagic proteins and their subcellular localisation. Caspase-3 and DNA fragmentation were assessed using western blotting and TUNEL assays, respectively, in the same GC population to investigate the simultaneous apoptosis. The novel results of this study demonstrated enhanced LC3B-II protein expression in GCs of atretic follicles compared to that of healthy ones (1.3-fold increase; P = 0.0001, ANOVA), indicating a correlation between autophagy enhancement in GCs and antral follicular atresia. Autophagy, either functioning independently or in tandem with apoptosis, may be involved in the atresia of growing antral follicles in ewe ovaries because atretic GCs also showed high levels of apoptotic markers. The findings of this study might have important implication on scientific understanding of ovarian follicle dynamics. • Ovine granulosa cells undergo autophagy during follicular atresia at antral stage • The autophagic marker level is higher in atretic than in healthy granulosa cells • Granulosa cells of atretic follicles undergo apoptosis as well • Autophagy and apoptosis could regulate granulosa cell death • Both autophagy and apoptosis could be involved in antral follicle atresia in sheep [ABSTRACT FROM AUTHOR]

Normal and optimal functioning of the gastrointestinal tract is paramount to ensure optimal nutrition through digestion, absorption and motility function. Disruptions in these functions can lead to adverse physiological symptoms, reduced quality of life and increased nutritional risk. When disruption or dysfunction of neuromuscular function occurs, motility disorders can be classified depending on whether coordination or strength/velocity of peristalsis are predominantly impacted. However, due to their nonspecific presenting symptoms and overlap with sensory disruption, they are frequently misdiagnosed as disorders of the gut–brain interaction. Motility disorders are a prevalent issue in the pediatric population, with management varying from medical therapy to psychological therapy, dietary manipulation, surgical intervention or a multimodal approach. This narrative review aims to discuss the dietary management of common pediatric motility disorders including gastroesophageal reflux, esophageal atresia, achalasia, gastroparesis, constipation, and the less common but most severe motility disorder, pediatric intestinal pseudo-obstruction. [ABSTRACT FROM AUTHOR]

Accurate assessments of female reproductive development are an important component to the sustainable management of the fishery of the white shrimp Penaeus setiferus (Linnaeus, 1767) in the southeastern U.S. Reproductive development has been commonly assessed macroscopically based on ovarian color; however, distinguishing females that have never spawned from those that have previously spawned using this approach can be challenging due to their similarity in appearance. Histological approaches allow for higher resolution in quantifying microscopic phases of reproductive development and may reveal evidence of prior spawning events. Our objective was to characterize reproductive development and spawning activity in female P. setiferus through histology by: 1) defining major phases of reproductive development; 2) investigating and distinguishing the characteristics of oocyte atresia; and 3) using a standardized framework to describe the phenology of ovarian development in P. setiferus. Weekly samples of female P. setiferus were collected from March to June 2022 and ovarian tissues from 520 individuals were processed histologically. A detailed framework for distinguishing microscopically-observed ovarian development phases based on defining oocyte characteristics is provided. Oocyte atresia was observed in the ovarian tissue of 51% (N = 264) of individuals examined, with further examination differentiating between non-spawning atresia (N = 205) and post-spawning atresia (N = 59). Individuals with no atresia and non-spawning atresia were present from all sampling events, whereas individuals with post-spawning atresia first appeared on 22 April 2022. Our descriptions of ovarian development and oocyte atresia contribute to a growing framework of standardized microscopic assessments that should be tested more broadly for applicability to other commercially important crustaceans. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Jejunalileal atresia is a cause of intestinal obstruction in the newborn, hence a surgical emergency. Prenatal diagnosis can be made by simple obstetric ultrasound and postnatal by plain abdominal x‐ray to plan a multidisciplinary approach to reduce morbidity and neonatal mortality. Atresia can occur anywhere along the intestines and is a common cause of intestinal obstruction in neonates. Jejunoileal atresia (JIA) is a rare disease occurring in 2.1 per 10,000 live births. Type 3b jejunoileal atresia occurs in 11% of all small bowel atresia. We present three cases of type 3b jejunoileal atresia. They were all missed by prenatal ultrasonography, and presented with features of intestinal obstruction. The diagnosis was confirmed by plain abdominal x‐rays and ultrasound, followed by laparotomy. Postoperative care was given in the neonatal unit according to local protocols. One recovered, however, two succumbed from neonatal infection. Jejunoileal atresia requires surgery and long postoperative care, with outcomes associated with numerous prognostic factors including multidisciplinary care and neonatal intensive care. Jejunoileal atresia is less commonly associated with other congenital anomalies, unlike duodenal atresia. Efforts are needed to scale up prenatal diagnosis of jejunoileal atresia, and therefore to plan for appropriate care after delivery. Also, further studies are needed to understand neonatal sepsis in the postoperative period and ways to improve outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Intestinal atresia is an uncommon cause of intestinal obstruction. In the vast majority of the cases, signs and symptoms develop early in the neonatal period. Presentations beyond the neonatal period are rare. Case presentation: A former premature female infant who was otherwise healthy developed recurrent, non-bilious vomiting associated with feedings at the age of 8 months. Up until that time her weight gain had been appropriate, and she had regular bowel movements. Over the course of the following weeks, the vomiting became more frequent. A few days after her 9-month well-child visit during which she still appeared to be in good health, her vomiting turned bilious and was not related to feedings. Her parents brought her to the emergency room. She was admitted to the hospital and underwent imaging studies to investigate the source of what seemed to be an intestinal obstruction. The upper gastrointestinal series (UGI) showed delayed passage of contrast, and a caliber change in the proximal small bowel. The computerized tomography (CT) confirmed the findings, which were suggestive of a partial proximal intestinal obstruction. She underwent a laparotomy. We identified an area of caliber change 15 cm distal to the ligament of Treitz. We opened the proximal side and identified a jejunal membrane that had a pinhole opening in the center. We resected a 4-cm segment of jejunum that included the caliber transition and the membrane and did an end-to-end anastomosis. She tolerated the operation well and was discharged home 12 days later. At the age of 1 year, she is thriving well. Conclusion: Although type-I jejunal atresia typically presents in the neonatal period, it should be included in the differential diagnosis of infants with recurrent vomiting and signs of a partial bowel obstruction.

