Buccal mucosal graft urethroplasty in male cats with traumatic complete urethral rupture

OBJECTIVE To evaluate the feasibility of buccal mucosal graft urethroplasty for repairing complete urethral rupture in cats. ANIMALS 15 male domestic shorthair cats with traumatic complete urethral rupture. PROCEDURES In each cat, a section of buccal mucosa was harvested, sutured, and formed into a tubule by use of an 8F indwelling catheter as support. This tubular graft was connected to both ruptured ends of the urethra to renew the urinary passage. The catheter was left in place until the absence of leakage was confirmed by positive contrast retrograde urethrography. After spontaneous urination was confirmed, cats were discharged from the hospital. Six months later, urethrography was repeated and owners were asked to score their cats’ urinary function and quality of life. RESULTS 13 cats recovered well following surgery, with no complications in the oral cavity or surgical site and no signs of difficulty or discomfort when urinating. Urethrography 2 weeks and 6 months after surgery revealed no stricture or leakage in the abdominal cavity. The 2 remaining cats developed a urethral stricture and underwent second surgery with a successful outcome. At the 6-month follow-up, 14 cats had only mild urinary signs, and 1 cat had incontinency. Owners indicated they were delighted (n = 14) or pleased (1) with their cats’ quality of life. CLINICAL RELEVANCE Buccal mucosa was found to be a good source of graft tissue for performance of urethroplasty in male cats, yielding satisfactory outcomes with few postoperative complications. The described technique may be suitable for severe and complicated cases of urethral rupture in male cats.

Effects of Display and Ambient Illuminance on Visual Comfort for Reading on a Mobile Device

A psychophysical experiment was carried out to investigate visual comfort when reading on three OPPO Find X3s displays at three luminance levels (100, 250 and 500 cd/m2) at five illuminance levels (0, 10, 100, 500 and 1000 lx). Twenty young observers evaluated visual comfort using a 6-category points method. The results showed that observers felt most comfortable at the illuminance of 500 lx or display luminance of 500 cd/m2. There was an interaction between ambient illuminance and display luminance. High ambient light and display brightness levels provide a more pleasant visual experience. In low ambient light, however, the lower the brightness level, the more comfortable it is to see. Regarding the influence of background colour on visual comfort, the observers felt more comfortable having a grey background than white or black colour. When at dim illuminance, the background colour would have a great influence on visual comfort for negative contrast conditions, but when at higher illuminance, different background lightness levels had a great impact on visual comfort for positive contrast conditions. The above findings are very similar to the display luminance levels of 100 and 250 cd/m2.

Ischiocavernosus Muscle Release for Urethral Obstruction Treatment after Pelvic Symphyseal Distraction Osteotomy in a Cat with Pelvic Stenosis

Symphyseal distraction osteotomy (SDO) with a polymethyl methacrylate (PMMA) spacer is an effective surgical treatment for cats with pelvic stenosis. This study reports the successful treatment of urethral obstruction due to ischiocavernosus muscle (IM) tension after SDO with a PMMA spacer. A 2-year-old castrated male Korean domestic shorthair feline had megacolon and pelvic canal stenosis. The ratio of the maximal diameter of the colon to the L5 length and the pelvic canal diameter ratio were 1.6 and 0.45, respectively. Pelvic SDO was performed with a PMMA spacer, leading to pelvic canal enlargement (pelvic canal diameter ratio: 0.73). Two days after surgery, dysuria was identified immediately after removing the preoperatively placed urinary catheter. Complete blood counts and serum biochemical profiles were within the reference intervals, and a positive contrast retrograde urethrogram confirmed urethral obstruction at the level of the membranous–pelvic urethra region. Increased tension of the IM leading to a narrowed urethra was suspected as the cause of urethral obstruction. After IM release at the level of origin on the ischium, the patient had an uneventful recovery with spontaneous urination. Muscle release resulted in excellent functional restoration, with no intraoperative or postoperative complications reported during the 12-month long-term follow-up. Therefore, SDO with IM release could be a feasible therapeutic option for severe pelvic stenosis without complications, such as urethral obstruction, in cats.

