Effect of one-week treatment with vaginal estrogen preparations on serum estrogen levels in postmenopausal women

OBJECTIVE: Approximately 50% of postmenopausal women suffer from vaginal atrophy, and a large proportion of them choose intravaginal estrogen preparations administered for local action to avoid systemic exposure to estrogens and its associated risk of breast and uterine cancer. The primary objective of this study was the evaluation of the systematic bioavailability of estradiol and estrone and the pharmacokinetics of two of the most frequently used intravaginal estrogen preparations, namely Vagifem and Premarin cream. DESIGN: While immunobased assays could not previously provide accurate measurement of serum estrogen concentrations in postmenopausal women, we have used validated mass spectrometry assays to measure the pharmacokinetics of serum estradiol and estrone during the 24 hours following the seventh daily application of 25 microg estradiol (Vagifem) and 1 g (0.625 mg) conjugated estrogens (Premarin) cream in 10 postmenopausal women in each group. RESULTS: Serum estradiol was increased on average by 5.4-fold from 3 to 17 pg/mL during the 24-hour period after daily administration of 25 microg estradiol or 1 g (0.625 mg) conjugated estrogens cream. Serum estrone, conversely, increased 150% with Vagifem and 500% with Premarin cream. CONCLUSIONS: The present data using validated, accurate, and sensitive mass spectrometry assays of estrogens show that the Vagifem pill and Premarin cream, after 1 week of daily treatment, cause an approximately fivefold increase in serum estradiol in postmenopausal women, thus indicating that the effects are unlikely to be limited to the vagina and that systemic actions are expected after application of these intravaginal estrogen preparations.     

Can Quiet Standing Posture Predict Compensatory Postural Adjustment?

OBJECTIVE

The aim of this study was to analyze whether quiet standing posture is related to compensatory postural adjustment.

INTRODUCTION

The latest data in clinical practice suggests that static posture may play a significant role in musculoskeletal function, even in dynamic activities. However, no evidence exists regarding whether static posture during quiet standing is related to postural adjustment.

METHODS

Twenty healthy participants standing on a movable surface underwent unexpected, standardized backward and forward postural perturbations while kinematic data were acquired; ankle, knee, pelvis and trunk positions were then calculated. An initial and a final video frame representing quiet standing posture and the end of the postural perturbation were selected in such a way that postural adjustments had occurred between these frames. The positions of the body segments were calculated in these initial and final frames, together with the displacement of body segments during postural adjustments between the initial and final frames. The relationship between the positions of body segments in the initial and final frames and their displacements over this time period was analyzed using multiple regressions with a significance level of p ≤ 0.05.

RESULTS

We failed to identify a relationship between the position of the body segments in the initial and final frames and the associated displacement of the body segments.

DISCUSSION

The motion pattern during compensatory postural adjustment is not related to quiet standing posture or to the final posture of compensatory postural adjustment. This fact should be considered when treating balance disturbances and musculoskeletal abnormalities.

CONCLUSION

Static posture cannot predict how body segments will behave during compensatory postural adjustment.     

Risk factors for the formation of striae gravidarum in women in Jiangsu Province of China

ObjectiveWe study the risk factors that affect the formation of striae gravidarum in women in Jiangsu Province of China under current living habits.Materials and methodsThis sample is based on 400 primiparas from obstetric of the Affiliated Hospital of Jiangnan University in Wuxi from February 2017 to October 2017. Among them, there are 200 pregnant women with striae gravidarum and 200 without striae gravidarum. Striae gravidarum predictors were selected such as age, height, pre-pregnancy BMI, postpartum BMI, daily sitting time, weight gain during pregnancy, fetal weight, and diet on maternal.Results(1) The pregnant women who had striae gravidarum were generally lower in height than those who did not have striae gravidarum and had a higher BMI index than those who did not have striae gravidarum before and after childbirth. (2) In the pregnant women who have had striae gravidarum, the incidence of abdominal striae gravidarum in sedentary women is significantly lower than those in non-sedentary women, the incidence of striae gravidarum in legs is higher than those in non-sedentary women, and no significant difference in hip striae gravidarum. (3) In all pregnant women who have striae gravidarum, abdomen striae gravidarum tend to be lighter and leg striae gravidarum tends to be heavier in sedentary women, but no significant effect on the hip. (4) Regular consumption of honey, milk, trotters, freshwater fish, eggs, and tremella can reduce the incidence of striae gravidarum.ConclusionThe lifestyle and eating habits have a certain influence on the formation and severity of stretch marks.     

