Long-term results of transvaginal colposuspension for the treatment of genuine stress incontinence combined with vaginal hysterectomy

We assessed the long-term efficacy of a modified transvaginal needle bladder neck suspension, combined with vaginal hysterectomy, for the treatment of female stress incontinence. Thirty-two women who underwent this procedure were followed up clinically and urodynamically 1 and 5 years postoperatively. A total of 27 women (84.4%) were cured 1 year postoperatively. Of the 29 women who were followed up 5 years postoperatively, 21 (72.4%) had a satisfactory result (p = 0.157). No significant differences were observed in maximum urine flow rate, residual volume of urine, and functional length of the urethra. On the contrary, the maximum urethral closure pressure was significantly decreased (p = 0.004). Although the results of our study show a decline in success rate by time, the overall long-term efficacy of this technique is undoubtedly satisfactory. This technique is promising as an easy and minimally invasive surgical procedure for bladder neck suspension.     

A very late onset urethral fistula coexisting with skin bridge after neonatal circumcision: a case report

Complications of neonatal circumcision are generally minor and occur early; a few reports exist on the late or serious kind. The authors describe a case of urethrocutaneous fistula occurring 13 years postcircumcision. The patient also had a skin bridge, another late complication of circumcision. The authors suggest erections in puberty as the triggering factor for onset of fistula. To our knowledge, neither such a late occurrence of fistula nor coexistence of these complications have been reported.     

Diffuse alveolar hemorrhages and hemorrhagic pleural effusion after thrombolytic therapy with streptokinase for acute myocardial infarction

Thrombolytic therapy with streptokinase is commonly used in acute myocardial infarction and has markedly reduced morbidity and mortality from this condition. However, it can cause various hemorrhagic and immunological complications. We report a patient who developed diffuse pulmonary hemorrhages and bilateral hemorrhagic pleural effusion after thrombolytic therapy with streptokinase for acute myocardial infarction. This was recognized by a drop of hematocrit, pulmonary infiltrates, hemorrhagic pleural effusion and hypoxemia. The diagnosis was confirmed by demonstration of iron-laden macrophages (siderophages) in bronchoalveolar lavage. The patient required mechanical ventilation and recovered successfully. This combination of pulmonary hemorrhages and hemorrhagic pleural effusion following streptokinase therapy is extremely unusual and has not been reported previously.     

Glutathione peroxidase, glutathione reductase, Cu-Zn superoxide dismutase activities, glutathione, nitric oxide, and malondialdehyde concentrations in serum of patients with chronic lymphocytic leukemia

BACKGROUND: Chronic lymphocytic leukemia (CLL) is a rare neoplasm that comprises a substantial proportion of all leukemias in middle-aged persons and is the most common type among elderly persons. The major causes are not known nor is there a detailed understanding about how the elusive origin(s) may relate to clinical expression, basic biological mechanisms, or pathogenesis. METHODS: Glutathione peroxidase (GSH-Px), glutathione reductase (GRD), Cu-Zn superoxide dismutase (Cu-Zn SOD) activities, glutathione (GSH), nitric oxide (NO(*), and malondialdehyde (MDA) concentrations were measured in serum of patients with CLL and a healthy control group. RESULTS: Serum GSH-Px, Cu-Zn SOD activities, GSH concentration were lower in patients with CLL while serum NO(*) and MDA concentrations were higher in these patients compared with the control group. Serum GRD activity was not statistically significant in patients with CLL compared with the control. However, there was no statistically significant difference in the parameters on the basis of stages in these patients. Serum GSH concentration negatively correlated with serum MDA (r=30.63, p<0.05) and NO(*) concentrations (r=0.72, p<0.05) in patients with advanced stage (III+IV). However, no other correlation could be found among the parameters in healthy controls and patients with CLL CONCLUSIONS: There is significant changes in antioxidant defense system in CLL cases, which may lead to enhanced action of oxygen radical, resulting in lipid peroxidation.     

