Long-term follow-up of total penile reconstruction with sensate osteocutaneous free fibula flap in 18 biological male patients

Surgical reconstruction of the penis is challenging because of the many cosmetic and functional (e.g., sexual intercourse and voiding) requirements that must be addressed. Since the free sensate osteocutaneous fibula flap was first described for total penile reconstruction in 1993 it has been widely accepted, with its advantages and minimal shortcomings. In this article, the authors present the longest follow-up of biologically male patients with free fibular phalloplasties. Since 1994, 18 biologically male patients with total penile losses for various reasons were treated with free sensate osteocutaneous fibula flaps. All patients were included in the study. The ages of the patients ranged between 20 and 26 years (mean, 22.2 years). The average follow-up period was 5.4 years (range, 1 to 9 years). Patient satisfaction was evaluated by a questionnaire regarding both quality of orgasm and daily activities. Conventional radiographic imaging, magnetic resonance imaging, and bone mineral densitometry were performed to evaluate the fate of the bony component of the flap. Also, sensibility was evaluated by bulbocavernous reflex and penile somatosensory evoked potentials testing in nine patients. Six patients married, and five of them had six children. Most patients and their partners reported pleasurable sexual intercourse and orgasm. Conventional radiographs of the fibular bone in neophalluses showed robust, calcified bone structure without any evidence of bone resorption or fracture. The magnetic resonance images showed the cortical substance and spongiosum of the bone marrow, which are characteristic signs of bone viability. After intravenous injection of gadolinium, the neophallus bone showed uptake of contrast medium. Viability of neophallus bone was shown even at 9-year follow-up (the longest follow-up in the literature). Dual energy x-ray absorptiometry measurements of the penile bone grafts showed that fibular components in the penis had bone mineral density values that were close to but lower than those of intact fibula in the same subjects. These results were considered as evidence of viability of bone grafts. Neural integrity was found between the nerves of the neophallus and the residual penile bodies by both bulbocavernous reflex and penile somatosensory evoked potentials tests. In conclusion, free sensate fibula flap phalloplasty provides the cosmetic and functional requirements that an ideal penis should have. All results put an end to the discussion that the fibular component of the neophallus could resorb. Constitution of neural integrity is important in terms of pleasurable sexual intercourse. The authors believe the free sensate osteocutaneous fibula flap should be considered as the standard in penile reconstruction.     

Somatic embryogenesis and plant regeneration through leaf culture in <Emphasis Type="Italic">Arachis glabrata (Leguminosae)</Emphasis>

Plants of two accessions of Arachis glabrata were regenerated via somatic embryogenesis. Embryogenic calli were initiated from leaflet explants on Murashige and Skoog medium supplemented with picloram alone or picloram in combination with 6-benzylaminopurine. Leaflets of accession A6138 induced the highest percentage of somatic embryos in media composed of 10 mg dm⁻³ and 15 mg dm⁻³ picloram. In contrast, 5 mg dm⁻³ picloram with 0.1 mg dm⁻³ 6-benzylaminopurine was one of the most effective combinations in accession AF385. MS medium supplemented with 2 g dm⁻³ activated charcoal (AC) used for 30 days was the most effective for embryo maturation. After 20 days of culture on MS medium devoid of growth regulators, 6 % of embryos converted into plantlets in accession A6138.     

Experimental studies on bacterial product cantastim derived from Pseudomonas aeruginosa. VI. Protection in tolerant mice

Endotoxin tolerance is defined as a hyporesponsiveness state to a second stimulation with lipopolysaccharide (LPS). This refractory state is primarily associated with an attenuated cytokine production. Whether this down-regulation of cytokine production results in an increased susceptibility to infection remains a matter of controversy. The aim of this study was to investigate the resistance of tolerant mice to a subsequent bacterial infection and the role of bacterial immunomodulator CANTASTIM (CS) in this experimental model. We have shown that the LPS-tolerant mice (intraperitoneally inoculated with LPS Salmonella typhimurium 10 microg/mouse, daily for two days) were protected against a challenge with Pseudomonas aeruginosa (LD 100) administered 24 h later. On the contrary, when the animals were challenged 1 h after the last LPS injection, they did not survive. However if these animals were pre-treated with CS 3 days before LPS treatment, they became resistant to a subsequent bacterial challenge. More interestingly, if the treatment with LPS was substituted with CS (same schedule, route of administration and doses) there was a significant increase in the survival of mice challenged with Pseudomonas aeruginosa after either 1 h or 24 h. In this case, the increase in the rate of survival was correlated with an enhanced production of IL-10 in the peritoneal cavities of CS treated mice as compared to LPS treated mice.     

