Quality of life assessments in women operated on by tension-free vaginal tape (TVT)

The aim of the study was to evaluate quality of life (QOL) prospectively in women who undergo tension-free vaginal tape (TVT) operation for stress urinary incontinence. Sixty-six women who completed QOL questionnaires and a 2-year follow-up examination were included. Improvement of health-related QOL was assessed by the Incontinence Impact Questionnaire-7 (IIQ-7), the Urogenital Distress Inventory-6 (UDI-6), and two questions regarding patient satisfaction and de novo urge incontinence. Prior to surgery, patients complained most of stress symptoms followed by physical activities and emotional health. Postoperatively IIQ-7 and UDI-6 as a whole and all seven domains improved significantly (p<0.001). Scores of IIQ-7, UDI-6, and seven domains did not differ between the adult and the elderly groups. Of the patients 88% were much satisfied or satisfied with surgical outcomes. Incidence of de novo urge incontinence was 12%. It is concluded that the TVT procedure significantly improved health-related quality of life.The authors listed above wrote this contribution on behalf of the Tension-free Vaginal Tape Trial GroupEditorial Comment: This study adds to the body of literature on the efficacy of the TVT procedure. Using quality of life instruments 88% of the patients were much satisfied or satisfied with surgical outcomes. Incidence of de novo urge incontinence was 12%. The biggest deficiency of the study was that follow-up was only available on 66 of 161 women     

3D-CT highly useful in diagnosing foreign bodies in the paraesophageal orifice

Multislice computed tomography (CT) enables rapid, easy construction of 3-dimensional CT images (3D-CT), aiding diagnostic imaging. 3D-CT is reported to be highly useful in diagnosing temporal bone disorders, in otorhinolaryngology, especially abnormal shape and the ossicular chain of the auditory ossicles and facial bone fractures. Given the complexity of laryngeal anatomy, 3D-CT is useful in diagnosing the extent of infiltration of laryngeal cancer and in examining vocal cord movement, which is difficult to evaluate by conventional CT, magnestic resonance imaging (MRI), and fiberscopy. Among patients seen for a suspected foreign body between June 2002 and May 2003, we chose 3 in whom laryngoscopy at the first examination could not detect a foreign body but in whom symptoms and findings suggested such presence in the paraesophageal orifice. In all 3 cases, 3D-CT imaging showed the size, length, location, and direction of the foreign body, providing information useful for the surgical approach.     

Methodology to evaluation the habitual physical activity in men aged 50 years or more

OBJECTIVE: To describe the methodology for evaluating habitual physical activity that was adopted for a survey among the male population utilizing a questionnaire validated earlier. METHODS: The Baecke questionnaire on habitual physical activity was translated into Portuguese and then back-translated into English by two anglophone teachers. The final version of the questionnaire was applied in a cross-sectional epidemiological study done on 326 men aged 50 years or over. The internal consistency among the questions was evaluated using the Cronbach a statistic. The Spearman correlation coefficients between the habitual physical activity scores were calculated. Partial correlation coefficients with adjustments for age, body mass index and schooling were also calculated. RESULTS: There was satisfactory internal consistency in relation to the magnitudes of occupational physical activity and leisure-time physical exercises. Significant correlation was obtained between all the physical activity scores and the total habitual physical activity score, independent of age, body mass index and schooling. CONCLUSIONS: The Baecke questionnaire was found to be a practical instrument for assessing habitual physical activity that is quickly applied and easily understood, and it is recommended for epidemiological studies in Brazil.     

Community-Based Prevention for Suicide in Elderly by Depression Screening and Follow-Up

The aim of the study was to evaluate the outcome of a community-based prevention program against suicides among the elderly aged 65 and over in the Japanese rural town of Joboji (population 7,010), using a quasi-experimental design with two neighboring control areas. During the 10-year implementation of the program based on strategies including screening for depression, follow up with mental health care or psychiatric treatment and health education on depression, the relative risks estimated by the age-adjusted odds ratios for both males and females were reduced to almost one quarter more than a regional historical trend, with a better response to education for females than for males. A community-based management for later-life depression with mental health care supported by the psychiatric treatment can be effective against suicide among the elderly for both males and females.     

1-amino-4-phenyl-1,2,3,6-tetrahydropyridine and 1-amino-4-phenylpyridinium salt, the 1-amino analogues of neurotoxins, MPTP and MPP+, induce apoptosis in PC12 cells: detection of apoptotic cells by Comet assay and flow cytometric analysis

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is known to induce parkinsonism in humans when it is oxidized to the 1-methyl-4-phenylpyridinium salt (MPP+). We previously reported the syntheses of 1-amino-4-phenyl-1,2,3,6-tetrahydropyridine (APTP) and 1-amino-4-phenyl-pyridinium salt (APP+), the 1-amino analogues of the dopaminergic neurotoxins, MPTP and MPP+, respectively, and demonstrated that both APTP and APP+ are cytotoxic to PC12 cells. In this study, we found that both APTP and APP+ induce apoptotic cell death in PC12 cells. Apoptosis was determined by the Comet assay and flow cytometric analysis. Prior to using the Comet assay for detection of apoptotic PC12 cells, Comet images of apoptotic and necrotic cells were first distinguished by using several standards. Comet images were classified into four groups (A to D) according to their shapes. Class D consisted of the apoptotic cells and was easily distinguished. We also demonstrated that apoptotic and necrotic PC12 cells can be easily differentiated and quantified using the convenient Comet assay.     

