First case of a reversed Parabothus taiwanensis Amaoka & Shen, 1993 from Taiwan (Pleuronectiformes: Bothidae), with first evidence of situs inversus viscerum in bothid

Background

Reversed condition is rarely found in most flatfishes in natural environment, except for some certain species. The mechanism controlling the reversals in flatfishes has been studied in some cultivated species, whereas some have only few cases for the entire family and remain unclear. Here, we report the first record of a dextral (reversed) specimen of Parabothus taiwanensis Amaoka & Shen, 1993 collected off southwestern Taiwan recently. It represents the second reversed case ever recorded in Bothidae. We aim to provide a detailed description of this dextral specimen and compared to the sinistral (normal) specimens collected from the vicinity.

Methods

Specimens were fixed in 4% formaldehyde and transferred to 70% ethanol for preservation. Meristic and morphometric characters were examined for both dextral and sinistral specimens. Dissections were made on specimens to confirm the position of internal organs. Lastly, X-radiographs were taken to elucidate the osteological features.

Results

As a result, no differences of both meristic and morphometric characters were observed between the dextral and sinistral specimens. Nevertheless, situs inversus viscerum is discovered in the dextral specimen for the first time in Bothidae and the sixth record within flatfishes.

Painful snapping of the middle finger caused by hyperplasia of the ulnar lateral band: A case report

Snapping of fingers can be caused by pathologies such as stenosing flexor tenosynovitis. However, snapping symptoms in the metacarpophalangeal (MP) joint caused by hypertension and hyperplasia of the lateral band are rare. We present a 26-year-old female with symptoms of painful snapping of the middle finger. When the finger was actively flexed from the hyperextension of the MP joint, the ulnar lateral band was prominent, and a snapping phenomenon occurred. The cause of the snapping finger was considered to be tightness of the ulnar lateral band, and surgery was planned. Intraoperatively, the ulnar lateral band was tense and hyperplastic. The snapping phenomenon disappeared immediately after the resection of the lateral band. It is important to consider this condition as one of the differential diagnoses of snapping finger when the patient complains of an atypical snapping phenomenon.

Pathogenic/likely pathogenic copy number variations and regions of homozygosity in fetal central nervous system malformations

OBJECTIVE

To explore pathogenic/likely pathogenic copy number variations (P/LP CNVs) and regions of homozygosity (ROHs) in fetal central nervous system (CNS) malformations.

METHODS

A cohort of 539 fetuses with CNS malformations diagnosed by ultrasound/MRI was retrospectively analyzed between January 2016 and December 2019. All fetuses were analyzed by chromosomal microarray analysis (CMA). Three cases with ROHs detected by CMA were subjected to whole-exome sequencing (WES). The fetuses were divided into two groups according to whether they had other structural abnormalities. The CNS phenotypes of the two groups were further classified as simple (one type) or complicated (≥ 2 types).

RESULTS

(1) A total of 35 cases with P/LP CNVs were found. The incidence of P/LP CNVs was higher in the extra-CNS group [18.00% (9/50)] than in the isolated group [5.32% (26/489)] (P < 0.01), while there was no significant difference between the simpletype and complicated-type groups. (2) In the simple-type group, the three most common P/LP CNV phenotypes were holoprosencephaly, Dandy-Walker syndrome, and exencephaly. There were no P/LP CNVs associated with anencephaly, microcephaly, arachnoid cysts, ependymal cysts, or intracranial hemorrhage. (3) Only four cases with ROHs were found, and there were no cases of uniparental disomy or autosomal diseases.

CONCLUSION

The P/LP CNV detection rates varied significantly among the different phenotypes of CNS malformations, although simple CNS abnormalities may also be associated with genetic abnormalities.

Robot-assisted laparoscopic pyeloplasty is a valid option for ureteropelvic junction obstruction repair in adults with congenital renal abnormalities: a case series study

BACKGROUND

Congenital renal anomalies are rare but may be associated with obstruction of the ureteropelvic junction. Given the rarity of simultaneous ureteropelvic junction obstruction [UPJO] and renal anomalies in the adult population, there is limited literature on approaching these patients. We report our experience with robotic assisted laparoscopic pyeloplasty for UPJO repair in this subset of patients.

METHODS

Data on adult patients with simultaneous congenital renal abnormalities and UPJO who underwent robotic assisted laparoscopic pyeloplasty between 2008 and 2020 was reviewed. Pre-operative data, intraoperative parameters as well as post-operative data including symptom resolution and radiologic findings were recorded.

RESULTS

Ten patients, 4 female and 6 males, with a mean age of 47 years were identified as having simultaneous congenital renal abnormalities and UPJO. Anomalies identified were horseshoe kidney in four patients, duplex kidney with obstruction of one moiety in two patients, malrotated kidney in two patients, and pelvic kidney in two patients. Eight out of ten were symptomatic at presentation with flank pain being the most common symptom. Eight patients underwent robotic pyeloplasty via the dismembered technique, while two underwent robotic Y-V pyeloplasty. With a mean follow up time of 13 months, 8/9 (88%) symptomatic patients enjoyed symptom resolution. Post-op renogram was available for nine patients and showed resolution of obstruction in all patients (100%). One patient developed a urine leak which was managed successfully with drainage.

CONCLUSIONS

Robotic assisted laparoscopic pyeloplasty is a safe, feasible and effective surgical approach in management of adult patients with concomitant UPJO and renal anomalies.

The effect of a course of selected corrective exercises on posture, scapula-humeral rhythm and performance of adolescent volleyball players with upper cross syndrome

BACKGROUND

This study aims to investigate the effect of a course of selected corrective exercises on posture, scapula-humeral rhythm and performance of adolescent volleyball players.

METHODS

30 adolescent volleyball players with upper cross syndrome were purposefully selected and assigned into 2 control and training groups. The degree of back curvature was evaluated using a flexible ruler, forward head and forward shoulder size by photographic method, scapula-humeral rhythm by Lateral Scapular Slide Test (LSST), and performance by closed kinetic chain test. The training group performed the exercises for 10 weeks. After the exercises, the post-test was administered. To analyze the data, analysis of co-variance tests and paired t-test at the level of 0.05 were employed.

RESULTS

The research results showed that corrective exercises have a significant effect on abnormalities of forward head, forward shoulder, kyphosis, scapula-humeral rhythm and performance.

CONCLUSIONS

Corrective exercises can be effective in reducing shoulder girdle and spine abnormalities and improving scapula- humeral rhythm and performance of volleyball players.