Cheese whey: an alternative growth and protective medium for<Emphasis Type="Italic"> Rhizobium loti</Emphasis> cells

Cheese whey (CW)-based growth medium efficiently protects Rhizobium loti cells during freezing and desiccation and can maintain their growth in a manner similar to that of traditional mannitol-based medium (YEM). The cheese-whey-based medium (CW) improved viability when used to re-suspend cell pellets kept at –20 °C and –80 °C and resulted in the survival of over 90% of the cells. Moreover, bacterial pellets obtained from cells grown in CW withstand desiccation better than cells grown in YEM. Survival was over 60% after 30 days at 4 °C. No differences were observed in nodulation efficiency between YEM-grown and CW-grown cells. Fast protein liquid chromatography (FPLC) protocols are presented for total protein profile analyses of sweet and acid cheese whey.In memoriam of Sylvio Cortina Vicepresident of Fundación COREPRO     

Breeding biology and social behaviour of Magellanic Woodpeckers (<Emphasis Type="Italic">Campephilus magellanicus</Emphasis>) in Argentine Patagonia

The Magellanic Woodpecker (Campephilus magellanicus) is a poorly known species endemic of the Austral Temperate Forests of South America, where it is a potential keystone habitat modifier. Here, I summarize data on the social and breeding biology of this woodpecker, based on 22 active nests located from 1998–2002 in forests from northwestern Argentine Patagonia. Woodpeckers normally traveled in pairs or family parties. In late Austral winter, one to three cavities were selected for completion at each territory. Breeding occurred between mid- to late spring and early to mid-summer, and took about 65 days. Monogamous parents shared duties in nest excavation, incubation and young rearing. Egg length (±SD) measured 34.13±0.79 mm and egg breadth 23.91±0.67 mm, and incubation took roughly 20 days. Nestlings were altricial and remained at the nest for about 45 days. Clutch size was one, occasionally two eggs, and one nestling was produced at all successful nests. Young remained with their family group for up to 2 years or more, and were fed by adults, who normally bred every second year. Nest re-use, nest predation and helpers at the nest were not recorded. Holes were placed (±SD) 8.84±3.71 m high and were 32.3±5.32 cm deep. Entrances (±SD) were 8.92±0.46 cm wide and 15.59±2.54 cm high and mostly oval in shape. Peculiarities of the breeding biology and social behaviour of this species are discussed in the light of patterns common to picids, especially Campephilus spp.     

Levels of superoxide dismutase and malondialdehyde in primary spontaneous pneumothorax

The aim of the present study is to determine whether patients with primary spontaneous pneumothorax (PSP) are subject to oxidative stress. For this purpose, we measured the activities of red blood cell superoxide dismutase, which is an antioxidant enzyme, and the level of plasma malondialdehyde, which is one of the lipid peroxidation markers, in a group of patients with PSP. The study was carried out with 16 patients with PSP and 24 healthy individuals. The two groups were similar to each other in terms of sex, age and smoking attitudes. Erythrocyte superoxide dismutase activity was found to be significantly lower in patients with PSP than in the control group (p < 0.01). The plasma malondialdehyde levels were significantly high in patients with PSP (p < 0.01). Our results suggest that oxidative stress may contribute to the pathogenesis of PSP.     

A review of 35 cases of asymmetric crying facies

A review of 35 cases of asymmetric crying facies: Congenital asymmetric crying facies (ACF) is caused by congenital hypoplasia or agenesis of the depressor anguli oris muscle (DAOM) on one side of the mouth. It is well known that this anomaly is frequently associated with cardiovascular, head and neck, musculoskeletal, respiratory, gastrointestinal, central nervous system, and genitourinary anomalies. In this article we report 35 ACF patients (28 children and 7 adults) and found additional abnormalities in 16 of them (i.e. 45%). The abnormalities were cerebral and cerebellar atrophy, mega-cisterna magna, mental motor retardation, convulsions, corpus callosum dysgenesis, cranial bone defect, dermoid cyst, spina bifida occulta, hypertelorism, micrognatia, retrognatia, hemangioma on the lower lip, short frenulum, cleft palate, low-set ears, preauricular tag, mild facial hypoplasia, sternal cleft, congenital heart defect, renal hypoplasia, vesicoureteral reflux, hypertrophic osteoarthropathy, congenital joint contractures, congenital hip dislocation, polydactyly, and umbilical and inguinal hernia. Besides these, one infant was born to a diabetic mother, and had atrial septal defect and the four other children had 4p deletion, Klinefelter syndrome, isolated CD4 deficiency and Treacher-Collins like facial appearance, respectively Although many of these abnormalities were reported in association with ACF, cerebellar atrophy, sternal cleft, cranial bone defect, infant of diabetic mother, 4p deletion, Klinefelter syndrome, isolated CD4 deficiency and Treacher-Collins like facial appearance were not previously published.