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Penile calciphylaxis is a rare and life-threatening condition, most commonly seen in patients with end-stage renal disease (ESRD) undergoing dialysis. The pathophysiology includes calcification of small blood vessels, leading to ischemic changes, most commonly affecting the extremities. Treatment modalities vary based on the history and condition of the patient. In this report, we present a case of a 58-year-old male with ESRD on hemodialysis (HD) who presented with sloughed necrosis of his penis due to systemic calciphylaxis. Despite the severity of the necrosis, he was deemed unfit to undergo surgical intervention due to his complex comorbidities and was instead treated with less invasive local wound care., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chagam et al.)

Fournier's gangrene is a rare form of infectious fasciitis in the genital region. It is a rapidly progressing, life-threatening infection that requires immediate diagnosis and treatment. Common risk factors for Fournier's gangrene include diabetes mellitus, obesity, trauma, alcoholism, and cigarette smoking. The infection is more commonly seen in men than women, but we present here a case of Fournier's gangrene in a 74-year-old woman. The incident started as a small lump in the genital region from a fall and progressed into a severe case of necrotizing fasciitis. Emergent surgical debridement and antibiotics were required, as mortality depends greatly on prompt management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Barnes et al.)

Ureteral injury is a rare occurrence in medical practice. Most cases encountered stem from blunt trauma or are iatrogenic, occurring during open abdominal or pelvic surgery and laparoscopic procedures. Prompt diagnosis of ureteral injury allows clinicians to avoid complications including ureteral strictures, abscess, renal failure, sepsis, and loss of the ipsilateral kidney. Treatment depends on whether the ureteral injury was discovered intraoperatively or if it was a delayed diagnosis. Several procedures can be used, including ureteroureterostomy, ureteroileal interposition, and nephrectomy. Stenting can also be a viable option as it can reestablish urinary drainage. Herein, we present the case of a 43-year-old male who presented with complaints of progressive abdominal pain that was subsequently diagnosed as a left ureteral injury and how the use of a ureteral stent allowed him to have a full recovery with optimized normal ureteral function., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Herson et al.)

Lipopolysaccharide (LPS) and outer membrane protein (OMP) preparations of Bordetella pertussis were incorporated into multilamellar liposomes composed of soya bean-derived phospholipids which were then used for oral and intranasal immunization of mice. Specific antibody responses of animals immunized by either route were measured in lung washes. A specific IgA response to LPS was detected after immunization with the OMP-containing liposomes but not with the LPS-containing liposomes, indicating adjuvant activity of the proteins. The OMP-containing liposomes were significantly more effective in inducing immune responses than the OMP preparation alone. Responses were highest when mice were given a booster 30 days after primary immunization. Maximum responses occurred 20 days after the booster but specific antibody was still detected 75 days after the secondary immunization. These results suggest that this liposome antigen delivery system has potential in stimulating secretory antibody responses which may be helpful in protecting against infection from B. pertussis.

Mice were orally vaccinated with liposomes coated with filamentous hemagglutinin (FHA) and detoxified pertussis toxin (PT) of Bordetella pertussis. FHA- and PT-specific immunoglobulin G (IgG) was detected in serum, and both IgG and IgA were detected in lung washes following the immunization. Antibody responses in mice immunized with liposomes coated with FHA and PT were significantly higher than those in mice immunized with free FHA and PT, which demonstrated the adjuvanticity of the liposome carrier. The results indicate the potential usefulness of this approach for eliciting immune responses against FHA and PT (and perhaps other pertussis antigens) in humans and its possible utility in large-scale vaccination to protect against both B. pertussis infection and disease.

1. Liposomes (multilamellar vesicles, MLV) were prepared which entrapped triiodothyronine (T3). The MLV were composed of dimyristoylphosphatidylcholine, cholesterol and dicetylphosphate as DMPC alone, DMPC:Chol (7.2 molar ratio) and DMPC:Chol:DCP (7:2:1 molar ratio). 2. The optimal T3 entrapment was within MLV composed of DMPC: Chol:DCP. The entrapped concentrations of T3 was 63.1%. 3. The MLV composed of DMPC:Chol:DCP did not leak T3 from the MLV into buffered saline but did leak T3 into serum (42.5% after 4 h). 4. The MLV composed of DMPC:Chol:DCP exhibited a distribution of T3 between membrane associated and membrane entrapped of 42.58%.