Multiple expressions of "expert" abnormality gist in novices following perceptual learning

With a brief half-second presentation, a medical expert can determine at above chance levels whether a medical scan she sees is abnormal based on a first impression arising from an initial global image process, termed "gist." The nature of gist processing is debated but this debate stems from results in medical experts who have years of perceptual experience. The aim of the present study was to determine if gist processing for medical images occurs in naïve (non-medically trained) participants who received a brief perceptual training and to tease apart the nature of that gist signal. We trained 20 naïve participants on a brief perceptual-adaptive training of histology images. After training, naïve observers were able to obtain abnormality detection and abnormality categorization above chance, from a brief 500 ms masked presentation of a histology image, hence showing "gist." The global signal demonstrated in perceptually trained naïve participants demonstrated multiple dissociable components, with some of these components relating to how rapidly naïve participants learned a normal template during perceptual learning. We suggest that multiple gist signals are present when experts view medical images derived from the tens of thousands of images that they are exposed to throughout their training and careers. We also suggest that a directed learning of a normal template may produce better abnormality detection and identification in radiologists and pathologists.

Adaptive Spectral Model for abnormality detection based on physiological status monitoring of dairy cows

This research study developed milk spectral data-driven approach, called Adaptive Spectral Model for Abnormality Detection - ASMAD, for detection of physiological abnormalities of individual dairy cows. The algorithm is based on the logic that milk spectra of each individual cow is highly animal-specific, which means it could be used as a respective individual marker for identification. When the algorithm fails to recognize the milk spectra as coming from a certain animal, instead of being treated as a mistake, this outcome is accepted as a deviation of the respective individual marker, and a potential indicator of abnormal physiological state. For the purpose of ASMAD development, near infrared spectra of milk of seven dairy cows have been collected daily during 1-year period. The abnormality detection model is built using supervised recognition method Soft Independent Modeling of Class Analogies - SIMCA, and optimized with respect to spectral pre-processing, choice of the wavelength region and size of the time-window when developing the adaptive model. The sensitivity and specificity of ASMAD were dependent on the animal, and in the ranges 40.00-64.29% and 87.23-98.86%, respectively. Considering significant level of day-to-day spectral variation and multitude of physiological and environmental factors influence on milk constituents and spectra, these results represent a significant potential for creating a health-status monitoring and detection of abnormal physiological states in dairy animals. The adaptive modeling based on the time series of spectral data collected from the individual organism utilized in this work for monitoring physiological status and abnormality detection in dairy cows, has a good potential to be used for similar purposes in other animals and humans.

A Rare Intra-articular Abnormality in the Posterior Radiocapitellar Joint: A Case Report

Introduction

Posterior radiocapitellar synovial plica excision is sometimes performed for lateral epicondylitis after debridement of the extensor carpi radialis brevis (ECRB) tendon. We describe a rare intra-articular abnormality of the posterior radiocapitellar joint diagnosed on posterior arthroscopic observation.

Case Report

A 48-year-old man presented with posterolateral pain and discomfort in his left elbow. A diagnosis of lateral epicondylitis was made, and arthroscopic debridement of the ECRB tendon was performed. Posterior arthroscopic examination revealed a tendon-like abnormality running longitudinally along the articular surface of the capitulum of the humerus. The abnormality was resected using a shaver, and symptoms improved postoperatively.

Conclusion

In patients with posterolateral pain and discomfort or catching of the elbow, posterior arthroscopic confirmation of the intra-articular structure is recommended after debridement of the ECRB tendon.

Abnormal synaptic plasticity and impaired cognition in schizophrenia

Schizophrenia (SCZ) is a severe mental illness that affects several brain domains with relation to cognition and behaviour. SCZ symptoms are typically classified into three categories, namely, positive, negative, and cognitive. The etiology of SCZ is thought to be multifactorial and poorly understood. Accumulating evidence has indicated abnormal synaptic plasticity and cognitive impairments in SCZ. Synaptic plasticity is thought to be induced at appropriate synapses during memory formation and has a critical role in the cognitive symptoms of SCZ. Many factors, including synaptic structure changes, aberrant expression of plasticity-related genes, and abnormal synaptic transmission, may influence synaptic plasticity and play vital roles in SCZ. In this article, we briefly summarize the morphology of the synapse, the neurobiology of synaptic plasticity, and the role of synaptic plasticity, and review potential mechanisms underlying abnormal synaptic plasticity in SCZ. These abnormalities involve dendritic spines, postsynaptic density, and long-term potentiation-like plasticity. We also focus on cognitive dysfunction, which reflects impaired connectivity in SCZ. Additionally, the potential targets for the treatment of SCZ are discussed in this article. Therefore, understanding abnormal synaptic plasticity and impaired cognition in SCZ has an essential role in drug therapy.

From Monsters to Malformations: Anatomical Preparations as Objects of Evidence for a Developmental Paradigm of Embryology, 1770-1850

A common object found within medical museums is the developmental series: an arrangement of embryos depicting the transformation of an unremarkable blob into an anatomically organized and recognizable organism. The developmental series depicts a normative process, one where bodies emerge in reliable sequential stages to reveal anatomically perfect beings. Yet a century before the developmental series would become a visual model of embryological development, the very process of development itself was discerned through the comparative study of preserved human fetuses-specifically, those deemed "monstrous" or characterized as "malformations." This article examines how anatomically diverse fetal bodies were reformulated from singular curiosities into alternative developmental pathways whose characteristics testified to the laws of nature and to the primordial, physical relationship between humans and other species. In early nineteenth century Amsterdam, the father-son team of physicians Gerard and Willem Vrolik built up an internationally renowned anatomical museum famous especially for Willem's collection of fetal malformations. Physical preparations of fetal malformations play a central role in Willem's monumental handbook on developmental embryology: comparing human embryos against one another and the embryos of other species, Willem plots out a sequence of embryological development in which a body's form marks its place within the ever-unfolding natural order. In conversation with the literature on model organisms, this article explores how the "monstrous" gets standardized and, in doing so, contributes to the scientific production of a normative physiological process.

Multiple periapical dysplasias analyzed by cone-beam-computer tomography and 99Tcm-Scintigraphy

Periapical cemental dysplasia (PCD) is considered a non-neoplastic proliferation of fibrous tissues and cementum-like hard tissues, usually occurring in the periapical regions of teeth. PCD is characterized by the presence of vital pulp and is often accidentally discovered during a general radiographic survey. PCD may arise from the tissue of odontogenic origin or occur as a reactive process in the periapical tissue. Multilocular occurrences in both jaws are rare. However, we encountered a case of multiple PCDs by orthopantomography, which showed different degrees of maturation in the mandible and maxilla by osteodensitometric detection via cone-beam computed tomography (CB-CT) validated by Tc-99m bone-scintigraphy (BS). Biopsies confirmed the radiological results. CB-CT osteodensitometry allows for the categorization and assessment of different stages of PCD maturation from beginning to florid, detection of remittent osseous changes, and evaluation in the clinical follow-up. When using the local cortical bone as a reference value of 100%, periapical dysplasias show density values of 75% in the mandible and 80% in the maxilla. Early classification of PCD is possible with CB-CT osteodensitometry.

