bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment with Recombinant Trichinella spiralis Cathepsin B–like Protein Ameliorates Intestinal Ischemia/Reperfusion Injury in Mice by Promoting a Switch from M1 to M2 Macrophages
Authors: Liu Wei-Feng , Wen Shi-Hong , Zhan Jian-Hua , Li Yun-Sheng , Shen Jian-Tong , Yang Wen-Jing , Zhou Xing-Wang , Liu Ke-Xuan
Published: May 2015

Intestinal ischemia/reperfusion (I/R) injury, in which macrophages play a key role, can cause high morbidity and mortality. The switch from classically (M1) to alternatively (M2) activated macrophages, which is dependent on the activation of STAT6 signaling, has been shown to protect organs from I/R injuries. In the current study, the effects of recombinant Trichinella spiralis cathepsin B–like protein (rTsCPB) on intestinal I/R injury and the potential mechanism related to macrophage phenotypes switch were investigated. In a mouse I/R model undergoing 60-min intestinal ischemia followed by 2-h or 7-d reperfusion, we demonstrated that intestinal I/R caused significant intestinal injury and induced a switch from M2 to M1 macrophages, evidenced by a decrease in levels of M2 markers (arginase-1 and found in inflammatory zone protein), an increase in levels of M1 markers (inducible NO synthase and CCR7), and a decrease in the ratio of M2/M1 macrophages. RTsCPB reversed intestinal I/R-induced M2–M1 transition and promoted M1-M2 phenotype switch evidenced by a significant decrease in M1 markers, an increase in M2 markers, and the ratio of M2/M1 macrophages. Meanwhile, rTsCPB significantly ameliorated intestinal injury and improved intestinal function and survival rate of animals, accompanied by a decrease in neutrophil infiltration and an increase in cell proliferation in the intestine. However, a selective STAT6 inhibitor, AS1517499, reversed the protective effects of rTsCPB by inhibiting M1 to M2 transition. These findings suggest that intestinal I/R injury causes a switch from M2 to M1 macrophages and that rTsCPB ameliorates intestinal injury by promoting STAT6-dependent M1 to M2 transition.
Migraciones emergentes hacia la Argentina: colombianos y ecuatorianos. Breve panorama y estrategias de inserción cultural
Authors: Melella Cecilia
Published: May 2015

Argentina es un país de inmigración. Durante las últimas décadas se han mantenido constantes y/o han aumentado las migraciones de países de la región como Paraguay, Bolivia y Perú. Estas colectividades tienen gran arraigo en el país y poseen una cantidad considerable de asociaciones civiles, religiosas y culturales, y medios de comunicación como periódicos, radios y páginas web. También han desarrollado diversas festividades en la sociedad receptora. Según datos de la Dirección Nacional de Migraciones, cada vez es mayor la cantidad de colombianos y ecuatorianos que migran hacia Argentina en búsqueda de capacitación profesional y educativa. El perfil de estas migraciones se caracteriza por incluir jóvenes que no proyectan una residencia definitiva. El objetivo de este trabajo es describir las particularidades de estos desplazamientos recientes y analizar las estrategias de inserción cultural de estos grupos no demasiado afincados en nuestro país. Recursos como la gastronomía, las prácticas deportivas y culturales y la centralidad de las tecnologías de la información y de la comunicación (TIC) conforman las modalidades de inserción elegidas por estos embrionarios colectivos para articular lazos en la sociedad de destino
La Guerra del Pacífico como referente nacional y punto condicionante de las relaciones chileno-peruanas
Authors: Ugarte Díaz Emilio José
Published: May 2015

El presente artículo analiza las consecuencias que causó la Guerra del Pacífico (1879-1883) en la relación chileno-peruana. El conflicto ha condicionado las relaciones, siendo, incluso, utilizado como parte de la construcción identitaria y nacional de cada país. Se analizan las consecuencias que la guerra trajo para Perú, abordando las implicancias que tuvo en el desarrollo de la identidad nacional y sus relaciones con Chile. Posteriormente se realiza el mismo ejercicio en el caso chileno, examinando cómo el conflicto influyó en las percepciones e identidad del país y sus condicionantes en las relaciones con Perú. En las conclusiones se analiza en resumen el legado del conflicto y cómo este ha contribuido a distanciar ambas naciones en un camino lleno de resquemores
Cardiovascular risk factors in sub-Saharan Africa: a review
Authors: Monti Manuel , Ruggieri Maria Pia , Vincentelli Giovanni Maria , Capuano Fernando , Pugliese Francesco Rocco
Published: May 2015

Ischemic heart disease is increasing dramatically in the Sub-Saharan Africa (SSA), despite an increasing prevalence of risk factors, and some characteristics of the African people that make the African population subject to the effects of major cardiovascular risk factors. The pace and direction of economic development, rates of urbanization, the changes in life expectancy, associated with different pathophysiological factors are causing an increased rate of atherosclerotic disease in these countries. The prevalence of ischemic heart disease in SSA has shown a significant rise in the next two following decades due to the rising prevalence of risk factors, especially hypertension, diabetes, overweight and obesity, physical inactivity, tobacco use and the dyslipidemia, mainly due to an increase in urbanization. Moreover, thanks to new knowledge, it has been pointed out the difference of individual risk factors in the African population and other populations due to genetic differences. It is estimated that age-standardized approach for ischemic heart disease mortality rates will rise by 27% in African men and 25% in women by 2015 and by 70 and 74%, respectively by 2030. More research is needed in Africa to provide evidence for cardiovascular prevention and treatment to mitigate the oncoming epidemic. Health interventions are needed for preventing or reducing the morbidity/ mortality and should be addressed to both children and adults, including score of the risk stratification modified, starting early and aggressive therapy, if necessary.
Overtreatment
Authors: Bobbio Marco , Lusiani Luigi , Frediani Roberto
Published: May 2015

