Unlike other rodents, organogenesis is shown to be completed during the fetal period in the spiny mice. Rodent submandibular salivary glands are characterized by a highly specialized portion of the ductal system called granular convoluted tubules (GCT), whose secretory cells synthesize a variety of growth factors. These factors may have a functional role in cell migration, proliferation and maturation within not only salivary glands but also other organs. Absence of the granular convoluted tubules from the submandibular gland of laboratory mice in the first week postnatally is documented, and the structure of such gland in the spiny mice has not been mentioned previously. So, The present work aimed to study the structural difference of the submandibular salivary gland in the spiny mice, in comparison to the corresponding age of laboratory mice. Material and Method: Tissue specimens of submandibular salivary gland were collected at the 7 th postnatal day from both species, and then processed for light and electron microscopic examination. Immunohistochemical study using epidermal growth factor (EGF) and chromogranin (CgA) was done. Results: On the contrary to laboratory mice aged one week postnatally, spiny mice submandibular gland of the same age showed well developed secretory unites and ductal system including the GCT. Conclusion: Well developed neonate spiny mice submandibular gland (early appearance of granular convoluted tubules) may refer to the role of growth factors in organogenesis. Keywords: Spiny mice, salivary gland, neonate

Background: Age-related changes in the retina are often accompanied by visual impairment. Oxidative injury and inflammation are intimately involved in the aging process and the development of age-related diseases. Green tea has been shown to have antioxidant and antiinflammatory effects on various types of cells. It contains a series of polyphenols called catechins and has been applicable for disease prevention and treatment. Aim of the study: to investigate the effects of green tea intake on age related changes in retina. Material&Methods: 30 female albino rats were divided into three equal groups; group I (control adult):6 months old, group II (aged):18 months old, group III (green tea treated): 12 months old rats received green tea daily at a dose of 300 mg/kg body weight in 1.5 ml distilled water orally by a gastric tube for 6 months. Retinal specimens from all groups were processed for light and electron microscopical examination. Statistical analysis was carried out to measure the retinal thickness in the three studied groups. Results: There were a degenerative changes in some layers of the retina.The ganglion cells appeared more vulnerable to age-related loss than other retinal cells. A significant reduction in the Retinal thickness was observed with ageing. Also, there was a significant increase in astrocytes number. After treatment with green tea, a recovery of both structural changes and retinal thickness was observed. Conclusion: Aging induced marked changes in the retina.These changes were mostly normalized after intake of green tea.

Electrocution induces several alterations of the heart, skin, blood vessels, muscles, and nerves. The main objective of the present study was to investigate possible alterations of the sciatic nerve of rats exposed to 220 V for 5 seconds by light and transmission electron microscope (TEM). Electric current was applied on the thigh region near by the gastrocneamus muscles of rats. The Sciatic nerve and the muscles were taken immediately fixed in 10% Neutral buffered formalin and 4 % cold glutraldehyde and processed for both light and TEM and stained by toulidine blue and lead acetate respectively and photographed by image soft ware. Light microscope showed irregularity of the shape with elongation of the sciatic nerve compared to the control. Moreover, annulations of the myelin sheath were detected. Mast cell infiltration were observed around the myelin sheath and suggested a response of the nerve tissue to injury may occurred. TEM showed the myelin sheath of non-exposed rats had no remarkable changes morphologically. The thickness of myelin sheath of non-exposed nerves was ranged from 1.41+ 0.7 micron. While the exposed nerve had remarkable increase in the thickness and was 1.69 + 0.8 micron. The exposed nerves had fragmentation either in localized area of the nerve and appeared bulby or onion-like or totally surround the whole nerve. No changes were observed in Schwann cells. Mast cells were detected around the affected nerves and had shown empty vesicles and suggested degranulation occurred. These results can be a helpful tool in forensic toxicology .

Sixty five (65) rats were exposed to one tenth LD50 of crude latex of Calotropis Procera (CP) day by day for 12 weeks (long-term toxicity). Clinical signs, post-mortem lesions, and histopathological examination were made. Post-mortum examination showed marked dilatation of the stomach and contained the latex of crude CP . The stomach revealed severe necrosis of the entire mucosal epithelium. The kidney was the most affected organ with a variety of changes in long-term exposure. Absence of spermatozoa in the epididymal lumen was observed. Moreover, immature cells and cellular debris in the lumen were observed while the epithelium was intact. The livers of exposed rats in long term exposure had marked proliferation of Kupffer cells as well as dilatation of the hepatic sinusoids. In conclusion, calotropis procera crude latex is moderately toxic; in large doses has hazardous local and remote toxic effects in different body organs.

