Early, staged reconstruction in young women with severe breast asymmetry.

Study Objective: To retrospectively examine a cohort of young women with severe hypoplasia or asymmetric breast development who underwent breast reconstruction with tissue expansion and to determine complication rates as well as patient satisfaction.

Design: Chart review.

Setting: The University of Michigan Hospital, a tertiary care center.

Can routine neonatal circumcision help prevent human immunodeficiency virus transmission in the United States?

Primary prevention of human immunodeficiency virus (HIV) continues to pose an important challenge in the United States. Recent clinical trials conducted in Kenya, South Africa, and Uganda have demonstrated considerable benefit of male circumcision in reducing HIV seroincidence in males. These results have ignited debate over the appropriateness of implementing routine provision of neonatal circumcision in the United States for HIV prevention.

Should access to fertility-related services be conditional on body mass index?

Guidelines for the clinical management of obese, reproductive age women with reduced fertility in the USA are limited. Clinical professional organizations have yet to publish practice guidelines on this topic. Thus, treatment decisions are made at the provider and/or clinic level and the variation in clinic policy regarding fertility treatment for obese women is not readily available.

Resveratrol inhibits glucose metabolism in human ovarian cancer cells.

Objectives: Resveratrol is a phytoalexin found in grapes that inhibits the in vitro growth of multiple tumor cell types. We showed previously that resveratrol induces autophagic cell death in ovarian cancer cells. Because autophagy is typically an adaptive response to nutrient starvation, we hypothesized that autophagy would also be triggered when ovarian cancer cells are nutrient deprived and that resveratrol could in fact be acting by inducing a starvation-like signaling response.

Anterior vaginal wall length and degree of anterior compartment prolapse seen on dynamic MRI.

The objective of the study was to determine the relationship between midsagittal vaginal wall geometric parameters and the degree of anterior vaginal prolapse. We have previously presented data indicating that about half of anterior wall descent can be explained by the degree of apical descent present (Summers et al., Am J Obstet Gynecol, 194:1438-1443, 2006).

Surgical techniques: robot-assisted laparoscopic myomectomy with the da Vinci(®) surgical system.

Myomectomy remains the surgical option of choice for women with symptomatic leiomyomata who desire uterine conservation or in particular future fertility. The ability to enucleate leiomyomata and repair the uterus with a multilayer-sutured closure is both crucial and technically challenging. Advanced gynecologic pathology and the surgical limitations of conventional laparoscopy have often been cited as impediments to not only these critical steps but also to converting a myomectomy from a procedure predominantly performed by laparotomy to one accomplished by laparoscopy.

Anal incontinence: relationship to pregnancy, vaginal delivery, and cesarean section.

Objective: To review the current literature concerning anal incontinence (AI), pregnancy, and route of delivery.

Finding: AI is the involuntary loss of flatus, liquid, or solid stool that is a social or hygienic problem. AI has been reported in 5% to 26% of women during the first year following vaginal delivery.

Insurance coverage and health care use among near-elderly women.

Objectives: Data on near-elderly (ages 55-64) women's access to and use of health care have been limited. In this study, we sought to examine the status of near-elderly women's health insurance coverage in the United States and how it may influence their use of health care services.

Methods: A nationwide random sample of women aged 55-64 was drawn from the 2002 wave of the Health and Retirement Study.

Avoiding pitfalls: lessons in surgical teaching.

Becoming a good surgical educator takes time, patience, and dedication. Providing effective feedback is essential to improving the mentee's surgical skills. The operating room is a costly, high-risk classroom.

Evaluation of African-American and white racial classification in a surveillance, epidemiology, and end results cancer registry.

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry.

Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined.

Complementary and alternative medicine in obstetrics.

Objective: To identify, survey and review randomized controlled studies of the use of complementary and alternative medicine (CAM) for obstetric treatment or health promotion.

Methods: The MEDLINE database was searched to identify randomized controlled trials of CAM treatment and therapies in obstetrics. Studies examining modalities for treatment or improvement of health status were reviewed.

Preliminary experience with robot-assisted laparoscopic myomectomy.

The following retrospective case series evaluated the technique and feasibility of integrating robot-assisted technology in the performance of a laparoscopic myomectomy in order to overcome the limitations of conventional laparoscopy. We attempted 35 robot-assisted laparoscopic myomectomies in a university hospital setting with a conversion rate of 8.6%.

Dysfunctional apoptosome activation in ovarian cancer: implications for chemoresistance.

Alterations in the regulation of apoptosis may contribute to the pathogenesis of cancer and resistance of tumor cells to chemotherapy. In mammalian cells, nonreceptor-mediated apoptosis occurs predominantly via assembly of a cytochrome c-dependent apoptosome complex containing caspase-9 and apoptotic protease-activating factor-1 (Apaf-1). We show here that cytosolic extracts from human ovarian carcinoma cell lines and primary ovarian tumor samples are deficient in their ability to activate procaspase-9 in the presence of cytochrome c and dATP when compared with control extracts.