Detrimental effects of long-term exposure to heavy metals on histology, size and trace elements of testes and sperm parameters in Kermani Sheep

Exposure to endocrine-disrupting chemicals (EDCs) has been hypothesized as a cause of declining sheep reproductive efficiency. Understanding the long-term effects of EDCs such as heavy metals on reproductive health requires investigation in 'real life' of sheep that are reared in industrial areas. The aim of this study was to evaluate the effect of long-term exposure of Kermani rams to high levels of environmental heavy metals probably emitted from a copper smelter at KhatoonAbad in ShahreBabak, Kerman province. Testicular characteristics were determined in randomly-selected rams (3-4 years old) at 4 directions (south, north, east, and west) and 4 distances (10, 20, 30, and 40 km) from the smelter. Testicular trace element contents, size, serum testosterone, histological attributes and seminal characteristics, except semen volume, were affected by both the direction and the distance from the smelter (P < 0.05). Testicular contents of Pb, Cd, Cr, and Ni, and sperm abnormalities were higher at 10 km south from the smelter and lower at 40 km west. Other parameters were higher at 40 km west and lower at 10 km south. Interestingly, the testicular contents of Cu at 10 km south were lower and associated with higher sperm abnormalities in the rams reared closer to the smelter. The highest weight, length and circumference of the testis were found at 40 km west. The lowest concentration of testosterone was observed at 10 km south, being 92.6% lower than the highest values obtained at 40 km west. The diameter of seminiferous tubules and epithelial height at 10 km south were 8.9% and 27.5% lower than the highest values obtained at 40 km west. A positive correlation between Pb, Cd, Cr and Ni contents in the testis with sperm abnormalities, and a negative correlation between these elements with the other parameters were found. It was concluded that long-term exposure to heavy metals might have been a cause of decreased fertility in rams and probably other living species in this region.

Association of Vitamin D Deficiency with Cardiovascular Disease Among Saudi Patients in Saudi Arabia

Background:

Vitamin D deficiency has a far-reaching impact on several metabolic functions including cardiovascular health. This study aimed to test the association of serum 25 [OH]-vitamin D3 levels among cardiovascular disease (i.e., hypertension and ischemic heart disease) patients.

Methods:

A cross-sectional study was conducted among 360 participants from the tertiary care hospital. The simple random technique was used to select the participants. Only Saudi nationals were included in the study. Sociodemographic information, nutritional status, biochemical parameter (lipid profile, blood glucose level), and questions relating to cardiovascular disease were collected from the hospital record through data collection sheet. Serum Vit D level was determined by serum 25 (OH) blood test. Statistical package for social science (SPSS) software version 24 was used for data analysis. Binary logistic regression model was fitted to indentify the associated factors of vitamin D deficiency among cardiovascular disease patients.

Results:

Approximately 40.6% and 27.8% of study participants had vitamin D deficiency and insufficiency, respectively. After adjustment of covariates, among cardiac patients, vitamin D deficiency was associated with ischemic heart disease (OR 2.24, 95% CI 1.11–4.52), and blood triglyceride level (OR 2.27, 95% CI 1.22–4.22).

Conclusions:

Vitamin D deficiency and insufficiency are associated with ischemic heart disease, hyperglycemia, and hypertriglyceridemia. There is a need for the screening of cardiovascular disease patients for vitamin D levels.

Current Treatments for Congenital Aural Atresia

Congenital aural atresia is an ear malformation evident at birth, involving various degrees of failed external ear canal development. A true external ear canal is desirable, as devices that replace the canal are inconvenient and expensive. Therefore, an optimal surgical technique is required. Here, we review useful preoperative and operative techniques. Surgical correction is often not the preferred treatment; the hearing outcome is no better than the outcomes afforded by bone-conduction devices, and surgery may be associated with recurrence or complications such as meatal stenosis. Preoperative evaluation and appropriate management are important. Several means of preventing meatal stenosis are discussed in this review.

[Application of penile index in the diagnosis and therapeutic evaluation of concealed penis in children]

Objective: To explore the significance of penile index in the diagnosis of concealed penis and the evaluation of therapeutic efficacy. Methods: A retrospective study was conducted on 221 children with phimosis and 113 children with concealed penis aged 6-10, all of whom had undergone circumcision or phalloplasty respectively in Shanghai Children's Medical Center from January 2014 to December 2017. Penile index was measured before and after surgery. The values of phimosis and concealed penis were tested by group t test. Self -control test was performed for values of concealed penis before and after operations. Results: Penile index was 0.78±0.08 in children with phimosis. It was 0.23±0.10 in concealed penis before operation and changed to 0.84±0.11 postoperatively. In children with phimosis and concealed penile, the difference of penile index was statistically significant (P<0.001). The difference of penile index before and after operation was statistically significant (P<0.001) in children with concealed penis. Conclusion: Penile index is an effective index to evaluate the degree of penis exposure.

Prevalence of Hip Ultrasound Abnormalities in Newborns With a Hip Click

A hip click on examination of the newborn hip is believed to be the result of a ligament or myofascial structure and thought to be benign. Some studies suggest a link between hip clicks and developmental dysplasia of the hip. The purpose of our study is to estimate the prevalence of ultrasound hip abnormalities in newborns with a hip click and an otherwise normal physical examination. Results. Ninety patients meeting inclusion criteria of a hip click with an otherwise normal physical examination underwent diagnostic ultrasound with a 17.8% prevalence of hip abnormalities found (95% confidence interval ±7.9% [range of 9.9% to 25.7%]). Our study had 64 (71%) females and 26 (29%) males. The prevalence of hip pathology for females was 18.8% (12 of 64 patients) and for males was 15.4% (4 of 26 patients). Thirty-three patients were found to have bilateral hip clicks on presentation, with 21.2% (7 of 33) of those patients found to have hip pathology on ultrasound (3 of the 7 had pathology of both hips). Six patients had a family history of hip dysplasia and 1 of these patients (16.7%) had pathology on ultrasound. The average age to hip sonography was 6.6 weeks. Conclusions. In all, 17.8% of newborns with a hip click were found to have hip abnormalities on ultrasound. The prevalence of hip pathology, on ultrasound, suggests that additional larger, prospective studies are needed to clarify the association between a hip click and abnormal ultrasound found at 6 weeks of age or greater.

