Non-invasive therapeutic use of High-Intensity Focused Ultrasound (HIFU) with 3 Tesla Magnetic Resonance Imaging in women with symptomatic uterine fibroids

Benign uterine fibroids are common female genital tract tumors and if symptomatic often require extensive surgery. When tumors are multiple and large or unusually located, the operative treatment may lead to significant morbidity and compromise quality of life. Recovery period after surgical treatment may be complicated by patient’s medical condition and wound healing problems. Currently used other non-surgical treatment modalities usually provide only a temporal symptoms relief and may not be efficient in all affected women. In the last decade, minimally invasive treatment of uterine fibroids called Magnetic Resonance guided High-Intensity Focused Ultrasound (MRI HIFU) was introduced. This technique uses thermal ablation simultaneously with MRI imaging of the mass and tissue temperature measurements during the procedure where a focused ultrasound beam is applied externally to destroy tumors located in the human body. Successful application of MRI HIFU has been recently described in patients with various malignancies, such as breast, prostate and hepatocellular cancers as well as soft tissue and bone tumors. This technique is innovative and has been proven to be safe and effective but there are several limitations for treatment. The article highlights the relative advantages and disadvantages of MRI guided HIFU in women with uterine fibroids. The authors also describe high-resolution MRI technique on 3T MRI, along with the approach to interpretation of HIFU results applied to uterine fibroids that has been experienced at one institution

Presence of human papilloma virus in Caucasian women living in the central Europe diagnosed with vulvar intraepithelial neoplasia

Objectives: The role of human papilloma virus (HPV) in the development of cancerous states of female reproductive tracthas been widely debated. However, the information about presence of HPV in the Caucasian women living in the centralEurope diagnosed with vulvar intraepithelial neoplasia (VIN) is missing. So far, no recommendation was made to completeHPV detection in time of vulvar biopsy or after the results of positive VIN are obtained. We aimed to assess the presence ofHPV in women with vulvar intraepithelial neoplasia diagnosed at the Department of Gynecology, Obstetrics and OncologicalGynecology in Bytom, Poland.Material and methods: The retrospective examination of 120 consecutive vulvar biopsies obtained from women withpersistent vulvar itching was done. Only patients with diagnosis of VIN were included in the further analysis. HPV DNAwas detected using HPV Linear Array Genotyping Test including 14 HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56,58, 59, 66, 68).Results: Out of 120 vulvar samples retrieved, 18 women were positive for VIN, including15 usual VIN (uVIN) and three differentiatedtype (dVIN ). 10 samples were eligible for DNA detection. HPV DNA was found in two women with uVIN (HPV16 and 51).Conclusions: It is advisable to recommend HPV genotyping in women with VIN, regardless of their age and histologic type.The incidence of HPV infection in Caucasian women from the central Europe with VIN should be further studied

The Current Evidence on the Association Between the Urinary Microbiome and Urinary Incontinence in Women

Urinary incontinence (UI) is a burdensome condition with high prevalence in middle-aged to older women and an unclear etiology. Advances in our understanding of host-microbe interactions in the urogenital tract have stimulated interest in the urinary microbiome. DNA sequencing and enhanced urine culture suggest that similarly to other mucosal sites, the urinary bladder of healthy individuals harbors resident microbial communities that may play distinct roles in bladder function. This review focused on the urobiome (expanded quantitative urine culture-based or genomic sequencing-based urinary microbiome) associated with different subtypes of UI, including stress, urgency and mixed urinary incontinence, and related syndromes, such as interstitial cystitis and overactive bladder in women, contrasted to urinary tract infections. Furthermore, we examined clinical evidence for the association of the urinary microbiome with responses to pharmacotherapy for amelioration of UI symptoms. Although published studies are still relatively limited in number, study design and sample size, cumulative evidence suggests that certain Lactobacillus species may play a role in maintaining a healthy bladder milieu. Higher bacterial diversity in the absence of Lactobacillus dominance was associated with urgency UI and resistance to anticholinergic treatment for this condition. UI may also facilitate the persistence of uropathogens following antibiotic treatment, which in turn can alter the commensal/potentially beneficial microbial communities. Risk factors of UI, including age, menopausal status, sex steroid hormones, and body mass index may also impact the urinary microbiome. However, it is yet unclear whether the effects of these risks factors on UI are mediated by urinary host-microbe interactions and a mechanistic link with the female urogenital microbiome is still to be established. Strategies for future research are suggested