Tracking the fates of iron-labeled tumor cells in vivo using Magnetic Particle Imaging

The use of imaging to detect and monitor the movement and accumulation of cells in living subjects can provide significant insights that can improve our understanding of metastasis and guide therapeutic development. For cell tracking using Magnetic Resonance Imaging (MRI), cells are labeled with iron oxides and the effects of the iron on water provides contrast. However, due to low specificity and difficulties in quantification with MRI, other modalities and approaches need to be developed. Magnetic Particle Imaging (MPI) is an emerging imaging technique which directly detects magnetic iron, allowing for a specific, quantitative and sensitive readout. Here, we use MPI to image iron-labeled tumor cells longitudinally, from implantation and growth at a primary site to movement to distant anatomic sites. In vivo bioluminescent imaging (BLI) was used to identify tumor metastases and computed tomography (CT) allowed for correlation of these signals to anatomic locations. These three imaging modalities provide information on immune escape and metastasis of iron-labeled, and unlabeled, tumor cells, and the accumulation of cell-free iron contrast over time. We identified iron signals by MPI and tumor cells via BLI, and correlated these positive contrast images with CT scans to reveal the anatomic sites with cancer cells; histologic analysis confirmed the presence of iron-labeled tumor cells in the tissues, suggesting that the metastatic cells retained enough iron for MPI detection. The use of multi-modality cell tracking reveals the movement, accumulation and fates of labeled cells that will be helpful understanding cancer progression and guiding the development targeted therapies.

Video Capsule Endoscopy In Comparison To Radiological Examination In Detection Of Small Bowel Lesions

BACKGROUND Small bowel obscured its lesions as secrets which were difficult to diagnose before video capsule endoscopy as a new modality for investigation. Aim of the study Evaluation of video capsule endoscopy in comparison to radiological examination in detection of small bowel lesions. Patients and methods Fifty patients were recruited from Kafrawy Video Capsule Endoscopy Unit of Internal Medicine Department and endoscopy unit of Ain Shams University Hospital. The study included patients with occult or overt GIT bleeding, patients with unexplained microcytic iron deficiency anemia, patients with chronic diarrhea and abdominal pain, with normal upper GI endoscopy and colonoscopy. Exclusion of any patient younger than 18 years old, has intestinal stricture, achalasia, or dysphagia. All patients were studied biochemically with CBC and radiological by CT pelvis and abdomen with IV and oral positive contrast some of them were radiologically examined with CTE or CT mesenteric angiography. All patients were endoscopically examined by OGD, colonoscopy, VCE, and some of them were examined also with enteroscope. Results The study revealed that the detection rate of SB lesions with VCE was 84%. In the current study, (44%) of cases had AVMs, (72.73) % of them were above the age of forty five, and (27.27) % were below the age of forty five. All patients who were investigated with CT mesenteric angiography revealed negative results. In this study (20) % of patients had SB masses and polyps, (70) % of them were at age of forty five or more and only (30) % of them were below the age of forty five. All patients underwent CT pelvis and abdomen with IV and oral positive contrast, and we found that all patients had a negative results regarding the SB lesions. In comparison between CTE and VCE in detection of SB vascular lesions CTE did not detect SB vacular lesions. On the other hand, VCE detected the AVMs in the cases with negative CTE results. In this study one patient (2)% was diagnosed with hookworm infection. All patient underwent for OGD. We found that (20)% of patients had a significant gastric or duodenal lesions (proximal to the papilla) by VCE but missed by upper GI endoscopy. In our study the concomitant of VCE and enteroscope increase the detection of SB vascular lesions than isolated use of VCE only. Conclusion VCE has a high detection rate of SB lesions (84)%. CTE has a low significance in detection of SB vascular lesions and CT mesenteric angiography sensitivity relatively low. AVMs more common with increasing the age. PHE and SB ectopic varicies, were found to be common causes of GIT bleeding in CLD patient. There is a significant rate of missed gastric and duodenal (proximal to the papilla) lesions that the cause of GIT bleeding and unexplained iron deficiency anemia in OGD examination that were detected by VCE.