Over the years, dissociation between the widespread use of procedures and the lack of evidence (evidence-practice dissociation) has been observed in many circumstances in cardiology. Thirty-three years ago Mc Kinley described in 7 stages the career of a new procedure: from the enthusiastic presentation of pilot research up to oblivion. The Choosing Wisely project in the United States and the Doing more does not mean doing better project in Italy are intended to identify very commonly prescribed procedures at high risk of inappropriateness that do not bring significant benefits to many patients. Finally, the implementation of local experience of identifying inappropriate procedure in an Italian hospital is described.
Large Malignant Phyllodes Tumor of the Breast with Metastases to the Lungs
Authors: Augustyn Alexander , Sahoo Sunati , Wooldridge Rachel D.
Published: May 2015

Phyllodes tumors of the breast account for less than 0.5% of breast cancers and present most commonly in women 45 to 49 years old. The importance in managing fibroepithelial lesions lies in distinguishing fibroadenomas, which are benign, from phyllodes tumors, which can be malignant and require complete surgical excision. We report the case of a 56-year-old female who presented with a rapidly enlarging mass in her right breast 18 cm in maximum dimension that completely effaced the breast and distorted the nipple. The patient underwent a successful total mastectomy after core biopsy revealed a diagnosis of phyllodes tumor. Surgical resection is the primary treatment modality; neoadjuvant and adjuvant therapies remain controversial. Here, we report the case of a large malignant phyllodes tumor metastatic to the lungs, review the literature, and discuss diagnostic modalities and adjunct nonsurgical therapies.
Breast Metastasis from Medullary Thyroid Carcinoma in a Male Patient: Case Report and Review of the Literature
Authors: Mandanas Stylianos , Margaritidou Efterpi , Christoforidou Varvara , Karoglou Eleni , Geranou Chrysoula , Chrisoulidou Alexandra , Boudina Maria , Georgopoulos Konstantinos , Pazaitou-Panayiotou Kalliopi
Published: May 2015

Medullary thyroid carcinoma (MTC) is a rare malignancy that may metastasize to liver, lungs and bones. Breast is an unusual metastatic site for MTC and only 20 female cases have been reported in the literature. We present a male patient in whom histological examination and immunohistochemistry of a breast mass were indicative of breast metastasis from MTC. A 67-year-old man with recent diagnosis of MTC and metastases to cervical and upper mediastinum lymph nodes was referred to our department for further treatment. At first evaluation, diagnostic imaging techniques showed lung and bone metastases and three months later the presence of liver metastases. Due to the extension of the disease, treatment with vandetanib was decided, but serious adverse events led to its interruption after two weeks. During follow-up, patient developed a painful swelling in the right breast. Ultrasound and mammography showed the presence of multiple masses to the right breast suspicious for malignancy. Core needle biopsy and histological examination of the specimen confirmed the presence of metastatic MTC. Palliative external beam irradiation was used to relieve local pain and, after one month, the patient died. Consequently, breast masses should be cautiously evaluated, mainly in the presence of a known primary malignancy. Histological and/or cytopathological examination are requisite diagnostic tools, while external beam irradiation and tyrosine kinase inhibitors may be used as palliative therapies in the concurrent presence of breast metastases from MTC.
Definição de painel de indicadores de desempenho para instituições comunitárias de ensino superior
Authors: Zanin Antonio , Poli Odilon Luiz , Moura Geovanne Dias de , Jung Carlos Fernando , Caten Carla Schwengber ten
Published: May 2015

O estudo objetiva desenvolver um painel de indicadores de desempenho para auxiliar no processo de gestão das instituições comunitárias de ensino superior. Este estudo está baseado em uma abordagem qualitativa e quantitativa, utilizando grupo focal com gestores de uma IES comunitária, no sentido de propor um conjunto de indicadores elencados dentro de 4 (quatro) constructos: (I) Ensino; (II) Pesquisa; (III) Extensão; (IV) Gestão. A avaliação do grau de importância dos indicadores propostos no painel ocorreu por meio de aplicação de questionário a 9 (nove) gestores de IES comunitárias, sendo 3 (três) pertencentes ao Sistema ACAFE; 2 (duas) de IES associadas ao COMUNG; e 4 (quatro) confessionais. Estabeleceu-se como ponto de corte, os indicadores que atingiram uma média inferior a 3,5, excluindo-se do painel 4 indicadores. A principal contribuição deste estudo é a elaboração de um painel de indicadores de desempenho com 118 indicadores associados a 4 (quatro) constructos e 14 (quatorze) sub-constructos, podendo ser aplicado em Instituições de Ensino Superior comunitárias, alinhando ao planejamento estratégico de longo prazo.
Avaliação da qualidade percebida em serviços educacionais: proposta de uma escala
Authors: Bressan Verônica Paludo , Basso Kenny , Becker Larissa Carine Braz
Published: May 2015

