“
“Background and Purpose: Ascertaining the optimal depth of dilator progression is a crucial factor during tract dilation in percutaneous nephrolithotomy. Dilation is generally guided under fluoroscopy, ultrasonography, or combination of both techniques, and it is still difficult to prevent overdilation causing perforation and vascular injury or underdilation causing difficulty in establishment of access. Thus, improvements

in dilation technique bears clinical significance. Our aim was to evaluate the feasibility in an animal model of using the “”visual dilator system” for optimal percutaneous tract dilation under real-time visual guidance.

Materials and Methods: The visual this website dilator system consisted of a transparent hollow dilator made of polyvinyl chloride and a rigid ureteroscope inserted within its lumen. The ureteroscope was connected to a standard endoscopic camera system. The dilator system backloaded with an access sheath was passed over a guidewire to dilate the tract and position the access sheath under

visual guidance. Saline was used as GSI-IX in vivo irrigation to maintain clarity during dilation. The dilation technique was implemented to establish percutaneous access tract in six PCNL simulator models made from fresh porcine kidney placed inside an eviscerated chicken carcass and four female swine (eight kidneys) to experimentally evaluate its feasibility and efficacy.

Results: All tracts were successfully established with dilation through the CHIR 99021 intervening tissue layers, approach into the target calix, as well as access sheath placement being visually monitored through the dilator wall to confirm accuracy. All procedures were free

of dilation-related complications such as collecting system perforation, excessive bleeding (in-vivo model), or loss of access. The limited number of animal models and lack of randomized comparative study with other dilator modalities were major drawbacks of the study.

Conclusions: The study demonstrates feasibility of precutaneous access tract dilation using a Visual dilator system. This technique can provide visual confirmation of accuracy in dilation to improve safety and efficacy of the procedure.”
“Aspergillus fumigatus is a filamentous fungus that produces abundant pigmented conidia. Several fungal components have been identified as virulence factors, including melanin; however, the impact of these factors in a repeated exposure model resembling natural environmental exposures remains unknown. This study examined the role of fungal melanin in the stimulation of pulmonary immune responses using immunocompetent BALB/c mice in a multiple exposure model. It compared conidia from wild-type A. fumigatus to two melanin mutants of the same strain, Delta arp2 (tan) or Delta alb1 (white). Mass spectrometry-based analysis of conidial extracts demonstrated that there was little difference in the protein fingerprint profiles between the three strains.