Intestinal atresia is a common cause of neonatal bowel obstruction. Atresias are often associated with other congenital anomalies. The purpose of the study was to evaluate associated anomalies, operative management, and postoperative outcomes of infants with intestinal atresia. A review of patients presenting to a single free-standing children's hospital from March 2012 through February 2022 was performed. The variables examined were type of atresia, additional congenital anomalies, type of operative intervention, and postoperative outcomes. Standard statistical methods were utilized. A total of 75 patients with intestinal atresia were identified and several of these patients had multiple atresias. Isolated duodenal atresia patients were the most common (49.3%), followed by jejunal (32%) and ileal (12%). Mixed atresias were rare at 4%, with isolated pyloric and colonic also rare at 1.3% each. Malrotation was associated with 13% of patients and equally associated with duodenal and jejunoileal atresias. A low percentage (3%) of intestinal atresias was seen in conjunction with gastroschisis and concomitant malrotation. A majority of infants with duodenal atresia underwent standard duodenoduodenostomy (19% laparoscopic, 81% open). In infants with jejunoileal atresia, most underwent resection with primary anastomosis. A tapering enteroplasty was performed primarily in 13% of atresias. There were no significant differences noted in time to first feed or length of stay between those with and without tapering enteroplasty. Eleven percent of patients required subsequent intervention for stricture or small bowel obstruction. There was one death in this series. Consistent with other literature, duodenal atresia was the most common type of intestinal atresia. However, we demonstrated that malrotation was equally associated with duodenal and jejunoileal atresias while prior reports had shown a higher association with duodenal atresia. In our patient population, the use of tapering enteroplasty did not appear to be associated with outcomes. Overall, these infants have a low morbidity and mortality rate with a rare need for reoperation. [ABSTRACT FROM AUTHOR]

Introduction: Sacrococcygeal teratomas (SCTs) and jejunoileal atresias are both rare (1 in 35,000–40,000 births and 1 in 5000 births, respectively). We present a case of a concomitant diagnosis of a cystic sacrococcygeal teratoma and a jejunoileal atresia. Case presentation: A twenty-week screening ultrasound identified a cystic pelvic mass (5.5 x 2.8 × 2.2 cm), dilated bowel, and mild polyhydramnios in an otherwise healthy G1P0 woman. Fetal magnetic resonance image showed a multiseptated presacral cystic mass suspicious for an internal sacrococcygeal teratoma and dilated bowel, thought to represent dilated ascending and transverse colon. Scheduled delivery at 39 weeks of gestation was uncomplicated. Postnatal ultrasound and MRI were consistent with prenatal findings. Given the rarity of both congenital anomalies and no known association between SCTs and jejunoileal atresia, the prenatal bowel dilation was thought to be due to partial obstruction secondary to the SCT. The baby thus underwent SCT resection on day-of-life 2. Ongoing obstruction after resection prompted a contrast enema which demonstrated a microcolon with reflux into the terminal ileum but no reflux into more dilated proximal loops concerning for intestinal atresia. On day-of-life 5, the baby underwent exploratory laparotomy which identified a type-2 ileal atresia, and a primary anastomosis was performed. The patient had an uneventful recovery and was discharged home on day-of-life 22. Conclusion: Prenatal findings of dilated bowel should prompt providers to have a high index of suspicion for jejunoileal atresia, even if other diagnoses exist.

Key Clinical Message Jejunalileal atresia is a cause of intestinal obstruction in the newborn, hence a surgical emergency. Prenatal diagnosis can be made by simple obstetric ultrasound and postnatal by plain abdominal x‐ray to plan a multidisciplinary approach to reduce morbidity and neonatal mortality. Abstract Atresia can occur anywhere along the intestines and is a common cause of intestinal obstruction in neonates. Jejunoileal atresia (JIA) is a rare disease occurring in 2.1 per 10,000 live births. Type 3b jejunoileal atresia occurs in 11% of all small bowel atresia. We present three cases of type 3b jejunoileal atresia. They were all missed by prenatal ultrasonography, and presented with features of intestinal obstruction. The diagnosis was confirmed by plain abdominal x‐rays and ultrasound, followed by laparotomy. Postoperative care was given in the neonatal unit according to local protocols. One recovered, however, two succumbed from neonatal infection. Jejunoileal atresia requires surgery and long postoperative care, with outcomes associated with numerous prognostic factors including multidisciplinary care and neonatal intensive care. Jejunoileal atresia is less commonly associated with other congenital anomalies, unlike duodenal atresia. Efforts are needed to scale up prenatal diagnosis of jejunoileal atresia, and therefore to plan for appropriate care after delivery. Also, further studies are needed to understand neonatal sepsis in the postoperative period and ways to improve outcomes.