O objetivo geral desta pesquisa é desenvolver e validar uma escala com a finalidade de mensurar a qualidade percebida por alunos de graduação em serviços educacionais. Para sua realização, foi desenvolvida uma pesquisa bibliográfica relacionada aos conceitos de qualidade percebida no ensino e formas de mensuração da qualidade, identificando a necessidade de desenvolvimento de uma escala específica para serviços educacionais, uma vez que as ferramentas encontradas tratavam de serviços de forma genérica. Foram seguidas as etapas propostas por Churchill (1979), sendo realizadas entrevistas com 17 alunos, na etapa qualitativa exploratória, e aplicados questionários em 410 alunos, na etapa quantitativa descritiva, composta por duas amostras, de teste e validação. Os resultados obtidos através de análise fatorial exploratória e análise fatorial confirmatória demonstraram a confiabilidade da escala, permitindo sua aplicação no contexto gerencial das IES. A escala final foi composta por 20 indicadores e 6 dimensões: organização curricular, corpo docente, pesquisa e extensão, organização administrativa, infraestrutura e serviços agregados. Este estudo apresenta implicações acadêmicas, colaborando com a discussão sobre os indicadores que compõem a qualidade percebida em serviços educacionais. Também são identificadas implicações gerenciais, uma vez que apresenta uma nova ferramenta que poderá ser utilizada nas IES como forma de qualificar a entrega dos serviços aos alunos.
Aspectos impactantes no dimensionamento da força de trabalho em uma instituição de ensino superior
Authors: Reis Cisne Zélia Teixeira , Freitas Áurea Maria Resende de , Martins Simone , Oliveira Adriel Rodrigues de
Published: May 2015

O dimensionamento dos recursos humanos em uma instituição merece amplo estudo, em virtude de sua complexidade. Nas Instituições Federais de Ensino Superior (IFES), com o advento da Lei nº 11.091/05, que instituiu o Plano de Carreira, este se tornou essencial e obrigatório no planejamento estratégico, como forma de identificação, análise e quantificação da força de trabalho necessária ao cumprimento dos objetivos institucionais. Numa abordagem qualitativa e quantitativa, com caráter exploratório, buscou-se investigar juntamente aos dirigentes da Universidade Federal de Viçosa as variáveis impactantes no planejamento da Gestão de Pessoas relacionadas à necessidade de ampliação ou de redução da força de trabalho. Embora os resultados apontem para a existência de eficiência na gestão de pessoas, a recomposição do quadro atual de servidores, dissociado de políticas de gerenciamento de pessoas, pode não ser uma forma eficiente para atender às demandas e ao processo de expansão das universidades federais.
Avaliação da satisfação, percepção da reputação e lealdade estudantil na FEAAC
Authors: Kleinberg Maurício Nunes , Dias Pedro Rebouças Sílvia Maria , Costa Josimar
Published: May 2015

Este estudo teve por objetivo avaliar a satisfação dos alunos de uma faculdade federal, a percepção destes quanto à reputação da faculdade e do curso que frequentam e a sua lealdade com a instituição. Para tanto, foi realizada uma pesquisa com aplicação de um questionário, adaptado de Helgesen e Nesset (2007), autoaplicável subdividido em três seções (perfil do respondente, avaliação da satisfação, percepção da reputação e lealdade) e o critério exigido foi que o respondente fosse aluno da Faculdade de Economia, Administração, Atuária e Contabilidade da Universidade Federal do Ceará, exceto nos dois primeiros semestres. Os dados foram analisados através de estatística descritiva e inferencial, e por análise fatorial, por meio do programa SPSS – (Statistical Package for Social Sciences), e através de modelo de equações estruturais, por meio do programa AMOS – Analysis of Moment Structures). Nos resultados do estudo, verificou-se que a percepção da reputação está positivamente relacionada com a lealdade estudantil, a satisfação dos estudantes está positivamente relacionada com a sua lealdade, a satisfação dos estudantes está positivamente relacionada com a percepção que estes têm da reputação da FEAAC, validando as hipóteses da pesquisa.
As competências virtuais individuais desenvolvidas pela graduação a distância em um curso de administração: o caso da Universidade Federal de Santa Catarina
Authors: Pereira Ariane Rodrigues , Dalmau Marcos Baptista Lopez
Published: May 2015

O presente trabalho descreve a percepção de alunos de graduação quanto ao desenvolvimento de competências virtuais individuais – CVI no curso de administração modalidade Educação a Distância – EaD da Universidade Federal de Santa Catarina. Para tanto, a pesquisa foi conduzida dentro de uma abordagem fenomenológica e pode ser caracterizada como quali-quanti, aplicada e descritiva. Realizada num estudo transversal e compreendida como um estudo de caso. Utilizou se entrevistas semi-estruturadas e levantamento (surveys), o qual foi composto por questionário com perguntas fechadas e respostas em escala likert. Os dados foram tratados de forma a analisar a contribuição do curso de administração EaD para o desenvolvimento das CVIs. Foi utilizado o modelo de Wang e Haggert (2011) como base para a verificação dos componentes constituintes do construto CVI, a saber: autoeficácia virtual, habilidade com mídia virtual e habilidade social virtual. A partir deste modelo houve um levantamento das principais CVIs demandas para o profissional de administração. Os resultados preliminares apontam que o curso contribui para o desenvolvimento das CVIs. No entanto, o estímulo para que os alunos trabalhem em conjunto de forma virtual tem sido maior por parte dos colegas.
Identifying flood recharge and inter-aquifer connectivity using multiple isotopes in subtropical Australia
Authors: King A. C. , Raiber M. , Cendón D. I. , Cox M. E. , Hollins S. E.
Published: May 2015