The effect of concomitant administration in normal dogs of phenobarbital with either oral free digoxin, oral liposome-entrapped digoxin were examined. Phenobarbital induced a transient rise in serum digoxin concentrations during concomitant administration of oral free digoxin. Phenobarbital did not affect serum concentrations of either oral or intravenous liposome-entrapped digoxin. The results suggest that liposome-entrapped digoxin may be protected against transient fluctuations in serum concentrations during concomitant administration of phenobarbital. The protective liposome encapsulation of digoxin may prevent digoxin toxicosis in dogs induced by elevations in serum digoxin concentrations during concomitant administration of phenobarbital.

Lymphocytes incubated with liposomes prior to the addition of phytohemagglutinin (PHA) exhibited a time dependent suppression of blastogenesis which was reversible for phosphatidylcholine (PC):cholesterol (Chol) alpha-tocopherol (alpha-T) (1:0.5:0.5), and PC: alpha-T (1:1) liposomes but not for PC and PC:Chol (1:1) liposomes. Incubation of PHA with lymphocytes prior to the addition of liposomes caused a time dependent, reversible suppression of blastogenesis for PC: alpha-T:Chol (1:0.5:0.5), PC: alpha-T (1:1) and PC:Chol (1:1) liposomes but not reversible for PC liposomes. The effects of phospholipid concentration on the blastogenic response to PHA exhibited a concentration dependent suppression from 1 to 2 mumoles phospholipid/ml which was reversible, to varying degrees, at a concentration of 4 mumoles phospholipid/ml.

An enzyme-linked immunosorbent assay (ELISA) was developed to measure antibody to Bordetella bronchiseptica in dogs. The ELISA test was more rapid and sensitive and required 50 to 150 times less antigen than the amount of antigen required for the conventional tube agglutination test. A survey of 50 canine serum samples using ELISA suggested that 8% of all sera had titers greater than 1:64, 56% had titers of 1:8 to 1:64, and 36% had titers of less than 1:8. The mean titer of survey sera was 1:46 and the median titer was 1:16. Serum antibody responses in dogs inoculated with a commercially available bacterin were compared with responses in dogs inoculated with experimental endotoxin depleted bacterin.

In vitro intraphagocytic killing of Brucella abortus in bovine mononuclear leukocytes was enhanced by cationic, anionic, and neutral multilamellar liposomes-containing gentamicin. Free gentamicin not entrapped in liposomes. and liposomes without antibiotic did not enhance intraphagocytic killing of B. abortus in bovine phagocytes. In vivo killing of B. abortus in guinea pigs was also enhanced by liposomes-containing gentamicin when compared to free gentamicin. Liposomes-containing alpha tocopherol acetate failed to enhance in vivo killing of B. abortus.

A method has been developed for the rapid separation of cells in suspension from non-cell associated lipid vesicles in various assays for vesicle-cell interation. Separation is achieved on a discontinuous Ficoll-Paque gradient. Cells and free vesicles are totally separated, as evidenced by both radiolabelled vesicles, and vesicles containing the fluorescent dye 6-carboxyfluorescein. The main advantages of this method are the rapidity, efficacy, and gentleness of the separation. Viability of the cells remains consistently high (greater than 96%) throughout the separation. Since this method involves a one-step centrifugation, it precludes the necessity for repeated washings of cells which have been incubated with lipid vesicles.

Stable plurilamellar vesicles (SPLVs) entrapping aminoglycosides were used to treat infections due to Brucella species (Brucella canis and Brucella abortus). SPLV-entrapped antibiotics effectively eliminated internalized B. canis in cultures of resident murine peritoneal macrophages and internalized B. abortus in cultures of resident guinea pig peritoneal macrophages. In vivo studies demonstrated that SPLV-entrapped aminoglycosides administered to B. canis-infected mice and B. abortus-infected guinea pigs effectively eliminated bacteria from infected organs. The dosage schedule used involved two intraperitoneal administrations of SPLV-entrapped aminoglycosides at three-day intervals. The results demonstrate the superiority of SPLV-entrapped aminoglycosides to free aminoglycosides in effecting elimination of facultative intracellular bacteria in vitro and in vivo. The use of SPLVs as a drug carrier has broad application to treatment of infections due to other organisms.

The interaction of liposomes with BW 5147 murine thymocytic leukemia cells was studied using fluorescent probes (entrapped carboxyfluorescein and fluorescent phosphatidylethanolamine) in conjunction with a Ficoll-Paque discontinous gradient system for rapid separation of liposomes from cells. Reversible liposomal binding to discrete sites on the BW cell surface was found to represent the major form of interaction; uptake of intact liposomal contents by a process such as liposome-BW cell membrane fusion was found to apparently represent a minor pathway of interaction (2%). Liposomal lysis was found to be associated with the process of liposomal binding (perhaps as a result of the binding itself). Lysis was followed by release of the entrapped carboxyfluorescein into the media and its subsequent uptake by the cells. This lysis was shown to be dependent upon discrete membrane-associated sites that have some of the properties of proteins. The results of these studies suggest that liposomal binding to the cells, subsequent lysis of the liposomes and cellular uptake of their contents should be seriously considered in all studies of liposome-cell interactions as an alternate mode of interaction to the four modes (fusion, endocytosis, adsorption and lipid exchange) previously emphasized in the literature.

