Transcription of message for tumor necrosis factor-alpha by lacrimal gland is regulated by corneal wounding.
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Animals↗
Biomedical subjects
D H Nguyen
Publications and source records attributed to D H Nguyen.
Lung manganese superoxide dismutase increases during cytokine-mediated protection against pulmonary oxygen toxicity in rats.
Parenteral injection of the cytokines interleukin-1 and tumor necrosis factor, or of endotoxin (lipopolysaccharide), protects rats against lethal pulmonary oxygen toxicity. To determine the potential importance of manganese superoxide dismutase (MnSOD) in this model, we measured MnSOD mRNA and activity in lung. In addition, we confirmed that increases in activities were related to changes in MnSOD protein, which was measured using an enzyme-linked immunosorbentassay (ELISA) technique. After cytokine or endotoxin administration, increases in lung MnSOD mRNA occurred promptly (4 h), with or without hyperoxic exposure. In parallel, lung MnSOD protein and activity were increased after 24 h, and protein levels remained elevated after 52 h. MnSOD activity and protein levels were closely correlated. Neither lung copper-zinc superoxide dismutase (CuZnSOD) mRNA nor activity increased following administration of cytokines. Small increases in CuZnSOD mRNA, which did not exceed those in beta-actin mRNA, occurred early (4 h) after endotoxin, but CuZnSOD activity was unchanged. Immunohistochemistry was used to demonstrate in which cell types the increase in MnSOD protein occurred after cytokine or endotoxin administration. In agreement with ELISA findings, immunoreactive MnSOD appeared to be increased in lung parenchyma, but not in lung neutrophils, 24 h after cytokine or endotoxin treatment. MnSOD was heavily concentrated in alveolar type II cells. However, the numbers of surfactant protein D-positive (type II) cells in lung sections did not appear to be increased after treatment with cytokines or endotoxin. We conclude that early and sustained increases in endogenous MnSOD, but not CuZnSOD or other antioxidant enzymes, are associated with protection of rat lungs against hyperoxic damage by cytokines or endotoxin.
Actins↗
Long-term evaluation of immune status in leprosy patients undergoing multiple drug therapy.
A long-term survey of leprosy patients of all clinical types, starting at the time of diagnosis, was carried out to monitor clinical, bacteriological and immunological parameters at regular intervals during multiple drug therapy (MDT). The patients were assigned to two groups for treatment following WHO guidelines: paucibacillary (PB) and multibacillary (MB). Immunoglobulin levels, specific antibodies, skin-test responses to different soluble mycobacterial antigens (new tuberculins), and in vitro proliferative responses to mitogens and to antigens were measured during treatment, as were clinical changes, the bacterial index, and clinical improvement. No exact relations between disease activity and IgM antibody levels, both IgM immunoglobulin and specific IgM antibody to a species-specific antigen (ND-O-BSA), could be seen for MB patients. Changes in in vitro cell-mediated immunity and skin-test response seemed to be more directly related to the bacterial load and could reflect the improvement of bacteriological and clinical parameters during MDT.
Agglutination Tests↗
Expression of manganese superoxide dismutase is not altered in transgenic mice with elevated level of copper-zinc superoxide dismutase.
In evaluating the relative expression of copper-zinc and manganese superoxide dismutase (CuZnSOD and MnSOD) in vivo in states like Down syndrome in which one dismutase is present at increased levels, we measured activities of both enzymes, in tissues of control and transgenic mice constitutively expressing increased levels of CuZnSOD, during exposure to normal and elevated oxygen tensions. Using SOD gel electrophoresis assay, CuZnSOD and MnSOD activities of brain, lung, heart, kidney, and liver from mice exposed to either normal (21%) or elevated (> 99% oxygen, 630 torr) oxygen tensions for 120 h were compared. Whereas CuZnSOD activity was elevated in tissues of transgenic relative to control mice under both normoxic or hyperoxic conditions, MnSOD activities in organs of transgenic mice were remarkably similar to those of controls under both conditions. To confirm the accuracy of this method in quantitating MnSOD relative to CuZnSOD expression, two other methods were utilized. In lung, which is the organ exposed to the highest oxygen tension during ambient hyperoxia, a sensitive, specific ELISA for MnSOD was used. Again, MnSOD protein was not different in transgenic relative to control mice during exposure to air or hyperoxia. In addition, lung MnSOD protein was not changed significantly by exposure to hyperoxia in either group. In kidney, a mitochondrion-rich organ, SOD assay, before and after inactivation of CuZnSOD with diethyldithiocarbamate, was used. MnSOD activity was not different in organs from air-exposed transgenic relative to control mice. The data indicated that expression of MnSOD in vivo was not affected by overexpression of the CuZnSOD and, therefore, the two enzymes are probably regulated independently.
