Anatomical premises for the variability of the results of transobturator mid-urethral sling

Introduction. The implantation of a synthetic sub-urethral sling is the main method of surgical correction of stress urinary incontinence (SUI). However, the investigation results of long-term effectiveness indicate the ambiguity of the surgery outcomes. In addition, the problem of pain in the perineum remains relevant for everyday practice. One of the important aspects in this matter may be a variant technique for installing a suburethral sling, including based on the anatomical variability of the small pelvis.Purpose of the study. To identify key anatomical factors that can negatively affect the effectiveness and safety of the environment of suburethral sling surgery for urinary incontinence in women.Materials and methods. The study consisted of 2 parts - anatomical and clinical. In the anatomical part of the study, a suburethral sling was implanted on 20 preparations of a female pelvis with a lower limb and preserved soft tissues. The clinical part of the study involved 50 patients with stress urinary incontinence. These patients underwent installation of a transobturator suburethral sling in two ways using the “inside-out” technique: using the standard “external landmarks” technique and using the proposed anatomical technique developed in the first part of the study. After visualization of the suburethral sling using the original method, the outcomes of the operations were assessed depending on the location of the sling in the patient's tissues.Results. In the anatomical part of the study, the most atraumatic method of suburethral sling implantation was determined by rotating the tool around the lower branch of the pubic bone. In the clinical part of the study, this method demonstrated a higher efficiency of the operation at a follow-up of 1 year, presumably due to the U-shaped angle of the «hammock» for the urethra, which is characteristic of the retropubic sling.Conclusion. Outcomes of operations for SUI depend, among other things, on the method of the suburethral sling implantation.

Pressurized Hot Liquid Extraction with 15% v/v Glycerol-Water as an Effective Environment-Friendly Process to Obtain Durvillaea Incurvata and Lessonia Spicata Phlorotannin Extracts with Antioxidant and Antihyperglycemic Potential

Brown seaweed phlorotannins have shown the potential to promote several health benefits. Durvillaea incurvata and Lessonia spicata—species that are widely distributed in central and southern Chile—were investigated to obtain phlorotannin extracts with antioxidant and antihyperglycemic potential. The use of an environmentally friendly and food-grade glycerol-based pressurized hot liquid extraction (PHLE) process (15% v/v glycerol water) was assessed for the first time to obtain phlorotannins. Multiple effects were analyzed, including the effect of the species, harvesting area (Las Cruces and Niebla), and anatomical part (holdfast, stipe, and frond) on the extracts’ polyphenol content (TPC), antioxidant capacity (AC), and carbohydrate-hydrolyzing enzyme—α-glucosidase and α-amylase—inhibitory activity. Contaminants, such as mannitol, heavy metals (As, Cd, Pb, Hg, and Sn), and 5-hydroxymethylfurfural (HMF), were also determined. The anatomical part used demonstrated a significant impact on the extracts’ TPC and AC, with holdfasts showing the highest values (TPC: 95 ± 24 mg phloroglucinol equivalents/g dry extract; DPPH: 400 ± 140 μmol Trolox equivalents/g dry extract; ORAC: 560 ± 130 μmol TE/g dry extract). Accordingly, holdfast extracts presented the most potent α-glucosidase inhibition, with D. incurvata from Niebla showing an activity equivalent to fifteen times that of acarbose. Only one frond and stipe extract showed significant α-glucosidase inhibitory capacity. No α-amylase inhibition was found in any extract. Although no HMF was detected, potentially hazardous cadmium levels (over the French limit) and substantial mannitol concentrations—reaching up to 50% of the extract dry weight—were found in most seaweed samples and extracts. Therefore, further purification steps are suggested if food or pharmaceutical applications are intended for the seaweed PHLE extracts obtained in this study.

