"Hour-glass" shape of the uterus in the diagnosis and treatment of cervical pregnancy

This study attempts to point out the importance of the anatomo-clinical finding of an "hour-glass" shape to the uterus in the diagnosis and treatment of cervical pregnancy. From 1973 to 2001, four cases of cervical pregnancy were treated in the 2nd Obstetrical and Gynecological Clinic of the Aristotelion University of Salonica. The incidence was 1:13,111 pregnancies (4 cervical in 52,446 pregnancies). Three of the patients underwent bilateral ligation of the anterior trunk of the internal iliac artery using absorbable ligatures. The fourth patient (a 42-year-old), elected to have a hysterectomy. All patients were well and discharged from hospital on the seventh postoperative day. Two of the three patients treated by ligation of the anterior trunk of the internal iliac arteries subsequently had normal pregnancies and deliveries. We lost contact with the third patient. The finding of an "hour-glass" uterine shape was very helpful in the diagnosis of cervical pregnancy. The Aristotelion University of Salonica has found that treatment by ligation of the anterior trunk of the internal iliac arteries is effective, causes no complications, never ends in hysterectomy, and maintains the normal menstrual cycles and reproductive ability of the woman.     

1049例育龄妇女下生殖道感染情况调查

目的了解育龄妇女下生殖道感染情况,为育龄女性生殖健康提供进一步的数据资料。方法对1049例来自健康体检中心的21~40岁育龄妇女的阴道后穹窿及宫颈分泌物标本进行检测,阴道清洁度、滴虫采用显微镜镜检法,淋球菌、解脲支原体、人型支原体、真菌采用培养法,沙眼衣原体则采用免疫层析法。检测结果进行统计学分析。结果女性生殖道感染的感染率为53.3%,其中混合感染率为9.8%,而清洁度异常率仅为28.4%;前三位病原体感染依次为解脲支原体(35.9%)、衣原体(18.1%)、真菌(6.7%)。结论女性生殖道感染情况严重,具有隐匿性,应加强对无症状感染的育龄妇女的监测。     

Blood coagulation and fibrinolysis after long-duration treadmill exercise controlled by individual anaerobic threshold

For rehabilitation training it is recommended that the intensity of exercise should be clearly below the individual anaerobic threshold (IAT). We investigated blood coagulation, particularly endogenous thrombin potential (ETP) and fibrinolysis following a standardized treadmill (TR) ergometer test at 90% IAT for 60–120 min. Sixteen healthy male non-smokers underwent the TR test. Blood samples were taken after a 30-min rest, immediately after exercise, and 2 h after exercise completion. Extrinsic and intrinsic total (TTP_ex+in) and endogenous (ETP_ex+in) thrombin potential, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT), plasmin-2-antiplasmin complex (PAP), D-dimer, tissue plasminogen activator antigen and activity (tPA-AG and tPA-ACT) and plasminogen activator inhibitor type 1 antigen and activity (PAI-1-AG and PAI-1-ACT) were measured. Immediately after TR, F1+2, TAT and TTP_ex+in were increased (P<0.05) while ETP_ex+in remained unchanged. In contrast, PAP, D-dimer, tPA-AG, tPA-ACT (P<0.05) were distinctly enhanced while PAI-1-ACT was decreased (P<0.05) immediately after exercise. The changes in tPA-AG, tPA-ACT, and PAI-1-ACT were reversed to nearly baseline while the enhancement in PAP and D-dimer was prolonged by more than 2 h after exercise. Long-duration exercise between 60 and 120 min controlled by IAT (90%) on a TR ergometer only implicates a small increase in thrombin generation markers and total (free and ₂-macroglubulin-bound thrombin), but not in endogenous (free) thrombin potential alone. In contrast, fibrinolysis is distinctly increased after this type of exercise. Endurance exercise with an intensity below 90% IAT and a duration below 2 h generates a more favourable condition for fibrinolysis than for blood coagulation in healthy young subjects. Data are given as mean (SD).     

