Vesicovaginal fistula resulting from loop electrosurgical excision in a woman with intraepithelial neoplasia of the cervix and vagina: a case report

A 52-year-old woman had concomitant cervical intraepithelial neoplasia (CIN) grade 3 and vaginal intraepithelial neoplasia grade 3. On performing a loop electrosurgical excision procedure, a vesicovaginal fistula accidentally occurred. The vaginal intraepithelial neoplasia covering the anterior fornix could have been a contributing factor in the occurrence of the fistula.     

Efficient replication of full-length murine leukemia viruses modified at the dimer initiation site regions

Retroviruses encapsidate two copies of full-length viral RNA molecules linked together as a dimeric genome. RNA stem loop structures harboring palindromic (or "kissing") loop sequences constitute important cis-elements for viral dimerization known as dimer initiation sites (DIS). In murine leukemia virus (MLV), a 10-mer and a 16-mer palindrome (DIS-1 and DIS-2, respectively) located in the viral leader region mediate dimerization in vitro and affect dimer stability of vector RNA in vivo. We have investigated the effect on viral replication of introducing deletions or nucleotide substitutions within these palindromes in a full-length MLV genome. Our results demonstrate that viruses modified at the dimer initiation site regions are viable and show wild-type levels of RNA encapsidation. One mutant lacking the DIS-1 palindrome was severely impaired and displayed an increased cellular ratio of spliced versus genomic RNA that most likely contributes to the inefficient replication. The implications for development of DIS-modified retrovirus-based vectors are discussed.     

Effects of breastfeeding chemosignals on the human menstrual cycle

BACKGROUND: To date, there has not been an investigation to determine whether lactating women and their infants influence the ovarian function of other women with whom they interact. METHODS: In a randomized, double-blind, placebo-controlled study of 47 nulliparous women, we utilized both within- and between-subjects controls to assess the effects of sustained exposure to breastfeeding compounds on menstrual cycle length, as well as characteristics of each phase of the ovarian cycle. RESULTS: Breastfeeding compounds modulated ovarian cycle length in comparison with the carrier control (0.01 < or = all P values < or = 0.05), disrupting the normal homeostatic regulation of cycle length and tripling its variance. Hence, women with long cycles stayed long and did not regress to the mode of 29 days and women with short cycles maintained short cycles. This effect was driven by changes in both the follicular and luteal phases of the cycle (0.01 < or = all P values < or = 0.04) and changed the timing of the pre-ovulatory surge of LH. CONCLUSIONS: Because compounds from lactating women and their infants modulated the ovarian cycles of women, as is seen in other mammals, they have the potential to function as pheromones, regulating fertility within groups of women.     

A re-evaluation of the premaxillary bone in humans

The discovery of the premaxillary bone (os incisivum, os intermaxillare or premaxilla) in humans has been attributed to Goethe, and it has also been named os Goethei. However, Broussonet (1779) and Vicq dAzyr (1780) came to the same result with different methods. The first anatomists described this medial part of the upper jaw as a separate bone in the vertebrate skull, and, as we know, Coiter (1573) was the first to present an illustration of the sutura incisiva in the human. This fact, and furthermore its development from three parts:—(1) the alveolar part with the facial process, (2) the palatine process, and (3) the processus Stenonianus—can no longer be found in modern textbooks of developmental biology. At the end of the nineteenth and in the early twentieth century a vehement discussion focused on the number and position of its ossification centers and its sutures. Therefore, it is hard to believe that the elaborate work of the old embryologists is ignored and that the existence of a premaxillary bone in humans is even denied by many authors. Therefore this re-evaluation was done to demonstrate the early development of the premaxillary bone using the reconstructions of Felber (1919), Jarmer (1922) and data from our own observations on SEM micrographs and serial sections from 16 mm embryo to 68 mm fetus. Ossification of a separate premaxilla was first observed in a 16 mm embryo. We agree with Jarmer (1922), Peter (1924), and Shepherd and McCarthy (1955) that it develops from three anlagen, which are, however, not fully separated. The predominant sutura incisiva (rudimentarily seen on the facial side in a prematurely born child) and a shorter sutura intraincisiva argue in this sense. The later growth of this bone and its processes establish an important structure in the middle of the facial skull. Its architecture fits well with the functional test of others. We also focused on the relation of the developing premaxilla to the forming nasal septum moving from ventral to dorsal and the intercalation of the vomer. Thus the premaxilla acts as a stabilizing element within the facial skeleton comparable with the keystone of a Roman arch. Furthermore, the significance of the premaxillary anlage for the closure of the palatine was documented by a synopsis made from a stage 16, 10.2 mm GL embryo to a 49 mm GL fetus. Finally the growth of the premaxilla is closely related to the development of the human face. Abnormal growth may be correlated to characteristic malformations such as protrusion, closed bite and prognathism. Concerning the relation of the premaxillary bone to cleft lip and palate we agree with others that the position of the clefts is not always identical with the incisive suture. This is proved by the double anlagen of an upper–outer incisor in a 55 mm fetus and an adult.     