1. Digoxin was associated into phosphotidylcholine liposomes at concentrations of 28-33 mol% in Hank's Buffer, pH 7.4 at 28 degrees C. 2. Digoxin-liposomes (digoxin concentration 0.022 mg/kg per dog per day) administered intravenously in five adult male dogs attained therapeutic serum concentrations (0.7-3.0 ng/ml) beginning with day 1 of administration. 3. Digoxin serum concentrations obtained by intravenous digoxin-liposomes compared favorably with normal oral digoxin administration (0.022 mg/kg per dog per day) in all 5 dogs monitoring serum digoxin levels for 7 days showed no significant (P < 0.05) differences in mean serum digoxin concentrations +/- s.e.m. on 6 of 7 days of treatments.

Liposomes transferred alpha-tocopherol to bovine peripheral blood lymphocytes (BPBL) at 39 degrees C. Phospholipid ([14C] DMPC) transferred into BPBL at rates similar to [3H] alpha-tocopherol but with less efficiency than [3H] alpha-tocopherol from liposomes containing both labels. Liposomes containing unsaturated phospholipids DOPC and DLPC reduced but did not stop the rates of transfer of alpha-T to BPBL when compared to liposomes composed of DMPC. The presence of [14C] cholesterol in liposomes with [3H] alpha-tocopherol does not restrict but possibly enhances the alpha-tocopherol transfer into BPBL.

Studies were performed to determine the ability of alpha-tocopherol and cholesterol to influence the effect of phosphatidylcholine (PC) liposomes on the blastogenic response of bovine peripheral blood lymphocytes (BPBL) to phytohemagglutinin (PHA). BPBL were cultured with liposomes having a molar ratio of cholesterol to PC (C/P) ranging from 0 to 2.0, a molar ratio of alpha-tocopherol to PC (E/P) of 1.0 and a molar ratio of cholesterol + alpha-tocopherol to PC [(C + E)/P] of 2.0 and 4.0 PC liposomes significantly suppressed BPBL blastogenic response to PHA. Cholesterol-rich (C/P greater than or equal to 1.0) liposomes, alpha-tocopherol-rich (E/P = 1.0) liposomes and liposomes rich in cholesterol and alpha-tocopherol [(C + E)/P greater than or equal to 2.0] were able to completely reverse PC liposome suppression of BPBL. There was no molar ratio [C/P, E/P or (C + E)/P] that was able to enhance the blastogenic response of BPBL above the response obtained with PHA alone. The results suggest that the augmentation of PC liposomes rich in cholesterol, alpha-tocopherol and cholesterol with alpha-tocopherol (C/P and E/P greater than or equal to 1.0) was equally capable of restoring normal responses in BPBL but did not enhance or suppress the response to PHA.

Multilamellar lipid vesicles (MLV) composed of egg yolk lecithin (EYL) suppressed the response of bovine peripheral blood lymphocytes (BPBL) to phytohemagglutinin (PHA). EYL contains 18:1 and 18:2 as the major unsaturated phospholipids. Dioleoyllecithin (DOL; cis 9) MLV did not suppress BPBL blastogenesis. Dilinoeyllecithin (DLL; cis, cis 9, 12) MLV suppressed BPBL blastogenesis. The suppressive effect could be reversed by increasing the MLV DML concentration. The addition of alpha-tocopherol (alpha-T) at 10 mole% into MLV containing DLL reversed blastogenic suppression of BPBL. MLV composed of mixed saturated phospholipids (dimyristoyllecithin and dipalmitoyllecithin) and alpha-T enhanced the BPBL blastogenic response to PHA. BPBL incubated with varying PHA concentrations (11.82-375 mg/ml) and a constant concentration (2 mumoles/ml) of MLV composed of EYL remained suppressed either when PHA and MLV were added simultaneously or when MLV were incubated for 1 hr prior to the addition of PHA. This suggests that alpha-T may act as an immunomodulator in the blastogenic response to PHA. Results suggest that alpha-T reversion of EYL suppression of BPBL blastogenesis may be due to interactions of alpha-T with unsaturated acyl chains in EYL phospholipids.