Animals↗
The syndrome of dysuria and hematuria in pediatric urinary reconstruction with stomach.
Between July 1989 and March 1992 at a single institution 27 male and 30 female patients underwent lower urinary reconstruction with stomach. Mean patient age was 9.9 years (range 1.5 to 28 years). The diagnoses were epispadias/exstrophy complex (19 patients), myelodysplasia (11), cloacal exstrophy (6), posterior urethral valves (6), Hinman syndrome (4), sacral agenesis (3) and other (8). Indications for surgery were urinary incontinence, upper tract deterioration or undiversion. A total of 54 patients underwent augmentation gastrocystoplasty and 3 had total bladder replacement. Mean followup time was 23.2 months (range 12 to 39 months). The syndrome of dysuria and hematuria is defined as 1 or a combination of the following symptoms: bladder spasm or suprapubic, penile or periurethral pain, coffee brown or bright red hematuria without infections, skin irritation or excoriation and dysuria without infections. Telephone and clinic interviews identified 21 patients (36%) with symptoms of the dysuria and hematuria syndrome. The most common symptoms were hematuria (71%) and bladder or suprapubic pain (76%). Of the patients 18 (86%) ranked the severity of symptoms as mild to moderate and 3 (14%) ranked them as severe. No medications were required to control the symptoms in 13 patients (62%) and 3 other patients only required medications on an as needed basis. Overall patients who required no medications had lower symptom scores than those who required medications. Patients with decreased renal function may be more at risk for the dysuria and hematuria syndrome than those with normal renal function. Patients who were wet were more prone to have the dysuria and hematuria syndrome than those who were totally dry. The pathophysiology of the dysuria and hematuria syndrome is currently unknown. Patients who require urinary reconstruction with stomach tissue need to be made aware of the potential of the dysuria and hematuria syndrome.
Adolescent↗
The use of the AMS800 artificial urinary sphincter in combination with the gastric tube for continence in the canine model.
An experimental canine model was designed to examine the potential use of the artificial urinary sphincter around a gastric tube. The artificial urinary sphincter was placed around a tubularized gastric flap as part of a continent gastric reservoir in 4 dogs and in 2 additional dogs the gastric tube was anastomosed to the native bladder. Two dogs underwent placement of the artificial urinary sphincter around the gastric tube 4 weeks postoperatively and the remainder had the sphincter placed simultaneously with creation of the gastric tube. All dogs with the gastric reservoir underwent urodynamics before and after activation of the sphincter. Only 61 to 70 cm. water pressure balloons were used. All dogs were continent postoperatively on clean intermittent catheterization every 8 hours. There were no erosions or problems with catheterization. Urodynamics confirmed a complaint system and an average increase of capacity of 410% after artificial urinary sphincter activation (4 dogs). There was no leakage at capacity. Histology of the artificial urinary sphincter and neighboring (control) regions, and of the reservoir at 1 (2 dogs), 3 (3 dogs) and 6 months (1 dog) was obtained. Microscopic examination of the cuff site showed mild serosal hyperplasia and fibrosis, a well preserved muscularis and mild to moderate focal mucosal atrophy. These changes were slightly more evident at 6 months. Mucosal folds were well preserved with normal submucosa and lamina propria. In the control region histology was well preserved and similar to native stomach. We conclude that the artificial urinary sphincter around a gastric tube can provide urinary continence. The minimal changes in histology under the cuff are encouraging and support the potential for use of the gastric tube with the artificial urinary sphincter, although longer term effects are unknown.
Animals↗
Ureteral obstruction due to compression by the vas deferens following Fowler-Stephens orchiopexy.
A rare complication following a difficult unilateral 1-stage Fowler-Stephens orchiopexy resulting in ipsilateral distal ureteral obstruction is reported. To our knowledge excessive vasal traction during orchiopexy causing partial obstruction at the ureterovesical junction has not been previously described. The complication arose when the transected spermatic vessels allowed tension to be placed solely on the vas when the testis was placed in the scrotum. The vas in turn compressed the ureter during bladder filling.
Child, Preschool↗
Lower urinary tract reconstruction using stomach and the artificial sphincter.
