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1

Barbed Suture for Vaginal Cuff Closure in Laparoscopic Hysterectomy  

PubMed Central

Background and Objectives: Our aim was to evaluate whether the use of barbed suture for vaginal cuff closure is associated with a decrease in postoperative vaginal bleeding compared with cuff closure with polyglactin 910 in patients who have undergone laparoscopic hysterectomy. Methods: We performed a cohort study of patients who underwent laparoscopic hysterectomy between January 2008 and July 2012 by the minimally invasive gynecologic surgery division of the Gynecology, Obstetrics and Human Reproduction Department at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia. Results: A total of 232 women were studied: 163 were in the polyglactin 910 group, and 69 were in the barbed suture group. The main outcome, postoperative vaginal bleeding, was documented in 53 cases (32.5%) in the polyglactin 910 group and in 13 cases (18.8%) in the barbed suture group (relative risk, 0.57; 95% confidence interval, 0.34–0.9; P = .03). No statistically significant differences were found in other postoperative outcomes, such as emergency department admission, vaginal cuff dehiscence, infectious complications, and the presence of granulation tissue. Conclusion: In this study an inverse association was observed between the use of barbed suture for vaginal cuff closure during laparoscopic hysterectomy and the presence of postoperative vaginal bleeding.

Medina, Byron Cardoso; Riano, Giovanni; Hoyos, Luis R.; Otalora, Camila

2014-01-01

2

Laparoscopic vaginal vault closure with conventional straight instruments in single-port access total laparoscopic hysterectomy  

PubMed Central

Objective Laparoscopic vaginal vault closure with conventional straight instruments is the final barrier to single-port access total laparoscopic hysterectomy (SPA-TLH). The aim of this study is to find out the safer, easier, simpler, faster, and even cheaper way to overcome it. Methods Vaginal vault suturing techniques of 152 consecutive single-port access total laparoscopic hysterectomy cases performed by the author in Gangnam CHA Hospital, CHA University from October 1, 2003 to June 30, 2012, were retrospectively analysed with medical records and DVDs. Results Of 152 patients who were attempted SPA-TLH, 119 patients (78%) were finished their operations without conversion to multi-port laparoscopy or laparotomy. Of women with successful SPA-TLH, 8 cases (7%) were closed their vaginal vaults vaginally (median, 20 minutes; range, 15-44 minutes), and 111 cases (93%) laparoscopically (median, 44 minutes; range, 13-56 minutes). Laparoscopic vault closure techniques were continuous suture (4 cases, 3%; median, 36 minutes; range, 30-45 minutes), interrupted sutures using knot-pusher (7 cases, 6%; median, 52 minutes; range, 48-56 minutes) Endo Stitch suture (2 cases, 2%; median, 32 minutes; range, 13-50 minutes), continuous vault closure using percutaneous sling sutures (PCSS) (92 cases, 77%; median, 40 minutes; range, 19-56 minutes), and continuous vault closure without PCSS (6 cases, 5%; median, 23 minutes; range, 16-31 minutes). Conclusion Laparoscopic vault closure using PCSS in SPA-TLH only with conventional straight instruments is the best way to overcome the barrier and the short-cut to shorten the learning curve to date.

Park, Daehyun; Kim, Juyoung; Jun, Hye Sun; Jeong, Hyangjin

2013-01-01

3

Acoustic emission measurement of fatigue crack closure  

SciTech Connect

In this study the acoustic emission (AE) technique has been applied to measure the crack closure loads precisely and the results have been compared with those measured by the conventional techniques such as the crack opening displacement (COD) method, back face strain gage (BFS) method, and surface strain gage method. In addition, fatigue tests at high stress ratio (R=0.8) have also been conducted to compared the results with those of the above methods at R=0.1 and to verify the accuracy of each method. The material used in the present investigation was an Al-Li 8090 alloy which was supplied as a 44.5mm thick rolled plate in the solution heat treated, 6% stretched and naturally aged condition. The COD and BFS methods show relatively good agreement with each other and measure the through-thickness mean value of crack closure loads. In the plane strain condition, the crack closure levels obtained by the COD and BFS methods were lower than those by the AE and surface train gage methods. The data obtained by the surface strain gage method must be interpreted carefully, because the shape of the compliance curves is affected by the location relative to the crack tip. The intrinsic fatigue life curve (da/dN vs. [Delta]K[sub eff]) obtained by the AE technique fitted well with the curve of high stress ratio (R=0.8) test at high [Delta]K, suggesting that the AE technique is sensitive to local crack-tip behavior on a microscopic scale and can be considered as a reliable measurement method for crack closure phenomena under repetitive loads.

Lee, C.S.; Rhyim, Y.M. (Pohang Univ. of Science and Technology (Korea, Republic of). Center for Advanced Aerospace Materials); Kwon, D. (Seoul National Univ. (Korea, Republic of). Dept. of Metallurgical Engineering); Ono, K. (Univ. of California, Los Angeles, CA (United States). Dept. of Materials Science and Engineering)

1995-03-01

4

Assemblies for in vitro measurement of bioadhesive strength and retention characteristics in simulated vaginal environment.  

PubMed

The vaginal route of administration offers a promising option for local and systemic delivery of drugs. Conventional vaginal formulations are associated with limitations of poor retention, leakage, and messiness, thereby causing inconvenience to users. To overcome these limitations, formulations that adhere to the vaginal mucosa for a sufficient period of time need to be developed. Bioadhesion and retention are desirable characteristics of a vaginal formulation to achieve desired efficacy. These properties can be built in during formulation development by the use of bioadhesive polymers. In the present study, assemblies for in vitro measurement of bioadhesive strength and retention characteristics of vaginal formulations have been developed. A modified simulated vaginal fluid (SVFM) was used to simulate vaginal conditions for bioadhesion studies. Cellophane hydrated with SVFM and isolated sheep vaginal mucosa were used as model membranes. The bioadhesive potential of various polymers and their combinations was evaluated. Among the polymers evaluated, xanthan gum (XG), sodium alginate (SA), Polycarbophil (PC), and their combinations (XG + SA and XG + PC) were found to possess significant bioadhesive strength. In retention experiments, XG, SA, and combinations (XG + SA and XG + PC) were retained in isolated sheep vaginal tissue, while PC exhibited poor retention under experimental conditions. Based on the results of the study conducted, XG, SA, and combinations (XG + SA and XG + PC) have been proposed as potential candidates for developing bioadhesive vaginal drug delivery systems. PMID:12455472

Vermani, Kavita; Garg, Sanjay; Zaneveld, Lourens J D

2002-10-01

5

Three-dimensional measurements of fatigue crack closure  

NASA Technical Reports Server (NTRS)

Three dimensional fatigue crack opening profiles in transparent polymer test specimens were determined. The load required to separate crack faces was measured along the crack profile at various positions through the specimens thickness. Crack opening loads at the specimen surface (under plane stress conditions) were compared with measurements made under plane strain conditions the specimen interior. The fatigue crack opening load was correlated with fatigue crack retardation behavior caused by peak overloads, and the results discussed in terms of three dimensional aspects of the fatigue crack closure mechanism for fatigue crack retardation.

Grandt, A. F., Jr.

1984-01-01

6

Vaginal dryness  

MedlinePLUS

Vaginal dryness is present when the tissues of the vagina are no longer well-lubricated and healthy. When ... sexual intercourse more comfortable. It also helps decrease vaginal dryness. If estrogen levels drop off, the vaginal tissue ...

7

Vaginal Diseases  

MedlinePLUS

... symptoms. Common causes are bacterial infections, trichomoniasis, and yeast infections. Some other causes of vaginal symptoms include sexually transmitted diseases, vaginal cancer, and vulvar cancer. Treatment of vaginal problems depends ...

8

Calculated and measured drift closure during the spent-fuel test in Climax granite  

SciTech Connect

Horizontal and vertical measurements of drift closures have been made with a manually operated tape extensometer since about 6 weeks after the emplacement of the spent fuel at various locations along the length of the drifts. The averaged closures are less than 0.6 mm from the onset of measurements through about two years after the spent fuel emplacement. These results have been compared with thermo-elastic finite element calculations using measured medium properties. The comparisons show that most of the closure of the drifts occurred between the time the spent fuel was emplaced and the time of first measurement. The comparisons show that the results track each other, in that where closure followed by dilation is measured, the calculations also show this effect. The agreement is excellent, although where closures of less than 0.2 mm are measured the comparison with calculations is limited by measurement reproducability. Once measurements commenced the averaged measured closures remain to within 30% of the calculated total closure in each drift. 9 figures, 1 table.

Yow, J.L. Jr.; Butkovich, T.R.

1982-04-01

9

Optical instrument for measurement of vaginal coating thickness by drug delivery formulations  

SciTech Connect

An optical device has been developed for imaging the human vaginal epithelial surfaces, and quantitatively measuring distributions of coating thickness of drug delivery formulations - such as gels - applied for prophylaxis, contraception or therapy. The device consists of a rigid endoscope contained within a 27-mm-diam hollow, polished-transparent polycarbonate tube (150 mm long) with a hemispherical cap. Illumination is from a xenon arc. The device is inserted into, and remains stationary within the vagina. A custom gearing mechanism moves the endoscope relative to the tube, so that it views epithelial surfaces immediately apposing its outer surface (i.e., 150 mm long by 360 deg. azimuthal angle). Thus, with the tube fixed relative to the vagina, the endoscope sites local regions at distinct and measurable locations that span the vaginal epithelium. The returning light path is split between a video camera and photomultiplier. Excitation and emission filters in the light path enable measurement of fluorescence of the sited region. Thus, the instrument captures video images simultaneously with photometric measurement of fluorescence of each video field [{approx}10 mm diameter; formulations are labeled with 0.1% w/w United States Pharmacoepia (USP) injectable sodium fluorescein]. Position, time and fluorescence measurements are continuously displayed (on video) and recorded (to a computer database). The photomultiplier output is digitized to quantify fluorescence of the endoscope field of view. Quantification of the thickness of formulation coating of a surface sited by the device is achieved due to the linear relationship between thickness and fluorescence intensity for biologically relevant thin layers (of the order of 0.5 mm). Summary measures of coating have been developed, focusing upon extent, location and uniformity. The device has begun to be applied in human studies of model formulations for prophylaxis against infection with HIV and other sexually transmitted pathogens.

Henderson, Marcus H.; Peters, Jennifer J.; Walmer, David K.; Couchman, Grace M.; Katz, David F. [Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States); Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina 27710 (United States); Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 and Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina 27710 (United States)

2005-03-01

10

Optical instrument for measurement of vaginal coating thickness by drug delivery formulations  

NASA Astrophysics Data System (ADS)

An optical device has been developed for imaging the human vaginal epithelial surfaces, and quantitatively measuring distributions of coating thickness of drug delivery formulations-such as gels-applied for prophylaxis, contraception or therapy. The device consists of a rigid endoscope contained within a 27-mm-diam hollow, polished-transparent polycarbonate tube (150 mm long) with a hemispherical cap. Illumination is from a xenon arc. The device is inserted into, and remains stationary within the vagina. A custom gearing mechanism moves the endoscope relative to the tube, so that it views epithelial surfaces immediately apposing its outer surface (i.e., 150 mm long by 360° azimuthal angle). Thus, with the tube fixed relative to the vagina, the endoscope sites local regions at distinct and measurable locations that span the vaginal epithelium. The returning light path is split between a video camera and photomultiplier. Excitation and emission filters in the light path enable measurement of fluorescence of the sited region. Thus, the instrument captures video images simultaneously with photometric measurement of fluorescence of each video field [~10 mm diameter; formulations are labeled with 0.1% w/w United States Pharmacoepia (USP) injectable sodium fluorescein]. Position, time and fluorescence measurements are continuously displayed (on video) and recorded (to a computer database). The photomultiplier output is digitized to quantify fluorescence of the endoscope field of view. Quantification of the thickness of formulation coating of a surface sited by the device is achieved due to the linear relationship between thickness and fluorescence intensity for biologically relevant thin layers (of the order of 0.5 mm). Summary measures of coating have been developed, focusing upon extent, location and uniformity. The device has begun to be applied in human studies of model formulations for prophylaxis against infection with HIV and other sexually transmitted pathogens.

Henderson, Marcus H.; Peters, Jennifer J.; Walmer, David K.; Couchman, Grace M.; Katz, David F.

2005-03-01

11

Differences in Airway Closure between Normal and Asthmatic Subjects Measured with Single-Photon Emission Computed Tomography and Technegas  

Microsoft Academic Search

The absence of a maximal dose-response plateau as well as gas trapping and increases in closing ca- pacity (CC) suggest that increased airway closure is an important mechanical abnormality of asth- matic airways. We compared the extent and distribution of airway closure in 13 normal and in 23 asthmatic subjects. Airway closure (LVclosed) was measured with single-photon emission computed tomography

GREGORY G. KING; STEFAN EBERL; CHERYL M. SALOME; IVEN H. YOUNG; ANN J. WOOLCOCK

12

A vaginal temperature registration system  

Microsoft Academic Search

A radiotelemetric method for measurements of vaginal temperature in the home milieu is presented. Registrations from two subjects show that vaginal temperatures vary up to and about 1°C nighttime. Initially, on going to bed, vaginal temperature drops. A further distinct drop occurs with any kind of experienced sexual arousal, reaching a minimum when and if orgasm is achieved. At rest,

Axel R. Fugl-Meyer; Kerstin Sjögren; Kenneth Johansson

1984-01-01

13

Vaginal Atrophy  

MedlinePLUS

... no symptoms at all. Or you may have Vaginal dryness Burning feelings in your vagina Discomfort or pain ... uptodate.com/patients/index.html and search for vaginal dryness About Us Contact Us Donate Connect: © 2014 Copyright ...

14

Vaginal leiomyoma  

PubMed Central

Leiomyomas are common benign tumors in the uterus. However, vaginal leiomyomas remain an uncommon entity with only about 300 reported cases. Here, we report a case of a 38-year-old multigravida who presented with lower abdominal pain and vaginal bleeding. A physical examination and ultrasonography were performed, and a diagnosis of cervical fibroid was made. Pervaginal removal of the tumor was performed and subsequent histopathology revealed a vaginal leiomyoma. Although a rare tumor, vaginal leiomyomas may present with a variety of clinical features and may be mistaken preoperatively for cervical fibroid. Removal of tumor by vaginal route, wherever possible, with subsequent histopathological examination appears to be the optimum management plan.

Chakrabarti, Indranil; De, Anuradha; Pati, Shyamapada

2011-01-01

15

[Vaginal leiomyoma].  

PubMed

Vaginal leiomyomas are rare benign tumors. This is a case report with menstrual and urinary difficulties and vaginal mass with inner urethral meatus and hymen displacement. Miccional cystourethrography showed a posterior displaced, comprised and elongated urethra. Excretory urography and pelvic sonogram were normal. Preurethral enucleation extirpation with no complications was practiced. Current literature is reviewed. PMID:16972526

Briceño Pérez, Carlos; Briceño Sanabria, Liliana; Briceño Sanabria, Juan; Briceño Sanabria, Carlos

2006-05-01

16

Vaginal leiomyoma.  

PubMed

Leiomyomas are common benign tumors in the uterus. However, vaginal leiomyomas remain an uncommon entity with only about 300 reported cases. Here, we report a case of a 38-year-old multigravida who presented with lower abdominal pain and vaginal bleeding. A physical examination and ultrasonography were performed, and a diagnosis of cervical fibroid was made. Pervaginal removal of the tumor was performed and subsequent histopathology revealed a vaginal leiomyoma. Although a rare tumor, vaginal leiomyomas may present with a variety of clinical features and may be mistaken preoperatively for cervical fibroid. Removal of tumor by vaginal route, wherever possible, with subsequent histopathological examination appears to be the optimum management plan. PMID:21897740

Chakrabarti, Indranil; De, Anuradha; Pati, Shyamapada

2011-01-01

17

Closure measuring technique on the datum of an end-tooth indexing table  

NASA Astrophysics Data System (ADS)

The end-tooth indexing table (EIT) is widely used as angular reference in precision measurement or precision manufacturing fields. In order to improve the pitch accuracy of ultra-precision master gears, we designed an automatic end-tooth indexing system on a specific gear grinder. Theoretically, the indexing accuracy of an EIT can reach ±0.2? or even more, which can meet the machining requirements of ultra-precision gears with pitch deviation up to grade 0 (ISO1328-1:1995). However, the axial and radial misalignment of an EIT to the spindle will decrease the indexing accuracy of the gear grinder. In order to solve this difficulty, precision measurement and lapping on the datum face of an EIT will be necessary. How to measure the parallelism deviation correctly at the datum of the mating face of the EIT will be another difficulty. Using the closure measuring technique which allows error separation, in this paper the measurement platform is set up, the data acquisition and handling method are presented and an experimental measurement is carried out. The maximum parallelism deviation, which is between the target face of an EIT and its mating face, was reduced from about 4 to 0.29 µm by adopting the closure measuring technique and precision lapping. It confirms that the closure measuring technique can implement precision measurement of dimensional measurands for an axisymmetric part.

Ling, Siying; Lou, Zhifeng; Wang, Liding

2012-04-01

18

Effect of a collector bag for measurement of postpartum blood loss after vaginal delivery: cluster randomised trial in 13 European countries  

Microsoft Academic Search

Objective To evaluate the effectiveness of the systematic use of a transparent plastic collector bag to measure postpartum blood loss after vaginal delivery in reducing the incidence of severe postpartum haemorrhage.Design Cluster randomised trial.Setting 13 European countries.Participants 78 maternity units and 25 381 women who had a vaginal delivery.Interventions Maternity units were randomly assigned to systematic use of a collector

Wei-Hong Zhang; Catherine Deneux-Tharaux; Peter Brocklehurst; Edmund Juszczak; Matthew Joslin; Sophie Alexander

2010-01-01

19

Vaginal leiomyoma in pregnancy presenting as a prolapsed vaginal mass.  

PubMed

Vaginal leiomyomas are rare benign solid tumours of the vagina. They can cause mechanical dystocia, which is a common problem in obstetrics leading to serious maternal and perinatal complications. Here we describe a patient with a vaginal leiomyoma diagnosed during the mid-trimester that could have caused dystocia. This 22-year-old woman presented with a vaginal mass and leaking vaginal fluid during pregnancy. On examination, a prolapsed, pedunculated mass, measuring 5 × 3 × 4 cm was detected in the anterior vaginal wall. Via a midline incision, the mass was easily enucleated and removed. Transvaginal surgical enucleation of the vaginal leiomyoma is usually curative and recommended as the initial treatment of choice to prevent for dystocia. Such treatment is indicated when the tumour is a potential obstacle to normal labour. PMID:23223657

Dane, Cem; Rustemoglu, Yaprak; Kiray, Murat; Ozkuvanci, Unsal; Tatar, Zeynep; Dane, Banu

2012-12-01

20

Vaginal Discharge  

MedlinePLUS

... who is infected. What about other infections? Two sexually transmitted infections, chlamydia and gonorrhea, can also cause vaginal discharge. ... I need any tests, such as tests for sexually transmitted infections? What do my test results mean? Based on ...

21

Vaginal Pessary  

MedlinePLUS

... your vagina). A pessary can also help many women who have stress urinary incontinence (the leaking of urine when you cough, strain or exercise). Pregnant women who have incontinence can also use a vaginal ...

22

Estrogen Vaginal  

MedlinePLUS

... estradiol vaginal ring is also used to treat hot flushes ('hot flashes'; sudden strong feelings of heat and sweating) ... mild soap and warm water. Do not use hot water or boil the applicator. Ask your pharmacist ...

23

Effect of a collector bag for measurement of postpartum blood loss after vaginal delivery: cluster randomised trial in 13 European countries  

PubMed Central

Objective To evaluate the effectiveness of the systematic use of a transparent plastic collector bag to measure postpartum blood loss after vaginal delivery in reducing the incidence of severe postpartum haemorrhage. Design Cluster randomised trial. Setting 13 European countries. Participants 78 maternity units and 25?381 women who had a vaginal delivery. Interventions Maternity units were randomly assigned to systematic use of a collector bag (intervention group) or to continue to visually assess postpartum blood loss after vaginal delivery (control group). Main outcome measures The primary outcome was the incidence of severe postpartum haemorrhage in vaginal deliveries, defined as a composite of one or more of blood transfusion, intravenous plasma expansion, arterial embolisation, surgical procedure, admission to an intensive care unit, treatment with recombinant factor VII, and death. Results Severe postpartum haemorrhage occurred in 189 of 11?037 of vaginal deliveries (1.71%) in the intervention group compared with 295 of 14?344 in the control group (2.06%). The difference was not statistically significant either in individual level analysis (adjusted odds ratio 0.82, 95% confidence interval 0.26 to 2.53) or in cluster level analysis (difference in weighted mean rate adjusted for baseline rate 0.16%, 95% confidence interval ?0.69% to 1.02%). Conclusion Compared with visual estimation of postpartum blood loss the use of a collector bag after vaginal delivery did not reduce the rate of severe postpartum haemorrhage. Trial registration Current Controlled Trials ISRCTN66197422.

2010-01-01

24

Vaginal Anomalies: Congenital Vaginal Obstruction  

MedlinePLUS

... Female infants are normally born with a thin membrane ( hymen ) that surrounds the vaginal opening. In rare ... specific physiological purpose. high transverse septum: A thin membrane up high in an organism that lies crosswise. ...

25

Designing preclinical perceptibility measures to evaluate topical vaginal gel formulations: relating user sensory perceptions and experiences to formulation properties.  

PubMed

Abstract The effectiveness of any biomedical prevention technology relies on both biological efficacy and behavioral adherence. Microbicide trials have been hampered by low adherence, limiting the ability to draw meaningful conclusions about product effectiveness. Central to this problem may be an inadequate conceptualization of how product properties themselves impact user experience and adherence. Our goal is to expand the current microbicide development framework to include product "perceptibility," the objective measurement of user sensory perceptions (i.e., sensations) and experiences of formulation performance during use. For vaginal gels, a set of biophysical properties, including rheological properties and measures of spreading and retention, may critically impact user experiences. Project LINK sought to characterize the user experience in this regard, and to validate measures of user sensory perceptions and experiences (USPEs) using four prototype topical vaginal gel formulations designed for pericoital use. Perceptibility scales captured a range of USPEs during the product application process (five scales), ambulation after product insertion (six scales), and during sexual activity (eight scales). Comparative statistical analyses provided empirical support for hypothesized relationships between gel properties, spreading performance, and the user experience. Project LINK provides preliminary evidence for the utility of evaluating USPEs, introducing a paradigm shift in the field of microbicide formulation design. We propose that these user sensory perceptions and experiences initiate cognitive processes in users resulting in product choice and willingness-to-use. By understanding the impact of USPEs on that process, formulation development can optimize both drug delivery and adherence. PMID:24180360

Morrow, Kathleen M; Fava, Joseph L; Rosen, Rochelle K; Vargas, Sara; Shaw, Julia G; Kojic, E Milu; Kiser, Patrick F; Friend, David R; Katz, David F

2014-01-01

26

A novel breath test to directly measure use of vaginal gel and condoms.  

PubMed

We assessed the feasibility of a breath test to detect women's single or concurrent use of vaginal products by adding ester taggants to vaginal gel and condom lubricant. Healthy non-pregnant women were enrolled into a two-day cohort (N = 13) and a single-day cohort (N = 12) in San Francisco. Within each cohort, women were randomized (5:1) to tagged or untagged products, and inserted in a clinical setting: 4 mL of tenofovir placebo gel (ten tagged with 15 mg 2-pentyl acetate; three untagged), and an artificial phallus with a lubricated condom (11 tagged with 15 mg 2-butyl acetate; two untagged), on two separate days (two-day cohort) or concurrently (single-day cohort). Using a portable mini-gas chromatograph, the presence/absence of taggants was determined in breath specimens collected prior to, and at timed intervals following product exposure. Demographic, clinical and product use experience data were collected by structured interview. All participants completed all visits and inserted their assigned products. At 5 min post-insertion, the breath test was 100% accurate in identifying insertion of the tagged (or untagged) gel and/or condom. The half-life in breath of the two esters tested was <1 h with large variability between individuals, taggants and cohorts. Overall, among those receiving tagged product, six mild and two moderate product-related AEs were reported. All were transient and resolved spontaneously. Additional sensations included taste in mouth (N = 4) and scent (N = 5). The tagged products were well tolerated. This breath test has the potential to accurately and objectively monitor adherence to vaginal gel and condom used separately or concurrently. PMID:23321948

van der Straten, Ariane; Cheng, Helen; Wasdo, Scott; Montgomery, Liz; Smith-McCune, Karen; Booth, Matthew; Gonzalez, Daniel; Derendorf, Hartmut; Morey, Timothy E; Dennis, Donn M

2013-07-01

27

[Vaginal leiomyoma].  

PubMed

Vaginal leiomyoma is a very rare condition. The earliest reference made to such a tumor is attributed to Denys De Leyden in 1773, and the first review of the literature concerning such tumors was published in 1882. It is estimated approximately 300 leiomyomas of the vagina have been reported in the world literature. The case of a 39-year-old female with large vaginal leiomyoma illustrates the diagnostic difficulties in such cases. In leiomyoma of the vagina surgical treatment is recommended. PMID:12916261

Gottwald, Leszek; Welfel, Jakub; Akoel, Kindah Mo; Lech, Waldemar; Suzin, Jacek; Bie?kiewicz, Andrzej

2003-03-01

28

Effect of tension-free vaginal tape procedure on urodynamic continence indices  

Microsoft Academic Search

OBJECTIVE:To assess the difference in measured urethral function before and after tension-free vaginal tape procedure (TVT).METHODS:Women who underwent TVT for genuine stress incontinence with or without intrinsic sphincter deficiency completed this study. Multichannel urodynamic testing was performed preoperatively and 6 weeks postoperatively. Maximum urethral closure pressure and pressure transmission ratio were recorded. Valsalva leak point pressures were determined at 150

Nina Mutone; Marisa Mastropietro; Edward Brizendine; Douglass Hale

2001-01-01

29

Use of measurement uncertainty analysis to assess accuracy of carbon mass balance closure for a cellulase production process.  

PubMed

Closing carbon mass balances is a critical and necessary step for verifying the performance of any conversion process. We developed a methodology for calculating carbon mass balance closures for a cellulase production process and then applied measurement uncertainty analysis to calculate 95% confidence limits to assess the accuracy of the results. Cellulase production experiments were conducted in 7-L fermentors using Trichoderma reesei grown on pure cellulose (Solka-floc), glucose, or lactose. All input and output carbon-containing streams were measured and carbon dioxide in the exhaust gas was quantified using a mass spectrometer. On Solka-floc, carbon mass balances ranged from 90 to 100% closure for the first 48 h but increased to 101 to 135% closure from 72 h to the end of the cultivation at 168 h. Carbon mass balance closures for soluble sugar substrates ranged from 92 to 127% over the entire course of the cultivations. The 95% confidence intervals (CIs) for carbon mass balance closure were typically +/-11 to 12 percentage points after 48 h of cultivation. Many of the carbon mass balance results did not bracket 100% closure within the 95% CIs. These results suggest that measurement problems with the experimental or analytical methods may exist. This work shows that uncertainty analysis can be a useful diagnostic tool for identifying measurement problems in complex biochemical systems. PMID:12018278

Schell, Daniel J; Sáez, Juan Carlos; Hamilton, Jenny; Tholudur, Arun; McMillan, James D

2002-01-01

30

Energy balance closure evaluation based on closed path and enclosed path eddy covariance measurements  

NASA Astrophysics Data System (ADS)

Evapotranspiration has a great role in the water cycle of the terrestrial ecosystems. A large number of methods for measuring and estimating LE do exist. LE measured by eddy-covariance technique is usually underestimated. In case of heat flux without phase changes of water, sensible heat flux (H), there is a similar situation. Available energy for turbulent LE and H fluxes can be estimated by energy balance closure (EBC) approach almost independently of the eddy-covariance (EC) technique. Enclosed path EC system is supposed to measure LE fluxes more precisely compared to closed path EC system due to short inlet tubes etc. EBC was defined as Rn-G - J = H+LE, where available energy consists of net radiation balance (Rn), soil heat flux (G) and heat storage term (J). The heat storage term expresses instantaneous change of heat inside the vegetation cover. This extra term should be specified when EBC is applied for forest study sites. Imbalance between available energy and energy used for turbulent fluxes H and LE is known as a lack of energy balance closure. A mean imbalance varies in order of 20% in FLUXNET study sites at mediterranean, temperate and arctic ecosystems. We have performed a simultaneous measurement of LE and H by closed path (with analyser LI-7000) and enclosed (with analyser LI-7200) EC systems in young spruce forest from August to September 2011. In case of closed path eddy covariance system, there was no correction for adsorption of water on the tubing system. Raw data were post-processed using software EddyPro 3.0. Days with rain events were included. The aim of this study was to (i) quantify available energy by EBC from micrometeorological parameters and biomass temperature measurement, (ii) to evaluate EBC calculated by both EC systems and (iii) to evaluate possible differences between LE fluxes expressed in evapotranspiration term for both EC systems too.Mean daytime lack of energy balance closure for enclosed path and closed path EC systems were about 27% and 48%, respectively. Mean LE fluxes measured by enclosed path EC were significantly higher (t = 4.99, df = 53, p

Slipkova, R.; Sedlák, P.; Pokorný, R.

2012-04-01

31

Development of an LC-MS Method for Measuring TNF in Human Vaginal Tissue  

PubMed Central

A sensitive, accurate, and precise liquid chromatography–mass spectrometry assay for the determination of tenofovir (TNF) in human vaginal tissue was developed and validated. After homogenization of the tissue, solid-phase extraction on Varian Bond Elut-C18 column was used for sample clean up. Chromatographic separation of TNF and the internal standard (tolbutamide) was achieved with a Varian Polaris 3C18-A reversed-phase analytical column (150 mm × 2 mm). A gradient method using 0.1% formic acid in water and 0.1% formic acid in acetonitrile was employed. Detection of TNF and tolbutamide was achieved by electrospray ionization mass spectrometry in the positive ion mode using 288.05 and 271.00 m/z, respectively. Linear TNF calibration curves were obtained between 1–1,000 ng/mL with a correlation coefficient (r2) greater than 0.999. Intra-and inter-day accuracy for TNF ranged from 89.7% and 109.4% and from 97.3% and 104.9%, and precision ranged from 1.3% and 10.9% and 2.6% and 9.0%, respectively. This is the first validated method developed to quantitate TNF in human tissues.

Choi, S.O.; Rezk, N.; Kim, J.S.; Kashuba, A.D.M.

2010-01-01

32

Development of an LC-MS method for measuring TNF in human vaginal tissue.  

PubMed

A sensitive, accurate, and precise liquid chromatography-mass spectrometry assay for the determination of tenofovir (TNF) in human vaginal tissue was developed and validated. After homogenization of the tissue, solid-phase extraction on Varian Bond Elut-C(18) column was used for sample clean up. Chromatographic separation of TNF and the internal standard (tolbutamide) was achieved with a Varian Polaris 3C(18)-A reversed-phase analytical column (150 mm x 2 mm). A gradient method using 0.1% formic acid in water and 0.1% formic acid in acetonitrile was employed. Detection of TNF and tolbutamide was achieved by electrospray ionization mass spectrometry in the positive ion mode using 288.05 and 271.00 m/z, respectively. Linear TNF calibration curves were obtained between 1-1,000 ng/mL with a correlation coefficient (r(2)) greater than 0.999. Intra- and inter-day accuracy for TNF ranged from 89.7% and 109.4% and from 97.3% and 104.9%, and precision ranged from 1.3% and 10.9% and 2.6% and 9.0%, respectively. This is the first validated method developed to quantitate TNF in human tissues. PMID:20223089

Choi, S O; Rezk, N; Kim, J S; Kashuba, A D M

2010-03-01

33

MRI of vaginal conditions.  

PubMed

Magnetic resonance imaging (MRI) has become an important part of the assessment of suspected vaginal pathology. This pictorial review demonstrates the MRI features and some of the histopathological findings of a variety of vaginal conditions. These may be congenital (total vaginal agenesis, partial vaginal agenesis, longitudinal vaginal septum, transverse vaginal septum), benign (Bartholin's cyst, diffuse vaginal inflammation, invasive endometriosis, ureterovaginal fistula, post-surgical appearances with the formation of a neovagina and adhesions) or malignant, usually due to extension or recurrence from another pelvic malignancy. In this paper, examples of the above are described and illustrated together with examples of the much rarer primary vaginal malignancies. PMID:16038691

López, C; Balogun, M; Ganesan, R; Olliff, J F

2005-06-01

34

Vaginal Birth  

NSDL National Science Digital Library

This patient education program reviews female reproductive anatomy and explains vaginal birth. It also discusses the stages of labor and delivery, as well as potential risks and complications. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Institute, Patient E.