Septo-optic dysplasia with fovea plana: A case report

Septo-optic dysplasia (SOD) is characterized by optic nerve hypoplasia, pituitary gland hypoplasia, and midline abnormalities of the brain. The phenotype of SOD is highly heterogeneous, and the existence of at least two features is considered sufficient for diagnosis. Fovea plana is the absence of a foveal pit in the central fovea, and despite being a developmental abnormality of the fovea, good visual acuity may be retained in some individuals. In this case, a 12-year-old female presented to the ophthalmology clinic with the complaint of blurred vision in her right eye. In dilated fundus examination, optic disc hypoplasia and no foveal light reflex were seen. Magnetic resonance imaging and optical coherence tomography revealed optic nerve, brain midline, and foveal abnormalities. The patient was diagnosed as having SOD with optic nerve hypoplasia and septum pellucidum agenesis, and fovea plana. Both SOD and fovea plana are rare conditions, and there are several reports in the literature that separately describe their clinical features. The most important aspect of this case report is to reveal the unusual co-existence of SOD and fovea plana in a young patient.

Sodium Fluoride and Fluoride Contaminated Ground Water Induced Altered Reproductive Performances in Male Rats

Present study was undertaken to investigate the toxic effect of sodium fluoride (NaF)- and fluoride (F)-contaminated ground water on reproductive performances of male rats. Healthy adult male rats were categorised into three groups, first group of rats were served as control, whereas second group of rats were orally intubated with NaF (10 mg/kgbw/1 ml/rat) and third group of rats were allowed to drink F-contaminated ground water (5 mg/L) through drinking water bottles for 52 days. Exposure of NaF- and F-contaminated ground water caused significant decline in sperm motility, serum concentration of testosterone, and increase in sperm abnormality compared with controls. Further, significant histological alterations characterized with shrunken seminiferous tubules and degeneration of different stages of spermatogonial cells were observed in rats treated with NaF- and F-contaminated ground water. After the confirmation of toxic effect of F, these NaF- and F-contaminated ground water-treated male rats were allowed to mate with proven fertile untreated female rats to study the reproductive performances of male rats. There was a decline in parturition index, fertility index of male and female, gestation index and number of pups delivered in NaF-treated male rats compared with controls. However, gestation index and number of pups delivered were declined in F-contaminated ground water-treated male rats compared with controls. These results clearly indicate that F exposure affected the reproductive performances of male rats. The present study further revealed the fact that F-induced decline in testosterone levels, reduced sperm motility, and loss of spermatogonial cells affected the reproductive performances of male rats.

Optimization of vitrification factors for embryo cryopreservation of kelp grouper (Epinephelus moara)

Cryopreservation of marine fish embryos causes to severe cryogenic damage, and to date, adults have not been reared from embryos that were cryopreserved. Here, we optimized vitrification factors to improve the survival and hatching rate of kelp grouper (Epinephelus moara) embryos after cryopreservation. We screened the effects of 11 vitrification solution concentrations (25-50%) on the survival rate of embryos at four developmental stages (16S, 18S, 22S, TB). We investigated the effects of different equilibration time (25-45min) on the survival rate and the influence of vitrification solutions on embryonic volume. In addition, we tested the effects of treating embryos at five different developmental stages (4-6S, 16S, 22S, TB, HB) with different vitrification solutions (35% PMG3S and 35% PMG3T), prechilling temperature (-5 °C and 4 °C) and prechilling time. In total, 9855 embryos were cryopreserved at 10 developmental stages, from optic capsule stage to pre-hatch stage. We found that kelp grouper embryos performed best at equilibration time of 30 min. Embryos at the tail-bud stage exhibited greater tolerance to vitrification than other stages. Vitrification solutions that contained sucrose showed better survival rates compared to embryos treated with vitrification solutions containing trehalose. Pre-chilling treatment improved viability before freezing, but did not improve viability after freezing. In the most optimal condition we identified in this study, the average survival, normal development and malformation rates of cryopreserved embryos were 6.32%, 2.36% and 3.49%, and 39.85% of the surviving embryos that were cryopreserved hatched. The hatched larvae gradually died at day 12 of cultivation, where the longest surviving individuals lived for 16 days. This study provides valuable data for improving survival and hatching rate of cryopreserved grouper embryos, and provides references for further exploring techniques in fish embryo cryopreservation.

Compensatory sagittal plane ankle gait mechanics: Are they present in patients with a weak or stiff hip?

INTRODUCTION

Simulations suggest that subjects with reduced hip range of motion (ROM) and/or weakness can achieve more normal walking mechanics through compensations at the ankle. The aims of this study were to assess whether subjects with reduced hip ROM (Stiff hip) or hip flexor weakness (Weak hip) exhibit ankle compensations during walking and investigate redistribution of power in the lower extremity joints.

METHODS

Retrospective gait data were reviewed (IRB-approved hip registry). Preoperative kinematic/kinetic walking data were collected in patients with: adolescent hip dysplasia (AHD), femoral acetabular impingement (FAI), and Legg-Calvé Perthes disease (Perthes). AHD patients with significantly weak hip flexors on their affected side were included (Weak hip group). The Gait Profile Score (GPS) was calculated on the affected side of the FAI and Perthes groups to identify patients who had a Stiff hip. Patients who had undergone a hip arthrodesis (Fusion) were also included (Stiff hip group). Ankle kinematics/kinetics were compared to healthy participants (Control). The total positive work of sagittal plane hip, knee and ankle power were compared along with the distribution of power.

RESULTS

Patients in the Weak/Stiff hip groups did not walk with greater ankle plantarflexion, peak push-off power or positive ankle work on their affected sides compared to Control. Ankle work contribution (percentage of total positive work) on the affected or unaffected sides was greater in the Perthes and Hip Fusion patients compared to Control. Significant gait abnormalities on the unaffected side were observed.

CONCLUSIONS

Patients with a weak or stiff hip did exhibit altered ankle mechanics during walking. Greater percent ankle work contribution appeared to correspond with hip stiffness. In patients with hip pathology the redistribution of power among the lower extremity joints can highlight the importance of preserving ankle function.

Infected urachal cyst in an adult: A case report

The urachus is an embryologic remnant which degenerates after the birth. An infected urachal cyst is one of a spectrum of presentations of urachal pathology, all of which are rare in adulthood. Infected urachal cyst is a rare pathology in adult women and it should be considered in the differential diagnosis of acute abdomen. We report here a case of a 50-year-old women with an infected urachal cyst reveled by an acute abdomen.

