Tract Size Research Articles

Gαo1 and Gαo1/Gαo2 deletion differentially affect hippocampal mossy fiber tract anatomy and neuronal morphogenesis.

The heterotrimeric G-protein αo subunit is ubiquitously expressed in the CNS as two splice variants Gαo1 and Gαo2, regulating various brain functions. Here, we investigated the effect of single Gαo1, Gαo2, and double Gαo1/2 knockout on the postnatal development of the murine mossy fiber tract, a central pathway of the hippocampal connectivity circuit. The size of the hippocampal synaptic termination fields covered by mossy fiber boutons together with various fiber length parameters of the tract was analyzed by immunohistochemical staining of the vesicular Zinc transporter 3 (ZnT3) or Synaptoporin at postnatal days 2, 4, 8, 12, 16, and in the adult. Ultimately, Gαo1 knockout resulted in a reduced developmental growth of synaptic mossy fiber terminal fields by 37% in the adult Stratum lucidum and by 30% in the total mossy fiber tract size. Other morphological parameters such as projection length of the infrapyramidal bundle of the tract were increased (+52% in Gαo1 -/- mice). In contrast, Gαo2 knockout had no effects on the mossy fiber tract. Moreover, by using primary heterozygous and homozygous Gαo1 knockout hippocampal cultures, we detected a strongly pronounced reduction in axon and dendrite length (-50% and -38%, respectively) as well as axon and dendrite arborization complexity (-75% and -72% branch nodes, respectively) in the homozygous knockout. Deletion of both splice variants Gαo1 and Gαo2 partially rescued the invivo and completely reconstituted the invitro effects, indicating an opposing functional relevance of the two Gαo splice variants for neuronal development and synaptic connectivity.

Сравнение мини-перкутанной нефролитотомии с супер-мини-перкутанной нефролитотомией: когортное исследование

Introduction. Over the past 20 years mini-percutaneous nephrolithotomy (mini-PCNL) is remaining an effective method non inferior to standard PCNL with lower rates of serious complication related to bigger nephrotomy tract size like bleeding. However, in comparison to standard PCNL miniPCNL diminishes visualization, leads to increase of intrarenal pressure (IRP), difficulties in stone fragments evacuation, and longer operative time. In 2016 Zeng has developed an innovative aspiration sheath. Novel modification of miniPCNL with suction was called superminiPCNL (SMP) [1]. We have modified this aspiration sheath. There is the lack of data regarding efficacy and safety of this innovative method. Objectives. The aim of the study is to compare efficacy and safety of miniPCNL with SMP using an innovative suction sheath in the treatment of kidney stone disease. Material and methods. Between September 2021 and March 2023, 140 underwent PCNL. Patient were divided into 2 groups 1:1, 70 patients in each group. MiniPCNL was used in control group, SMP using aspiration suction sheath – in intervention group. Operative time, stone-free rate (SFR), bleeding, postoperative complications were compared between two groups. Results. SFR didn`t significantly differ between the groups and was 91.3% and 98.4% respectively (p = 0.117). Mean operative time was less in SMP group with a mean shortening of the procedural time of 13 min (p < 0.001). Hemoglobin drop was comparable between the groups (p = 0.73). Fever was significantly less frequent in SMP group, 11.6% in miniPCNL vs. 1.6% in SMP group (p = 0.042). There were no serious complications (Clavien III and IV) in any group. Discussion. PSMP is not inferior to miniPCNL in terms of efficy and safety. Moreover, it leads to shorter operative ime, decreases complication rates, and thus is a preferable method of renal stone treatment. Keywords: Kidney stone disease, percutaneous nephrolithotomy, surgery, supermini-PCNL.

The impacts of physical factors on huge hepatocellular carcinoma treated by transarterial chemoembolization combined with radiotherapy.

Aims: To assess the influence of various physical factors on the outcome of transarterial chemoembolization combined with γ-ray hypofractionated radiation therapy (TACE-γHRT) for unresectable huge (≥10cm) hepatocellular carcinoma (UH-HCC) patients.Materials & methods: A total of 162 UH-HCC patients with different tumor locations treated with TACE-γHRT and a retrospective analysis was conducted to evaluate the impacts of selected physical parameters on clinical outcomes.Results: The selected physical factors influenced the clinical outcomes significantly. No adverse events exceeding grade 3 were observed in the enrolled patients.Conclusion: Higher P70 and marginal dose, smaller tumor size and tumor location of neither skin nor gastrointestinal tracts involved were independent predictors for better overall survival and progression free survival.