We implanted the artificial urinary sphincter at gastrocystoplasty in 13 male and 5 female patients. The diagnoses were classical bladder exstrophy (8 patients), myelodysplasia (8), cloacal exstrophy (1) and bilateral ectopic ureters (1). Mean patient age was 14.3 years (range 7 to 32.5). Six patients (5 with bladder exstrophy and 1 with clocal exstrophy) had failed bladder neck continence procedures, 3 myelodysplastic patients had failed artificial urinary sphincter placement, and 1 exstrophy patient had failed a Young-Dees bladder neck repair and artificial urinary sphincter placement. The sphincter cuff was placed around the reconstructed bladder neck in these patients, while in the remainder the artificial urinary sphincter was placed around the intact bladder neck. Mean followup was 20.3 months (range 1 to 5). Of the patients 16 (88%) are continent day and night, while 2 are wet. A total of 11 patients (61%) use Valsalva's maneuver alone for voiding and the remainder use Valsalva's maneuver and/or clean intermittent catheterization for bladder evacuation. Complications related to the artificial urinary sphincter were recurrent pump erosion requiring conversion to a Mitrofanoff continent stoma in 1 patient, and mechanical dysfunction requiring pump cuff and reservoir replacement in 3. There were no complications due to infection. Our report demonstrates that the combination of augmentation gastrocystoplasty and an artificial urinary sphincter leads to urinary continence and can allow for spontaneous urination. The rate of infectious complications is not increased when the 2 procedures are combined simultaneously.
Adolescent↗
[The problem of cataract extraction in Vietnam].
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Cataract Extraction↗
Intraoperative cardiovascular collapse secondary to latex allergy.
An apparent allergic reaction has been noted in children undergoing open urological surgery. This condition is characterized by precipitous hypotension, tachycardia and upper body flushing, and it often causes termination of the procedure. Latex allergy has been identified as the possible inciting event. Contact of latex rubber gloves with intra-abdominal structures (handling bowel) appears to be the most dramatic trigger mechanism for this reaction. We report on 10 patients with latex allergy, 6 of whom have myelomeningocele, who have undergone reconstructive surgery. Severe anaphylactic shock developed intraoperatively in 5 patients and during a barium enema performed with a latex catheter in 1 patient. These 6 patients had previous allergic reactions to latex material, which was not detected preoperatively. In the remaining 4 patients latex allergy was diagnosed preoperatively. A total of 6 patients agreed to a skin prick test to liquid latex. Three patients reacted with a wheal size greater than or equal to a histamine control at a dilution of 1:1,000 and 3 patients at 1:100. In contrast, none of the 5 normal controls reacted to any of the concentrations including full strength latex. A history of exposure to latex products (balloons, surgical gloves, catheters, condoms and so forth) with allergic reactions should heighten surgeon awareness of a potentially severe intraoperative reaction. Furthermore, a skin prick test may be used to screen high risk patients such as those with myelomeningocele. A protocol involving preoperative corticosteroid and antihistamine therapy is recommended.
Adolescent↗
Prevention and treatment of trachoma and the anti-blindness program.
The author considers the main causes of blindness in VIETNAM which are a little different from the studies of W.H.O. These are: 1. Trachoma. 2. Avitaminosis A. 3. Senile cataract. 4. Glaucoma. 5. Eye injuries in workers and in current life. For each cause, the author considers the efforts. Which are already made and which be made in the future. In case of trachoma, the author hopes that it will be eradicated in the year of 2000.
Blindness↗
Gastric bladder reconstruction.
Overall, stomach is an ideal tissue that is readily accessible for bladder augmentation or substitution. It has excellent muscle backing for antireflux and continence procedures. Its fibroelastic characteristics allow construction of a capacious and compliant reservoir. It has special merit in patients who have been irradiated by virtue of being rarely involved in the field of radiation; in patients with short bowel, because it usually is not associated with congenital abnormalities of the gastrointestinal tract; in patients with renal compromise and metabolic acidosis, because of its ability to secrete chloride and hydrogen ions; in patients with chronic urinary infections; and in patients with difficulty with catheterization because of excessive mucus.
Acidosis↗
Outcome of renal transplantation after urinary diversion and enterocystoplasty: a retrospective, controlled study.
A total of 17 patients with intestinal urinary diversion of enterocystoplasty underwent renal transplantation between 1970 and 1988. Patient age ranged from 4 to 35 years (mean age 20 years). The patients were divided into 2 groups. In group 1 (10 patients, 2 of whom required retransplantation) the ureter of the transplanted kidney was implanted into an ileal (7) or colonic (1) conduit or enterocystoplasty (2). In group 2 (7 patients, 1 of whom required a second transplant) the diversion was taken down and the transplanted ureter was implanted into the defunctionalized bladder. There were 14 living related and 6 cadaveric kidneys transplanted. Graft survival rates were 58 and 87% in groups 1 and 2, respectively, with an over-all rate of 70% (14 of 20 kidneys). There was no statistical difference in the graft survival rate between the 2 groups. The complications in group 1 included ureteroileal anastomotic leak (3 patients), ureteroileal stenosis (1), calculus formation (1), urosepsis (1), hyperchloremic metabolic acidosis (1), and wound infection and dehiscence (1). There were no complications in group 2. Renal transplantation into a pre-existing urinary intestinal conduit or augmented bladder does not statistically adversely affect patient or graft survival. However, the complication rate is much higher when the ureter is implanted into an intestinal segment. Therefore, it is preferable whenever possible to implant the ureter into the native bladder.