2008-11-28

35

Prediction and measurement of direct-normal solar irradiance: A closure experiment  

SciTech Connect

Direct-normal solar irradiance (DNSI), the total energy in the solar spectrum incident on a plane perpendicular to the Sun`s direction on a unit area at the earth`s surface in unit time, depends only on the atmospheric extinction of sunlight without regard to the details of extinction--whether absorption or scattering. Here the authors describe a set of closure experiments performed in north-central Oklahoma, wherein measured atmospheric composition is input to a radiative transfer model, MODTRAN-3, to predict DNSI, which is then compared to measured values. Thirty six independent comparisons are presented; the agreement between predicted and measured values falls within the combined uncertainties in the prediction (2%) and measurement (0.2%) albeit with a slight bias ({approximately} 1% overprediction) that is independent of the solar zenith angle. Thus these results establish the adequacy of current knowledge of the solar spectrum and atmospheric extinction as embodied in MODTRAN-3 for use in climate models. An important consequence is the overwhelming likelihood that the atmospheric clear-sky absorption is accurately described to within comparable uncertainties.

Halthore, R.N.; Schwartz, S.E. [Brookhaven National Lab., Upton, NY (United States); Michalsky, J.J. [State Univ. of New York, Albany, NY (United States); Anderson, G.P. [Hanscomb AFB (United States); Ferrare, R.A. [National Aeronautics and Space Administration, Greenbelt, MD (United States). Goddard Space Flight Center; Ten Brink, H.M. [Energy Research Inst. (Netherlands)

1997-03-01

36

Large Vaginal and Bladder Calculi in a Woman With Previous Operation of Bladder Exstrophy: A Case Report  

PubMed Central

This is to report the case of a huge vaginal stone, and bladder calculi in a 26-year-old woman with previous operation of bladder exstrophy. It seems that the vaginal stone was secondary to the remaining wire used in her previous reconstructive surgery for pelvic closure 20 years ago and now surgery is performed to remove the vaginal and bladder stones.

Tavakkoli, Mahmoud; Ghoreifi, Alireza

2013-01-01

37

78 FR 72583 - Reef Fish Fishery of the Gulf of Mexico; 2013 Accountability Measure and Closure for Hogfish in...  

Federal Register 2010, 2011, 2012, 2013

...0648-XC981 Reef Fish Fishery of the Gulf of Mexico; 2013 Accountability Measure and Closure for Hogfish in the Gulf of Mexico AGENCY: National Marine Fisheries...exclusive economic zone (EEZ) of the Gulf of Mexico (Gulf) for the 2013 fishing...

2013-12-03

38

Vaginal Laser Doppler Flowmetry Pre and Posthysterectomy  

Microsoft Academic Search

The objective of this study was to demonstrate the applicability of laser doppler flowmetry to pre- and posthysterectomy vaginal blood flow assessment. We used laser Doppler flowmetry to measure pre-and postoperational vaginal blood flow in 8 premenopausal women undergoing benign hysterectomies; we also measured serum E2, FSH, FT and administered a brief sexual function questionnaire. We analyzed data using two

SUSAN M. RICHMAN; PHILIP M. SARREL

2004-01-01

39

An Evaluation of the Plasticity-Induced Crack-Closure Concept and Measurement Methods  

Microsoft Academic Search

An assessment of the plasticity-induced crack-closure concept is made, in light ofsome of the questions that have been raised on the validity of the concept, and theassumptions that have been made concerning crack-tip damage below the crack-openingstress. The impact of using other crack-tip parameters, such as the cyclic crack-tipdisplacement, to model crack-growth rate behavior was studied. Crack-growth simulations,using a crack-closure

James C. Newman

1998-01-01

40

Retrohymenal vaginal atresia with perforate transverse vaginal septum.  

PubMed

A transverse vaginal septum is the most common congenital anomaly of the vagina. Vaginal atresia is seen less frequently. There have been some variations in cases of transverse vaginal septum and vaginal atresia. This is the first report of a patient with retrohymenal vaginal atresia and perforate transverse vaginal septum. PMID:1427424

Oga, M; Anai, T; Yoshimatsu, J; Kawano, Y; Hayata, T; Miyakawa, I

1992-01-01

41

Retrohymenal Vaginal Atresia with Perforate Transverse Vaginal Septum  

Microsoft Academic Search

A transverse vaginal septum is the most common congenital anomaly of the vagina. Vaginal atresia is seen less frequently. There have been some variations in cases of transverse vaginal septum and vaginal atresia. This is the first report of a patient with retrohymenal vaginal atresia and perforate transverse vaginal septum.Copyright © 1992 S. Karger AG, Basel

Masayuki Oga; Takanobu Anai; Jun Yoshimatsu; Yasushi Kawano; Takashi Hayata; Isao Miyakawa

1992-01-01

42

Vaginal misoprostol for late first trimester abortion  

Microsoft Academic Search

A group of 120 women with gestations from 64 to 84 days received 800 ?g of vaginal misoprostol every 24 h for a maximum of three doses without performing postexpulsion systematic preventive curettage. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side effects, and mean time of expulsion and vaginal bleeding. Complete abortion occurred in 104

J. L Carbonell Esteve; L Varela; A Velazco; E Cabezas; R Tanda; C Sánchez

1998-01-01

43

Airborne Sunphotometer Studies of Aerosol Properties and Effects, Including Closure Among Satellite, Suborbital Remote, and In situ Measurements  

NASA Technical Reports Server (NTRS)

Airborne sunphotometry has been used to measure aerosols from North America, Europe, and Africa in coordination with satellite and in situ measurements in TARFOX (1996), ACE-2 (1997), PRIDE (2000), and SAFARI 2000. Similar coordinated measurements of Asian aerosols are being conducted this spring in ACE-Asia and are planned for North American aerosols this summer in CLAMS. This paper summarizes the approaches used, key results, and implications for aerosol properties and effects, such as single scattering albedo and regional radiative forcing. The approaches exploit the three-dimensional mobility of airborne sunphotometry to access satellite scenes over diverse surfaces (including open ocean with and without sunglint) and to match exactly the atmospheric layers sampled by airborne in situ measurements and other radiometers. These measurements permit tests of the consistency, or closure, among such diverse measurements as aerosol size-resolved chemical composition; number or mass concentration; light extinction, absorption, and scattering (total, hemispheric back and 180 deg.); and radiative fluxes. In this way the airborne sunphotometer measurements provide a key link between satellite and in situ measurements that helps to understand any discrepancies that are found. These comparisons have led to several characteristic results. Typically these include: (1) Better agreement among different types of remote measurements than between remote and in situ measurements. (2) More extinction derived from transmission measurements than from in situ measurements. (3) Larger aerosol absorption inferred from flux radiometry than from in situ measurements. Aerosol intensive properties derived from these closure studies have been combined with satellite-retrieved fields of optical depth to produce fields of regional radiative forcing. We show results for the North Atlantic derived from AVHRR optical depths and aerosol intensive properties from TARFOX and ACE-2. Companion papers show analogous, preliminary results for Asian-Pacific aerosols and results of SAFARI-2000 closure studies on African aerosols.

Russlee, Philip B.; Schmid, B.; Redemann, J.; Livingston, J. M.; Bergstrom, R. W.; Ramirez, S. A.; Hipskind, R. Stephen (Technical Monitor)

2001-01-01

44

Vaginal sensitivity to electric stimuli: Theoretical and practical implications  

Microsoft Academic Search

Vaginal sensitivity was investigated in a group of 60 volunteers by means of an electric stimulus and under nonerotic conditions. In comparison to the dorsum of the hand, the genital area has a low sensitivity for electric stimuli (p 0.001). Of the genital area, the vaginal wall measured 2 to 4 cm from the vaginal introitus was found to be

W. C. M. Weijmar Schultz; J. A. Klatter; B. E. Sturm; J. Nauta

1989-01-01

45

Vaginal wall fibroid.  

PubMed

Localization of leiomyomas in the vaginal wall is very rare. We report about a case of a vaginal leiomyoma in the anterior vaginal wall, preoperatively identified with sonography and CT. Surgical enucleation was performed. Surgical removal in these cases is safe and usually with minimal bleeding. PMID:18317784

Theodoridis, T D; Zepiridis, L; Chatzigeorgiou, K N; Papanicolaou, A; Bontis, J N

2008-09-01

46

Closure device  

Microsoft Academic Search

A closure device connectible to a well head through which the polished rod of a rod string extends into a well tubing for operating pump means for moving well fluids to a surface flow conductor, the closure device having a tubular ram provided with a packing or plug for closing an annular passage between the polished rod and a tubular

Sable

1985-01-01

47

Reconstruction of vaginal agenesis.  

PubMed

Vaginal ageneses are by no means rare anomalies. Complete Mullerian agenesis is the most common reason for vaginal agenesis requiring reconstruction. Patients usually present with pain, hematocolpos, or hematometra in puberty, and later with amenorrhea and dyspareunia. Detailed information is given here regarding etiologies, timing of surgery, and current treatment options for vaginal agenesis. Outcomes and short- and long-term complications of recent treatment options are also discussed. PMID:21372677

Ozkan, Ozlenen; Erman Akar, Münire; Ozkan, Omer; Do?an, N Utku

2011-06-01

48

Early healing rates and wound area measurements are reliable predictors of later complete wound closure.  

PubMed

This study was undertaken to determine if healing rates are reliable early predictors of ultimate complete wound closure in venous leg ulcers and diabetic foot wounds. We conducted a retrospective analysis of 306 venous leg ulcers and 241 diabetic foot ulcers enrolled in two large controlled, prospective, randomized pivotal trials to compare topical wound treatments, to determine whether certain early markers of healing could be correlated with later total wound closure. Two-sided tests at 95% confidence demonstrated that wound margin advance, initial healing rate, percent wound surface area reduction, and wound healing trajectories (all p<0.001) were powerful predictors of complete wound healing at 12 weeks. Wounds with poor healing progress by these criteria at 4 weeks were highly likely to remain unhealed after 8 additional weeks of treatment. Analysis of the diabetic foot ulcers and venous leg ulcers subgroups separately demonstrated consistent statistical test results with high significance; similarly, the results remained valid independent of the topical treatment used. The early prediction of eventual wound healing or nonhealing using early healing rates may enable more efficient triage of patients to advanced healing technologies. We believe that these surrogate markers are robust predictors of healing regardless of wound etiology and that they merit wider use in clinical trials and routine patient care. PMID:18211575

Cardinal, Matthew; Eisenbud, David E; Phillips, Tania; Harding, Keith

2008-01-01

49

Extension of the Averaging Time in Eddy-Covariance Measurements and Its Effect on the Energy Balance Closure  

NASA Astrophysics Data System (ADS)

The modified ogive analysis and the block ensemble average were employed to investigate the impact of the averaging time extension on the energy balance closure over six land-use types. The modified ogive analysis, which requires a steady-state condition, can extend the averaging time up to a few hours and suggests that an averaging time of 30 min is still overall sufficient for eddy-covariance measurements over low vegetation. The block ensemble average, which does not require a steady-state condition, can extend the averaging time to several days. However, it can improve the energy balance closure for some sites during specific periods, when secondary circulations exist in the vicinity of the sensor. These near-surface secondary circulations mainly transport sensible heat, and when near-ground warm air is transported upward, the sensible heat flux observed by the block ensemble average will increase at longer averaging times. These findings suggest an alternative energy balance correction for a ground-based eddy-covariance measurement, in which the attribution of the residual depends on the ratio of sensible heat flux to the buoyancy flux. The fraction of the residual attributed to the sensible heat flux by this energy balance correction is larger than in the energy balance correction that preserves the Bowen ratio.

Charuchittipan, Doojdao; Babel, Wolfgang; Mauder, Matthias; Leps, Jens-Peter; Foken, Thomas

2014-04-01

50

Thromboprophylaxis post vaginal delivery: are we forgetting it? Audit on thromboprophylaxis prescription post vaginal births.  

PubMed

Pulmonary thromboembolism is the leading direct cause of maternal deaths in the UK. The majority of deaths occur in the puerperium. Caesarean section has been recognised as a risk factor but there is concern that more attention to thromboprophylaxis after vaginal births is needed. The hospital maternity unit in Dumfries has written guidelines on thromboprophylaxis after vaginal births. This audit assessed the compliance with these guidelines within this maternity unit. The case notes relating to spontaneous vaginal births over a 2-month period (n=148) and instrumental vaginal births over a 7-month period (n=29) were reviewed. Information concerning venous thromboembolism risk and any thromboprophylaxis given was extracted. The audit showed that 9% of spontaneous vaginal births and 62% of instrumental vaginal births required specific thromboprophylaxis. However, only 31% of the spontaneous vaginal births and 22% of the instrumental vaginal births in which thromboprophylaxis was indicated did indeed receive the required treatment. Failure to respond to venous thromboembolism risk factors was common. Measures to increase the awareness of maternity staff to these factors are suggested. PMID:16390705

Tan, E K; Wisdom, S J

2006-01-01

51

Vaginal erotic sensitivity  

Microsoft Academic Search

Vaginal erotic sensitivity was investigated in a group of 48 coitally experienced volunteers by means of systematic digital stimulation of both vaginal walls. It was found that 45 subjects reported erotic sensitivity located in most cases on the upper anterior wall, and of those, 30 (66. 7%) either reached orgasm or requested to stop stimulation short of orgasm. This study

Heli Alzate; Maria Ladi Londono

1984-01-01

52

Portable device for vaginal thermal conductance studies.  

PubMed

Design and development of a portable and self-contained vaginal probe, consisting of an acetone-filled silver cylinder attached to a pressure gauge, is described. Qualitative changes in vaginal thermal conductance were inferred from rates of thermal expansion of precooled acetone measured as a pressure rise. Administration of 10 mg estradiol-17 beta i.v. to ovariectomized heifers resulted in significant increases in rate of thermal expansion. PMID:1176036

Abrams, R M; Thatcher, W W; Gwazdauskas, F C; Sharp, D C; Bazer, F W; Wilcox, C J; Stolwijk, J A

1975-01-01

53

Vaginal agenesis or distal vaginal atresia associated with anorectal malformations  

Microsoft Academic Search

Background: Mayer-Rokitansky-Küster-Hauser syndrome is defined as Müllerian aplasia with vaginal agenesis and uterine remnants. It is commonly associated with renal and sometimes vertebral anomalies. MRKH syndrome or distal vaginal atresia is sometimes associated with anorectal malformations. The purpose of this study was to describe seven females with vaginal agenesis or distal vaginal atresia and an anorectal malformation and review the

Tomas Wester; Juan A. Tovar; Risto J. Rintala

54

Vaginal hysterectomy in generally considered contraindications to vaginal surgery  

Microsoft Academic Search

Objective The objective was to evaluate the feasibility and complication rate of vaginal hysterectomy with or without adnexectomy in women with enlarged uteri and\\/or other considered contraindications to the vaginal route. Study design Over a period of 2 years, a total of 204 women underwent vaginal hysterectomy for benign pathology. Normally considered contraindications to the vaginal route were: moderate to excessive

Pierluigi Paparella; Ornella Sizzi; Alfonso Rossetti; Franco De Benedittis; Raffaele Paparella

2004-01-01

55

Large vaginal and bladder calculi in a woman with previous operation of bladder exstrophy: a case report.  

PubMed

This is to report the case of a huge vaginal stone, and bladder calculi in a 26-year-old woman with previous operation of bladder exstrophy. It seems that the vaginal stone was secondary to the remaining wire used in her previous reconstructive surgery for pelvic closure 20 years ago and now surgery is performed to remove the vaginal and bladder stones. PMID:24719809

Tavakkoli, Mahmoud; Ghoreifi, Alireza

2014-01-01

56

Vaginal repair of vaginal vault dehiscence after postpartum hysterectomy.  

PubMed

Vaginal vault dehiscence (VVD) may occur rarely after hysterectomy. Although mostly, a vaginal cuff dehiscence is seen after robotic or laparoscopic hysterectomy, it may also be observed as a complication of abdominal or vaginal hysterectomy. Vaginal repair is one of the techniques used for VVD. Here, we will describe a case of vaginally repaired VVD, associated with intra-abdominal hematoma after postpartum hysterectomy. PMID:24876366

Avc?o?lu, Sümeyra Nergiz; Alt?nkaya, Sündüz Özlem; Küçük, Mert; Yüksel, Hasan; Demircan-Sezer, Selda

2014-01-01

57

Preactivated thiomers for vaginal drug delivery vehicles.  

PubMed

It was the purpose of this study to design and evaluate a chitosan derivative as mucoadhesive excipient for vaginal drug delivery systems. The chemical modification of chitosan was achieved by conjugation of thioglycolic acid (TGA) resulting in 1594 ?mol thiol groups per gram of polymer followed by the linkage of mercaptonicotinic acid (MNA) to the immobilized thiol groups via disulfide bonding leading to 702 ?mol ligand per gram of preactivated polymer. The mucoadhesive properties of these polymers within newly designed vaginal formulations (Chitosan-TGA and Chitosan-TGA-MNA) and commercially available vaginal formulations (Candibene®, Daktarin®, Dalacin®, GynoPevaryl®) were tested over a time period of 24 h via a mucoadhesion test system simulating vaginal conditions, tensile studies and mucus polymer interaction studies via viscosity measurements. Within the vaginal test system simulating vaginal in situ conditions, a 1.5-fold increase in mucoadhesion could be observed for preactivated thiomer formulations after 24 h in comparison to commercially available formulations. Similar results were achieved for tensile studies, as the chitosan-TGA-MNA containing formulation resulted in a 4.9-fold increase in total work of adhesion (TWA) in comparison to Candibene which showed the highest TWA value of all tested commercial formulations. Also in terms of rheology investigations of mucus/formulation mixtures, a 5.8-fold increase in dynamic viscosity for chitosan-TGA-MNA containing mixtures could be observed in comparison to the mucus-free control. In contrast, commercially available formulations achieved a maximum enhancement of 1.9-fold. These outcomes confirm that the newly developed polymer is a promising tool for vaginal drug delivery likely providing a prolonged vaginal residence time due to its comparatively high mucoadhesive properties. PMID:23886732

Friedl, Heike E; Dünnhaupt, Sarah; Waldner, Claudia; Bernkop-Schnürch, Andreas

2013-10-01

58

Vaginal bleeding between periods  

MedlinePLUS

... IUD use (may cause occasional spotting) Ectopic pregnancy Miscarriage Other pregnancy complications Vaginal dryness due to lack ... information Are you pregnant? Have you had a miscarriage or abortion? Have you had a D and ...

59

Review of Vaginitis  

PubMed Central

Adisruption of the dynamic equilibrium of the healthy vagina may have significant sequelae, leading to chronic or serious conditions. Therefore, all cases of vaginitis should be accurately diagnosed and appropriately treated.

1993-01-01

60

MRI of vaginal leiomyomas.  

PubMed

The MR appearances of two cases of vaginal leiomyoma are described. Both patients presented with a periurethral mass; one patient presented during pregnancy. MRI allowed precise anatomic localization of the masses and confident preoperative characterization in both cases. PMID:11351183

Shadbolt, C L; Coakley, F V; Qayyum, A; Donat, S M

2001-01-01

61

Vaginal fibroma. Case report.  

PubMed

A case of a vaginal fibroma in a 50-year-old woman is presented. The tumor presented as a solid mass in the upper third of the anterior vaginal wall. Intravenous pyelography (IVP) and cystoscopy excluded any association of the mass with the urinary tract. Surgical excision of the tumor was easily accomplished and histopathological examination established the diagnosis of a fibroid tumor of the vagina. PMID:12556111

Daskalakis, G J; Karabinas, C D; Papantoniou, N E; Papaspyrou, I A; Antsaklis, A J; Michalas, S

2002-01-01

62

50 CFR 648.141 - Closure.  

Code of Federal Regulations, 2010 CFR

...NORTHEASTERN UNITED STATES Management Measures for the Black Sea Bass Fishery § 648.141 Closure. EEZ closure...Regional Administrator shall close the EEZ to fishing for black sea bass by commercial vessels issued a moratorium...

2010-10-01

63

CLOSURE BETWEEN SEMI-CONTINUOUS MEASUREMENT OF PM 2.5 MASS AND COMPOSITION  

EPA Science Inventory

This extended abstract reports the first successful attempt to quantitatively measure all the major species of PM2.5 on a semi-continuous basis. Comparisons are made between both PC-BOSS integrated species concentration measurements with semi-continuous species measur...

64

Energy Balance Closure Using Eddy Covariance Above Two Different Land Surfaces and Implications for CO2 Flux Measurements  

NASA Astrophysics Data System (ADS)

Components of the surface energy balance of a mature boreal jack pine forest and a jack pine clearcut were analysed to determine the causes of the imbalance that is commonly observed in micrometeorological measurements. At the clearcut site (HJP02), a significant portion of the imbalance was caused by: (i) the overestimation of net radiation ( R n ) due to the inclusion of the tower in the field of view of the downward facing radiometers, and (ii) the underestimation of the latent heat flux (? E) due to the damping of high frequency fluctuations in the water vapour mixing ratio by the sample tube of the closed-path infrared gas analyzer. Loss of low-frequency covariance induced by insufficient averaging time as well as systematic advection of fluxes away from the eddy-covariance (EC) tower were discounted as significant issues. Spatial and temporal distributions of the total surface-layer heat flux ( T), i.e. the sum of sensible heat flux ( H) and ? E, were well behaved and differences between the relative magnitudes of the turbulent fluxes for several investigated energy balance closure ( C) classes were observed. Therefore, it can be assumed that micrometeorological processes that affected all turbulent fluxes similarly did not cause the variation in C. Turbulent fluxes measured at the clearcut site should not be forced to close the energy balance. However, at the mature forest site (OJP), loss of low-frequency covariance contributed significantly to the systematic imbalance when a 30-min averaging time was used, but the application of averaging times that were long enough to capture all of the low-frequency covariance was inadequate to resolve all of the high-frequency covariance. Although we found qualitative similarity between T and the net ecosystem exchange (NEE) of carbon dioxide (CO2), forcing T to closure while retaining the Bowen ratio and applying the same factor to CO2 fluxes ( F C ) cannot be generally recommended since it remains uncertain to what extent long wavelength contributions affect the relationship between T, F C and C.

Kidston, Joe; Brümmer, Christian; Black, T. Andrew; Morgenstern, Kai; Nesic, Zoran; McCaughey, J. Harry; Barr, Alan G.

2010-08-01

65

Duct closure  

DOEpatents

A closure for an inclined duct having an open upper end and defining downwardly extending passageway. The closure includes a cap for sealing engagement with the open upper end of the duct. Associated with the cap are an array of vertically aligned plug members, each of which has a cross-sectional area substantially conforming to the cross-sectional area of the passageway at least adjacent the upper end of the passageway. The plug members are interconnected in a manner to provide for free movement only in the plane in which the duct is inclined. The uppermost plug member is attached to the cap means and the cap means is in turn connected to a hoist means which is located directly over the open end of the duct.

Vowell, Kennison L. (Canoga Park, CA)

1987-01-01

66

Randomized controlled trial of a prenatal vaginal birth after cesarean section education and support program  

Microsoft Academic Search

OBJECTIVE: Our objective was to assess whether, for women with previous cesarean section, a prenatal education and support program promoting vaginal birth after cesarean delivery increases the probability of vaginal delivery.STUDY DESIGN: Women with a single previous cesarean were recruited before 28 weeks' gestation. Women's self-assessed motivation to attempt vaginal birth after a previous cesarean delivery was measured on a

William Fraser; Elizabeth Maunsell; Ellen Hodnett; Jean-Marie Moutquin

1997-01-01

67

Closure Study of Modeled and Measured Cloud Condensation Nuclei During CLASIC 2007  

NASA Astrophysics Data System (ADS)

A Differential Mobility Analyzer/Tandem Differential Mobility Analyzer (DMA/TDMA) was operated aboard the Center for Interdisciplinary Remotely-Piloted Aircraft Studies (CIRPAS) Twin Otter during The Cloud and Land Surface Interaction Campaign (CLASIC) in June of 2007 to characterize the size-resolved concentration and hygroscopicity of the submicron aerosol. A Droplet Measurement Technologies (DMT) Cloud Condensation Nuclei Counter (CCNc) was also operated on the aircraft to measure the concentration of CCN active at supersaturations of 0.165, 0.305, and 0.60 %. The campaign included 14 research flights designed to study how land surface processes affect atmospheric aerosol loading and chemistry and the resulting effects on the microphysical and macrophysical properties of cumulus cloud fields. Over 1300 size distributions were measured along with 110 hygroscopic growth factor distributions for each dry diameter of 0.025, 0.050, 0.100, 0.200, and 0.400 micrometer. The CCN number concentration at each specified supersaturation was predicted from the combined size-resolved concentration and hygroscopicity measurements. Here we present a comparison of the predicted concentrations with those directly measured with the CCNc.

Tomlinson, J. M.; Collins, D. R.; Spencer, C. W.

2008-12-01

68

Vaginal bleeding in early pregnancy  

MedlinePLUS

Vaginal bleeding during pregnancy is any discharge of blood from the vagina. It can happen any time from conception ( ... out of every 10 pregnant women have vaginal bleeding during their first 20 weeks of pregnancy.

69

Vaginal Anomalies: Fusion and Duplication  

MedlinePLUS

... dolor sit amet, consectetur adipiscing elit. Vaginal Abnormalities: Fusion and Duplication Having two of everything may be ... if your child's doctor diagnoses an "anomaly of fusion and duplication." What causes vaginal fusion and duplication? ...

70

Cadmium mass measurements between the neutron shell closures at N = 50 and 82  

SciTech Connect

The mass values of the neutron-deficient cadmium isotopes {sup 99-109}Cd and of the neutron-rich isotopes {sup 114,120,122-124,126,128}Cd have been measured using ISOLTRAP. The behavior of the separation energies of the cadmium isotopes from N = 50 to 82 is discussed.

Borgmann, Ch.; Blaum, K.; Boehm, Ch.; George, S.; Kreim, S. [Max-Planck-Institut fuer Kernphysik, 69117 Heidelberg (Germany); Breitenfeldt, M. [Instituut voor Kern- en Stralingsfysica, Katholieke Universiteit Leuven, B-3001 Leuven (Belgium); Audi, G.; Lunney, D.; Naimi, S. [CSNSM-IN2P3-CNRS, Universite Paris-Sud 11, 91405 Orsay France (France); Baruah, S.; Rosenbusch, M.; Schweikhard, L. [Institut fuer Physik, Ernst-Moritz-Arndt-Universitaet, 17487 Greifswald (Germany); Beck, D.; Dworschak, M.; Herfurth, F.; Minaya-Ramirez, E.; Savreux, R.; Yazidjian, C. [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, 64291 Darmstadt (Germany); Cakirli, R. B. [Max-Planck-Institut fuer Kernphysik, 69117 Heidelberg (Germany); Department of Physics, University of Istanbul, Istanbul (Turkey); Casten, R. F. [Wright Nuclear Structure Laboratory, Yale University, New Haven, Connecticut 06520 (United States)

2011-10-28

71

Spontaneous vaginal evisceration  

PubMed Central

Management of vaginal prolapse in the elderly lacks a uniform consensus and continues to remain challenging. The authors report a case of an elderly lady who presented with a spontaneous vaginal evisceration. She had a long-standing vaginal prolapse being controlled by a shelf pessary, which, in her case became displaced 2 weeks prior to admission. The patient underwent a laparotomy with an intent to replace the bowel back within the peritoneal cavity and repair the vault. During the pelvic floor repair, she sustained an inadvertent button-hole injury to the rectum, which was oversewn. She went on to develop a rectovaginal fistula requiring a de-functioning colostomy. The patient made good recovery subsequently.

I, Siddiqui; A, Samee; C, Hall; J, Cooper; F, O'Mahony

2011-01-01

72

Vaginal Tactile Imaging  

PubMed Central

Changes in the elasticity of the vaginal walls, connective support tissues, and muscles are thought to be significant factors in the development of pelvic organ prolapse, a highly prevalent condition affecting at least 50% of women in the United States during their lifetimes. It creates two predominant concerns specific to the biomechanical properties of pelvic support tissues: how does tissue elasticity affect the development of pelvic organ prolapse and how can functional elasticity be maintained through reconstructive surgery. We designed a prototype of vaginal tactile imager (VTI) for visualization and assessment of elastic properties of pelvic floor tissues. In this paper, we analyze applicability of tactile imaging for evaluation of reconstructive surgery results and characterization of normal and pelvic organ prolapse conditions. A pilot clinical study with 13 patients demonstrated that VTI allows imaging of vaginal walls with increased rigidity due to implanted mesh grafts following reconstructive pelvic surgery and VTI has the potential for prolapse characterization and detection.

van Raalte, Heather; Sarvazyan, Armen P.

2010-01-01

73

Vaginal Toxic Shock Reaction Triggering Desquamative Inflammatory Vaginitis  

PubMed Central

Objective To report two cases of desquamative inflammatory vaginitis (DIV) associated with toxic shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus strains. Materials and Methods Case report of two patients, one with an acute and one with a chronic presentation, diagnosed with DIV on the basis of clinical findings and wet mount microscopy. Pre- and posttreatment vaginal bacterial and yeast cultures were obtained. Results Pretreatment vaginal bacterial cultures from both patients grew TSST-1-producing S. aureus. Subsequent vaginal bacterial cultures following oral antibiotic therapy were negative. Conclusions DIV may be triggered through TSST-1-mediated vaginal toxic shock reaction.

Pereira, Nigel; Edlind, Thomas D.; Schlievert, Patrick M.; Nyirjesy, Paul

2012-01-01

74

Paraurethral vaginal leiomyoma.  

PubMed

A case of paraurethral vaginal leiomyoma becoming clinically apparent in the postpartum period is presented. As is frequently the case, the diagnosis was not apparent. Urinary tract origin is commonly suspected, since the majority of these tumors occur in the midline of the anterior vaginal wall. The tumors are often asymptomatic, but can cause dysuria, urinary frequency, urinary retention, and dyspareunia. Pathologically, they are well circumscribed and have the typical microscopic features of leiomyomas found elsewhere. Simple excision is usually adequate treatment. PMID:3603914

Castle, W N; McLaughlin, W L

1987-07-01

75

Approaching the N=82 shell closure with mass measurements of Ag and Cd isotopes  

SciTech Connect

Mass measurements of neutron-rich Cd and Ag isotopes were performed with the Penning trap mass spectrometer ISOLTRAP. The masses of {sup 112,114-124}Ag and {sup 114,120,122-124,126,128}Cd, determined with relative uncertainties between 2x10{sup -8} and 2x10{sup -7}, resulted in significant corrections and improvements of the mass surface. In particular, the mass of {sup 124}Ag was previously unknown. In addition, other masses that had to be inferred from Q values of nuclear decays and reactions have now been measured directly. The analysis includes various mass differences, namely the two-neutron separation energies, the applicability of the Garvey-Kelson relations, double differences of masses deltaV{sub pn}, which give empirical proton-neutron interaction strengths, as well as a comparison with recent microscopic calculations. The deltaV{sub pn} results reveal that for even-even nuclides around {sup 132}Sn the trends are similar to those in the {sup 208}Pb region.

Breitenfeldt, M.; Baruah, S.; Rosenbusch, M.; Schweikhard, L. [Institut fuer Physik, Ernst-Moritz-Arndt-Universitaet, D-17487 Greifswald (Germany); Borgmann, Ch.; Boehm, Ch.; George, S. [Max-Planck-Institut fuer Kernphysik, Saupfercheckweg 1, D-69117 Heidelberg (Germany); Audi, G.; Lunney, D.; Minaya-Ramirez, E.; Naimi, S. [CSNSM-IN2P3-CNRS, Universite de Paris Sud, F-91405 Orsay (France); Beck, D.; Dworschak, M.; Herfurth, F.; Savreux, R.; Yazidjian, C. [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, Planckstrasse 1, D-64291 Darmstadt (Germany); Blaum, K. [Max-Planck-Institut fuer Kernphysik, Saupfercheckweg 1, D-69117 Heidelberg (Germany); Ruprecht-Karls-Universitaet, Physikalisches Institut, D-69120 Heidelberg (Germany); Cakirli, R. B. [Max-Planck-Institut fuer Kernphysik, Saupfercheckweg 1, D-69117 Heidelberg (Germany); Department of Physics, University of Istanbul, Istanbul (Turkey); Casten, R. F. [Wright Nuclear Structure Laboratory, Yale University, New Haven, Connecticut 06520 (United States); Delahaye, P. [CERN, Physics Department, 1211 Geneva 23 (Switzerland)

2010-03-15

76

Is vaginal hyaluronic acid as effective as vaginal estriol for vaginal dryness relief?  

PubMed

In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0.31). At V2, the percentage improvement rates were 84 and 89 % (p = 0.13), respectively. Improvement rates for vaginal itching, burning, and dyspareunia at V2 were about 86, 85, and 57 % for hyaluronic acid vaginal gel, and 82, 87, and 62 % for estriol vaginal cream (p[0.05), respectively. After treatment, vaginal pH was significantly lower in estriol-treated women compared to those having received hyaluronic acid. Endometrial thickness did not differ between groups. In the majority of women, the vaginal microenvironment remained unaffected by treatment. However, the proportion of women whose abnormal vaginal microecological results became normal was higher in women using estriol vaginal cream. Adverse events (suspected to be) related to the investigational compounds were minor and included vaginal infection and genital itching. The authors concluded that hyaluronic acid vaginal gel was not inferior to estriol vaginal cream in women presenting with vaginal dryness. They suggest using hyaluronic acid vaginal gel not only as an alternative treatment to vaginal estrogens, but also to consider its general use in women presenting with vaginal dryness of any cause. PMID:24178484

Stute, Petra

2013-12-01

77

Vaginitis in adolescents.  