Background: Situs ambiguous is a rare congenital anomaly characterized by an unusual and irregular distribution of the major visceral organs and vessels within the chest and abdomen. In this condition, the organs are arranged in a way that cannot be classified as either situs inversus or situs solitus. We report this case due to the rarity of this anomaly and its uncommon association with duodenal atresia in a neonate. Case Presentation: A full-term newborn female presented with repeated bilious vomiting and failure to pass meconium for five days. An erect abdominal X-ray revealed a double-bubble sign in the left hemiabdomen, and a CT scan confirmed an abnormal relationship between the liver and stomach. Operative exploration confirmed the diagnosis of situs ambiguous with duodenal atresia, which was treated with a diamond duodenoduodenostomy. Conclusion: Situs ambiguous is a rare variant of situs anomaly with few reported cases worldwide. It has two subtypes: left and right isomerism, based on the anatomy of the spleen. Clinically, it can present with features of intestinal obstruction when associated with duodenal atresia.

A 2-year-old, male, intact dog presented with a history of stertorous breathing since infancy, unresponsive to antibiotic therapy. On rostral rigid endoscopy, there were no remarkable findings. However, computed tomography revealed bilateral atresia of the nasal choanae, with focal hyperossification and severe narrowing, with accompanying hypoventilation of the nasopharynx. Retrograde flexible nasopharyngoscopy confirmed the severe partial choanal atresia. Surgical intervention was declined by the owner due to reasonably acceptable quality of life; therefore, only environmentalmodifications and symptomatic care have been implemented so far. [ABSTRACT FROM AUTHOR]

Forty-nine children who started wearing cartilage conduction hearing aids (CC-HAs) before completing elementary school (17 with bilateral hearing loss and 32 with unilateral hearing loss) were followed-up and examined. The wearing and utilization status of the CC-HA and its progress to date were evaluated. In addition, 33 participants who purchased the CC-HAs were interviewed to assess the wearing effect. Eleven of seventeen children with bilateral hearing loss and 25 of 32 children with unilateral hearing loss continued to use the CC-HAs. In terms of wearing effect, a good wearing effect was reported, even by those with unilateral hearing loss. In cases where it was difficult to wear CC-HAs stably with pasting or ear tips, it was possible to fix them stably using commercially available hair bands and eyeglass vines. In two cases, the CC-HAs were worn from infancy. With ingenuity and appropriate educational and medical support, it is possible to wear CC-HAs from infancy.

This systematic review evaluates the efficacy and benefit of cartilage conduction hearing aids (CC-HAs) and that factors that influence purchasing decisions. The hearing thresholds and functional gain following CC-HA wear were synthesised. A one-way analysis of variance compared the differences in the hearing thresholds and functional gain at individual frequencies and in patients with a variety of pathological changes. The synchronised aided hearing threshold and functional gain at 2.0 kHz were significantly better than at 0.5, 1.0, and 4.0 kHz. There was no significant difference in the synchronised unaided hearing thresholds across individual frequencies between 0.5 and 4.0 kHz. The synchronised functional gain in patients with atresia was significantly greater than in patients with aural atresia or stenosis and middle ear pathologies with normal ear canals. The acceptability of CC-HAs in terms of purchase decision is influenced by the condition of the external auditory meatus and severity of hearing loss, with the highest purchase rate seen in patients with aural atresia or stenosis. CC-HAs’ fitting procedure advantages and cosmetic considerations make these devices a viable and preferred choice for individuals with microtia and aural atresia. Additional research to evaluate the benefits towards emotional well-being is crucial to gain insights into the psychological impact of CC-HA use.

Forty-nine children who started wearing cartilage conduction hearing aids (CC-HAs) before completing elementary school (17 with bilateral hearing loss and 32 with unilateral hearing loss) were followed-up and examined. The wearing and utilization status of the CC-HA and its progress to date were evaluated. In addition, 33 participants who purchased the CC-HAs were interviewed to assess the wearing effect. Eleven of seventeen children with bilateral hearing loss and 25 of 32 children with unilateral hearing loss continued to use the CC-HAs. In terms of wearing effect, a good wearing effect was reported, even by those with unilateral hearing loss. In cases where it was difficult to wear CC-HAs stably with pasting or ear tips, it was possible to fix them stably using commercially available hair bands and eyeglass vines. In two cases, the CC-HAs were worn from infancy. With ingenuity and appropriate educational and medical support, it is possible to wear CC-HAs from infancy. [ABSTRACT FROM AUTHOR]

Background: Anorectal malformations in infants is not an uncommon finding raising concerns. The presence of the associated anomalies, delayed referral, and diagnosis can further negatively affect the outcomes of the anorectal malformations. Aim: The present study aimed to assess the early outcomes of anorectal malformations seen in the neonate. Methods: The study prospectively assessed all the neonates admitted to the NICU (neonatal intensive care unit) with anorectal malformations. The subjects were assessed postoperatively for 1 month to evaluate the short-term surgical outcomes in infants with anorectal malformations. Results: Among 157 neonates, 75.15% (n=118) were males and 24.84% (n=39) were females. High anorectal malformations and low anorectal malformations were seen in 84.07% (n=132) and 15.92% (n=25) study subjects respectively. Associated congenital anomalies along with anorectal malformations were seen in 38.21% (n=60) of study subjects. The most common associated anomalies were gastrointestinal in 40.76% (n=64) subjects followed by esophageal and genitourinary in 31.21% (n=49) and 19.74% (n=31) subjects respectively. The most common surgical procedure was transverse colostomy done in 63.69% (n=100) subjects and the most common complication seen was thrombocytopenia in 36.30% (n=57) subjects followed by sepsis in 31.21% (n=49) subjects. Mortality was seen in 28.02% (n=44) subjects with 31.06% (n=41) in HARM and 12% (n=3) in LARM. A significant association was seen in mortality with birth weight and associated malformations with p=0.0001 and 0.003 respectively. Conclusion: The study concludes that in subjects with anorectal malformations, a higher mortality rate is seen in neonates with cardiac anomalies, esophageal anomalies, sepsis on admission, GIT perforation, double/triple atresia, and low birth weight. The majority of deaths are associated with anomalies warranting a detailed systematic evaluation of the subtypes. [ABSTRACT FROM AUTHOR]