Electrostimulation via a 3D-printed, biomimetic, neurotrophic, electroconductive scaffold for the promotion of axonal regrowth after spinal cord injury

Spinal cord injury (SCI) is a devastating neurotrauma, affecting 250,000 to 500,000 people annually, and typically results in paralysis. Electrostimulation can promote neuronal growth, but the formation of a lesion cavity post-SCI inhibits regrowth, limiting its efficacy. Bridging the lesion with a structured, electroactive substrate to direct electrostimulation to growing neurites could support and drive neuronal regrowth through the lesion to enable functional recovery but to date, no such platform exists. This study describes the development of an electroconductive (15 ± 5 S/m), 3D-printed scaffold, comprising a polypyrrole/polycaprolactone framework filled with biomimetic & neurotrophic extracellular matrix. 3D printing allowed inclusion of channels in the scaffold designed to mimic the size of human corticospinal tracts to direct electrostimulation to growing neurons. Scaffolds exhibited excellent biocompatibility with both neurons and human primary astrocytes and maintained electrical and biofunctionality when scaled to match the size of human corticospinal tracts. When neurons were cultured for 7 days on the scaffolds under continuous electrostimulation (200 mV/mm, 12 Hz), significantly longer neurites were observed on electrically stimulated electroconductive scaffolds. These results demonstrate that electrostimulation applied via an anatomically-mimetic, 3D-printed electroconductive scaffold drives neurite outgrowth and represents a promising approach for treatment of spinal cord injury.

Comparative study of gastrointestinal tract size in three parent breeds for the production of dual-purpose organic chickens.

An alternative to culling male hatchlings of layers is breeding dual-purpose chickens. One breeding objective is the ability to digest low-quality feed. Certain measurements of the gastrointestinal tract may be useful indicators of this ability. The present study compared the gastrointestinal tract of adult hens of two layer-type breeds (White Rock (WR), New Hampshire (NH)) and the meat-type ÖTZ (Ökologische Tierzucht gGmbH) Bresse Gauloise (BR), used for the production of dual-purpose organic chickens. Flocks had the same housing and feeding conditions. At slaughter at 19 months, the body weight and gastrointestinal organs of 134 hens (51 WR, 55 NH and 28 BR) were measured. The muscle thickness of the proventriculus and ventriculus and the length and width of the duodenum, jejunoileum, caeca and colorectum were measured and variances between the groups were analysed using a one-factor covariance analysis. Significant differences between the breeds were found in total intestine length and the lengths and/or widths of single gastrointestinal segments. For example NH showed the highest mean total intestinal length and BR showed the lowest mean (NH: 186.73 cm, WR 185.86 cm, BR 157.91 cm; p = 0.001). To our knowledge, this is the first study comparing the gastrointestinal tract size of adult female layer- and meat-type chicken breeds kept under the same feeding and housing conditions. Given the possible relationship between intestinal length parameters and chicken performance, measurement of the gastrointestinal tract may be a simple, quick and inexpensive additional method to help select layer-, meat-type and dual-purpose chickens suitable for organic production when a selection process using genetic markers is not possible.

A Comparative Study between Ultra mini Percutaneous Nephrolithotomy versus Stented Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones in Egypt

