Comparison of quartz vials with polypropylene vials for rapid cryopreservation of human ovarian tissue.

BACKGROUND: Because higher survival of follicles during the freezing/thawing procedure improves the quality of cryopreserved tissue reimplanted after oncological therapies, defining an optimal method for human ovarian tissue cryopreservation remains a major issue in this field. One option to improve the cryopreservation procedure is to use better materials, i.e., vials with better conductivity. The aim of this study was to compare polypropylene (PP) with quartz vials. Between September 2012 and January 2013, eight patients were recruited. The ovarian cortex was cut into 3 slices, assigned randomly to a fresh and a cryopreserved group in PP (method B) or quartz vials (method C). Histological and immunohistochemical (IHC) analysis were used. For IHC three antibodies were analyzed: Ki67 (proliferation index), Bcl2 (anti apoptotic index) and Hsp70 (stress index). RESULTS: The majority of GCs showed positive staining for Bcl2 in both cryopreservation device, with higher expression in group C than in group B. Oocytes and their nuclei showed intense positive staining for ki67 in both methods B and C, and also a patch positive stromal cells staining for Ki67. Expression of hsp70 was not increased after cryopreservation. CONCLUSIONS: Cryopreservation using quartz vials led to larger numbers of good follicles while maintaining consistent preservation for stromal cells and vessels.

[Gynecology: urinary incontinence - mini-review and case reports]. / Gynäkologie: Fälle aus der Harninkontinenz-Sprechstunde.

Although urinary incontinence affects one in three women, it is still a taboo topic. Today, effective conservative and surgical treatment options are available. When conservative therapies fail, minimally invasive surgical methods can be offered. The tension-free vaginal tape TVT is gold standard in the treatment of female stress urinary incontinence. In case of immobile urethra or in multi-morbid patients, the minimally invasive technique of periurethral injection of bulking agents may be useful. In patients with refractory overactive bladder, the intravesical injection of botulinum neurotoxin is available.

Prospects and limitations of treatment with botulinum neurotoxin type A for patients with refractory idiopathic detrusor overactivity.

In this review we summarize the recent innovation of botulinum-A neurotoxin (BoNT-A) injections in the bladder as a potential new treatment option for idiopathic detrusor overactivity, refractory to conventional anticholinergic medication. BoNT-A is produced by Clostridium botulinum and consists of a 150-kDa neurotoxic protein that has the ability to cleave proteins within the nerve terminal. BoNT-A is thereby able to prevent acetylcholine release at the presynaptic membrane, resulting in a chemodenervation of the detrusor muscle after intravesical injection; this can reduce symptoms in patients with refractory idiopathic detrusor overactivity. BoNT-A intradetrusor injections might be an alternative to invasive surgery for patients in whom conservative measures and anticholinergic treatment have failed. Clinical studies with different dosages and injection protocols show success rates of 60-96% for neurogenic and non-neurogenic detrusor overactivity, with wide variations in the duration of response. The drug is still under development for the indication of idiopathic detrusor overactivity, and is under ongoing investigation for long-term efficacy and safety.

Histomorphological analysis of the urogenital diaphragm in elderly women: a cadaver study.

The objective of this study was to describe the histomorphological structure of the urogenital diaphragm in elderly women using a modern morphometric procedure. Biopsies were taken from the posterior margin of the urogenital diaphragm of 22 female cadavers (mean age, 87 years) using a 60-mm punch. Hematoxylin/eosin and Goldner sections were analyzed with the Cavalieri estimator. The mean thickness of the urogenital diaphragm was 5.5 mm. The main component was connective tissue. All biopsies contained smooth muscle. Eighteen biopsies contained more smooth muscle than striated muscle. In six of 22 biopsies, no striated muscle was found. The ratio of striated to smooth muscle to connective tissue was 1:2.3:13.3. Muscle fibers were dispersed in all parts of the urogenital diaphragm. The urogenital diaphragm of elderly women mainly consists of connective tissue. Smooth muscle was also found but to a lesser extent. The frequently used English term "perineal membrane" for the urogenital diaphragm is justified and well describes our findings in elderly women.

[Overactive bladder: prospects and limitations of botulinum toxin]. / Uberaktive Blase: Möglichkeiten und Grenzen der Botoxtherapie.

