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Urethroplasty among Elderly Men, Surgical Techniques and Outcomes

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Open Journal of Urology 2024年第3期14卷 179-187页

作者： Kwaku Addai Arhin Appiah george Amoah Patrick Opoku Manu Maison Roland Azorliade Kwaku Otu-Boateng Douglas Arthur Dominic Annor Mintah Joseph Yorke george Asafu Adjaye Frimpong Christian Kofi Gyasi-Sarpong department of surgery School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana department of surgery Komfo Anokye Teaching Hospital Kumasi Ghana department of surgery School of Medical Sciences University of Cape Coast Cape Coast Ghana department of Radiology School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana

Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye teaching hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the pr

关键词： Urethral Stricture Elderly Men Urethroplasty Surgical Techniques

Ethmoidal Polyposis, Adenoid Hypertrophy and Tympanic Membrane Perforation—A Case Report

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International Journal of Otolaryngology and Head & Neck surgery 2024年第3期13卷 178-186页

作者： Ahmad Mahmud Mohammed Bello Fufore Abubakar Umar Hamisu Abdullahi Thomas Musa Samdi Auwal Adamu Onyekwere george B. Nwaorgu department of Otorhinolaryngology Modibbo Adama University/Modibbo Adama University Teaching Hospital Yola Nigeria department of Otorhinolaryngology Bayero University/Aminu Kano Teaching Hospital Kano Nigeria National Ear Care Centre (NECC) Kaduna Nigeria department of ENT Abubakar Tafawa Balewa Teaching Hospital Bauchi Nigeria department of ENT Federal University of Health Sciences Azare Bauchi Nigeria department of Otorhinolaryngology University College Hospital Ibadan/College of Medicine University of Ibadan Ibadan Nigeria

Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexists with adenoid enlargement especially in the young which was in sharp contrast to ethmoidal polyposis occurring in the presence of adenoid enlargement. Moreover, the hidden location of nasopharynx housing the adenoids, coupled with the masking effect of bilateral sinonasal polyps, leads to inadvertent misdiagnosis of this complex pathology with subsequent difficulty in providing effective management. Case Presentation: A 24 year-old lady presented with recurrent bilateral nasal obstruction that became persistent associated with nasal discharge and anosmia. She also had recurrent right otorrhoea with associated hearing loss. Diagnostic rigid nasal endoscopy revealed mucoid discharge with bilateral polypoid masses filling both nasal cavities. Otoendoscopic finding revealed a small (about 5%) central tympanic membrane perforation. A clinical assessment of chronic rhinosinusitis with nasal polyposis complicated by chronic suppurative otitis media (CSOM) was made. A non-contrast CT scan of the paranasal sinuses showed isodense lesions in the nasal cavities, all paranasal sinuses and the entire nasopharynx. She had endoscopic sinus surgery and a nasopharyngeal clearance biopsy. The nasal, paranasal and nasopharyngeal masses had histologic confirmation of inflammatory nasal polyps and lymphoid (adenoid) hyperplasia respectively. Her condition improved remarkably with subsequent medical treatment. She was followed up for 8 months and no recurrence was observed. Conclusion: Sinonasal polyposis can coexist with adenoid hypertrophy and middle ear disease as a single pathological condition. Hence, a high index of suspicion and thorough evaluation become necessary for making timely diagnoses and instituting effective management.

关键词： Sino-Nasal Polyps Adenoid Enlargement Rhinosinusitis Otitis Media Endoscopic Sinus surgery

Uterine-ileal perforation post pregnancy related dilatation and curettage managed by laparoscopic small bowel resection and primary anastomosis: A case report

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Laparoscopic, Endoscopic and Robotic surgery 2020年第3期3卷 94-96页

作者： Melissa Kyriakos Saad Saleem Abdel Baki Elias Saikaly General surgery department Saint George Hospital University Medical CenterBeirutLebanon

Although rare,small bowel perforation post pregnancy related dilation and curettage presents a serious ***,we reported a case of 34-year-old female patient presenting for uterine-ileal perforation post pregnancy relat... 详细信息

关键词： Dilatation and curettage Small bowel perforation Laparoscopic small bowel resection Primary anastomosis

Significance and prognostic value of lysosomal enzyme activities measured in surgically operated adenocarcinomas of the gastroesophageal junction and squamous cell carcinomas of the lower third of esophagus