Cartilage conduction hearing aids (CC-HAs) are a novel type of hearing aid relying on cartilage conduction, the so-called third auditory conduction pathway. However, CC-HAs have only recently entered routine clinical use, and therefore data on their usefulness are lacking. The purpose of this study was to examine the possibility of assessing whether individual patients would show good adaptation to CC-HAs. Thirty-three subjects (41 ears in total) underwent a free trial of CC-HAs. Age, disease category, and the pure-tone threshold of air and bone conduction, unaided field sound threshold, aided field sound threshold, and functional gain (FG) at 0.25, 0.5, 1, 2, and 4 kHz were compared between patients who subsequently purchased and did not purchase the CC-HAs. Overall, 65.9% of the subjects purchased CC-HAs after the trial. In comparison to non-purchasers, those who decided to purchase CC-HAs showed better pure tone hearing thresholds at high frequencies for both air conduction (2 and 4 kHz) and bone conduction (1, 2, and 4 kHz), as well as for aided thresholds in the sound field (1, 2, and 4 kHz) when using CC-HAs. Therefore, the high-frequency hearing thresholds of subjects trialing CC-HAs might be helpful for identifying those who are likely to benefit from them.

Aim of the work: To evaluate the submucosal resection of the posterior part of septum in the management of bilateral congenital choanal atresia.Patients and Methods: seventeen new-born infants with bilateral congenital choanal atresia were managed endoscopically by a transnasal repair together with submucosal resection of the posterior part of the septum. On CT scan, 14 infants had mixed atresia, and 3 infants had pure bony atresia. Using a 2.7 mm, 0° sinuscope, the site of the atretic plate and the adjacent part of the posterior septum were infiltrated. A vertical incision was taken at the bony cartilaginous junction of the septum using a round/sickle knife. The bony septum was drilled out along with the atretic plates of both sides. The two septal mucoperiosteal flaps were then approximated and the soft tissue that was occluding the choana was then excised on both sides. The remaining bones of the atretic plates were then removed from the remaining superior, lateral and inferior walls to widen the neo-choana and create a wider than normal choanaResults: A follow-up period for at least one year, revealed that 10 cases remained patent for adequate size bilaterally, four cases were found with bilateral concentric narrowing but still adequate for breathing, one case required revision surgery of the right side, two cases required bilateral revision surgery.Conclusion: Endoscopic submucous resection of the posterior part of the septum for the repairing of bilateral choanal atresia meets the goals of efficacy and safety, and diminished incidence of restenosis.

Background: Pulmonary atresia is a congenital heart defect that results from failure in the formation of the pulmonary valve that leads to right ventricular outflow obstruction, preventing the right heart ejection of blood to the lungs. It is also associated with a high incidence of chromosomal anomalies. Methods: A retrospective study of all infants diagnosed with pulmonary in Bahrain was undertaken. Pulmonary atresia was classified into pulmonary atresia with intact ventricular septum, pulmonary atresia in Tetralogy of Fallot, and pulmonary atresia in complex cyanotic heart defects. Short-term outcomes, survival, and associated genetics were analyzed. Results: 84 patients were diagnosed. 57 (67.9%) were males and 27 (32.1%) were females (p = 0.204). The median age at diagnosis was 25 days. Patients diagnosed with pulmonary atresia and complex cyanotic heart defects had the highest early survival rate. The early survival rate of patients diagnosed with pulmonary atresia with intact ventricular septum was lowest (p = 0.0179). Twenty-two patients (26.19%) had chromosomal anomalies. The DiGeorge syndrome was found in 18 patients, and 2 with Down Syndrome and other dysmorphisms in 2. 19 (86.36%) with chromosomal anomalies had pulmonary atresia and Tetralogy of Fallot, and 3(13.64%) with pulmonary atresia and complex cyanotic heart defects (p = 0.027). Conclusions: Pulmonary atresia is a rare but serious congenital heart defect. The lowest short-term survival is in those with intact intraventricular septum. There is a high incidence of chromosomal deletion of 22q11 leading to DiGeorge syndrome in those with Tetralogy of Fallot with pulmonary atresia. Early catheterization and surgical techniques are effective palliation for short-term survival. [ABSTRACT FROM AUTHOR]

Post-mortem ovarian tissue degradation from handling effects, such as delays in preservation, can lead to inaccurate reproductive assessments. Therefore, it is important to understand the differences between handling effects and natural ovarian atresia. Seven treatments of various holding temperatures and times to preservation were applied to whole fish and extracted ovaries of three tropical deepwater snapper species. Ovarian post-mortem degradation was observed at 12 h at ambient temperature and after 48 h iced or refrigerated for both whole fish and extracted ovaries; however, degradation did not adversely affect correct reproductive phase classification in fishes stored in ice from 12 to 48 h post-capture. A clear histological indicator of post-mortem degradation was the breakdown of ooplasm organelles at the oocyte periphery observed in vitellogenic and cortical alveolar oocytes. However, the chorion typically remains intact during post-mortem degradation, in contrast to natural atresia. Effects on post-ovulatory follicles were most discernible after 96 h on ice or refrigeration. Freezing gonadal tissue resulted in drastic changes to oocyte shape and morphology, making reproductive phase classification challenging. We advise that (1) freezing ovaries should be avoided where possible, and (2) gonad tissue should ideally be preserved immediately but no later than 48 h post-capture. [ABSTRACT FROM AUTHOR]