Prolonged ocular exposure leads to retinal lesions in mice

Retinal lesions in the posterior pole of laboratory mice occur due to native, developmental abnormalities or as a consequence of environmental or experimental conditions. In this study, we investigated the rate and extent of retinal lesions as a result of prolonged ocular exposure following general anesthesia. Following experimental preparation induction procedures (EPIP) involving general anesthesia, mydriasis/cycloplegia, and topical anesthesia to the cornea, two ocular recovery conditions (protected and unprotected) were tested within two different animal recovery chambers (open or closed). The anterior and posterior poles were evaluated for the development of retinal lesions using digital color photography, scanning laser ophthalmoscopy, and spectral-domain optical coherence during anesthesia recovery and up to 2.5 months thereafter. In some mice, electroretinograms, histological and immunohistological evaluations were performed to assess functional and structural changes that accompanied the retinal lesions detected by in vivo imaging. Our data suggests that prolonged ocular surface exposure to circulating ambient room air leads to significant anterior and posterior segment ocular complications. The most abundant, semi-reversible complication observed was the development of lesions in the outer retina, which had a 90% probability of occurring after 45 min of exposure. The lesions mostly resolved short-term, but functional and imaging evidence suggest that some perturbations to the outer retina may persist one or more months following initial development.

Trisomy 3 as an acquired cytogenetic abnormality in primary acute megakaryoblastic leukemia

Acute myeloid leukemia has a rare subtype in French-American-British classification as M7 or acute megakaryoblastic leukemia. Chromosome abnormalities in cases with acute megakaryoblastic leukemia can affect their prognosis. Evaluation of these abnormalities and their impact are not fully elucidated. This case presentation is about 16 months female who has a rare abnormality (trisomy 3) alongside acute megakaryoblastic leukemia. The remarkable point is that her malignancy is as primary or non-Down syndrome acute megakaryoblastic leukemia. The author's suggestion through this case presentation is the necessity of drawing a cytogenetic profile, especially in cases with acute megakaryoblastic leukemia for better treatment strategies.

Machine learning based brain tumour segmentation on limited data using local texture and abnormality

Brain tumour segmentation in medical images is a very challenging task due to the large variety in tumour shape, position, appearance, scanning modalities and scanning parameters. Most existing segmentation algorithms use information from four different MRI-sequences, but since this is often not available, there is need for a method able to delineate the different tumour tissues based on a minimal amount of data. We present a novel approach using a Random Forests model combining voxelwise texture and abnormality features on a contrast-enhanced T1 and FLAIR MRI. We transform the two scans into 275 feature maps. A random forest model next calculates the probability to belong to 4 tumour classes or 5 normal classes. Afterwards, a dedicated voxel clustering algorithm provides the final tumour segmentation. We trained our method on the BraTS 2013 database and validated it on the larger BraTS 2017 dataset. We achieve median Dice scores of 40.9% (low-grade glioma) and 75.0% (high-grade glioma) to delineate the active tumour, and 68.4%/80.1% for the total abnormal region including edema. Our fully automated brain tumour segmentation algorithm is able to delineate contrast enhancing tissue and oedema with high accuracy based only on post-contrast T1-weighted and FLAIR MRI, whereas for non-enhancing tumour tissue and necrosis only moderate results are obtained. This makes the method especially suitable for high-grade glioma.

Analysis of Lethality and Malformations During Zebrafish (Danio rerio) Development

The versatility offered by zebrafish (Danio rerio) makes it a powerful and an attractive vertebrate model in developmental toxicity and teratogenicity assays. Apart from the newly introduced chemicals as drugs, xenobiotics also induce abnormal developmental abnormalities and congenital malformations in living organisms. Over the recent decades, zebrafish embryo/larva has emerged as a potential tool to test teratogenicity potential of these chemicals. Zebrafish responds to compounds as mammals do as they share similarities in their development, metabolism, physiology, and signaling pathways with that of mammals. The methodology used by the different scientists varies enormously in the zebrafish embryotoxicity test. In this chapter, we present methods to assess lethality and malformations during zebrafish development. We propose two major malformations scoring systems: binomial and relative morphological scoring systems to assess the malformations in zebrafish embryos/larvae. Based on the scoring of the malformations, the test compound can be classified as a teratogen or a nonteratogen and its teratogenic potential is evaluated.

Adverse effects of BDE-47 on in vivo developmental parameters, thyroid hormones, and expression of hypothalamus-pituitary-thyroid (HPT) axis genes in larvae of the self-fertilizing fish Kryptolebias marmoratus

2,2',4,4'-tetrabromodiphenylether (BDE-47) is known to have the potential to disrupt the thyroid endocrine system in fishes due to its structural similarity to the thyroid hormones triiodothyronine (T3) and thyroxine (T4). However, the effects of BDE-47 on thyroid function in fishes remain unclear. In this study, abnormal development (e.g. deformity, hemorrhaging) and an imbalance in thyroid hormone (TH) homeostasis was shown in the early developmental stages of the mangrove killifish Kryptolebias marmoratus in response to BDE-47 exposure. To examine the thyroid endocrinal effect of BDE-47 exposure in mangrove killifish K. marmoratus larvae, transcript levels of genes involved in TH homeostasis and hypothalamus-pituitary-thyroid (HPT) axis-related genes were measured. The expression of thyroid hormone metabolism-related genes (e.g. deiodinases, UGT1ab) and HPT axis-related genes was up-regulated and there were significant changes in TH levels (P < 0.05) in response to BDE-47 exposure. This study provides insights into the regulation of TH homeostasis at the transcriptional level and provides a better understanding on the potential impacts of BDE-47 on the thyroid endocrine system of fishes.

Endoscopic description of renal papillary abnormalities in stone disease by flexible ureteroscopy: a proposed classification of severity and type

INTRODUCTION

The goal of this original work was to describe papillary abnormalities using flexible ureteroscopy into a new classification and to assess their relation with stone composition.

PATIENTS AND METHODS

We performed a prospective monocentric single-operator study aiming to describe various aspects of renal papillae. Data have been prospectively collected during consecutive 164 sequential flexible ureterorenoscopies required for the treatment of renal stones from May 2011 to March 2015. The collected stones have been examined by microscopy and infrared spectrometry. Serum and urine biochemical samples have been systematically analyzed.

RESULTS

A total of 74 patients (45.1 %) had renal papillary abnormalities on at least one papilla, excluding typical Randall's deposits alone. Various abnormalities were reported, some of them being present in the same patient: tip papillary erosions (51.3 %), anchored papillae calculi (47.3 %), subepithelial stones (18.9 %), cryptic papillae (10.8 %), extrophic papillae (9.46 %) and intraductal deposits (2.7 %). Associations between papillary abnormalities and stone types were found. Intraductal deposits were systematically associated with carbonate apatite IVa2 stones and hypocitraturia. A "first step" classification has been established to standardize the description of these papillary abnormalities for future reports and studies.