Outcome of Surgery for Crooked Nose: An Objective Method of Evaluation

Objectives: The aim of this study was to report the authors surgical results, and to present their method of angle measurement using the Scion Image computer program to evaluate surgical results for crooked noses.Methods: The study included 27 patients with crooked noses: classified as C-type and 14 classified as I-type. Deviation angles were measured by using the Scion Image computer program on frontal views before and at least 3 months after the operation. Correction of the crooked nose was performed through an open approach with the patients under general anesthesia.Results: Significant correction was achieved for both types of crooked noses (p < 0.05). The results for the I-type crooked noses were closer to the ideal angles than those for the C-type, but the difference was not significant. The findings showed that 66.7% of the patients with crooked noses, had good or excellent results after surgery: 53.8% of those with the C-Type and 78.6% of those with the I-type.Conclusion: It is difficult to achieve satisfactory results in the correction of crooked noses. The angle measurement method using the Scion Image computer program may be helpful in evaluating the effectiveness of different surgical techniques.This study was reported as oral presentation at 27th National Meeting of the Turk Otorhinolaryngology and Head and Neck Surgery Society, Antalya, Turkey, 4–9 October 2003     

Bioefficacy of Mentha piperita essential oil against dengue fever mosquito Aedes aegypti L

Objective

To assess the larvicidal and repellent potential of the essential oil extracted from the leaves of peppermint plant, Mentha piperita (M. piperita) against the larval and adult stages of Aedes aegypti (Ae. Aegypti).

Methods

The larvicidal potential of peppermint oil was evaluated against early fourth instar larvae of Ae. aegypti using WHO protocol. The mortality counts were made after 24 and 48 h, and LC₅₀ and LC₉₀ values were calculated. The efficacy of peppermint oil as mosquito repellent was assessed using the human-bait technique. The measured area of one arm of a human volunteer was applied with the oil and the other arm was applied with ethanol. The mosquito bites on both the arms were recorded for 3 min after every 15 min. The experiment continued for 3 h and the percent protection was calculated.

Results

The essential oil extracted from M. piperita possessed excellent larvicidal efficiency against dengue vector. The bioassays showed an LC₅₀ and LC₉₀ value of 111.9 and 295.18 ppm, respectively after 24 h of exposure. The toxicity of the oil increased 11.8% when the larvae were exposed to the oil for 48 h. The remarkable repellent properties of M. piperita essential oil were established against adults Ae. aegypti. The application of oil resulted in 100% protection till 150 min. After next 30 min, only 1-2 bites were recorded as compared with 8-9 bites on the control arm.

Conclusions

The peppermint essential oil is proved to be efficient larvicide and repellent against dengue vector. Further studies are needed to identify the possible role of oil as adulticide, oviposition deterrent and ovicidal agent. The isolation of active ingredient from the oil could help in formulating strategies for mosquito control.     

Stability of cucurbitacin E in human plasma: chemical hydrolysis and role of plasma esterases

It was shown previously that the anticancerous cytotoxic oxygenated triterpenes, cucurbitacin E (Cuc E) and its deacetylated form, cucurbitacin I (Cuc I), interacted differently with human serum albumin. In this study, the biochemical stability of Cuc E was investigated in vitro by reverse‐phase high performance liquid chromatography. The hydrolysis rate in acidic and alkaline solutions, and in enzymatic conditions in human plasma and in purified plasma esterase solutions of butyrylcholinesterase and albumin, was compared with that measured in phosphate buffer saline (pH 7.4). Cuc E hydrolysis was detected in all the in vitro tests, but the extent of hydrolysis varied according to the different enzymatic and non‐enzymatic conditions. A remarkable rapid hydrolysis of Cuc E was detected in acidic and alkaline solutions. A significant rate of hydrolysis of Cuc E was monitored in human plasma and was associated with the detection of Cuc I. The stability of Cuc E was greatly enhanced in the presence of albumin. However, purified butyrylcholinesterase had no effect on Cuc E stability. Among specific inhibitors of plasma esterases, only EDTA increased Cuc E stability, suggesting that paraoxonase is the human plasma esterase involved in the hydrolysis of Cuc E. Copyright © 2009 John Wiley & Sons, Ltd.     

Defined epitope blocking with Murray Valley encephalitis virus and monoclonal antibodies: laboratory and field studies.

In an attempt to develop a specific serological test for Murray Valley encephalitis (MVE) virus antibodies, a panel of MVE monoclonal antibodies was utilised in defined-epitope blocking ELISA tests. In sera of mice immunised singly and in combinations of MVE, Alfuy (ALF), and Kunjin (KUN) viruses, blocking patterns usually distinguished MVE infections from those of the other flaviviruses. When blocking tests with selected MAbs were applied to 468 flavivirus antibody positive sera collected from human subjects throughout New South Wales, sera with blocking patterns consistent with previous MVE infection were found in 18 subjects. All were long-term residents of areas previously frequented by MVE, and all were of an age to have been exposed to the virus in past epidemics. No such sera were found in subjects living in coastal areas of NSW where MVE has never been reported.