Conservative management of hostile bladders with intravesical botulinum toxin for successful renal transplantation

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Introduction: Renal transplant is the most desired and cost-effective therapy for patients with end stage renal disease. While a lower urinary tract cause of end-stage renal disease (ESRD) is not an absolute contraindication to renal transplantation, appropriate vesical storage and drainage is imperative for survival and function of the graft. It is crucial to address and resolve any urological causes of renal failure prior to transplantation to prevent subsequent graft failure. Most patients can be managed with conservative measures such as intermittent self-catheterization, but select cases may require more aggressive intervention including bladder augmentation or urinary diversion to address a hostile bladder environment prior to transplantation. To our knowledge, this is the first report of a poorly compliant bladder noted during pre-transplant evaluation that was managed conservatively with intravesical botulinum injections leading to a successful transplantation. Conclusion: We found through our experience that intravesical botulinum injections offers a conservative approach to increase bladder compliance and lower storage pressures thereby permitting safe renal transplantation. This management strategy can be employed in carefully selected patients who have failed oral anticholinergics and CIC, and wish to avoid bladder augmentation and urinary diversion. Careful follow-up is necessary to detect changes in urinary symptoms and bladder parameters, which may be a sign of possible botulinum failure necessitating the need to revisit more aggressive management options

Differential responses of Duo grass (Lolium × Festuca), a phosphorus hyperaccumulator to high phosphorus and poultry manure treatments

Use of suitable plants to extract and concentrate excess phosphorus (P) from contaminated soil serves as an attractive method of phyto-remediation. Plant species vary considerably in their potential to assimilate different organic and inorganic P substrates. Duo grass (a hybrid of Lolium × Festuca) seedlings were grown in liquid nutrient media supplemented with various concentrations of potassium dihydrogen phosphate (KH2PO4) and phytate to study their P-accumulation potential. Plants that received extra P showed significantly greater plant biomass and accumulated more shoot P compared to the plants that were supplied with normal P. Duo was also grown in poultry manure amended soil and liquid media to evaluate their ability to grow and accumulate biomass in poultry manure impacted soils. Thus this grass species may be utilized as a P hyper-accumulator for phyto-extraction of excess P into their biomass from soils. Duo grass can utilize both organic (phytate), as well as, inorganic P from the growth medium as evidenced in the results.Keywords: Duo grass, phosphorus, phosphorus substrates, phytate, phosphorus accumulation, phytoremediationAfrican Journal of Biotechnology Vol. 12(21), pp. 3191-319

Inflammatory Myofibroblastic Tumor: A Case Study

AbstractInflammatory myofibroblastic tumor (IMT) is a rare benign lesion found in many locations throughout the body and genitourinary tract. Endoscopically and radiographically, these solid lesions cannot be distinguished from malignant bladder tumors. We present the case of a 21-year-old woman who presented with painful obstructive and irritative voiding symptoms of short duration. After extensive preoperative evaluation failed to reveal a definitive diagnosis, the patient underwent partial cystectomy. Final pathology revealed IMT. A high index of suspicion is required for diagnosis of IMT as it is often difficult to distinguish from its malignant counterparts

Composition of phenolics and volatiles in strawberry cultivars and influence of preharvest hexanal treatment on their profiles

Biochemical changes of quality-determining components were evaluated in strawberry fruit subjected to preharvest spray treatments using a hexanal-containing formulation that is known to enhance shelf life and quality of fruits. Phenolic compounds and volatiles of fruits of four strawberry cultivars (Mira, Jewel, Kent, and St. Pierre) grown in southern Ontario were characterized by HPLC-MS and solid phase micro extraction (SPME) analysis. Qualitative and quantitative profiles of phenolic compounds varied among the cultivars. In all the cultivars, anthocyanins constituted the most prominent class of phenolic compounds. Volatile profiles of strawberry homogenate differed among the cultivars. Changes in phenolics and volatiles composition were determined in fruits of Mira and Jewel after spraying with a hexanal-containing formulation at weekly intervals. In Jewel, preharvest hexanal spraying altered the profiles of polyphenolic components, while minimal changes were noticed in Mira. Interestingly, very few differences were identified in ester profiles of treated and untreated Mira. In general, hexanal spray application resulted in a decrease in the abundance of several volatile components including esters, ketones, and lactones in treated Jewel compared with the control. The results suggest that cultivar-specific quality changes may result from a preharvest application of hexanal formulations, which may also imply different patterns of metabolite channeling and delay of fruit ripening processes