This systematic review evaluates the efficacy and benefit of cartilage conduction hearing aids (CC-HAs) and that factors that influence purchasing decisions. The hearing thresholds and functional gain following CC-HA wear were synthesised. A one-way analysis of variance compared the differences in the hearing thresholds and functional gain at individual frequencies and in patients with a variety of pathological changes. The synchronised aided hearing threshold and functional gain at 2.0 kHz were significantly better than at 0.5, 1.0, and 4.0 kHz. There was no significant difference in the synchronised unaided hearing thresholds across individual frequencies between 0.5 and 4.0 kHz. The synchronised functional gain in patients with atresia was significantly greater than in patients with aural atresia or stenosis and middle ear pathologies with normal ear canals. The acceptability of CC-HAs in terms of purchase decision is influenced by the condition of the external auditory meatus and severity of hearing loss, with the highest purchase rate seen in patients with aural atresia or stenosis. CC-HAs' fitting procedure advantages and cosmetic considerations make these devices a viable and preferred choice for individuals with microtia and aural atresia. Additional research to evaluate the benefits towards emotional well-being is crucial to gain insights into the psychological impact of CC-HA use. [ABSTRACT FROM AUTHOR]

Ovarian cryopreservation is an alternative for the preservation of fertility, and the subcutaneous transplantation site is considered one of the most promising. Studies evaluating the follicular growth and its relationship with gene expression and vascular perfusion are essential for improving this technique and its clinical application. Thus, the aim of this study was to evaluate the effect of subcutaneous autotransplantation and vitrification on follicular growth and atresia and their relationship with vascular perfusion and gene expression. Therefore, female mice were ovariectomized, and the ovaries were divided in two experimental groups (1) vitrified (treatment, n = 97) and (2) not vitrified (control, n = 97) and subsequently were transplanted. Then grafts, from both groups, were recovered after 1, 12, or 23 days (D1, D12, D23) and subjected to follicular quantification, morphometry, and qPCR. Non-transplanted ovaries (D0) were also used. The estrous cycle and vascular perfusion were monitored throughout the experiment. On D9, 100% of the animals had reestablished their estrous cycles (p > 0.05). Blood perfusion at the transplant site was similar for both treatments (p > 0.05), with greater perfusion at the site of vitrified transplants only on D1 (p < 0.05). A drastic reduction in the number of antral follicles and an increased number of atretic follicles were observed on D1 (p < 0.0001), associated with upregulation of Casp3, Fshr, and Igf1r; and downregulation of Bax, Acvr1, Egfr, and Lhcgr (p < 0.05). Our findings indicate that the first day after subcutaneous transplantation is a critical period for follicular survival, with intense follicular atresia independent of Bax upregulation. [ABSTRACT FROM AUTHOR]

• ICG-FA is used to determine anastomotic perfusion rates, thereby reducing surgical complications and aiding in intraoperative decision-making in adults, but not yet extensively described in pediatric surgery. • This systematic review analyzes the current knowledge on usefulness of ICG for intestinal perfusion assessment in pediatric gastrointestinal surgery and its safety in neonates. • ICG might be useful for intraoperative intestinal perfusion assessment, perhaps even more than conventional clinical assessment. • The safety profile of ICG looks promising in neonates. Larger prospective studies are necessary to confirm these assumptions and seem warranted given the safety profile. Although ICG-FA may be valuable in assessing anastomotic perfusion, reliable data on its use in pediatric gastrointestinal surgery is lacking. This systematic review analyzes whether ICG is useful for intestinal perfusion assessment in pediatric gastrointestinal surgery and safe to use in neonates. Systematic searches of PubMed, EMBASE & MEDLINE and CENTRAL were performed (last conducted December 6, 2021). The main inclusion criteria were (1) use of ICG for intestinal perfusion assessment and (2) use of ICG in young infants. Exclusion criteria were lack of an English or Dutch full-text and MINORS quality score <60%. Data was presented in overview tables. The usefulness in pediatric gastrointestinal surgery was assessed by surgical outcome. Safety of ICG in neonates was assessed by complication or adverse event occurrence. Regarding intestinal perfusion assessment, four studies were included, reporting 45 patients (median age 1.5 years). ICG was considered useful for anastomotic blood flow evaluation and intraoperative determination of resection length. Regarding ICG safety in neonates, eight studies were included, reporting 46 infants (median age 24.9 days), of which 18 neonates. All but one studies reported the absence of complications or adverse events. Two studies reported subcutaneous dye retention, which fully disappeared within two weeks. Although the number of available studies is small, ICG might be useful for intraoperative intestinal perfusion assessment, perhaps even more than conventional clinical assessment. Furthermore, its safety profile looks promising in neonates. Larger prospective studies are necessary to confirm these assumptions and seem warranted given the safety profile. Since this is a systematic review, a Level of Evidence for clinical studies cannot be determined for this manuscript. [ABSTRACT FROM AUTHOR]

