p ) Another cohort of mice was tested for reinstatement followin

p.). Another cohort of mice was tested for reinstatement following administration

of the cannabinoid agonist CP 55,940 (10, 20, or 40 mu g/kg, i.p.). The alpha-2 adrenergic antagonist BRL-44408 (5 mg/kg, i.p.) with or without CP 55,940 (20 Ag/kg) was administered to a third group of mice. We found that: (1) AM-251 blocked forced swim-induced, but not cocaine-induced, reinstatement of cocaine-seeking behavior; (2) the cannabinoid agonist CP 55,940 did not reinstate cocaine-seeking behavior when administered alone but did synergize with a non-reinstating dose of the alpha-2 adrenergic antagonist BRL-44408 to cause reinstatement. These results are consistent with the hypothesis that stress exposure this website triggers the endogenous activation of CBI receptors and that activation of the endocannabinoid system is required for the stress-induced relapse of the mice to cocaine seeking. Further,

the data suggest that the endocannabinoid system interacts with noradrenergic mechanisms to influence stress-induced reinstatement of cocaine-seeking behavior.

This article is part of a Special Issue entitled: Stress, Emotional Behavior and the Endocannabinoid System. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.”
“ATP-binding cassette (ABC) transporters are known for their involvement in clinical multidrug Regorafenib ic50 resistance (MDR) and their physiological defensive functions in barrier organs. More recently, attention has been focused on their possible involvement in the regulation of immune responses following the identification of their substrates as known immunomodulating agents (e.g. prostaglandins, leukotrienes and cyclic nucleotides) and their functional expression in various immune effector cells, most notably in dendritic cells (DCs). This review addresses the possible roles of ABC transporters in DC development and function, as

well as the putative immunostimulatory potential of their cytostatic substrates and how this knowledge might benefit DC-based chemo-immunotherapies.”
“In contrast to the substantial number of studies investigating Resminostat the effects of stress on declarative memory, effects of stress on working memory have received less attention. We compared working memory (numerical n-back task with single digits) in 40 men exposed either to psychosocial stress (Trier Social Stress Test (TSST)) or a control condition. Task difficulty was varied using two conditions (2-back vs. 3-back). Salivary cortisol (as a marker of hypothalamus-pituitary-adrenal (HPA) activity) and salivary alpha-amylase (sAA as a marker of sympathetic nervous system (SNS) activity) were assessed immediately before and three times after the stress or control condition. As expected stress resulted in an increase in cortisol, sAA, and negative affect. Subjects exposed to stress showed significant working memory impairments in both workload conditions. The analysis of variance indicated a main effect of stress for reaction time as well as accuracy.

At adulthood, rats were tested in the novel object recognition, s

At adulthood, rats were tested in the novel object recognition, social interaction, and forced swim tests, to evaluate possible alterations in recognition memory, social behavior, and coping strategy. Moreover, buy PS-341 cannabinoid CB1 receptor density and functionality, as well as NMDA and dopamine D1 and D2 receptor densities were measured through autoradiographic binding studies. In female maternally deprived rats, THC failed to impair recognition memory, counteracted aggressiveness induced by maternal deprivation, whereas no interaction was observed in the passive coping behavior. In males,

the association of the two events increased passive coping response without affecting other behaviors. This behavioral picture was accompanied by gender-dependent and region-specific alterations in NMDA, D1 and D2 receptors. In conclusion, this study demonstrates that adolescent THC exposure might have different behavioral outcomes 3-MA solubility dmso in animals previously exposed to early-life stress compared with non-stressed controls. The interaction between the two events is not univocal, and different combinations may arise depending on the sex of the animals and the behavior considered. Alterations in NMDA, D1 and D2 receptors might be involved in the

behavioral responses induced by maternal deprivation and in their modulation by THC.