PubMed

Vaginitis is a common complaint of adolescent females. It can cause extreme distress for some patients, especially those with recurrent symptoms. Thus, it is important to take care when evaluating these patients and to acknowledge their frustration when appropriate. A thoughtful and thorough history will determine most causes, with the most common being yeast, trichomoniasis, and BV. PMID:15449843

Syed, Tahniat S; Braverman, Paula K

2004-06-01

78

Temperature dependence of the intrinsic small fatigue crack growth behavior in ni-base superalloys based on measurement of crack closure  

Microsoft Academic Search

The effect of temperature on the small fatigue crack growth behavior of a single crystal and directionally solidified Ni-base\\u000a superalloys was investigated at temperatures between 873 to 1123 K by measuring the crack closure. The results were also compared\\u000a with those of the physically long crack. It was found that the propagation resistance and the fatigue threshold of the long

M. Okazaki; H. Yamada; S. Nohmi

1996-01-01

79

Increased CCL2 expression and macrophage/monocyte migration during microbicide-induced vaginal irritation.  

PubMed

Despite availability of successful prevention strategies, HIV continues to spread at alarming rates, especially among women in developing countries. Vaginal microbicides offer a promising approach for blocking transmission of HIV when condom use cannot be negotiated with male partners. A major problem in the development of vaginal microbicides is chemically induced vaginal irritation, which can enhance the risk of HIV transmission. Evaluation of vaginal irritation prior to clinical trials typically uses an expensive and animal-intensive rabbit vaginal irritation model, which could be supplemented by measuring additional inflammatory biomarkers. We studied several immunological parameters as potential biomarkers of vaginal irritation, using the spermicides nonoxynol-9 and benzalkonium chloride as test microbicides. We measured amounts of cytokines, as well as inflammatory cells, in vaginal tissue lysates and on the vaginal surface. We observed that treatment with the selected microbicides increases quantities of the inflammatory cytokines interleukin-1beta, CXCL8, and CCL2 in the vaginal tissue parenchyma, and of CCL2 on the vaginal surface. This observation was correlated with increases in macrophages in the vaginal parenchyma. We suggest that measurements of CCL2 and macrophages can serve as new inflammatory biomarkers to evaluate the safety of promising novel microbicides for prevention of HIV. PMID:19929801

Alt, Carsten; Harrison, Travis; Dousman, Linda; Fujita, Nahoko; Shew, Ken; Tran, Thanh-Thuy; Shayesteh, Sara; Matsukawa, Akihiro; Mirsalis, Jon; D'Andrea, Annalisa

2009-11-01

80

Increased CCL2 expression and macrophage/monocyte migration during microbicide-induced vaginal irritation  

PubMed Central

Despite availability of successful prevention strategies, HIV continues to spread at alarming rates, especially among women in developing countries. Vaginal microbicides offer a promising approach for blocking transmission of HIV when condom use cannot be negotiated with male partners. A major problem in the development of vaginal microbicides is chemically induced vaginal irritation, which can enhance the risk of HIV transmission. Evaluation of vaginal irritation prior to clinical trials typically uses an expensive and animal-intensive rabbit vaginal irritation model, which could be supplemented by measuring additional inflammatory biomarkers. We studied several immunological parameters as potential biomarkers of vaginal irritation, using the spermicides nonoxynol-9 and benzalkonium chloride as test microbicides. We measured amounts of cytokines, as well as inflammatory cells, in vaginal tissue lysates and on the vaginal surface. We observed that treatment with the selected microbicides increases quantities of the inflammatory cytokines interleukin-1?, CXCL8, and CCL2 in the vaginal tissue parenchyma, and of CCL2 on the vaginal surface. This observation was correlated with increases in macrophages in the vaginal parenchyma. We suggest that measurements of CCL2 and macrophages can serve as new inflammatory biomarkers to evaluate the safety of promising novel microbicides for prevention of HIV.

Alt, Carsten; Harrison, Travis; Dousman, Linda; Fujita, Nahoko; Shew, Ken; Tran, Thanh-Thuy; Shayesteh, Sara; Matsukawa, Akihiro; Mirsalis, Jon; D'Andrea, Annalisa

2009-01-01

81

On the measurement of the crack tip stress field as a means of determining Delta K(sub eff) under conditions of fatigue crack closure  

NASA Technical Reports Server (NTRS)

The optical method of caustics has been successfully extended to enable stress intensity factors as low as 1MPa square root of m to be determined accurately for central fatigue cracks in 2024-T3 aluminium alloy test panels. The feasibility of using this technique to study crack closure, and to determine the effective stress intensity factor range, Delta K(sub eff), has been investigated. Comparisons have been made between the measured values of stress intensity factor, K(sub caus), and corresponding theoretical values, K(sub theo), for a range of fatigue cracks grown under different loading conditions. The values of K(sub caus) and K(sub theo) were in good agreement at maximum stress, where the cracks are fully open, while K(sub caus) exceeded K(sub theo) at minimum stress, due to crack closure. However, the levels of crack closure and values of Delta K(sub eff) obtained could not account for the variations of crack growth rate with loading conditions. It is concluded that the values of Delta K(sub eff), based on caustic measurements in a 1/square root of r stress field well outside the plastic zone, do not fully reflect local conditions which control crack tip behavior.

Wallhead, Ian R.; Edwards, Lyndon; Poole, Peter

1994-01-01

82

Effective treatment of vaginal atrophy with isoflavone vaginal gel.  

PubMed

OBJETIVE: To assess efficacy and tolerability of a isoflavone (Glycine max L. Merr.) vaginal gel to the treatment of vaginal atrophy in postmenopausal women. METHODS: The double-blind, randomized, placebo-controlled, clinical trial. Ninety women were treated for 12 weeks with isoflavone vaginal gel 4% (1g/day) and a placebo gel and conjugated equine estrogen cream (0.3mg/day). After 4 and 12 weeks, the vaginal atrophy symptoms were classified at none, mild, moderate and severe and the vaginal cytology were taken to determine the maturation value. The endometrial safety (by transvaginal ultrasonography) was evaluated through at screening and the end of the trial. RESULTS: Isoflavone vaginal gel appears to be effective for relief of vaginal dryness and dyspareunia symptons and an increase in the intermediate and superficial cells was noted. These results were similar to the effects with use of conjugated equine estrogens and superior to placebo gel. No changes in endometrial thickness, sera FSH and estradiol levels were observed at study endpoint. CONCLUSION: Glycine max (L.) Merr. at 4% vaginal gel on a daily basis in postmenopausal women led to improvements in vaginal atrophy symptoms and a significant increase in cell maturation values. Isoflavones proved good treatment options for relief of vulvovaginal symptoms especially in women who do not wish to use hormonal therapy or have contra-indications for this treatment. PMID:23312487

Lima, Sonia M Rolim Rosa; Yamada, Silvia Saito; Reis, Benedito Fabiano; Postigo, Sostenes; Galvão da Silva, Maria Antonieta L; Aoki, Tsutomu

2013-01-01

83

Vaginal Vault Prolapse  

PubMed Central

Introduction. Vaginal vault prolapse is a common complication following vaginal hysterectomy with negative impact on women's quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanism for the uterus and vagina is important in making the right choice of corrective procedure. Management should be individualised, taking into consideration the surgeon's experience, patients age, comorbidities, previous surgery and sex life. Result. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced at hysterectomy to prevent vault prolapse. Studies have shown the McCall's culdoplasty under direct visualisation to be superior. Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article. Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future.

Uzoma, Azubuike; Farag, K. A.

2009-01-01

84

Temperature dependence of the intrinsic small fatigue crack growth behavior in Ni-base superalloys based on measurement of crack closure  

SciTech Connect

The effect of temperature on the small fatigue crack growth behavior of a single crystal and directionally solidified Ni-base superalloys was investigated at temperatures between 873 to 1,123 K by measuring the crack closure. The results were also compared with those of the physically long crack. It was found that the propagation resistance and the fatigue threshold of the long cracks increased with temperature in all the materials. The long crack growth rates at three temperatures were approximately represented by an unique curve, after taking account of crack closure level and elastic modulus. In contrast, the small crack growth resistance decreased with temperature even when the crack closure phenomenon was taken into consideration. Furthermore, the small fatigue cracks exhibited considerably higher growth rates than the long cracks at a given effective stress intensity factor range and also grew under effective stress intensity factor ranges below the long crack threshold. The factors responsible for the lack of similitude in propagation rates between small and long cracks were also discussed, based on these observations and the chemical analysis near the crack tip using the electron probe microanalyzer.

Okazaki, M.; Yamada, H. [Nagaoka Univ. of Technology (Japan). Dept. of Mechanical Engineering; Nohmi, S. [Kawasaki Heavy Industries Co. Ltd., Akashi (Japan)

1996-04-01

85

Venlafaxine-associated vaginal bleeding.  

PubMed

A 41-year-old amenorrheic woman started taking venlafaxine 37.5 mg/day for treatment of depression; 7 days later, she experienced vaginal bleeding, which ceased 1 day after she stopped taking the drug. On rechallenge with venlafaxine, she again experienced vaginal bleeding that resolved after discontinuation. We found no published reports describing vaginal bleeding associated with venlafaxine. However, premarketing and postmarketing data report similar adverse effects in patients taking the agent. In addition, several cases of menstrual irregularities have occurred with two other antidepressants: fluoxetine and bupropion. This case report supports previous surveillance data indicating that venlafaxine may cause vaginal bleeding. PMID:12013367

Linnebur, Sunny A; Saseen, Joseph J; Pace, Wilson D

2002-05-01

86

Clear-column closure studies of lower tropospheric aerosol extinction during ACE-Asia using airborne sunphotometer, airborne in-situ and ship-based lidar measurements  

NASA Astrophysics Data System (ADS)

The Asian Pacific Regional Aerosol Characterization Experiment (ACE-Asia) studied aerosol outflow from the Asian continent to the Pacific basin. It was designed to integrate suborbital and satellite measurements and models to reduce the uncertainty in calculations of the climate forcing due to aerosols. Closure experiments are an important step towards reducing these uncertainties. Closure studies have revealed important insights about aerosol sampling and inadvertent modification in such previous aerosol studies as TARFOX, ACE-2 and SAFARI 2000. In this paper we assess the consistency (closure) between solar beam attenuation measured by the 14-channel NASA Ames Airborne Tracking Sunphotometer (AATS-14) and derived from airborne in situ and ship-based lidar methods during the Spring 2001 phase of the ACE-Asia field experiment. Aboard the CIRPAS Twin Otter, AATS-14 measured solar beam transmission at 14 wavelengths between 354 and 1558 nm, yielding aerosol optical depth (AOD) spectra and columnar water vapor (CWV). Vertical differentiation in profiles yielded aerosol extinction spectra and water vapor concentration. Aboard the same aircraft aerosol extinction has also been derived from in situ measurements of scattering (nephelometers) and absorption (particle soot absorption photometer, PSAP) or calculated from particle size distribution measurements (mobility analyzers and aerodynamic particle sizers). Twin Otter vertical profiles flown near the R. V. Ronald H. Brown allowed extinction profile comparisons with a Micro Pulse Lidar operated aboard the ship. The extinction profiles obtained by the different techniques show good agreement for the vertical distribution of aerosol layers. However, the level of agreement in absolute magnitude of the derived aerosol extinction varied among the aerosol layers sampled.

Schmid, B.; Hegg, D.; Wang, J.; Bates, D.; Redemann, J.; Welton, E.; Russell, P.; Livingston, J.; Jonsson, H.; Seinfeld, J.; Flagan, R.; Covert, D.

2002-12-01

87

Characterisation of the vaginal Lactobacillus microbiota associated with preterm delivery.  

PubMed

The presence of an abnormal vaginal microflora in early pregnancy is a risk factor for preterm delivery. There is no investigation on vaginal flora dominated by lactic acid bacteria and possible association with preterm delivery. We assessed the dominant vaginal Lactobacillus species in healthy pregnant women in early pregnancy in relation to pregnancy outcome. We observed 111 low risk pregnant women with a normal vaginal microflora 11 + 0 to 14 + 0 weeks of pregnancy without subjective complaints. Vaginal smears were taken for the identification of lactobacilli using denaturing gradient gel electrophoresis (DGGE). Pregnancy outcome was recorded as term or preterm delivery (limit 36 + 6 weeks of gestation). The diversity of Lactobacillus species in term vs. preterm was the main outcome measure. L. iners alone was detected in 11 from 13 (85%) women who delivered preterm. By contrast, L. iners alone was detected in only 16 from 98 (16%) women who delivered at term (p < 0.001). Fifty six percent women that delivered at term and 8% women that delivered preterm had two or more vaginal Lactobacillus spp. at the same time. This study suggests that dominating L. iners alone detected in vaginal smears of healthy women in early pregnancy might be associated with preterm delivery. PMID:24875844

Petricevic, Ljubomir; Domig, Konrad J; Nierscher, Franz Josef; Sandhofer, Michael J; Fidesser, Maria; Krondorfer, Iris; Husslein, Peter; Kneifel, Wolfgang; Kiss, Herbert

2014-01-01

88

Characterisation of the vaginal Lactobacillus microbiota associated with preterm delivery  

PubMed Central

The presence of an abnormal vaginal microflora in early pregnancy is a risk factor for preterm delivery. There is no investigation on vaginal flora dominated by lactic acid bacteria and possible association with preterm delivery. We assessed the dominant vaginal Lactobacillus species in healthy pregnant women in early pregnancy in relation to pregnancy outcome. We observed 111 low risk pregnant women with a normal vaginal microflora 11 + 0 to 14 + 0 weeks of pregnancy without subjective complaints. Vaginal smears were taken for the identification of lactobacilli using denaturing gradient gel electrophoresis (DGGE). Pregnancy outcome was recorded as term or preterm delivery (limit 36 + 6 weeks of gestation). The diversity of Lactobacillus species in term vs. preterm was the main outcome measure. L. iners alone was detected in 11 from 13 (85%) women who delivered preterm. By contrast, L. iners alone was detected in only 16 from 98 (16%) women who delivered at term (p < 0.001). Fifty six percent women that delivered at term and 8% women that delivered preterm had two or more vaginal Lactobacillus spp. at the same time. This study suggests that dominating L. iners alone detected in vaginal smears of healthy women in early pregnancy might be associated with preterm delivery.

Petricevic, Ljubomir; Domig, Konrad J.; Nierscher, Franz Josef; Sandhofer, Michael J.; Fidesser, Maria; Krondorfer, Iris; Husslein, Peter; Kneifel, Wolfgang; Kiss, Herbert

2014-01-01

89

Vaginal contraceptives still evolving.  

PubMed

The effort to develop vaginal contraceptives began in the distant past and is still underway today. 1000 years ago, South American Indians inserted into the vagina bark strips impregnated with quinine. In medieval times women used vaginal inserts of cloth soaked in honey or vinegar. Quinine pessaries were introduced into Europe in the late 1800s, and in the early 1900s investigators began to study the effects of various chemicals on sperm motility. Following World War II, surfactant spermicides which disrupt the sperm membrane were developed and marketed. Many of these preparations contained nonoxynol-9. Currently, the D-isomer of propranolol is being examined as a spermicidal contraceptive, and several bacteriocides, e.g., benzalkonium and chlorhexidine, are being developed as spermicides which reduce the penetrability of cervical mucus. Other chemicals being investigated act by inhibiting the acrosome reaction. Advantages of vaginal contraceptives are that they are inexpensive, reversible, and relatively safe and easy to use. Generally they require no medical intervention or supervision. In addition, spermicides may kill or inhibit the growth of organisms responsible for sexually transmitted diseases. Disadvantages of spermicides are that they are generally less effective than many other methods, some interfere with sexual spontaneity, they may cause local irritations, and some women find them messy to use. Recently, concerns were expressed about the possible teratogenic effects of sperimicides. Most of these concerns proved to be unfounded. Given the many new avenues of research, the major disadvantage of sperimicides, i.e., their high failure rates, may be minimized in the near future. PMID:12340621

Pearson, R M

1986-01-01

90

Vaginal eroticism: A replication study  

Microsoft Academic Search

Vaginal eroticism was investigated in a group of 27 coitally experienced volunteers by means of systematic digital stimulation of both vaginal walls. Erogenous zones were found in all subjects, mainly located on the upper anterior wall and the lower posterior one. An orgasmic response was elicited by stimulation of these zones in 89% of the subjects.

Heli Alzate

1985-01-01

91

Vaginal fistula following restorative proctocolectomy  

Microsoft Academic Search

Vaginal fistula (VF) is a devastating complication following restorative proctocolectomy. PURPOSE: This study was designed to examine the perioperative factors influencing the outcome and management of vaginal fistula. METHOD: Between October 1983 and September 1994, 526 women underwent restorative proctocolectomy. Nineteen develop VF (3.6 percent), and six were referred from other institutions with this complication. These 25 women were followed

Patrick Y. Lee; Victor W. Fazio; James M. Church; Tracy L. Hull; Kong-Weng Eu; Ian C. Lavery

1997-01-01

92

Quantitative studies of vaginal bacteria  

Microsoft Academic Search

A quantitative method of culture, based on a weighed sample and with results expressed as colony forming units (cfu)\\/g was assessed and used to investigate the vaginal flora of normal women and that of women with vaginal disease. Samples were collected by means of disposable plastic loops into modified proteose peptone water transport medium in preweighed bottles. Counts expressed as

A N Masfari; B I Duerden; G R Kinghorn

1986-01-01

93

Treatment of vaginal atrophy.  

PubMed

Vaginal or vulvovaginal atrophy is a widespread but poorly recognized condition of peri- and post-menopausal women. It causes urogenital symptoms of dryness, reduced lubrication, itching, burning, irritable bladder symptoms and painful intercourse. This impacts quality of life and sexual health, but increases with time rather than reduces, as with most other menopausal symptoms. With early identification, treatments can improve these symptoms and reverse the physical changes. However, when embedded, bladder and sexual changes have occurred and these may be more difficult to remedy. Therefore, it is important to educate both healthcare professionals and women about these symptoms and advise on the range of interventions available. PMID:24601810

Domoney, Claudine

2014-03-01

94

Red herring vaginal discharge.  

PubMed

Labial hair tourniquet syndrome is a rare condition that can be easily misdiagnosed and ultimately lead to irreversible damage. An 11-year-old premenarche girl presented with a 5-day history of pain and swelling in the labia with associated vaginal discharge. The general practitioner treated her with clotrimazole without improvement. On examination, there was an oedematous swelling of the right labia with a proximal hair tourniquet. Local anaesthetic was applied and the hair removed with forceps. There was instant relief of pain and the discharge stopped within 24 h. The patient was sent home with a course of antibiotics. PMID:24049092

Lee, Jun Hee; Pringle, Kirsty; Rajimwale, Ashok

2013-01-01

95

Heterogeneity of Vaginal Microbial Communities within Individuals? #  

PubMed Central

Recent culture-independent studies have revealed that a healthy vaginal ecosystem harbors a surprisingly complex assemblage of microorganisms. However, the spatial distribution and composition of vaginal microbial populations have not been investigated using molecular methods. Here, we evaluated site-specific microbial composition within the vaginal ecosystem and examined the influence of sampling technique in detection of the vaginal microbiota. 16S rRNA gene clone libraries were prepared from samples obtained from different locations (cervix, fornix, outer vaginal canal) and by different methods (swabbing, scraping, lavaging) from the vaginal tracts of eight clinically healthy, asymptomatic women. The data reveal that the vaginal microbiota is not homogenous throughout the vaginal tract but differs significantly within an individual with regard to anatomical site and sampling method used. Thus, this study illuminates the complex structure of the vaginal ecosystem and calls for the consideration of microenvironments when sampling vaginal microbiota as a clinical predictor of vaginal health.

Kim, Tae Kyung; Thomas, Susan M.; Ho, Mengfei; Sharma, Shobha; Reich, Claudia I.; Frank, Jeremy A.; Yeater, Kathleen M.; Biggs, Diana R.; Nakamura, Noriko; Stumpf, Rebecca; Leigh, Steven R.; Tapping, Richard I.; Blanke, Steven R.; Slauch, James M.; Gaskins, H. Rex; Weisbaum, Jon S.; Olsen, Gary J.; Hoyer, Lois L.; Wilson, Brenda A.

2009-01-01

96

Crack-closure and crack-growth measurements in surface-flawed titanium alloy Ti6Al-4V  

NASA Technical Reports Server (NTRS)

The crack-closure and crack-growth characteristics of the titanium alloy Ti-6Al-4V were determined experimentally on surface-flawed plate specimens. Under cyclic loading from zero to tension, cracks deeper than 1 mm opened at approximately 50 percent of the maximum load. Cracks shallower than 1 mm opened at higher loads. The correlation between crack-growth rate and the total stress-intensity range showed a lower threshold behavior. This behavior was attributed to the high crack-opening loads at short cracks because the lower threshold was much less evident in correlations between the crack-growth rates and the effective stress-intensity range.

Elber, W.

1975-01-01

97

Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study.  

PubMed

The purpose of this study was to evaluate the effectiveness of lactobacilli on vaginal health and proinflammatory cytokines. Sixty-seven patients with bacterial vaginosis (BV), 50 with intermediate flora and 42 with normal vaginal flora were enrolled in this double-blind study. The subjects were randomized to receive probiotic lactobacilli vaginal tablets (L. brevis CD2, L. salivarius subsp. salicinius, L. plantarum) or the vaginal pH tablet (active comparator). Cervico-vaginal lavage was collected to measure the concentrations of IL-1?, TNF? and IL-6 by ELISA. Neutral sphingomyelinase activity was also quantified in both arms before and after treatment. The probiotic vaginal tablet was well tolerated and no side effects were reported. The study demonstrated a cure rate of nearly 80 %; i.e., 32 % of the women could restore normal vaginal flora and 47 % had improved Nugent score, whereas 20 % of the subjects did not clear BV in the first follow-up (after 8 days treatment). The pH tablet containing pH lowering compounds induced resolution of BV and restoration of normal vaginal flora in 74 % and 26 %, respectively. The lactobacilli tablet was found to be better than the pH tablet in preventing BV in healthy subjects. A significant reduction in IL-1? and IL-6 vaginal cytokines was observed after treatment with lactobacilli, while the active comparator did not have any effect on local proinflammatory cytokines. Vaginal neutral sphingomyelinase activity was not modified in either group. Vaginal tablets containing lactobacilli can cure BV and reduce vaginal inflammatory response. PMID:22777592

Hemalatha, R; Mastromarino, P; Ramalaxmi, B A; Balakrishna, N V; Sesikeran, B

2012-11-01

98

Vaginoscopic resection of vaginal septum.  

PubMed

We report the resection of a vaginal septum while preserving the virginity of a 12-year-old girl with Herlyn-Werner-Wunderlich Syndrome (HWWS) having a didelphys uterus, obstructed hemivagina, and an ipsilateral renal agenesis with follow-up at 18 months. Successful resection of the vaginal septum with conservation of the hymenal ring and complete drainage of both the hematocolpos and the hematometra were achieved. Cyclic dysmenorrhea and pelvic pain were completely resolved on follow-up visits at 4, 6, and 18 months. Office hysteroscopy performed during the last follow-up visit revealed a patent vaginal vault without evidence of adenosis or recurrence of the vaginal septum. Vaginoscopy is a safe, convenient, and efficient diagnostic and therapeutic modality that can be used in the management of patients with an obstructed hemivagina. It maintains the patient's virginity and it is useful in patients with a restrictive vaginal opening or narrow vaginal canal. Furthermore, the hysteroscopic excision of the vaginal septum offers minimal risk of recurrence of the septal defect. PMID:23315718

Nassif, Joseph; Al Chami, Ali; Abu Musa, Antoine; Nassar, Anwar H; Kurdi, Ahmad; Ghulmiyyah, Labib

2012-12-01

99

Closure or Non-Closure of Peritoneum in Cesarean Section: Outcomes of Short-Term Complications  

PubMed Central

Background Cesarean section (CS) is one of the most frequently performed surgical procedures worldwide. The complications following a CS include fever, wound infection, post-operative pain and bleeding which are not usually found in a normal vaginal delivery. Traditionally, suturing of peritoneal layers for CS patients has been done, but in some studies it has been shown that this procedure could be eliminated without affecting the rate of morbidity. Objectives The objective of this study was to assess the short-term outcomes of two different cesarean delivery techniques. Patients and Methods A total of 100 cases who underwent CS were randomly assigned equally to either closure of both the visceral and parietal peritoneum or no peritoneum closure. Duration of operation, pain scores, analgesic requirements, alterations in hemoglobin levels and febrile morbidity were assessed accordingly. Results Pain scores, analgesic requirements assessed at 24 hours and operation duration were significantly lower in the non-closure group as compared to the closure group. Febrile conditions and changes in hemoglobin levels were similar in both groups. Conclusions Non-closure of both visceral and the parietal peritoneum when performing a CS produces a significant reduction in pain, fewer analgesic requirements and a shorter operation duration without increasing the febrile morbidity and changes in hemoglobin levels as compared to the standard methods.

Tabasi, Zohreh; Mahdian, Mehrdad; Abedzadeh-Kalahroudi, Masoumeh

2013-01-01

100

Review of Crack Closure.  

National Technical Information Service (NTIS)

A comprehensive review and critique of the literature on fatigue crack closure is presented. The elements of closure; its mechanisms, experimental procedures for its determination; the phenomenological study of its dependence on different variables, and m...

S. Banerjee

1984-01-01

101

Vaginal leiomyoma in a dog.  

PubMed

The surgical treatment of vaginal leiomyoma in a seven year old Blue Heeler bitch is described. A smooth, 12 cm diameter submucosal, intraluminal, firm mass was found on vaginal examination. It appeared to arise from the left ventral vaginal wall, cranial to the clitoris but caudal to the cervix. There was no history of urinary problems and the dog was normal in all other aspects. The treatment was surgical excision of the mass via an episiotomy. Histological examination indicated a leiomyoma. The differential diagnoses, possible etiologies and control or prevention of the condition by ovariohysterectomy are also discussed. PMID:17422296

Kang, T B; Holmberg, D L

1983-08-01

102

Vaginal Leiomyoma in a Dog  

PubMed Central

The surgical treatment of vaginal leiomyoma in a seven year old Blue Heeler bitch is described. A smooth, 12 cm diameter submucosal, intraluminal, firm mass was found on vaginal examination. It appeared to arise from the left ventral vaginal wall, cranial to the clitoris but caudal to the cervix. There was no history of urinary problems and the dog was normal in all other aspects. The treatment was surgical excision of the mass via an episiotomy. Histological examination indicated a leiomyoma. The differential diagnoses, possible etiologies and control or prevention of the condition by ovariohysterectomy are also discussed. ImagesFigure 1.Figure 2.

Kang, T. B.; Holmberg, D. L.

1983-01-01

103

Vaginal aplasia and reconstruction.  

PubMed

Congenital vaginal agenesis, with a prevalence of 1 in 4000 females, occurs mainly as a feature of the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Management of patients with MRKH syndrome includes, along with the proper psychological support, the creation of a neovagina to give them the opportunity to have a normal sexual life. Both surgical and non-surgical techniques have been suggested during the past century, for neovagina creation. Among them, the most widespread non-surgical techniques performed are the Frank technique and its modification by Ingram, while the surgical techniques include the McIndoe operation, the Vechietti procedure and its laparoscopic modification and the Williams vaginoplasty and its Creatsas modification. The Creatsas vaginoplasty is a simple, fast and safe technique that has been performed in 178 patients in our Institution over the past 22 years and has provided excellent results in the vast majority of patients. PMID:20089458

Creatsas, G; Deligeoroglou, E

2010-04-01

104

Vaginal Misoprostol versus Vaginal Estradiol in Overcoming Unsatisfactory Colposcopy.  

PubMed

Background: Unsatisfactory colposcopy, an inability to visualize the entire transformation zone, is found in about 10-20% of the patients undergoing the procedure. These patients usually require conization for a comprehensive evaluation of the cervix. Our study aims to compare the efficacy and safety of vaginal misoprostol versus vaginal estradiol in overcoming unsatisfactory colposcopy. Methods: We studied 48 women with unsatisfactory colposcopy. They were randomized into two groups: group I (n = 24) received 200 µg misoprostol vaginally and colposcopy was repeated after 6 h, while the subjects in group II (n = 24) were prescribed a 7-day course of 50 µg estradiol for vaginal insertion followed by a repeat colposcopy. The efficacy and safety of these two drugs were compared. Results: Repeat colposcopy was satisfactory in 70.8% of the women given vaginal misoprostol compared to 82.6% of the women who used vaginal estradiol. The difference was not statistically significant. The adverse effects were reported more often by the women in the misoprostol group (41.6%) as compared to those in estradiol group (13%) (p = 0.04). Conclusion: Both estradiol and misoprostol were comparable in overcoming unsatisfactory colposcopy. However, a higher incidence of adverse effects was noted with misoprostol as compared to estradiol. © 2014 S. Karger AG, Basel. PMID:24642984

Makkar, Binni; Batra, Swaraj; Gandhi, Gauri; Zutshi, Vijay; Goswami, Deepti

2014-01-01

105

Follow-up evaluation of the effect of vaginal delivery on the pelvic floor  

Microsoft Academic Search

PURPOSE: The aim of this study was to evaluate the effect of vaginal delivery on the pelvic floor by serial measurement of pudendal nerve terminal motor latency, perineal descent, and anal pressure before and after delivery. METHODS: Eighty pregnant females (40 primigravidae, 40 multigravidae) expecting vaginal delivery were prospectively evaluated. Measurements of pudendal nerve terminal motor latency, perineometry, and manometry

Sang-Jeon Lee; Jin-Woo Park

2000-01-01

106

Transverse vaginal septum with congenital vesical-vaginal communication and cyclical hematuria.  

PubMed

Cyclical hematuria is an unusual presentation of a müllerian fusion anomaly. We report a patient with transverse vaginal septum and menstruation by way of the lower urinary tract because of a vesical-vaginal communication. A defect of vertical fusion, transverse vaginal septum results from failure of canalization of the vaginal plate. Reconstruction using a transvaginal and transabdominal approach created a direct anastomosis between the proximal vaginal segment and the distal vaginal pouch. Previously described cases are reviewed. PMID:17382175

Chin, Arnold I; Rutman, Matthew; Raz, Shlomo

2007-03-01

107

Vaginal bleeding in late pregnancy  

MedlinePLUS

One out of 10 women will have vaginal bleeding during their third trimester. At times, it may ... few months of pregnancy, you should always report bleeding to your health care provider right away. You ...

108

Humoral immunity in vaginal candidiasis.  

PubMed Central

Serum antibody titers to Candida albicans were estimated in 37 women with recurrent vaginal candidiasis and in 148 normal American and Finnish subjects, using the passive-hemagglutination technique. The antibody titers ranged from 0 to 16 in normal individuals and 4 to 256 in vaginal candidiasis patients. Antibodies to C. albicans in the sera of vaginal candidiasis patients were found to be the secretory immunoglobulin A type, as determined by gel filtration and double-diffusion tests. The results were confirmed by the indir-ct fluorescent-antibody technique. Our findings suggest that, in vaginal candidiasis, the antibody response is mainly local, consisting of secretory immunoglobulin A, some of which finds its way into systemic circulation. Images

Mathur, S; Koistinen, G V; Horger, E O; Mahvi, T A; Fudenberg, H H

1977-01-01

109

How Is Vaginal Cancer Diagnosed?  

MedlinePLUS

... tumors, it may be used to biopsy possible metastasis. Magnetic resonance imaging (MRI) Magnetic resonance imaging (MRI) ... in detecting cancer that has spread to the brain or spinal cord. This rarely occurs in vaginal ...

110

Vaginal creation for müllerian agenesis  

Microsoft Academic Search

Objective: The purpose of this study was to determine the effectiveness of passive vaginal dilation and McIndoe vaginoplasty in the creation of a neovagina for patients with müllerian agenesis. Study Design: Fifty-one patients with Mayer-Rokitansky-Kuster-Hauser syndrome were treated for vaginal agenesis at either Johns Hopkins Hospital or Emory University. These historic prospective data were obtained by a review of medical

Carla P. Roberts; Michael J. Haber; John A. Rock

2001-01-01

111

Vaginal Bleeding and Preterm Delivery  

Microsoft Academic Search

\\u000a Vaginal bleeding during gestation is an ominous sign indicating an adverse pregnancy outcome. Bleeding can occur during all\\u000a stages of gestation. It complicates up to 20% of pregnancies during the first trimester and is regarded as a sign of threatened\\u000a abortion. During the second and third trimesters, vaginal bleeding was found to be a risk factor for adverse maternal and

Offer Erez; Idit Erez-Weiss; Ruth Beer-Weisel; Vered Kleitman-Meir; Moshe Mazor

112

MTN-001: Randomized Pharmacokinetic Cross-Over Study Comparing Tenofovir Vaginal Gel and Oral Tablets in Vaginal Tissue and Other Compartments  

PubMed Central

Background Oral and vaginal preparations of tenofovir as pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection have demonstrated variable efficacy in men and women prompting assessment of variation in drug concentration as an explanation. Knowledge of tenofovir concentration and its active form, tenofovir diphosphate, at the putative vaginal and rectal site of action and its relationship to concentrations at multiple other anatomic locations may provide key information for both interpreting PrEP study outcomes and planning future PrEP drug development. Objective MTN-001 was designed to directly compare oral to vaginal steady-state tenofovir pharmacokinetics in blood, vaginal tissue, and vaginal and rectal fluid in a paired cross-over design. Methods and Findings We enrolled 144 HIV-uninfected women at 4 US and 3 African clinical research sites in an open label, 3-period crossover study of three different daily tenofovir regimens, each for 6 weeks (oral 300 mg tenofovir disoproxil fumarate, vaginal 1% tenofovir gel [40 mg], or both). Serum concentrations after vaginal dosing were 56-fold lower than after oral dosing (p<0.001). Vaginal tissue tenofovir diphosphate was quantifiable in ?90% of women with vaginal dosing and only 19% of women with oral dosing. Vaginal tissue tenofovir diphosphate was ?130-fold higher with vaginal compared to oral dosing (p<0.001). Rectal fluid tenofovir concentrations in vaginal dosing periods were higher than concentrations measured in the oral only dosing period (p<0.03). Conclusions Compared to oral dosing, vaginal dosing achieved much lower serum concentrations and much higher vaginal tissue concentrations. Even allowing for 100-fold concentration differences due to poor adherence or less frequent prescribed dosing, vaginal dosing of tenofovir should provide higher active site concentrations and theoretically greater PrEP efficacy than oral dosing; randomized topical dosing PrEP trials to the contrary indicates that factors beyond tenofovir’s antiviral effect substantially influence PrEP efficacy. Trial Registration ClinicalTrials.gov NCT00592124

Hendrix, Craig W.; Chen, Beatrice A.; Guddera, Vijayanand; Hoesley, Craig; Justman, Jessica; Nakabiito, Clemensia; Salata, Robert; Soto-Torres, Lydia; Patterson, Karen; Minnis, Alexandra M.; Gandham, Sharavi; Gomez, Kailazarid; Richardson, Barbra A.; Bumpus, Namandje N.

