Isolation and identification of actinomycetes from women using intrauterine contraceptive devices

Of 259 women using intrauterine contraceptive devices 80 (31%) had visible actinomyces-like filaments in their cervical smears. Actinomycetes were cultured from a total of 31 women. Suspicious cultures were identified with the aid of a commercially available kit in conjunction with a computer data base. Culture was found to be less sensitive than microscopical examination of cervical smears in detecting actinomycetes in these women.     

Fetal death associated with asymptomatic intrauterine Candida albicans infection and a retained intrauterine contraceptive device

We present a case of intrauterine fetal death at 18 weeks of gestation associated with a retained intrauterine contraceptive device and asymptomatic intraamniotic and fetal infection by Candida albicans. The infection was verified by histopathologic examination of the placenta and umbilical cord, growth of C. albicans in samples of amniotic fluid and the presence of high levels of IL-6 in the amniotic fluid.     

Three quaternary structures for a single protein.

The structure of a multisubunit protein (immunoglobulin light chain) was solved in three crystal forms, differing only in the solvent of crystallization. The three structures were obtained at high ionic strength and low pH, high ionic strength and high pH, and low ionic strength and neutral pH. The three resulting "snapshots" of possible structures show that their variable-domain interactions differ, reflecting their stabilities under specific solvent conditions. In the three crystal forms, the variable domains had different rotational and translational relationships, whereas no alteration of the constant domains was found. The critical residues involved in the observed effect of the solvent are tryptophans and histidines located between the two variable domains in the dimeric structure. Tryptophan residues are commonly found in interfaces between proteins and their subunits, and histidines have been implicated in pH-dependent conformation changes. The quaternary structure observed for a multisubunit protein or protein complex in a crystal may be influenced by the interactions of the constituents within the molecule or complex and/or by crystal packing interactions. The comparison of buried surface areas and hydrogen bonds between the domains forming the molecule and between the molecules forming the crystals suggest that, for this system, the interactions within the molecule are most likely the determining factors.     

Laparoscopic treatment of peri-appendicitis caused by intrauterine contraceptive device

BACKGROUND: Intrauterine device may perforate the uterus and cause several complications. AIM: To report a case of laparoscopic treatment of peri-appendicitis caused by intrauterine device. PATIENT AND METHOD: A young female presented with pain in the right lower abdomen of 4 days of duration. On the physical examination, she had localized abdominal pain in the right lower abdomen with discrete guarding and pain on percussion and rebound tenderness. Ultrasonography showed an intrauterine device outside of the uterus, in the right lower of the abdomen. RESULTS: At laparoscopy, an inflammatory mass that consisted of the intrauterine device blocked by the mesoappendix and the appendix was observed. Appendectomy and removal of the intrauterine device were performed. CONCLUSION: Laparoscopy allows adequate treatment of peri-appendicitis caused by intrauterine device, inclusive with complete evaluation of the entire pelvic region to rule out associated complications     

Blocking LIF action in the uterus by using a PEGylated antagonist prevents implantation: a nonhormonal contraceptive strategy

Blastocyst implantation is a critical stage in the establishment of pregnancy. Leukemia inhibitory factor (LIF) is essential for mouse blastocyst implantation and also plays a role in human pregnancy. We examined the effect of a potent LIF antagonist (LA) on mouse implantation. In mice, LIF expression peaks on day 3.5 of pregnancy (D3.5) (D0.5 = day of mating plug detection) in the uterine glandular epithelium. LA (7 mg/kg per day) administered from D2.5 to D4.5 via four hourly i.p. injections plus continuous administration via miniosmotic pump resulted in complete implantation failure. To improve its pharmacokinetic properties, we conjugated LA to polyethylene glycol (PEG), achieving a significant increase in serum levels. PEGylated LA (PEGLA) (37.5 mg/kg per day) administered via three i.p. injections between D2.5 and D3.5 also resulted in complete implantation failure. PEGLA immunolocalized to the uterine luminal epithelium at the time of blastocyst implantation. Both LA and PEGLA reduced phosphorylation of the downstream signaling molecule STAT3 in luminal epithelial cells on D3.5. The effects of PEGLA were found to be endometrial, with no embryo-lethal effects observed. These data demonstrate that administration of a PEGylated LIF antagonist is an effective method of targeting LIF signaling in the endometrium and a promising novel approach in the development of nonhormonal contraceptives for women.     

Forgotten intrauterine devices presenting with pre- and postmenopausal bleeding: a case series

We present two cases of retained intrauterine contraceptive devices (IUCDs). The first presented with perimenopausal bleeding and dysmenorrhoea and the symptoms were resolved following the removal of an IUCD. The second presented with postmenopausal bleeding and had a Lippes loop in the uterine cavity. The symptoms resolved after the removal of the device.     

A new endoscopic method of retrieval of a migrated and transmurally embedded intrauterine contraceptive device in the rectum

A 45-year-old lady presented with left lower quadrant abdominal pain and hematochezia of 1 month duration. She had Copper-T, an intrauterine contraceptive device (IUCD) inserted in the immediate post-partum period 25 years ago elsewhere and was lost to follow up. CT abdomen done 2 weeks earlier before reporting to us revealed a migrated and translocated IUCD embedded in the right lateral wall of the rectum. On colonoscopy, an area of friable mucosal nodule was noticed in the right lateral wall 10 cm from the anal verge but the IUCD was not visible intraluminally. Fluoroscopy showed the horizontal limb lying in close approximation with the rectal wall and the vertical limb of the IUCD embedded at the site of mucosal nodule in the rectum. After a careful endoscopic mucosotomy, the vertical limb was exposed and the Copper-T in its entirety was retrieved using a polypectomy snare. The mucosal defect was closed with hemoclips. She became asymptomatic after the procedure.     

放置曼月乐环和口服避孕药治疗子宫腺肌病的疗效对比观察

目的对比放置曼月乐环和低剂量复方口服避孕药(COC)治疗子宫腺肌病患者疼痛和月经过多的临床效果。方法 62例主诉疼痛和月经过多的子宫腺肌病患者随机分为曼月乐环组和COC组。采用视觉模拟评分法(visual analogue scale,VAS)评估疼痛程度,用月经日记评估月经血量和超声检查估计子宫体积的变化。对比两组患者治疗6个月前后的疼痛程度、月经量和子宫体积的变化情况。结果两种方法治疗6个月后,疼痛均明显减轻,而且曼月乐环组与COC组相比效果更为明显(P0.01);两种治疗方法均显著减少子宫出血量,子宫体积明显缩小,且曼月乐环组比COC组显著(P0.01)。结论曼月乐环和COC用于子宫腺肌病的治疗,均能减轻相关疼痛及减少月经出血量,放置曼月乐环比口服COC疗效更好。