This article is part of a Special Issue entitled: Stress, Emotional Behavior and the Endocannabinoid Amino acid System. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Enterococci have become an important cause of nosocomial infections since the late 1980s. Several surface proteins have been implicated in contributing to infections caused by Enterococcus faecalis and Enterococcus faecium. Understanding the in vivo function of enterococcal surface proteins, particularly their role in directing interactions with the host during infection, is essential to explain the

success of enterococci as nosocomial pathogens. Here we review current knowledge of enterococcal LPxTG surface proteins, including aggregation substance, enterococcal surface protein, three collagen-binding microbial surface components that recognize adhesive matrix molecules (Ace, Acm, Scm) and pili (Ebp, PilA and PilB), their interactions with host molecules and their role in pathogenicity and biofilm development.”
“The hummingbird beak, specialized for feeding on floral nectars, is also uniquely adapted to eating flying insects. During insect capture the beak often appears to close at a rate that cannot be explained by direct muscular action alone. Here we show that the lower jaw of hummingbirds has a shape and compliance that allows for a controlled elastic snap. Furthermore, hummingbirds have the musculature needed to independently bend and twist the sides of the lower jaw.

These increases

were completely abolished in Ca2+-free so

These increases

were completely abolished in Ca2+-free solution, suggesting that the modulation of capsaicin on PKC and SP are Ca2+-dependent. Interestingly, the maximal cAMP increase by TRPV1 activation was not blocked Ca2+ removal, suggesting at least in part a Ca2+-independent pathway is involved. Further study showed that cAMP increase was totally abolished by G-protein and adenylate cyclase (AC) antagonist, suggesting a G-protein-dependent pathway in cAMP increase. However, DMXAA cell line SP release was blocked by inhibiting PKC, but not G-protein or AC, suggesting a G-protein independent pathway in SP release. These results suggest that both Ca2+-dependent and independent mechanisms are involved

in the regulation of capsaicin on second messengers systems, which could be a novel mechanism underlying distinct desensitization of capsaicin and might provide additional opportunities in the development of effective analgesics in pain treatment. (c) 2012 Elsevier Ireland Ltd. All rights reserved.”
“Purpose: No prospective followup study to date to our knowledge has evaluated the relationship between stone disease and the subsequent risk of diabetes mellitus. In this population based study we examine the relationship between a history of urinary calculi and the risk of diabetes mellitus in Taiwan.

Materials and Methods: A total of 23,569 adult patients with new diagnoses of urinary calculi from 2001 to 2003 were recruited Transferase inhibitor together with 70,707 matched enrollees as a comparison cohort. All patients were tracked for a 5-year period from the index health care encounter to identify those who had a subsequent diagnosis of diabetes mellitus. Cox proportional hazards models were used to compute the risk of diabetes mellitus for the study and comparison cohorts.

Results: Of a total of 94,276 patients 2,921 (12.39%) from the urinary calculi group and 6,171 (8.73%)

from the comparison group received a subsequent diagnosis of diabetes mellitus during the followup period. The stratified Cox proportional analysis showed that, after censoring individuals who died during followup, and adjusting for patient monthly income, geographic location, urbanization level, hypertension, hyperlipidemia and obesity, the hazard of receiving a first Inositol monophosphatase 1 diagnosis of diabetes during the 5-year followup was 1.32 times greater for patients with urinary calculi than for those in the comparison cohort (95% CI 1.26-1.39, p <0.001).

Conclusions: Our results suggest that patients who receive a diagnosis of urinary calculi are at increased risk for diabetes mellitus at 5-year followup.”
“The activation and differentiation of CD8 T cells is a necessary first step that endows these cells with the phenotypic and functional properties required for the control of intracellular pathogens.

Results: Among the 585 patients, there were 54 5% with a positive

Results: Among the 585 patients, there were 54.5% with a positive family history for hypertension and 14% for kidney diseases. MAU was significantly more frequent (30 vs. 11%) and the mean estimated glomerular filtration rate (eGFR) higher (71 +/- 14 vs. 64 +/- 14 ml/min/1.73 m(2)) in patients without hypertension than in those Dibutyryl-cAMP purchase with hypertension. The majority of patients with stage 3 CKD had eGFR >45 ml/min/1.73 m(2) with

normal urinary findings. Multivariate logistic regression analysis found age and treatment with angiotensin-converting enzyme inhibitors to be associated with reduced eGFR, MAU and proteinuria. In addition, smoking was associated with eGFR, but a family history for kidney disease and belonging to the group without hypertension were associated with MAU. Conclusion: The high prevalence of markers for CKD in symptomless elderly without hypertension confirmed that the elderly, as a high-risk population, should be screened based on increased age alone. Copyright (C) 2012 S. Karger AG, Basel”
“Zolpidem is a nonbenzodiazepine sedative/hypnotic that acts at GABA(A) receptors to influence inhibitory neurotransmission throughout the central nervous selleck system. A great deal is known about the behavioral effects of this drug in humans and laboratory

animals, but little is known about zolpidem’s specific effects on neurochemistry in vivo.