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World Journal of Gastroenterology 2005年第37期11卷 5751-5756页

作者： Aron Altorjay Balazs Paal Nicolette Sohar Janos Kiss Imre Szanto Istvan Sohar department of surgery saint george university teaching hospital Székesfehérvár Seregélyesi u. 3. H-8000 Hungary Center for Advanced Biotechnology and Medicine UMDNJ Piscataway NJ USA National Medical Center department of surgery Budapest Szabolcs u.33-35. H-1135 Hungary

AIM： To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction （GEJ） and the squamous cell carcinomas of the lower third of the esophagus （LTE）. METHODS： Between February 1, 1997 and February 1, 2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients＇ samples （81%）. Of these, 29 were adenocarcinomas of the GEJ Siewert type Ⅰ （n = 8）, type Ⅱ （n = 12）, type Ⅲ （n = 9）, and 18 presented as squamous cell carcinomas of the LTE. We evaluated the mean values of 11-lysosomal enzyme and 1-cytosol protease activities of the tumorous and surrounding mucosae as well as their relative activities, measured as the ratio of activity in tumor and normal tissues from the same patient. These data were further analyzed to establish the correlation with tumor localization, TNM stage （lymph-node involvement）, histological type （papillary, signet-ring cell, tubular）, state of differentiation （good, moderate, poor）, and survival （≤24 or ≥24 mo）. RESULTS： In adenocarcinomas, the activity of α-mannosidase （AMAN）, cathepsin B （CB） and dipeptidyl-peptidase Ⅰ （DPP Ⅰ） increased significantly as compared to the normal gastric mucosa. In squamous cell carcinomas of the esophagus, we also found a significant difference in the activity of cathepsin L and tripeptidyl-peptidase Ⅰ in addition to these three. There was a statistical correlation of AMAN, CB, and DPP Ⅰ activity between the level of differentiation of adenocarcinomas of the GEJ and lymph node involvement,because tumors with no lymph node metastases histologically confirmed as well-differentiated, showed a significantly lower activity. The differences in CB and DPP Ⅰ activity correlated well with the differences in survival rates, since the CB and DPP Ⅰ values of those who died within 24 mo following surgical intervention were significantly higher tha

关键词： Prognostic value Lysosomal enzymes Cardiac adenocarcinomas Siewert classification Esophageal squamous cell carcinoma

Maternal inheritance of severe hypertriglyceridemia impairs glucose metabolism in offspring

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The Journal of Biomedical Research 2015年第2期29卷 125-131页

作者： Ya-Hong Ma Caiguo Yu Abudurexiti Kayoumu Xin Guo Zhili Ji george Liu department of Endocrinology Beijing Puren Hospital Institute of Cardiovascular Sciences Peking University and Key Laboratory of Cardiovascular SciencesAdministration of Education department of Endocrinology Luhe Teaching Hospital of Capital Medical University department of General surgery Luhe Teaching Hospital of Capital Medical University

Maternally inherited familial hypercholesterolemia（FH） impairs glucose metabolism and increases cardiovascular risks in the offspring to a greater degree than paternal inherited ***,it remains unknown whether hypertriglyceridemia affects glucose metabolism via *** this study,we sought to compare the impact of maternally and paternally inherited hypertriglyceridemia on glucose and lipid metabolism in *** CIII transgenic mice with severe hypertriglyceridemia were mated with non-transgenic control mice to obtain 4 types of offspring：maternal non-transgenic control and maternal transgenic offspring,and paternal control and paternal transgenic *** triglycerides（TG）,total cholesterol（TC）,fasting plasma glucose（FPG） and fasting insulin（FINS） were *** CIII overexpression caused severe hypertriglyceridemia,but the transgenic female mice had unaltered fertility with normal pregnancy and birth of *** 4 groups of offspring had similar birth weight and growth *** plasma TG of maternal and paternal transgenic offspring were nearly 40-fold higher than maternal and paternal control mice,but there was no difference in plasma TG between maternal and paternal transgenic *** the FPG of the 4 groups of animals had no difference,the maternal transgenic mice showed impaired glucose tolerance,increased FINS levels and higher homeostasis model assessment insulin resistance index（HOMA-IR） than the other 3 *** conclusion,maternally inherited hypertriglyceridemia in Apo CIII transgenic mice displayed impaired glucose tolerance,hyperinsulinemia and increased HOMA-R,while paternally inherited hypertriglyceridemia did not have such impacts.

