Apoptosis and proliferation in human undescended testes

OBJECTIVE: To study apoptosis and proliferation in the testes of children with undescended testes; the degree to which undescended testes contributes to a patient's ultimate fertility is debatable, but undescended testes have fewer germ cells, and some have proposed that apoptosis is an important cause. PATIENTS AND METHODS: Testis biopsies were taken at the time of orchidopexy in a consecutive series of children undergoing surgical repair for undescended testes. Immunohistological techniques were used to detect apoptosis and proliferation, and the numbers of cells undergoing apoptosis or proliferation per 50 seminiferous tubules were recorded. RESULTS: Inguinal testes had less apoptosis than abdominal testes, with a mean (sd) of 0.71 (1.31) vs 1.63 (1.95) apoptotic cells per 50 seminiferous tubules (P < 0.02). Similarly, there was less apoptosis in children aged > 1 years than in children aged < 1 years (0.68 (1.40) vs 1.35 (1.56); P < 0.03). Proliferation was very limited in all cryptorchid testes. In contrast to cryptorchid testes, five autopsy controls had many more apoptotic cells, (10.60 (1.34) per 50 seminiferous tubules), and many more proliferating cells, (8.40 (6.43) per 50 seminiferous tubules). CONCLUSION: In contrast to animal studies, neither apoptosis nor proliferation was common in undescended testes from 6 months of age onward. However, apoptosis was more common in abdominal testes and in children aged < 1 year. It is likely that, if substantial apoptosis occurs in human undescended testes, it occurs before 6 months of age.     

Sexual function in women with urinary incontinence

To date limited data exists that addresses the impact of urinary incontinence on sexual function. In the present study, we assessed sexual functions in patients with urinary incontinence and compared with healthy continent subjects by means of Female Sexual Function Index (FSFI) questionnaire. A total of 21 premenopausal incontinent women (three stress incontinence, nine overactive bladder and nine mixed incontinence) were enrolled in the study, and 18 healthy continent subjects served as controls. All subjects were asked to complete FSFI questionnaire and each FSFI domain scores including desire, arousal, lubrication, orgasm, satisfaction and pain were calculated. The mean scores in each domain were compared between the groups. Mean age of subjects with urinary incontinence and controls were 39.5+/-6.6 and 32.6+/-9.1 y, respectively. All domain scores were significantly lower in incontinent women except for pain. Among the incontinence types, no significant difference was determined in all domains of FSFI. Urinary incontinence significantly reduces sexual functions in premenopausal sexually active women.     

A prospective analysis of sexual functions during pregnancy

The aim of the study was to evaluate the sexual functions during pregnancy using the Female Sexual Function Index (FSFI) questionnaire. Pregnancies were recorded in a prospective cohort study comprising 40 healthy pregnant women. Pregnant women who had a stable relationship with their partner were enrolled in the study when were first diagnosed to be pregnant. During their antenatal visits, subjects were asked to complete the FSFI questionnaire and other information about their sexual life in each trimester. Each FSFI domain score was calculated and mean scores in each domain were compared according to the trimesters of pregnancy. Data of 37 subjects for the first, 36 for the second and 34 for the third trimesters of pregnancy were eligible for the analysis. The mean age was 25.5+/-4.5 y; mean parity was 0.4+/-0.7 and mean gravity was 1.6+/-0.9. The frequency of intercourse attempts during the last 4 weeks was 8.6+/-3 before pregnancy, and 6.9+/-2.5, 5.4+/-2.6 and 2.5+/-1.4 in the first, second and third trimesters of pregnancy, respectively. In all domains of FSFI, significant decline in domain scores was determined during pregnancy. The comparison of satisfaction and pain domain scores between first and second trimesters showed significant differences. All of the domain scores significantly decreased in the third trimester of pregnancy. Our results showed that sexual functions are significantly decreased during pregnancy and worsen as the pregnancy progresses. Childbearing couples should be given information about the sexual problems and fluctuations in the patterns of sexuality during pregnancy.     

Histologic characteristics of the human prepuce pertaining to its clinical behavior as a dual graft

The aim of this study was to investigate the unique histologic structure of the normal human prepuce, paying particular attention to the resemblance and dissimilarities between the inner (ie, mucosa) and outer (ie, skin) layers. Histologic sections were stained using hematoxylin-eosin and Van Gieson stains. Transmission electron microscopy was used to evaluate the ultrastructure. Dense capillary networks can be observed in both the upper and lower dermal zones. The dermis lacks a dense collagenous zone. Melanocytes could not be observed in the mucosa. Elastin fibers and bundles were very abundant and dense. Early edema formation can be explained by the loose character of the dermal structure. Better graft "take" in mucosal grafts may be the result of the dense vascular dermal network. Mild hyperpigmentation can be explained by the limited number of melanocytes. However, this can also be observed in mucosal grafts, despite the absence of melanocytes. This may be solely the result of inflammatory hyperpigmentation, which can be seen in skin grafts. The abundance of elastin fibers in the prepuce may be the reason behind the superior wound contraction inhibition.     

Medicolegal childhood deaths in Adana, Turkey

The objective of this study is to determine the characteristics of and changes in the medicolegal childhood deaths that occurred in the provincial center of Adana, and to contribute to the establishment of a database for the development of national and international policies. The study is a retrospective research examining the 1,110 cases in the age group 0 to 18, which were specified as medicolegal deaths in the provincial center of Adana-Turkey between the years 2000-2004. The cases were examined according to age, sex, causes of deaths, the origins and scenes of occurrence. Among all the deaths, 523 cases (47.2%) were seen in the age group of 0-6 years. Accidents account for 900 cases (81.1%), and blunt traumas (594 cases) represent the most common cause of deaths. The share of traffic accidents in total blunt traumas was found to be 441 cases (74.2%). And 270 (24.3%) of all medicolegal deaths occurred as a result of household accidents. The present study has also indicated that the home and surroundings represent the highest-risk areas. As a conclusion, setting up childhood injury prevention committees and providing training programs for parents will be effective for the prevention of childhood injuries and deaths.     

Effect of thermal energy produced by drilling on the facial nerve: histopathologic evaluation in guinea pigs

The effect of thermal energy due to drilling around the facial nerve canal on the facial nerve was histopathologically evaluated in four guinea pigs. The bony canal of the facial nerve was drilled using a 3 mm diamond burr for one minute. The temperature changes on the facial nerve canal were noted before and after dissection. The temporal bones of the animals were histopathologically examined under light microscopy using haematoxylin & eosin (H&E) and solochrome cyanine staining for myelin, and immunohistochemical staining for neuronal nitric oxide synthase (nNOS). Compared to the control group, it was observed with H&E staining that there was oedema among the axonal fibres and with solochrome cyanine staining that the thickness of the myelin fibres was decreased, and that the severity and extent of nNOS activity was decreased in the axonal fibres. It was concluded that a temperature increase on the facial canal may potentially lead to inflammation of the nerve, and may also cause deterioration of nerve conduction to some extent.     

Considerations of isolated destruction of the short process of the incus in a case of cholesteatoma

Cholesteatoma occurs frequently with the destruction of the ossicles. The most commonly eroded ossicle has been reported to be the incus. Many studies report destruction of the long process and body of the incus. However, isolated erosion of the short process of the incus is an unusual finding. We present such a case with a slight conductive hearing loss that remained unchanged at 2 1/2 years postoperatively. The short process of the incus may contribute to hearing up to 10–15 dB. It is also possible that it plays a role in epitympanic aeration by supplying an attachment surface to the incudal folds.