MRI of female genital and pelvic organs during sexual arousal

We utilized contrast enhanced magnetic resonance imaging (MRI) to delineate the anatomy of the female genital and pelvic organs during sexual arousal. Eleven healthy pre-menopausal women and eight healthy post-menopausal women underwent MRI of the pelvis while watching an erotic video. A 1.5 Tesla MR system was used to produce T1-weighted images following administration of MS-325, a gadolinium-based blood pool contrast agent. Selected structural dimensions and enhancement were measured prior to and during sexual arousal. In both pre- and post-menopausal subjects, vestibular bulb and labia minora width increased with arousal. Enhancement measurements increased in the bulb, labia minora and clitoris in both pre- and post-menopausal subjects, and in the vagina in pre-menopausal subjects. There were no marked changes in size or enhancement of the labia majora, urethra, cervix, or rectum during sexual arousal in pre- or post-menopausal subjects. Using MRI, we observed specific changes in the female genitalia and pelvic organs with sexual arousal, in both pre- and post-menopausal women. MRI can potentially provide detailed anatomical information in the assessment of female sexual function, particularly with regard to changes in blood flow.     

Gastric perforation in an adult male following nasogastric intubation

Introduction

Spontaneous gastric perforation is a well known surgical emergency which carries significant mortality and morbidity. Well documented causes in adults include peptic ulcer disease, drugs such as non-steroidal and gastric malignancy. Iatrogenic causes still remain relatively rare. We report an interesting case of an acutely unwell young man who developed gastric perforation secondary to nasogastric intubation.

Case Report

A 32 year old man initially treated for gastroenteritis underwent laparotomy for acute intra-abdominal bleeding. This was found to be secondary to a ruptured left hepatic artery aneurysm which was subsequently embolised. Patient had multiple laparotomies, a nasogastric tube inserted at the second laparotomy was later found to be the cause of gastric perforation. On further investigation the patient’s multiple aneurysms were histologically confirmed to be secondary to fibromuscular dysplasia (FMD).

Conclusion

We present here a case of gastric perforation from a nasogastric tube in an adult male and discussed its relevance to the diagnosis of FMD. This case highlights the importance of having a high index of suspicion for this complication when managing patients with severe abdominal sepsis.     

B细胞能够部分自主控制命运

最近,澳大利亚和爱尔兰科学家在B细胞研究中证实B细胞可在某种程度上控制自己的命运.这一发现在很大程度上会改变科学家们对于细胞命运决定因素的理解.在淋巴结中增殖的B细胞面临着多种命运的抉择：常见的包括细胞死亡、细胞分裂、成为能够分泌抗体的细胞或是改变它们产生的抗体.过去科学界普遍认可的观点是B细胞的命运取决于例如特定激素或细胞信号分子等外部信号.而新研究发现B细胞的命运在很大程度上是由内部的程序所决定.他们开发了新型技术与图像分析方法,通过重建B细胞分化形成不同细胞类型所需的条件,对B细胞进行了追踪成像观测.结果 表明不同的细胞命运是细胞内竞争的结果.即使这些细胞获得相同的外部信号,细胞群体中发生的事件仍会出现相当大的差异.这表明激素或细胞信号分子等外部因素并非是B细胞命运的主宰因子,它们只不过能改变细胞命运选择的概率.     

In ova angiogenesis analgesic and anti inflammatory potency of Aerva Monsoniae (Amaranthaceae)

