The impact of transvaginal, mesh-augmented level one apical repair on anorectal dysfunction due to pelvic organ prolapse.

INTRODUCTION AND HYPOTHESIS: The objective was to investigate the symptom prevalence of anorectal dysfunction (AD) in women with pelvic organ prolapse (POP) and whether symptom improvement can be achieved by pelvic floor surgery. METHODS: Secondary analysis of the Propel Study data from 277 women with POP stage II-IV regarding bothersome AD symptoms, which were assessed using the Pelvic Floor Distress Inventory (PFDI) questionnaire preoperatively, and 6, 12, and 24 months after transvaginal prolapse repair with Elevate anterior and posterior. RESULTS: Prevalence of AD was high in the study cohort (14.4-56.3%) and could be reduced significantly throughout a 2-year follow-up (cure rates 44.3-83.1%). AD symptoms decreased in a similar manner after posterior/apical fixation to the way they did after anterior/apical fixation (e.g., feeling of incomplete bowel emptying 66.7% to 25.5% vs 46.5% to 10.7% respectively). Hemorrhoids and loss of loose stool decreased even more after anterior/apical fixation than after posterior/apical fixation. Even though AD symptoms decreased significantly more in patients with POP stage III-IV, there was still a considerable improvement in patients with POP stage II (e.g., pain when passing stool 31.1 to 7.7% vs 21.4 to 0% respectively). Notably, even symptoms of hemorrhoids and rectal prolapse improved substantially (cure rates 44.2% and 70.1% respectively). CONCLUSIONS: Symptoms of AD were frequent in our study cohort, and they significantly improved after vaginal mesh-augmented sacrospinous prolapse repair with Elevate anterior and posterior throughout the follow-up period. Anterior/apical fixation showed results that were almost as good as those after posterior/apical fixation. Patients with POP stage II experienced considerable symptom improvement, but cure rates were significantly higher in patients with POP stage III-IV. Vaginal mesh-augmented prolapse repair with good apical fixation is efficacious in resolving AD symptoms with low de novo rates in women suffering of POP.

[Gender affirmation female to male-metaidoioplasty]. / Geschlechtsangleichung von Frau zu Mann ­ Klitorispenoid.

BACKGROUND: Description of an improved technique of metaidoioplasty (clitoris penoid) and presentation of the follow-up of our own patients in comparison to results in the literature. PATIENTS AND METHODS: To reduce the complication rate of urethral strictures and urethrocutaneous fistula, the technique of metaidoioplasty was modified: After elongation of clitoris by incision of chorda the urethra-including the clitoral hood-was reconstructed by distally, broadly based flap of labia minora. In a retrospective follow-up study over 4 years, 75 patients completed questionnaires to assess complications and satisfaction/quality of life and urinary symptoms (ICIQ-FLUTS questionnaire). The same questionnaires were completed by 25 patients pre- and 3 months postoperatively. RESULTS: In the retrospective study, urethral strictures were detected in 1.4% of patients and urethrocutaneous fistulas in 9.4% of patients, which could be repaired in all cases. Furthermore, 39.5% of patients did not decide for phalloplasty and were satisfied with the appearance of the clitoris penoid in 85% and with their function in 88%. A small proportion of the patients developed urinary symptoms, which were mainly of minor severity and significantly dependent on age. In the prospective study, postoperative-versus preoperative-symptoms of urinary incontinence, nocturia, and obstructive micturition were slightly elevated, but mainly of minor severity. CONCLUSIONS: The improved technique of metaidoioplasty using distally broadly based labia-minora flaps resulted in high satisfaction with low urethral complication rates.

Evaluation of micronuclei in mice bone marrow and antioxidant systems in erythrocytes exposed to α-amanitin.