Abstract. An understanding of hydrological processes is vital for the sustainable management of groundwater resources, especially in areas where an aquifer interacts with surface water systems or where aquifer interconnectivity occurs. This is particularly important in areas that are subjected to frequent drought/flood cycles, such as the Cressbrook Creek catchment in Southeast Queensland, Australia. In order to understand the hydrological response to flooding and to identify inter-aquifer connectivity, multiple isotopes (δ2H, δ18O, 87Sr/86Sr, 3H and 14C) were used in this study in conjunction with a comprehensive hydrochemical assessment, based on data collected 6 months after severe flooding in 2011. The relatively depleted stable isotope signatures of the flood-generating rainfall (δ2H: −30.2 to −27.8‰, δ18O: −5.34 to −5.13‰ VSMOW) were evident in surface water samples (δ2H: −25.2 to −23.2‰, δ18O: −3.9 to −3.6‰ VSMOW), indicating that these extreme events were a major source of recharge to the dam in the catchment headwaters. Furthermore, stable isotopes confirmed that the flood generated significant recharge to the alluvium in the lower part of the catchment, particularly in areas where interactions between surface waters and groundwater were identified and where diffuse aquifer recharge is normally limited by a thick (approximately 10 m) and relatively impermeable unsaturated zone. However, in the upper parts of the catchment where recharge generally occurs more rapidly due to the dominance of coarse-grained sediments in the unsaturated zone, the stable isotope signature of groundwater resembles the longer-term average rainfall values (δ2H: −12.6, δ18O: −3.4‰ VSMOW), highlighting that recharge was sourced from smaller rainfall events that occurred subsequent to the flooding. Interactions between the bedrock aquifers and the alluvium were identified at several sites in the lower part of the catchment based on 87Sr/86Sr ratios; this was also supported by the hydrochemical assessment, which included the modelling of evaporation trends and saturation indices. The integrated approach used in this study facilitated the identification of hydrological processes over different spatial and temporal scales, and the method can be applied to other complex geological settings with variable climatic conditions.
A snow cover climatology for the Pyrenees from MODIS snow products
Authors: Gascoin S. , Hagolle O. , Huc M. , Jarlan L. , Dejoux J.-F. , Szczypta C. , Marti R. , Sánchez R.
Published: May 2015

Abstract. The seasonal snow in the Pyrenees is critical for hydropower production, crop irrigation and tourism in France, Spain and Andorra. Complementary to in situ observations, satellite remote sensing is useful to monitor the effect of climate on the snow dynamics. The MODIS daily snow products (Terra/MOD10A1 and Aqua/MYD10A1) are widely used to generate snow cover climatologies, yet it is preferable to assess their accuracies prior to their use. Here, we use both in situ snow observations and remote sensing data to evaluate the MODIS snow products in the Pyrenees. First, we compare the MODIS products to in situ snow depth (SD) and snow water equivalent (SWE) measurements. We estimate the values of the SWE and SD best detection thresholds to 40 mm water equivalent (w.e.) and 150 mm, respectively, for both MOD10A1 and MYD10A1. κ coefficients are within 0.74 and 0.92 depending on the product and the variable for these thresholds. However, we also find a seasonal trend in the optimal SWE and SD thresholds, reflecting the hysteresis in the relationship between the depth of the snowpack (or SWE) and its extent within a MODIS pixel. Then, a set of Landsat images is used to validate MOD10A1 and MYD10A1 for 157 dates between 2002 and 2010. The resulting accuracies are 97% (κ = 0.85) for MOD10A1 and 96% (κ = 0.81) for MYD10A1, which indicates a good agreement between both data sets. The effect of vegetation on the results is analyzed by filtering the forested areas using a land cover map. As expected, the accuracies decrease over the forests but the agreement remains acceptable (MOD10A1: 96%, κ = 0.77; MYD10A1: 95%, κ = 0.67). We conclude that MODIS snow products have a sufficient accuracy for hydroclimate studies at the scale of the Pyrenees range. Using a gap-filling algorithm we generate a consistent snow cover climatology, which allows us to compute the mean monthly snow cover duration per elevation band and aspect classes. There is snow on the ground at least 50% of the time above 1600 m between December and April. We finally analyze the snow patterns for the atypical winter 2011–2012. Snow cover duration anomalies reveal a deficient snowpack on the Spanish side of the Pyrenees, which seems to have caused a drop in the national hydropower production.
Volumetric assessment of lymph node metastases in patients with non-seminomatous germ cell tumors treated with chemotherapy
Authors: Basilio Carlos , Villeda Christian , Culebro Carolina , Rodríguez-Covarrubias Francisco , Castillejos-Molina Ricardo
Published: May 2015