关键词： Apolipoprotein CIII Transgenic mice Hypertriglyceidemia Insulin resistance

Multiplex RT-PCR-based detections of CEA, CK20 and EGFR in colorectal cancer patients

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World Journal of Gastroenterology 2010年第47期16卷 5965-5974页

作者： Aikaterini Tsouma Chrysanthi Aggeli Panagiotis Lembessis george N Zografos Dimitris P Korkolis Dimitrios Pectasides Maria Skondra Nikolaos Pissimissis Anastasia Tzonou Michael Koutsilieris department of Experimental Physiology Medical School National and Kapodistrian University of Athens Third department of surgery Athens General Hospital "G. Gennimatas" department of Surgical Oncology Hellenic Anticancer Institute "Saint Savvas" Hospital Endo/OncoResearch Medical Center department of Surgical Oncology Hellenic Anticancer Institute "Saint Savvas" Hospital 11522 Athens Greece Second department of Internal Medicine Propaedeutic Oncology Section University of Athens Attikon University Hospital department of Hygiene Epidemiology and Medical Statistics Medical School National and Kapodistrian University of Athens

AIM: To develop a multiplex reverse transcription polymerase chain reaction (RT-PCR) method detecting cir-culating tumor cells in the peripheral blood of colorectal cancer (CRC) patients. METHODS: Peripheral blood samples were collected from 88 CRC patients and 40 healthy individuals from the blood donors' clinic and subsequently analyzed by multiplex RT-RCR for the expression of carcinoembryonic antigen (CEA), cytokeratin 20 (CK20) and epidermal growth factor receptor (EGFR) mRNA. The analysis involved determining the detection rates of CEA, CK20 and EGFR transcripts vs disease stage and overall survival. Median follow-up period was 19 mo (range 8-28 mo). RESULTS: Rates of CEA, CK20 and EGFR detection in CRC patients were 95.5%, 78.4% and 19.3%, respectively. CEA transcripts were detected in 3 healthy volunteer samples (7.5%), whereas all control samples were tested negative for CK20 and EGFR transcripts. The increasing number of positive detections for CEA, CK20 and EGFR transcripts in each blood sample was positively correlated with Astler-Coller disease stage (P< 0.001) and preoperative serum levels of CEA (P=0.029) in CRC patients. Data analysis using Kaplan-Meier estimator documented signif icant differences in the overall survival of the different CRC patient groups as formed according to the increasing number of positivity for CEA, CK20 and EGFR transcripts. CONCLUSION: These data suggest that multiplex RTPCR assay can provide useful information concerning disease stage and overall survival of CRC patients.

关键词： Peripheral blood Carcinoembryonic antigen Cytokeratin 20 Epidermal growth factor receptor Multiplex reverse transcription polymerase chain reaction

Bone Defect Reconstruction in a 2 Years Old Boy with Non-Vascularized Fibular Graft Using the Induced Membrane Technique in Country with Low-Income: A Case Report

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Open Journal of Orthopedics 2018年第12期8卷 453-463页

作者： Kombate Noufanangue Kanfitine Ayouba Gamal Bakriga Batarabadja Walla Atchi Abalo Anani Grégoire department of Orthopaedic and Traumatology surgery Saint-Jean de Dieu d’Afagnan Hospital Lomé Togo department of Orthopaedic and Traumatology surgery Teaching University Hospital Sylvanus Olympio Lomé Togo department of Orthopaedic and Traumatology surgery Campus Teaching University Hospital Lomé Togo

Chronic osteomyelitis in children is frequent in the developing countries. Their complications and morbidity burden the functional prognosis. The reconstruction of diaphyseal bone loss after sequestrectomy in young children remains a difficult and expensive challenge in our context. The delay in care and the lack of social security for all, are risk factors for morbidity. The induced membrane technique described by Masquelet starts to be applied and showed satisfactory results. We report the results of a case of reconstruction of the proximal humerus by using a non-vascularized fibula and supplemental bone substitute in a boy of 2 years with sickle cell. No scarring occurred at the sampling site. The process of bone consolidation is underway.