Abstract Background Nephrolithiasis is the third most common disease of the urinary tract with a 1-year recurrence rate of 7% and 10-year recurrence rate of 50%. Shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolithotomy (PCNL) are different surgeries to treat renal stones. Percutaneous nephrolithotripsy (24- 30F) remains the standard procedure for treating large renal calculi. While achieving high SFR, it also has many drawbacks such as bleeding, postoperative pain, and a long recovery period due to its large access tract, so the Ultra mini percutaneous nephrolithotripsy (12-14F) with a smaller tract size came into existence to reduce renal parenchymal injury associated with standard PCNL. ESWL is a minimally invasive intervention with good patient tolerance; it is regarded as the first line treatment for nephrolithiasis < 20 mm in size. Aim andObjectives Compare results, safety and outcome of Ultra mini PCNL versus stented extracorporeal shock wave lithotripsy (ESWL) for the management of renal calculi from 10 – 20 mm. Materials and Methods This study was conducted at Urology department, Faculty of Medicine, Ain Shams University. Patients were recruited from the outpatient urology clinic between March 2021 till September 2022. Inclusion criteria included patients between 18 and 60 years, having radioopaque renal stones ranging from 10-20 mm with BMI not exceeding 40. Exclusion criteria were patients who had radiolucent stones, smaller than 10 mm or larger than 20 mm, with congenital renal anomalies or spinal deformity or BMI exceeding 40. Patients with uncorrected bleeding diathesis or pregnant females or untreated UTI were also excluded. After meeting our inclusion and exclusion criteria, 90 patients were thoroughly informed about the study, feeling well about participating in it, an informed written consent was taken from them. Patients were randomized to either Ultra-Mini-Percutaneous nephrolithotomy group or stented SWL group via the closed envelope method(each group 45 patients). Results Stone free rate was higher in the Ultra-mini-PCNL group compared to the stented ESWL group with no statistically significant difference with P-value = 0.316. As for the need for retreatment was slightly higher in the stented ESWL group compared to the Ultra-mini-PCNL group yet this difference was statistically insignificant with P-value 0.681. No statistical significant difference between both groups regarding post operative complications fever, hematuria and need for blood transfusion respectively. Operative time and hospital stay were significantly higher in the ultra-Mini-PCNL group compared to the stented ESWL group with P-value <0.001 for both. Conclusion Both stented ESWL and Ultra-Mini-PCNL are good treatment choices for renal stones less than 2 cm with low complication rates. Denying Ultra-Mini-PCNL from patients with medium sized stones for fear of complications is considered unwarranted. Stone size indices were significant predictor for the need of retreatment. Further studies to compare stone free rate based on stone size in both interventions are needed.

Intersexual patterns of the digestive tract and body size are opposed in a large bird

The appropriate structure of the digestive tract is crucial for individual adaptation to ecological conditions. In birds, the length of the small intestine, responsible for food absorption, is generally believed to be positively correlated with body size. In this study, we investigated the variation in small intestine length in the White Stork (Ciconia ciconia), a monomorphic species without visible sexual dimorphism, but characterized by differing parental efforts, which can be reflected by the small intestine lengths between the sexes. We examined the relationship between small intestine length and body size within the sexes. Our findings show that male White Storks have significantly shorter small intestines than females, despite having larger body sizes than the latter. Furthermore, we found a significant relationship between body size and small intestine length, but it was of a different nature in the two sexes. Males exhibited a previously unreported phenomenon, whereby increasing body size was associated with shortening small intestines, whereas females exhibited the opposite pattern. These novel findings shed light on the anatomical adaptations of the digestive tract in birds.

Association of left ventricular outflow tract size with arch morphology in interrupted aortic arch.

Left ventricular outflow tract obstruction (LVOTO) is a major cause of morbidity and mortality in infants with interrupted aortic arch (IAA). LVOT development may be flow-mediated, thus IAA morphology may influence LVOT diameter and subsequent reintervention. We investigated the association of IAA morphology (type and presence of aortic arch aberrancy) with LVOT diameter and reintervention. All surgical patients with IAA (2001-2022) were reviewed at a single institution. We compared IAA-A versus IAA-B; IAA with aortic arch aberrancy (AAb) versus none; IAA-B with aberrant subclavian artery (AAbS) versus Others. Primary outcomes included LVOT diameter (mm), LVOTO at discharge (≥50mmHg), and LVOT reintervention. Seventy-seven infants (mean age 10±19 days) were followed for 7.6 (5.5-9.7) years. Perioperative mortality was 3.9% (3/77) and long-term mortality was 5.2% (4/77). Out of 51 IAA-B (66%) and 22 IAA-A (31%) patients, 30% (n = 22) had AAb. Smaller LVOT diameter was associated with IAA-B [IAA-A: 5.40 (4.68-5.80), IAA-B: 4.60 (3.92-5.50), p = 0.007], AAb [AAb: 4.00 (3.70-5.04) vs None: 5.15 (4.30-5.68) p = 0.006], and combined IAA-B+AAbS [IAA-B+AAbS: 4.00 (3.70-5.02) vs Other: 5.00 (4.30-5.68), p = 0.002]. The likelihood of LVOTO was higher among AAb (N = 6 (25%) vs N = 1 (2%), p = 0.004) and IAA-B+AAbS (N = 1 (2%) vs N = 6 (30%), p = 0.002). Time-to-event analysis showed a signal towards increased LVOT reintervention in IAA-B+AAbS (p = 0.11). IAA-B and AAb are associated with small LVOT diameter and early LVOTO, especially in combination. This may reflect lower flow in the proximal arch during development. Most reinterventions occur in IAA-B+AAbS, hence these patients should be carefully considered for LVOT intervention at the time of initial repair.

