Functional Anatomy of the Female Pelvic Floor

The anatomic structures in the female that prevent incontinence and genital organ prolapse on increases in abdominal pressure during daily activities include sphincteric and supportive systems. In the urethra, the action of the vesical neck and urethral sphincteric mechanisms maintains urethral closure pressure above bladder pressure. Decreases in the number of striated muscle fibers of the sphincter occur with age and parity. A supportive hammock under the urethra and vesical neck provides a firm backstop against which the urethra is compressed during increases in abdominal pressure to maintain urethral closure pressures above the rapidly increasing bladder pressure. This supporting layer consists of the anterior vaginal wall and the connective tissue that attaches it to the pelvic bones through the pubovaginal portion of the levator ani muscle, and the uterosacral and cardinal ligaments comprising the tendinous arch of the pelvic fascia. At rest the levator ani maintains closure of the urogenital hiatus. They are additionally recruited to maintain hiatal closure in the face of inertial loads related to visceral accelerations as well as abdominal pressurization in daily activities involving recruitment of the abdominal wall musculature and diaphragm. Vaginal birth is associated with an increased risk of levator ani defects, as well as genital organ prolapse and urinary incontinence. Computer models indicate that vaginal birth places the levator ani under tissue stretch ratios of up to 3.3 and the pudendal nerve under strains of up to 33%, respectively. Research is needed to better identify the pathomechanics of these conditions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72597/1/annals.1389.034.pd

Controlling PbI2 stoichiometry during synthesis to improve the performance of perovskite photovoltaics

Over the past decade, remarkable progress has advanced the field of perovskite solar cells to the forefront of thin film solar technologies. The stoichiometry of the perovskite material is of paramount importance as it determines the optoelectronic properties of the absorber and hence the device performance. However, little published work has focused on the synthesis of fully stoichiometric precursor materials of high purity and at high yield. Here, we report a low-cost, energy-efficient, and solvent-free synthesis of the lead iodide precursor by planetary ball milling. With our synthetic approach, we produce low-oxygen, single or multiple polytypic phase PbI2 with tunable stoichiometry. We determine the stoichiometry and the polytypes present in our synthesized materials and further compare them to commercially available materials, using X-ray diffraction, X-ray photoelectron spectroscopy, and Rutherford backscattering spectroscopy. Both the stoichiometric PbI2 we synthesized and a substoichiometric commercially available PbI2 (where the iodide content is below the optimum Pb:I atomic ratio of 1:2) were used to grow methylammonium lead iodide microcrystals (which corrects the iodide content). Perovskite solar cells were then produced using stoichiometric and substoichiometric PbI2 mixed with an equimolar amount of methylammonium iodide and compared to devices produced from re-dissolved microcrystals. The photoactive perovskite layer deposition was processed in air, enabled by the use of a single low-toxicity solvent (dimethyl sulfoxide) combined with vacuum-assisted solvent evaporation. We find that the device performance is strongly dependent upon the stoichiometry of the lead iodide precursor, reaching champion efficiencies over 17%, with no obvious correlation with its polytypic phases. This work highlights the critical role of PbI2 stoichiometry in hybrid perovskites as well as demonstrating synthesis methods and perovskite layer fabrication protocols suitable for low-cost solar energy harvesting

Anatomical and functional changes in the lower urinary tract during pregnancy

Objective To assess the prevalence and the development of urinary incontinence in nulliparous pregnant women, both subjectively and objectively, and to investigate the relation of incontinence with the mobility of the urethro-vesical junction measured by perineal ultrasound. Design A prospective longitudinal study. Setting University Hospital and Martini Hospital Groningen, the Netherlands. Population A cohort of 117 nulliparous pregnant women and 27 nulliparous non-pregnant controls. Methods Urinary incontinence was measured by a questionnaire and by a 24-hour pad test. The position of the urethro-vesical junction and its mobility were measured by perineal ultrasound. Main outcome measure Prevalence of urinary incontinence; mobility of the urethro-vesical junction, indicated by the displacement/pressure coefficient. Results Up to 35% of the women reported urinary incontinence in pregnancy, and 20% of the women had a positive pad test. The angle of the urethro-vesical junction angle at rest and the displacement/pressure coefficient during coughing showed a significant increasing trend during pregnancy, but no changes were seen during the Valsalva manoeuvre. No relationship was found between subjective and objective incontinence data and the position and mobility of the urethro-vesical junction. Conclusion The prevalence of incontinence in nulliparous women as found by the pad test was significantly higher in pregnancy (20%) than in the non-pregnant control group (4%). Perineal ultrasound of the urethrovesical junction showed lowering of the pelvic floor occurring as early as 12-16 weeks of pregnancy. Serial measurements of the displacement/pressure coefficient suggest that the dynamic characteristics of the connective tissues of the pelvic floor remain unaltered,whereas a significant decrease in pelvic floor muscle contraction occurs. Since no relation was found between measurements of the urethro-vesical junction and incontinence, urinary incontinence in pregnancy is most likely explained by other factors