We evaluated how acute administration of zolpidem affected levels of GABA, glutamate, glutamine, Alanine-glyoxylate transaminase and other brain metabolites.

Proton magnetic resonance spectroscopy ((1)H MRS) at 4 T was employed to measure the effects of zolpidem on brain chemistry in 19 healthy volunteers. Participants underwent scanning following acute oral administration of a therapeutic dose of zolpidem (10 mg) in a within-subject,

single-blind, placebo-controlled, single-visit study. In addition to neurochemical measurements from single voxels within the anterior cingulate (ACC) and thalamus, a series of questionnaires were administered periodically throughout the experimental session to assess subjective mood states.

Zolpidem reduced GABA levels in the thalamus, but not the ACC. There were no treatment effects with respect to other metabolite levels. Self-reported ratings of “”dizzy,”" “”nauseous,”" “”confused,”" and “”bad effects”" were increased relative to placebo, as were ratings on the sedation/intoxication (PCAG) and psychotomimetic/dysphoria (LSD) scales of the Addiction Research Center Inventory. Moreover, there was a significant correlation between the decrease in GABA and “”dizzy.”"

Zolpidem engendered primarily dysphoric-like effects and the correlation between reduced thalamic GABA and “”dizzy”" may be a function of zolpidem’s interaction with alpha 1GABA(A) receptors in the cerebellum, projecting through the vestibular system to the thalamus.”
“The notion of a frontoparietal human mirror neuron system (HMNS) has been used to explain a range of social phenomena.

However, the precise regulation of Kv4 in the development of epil

However, the precise regulation of Kv4 in the development of epilepsy and its underlying mechanism remain unclear. In this study, we investigated whether the expression of the Kv4.2 channel and of its major modulator, voltage-dependent potassium channel-interacting protein OSI-027 in vivo (KChIP1), is altered following lithium-pilocarpine induced status epilepticus (SE) and the chronic-epilepsy phase in the rat model. We found that Kv4.2 and KChIP1 expression was transiently up-regulated following SE, whereas it was down-regulated during the chronic phase: this was most prominent in the CA1 and CA3 regions. The time-course analysis of the protein expression level showed that

the peak Kv4.2 up-regulation was between 6 and 24 h after SE, whereas KChIP1 expression was increased earlier and for a shorter period. The temporospatial changes in Kv4.2 were very similar to those

of its major modulator KChIP1. We compared the difference in 4-aminopyridine (4-AP)-induced intracellular calcium ([Ca(2+)]i) elevation between model and control brain slices. The results showed that the [Ca(2+)]i elevation induced by the Kv4 channel blocker 4-AP was aggravated and prolonged in the model slice after SE. The functional relevance of these changes in Ca(2+) homeostasis and Kv4.2 and KChIP1 expression may be associated with intrinsic neuronal excitability regulation and epileptogenesis. (C) 2008 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Episodic ataxia type 1 (EA1) is a rare human neurological syndrome characterized by continuous myokymia and attacks of generalized ataxia that can be triggered by abrupt movements, emotional stress and fatigue. An Italian family has see more been identified where related members displayed continuous myokymia, episodes of ataxia, attacks characterized by myokymia only, and neuromyotonia. A novel missense mutation (F414C), in the C-terminal region of the K(+) channel Kv1.1, was identified in the affected individuals. The mutant homotetrameric channels were non-functional in Xenopus laevis oocytes. In addition, heteromeric channels resulting from the co-expression of wild-type Kv1.1 and Kv1.1(F414C), or wild-type Kv1.2 and Kv1.1(F414C) subunits

NADPH-cytochrome-c2 reductase displayed reduced current amplitudes and altered gating properties. This indicates that the pathogenic effect of this KCNA1 mutation is likely to be related to the defective functional properties we have identified. (C) 2008 IBRO. Published by Elsevier Ltd. All rights reserved.”
“DYT1 is the most common inherited dystonia, a neurological syndrome that causes disabling involuntary muscle contractions. This autosomal dominant disease is caused by a glutamic acid deletion near the carboxy-terminus in the protein torsinA. Cell- and animal-based studies have shown how the DYT1 mutation causes mutant torsinA to redistribute from the endoplasmic reticulum to the nuclear envelope, acting through a dominant negative effect over the wild type protein.