Botulinum toxin is the most potent poison known to man. It is produced by Clostridium botulinum and consists of a heavy chain which is responsible for the internalization of the toxin into the cytosol and a light chain that has the ability to cleave proteins within the nerve terminal. As those proteins are essential for normal vesicular transport and fusion of acetylcholine, botulinum toxins are able to prevent its release at the presynaptic membrane, resulting in a chemodenervation of the detrusor muscle after intravesical injection of the toxin and an impressive reduction of symptoms of overactive bladder. Clinical studies show success rates between 60 and 96% for neurogenic and non-neurogenic detrusor overactivity. Thus, application of botulinum toxin to the lower urinary tract appears to be an efficient, safe and minimally invasive procedure.

Experience with 100 cases treated with botulinum-A toxin injections in the detrusor muscle for idiopathic overactive bladder syndrome refractory to anticholinergics.

PURPOSE: In this prospective, nonrandomized, ongoing study we evaluated the efficacy and safety of botulinum-A toxin injections in the detrusor muscle to treat patients with idiopathic overactive bladder resistant to conventional treatment, such as anticholinergic drugs. MATERIALS AND METHODS: A total of 23 men and 77 women with a mean age of 63 years (range 24 to 89) with nonneurogenic overactive bladder, including urgency-frequency syndrome, and incontinence despite the administration of maximal doses of anticholinergics were consecutively treated with injections of 100 U botulinum-A toxin in the detrusor muscle at 30 sites under cystoscopic guidance. Micturition diary, full urodynamics, neurological status and urine probes were performed in all participants before treatment. Bladder biopsies were done only in cases of suspected bladder fibrosis or unclear findings. Special attention was given to reflex volume, maximal bladder capacity, detrusor compliance, post-void residual urine, urgency and frequency/nocturia. Clinical, urodynamic and quality of life assessments were performed at baseline, and 4, 12 and 36 weeks after botulinum-A toxin treatment. RESULTS: Overall after 4 and 12 weeks 88% of our patients showed significant improvement in bladder function in regard to subjective symptoms, quality of life and urodynamic parameters (p <0.001). Urgency disappeared in 82% of the patients and incontinence resolved in 86% within 1 to 2 weeks after botulinum-A toxin injections. Mean frequency decreased from 14 to 7 micturitions daily (-50%) and nocturia decreased from 4 to 1.5 micturitions. Mean maximal bladder capacity increased 56% from 246 to 381 ml, mean detrusor compliance increased from 24 to 41 ml/cm H(2)O and pretreatment detrusor instability (mean reflex volume 169 ml) resolved in 74% of patients. Mean volume at first desire to void increased from 126 to 212 ml and mean urge volume increased from 214 to 309 ml. There were no severe side effects except temporary urine retention in 4 cases. Only in 8 patients was the clinical benefit poor and analysis revealed preoperative low detrusor compliance. Mean efficacy duration +/- SD was at least approximately 6 +/- 2 months and then symptoms began to increase. CONCLUSIONS: Our results show that intradetrusor botulinum-A toxin injections may be an efficient and safe treatment option in patients with severe overactive bladder resistant to all conventional treatments.

Brachymetatarsia: a review and case study.

Brachymetatarsia is a perplexing podiatric abnormality. Various surgical approaches have been discussed and the methods of surgical treatment detailed. Each patient must be individually evaluated and the appropriate procedure chosen.

Anatomically-related variations in trace-metal concentrations in hair.

Scalp-hair analysis is used as an indicator of trace-metal concentrations in the human body. The major shortcoming of this approach is the inability to differentiate between endogenous and exogenous trace metals. Our analyses show no correlation between the concentrations of calcium, magnesium, copper, iron, or zinc in scalp hair and pubic hair in 67 donor-matched hair samples. We interpret this as a strong indication that exogenous trace metals make a significant contribution to the results for trace metals in human hair.

Dysconjugate gaze in hepatic coma.

During an episode of hepatic encephalopathy, an elderly woman developed ocular divergence at rest and dysconjugate gaze after caloric stimulation. Metabolic encephalopathy may rarely produce oculomotor dysfunction, usually attributed to structural brainstem lesions.

Attempts to induce sensitization in guinea pigs with nickel complexes.

A technique for the induction of sensitization in pigs with a nickel-alanine conjugate has been reported by other investigators. Similar results were observed in our experiments in mini-pigs. However, using the identical technique, we were unable to induce sensitization in guinea pigs with NiSO4, with nickel-alanine or other nickel-amino acid complexes, or with a complex of nickel with soluble guinea pig skin extract. These results indicate that nickel-amino acid complexes and nickel-guinea pig skin complex were not antigenic in guinea pigs with this technique. Hypotheses for the apparent failure to induce sensitization are proposed.