Since the introduction of microvascular surgeries, the sophisticated ideas and techniques of tissue transplantations are continually advancing and searching for the best work conditions to present the best outcomes in these critical interferences. Every tissue transplant has its donor vessels, artery and vein, which should be anastomosed to recipient vessels. A new instrument, the double transverse microvascular clamp (DTMC), has been developed to be applied simultaneously, as one clamp, to both the artery and its accompanying vein. The transverse design of this clamp keeps the artery separate from its vein, allowing each anastomosis to be performed more easily. The limited clamp surface area minimizes the glazing and blurring effects. Applying only one clamp to the two vessels presents more work space and overcomes the crowdedness caused by the use of two single clamps. Using a DTMC on both the recipient and donor vessels provides optimal suture maneuverability and ideal work situation compared with the use of two double approximating clamps. We believe this DTMC would be a valuable addition to the microsurgical instruments market. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

BACKGROUND: Dorsal nasal augmentation plays an important role in cosmetic and reconstructive rhinoplasties performed to achieve an aesthetically pleasing result while creating facial harmony. Although it is known that the ideal implant should be biocompatible, biointegrated, nonabsorbable, and without inflammatory response, the selection of an ideal implant still remains controversial as to whether it should be biologic or synthetic. This study introduces a new question: ''What is better for the nasal dorsum, a soft or a hard implant?''. METHODS: In this study, 21 women and 7 men with a mean age of 23.5 years underwent augmentation rhinoplasty between December 2007 and July 2011. Conchal and septal cartilage grafts and Medpor were categorized as hard implants and applied for 15 patients. Soft implants, inserted in 13 patients, included diced auricular cartilage wrapped in Surgicel sheets, dermofat blocks, and rolls of Prolene mesh. RESULTS: Patient satisfaction was assessed through simple postoperative questionnaires. The satisfaction rate in the soft implant group was 100 %, whereas the overall satisfaction rate was 82.2 %. Unsatisfactory results and complications were recorded in the hard implant group, which had a dissatisfaction rate of 33.3 %, contributing to a general dissatisfaction rate of 17.8 % in the whole series. CONCLUSION: The authors recommend soft implants for both aesthetic and reconstructive surgeries because of their better ability to achieve a dorsum with a smoother contour and pad. Soft implants have fewer complications and higher satisfaction rates and can be applied for most indications using both closed and open methods. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

BACKGROUND: There is no general consensus about the best vascularized layer between the neourethra and the skin in tubularized incised plate urethroplasty (TIPU) of Snodgrass. Inclusion of 1 surgeon to repair specific forms of hypospadias by using determined surgical materials and exclusion of definite patients and conditions and definite anomaly parameters may present the needed reliable data about the role of a specific type of interpositional coverage of the neourethra. PATIENTS AND METHODS: The 37 patients had been operated by TIPU with a ventral subcutaneous dartos flap covering the neourethra who designed as group A, while 26 patients had been operated by the standard TIPU without urethral coverage who designed as group B. RESULTS: Good cosmetic results were obtained in 93.65% of the patients. In group A, urethral fistulae were encountered in 2 cases of distal hypospadias and 1 case of midpenile hypospadias with a total fistula rate of 8.1%. In group B, urethral fistulae were found in 5 cases of distal hypospadias and 3 cases of midpenile hypospadias with a total fistula rate of 30.7%. CONCLUSIONS: Flapless repair should not be tried as long as there is the needed experience to harvest a well-vascularized coverage. Interpositional flap coverage of the neourethra is crucial to decrease the rate of fistula in primary hypospadias TIPU repair. However, before designating a relative study, different forms of the anomaly, surgeon's experience, the potential harvesting complications, complexity degrees of different repairs, and the used surgical materials should be really considered.

