Immediate management of posterior urethral disruptions due to pelvic fracture: therapeutic alternatives

PURPOSE: We retrospectively reviewed the results of 3 types of initial management of pelvic fracture urethral disruption in children. MATERIALS AND METHODS: From 1980 to 1994, 35 boys 2 to 15 years old (mean age 8.1) with prostatomembranous urethral disruption were treated, including 17 who also had associated injuries. Immediate treatment included suprapubic cystostomy and delayed urethroplasty in 19 patients (group 1), urethral catheter alignment without traction and concomitant suprapubic cystostomy in 10 (group 2), and primary retropubic anastomotic urethroplasty in 6 (group 3). RESULTS: In all patients in groups 1 and 2 severe urethral obliteration developed. Four group 3 patients (66%) had a stricture at the site of anastomotic repair. After delayed urethroplasty 16 group 1 (84%) and all 10 group 2 patients were continent. However, only 3 group 3 patients (50%) achieved continence. Retrospectively associated bladder neck injury occurred in 5 of the 6 incontinent boys. Erections were observed before and after treatment in all but 3 children. Unstable pelvic ring fractures (type IV) comprised 28% of all pelvic fractures with a high rate of associated injuries. CONCLUSIONS: As described, urethral alignment was not beneficial for avoiding urethral obliteration. Therefore we recommend suprapublic cystostomy as the only form of initial treatment in these cases. Urinary incontinence seems more likely related to associated bladder neck rupture and the severity of pelvic fracture rather than to initial treatment or delayed urethral repair. Consequently, when associated bladder neck injury is present, we advocate immediate surgical repair.     

Persian Variations

The concept of variation is essential in geometric design. It is surprising that patterns very different may be variations of the same model. We define two families of pentagonal patterns with three kind of variations, and give some suggestions how to analyse these patterns and create in this style. We then search for self-similarity systems in a strict sense. Although from a systematic search, the two solutions proposed here can also generate some traditional 2-level patterns. In searching for subdivisions of the tiles into rhombuses, we found two solutions. Both can be compatible with the Binary Tiling (not with the Penrose Tiling). Then, using the concept of X-Tiles defined in a previous paper (Castera et al., http://castera.net/entrelacs/public/articles/Flying_Patterns.pdf, 2011), we find new relationship between the two families of pentagonal patterns. In the last chapter we show and comment some examples taken from traditional architecture in Iran, and infer a self-similar system for pattern with interlaces from a 2-level tiling in Isfahan. This paper reflect the point of view of a pattern designer.     

Analysis of medium-garnet interaction in a parallel high-density magneto-optic read head

Signal reproduction by the domain pattern in a garnet layer from a magnetic medium, to be used in a magneto-optic readout system, has been analyzed. The results are used to specify garnet material parameter requirements. Observations of reproducing garnet domain patterns are related to the findings of the analysis. Bi-substituted YIG samples resolving about 2 μm²are reported.     

Acute pancreatitis revealing diffuse infiltration of the pancreas by melanoma

Hormonal replacement therapy is prescribed both to relieve menopausal symptoms and for preventive purposes. The preventive benefit, however, is dubious because the increased risk of breast cancer may be more important than the decreased risk of myocardial infarction and osteoporotic fractures. The transdermal administration may be associated with higher breast cancer risk and lower cardiovascular benefit than the oral administration; only the latter, in fact, is able to stimulate the liver synthesis of sex hormone binding globulin (SHBG, which reduces the availability of testosterone and estradiol to target organs) and of HDL cholesterol, and to inhibit the liver synthesis of IGF-I (which cooperates with sex steroids to enhance the breast cancer cell proliferation).     