Adult↗
Compatibility of enterocystoplasty and the artificial urinary sphincter.
Placement of the artificial urinary sphincter during augmentation enterocystoplasty may lead to infection, erosion and eventual removal of the device. To assess compatibility of artificial urinary sphincter implantation and enterocystoplasty we reviewed the records of 30 patients who had undergone enterocystoplasty and artificial urinary sphincter placement simultaneously (11), enterocystoplasty before artificial urinary sphincter placement (12) and artificial urinary sphincter placement before enterocystoplasty (7). The 19 male and 11 female patients were between 4 and 42 years old (median age 13.5 years). Followup in 28 patients ranged from 6 months to 8 years (average 17 months). Incontinence resulted from myelodysplasia in 16 patients, sacral agenesis in 3, spinal cord injury in 6, posterior urethral valves in 1, bilateral ectopic ureters in 1 and epispadias-exstrophy in 3. Erosion occurred in 2 patients (7 per cent): 1 female patient who underwent simultaneous sphincter implantation and enterocystoplasty and who had undergone previously many bladder neck reconstructive procedures, including polytetrafluoroethylene (Teflon) injection, and 1 female patient in whom the augmented bladder was entered at artificial urinary sphincter implantation. Mechanical failure occurred 4 times in 3 patients and the artificial urinary sphincter was improperly placed in 1. Over-all continence rate was 87 per cent (26 of 30 patients). Simultaneous placement of the artificial urinary sphincter and enterocystoplasty did not seem to affect the outcome of sphincter implantation if good bowel preparation, intravenous antibiotics and sterility of urine were accomplished preoperatively. Entering the augmented bladder during sphincter implantation may predispose to infection and erosion.
Adolescent↗
Nonintubated Anderson-Hynes repair of ureteropelvic junction obstruction in 60 patients.
We reviewed our experience with 68 consecutive Anderson-Hynes ureteropyeloplasties. The 64 infants, children and young adults ranged from 2 days to 28 years old (median age 2 years), and 28 were less than 1 year old. Intubation was used in only 4 patients: 2 who also underwent ureteral reimplantation for vesicoureteral reflux, 1 with stones in the renal pelvis and 1 with pyonephrosis. We successfully repaired 60 of 64 nonintubated renal units (93.4 per cent). Temporary postoperative ureteral stenting was required for extravasation from 8 renal units (12.5 per cent). Two patients later underwent repeat ureteropyeloplasty for recurrent obstruction. Nephrectomy was performed for pyonephrosis in 1 patient and for a nonfunctioning kidney that had exhibited poor function preoperatively in 1. Prolonged ileus necessitated extended hospitalization in 3 patients (4.6 per cent). We conclude that nonintubated dismembered ureteropyeloplasty for uncomplicated, primary ureteropelvic junction obstruction can be performed safely and successfully, and should be considered the standard treatment. Positioning of the Penrose drain is critical to avoid urinoma formation. When persistent urinary leakage occurs temporary diversion is easy and well tolerated. Hospital stay averaged 12.1 days for patients with extravasation compared to 4.3 days when no extravasation occurred. Immediate preoperative retrograde pyelography did not seem to contribute to postoperative urinary extravasation by causing edema of the ureteral orifice.
Adolescent↗
Retroiliac ureter in a male newborn with multiple genitourinary anomalies: case report and review of the literature.
We report a case of a male newborn with unilateral retroiliac ureter, ectopic left vas deferens, ectopic ureters and imperforate anus. A review of the urological literature has revealed only 2 other instances of an association of anomalies similar to that in our patient.
Anus, Imperforate↗
Role of the surgeon in the treatment of children's cancer.
The management of children's tumors has changed significantly in the past several years. New techniques and combined surgical, chemotherapeutic, and radiation approaches are responsible for improved survival in most instances. Cooperation of the surgeon with the specialists in separate disciplines is imperative to continued advancements in neoplastic disease of childhood.
Adolescent↗
Serum immunoglobulins, including IgG subclasses, in Vietnamese leprosy patients.
Levels of serum immunoglobulins were measured in healthy Vietnamese and in leprosy patients. Healthy Vietnamese had higher levels of IgG, IgA, IgM, and IgE than did healthy Dutch controls, as well as higher levels of three of the four subclasses of IgG (IgG1, IgG2, IgG3). Lepromatous leprosy patients had significant increases in all classes and subclasses of immunoglobulins, except for IgG2, in comparison with local controls. Tuberculoid leprosy patients had more IgG1, IgG3, and IgG4 than did local controls and had higher total IgG levels. The patients had no increase in autoantibodies against tissue antigens compared to local or Dutch controls.
Autoantibodies↗