Microvascular transfers of serratus anterior muscles in rats

Summary The serratus anterior muscle in the rat is supplied by the serratus division of thoracodorsal vessels, in a pattern similar to man [2]. The serratus anterior muscles were transferred to the groin area as a free muscle flap in 17 rats and as a free muscle graft in 13 rats. In the free muscle flap group, the serratus anterior muscles of 8 of 10 rats survived; histological examination showed them to be viable and the vascular anastomoses were patent at the 30th day. In the free muscle graft group, all of the muscle grafts became necrotic. As a result, it is concluded that the microvascular transfer of serratus anterior muscles in rats is a useful small animal model for microsurgical laboratory training of clinical free flap transfers and also for performing pharmacological and biochemical studies in transplanted muscle.     

Adiponectin is an independent determinant of insulin resistance in women with polycystic ovary syndrome.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is frequently associated with insulin resistance and a consequent increased risk of metabolic diseases. The aim of the present study was to investigate the role of adiponectin in insulin resistance in PCOS women. MATERIALS AND METHODS: Forty-seven patients with PCOS and 23 control subjects, matched for age and body mass index (BMI), were enrolled in the study. Clinical, metabolic and hormonal parameters and adiponectin levels were measured, and HOMA-IR score (homeostasis model assessment-insulin resistance index) was calculated for each subject. RESULTS: There was no difference in adiponectin levels between PCOS patients and the control group. However, adiponectin levels were negatively correlated with obesity-associated parameters and HOMA-IR score in PCOS patients and controls. As adiponectin is modulated by BMI we adjusted for BMI among the PCOS patients, and found a negative correlation between adiponectin levels and HOMA-IR score (r = -0.51, p < 0.001). Adiponectin and BMI were independent determinants of insulin resistance in PCOS patients (adjusted R2 = 0.66, p < 0.001). CONCLUSION: Adiponectin did not seem to be actively involved in the pathogenesis of PCOS. However, adiponectin levels were independently associated with insulin resistance in PCOS patients, suggesting that adiponectin might play a role in the complicated metabolic abnormalities of PCOS.     

Milk of calcium hydronephrosis

There are very few reported cases of 'milk of renal calcium' since Holm's first presentation of this rare condition in 1948 [Rosenberg, J. Urol., 101: 714, 1967]. We recently had the opportunity to study 2 more cases, which are described herein.     

Effects of Different Doses of Caffeinated Coffee on Muscular Endurance,Cognitive Performance,and Cardiac Autonomic Modulation in Caffeine Naive Female Athletes

Caffeine is widely consumed among elite athletes for its well-known ergogenic properties, and its ability to increase exercise performance. However, studies to date have predominantly focused on the anhydrous form of caffeine in male participants. The aim of the study was to investigate the effect of caffeinated coffee ingestion on lower-upper body muscular endurance, cognitive performance, and heart rate variability (HRV) in female athletes. A total of 17 participants (mean ± standard deviation (SD): age = 23 ± 2 years, body mass = 64 ± 4 kg, height = 168 ± 3 cm) in a randomized cross-over design completed three testing sessions, following the ingestion of 3 mg/kg/bm of caffeine (3COF), 6 mg/kg/bm of caffeine (6COF) provided from coffee or decaffeinated coffee (PLA) in 600 mL of hot water. The testing results included: (1) repetition number for muscular endurance performance; (2): reaction time and response accuracy for cognitive performance; (3): HRV parameters, such as standard deviation of normal-to-normal (NN) intervals (SDNN), standard deviation of successive differences (SDSD), root mean square of successive differences (RMSSD), total power (TP), the ratio of low- and high-frequency powers (LF/HF), high-frequency power (HF), normalized HF (HFnu), low-frequency power (LF), and normalized LF (LFnu). A one-way repeated measures ANOVA revealed that 3COF (p = 0.024) and 6COF (p = 0.036) improved lower body muscular endurance in the first set as well as cognitive performance (p = 0.025, p = 0.035 in the post-test, respectively) compared to PLA. However, no differences were detected between trials for upper body muscular endurance (p = 0.07). Lastly, all HRV parameters did not change between trials (p > 0.05). In conclusion, ingesting caffeinated coffee improved lower body muscular endurance and cognitive performance, while not adversely affecting cardiac autonomic function.     

Extraperitoneal laparoscopic bladder neck suspension using hernia mesh and tacker

OBJECTIVES: To report our initial experience with extraperitoneal bladder neck suspension for female stress incontinence due to urethral hypermobility. METHODS: Between September 1996 and September 1999, 35 patients (mean age 49.5 years) underwent extraperitoneal bladder neck suspension at our institution. An extraperitoneal space was created by a trocar-mounted balloon device, and suspension was created using a 5-mm endoscopic hernia stapler and polypropylene mesh. RESULTS: The mean operative time was 39.5 minutes. In 2 patients, the bladder was inadvertently perforated during the bladder neck dissection. The perforation was repaired by laparoscopic suture ligation. The mean urethral catheterization and hospitalization time was 2.1 and 2.3 days, respectively. Urethral recatheterization because of temporary urinary retention was required in 11.4% of the patients. Symptoms of bladder instability were experienced by 13.5% of the patients in the early postoperative period. A total of 28 patients (80.0%) reported that they were totally dry after a mean of 23.2 months. CONCLUSIONS: Extraperitoneal bladder neck suspension using hernia mesh and a stapler seems to be an effective and safe procedure, with a shorter operative time, in selected patient groups.