Unilateral Genital Tract Obstruction with Ipsilateral Renal Anomaly Syndrome: Classification, Clinical Manifestations, and Precise Diagnose.

To recommend the classification of unilateral genital tract obstruction with ipsilateral renal anomaly (UGTOIRA) syndrome into five types based on the site of obstruction, and to analyze the clinical manifestations and precise diagnosis of the syndrome. The data, including demographic characteristics, symptoms, and precise diagnoses from 59 patients over the last decade, were retrospectively analyzed. Data analysis was conducted using the statistical software package SPSS 26.0. All 59 patients diagnosed with UGTOIRA syndrome were classified into five types based on the site of obstruction: Type I (vaginal obstruction) (45, 76.3%), Type II (cervicovaginal obstruction) (7, 11.9%), Type III (cervical obstruction) (3, 5.1%), Type IV (unilateral partial cervical aplasia) (3, 5.1%), and Type V (Unilateral isthmus atresia) (1, 1.7%). Of these cases, there were 34 cases (57.6%) with communication and 25 cases (42.4%) without communication between the left and right genital tracts. The chief complaints included dysmenorrhea alone in 28 cases (47.5%), dysmenorrhea accompanied by blood dripping after menstruation in 12 cases (20.3%), blood dripping after menstruation alone in 14 cases (23.7%), purulent vaginal secretions in one case (1.7%), vaginal pain in one case (1.7%), irregular menstruation in one case (l.7%), and infertility in two cases (3.4%). The precise diagnostic criteria include the affected side, abnormalities in the kidney and ureter, the site of obstruction, the location of blood accumulation, the size of the ipsilateral genital tract, whether there is communication and its site, the type based on the site of obstruction, and the presence and type of complications. This classification of UGTOIRA syndrome encompasses the anatomical features of all cases reported in our study. Only by fully understanding the anatomical characteristics of this syndrome and identifying its clinical manifestations can clinicians make precise diagnoses as early as possible and provide individualized management.

Response of Digestive Tract Size In Indonesian Native Chickens Fed Indigofera sp.

The development of Balitbangtan native chicken through tractic feed is continually being advocated by the Indonesian government to enhance poultry protein consumption. Indigofera sp. is known for its flavonoid, tannin, and saponin content, which act as antimicrobial and anti-inflammatory agents for chicken digestive tract. The study aimed to investigate the response of Balitbangtan chicken’s digestive tract size substituted with Indigofera sp. A total of 40 chickens were used in four treatments with five replications. The four treatments were T0 (25% concentrate + 35% rice bran + 40% maize); T1 (T0 with substitution of concentrate with 10% Indigofera sp. meal); T2 (T1 + 2cc/l Bio-B); and T3 (22% concentrate + 31.5% rice bran + 10% Indigofera sp. meal + 36.5% maize). The collection of digestive tracts was measured by unit/100g. Data were analyzed using ANOVA by SPSS 26. Overall, the treatments did not differ significouldtly in digestive tract size (p>0.05). Treatment T1 showed great size of crop, proventriculus, duodenum, jejunum, cecum, colon, and pancreas sizes compared to T0, T2, and T3. In conclusion, the substitution of 10% Indigofera sp. meal in T1 resulted the best response in Balitbangtan chicken’s digestive tract size.