Many non-fusion instrumentation techniques were shown to be effective in controlling the progression of spinal deformity in young children, and maintaining the growth potential of the immature spine. Of these, the Vertical Expandable Prosthetic Titanium Rib (VEPTR) has been approved by the FDA in the treatment of Thoracic Insufficincy Syndrome (TIS) in skeletally immature patients. The aim of this presentation is to demonstrate the effect of expansion thoracoplasty and implantation of a VEPTR in three children with progressive spinal deformity despite previous convex- sided hemiepiphysiodesis. Three patients with progressive congenital thoracic scoliosis, who had previously undergone anterior and posterior convex hemiepiphysiodesis of the thoracic spine at the age of 17 to 36 months, were treated with expansion thoracoplasty of the concavity using the VEPTR device at the age of 5 to 9 years. They were evaluated after a minimum of two years in order to assess the effect of the procedure on the spinal deformity, spinal growth, and chest wall expansion. At the latest follow-up, the Cobb angle of the fused segments, the length of the thoracic spine from T1 o T12, and the Space Availabel for the Lungs (SAL) improved in all three patients. Detailed results are listed in the next table. Thoracic spinal height increased from 11.25 to 15.68 cm in patient 1, from 15.40 to 17.15 cm in patient 2, and from 16.35 to 18.25 cm in patient 3. Sagittal Balance improved from +4.5 cm to neurtral in patient 1, and from +6 cm to +1 cm in patient 2, but deteriorated from -0.5 cm to -1.5 cm in patient 3. Expansion Thoracoplasty and VEPTR implantation seem to be effective in rigid congenital scoliosis even after prior convex-sided hemipepiphysiodesis.

Objective: Recurrent miscarriage is one of the most common clinical problems in reproduction. Many pathophysiological mechanisms postulated including hypercoagulability and immunological causes from undetectable autoantibodies. The current study aims to evaluate the effect of LMWH versus no heparin in treatment of women with recurrent miscarriage who were negatively tested for antiphosholipid antidodies. Design: It is an open labeled randomized controlled trial. Materials and Methods: Women who attend the outpatient Clinic in a University Hospital in Egypt and fulfilling the ACOG criteria of recurrent unexplained ptegnancy loss were approached for participation. Eligible participants were randomly assigned into 2 groups. The study group includes 91 patients received LMWH ( Tinzaparin sodium 4500IU) subcutaneous daily injection with 500 micrograms folic acid once daily started once positive pregnancy test. The control group includes 59 patients received folic acid alone. The primary outcome ( upon which sample size estimated ) was the continuation of a viable pregnancy up to 20 weeks pregnancy. Results: There was no significant difference between the study and the control groups as regard age, parity or socioeconomic level .There was a significant increase in the number of patients who continued beyond 20 weeks of gestation in the study group compared with the control 70.1% versus 54.5% , respectively (p=0.002) . The take home baby rate were also significantly higher in the heparin in the heparin group compared with the control group 65.7% versus 35.3%; respectively (p=0.001). Conclusions: Early start of LMWH decrease the incidence of miscarriage in the first 20 weeks of pregnancy in patients with recurrent unexplained pregnancy loss negative for antiphospholipid antibodies.

Purpose: Advanced glycation end products (AGEs) are created by non-enzymatic glycation or after their interaction with exact receptors. Facts of the role of the soluble receptor's of advanced glycation end products (sRAGE) in pediatric heart failure (HF) resulting from either idiopathic dilated cardiomyopathy (IDCM) and chronic renal failure (CRF) in children are very limited on the contrary to numerous investigations in adults. We hypothesized the relationships between plasma levels of sRAGE in IDCM and CRF as well as plasma levels of oxidized low-density lipoprotein (oxLDL), as a marker of oxidative stress and serum levels of high sensitivity C-reactive protein as a marker of inflammation (hsCRP) compared to healthy controls (HC). Methods: Sixty HF children (aged 4–14 years) were recruited [30 child with IDCM were compared to 30 child with CRF, will be prospectively included in the study, advancing New York Heart Association functional class score (NYHA) will be defined for all patients] and 20 healthy controls HC].Plasma Levels of sRAGE and ox LDL were measured by ELISA and serum hsCRP levels were determined by a nephelometry, arterial blood gases and hemodynamic data were also obtained. Results: Plasma levels of sRAGE, oxLDL and serum levels hsCRP values were significantly higher in children with CRF compared to HC (p0.0001). CRF patients had significantly elevated sRAGEs levels compared IDCM patients [1617(1456-1678);1226 (982.5 –1263) ;p0.0001], respectively. IDCM patients had significantly elevated sRAGEs levels compared HC[1226 (982.5 –1263);820.5 (678 –987);p0.01], correspondingly. There were significantly higher plasma level of oxLDL and serum levels of hsCRP in CRF and IDCM compared to HC subjects (p 0.0001). No significance difference in plasma levels of oxLDL in CRF compared to IDCM (p=NS). Significant correlations (Spearman’s rho) were evident between sRAGE and serum level of creatinine in CRF (r = 0.50; p0.05). Conclusions: Abnormal levels of all indices were supposed to be a predictor of HF severity. Findings from these studies will assist clinicians in formative the significance of targeting advanced glycation as a therapeutic approach for reducing cardiovascular diseases complications, which may reflect relative roles in the biology of HF.