Effect of pelvic floor muscles exercises by extracorporeal magnetic innervations on the bladder neck and urinary symptoms

BACKGROUND

This study aimed to investigate the changes in the bladder neck (BN) and urinary symptoms using extracorporeal magnetic innervation (ExMI) therapy before and after performing passive pelvic floor exercises.

METHODS

Twenty women with stress urinary incontinence (SUI) were assessed by transperineal ultrasound and questionnaires before and after the ExMI therapy from January 2011 to February 2021.

RESULTS

The incidence of urinary frequency and SUI were significantly decreased after the therapy (McNemar test, p < 0.01). The therapeutic efficacy of SUI was 75%. A significant decrease was noted in pad test results (paired t test, p < 0.05). At the same time, there was a considerable difference in Urinary Distress Inventory-6 scale measures (paired t test, p < 0.001). However, results for the Incontinence Impact Questionnaire-7 showed a marginally significant difference (paired t test, p = 0.066). Three domains of lubrication, orgasm, and satisfaction in the Female Sexual Function Index showed significant differences (paired t test, p < 0.05). Transperineal ultrasound found that BN mobility and Q-tip straining angle were not statistically significant (paired t test, p > 0.05).

CONCLUSION

The ExMI is effective for SUI by strengthening the pelvic floor muscle without significantly decreasing BN mobility.

Tape-Releasing Suture with "Long Loop" on Mid-Urethral Sling: A Novel Procedure for Management of Iatrogenic Urethral Obstruction

BACKGROUND

To report our experiences of a tape-releasing suture with "long-loop" in women with iatrogenic urethral obstruction following the mid-urethral sling procedure.

METHODS

A total of 149 women underwent a tape-releasing suture with "Long Loop" during the operation. Post-void residual volume was evaluated after Foley removal. Lower urinary tract symptoms and urodynamic studies were assessed before and six months postoperatively.

RESULTS

Nine women out of 149 who underwent mid-urethral sling surgery were found to have iatrogenic urethral obstruction post-operatively based on their urinary symptoms and ultrasound findings. There was no apparent difference between tested groups in mid-urethral sling products and concomitant procedures. 77.8% had successful releases after the first Long-loop manipulation procedure, and 22.2% required two or more releases. However, the SUI cure rate is similar in groups receiving the Long-loop manipulation or not (88.9% and 87.1%, respectively).

CONCLUSIONS

We are convinced of the practicability and efficacy of the tape-releasing suture "Long-loop." We adopted subjective and objective means to evaluate both groups before and after a six-month follow-up. The Long-loop manipulation procedure can successfully resolve the iatrogenic urethral obstruction without compromising the effectiveness of mid-urethral sling for the treatment of SUI.

Predictors of voiding dysfunction following Uphold™ mesh repair for the treatment of pelvic organ prolapse

OBJECTIVE

To identify factors associated with voiding dysfunction after Uphold™ transvaginal mesh (TVM) repair in women with pelvic organ prolapse (POP).

STUDY DESIGN

We performed a retrospective analysis of 110 women with symptomatic pelvic organ prolapse (POP), anterior vaginal wall prolapse and/or apical prolapse (stage II to IV) who were scheduled for Uphold™ mesh surgery from September 2015 through December 2016. All subjects underwent urinalyses, UDI-6, IIQ-7, ICI-Q, POPDI-6, and pelvic examinations using the POP quantification (POP-Q) staging system before and after surgeries, with follow-up durations ranging from 24-36 months.

RESULTS

A total of 12 (10.9 %) of 110 women reported voiding dysfunction after Uphold™ mesh surgery. Using univariate analysis, there were no differences in body mass index and urodynamic parameters between normal voiding group and dysfunctional voiding group (P > 0.05). However, in patients aged above 71, POPDI-6 score≧13, preoperative concomitant urinary hesitancy, and incomplete emptying were found to be significant predictors of voiding dysfunction following Uphold™ mesh surgeries (P < 0.05).

CONCLUSION

In patients aged above 71, POPDI-6 score≧13, preoperative concomitant urinary hesitancy, and incomplete emptying were significant predictors of voiding dysfunction after Uphold™.

Evaluation of single-incision apical vaginal suspension for treatment of pelvic organ prolapse

OBJECTIVE

To present a comprehensive evaluation of anterior/apical and/or posterior prolapse repair systems with a focus on safety and surgical efficacy.

METHODS

Two hundred and twenty women with pelvic organ prolapse (POP) stage II-IV were referred for single-incision transvaginal mesh procedures in a single institution. Pre- and postoperative assessments included pelvic examination, urodynamic studies, and personal interviews about patients' quality of life and urinary symptoms.