2013-01-01

113

Neutron Multiplicity Measurements for 19F+194,196,198Pt Systems to Investigate the Effect of Shell Closure on Nuclear Dissipation  

SciTech Connect

Pre- and post-scission neutron multiplicities are measured for the three isotopes of Fr (217Fr, 215Fr, and 213Fr) in the excitation energy range of 48 91.8 MeV. Out of these three isotopes, 213Fr has shell closure (NC = 126) while the other two are non-closed-shell nuclei. Statistical model calculations using Kramers fission width are performed to investigate shell effects on the dissipation strength which fit the experimental data. It is observed that shell correction to the binding energies of the evaporated particles strongly affects the fitted values of the dissipation strength. However, the best-fit dissipation strength is only weakly influenced by the inclusion of shell correction in fission barrier.

Singh, Varinderjit [Panjab University, Chandigarh, India; Behera, B. R. [Panjab University, Chandigarh, India; Kaur, Maninder [Panjab University, Chandigarh, India; Kumar, A. [Panjab University, Chandigarh, India; Sugathan, P. [Inter University Accelerator Centre, New Delhi, India; Golda, K. S. [Inter University Accelerator Centre, New Delhi, India; Jhingan, A. [Inter University Accelerator Centre, New Delhi, India; Chatterjee, M. B. [Inter University Accelerator Centre, New Delhi, India; Bhowmik, R. K. [Inter University Accelerator Centre, New Delhi, India; Siwal, Davinder [Delhi University, Delhi, India; Goyal, S. [Delhi University, Delhi, India; Sadhukhan, Jhilam [UTK/ORNL; Pal, Santanu [Variable Energy Cyclotron Centre, Kolkata, India; Saxena, A. [Bhabha Atomic Research Centre, Mumbai, India; Santra, S. [Bhabha Atomic Research Centre, Mumbai, India; Kailas, S. [Bhabha Atomic Research Centre, Mumbai, India

2013-01-01

114

Three-dimensional crack closure behavior  

NASA Technical Reports Server (NTRS)

A crack closure measurement technique involving fatigue striations was used to produce a three-dimensional crack opening load profile for 2024-T351 aluminum alloy. The crack opening load profile, determined through the specimen thickness, was compared with crack opening load measurements made with strain gages and displacement gages. The results of this study indicate that a significant three-dimensional variation in crack closure behavior occurs in the alloy examined. An understanding of this phehomenon is important in understanding crack growth behavior, predicting crack shape changes, and interpreting 'standard' crack closure measurement techniques.

Dawicke, D. S.; Grandt, A. F., Jr.; Newman, J. C., Jr.

1990-01-01

115

Effect of crack surface geometry on fatigue crack closure  

Microsoft Academic Search

The geometry of crack faces often plays a critical role in reducing crack extension forces when crack closure occurs during fatigue crack growth. Most previous studies of fatigue crack closure are concerned with mechanical measures of closure as related to the crack growth rate; very little attention has been given to the geometry of the crack surfaces. Our objective is

W. J. Drury; Arun M. Gokhale; S. D. Antolovich

1995-01-01

116

Closure of colostomy.  

PubMed Central

We analyzed the records of 77 cases of loop colostomy closure in Vietnam War Casualties. All records were complete from the date of injury to discharge following colostomy closure. Simple of the loop colostomy was performed in 44 patients and resection of the stoma and reanastomosis of bowel segments was performed in 33 patients. Average operating time for simple closure of the loop was 70 minutes compared to 115 minutes for resection and anastomosis. Nasogastric suction was used less frequently and for a shorter time with simple loop closure. The total postoperative complication rate was 9% with simple loop closure as compared to 24% for resection and anastomosis. Simple closure of the loop described in this report is technically easier and as safe as resection of the stoma and reanastomosis. Images Fig. 1.

Beck, P H; Conklin, H B

1975-01-01

117

Determination of closure disk rupture parameters  

SciTech Connect

The necessity of decoupling strain rate from burn rate effects for tests designed to characterize closure disks is discussed. A method for simulating the high rates of pressure increase to which closure disks are subjected and which does not employ pyrotechnic material as a means of pressurization is presented. It consists of slowly pressurizing both sides of a closure disk to a high pressure and then rapidly releasing the pressure from one side of the disk. Means of rapidly releasing gas from the downstream side of the closure disk and measuring the pressure differential across the closure disk are discussed in detail. Rates of pressure decrease as high as 335,000,000 psi/sec downstream from the closure disk have been attained. Baseline disks slotted by wire EDM failed at an average pressure differential of 10,150 psi. Disks slotted by chemical etching exhibited a higher burst pressure differential and greater variability. Glass-ceramic closure disks had the lowest average burst pressure and highest variability. An increase in the diameter of a closure disk was found to lower the pressure differential required to rupture the disk. Burst pressure was found to increase linearly with the thickness of the web in the slot. 5 refs., 6 figs., 5 tabs.

Merten, C.W.; Robinson, M.A. (EG and G Mound Applied Technologies, Miamisburg, OH (USA)); Evans, N.A. (Sandia National Labs., Albuquerque, NM (USA))

1990-01-01

118

High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse  

Microsoft Academic Search

Objective: The purpose of this study was to review retrospectively the functional and anatomic outcomes of women who underwent vaginal repair of enterocele and vault prolapse with the use of an intraperitoneal suspension of the vaginal vault to the uterosacral ligaments in conjunction with fascial reconstruction of the anterior and posterior vaginal wall. Study Design: Two hundred two women with

M. Karram; S. Goldwasser; S. Kleeman; A. Steele; B. Vassallo; P. Walsh

2001-01-01

119

Vaginitis: Questions to Discuss with Your Doctor  

MedlinePLUS

... contact us Vaginitis Questions to Discuss with Your Doctor: How long have you had this vaginal discomfort? ... abdominal pain, joint pain, or a rash? Your Doctor Might Examine the Following Body Structures or Functions: ...

120

Vaginal itching and discharge - Adult and adolescent  

MedlinePLUS

... and low estrogen levels, which may lead to vaginal dryness and other symptoms ( Atrophic vaginitis ). Forgotten tampon or foreign body, which may cause a foul odor. Chemicals found in ... irritate the vagina or the skin around the vagina Less common ...

121

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II...

2010-04-01

122

21 CFR 884.3900 - Vaginal stent.  

Code of Federal Regulations, 2010 CFR

...3900 Vaginal stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery. (b) Classification. Class II...

2009-04-01

123

Heterogeneity of Vaginal Microbial Communities within Individuals  

Microsoft Academic Search

Recent culture-independent studies have revealed that a healthy vaginal ecosystem harbors a surprisingly complex assemblage of microorganisms. However, the spatial distribution and composition of vaginal micro- bial populations have not been investigated using molecular methods. Here, we evaluated site-specific micro- bial composition within the vaginal ecosystem and examined the influence of sampling technique in detection of the vaginal microbiota. 16S

Tae Kyung Kim; Susan M. Thomas; Mengfei Ho; Shobha Sharma; Claudia I. Reich; Jeremy A. Frank; Kathleen M. Yeater; Diana R. Biggs; Noriko Nakamura; Rebecca Stumpf; Steven R. Leigh; Richard I. Tapping; Steven R. Blanke; James M. Slauch; H. Rex Gaskins; Jon S. Weisbaum; Gary J. Olsen; Lois L. Hoyer; Brenda A. Wilson

2009-01-01

124

[Vaginal hysterectomy leniens: intrafascial technique].  

PubMed

The appearance of a new intrafascial technique for vaginal hysterectomy serves to remind us that in spite of well-standardized techniques, gynecologists perform this less often than formerly. The described technique is an intrafascial variation of the extrafascial vaginal hysterectomy beginning at the fundus uteri. We mobilize the anterior vaginal wall using Strassmann's incision. The body of the uterus should be delivered through the anterior fornix. Then follows the ligation of the broad ligaments and careful dissection of the fibroareolar space of the posterior cervical wall. The cardinal ligament requires intrafascial clamping and ligation. This technique is simple and avoids injury to the ureters. If this operation is successfully performed, postoperative pain is minimal, and hospitalization could be greatly reduced. PMID:15459520

Tapia, Jorge E

2004-10-01

125

What is normal vaginal flora?  

PubMed Central

OBJECTIVE: To observe the composition of the vaginal flora of healthy women over time, and in relation to hormonal changes, sexual activity, and hygiene habits. DESIGN: A longitudinal surveillance of the vaginal flora over an eight week period. SUBJECTS: 26 female health care workers in local genitourinary medicine clinics. METHODS: The participants were anonymised. They filled in diary cards daily. Blind vaginal swabs were self-taken two-seven times weekly. A smear was air-dried for later Gram staining. The swabs were also cultured for Candida spp, Gardnerella vaginalis, anaerobes, Mycoplasma hominis and Ureaplasma urealyticum. RESULTS: Of 26 subjects, only four had normal vaginal microbiology throughout. One woman, who was not sexually active, had bacterial vaginosis (BV) throughout and nine (35%) had intermittent BV. Candidiasis was found intermittently in eight women (31%), and eight had normal microscopy. U urealyticum was isolated intermittently in 40% of women with BV, 25% with candida, and 50% with normal microscopy. Many women were symptomatic, but symptoms correlated poorly with microbiological findings. All but two women were sexually active; however, more women with BV were exposed to semen. BV seemed to be related to frequent use of scented soap, and there appeared to be an additive effect of clothing and hygiene factors. CONCLUSIONS: Our study raises doubts about what should be regarded as normal vaginal flora. It calls into question the significance of finding BV or U urealyticum on a single occasion in asymptomatic women, or of finding normal flora in symptomatic women. The effect of external factors on the vaginal flora deserve further study.

Priestley, C J; Jones, B M; Dhar, J; Goodwin, L

1997-01-01

126

Shortwave Radiative Closure Studies for Clear Skies During the Atmospheric Radiation Measurement 2003 Aerosol Intensive Observation Period  

SciTech Connect

The Department of Energy's Atmospheric Radiation Measurement (ARM) program sponsored a large aerosol intensive observation period (AIOP) to study aerosol during the month of May 2003 around the Southern Great Plains (SGP) Climate Research Facility (CRF) in north central Oklahoma. Redundant measurements of aerosol optical properties were made using different techniques at the surface as well as in vertical profile with sensors aboard two aircraft. One of the principal motivations for this experiment was to resolve the disagreement between models and measurements of diffuse horizontal broadband shortwave irradiance at the surface, especially for modest aerosol loading. This paper focuses on using the redundant aerosol and radiation measurements during this AIOP to compare direct beam and diffuse horizontal broadband shortwave irradiance measurements and models at the surface for a wide range of aerosol cases that occurred during 30 clear-sky periods on 13 days of May 2003. Models and measurements are compared over a large range of solar-zenith angles. Six different models are used to assess the relative agreement among them and the measurements. Better agreement than previously achieved appears to be the result of better specification of input parameters and better measurements of irradiances than in prior studies. Biases between modeled and measured direct irradiances are in the worst case 1%, and biases between modeled and measured diffuse irradiances are less than 1.9%.

Michalsky, Joseph J.; Anderson, Gail; Barnard, James C.; Delamere, Jennifer; Gueymard, C.; Kato, Seiji; Kiedron, P.; McComiskey, A.; Ricchiazzi, P.

2006-07-20

127

Fast Action Optic Closure.  

National Technical Information Service (NTIS)

The purpose of the project is to develop an optic closure with a function time of less than one mirror period for high speed cameras. This closure will prevent rewrite or bleed-through from a light source in excess of 300 million candle power. (ERA citati...

L. L. Wooten

1979-01-01

128

The vaginal microbiome in health and disease  

PubMed Central

Infections of the vaginal tract result from perturbations in the complex interactions between the microbiome and the host vaginal ecosystem. Recent data have linked specific vaginal microbes and urogenital infection with pre-term birth. Here we discuss how next generation sequencing-based approaches to study the vaginal microbiome will be important for defining what constitutes an imbalance of the microbiome and the associated host conditions that lead to subsequent infection and disease states. These studies will provide clinicians reliable diagnostic tools and treatments for women who are at increased risk for vaginal infections, preterm birth, HIV and other sexually acquired diseases, and will provide opportunities for intervention.

White, Bryan A.; Creedon, Douglas J.; Nelson, Karen E.; Wilson, Brenda A.

2011-01-01

129

Current Concepts of Treating Vaginitis  

PubMed Central

Vaginitis can be a frustrating entity to treat, since the incidence of recurrence is high. This paper examines evidence from the literature concerning diagnosis and treatment of Candida albicans, Trichomonas vaginalis, Corynebacterium vaginale, herpes simplex type 2 and gonorrhea. A protocol based on these readings is outlined.

Robinson, Theresa

1977-01-01

130

[Natural remedies for vaginal infections].  

PubMed

Vaginal infections, affecting half of all women, are more severe in women with AIDS. The infection vulva vaginitis, caused by candida, may require medical attention. The doctor performs a pelvic exam and examines vaginal fluids under a microscope. Antibiotics, diet, or a suppressed immune system can increase candida yeast presence. Sweets should be avoided, as well as foods high in leavening, such as bread, cheese, fruit, or alcoholic beverages. Vegetables, grains, rice and wheat can be added to the diet. Eating a half-cup of yogurt daily will help maintain a proper level of yeast. Acidophilus capsules can be taken two or three times daily to relieve digestive problems. Raw or cooked garlic can be used as a vaginal suppository at night. Pau D'arco, the bark of a South American tree, is also anti-yeast. Boil for ten to twenty minutes, and take a teaspoon two or three times a day. Tea, or vinegar and water, can be used as a douche. Some women get relief by adding a half-cup of white vinegar to their bath. Do not wash genitals with soap and do not use sanitary napkins or tampons. Visit a doctor if the condition persists. PMID:11362438

Genet, J

1995-01-01

131

Associations between vaginal bacteria and levels of vaginal defensins in pregnant women  

PubMed Central

Objective We evaluated vaginal defensin concentrations and levels of BV-associated bacterial species in pregnant women. Study Design Self-collected vaginal swabs from two visits during pregnancy were tested with qPCR for nine bacterial species. Beta defensin 2 (HBD2), HBD3 and alpha defensins 1–3 (HNP1–3) were measured by ELISA. Results Our 126 participants were primarily African American (60%), had a mean gestational age at enrollment of 10 weeks (±3) and at follow-up of 25 weeks (± 6). At enrollment, prevalence of BV was 74% (94/126), which decreased to 60% (75/126) at follow-up. At enrollment, HBD3 concentrations were significantly lower in women with BV (2.64 + 0.91 vs. 3.25 + 0.99 log10 pg/mL; p = 0.003). Higher concentrations of Atopobium vaginae, BVAB1 and BVAB2 were associated with significantly lower concentrations of HBD3 (p < 0.01). Conclusions BV was associated with lower vaginal concentrations of HBD3, but not HBD2 or HNP1–3, in pregnant women.

Mitchell, Caroline; Gottsch, Michelle L.; Liu, Congzhou; Fredricks, David N.; Nelson, Deborah B.

2013-01-01

132

A comparison of eddy-covariance and large aperture scintillometer measurements with respect to the energy balance closure problem  

NASA Astrophysics Data System (ADS)

We analyzed the seasonal variations of energy balance components over three different surfaces: irrigated cropland (Yingke, YK), alpine meadow (A'rou, AR), and spruce forest (Guantan, GT). The energy balance components were measured using eddy covariance (EC) systems and a large aperture scintillometer (LAS) in the Heihe River Basin, China, in 2008 and 2009. We also determined the source areas of the EC and LAS measurements with a footprint model for each site and discussed the differences between the sensible heat fluxes measured with EC and LAS at AR. The results show that the main EC source areas were within a radius of 250 m at all of the sites. The main source area for the LAS (with a path length of 2390 m) stretched along a path line approximately 2000 m long and 700 m wide. The surface characteristics in the source areas changed with the season at each site, and there were characteristic seasonal variations in the energy balance components at all of the sites. The sensible heat flux was the main term of the energy budget during the dormant season. During the growing season, however, the latent heat flux dominated the energy budget, and an obvious "oasis effect" was observed at YK. The sensible heat fluxes measured by LAS at AR were larger than those measured by EC at the same site. This difference seems to be caused by the so-called energy imbalance phenomenon, the heterogeneity of the underlying surfaces, and the difference between the source areas of the LAS and EC measurements.

Liu, S. M.; Xu, Z. W.; Wang, W. Z.; Jia, Z. Z.; Zhu, M. J.; Bai, J.; Wang, J. M.

2011-04-01

133

77 FR 60945 - 2012-2013 Accountability Measure and Closure for Commercial Black Sea Bass in the South Atlantic  

Federal Register 2010, 2011, 2012, 2013

...NMFS implements an accountability measure (AM) for the commercial sector of black sea...West, Florida), as described above. The AM at 50 CFR 622.49(b)(5)(i) requires...Accordingly, NMFS is implementing an AM to close the commercial sector for...

2012-10-05

134

78 FR 61827 - Reef Fish Fishery of the Gulf of Mexico; 2013 Recreational Accountability Measure and Closure for...  

Federal Register 2010, 2011, 2012, 2013

...NMFS implements an accountability measure (AM) for recreational gray triggerfish in the...37 to the FMP implemented an in-season AM to close the recreational sector when its...Therefore, NMFS implements the in-season AM and the recreational harvest of Gulf...

2013-10-04

135

Use of limbal and central anterior chamber depth measurements in detecting eyes with gonioscopically occludable angles and primary angle closure glaucoma in Ibadan.  

PubMed

The routine use of gonioscopy for the evaluation of drainage angles in developing countries is not always done because of the busy clinics. The purpose of this study was to evaluate the performance of 2 tests: Peripheral Anterior Chamber Depth (PACD) measurement and Central Anterior Chamber Depth (CACD) measurement in detecting occludable angles and primary angle closure within subjects with primary glaucoma and control subjects. Two hundred and forty subjects with primary glaucoma and a control group of 250 subjects were studied. PACD was measured with the Van Herrick's method while CACD was measured by the technique described by Lowe. The findings were compared to the gonioscopic appearance of the drainage angles in the two groups. PACD gradings 0 to 2 correctly identified 28 out of 36 eyes (77.8%) of subjects with PACG who had gonioscopically closed angles. The test identified correctly 168 out of 204 eyes (82.4%) with gonioscopically open angles among subjects with primary glaucoma. Among subjects with no glaucoma, PACD gradings 0 to 2 correctly identified 12 out of the 14 eyes with gonioscopically occludable angles, while the test identified 238 eyes without occludable angles, gonioscopy identified 236 out of 250 of such eyes. A CACD less than 2.5 mm was present in only 21 eyes of 36 eyes with occludable angles by gonioscopy among those with PACG. In the other 15 eyes with occludable angles, CACD was more than 2.5 mm. PACD performed well in detecting occluded angles in this study, CACD was useful but less so than PACD in established cases of PACG. Subjects with PACG but whose CACD was 2.5 mm or more may have plateau iris. PACD and CACD are both useful methods in identifying occludable angles in eyes of Nigerian subjects studied. PMID:15259929

Ashaye, A O

2003-12-01

136

Voluntary vaginal musculature contractions as an enhancer of sexual arousal  

Microsoft Academic Search

In a study of the effects of vaginal musculature contractions (Kegel's exercises) on both subjective and physiological measures of sexual arousal, 30 normal females were randomly assigned to one of three groups. The first group was informed about these exercises and was asked to practice them both during lab sessions and during the week intervening between sessions. The second group

Madelyn Renée Messé; James H. Geer

1985-01-01

137

Closure of oroantral fistula.  

PubMed

Oroantral fistula is an uncommon complication in oral surgery. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. The literature review revealed various procedures for the closure of oroantral fistulas. These procedures may be subdivided into local flap, distant flap and grafting. Procedures involving local flaps are usually adequate to close minor to moderate size defects. Those procedures utilizing the buccal mucoperiosteal flap as the tissue closure include straight-advancement, rotated, sliding and transversal flap procedures; while those involving the palatal mucoperiosteum are straight advancement, rotational-advancement, hinged and island flap procedures. The combinations of various local flaps to strengthen the tissue closure are also being advocated. The advantages and the limitations of these procedures are discussed. Distant flaps and bone grafts are usually indicated in the closure of larger defects in view of their greater tissue bulks. Tongue flaps have superseded extra-oral flaps from extremities and forehead for aesthetic reasons and also in view of their similar tissue replacement. Various tongue flap procedures are described. At present, various alloplastic materials such as gold, tantalum and polymethylmethacrylate are infrequently reported in the closure of oroantral fistulas. However, in the light of successful reports over the use of biological materials, collagen and fibrin, in the closure of oroantral fistulas, there seems to be another simple alternative technique for treating oroantral fistulas. PMID:3133418

Awang, M N

1988-04-01

138

Labial and vaginal blood volume responses to visual and tactile stimuli  

Microsoft Academic Search

Five women volunteers participated in two experimental sessions designed to evaluate the response patterns of two objective psychophysiological measures of women's sexual arousal to different methods (and intensities) of sexual stimulation (i.e., an erotic film and manual self-stimulation). A vaginal photoplethysmograph was used to measure vaginal blood volume response and a labial thermistor-clip was used to measure temperature changes of

Donald E. Henson; H. B. Rubin; Claudia Henson

1982-01-01

139

Pharmacokinetics and efficacy of a vaginally administered maraviroc gel in rhesus macaques  

PubMed Central

Objectives To investigate the pharmacokinetics (PK) of maraviroc, a CCR5-targeted HIV-1 entry inhibitor, in rhesus macaques following vaginal administration of various maraviroc-loaded aqueous hydroxyethylcellulose (HEC) gels, and to correlate the PK data with efficacy in a single high-dose vaginal SHIV-162P3 challenge model. Methods Maraviroc concentrations in vaginal fluid (Weck-Cel® sponge), vaginal tissue (punch biopsy) and plasma were assessed over 72 h following single-dose vaginal application of various maraviroc-loaded HEC gels. The range of maraviroc gel concentrations was sufficiently broad (0.003%–3.3% w/w) that test gels included both fully solubilized and predominantly dispersed formulations. The efficacy of the HEC gels against a single high-dose vaginal SHIV-162P3 challenge was also measured, and correlated with the PK concentrations. Results Maraviroc concentrations in vaginal fluid (range 104–107 ng/mL), vaginal tissue (100–1200 ng/g) and plasma (<102 ng/mL) were highly dependent on maraviroc gel loading, irrespective of the form of the maraviroc component within the gel (solubilized versus dispersed). Fluid and plasma concentrations were generally highest 0.5 or 2 h after gel application, before declining steadily through to 72 h. Maraviroc concentrations in the various biological compartments correlated strongly with the extent of protection against vaginal SHIV-162P3 challenge. Complete protection was achieved with a 3.3% w/w maraviroc gel. Conclusions A high degree of correlation between PK and efficacy was observed. Based on the data obtained with the 3.3% w/w maraviroc gel, maintenance of vaginal fluid and tissue levels in the order of 107 ng/mL and 103 ng/g, respectively, are required for complete protection with this compound.

Malcolm, R. Karl; Forbes, Claire J.; Geer, Leslie; Veazey, Ronald S.; Goldman, Laurie; Johan Klasse, Per; Moore, John P.

2013-01-01

140

Interval estimates for closure-phase and closure-amplitude imaging in radio astronomy  

NASA Technical Reports Server (NTRS)

Interval estimates for closure-phase and closure-amplitude imaging that enable the reconstruction of a radioimage from results of approximate measurements are presented. If the intervals for the measured values are known, the precision of the result of the reconstruction cannot be solved by standard interval methods, because the phase value is based on a circle but not on a real line. If the phase theta (x bar) is measured with precision epsilon, so that the closure phase theta (x bar) + theta (y bar) - theta (x bar + y bar) is known with precision 3 epsilon, then from these measurements theta can be reconstructed with precision 6 epsilon. Similar estimates are given for closure amplitude.

Kreinovich, Vladik; Bernat, Andrew; Kosheleva, Olga; Finkel'shtejn, Andrej

1992-01-01

141

Round Cell Vaginal Malignant Melanoma  

PubMed Central

Malignant melanoma is predominantly a skin disease but in rare instances it may occur at other sites. A vaginal melanoma is a rare clinical entity and the round cell type is an uncommon variant. Although the present case was clinically diagnosed as a urethral caruncle, on histopathological examination and immunostaining it was diagnosed as a round cell pigmented malignant melanoma. The patient refused radical surgery and was given a full course radiotherapy treatment but died a year later. Malignant vaginal melanoma carries a very poor prognosis even when lesion is localised at the time of presentation. The five-year survival rate ranges from 10–20% with the prognosis being influenced by tumour size. A tumour size ?3cm has a poor prognosis. Age, mitotic count, stage, and location of the lesion do not influence survival rates.

Chauhan, Neena; Gaur, Dushyant S.; Pathak, Ved P.

2012-01-01

142

Evaluation and Management of Vaginitis  

PubMed Central

OBJECTIVE To evaluate recent advances in our understanding of the clinical relevance, diagnosis, and treatment of vaginal infections, and to determine an efficient and effective method of evaluating this clinical problem in the outpatient setting. DATA SOURCES Relevant papers on vaginitis limited to the English language obtained through a MEDLINE search for the years 1985 to 1997 were reviewed. DATA SYNTHESIS Techniques that enable the identification of the various strains of candida have helped lead to a better understanding of the mechanisms of recurrent candida infection. From this information a rationale for the treatment of recurrent disease can be developed. Bacterial vaginosis has been associated with complications, including upper genital tract infection, preterm delivery, and wound infection. Women undergoing pelvic surgery, procedures in pregnancy, or pregnant women at risk of preterm delivery should be evaluated for bacterial vaginosis to decrease the rate of complications associated with this condition. New, more standardized criteria for the diagnosis of bacterial vaginosis may improve diagnostic consistency among clinicians and comparability of study results. Use of topical therapies in the treatment of bacterial vaginosis are effective and associated with fewer side effects than systemic medication. Trichomonas vaginalis, although decreasing in incidence, has been associated with upper genital tract infection. Therapy of T. vaginalis infection has been complicated by an increasing incidence of resistance to metronidazole. CONCLUSIONS Vaginitis is a common medical problem in women that is associated with significant morbidity and previously unrecognized complications. Research in recent years has improved diagnostic tools as well as treatment modalities for all forms of vaginitis.

Carr, Phyllis L; Felsenstein, Donna; Friedman, Robert H

1998-01-01

143

Pregnancy Interruption by Vaginal Misoprostol  

Microsoft Academic Search

A total of 132 pregnant women with average gestational age of 14.2 weeks (range 11–22 weeks) undergoing legal abortion volunteered for a trial utilizing vaginal administration of misoprostol. In 106 women a dose of 800 ?g was utilized, whilst in 26 women 1,200-1,600 ?g were given. Nonsurgical expulsion of the fetus was successful in 117 cases (88.6%). Four cases had

Antonio Bugalho; Cassimo Bique; Luisa Almeida; Staffan Bergström

1993-01-01

144

Vaginal leiomyoma--an imitator of prolapse.  

PubMed

Vaginal leiomyoma is a rare tumor with a variable clinical presentation and broad differential diagnosis that can lead to preoperative misdiagnosis. We present a case of vaginal leiomyoma with a symptom complex of prolapse, urinary urgency and urge incontinence. A 50-year-old woman presented with a 4-year history of deteriorating sensation of prolapse, significant complex urinary complaints and prolonged vaginal bleeding. Clinical examination revealed a mobile 6 x 8 cm mass arising from the anterior vaginal wall. She underwent hysteroscopy, curettage, urethrocystoscopy (normal findings) and mass enucleation through a vertical incision. Histology showed a benign leiomyoma. Ultrasonography, MRI, positive-pressure urethrography and urethrocystoscopy should be considered in the evaluation of an anterior wall vaginal mass. Surgical enucleation via a vaginal approach is the treatment of choice. If this surgical procedure results in skeletonization of the urethral and bladder support, a colporrhaphy/pubourethral ligament plication is required. PMID:11484748

Leron, E; Stanton, S L

2000-06-01

145

The vaginal microbiome: rethinking health and diseases  

PubMed Central

Vaginal microbiota form a mutually beneficial relationship with their host and have major impact on health and disease. In recent years our understanding of vaginal bacterial community composition and structure has significantly broadened as a result of investigators using cultivation-independent methods based on the analysis of 16S ribosomal RNA (rRNA) gene sequences. In asymptomatic, otherwise healthy women, several kinds of vaginal microbiota exist, the majority often dominated by species of Lactobacillus, while others comprise a diverse array of anaerobic microorganisms. Bacterial vaginosis is the most common vaginal conditions and is vaguely characterized as the disruption of the equilibrium of the ‘normal’ vaginal microbiots. A better understanding of ‘normal’ and ‘healthy’ vaginal ecosystems that is based on its ‘true’ function and not simply on its composition would help better define health and further improve disease diagnostics as well as the development of more personalized regimens to promote health and treat diseases.

Ma, Bing; Forney, Larry J.; Ravel, Jacques

2013-01-01

146

Antifungal resistance in yeast vaginitis.  

PubMed Central

The increased number of vaginal yeast infections in the past few years has been a disturbing trend, and the scientific community has been searching for its etiology. Several theories have been put forth to explain the apparent increase. First, the recent widespread availability of low-dosage, azole-based over-the-counter antifungal medications for vaginal yeast infections encourages women to self-diagnose and treat, and women may be misdiagnosing themselves. Their vaginitis may be caused by bacteria, parasites or may be a symptom of another underlying health condition. As a result, they may be unnecessarily and chronically expose themselves to antifungal medications and encourage fungal resistance. Second, medical technology has increased the life span of seriously immune compromised individuals, yet these individuals are frequently plagued by opportunistic fungal infections. Long-term and intense azole-based antifungal treatment has been linked to an increase in resistant Candida and non-Candida species. Thus, the future of limiting antifungal resistance lies in identifying the factors promoting resistance and implementing policies to prevent it.

Dun, E.

1999-01-01

147

Vaginal Birth after Cesarean Section  

PubMed Central

Background: The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS. Aims: The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS). Materials and Methods: The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study. Results: In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality. Conclusion: Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

Bangal, Vidyadhar B; Giri, Purushottam A; Shinde, Kunaal K; Gavhane, Satyajit P

2013-01-01

148

Effect of estrogen on molecular and functional characteristics of the rodent vaginal muscularis  

PubMed Central

Introduction Vaginal atrophy is a consequence of menopause however little is known concerning the effect of a decrease in systemic estrogen on vaginal smooth muscle structure and function. As the incidence of pelvic floor disorders increases with age, it is important to determine if estrogen regulates the molecular composition and contractility of the vaginal muscularis. Aim The goal of this study was to determine the effect of estrogen on molecular and functional characteristics of the vaginal muscularis utilizing a rodent model of surgical menopause. Methods 3–4 month old Sprague Dawley rats underwent sham laparotomy (Sham, n=18) or ovariectomy (Ovx, n=39). Two weeks following surgery, animals received a subcutaneous osmotic pump containing vehicle (Sham, Ovx) or 17- ? estradiol (Ovx). Animals were euthanized one week later and the proximal vagina was collected for analysis of contractile protein expression and in vitro studies of contractility. Measurements were analyzed using a one-way ANOVA followed by Tukey's post hoc analysis (?= 0.05). Main Outcome Measures Protein and mRNA transcript expression levels of contractile proteins, in vitro measurements of vaginal contractility Results Ovariectomy decreased the expression of carboxyl-terminal myosin heavy chain isoform SM1 and h-caldesmon and reduced the amplitude of contraction of the vaginal muscularis in response to KCl. Estradiol replacement reversed these changes. No differences were detected in the % vaginal muscularis, mRNA transcript expression of amino terminal MHC isoforms, l-caldesmon expression and maximal velocity of shortening. Conclusion Systemic estrogen replacement restores functional and molecular characteristics of the vaginal muscularis of ovariectomized rats. Our results indicate that menopause is associated with changes in the vaginal muscularis, which may contribute to the increased incidence of pelvic floor disorders with age.