Types and circumstances of injury occurence at competitors practicing football

Introduction It is believed that football injuries account for up to 3% of all injuries that requires hospitalization. Often the cause of accidents is brutal and incompatible with the game. Aim The aim of this study was to determine the prevalence of sports injuries in football competitors in group of players from Złotoryjski Klub Sportowy. Material and methods The research material was a group of 25 male trainees actively football. The respondents were men aged 16 to 38 years old. Players train average 3 times a week for 90 minutes. In research was used the questionnaire of diagnostic sounding. The answers of the respondents were divided into categories and analyzed statistically. Test results In ZKS Górnik Złotoryja team the most common injuries occured on incorrectly prepared grass pitch, said the vast majority – 75%. In studied group the most common injury was sprain ankle which suffered 16 respondents which gives 41%, other suffered of back pain 13%, 11% suffed of hip-joint, 10% suffered of other injuries such as head injuries. Among other injuries, respondents mentioned: twisted knee-joint, twisted wrist, breaking shoulder, back pain, meniscus damage. Conclusions 1. Players in the vast majority suffered injuries of musculoskeletal system. 2. Due to nature of fooball the most vulnerable to injuries were lower limbs. 3. The most common injuries in surveyed group were sprains and bruises in lower limbs. 4. Among the circumstances in which players suffered injuries pointed on overtrain and direct clash with the opponent. Among technical reasons the most pointed was improperly prepared football pitch

The use of CO2 laser in vulvar lichen sclerosus treatment — molecular evidence

Vulvar lichen sclerosus is chronic and difficult to treat disorder, which offer is recurrent and leads to multiple complications. The limited efficacy of pharmacologic treatment directed the search for new therapies including use of CO2 laser. In our study we focused on collagen and elastin gene expression as well as heat shock proteins and p53 expression in two patients with vulvar lichen sclerosus who underwent CO2 laser therapy. In both patients we observed decreased clinical symptoms observed by an experienced gynecologist as well as significant changes in gene expression before and after laser treatment

Collagen and elastin differences in vulvar tissue of women with lichen planus, lichen sclerosus and healthy women

Objectives: Lichen sclerosus and lichen planus are two debilitating dermatoses. Their etiology remains unknown. Skin changes resulting from these disorders are important to understand, so we can provide targeted treatment to patients. We examined the differences in collagen (COL1A1, COL1A2, COL3A1, COL5A1, COL5A2, COL5A3) and elastin (ELN) expression between vulvar tissue of women with lichen planus, lichen sclerosus and healthy women. Material and methods: Vulvar tissue was taken from areas affected by lichen planus or lichen sclerosus. In healthy controls, we biopsied vulva at five and eight o’clock in a standardized manner. The tissue was simultaneously sent for pathological and genetic analysis. When either lichen planus or sclerosus or healthy tissue was confirmed by pathologist, we processed the genetic sample. RNA was isolated, transcribed and gene expression was analyzed using Real Time Custom Panel 96-16 and LightCycler 480 Probe Master. Kolmogorov-Smirnov test was employed to determine if the data on the population show normal distribution. For genes with normal distribution, t-Test was employed and for those lacking normality, we used Mann-Whitney 1-tail test. The threshold for p-value was set less than 0.05. Results: Thirty-nine vulvar samples were examined. The mean expression of COL1A1 was 11.13, COL1A2 was 6.72, COL3A1 was 8.43, COL5A1 was 11.91, COL5A2 was 10.62 and COL5A3 was 12.79. The mean expression of elastin (ELN) was 13,13. We found statistically significant difference in expression of collagen (COL1A2) and elastin (ELN) between healthy controls and patients with lichen planus (p = 0.4). We did not find differences for other genes (p < 0.05). Conclusions: Collagen and elastin are differentially expressed between patients with lichen planus and healthy controls

Expression of heat shock proteins HSPA1A, HSPA1B and TP53 in vulval lichen planus and vulval lichen sclerosus