Developmental expression of NCS-1 (frequenin), a regulator of Kv4 K+ channels,in mouse heart

The channel proteins responsible for the cardiac transient outward K+ current (Ito) of human and rodent heart are composed, in part, of pore-forming Kv4.3 or Kv4.2 principal subunits. Recent reports implicate K+ channel interacting proteins (members of the neuronal Ca2+-binding protein family) as subunits of the Ito channel complex. We reported that another Ca2+-binding protein, frequenin [or neuronal calcium center protein-1 (NCS-1)], also functions as a Kv4 auxiliary subunit in the brain. By examining cardiac expression of NCS-1, the aim of this study was to examine the potential physiologic relevance of this protein as an additional regulator of cardiac Ito. Immunoblot analysis demonstrates NCS-1 protein to be expressed in adult mouse ventricle at levels comparable to that found in some brain regions. Cardiac NCS-1 protein expression levels are much higher in fetal and neonatal mouse hearts when compared with the adult. Immunocytochemical analysis of isolated neonatal mouse ventricular myocytes demonstrates co-localization of NCS-1 and Kv4.2 proteins at the sarcolemma. Given its high levels of expression in the heart, NCS-1 should be considered an important potential Kv4 regulatory subunit, particularly in the immature heart.     

Information flow related to visual search assessed using magnetoencephalography

The sequence of neural activation during a visual search task was investigated using magnetoencephalography and the source locations for the activations were analyzed using a single-dipole algorithm. Five components (M1-5) were detected at mean latencies of 110, 146, 196, 250 and 333 ms in both of two different stimulus conditions; a target popped out in one stimulus condition (pop-out), while it did not in the other condition (non-pop-out). Statistical analysis showed that the M3 amplitude was larger and the M5 latency was shorter in the pop-out condition than in the non-pop-out condition, while there was no difference in the other components between the conditions. Neural sources were localized in the calcarine sulcus (M1) and the posterior fusiform gyrus (M2) of the hemisphere contralateral to the stimuli, the intraparietal sulcus and the posterior superior temporal sulcus (M3) in either of the hemispheres, and the calcarine sulcus (M4) of the same hemisphere in which the early processing (M1 and M2) occurred. The criteria for source localization were not satisfied for M5. The results suggest that the processing for pop-out and non-pop-out stimuli share a common mechanism; after early feature processing in the occipital cortex (M1 and M2), visual information is processed in the parietal and temporal regions (M3) and then some of this information is fed back to the occipital cortex (M4).     

Biosynthesis of proteoglycan in bone and cartilage of parathyroid hormone-related protein knockout mice

Proteoglycans are suggested to regulate cell adhesion, differentiation and mineralization of hard tissues. In vitro studies have shown that many humoral and local factors regulate proteoglycan synthesis. Among them, parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP) have potent stimulating effects on proteoglycan synthesis. However, the exact role of PTHrP on the biosynthesis and metabolism of proteoglycans during skeletal development is not clear. To clarify this point, we examined bony and cartilaginous explants of newborn mice with disrupted PTHrP alleles. Ribs of homozygous PTHrP-knockout mice and wild-type littermates were dissected into bony and cartilaginous regions and metabolically labeled with [³⁵S]sulfate in culture. Radiolabeled proteoglycans were analyzed by column chromatography. The elution profiles of [³⁵S]-labeled proteoglycan from cartilaginous explants did not differ between homozygous PTHrP-knockout mice and wild-type littermates. However, the amount of labeled proteoglycan in homozygous PTHrP-knockout mice was only 4%–5% that of wild-type littermates. In contrast with cartilaginous explants, the amount of labeled proteoglycans in bony explants did not differ between the two genotypes. Interestingly, besides the common major peak (K_d = 0.10–0.16) observed in the bony explants of both genotypes, a minor peak (K_d = 0.42) was specifically present in homozygous PTHrP-knockout mice. This minor peak was earlier than that of free glycosaminoglycan (GAG) chains, suggesting that the core protein, but not GAG chain, was cleaved in the bony explants of homozygous PTHrP. These findings demonstrate a crucial and nonredundant role of PTHrP in the regulation of proteoglycan synthesis and metabolism during skeletal development. Received: February 21, 2000 / Accepted: June 16, 2000