Basha, Maureen E.; Chang, Shaohua; Burrows, Lara J.; Lassmann, Jenny; Wein, Alan J.; Moreland, Robert S.; Chacko, Samuel K.

2013-01-01

149

Refinement of McIndoe's vaginal reconstruction with ORFIT "S" vaginal stent.  

PubMed

Using McIndoe's vaginal reconstruction with the ORFIT "S" vaginal stent, we achieved good results in 5 patients with congenital vaginal absence over the past 3 years. The ORFIT "S" vaginal stent is a semirigid, porous, and inexpensive stent. The application is easy intraoperatively, and minimal daily care is required for long-term postoperative dilatation. The stent keeps the neovagina in full acceptance of the speculum after long-term follow-up. PMID:8041835

Chen, T H

1994-08-01

150

Assisted breech delivery with transverse vaginal septum.  

PubMed

The incidence of vaginal septum is rare. The infrequency of this anomaly makes accurate estimates of the true incidence very difficult to obtain. Diagnosis is based on careful historyand examination. This is the case of a patient who presented with transverse vaginal septum in labour and breech presentation. The septum was resected and the foetus delivered normally. Careful vaginal examination should be performed in pregnant women at term before labour to detect such manageable abnormalities. PMID:24397081

Anwar, Sadia; Moon, Tooba; Baloch, Sajjad Ahmad; Shah, Syed Humayun

2012-01-01

151

A Side by Side Comparison of Filter-Based PM(sub 2.5) Measurements at a Suburban Site: A Closure Study  

NASA Technical Reports Server (NTRS)

Reliable determination of the effects of air quality on public health and the environment requires accurate measurement of PM(sub 2.5) mass and the individual chemical components of fine aerosols. This study seeks to evaluate PM(sub 2.5) measurements that are part of a newly established national network by comparing them with a more conventional sampling system. Experiments were carried out during 2002 at a suburban site in Maryland, United States, where two samplers from the U.S. Environmental Protection Agency (USEPA) Speciation Trends Network: Met One Speciation Air Sampling System STNS and Thermo Scientific Reference Ambient Air Sampler STNR, two Desert Research Institute Sequential Filter Samplers DRIF, and a continuous TEOM monitor (Thermo Scientific Tapered Element Oscillating Microbalance) were sampling air in parallel. These monitors differ not only in sampling configuration but also in protocol-specific sample analysis procedures. Measurements of PM(sub 2.5) mass and major contributing species were well correlated among the different methods with r-values > 0.8. Despite the good correlations, daily concentrations of PM(sub 2.5) mass and major contributing species were significantly different at the 95% confidence level from 5 to 100% of the time. Larger values of PM(sub 2.5) mass and individual species were generally reported from STNR and STNS. The January STNR average PM(sub 2.5) mass (8.8 (micro)g/per cubic meter) was 1.5 (micro)g/per cubic meter larger than the DRIF average mass. The July STNS average PM(sub 2.5) mass (27.8 (micro)g/per cubic meter) was 3.8 (micro)g/per cubic meter larger than the DRIF average mass. These differences can only be partially accounted for by known random errors. Variations in flow control, face velocity, and sampling artifacts likely influence the measurement of PM(sub 2.5) speciation and mass closure. Simple statistical tests indicate that the current uncertainty estimates used in the STN network may underestimate the actual uncertainty.

Haines, Jennifer C.; Chen, Lung-Wen A.; Taubman, Brett F.; Doddridge, Bruce G.; Dickerson, Russell R.

2007-01-01

152

Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse  

Microsoft Academic Search

This study compares the outcomes of laparoscopic uterosacral ligament uterine suspension (LUSUS) to those of vaginal vault suspension with total vaginal hysterectomy (TVH) for the treatment of symptomatic uterovaginal prolapse. We compared the outcomes of 25 LUSUS to those of 25 TVH with vaginal vault suspension among age-matched controls. No significant complications occurred in either group. EBL and hospitalization duration

Aparna Diwan; Charles R. Rardin; William C. Strohsnitter; Alexandra Weld; Peter Rosenblatt; Neeraj Kohli

2006-01-01

153

Continuous low dose estradiol released from a vaginal ring versus estriol vaginal cream for urogenital atrophy  

Microsoft Academic Search

Objectives: To determine if the efficacy of continuous low dose estradiol released from a vaginal ring is equivalent to estriol vaginal cream regarding improvement of the patient's subjective feeling of vaginal dryness and to determine if there is a preference for either of the two study treatments. Methods: Open-label randomized parallel group trial with active control with a blind evaluation

Ronald Barentsen; Peter H. M. van de Weijer; Jan H. N. Schram

1997-01-01

154

Simple vaginal mold for use in the postoperative care of patients with a transverse vaginal septum.  

PubMed

Severe vaginal stenosis is a potentially disabling complication of transverse vaginal septum resection due to the constriction of the resulting circular scar. We describe a vaginal mold that can be easily created by an occupational therapist, and used as a long-term stent of the vagina in young girls. PMID:17418828

Lacy, Judith; Correll, Gretchen R; Walmer, David K; Price, Thomas M

2007-05-01

155

Vaginal leucocyte counts in women with bacterial vaginosis: relation to vaginal and cervical infections  

PubMed Central

Objectives: To evaluate whether an elevated vaginal leucocyte count in women with bacterial vaginosis (BV) predicts the presence of vaginal or cervical infections, and to assess the relation of vaginal WBC counts to clinical manifestations. Methods: We retrospectively analysed the relation of vaginal leucocyte counts to vaginal and cervical infections and to clinical manifestations in non-pregnant women diagnosed with BV at an STD clinic visit. Results: Of 296 women with BV studied, the median age was 24 years and 81% were African-American. Elevated vaginal leucocyte counts were associated with objective signs of vaginitis and cervicitis and also predicted candidiasis (OR 7.9, 95% CI 2.2 to 28.9), chlamydia (OR 3.1, 95% CI 1.4 to 6.7), gonorrhoea (OR 2.7, 95% CI 1.3 to 5.4), or trichomoniasis (OR 3.4, 95% CI 1.6 to 7.3). In general, as a screening test for vaginal or cervical infections, vaginal leucocyte count had moderate sensitivities and specificities, low positive predictive values, and high negative predictive values. Conclusions: An elevated vaginal leucocyte count in women with BV was a strong predictor of vaginal or cervical infections. Vaginal leucocyte quantification may provide an alternative approach to assessing need for empirical therapy for chlamydia and gonorrhoea, particularly in resource-limited high STD risk settings that provide syndromic management.

Geisler, W; Yu, S; Venglarik, M; Schwebke, J

2004-01-01

156

What Are the Key Statistics about Vaginal Cancer?  

MedlinePLUS

... factors for vaginal cancer? What are the key statistics about vaginal cancer? Vaginal cancer is rare. Only ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

157

[Vaginal contraception. Pt. 1 (author's transl)].  

PubMed

Vaginal contraception is enjoying a revival among women who fear the side effects of the pill or of the IUD. Vaginal contraception by vaginal diaphragm or by cervical cap is totally reversible and never causes complications; there may be short term reversible side effects with the diaphragm, such as cystitis, uretritis, and hemorroids; no side effects are associated with the use of cervical caps. Vaginal contraception has the added advantage of exercising a notable prophylactic actions on the diffusion of verereal diseases and of other vaginal infections such as trichomoniasis and candidosis. It is also possible that vaginal contraception offers protection against cervical neoplasia. Failure rate of diaphragm use is an average 10/100 women years, and for the cervical cap it is about 7.6/100 women years, when both devices are properly used. Vaginal contraception needs to be used in conjunction with spermicidal agents. Spermicidal agents can be used alone and can be very effective; they are, however, not well accepted by most couples, who resent the interruption of the sexual act. Two experimental models of vaginal sponge are now under study; vaginal sponges can be left in place for some time, and insertion is very easy. PMID:12336893

Keith, L; Berger, G S; Jackson, M

1981-04-01

158

Vaginal Hygiene and Douching: Perspectives of Hispanic Men  

PubMed Central

Vaginal douching is widely practiced by women in the USA, particularly among minority ethnic groups, and is associated with increased risk of pelvic and vaginal infections. Douching practices are shaped by social and cultural norms regarding female hygiene, reproduction, and sexuality. Little previous research has addressed the beliefs and practices of Latina women, and none has included the perspective of men, though limited data suggests that women may douche to please male partners. The present study seeks to identify the socially and culturally shaped beliefs and attitudes that influence douching practices from the perspective of Latino men. We conducted in-depth qualitative interviews in English or Spanish with adult Latino men seeking primary care at a community health centre in New York City (USA). Results indicate that these Latino men (mostly of Caribbean descent) are emphatic about the role of cleanliness in vaginal health, reporting that it substantially influences their choice of partner. Most are very supportive of douching, which they consider a necessary hygiene activity. Vaginal health is perceived as a state that must be attained and maintained through proactive hygiene measures that remove seminal residue, menstrual blood, sweat and bacteria that contaminate the vagina. The implications of these findings for interventions with Latina women are discussed.

Mckee, M Diane; Baquero, Maria; Anderson, Matthew; Karasz, Alison

2009-01-01

159

A CLOSURE STUDY OF AEROSOL MASS CONCENTRATION MEASUREMENTS: COMPARISON OF VALUES OBTAINED WITH FILTERS AND BY DIRECT MEASUREMENTS OF MASS DISTRIBUTIONS. (R826372)  

EPA Science Inventory

We compare measurements of aerosol mass concentrations obtained gravimetrically using Teflon coated glass fiber filters and by integrating mass distributions measured with the differential mobility analyzer–aerosol particle mass analyzer (DMA–APM) technique (Aero...

160

Evaluation of vaginal pH for detection of bacterial vaginosis  

PubMed Central

Background & objectives: Bacterial vaginosis (BV) is highly prevalent among women in reproductive age group. Little information exists on routine vaginal pH measurement in women with BV. We undertook this study to assess the utility of vaginal pH determination for initial evaluation of bacterial vaginosis. Methods: In this cross-sectional study vaginal swabs were collected from women with complaints of white discharge, back ache and pain abdomen attending a government hospital and a community health clinic, and subjected to vaginal pH determination, Gram stain, wet mount and whiff test. Nugent score and Amsel criteria were used for BV confirmation. Results: Of the 270 women included in the analysis, 154 had BV based on Nugents’ score. The mean vaginal pH in women with BV measured by pH strips and pH glove was 5 and 4.9, respectively. The vaginal pH was significantly higher in women with BV. Vaginal discharge was prevalent in 84.8 per cent women, however, only 56.8 per cent of these actually had BV by Nugent score (NS). Presence of clue cells and positive whiff test were significant for BV. Vaginal pH >4.5 by pH strips and pH Glove had a sensitivity of 72 and 79 per cent and specificity of 60 and 53 per cent, respectively to detect BV. Among the combination criteria, clue cells and glove pH >4.5 had highest sensitivity and specificity to detect BV. Interpretation & conclusions: Vaginal pH determination is relatively sensitive, but less specific in detecting women with BV. Inclusion of whiff test along with pH test reduced the sensitivity, but improved specificity. Both, the pH strip and pH glove are equally suitable for screening women with BV on outpatient basis.

Hemalatha, R.; Ramalaxmi, Baru Anantha; Swetha, Eluru; Balakrishna, N.; Mastromarino, Paola

2013-01-01

161

Vaginal swab specimen processing methods influence performance of rapid semen detection tests: A cautionary tale  

PubMed Central

Background Detection of semen biomarkers in vaginal fluid can be used to assess women’s recent exposure to semen. Quantitative tests for detection of prostate-specific antigen (PSA) perform well, but are expensive and require specialized equipment. We assessed two rapid immunochromatographic strip tests for identification of semen in vaginal swabs. Study Design We tested 581 vaginal swabs collected from 492 women. Vaginal secretions were eluted into saline, and PSA was measured using the quantitative IMx (Abbott Laboratories) assay. Specimens were also tested using the ABAcard p30 test (Abacus Diagnostics) for detection of PSA and RSID-Semen test (Independent Forensics) for detection of semenogelin (Sg). Results Vaginal swab extraction using saline was compatible with direct assessment of vaginal swab eluates using ABAcard for PSA detection, but not for Sg detection using RSID. The rapid PSA test detected 91% of specimens containing semen compared to 74% by the rapid Sg test. Conclusion Investigators are urged to optimize vaginal swab specimen preparation methods for performance of RSID or other tests to detect semen components other than PSA. Previously described methods for PSA testing are not uniformly applicable to other tests.

Hobbs, Marcia M.; Steiner, Markus J.; Rich, Kimberly D.; Gallo, Maria F.; Warner, Lee; Macaluso, Maurizio

2010-01-01

162

Prospective comparison of vaginal and abdominal sonography in normal early pregnancy.  

PubMed

Vaginal and abdominal sonography were prospectively compared in 309 consecutive pregnancies of which 175 were normal. Two sonographic criteria of normal were analyzed: (1) the presence of an embryo compared with average gestational sac size and (2) the presence of embryonic cardiac activity compared with crown-rump length. Vaginally, 100% (160/160) of embryos were visualized when the average sac diameter was greater than or equal to 12 mm. Abdominally, an embryo was noted in 99.2% (123/124) of gestational sacs greater than or equal to 27 mm. Vaginal sonography revealed cardiac motion in all embryos of greater than or equal to 5 mm (149/149 cases); abdominal sonography revealed cardiac activity in 100% (132/132) of embryos with a crown-rump length of greater than or equal to 9 mm. One-third of normal embryos less than 5 mm crown-rump length did not demonstrate cardiac activity. The study demonstrates through objective comparison that vaginal sonography is superior to abdominal sonography for detection of an intrauterine embryo and its cardiac activity before 8 menstrual weeks. The diagnosis of embryonic demise should not be made by vaginal sonography in embryos measuring less than 5 mm crown-rump length without a heartbeat, and an empty gestational sac of less than 12 mm average diameter should not be diagnosed as blighted ovum by vaginal scans. In these cases follow-up vaginal sonography is suggested. PMID:2020050

Pennell, R G; Needleman, L; Pajak, T; Baltarowich, O; Vilaro, M; Goldberg, B B; Kurtz, A B

1991-02-01

163

Effect of crack surface geometry on fatigue crack closure  

Microsoft Academic Search

The geometry of crack faces often plays a critical role in reducing crack extension forces when crack closure occurs during\\u000a fatigue crack growth. Most previous studies of fatigue crack closure are concerned with mechanical measures of closure as\\u000a related to the crack growth rate; very little attention has been given to the geometry of the crack surfaces. Our objective\\u000a is

W. J. Drury; Arun M. Gokhale; S. D. Antolovich

1995-01-01

164

Cloud condensation nuclei (CCN) and HR-ToF-AMS measurements at a coastal site in Hong Kong: size-resolved CCN activity and closure analysis  

NASA Astrophysics Data System (ADS)

The cloud condensation nuclei (CCN) properties of atmospheric aerosols were measured on 1-30 May 2011 at a coastal site in Hong Kong. Size-resolved CCN activation curves, the ratio of number concentration of CCN (NCCN) to aerosol concentration (NCN) as a function of particle size, were obtained at supersaturation (SS) = 0.15%, 0.35%, 0.50%, and 0.70% using a DMT CCN counter (CCNc) and a TSI scanning mobility particle sizer (SMPS). The mean bulk size-integrated NCCN ranged from ∼500 cm-3 at SS = 0.15% to ∼2100 cm-3 at SS = 0.70%, and the mean bulk NCCN / NCN ratio ranged from 0.16 at SS = 0.15% to 0.65 at SS = 0.70%. The average critical mobility diameters (D50) at SS = 0.15%, 0.35%, 0.50%, and 0.70% were 116 nm, 67 nm, 56 nm, and 46 nm, respectively. The corresponding average hygroscopic parameters (?CCN) were 0.39, 0.36, 0.31, and 0.28. The decrease in ?CCN can be attributed to the increase in organic to inorganic volume ratio as particle size decreases, as measured by an Aerodyne high resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS). The ?CCN correlates reasonably well with ?AMS based on size-resolved AMS measurements: ?AMS = ?org × forg + ?inorg × finorg, where forg and finorg are the organic and inorganic volume fractions, respectively, ?org = 0.1 and ?inorg = 0.6, with a R2 of 0.51. In closure analysis, NCCN was estimated by integrating the measured size-resolved NCN for particles larger than D50 derived from ? assuming internal mixing state. Estimates using ?AMS from size-resolved AMS measurements show that the measured and predicted NCCN were generally within 10% of each other at all four SS. The deviation increased to 26% when ?AMS was calculated from bulk PM1 AMS measurements of particles because PM1 was dominated by particles of 200 nm to 500 nm in diameter, which had a larger inorganic fraction than those of D50 (particle diameter < 200 nm). A constant ? = 0.33 (the average value of size-resolved ?AMS over the course of campaign) was found to give an NCCN prediction within 12% of the actual measured values. We also compared NCCN estimates based on the measured average D50 and the average size-resolved CCN activation ratio to examine the relative importance of hygroscopicity and mixing state. NCCN was found to be relatively more sensitive to the mixing state and hygroscopicity at a high SS = 0.70% and a low SS = 0.15%, respectively.

Meng, J. W.; Yeung, M. C.; Li, Y. J.; Lee, B. Y. L.; Chan, C. K.

2014-04-01

165

Phase closure nulling: Theory and practice  

NASA Astrophysics Data System (ADS)

We provide a complete theory of the phase closure of a binary system in which a small, feeble, and unresolved companion acts as a perturbing parameter on the spatial frequency spectrum of a dominant, bright, resolved source. We demonstrate that the influence of the companion can be measured with precision by measuring the phase closure of the system near the nulls of the primary visibility function. In these regions of phase closure nulling, frequency intervals always exist where the phase closure signature of the companion is larger than any systematic error and can thus be measured. We show that this technique allows retrieval of many astrophysically relevant properties of faint and close companions such as flux, position, and in favorable cases, spectrum. As a proof of concept, using the AMBER/VLTI instrument with 3 auxiliary telescopes of 1.8 m and only 15 minutes of on-sky integration, we detected the five magnitudes fainter companion of HD 59717 at only 3.5 stellar radii distance from the primary. This is one of the highest contrast detected by interferometry between a companion and its parent star. We conclude by a rapid study of the potentialities of phase closure nulling observations with current interferometers and explore the requirements for a new type of dedicated instrument.

Chelli, A.; Duvert, G.; Malbet, F.; Kern, P.

2009-11-01

166

Treatment of postmenopausal vaginal atrophy with 10-?g estradiol vaginal tablets.  

PubMed

Postmenopausal estrogen deficiency can lead to symptoms of urogenital atrophy. Individuals with urogenital atrophy have symptoms that include vaginal dryness, vaginal and vulval irritation, vaginal soreness, pain and burning during urination (dysuria), increased vaginal discharge, vaginal odour, vaginal infections, recurrent urinary tract infections, pain associated with sexual activity (dyspareunia) and vaginal bleeding associated with sexual activity. Despite the frequency and effects of vaginal atrophy symptoms, they are often under-reported and, consequently, under-treated. Therefore, care of a menopausal woman should include a physical assessment of vaginal atrophy and a dialogue between the physician and the patient that explores existing symptoms and their effect on vulvovaginal health, sexuality and quality-of-life issues. The development of the ultra-low-dose 10-µg estradiol vaginal tablets is in line with the requirements of regulatory agencies and women's health societies regarding the use of the lowest effective hormonal dose. Because of its effectiveness and safety profiles, in addition to its minimal systemic absorption, the 10-µg estradiol vaginal tablet can offer greater reassurance to health-care providers and postmenopausal women with an annual estradiol administration of only 1.14 mg. PMID:22393176

Panay, Nick; Maamari, Ricardo

2012-03-01

167

Effects of tamoxifen on vaginal blood flow and epithelial morphology in the rat  

PubMed Central

Background Tamoxifen, a selective estrogen receptor modulator with both estrogenic and anti-estrogenic activity, is widely used as adjuvant therapy in breast cancer patients. Treatment with tamoxifen is associated with sexual side effects, such as increased vaginal dryness and pain/discomfort during sexual activity. There have been limited investigations of the effect of tamoxifen on estrogen-dependent peripheral genital arousal responses. The objective of this study was to investigate the effects of tamoxifen on vaginal physiology in the rat. Methods Female Sprague-Dawley rats were subjected to sham surgery or bilateral ovariectomy. After 2 weeks, sham-operated rats were implanted with subcutaneous osmotic infusion pumps containing vehicle (control) or tamoxifen (150 ?g/day). Ovariectomized rats were similarly infused with vehicle. After an additional 2 weeks, vaginal blood flow responses to pelvic nerve stimulation were measured by laser Doppler flowmetry and vaginal tissue was collected for histological and biochemical assay. Results Tamoxifen treatment did not change plasma estradiol concentrations relative to control animals, while ovariectomized rats exhibited a 60% decrease in plasma estradiol. Tamoxifen treatment caused a significant decrease in mean uterine weight, but did not alter mean vaginal weight. Vaginal blood flow was significantly decreased in tamoxifen-infused rats compared to controls. Similar to ovariectomized animals, estrogen receptor binding was increased and arginase enzyme activity was decreased in tamoxifen-infused rats. However, different from control and ovariectomized animals, the vaginal epithelium in tamoxifen-infused rats appeared highly mucified. Periodic acid-Schiff staining confirmed a greater production of carbohydrate-rich compounds (e.g. mucin, glycogen) by the vaginal epithelium of tamoxifen-infused rats. Conclusion The observations suggest that tamoxifen exerts both anti-estrogenic and pro-estrogenic effects in the vagina. These physiological alterations may eventually lead to vaginal atrophy and compromise sexual function.

Kim, Noel N; Stankovic, Miljan; Armagan, Abdullah; Cushman, Tulay T; Goldstein, Irwin; Traish, Abdulmaged M

2006-01-01

168

Comparative Study of Oral and Vaginal Misoprostol for Induction of Labour, Maternal and Foetal Outcome  

PubMed Central

Background: Misoprostol is a new promising agent for cervical ripening and induction of labour .The ideal dose, route and frequency of administration of misoprostol are still under investigation. Although, vaginal application of misoprostol has been validated as a reasonable mean of induction, there is a patient resistance to digital examination and there is a risk of ascending infection. For this reason, oral administration of misoprostol for cervical ripening and labour induction has been tried. Aims and Objectives: To compare 50?g of oral misoprostol versus 25?g of intravaginal misoprostol for induction of labour at term and maternal, foetal outcomes. Methods: Two hundred women who were at term, with indication for induction of labour and Bishop scores of ?5 were randomly assigned to receive misoprostol 50?g or 25?g intravaginal, every 4-6 hours, for a maximum of 5 doses. In either group, pregnant females with inadequate uterine contractions despite being given maximum 5 doses of misoprostol, were augmented using oxytocin. The primary outcome measure was time-interval from induction to vaginal delivery and vaginal delivery rate within 24 hours. Results: The median induction to vaginal delivery time in oral group (12.92h) and vaginal group (14.04 h) was not significant. Oral misoprostol resulted in more number of vaginal deliveries as compared to vaginal misoprostol (94% as compared to 86%), which was not significant. There was a significantly higher incidence of uterine tachysystole in the vaginal group, as compared to oral group. There were no significant differences between the groups with respect to oxytocin augmentation, caesarean section rate, analgesic requirement and neonatal outcome. Conclusion: Oral misoprostol is as efficacious as vaginal misoprostol because of shorter induction delivery interval, lower caesarean section rates, and lower incidence of failed induction rates. Lower incidence of foetal distress and easy intake are observed if the drug is administered orally.

Komala, Kambhampati; Reddy, Meherlatha; Quadri, Iqbal Jehan; B., Suneetha; V., Ramya

2013-01-01

169

Tank closure reducing grout  

SciTech Connect

A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr{sup 90}, the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel.

Caldwell, T.B.

1997-04-18

170

Evaluation of vaginal antifungal formulations in vivo.  

PubMed Central

Relatively simple and rapid procedures have been developed for evaluating the local efficacy of vaginal antifungal agents in vivo in a vaginal candidiasis model in ovariectomized rats. The results of this investigation indicate that the model and methods described are quite suitable for screening potential antifungal substances and for assessing the chemotherapeutic effectiveness of new antifungal agents and formulations before carrying out clinical studies.

McRipley, R. J.; Erhard, P. J.; Schwind, R. A.; Whitney, R. R.

1979-01-01

171

Excision of high vaginal septum  

Microsoft Academic Search

Introduction  Transverse vaginal septum occurs because there is a defect in vertical fusion during embryological development of the vagina.\\u000a It is quite rare and is infrequently encountered by most obstetricians and gynecologists in their practice.\\u000a \\u000a \\u000a \\u000a \\u000a Case report  A 14-year-old unmarried student, Miss AUX, presented to a private gynecologist complaining of absent menses. Initial examination\\u000a and investigation revealed intact hymen, normal uterus but

Fahed Al-Abdulhadi; Michael Fidelis Diejomaoh; Assem El Biaa; Jiri Jirous; Mona Al-Qenae

2010-01-01

172

Role of the pelvic floor in Bladder neck opening and closure II: Vagina  

Microsoft Academic Search

The aim of the study was to examine the role of vaginal stretching during bladder neck opening and closure. The study group\\u000a comprised 12 patients with GSI and 4 controls. The position of the bladder neck relative to the vagina was assessed in the\\u000a resting, straining and ‘squeezing’ positions using video-radiological studies. Radio-opaque dye was instilled into the bladder,\\u000a vagina,

P. E. Papa Petros; U. Ulmsten

1997-01-01

173

Ultra-low-dose estriol and Lactobacillus acidophilus vaginal tablets (Gynoflor(®)) for vaginal atrophy in postmenopausal breast cancer patients on aromatase inhibitors: pharmacokinetic, safety, and efficacy phase I clinical study.  

PubMed

Phase I pharmacokinetic (PK) study assessed circulating estrogens in breast cancer (BC) patients on a non-steroidal aromatase inhibitor (NSAI) with vaginal atrophy using vaginal ultra-low-dose 0.03 mg estriol (E3) and Lactobacillus combination vaginal tablets (Gynoflor(®)). 16 women on NSAI with severe vaginal atrophy applied a daily vaginal tablet of Gynoflor(®) for 28 days followed by a maintenance therapy of 3 tablets weekly for 8 weeks. Primary outcomes were serum concentrations and PK of E3, estradiol (E2), and estrone (E1) using highly sensitive gas chromatography-mass spectrometry. Secondary outcomes were clinical measures for efficacy and side effects; microscopic changes in vaginal epithelium and microflora; and changes in serum FSH, LH, and sex hormone-binding globulin. Compared with baseline, serum E1 and E2 did not increase in any of the women at any time following vaginal application. Serum E3 transiently increased after the first application in 15 of 16 women, with a maximum of 168 pg/ml 2-3 h post-insertion. After 4 weeks, serum E3 was slightly increased in 8 women with a maximum of 44 pg/ml. The vaginal atrophy resolved or improved in all women. The product was well tolerated, and discontinuation of therapy was not observed. The low-dose 0.03 mg E3 and Lactobacillus acidophilus vaginal tablets application in postmenopausal BC patients during AI treatment suffering from vaginal atrophy lead to small and transient increases in serum E3, but not E1 or E2, and therefore can be considered as safe and efficacious for treatment of atrophic vaginitis in BC patients taking NSAIs. PMID:24718774

Donders, Gilbert; Neven, Patrick; Moegele, Maximilian; Lintermans, Anneleen; Bellen, Gert; Prasauskas, Valdas; Grob, Philipp; Ortmann, Olaf; Buchholz, Stefan

2014-06-01

174

Burn Wound Closure.  

National Technical Information Service (NTIS)

Wound closure should be carried out at the earliest possible stage. In suitable cases it can be done almost immediately, i.e., at day 2 or 3, with some form of excision being followed by the immediate application of autograft. If necessary, further staged...

J. H. Heslop

1983-01-01

175

Pregnancy interruption by vaginal misoprostol.  

PubMed

A total of 132 pregnant women with average gestational age of 14.2 weeks (range 11-22 weeks) undergoing legal abortion volunteered for a trial utilizing vaginal administration of misoprostol. In 106 women a dose of 800 micrograms was utilized, whilst in 26 women 1,200-1,600 micrograms were given. Nonsurgical expulsion of the fetus was successful in 117 cases (88.6%). Four cases had to be excluded for various social reasons. A total of 11 did not achieve fetal expulsion within 56 h after application of misoprostol. These cases (11/132; 8.3%) were considered failures. Previous reports in the literature of toxicity trials on animals reporting no fetotoxic nor teratogenic effects of misoprostol at doses up to 10,000 micrograms/kg body weight seem to be of no validity in the human since we could demonstrate that almost 80% of pregnancies were interrupted at a dose of 10-15 micrograms/kg body weight. The conclusion is that vaginal administration of this prostaglandin analogue, not requiring cool temperature for storage, is remarkably effective in achieving safe interruption of pregnancy without any significant complications. PMID:8300007

Bugalho, A; Bique, C; Almeida, L; Bergström, S

1993-01-01

176

Phase I clinical trial of vaginal mucosal immunization for recurrent urinary tract infection.  

PubMed

In a phase I clinical trial to test safety and patient acceptance 25 women with a history of recurrent urinary tract infections but no identifiable anatomic abnormality received a multivalent vaccine instilled into the vagina. The vaccine contained 6 heat-killed Escherichia coli strains and 4 nonE. coli uropathogens. Only minimal adverse reactions were observed in the 5-month period following immunization. Total vaginal and urinary IgG and IgA increased significantly (p < 0.01 by repeated measures analysis of variance). Serum antibodies to some of the nonE. coli strains but not to the E. coli strains increased after vaginal immunization. While efficacy is yet to be shown, this study indicates that this vaginally applied urinary tract infection vaccine is well tolerated, and capable of increasing vaginal and urinary antibody. PMID:7966729

Uehling, D T; Hopkins, W J; Dahmer, L A; Balish, E

1994-12-01

177

Early results of a novel technique for anterior vaginal wall prolapse repair: anterior vaginal wall darn  

PubMed Central

Background The aim of this study was to describe the results of a 1-year patient follow-up after anterior vaginal wall darn, a novel technique for the repair of anterior vaginal wall prolapse. Methods Fifty-five patients with anterior vaginal wall prolapse underwent anterior vaginal wall darn. The anterior vaginal wall was detached using sharp and blunt dissection via an incision beginning 1 cm proximal to the external meatus and extending to the vaginal apex. The space between the tissues that attach the lateral vaginal walls to the arcus tendineus fasciae pelvis was then darned. Cough Stress Test, Pelvic Organ Prolapse Quantification, seven-item Incontinence Impact Questionnaire, and six-item Urogenital Distress Inventory scores were performed 1-year postoperatively to evaluate recovery. Results One-year postoperatively, all patients were satisfied with the results of the procedure. No patient had vaginal mucosal erosion or any other complication. Conclusions One-year postoperative findings for patients in this series indicate that patients with stage II–III anterior vaginal wall prolapse were successfully treated with the anterior vaginal wall darn technique.

2014-01-01

178

Vaginal hysterectomy: a new approach using bicoagulation forceps  

Microsoft Academic Search

This study is to assess the feasibility and outcome of vaginal hysterectomies using bicoagulation forceps. Eighty patients undergoing vaginal hysterectomy for several diagnoses were enrolled. In 40 patients, bicoagulation forceps were used for the entirety of the operation. In 19 patients, only vaginal hysterectomy was performed; in 21 patients, vaginal hysterectomy was part of surgery for pelvic floor repair. Forty

Wolfgang Zubke; Sven Becker; Bernhard Krämer; Diethelm Wallwiener

2004-01-01

179

Throwing the dice for the diagnosis of vaginal complaints?  

Microsoft Academic Search

BACKROUND: Vaginitis is among the most common conditions women are seeking medical care for. Although these infections can easily be treated, the relapse rate is high. This may be due to inadequate use of the diagnostic potential. METHODS: We evaluated the misjudgement rate of the aetiology of vaginal complaints. A total of 220 vaginal samples from women with a vaginal

Andreas Schwiertz; David Taras; Kerstin Rusch; Volker Rusch

2006-01-01

180

Novel application of polyelectrolyte multilayers as nanoscopic closures with hermetic sealing.  

