Ketamine is a popular choice for young drug abusers. Ketamine abuse causes lower urinary tract symptoms, with the underlying pathophysiology poorly understood. Disruption of urothelial barrier function has been hypothesized to be a major mechanism for ketamine cystitis, yet the direct evidence of impaired urothelial barrier function is still lacking. To address this question, 8-wk-old female C57BL/6J mice were injected intraperitoneally with 30 mg·kg(-1)·day(-1) ketamine for 12 wk to induce ketamine cystitis. A spontaneous voiding spot assay showed that ketamine-treated mice had increased primary voiding spot numbers and smaller primary voiding spot sizes than control mice (P < 0.05), indicating a contracted bladder and bladder overactivity. Consistently, significantly increased voiding frequency was observed in ketamine-treated mice on cystometrograms. These functional experiments indicate that ketamine induces voiding dysfunction in mice. Surprisingly, urothelial permeability in ketamine-treated mice was not changed when measured using an Ussing chamber system with isotopic urea and water. Mouse urothelial structure was also not altered, and intact umbrella cell structure was observed by both transmission and scanning electron microscopy. Furthermore, immunostaining and confocal microscopy confirmed the presence of a well-defined distribution of zonula occuldens-1 in tight junctions and uroplakin in umbrella cells. In conclusion, these data indicate that ketamine injection induces voiding dysfunction in mice but does not necessarily disrupt mouse bladder barrier function. Disruption of urothelial barrier function may not be the major mechanism in ketamine cystitis.

https://www.physiology.org/doi/pdf/10.1152/ajprenal.00483.2015

Intact urothelial barrier function in a mouse model of ketamine induced voiding dysfunction

in the early Byzantine coastal settlement at punta Secca (province of ragusa), traditionally identified with the Kaukana of the ancient sources, excavations in a hitherto unexplored building took place over three seasons from 2008 to 2010. the structure, consisting of four chambers set around a yard (the latter contained a staircase to an upper story), has every appearance of being a domestic dwelling. Seven structural phases were identified, all probably occurring within the first half of the seventh century c.e. the most surprising and unusual discovery was an elite tomb, erected ca. 625/30 c.e. in an area probably open to the sky, in which the bodies of a pregnant woman aged about 25 and of a child aged about four were found. A libation hole in one tomb slab and the presence of a bench and offering table (mensa), as well as hearths and a plentiful array of amphoras, cooking pots, and red slip tableware, indicate that meals were consumed here in honor of the deceased, who were almost certainly christians. the discovery, unique in Sicily, is discussed in the context of what else is known archaeologically about funerary feasting in a christian context in the Mediterranean world of late antiquity.*

https://www.jstor.org/stable/10.3764/aja.115.2.0263

Funerary Feasting in Early Byzantine Sicily: New Evidence from Kaukana

Introduction
Vertex cephaloceles (VCs), also known as midline parietal cephaloceles, are among the most common midline scalp masses. Usually composed by a meningeal wall herniating from a vertex skull defect and covered by skin, VCs may also contain both anomalous vessels and neural elements. In spite of their harmless appearance, VCs often hide complex intracranial venous and/or brain malformations so that they represent a “tip of the iceberg”. Vertical embryonic positioned straight sinus, elongation of the vein of Galen, persistence of the falcine sinus, fenestration of the superior sagittal sinus, corpus callosum agenesis, intracranial cysts, tentorial malformations, cerebellar vermis agenesis, hydrocephalus, and gray matter heterotopia are some of such associated anomalies.

Vertex cephaloceles: a review

We describe a case of atretic cephalocele (AC) characterized by the presence of various cerebral anomalies of different midline structures. In our patient the presence of a parietal AC was associated with an embryonic position of the straight sinus, fenestration of the superior sagittal sinus, an abnormal insertion of the cerebellar tentorium with prominence of the superior cerebellar cistern and a septum pellucidum cyst. These findings, associated with AC, could lead to a worse prognosis with regard to neurodevelopmental milestones. This suggests that even if AC is a benign lesion, a complete evaluation of the brain structures should always be performed in these young patients.

Parietal atretic cephalocele: Associated cerebral anomalies identified by CT and MR imaging.

Clinicopathologic and radiologic features of extraskeletal myxoid chondrosarcoma: a retrospective study of 40 Chinese cases with literature review.

A 6 year-old girl presented with a midline parietal scalp swelling that had been gradually enlarging since birth. Magnetic resonance imaging revealed communication of the cyst with the subarachnoid space through a calvarial defect, with concomitant findings of vertically positioned straight venous sinus and subependymal grey matter heterotopia. A diagnosis of atretic cephalocele was thus made based on these classical imaging findings.

Atretic cephalocele - an uncommon cause of cystic scalp mass.

Background: This study observed the widest ureteric diameter in
negative intravenous urogram (IVU) examinations using low osmolar
contrast media. Methods: We reviewed a total of one hundred and eighty
four ureters from 92 negative IVUs. Results: The results show a mean
diameter for the abdominal ureter of 4.19mm with an SD of 1.27 mm and a
mean pelvic ureteric diameter of 4.45mm with an SD of 1.37 mm. The
upper limits for abdominal ureter and pelvic ureter based on a
confidence interval of 95% were 4.37 mm and 4.64 mm, respectively.
Conclusions: There was no significant difference between the right and
left ureteric diameter in both female and male subjects. There was no
significant correlation between ureteric diameters and the age of
subjects, from the second to the eighth decades.

/pdf/observation-of-ureteric-diameter-in-negative-intravenous-zm51yt1rgy.pdf

Observation of ureteric diameter in negative intravenous urogram in hospital universiti kebangsaan malaysia.

Extraskeletal myxoid chondrosarcoma (EMC) is aggressive in children. The condition in children differs to that in adults and to skeletal myxoid chondrosarcoma. We report on a 9-year-old girl with EMC in her left thigh. She underwent above-knee amputation. Five months later, a small mass was noted at the right lower lobe of the lung. The patient underwent one course of ifosfamide, carboplatin, and etoposide chemotherapy, followed by resection of the mass and 8 more courses of chemotherapy. At the 2-year follow-up, she was in remission radiologically.

https://journals.sagepub.com/doi/pdf/10.1177/230949901402200331

Extraskeletal Myxoid Chondrosarcoma of the Thigh in a Child: A Case Report

Laryngeal amyloidosis is a rare cause of stridor in a healthy young adult. We report a case of localised laryngeal amyloidosis, including our MRI findings, which included a necrotic centre that has not previously been described. This case also highlights the need for a high index of clinical suspicion to achieve the correct histopathological interpretation.

/pdf/an-unexpected-cause-of-hoarseness-of-voice-in-a-healthy-sgwydbgno3.pdf

An unexpected cause of hoarseness of voice in a healthy teenager.

Fat embolism to the lungs and brain is an uncommon complication following fractures. Few reports with descriptions of computed tomographic (CT) findings of emboli to the brain or cerebral fat embolism are available. We report a case of cerebral fat embolism following multiple skeletal fractures and present its CT findings here.

/pdf/computed-tomographic-findings-of-cerebral-fat-embolism-33bsog91c3.pdf

Siong Lung Wong

Papers

Atretic cephalocele - an uncommon cause of cystic scalp mass.

Observation of ureteric diameter in negative intravenous urogram in hospital universiti kebangsaan malaysia.

Extraskeletal Myxoid Chondrosarcoma of the Thigh in a Child: A Case Report

An unexpected cause of hoarseness of voice in a healthy teenager.

Computed tomographic findings of cerebral fat embolism following multiple bone fractures.