Jejunal Perforation During Percutaneous Nephrolithotrypsy

Colonic and duodenal perforations, albeit rare, are known complications of PCNL; however, to our knowledge, jejunal perforation has never been reported. We report a case of an 83-year-old man, underwent left PCNL for a 2cm stone in the renal pelvis, confirmed to have a jejunal perforation. He was successfully managed conservatively. His diagnostic work up and management will be discussed

Diffusion of Alexa Fluor 488-Conjugated Dendrimers in Rat Aortic Tissue

In this study, the distribution of labeled dendrimers in native and aneurysmal rat aortic tissue was examined. Adult male rats underwent infrarenal aorta perfusion with generation 5 (G5) acetylated Alexa Fluor 488-conjugated dendrimers for varying lengths of time. In a second set of experiments, rats underwent aortic elastase perfusion followed by aortic dendrimer perfusion 7 days later. Aortic diameters were measured prior to and postelastase perfusion, and again on the day of harvest. Aortas were harvested 0, 12, or 24 h postperfusion, fixed, and mounted. Native aortas were harvested and viewed as negative controls. Aortic cross-sections were viewed and imaged using confocal microscopy. Dendrimers were quantified (counts high-powered field). Results were evaluated by repeated measures ANOVA and Student's t -test. We found that in native aortas, dendrimers penetrated the aortic wall in all groups. For all perfusion times, fewer dendrimers were present as time between dendrimer perfusion and aortic harvest increased. Longer perfusion times resulted in increased diffusion of dendrimers throughout the aortic wall. By 24 h, the majority of the dendrimers were through the wall. Dendrimers in aneurysmal aortas, on day 0 postdendrimer perfusion, diffused farther into the aortic wall than controls. In conclusion, this study documents labeled dendrimers delivered intra-arterially to native rat aortas in vivo , and the temporal diffusion of these molecules within the aortic wall. Increasing perfusion time and length of time prior to harvest resulted in continued dendrimer diffusion into the aortic wall. These preliminary data provide a novel mechanism whereby local inhibitory therapy may be delivered locally to aortic tissue.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72448/1/annals.1383.004.pd

Long Term Stabilization of Expanding Aortic Aneurysms by a Short Course of Cyclosporine A through Transforming Growth Factor-Beta Induction

Abdominal aortic aneurysms (AAAs) expand as a consequence of extracellular matrix destruction, and vascular smooth muscle cell (VSMC) depletion. Transforming growth factor (TGF)-beta 1 overexpression stabilizes expanding AAAs in rat. Cyclosporine A (CsA) promotes tissue accumulation and induces TGF -beta1 and, could thereby exert beneficial effects on AAA remodelling and expansion. In this study, we assessed whether a short administration of CsA could durably stabilize AAAs through TGF-beta induction. We showed that CsA induced TGF-beta1 and decreased MMP-9 expression dose-dependently in fragments of human AAAs in vitro, and in animal models of AAA in vivo. CsA prevented AAA formation at 14 days in the rat elastase (diameter increase: CsA: 131.9±44.2%; vehicle: 225.9±57.0%, P = 0.003) and calcium chloride mouse models (diameters: CsA: 0.72±0.14 mm; vehicle: 1.10±0.11 mm, P = .008), preserved elastic fiber network and VSMC content, and decreased inflammation. A seven day administration of CsA stabilized formed AAAs in rats seven weeks after drug withdrawal (diameter increase: CsA: 14.2±15.1%; vehicle: 45.2±13.7%, P = .017), down-regulated wall inflammation, and increased αSMA-positive cell content. Co-administration of a blocking anti-TGF-beta antibody abrogated CsA impact on inflammation, αSMA-positive cell accumulation and diameter control in expanding AAAs. Our study demonstrates that pharmacological induction of TGF-beta1 by a short course of CsA administration represents a new approach to induce aneurysm stabilization by shifting the degradation/repair balance towards healing

‘That’s how Muslims are required to view the world’:race, culture and belief in non-Muslims’ descriptions of Islam and science