RESULTS

The anatomical success rate was 92.3 % (203/220), regardless of primary or de-novo POP, at 12-38 month follow-up. The POP quantification parameters, except total vaginal length, improved significantly after surgery (p < 0.05). Complications included bladder injury (one case), mesh exposure (six cases) and urinary retention that required intermittent catheterization (five cases). There were no cases of bowel injury during surgery. The results indicated that 29 % of patients had de-novo stress urinary incontinence and 7.7 % of patients had de-novo POP after surgery.

CONCLUSION

The apical vaginal suspension system is a safe and effective procedure, creating good anatomical restoration and significant improvement in quality of life. However, the rate of de-novo POP in the anterior compartment of the vagina (31.8 %) seems high after treatment with apical and posterior prolapse repair systems.

Investigating Novel Genes Potentially Involved in Endometrial Adenocarcinoma using Next-Generation Sequencing and Bioinformatic Approaches

Endometrial cancer is one of the most common cancers in women worldwide, affecting more than 300,000 women annually. Dysregulated gene expression, especially those mediated by microRNAs, play important role in the development and progression of cancer. This study aimed to investigate differentially expressed genes in endometrial adenocarcinoma using next generation sequencing (NGS) and bioinformatics. The gene expression profiles and microRNA profiles of endometrial adenocarcinoma (cancer part) and normal endometrial tissue (non-cancer part) were assessed with NGS. We identified 56 significantly dysregulated genes, including 47 upregulated and 9 downregulated genes, in endometrial adenocarcinoma. Most of these genes were associated with defense response, response to stimulus, and immune system process, and further pathway analysis showed that human papillomavirus infection was the most significant pathway in endometrial adenocarcinoma. In addition, these genes were also associated with decreased cell death and survival as well as increased cellular movement. The analyses using Human Protein Atlas, identified 6 genes (PEG10, CLDN1, ASS1, WNT7A, GLDC, and RSAD2) significantly associated with poorer prognosis and 3 genes (SFN, PIGR, and CDKN1A) significantly associated with better prognosis. Combining with the data of microRNA profiles using microRNA target predicting tools, two significantly dysregulated microRNA-mediated gene expression changes in endometrial adenocarcinoma were identified: downregulated hsa-miR-127-5p with upregulated CSTB and upregulated hsa-miR-218-5p with downregulated HPGD. These findings may contribute important new insights into possible novel diagnostic or therapeutic strategies for endometrial adenocarcinoma.

KRAS mutation coupled with p53 loss is sufficient to induce ovarian carcinosarcomas in mice

Ovarian carcinosarcoma cancer is the most lethal form of gynecological malignancy, but the pathogenesis and biological function for this ovarian cancer remain unknown. We establishment the transgenic mouse model of K-ras^G12D p53^loxP/loxP and found that K-ras mutation and p53 deletion within the ovarian surface epithelium gave rise to ovarian lesions with a hyperproliferation and endometrioid glandular morphology. Furthermore, double mutant ovaries formed ovarian carcinosarcomas that were high grade and poorly differentiated. Induction was widely metastatic and spread to abdominal organs including liver, spleen, and kidney at 4 wk. We also confirmed the role of K-ras^G12D in ovarian cancer cell lines MCAS and PA-1 and showed that K-ras^G12D overexpression strongly induced cell proliferation, migration, and invasion. The ovarian cancer model we developed recapitulates the specific tumor histomorphology and the probable mechanism of malignant transformation in endometriosis.

Remarks on the validity of Myxobolus ampullicapsulatus and Myxobolus honghuensis (Myxozoa: Myxosporea) based on SSU rDNA sequences

In the present study, we isolated three populations of Myxobolus ampullicapsulatus from the gills of crucian carp, Carassius auratus auratus, two from Yongchuan, Chongqing area and one from Poyang Lake, Jiangxi area, China, sequenced their complete small subunit ribosome RNA gene, analyzed their genetic distance and gene similarity, and explored their relationship based on Bayesian inference and maximum likelihood analyses of their small subunit ribosomal DNA. The results combined with their morphological characteristics suggest that M. ampullicapsulatus infecting the gills and pharynx of allogynogenetic gibel carp, Carassius auratus gibelio, should be Myxobolus honghuensis. This study highlights the importance of DNA sequence comparisons for distinguishing Myxobolus species and indicates that the intra-species identification for the two Myxobolus species mentioned in the present research should be less than ten variation sites. In morphology, M. honghuensis Liu et al. (2012) parasitic on the gills of C. auratus auratus (goldfish) was collected from Chongqing area, and its mature spore was 16.5–19.5 × 8.5–10.0 μm in size, polar capsule was 7.0–10.0 × 2.5–4.0 μm in size, and polar filament had 9–10 coils. M. honghuensis Liu et al. (2012) isolated from the pharynx of C. auratus gibelio was sampled in Hubei area, and its mature spore was 15.1–19.5 × 9.0–11.3 μm in size, polar capsule was 7.9–8.1 × 3.0–4.5 μm in size, and polar filament had 7–8 coils.