Spontaneous poisoning by larvae of Perreyia flavipes (Pergidae) in sheep Intoxicação espontânea por larvas de Perreyia flavipes (Pergidae) em ovinos

From a flock of 175 Texel sheep 25 animals died after consumption of a sawfly larvae subsequently identified as Perreyia flavipes. The disease occurred in June-July 2006 on a farm located in the county of Encruzilhada do Sul, Rio Grande do Sul, Brazil. Although there were 11 cattle in the same paddock, none of them was affected. High numbers of compact masses containing up to 150 larvae were scattered in the paddock where the animals were grazing. Most affected sheep showed severe apathy during 24-36 h before death, but weakness, muscular tremors and depression were also observed. Necropsy was performed on six sheep and the main macroscopic lesions were hemorrhages in the subcutaneous tissues, endocardium, gallbladder wall, and abomasal mucosa. In all animals was found hydrothorax, hydropericardium, ascites, and mild jaundice. Edema in the abomasal folds, mesentery, perirenal tissues, and gallbladder wall were also seen. The livers were yellowish with disseminated pinpoint hemorrhages in the parenchyma and had an enhanced lobular pattern. Perreyia flavipes larval body fragments and heads were found in the forestomach contents of the six sheep. Feces were scant, dry and formed balls coated by mucus and streaks of blood. Similar contents were also present at the end of the cecum. Prominent microscopic lesions included severe and diffuse periacinar or massive necrosis of hepatocytes associated with multifocal random hemorrhages. Diffuse necrosis of lymphoid follicles in lymph nodes and Peyer's patches, lymphoid depletion and necrosis in germinative centers of the spleen, and diffuse vacuolization in the renal tubular epithelia were also seen.<br>Vinte e cinco ovinos Texel de um rebanho de 175 morreram após ingerirem larvas posteriormente identificadas como Perreyia flavipes. A doença ocorreu em Junho e Julho de 2006, em uma propriedade localizada em Encruzilhada do Sul, Rio Grande do Sul. Embora houvesse também 11 bovinos no mesmo potreiro, nenhum foi afetado. Grandes quantidades de massas compactas, contendo cada uma mais de 150 larvas, estavam espalhadas na pastagem onde os animais pastoreavam. Os ovinos afetados apresentavam apatia severa por 24 a 36 horas antes da morte. Fraqueza, tremores musculares e depressão também foram vistos. Em necropsias realizadas em seis animais, as principais alterações macroscópicas foram hemorragias no tecido subcutâneo, endocárdio, parede da vesícula biliar e mucosa abomasal. Hidrotórax, hidropericárdio, ascite e icterícia estavam presentes em todos os animais. Edema nas pregas do abomaso, mesentério, tecidos peri-renais e parede da vesícula biliar também foram observados. Os fígados estavam amarelados, com petéquias disseminadas no parênquima e padrão lobular aumentado. Fragmentos de corpos e cabeças de larvas de Perreyia flavipes foram encontrados nos conteúdos ruminais dos seis animais. O conteúdo da porção final do cólon, ceco e reto estava seco, com muco aderido e estrias de sangue. Necrose de hepatócitos periacinar ou massiva associada com hemorragias multifocais aleatórias foi o principal achado histológico, mas também havia necrose difusa em folículos linfóides nas placas de Peyer e linfonodos, depleção linfóide e necrose em centros germinativos no baço e vacuolização no epitélio tubular renal

PrP(106-126) Does Not Interact with Membranes under Physiological Conditions

Transmissible spongiform encephalopathies are neurodegenerative diseases characterized by the accumulation of an abnormal isoform of the prion protein PrPSc. Its fragment 106-126 has been reported to maintain most of the pathological features of PrPSc, and a role in neurodegeneration has been proposed based on the modulation of membrane properties and channel formation. The ability of PrPSc to modulate membranes and/or form channels in membranes has not been clearly demonstrated; however, if these processes are important, peptide-membrane interactions would be a key feature in the toxicity of PrPSc. In this work, the interaction of PrP(106-126) with model membranes comprising typical lipid identities, as well as more specialized lipids such as phosphatidylserine and GM1 ganglioside, was examined using surface plasmon resonance and fluorescence methodologies. This comprehensive study examines different parameters relevant to characterization of peptide-membrane interactions, including membrane charge, viscosity, lipid composition, pH, and ionic strength. We report that PrP(106-126) has a low affinity for lipid membranes under physiological conditions without evidence of membrane disturbances. Membrane insertion and leakage occur only under conditions in which strong electrostatic interactions operate. These results support the hypothesis that the physiological prion protein PrPC mediates PrP(106-126) toxic effects in neuronal cells