Introduction: We evaluate volumetry and RECIST (Response Evaluation Criteria In Solid Tumors) as methodologies for response after chemotherapy for non-seminomatous germ cell tumour with retroperitoneal lymph node metastases.Methods: We performed a retrospective analysis of non-seminomatous testicular tumours and concurrent retroperitoneal lymph node metastases, which received chemotherapy and had computed tomography scans before and after treatment. Volumetric analysis and RECIST criteria were used to calculate response rates. We included a new category (favourable response) for patients with response rates between 70%. We calculated the correlation between volumetric and RECIST criteria with histological and clinical variables.Results: In total, 18 patients met the inclusion criteria. Histopathologic analysis of orchiectomy showed teratoma in 55.5% of patients, and those without teratoma had predominantly embryonal carcinoma. The mean baseline volume of retroperitoneal metastases was 447 cc, the mean post-chemotherapy volume was 33.6 cc, and the response rate was 62.6%. According to RECIST criteria, the mean baseline diameter was 4.93 cm, the mean post-chemotherapy diameter was 2.39 cm, and the response rate was 42.4%. Large post-chemotherapy residual masses correlated in both classifications with teratoma. The response rate was associated with the need for surgical treatment and the volumetric classification correlated with the need for lymphadenectomy.Conclusions: This study evaluated volumetry as a way to measure clinical response in lymph node metastases of non-seminomatous germ cell tumours. Volumetric analysis is the next step in the evaluation of response rate; its accuracy remains to be determined. Teratoma had greater residual masses and our classification correlated with the need for lymphadenectomy.
Angiosarcoma of the adrenal gland with concurrent contralateral advanced renal cell carcinoma: A diagnostic and management dilemma
Authors: Gusenbauer Kaela , Ruzhynsky Vladimir , Kak Ipshita , Adili Anthony F. , Giedraitis Kyle , Popovic Snezana , Kapoor Anil
Published: May 2015

Angiosarcoma is a rare high-grade malignant neoplasm with poor clinical outcome and survival rates, occurring most commonly in the skin and soft tissue. It is composed of neoplastic cells that demonstrate endothelial differentiation. The diagnosis of angiosarcoma can be difficult due to its pathohistologic presentation as a poorly differentiated neoplasm with associated secondary changes. We report a case of angiosarcoma of the adrenal gland with concurrent contralateral renal cell carcinoma (RCC) and renal vein thrombus. The presumptive clinical diagnosis was metastatic renal cell carcinoma to the contralateral adrenal gland. Pathohistologic evaluation demonstrated massive hematoma associated with intravascular papillary endothelial hyperplasia (IPEH)-like features. We discuss the pathohistological features used to ascertain a diagnosis of angiosarcoma in the presence of IPEH-like changes and differentiate it from reactive vascular proliferation seen in IPEH (Masson’s tumour).
Multiple urethral anomalies: Parameatal urethral cyst, penil curvature, incomplete hypospadiac anterior duplication of the urethra and distal hipospadias
Authors: Tuglu Devrim , Yuvanc Ercan , Yılmaz Erdal , Gur Serhan , Batislam Ertan
Published: May 2015

The male genitourinary system is quite complex. There are numerous known anomalies of the male urethra either as isolated cases or in combination with other disorders. An improved understanding of the embryology and anatomy of the normal male urethral development might help explain the causes of the various urethral abnormalities. We contribute to the etiology of congenital anomalies with this multiple urethral anomalies case.
Ureteric foreign body following previous aorto-iliac graft
Authors: Da Silva Vitor , Taylor Jonathan
Published: May 2015

Foreign bodies in the ureter are extremely rare. We report a case of an 82-year-old man who, after an incidental presentation with asymptomatic hydroureteronephrosis, had an intraureteric foreign body. The patient was managed with atraumatic endoscopic extraction of the specimen.
The prostatic utricle cyst with huge calculus and hypospadias: A case report and a review of the literature
Authors: Wang Weigang , Wang Yuantao , Zhu Dezhun , Yan Pengfei , Dong Biao , Zhou Honglan
Published: May 2015

Prostatic utricle cysts with calculus and hypospadias are rare in clinical practice. According to our literature review, only few cases have been reported. Recently, we experienced a case of prostatic utricle cyst with huge calculus in a 25-year-old male patient. He had a history of left cryptorchidism and surgery for penoscrotal hypospadias in his infancy. He was referred for frequent micturition, urgency of urination, urine pain, terminal hematuria and dysuria. Computed tomography (CT) revealed a retrovesical cystic lesion of low density, in which a 5×5 cm calcification was shown. Retrograde urethrocystography showed a 5×5 cm high-density shadow in the posterior urethra. The cyst was incised by transperineal approach and the stone was clearly observed and removed. Urethral stricture repair was performed simultaneously. The patient recovered smoothly after operation.
Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case
Authors: McAlpine Kristen , Leveridge Michael J. , Beiko Darren
Published: May 2015

Percutaneous nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for renal calculi in renal allografts. The advent of tubeless PCNL has led to reports of ambulatory or outpatient PCNL. This case report describes the successful outpatient management of a 49-year-old female with a symptomatic renal pelvic calculus in her transplanted kidney. Tubeless PCNL successfully removed the stone, free of complication, and the patient was discharged 2 hours and 17 minutes after the procedure in stable condition with minimal pain. This is, to the best of our knowledge, the first successful case of outpatient tubeless PCNL in a transplanted kidney.
L’éjaculation prématurée : Approche psychosomatique et prise en charge
Authors: Lahyani Mounir , Karmouni Tarik , Elkhader Khalid , Koutani Abdellatif , Ibn Attya Andaloussi Ahmed
Published: May 2015

