Clinical management of bladder dysfunction caused by sexual abuse.

BACKGROUND: Victims of sexual abuse are prone to develop posttraumatic stress disorder and lower urinary tract symptoms. Conservative treatment is recommended in these patients. We reviewed the treatment results of patients in which drug treatment failed. PATIENTS AND METHODS: In a retrospective study, results of 5 women with chronic posttraumatic stress disorder and symptoms of dysfunctional voiding were evaluated. RESULTS: One patient was successfully treated by electrostimulation. After failure of conservative treatment, 3 patients received a sacral neuromodulator, which was revised and finally explanted in all patients. One patient received botulinum toxin-A injections in the detrusor, 2 patients underwent urinary diversion. With a follow-up of 1 year, these 2 patients are asymptomatic. CONCLUSIONS: Although conservative treatment is recommended in these patients, surgical treatment may be inevitable in some cases. Successful surgical treatment is possible if an interdisciplinary approach with a close collaboration between psychotherapists and urologists is utilized.

Phosphoenolpyruvate carboxylase in mistletoe leaves: Regulation of gene expression, protein content, and covalent modification.

Seasonal changes in the activity of phosphoenolpyruvate carboxylase (PEPCase, EC 4.1.1.31), a key enzyme in the interaction of carbohydrate and nitrogen metabolism, were studied in leaves of the C3 semiparasitic mistletoe, Viscum album, growing on different host trees. Maximum extractable PEPCase activities were higher in leaves of mistletoes growing on Betula pendula and Alnus glutinosa hosts compared with those on the conifers, Abies alba and Larix decidua. Independent of host, maximum extractable PEPCase activities were high in spring and autumn while low in summer. Samples with higher PEPCase activities showed higher amounts of PEPCase protein and higher PEPCase mRNA levels. A curvilinear correlation between leaf total nitrogen content and the maximum extractable PEPCase activity as well as PEPCase mRNA level suggested that nitrogen might affect the activity of PEPCase of mistletoe by up-regulating gene expression. In addition to extractable activity, seasonal changes of the PEPCase activation state, the ratio of activities resulting from limited:non-limited assays, were found, which was correlated to the variation of malate content in leaves of mistletoe. ATP-dependent activation of PEPCase was characterized by an increase in I0.5(L-malate), indicating that PEPCase of leaves of mistletoes is probably regulated via phosphorylation.

Mycorrhiza formation and elevated CO2 both increase the capacity for sucrose synthesis in source leaves of spruce and aspen.

The effects of mycorrhiza formation in combination with elevated CO2 concentrations on carbon metabolism of Norway spruce (Picea abies) seedlings and aspen (Populus tremula×Populus tremuloides) plantlets were analysed. Plants were inoculated for 6 wk with the ectomycorrhizal fungi Amanita muscaria and Paxillus involutus (aspen only) in an axenic Petri-dish culture at 350 and 700 µl l-1 CO2 partial pressure. After mycorrhiza formation, a stimulation of net assimilation rate was accompanied by decreased activities of sucrose synthase, an increased activation state of sucrose-phosphate synthase, decreased fructose-2,6-bisphosphate and starch, and slightly elevated glucose-6-phosphate contents in source leaves of both host species, independent of CO2 concentration. Exposure to elevated CO2 generally resulted in higher net assimilation rates, increased starch as well as decreased fructose-2,6-bisphosphate (aspen only) content in source leaves of both mycorrhizal and nonmycorrhizal plants. Our data indicate only slightly improved carbon utilization by mycorrhizal plants at elevated CO2 . They demonstrate however, that both factors which modulate the sink-source properties of plants increase the capacity for sucrose synthesis in source leaves mainly by allosteric enzyme regulation.

Influence of different nutrient regimes on the regulation of carbon metabolism in Norway spruce [Picea abies (L.) Karst.] seedlings.

Phosphoenolpyruvate carboxylase (PEPC) activity, fructose 2, 6-bisphosphate (F26BP), starch and soluble sugar contents were determined m needles and roots of Norway spruce seedlings grown in a semi-hydroponic cultivation system under different nutrient regimes, tn needles, a surplus of nitrogen caused an increase in specific PEPC activity (up to six times control activity) and F26BP content (up to three times control level) while starch content was reduced. Sucrose contents were not affected. Basically, the responses in root samples were similar. Here, PEPC was highest at an imbalance in nutrition (+ N/ -P) F26BP, with root contents being 3- to 11 -times higher than those in needles, significantly exceeded control values at + N/+ P. The results show that alteration of nitrogen supply leads to marked changes in allocation of carbon between pathways, which is also influenced by P-nutrition. Pool sizes of F26BP and activity of PEPC are indicators for these changes in leaf as well as in root tissues of Norway spruce.