CONCLUSIONS

This study highlights the necessity of papillary abnormalities description in further multicentric studies and ureteroscopy's reports. The established classification needs multicentric evaluation and validation. The endoscopic observation and knowledge of pathological aspects of the papillae should help to better understand pathogenesis of nephrolithiasis. Medical or surgical treatments of some abnormalities should be also discussed and evaluated to improve the prevention of stone recurrence.

[Lymphatic malformations in the head and neck area]

Lymphatic malformations are congenital malformations of the lymphatic system. They are mainly located in the head and neck area, and grow proportional to the patients' body growth. Depending on the morphology, it can be distinguished between macrocystic, microcystic and mixed lymphatic malformations. Due to their infiltrative growth, microcystic lymphatic malformations are particularly difficult to treat. Therapeutic approaches include conventional surgical resection, laser therapy, sclerotherapy and systemic drug therapies.

Clinical abnormalities of the nipple-areola complex: The role of imaging

Clinical examination of the nipple is part of normal breast screening procedures. Abnormal processes of benign or malignant nature may be reflected by erythema, erosion, swelling or acquired inversion. In patients presenting with a persistent unilateral nipple lesion, it is advisable to collect a sample to exclude Paget's disease of the nipple, a rare form of ductal carcinoma in situ (DCIS). Imaging should be performed to detect breast cancer, which is found in more than 80% of cases, and determine its possible multifocal nature. Breast MRI is indicated if breast-conserving surgery is planned. The main differential diagnoses are erosive adenomatosis and eczema of the nipple. Acquired inverted nipple is generally of inflammatory origin. It is usually diagnosed by conventional breast examination but breast MRI can be helpful when in doubt about possible underlying neoplasia.

Identification of Skeletal Deformities in Far Eastern Catfish, Silurus asotus under Indoor Aquaculture Condition

For the 2 years of farming, at the indoor circulating aquaculture system, four kinds of skeletal deformities were found among 60 Far Eastern catfish, Silurus asotus. Deformities saw jawbone's luxation, abnormality of upper lip and malocclusion. Spinal deformity was most fatal deformities with low weight and small length. Jawbone's luxation had 1 maxilla and 2 mandibles. Abnormality of upper lip had just lip was back over. Malocclusion's left maxilla and right maxilla were not balanced. This experiment was any deformities in this species through the deformity can grasp how it affects.

The adverse effects of the methoxsalen and ultraviolent A radiation on spermatogenesis in mice

BACKGROUND

Different investigation showed that 5-methoxypsoralen and 8- methoxypsoralen reduce birth rates in the rats.

OBJECTIVE

In this study we worked out the effect of methoxsalen together with ultraviolent A (UVA) radiation on mature Balb/C mice spermatogenesis.

MATERIALS AND METHODS

The LD50 standard was determined 160 mg/kg and the UVA dose which causes erythema was calculated 0.046 J/cm2. A sub-lethal dose of 80 mg/kg of methoxsalen solution was injected intrapritoneally to mature mice and after one hour they were exposed to UVA radiation for 20 minutes. Experiments applied included methoxsalen alone, methoxsalen with UVA, UVA alone, sham group (a group received Tween 80), and control group (N=6). In all experimental groups except UVA alone group, injections were carried out, during two consecutive weeks. Serial cross sections (5 µm thickness) were prepared for morphological and histological studies. Tunica albuginea diameter, and number of type A and type B spermatogonia and histological investigation of the testes were measured.

RESULTS

Microscopical and statistical analyses showed significant anomalies among the experimental groups compared to control and sham group. These anomalies included decrease the body weight; increase the relative testis weight; and decrease the number of spermapogonia (type A and B), primary spermatocytes, spermatids and sperms in experimental groups I and II compared to control group. Our results showed the number of spermatozoa in experimental group I was 22.6±2.12, in experimental group II was 33.6±2.05 and in control group was 44.3±2.77 (p<0.05). Moreover in some experimental groups (I and II) shrinkage of seminiferous tubules and release of primary spermatocyte and spermatids were observed to the lumen of them.

CONCLUSION

It is concluded from the results of this work that treatment with methoxsalen with UVA can damage and disorganize seminiferous tubules and decrease spermatogenic cells.

Anatomic variation of palmaris longus and flexor digitorum superficialis of little finger in Indian population

INTRODUCTION

Palmaris longus and flexor digitorum superficialis of the little finger are highly variable anatomically. The tendons vary in different parts of the globe and different regions of the same country. Many studies have negated an association between the tendons. However, most of the studies have a sample size of less than 500 subjects.

AIMS AND OBJECTIVES

The aim was to study the tendons in the Indian population and study the association, if any between the tendons and to test functional significance of the tendons using the Michigan Hand Outcomes Questionnaire.

METHODS AND MATERIAL

It was a single centre cross-sectional study with a sample size of 1500 in the age group of 20-60 years. The subjects were tested for the presence of the tendons and their functionality was assessed by Michigan Hand Outcomes Questionnaire. The data was tabulated and was assessed using SPSS 13.0 software.

RESULTS

Palmaris longus was bilaterally absent in 10.9% and flexor digitorum superficialis of the little finger was bilaterally absent in 42% of the cases. There was a statistically significant association between the tendons when considered bilaterally. The tendons did not have any bearing on the functionality as assessed by the Michigan Hand Outcomes Questionnaire.

CONCLUSIONS

There is significant variability in the palmaris longus and flexor digitorum superficialis tendon to the little finger not only in the different countries but in different regions of the same country. However despite the various clinical and medicolegal aspects concerning both the tendons, they do not have much bearing on the functionality of the hand.

The 'abnormal' state: Identity, norm/exception and Japan

The term 'abnormal' has frequently been used to describe post-war Japan. Together with the idea that the country will, or should have to, 'normalise' its foreign and security policy, it has been reproduced in both academia and Japanese society. Why is Japan branded as 'abnormal', and from where does the desire to 'normalise' it come? Drawing on a relational concept of identity, and the distinction between norm and exception, this article argues that the 'abnormality-normalisation nexus' can be understood in terms of three identity-producing processes: (1) the process whereby the Japanese Self is socialised in US/'Western' norms, ultimately constructing it as an Other in the international system; (2) the process whereby the Japanese Self imagines itself as 'legitimately exceptional' (what is called 'exceptionalisation'), but also 'illegitimately abnormal' - both of which are epitomised by Japan's 'pacifism'; and (3) the process whereby both the Self's 'negative abnormality' and China/Asia are securitised in attempts to realise a more 'normal' (or super-normal) Japanese Self. How Japan is inter subjectively constructed on a scale between 'normal' and 'abnormal' enables and constrains action. Although Japan has not remilitarised nearly as much in the 2000s as is often claimed, these processes might very well forebode an exceptional decision to become 'normal' and therefore more significant steps towards remilitarisation.