What Am I, a Piece of Meat? Synecdochical Utterances Targeting Women

In a September 2004 interview, Donald Trump agreed with Howard Stern’s statement that his daughter Ivanka is “a piece of ass.” This utterance is a synecdochical utterance targeting women (SUTW), by which I mean that its form is such that a term for an anatomical part is predicated of, or could be used by a speaker to refer to, a woman. I propound a theory of what SUTW speakers do in undertaking an SUTW on which the SUTW speaker prompts the hearer to engage in a certain derogatory pattern of associational thinking—that is, taking a “perspective” in Elisabeth Camp’s sense—on the female subject. This perspective is one that reduces her to the bodily part in question—that is, fragments her (reduces her to a part) and biologizes her (characterizes her as mere living tissue). Essentially, the hearer thinks of the woman as a “piece of meat.”

The volume of the anatomical connections of the frontal lobes

The question of the connection between the frontal lobes and the various parts of the brain still remains far from solved completely, despite a whole series of studies in this direction. In view of this, at the suggestion of the highly respected teacher V.M.Bekhterev, I undertook this work with the aim of clarifying this issue in detail. My study consisted in the destruction of the frontal lobes in animals with the subsequent processing of their brains according to the Marchi method, and in addition, in a detailed study of physiological phenomena in the operated animals. But regarding the second part of my work, I intend to speak in another section, limiting myself at the present to the anatomical part. Before proceeding to the presentation of the results obtained by me, I will try to briefly outline the literature of the question of interest to me. The literature on the connections of the frontal lobe with various areas of the brain is directly adjacent to the literature on the connections of the cerebral cortex in general and seems to be very extensive, which is why I will confine myself to a more detailed sketch of a part of it, concerning more or less controversial issues, mentioning only briefly about the research on which there is a contradiction.

Fetal Malpresentation in Pregnancy

Fetal presentation refers to that anatomical part of the fetus that presents at the maternal pelvic inlet. The most common and most desirable fetal presentation is cephalic (head first). Any presentation other than cephalic is referred to as a malpresentation. Breech is the most common fetal malpresentation. The prevalence of breech presentation varies with gestational age (25% at 28 weeks and 3-5% of at term). Ultrasound evaluation is the gold standard for the diagnosis of fetal presentation. External cephalic version (ECV) refers to a series of manual manipulations designed to convert a malpresenting fetus to cephalic to promote vaginal delivery. There are two strategies around the timing of ECV; at 36-37 weeks and/or at or shortly after 39 weeks’ gestation. Each has advantages and disadvantages. Currently, most breech pregnancies at term are delivered by cesarean at 39 weeks prior to the onset of labor. Malpresentation is the second most common indication for planned cesarean (behind elective repeat cesarean). Vaginal delivery for a breech fetus at term should only be attempted if the mother is strongly motivated, if the obstetric care provider is experienced, and if the medical center has the requisite facilities to manage any and all complications. This review contains 3 figures, 2 tables, and 66 references. Keywords: fetal presentation, malpresentation, breech presentation, ultrasound evaluation, external cephalic version (ECV), cesarean delivery, vaginal breech delivery

Video Head Impulse Test (vHIT) and Vestibular Evoked Myogenic Potential (VEMP) Test for Assessment of Vertigo: Our Initial Experience

Introduction: Loss of balance causes the sensation of vertigo. Balance is maintained by vestibular afferent from labyrinth, eyes and proprioceptors and their central integration. For diagnosis of vertigo, along with history different vestibulometric tests can be done to identify the specific anatomical part that is involved. Material and methods: A cross sectional study was done among 82 patients who did video Head Impulse Test (vHIT) and among 75 patients who did Vestibular Evoked Myogenic Potential (VEMP) test at AudiovestibularCentre(AVC) at Bangladesh ENT Hospital Ltd. during the period from April 2018 to September 2019. Results: Age range of the sample was 16 to 80 years. Among the 82 patients who did vHIT 62(75.6%) had abnormality in either Semi Circular Canal. Among 75 patients who did VEMP 27(36%) were detected to have abnormality in either in saccule or utricle. Conclusion: For diagnosis of cause of vertigo the appropriate test for individual part of vestibule is essential. vHIT and VEMP are two tests which are complementary to each other in explaining common peripheral causes of vertigo. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 5-9