An exploration of the genetics of the mutant Huntingtin (mHtt) gene in a cohort of patients with chorea from different ethnic groups in sub-Saharan Africa.

Africans are underrepresented in Huntington's disease (HD) research. A European ancestor was postulated to have introduced the mutant Huntingtin (mHtt) gene to the continent; however, recent work has shown the existence of a unique Htt haplotype in South-Africa specific to indigenous Africans. We aimed to investigate the CAG trinucleotide repeats expansion in the Htt gene in a geographically diverse cohort of patients with chorea and unaffected controls from sub-Saharan Africa. We evaluated 99 participants: 43 patients with chorea, 21 asymptomatic first-degree relatives of subjects with chorea, and 35 healthy controls for the presence of the mHtt. Participants were recruited from 5 African countries. Additional data were collected from patients positive for the mHtt gene; these included demographics, the presence of psychiatric and (or) cognitive symptoms, family history, spoken languages, and ethnic origin. Additionally, their pedigrees were examined to estimate the number of people at risk of developing HD and to trace back the earliest account of the disease in each region. HD cases were identified in all countries. Overall, 53.4% of patients with chorea were carriers for the mHTT; median tract size was 45 CAG repeats. Of the asymptomatic relatives, 28.6% (6/21) were carriers for the mHTT; median tract size was 40 CAG. No homozygous carries were identified. Median CAG tract size in controls was 17 CAG repeats. Men and women were equally affected by HD. All patients with HD-bar three who were juvenile onset of <21 years-were defined as adult onset (median age of onset was 40 years). HD transmission followed an autosomal dominant pattern in 84.2% (16/19) of HD families. In familial cases, maternal transmission was higher 52.6% (10/19) than paternal transmission 36.8% (7/19). The number of asymptomatic individuals at risk of developing HD was estimated at ten times more than the symptomatic patients. HD could be traced back to the early 1900s in most African sites. HD cases spread over seven ethnic groups belonging to two distinct linguistic lineages separated from each other approximately 54-16kya ago: Nilo-Sahara and Niger-Congo. This is the first study examining HD in multiple sites in sub-Saharan Africa. We demonstrated that HD is found in multiple ethnic groups residing in five sub-Saharan African countries including the first genetically confirmed HD cases from Guinea and Kenya. The prevalence of HD in the African continent, its associated socio-economic impact, and genetic origins need further exploration and reappraisal.

A Stochastic Production Frontier Analysis of Factors That Affect Productivity and Efficiency of Logging Businesses in Virginia

Abstract Understanding the effect of the relationship between timber harvesting attributes on loggers’ productivity and efficiency is crucial for the feasibility and expansion of sustainable forest management and logging. We applied a stochastic production frontier model to firm-level operational data collected from 202 loggers in Virginia, United States, in 2019. Logging equipment value, physiographic region, tract area, number of workers and crews in the woods, college education level, and harvest type statistically increase harvesting productivity. Harvesting productivity in the Coastal Plain was the greatest of all physiographic regions, and pine clearcut productivity was statistically greater than that of hardwood thinning. On the other hand, manual felling reduces harvesting productivity. We found an average efficiency rate of 67% among firms in our sample, which is similar to that found in the literature. The estimated values can show factors that improve forest harvest productivity through better planning and investments while improving the sustainable use of inputs and resources. Study Implications: We empirically analyzed factors affecting logging productivity and efficiency in the southern US state of Virginia. Increased productivity was associated with working in the Coastal Plain physiographic region, investing in logging equipment, increasing the number of workers and crews in the woods, increasing pine clearcut as opposed to hardwood thinning, choosing optimal harvesting tract size, and having a college education as opposed to no high school degree. Manual felling reduces harvesting productivity, and average BMP implementation time does not affect harvesting productivity. Our results can be used as a guide in planning future decisions to increase logging productivity.

Supine versus prone percutaneous nephrolithotomy in management of patient with complex renal stone diseases.

