278 research outputs found

    Rectus Fascia Sling for the Treatment of Total Urethral Incontinence in Males

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    Objectives: Urinary incontinence in patients with neurological disease is a major health problem. A modified rectus fascial sling has been assessed in incontinent male patients.Patients and Methods: Fourteen adult male patients with total incontinence due to neurogenic or post-traumatic and etiology were included in this study. A rectangular rectus sheath flap was harvested and defatted.The flap was placed around the bulbar urethra and sutures were passed both in front of and behindthe pubic bone. Both sutures on each sidewere tied to each other over the pubic bone.Results: Of the 14 patients, 9 (64.3%) were completely dry, 3 (21.4%) reported improved continence, while 2 (14.3 %) were a failure. In total, 71.4% of the patients showed significant improvement using the Incontinence Quality of Life (IQoL) questionnaire. A significantdecrease in the number of pads used per day of 61.3 % (

    Rolled vaginal wall flap for the treatment of stress urinary incontinence

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    Objectives: Anterior vaginal wall slings (AVWS) have been used for decades in the treatment of female stress urinary incontinence (SUI). The main drawback of using the vaginal wall as a sling is its tendency to weaken and stretch over the course of years. The use of synthetic tapes for the treatment of SUI is effective but costly. For patients who cannot afford synthetic tapes, we describe the preliminary results of a modified AVWS technique for the treatment of SUI types II and III.Patients and Methods: In this series, a modification of the AVWS was applied in 35 female patients with SUI. A fortified and rolled flap is used to provide compression and support of the urethra. The vaginal mucosal surface of the flap is cauterized and two diagonal sutures are placedacross it. The flap is then rolled on itself with a running 2/0 vicryl suture. Two sutures attached to both ends are passed retropubically to the anterior abdominal wall and tied over the rectus sheath.Results: All 35 female patients had type II/III SUI. After a median follow up of 43 months, 91% of the patients were dry or used 0-1 pad per day. Only one patient suffered from transient retention for one week post-operatively.Conclusion: This is a simple method to reinforce vaginal wall flaps. It could offer a durable and effective option for the treatment of SUI in patients who can not afford synthetic tapes. Long-term follow up is required to evaluate the durability of the procedur

    Brain erythropoietin fine-tunes a counterbalance between neurodifferentiation and microglia in the adult hippocampus

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    In adult cornu ammonis hippocampi, erythropoietin (EPO) expression drives the differentiation of new neurons, independent of DNA synthesis, and increases dendritic spine density. This substantial brain hardware upgrade is part of a regulatory circle: during motor-cognitive challenge, neurons experience ‘‘functional’’ hypoxia, triggering neuronal EPO production, which in turn promotes improved performance. Here, we show an unexpected involvement of resident microglia. During EPO upregulation and stimulated neurodifferentiation, either by functional or inspiratory hypoxia, microglia numbers decrease. Treating mice with recombinant human (rh)EPO or exposure to hypoxia recapitulates these changes and reveals the involvement of neuronally expressed IL-34 and microglial CSF1R. Surprisingly, EPO affects microglia in phases, initially by inducing apoptosis, later by reducing proliferation, and overall dampens microglia activity and metabolism, as verified by selective genetic targeting of either the microglial or pyramidal neuronal EPO receptor. We suggest that during accelerating neuronal differentiation, EPO acts as regulator of the CSF1R-dependent microglia

    Widespread expression of erythropoietin receptor in brain and its induction by injury