PubMed

Closure systems for personnel protection applications, such as protective clothing or respirator face seals, should provide effective permeation barrier to toxic gases. Currently available mechanical closure systems based on the hook and loop types (example, Velcro) do not provide adequate barrier to gas permeation. To achieve hermetic sealing, we propose a nonmechanical, nanoscopic molecular closure system based on complementary polyelectrolyte multilayers, one with a polycation outermost layer and the other with a polyanion outermost layer. The closure surfaces were prepared by depositing polyelectrolyte multilayers under a variety of deposition conditions, on conformable polymer substrates (thin films of polyethylene teraphthalate, PET or polyimide, PI). The hermetic sealing property of the closures was evaluated by measuring the air flow resistance using the dynamic moisture permeation cell (DMPC) at different humidity conditions. The DMPC measurements show that the polyelectrolyte multilayer closures provide significantly large resistance to air flow, approximately 20-800 times larger than that possible with conventional hook and loop type closure systems, at all humidity levels (from 5 to 95% relative humidity). Hence, from the point of view of providing a hermetic seal against toxic gas permeation, the polyelectrolyte multilayer closures are viable candidates for further engineering development. However, the adhesive strength of the multilayer closures measured by atomic force microscopy suggests that the magnitude of adhesion is much smaller than what is possible with mechanical closures. Therefore, we envisage the development of a composite closure system combining the mechanical closure to provide strong adhesion and the multilayer closure to provide hermetic sealing. PMID:22391415

Marcott, Stephanie A; Ada, Sena; Gibson, Phillip; Camesano, Terri A; Nagarajan, R

2012-03-01

181

Vaginitis  

MedlinePLUS

... resources for press Selected Profiles & Interviews Selected biographies & science-focused interviews Multimedia Audio briefings, videos & podcasts related to NICHD research About NICHD Institute Overview ...

182

[Local combined therapy of vaginal infections by nifuratel-nistatin].  

PubMed

A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too. PMID:20387731

Jahi?, Mahira; Bali?, Adem; Nurki?, Mahmud; Dragovi?, Jasmina; Adzajli?, Amela; Habibovi?, Amra; Mesali?, Lejla; Zigi?, Aza

2010-02-01

183

Development of an arid site closure plan  

SciTech Connect

This document describes the development of a prototype plan for the effective closure and stabilization of an arid low-level waste disposal site. This plan will provide demonstrated closure techniques for a trench in a disposal site at Los Alamos. The accuracy of modeling soil water storage by two hydrologic models, CREAMS and HELP, was tested by comparing simulation results with field measurements of soil moisture in eight experimental landfill cover systems having a range of well-defined soil profiles and vegetative covers. Regression analysis showed that CREAMS generally represented soil moisture more accurately than HELP simulations. Precautions for determining parameter values for model input and for interpreting simulation results are discussed. A specific example is presented showing how the field-validated hydrologic models can be used to develop a final prototype closure plan. 15 refs., 13 figs., 3 tabs.

Nyhan, J.W.; Barnes, F.J.

1987-01-01

184

Fatigue Crack Closure Analysis Using Digital Image Correlation  

NASA Technical Reports Server (NTRS)

Fatigue crack closure during crack growth testing is analyzed in order to evaluate the critieria of ASTM Standard E647 for measurement of fatigue crack growth rates. Of specific concern is remote closure, which occurs away from the crack tip and is a product of the load history during crack-driving-force-reduction fatigue crack growth testing. Crack closure behavior is characterized using relative displacements determined from a series of high-magnification digital images acquired as the crack is loaded. Changes in the relative displacements of features on opposite sides of the crack are used to generate crack closure data as a function of crack wake position. For the results presented in this paper, remote closure did not affect fatigue crack growth rate measurements when ASTM Standard E647 was strictly followed and only became a problem when testing parameters (e.g., load shed rate, initial crack driving force, etc.) greatly exceeded the guidelines of the accepted standard.

Leser, William P.; Newman, John A.; Johnston, William M.

2010-01-01

185

Spacesuit torso closure  

NASA Technical Reports Server (NTRS)

A simple, economical and reliable entry closure is described for joining opposite halves of a torso section for a pressure suit in a manner which simplifies self-donning. A single coupling joins coaxially aligned, axially separable, tubular segments of a hard spacesuit along an angulated zone of separation, adapted to be mated in an hermetrically sealing relation. A releasable C section clamp secures the members in their mated relationship.

Webbon, B. W.; Vykukal, H. C. (inventors)

1978-01-01

186

Clinical evaluation of econazole nitrate in 1% vaginal cream for treatment of vaginal candidosis.  

PubMed

30 patients with mycologically confirmed vaginal candidosis on culture were treated with econazole vaginal cream (Gyno-Pevaryl) applied intravaginally once a day for 2 wk. 8 days after the end of treatment, mycological and clinical cures were demonstrated in 26 patients. Symptoms generally subsided rapidly, and the drug was well tolerated. This study confirms the efficacy of econazole in the treatment of vaginal candidosis. PMID:264069

Schuerwegh, W

1978-02-01

187

Primary intent vaginal hysterectomy: outcomes for common contraindications to vaginal approach hysterectomy  

Microsoft Academic Search

The objective of this study is, within a broadly inclusive selection strategy for benign vaginal hysterectomy, to determine\\u000a whether the most commonly invoked “contraindications” to vaginal hysterectomy—fibroid enlargement >14 weeks, prior cesarean,\\u000a need for oophorectomy—result in increased risk of complications. This study is of retrospective design within a rural community\\u000a hospital. All vaginal hysterectomies performed by a single practitioner over an

Malcolm W. Mackenzie; Jeffrey D. Johnson

2011-01-01

188

Development of an in vitro alternative assay method for vaginal irritation  

PubMed Central

The vaginal mucosa is commonly exposed to chemicals and therapeutic agents that may result in irritation and/or inflammation. In addition to acute effects, vaginal irritation and inflammation can make women more susceptible to infections such as HIV-1 and herpes simplex virus-2. Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant public health concern. Traditionally, testing of such materials has been performed using the rabbit vaginal irritation (RVI) assay. In the current study, we investigated whether the organotypic, highly differentiated EpiVaginal™ tissue could be used as a non-animal alternative to the RVI test. The EpiVaginal tissue was exposed to a single application of ingredients commonly found in feminine hygiene products and the effects on tissue viability (MTT assay), barrier disruption (measured by transepithelial electrical resistance, TEER and sodium fluorescein (NaFl) leakage), and inflammatory cytokine release (interleukin (IL)-1?, IL-1?, IL-6, and IL-8) patterns were examined. When compared to untreated controls, two irritating ingredients, nonoxynol 9 and benzalkonium chloride, reduced tissue viability to <40% and TEER to <60% while increasing NaFl leakage by 11–24% and IL-1? and IL-1? release by >100%. Four other non-irritating materials had minimal effects on these parameters. Assay reproducibility was confirmed by testing the chemicals using three different tissue production lots and by using tissues reconstructed from cells obtained from three different donors. Coefficients of variation between tissue lots reconstructed with cells obtained from the same donor or lots reconstructed with cells obtained from different donors were less than 10% and 12%, respectively. In conclusion, decreases in tissue viability and barrier function and increases in IL-1? and IL-1? release appear to be useful endpoints for preclinical screening of topically applied chemicals and formulations for their vaginal irritation potential.

Ayehunie, Seyoum; Cannon, Chris; LaRosa, Karen; Pudney, Jeffrey; Anderson, Deborah J.; Klausner, Mitchell

2010-01-01

189

Vaginal pH and Microbicidal Lactic Acid When Lactobacilli Dominate the Microbiota  

PubMed Central

Lactic acid at sufficiently acidic pH is a potent microbicide, and lactic acid produced by vaginal lactobacilli may help protect against reproductive tract infections. However, previous observations likely underestimated healthy vaginal acidity and total lactate concentration since they failed to exclude women without a lactobacillus-dominated vaginal microbiota, and also did not account for the high carbon dioxide, low oxygen environment of the vagina. Fifty-six women with low (0-3) Nugent scores (indicating a lactobacillus-dominated vaginal microbiota) and no symptoms of reproductive tract disease or infection, provided a total of 64 cervicovaginal fluid samples using a collection method that avoided the need for sample dilution and rigorously minimized aerobic exposure. The pH of samples was measured by microelectrode immediately after collection and under a physiological vaginal concentration of CO2. Commercial enzymatic assays of total lactate and total acetate concentrations were validated for use in CVF, and compared to the more usual HPLC method. The average pH of the CVF samples was 3.5 ± 0.3 (mean ± SD), range 2.8-4.2, and the average total lactate was 1.0% ± 0.2% w/v; this is a five-fold higher average hydrogen ion concentration (lower pH) and a fivefold higher total lactate concentration than in the prior literature. The microbicidal form of lactic acid (protonated lactic acid) was therefore eleven-fold more concentrated, and a markedly more potent microbicide, than indicated by prior research. This suggests that when lactobacilli dominate the vaginal microbiota, women have significantly more lactic acid-mediated protection against infections than currently believed. Our results invite further evaluations of the prophylactic and therapeutic actions of vaginal lactic acid, whether provided in situ by endogenous lactobacilli, by probiotic lactobacilli, or by products that reinforce vaginal lactic acid.

O'Hanlon, Deirdre E.; Moench, Thomas R.; Cone, Richard A.

2013-01-01

190

Development of an in vitro alternative assay method for vaginal irritation.  

PubMed

The vaginal mucosa is commonly exposed to chemicals and therapeutic agents that may result in irritation and/or inflammation. In addition to acute effects, vaginal irritation and inflammation can make women more susceptible to infections such as HIV-1 and herpes simplex virus 2 (HSV-2). Hence, the vaginal irritation potential of feminine care formulations and vaginally administered therapeutic agents is a significant public health concern. Traditionally, testing of such materials has been performed using the rabbit vaginal irritation (RVI) assay. In the current study, we investigated whether the organotypic, highly differentiated EpiVaginal™ tissue could be used as a non-animal alternative to the RVI test. The EpiVaginal tissue was exposed to a single application of ingredients commonly found in feminine hygiene products and the effects on tissue viability (MTT assay), barrier disruption (measured by transepithelial electrical resistance, TEER and sodium fluorescein (NaFl) leakage), and inflammatory cytokine release (interleukin (IL)-1?, IL-1?, IL-6, and IL-8) patterns were examined. When compared to untreated controls, two irritating ingredients, nonoxynol 9 and benzalkonium chloride, reduced tissue viability to <40% and TEER to <60% while increasing NaFl leakage by 11-24% and IL-1? and IL-1? release by >100%. Four other non-irritating materials had minimal effects on these parameters. Assay reproducibility was confirmed by testing the chemicals using three different tissue production lots and by using tissues reconstructed from cells obtained from three different donors. Coefficients of variation between tissue lots reconstructed with cells obtained from the same donor or lots reconstructed with cells obtained from different donors were less than 10% and 12%, respectively. In conclusion, decreases in tissue viability and barrier function and increases in IL-1? and IL-1? release appear to be useful endpoints for preclinical screening of topically applied chemicals and formulations for their vaginal irritation potential. PMID:20937349

Ayehunie, Seyoum; Cannon, Chris; Larosa, Karen; Pudney, Jeffrey; Anderson, Deborah J; Klausner, Mitchell

2011-01-11

191

Feasibility of a breath test for monitoring adherence to vaginal administration of antiretroviral microbicide gels.  

PubMed

Adherence to microbicide gel use is critical to optimizing effectiveness in preventing human immunodeficiency virus transmission. The authors hypothesized that ester taggants added to vaginal gels would generate exhaled alcohol and ketone metabolites and provide a "breath test" for vaginal gel use. This 2-arm (vaginal and dermal), randomized, participant-blinded, pilot study tested this hypothesis. On 8 visits, healthy women (n = 8) received intravaginal taggant (2-butyl acetate, 2-pentyl acetate, isopropyl butyrate, or 2-pentyl butyrate; 30 mg) formulated in hydroxyethylcellulose or tenofovir placebo gel. A second group (n = 4) of women received the same formulations administered dermally on the forearm to determine if skin administration might confound the system. Breath samples were collected using bags before and after taggant administration for 1 hour. Samples were measured using a miniature gas chromatograph and/or gas chromatography-mass spectroscopy for ester taggant, alcohol, and ketone concentrations. After vaginal administration, 2-butyl acetate, 2-pentyl acetate, and metabolites were observed in breath, whereas isopropyl butyrate, 2-pentyl butyrate, and metabolites were not. Some women reported self-resolving, mild burning (24/64 visits) with vaginal administration or a "bubblegum" taste (7/64 visits). No taggants or metabolites were detected following dermal application. A "breath test" for adherence to antiretroviral vaginal gel application appears physiologically and technically feasible. PMID:23400750

Morey, Timothy E; Wasdo, Scott; Wishin, Judith; Quinn, Brian; van der Straten, Ariane; Booth, Matthew; Gonzalez, Daniel; Derendorf, Hartmut; Melker, Richard J; Dennis, Donn M

2013-01-01

192

Analysis of mechanical properties of cork stoppers and synthetic closures used for wine bottling  

Microsoft Academic Search

There is an increasing interest towards synthetic closures as an alternative to cork stoppers for sealing wine bottles. In this preliminary study, a set of testing conditions using the TA-HDI Texture Analyzer were implemented to measure selected mechanical parameters for the characterization of wine closures (natural and technical corks, co-extruded and injected synthetic closures in terms of compression force, extraction

Alessandro Giunchi; Andrea Versari; Giuseppina P. Parpinello; Sergio Galassi

2008-01-01

193

Trypan Blue Staining to Determine Vaginal Exposure in Two Types of Plastic Vaginal Applicators Containing Two Different Microbicide Formulations  

PubMed Central

Dye staining of applicators has been shown to be a reliable and objective method to test vaginal insertion in clinical microbicide trials, but different plastics, dyes and product formulations may impact the accuracy of this method. Reportedly used applicators returned from three clinical trials were stained with 1% Trypan Blue. In a phase 1 study (VivaGel®), using gel-filled HTI polypropylene applicators, 1271 (97%) of applicators stained positive. In two phase 1 and 2a studies (LACTIN-V) using linear low-density polyethylene applicators to deliver a dry powder formulation, 57 (95%) and 135 (86%) tested positive, respectively. Dye staining of vaginal applicators is an objective, low cost measure suitable for low resource settings.

Hemmerling, A; Harrison, WG; Brown, JM; Moscicki, AB; Oziemkowska, M; Bukusi, EA; Cohen, CR

2013-01-01

194

Vaginal involvement in genital erosive lichen planus.  

PubMed

A specialized Vulva Clinic with dedicated gynecologists and dermatologists was established in Oslo, Norway, in 2003. Fifty-eight women referred to the clinic in 2003-2009 were diagnosed with genital erosive lichen planus. All patients filled out a questionnaire. Gynecological examination, including vaginal inspection, was performed, if necessary in general anesthesia. Median age at symptom start was 51 years (range 17-78 years) with 15 women (26%) being younger than 40 years old. Sexual abstinence was reported by 36 women and dyspareunia by another 10. On examination, vaginal involvement was seen in 49 women, including vaginal synechiae in 29 and total obliteration of the vagina in 9. Of 56 women treated with topical corticosteroids for at least three months, two had complete response and 36 partial responses. Similarly, of 22 women treated with tacrolimus, three had complete and six partial response. We conclude that vaginal involvement is more common in genital erosive lichen planus than previously reported. PMID:20583940

Helgesen, Anne Lise Ording; Gjersvik, Petter; Jebsen, Peter; Kirschner, Rolf; Tanbo, Tom

2010-07-01

195

Symptoms of Vaginal and Vulvar Cancers  

MedlinePLUS

... Announcements Radio Public Service Announcements Print Materials Campaign Research Doctors Who Use Social Media Poster Presentation Buttons and Badges Related Resources Gynecologic Cancer Symptoms Diary [PDF-503KB] Vaginal and Vulvar Cancer fact sheet [ ...

196

Vaginal childbirth and pelvic floor disorders  

PubMed Central

Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist in clusters; hence, the isolated effect of these variables on the pelvic floor is difficult to study.

Memon, Hafsa U; Handa, Victoria L

2013-01-01

197

Urinary incontinence - tension-free vaginal tape  

MedlinePLUS

... vaginal tape is surgery to help control stress urinary incontinence . This is urine leakage that happens when you ... Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education ...

198

[A new approach to urinary continence disorders in women: urodynamic ultrasonic examination by the vaginal route].  

PubMed

The vesicourethral junction, the urethra cannot be seen when using the abdominal approach because of the interposition of the pubic symphysis. The ultrasonic vaginal approach makes it possible. 53 patients were ultrasonically observed during an urodynamic exploration. The simultaneous utilization of both methods has permit to observe the mechanisms of normal or pathological voiding. When initiating a voluntary micturition, an area (called "prepubic muscle") located in front of the pubic symphysis between the clitoris and the urethral meatus, exert a traction on the periurethral sphincteric area. This sphincteric area, which is well shown by ultrasound, contracts longitudinally (causing shortening of the urethra and opening of the bladder neck) and causes a drop in urethral closure pressure. The increase in the distance between the inferior part of the pubic symphysis and the anterior vaginal wall comes about because of slackening of the elevator ani muscles. This slackening occurs at different times before the bladder contracts. The urethra opens; the complete course of this organ is well defined. Things return to their previous state when voiding finishes. In the case of stress incontinence, the lack of transmission of pressure urodynamically found when the woman is coughing can be seen as a sliding mechanism within the space of Retzius and at the urethro-vesical junction behind the symphysis pubis. The degree of sliding depends on the strength of the cough. In all cases of pure stress incontinence without there being low urethral closure pressure, a maximum stress caused by coughing will produce more than 5 MM sliding before the urethra opens. If the urinary incontinence is due to low urethral closure pressure, the urethra opens without sliding of the urethro-vesical junction whenever the abdominal pressure increases. Urethral instability resembles voluntary voiding but without any voluntary command. "Prepubic" contractions, longitudinal contractions in the sphincteric area and slackening of the levator ani muscles, alone or in association, explain why urethral closure pressure drops. Sometimes this drop is followed by an increase in bladder pressure. PMID:3330102

Beco, J; Sulu, M; Schaaps, J P; Lambotte, R

1987-01-01

199

Comparison of the vaginal microbiota diversity of women with and without human papillomavirus infection: a cross-sectional study  

PubMed Central

Background The female genital tract is an important bacterial habitat of the human body, and vaginal microbiota plays a crucial role in vaginal health. The alteration of vaginal microbiota affects millions of women annually, and is associated with numerous adverse health outcomes, including human papillomavirus (HPV) infection. However, previous studies have primarily focused on the association between bacterial vaginosis and HPV infection. Little is known about the composition of vaginal microbial communities involved in HPV acquisition. The present study was performed to investigate whether HPV infection was associated with the diversity and composition of vaginal microbiota. Methods A total of 70 healthy women (32 HPV-negative and 38 HPV-positive) with normal cervical cytology were enrolled in this study. Culture-independent polymerase chain reaction-denaturing gradient gel electrophoresis was used to measure the diversity and composition of vaginal microbiota of all subjects. Results We found significantly greater biological diversity in the vaginal microbiota of HPV-positive women (p?vaginal microbiota from the two groups had different profiles. Conclusions Our study is the first systematic evaluation of an association between vaginal microbiota and HPV infection, and we have demonstrated that compared with HPV-negative women, the bacterial diversity of HPV-positive women is more complex and the composition of vaginal microbiota is different.

2013-01-01

200

Vaginal Bleeding during Pregnancy and Preterm Birth  

Microsoft Academic Search

This study investigated the relation between self-reported vaginal bleeding during pregnancy and preterm birth in a prospective cohort of 2,829 pregnant women enrolled from prenatal clinics between 1995 and 2000 in central North Carolina. The overall association between vaginal bleeding and preterm birth was modest (risk ratio (RR) = 1.3, 95% confidence interval (CI): 1.1, 1.6). Bleeding in the first

Juan Yang; Katherine E. Hartmann; David A. Savitz; Amy H. Herring; Nancy Dole; Andrew F. Olshan; John M. Thorp

201

Delayed Macular Hole Closure  

PubMed Central

Purpose The presented case raises questions regarding the favorable scheduling of planned postoperative care and the ideal observation interval to decide for reoperations in macular hole surgery. Furthermore a discussion about the use of short- and long-acting gas tamponades in macular hole surgery is encouraged. Methods We present an interventional case report and a short review of the pertinent literature. Results We report a case of spontaneous delayed macular hole closure after vitreoretinal surgery had been performed initially without the expected success. A 73-year-old male Caucasian patient presented at our clinic with a stage 2 macular hole in his left eye. He underwent 23-gauge pars plana vitrectomy and internal limiting membrane peeling with a 20% C2F6-gas tamponade. Sixteen days after the procedure, an OCT scan revealed a persistent stage 2 macular hole, and the patient was scheduled for reoperation. Surprisingly, at the date of planned surgery, which was another 11 days later, the macular hole had resolved spontaneously without any further intervention. Conclusions So far no common opinion exists regarding the use of short- or long-acting gas in macular hole surgery. Our case of delayed macular hole closure after complete resorption of the gas tamponade raises questions about the need and duration of strict prone positioning after surgery. Furthermore short-acting gas might be as efficient as long-acting gas. We suggest to wait with a second intervention at least 4 weeks after the initial surgery, since a delayed macular hole closure is possible.

Distelmaier, Peter; Meyer, Linda M.; Fischer, Marie T.; Philipp, Sebastian; Paquet, Patrick; Mammen, Antje; Haller, Katharina; Schonfeld, Carl-Ludwig

2014-01-01

202

Orbiter door closure tools  

NASA Technical Reports Server (NTRS)

Safe reentry of the shuttle orbiter requires that the payload bay doors be closed and securely latched. Since a malfunction in the door drive or bulkhead latch systems could make safe reentry impossible, the requirement to provide tools to manually close and secure the doors was implemented. The tools would disconnect a disabled door or latch closure system and close and secure the doors if the normal system failed. The tools required to perform these tasks have evolved into a set that consists of a tubing cutter, a winch, a latching tool, and a bolt extractor. The design, fabrication, and performance tests of each tool are described.

Acres, W. R.

1980-01-01

203

Tension–Free Vaginal Mesh Repair for Anterior Vaginal Wall Prolapse  

Microsoft Academic Search

Objectives: We determined the efficacy of the use of a tension free prolene mesh to correct a grade III anterior vaginal wall prolapse recurrence.Methods: Twelve women (mean age 65.6 years) with stress urinary incontinence (SUI) (4 type II and 1 type III) and bladder prolapse entered the study. After vaginal incision a pretailored polypropylene mesh was fixed to its four

Roberto Migliari; Michele De Angelis; Giuliana Madeddu; Tiziano Verdacchi

2000-01-01

204

EMAS clinical guide: low-dose vaginal estrogens for postmenopausal vaginal atrophy.  

PubMed

Vaginal atrophy is common in postmenopausal women. This clinical guide provides the evidence for the clinical use of vaginal estrogens for this condition focussing on publications since the 2006 Cochrane systematic review. Use after breast cancer, before assessment of cervical cytology and prolapse surgery is also discussed. PMID:22818886

Rees, Margaret; Pérez-López, Faustino R; Ceasu, Iuliana; Depypere, Herman; Erel, Tamer; Lambrinoudaki, Irene; Schenck-Gustafsson, Karin; Simoncini, Tommaso; van der Schouw, Yvonne; Tremollieres, Florence

2012-10-01

205

Removal of a vaginal leiomyoma presenting as tumor previa allowing vaginal birth.  

PubMed

Leiomyomas of the vagina are very rare tumors of the female genital tract with only 300 cases reported so far. A case of removal of the vaginal leiomyoma presenting as tumor previa in advanced pregnancy is described. Removal of the tumor allowed vaginal birth three weeks after surgery. PMID:22873113

Boskovic, V; Vrzic-Petronijevic, S; Petronijevic, M; Atanackovic, J; Bratic, D

2012-01-01

206

Clinical Features of Bacterial Vaginosis in a Murine Model of Vaginal Infection with Gardnerella vaginalis  

PubMed Central

Bacterial vaginosis (BV) is a dysbiosis of the vaginal flora characterized by a shift from a Lactobacillus-dominant environment to a polymicrobial mixture including Actinobacteria and Gram-negative bacilli. BV is a common vaginal condition in women and is associated with increased risk of sexually transmitted infection and adverse pregnancy outcomes such as preterm birth. Gardnerella vaginalis is one of the most frequently isolated bacterial species in BV. However, there has been much debate in the literature concerning the contribution of G. vaginalis to the etiology of BV, since it is also present in a significant proportion of healthy women. Here we present a new murine vaginal infection model with a clinical isolate of G. vaginalis. Our data demonstrate that this model displays key features used clinically to diagnose BV, including the presence of sialidase activity and exfoliated epithelial cells with adherent bacteria (reminiscent of clue cells). G. vaginalis was capable of ascending uterine infection, which correlated with the degree of vaginal infection and level of vaginal sialidase activity. The host response to G. vaginalis infection was characterized by robust vaginal epithelial cell exfoliation in the absence of histological inflammation. Our analyses of clinical specimens from women with BV revealed a measureable epithelial exfoliation response compared to women with normal flora, a phenotype that, to our knowledge, is measured here for the first time. The results of this study demonstrate that G. vaginalis is sufficient to cause BV phenotypes and suggest that this organism may contribute to BV etiology and associated complications. This is the first time vaginal infection by a BV associated bacterium in an animal has been shown to parallel the human disease with regard to clinical diagnostic features. Future studies with this model should facilitate investigation of important questions regarding BV etiology, pathogenesis and associated complications.

Gilbert, Nicole M.; Lewis, Warren G.; Lewis, Amanda L.

2013-01-01

207

Clinical features of bacterial vaginosis in a murine model of vaginal infection with Gardnerella vaginalis.  

PubMed

Bacterial vaginosis (BV) is a dysbiosis of the vaginal flora characterized by a shift from a Lactobacillus-dominant environment to a polymicrobial mixture including Actinobacteria and gram-negative bacilli. BV is a common vaginal condition in women and is associated with increased risk of sexually transmitted infection and adverse pregnancy outcomes such as preterm birth. Gardnerella vaginalis is one of the most frequently isolated bacterial species in BV. However, there has been much debate in the literature concerning the contribution of G. vaginalis to the etiology of BV, since it is also present in a significant proportion of healthy women. Here we present a new murine vaginal infection model with a clinical isolate of G. vaginalis. Our data demonstrate that this model displays key features used clinically to diagnose BV, including the presence of sialidase activity and exfoliated epithelial cells with adherent bacteria (reminiscent of clue cells). G. vaginalis was capable of ascending uterine infection, which correlated with the degree of vaginal infection and level of vaginal sialidase activity. The host response to G. vaginalis infection was characterized by robust vaginal epithelial cell exfoliation in the absence of histological inflammation. Our analyses of clinical specimens from women with BV revealed a measureable epithelial exfoliation response compared to women with normal flora, a phenotype that, to our knowledge, is measured here for the first time. The results of this study demonstrate that G. vaginalis is sufficient to cause BV phenotypes and suggest that this organism may contribute to BV etiology and associated complications. This is the first time vaginal infection by a BV associated bacterium in an animal has been shown to parallel the human disease with regard to clinical diagnostic features. Future studies with this model should facilitate investigation of important questions regarding BV etiology, pathogenesis and associated complications. PMID:23527214

Gilbert, Nicole M; Lewis, Warren G; Lewis, Amanda L

2013-01-01

208

8. Launch closure, closure track apron, tracks and track beam, ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Launch closure, closure track apron, tracks and track beam, view towards west - Ellsworth Air Force Base, Delta Flight, Launch Facility D-6, 4 miles north of Badlands National Park Headquarters, 4.5 miles east of Jackson County line on county road, Interior, Jackson County, SD

209

Perturbed airway closure  

NASA Astrophysics Data System (ADS)

The small airways of the lungs are lined with a thin viscous film. A surface-tension driven instability at the air-liquid interface may induce the formation of a liquid bridge blocking airflow if there is sufficient fluid within the film. As a result of the pressures generated within the non-uniform film, the airway wall may also collapse. These instabilities often occur in premature neonates who do not produce sufficient quantities of surfactant. Often, they are placed in ventilators to diminish the risk of airway closure. Two fundamental parameters are the frequency of the ventilation and the tidal volume of the delivered gas. In the current study, we consider the effect of an oscillatory shear stress impinged by the air on a thin film coating a single compliant tube. Nonlinear evolution equations are derived for the film thickness and the wall position. Numerical solutions show that the oscillatory shear stress can saturate the growth of a disturbance at the air-liquid interface. For a given film thickness, there is a critical frequency, dependent on wall parameters, above which closure does not occur when forced by oscillatory shear but will close when unforced.

Grotberg, James B.; Halpern, David

1998-11-01

210

Outcomes following vaginal Prolapse repair and mid Urethral Sling (OPUS) trial  

PubMed Central

Background Many women without preexisting stress urinary incontinence (SUI) who undergo vaginal surgery to correct pelvic organ prolapse will develop symptoms of SUI. A concomitant prophylactic anti-incontinence procedure may prevent SUI symptom development in women undergoing vaginal prolapse surgery. Purpose To present the rationale, design and methodology of a randomized controlled surgical trial (RCT), the Outcomes Following Vaginal Prolapse Repair and Mid Urethral Sling (OPUS) Trial. The primary aims of this RCT are to determine (1) whether the prevalence of post-operative urinary incontinence (UI) differs between stress continent women receiving vaginal prolapse repair with concomitant tension-free vaginal tape (TVT®; a sling procedure commonly used to treat SUI) and those with only sham incisions at 3 months post surgery (2) whether it is more cost-effective to place a TVT prophylactically than to treat the SUI symptoms postoperatively as they occur over a 12 month period after the index surgery.. The study also incorporates a patient preference trial (PPT). Methods Primary outcome, defined as signs (positive cough stress test), symptoms (per validated questionnaire) and/or need for treatment of SUI and its associated cost, at 3 and 12 months post-operatively. Secondary outcomes consist of group differences in lower urinary tract and prolapse symptoms, health related quality of life, measures of vaginal anatomy, and surgical complications. Limitations Given the invasive nature of surgical intervention trials, some individuals may be reluctant to agree with random assignment, potentially impacting result generalizability. To evaluate the magnitude and direction of non-participation bias, the PPT will enroll a sample of those who decline participation in the RCT but are otherwise eligible. Conclusion This sham-controlled RCT will provide important information for patients and surgeons regarding both the short- and long-term optimal treatment approach for stress continent women undergoing a vaginal surgery for prolapse. Non-participation bias will be estimated.

Wei, John T.; Nygaard, Ingrid; Richter, Holly E.; Brown, Morton B; Barber, Matthew D.; Xu, Xiao; Kenton, Kim; Nager, Charles W.; Schaffer, Joseph; Visco, Anthony; Weber, Anne

2010-01-01

211

Clinical evaluation of postpartum vaginal mucus reflects uterine bacterial infection and the immune response in cattle.  

PubMed

Bacteria contaminate the uterus of most dairy cattle after parturition and endometritis causes infertility. An endometritis score can be ascribed based on the vaginal mucus character and odour but it is not clear if the clinical score reflects the number of uterine bacteria or the inflammatory response. The present study tested the hypothesis that clinical evaluation of endometritis reflects the number of bacteria present in the uterus, and the acute phase protein response. Swabs (n = 328) were collected from the uterine lumen of dairy cattle, 21 and 28 days postpartum, vaginal mucus was scored for character and odour, and blood samples collected for acute phase protein measurement. Bacteria were identified following aerobic and anaerobic culture, and the bacterial growth density was scored semi-quantitatively. When bacteria were categorised by their expected pathogenic potential in the uterus, purulent or fetid odour vaginal mucus was associated with the growth density of pathogenic bacteria but not opportunist contaminants. When bacteria were analysed independently, Arcanobacterium pyogenes, Proteus and Fusobacterium necrophorum growth densities were associated with mucopurulent or purulent vaginal mucus. The bacterial growth densities for A. pyogenes, Escherichia coli, non-hemolytic Streptococci, and Mannheimia haemolytica were associated with a fetid mucus odour. Peripheral plasma concentrations of alpha(1)-acid glycoprotein were higher if there was a fetid compared with a normal vaginal mucus odour (1.50 +/- 0.09 mg/mL versus 1.05 +/- 0.02 mg/mL, P < 0.001), but did not differ significantly between vaginal mucus character scores. The evaluation of the character and odour of vaginal mucus reflects the number of bacteria in the uterus, and the acute phase protein response. PMID:15589277

Williams, Erin J; Fischer, Deborah P; Pfeiffer, Dirk U; England, Gary C W; Noakes, David E; Dobson, Hilary; Sheldon, I Martin

2005-01-01

212

Interleukin-7 Facilitates HIV-1 Transmission to Cervico-Vaginal Tissue ex vivo  

PubMed Central

The majority of HIV-1 infections in women occur through vaginal intercourse, in which virus-containing semen is deposited on the cervico-vaginal mucosa. Semen is more than a mere carrier of HIV-1, since it contains many biological factors, in particular cytokines, that may affect HIV-1 transmission. The concentration of interleukin (IL)-7, one of the most prominent cytokines in semen of healthy individuals, is further increased in semen of HIV-1-infected men. Here, we investigated the potential role of IL-7 in HIV-1 vaginal transmission in an ex vivo system of human cervico-vaginal tissue. We simulated an in vivo situation by depositing HIV-1 on cervico-vaginal tissue in combination with IL-7 at concentrations comparable with those measured in semen of HIV-1-infected individuals. We found that IL-7 significantly enhanced virus replication in ex vivo infected cervico-vaginal tissue. Similarly, we observed an enhancement of HIV-1 replication in lymphoid tissue explants. Analysis of T cells isolated from infected tissues showed that IL-7 reduced CD4+ T cell depletion preventing apoptosis, as shown by the decrease in the number of cells expressing the apoptotic marker APO2.7 and the increase in the expression of the anti-apoptotic protein B-cell lymphoma (Bcl)-2. Also, IL-7 increased the fraction of cycling CD4+ T cells, as evidenced by staining for the nuclear factor Ki-67. High levels of seminal IL-7 in vivo may be relevant to the survival of the founder pool of HIV-1-infected cells in the cervico-vaginal mucosa at the initial stage of infection, promoting local expansion and dissemination of HIV infection.