Compare the surgical outcomes, safety, stone free rate, hospital stay, and complication of prone and supine PCNL in case of complex renal stone. This is an observational study conducted in our institute, it consist of 120 patients over the period of 2 years from July 2021 to June 2023, all the patients were divided into two groups: 60 patients underwent modified supine percutaneous nephrolithotomy (PCNL) and remaining 60 patients underwent standard prone PCNL. The measured data included operative time, number of punctures, blood loss, stone-free rate, length of hospital stays, and rate of complications. The two groups were comparable in mean age, male to female ratio, number of punctures, number of tract, size of tract, residual calculi in follow up period, blood transfusion, re-do surgery, chest complication, hospital stay, and postoperative fever and pain. The mean operating time was 1.59 h in supine PCNL and 2.49 h in prone PCNL. The p value was significant (p = 0.001). By this study we observed that the supine PCNL is associated with statistically significant reduced operating time as compared to conventional prone PCNL with advantages of not putting the patient in prone position. The postoperative complications such as pain and fever were not significant when compared in both groups. We conclude our study and found that, the supine PCNL is an equally effective in treating complex renal stone as compared to prone PCNL.

Predictors of acute kidney injury after percutaneous nephrolithotomy in adult patients: prospective observational study.

To assess the frequency and the predictive factors of Acute Kidney injury (AKI) in patients undergoing percutaneous nephrolithotomy (PNL). A prospective observational work. Demographic, preoperative laboratory data, stone characteristics, and intraoperative and postoperative data were gathered. Perioperative AKI had been defined as an elevation in serum creatinine by ≥ 0.3 mg/dl within 48h, or ≥ 1.5 times baseline, or urine volume less than 0.5ml/ kg/hour for 6hours. A multivariate logistic regression analysis was performed to determine the predictive factors of AKI. ROC curves were utilized to determine the cutoff values of the risk variables. P-values were deemed statistically significant when they were less than 0.05. A total of 418 participants had been involved. The frequency of AKI was 13.9, and 17.2% of patients with AKI developed CKD. The risk factors were age > 46.5 years, smoking, BMI > 28.5 kg/m2, hypertension, diabetes, utilization of angiotensin-converting enzyme inhibitors (ACEI), haemoglobin < 10.8 gm/dl, baseline creatinine > 1.41 mg/dl, eGFR < 65.2 ml/min./1.73 m2, serum uric acid > 5.2 mg/dl, stone volume > 1748 mm3, large tract size, long operative time, and intra-operative bleeding. Patients with AKI had a notably extended duration of hospitalization (3.2 days ± 0.45 vs 2.1 ± 0.42, p < 0.001). Perioperative AKI occurred in 13.9% of individuals undergoing PNL. Identification and optimization of the risk factors and meticulous technique during PNL procedures should be attempted to decrease the risk of AKI.

Percutaneous pulmonary valve implantation in children and adults with an age and gender-specific analysis.

There are limited studies with medium-term follow-up following percutaneous pulmonary valve implantation and no studies with a gender-specific analysis. To report clinical outcomes up to five years following percutaneous pulmonary valve implantation using the two most common balloon expandable valves in a mixed population of paediatric and adult patients with an age and gender-specific analysis. This was a single-centre retrospective observation study. Relevant data were obtained retrospectively from the case files. Age and gender- specific analysis was performed using SPSS. Totally, 58 patients (13 children, 45 adults) underwent percutaneous pulmonary valve implantation. Statistically significant reduction in median right ventricular outflow tract flow velocity following valve implantation was maintained for the whole five years in adults but not in children. There were no gender-specific differences despite the study being adequately powered. Independent of valve type used, there was significant reduction of the right ventricular outflow tract flow velocity in the immediate post valve implantation period (Edwards P = 0.001, Melody P = 0.013). There was a significant negative correlation between implanted valve Z-score and subsequent right ventricular outflow tract gradient during the first two years following valve implantation. Gender does not significantly affect valve function following percutaneous pulmonary valve implantation. It is important to consider patients' age and body surface area in relation to existing right ventricular outflow tract size during decisions for percutaneous pulmonary valve implantation.