Interestingly, GppppA-capped and polyadenylated full-length mRNAs

Interestingly, GppppA-capped and polyadenylated full-length mRNAs were also found to be synthesized by an in vitro transcription system with the native VSV RNP.”
“Introduction Large, symptomatic aneurysms of the cavernous internal carotid artery (ICA) can

be successfully treated by a combination of aneurysm coiling and occlusion of the parent vessel.

Case presentation We describe the use of an Amplatzer (AGA medical corporation, Plymouth, MA, USA) detachable nitinol vascular plug to occlude the ICA in four patients with symptomatic cavernous ICA aneurysms.”
“We previously described a T20-dependent human immunodeficiency virus type 1 variant from a patient on T20 therapy (3). This TSA HDAC nmr virus carries two mutations in the gp41 domain of the envelope

protein (Env) that was proposed to undergo a premature conformational switch to the 6-helix bundle structure. The T20 peptide can rescue this hyperfusogenic Env protein by preventing the premature switch and preserving an earlier prefusion conformation, thus restoring virus infectivity and replication. In this study, we set out to critically test this mechanistic explanation with selleck chemicals llc alternative effectors that may control the Env switch, including other fusion inhibitors and antibodies that target gp41.”
“Introduction Periventricular white matter (WM) echodensities, frequently seen in preterm infants, can be associated with suboptimal neurodevelopment. Major WM injury is well detected on cranial ultrasound (cUS). cUS seems less sensitive for diffuse or more subtle WM injury. Our aim was to assess the value of cUS and magnetic resonance imaging (MRI) for evaluating WM changes and the predictive value of cUS and/or MRI findings for neurodevelopmental outcome in very preterm infants

with normal to severely abnormal WM on sequential high-quality cUS.

Materials and methods Very preterm infants (< 32 weeks) who had sequential cUS and one MRI within GBA3 the first three postnatal months were included. Periventricular WM on cUS and MRI was compared and correlated with neurodevelopmental outcome at 2 years corrected age.

Results Forty preterm infants were studied; outcome data were available in 32. WM changes on sequential cUS were predictive of WM changes on MRI. Severely abnormal WM on cUS/MRI was predictive of adverse outcome, and normal-mildly abnormal WM of favorable outcome. Moderately abnormal WM on cUS/MRI was associated with variable outcome. Additional MRI slightly increased the predictive value of cUS in severe WM changes.

Conclusion Sequential cUS in preterm infants is reliable for detecting WM changes and predicting favorable and severely abnormal outcome. Conventional and diffusion-weighted MRI sequences before term equivalent age in very preterm infants, suggested on cUS to have mild to moderately abnormal WM, do not seem to be warranted.

Results: At 30 days, patients undergoing off-pump coronary artery

Results: At 30 days, patients undergoing off-pump coronary artery bypass grafting selleck had fewer events of bleeding (43.7% vs 56.3%, P = .0005) and myocardial infarction (7.3% vs 12.1%, P = .055) but higher rates of reintervention (3.7% vs 1.2%, P = .02). At 1 year, there was no difference between groups in death, total myocardial infarctions, reinterventions, strokes, or major adverse cardiac events, but there was a lower rate of non-Q-wave myocardial infarctions in the off-pump coronary artery bypass

grafting group (4.6% vs 9.2%, P = .03).

Conclusions: In this large-scale study evaluating the outcomes of patients with acute coronary syndromes, off-pump coronary artery bypass grafting was associated with lower rates of bleeding and non-Q-wave myocardial infarction but more reinterventions early after the procedure. At 1 year, there was no major outcome difference between the

2 surgical strategies. (J Thorac Cardiovasc Surg 2011;142:e33-9)”
“Rationale Hippo pathway inhibitor Female rats display higher sensitivity to cocaine relative to males under a variety of conditions. Time-dependent increases in cocaine-seeking behavior (as measured by nonreinforced operant responses) during cocaine withdrawal have been reported in male, but not female, rats.

Objectives The present study determines sex and estrous cycle influences on time-dependent changes in cocaine-seeking Olopatadine behavior.