Correlation between onset and severity of hepatic encephalopathy and electroencephalogram changes

AIM: To explore the relationship between the onset and severity of hepatic encephalopathy (HE) and electroencephalogram (EEG) changes.

METHODS: Seventy-eight patients with HE treated at our hospital from June 2013 to June 2014 were included as an observation group, and 73 healthy people were used as a control group. An EEG recorder was used for EEG analysis. The degree of abnormality of EEG was graded according to the EEG results. The distribution of EEG abnormalities in the two groups of subjects was compared. The relationships between EEG changes and the onset and clinical stages of HE were analyzed.

RESULTS: The observation group had an overall EEG abnormality rate of up to 85.90%, with 19 patients having mild EEG abnormalities, 37 having moderate abnormalities, and 11 having severe abnormalities. The control group had an overall EEG abnormality rate of 10.96%, with only 8 patients showing mild EEG abnormalities. The EEG abnormality rate was significantly different between the two groups (P < 0.05). In 78 patients with HE, mild EEG abnormalities often occurred in the prodromal period of HE, while severe abnormalities often occurred in the coma period of HE. With the aggravation of HE, the degree of EEG abnormalities became severe, and there was a positive correlation between them (P < 0.05).

CONCLUSION: The onset and severity of HE are closely related to EEG changes. EEG can be used as a diagnostic marker and an important means of monitoring changes in the condition of patients with HE.

Urethral duplication in a 15-year-old: case report with review of the literature

Urethral duplication is a rare congenital malformation mainly affecting men and boys. Although a number of theories have been proposed to describe this condition, the actual mechanism of this disorder is still not clear. This article highlights a case of urethral duplication in a 15-year-old boy. The malformation was characterized by the presence of continent epispadic and normal apical urethra. Retrograde urethrogram through both urethral tracts simultaneously revealed the malformation as Effmann type IIA2. The patient was not offered surgical intervention as he was asymptomatic and had no problems except for a double stream of urine.

The adverse effects of methoxsalen on the oogenesis of BALB/c mice

OBJECTIVE

Methoxsalen is a natural photoactive compound which is found in many seed plants. A number of epidermal proliferative disorders can be treated by methoxsalen along with long wave ultraviolet A (UVA).

MATERIALS AND METHODS

In an experimental study, we aimed to demonstrate the effect of methoxsalen, UVA and their combination on oogenesis Balb/C mice. There were two experimental groups and a control group. The experimental groups were composed of i. a short term group with treatment duration of 15 days and ii. a long term group with treatment duration of 5 weeks. Both the long term and short term experimental groups were further subdivided into a UVA group, a methoxsalen group and a methoxsalen plus UVA group. After treatment, mature females in prosterus phase of ovarian cycle were scarified with ether, while their ovaries were removed and prepared for histological studies.

RESULTS

Both macro and microscopic studies showed significant anomalies (p<0.05) among experimental group ovaries as compared to control group. The obtained results showed a significant decrease in the following factors: number and diameter of corpus lutei, Graafian follicles, diameter of granulosa cell layer and oocytes, number of primordial and primary and growing follicles, while we observed an increase in number of atretic follicle. Furthermore, our findings confirmed an increase in theca diameter only through UVA treatment. Methoxsalen also reduced circulating estrogen levels in blood serum, significantly. Other cases of teratogenecity, such as follicles with three oocytes and disorganization in corpus luteum cells were observed.

CONCLUSION

The result suggests that UVA, methoxsalen and their combination cause health problems and cell injuries.

Congenital abnormality effect of methamphetamine on histological, cellular and chromosomal defects in fetal mice

BACKGROUND

Methamphetamine (MA) is a potent psychomotor stimulant with high abuse and addictive potential. MA is a neurotoxic drug which is widely abused by females of childbearing age, raising serious public health concerns in terms of exposure of the fetus to the drug. Neurotoxic effects of MA on adult are well known, such as dopaminergic nerve terminal degeneration and cell death in regions of brain in some doses.

OBJECTIVE

In the present study, we examined effect of prenatal MA exposure on mouse fetuses.

MATERIALS AND METHODS

In this study, forty 8-12 week-old NMRI female mice were used which were mated with male mice in serial days. When sperm plug was observed it was designated as gestational day (GD) 0. Pregnant mice were individually housed in plastic cages. Pregnant mice were divided into four groups: in first group 10 mg/kg /day MA, in second group 5 mg/kg /day MA and in third group saline were injected subcutaneously from GD 6 to GD 14, corresponding to organogenesis period, while fourth or control group were without injection. On GD 14 fetuses were removed and accomplished chromosome preparation from fetal liver. Then fetal were fixed in formalin for brain hematoxilin and eosine staining and TUNEL assay.

RESULTS

We observed morphological abnormality including exencephal fetus in 5mg/kg MA group and premature fetuses in 10 mg/kg MA group. Also brain histological study showed subarachnoid hemorrhage in fetal brain in both experimental groups. Fetal liver karyotyping analysis was normal in fetuses of all groups and TUNEL assay in fetal striatum did not show significant difference in number of apoptotic cells between groups.

CONCLUSION

From our results, it could be concluded that chronic abuse of MA by pregnant females during organogenesis period can cause teratogenic effect and brain hemorrage in fetus.

Micropropagation of Araucaria excelsa R. Br. var. glauca Carrière from orthotropic stem explants

The objectives of the present work were in vitro propagation of Araucaria excelsa R. Br. var. glauca Carrière (Norfolk Island pine) with focus on the evaluation of the mean number of shoots per explant (MNS/E) and mean length of shoots per explants (MLS/E) produced by different parts of the orthotropic stem of A. excelsa R. Br. var. glauca in response to plant growth regulators. Norfolk Island pine axillary meristems responded very well to the 2-iso-pentenyl adenine (2iP) and thidiazuron (TDZ) levels. Explants taken from stem upper segments in the media containing 2iP had a higher MNS/E (3.47) and MLS/E (6.27 mm) in comparison to those taken from stem lower segments, which were 0.71 and 0.51 mm, respectively. Using 0.045 μM TDZ in the MS medium not only resulted in 4.60 MNS/E with 7.08 mm MLS/E but proliferated shoots showed a good performance as well. Investigating the best position of stem explant on mother plant as well as the best concentrations of growth regulators were performed which were useful for efficient micropropagation of this plant. Thirty three percent of explants were rooted in the MS medium containing 3 % sucrose, supplemented with 7.5 μM of both NAA and IBA for 2 weeks before transferring to a half strength MS medium without any growth regulator. Plantlets obtained were acclimatized and transferred to the greenhouse with less than 20 % mortality. This procedure considered the first successful report for regeneration and acclimatization of A. excelsa R. Br. var. glauca plantlet through main stem explants.