Introini, Andrea; Vanpouille, Christophe; Lisco, Andrea; Grivel, Jean-Charles; Margolis, Leonid

2013-01-01

213

Interleukin-7 facilitates HIV-1 transmission to cervico-vaginal tissue ex vivo.  

PubMed

The majority of HIV-1 infections in women occur through vaginal intercourse, in which virus-containing semen is deposited on the cervico-vaginal mucosa. Semen is more than a mere carrier of HIV-1, since it contains many biological factors, in particular cytokines, that may affect HIV-1 transmission. The concentration of interleukin (IL)-7, one of the most prominent cytokines in semen of healthy individuals, is further increased in semen of HIV-1-infected men. Here, we investigated the potential role of IL-7 in HIV-1 vaginal transmission in an ex vivo system of human cervico-vaginal tissue. We simulated an in vivo situation by depositing HIV-1 on cervico-vaginal tissue in combination with IL-7 at concentrations comparable with those measured in semen of HIV-1-infected individuals. We found that IL-7 significantly enhanced virus replication in ex vivo infected cervico-vaginal tissue. Similarly, we observed an enhancement of HIV-1 replication in lymphoid tissue explants. Analysis of T cells isolated from infected tissues showed that IL-7 reduced CD4? T cell depletion preventing apoptosis, as shown by the decrease in the number of cells expressing the apoptotic marker APO2.7 and the increase in the expression of the anti-apoptotic protein B-cell lymphoma (Bcl)-2. Also, IL-7 increased the fraction of cycling CD4? T cells, as evidenced by staining for the nuclear factor Ki-67. High levels of seminal IL-7 in vivo may be relevant to the survival of the founder pool of HIV-1-infected cells in the cervico-vaginal mucosa at the initial stage of infection, promoting local expansion and dissemination of HIV infection. PMID:23408885

Introini, Andrea; Vanpouille, Christophe; Lisco, Andrea; Grivel, Jean-Charles; Margolis, Leonid

2013-02-01

214

Transverse vaginal septum associated with tubal atresia.  

PubMed

Transverse vaginal septum is a defect of vertical fusion during embryogenesis of the vagina. The estimated incidence is 1 per 30,000 to 84,000 women. It is infrequently associated with genitourinary tract, gastrointestinal tract, musculoskeletal, and cardiac malformations. Previous reports of transverse vaginal septum have included unilateral absence of the fallopian tube and ovary and absence of the proximal portion of the fallopian tube. This report describes bilateral tubal atresia associated with a transverse vaginal septum. A 17-year-old nulligravida sought medical assessment because of primary amenorrhea and cyclic pelvic pain. Physical examination revealed a blind vaginal pouch and a tender pelvic mass. Radiologic studies showed a transverse vaginal septum 1.5 cm distal to the cervix. The septum was resected with laparoscopic guidance, and bilateral fallopian tubal atresia was noted. The pelvis was otherwise normal. Patients commonly have a pelvic or abdominal mass, pain, and amenorrhea at time of expected menarche. Surgical resection is the treatment of choice. Postoperative dilation may be necessary to prevent restenosis. Outlook for pregnancy is encouraging despite a higher than normal incidence of spontaneous abortion and endometriosis in such patients. PMID:7564549

Polasek, P M; Erickson, L D; Stanhope, C R

1995-10-01

215

Breech vaginal delivery at or near term.  

PubMed

Three percent to 4% of term fetuses will be breech at delivery. Evidence from randomized controlled trials has found a policy of planned cesarean section to be significantly better for the singleton fetus in breech presentation at term compared to a policy of planned vaginal birth. However, some women may wish to avoid cesarean section and for others, cesarean section may not be possible. We undertook this review to identify factors associated with higher and lower risk of adverse fetal or neonatal outcome at term during vaginal breech delivery. We searched MEDLINE from 1966 to 2002 using the search terms vaginal breech delivery and breech presentation and retrieved all relevant articles. We also reviewed personal references and reference lists of articles retrieved. Women who are older or who have a fetus that is either in footling presentation, has a hyperextended head or is estimated to weigh <2500 g or >4000 g may be at higher risk of adverse fetal outcome. Prolonged labor or not having an experienced clinician at vaginal breech birth may also increase the risk. Women with a fetus in breech presentation at term should be offered the option of delivery by planned cesarean section and should be informed that this will reduce their risk of adverse fetal or neonatal outcome. Practitioners should develop and maintain skills at vaginal breech delivery for those women not wishing or not able to be delivered by cesarean section. PMID:12641301

Tunde-Byass, Modupe O; Hannah, Mary E

2003-02-01

216

Closure plan for Solid Waste Storage Area 6: Volume 1, Closure plan  

SciTech Connect

This Closure Plan for Solid Waste Storage Area 6 (SWSA 6) a disposal area for low-level radioactive wastes and hazardous materials, of the US Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) describes how portions of SWSA 6 will be closed under Resource Conservation and Recovery Act (RCRA) Interim Status per 40 CFR 265 Subpart G (TN Rule 1200-1-11-.05(7)). An overview is provided of activities necessary for final closure and corrective measures for all of SWSA 6. Results of surface waters and groundwater sampling are provided.

Not Available

1988-09-01

217

Environment-sensitive closure and fatigue crack propagation behavior of Al 2090  

NASA Astrophysics Data System (ADS)

Fatigue crack propagation (FCP) behavior of Al-Li alloys is largely influenced by extrinsic crack closure. The studies on closure have been confined to the relatively benign moist air environment. The synergistic interaction between the aggressive environment and closure on FCP, particularly that in the near-threshold ? K regime, has often been neglected due to the difficulties in closure measurement in aqueous environments. In the present study, FCP behavior of Al 2090 was examined in moist air, vacuum, and aqueous 3.5 pct NaCl at different R ratios with an emphasis on the understanding of environment-sensitive crack closure mechanisms. The closure in Al 2090 was strongly affected by applied ? K, R ratio, and environment. The increase in near-threshold da/dN in aqueous 3.5 pct NaCl over that in moist air mostly disappeared after crack closure correction, indicating that environment-sensitive closure was a major determining factor for the FCP rates of high-closure materials. Interestingly, Al 2090 showed a lower closure level in vacuum than in moist air, despite the enhanced fracture surface roughness and reduced FCP rates in low and intermediate ? K regimes. The increasing R ratio tends to reduce closure contribution and eventually increase the FCP rates of Al 2090 for each environment. The trends observed in the present study show that closure is determined by complex interactions between the environment and R ratio, particularly in a low stress intensity regime.

Kim, Sang Shik; Shin, Kwang Seon

1998-10-01

218

Protective activity of geranium oil and its component, geraniol, in combination with vaginal washing against vaginal candidiasis in mice.  

PubMed

In order to evaluate an effective administration method of essential oils for vaginal candidiasis, efficacy of vaginal application of essential oils against murine experimental candidiasis was investigated. The effect on vaginal inflammation and Candida growth form was also studied. Vaginal candidiasis was established by intravaginal infection of C. albicans to estradiol-treated mice. These mice intravaginally received essential oils such as geranium and tea tree singly or in combination with vaginal washing. Vaginal administration of clotrimazole significantly decreased the number of viable C. albicans cells in the vaginal cavity by itself. In contrast, these essential oils did not lower the cell number. When application of geranium oil or geraniol was combined with vaginal washing, the cell number was decreased significantly. The myeloperoxidase activity assay exhibited the possibility that essential oils worked not only to reduce the viable cell number of C. albicans, but also to improve vaginal inflammation. The smear of vaginal washing suspension suggested that more yeast-form cells appeared in vaginal smears of these oil-treated mice than in control mice. In vitro study showed that a very low concentration (25 microg/ml) of geranium oil and geraniol inhibited mycelial growth, but not yeast growth. Based on these findings, it is estimated that vaginal application of geranium oil or its main component, geraniol, suppressed Candida cell growth in the vagina and its local inflammation when combined with vaginal washing. PMID:18670079

Maruyama, Naho; Takizawa, Toshio; Ishibashi, Hiroko; Hisajima, Tatsuya; Inouye, Shigeharu; Yamaguchi, Hideyo; Abe, Shigeru

2008-08-01

219

Evaluation of Two Energy Balance Closure Parametrizations  

NASA Astrophysics Data System (ADS)

A general lack of energy balance closure indicates that tower-based eddy-covariance (EC) measurements underestimate turbulent heat fluxes, which calls for robust correction schemes. Two parametrization approaches that can be found in the literature were tested using data from the Canadian Twin Otter research aircraft and from tower-based measurements of the German Terrestrial Environmental Observatories (TERENO) programme. Our analysis shows that the approach of Huang et al. (Boundary-Layer Meteorol 127:273-292, 2008), based on large-eddy simulation, is not applicable to typical near-surface flux measurements because it was developed for heights above the surface layer and over homogeneous terrain. The biggest shortcoming of this parametrization is that the grid resolution of the model was too coarse so that the surface layer, where EC measurements are usually made, is not properly resolved. The empirical approach of Panin and Bernhofer (Izvestiya Atmos Oceanic Phys 44:701-716, 2008) considers landscape-level roughness heterogeneities that induce secondary circulations and at least gives a qualitative estimate of the energy balance closure. However, it does not consider any feature of landscape-scale heterogeneity other than surface roughness, such as surface temperature, surface moisture or topography. The failures of both approaches might indicate that the influence of mesoscale structures is not a sufficient explanation for the energy balance closure problem. However, our analysis of different wind-direction sectors shows that the upwind landscape-scale heterogeneity indeed influences the energy balance closure determined from tower flux data. We also analyzed the aircraft measurements with respect to the partitioning of the "missing energy" between sensible and latent heat fluxes and we could confirm the assumption of scalar similarity only for Bowen ratios 1.

Eder, Fabian; De Roo, Frederik; Kohnert, Katrin; Desjardins, Raymond L.; Schmid, Hans Peter; Mauder, Matthias

2014-05-01

220

A Novel Technique for Anterior Vaginal Wall Prolapse Repair: Anterior Vaginal Wall Darn  

PubMed Central

Aim. The aim of this study is to introduce a new technique, anterior vaginal wall darn (AVWD), which has not been used before to repair the anterior vaginal wall prolapse, a common problem among women. Materials and Methods. Forty-five women suffering from anterior vaginal wall prolapse were operated on with a new technique. The anterior vaginal wall was detached by sharp and blunt dissection via an incision beginning from the 1?cm proximal aspect of the external meatus extending to the vaginal apex, and the space between the tissues that attach the lateral walls of the vagina to the arcus tendineus fascia pelvis (ATFP) was then darned. Preoperation and early postoperation evaluations of the patients were conducted and summarized. Results. Data were collected six months after operation. Cough stress test (CST), Pelvic Organ Prolapse Quantification (POP-Q) evaluation, Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores indicated recovery. According to the early postoperation results, all patients were satisfied with the operation. No vaginal mucosal erosion or any other complications were detected. Conclusion. In this initial series, our short-term results suggested that patients with grade II-III anterior vaginal wall prolapsus might be treated successfully with the AVWD method.

Kose, Osman; Saglam, Hasan S.; Kumsar, Sukru; Budak, Salih; Adsan, Oztug

2013-01-01

221

Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse  

PubMed Central

Introduction and hypothesis To estimate the risk of repeat surgery for recurrent prolapse or mesh removal after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. Methods We utilized longitudinal, adjudicated, healthcare claims from 2005 to 2010 to identify women ?18 years who underwent an anterior colporrhaphy (CPT 57420) with or without concurrent vaginal mesh (CPT 57267). The primary outcome was repeat surgery for anterior or apical prolapse or for mesh removal/revision; these outcomes were also analyzed separately. We utilized Kaplan–Meier curves to estimate the cumulative risk of each outcome after vaginal mesh versus native tissue repair. Cox proportional hazards models were used to estimate the hazard ratio (HR) for vaginal mesh versus native tissue repair, adjusted for age, concurrent hysterectomy, and concurrent or recent sling. Results We identified 27,809 anterior prolapse surgeries with 49,658 person-years of follow-up. Of those, 6,871 (24.7%) included vaginal mesh. The 5-year cumulative risk of any repeat surgery was significantly higher for vaginal mesh versus native tissue (15.2 % vs 9.8 %, p<0.0001) with a 5-year risk of mesh revision/removal of 5.9%. The 5-year risk of surgery for recurrent prolapse was similar between vaginal mesh and native tissue groups (10.4 % vs 9.3 %, p=0.70. The results of the adjusted Cox model were similar (HR 0.93, 95%CI: 0.83, 1.05). Conclusions The use of mesh for anterior prolapse was associated with an increased risk of any repeat surgery, which was driven by surgery for mesh removal. Native tissue and vaginal mesh surgery had similar 5-year risks for surgery for recurrent prolapse.

Funk, Michele Jonsson; Visco, Anthony G.; Weidner, Alison C.; Pate, Virginia

2013-01-01

222

Intermittent local prophylaxis against recurrent vaginal candidosis.  

PubMed Central

Women with recurrent vaginal candidosis were treated until the infection cleared and were then given one clotrimazole 500 mg vaginal tablet a month or an identical placebo as prophylaxis. Of 21 women who received placebo, 16 developed symptoms or signs within three months, compared with nine of 17 women given active treatment. Women who relapsed were treated and then given active prophylaxis once a month. Of 30 women given such treatment, 13 relapsed within three months. Women who relapsed were treated and then given two clotrimazole 500 mg vaginal tablets a month. Of 17 women given prophylaxis twice a month, four developed symptoms or signs within three months, but 10 remained clear for 12 months. No appreciable difference was seen in the incidence of mycological recurrence between the different regimens; within three months over half the women in all treatment groups had become recolonised.

Bushell, T E; Evans, E G; Meaden, J D; Milne, J D; Warnock, D W

1988-01-01

223

Vaginal Leiomyoma with Heterologous Paragangliomatous Elements.  

PubMed

A vaginal leiomyoma with heterologous paragangliomatous elements is reported. The patient was a 62-year-old woman who presented with uterovaginal prolapse and an asymptomatic vaginal mass that had been present for many years. Histology of the excised mass showed a leiomyoma in a submucosal location, with irregularly shaped islands of chief cells scattered throughout the lesion. These cells were arranged in nests and were surrounded by S100 protein-positive sustentacular cells. The chief cells showed immunoreactivity with chromogranin, synaptophysin, and neuron-specific enolase. Although various heterologous elements are commonly encountered within uterine leiomyomata, such elements have not been described within vaginal leiomyomata. Furthermore, the occurrence of paragangliomatous tissue within leiomyomata has not been reported to date. Int J Surg Pathol 8(4):359-365, 2000 PMID:11494018

Naidoo, Prabha

2000-10-01

224

Canine vaginal leiomyoma diagnosed by CT vaginourethrography.  

PubMed

A 13 yr old female spayed Labrador retriever presented for vulvar bleeding. Abdominal radiographs revealed a soft tissue mass in the ventral pelvic canal. A computed tomography (CT) exam and a CT vaginourethrogram localized the mass to the vagina, helped further characterize the mass, and aided in surgical planning. A total vaginectomy was performed and the histologic diagnosis was leiomyoma. Vaginal tumors make up 1.9-3% of all tumors. Seventy-three percent of vaginal tumors are benign, and 83% of those are leiomyomas. Leiomyomas often have a good long-term prognosis with surgical resection. The diagnostic investigation of this case report utilized a multimodal imaging approach to determine the extent and respectability of the vaginal mass. To the best of the authors' knowledge, this is the first report describing a CT vaginourethrogram. PMID:24051257

Weissman, Andrea; Jiménez, David; Torres, Brian; Cornell, Karen; Holmes, Shannon P

2013-01-01

225

Fasciocutaneous flap for vaginal and perineal reconstruction  

SciTech Connect

A skin and fascia flap from the medial thigh is proposed for vaginal and perineal reconstruction. Dissection, vascular injection, and radiographs of 20 fresh cadaver limbs uniformly demonstrated the presence of a communicating suprafascial vascular plexus in the medial thigh. Three to four nonaxial vessels were consistently found to enter the proximal plexus from within 5 cm of the perineum. Preservation of these vessels permitted reliable elevation of a 9 X 20 cm fasciocutaneous flap without using the gracilis muscle as a vascular carrier. Fifteen flaps in 13 patients were used for vaginal replacement and coverage of vulvectomy, groin, and ischial defects. Depending on the magnitude of the defect, simultaneous and independent elevation of the gracilis muscle provided additional vascularized coverage as needed. Our experience indicates that the medial thigh fasciocutaneous flap is a durable, less bulky, and potentially sensate alternative to the gracilis musculocutaneous flap for vaginal and perineal reconstruction.

Wang, T.N.; Whetzel, T.; Mathes, S.J.; Vasconez, L.O.

1987-07-01

226

Pregnancy's Stronghold on the Vaginal Microbiome  

PubMed Central

Objective To assess the vaginal microbiome throughout full-term uncomplicated pregnancy. Methods Vaginal swabs were obtained from twelve pregnant women at 8-week intervals throughout their uncomplicated pregnancies. Patients with symptoms of vaginal infection or with recent antibiotic use were excluded. Swabs were obtained from the posterior fornix and cervix at 8–12, 17–21, 27–31, and 36–38 weeks of gestation. The microbial community was profiled using hypervariable tag sequencing of the V3–V5 region of the 16S rRNA gene, producing approximately 8 million reads on the Illumina MiSeq. Results Samples were dominated by a single genus, Lactobacillus, and exhibited low species diversity. For a majority of the patients (n?=?8), the vaginal microbiome was dominated by Lactobacillus crispatus throughout pregnancy. Two patients showed Lactobacillus iners dominance during the course of pregnancy, and two showed a shift between the first and second trimester from L. crispatus to L. iners dominance. In all of the samples only these two species were identified, and were found at an abundance of higher than 1% in this study. Comparative analyses also showed that the vaginal microbiome during pregnancy is characterized by a marked dominance of Lactobacillus species in both Caucasian and African-American subjects. In addition, our Caucasian subject population clustered by trimester and progressed towards a common attractor while African-American women clustered by subject instead and did not progress towards a common attractor. Conclusion Our analyses indicate normal pregnancy is characterized by a microbiome that has low diversity and high stability. While Lactobacillus species strongly dominate the vaginal environment during pregnancy across the two studied ethnicities, observed differences between the longitudinal dynamics of the analyzed populations may contribute to divergent risk for pregnancy complications. This helps establish a baseline for investigating the role of the microbiome in complications of pregnancy such as preterm labor and preterm delivery.

Walther-Antonio, Marina R. S.; Jeraldo, Patricio; Berg Miller, Margret E.; Yeoman, Carl J.; Nelson, Karen E.; Wilson, Brenda A.; White, Bryan A.; Chia, Nicholas; Creedon, Douglas J.

2014-01-01

227

Collagen-based bioadhesives for wound closure  

NASA Astrophysics Data System (ADS)

In this paper, we reported the results of an in vitro pilot study designed to evaluate the possible use of type-I collagen for corneal wound closure via an in situ photo-crosslink process. The wound strength was measured by rising the intraocular pressure (IOP) at a constant rate until wound breakage (blow-up test). In addition, histology was performed to study the wound appearance after photosoldering.

Ren, Qiushi; Simon, Gabriel; Parel, Jean-Marie A.

1992-08-01

228

Transverse vaginal septum. A case report.  

PubMed

A case occurred of imperforate, complete transverse vaginal septum in the lower third of the vagina. The patient presented at 16 years of age with primary amenorrhea and was found to have hematocolpos. The clinical impression was an imperforate hymen because of the very low position of the septum in the vagina. After excision the diagnosis of transverse vaginal septum was made histologically because of the presence of müllerian duct (mesodermal origin) tissue in the septum. The patient also had syndactyly of the second and third toes on her right foot. The association of these two congenital abnormalities has not been reported previously. PMID:7738932

Wang, J; Ezzat, W; Davidson, M

1995-02-01

229

Group B Streptococcus CovR regulation modulates host immune signalling pathways to promote vaginal colonization.  

PubMed

Streptococcus agalactiae (Group B?Streptococcus, GBS) is a frequent commensal organism of the vaginal tract of healthy women. However, GBS can transition to a pathogen in susceptible hosts, but host and microbial factors that contribute to this conversion are not well understood. GBS CovR/S (CsrR/S) is a two component regulatory system that regulates key virulence elements including adherence and toxin production. We performed global transcription profiling of human vaginal epithelial cells exposed to WT, CovR deficient, and toxin deficient strains, and observed that insufficient regulation by CovR and subsequent increased toxin production results in a drastic increase in host inflammatory responses, particularly in cytokine signalling pathways promoted by IL-8 and CXCL2. Additionally, we observed that CovR regulation impacts epithelial cell attachment and intracellular invasion. In our mouse model of GBS vaginal colonization, we further demonstrated that CovR regulation promotes vaginal persistence, as infection with a CovR deficient strainresulted in a heightened host immune response as measured by cytokine production and neutrophil activation. Using CXCr2 KO mice, we determined that this immune alteration occurs, at least in part, via signalling through the CXCL2 receptor. Taken together, we conclude that CovR is an important regulator of GBS vaginal colonization and loss of this regulatory function may contribute to the inflammatory havoc seen during the course of infection. PMID:23298320

Patras, Kathryn A; Wang, Nai-Yu; Fletcher, Erin M; Cavaco, Courtney K; Jimenez, Alyssa; Garg, Mansi; Fierer, Joshua; Sheen, Tamsin R; Rajagopal, Lakshmi; Doran, Kelly S

2013-07-01

230

Role of Oxidative Stress on Vaginal Bleeding during The First Trimester of Pregnant Women  

PubMed Central

Background: Reactive oxygen species (ROS) are produced in many metabolic and physiologic processes. Antioxidative mechanisms remove these harmful species. Our aim was to assess whether serum total antioxidant capacity and total oxidant status altered during first trimester pregnancies with vaginal bleeding. Materials and Methods: In this cross-sectional study, A group of pregnant women at less than 10 weeks of gestation with vaginal bleeding (n=25) and a control group of healthy pregnancies with similar characteristics (n=25) were included. All of the patients in the two groups were matched for age, gestational age and body mass index. Serum total antioxidant capacity and total oxidant status levels were determined using a Hitachi 912 analyzer and compared between the two groups. Results: Characteristics, including maternal age, parity, and gestational age were similar between the two groups. Serum total antioxidant capacity levels were significantly lower in the women with vaginal bleeding than in control women (1.16 ± 0.20 vs. 1.77 ± 0.08 mmol Trolox Equiv./L; p=0.001), whereas higher total oxidant status measurements were found in women with vaginal bleeding compared to the control group (4.01 ± 0.20 vs. 2.57 ± 0.65 µmol H2O2 Equiv./L; p=0.001). Conclusion: Increased total oxidant status might be involved in the pathophysiology of vaginal bleeding during early first trimester pregnancies.

Deveer, Ruya; Deveer, Mehmet; Engin-Ustun, Yaprak; Akbaba, Eren; Uysal, Sema; Sarikaya, Esma; Gulerman, Cavidan; Mollamahmutoglu, Leyla

2014-01-01

231

Accelerated Tank Closure Demonstration Project  

SciTech Connect

Among the highest priorities for action under the ''Hanford Federal Facility and Agreement and Consent Order'', hereafter referred to as the Tri-Party Agreement, is the retrieval, treatment and disposal of Hanford Site tank waste. Tank waste is recognized as one of the primary threats to the Columbia River and one of the most complex technical challenges. Progress has been made in resolving safety issues, characterizing tank waste and past tank leaks, enhancing double-shell tank waste transfer and operations systems, retrieving single-shell tank waste, deploying waste treatment facilities, and planning for the disposal of immobilized waste product. However, limited progress has been made in developing technologies and providing a sound technical basis for tank system closure. To address this limitation the Accelerated Tank Closure Demonstration Project was created to develop information through technology demonstrations in support of waste retrieval and closure decisions. To complete its mission the Accelerated Tank Closure Demonstration Project has adopted performance objectives that include: protecting human health and the environment; minimizing/eliminating potential waste releases to the soil and groundwater; preventing water infiltration into the tank; maintaining accessibility of surrounding tanks for future closure; maintaining tank structural integrity; complying with applicable waste retrieval, disposal, and closure regulations; and maintaining flexibility for final closure options in the future.

SAMS, T.L.

2003-02-01

232

Closure report for N Reactor  

SciTech Connect

This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule.

Not Available

1994-01-01

233

A study of fatigue crack closure using electric potential and compliance techniques  

NASA Technical Reports Server (NTRS)

The objective of this study was to compare closure data obtained on the same specimen with crack tip compliance gage and electric potential techniques. Equivalent results on closure using the two techniques were obtained on 7075-T651 aluminum center cracked panels. The results also indicated that closure was a function of stress ratio, specimen thickness and maximum applied stress intensity. Maximum stress intensity had a particularly strong effect on closure in the range of applied stresses used. This observed dependence of closure on specimen thickness and maximum stress intensity should account for many of the discrepancies in closure behavior found in the literature. Observations on potential system behavior during closure measurements are also reported.

Clarke, C. K.; Cassatt, G. C.

1977-01-01

234

A case of a large rectovaginal mass presenting as posterior vaginal wall prolapse.  

PubMed

A 66-year-old female presented with symptoms suggestive of pelvic organ prolapse, history of fibroid uterus, and rectal pressure. Pelvic examination revealed a large pelvic mass filling the posterior cul-de-sac, occupying the rectovaginal septum, and compressing the rectum. There was a stage II pelvic organ prolapse of the posterior vaginal wall with distal vaginal wall extending to the hymen during valsalva. A CT scan confirmed the large pelvic mass distinct from the uterus measuring 9.4 × 9.8 × 6.2 cm. Colorectal workup revealed adenocarcinoma of colon on screening colonoscopy with biopsies. Patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, colon resection, and abdominal resection of the pelvic mass in the rectovaginal septum and inferior to the uterus. The patient did not require any concomitant pelvic reconstruction and the posterior vaginal wall prolapse resolved after resecting the pelvic mass. PMID:21416285

Cui, Nuan; Zormpa, Maria; Lazarou, George

2011-09-01

235

Development and in vitro evaluation of an acid buffering bioadhesive vaginal gel for mixed vaginal infections.  

PubMed

An acid buffering bioadhesive vaginal (ABBV) gel was developed for the treatment of mixed vaginal infections. Different bioadhesive polymers were evaluated on the basis of their bioadhesive strength, stability and drug release properties. Bioadhesion and release studies showed that guar gum, xanthan gum and hydroxypropyl methylcelullose K4M formed a good combination of bioadhesive polymers to develop the ABBV gel. Monosodium citrate was used as an acid buffering agent to provide acidic pH (4.4). The drugs clotrimazole (antifungal) and metronidazole (antiprotozoal as well as antibacterial) were used in the formulation along with Lactobacillus spores to treat mixed vaginal infections. The ex vivo retention study showed that the bioadhesive polymers hold the gel for 12-13 hours inside the vaginal tube. Results of the in vitro antimicrobial study indicated that the ABBV gel had better antimicrobial action than the commercial intravaginal drug delivery systems and retention was prolonged in an ex vivo retention experiment. PMID:19103575

Ahmad, Farhan Jalees; Alam, Mohd Aftab; Khan, Zeenat Iqbal; Khar, Roop Krishen; Ali, Mushir

2008-12-01

236

Clinical Evaluation of a Wireless Intra-Vaginal Pressure Transducer  

PubMed Central

Objective To describe the development, feasibility and validity of a wireless intra-vaginal pressure transducer (IVT) which can be used to measure intra-abdominal pressure in real-world settings. Study Design A feasibility study was conducted in sixteen physically active women to determine retention and comfort of various IVT prototype designs during activity. A criterion validity study was conducted among women undergoing urodynamic testing to determine the accuracy of the IVT prototypes when compared to accepted clinical standards. Results A final prototype wireless IVT was developed after four design revisions of the second generation model. The feasibility study found that women reported the final prototype comfortable to wear and easily retained during physical activity. Intra-abdominal pressure measurements from the final prototype IVT compared favorably to standard urodynamic transducers, thus confirming evidence of its utility. Conclusion We have successfully advanced the design of a wireless, intra-vaginal pressure transducer which provides accurate measures of intra-abdominal pressure. The final wireless IVT is better tolerated by patients and overcomes limitations of traditional urodynamic testing while laying the foundations for intra-abdominal pressure monitoring outside of the clinic environment.

Hsu, Yvonne; Coleman, Tanner J; Hitchcock, Robert W; Heintz, Kristina; Shaw, Janet M; Nygaard, Ingrid E

2013-01-01

237

Development and evaluation of acid-buffering bioadhesive vaginal tablet for mixed vaginal infections  

Microsoft Academic Search

An acid-buffering bioadhesive vaginal tablet was developed for the treatment of genitourinary tract infections. From the bioadhesion\\u000a experiment and release studies it was found that polycarbophil and sodium carboxymethylcellulose is a good combination for\\u000a an acid-buffering bioadhesive vaginal tablet. Sodium monocitrate was used as a buffering agent to provide acidic pH (4.4),\\u000a which is an attribute of a healthy vagina.

Mohd Aftab Alam; Farhan Jalees Ahmad; Zeenat Iqbal Khan; Roop Krishen Khar; Mushir Ali

2007-01-01

238

Closure of fatigue cracks at high strains  

NASA Technical Reports Server (NTRS)

Experiments were conducted on smooth specimens to study the closure behavior of short cracks at high cyclic strains under completely reversed cycling. Testing procedures and methodology, and closure measurement techniques, are described in detail. The strain levels chosen for the study cover from predominantly elastic to grossly plastic strains. Crack closure measurements are made at different crack lengths. The study reveals that, at high strains, cracks close only as the lowest stress level in the cycle is approached. The crack opening is observed to occur in the compressive part of the loading cycle. The applied stress needed to open a short crack under high strain is found to be less than for cracks under small scale yielding. For increased plastic deformations, the value of sigma sub op/sigma sub max is observed to decrease and approaches the value of R. Comparison of the experimental results with existing analysis is made and indicates the limitations of the small scale yielding approach where gross plastic deformation behavior occurs.

Iyyer, N. S.; Dowling, N. E.

1985-01-01

239

Vaginal Lacerations from Consensual Intercourse in Adolescents  

ERIC Educational Resources Information Center

Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods:…

Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.

2011-01-01

240

The tension-free vaginal tape procedure.  

PubMed

This article discusses the tension-free vaginal tape (TVT) procedure, which attempts to recreate urethral support at the level of the pubourethral ligaments by placing a polypropylene sling at the midurethra as opposed to the bladder neck. The procedure has the proposed advantage of being done under local anesthesia and being an outpatient surgery and can be performed transvaginally or suprapubically. PMID:21353078

Kleeman, Steven D; Karram, Mickey M

2011-02-01

241

Characteristics of vaginal bleeding during pregnancy  

Microsoft Academic Search

Objective: To describe vaginal bleeding and associated pain in pregnancies terminated by childbirth. Design: A descriptive study based on information obtained by questionnaires administered during pregnancy. Setting: Antenatal care clinic at the Obstetrical Department, Aarhus University Hospital, Denmark. Subjects: Women (n = 8714) with singleton pregnancies attending routine antenatal care at the Department during a 2-year period from 1989 to

Susanne Maigaard Axelsen; Tine Brink Henriksen; Morten Hedegaard; Niels Jørgen Secher

1995-01-01

242

Vaginal Douching and Intimate Partner Violence  

Microsoft Academic Search

Findings. Six percent of the sample reported experiencing any type of IPV in the past year, and 23% reported douching in the past year. IPV is significantly associated with douching after controlling for sociodemographic and health-related covariates. This finding holds for women with and without current reproductive capacity. Conclusions. This is the first study to identify an association between vaginal

Carol S. Weisman; Diane M. Grimley; Lucy Annang; Marianne M. Hillemeier; Gary A. Chase; Anne-Marie Dyer

2007-01-01

243

Abnormal Vaginal pH and Mycoplasma genitalium infection  

PubMed Central

Study Objective Mycoplasma genitalium (MG) is a sexually transmitted pathogen linked to female morbidity, but testing for MG is not standardized. We aimed to determine which point-of-care (POC) vaginal tests could predict MG infection. Design, Setting, Participants A cross sectional study recruited sexually active adolescent women, aged 14–22 years (n=217) from an urban medical center. Interventions and Main Outcome Measures Vaginal swabs were POC tested for pH, amines, clue cells, sialidase and Trichomonas vaginalis (TV). MG was detected by research-use-only transcription mediated amplification (TMA) assay. Presence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were confirmed using TMA. Three criteria were required for diagnosis of Clinical BV: pH >4.5, presence of amines, and > 20% clue cells. Associations were assessed using logistic regression (LR). Results TMA detected MG in 30 (14%), CT in 49 (23%), and NG in 21 (10%) of the samples tested. POC vaginal tests were positive for TV in 21%, amines in 52%, clue cells in 33%, sialidase in 22%, pH > 4.5 in 56%, and clinical BV in 19% of the samples tested. Using logistic regression, pH > 4.5 was a predictor of MG (odds ratio 4.4, p<.05). Of 131 women without clinical BV or TV, 25% of those with pH>4.5 had MG, compared to 9% of those with pH?4.5 (p=.02). Conclusions Until standardized, approved testing for MG is available, pH may be a useful indicator to suspect MG, especially in the absence of BV and TV.