Materials and methods Male and female Sprague-Dawley rats were reinforced for “”active lever”" responses by a cocaine infusion (0.50 mg/kg/infusion, i.v., fixed ratio schedule of reinforcement, FR1) followed

by a 20-s time-out when reinforcement was not delivered. Infusions were paired with a light + tone conditioned stimulus. Next, rats underwent cocaine withdrawal for 1, 14, 60, or 180 days before testing cocaine-seeking behavior. Each rat was tested for extinction of operant responding, conditioned-cued reinstatement, and cocaine-primed (10 mg/kg, i.p.) reinstatement.

Results Both males and females displayed a time-dependent increase in cocaine-seeking behavior (active lever presses) under extinction of operant responding and conditioned-cued reinstatement conditions after 60 days of cocaine withdrawal. Moreover, cocaine-seeking behavior during extinction of operant responding in females, but not males, remained elevated at 180 days of cocaine withdrawal. Furthermore, females tested during estrus exhibited higher cocaine-seeking behavior under both extinction of operant responding and cocaine-primed reinstatement conditions relative to other rats independent of the duration of cocaine withdrawal.

Conclusions The effects of reproductive cycle and withdrawal duration on cocaine-seeking behavior are additive and time-dependent increases in cocaine-seeking behavior are more enduring in females than in male rats.

The total sizes

of these plasmids (pAQ2-1 and pAQ2-2) wer

The total sizes

of these plasmids (pAQ2-1 and pAQ2-2) were 6900 bp and 6903 bp, respectively, and they were 99.1% identical to each other. The genes (oriV and repA) for plasmid replication were organized similar to the corresponding genes in the ColE2-type plasmids, pAsa3 and pAsa1, isolated from Aeromonas salmonicida subsp. salmonicida, but the gene (mobA) for mobilization was homologue to ColE1-type plasmid (pAsa2) from Aer. salmonicida subsp. salmonicida. Additionally, the qnrS2 gene was part of a mobile insertion cassette element in the plasmid. Conclusions: Two plasmids were assumed to be the same BIBF 1120 molecular weight plasmid, and this identification of a plasmid-mediated qnrS2 gene from the two different strains underlines a possible diffusion of these resistance determinants in an aquaculture system. Significance and Impact of the Study: This is the first finding of the ColE-type plasmid carrying the qnrS2 gene.”
“alpha-Synuclein function is thought to be related to its membrane binding ability. Solution NMR studies have identified several alpha-synuclein-membrane

interaction modes in small unilamellar vesicles (SUVs), but how membrane properties affect binding remains unclear. Here, we use F-19 NMR to study alpha-synuclein-membrane interactions by using 3-fluoro-L-tyrosine Selleck BLZ945 (3FY) and trifluoromethyl-L-phenylalanine (tfmF) labeled proteins. Our results indicate that the affinity is affected

by both the head group and the acyl chain of the SUV. Negatively charged head groups have higher affinity, but different head groups with the same charge also affect binding. We show that the saturation of the acyl chain has a dramatic effect on the alpha-synuclein-membrane interactions by studying lipids with the same head group but different chains. Taken together, the data show that alpha-synuclein’s N-terminal region is the most important determinate of SUV binding, but its C-terminal region also modulates the interactions. Our data support the existence of multiple tight phospholipid-binding modes, a result incompatible with the model that alpha-synuclein Interleukin-3 receptor lies solely on the membrane surface.”
“Aims: We sought to develop a new method that enables the assessment of the immune response of guinea pigs during TB vaccine evaluation studies, without the need to cull or anaesthetize animals. Method and Results: Guinea pigs were vaccinated with five different formulations of oral BCG. One week prior to challenge with Mycobacterium bovis, blood (50200 mu l) was taken from the ears of vaccinated subjects. Host RNA was isolated and amplified following antigenic restimulation of PBMCs for 24 h with 30 mu g of bovine PPD. The up- or down-regulation of gamma-interferon (IFN-gamma), a key cytokine involved in protection against tuberculosis, was assessed using real-time PCR.