Mandibular first premolar with three roots: a case report

Anatomy of the root canal system always effects endodontic treatment outcome. Mandibular premolar teeth show extreme variations in root canal morphology. First premolars usually exhibit basic one root and one canal anatomy. The occurrence of three roots in mandibular first premolar has not been commonly reported in literature. This article reports a case of successful nonsurgical endodontic management of mandibular first premolar with three canals and three different apical foramina.

Controversies related to living kidney donors

Background

Increasing the living-donor pool by accepting donors with an isolated medical abnormality (IMA) can significantly decrease the huge gap between limited supply and rising demand for organs. There is a wide range of variation among different centres in dealing with these categories of donors. We reviewed studies discussing living kidney donors with IMA, including greater age, obesity, hypertension, microscopic haematuria and nephrolithiasis, to highlight the effect of these abnormalities on both donor and recipient sides from medical and surgical perspectives.

Methods

We systematically searched MEDLINE, ISI Science Citation Index expanded, and Google scholar, from the inception of each source to January 2011, using the terms ‘kidney transplant’, ‘renal’, ‘graft’, ‘living donor’, ‘old’, ‘obesity’, ‘nephrolithiasis’, ‘haematuria’ and ‘hypertension’. In all, 58 studies were found to be relevant and were reviewed comprehensively.

Results

Most of the reviewed studies confirmed the safety of using elderly, moderately obese and well-controlled hypertensive donors. Also, under specific circumstances, donors with nephrolithiasis can be accepted. However, persistent microscopic haematuria should be considered seriously and renal biopsy is indicated to exclude underlying renal disease.

Conclusion

Extensive examination and cautious selection with tailored immunosuppressive protocols for these groups can provide a satisfactory short- and medium-term outcome. Highly motivated elderly, obese, controlled hypertensive and the donor with a unilateral small stone (<1.5 cm, with normal metabolic evaluation) could be accepted. Donors with dysmorphic and persistent haematuria should not be accepted. A close follow-up after donation is crucial, especially for obese donors who developed microalbuminuria.

Hyperechogenic renal parenchyma in potential live related kidney donors: Does it justify exclusion?

Objectives

To assess the predictive importance of ultrasonic grade 1 hyperechogenicity in potential live related kidney donors in the absence of urinary abnormalities and with perfect renal function.

Subjects and methods

The study included 34 potential living related kidney donors with this abnormality; their mean (SD, range) age was 32.7 (8.45, 23–48) years. Ten matched healthy donors with normal ultrasonographic appearance of the kidneys were studied as controls. All cases were thoroughly investigated, including measuring glomerular filtration rate by isotopic scintigraphy. The renal reserve was estimated by dopamine and amino-acid infusion in all subjects (study and control groups). A percutaneous renal biopsy was taken from 17 subjects in the abnormal echogenicity group and open renal biopsy was taken from eight of the control subjects.

Results

The renal reserve was comparable in both groups. Abnormal histopathological changes were found in seven subjects (41%) of the abnormal echogenicity group, i.e. partial glomerulosclerosis in one, mesangial thickening in two, interstitial fibrosis in one, focal tubular atrophy in one, immunoglobulin (Ig M) immune deposits in three and IgA in one. Only one subject in the control group showed mild mesangial thickening.

Conclusion

Grade 1 echogenicity might be a sign of unrecognized kidney disease. Renal biopsy is mandatory when such related donors are the only available ones. Abnormal histopathology contraindicates donation.

Simple anchoring of the penopubic skin to the prepubic deep fascia in surgical correction of buried penis

Purpose

The aim of this study was to categorize concealed penis and buried penis by preoperative physical examination including the manual prepubic compression test and to describe a simple surgical technique to correct buried penis that was based on surgical experience and comprehension of the anatomical components.

Materials and Methods

From March 2007 to November 2010, 17 patients were diagnosed with buried penis after differentiation of this condition from concealed penis. The described surgical technique consisted of a minimal incision and simple fixation of the penile shaft skin and superficial fascia to the prepubic deep fascia, without degloving the penile skin.

Results

The mean age of the patients was 10.2 years, ranging from 8 years to 15 years. The median follow-up was 19 months (range, 5 to 49 months). The mean penile lengths were 1.8 cm (range, 1.1 to 2.5 cm) preoperatively and 4.5 cm (range, 3.3 to 5.8 cm) postoperatively. The median difference between preoperative and postoperative penile lengths was 2.7 cm (range, 2.1 to 3.9 cm). There were no serious intra- or postoperative complications.

Conclusions

With the simple anchoring of the penopubic skin to the prepubic deep fascia, we obtained successful subjective and objective outcomes without complications. We suggest that this is a promising surgical method for selected patients with buried penis.

Nonsurgical correction of congenital ear abnormalities in the newborn: Case series

OBJECTIVE

To determine whether a simple, nonsurgical treatment for congenital ear abnormalities (lop-ear, Stahl's ear, protruding ear, cryptotia) improved the appearance of ear abnormalities in newborns at six weeks of age.

METHODS

This is a descriptive case series. All newborns with identified abnormalities were referred by their family physician to one paediatrician (WGS) in a small level 2 perinatal centre. The ears were waxed and taped in a standard manner within 10 days of birth. Pictures were taken before taping and at the end of taping (one month). All patients and pictures were assessed by one plastic surgeon (JWT) at six weeks of age and scored using a standard scoring system. A telephone survey of the nontreatment group was conducted.

RESULTS

The total number of ears assessed was 90. Of this total, 69 ears were taped and fully evaluated in the study (77%). The refusal rate was 23%. In the treatment group, 59% had lop-ear, 19% had Stahl's ear, 17% had protruding ear and 3% had cryptotia. Overall correction (excellent/improved) for the treatment group was 90% (100% for lop-ear, 100% for Stahl's ear, 67% for protruding ear and 0% for cryptotia). In the nontreatment (refusal) group, 67% of the ears failed to correct spontaneously. No complications were recognized by the authors or parents by six weeks. The percentage of newborns in one year in the perinatal centre with recognized ear abnormalities was 6% (90 of 1600).

CONCLUSIONS

A simple, nonsurgical treatment in a Caucasian population appeared to be very effective in correcting congenital ear abnormalities with no complications and high patient/parent satisfaction.