Effect of endurance and sprint exercise on the sensitivity of glucose metabolism to insulin in the epitrochlearis muscle of sedentary and trained rats

Summary The effects of two types of acute exercise (1 h treadmill running at 20 m· min^–1, or 6 × 10-s periods at 43 m · min^–1, 0° inclination), as well as two training regimes (endurance and sprint) on the sensitivity of epitrochlearis muscle [fast twitch (FT) fibres] to insulin were measured in vitro in rats. The hormone concentration in the incubation medium producing the half maximal stimulation of lactate (la) production and glycogen synthesis was determined and used as an index of the muscle insulin sensitivity. A single period of moderate endurance as well as the sprint-type exercise increased the sensitivity of la production to insulin although the rate of la production enhanced markedly only after sprint exercise at 10 and 100 U· ml^–1 of insulin. These effects persisted for up to 2 h after the termination of exercise. Both types of exercise significantly decreased the muscle glycogen content, causing a moderate enhancement in the insulin-stimulated rates of glycogen synthesis in vitro for up to 2 h after exercise. However, a significant increase in the sensitivity of this process to insulin was found only in the muscle removed 0.25 h after the sprint effort. Training of the sprint and endurance types increased insulin-stimulated rates of glycolysis 24 h after the last period of exercise. The sensitivity of this process to insulin was also increased at this instant. Both types of training increased the basal and maximal rates of glycogen snythesis, as well as the sensitivity of this process to insulin at the 24^th following the last training session. It was concluded that in the epitrochlearis muscle, containing mainly FT fibres, both moderate and intensive exercise (acute and repeated) were effective in increasing sensitivity of glucose utilization to insulin. Thus, the response in this muscle type to increased physical activity differs from that reported previously in the soleus muscle, representing the slow-twitch, oxidative fibres in which sprint exercise did not produce any changes in the muscle insulin sensitivity.     

Red cell hemoglobin,hydrogen ion and electrolyte concentrations during exercise in trained and untrained subjects

Summary Red cell concentrations of hemoglobin (MCHC), H⁺, Na⁺, K⁺, Mg⁺⁺, Cl^– were measured in femoral venous blood of six untrained (UT), six endurance trained (TR) and three semitrained (ST) subjects during graded increasing work (4, 8, 12, 18 and 24 mkp/s, 10–15 min on each step) on a bicycle ergometer. Before exercise no significant differences were detected for the measured variables when comparing UT and TR. During exercise MCHC, [Na⁺], [K⁺] and [Mg⁺⁺] remained constant indicating lack of water shift into the erythrocytes in spite of a marked acidosis (lowest pH_Blood value 7.225). This lack resulted from an elevated extracellular osmolality. [H⁺]_Ery and [Cl^–]_Ery maximally increased by 2.0×10^–8 eq/kg H₂O and 10 meq/l, respectively. The change was markedly greater in UT than in TR at equal load. However, if [H⁺]_Ery and [Cl^–]_Ery were related to pH of whole blood, differences between groups almost disappeared and the ions were distributed as predictable from in vitro experiments (Fitzsimmons and Sendroy, 1961). Behaviour of H⁺ and Cl^– may be of importance for oxygen dissociation under in vivo conditions.Supported by Bundesinstitut für Sportwissenschaften, Köln     

Skin vascular response in the hand during sinusoidal exercise in physically trained subjects

The effect of physical training on the cutaneous vascular response during transient exercise load is unclear. We determined the phase response and amplitude response of cutaneous vascular conductance (CVC) in the hand during sinusoidal exercise in endurance exercise-trained and untrained subjects. Subjects exercised on a cycle ergometer with a sinusoidal load for 32 min. The load variation ranged from 10% [23 (1) W in the trained group, 19 (1) W in the untrained group] to 60% [137 (4) W, 114 (6) W] of peak O₂ uptake, and five different time periods (1, 2, 4, 8, and 16 min) were selected. Skin blood flow in the dorsal hand and palm were monitored by laser-Doppler flowmetry. CVC was evaluated from the ratio of blood flow to mean arterial pressure. During sinusoidal exercise, the amplitude of CVC was smaller in the dorsal hand than palm for shorter periods (1, 2, and 4 min) (P<0.05). The phase lag of CVC was smaller in the dorsal hand than palm for longer periods (8 and 16 min) (P<0.05). The amplitude response did not differ significantly between the two groups. The phase lag of CVC in the dorsal hand (P<0.05) and palm (P=0.06) was larger in the trained group than untrained group. These findings suggest that glabrous and nonglabrous skin vascular responses in the hand differ during transient exercise load, and physically trained subjects show a slower vascular response in the two skin areas to exercise stimulation than do untrained subjects.     