L’éjaculation précoce est une dysfonction sexuelle très fréquente, caractérisée par la perte de contrôle de l’éjaculation, qui entraîne une anxiété de performance et, par conséquent, une altération de la qualité de vie des patients et de leur partenaire. Son étiopathogénie est multifactorielle et sujette à controverse. L’approche thérapeutique reste difficile malgré les divers traitements possibles.
Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases
Authors: Xiao Jiantao , Lei Jun , He Leye , Yin Guangming
Published: May 2015

Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC.
Colon perforation during percutaneous nephrolithotomy and fistula closure with Spongostan following conservative therapy
Authors: Ün Sitki , Çakır Volkan , Köse Osman , Türk Hakan , Yılmaz Yüksel
Published: May 2015

Percutaneous nephrolithotomy (PCNL) is the first-line treatment for kidney stones. Colon perforation is a rare, but dangerous, complication. Colonic perforation might be very serious if it is not found early. After an unsuccessful extracorporeal shockwave lithotripsy, a 45-year-old female underwent a left-sided PCNL for two 1-cm kidney stones in the left kidney upper pole calyx. During dilatation, a colon perforation was suspected. The procedure was finished by inserting a 14Fr re-entry catheter into the colon. On postoperative day 5, a fluoroscopy was performed by injecting contrast dye through the re-entry catheter, which showed a fistula formation between skin and colon. The catheter was removed completely. A 16Fr external drainage catheter was inserted over the guidewire through the fistula tract. The fistula was closed by introducing prepared absorbable hemostatic gelatin powder (Spongostan) particles into the fistula tract through the catheter. Fistula tracks can be closed early by injecting absorbable Spongostan particles into the colonic fistula tract, thereby reducing inpatient time and increasing patient comfort.
Penile amputation and successful reattachment and the role of winter shunt in postoperative viability: A case report and literature review
Authors: Fuoco Michael , Cox Leonard , Kinahan Thomas
Published: May 2015

Traumatic self-amputation of the penis by a psychotic patient is rare. Microvascular replantation is the favored management approach. There are no known cases of self-amputation followed by ingestion of the stump and subsequent replantation. A 51-yearold patient with paranoid schizophrenia presented 2 hours following penile amputation. He had swallowed the excised portion, which was endoscopically retrieved from the stomach in the emergency department. Successful reattachment was achieved including microvascular repair of the dorsal penile arteries without cavernosal arterial anastamoses. A Winter’s shunt was performed to improve venous circulation. The patient has been followed for 3 years from the date of repair. He has adequate erection for intercourse and good urinary function, but has experienced sensory loss over the dorsal aspect and glans and urethral stricture dilation. This is the first report of replantation following ingestion of an amputated penis.
Large diverticulum of the urinary bladder: A rare cause of deep vein thrombosis with consecutive pulmonary embolism
Authors: Zimmermann Oliver , Torzewski Jan , Reichenbach-Klinke Ekkehard , Zenk Christine
Published: May 2015

A 73-year-old man was admitted with progressive dyspnea; he also had benign prostatic hyperplasia (BPH). An angio computed tomography scan showed pulmonary embolism with thrombi in both main pulmonary arteries. By duplex ultrasonography, we detected a thrombus in the right vena femoralis superficialis and vena femoralis communis. Simultaneously, we also noticed a large diverticulum on the right side of the urinary bladder and urinary stasis II of the left kidney. We consider the BPH as the trigger for a secondary diverticulum of the urinary bladder. As a result of its large dimensions, mechanical compression of the deep right pelvic veins resulted in thrombosis which finally caused the pulmonary embolism. With respect to the urinary stasis II, surgical excavation of the diverticulum with infravesical desobstruction was planned. The potentially lethal course of large diverticula may require surgery.
Magnetic resonance imaging detected prostate evasive anterior tumours: Further insights
Authors: Al Edawn Ghazi , Ghai Sangeet , Margel David , Kulkarni Girish , Hamilton Rob , Toi Ants , Haidar Masoom A. , Finelli Antonio , Fleshner Neil
Published: May 2015

Introduction: Clinical confusion continues to exist regarding the underestimation of cancers among patients on active surveillance and among men with repeated negative prostate biopsies despite worrisome prostate-specific antigen (PSA) levels. We have previously described our initial experience with magnetic resonance imaging (MRI)-based detection of tumours in the anterior prostate gland. In this report, we update and expand our experience with these tumours in terms of multiparametric-MRI findings, staging, and grading. Furthermore, we report early treatment outcomes with these unique cancers.Methods: We reviewed our prostate MRI dataset of 1117 cases from January 2006 until December 2012 and identified 189 patients who fulfilled criteria for prostate evasive anterior tumors (PEATS). Descriptive analyses were performed on multiple covariates. Kaplan-Meier actuarial technique was used to plot the treatmentrelated outcomes from PEATS tumours.Results: Among the 189 patients who had MRI-detectable anterior tumours, 148 had biopsy proven disease in the anterior zone. Among these tumours, the average PSA was 18.3 ng/mL and most cancers were Gleason 7. In total, 68 patients chose surgical therapy. Among these men, most of their cancers had extra prostatic extension and 46% had positive surgical margins. Interestingly, upgrading of tumours that were biopsy Gleason 6 in the anterior zone was common, with 59% exhibiting upgrading to Gleason 7 or higher. Biochemical-free survival among men who elected surgery was not ideal, with 20% failing by 20 months.Conclusion: PEATS tumours are found late and are disproportionally high grade tumours. Careful consideration to MRI testing should be given to men at risk for PEATS.
Pre-pubertal diagnosis of Klinefelter syndrome due to peno-scrotal malformations; Case report and review of literature
Authors: Hodhod Amr , Umurangwa Florence , El-Sherbiny Mohamed
Published: May 2015