Effects of static compression with different loading magnitudes and durations on the intervertebral disc: an in vivo rat-tail study

STUDY DESIGN

An in vivo rat-tail model was used to study the effects of static compression with different loading magnitudes and durations on the intervertebral disc.

OBJECTIVE

To investigate the effects of static compression with different loading magnitudes and durations on the intervertebral disc over a period of time.

SUMMARY OF BACKGROUND DATA

A disc degeneration model is essential for studying therapeutic effects on degenerated disc. Static compression can induce degenerative-like changes in the intervertebral disc. However, the consequences of the simulation model over a period of resting have not been clearly documented, which may have confounding effects on the experimental outcome.

METHODS

Thirty-five rats were used. Static compressions with different loads (11 or 17 N) and durations (1 hour daily or continuous) were applied to the rat-tail caudal 8-9 disc for 2 weeks, and followed with 3 weeks of rest. The disc height was quantified in vivo on days 4, 18, and 39. The rats were killed and the discs were harvested for morphologic examination on day 39 after the disc height measurement.

RESULTS

Significant decrease in disc height was observed after continuous static compression for both 11 and 17 N, and continued during the resting period. The morphologic evaluation of the continuous compressed disc showed a decreased nuclear size, reduced number of nuclear cells, and irregular nuclear shape with inward bulging of disorganized annular collagen lamellas. Daily compression of 1 hour was found to induce a transient increase in disc height, but restored after the 3-week resting period. Favorable morphologic changes, including vacuolated nuclear cells and oval nuclear shape with well-organized annular collagen lamellas, were seen in the rat disc specimens with daily compression of 1 hour.

CONCLUSION

Disc degenerative-like changes without recovery were demonstrated in the rat caudal disc after continuous compression. The changes in disc height and disc morphology were found to be dependent on the duration of load application and may have clinical implication.

Reliability of radiographic intervertebral disc height measurement for in vivo rat-tail model

Quantification of changes in intervertebral disc height is critical for studying intervertebral disc degeneration. Reliability of disc height measurement is therefore especially important for in vivo studies using animal models of disc degeneration. In this study, the effects of image intensity and percentage of disc width used for disc height measurement from radiographic images were evaluated in a rat-tail model. Radiographs were taken for 10 Sprague-Dawley rats using a standardized protocol. Average disc heights of the caudal 8-9 discs were determined using original and intensity adjusted images with different percentages of disc width. The average disc height was found to be significantly affected by both the image intensity and the percentage of disc width measured. A higher reliability was found in the measurement for image with adjusted intensity and using smaller disc width. Image intensity is suggested to be controlled and the disc width should be taken into account in quantifying the disc height.

International Internet-2 performance and automatic tuning protocol for medical imaging applications

Internet-2 is an advanced computer network, which has been widely used for medical imaging applications such as teleradiology and teleconsultation, since Internet-2 can fulfill the requirements for high-speed data transmission and short turn-around time with low operation cost once installed. However, such high performance of Internet-2 may not be retained for global access from international network peers. Considering the international Internet-2 connection between the PolyU and the IPI/USC, there exist two major factors, network looping in the US and bottleneck of the connection, raising the round-trip time and limiting the available bandwidth, respectively. The available bandwidth will be further underutilized if the TCP/IP parameters at the sending and receiving computers are not appropriately chosen. This paper proposes a repeatable and consistent protocol to automatically tune these parameters for the clinical applications.

Adhesion formation after nerve repair: an experimental study of early protected mobilization in the rabbit

The common peroneal nerve and its surrounding muscles were cut and repaired in 14 rabbits. The injured limb was then either immobilized for 3 weeks or passively mobilized within a "safety range" every day. At 3 weeks after operation, the "stretch test" and "peel test" showed no difference in the biomechanical features of the adhesions between the nerve repair and the surrounding soft tissues.

Monte Carlo simulation of x-ray spectra in mammography

A model for generating x-ray spectra in mammography is presented. This model used the ITS version 3 Monte Carlo code for simulating the radiation transport. Various target/filter combinations such as tungsten/aluminium, molybdenum/molybdenum, molybdenum/rhodium and rhodium/rhodium were used in the simulation. Both bremsstrahlung and characteristic x-ray production were included in the model. The simulated x-ray emission spectra were compared with two sets of spectra, those of Boone et al (1997 Med. Phys. 24 1863-74) and IPEM report 78. The chi2 test was used for the overall goodness of fit of the spectral data. There is good agreement between the simulated x-ray spectra and the comparison spectra as the test yielded a probability value of nearly 1. When the transmitted x-ray spectra for specific target/filter combinations were generated and compared with a measured molybdenum/rhodium spectrum and spectra generated in IPEM report 78, close agreement is also observed. This was demonstrated by the probability value for the chi2 test being almost 1 for all the cases. However, minor differences between the simulated spectra and the 'standard' ones are observed.