α-Amanitin, the main toxic substance from mushroom species (Amanita genus), blocks the activity of RNA polymerase II (Pol II) in mammalian cells causing inhibition of transcription and subsequent synthesis of structural and enzymatic proteins. It has been postulated that α-amanitin generates the increase of reactive oxygen species (ROS) concentration. The micronucleus (MN) test was used on an animal experimental model to evaluate possible potential genotoxic effect of α-amanitin on mice bone marrow cells. At the same time the activity of antioxidant enzymes: superoxide dismutase (SOD) and catalase (CAT) as well as concentration of thiobarbituric acid reactive substance (TBARS) were investigated in the lysate of mice erythrocytes. α-Amanitin was administered intraperitoneally at the doses: 0.1, 0.15, and 0.25 mg/kg bw (LD(50) for mice) 48 h prior to sacrification. A statistically significant increase of SOD activity was observed in the hemolysate for all the investigated α-amanitin doses as compared to the negative control (p < 0.05). CAT activity for α-amanitin doses 0.1 and 0.15 mg/kg was higher in comparison to the negative control but the differences were not statistically significant (p > 0.05). However, for the dose 0.25 mg/kg the activity of CAT was statistically significantly higher (p < 0.001). All the tested α-amanitin doses decreased TBARS concentration in the hemolysate as compared to the negative control but the differences were not statistically significant (p > 0.05). A statistically significant increase of mean values of MN percent was found in polychromatic erythrocytes (PCEs) as compared to the negative control for α-amanitin dose 0.1 and 0.25 mg/kg (p < 0.05). For the dose 0.15 mg/kg the mean value of MN percent was higher but it did not demonstrate statistical significance (p > 0.1). The observed disturbances in the activity of the examined antioxidant enzymes in cells exposed in vivo to α-amanitin suggest indirect genotoxic effect of α-amanitin through ROS generation.

Moisture sorption isotherms and glass transition temperature of elecampe (Inula helenium L.) and burdock (Arctium lappa L.) roots at 25°C.

Sorption isotherms of elecampe (Inula helenium L.) and burdock (Arctium lappa L.) root samples were obtained at 25 °C. Elecampe exhibited hysteresis loop in the range of 0.35-0.90 a(w) , whereas burdock roots showed significant differences between adsorption and desorption isotherms from 0.65 to 0.80 a(w) . Blahovec-Yanniotis was considered to give the best fit over the whole range of a(w) tested. Various parameters describing the properties of sorbed water derived from GAB, Henderson and Blahovec-Yanniotis models have been discussed. Differential scanning calorimetric method was used to measure the glass transition temperature (T (g)) of root samples in relation to water activity. The safe moisture content was determined in 12.01 and 14.96 g/100 g d. b. for burdock and elecampe root samples at 25 °C, respectively. Combining the T (g) line with sorption isotherm in one plot, it was found that the glass transition temperature concept overestimated the temperature stability for both root samples.

HPLC method for determination of the purity of a mebrofenin-ligand for 99mTc-complexes.

A reversed-phase HPLC method has been developed for the estimation of purity and quantitative determination of mebrofenin UV detection at 205 nm was used. The stability of mebrofenin alone and in the presence of stannous chloride at 25 degrees C was studied. No decomposition product was found and there was no influence of SnCl2 on the stability of mebrofenin.

[Clinical analysis of preterm labor]. / Kliniczna analiza porodów przedwczesnych.

576 patients with preterm deliveries that occurred between the 22nd to 37th gestation weeks were undergone clinical analysis. The material was collected in the years 1995 to 1999 at Clinic of Obstetric and Perinatology of Pomeranian Academy of Medicine in Szczecin. In our study the rate of preterm delivery was 10.5%. Special attention was paid to mother's age, obstetrics history, socioeconomic, medical and psychogenic conditions of pregnant women, condition of infants, infant mortality and their birth-weight. The rate of premature preterm rupture of fetal membranes was 52.7%. The frequency of caesarean sections in our study in preterm births was about 50% like in other publications and the most important indication for them was amnionitis. In almost 40% the general state of infants was poor and medium. Almost 25% of preterm deliveries is connected with other systemic diseases during pregnancy.

Synthesis of L-cysteine derivatives of immunotropic activity.

The new immunosuppressive and anti-inflammatory agents have been searched in a group of the synthetic L-cysteine and 3-acetyl-thiazolidine-4-carboxylic acid derivatives. Synthesis of 17 compounds is reported.