The relationship of age and cardiovascular fitness to cognitive and motor processes

Older and younger aerobically trained and sedentary adults participated in an S1-S2-S3 paradigm designed to elicit event-related potential (ERP) and behavioral responses to determine the influence of cardiovascular fitness on cognitive and motor processes. The paradigm provided warning (S1) as to the difficulty level of an upcoming decision task (S2). Participants had to decide the taller of two bars on presentation of S2 but hold their response until S3, to which they indicated their choice motorically. Results revealed age-related differences for ERP measures as older participants showed increased amplitude of the stimulus preceding negativity (SPN) prior to S2, and longer latencies and equipotentiality of P3 in response to S2. Fitness effects were also observed for the contingent negative variation (CNV) with decreased amplitude for fit relative to sedentary individuals. Age interacted with fitness for P3 latency to S2 as older sedentary individuals showed the longest latency followed by older fit and both younger groups. No significant group differences were observed for reaction time (RT) to S3. Therefore, physical fitness is associated with attenuation of cognitive decline in older individuals and greater economy of motor preparation for both young and older participants.     

Numerous eosinophilic globules (skeinoid fibers) in a duodenal stromal tumor: An exceptional case showing smooth muscle differentiation

A unique case of duodenal stromal tumor In a 51-year-old man is reported. The tumor histologically showed spindle cell proliferation and numerous eosinophilic globules. Most globules were composed of tangled 45 nm thick fibrils, which were ultrastructurally Identical to 'skelnoid fibers'. The presence of glycogen granules in the tumor cells and the Immunoreactivity for α-smooth muscle actin suggested smooth muscle differentiation. Focal ultrastructural findings also supported the smooth muscle nature of this tumor. There were no immunohistochemical and ultra-structural features indicating neural differentiation. In previous studies, the presence of such 'skeinoid fibers' was suggested to be a histological marker for neural differentiation in gastrointestinal stromal tumor. However, the findings In the present case suggest that numerous 'skeinoid fibers' can be Identified in duodenal stromal tumor with smooth muscle differentiation, although this condition may be rare.     

The effect of physical conditioning on antipyrine clearance

The effects of physical conditioning on antipyrine clearance were studied in two groups of subjects. Healthy men not engaged in the systematic practice of any sport were compared with endurance runners (defined as men running >80 km/week). Studies were carried out at three different periods of the annual plan training at 4-month intervals. Antipyrine was administered orally and pharmacokinetic parameters were obtained from saliva samples by the multiple-sample method. Endurance performance, expressed in terms of the maximal oxygen uptake (V˙O_{2 max}), the ventilatory threshold and the 4-mM · l⁻¹ lactate threshold (OBLA), was higher in trained than in control subjects at each of the three periods. Antipyrine clearance was also significantly elevated and antipyrine half-life reduced in runners during all periods. No significant difference in V˙O_{2 max} or antipyrine clearance was found between the various periods in either trained or control subjects. Both ventilatory threshold and OBLA increased significantly along the training period in conditioned subjects. Significant correlations were found between antipyrine clearance and V˙O_{2 max}, ventilatory threshold and OBLA. In summary, these results indicate an association between aerobic conditioning and increased hepatic oxidative metabolism of low-clearance drugs. Accepted: 15 July 1997     

Retrograde migration of glove powder in the human female genital tract

BACKGROUND: This study in humans was undertaken to evaluate earlier results from animal research showing a retrograde migration of glove powder from the vagina into the intra-abdominal cavity. METHODS: One study group was gynaecologically examined with powdered gloves the day before an abdominal hysterectomy and another group 4 days pre-operatively. There were two control groups similarly examined with powder-free gloves. Cell smears were taken from the peritoneal fluid and during the operation further smears were taken from the Fallopian tubes, uterine cavity and cervical canal. RESULTS: Statistically significant differences were found for large starch particles at all locations between the study and control groups examined 1 day pre-operatively. Considering small starch particles, there were significant differences in cervix (P < 0.001), uterus (P < 0.01) and the Fallopian tubes (P < 0.01). The combined results also show significant differences between both large and small starch particles in cervix, uterus and the Fallopian tubes. There were also differences between the study and control groups examined 4 days pre-operatively, but these were not statistically significant except for small and large starch particles in uterus (P < 0.01, P < 0.05) and cervix (P < 0.05, P < 0.05). CONCLUSIONS: This study has pointed out a retrograde migration of starch also in humans after a gynaecological examination with powdered gloves. Consequently, powder or any other potentially harmful substance that can migrate from the vagina should be avoided.