Purpose: Long-term follow-up of congenital duodenal obstruction patients often falls on care providers with little experience of this condition. We performed a systematic review of the long-term outcomes of duodenal obstruction and provide a summary of sequelae care providers should anticipate. Methods: In 2022, after registering with PROSPERA, Medline (Ovid), EMBASE, PSYCHINFO, CNAHL and SCOPUS databases were searched using the title keyword 'intestinal atresia'. Abstracts were filtered for inclusion if they included the duodenum. Papers of filtered abstracts were included if they reported post-discharge outcomes. Methodological Index for Non-Randomized Studies was used to grade the papers. Results: Of the 1068 abstracts were screened, 32 papers were reviewed. Eleven studies were included. Thirty additional papers were included after reviewing references, for a total of 41 papers. The average MINORS was 7/16. Conclusion: There is good evidence that children with congenital duodenal obstruction do well in terms of survival, growth and general well-being. Associated cardiac, musculoskeletal and renal anomalies should be ruled-out. Care providers should be aware of anastomotic dysfunction, blind loop syndrome, bowel obstruction and reflux. Reflux may be asymptomatic. Laparoscopic repair does not change long-term outcomes, and associated Trisomy 21 worsens neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

Cartilage conduction hearing aids (CC-HAs) are a novel type of hearing aid relying on cartilage conduction, the so-called third auditory conduction pathway. However, CC-HAs have only recently entered routine clinical use, and therefore data on their usefulness are lacking. The purpose of this study was to examine the possibility of assessing whether individual patients would show good adaptation to CC-HAs. Thirty-three subjects (41 ears in total) underwent a free trial of CC-HAs. Age, disease category, and the pure-tone threshold of air and bone conduction, unaided field sound threshold, aided field sound threshold, and functional gain (FG) at 0.25, 0.5, 1, 2, and 4 kHz were compared between patients who subsequently purchased and did not purchase the CC-HAs. Overall, 65.9% of the subjects purchased CC-HAs after the trial. In comparison to non-purchasers, those who decided to purchase CC-HAs showed better pure tone hearing thresholds at high frequencies for both air conduction (2 and 4 kHz) and bone conduction (1, 2, and 4 kHz), as well as for aided thresholds in the sound field (1, 2, and 4 kHz) when using CC-HAs. Therefore, the high-frequency hearing thresholds of subjects trialing CC-HAs might be helpful for identifying those who are likely to benefit from them. [ABSTRACT FROM AUTHOR]

The present study described the changes of steroidogenic cells accompanied the ovarian maturation in flathead grey mullet, Mugil cephalus, from Al-Bardawil lagoon. Here, five periods of ovarian development including previtellogenesis, vitellogenesis (early, mid, and late), and pre-spawning ones were successfully obtained from mullet female inhabiting Al-Bardawill lagoon. In addition, abnormal feature of atresia was noticed in the vitellogenic stages of the ovaries. In atretic follicles, the granulosa cells converted into active phagocytic cells digesting and consuming the yolk in those oocytes. The histochemical and ultrastructural observations showed that the follicular cells, theca and granulosa of the developing oocytes are the site of the sex hormones synthesis. Both theca and granulosa have manifested both quantitative and qualitative alterations concomitant during oogenesis as reflected by an obvious increase in number, size, and content of lipid droplets of those cells. In conclusion, the present observations show the histological and ultrastructural changes of steroidogenic cells during ovarian maturation and atresia of the grey mullet. This new information is essential for managing and preserving Al-Bardawil lagoon as a natural source of mullet broodstock and for achieving sustainable development for this fish. [ABSTRACT FROM AUTHOR]

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Atresia of the inferior vena cava (IVC) is a rare anomaly associated with increased risk of deep venous thrombosis and lower extremity venous stasis. A significant number of patients with caval atresia remain asymptomatic however, due to compensatory lower extremity collateral venous networks. Over time, these venous tributaries may become insufficient and lead to venous hypertension and subsequent ulcer formation. The following case report describes a 54-year-old male with sickle cell trait who presented with IVC atresia and successfully underwent a technically challenging endovascular reconstruction.Given the scarcity of the condition, there is no established treatment paradigm in patients with atresia of the IVC. Additionally, given the variety of clinical presentation, it is important to tailor treatment to the individual. Our patient's medical history, clinical course, and physical exam findings raised suspicion of a condition affecting the central venous system, confirmed by a CT angiogram with dedicated venous phase. Given his clinical picture as well as our prior experience with central venous pathology, an endovascular reconstruction was offered. Now more than 18 months after surgery, the patient is living well and has not presented any new thrombotic events.Although not all patients with atresia of the inferior vena cava require surgical intervention, we propose that an endovascular approach is a successful strategy that leads to prompt recovery and a favorable outcome.

El objetivo general de la investigación fue evaluar los efectos a nivel ovárico que provoca la contaminació proveniente de tierra en la especie Stegastes partitus, haciendo énfasis en el proceso de la atresia. Fueron analizados histológicamente los ovarios de 12 peces provenientes de tres sitios con diferente grado de contaminación de la zona arrecifal del litoral habanero: la entrada de la bahía de La Habana, BR, la desembocadura del río Almendares, RIO, y un sitio de referencia, C30. Se obtuvieron diferencias significativas entre sitios en cuanto a la aparición de oocitos atrésicos vitelogénicos. El RIO presentó valores significativamente más altos, mientras que en BR y C30 la frecuencia de estos fue mucho menor. El índice gonadosomático, por el contrario, tuvo valores más bajos en la zona de RIO. En RIO se encuentren los mayores índices de atresia y de centros melanomacrofágicos, unido a los menores valores del índice gonadosomático, esto pudiera ser reflejo de las condiciones ambientales degradadas en este sitio, particularmente la contaminación. En este trabajo se describen por primera vez para S. partitus, tres estadios de la atresia. El inicial se caracteriza por la ruptura de la envoltura nuclear del oocito y por el ondulamiento de la zona radiata; el intermedio caracterizado por la fusión de algunos glóbulos de vitelo y porque las células foliculares presentan características fagocíticas y el estadio final donde hay pérdida total de la zona radiata. En este último, además, aparecen los cuerpos melanomacrofágicos.