关键词： Chronic Osteomyelitis Bone Defect Bony Bone Reconstruction Induced Membrane Fibula

Components of the mitogen-activated protein kinase cascade are activated in hepatic cells by Echinococcus multilocularis metacestode

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World Journal of Gastroenterology 2009年第17期15卷 2116-2124页

作者： Ren-Yong Lin Jun-Hua Wang Xiao-Mei Lu Xiao-Tao Zhou georges Mantion Hao Wen Dominique A Vuitton Lysiane Richert Xinjiang Key Laboratory on Echinococcosis and Liver surgery 1st Teaching Hospital of Xinjiang Medical University No. 1 Liyushan Road Urumqi 830054 China Ren-Yong Lin Lysiane Richert Laboratoire de Toxicologie Cellulaire EA 4267 Faculte de Medecine et Pharmacie University of Franche-Comte Place Saint-Jacques 25030 Besangon France Liver surgery and Transplantation Unit EA 3921 Department of Digestive Surgery University Hospital Jean Minjoz Boulevard Fleming 25030 Besangon France WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis University of Franche-Comte Place Saint Jacques 25030 Besancon France WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis University of Franche-Comte Place Saint Jacques 25030 Besancon France

AIM： To explore the effect of Echinococcusmultilocularis on the activation of mitogen-activated protein kinase （MAPK） signaling pathways and on livercell ***： Changes in the phosphorylation of MAPKs and proliferating cell nuclear antigen （PCNA）expression were measured in the liver of patients withalveolar echinococcosis （AE）. MAPKs, MEK1/2 [MAPK/extracellular signal-regulated protein kinase （ERK）kinase] and ribosomal S6 kinase （RSK） phosphorylationwere detected in primary cultures of rat hepatocytesin contact in vitro with （1） E. multilocu/aris vesicle fluid（EmF）, （2）E. multilocularis-conditioned medium （EmCM）.RESULTS： In the liver of AE patients, ERK 1/2 andp38 MAPK were activated and PCNA expression wasincreased, especially in the vicinity of the *** exposure to EmF, p38, c-Jun N-terminal kinase（JNK） and ERK1/2 were also activated in hepatocytesin vitro, as well as MEK1/2 and RSK, in the absenceof any toxic effect. Upon exposure to EmCM, only JNKwas ***： Previous studies have demonstratedan influence of the host on the MAPK cascade inE. multilocularis. Our data suggest that the reverse,i.e. parasite-derived signals efficiently acting onMAPK signaling pathways in host liver ceils, is actuallyoperating.

关键词： Echinococcus multilocularis Hepaticalveolar echinococcosis Mitogen-activated proteinkinase Host-parasite interactions Liver

Cryopreservation of the Trachea Can Reduce Its Antigenicity in Various Species

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Open Journal of Gastroenterology 2015年第5期5卷 31-36页

作者： Arpad Juhasz Norbert Lippai Agnes Novak Ibolya Szekeres Sumeet K. Mittal Aron Altorjay department of surgery St George University Teaching Hospital Szekesfehervar Hungary department of surgery Creighton University Medical Center Omaha USA department of Pathology Geza Hetenyi County Hospital Szolnok Hungary

Background: Cryopreserved tracheal allograft has been used successfully for esophageal replacement in the canine model. The working hypothesis was cryopreservation decreases antigenicity but epithelial desquamation remains. However, cryopreservation of human tracheal samples collected at tracheostomy, resulted in no significant desquamation. The aim of this study was to examine the extent of desquamation of the epithelial layer of cryopreserved animal tracheas and find a reason for decreased antigenicity of cryopreserved canine and pig’s trachea. Methods: 5 cm long tracheal segments were removed from 6 dogs and 125 pigs and stored in liquid nitrogen for 21 days. Cross section samples were taken from the end of the segment, 1 cm from the end and at the middle of the segment. Histological examination was performed using haematoxyllineosin and MHC-II antigen specific antibody staining. Changes in histological structure were analyzed. Results: General histological morphology of samples changed after cryopreservation. The percentage of intact epithelium and the overall intensity of immune-staining increased significantly from the ends to the middle of the segments, but the intensity of immune-staining showed no difference in the remaining epithelial cells. Conclusion: Cryopreservation damages the epithelial cells, but does not influence the cell’s antigenicity or cause desepithelisation. The main effect is a retraction of the epithelial layer from the ends to the midpart and this effect may be protection against organ rejection. Based on our canine and pig results a 5 cm, long tracheal segment seems to be a promising organ for human esophageal replacement.

关键词： Cryopreservation Trachea Transplantation Esophagus Replacement