Persistent levator co-activation is not associated with symptoms or bother of obstructed defecation.

Introduction And Hypothesis: The objective was to determine whether levator contraction during Valsalva (i.e. levator co-activation), as visualised on four-dimensional translabial ultrasound (4D-TLUS), is associated with obstructed defecation (OD).

Prospective comparison of obstetric anal sphincter injury incidence between an Asian and Western hospital.

Introduction And Hypothesis: Obstetric anal sphincter injury (OASIS) rates are reported to be higher in Asian women living in Western countries than in those living in Asia, but the reasons for the differences remain unclear. The objectives of this study were for a single examiner to prospectively compare OASIS rates in primiparous Asian women in an Asian and Western birth unit and determine potential birth factors that may influence the possible difference in OASIS incidence.

Methods: This was a prospective observational study based in Hong Kong, China, and Sydney, Australia, involving primiparous women > 36 weeks gestation of Asian descent undergoing vaginal delivery.

Cystourethroscopy following midurethral slings: is it always necessary?

Midurethral slings are the mainstay of treatment for stress urinary incontinence. The role of cystourethroscopy to detect lower urinary tract injury following retropubic midurethral slings is well-established; however, its role following transobturator or single-incision sling placement remains controversial. Some advocate "routine" whereas others advocate for "selective" cystourethroscopy.

Video of the laparoscopic repair of a vesico-uterine fistula.

Aim: Vesico-uterine fistulas (VUFs) are rare in modern gynecological practice. We aim to demonstrate with a video the surgical techniques involved in laparoscopic repair of a vesico-uterine fistula (Youssef's syndrome).

Methods: A 37-year-old woman, para 2 and otherwise healthy, was referred to the Urogynaecology Unit 4 months following a vaginal birth after a previous cesarean, with ongoing pink-colored vaginal watery discharge.

Evolution of social media: review of the role of podcasts in gynaecology.

Podcasts are an emerging social media phenomenon in medicine, originating from critical care specialities and now expanding to other domains. Aided by the rapid increase in popularity of social media platforms and the advantage of accessibility, universality and portability, there has been a slow but significant expansion of podcast use in gynaecology. Current literature suggests that there is potential for digital communication to enhance dissemination of information, however there is conflicting evidence on its ability to increase users' knowledge.

Value of Specialist Pathology Review in a Single Statewide Gynecologic Cancer Service.

Objective: A case review by specialist diagnostic pathologists as part of a Gynecologic Oncology Multi-disciplinary Tumor group has the potential to influence the management of patients with cancer. The primary aim of this study was to determine the frequency of diagnostic discrepancies between the initial (nonspecialist) and final pathological diagnoses in cases referred to the Gynecologic Oncology Tumor Conference (TC) in Western Australia and the impact of such revised diagnosis on clinical management. A secondary aim was to assess the evolving workload encountered by the TC during a 5-year interval.

On how insulin may influence ageing and become atherogenic throughout the insulin-like growth factor-1 receptor pathway: in vitro studies with human vascular smooth muscle cells.

Background: It is known that growth factors play a role in ageing and atherogenesis, and insulin develops mitogenic activity in vitro.

Objectives: This study focuses on the pathway by which insulin induces proliferation and mobility in vascular smooth muscle cells (SMCs) compared with that of insulin-like growth factor-1 (IGF-1), because they are two basic phenomena for atherogenesis that could also help to understand the role of insulin in the ageing process.

Methods: Bromodeoxyuridine DNA incorporation, chemotaxis and the appearance of membrane ruffles were measured in cultured SMCs after incubation with insulin or IGF-1 in the presence of insulin or IGF-1 receptor-blocking antibodies.

Age-dependent decline of in vitro migration (basal and stimulated by IGF-1 or insulin) of human vascular smooth muscle cells.

Since biological aging causes a decrease in functions such as cell proliferation, we have studied the possible effect of age on the migration capacity of human vascular smooth muscle cells (SMCs). To this aim, the migration activity of cultured SMCs from arteries of male human donors ranging in age from 43-77 years was determined in a Boyden chamber, under basal conditions and after insulin-like growth factor-1 (IGF-1) or insulin stimulation. Migration activity decreased with donor age (r2 = 87%, 85%, and 78%, respectively).