Objectives: Heat shock proteins (HSPs) are proteins involved in protein folding and maturation. HSP expression is induced by heat shock or other stressors including cellular damage and hypoxia. The major groups, which are classified based on their molecular weight, include HSP27, HSP40, HSP60, HSP70, HSP90, and large HSP (HSP110 and glucose-regulated protein 170). The comparison of heat shock proteins and TP53 expression is yet not well studied in both vulval lichen sclerosus and lichen planus. Our aim was to assess the HSP and TP53 gene expression in women suffering from LS or LP and compare it within these groups and also healthy controls. Material and methods: The inclusion criteria were willingness to donate vulval biopsies, not currently or in the prior two weeks received any local nor systemic treatment for vulval disorder, age > 18 years old.  The exclusion criteria were lack of consent, current vaginal infection confirmed with microbiological studies, current local or systemic treatment for vulval disease. 45 consecutive women were recruited into the study. All appropriate vulval samples were process by genetic analysis. Results: The mean expression (± SD) of HPSA1A for controls was 5.52 ± 3.18, for LS was 7.44 ± 2.16 and for LP was 7.89 ± 2.48. The mean expression (± SD) of HPSA1B for controls was 6.54 ± 3.41, for LS was 9.94 ± 6.88 and for LP was 9.43 ± 2.31. The mean expression (± SD) of TP53 for controls was 9.11 ± 1.14, for LS was 9.94 ± 1.27 and for LP was 10.41 ± 2.00. HSPA1A expression was 3,8 higher in women with lichen sclerosus than in control group. Conclusions: Heat shock protein-70 is more often expressed in LS than in healthy controls. HSP-70 not only supports tumor growth and metastasis, but on the other hand mat help to develop immune-driven treatment strategies

RENEB accident simulation exercise

Purpose: The RENEB accident exercise was carried out in order to train the RENEB participants in coordinating and managing potentially large data sets that would be generated in case of a major radiological event. Materials and methods: Each participant was offered the possibility to activate the network by sending an alerting email about a simulated radiation emergency. The same participant had to collect, compile and report capacity, triage categorization and exposure scenario results obtained from all other participants. The exercise was performed over 27 weeks and involved the network consisting of 28 institutes: 21 RENEB members, four candidates and three non-RENEB partners. Results: The duration of a single exercise never exceeded 10 days, while the response from the assisting laboratories never came later than within half a day. During each week of the exercise, around 4500 samples were reported by all service laboratories (SL) to be examined and 54 scenarios were coherently estimated by all laboratories (the standard deviation from the mean of all SL answers for a given scenario category and a set of data was not larger than 3 patient codes). Conclusions: Each participant received training in both the role of a reference laboratory (activating the network) and of a service laboratory (responding to an activation request). The procedures in the case of radiological event were successfully established and tested

Dose assessment intercomparisons within the RENEB network using G0-lymphocyte prematurely condensed chromosomes (PCC assay)

Purpose: Dose assessment intercomparisons within the RENEB network were performed for triage biodosimetry analyzing G0-lymphocyte PCC for harmonization, standardization and optimization of the PCC assay. Materials and methods: Comparative analysis among different partners for dose assessment included shipment of PCC-slides and captured images to construct dose-response curves for up to 6 Gy c-rays. Accident simulation exercises were performed to assess the suitability of the PCC assay by detecting speed of analysis and minimum number of cells required for categorization of potentially exposed individuals. Results: Calibration data based on Giemsa-stained fragments in excess of 46 PCC were obtained by different partners using galleries of PCC images for each dose-point. Mean values derived from all scores yielded a linear dose-response with approximately 4 excess-fragments/cell/Gy. To unify scoring criteria, exercises were carried out using coded PCC-slides and/or coded irradiated blood samples. Analysis of samples received 24 h post-exposure was successfully performed using Giemsa staining (1 excess-fragment/cell/Gy) or centromere/telomere FISH-staining for dicentrics. Conclusions: Dose assessments by RENEB partners using appropriate calibration curves were mostly in good agreement. The PCC assay is quick and reliable for whole- or partial-body triage biodosimetry by scoring excess-fragments or dicentrics in G0-lymphocytes. Particularly, analysis of Giemsa-stained excess PCC-fragments is simple, inexpensive and its automation could increase throughput and scoring objectivity of the PCC assay

Innovative in vitro method to study ventilator induced lung injury.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadMechanical ventilation (MV) is a life-saving therapy for critically ill patients, alleviating the work of breathing and supporting adequate gas exchange. However, MV can cause ventilator induced lung injury (VILI) by baro/volu- and atelectrauma, even lead to acute respiratory distress syndrome (ARDS), and substantially augment mortality. There is a need for specific biomarkers and novel research platforms for VILI/ARDS research to study these detrimental disorders and seek ways to avoid or prevent them. Previous in vitro studies on bronchial epithelium, cultured in air-liquid interface (ALI) conditions, have generally utilized static or constant pressure. We have developed a Cyclical Pressure ALI Device (CPAD) that enables cyclical stress on ALI cultured human bronchial cells, with the aim of mimicking the effects of MV. Using CPAD we were able to analyze differentially expressed VILI/ARDS and innate immunity associated genes along with increased expression of associated proteins. CPAD provides an easy and accessible way to analyze functional and phenotypic changes that occur during VILI and may provide a platform for future drug testing.Technology development fund - Icelandic research council University of Iceland Land-spitali, University Hospital, Science fun