IN VITRO STUDIES TO ELUCIDATE THE BIOCHEMICAL FUNCTIONS OF EPSTEIN-BARR VIRUS TEGUMENT PROTEIN BKRF4

Epstein Barr Virus (EBV) is an opportunistic pathogen that causes infectious mononucleosis and associated with Burkitt\u27s lymphoma, nasopharyngeal carcinoma and lymphoproliferative diseases. Throughout the life cycle, EBV genomes attain different levels of chromatinization, transitioning from a fully chromatinized form, which mimics cellular chromatin during latency, through an intermediately chromatinized form during the lytic phase, to a completely non-chromatinized DNA when packaged into the virions. Chromatinization dynamics in vivo requires the coordinated action of multiple proteins including histone chaperones, which are responsible for histone transport, deposition and exchange. Previous studies show that viruses often exploit cellular histone chaperones; however, no virally-encoded histone chaperone has been identified to date. Studies presented here, describe in vitro activities of the EBV tegument protein BKRF4, and suggest that it might represent the first bona-fide viral histone chaperone. This is based on the following observations: (1) BKRF4 protein contains acidic domains, negatively charged clusters that are involved in interaction with histones and neutralization of their positive charge; (2) purified BKRF4 protein interacts with core histone octamers in vitro, preferentially binding H2B, H3 and H4; (3) BKRF4 facilitates the dissociation of DNA from core histones in vitro similar to cellular histone chaperones; (4) immunofluorescence staining and biochemical fractionation experiments demonstrate that BKRF4 protein localizes in the nucleus, predominantly, in the chromatin fraction along with histones. These data indicate that BKRF4 might contribute to the chromatinization dynamics of the EBV genomes, in particular at the step of DNA packaging that requires removal of remaining histones. Further studies are warranted to verify our in vitro data in the context of viral infection in order to extend our understanding of the mechanisms and significance of herpesvirus genome chromatinization and virus-host chromatin interactions

Surgical management of post prostatectomy incontinence

Post prostatectomy incontinence (PPI) is a well-recognized and bothersome complication following radical prostatectomy. Conservative measures such as pelvic floor physical therapy, biofeedback, and medication are first line management of PPI. When first line therapies fail, patients are offered a variety of surgical procedures based on the degree of incontinence, prior radiation therapy, and comorbidities. Among the various surgical options, placement of an artificial urinary sphincter (AUS) is the gold standard for PPI. However, AUS placement has a high rate of re-operation and requires good manual dexterity. In cases of mild-moderate incontinence, especially in patients without prior radiation therapy, male slings and proACT are a less invasive option. Bulking therapy, although highly successful for female stress urinary incontinence (SUI), is not currently advised in the treatment of male SUI. Regardless of surgical approach used to treat PPI, providers should counsel patients regarding risks of re-operation and have an open an honest discussion regarding the degree of continence that can be restored following each procedure

Identification of a differentially expressed thymidine kinase gene related to tapping panel dryness syndrome in the rubber tree (Hevea brasiliensis Muell. Arg.) by random amplified polymorphic DNA screening

Tapping panel dryness (TPD) syndrome is one of the latex yield affecting factors in the rubber tree (Hevea brasiliensis Mull. Arg.). Therefore, identification of a DNA marker will be highly useful for screening progenies in breeding programs. The major goal of this study was to detect genetic variations and/or identification of gene fragments among 37 Hevea clones by the random amplified polymorphic DNA “fingerprinting” technique. Different levels of DNA polymorphism were detected with various primers and a distinct polymorphic band (2.0 kb) was obtained with OPA-17 primer. It was cloned into a plasmid vector for further sequence characterization and the nucleotide sequence shows homology with a novel putative plant thymidine kinase (TK) gene, designated as HbTK (Hevea brasiliensis thymidine kinase; GenBank accession number AY130829). The protein HbTK has 67%, 65%, 64%, and 63% similarity to TK genes of Medicago, Oryza, Arabidopsis, and Lyco- persicon, respectively, and it was highly conserved in all species analyzed. The predicted amino acid sequence contained conserved domains of TK proteins in the C-terminal half. Southern blot analysis indicated that HbTK is one of the members of a small gene family. Northern blot results revealed that the expression of the HbTK gene was up-regulated in mature bark tissues of the healthy tree while it was down-regulated in the TPD-affected one. These results suggest that this gene may play important roles in maintaining active nucleotide metabolism during cell division at the tapped site of bark tissues in the healthy tree under stress (tapping) conditions for normal latex biosynthesis

Corneal changes following collagen cross linking and simultaneous topography guided photoablation with collagen cross linking for keratoconus

Purpose: To compare the outcome of Collagen cross-linking (CXL) with that following topography-guided customized ablation treatment (T-CAT) with simultaneous CXL in eyes with progressive keratoconus. Materials and Methods: This was a prospective, non-randomized single centre study of 66 eyes with progressive keratoconus. Of these, 40 eyes underwent CXL and 26 eyes underwent T-CAT + CXL. The refractive, topographic, tomographic and aberrometric changes measured at baseline, 1, 3 and 6 months post-operatively were compared between both groups. Results: After a mean follow-up of 7.7 ± 1.3 months, the mean retinoscopic cylinder decreased by 1.02 ± 3.16 D in the CXL group ( P = 0.1) and 2.87 ± 3.22 D in the T-CAT + CXL group ( P = 0.04). The Best corrected visual acuity increased by 2 lines or more in 10% of eyes in the CXL group and in 23.3% of eyes in the T-CAT + CXL group. The mean steepest-K reduced by 0.40 ± 3.71 D ( P = 0.77) in the CXL group and by 2.91 ± 2.01D ( P = 0.03) in the T-CAT + CXL group. The sag factor and surface asymmetry index showed no significant change in the CXL group but reduced by 3.59 ± 5.94 D ( P = 0.01) and 0.72 ± 1.18 ( P = 0.02) respectively in the T-CAT + CXL group. There was a significant increase in the highest posterior corneal elevation in both groups (9.57 ± 14.93 μ in the CXL group and 7.85 ± 9.25 μ in the T-CAT + CXL group, P ≤ 0.001 for both). There was significantly greater reduction of mean coma ( P < 0.001) and mean higher-order aberrations ( P = 0.01) following T-CAT + CXL compared to CXL. Conclusions: CAT + CXL is an effective approach to confer biomechanical stability and to improve the corneal contour in eyes with keratoconus and results in better refractive, topographic and aberrometric outcomes than CXL alone