Characterization of Olive-Leaf Phenolics by ESI-MS and Evaluation of their Antioxidant Capacities by the CAT Assay

Olive leaves are a very abundant vegetable material containing various phenolic compounds, such as secoiridoids and flavonoids, that are expected to exert strong antioxidant capacity. However, little is known about the variation of olive-leaf phenolic composition during maturation and its influence on antioxidant capacity. To answer this question, young and mature Olea Europaea L. leaves were submitted to successive extraction with dichloromethane, ethyl acetate, and methanol, then characterized by ESI-MS. It appeared that mature olive-leaf extracts contained higher levels of verbascoside isomers and glucosylated forms of luteolin, while young ones presented higher contents of oleuropein, ligstroside, and flavonoid aglycones. Moreover, antioxidant capacity evaluation using our newly developed conjugated autoxidizable triene assay showed that, in a lipid-based emulsified system, this phenolic composition variation leads to a change in the ability of extracts to counteract lipid oxidation. Mature olive-leaf extracts exhibit higher antioxidant capacity than young olive-leaf extracts. This result enables us to hypothesize that two main bioconversion scenarios may occur during maturation of olive leaves, which could explain changes observed in antioxidant capacity: (1) a bioconversion of oleuropein and ligstroside into verbascoside isomers and oleuroside, and (2) a bioconversion of flavonoid aglycones into glucosylated forms of luteolin. Finally, this study leads to a better understanding of the relationship between phenolic profile and antioxidant capacity of olive leaves.     

Influence des effets de contrainte induits par la température sur la conversion TE-TM dans des guides planaires de YIG substitué

We have demonstrated the tuning of linear birefringence in magnetooptic planar thin film waveguides by temperature adjustment. Using this method, phase-matching between coupled te₀and tm₀ modes, a necessary condition for the integrated optical isolator based on mode conversion, has been obtained at λ = 1.52 µm in bilayer gadolinium gallium substituted yig films. The waveguide temperature was 85°C. Moreover, phase-matching temperature can be modified by a slight variation of gadolinium and gallium substitutions as shown by a phase-matching observed in a waveguide at room temperature.     

Urethral duplication in children: surgical treatment and results

PURPOSE: Urethral duplication is a rare congenital anomaly. We report the clinical presentation, imaging findings and surgical treatment in 7 boys with incomplete sagittal duplication of the urethra. MATERIALS AND METHODS: Duplication involved hypospadias in 5 cases (group 1) and a bifid urethra with an accessory preanal tract (Y duplication) in 2 (group 2). Group 1 was treated with 1-stage urethroplasty, including marsupialization of the dorsal orthotopic urethra, ventral-to-dorsal urethrourethrostomy and penile island flap onlay repair to cover the open dorsal urethra. In contrast, group 2 was treated with 2-stage urethral reconstruction with detachment and mobilization of the accessory preanal branch in association with a scrotal tubed neourethra followed by urethroplasty, as in group 1. In all cases the dorsal penile urethra was located between the corpora cavernosa and surrounded by the tunica albuginea. RESULTS: A urethrocutaneous fistula developed in 1 of the 5 group 1 patients. In group 2, 1 patient had recurrent penoscrotal meatal stenosis after the 1-stage procedure and 1 had a urethral diverticulum with calculi at the scrotal tubed neourethra 7 years after urethral reconstruction. Six of the 7 patients now void spontaneously through a meatus located normally at the tip of the glans. The remaining patient with a neurogenic bladder is on intermittent catheterization via appendicovesicostomy due to difficult catheterization of the irregular and sensitive neourethra. CONCLUSIONS: While the ideal surgical management of urethral duplication anomalies remains uncertain, we used a combination of surgical techniques to correct this severe malformation.     

Hepatocellular carcinoma complicating agenesis of the portal vein]

Skin diseases due to Nocardia are rare in Europe and usually occur as the secondary localization of a pulmonary lesion in immunocompromised patients. We describe a cutaneous pyoderma and cold abscess due to Nocardia asteroides infection in a cardiac transplant recipient. An insect bite represents the wound of this soil saprophyte belonging to the actinomycetes. Treatment by sulfone and ampicillin-clavulanic acid allowed the regression of lesions without extracutaneous dissemination.     

Phase matching in magneto-optic YIG films by waveguide temperature control

Demonstrates the tuning of linear birefringence in magneto-optic planar thin-film waveguides by temperature adjustment. Using this method, phase matching between coupled TE/sub 0/ and TM/sub 0/ modes, a necessary condition for the integrated optical isolator based on mode conversion, has been obtained at lambda =1.52 mu m in bilayer gadolinium gallium-substituted YIG films. The waveguide temperature was 85 degrees C. Moreover, the phase-matching temperature can be modified by a slight variation of gadolinium and gallium substitutions as shown by a phase matching observed in a waveguide at room temperature.<>