Use of High-Frequency Electrical Stimulation in Gastrocutaneous Fistula Closure: A Case Report

Background. Gastrocutaneous fistula is a rare complication following Roux-en-Y gastric bypass, a commonly performed bariatric surgery. While most ECFs respond to conservative management, some do not close despite adequate nutritional support, infection source control, and drainage management. As such, the chronicity of these difficult-to-treat wounds can be physically and economically costly to patients. Case Report. A 53-year-old female with a history of Roux-en-Y gastric bypass developed a gastrocutaneous fistula secondary to a perforated gastrojejunal ulcer, requiring immediate surgical intervention. After being discharged from the hospital, 37 days of conservative management and NPWT did not reduce the size of the fistula tract. To help control the patient’s chronic abdominal pain and increase the rate of wound healing, the patient underwent treatment with HFES (20 kHz) delivered using a handheld transcutaneous electrical nerve stimulator. This electrotherapy was found to reduce the majority of the patient’s pain within the first treatment session. The patient's fistula also began to decrease in size within 1 week of initiating treatment. Conclusion. This case report details the successful closure of a gastrocutaneous fistula after administration of HFES 3 times a week over the course of 25 days. The mechanism of action of HFES and its role in the wound healing process are also discussed.

Comparison of ultrasonographic measures of reproductive tract in Thai swamp buffalo heifers and cows

Although artificial insemination (AI) technology is widely used in buffalo breeding in Thailand, AI in buffaloes has a lower conception rate compared to AI in beef cattle. It is crucial to understand the development of the ovary and reproductive system of buffalo heifers and cows. The objective of the present study was to evaluate the reproductive tract characteristic using ultrasound measurements during the luteal and follicular phases in Thai swamp buffalo heifers and cows. The studies of reproductive tract were conducted in buffalo cows (n=8; BCS=3.38) and heifers (n=8; BCS=3.25). The reproductive tract was evaluated by measuring the size of the ovary, dominant follicle, CL, uterine horn, cervix, and vulva. The buffalo cows had larger diameter of the cervix and vulvar width (P&lt;0.05) compared with those of heifers. In the follicular phase, buffalo cows had a mean ovarian diameter (ipsilateral POF) of 2.35 cm, and heifers had a mean ovarian diameter of 2.24 cm (P&gt;0.05). The average preovulatory follicle diameter was 1.29 cm in buffalo cows and 1.18 cm in heifers (P&gt;0.05). In the luteal phase, the mean ovarian diameter (ipsilateral CL) of buffalo cows was significantly larger than heifers (P&lt;0.05; 2.46 vs. 2.09 cm, respectively). The diameters of the CL in buffalo heifers and cows were 1.27 and 1.47 cm, respectively (P&gt;0.05). Buffalo cows and heifers have no differences in ovarian components in the follicular and luteal phases, but there are differences in the size of the reproductive tract, which reproductive tract of buffalo cows is larger than heifers.

A comparative analysis of the efficacy and safety of mini-percutaneous nephrolithotomy performed in the supine and prone positions for the treatment of pediatric kidney stones: a single-center experience.

Mini-percutaneous nephrolithotomy (MPCNL), which has a smaller tract size (14-20 Fr) than conventional percutaneous nephrolithotomy, has been shown to be safe and effective in pediatric patients with large and complex upper urinary tract stones. This study aimed to compare the efficacy and safety of MPCNL between the supine and prone positions in a pediatric population. The data of pediatric patients who underwent MPCNL at our center between January 2010 and March 2023 were retrospectively analyzed. According to the surgical position, the patients were divided into the prone (Group P) and supine (Group S) groups. In both groups, dilatation was performed using 14-18 Fr metallic dilators. The two groups were compared in terms of perioperative data, postoperative stone-free rates (SFRs), and complications. There were 36 (59%) patients in Group P and 25 (41%) patients in Group S. Stones were mostly located in the pelvis (49.2%) and second most frequently in the lower pole (27.9%). Fluoroscopy time was shorter in Group S but did not statistically significantly differ compared to Group P (p = 0.181). However, operation time was statistically significantly shorter in Group S (73.8 ± 35 vs. 99.8 ± 37.4min, p = 0.008). Although there was no significant difference, relatively higher SFR were detected in Group S (88% vs. 83%, p = 0.725). Endoscopic combined intrarenal surgery (ECIRS) was performed on six (24%) patients in Group S, and the SFR was 100% among these patients. There was no significant difference between the two groups in terms of the presence of complications (16.7% vs. 16%, p = 0.945). Both supine and prone MPCNL appear to be safe and effective in the pediatric age group, with similar stone-free and complication rates. In the supine procedure, the operation time is shortened compared to the prone. In addition, simultaneous retrograde access has the potential to increase the overall success rate of surgery.