Increased expression of tuberin in human uterine leiomyoma

Female Eker rats harboring an insertional deletion in one copy of the tuberous sclerosis complex 2 (Tsc2) gene develop uterine leiomyoma, but the underlying mechanism of human uterine leiomyoma is not completely understood. To examine whether down-regulation of tuberin, a TSC2 gene product, is present in human uterine leiomyoma, we analyzed leiomyoma and matched myometrium tissues from 22 Chinese patients with Western blotting and real-time polymerase chain reaction analyses, and found that the expression of tuberin was significantly increased in leiomyoma tissues compared with matched myometrium tissues with inhibition of both the mammalian target of rapacmycin pathway and mitogen-activated protein kinase pathways.     

Ewing sarcoma-primitive neuroectodermal tumor of the uterus: a clinicopathologic,immunohistochemical and ultrastructural study of one case

Introduction  

Ewing sarcoma-primitive neuroectodermal tumors (ES/PNET) constitute a family of neoplasms characterized by a continuum of neuroectodermal differentiation. ES/PNET of the uterus is rare. There are 43 cases published in the English literature as far as we know. We describe an additional case.     

Sexual Rehabilitation and Penile Pain Associated with Intracavernous Alprostadil after Radical Prostatectomy

IntroductionIntracavernous alprostadil injection (IAI) is widely used for sexual rehabilitation (SR) after radical prostatectomy (RP). However, the rate of spontaneous erection recovery with IAI remains unclear, and IAI causes pain that may hinder SR.AimsTo assess SR in IAI users after RP and to evaluate the course and impact on SR of postinjection penile pain.MethodsWe prospectively studied 87 patients who underwent nerve‐sparing laparoscopic RP, reported normal preoperative erectile function, and used IAI for 12 months. Patients started with 2.5 µg alprostadil and were advised to increase the dose gradually until erection hardness allowed vaginal penetration.Main Outcome MeasuresAt 6 and 12 months, the International Index of Erectile Function (IIEF‐15) and Erection Hardness Score (EHS) were determined with and without IAI, and injection‐related penile pain was assessed using a numeric rating scale. Correlations linking penile pain, IIEF‐15, and EHS scores were evaluated.ResultsThe mean alprostadil dose was 8.1 µg after 6 months and 9.9 µg after 12 months. With/without IAI, mean IIEF‐15 scores for erectile and orgasmic function and mean EHS score were 14.6/4.6, 4.1/2.1, and 2.5/0.4, respectively, after 6 months; and 17.2/5.4, 4.9/2.6, and 2.7/0.9 after 12 months. Pain scores were 3.2 ± 2.5/10 and 2.5 ± 2.5/10 after 6 and 12 months, respectively. Pain intensity correlated with erectile function (r = ?0.23), intercourse satisfaction (r = ?0.23), and overall satisfaction (r = ?0.24) after 6 months but not after 12 months. Follow‐up was short and only patients who used IAI for 12 months were included.ConclusionsIn patients who were willing and able to use IAI, erectile function improved after 1 year but remained below preoperative levels. The adverse impact of pain on SR was significant during the first 6 months and diminished over time. These data may help to counsel IAI users with painful erections. Yiou R, Cunin P, de la Taille A, Salomon L, Binhas M, Lingombet O, Paul M, and Abbou C. Sexual rehabilitation and penile pain associated with intracavernous alprostadil after radical prostatectomy.     