Comparing the signal enhancement of a gadolinium based and an iron-oxide based contrast agent in low-field MRI

Recently, there has been a renewed interest in low-field MRI. Contrast agents (CA) in MRI have magnetic behavior dependent on magnetic field strength. Therefore, the optimal contrast agent for low-field MRI might be different from what is used at higher fields. Ultra-small superparamagnetic iron-oxides (USPIOs), commonly used as negative CA, might also be used for generating positive contrast in low-field MRI. The purpose of this study was to determine whether an USPIO or a gadolinium based contrast agent is more appropriate at low field strengths. Relaxivity values of ferumoxytol (USPIO) and gadoterate (gadolinium based) were used in this research to simulate normalized signal intensity (SI) curves within a concentration range of 0–15 mM. Simulations were experimentally validated on a 0.25T MRI scanner. Simulations and experiments were performed using spin echo (SE), spoiled gradient echo (SGE), and balanced steady-state free precession (bSSFP) sequences. Maximum achievable SIs were assessed for both CAs in a range of concentrations on all sequences. Simulations at 0.25T showed a peak in SIs at low concentrations ferumoxytol versus a wide top at higher concentrations for gadoterate in SE and SGE. Experiments agreed well with the simulations in SE and SGE, but less in the bSSFP sequence due to overestimated relaxivities in simulations. At low magnetic field strengths, ferumoxytol generates similar signal enhancement at lower concentrations than gadoterate.

Roadway Lighting’s Effect on Pedestrian Safety at Intersection and Midblock Crosswalks

This study evaluates the visual performance of four intersection lighting designs and five midblock crosswalk lighting designs along with two pedestrian safety countermeasures (rectangular rapid flashing beacons and flashing signs) at three light levels. The study involved a pedestrian detection task, which was completed at night on a realistic roadway intersection and a midblock crosswalk. The results from the study showed that driver nighttime visual performance at intersection and midblock crosswalks was influenced by the lighting design and light level. Intersections should be illuminated to an average horizontal illuminance of 14 lux (1.3 fc). This light level ensures optimal visibility of pedestrians regardless of the lighting design (or luminaire layout) of the intersection. The average horizontal illuminance of 14 lux (1.3 fc) also increases the visibility of pedestrians when glare from oncoming vehicles is present. The 14 lux (1.3 fc) average horizontal illuminance is valid for all lighting designs evaluated except the lighting design that illuminated the exits of the intersection. When the exits of the intersection are illuminated, an average horizontal illuminance of 24 lux (2.2 fc) is needed to offset the disability glare from opposing vehicles. Midblock crosswalks should be illuminated to an average vertical illuminance of 10 lux (0.9 fc) to ensure optimal pedestrian visibility. Where overhead lighting is available, midblock crosswalk lighting designs that render the pedestrian in positive contrast are recommended. Where overhead lighting is not available, crosswalk illuminators can be used to illuminate midblock crosswalks. At night, pedestrian crossing treatments such as rectangular rapid flashing beacons and flashing signs should not be used for pedestrian visibility at midblock crosswalks. Pedestrians crossing treatments should be used in conjunction with overhead lighting or crosswalk illuminators at the established vertical illuminance to ensure optimal pedestrian visibility at midblock crosswalks.

Development of an MRI-Based Workflow for Post-implant Dosimetry of Prostate Low-Dose-Rate (Ldr) Brachytherapy

Permanent implantation of low-dose-rate (LDR) brachytherapy seeds is a well-established treatment modality for patients with localized prostate cancer. The quality of the implant is assessed within 30 days following implantation through post-implant dosimetry. The standard recommended procedure for post-implant dosimetry is based on computed tomography (CT). CT provides excellent seed visualization and localization; however, due to poor soft tissue contrast and challenging anatomical identificatio,n it leads to significant interobserver variabilities. The current MRI-CT fusion-based workflow for post-implant dosimetry LDR prostate brachytherapy takes advantage of the superior soft tissue contrast of MRI but still relies on CT for seed visualization and detection, and it suffers from image fusion uncertainties and extra cost and logistics. The lack of positive contrast from brachytherapy seeds in conventional MR images remains a major challenge towards an MRI-only workflow for post-implant dosimetry of Low- Dose-Rate (LDR) brachytherapy. In this thesis, a clinically feasible MRI-based workflow has been developed for brachytherapy seed visualization and localization. The seed visualization is based on a novel Quantitative Susceptibility Mapping (QSM) algorithm. The proposed seed localization on QSM utilizes machine learning algorithms. The reliability of the proposed workflow has been validated on 23 patients by comparing the seed positions and final dosimetric parameters between the proposed MRI-only workflow and the clinical CT-MRI fusion-based approach and there was excellent agreement between the two methods.