ObjectiveTo evaluate the wound healing potency of aqueous extract of Aerva monsoniae (A. monsoniae) by in vitro method using fertilized eggs, in vivo analgesic and anti inflammatory activity in rodents and the anti bacterial activity on the bacterial strains that infect the wound.MethodsThe whole plant of A. monsoniae was extracted with water and then subjected to preliminary chemical screening. It was then evaluated for in ova angiogenesis on fertilized white leg horn eggs using the concentrations of 200-600 μ g/mL. The analgesic activity was evaluated in mice using the dose 100 and 250 mg/kg. The anti inflammatory activity was evaluated in rats using the dose 250 mg/kg and 500 mg/kg. In both the parameters water was used as the control and diclofenac was used the standard. The anti bacterial activity on Staphylococcus aureus and Pseudomonas aerugenosa was performed.ResultsThe phytochemical screening revealed the presence of tannins, flavonoids and saponins. The in ova angiogenesis revealed a dose dependent activity which proves the wound healing claim of the plant as more number of blood capillaries were formed at the site of the drug. The plant proved to be a potent analgesic and anti inflammatory agent at doses 100 mg/kg and 250 mg/kg. The anti bacterial activity was present but at higher doses.ConclusionsThe parameters studied in the present investigation proved that the plant is a potent wound healer. Further in vivo wound healing studies on animal model is desired. As the extract showed potent analgesic, anti inflammatory and anti bacterial properties, it can be considered that when formulated into suitable formulation, and it can reduce the pain, inflammation and infections related to wound very well.     

Developing ultra deformable vesicular transportation of a bioactive alkaloid in pursuit of vitiligo therapy

ObjectiveTo develop transfersomal formulation integrated with piperine intended for vitiligo.MethodsFilm hydration technique was employed in the preparation of transfersomes. Modified diffusion cell, consistency tester were fabricated for ex vivo diffusion studies and spreadability studies respectively while tape stripping method was integrated with tissue extraction in the determination of tissue drug concentration.ResultsWhen film hydration technique was used for, ultradeformable vesicles (transfersomes) of piperine in soabean phosphatidylcholine was formed with (67.11±0.22) to (70.55±3.62) and (60.12±1.04) to (80.43±0.14) mean size (μ) and entrapment efficiency (%) respectively. Transfersomes are capable of crossing the pores in permeability barriers extremely efficient even if the transfersome radius (t_r) is much greater than the pore size (r_pore) ie., tr/r_pore? 0.25 the driven flux rate depends on the transdermal osmotic gradient. The vesicles describes elasto-mechanical character of vesicles while penetrating through the pores. The proviso is that the vesicular membrane elasticity is dynamically to the local stress by the external. Diffusion and Spreadability studies showed maximum diffusion when the lipid was kept minimum. Tape stripping and tissue extraction method for the tissue drug retention showed that (75.25±1.72)% drug was retained in the dermis.ConclusionSpan 80 was preferred over tween 80 in terms of dermal retention. Size and encapsulation was slightly altered by phosphatidylcholine concentration. The kinetics, efficiency and the transfersome mediated transport can be tailored for trans-epidermal, deep tissues and systemic depending on the vesicular composition, dose and form. Thus we have offered a successful drug delivery of piperine targeting the deep epidermis.     

Premature thelarche in Kabuki make-up syndrome

A 2 year old girl who has Kabuki make-up syndrome with isolated premature thelarche is presented. She has unique ocular abnormalities which have not been reported previously. In the literature at least 85 patients, most of them from Japan, have been reported. This is the first reported non-Japanese Asian case.     

The geographical assignment of cancer units: patient accessibility as an optimal allocation problem

The seminal report A Policy Framework for Commissioning Cancer Services provides the foundation for a major reorganisation of cancer service provision in England and Wales. One central recommendation of the report, the establishment of a tier of specialised cancer units in each Health Authority Region has raised the fundamental question of where those units are to be located. In particular, a declared objective of the report is for services to be planned to maximise their accessibility to patients. This paper demonstrates a classical method (location-allocation modelling) by which the accessibility criterion can be used to determine the optimal number, location and capacity of units for a given cancer site. The method is illustrated with reference to cervical cancer in Trent Health Authority Region. The implications of the method for the guidance of access-related decisions on the placement of cancer services are considered, and the wider relevance of the method to the organisation of service provision in other branches of medicine is suggested.