CaMKIIδ在破骨细胞分化不同阶段表达规律的研究

目的:研究钙离子/钙调蛋白依赖性蛋白激酶II(Ca MKII)δ在破骨细胞分化不同阶段的表达规律,以揭示其在破骨细胞分化中的作用。方法:应用50μg/L核因子κB受体激活因子配体(RANKL)诱导小鼠RAW264.7细胞向破骨细胞分化;通过抗酒石酸酸性磷酸酶(TRAP)染色及骨磨片吸收陷窝检测评价破骨细胞生成情况;同时于诱导第0、1、3、5天末通过免疫荧光细胞化学、RT-q PCR和Western blot法检测Ca MKIIδ的mRNA及蛋白表达水平。结果:TRAP染色及骨吸收陷窝检测显示于诱导第5天有多核破骨细胞生成。第0、1、3、5天Ca MKIIδ的mRNA表达水平分别为1.028±0.041、2.478±0.087、10.524±1.284和42.914±2.667,蛋白相对水平分别为0.762、0.963、1.802和3.136,免疫荧光细胞化学检测显示Ca MKIIδ的荧光6强度呈时间依赖性递增。结论:Ca MKIIδ的表达随破骨细胞分化逐步增高,提示Ca MKIIδ在破骨细胞分化中可能起着关键调控作用。     

Recollection is delayed under changed viewing conditions: A graded effect on the latency of the late posterior component

Object recognition is a central human ability. In everyday life, the conditions under which objects have to be recognized are usually not perfect. Often, viewing conditions change in between two encounters with an object; typical are changes in illumination or in the object‐observer distance. With such changes, object recognition sometimes feels slightly delayed. We examined this phenomenon empirically by measuring the latency of the well‐established electrophysiological correlate of recollection, the late posterior component (LPC), in an object‐recognition task. Although the cognitive processes underlying successful recognition are well examined, thus far the consequences of changed viewing conditions on the timing of these processes have not been investigated. The ERP technique is well suited for investigating this question, because it allows differentiating between processes contributing to recognition times (in particular, recollection from familiarity as indexed by the FN400 component) and measuring their time course with high temporal precision. In the present study, participants' task was to differentiate previously studied (old) objects from a set of new objects. Viewing conditions for old objects changed slightly, changed strongly, or remained identical between learning and test. We found that the latency of the LPC in response to an old object was delayed whenever viewing conditions changed. Moreover, this delay in LPC latency scaled with the size of the change. These effects were absent for the FN400. This is the first examination of effects of changes in viewing conditions on the latency of recollection and the first dissociation of FN400 and LPC latencies.     

Neutrophil extracellular traps cause airway obstruction during respiratory syncytial virus disease

Human respiratory syncytial virus (RSV) is the most important cause of severe lower respiratory tract disease (LRTD) in young children worldwide. Extensive neutrophil accumulation in the lungs and occlusion of small airways by DNA‐rich mucus plugs are characteristic features of severe RSV–LRTD. Activated neutrophils can release neutrophil extracellular traps (NETs), extracellular networks of DNA covered with antimicrobial proteins, as part of the first‐line defence against pathogens. NETs can trap and eliminate microbes; however, abundant NET formation may also contribute to airway occlusion. In this study, we investigated whether NETs are induced by RSV and explored their potential anti‐viral effect in vitro. Second, we studied NET formation in vivo during severe RSV–LRTD in infants and bovine RSV–LRTD in calves, by examining bronchoalveolar lavage fluid and lung tissue sections, respectively. NETs were visualized in lung cytology and tissue samples by DNA and immunostaining, using antibodies against citrullinated histone H3, elastase and myeloperoxidase. RSV was able to induce NET formation by human neutrophils in vitro. Furthermore, NETs were able to capture RSV, thereby precluding binding of viral particles to target cells and preventing infection. Evidence for the formation of NETs in the airways and lungs was confirmed in children with severe RSV–LRTD. Detailed histopathological examination of calves with RSV–LRTD showed extensive NET formation in dense plugs occluding the airways, either with or without captured viral antigen. Together, these results suggest that, although NETs trap viral particles, their exaggerated formation during severe RSV–LRTD contributes to airway obstruction. Copyright © 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.