Background: Esophageal balloon dilatation is an effective treatment for anastomotic strictures, but the factors affecting the outcome of dilatation remain unclear. Objective: To investigate the predictive factors of esophageal balloon dilatation outcome in children with anastomotic stricture after esophageal atresia repair. Materials and methods: We retrospectively reviewed children with esophageal atresia who underwent esophageal balloon dilatation for postoperative strictures between August 2007 and February 2021. We investigated each child's age, weight and height; type of esophageal atresia surgery; shape, length and level of stricture; esophageal balloon dilatation balloon size; application of mitomycin; number of inflation sessions; and number of esophageal balloon dilatation sessions. The outcome of each esophageal balloon dilatation session was determined as improvement in stricture diameter between pre- and post-esophageal balloon dilatation esophagography. We used uni- and multivariate analyses with generalized estimating equations to evaluate outcome predictors. Results: Overall, 69 children (mean age, 2.3 years; 45 boys) underwent 227 esophageal balloon dilatations. In the univariate analysis, the positive effect of esophageal balloon dilatation decreased with increased age, weight, height, balloon size and number of esophageal balloon dilatation sessions. Additionally, the positive effect was decreased in cervical-level strictures and with the application of mitomycin during esophageal balloon dilatation. In the multivariate analysis, independent prognostic factors of the positive esophageal balloon dilatation effect were age (incidence rate ratio [IRR]: −0.01; 95% confidence interval [CI]: −0.01, −0.002), shape of stricture (IRR: –0.54; 95% CI: −0.91, −0.18) and number of esophageal balloon dilatation sessions (IRR, −0.10; 95% CI: −0.14, −0.18). Conclusion: Repeated esophageal balloon dilatation, older age and eccentric stricture shape are associated with poor response to esophageal balloon dilatation in children with anastomotic strictures after esophageal atresia repair. [ABSTRACT FROM AUTHOR]

Context: Gastrointestinal (GI) duplications are rare congenital malformations with diverse presentations. They usually present in the pediatric age, especially in the first 2 years of life. Aims: To present our experience with GI duplication (cysts) at a pediatric surgery tertiary care teaching institute. Settings and Design: It is a retrospective observational study undertaken in the department of pediatric surgery at our center between 2012 and 2022 for GI duplications. Materials and Methods: All children were analyzed for their age, sex, presentation, radiological evaluation, operative management, and outcomes. Results: Thirty-two patients were diagnosed with GI duplication. Slight male predominance was present in the series (M: F ≈ 4:3). Fifteen (46.88%) patients presented in the neonatal age group; 26 (81.25%) patients were under 2 years. In the majority of cases (n = 23, 71.88%), the presentation was acute onset. Double duplication cysts on opposite sides of the diaphragm were present in one case. The most common location was ileum (n = 17), followed by gallbladder (n = 6), appendix (n = 3), gastric (n = 1), jejunum (n = 1), esophagus (n = 1), ileocecal junction (n = 1), duodenum (n = 1), sigmoid (n = 1), and anal canal (n = 1). Multiple associations (malformations/surgical pathologies) were present. Intussusception (n = 6) was the most common, followed by intestinal atresia (n = 5), anorectal malformation (n = 3), abdominal wall defect (n = 3), hemorrhagic cyst (n = 1), Meckel's diverticulum (n = 1), and sacrococcygeal teratoma (n = 1). Four cases were associated with intestinal volvulus, three cases with intestinal adhesions, and two with intestinal perforation. Favorable outcomes were present in 75% of cases. Conclusion: GI duplications have varied presentations depending on site, size, type, local mass effect, mucosal pattern, and associated complications. The importance of clinical suspicion and radiology cannot be underrated. Early diagnosis is required to prevent postoperative complications. Management is individualized as per the type of duplication anomaly and its relation with the involved GI tract. [ABSTRACT FROM AUTHOR]

Background Information: Autophagy is a conserved process that functions as a cytoprotective mechanism; it may function as a cell death process called programmed cell death type II. There is considerable evidence for the presence of autophagic cell death during oocyte elimination in prepubertal rats. However, the mechanisms involved in this process have not been deciphered. Results: Our observations revealed autophagic cell death in oocytes with increased labeling of the autophagic proteins Beclin 1, light chain 3 A (LC3 A), and lysosomal‐associated membrane protein 1 (Lamp1). Furthermore, mTOR and phosphorylated (p)‐mTOR (S2448) proteins were significantly decreased in oocytes with increased levels of autophagic proteins, indicating autophagic activation. Moreover, phosphorylated protein kinase B (p‐AKT) was not expressed by oocytes, but mitogen‐activated protein kinase/extracellular signalregulated kinase (MAPK/ERK) signaling was observed. Additionally, selective and elevated mitochondrial degradation was identified in altered oocytes. Conclusions: All these results suggest that mTOR downregulation, which promotes autophagy, could be mediated by low energy levels and sustained starvation involving the phosphoinositide 3‐kinase (PI3K)/AKT/mTOR and MAPK/ERK pathways. Significance: In this work, we analyzed the manner in which autophagy is carried out in oocytes undergoing autophagic cell death by studying the behavior of proteins involved in different steps of the autophagic pathway. [ABSTRACT FROM AUTHOR]