The results demonstrate that the association between hormones and

The results demonstrate that the association between hormones and changes in brain plasticity is sex related. In particular, testosterone seems to be involved in the regulatory processes related to neuroplasticity in females. (C) 2009 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Chronic stress has been shown in animal models to result in altered dendritic

morphology of pyramidal neurons of the medial prefrontal cortex (mPFC). It has been hypothesized that the stress-induced dendritic retractions and spine loss lead Idasanutlin order to disrupted connectivity that results in stress-induced functional impairment of mPFC. While these alterations were initially viewed as a neurodegenerative event, it has recently been established that stress induced dendritic alterations are reversible if animals are given time to recover from chronic stress. However, whether spine growth accompanies dendritic extension remains to be demonstrated. It is also not known if recovery-phase dendritic extension allows for re-establishment of functional capacity. The goal of this study, therefore, was to characterize the structural and functional effects of chronic stress and recovery on

the infralimbic (IL) region of the rat mPFC. We compared neuronal morphology of IL layer V pyramidal neurons from male Sprague-Dawley rats subjected to 21 days of chronic restraint stress (CRS) to those that experienced CRS followed by a 21 day SAHA datasheet recovery period. Layer V pyramidal cell functional capacity was assessed by intra-IL long-term potentiation (LTP) both Montelukast Sodium in the absence and presence of SKF38393, a dopamine receptor partial agonist and a known PFC LTP modulator. We found that stress-induced IL apical dendritic retraction and spine loss co-occur with receptor-mediated impairments to catecholaminergic facilitation of synaptic plasticity. We also found that while post-stress recovery did not reverse distal dendritic

retraction, it did result in over extension of proximal dendritic arbors and spine growth as well as a full reversal of CRS-induced impairments to catecholaminergic-mediated synaptic plasticity. Our results support the hypothesis that disease-related PFC dysfunction is a consequence of network disruption secondary to altered structural and functional plasticity and that circuitry reestablishment may underlie elements of recovery. Accordingly, we believe that pharmacological treatments targeted at preventing dendritic retraction and spine loss or encouraging circuitry re-establishment and stabilization may be advantageous in the prevention and treatment, of mood and anxiety disorders. (C) 2009 IBRO. Published by Elsevier Ltd. All rights reserved.”
“The classical GABA/glycine hyperpolarizing inhibition is not observed in the immature spinal cord.

Conclusions: Genitourinary injuries in children result in approxi

Conclusions: Genitourinary injuries in children result in approximately 28,000 emergency department visits yearly. Efforts should be made to decrease the risk of genitourinary injuries in children by promoting

the use of protective selleck chemicals gear and safer product selection for those at greatest risk for injury.”
“Do the gestures that speakers produce while talking significantly benefit listeners’ comprehension of the message? This question has been the topic of many research studies over the previous 35 years, and there has been little consensus. The present meta-analysis examined the effect sizes from 63 samples in which listeners’ understanding of a message was compared when speech was presented alone with when speech was presented with gestures. It was found that across samples, gestures do provide a significant, moderate benefit to communication. Furthermore, the magnitude of this effect is moderated by 3 factors. First, effects

of gesture differ as a function of gesture topic, such that gestures that depict motor actions are more communicative than those that depict abstract topics. Second, effects of gesture on communication are larger when the gestures are not completely redundant with the accompanying speech; effects are smaller when there is more overlap between the information conveyed in the 2 modalities. Third, the KU-60019 purchase size of the effect of gesture is dependent on the age of the listeners, such that children benefit more from gestures than do adults. Remaining questions for future research are highlighted.”
“Purpose: A duplex collecting system is a common congenital renal tract abnormality associated with different clinical problems. We describe our experience with ureteral reimplantations of a complete duplex collecting system where 1 megaureter needing recalibration

and 3-mercaptopyruvate sulfurtransferase 1 normal-sized ureter coexisted. Recalibration of the megaureter was done by wrap plication around the normal-sized ureter.

Materials and Methods: Operative logs and case notes were reviewed of consecutive children with a complete duplex collecting system treated with wrap plication of the megaureter around the normal-sized ureter and reimplantation between 1997 and 2010. Reoperation, vesicoureteral reflux and obstruction rates were assessed.

Results: A total of 25 children underwent wrap plication and ureteral reimplantation. Of the cases 19 (76%) were completely successful and 6 (24%) needed reoperation. Three children (12%) had persistent high grade vesicoureteral reflux, 2 (8%) underwent endoscopic correction and 1 (4%) underwent repeat reimplantation of the duplex system. Three children (12%) had postoperative obstruction and 2 (8%) underwent endoscopic incision of the ureteral orifice. In 1 child (4%) a nonfunctioning lower moiety of the kidney developed, which was managed by heminephrectomy.