We report a case of 4 months old infant diagnosed as Klinefelter syndrome associated with perineal hypospadias, severe ventral chordee and complete penoscrotal transposition. A review of previous reported cases was carried out. Penoscrotal malformations at birth are very rare in Klinefelter syndrome. Awareness of the current standard indications of Karyotyping can help early detection of these cases.
Improved effectiveness and safety of flexible ureteroscopy for renal calculi (<2 cm): A retrospective study
Authors: Chen Shuqiu , Xu Bin , Liu Ning , Jiang Hua , Zhang Xiaowen , Yang Yu , Liu Jing , Sha Guozhu , Zhu Weidong , Chen Ming
Published: May 2015

Introduction: We discuss the efficacy and safety of flexible ureteroscopy for renal calculi with a burden of <2 cm, as well as the prevention and treatment of complications.Methods: A total of 108 renal calculi with flexible ureteroscopy and holmium laser treatment were retrospectively analyzed. The stone-free rate was evaluated. The effectiveness, safety, surgical technique, incidence of complications, and relevant treatments were analyzed.Results: All patients underwent only one lithotripsy procedure. The success rate of flexible ureteroscopy was 97.2% (105/108). Among the 105 cases, the total lithotripsy success rate was 97.1% (101/105). The total stone-free rate after 8 weeks post-operation was 94.3% (99/105), the stone-free rate of the lower calyx was 85.7% (30/35); it was 98.6% (69/70) in the middle‒upper calyceal and renal pelvis. The incidence of complications was 12.9% (14/108). None of the patients had serious adverse outcomes.Conclusion: Flexible ureteroscopy represents an optimal treatment option for selected renal calculi with burden of <2 cm. The effectiveness and safety of flexible ureteroscopy can be further improved through reasonable preoperative evaluation and advances in surgical techniques, as well as a better understanding of the inducement and treatment of complications.
Bricker versus Wallace anastomosis: A meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion
Authors: Davis Niall F. , Burke John P. , McDermott TED , Flynn Robert , Manecksha Rustom P. , Thornhill John A.
Published: May 2015

Introduction: Data comparing the incidence of ureteroenteric strictures for Bricker and Wallace anastomoses are limited. This study compares both anastomotic techniques in terms of ureteroenteric stricture rates after radical cystectomy and ileal conduit urinary diversion.Methods: Electronic databases (Medline, EMBASE, and Cochrane database) were searched for studies comparing Bricker and Wallace ureteroeneteric anastomoses for ileal conduit urinary diversion after radical cystectomy. Meta-analyses were performed using the random effects method. The primary outcome measure was to determine differences in postoperative ureteroenteric stricture rates for both surgical techniques. Four studies describing 658 patients met the inclusion criteria. The total number of ureters used for ureteroeneteric anastomoses was 1217 (545 in the Bricker group and 672 in the Wallace group).Results: There were no significant differences in age (p = 0.472), gender (p = 0.897), duration of follow-up (p = 0.168), and duration to stricture development between groups (p = 0.439). The overall stricture rate was 29 of 1217 (2.4%); 16 of 545 ureters (2.9%) in the Bricker group and 13 of 672 ureters (1.9%) in the Wallace group. The Bricker anastomosis was not associated with a significantly higher overall stricture rate compared to the Wallace ureteroenteric anastomosis (odds ratio: 1.393, 95% confidence interval: 0.441–4.394, p = 0.572).Conclusion: Accepting limitations in the available data, we found no significant difference in the incidence of ureteroenteric stricture for Bricker and Wallace anastomoses.
Organizing Pneumonia Appearing in B-Cell Chronic Leukemia Malignancy Progression—A Case Report
Authors: Polaczek Mateusz , Zych Jacek , Opoka Lucyna , Maksymiuk Beata , Roszkowski-Sliż Kazimierz
Published: May 2015

Patients with chronic lymphocytic leukemia or non-Hodgkin’s lymphoma are at risk of infectious diseases of respiratory system because of immunodeficiency. Occurrence of organizing pneumonia in leukemic patients is most commonly correlated with bone marrow transplant or treatment with antimitotic agents. There have been only four reported cases of organizing pneumonia related solitarily to leukemia or lymphoma. We present a case of 65-year old gentlemen, diagnosed 8 months earlier with B-cell chronic lymphocytic leukemia with no previous hematologic treatment, who presented symptoms of persistent pneumonia with no significant reaction to antibiotics. Chest computed tomography scans showed well-localized consolidation with ground glass opacities and some air bronchogram, suggesting infectious disease. All results of microbiological examinations were negative. Due to radiological progression of parenchymal consolidation despite two intravenous courses of antibiotics open lung biopsy was performed. The histologic examination of lung specimen revealed structures typical for organizing pneumonia pattern. There was no evidence for leukemic involvement in lung tissue, as no sign for infectious factors from histological staining was observed. In the inferior mediastinal lymph node sample progression of chronic lymphatic leukemia to mixed cell lymphoma was diagnosed. Patient was commenced on prednisone 60 mg/daily with fast improvement. We believe that this is the first case of organizing pneumonia as a reaction to the conversion of B-cell chronic lymphocytic leukemia progression to more malignant stage.
Association between Asthma Control Test, Pulmonary Function Tests and Non-Specific Bronchial Hyperresponsiveness in Assessing the Level of Asthma Control
Authors: Grzelewska-Rzymowska Iwona Florentyna , Mikołajczyk Joanna , Kroczyńska-Bednarek Jadwiga , Górski Paweł
Published: May 2015