Salivary gland choristomas have been described in the middle ear but tend not to involve the external auditory canal. A 6-year-old boy with situs inversus totalis presented with congenital hearing loss in the left ear due to external auditory canal atresia. High resolution computed tomography of the temporal bone demonstrated a soft tissue obstruction of the external auditory canal with a normal middle ear. Histopathologically, this was a salivary gland choristoma. Post operatively the patient had a facial nerve palsy. Salivary gland choristomas of middle ear have been reported, but have not been described with external auditory canal atresia and situs inversus totalis. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Esophageal atresia (EA) with or without trachea-esophageal fistula is relatively common congenital malformation with most patients living into adulthood. As a result, care of the adult patient with EA is becoming more common. Although surgical repair has changed EA from a fatal to a livable condition, the residual effects of the anomaly may lead to a lifetime of complications. These include effects related to the underlying deformity such as atonicity of the esophageal segment, fistula recurrence, and esophageal cancer to complications of the surgery including anastomotic stricture, gastroesophageal reflux, and coping with an organ transposition. This review discusses the occurrence and management of these conditions in adulthood and the role of an effective transition from pediatric to adult care to optimize adult care treatment. [ABSTRACT FROM AUTHOR]

Biliary atresia (BA) is an idiopathic, progressive, fibroinflammatory, and obliterative disease of the biliary tract that manifests in the neonatal period with scleral icterus, acholic stools, conjugated hyperbilirubinemia, and elevated serum-gamma glutamyl transferase. Definitive diagnosis is established by a multi-disciplinary team comprising of pediatricians, hepatologists, radiologists, surgeons, and pathologists. It is currently the most common cause of pediatric liver transplantation in the USA and worldwide. More than 100 diseases can present with neonatal cholestasis mimicking BA. Early diagnosis (<60 days of age) with a timely Kasai portoenterostomy (KP) is crucial to relieve biliary obstruction and achieve longer native liver survival. Histopathologic features of BA can differ based on age and specific surgical interventions. This review describes histopathologic features of BA at various stages and focuses on a variety of common and uncommon diseases mimicking BA. With the increasing use of molecular testing and comprehensive genetic cholestasis panels, several patients who would have otherwise been diagnosed as BA, are now classified with specific genetic conditions leading to cholestasis. [ABSTRACT FROM AUTHOR]

Dexamethasone (DEX), which is a corticosteroid hormone (glucocorticoid), has been used to treat different conditions, such as immune system disorders, certain skin and eye disorders, as well as breathing problems. Cefotaxime sodium, also called Claforan, is synthesized from a naturally occurring material (semisynthetic). It is a broad-spectrum cephalosporin antibiotic that could be utilized for parenteral administration. The present study aimed to investigate histological changes occurring in the tissues and cells of the rats’ ovary (primordial, primary, secondary, antral, and mature follicle) treated with Cefotaxime sodium, as well as DEX, and evaluate the impacts of these medications on animals’ fertility. In total, 40 female adult Wistar rats were divided into four groups (n=10). The control group received 0.5 ml/kg of distilled water daily for five days as a placebo. The second group was injected with 0.5 mg/kg of DEX daily for five days. The same amount of Claforan (0.5 mg/kg) was injected into the third group daily for five days, and the fourth group received 0.5 mg/kg of both Claforan and DEX daily for five days. Afterward, the ovaries were prepared for histological examination. The ImageJ image analysis system was used to detect morphometric parameters and calculate the area of these organs. The findings of the present study showed that the DEX and Claforan brought changes to the ovarian area and the number of follicles. The ovarian area significantly increased (P

The objective of this study was to investigate the early follicular apoptosis in canine ovarian follicles by examining the expression of anti-apoptotic BCL-2 and pro-apoptotic BAX proteins throughout the estrous cycle associated with oocyte maturation. Follicular cells from preantral and antral follicles of varying sizes were isolated and grouped based on follicle type and estrous phase. Antral follicles underwent flow cytometry analysis, whereas preantral follicles were subjected to Western blotting. The meiotic capacity of oocytes from these different follicle types was evaluated through in vitro maturation. Statistical analysis included ANOVA and Duncan's test. Results showed fluctuations in BCL-2 and BAX levels across different follicular stages and estrous phases. BCL-2 levels increased (P <0.05) with follicular development in antral follicles, particularly during estrus, while BAX exhibited variations peaking (P <0.05) during estrus. The BCL-2/BAX ratio in antral follicles was higher (P <0.05) in estrus and diestrus compared to anestrus and proestrus. Additionally, BCL-2 and BAX proteins were detected in preantral follicles, with varying expression levels (P <0.05) across estrous phases. The BCL-2/BAX ratio in preantral follicles was highest (P <0.05) during anestrus and estrus and decreased (P <0.05) in proestrus and diestrus. Oocytes from preantral follicles did not reach the MII stage, regardless of the levels of BCL-2/BAX. Conversely, oocytes obtained from large follicles during estrus showed the highest (P <0.05) maturation percentages, which were associated with the highest BCL-2/BAX ratio. These findings provide insights into the dynamic patterns of BCL-2 /BAX in canine follicles across the estrous cycle, shedding light on their potential roles in oocyte development. • BCL-2 and BAX levels vary across follicular and estrous phases in canines. • No preantral oocytes mature in vitro regardless of the BCL-2 or BAX levels • Large follicle oocytes showed the highest maturation rates and the highest BCL-2/BAX. [ABSTRACT FROM AUTHOR]