Minimal laser conization during pregnancy

The objective of this study was to evaluate a minimal laser conization procedure during pregnancy for safe diagnosis and treatment of carcinoma in situ. This was a clinical prospective study in a University Hospital. Seventy-five pregnant women selected on the basis of a cervical smear showing carcinoma in situ or dysplasia, or an extensive picture confirmed by colposcopy, were referred for minimal conization procedure. A free-hand minimal conization procedure using a carbon dioxide (CO₂) laser was performed in ambulant care under local anaesthesia. The minimal conization procedure is defined as the removal of a 7.0 mm high, slightly conical tissue specimen from the uterine cervix containing the entire transformation zone. After the cone specimen was taken, routine cervical curettage was also performed. There were no complications attributable to the conization procedure and no adverse effects either during pregnancy or at delivery. Histopathological examination of the cone specimens from 75 patients revealed carcinoma in situ or dysplasia in 65 cases. More advanced malignancy was found in 10 cases; micro-invasive carcinoma stage 1A (n = 7) or stage 1B (n = 3). The minimal conization procedure with CO₂ laser during pregnancy enables safe diagnosis of carcinoma in situ selected by cytology and colposcopy. It also proved useful for diagnosis and treatment of stage 1A or stage 1B carcinoma, enabling pregnancy to be preserved and radical cancer treatment to be postponed until delivery.     

Y-STR variation among Slavs: evidence for the Slavic homeland in the middle Dnieper basin

A set of 18 Y-chromosomal microsatellite loci was analysed in 568 males from Poland, Slovakia and three regions of Belarus. The results were compared to data available for 2,937 Y chromosome samples from 20 other Slavic populations. Lack of relationship between linguistic, geographic and historical relations between Slavic populations and Y-short tandem repeat (STR) haplotype distribution was observed. Two genetically distant groups of Slavic populations were revealed: one encompassing all Western-Slavic, Eastern-Slavic, and two Southern-Slavic populations, and one encompassing all remaining Southern Slavs. An analysis of molecular variance (AMOVA) based on Y-chromosomal STRs showed that the variation observed between the two population groups was 4.3%, and was higher than the level of genetic variance among populations within the groups (1.2%). Homogeneity of northern Slavic paternal lineages in Europe was shown to stretch from the Alps to the upper Volga and involve ethnicities speaking completely different branches of Slavic languages. The central position of the population of Ukraine in the network of insignificant AMOVA comparisons, and the lack of traces of significant contribution of ancient tribes inhabiting present-day Poland to the gene pool of Eastern and Southern Slavs, support hypothesis placing the earliest known homeland of Slavs in the middle Dnieper basin.     

Microparticle formation and its mechanism in single and double emulsion solvent evaporation.

The emulsification is the first step of the emulsification solvent evaporation method and has been extensively investigated. On the contrary the second step, the solvent transport out from the emulsion droplets that determine the particle morphology and with great influence on the microparticles encapsulation and release behavior has been scarcely studied. This study investigates the mechanism of the solvent elimination from the emulsion droplets and its influence on the particle morphology, encapsulation and release behavior. Usually, the solvent is highly volatile that makes the solvent elimination process very fast thus difficult to observe. In order to observe in detail the microparticle formation, the initial emulsion was monitored by optical microscope under controlled solvent evaporation conditions. The results from the optical microscopic observations corroborated with laser diffractometry analysis showed that in single emulsion formulations, spherical microparticles are formed by accelerated solvent elimination due to the combined effects of high solvent volatility and polymer precipitation. The solvent expulsion accompanied by important shrinkage generates on the microparticle surface a thin layer of nanoparticles attested by scanning electron microscopy and laser diffractometry. During the intense solvent elimination, the encapsulated substance is drained, affecting the loading efficiency. Furthermore, it will concentrate towards the microparticle surface contributing to the initial burst release. In double emulsion formulations, microparticles with different morphologies are generated due to the presence of the aqueous-phase microdroplets inside the emulsion droplet. During the solvent elimination, these microdroplets generally coalesce under the pressure of the precipitating polymer. Depending mainly on the polymer concentration and emulsification energies, the final microparticles will be a mixture of honeycomb, capsule or plain structure. During the shrinkage due to the incompressibility of the inner microdroplets, the precipitating polymer wall around them may break forming holes through which the encapsulated substance is partly expulsed. Through these holes, the encapsulated substance is further partitioning with the external aqueous phase during solvent evaporation and contributes to the initial burst release during the application.     

A Phase II study of neoadjuvant axitinib for reducing the extent of venous tumour thrombus in clear cell renal cell cancer with venous invasion (NAXIVA)

Background Surgery for renal cell carcinoma (RCC) with venous tumour thrombus (VTT) extension into the renal vein (RV) and/or inferior vena cava (IVC) has high peri-surgical morbidity/mortality. NAXIVA assessed the response of VTT to axitinib, a potent tyrosine kinase inhibitor.Methods NAXIVA was a single-arm, multi-centre, Phase 2 study. In total, 20 patients with resectable clear cell RCC and VTT received upto 8 weeks of pre-surgical axitinib. The primary endpoint was percentage of evaluable patients with VTT improvement by Mayo level on MRI. Secondary endpoints were percentage change in surgical approach and VTT length, response rate (RECISTv1.1) and surgical morbidity.Results In all, 35% (7/20) patients with VTT had a reduction in Mayo level with axitinib: 37.5% (6/16) with IVC VTT and 25% (1/4) with RV-only VTT. No patients had an increase in Mayo level. In total, 75% (15/20) of patients had a reduction in VTT length. Overall, 41.2% (7/17) of patients who underwent surgery had less invasive surgery than originally planned. Non-responders exhibited lower baseline microvessel density (CD31), higher Ki67 and exhausted or regulatory T-cell phenotype.Conclusions NAXIVA provides the first Level II evidence that axitinib downstages VTT in a significant proportion of patients leading to reduction in the extent of surgery.Clinical trial registration {"type":"clinical-trial","attrs":{"text":"NCT03494816","term_id":"NCT03494816"}}NCT03494816.Subject terms: Surgical oncology, Renal cell carcinoma, Predictive markers     

Prevalence of urinary incontinence in middle-aged women

An anonymous questionnaire was used to interview 946 premenopausal women (age 29-52 years), previously either hysterectomized or laparoscopically sterilized, concerning disorders of the urinary tract. Of the 750 (79.3%) women that responded, 307 (40.9%) admitted to some degree of urinary disorder. The prevalence of urinary disorders was 170/415 (40.9%) for the women with a previous supravaginal or total hysterectomy and 137/335 (40.8%) for the women in the sterilization group. Of the responding women 85 (11.3%) experienced a urinary loss sufficient to necessitate the wearing of a sanitary napkin or change of underclothing several times a day.     

Numerical Modeling of Blood Flow in the Ventricular Cavity of the Artificial Heart

Summary: The flow of blood as a viscous, Newtonian, incompressible liquid in an expanding spherical cavity with a ball-type inlet valve was examined. This type of flow can serve as a model of the phase of ventricular diastole in a sac-type artificial heart. The critical values of Reynolds numbers at which flow interruption behind the valve occurs were found. The optimum geometric ratios of the dimensions of the ventricular cavity and valve that permit a decrease in the input resistance of the cavity, the size of the valve, and the surface tensions in the bloodstream were determined.