Sacrohysteropexy: a way to spare the uterus

Study Objective: To show the safety and feasibility of laparoscopic sacrohysteropexy for treating uterine prolapse. Design: An educational video to explain the laparoscopic steps of this procedure by focusing on the main anatomic landmarks and on tips and tricks to avoid complications. Setting: A tertiary care university hospital. Interventions: Laparoscopic sacropexy with uterus preservation for grade 3 apical defect. Conclusion: This video shows a stepwise approach to laparoscopic sacrohysteropexy demonstrating its feasibility and safety. There is a wide choice of surgical procedures and approaches focused on pelvic organ prolapse repair. Since many years, uterine prolapse has been an indication for hysterectomy, regardless of the occurrence of uterine disease and patients’ desires. With the introduction of minimally invasive surgery, the uterine-sparing procedures are being increasingly taken into account, especially in young women [1]. Sacrohysteropexy is a uterus-sparing procedure that allows for a reduction in operating time, intraoperative blood loss, mesh-related complications, and surgical costs [2]. Furthermore, this technique has a high success rate with an objective cure rate of 100% for the apical compartment and 80% for all compartments and does not seem to increase the pelvic organ prolapse recurrence rate [3]. Sacropexy is not a life-threatening procedure, but its main objective is to restore functional anatomy with the primary goal of improvement in patient's quality of life. Moreove, no difference has been found with or without uterus preservation in term of postoperative recurrence rate or ent's quality of life [4]. However, high patient satisfaction has been recently reported; therefore, uterine preservation should be considered during patient's counseling

Comparative Studies on the Influence of β\beta-Sitosterol and Stigmasterol on Model Sphingomyelin Membranes: A Grazing-Incidence X-ray Diffraction Study

Sterols are essential constituents of membranes, both in the plant world and in human organisms. Therefore, their activity on model lipid systems has systematically been studied. Despite intensive investigations, differences in the effect induced by beta-sitosterol (beta-sito) and stigmasterol (stigma) (two major phytosterols) are very controversial and still under debate. To compare the influence of these compounds on model membranes, we have performed grazing incidence X-ray diffraction (GIXD) experiments on phytosterol/sphingomyelin (Sph) monolayers. The analysis of the X-ray scattering and the resulting in-plane parameters provided information on the lateral organization of pure lipid films and the mixed systems. The obtained results prove a nonideal mixing between the investigated lipids in the monolayers and the existence of strong interactions between phytosterols and Sph. Both the plant sterols incorporated into sphingolipid film condense the monolayer and order Sph chains. The results of GIXD experiments, compared with those obtained previously from Langmuir monolayer studies allowed us to observe the comparable influence of beta-sito and stigma on model membrane organization

A New Microcrystalline Phytosterol Polymorph generated using CO2-expanded solvents

Phytosterols have been receiving increasing attention due to their demonstrated health benefits. Micronization of phytosterol particles is desirable to enhance their physiological efficacy. Utilization of the environmentally friendly compressed fluid-based technology, called Depressurization of an Expanded Liquid Organic Solution (DELOS) was investigated to micronize a phytosterol mixture. A new polymorph of \u3b2-sitosterol, which was more crystalline than the native form, was obtained from the DELOS process regardless of the process conditions. In addition, particle size was reduced by an order of magnitude. The crystal structure of the new polymorph was determined from X-ray powder diffraction data. The proposed crystal structure for \u3b2-sitosterol, which contains a number of nearly isosteric vicariant molecules of lower molecular weight (mostly campesterol and campestanol, accounting in a crystalline solid-solution for nearly 10% of the molecular mixture) allows the presence of small cavities, in which some residual solvent molecules are temporarily trapped. Further structural analysis of the new and native polymorphs were performed by laser diffractometry, scanning electron microscopy, differential scanning calorimetry, thermogravimetric analysis, and X-ray powder diffraction. Findings of the study provide a route to obtain nutraceutical products that might show enhanced functional properties