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    Erythropoietin (EPO) exerts potent neuroprotective, neuroregenerative and procognitive functions. However, unequivocal demonstration of erythropoietin receptor (EPOR) expression in brain cells has remained difficult since previously available anti-EPOR antibodies (EPOR-AB) were unspecific. We report here a new, highly specific, polyclonal rabbit EPOR-AB directed against different epitopes in the cytoplasmic tail of human and murine EPOR and its characterization by mass spectrometric analysis of immuno-precipitated endogenous EPOR, Western blotting, immunostaining and flow cytometry. Among others, we applied genetic strategies including overexpression, Lentivirus-mediated conditional knockout of EpoR and tagged proteins, both on cultured cells and tissue sections, as well as intracortical implantation of EPOR-transduced cells to verify specificity. We show examples of EPOR expression in neurons, oligodendroglia, astrocytes and microglia. Employing this new EPOR-AB with double-labeling strategies, we demonstrate membrane expression of EPOR as well as its localization in intracellular compartments such as the Golgi apparatus. Moreover, we show injury-induced expression of EPOR. In mice, a stereotactically applied stab wound to the motor cortex leads to distinct EpoR expression by reactive GFAP-expressing cells in the lesion vicinity. In a patient suffering from epilepsy, neurons and oligodendrocytes of the hippocampus strongly express EPOR. To conclude, this new analytical tool will allow neuroscientists to pinpoint EPOR expression in cells of the nervous system and to better understand its role in healthy conditions, including brain development, as well as under pathological circumstances, such as upregulation upon distress and injury

    The Palestinian Terrestrial Vertebrate Fauna Preserved at the Biology Exhibitions of the Universities of the Gaza Strip

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    The Gaza Strip (365 km2 ) of Palestine (27,000 km2 ) is home to a wealth of terrestrial vertebrate fauna. Some of these faunistic species find their ways to preservation at the local universities. Hence, the current study comes to document the Palestinian terrestrial vertebrate fauna acquired by the biology exhibitions (BEs) of Al-Azhar University, Islamic University of Gaza and Al-Aqsa University that are located at the Gaza City of the Gaza Strip. The amphibians, reptiles, birds and mammals preserved at BEs of the universities in question were surveyed and scientifically classified during a three-month period extending from January to March, 2012. The study showed that all BEs of local universities are underdeveloped, lacking attention and suffer from specimen scarcity and good preservation. The BE at Al-Azhar University is the best in the arrangement and preservation of bird specimens. A total number of 200 specimens belonging to 54 terrestrial vertebrate fauna species, 39 families and 17 orders was recorded at BEs. Reptiles constituted 40.7% of the total species recorded, followed by birds (38.9%), mammals (14.8%) and amphibians (5.6%). The Islamic University of Gaza was considered the best in terms of the number of preserved species (39.8%), followed by Al-Azhar University (36.3%) and Al-Aqsa University (23.9%). The Common Toad (Bufo viridis) was the most preserved among the amphibian species recorded. Squamata was the biggest reptilian order, comprising 20 species (8 lizards and 12 snakes), with the Syrian Black Snake (Coluber jugularis asianus) was the commonest. The Palestine Viper (Vipera palaestinae) is endemic to Palestine and most venomous and dangerous to human health. The Great White Pelican (Pelecanus onocrotalus) was the largest Palestinian bird preserved at BE of Al-Azhar University. The Egyptian Mongoose (Herpestes ichneumon) and the Common Badger (Meles meles) were the biggest mammalian specimens preserved, while the Palestine Mole-rat (Spalax leucodon ehrenbergi) was the only Palestine endemic species encountered among the preserved mammals. Finally, the improvement of BEs of local universities and the construction of a Central Museum of Natural History is highly recommended in order to change the Palestinians’ attitudes toward a sustainable ecological conservation in the Gaza Strip

    Ketogenic diet uncovers differential metabolic plasticity of brain cells

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    To maintain homeostasis, the body, including the brain, reprograms its metabolism in response to altered nutrition or disease. However, the consequences of these challenges for the energy metabolism of the different brain cell types remain unknown. Here, we generated a proteome atlas of the major central nervous system (CNS) cell types from young and adult mice, after feeding the therapeutically relevant low-carbohydrate, high-fat ketogenic diet (KD) and during neuroinflammation. Under steady-state conditions, CNS cell types prefer distinct modes of energy metabolism. Unexpectedly, the comparison with KD revealed distinct cell type–specific strategies to manage the altered availability of energy metabolites. Astrocytes and neurons but not oligodendrocytes demonstrated metabolic plasticity. Moreover, inflammatory demyelinating disease changed the neuronal metabolic signature in a similar direction as KD. Together, these findings highlight the importance of the metabolic cross-talk between CNS cells and between the periphery and the brain to manage altered nutrition and neurological disease
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