Monaural and binaural perception of approaching and withdrawing auditory images in humans

Radial motion of the auditory image (approach or withdrawal) was modeled with the help of two loud-speakers placed at different distances from the listener in the anechoic chamber. The thresholds of sound duration for image motion and differential thresholds for its velocity at various azimuthal angles were studied. At azimuthal angles of 0 degrees, 30 degrees, 45 degrees, and 60 degrees, the threshold values of the stimulus durations were 150-200 ms. At an azimuthal angle of 90 degrees from the head midline, it increased by about 25-30% as compared to other angles. In the case of monaural listening to the signals by unilaterally deaf subjects, the threshold durations of the sound signals were two to three times higher as compared to healthy subjects. Differential thresholds for calculated velocity of the radial motion have been measured within the range 0.4-1.0 m/s, increasing with increase of the standard velocity from 3.4 to 6.9 m/s.     

Oral glutamine attenuates indomethacin-induced small intestinal damage

The use of NSAIDs (non-steroidal anti-inflammatory drugs), although of great therapeutic value clinically, is limited by their tendency to cause mucosal damage in the gastrointestinal tract. In the small intestine, the effects these drugs have been shown to produce include inhibition of cyclo-oxygenase, mitochondrial dysfunction and free radical-induced oxidative changes, all of which contribute to the mucosal damage seen. Glutamine is a fuel preferentially used by enterocytes and is known to contribute to maintaining the integrity of these cells. In the present study, we investigated the effect of glutamine on indomethacin-induced changes in the small intestinal mucosa. Rats were given 2% glutamine or glutamic acid or isonitrogenous amino acids, glycine or alanine, in the diet for 7 days. Indomethacin was then administered orally at a dose of 40 mg/kg of body weight. After 1 h, the small intestine was removed and used for the measurement of parameters of oxidative stress and mitochondrial and BBM (brush border membrane) function. Evidence of oxidative stress was found in the mucosa of the small intestine of drug-treated rats, as indicated by significantly increased activity of xanthine oxidase (P < 0.001) and myeloperoxidase (P < 0.001), with corresponding decreases in the levels of several free radical scavenging enzymes and alpha-tocopherol (P < 0.001 in all cases). Levels of products of peroxidation were also significantly elevated (P < 0.001 for all the parameters measured). In addition, oxidative stress was evident in isolated intestinal mitochondria and BBMs (P < 0.001 for all the parameters measured), with associated alterations in function of these organelles (P < 0.001 for all the parameters measured). Supplementation of the diet with glutamine or glutamic acid prior to treatment with indomethacin produced significant amelioration in all the effects produced by the drug in the small intestine (P < 0.001 for all the parameters measured). Glycine and alanine were found to be much less effective in these respects.     

Incidence and risk factors of HCV and HIV infections in a cohort of intravenous drug users in the North and East of France

In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among injecting drug users (IDUs), we conducted a prospective cohort study of HCV- and human immunodeficiency virus (HIV)-negative IDUs in the North and East of France. A total of 231 HCV and HIV IDUs who had injected drugs at least once in their lifetime were followed up every 3 months over a 12-month period. Serum anti-HCV and anti-HIV were tested at inclusion in the study and at the end of the follow-up. Data on injecting practices were collected at inclusion and at each visit. Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9/100 person-years (95% CI 4.6-13.4) for HCV infection. In a multivariable analysis, we found that syringe and cotton sharing were the only independent predictive factors of HCV seroconversion.