Introduction: Global Initiative for Asthma (GINA) reports emphasize the use of validated and simple tools in order to assess the level of asthma control, as the Asthma Control Test (ACT). However, an ACT does not include assessment of airway inflammation, which is better reflected when measuring nonspecific bronchial hyperresponsiveness (BHR). The authors aimed to find out if the level of asthma control quantified by an ACT correlates with BHR and pulmonary function tests. Materials and Methods: 118 asthmatics participated in the study. All patients completed an ACT. The scores of the ACTs were compared with pulmonary function tests and BHR assessed with the methacholine challenge test and expressed as a provocative concentration of methacholine, inducing a 20% decline in the FEV1 (PC20M in mg/ml). Results: Patients with controlled asthma amounted to 52 (44%) while those with uncontrolled asthma amounted to 66 (56%). In patients with controlled asthma (ACT score ≥ 20) the mean geometric value of PC20M was 2.72 mg/ml (range from 0.25 to > 8.0), whereas 0.94 mg/ml (range from 0.28 to 8.0) (p = 0.02) was observed in patients with uncontrolled asthma (ACT score < 20). Almost 64% (21/33) of uncontrolled asthmatics achieved normal lung function (FEV1 > 80% pred. value) while 19% (5/26) patients with controlled asthma presented an FEV1 < 80% predicted value. Asthma duration in years in controlled asthmatics was significantly shorter than in uncontrolled patients (6.2 ± 8.9 vs. 12.0 ± 11.4, p = 0.005). Conclusion: In determining the most accurate level of asthma control it is reasonable to use an ACT in conjunction with BHR, which provides more accurate assessment of bronchial inflammation than ventilatory parameters alone.
Keratin Expression Patterns in Stromal Cells of Benign Sclerosing Lesions of the Breast: A Potential Diagnostic Pitfall
Authors: Oh Eun-Yeong , Collins Laura C.
Published: May 2015

Context

Metaplastic carcinomas arising in association with benign sclerosing lesions (BSLs) are rare malignancies in which a neoplastic spindle cell proliferation can be recognized extending beyond the boundaries of the complex sclerosing lesion or papilloma. However, in cases in which the metaplastic carcinoma is of the low-grade fibromatosis-like type or is a low-grade adenosquamous carcinoma, distinction from the background BSL can be a significant challenge. Cytokeratin (CK) and/or p63 immunostains are helpful in confirming the diagnosis of metaplastic carcinoma, but the expression patterns of these markers in the stromal cells of BSLs have not been well characterized.

Objective

To characterize the expression patterns of CKs and p63 in BSLs.

Design

We evaluated the spindle cell component of 55 BSLs using CK 5/6, CK 903, CK MNF116, and p63.

Results

A total of 45 cases (81%) showed no staining for CKs or p63 in benign stromal cells. CK 5/6, CK 903, and p63 were positive in one case each. CK MNF116 stained spindle cells within 10 BSLs. No cases showed spindle cell reactivity for all 4 markers. Positive cases demonstrated very focal, weak staining of spindle cells; only 1 case showed focal, moderate CK staining. Spindle cell positivity was not associated with lesion type, growth pattern, spindle cell atypia, or mitoses.

Conclusions

These findings suggest that although the presence or absence of expression of CK 5/6, CK 903, and p63 may be useful to distinguish BSL from metaplastic carcinomas arising in this setting, CK MNF116 positivity may be a diagnostic pitfall.
Clinical Application of Three-Dimensional Printing Technology in Craniofacial Plastic Surgery
Authors: Choi Jong Woo , Kim Namkug
Published: May 2015

Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to medicine via computer-aided design, computer-aided manufacturing. To investigate the current status of 3D printing technology and its clinical application, a systematic review of the literature was conducted. In addition, the benefits and possibilities of the clinical application of 3D printing in craniofacial surgery are reviewed, based on personal experiences with more than 500 craniofacial cases conducted using 3D printing tactile prototype models.
Does Aging Matter? The Efficacy of Carpal Tunnel Release in the Elderly
Authors: Fung Bettina Wai Yan , Tang Chris Yuk Kwan , Fung Boris Kwok Keung
Published: May 2015

Open release remains the gold standard in the treatment of carpal tunnel syndrome in cases where conservative treatment fails. However, the efficacy of carpal tunnel release in the elderly has been debated in the literature throughout the years. This review aims to review the current evidence pertaining to the efficacy of carpal tunnel release in the elderly. Based on the current evidence, the outcome of carpal tunnel release is unpredictable in the elderly. Elderly patients are also less satisfied with the operation compared to younger patients. The authors recommend that these messages be conveyed to elderly patients before surgery. Moreover, open carpal tunnel release should be offered in the early stages of treatment whenever operative management is indicated.