No abstract

Purpose Planned interim analysis of GENESIS; a prospective pilot study investigating the role of genicular artery embolization (GAE) in patients with mild to moderate osteoarthritis of the knee using permanent microspheres. Methods Thirty-eight patients, median age = 60 (45–83), attended for GAE using 100–300 μm permanent microspheres. All patients had mild to moderate knee OA, resistant to conservative treatments over 6 months. Knee MRI was performed at baseline, and 12 months, enabling semi-quantitative analysis using Whole-Organ Magnetic Resonance Imaging Score (WORMS). Knee Injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS) (0–100 mm) were completed at baseline, 6 weeks, 3 months (n = 32), and 1-year (n = 16). Adverse events were recorded prospectively. Results Technical success of accessing and embolizing the target genicular arteries was 84%. Six patients were not embolized: four due to a presumed risk of non-target embolization, and two due to a lack of hyperaemic target. Mean VAS improved from 60 (SD = 20, 95% CI 53–66) at baseline to 36 (SD = 24, 95% CI 28–44) at 3 months (p < 0.001) and 45 (SD = 30, 95% CI 30–60) at 1-year (p < 0.05). All KOOS subscales showed a significant improvement at 6-weeks, 3-months, and 1-year follow-up, except function in daily living, which reached borderline significance (p = 0.06) at 1-year. Four patients experienced mild self-limiting skin discoloration over the embolized territory. One patient experienced a small self-limiting groin haematoma. WORMS scores at 1-year follow-up showed significant improvement in synovitis (p < 0.05). There were no cases of osteonecrosis. Conclusion GAE using permanent microspheres in patients with mild to moderate knee OA is safe, with potential efficacy at early follow-up.

No abstract

In this method for measuring conjugated urinary testosterone, testosterone-4-14 C is added to an aliquot of urine to correct for subsequent losses and an ethyl ether extract is then chromatographed in 2 Zaffaroni systems prior to chromic oxide oxidation of testosterone to A 4 -androstene-3,17-dione. A third Zaffaroni system confirms the completion of oxidation and purifies the steroid before a final fourth chromatography in a Bush system. Quantitation is carried out by a modified micro Zimmermann reaction. Values of testosterone glucuronide in 24-hr specimens (mean +SE) were found to be 19 ±3 ng in 20 normal women aged 20-40; 88+7 ng in 20 normal men aged 30-40; 151 ±22 ng in 5 young normal men aged 17-24; and 6 ±3 jug in 5 boys aged 7-12. A satisfactory correlation between the level of testosterone glucuronide and the degree of androgenicity in various pathologic states studied was observed. (J Clin Endocr 25: 95, 1965) T ESTOSTERONE 5 is properly considered the most potent of the known androgens. The growing evidence that low or normal values of 17-ketosteroids (17-KS) may coexist with virilization in the female has made the evaluation of testosterone indispensable to an adequate investigation of androgenic states.Free testosterone has been measured in blood and a good correlation was established between elevated values and virilizing conditions in women (1, 2). Testosterone glucuronide has been measured in human urine (3-6). A new, relatively simple method is described in this paper for the measurement of conjugated

No abstract

No abstract

Background Iatrogenic ureteral injuries arise as serious complication following obstetrics, gynecological, general, and urological surgery with incidence in the range of 0.5-10%. Retrograde placement of double-J ureteric stent is a possible treatment option if the injury is not recognized at the time of surgery. Purpose To assess technical success and long-term outcome associated with retrograde ureteric stent insertion for iatrogenic ureteric injury. Material and Methods Between 1999 and 2011, 26 patients with initially unrecognized iatrogenic ureteric injury underwent initial management with retrograde ureteric stenting. Full case-notes were available for review in 25 patients. Results The mean interval from injury to attempted stenting was 19.4 days. Successful retrograde ureteric stenting was achieved in 21/25 patients (81%). Retrograde stenting failed in four patients, and nephrostomy followed by alternative procedures were performed instead. At a median follow-up interval of 9.7 months, normal anatomy was demonstrated on 12/21 patients (57%) and a stricture was observed in 6/21 patients (28%) with three requiring surgical intervention. Conclusion Retrograde stenting is a safe and efficient initial management in patients with iatrogenic ureteric injuries.

No abstract