Acute stress assessment using infrared thermography in fattening rabbits reacting to handling under winter and summer conditions

Aim of study: This study assesses acute stress by measuring, through infrared thermography in summer and winter, the temperature of the eye, outer ear, inner ear and nose in 40 fattening rabbits before and after handling.Area of study: Seville (Spain).Material and methods: Body thermographic temperatures were recorded during a 38-day fattening period twice weekly and twice a day, before and after the handler held the rabbits in their arms for one minute. Ambient temperature and relative humidity were also recorded, and their influence on body temperatures was assessed. For each anatomical part, the variation of the temperature between the handled and undisturbed rabbit, and the differential temperature between the anatomical part in the undisturbed rabbit and the ambient temperature were calculated.Main results: The variation in temperatures between handled and undisturbed rabbits ranged from 0.25±0.041 ºC for eye to 3.09±0.221 ºC for outer ear in summer and -0.41±0.182 ºC for nose to 2.09±0.178 ºC for outer ear in winter. The day of the fattening period influenced all the temperature traits during summer and winter, except for the inner ear in winter. In summer, unlike winter, the temperature variation at the end of fattening period between handled and undisturbed rabbits was lower than at weaning (-0.04 to 1.94 ºC vs. 0.54 to 5.52 ºC, respectively). The temperatures in undisturbed rabbits were correlated with ambient temperature.Research highlights: Measuring body temperature with infrared thermography is a useful tool to evaluate acute stress in handled rabbits, with the inner ear and eye the most reliable body parts for measuring it.

A clinical study of external ear reconstruction: a study of 20 cases

Background: Auricular defects pose one of the most difficult challenges in reconstructive surgery of the head and neck. The reason is the unique three-dimensional anatomical architecture of the auricle, with its multiple concavities and convolutions of the cartilage and the thin, delicate skin cover. Acquired auricular deformities commonly result from traumatic injuries, burn trauma or tumour extirpation. These vary in severity from simple lacerations to complete auricular avulsions. Congenital ear deformity (microtia) occurs in every 1 out of 6000 live births. The goal of reconstruction is the precise duplication of the missing anatomical part with regard to size, orientation and anatomical landmarks.Methods: Range from healing by secondary intention to complete replacement with autologous rib cartilage and/or auricular prosthesis. Total auricular reconstruction was done by two methods: (1) Nagata and (2) Brent’s method. Nagata’s technique is commonly performed in this study. The present study aimed to evaluate the reconstruction of auricular defects using autologous rib cartilage graft with or without temperoparietal fascia flap covered by split-thickness skin graft.Results: Excellent cosmetic result can be obtained with adequate skills and training in carving the cartilage for auricular framework. This improves confidence and gives psychological support to microtia patients.Conclusions: With training and method, results in ear reconstruction using autologous rib cartilage are excellent and reproducible.

A comparative anatomical, histological and histochemical study of small intestine in Kestrel (Falco tunniculus) and white eared bulbul (Picnonotic leucotis) according to their food type

This study was conducted on 30 birds (15 birds for each type) divided as 10 birds for each part of study. Anatomical part revealed that the small intestine in both birds kestrel (Falco tinniculus) and white eared bulbul (Picnonotic leucotis) formed from 3 segments; duodenum, jejunum and ileum with no clear demarcation line between them. In kestrel the Meckel's diverticulum appeared as small projection to separate between jejunum and ileum. Both ratio of intestinal length to body length and of intestinal weight to body weight was higher in bulbul than those in kestrel. Histological study showed that the wall of all three parts of small intestine was composed of the same histological layers; these are mucosa, submucosa, muscularis and serosa. There was almost similarity in structure of these tunics but significant differences in several Histomorphometric measurements of each tunica. Goblet cells were more abundant in all parts of small intestine of bulbul than those in kestrel and there was a gradual increasing in the number of these cells toward the end of intestine of both birds. Histochemical part of this study appeared that in villi and crypts of all small intestinal segments of both birds the goblet cells secrete neutral mucin in nature because it showed negative reaction to Alcian blue stain and positive to PAS stain.