Islam’s positioning in relation to Western ideals of individuality, freedom, women’s rights and democracy has been an abiding theme of sociological analysis and cultural criticism, especially since September 11th 2001. Less attention has been paid, however, to another concept that has been central to the image of Western modernity: science. This article analyzes comments about Islam gathered over the course of 117 interviews and 13 focus groups with non-Muslim members of the public and scientists in the UK and Canada on the theme of the relationship between science and religion. The article shows how participants’ accounts of Islam and science contrasted starkly with their accounts of other religious traditions, with a notable minority of predominantly non-religious interviewees describing Islam as uniquely, and uniformly, hostile to science and rational thought. It highlights how such descriptions of Islam were used to justify the cultural othering of Muslims in the West and anxieties about educational segregation, demographic ‘colonization’ and Islamist extremism. Using these data, the article argues for: 1) wider recognition of how popular understandings of science remain bound up with conceptions of Western cultural superiority; and 2) greater attentiveness to how prejudices concerning Islamic beliefs help make the idea that Muslims pose a threat to the West respectable

Comparison of vasovasostomy with conventional microsurgical suture and fibrin adhesive in rats

OBJECTIVE: Microsurgical procedures are currently the gold standard for vasovasostomy with excellent results, but it takes an increased operative time demanding special training and experience in microsurgery. The objective of this study is to reach the same results with reduced operative time. MATERIALS AND METHODS: Male adults Wistar rats were divided into 3 groups: I) 20 rats in control group, II) 20 with conventional one-layer microsuture and III) 20 with fibrin glue. After four weeks each rat was left for two weeks with two female rats. RESULTS: The fertility rates were 80% in group I, 70% in group II and 65% in group III (p > 0.05). In group II granuloma was found in 75% of the rats, while in group III in 85% (p 0.05). Overall operative time was 41.7 &plusmn; 2.49 and 28.55 &plusmn; 1.14 minutes in groups II and III (p < 0.05) and the time to anastomosis of 24.6 &plusmn; 1.8 and 9.35 &plusmn; 0.78 minutes (p < 0.05), respectively. CONCLUSIONS: We can conclude that vasovasostomy with fibrin adhesive has the same results of the conventional microsurgery technique but with a reduced operative time and a simplified procedure

Coronary-coronary bypass graft: An arterial conduit–sparing procedure

AbstractFrom May 1989 to December 1995, 143 patients underwent myocardial revascularization with one (138 patients) or two (five patients) coronary-coronary bypass grafts in addition to other bypass grafts, for a total of 463 distal anastomoses (mean 3.2 ± 0.6 per patient). Coronary-coronary bypass grafts were chosen for the following reasons: arterial conduit–sparing procedure, inadequate length for in situ graft, calcified ascending aorta, and stenosed or occluded subclavian arteries. One hundred eleven arterial grafts (75%) were used: 85 right internal thoracic arteries, 18 left internal thoracic arteries, and eight radial arteries. Saphenous vein grafts were used in 37 cases (25%, mostly in our early experience). Coronary-coronary bypass grafts were performed on the right coronary artery in 134 cases (90.5%), on the circumflex artery in five cases (3.3%), on the left anterior descending coronary artery in four cases (2.7%), and between two different coronary arteries in five cases (3.3%). Three patients (2%) died of myocardial infarction. Early postoperative angiography showed a patency rate of 98.6% (72/73). During the mean follow-up of 34.6 ± 20.8 months, two patients died and two underwent reoperation. Results of exercise testing were normal at 2 months in 97% of patients (90/92), at 1 year in 96% (81/84), and at 3 years in 93% (30/32). In conclusion, the coronary-coronary bypass graft provides good results with a variety of conduits and allows the expanded use of arterial grafts, particularly the internal thoracic artery. This can lead to a sparing of arterial conduit and allow complex myocardial revascularization with a liberal use of internal thoracic arteries. (J THORAC CARDIOVASC SURG 1996;112:1223-30