Superperc: Minimally-Invasive Percutaneous Nephrolithotomy Initial Experience

Introduction: For the management of renal stones, Percutaneous nephrolithotomy (PCNL) has undergone significant changes in the last few years in the quest for improving efficacy and reducing morbidity. Minimally-invasive modalities of PCNL, such as mini- PCNL, ultra-mini PCNL, and micro-PCNL, have evolved with advancements in optics and technology. However, with these newer advancements, the migration of small fragments produced with laser lithotripsy remains a concern, which may result in incomplete stone clearance. A new technique of PCNL is termed “Superperc” that utilizes suction to remove all the fragments and maintain a one-way flow. Methods: This study involved 35 consecutive patients who underwent PCNL with the Superperc technique from March 2020 to December 2020. Surgery was performed using a pediatric ureteroscope used as a nephroscope and a specially designed sheath with a suction attachment. The Superperc uses a 10/12 F tract size, a specially designed Superperc sheath (Shah Sheath) with a suction mechanism, and a pediatric ureteroscope 4.5/6. Results: The age range is 20-65 years, with 23 males and 12 females. Stone size was 1- 3 cm, and operative time was 30-90 min. Upper calyceal punctures 7cases , 19 had middle, 6 lower calyceal and 3 had two punctures. DJ stent was placed in 7 patients, whereas 28 patients had a ureteric catheter for 24 hours. Only three patients required a nephrostomy tube. No blood transfusion. Postoperatively one patient had a mild fever, and one had transient hematuria. Complete stone clearance as per nephroscopy &amp;fluoroscopy. The hospital stay was 24-72 h. Conclusion: Superperc is a new technique of minimally-invasive PCNL and can be successfully done with minimal modification in the armamentarium, with the potential advantage of good stone clearance. Bangladesh J. Urol. 2022; 25(2): 71-75

Comparison between different radiological scoring systems in predicting post-PCNL outcome

Background: Various scoring systems, including Guy's stone score (GSS), S.T.O.N.E. score, and Clinical Research Office of the Endourological Society (CROES) nomogram, have been assessed for predicting post-percutaneous nephrolithotomy (PCNL) success in terms of stone-free status (SFS) and complications. Our study aims to determine the optimal predictor of SFS among these systems and assess their efficacy in predicting perioperative factors and complications, using modified Clavien grade. Methods: This prospective hospital-based cohort study involved 107 patients aged ≥18 years who underwent standard PCNL (tract size &gt;24 Fr) within a year. GSS, S.T.O.N.E. score, and CROES nomogram were calculated using preoperative computed tomography (CT) scans. Comparisons between 'stone-free' and 'residual-stone' groups were statistically analyzed. Results: All parameters effectively predicted SFS. S.T.O.N.E. score exhibited excellent discriminatory power (AUC 0.844; 95% CI: 0.762-0.907), followed by GSS (AUC 0.756; 95% CI: 0.663-0.834) and CROES nomogram (AUC 0.749; 95% CI: 0.656-0.828). S.T.O.N.E. score, with an AUC of 0.844, proved the most accurate predictor at ≤7 cut-off. GUY's score correlated positively with operative time and hospital stay (correlation coefficient 0.403, 0.34). S.T.O.N.E. score also positively correlated with these factors (correlation coefficient 0.443, 0.37). CROES nomogram negatively correlated with operative time and hospital stay (correlation coefficient -0.374, -0.314). Conclusions: All scoring systems effectively predict post-PCNL SFS, with S.T.O.N.E. score being the most predictive. GSS and S.T.O.N.E. score associate significantly with operative time and hospital stay. Both GSS and S.T.O.N.E. score show significant associations with perioperative complications assessed by modified Clavien grade.