L-calcium channel blockade induced by diltiazem inhibits proliferation, migration and F-actin membrane rearrangements in human vascular smooth muscle cells stimulated with insulin and IGF-1.

During the atheroma plaque formation, smooth muscle cells (SMC) have to change their differentiated phenotype in order to proliferate, migrate and synthesize collagen. These phenotypic changes are stimulated by insulin and IGF-1, and we have studied the effect of L-type calcium channel blockade produced by diltiazem on such changes. Mitotic activity was measured using bromodeoxyuridine DNA incorporation, the migration capability as chemotaxis index in a Boyden chamber, and cytoskeleton changes related to SMC movement in immunofluorescence studies.

Age-related loss of proliferative activity of human vascular smooth muscle cells in culture.

This work studied the proliferation activity in cultures of vascular smooth muscle cells (SMC) from individuals of different ages. The cells derived from arteries of 12 donors of both sexes from 45 to 91 years of age. The main parameter considered was the 'proliferation rate' (cells grown per day in the different culture passages) taking into account the age of the donor.

Phenotypic changes in vascular smooth muscle cells during aging: insulin effect on migration.

We examined the mechanisms by which insulin may be atherogenic during aging. We postulated that an increase in insulin secretion during aging produces growth factor effects on vascular smooth muscle cells (VSMCs), promoting these cells to synthesize collagen and to migrate. We have previously demonstrated that insulin stimulates collagen synthesis and release in senescent VSMCs that were obtained from a human organism with high levels of insulin secretion.

Insulin stimulates collagen synthesis in vascular smooth muscle cells from elderly patients.

The process of aging results in an increase in collagen in arterial walls, but the blood levels of insulin-like growth factor 1 (IGF-1) decrease remarkably as adults age. There is an almost simultaneous increase in insulin secretion, particularly in obese individuals. It is not known if, under these hormonal conditions, the enrichment of collagen in the arterial wall is due to insulin.

A comparative study of the efficacy and safety of loratadine syrup and terfenadine suspension in the treatment of 3- to 6-year-old children with seasonal allergic rhinitis.

The efficacy and safety of loratadine and terfenadine in the treatment of 3- to 6-year-old children with seasonal allergic rhinitis were compared in a third-party-blind, randomized, parallel-group study. A total of 96 children were included in the efficacy analysis: 49 children received 5 or 10 mg of loratadine once daily, and 47 received 15 mg of terfenadine twice daily, for 14 days. The mean total score for both nasal and non-nasal symptoms was decreased significantly from baseline at days 3, 7, and 14 in both treatment groups.

[Physiopathology of nasal respiration].

The static and dynamic aspects of nasal anatomy determine the characteristics of the air flow passing through the nose and the thermo-hygrometric and particulated conditioning of the inhaled air. Through rhinomanometry it is possible to measure nasal cavities resistance to the passage of inhaled and exhaled air. Ventilation obstacles in the nose are frequent and varied: they are examined with the consequences of nasal obstruction at local and zonal level.

[Neoplasm of the rhinopharynx: our experience].

We present 87 patients with cancer of the nasopharynx treated in the Fundación "Jiménez Díaz" de Madrid, in the last fifteen years. The clinical aspects of the illness, the therapeutic techniques and the results are analyzed. The global survival and the disease free survival at 5 years were 34 and 22% respectively.

[Intra-thoracic aneurysm of the right subclavian artery].

The aneurysm of subclavian artery is uncommon, and its differential diagnosis is posed with other mediastinal expansive processes in a conventional RX level. A case of right subclavian aneurysm is presented.

Spontaneous atherosclerotic lesions and prostacyclin formation in rabbits: effects of combined dipyridamole and aspirin.

The influence of dipyridamole and lysine acetylsalicylate on the incidence of atherosclerotic lesions and on arterial prostacyclin formation was studied in rabbits. Male New Zealand rabbits received i.m.

[Phrenic nerve paralysis complicating cervicofacial surgery].

Radical neck dissection remains the keystone to lymph nodes control in modern Head and Neck Surgery. Like any major operation, it has inherent complications ranging from minor surgical complications such as wound infection to potentially life-threatening complications such as fistula or carotid rupture. We have observed two cases of surgical damage of the phrenic nerve following radical neck dissection.