Huppert, Jill S.; Bates, Justin R.; Weber, Akilah F.; Quinn, Nicole; Gaydos, Charlotte A.

2012-01-01

244

Vaginal Douching Among Latinas: Practices and Meaning  

PubMed Central

Objectives Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching among Latinas. Methods In depth qualitative interviews conducted with English- and Spanish-speaking women aged 16–40, seeking care for any reason who reported douching within the last year (n = 34). Interviews were audiotaped, transcribed and analyzed using qualitative methods. One-third of interviews were conducted in Spanish. Results Two explanatory models for douching motives emerged: one stressed cosmetic benefits; the other, infection prevention and control. Most women reported douching to eliminate menstrual residue; a small number reported douching in context of sexual intercourse or vaginal symptoms. Many were unaware of associated health risks. Respondents typically learned about douching from female family members and friends. Male partners were described as having little to no involvement in the decision to douche. Women varied in their willingness to stop douching. Two-thirds reported receiving harm reduction messages about “overdouching”. About half indicated previous discussion about douching with health care providers; some had reduced frequency in response to counseling. A number of previously unreported vaginal hygiene practices and products were described, including use of a range of traditional hygiene practices, and products imported from outside the US. Conclusions Respondents expressed a range of commitment to douching. Counseling messages acknowledging benefits women perceive as well as health risks should be developed and delivered tailored to individual beliefs. Further research is needed to assess prevalence and safety of previously unreported practices.

Baquero, Maria; Anderson, Matthew R.; Alvarez, Adelyn; Karasz, Alison

2009-01-01

245

Heart rate change as evidence for vaginally elicited orgasm and orgasm intensity  

Microsoft Academic Search

The purposes of this study were a) to further replicate previous findings on vaginal eroticism, using heart rate change as corroborative evidence for the subjective perception of sexual arousal and orgasm; and b) to investigate the correlation between heart rate change and subjective intensity of female orgasm. Heart rate measurements were obtained from ECG tracings. Eleven coitally experienced volunteers were

Heli Alzate; Bernardo Useche; Magdalena Villegas

1989-01-01

246

Comparison of Daily and Retrospective Reports of Vaginal Sex in Heterosexual Men and Women  

Microsoft Academic Search

This study examined the agreement between daily and retrospective reports of vaginal sex over a two-month period in a sample of 376 heterosexually active men and women. We also examined whether gender, age, or method of daily data collection (self-administered vs. interviewer administered) were related to agreement between daily and retrospective reports. Both counts and categorical measures of frequency of

Mary Rogers Gillmore; Barbara C. Leigh; Marilyn J. Hoppe; Diane M. Morrison

2010-01-01

247

How safe is vaginal birth after cesarean section for the mother and fetus?  

PubMed

Compared with planned repeat low-transverse cesarean section, vaginal birth after cesarean section (VBAC) is not associated with increased risk of maternal or neonatal mortality (strength of recommendation [SOR]: B). Morbidity is slightly increased, as evidenced by higher uterine rupture rates and some neonatal outcome measures (SOR: B). PMID:16451783

Crawford, Paul; Kaufmann, Leonora

2006-02-01

248

Uncomplicated term vaginal delivery following magnetic resonance-guided focused ultrasound surgery for uterine fibroids  

PubMed Central

A 35 year-old para 1+0 underwent MRgFUS per study protocol for multiple uterine fibroids, the largest of which measured 5 cm. She conceived 10 months following the procedure. The patient was induced at 41+6 weeks and underwent a normal vaginal delivery.

Zaher, S; Lyons, D; Regan, L

2010-01-01

249

Evaluation of Swallowing Using 320-detector-row Multislice CT. Part II: Kinematic Analysis of Laryngeal Closure during Normal Swallowing  

Microsoft Academic Search

The purpose of this study was to (1) depict normal dynamic swallowing and (2) measure (a) the temporal characteristics of\\u000a three components of laryngeal closure, i.e., true vocal cord (TVC) closure, closure of the laryngeal vestibule at the arytenoid\\u000a to epiglottic base, and epiglottic inversion, and (b) the temporal relationship between these levels of laryngeal closure\\u000a and other swallowing events,

Yoko Inamoto; Naoko Fujii; Eiichi Saitoh; Mikoto Baba; Sumiko Okada; Kazuhiro Katada; Yasunori Ozeki; Daisuke Kanamori; Jeffrey B. Palmer

250

Turbulence processes and simple closure schemes  

NASA Technical Reports Server (NTRS)

The closure problem in turbulence is reviewed, and some simple closure schemes are introduced. Processes occurring in turbulent flow are discussed on the basis of solutions for some elementary flows such as homogeneous turbulence with and without uniform shear. Closure by specification of initial conditions, and finally practical closure schemes for more complicated flows are considered. The latter include Reynolds stress, eddy viscosity, and mixing-length closures.

Deissler, R. G.

1975-01-01

251

Lactobacillus acidophilus Contributes to a Healthy Environment for Vaginal Epithelial Cells  

PubMed Central

Lactobacillus species in the female genital tract are thought to act as a barrier to infection. Several studies have demonstrated that lactobacilli can adhere to vaginal epithelial cells. However, little is known about how the adherence of lactobacilli to vaginal epithelial cells affects the acidity, cell viability, or proliferation of the lactobacilli themselves or those of vaginal epithelial cells. Lactobacillus acidophilus was co-cultured with immortalized human vaginal epithelial cells (MS74 cell line), and the growth of L. acidophilus and the acidity of the culture medium were measured. MS74 cell density and viability were also assessed by counting cell numbers and observing the cell attachment state. L. acidophilus showed exponential growth for the first 6 hr until 9 hr, and the pH was maintained close to 4.0-5.0 at 24 hr after culture, consistent with previous studies. The growth curve of L. acidophilus or the pH values were relatively unaffected by co-culture with MS74 cells, confirming that L. acidophilus maintains a low pH in the presence of MS74 cells. This co-culture model could therefore potentially be used to mimic vaginal conditions for future in vitro studies. On the other hand, MS74 cells co-cultured with L. acidophilus more firmly attached to the culture plate, and a higher number of cells were present compared to cells cultured in the absence of L. acidophilus. These results indicate that L. acidophilus increases MS74 cell proliferation and viability, suggesting that lactobacilli may contribute to the healthy environment for vaginal epithelial cells.

Pi, Woojin; Ryu, Jae-Sook

2011-01-01

252

Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence  

PubMed Central

Objective To compare tension-free vaginal tape with colposuspension as primary treatment for stress incontinence. Design Multicentred randomised comparative trial. Setting Gynaecology or urology departments in 14 centres in the United Kingdom and Eire, including university teaching hospitals and district general hospitals. Participants 344 women with urodynamic stress incontinence; 175 randomised to tension-free vaginal tape and 169 to colposuspension Main outcome measures Assessment before treatment and at six months postoperatively with the SF-36, the Bristol female lower urinary tract symptoms questionnaire, the EQ-5D health questionnaire, a one week urinary diary, one hour perineal pad test, cystometry, and, in some centres, urethral profilometry. Results 23 women in the colposuspension group and 5 in the vaginal tape group withdrew before surgery. No significant difference was found between the groups for cure rates: 115 (66%) women in the vaginal tape group and 97 (57%) in the colposuspension group were objectively cured (95% confidence interval for difference in cure ?4.7% to 21.3%). Bladder injury was more common during the vaginal tape procedure; postoperative complications, in particular delayed resumption of micturition, were more common after colposuspension. Operation time, duration of hospital stay, and return to normal activity were all longer after colposuspension than after the vaginal tape procedure. Conclusion Surgery with tension-free vaginal tape is associated with more operative complications than colposuspension, but colposuspension is associated with more postoperative complications and longer recovery. Vaginal tape shows promise for the treatment of urodynamic stress incontinence because of minimal access and rapid recovery times; cure rates at six months were comparable with colposuspension. What is already known on this topicFew randomised trials exist on surgery for stress incontinenceSystematic reviews suggest that colposuspension is associated with cure rates of up to 90%Case series of tension-free vaginal tape suggest cure rates of about 85%, with rapid return to normal activityWhat this study addsAt six months the tension-free vaginal tape procedure is as effective as colposuspension for the primary treatment of stress incontinenceOperative complications were more common with vaginal tape, but duration of hospital stay and return to normal activity were shorter than with colposuspensionPostoperative complications were more common after colposuspension

Ward, Karen; Hilton, Paul

2002-01-01

253

In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen peroxide  

PubMed Central

Background Hydrogen peroxide (H2O2) produced by vaginal lactobacilli is generally believed to protect against bacteria associated with bacterial vaginosis (BV), and strains of lactobacilli that can produce H2O2 are being developed as vaginal probiotics. However, evidence that led to this belief was based in part on non-physiological conditions, antioxidant-free aerobic conditions selected to maximize both production and microbicidal activity of H2O2. Here we used conditions more like those in vivo to compare the effects of physiologically plausible concentrations of H2O2 and lactic acid on a broad range of BV-associated bacteria and vaginal lactobacilli. Methods Anaerobic cultures of seventeen species of BV-associated bacteria and four species of vaginal lactobacilli were exposed to H2O2, lactic acid, or acetic acid at pH 7.0 and pH 4.5. After two hours, the remaining viable bacteria were enumerated by growth on agar media plates. The effect of vaginal fluid (VF) on the microbicidal activities of H2O2 and lactic acid was also measured. Results Physiological concentrations of H2O2 (< 100 ?M) failed to inactivate any of the BV-associated bacteria tested, even in the presence of human myeloperoxidase (MPO) that increases the microbicidal activity of H2O2. At 10 mM, H2O2 inactivated all four species of vaginal lactobacilli but only one of seventeen species of BV-associated bacteria. Moreover, the addition of just 1% vaginal fluid (VF) blocked the microbicidal activity of 1 M H2O2. In contrast, lactic acid at physiological concentrations (55-111 mM) and pH (4.5) inactivated all the BV-associated bacteria tested, and had no detectable effect on the vaginal lactobacilli. Also, the addition of 10% VF did not block the microbicidal activity of lactic acid. Conclusions Under optimal, anaerobic growth conditions, physiological concentrations of lactic acid inactivated BV-associated bacteria without affecting vaginal lactobacilli, whereas physiological concentrations of H2O2 produced no detectable inactivation of either BV-associated bacteria or vaginal lactobacilli. Moreover, at very high concentrations, H2O2 was more toxic to vaginal lactobacilli than to BV-associated bacteria. On the basis of these in vitro observations, we conclude that lactic acid, not H2O2, is likely to suppress BV-associated bacteria in vivo.

2011-01-01

254

Effects of market position and competition on rural hospital closures.  

PubMed Central

OBJECTIVE: To examine the dynamic effects of competition and hospital market position on rural hospital closures. DATA SOURCE/STUDY SETTING: Analysis of all rural community hospitals operating between 1984 and 1991, with the exception of sole-provider hospitals. Data for the study are obtained from four sources: the AHA Annual Surveys of Hospitals, the HCFA Cost Reports, the Area Resource File, and a hospital address file constructed by Geographic Inc. DATA COLLECTION AND ANALYSIS: Variables are merged to construct pooled, time-series observations for study hospitals. Hospital closure is specified as a function of hospital market position, market level competition, and control variables. Discrete-time logistic regressions are used to test hypotheses. PRINCIPAL FINDINGS: Rural hospitals operating in markets with higher density had higher risk of closure. Rural hospitals that differentiated from others in the market on the basis of geographic distance, basic services, and high-tech services had lower risks of closure. Effects of market density on closure disappeared when market position was included in the model, indicating that differentiation in markets should be taken into account when evaluating the effects of competition on rural hospital closure. CONCLUSIONS: Our findings suggest that rural hospitals can reduce competitive pressures through differentiation and that accurate measures of competition in geographically defined market areas are critical for understanding competitive dynamics among rural hospitals.

Succi, M J; Lee, S Y; Alexander, J A

1997-01-01

255

Triapine, Cisplatin, and Radiation Therapy in Treating Patients With Cervical Cancer or Vaginal Cancer  

ClinicalTrials.gov

Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer; Therapy-related Toxicity

2014-04-21

256

Development of generic models for ambulatory vaginal surgery — a preliminary report  

Microsoft Academic Search

Generic guidelines are applied to reconstructive vaginal operations, so as to convert them to ambulatory procedures. Prototype operations are described and analyzed. These included conceptualizing vaginal prolapse as a type of intussusception caused by vaginal and ligamentous laxity in the middle or posterior parts of the vagina; the avoidance of vaginal excision, excessive tension, and refashioning excess vaginal tissue from

P. E. Papa Petros

1998-01-01

257

Improvements of Vaginal Atrophy without Systemic Side Effects after Topical Application of Pueraria mirifica, a Phytoestrogen-rich Herb, in Postmenopausal Cynomolgus Macaques  

PubMed Central

The estrogenic efficacy of topical vaginal application of Pueraria mirifica extract (PM) on the restoration of vaginal atrophy, and the presence of any systemic side effects, were investigated in postmenopausal cynomolgus macaques. Twelve postmenopausal cynomolgus macaques, with complete cessation of menstruation for at least 5 years before start of this experiment, were divided into three groups. They received a topical vaginal application daily of 0.1 or 1% (w/w) PM cream or a conjugated equine estrogen (CEE) cream (a mixture of estrone, equilin, 17?-dihydroequilin, 17?-estradiol and 17?-dihydroequilin at 0.625 mg total estrogen/g cream) for 28 days. Estrogenic efficacy was assessed weekly by vaginal cytology assay and vaginal pH measurement, whilst the plasma luteinizing hormone (LH) and sex skin coloration levels were determined at the end of each treatment period to evaluate the systemic side effects. PM significantly increased the proportion of superficial cells in a dose-dependent manner, with a similar efficacy between 1% (w/w) PM and CEE. Together with increased vaginal maturation, PM decreased the vaginal pH to acidic levels, as observed in the CEE group. PM induced no detected systemic side effects, whilst CEE decreased the plasma LH level and increased the reddish color of the sex skin during the posttreatment period. Topical vaginal treatment with PM stimulated the maturation of the vaginal epithelium without causing systemic side effects in postmenopausal monkeys. The implication is that PM could be a safer alternative to treat vaginal atrophy in postmenopausal women.

JAROENPORN, Sukanya; URASOPON, Nontakorn; WATANABE, Gen; MALAIVIJITNOND, Suchinda

2014-01-01

258

Improvements of Vaginal Atrophy without Systemic Side Effects after Topical Application of Pueraria mirifica, a Phytoestrogen-rich Herb, in Postmenopausal Cynomolgus Macaques.  

PubMed

The estrogenic efficacy of topical vaginal application of Pueraria mirifica extract (PM) on the restoration of vaginal atrophy, and the presence of any systemic side effects, were investigated in postmenopausal cynomolgus macaques. Twelve postmenopausal cynomolgus macaques, with complete cessation of menstruation for at least 5 years before start of this experiment, were divided into three groups. They received a topical vaginal application daily of 0.1 or 1% (w/w) PM cream or a conjugated equine estrogen (CEE) cream (a mixture of estrone, equilin, 17?-dihydroequilin, 17?-estradiol and 17?-dihydroequilin at 0.625 mg total estrogen/g cream) for 28 days. Estrogenic efficacy was assessed weekly by vaginal cytology assay and vaginal pH measurement, whilst the plasma luteinizing hormone (LH) and sex skin coloration levels were determined at the end of each treatment period to evaluate the systemic side effects. PM significantly increased the proportion of superficial cells in a dose-dependent manner, with a similar efficacy between 1% (w/w) PM and CEE. Together with increased vaginal maturation, PM decreased the vaginal pH to acidic levels, as observed in the CEE group. PM induced no detected systemic side effects, whilst CEE decreased the plasma LH level and increased the reddish color of the sex skin during the posttreatment period. Topical vaginal treatment with PM stimulated the maturation of the vaginal epithelium without causing systemic side effects in postmenopausal monkeys. The implication is that PM could be a safer alternative to treat vaginal atrophy in postmenopausal women. PMID:24748397

Jaroenporn, Sukanya; Urasopon, Nontakorn; Watanabe, Gen; Malaivijitnond, Suchinda

2014-07-01

259

The role of crack closure in fatigue crack propagation behavior of a TiAl-based alloy  

SciTech Connect

The fatigue crack growth rates measured in the case of the TiAl-based alloy investigated in the present study are highly sensitive to the {Delta}K value. The fatigue crack propagation is deeply affected by the crack closure phenomenon. As a consequence the crack growth rates are severely lessened as soon as closure develops. The role of crack closure is confirmed by the influence of the R load ratio: indeed the crack growth rate measured under closure-free conditions at high R ratios is equal to that obtained at low R values after crack closure correction for a given {Delta}K{sub eff} value.

Henaff, G.; Cohen, S.A.; Mabru, C.; Petit, J. [ENSMA, Futuroscope (France). Lab. de Mecanique et de Physique des Materiaux] [ENSMA, Futuroscope (France). Lab. de Mecanique et de Physique des Materiaux

1996-05-01

260

Linearly exact parallel closures for slab geometry  

SciTech Connect

Parallel closures are obtained by solving a linearized kinetic equation with a model collision operator using the Fourier transform method. The closures expressed in wave number space are exact for time-dependent linear problems to within the limits of the model collision operator. In the adiabatic, collisionless limit, an inverse Fourier transform is performed to obtain integral (nonlocal) parallel closures in real space; parallel heat flow and viscosity closures for density, temperature, and flow velocity equations replace Braginskii's parallel closure relations, and parallel flow velocity and heat flow closures for density and temperature equations replace Spitzer's parallel transport relations. It is verified that the closures reproduce the exact linear response function of Hammett and Perkins [Phys. Rev. Lett. 64, 3019 (1990)] for Landau damping given a temperature gradient. In contrast to their approximate closures where the vanishing viscosity coefficient numerically gives an exact response, our closures relate the heat flow and nonvanishing viscosity to temperature and flow velocity (gradients)

Ji, Jeong-Young; Held, Eric D. [Department of Physics, Utah State University, Logan, Utah 84322 (United States)] [Department of Physics, Utah State University, Logan, Utah 84322 (United States); Jhang, Hogun [National Fusion Research Institute, 52 Yeoeun-dong, Yusung-Gu, Daejon (Korea, Republic of)] [National Fusion Research Institute, 52 Yeoeun-dong, Yusung-Gu, Daejon (Korea, Republic of)

2013-08-15

261

Ultra-low-dose vaginal estrogen tablets for the treatment of postmenopausal vaginal atrophy.  

PubMed

Vaginal atrophy is a common chronic condition affecting up to 57% of postmenopausal women. The decrease in estrogen following cessation of menses can lead to bothersome symptoms that include vaginal dryness and irritation, pain and burning during urination (dysuria), urinary tract infections, and pain (dyspareunia) and bleeding during sexual activities. These symptoms can be safely and effectively managed with the use of local estrogen therapy, which reduces the risks associated with long-term systemic hormone therapy. The ultra-low-dose 10 ?g estradiol vaginal tablet is the lowest approved dose available and has an annual estradiol exposure of only 1.14 mg. Its development addresses recommendations from regulatory agencies and women's health societies regarding the use of the lowest hormonal dose. The 10 ?g vaginal tablet displays minimal estradiol absorption, causes no increased risk of endometrial hyperplasia or carcinoma, and provides significant symptom relief. The clinical evidence presented here may offer greater reassurance to health-care professionals and postmenopausal women that vaginal atrophy can be treated safely and effectively. PMID:23848490

Simon, J A; Maamari, R V

2013-08-01

262

Can group B streptococci cause symptomatic vaginitis?  

PubMed Central

BACKGROUND: Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality. About 15% of women are carriers of GBS. Usually, they are asymptomatic. CASES: We describe two patients with symptomatic vaginitis for which no apparent cause was found. Both patients were heavily colonized with GBS. After antibiotic treatment, both became asymptomatic and culture negative, but after recolonization with GBS, symptoms resumed. This phenomenon was repeatedly observed. After emergence of resistance to antibiotics, local application of chlorhexidine appeared to be the only useful treatment. CONCLUSION: We hypothesize that GBS-vaginitis may be a possible disease entity. Although at present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients.

Honig, E; Mouton, J W; van der Meijden, W I

1999-01-01

263

Murine models of vaginal trichomonad infections.  

PubMed

Trichomonas vaginalis and Tritrichomonas foetus cause common sexually transmitted infections in humans and cattle, respectively. Mouse models of trichomoniasis are important for pathogenic and therapeutic studies. Here, we compared murine genital infections with T. vaginalis and T. foetus. Persistent vaginal infection with T. foetus was established with 100 parasites but T. vaginalis infection required doses of 10(6), perhaps because of greater susceptibility to killing by mouse vaginal polymorphonuclear leukocytes. Infection with T. vaginalis persisted longest after combined treatment of mice with estrogen and dexamethasone, whereas infection was only short-lived when mice were given estrogen or dexamethasone alone, co-infected with Lactobacillus acidophilus, and/or pretreated with antibiotics. Infection rates were similar with metronidazole-resistant (MR) and metronidazole-sensitive (MS) T. vaginalis. High dose but not low dose metronidazole treatment controlled infection with MS better than MR T. vaginalis. These murine models will be valuable for investigating the pathogenesis and treatment of trichomoniasis. PMID:21976570

Cobo, Eduardo R; Eckmann, Lars; Corbeil, Lynette B

2011-10-01

264

Vaginal Bleeding and Gestational Trophoblastic Disease  

Microsoft Academic Search

\\u000a Molar pregnancy and gestational trophoblastic neoplasia (GTN) comprise a group of interrelated diseases, including complete\\u000a and partial molar pregnancy, placental-site trophoblastic tumor (PSTT), and choriocarcinoma, that have varying propensities\\u000a for local invasion and distal spread. Vaginal bleeding is a common presenting sign, seen in as many as 97% of women with a\\u000a complete molar pregnancy; it is also a frequent

Lisa M. Barroilhet; Donald Peter Goldstein; Ross S. Berkowitz

265

Vaginitis: Making Sense of Over-the-Counter Treatment Options  

PubMed Central

Background. The FDA approved over-the-counter (OTC) use of vaginal antifungals in 1990. Subsequently, a plethora of OTC products have become available to women on drugstore shelves. Objectives. The purpose of this study was to determine the availability of OTC products marketed for the treatment of vaginitis and to determine if their efficacy had been confirmed by published prospective randomized control trials (RCTs). Materials and methods. The authors chose four retail locations frequented by women seeking vaginitis treatment. All products deemed a viable treatment option were purchased. Results. All intravaginal imidazoles purchased, regardless of treatment duration or active ingredient, were found to be of proven efficacy. We were unable to find an RCT confirming the effectiveness of vaginal anti-itch creams and homeopathic treatments for vaginitis. Conclusion. 45% of products available to women in the feminine hygiene section of the stores surveyed could not be confirmed to be effective for treating infectious vaginitis.

B. Angotti, Lauren; C. Lambert, Lara; E. Soper, David

2007-01-01

266

Antibiotic Susceptibility of Potentially Probiotic Vaginal Lactobacilli  

PubMed Central

Objective. To study the antimicrobial susceptibility of six vaginal probiotic lactobacilli. Methods. The disc diffusion method in Müeller Hinton, LAPTg and MRS agars by the NCCLS (National Committee for Clinical Laboratory Standards) procedure was performed. Due to the absence of a Lactobacillus reference strains, the results were compared to those of Staphylococcus aureus ATCC29213. Minimal Inhibitory Concentration (MIC) with 21 different antibiotics in LAPTg agar and broth was also determined. Results. LAPTg and MRS agars are suitable media to study antimicrobial susceptibility of lactobacilli. However, the NCCLS procedure needs to be standardized for this genus. The MICs have shown that all Lactobacillus strains grew at concentrations above 10 ?g/mL of chloramphenicol, aztreonam, norfloxacin, ciprofloxacin, ceftazidime, ceftriaxone, streptomycin and kanamycin. Four lactobacilli were sensitive to 1 ?g/mL vancomycin and all of them were resistant to 1000 ?g/mL of metronidazole. Sensitivity to other antibiotics depended on each particular strain. Conclusions. The NCCLS method needs to be standardized in an appropriate medium to determine the antimicrobial susceptibility of Lactobacillus. Vaginal probiotic lactobacilli do not display uniform susceptibility to antibiotics. Resistance to high concentrations of metronidazole suggests that lactobacilli could be simultaneously used with a bacterial vaginosis treatment to restore the vaginal normal flora.

Ocana, Virginia; Silva, Clara; Nader-Macias, Maria Elena

2006-01-01

267

Herbal vaginal pessary induced acute renal failure  

PubMed Central

In Africa, the use of traditional herbal remedy is widespread. Acute renal failure (ARF) is one of the most serious complications. The use of herbal remedies (mostly orally) accounts for nearly 35% of all cases of acute renal failure in Africa. Development of renal failure following herbal vaginal pessary is rarely reported. In November 2003, a 35-year-old Nigerian female who is a petty trader and a primary school leaver with three children (all males) presented to us in the renal unit with oliguric ARF induced by herbal vaginal pessary. She had sought this alternative medicine in an attempt to have a female child as all her three children are males. Her condition was managed accordingly and required three sessions of hemodialysis. She started diuresing on the eighth day of admission. This case presentation highlights the potential tragedies of herbal preparation, of note, that herbal vaginal pessaries are as deleterious as the oral preparations, and that the dilemma of ignorance is still prevalent in our society.

Onyemekeihia, U. R.; Esume, C. O.; Oladele, C. O.; Oviasu, E.

2009-01-01

268

Vernix Caseosa Peritonitis After Vaginal Delivery  

PubMed Central

Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.

Sadath, Shameema A.; Abo Diba, Fathiya I.; Nayak, Surendra; Shamali, Iman Al; Diejomaoh, Michael F.

2013-01-01

269

Anti-STD vaginal contraceptive sponges.  

PubMed

Vaginal sponges offer women control over protection against both pregnancy and sexually transmitted diseases (STDs), including HIV. Spermicide-impregnated sponges combine the actions of a physical barrier that blocks the cervix with a material that absorbs the ejaculate and a spermicide. Commercially available spermicides contain 1-5% of nonoxynol-9, shown to inhibit organisms responsible for gonorrhea, chlamydia, candidiasis, genital herpes, syphilis, trichomoniasis, and HIV. On the other hand, nonoxynol-9 is associated with a significantly higher risk of vaginal colonization with bacterial agents, ulcerative genital diseases, and vulvitis. A lower dose of nonoxynol-9 appears to avert vaginal irritation without compromising contraceptive efficacy. Use of chlorhexidene, a spermicide less irritating to mucosal cells than nonoxynol-9 but active against HIV in vivo and in vitro, is under investigation. Also promising are initial findings regarding the Protectaid contraceptive sponge with F-5 gel. Epidemiologic studies and clinical trials should provide quantitative estimates of the level of protection offered by barrier methods and identify the method that combines the highest protection, ease of use, and user acceptability. PMID:9238301

Hassan, E; Creatsas, G; Gravanis, A; Georgoulias, V; Psychoyos, A

1997-06-17

270

Herbal vaginal pessary induced acute renal failure.  

PubMed

In Africa, the use of traditional herbal remedy is widespread. Acute renal failure (ARF) is one of the most serious complications. The use of herbal remedies (mostly orally) accounts for nearly 35% of all cases of acute renal failure in Africa. Development of renal failure following herbal vaginal pessary is rarely reported. In November 2003, a 35-year-old Nigerian female who is a petty trader and a primary school leaver with three children (all males) presented to us in the renal unit with oliguric ARF induced by herbal vaginal pessary. She had sought this alternative medicine in an attempt to have a female child as all her three children are males. Her condition was managed accordingly and required three sessions of hemodialysis. She started diuresing on the eighth day of admission. This case presentation highlights the potential tragedies of herbal preparation, of note, that herbal vaginal pessaries are as deleterious as the oral preparations, and that the dilemma of ignorance is still prevalent in our society. PMID:20535252

Onyemekeihia, U R; Esume, C O; Oladele, C O; Oviasu, E

2009-10-01

271

Vaginal agenesis: Experience with sigmoid colon neovaginoplasty  

PubMed Central

Aim: Objective of this study is to report our experience with sigmoid vaginoplasty in adolescents. Materials and Methods: A retrospective study of children with vaginal atresia and Mayer–Rokitansky–Kuster–Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the cases. Results: Eight children were studied over a period of 7 years. The postoperative complications were ileus in 2, mucosal prolapse of the neovagina in 1, and minor wound infection in 1 patient. Seven patients are on regular follow-up. All the neovaginas were patent and functional. One patient had unacceptable perineal appearance, that is, badly scarred perineum as a late complication. None of the patients had vaginal stenosis or excessive mucus discharge, during follow-up visits. Out of the 7 patients, 2 patients are sexually active and satisfied. Conclusions: Sigmoid vaginoplasty is a safe and acceptable procedure for vaginal agenesis with good cosmetic results and acceptable complications rate. Sigmoid colon vaginoplasty is the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, and short recovery time.

Rawat, Jiledar; Ahmed, Intezar; Pandey, Anand; Khan, Tanvir R.; Singh, Sarita; Wakhlu, Ashish; Kureel, Shiv N.

2010-01-01

272

Alarm sensor apparatus for closures  

DOEpatents

An alarm sensor apparatus for closures such as doors and windows, and particularly for closures having loose tolerances such as overhead doors, garage doors or the like, the sensor apparatus comprising a pair of cooperating bracket members, one being attached to the door facing or framework and the other to the door member, two magnetic sensor elements carried by said bracket members, the bracket members comprising a pair of cooperating orthogonal guide slots and plates and a stop member engageable with one of the sensors for aligning the sensors with respect to each other in all three orthogonal planes when the door is closed.

Carlson, J.A.; Stoddard, L.M.

1984-01-31

273

Alarm sensor apparatus for closures  

DOEpatents

An alarm sensor apparatus for closures such as doors and windows, and particularly for closures having loose tolerances such as overhead doors, garage doors or the like, the sensor apparatus comprising a pair of cooperating bracket members, one being attached to the door facing or frame work and the other to the door member, two magnetic sensor elements carried by said bracket members, the bracket members comprising a pair of cooperating orthogonal guide slots and plates and a stop member engageable with one of the sensors for aligning the sensors with respect to each other in all three orthogonal planes when the door is closed.

Carlson, James A. (Thornton, CO); Stoddard, Lawrence M. (Arvada, CO)

1986-01-01

274

Differential tissue-specific protein markers of vaginal carcinoma  

Microsoft Academic Search

The objective was to identify proteins differentially expressed in vaginal cancer to elucidate relevant cancer-related proteins. A total of 16 fresh-frozen tissue biopsies, consisting of 5 biopsies from normal vaginal epithelium, 6 from primary vaginal carcinomas and 5 from primary cervical carcinomas, were analysed using two-dimensional gel electrophoresis (2-DE) and MALDI-TOF mass spectrometry. Of the 43 proteins identified with significant

K Hellman; A A Alaiya; S Becker; M Lomnytska; K Schedvins; W Steinberg; A-C Hellström; S Andersson; U Hellman; G Auer

2009-01-01

275

Vaginal adhesions in a woman with the history of dystocia.  

PubMed

Postpartum genital tract adhesions are unusual, and their cause has not been evaluated. However, severe dystocia and numerous pelvic examinations have been suggested as possible causes. Here, we report a case of vaginal adhesions following a difficult labor that presented as dyspareunia for 5 months. Pelvic examination and ultrasonography revealed a transverse vaginal septum that obstructed the vaginal cavity, and fluid collection proximal to this septum. The patient was successfully treated with surgical resection and administration of antibiotics. PMID:24596821

Kim, Hyun Mi; Bae, Jin Young; Cho, Yoo Jin; Kim, Mi Ju; Cha, Hyun-Hwa; Cha, Hyun Wha; Seong, Won Joon

2014-01-01

276

Management of recto-vaginal fistulas after prosthetic reinforcement treatment for pelvic organ prolapse  

PubMed Central

AIM: To communicate our findings on successful treatment of recto-vaginal fistulas (RVFs) after prosthetic reinforcement surgery of pelvic organ prolapse (POP). METHODS: A retrospective single center study between 1998 and 2008 was performed. A total of 80 patients with RVF were identified, of which five patients (6%), with a mean age of 65 years (range: 52-73), had undergone previous surgery for POP with prosthetic reinforcement. RESULTS: All patients complained about ongoing vaginal infections and febrile episodes. These symptoms were reported after a mean period of 18 mo after POP repair. As a first intervention, three patients underwent ablation of the prosthetic material (PM). As a second intervention, open proctectomy with a primary anastomosis, an omental patch, and a protective ileostomy were performed in two patients. One patient required a terminal colostomy due to complete destruction of the anal sphincters. In two other patients, ablation of the PM and proctectomy was performed as a one-step procedure. The postoperative course in all patients was uneventful, with a mean length of hospitalization of 20 d (range: 15-30). Closure of the ileostomy was achieved in all four patients within four months. After a mean period of 35 mo (range: 4-60) of follow-up, no recurrence was observed with normal continence in four patients. CONCLUSION: In our experience, the definitive treatment of high RVFs after PM repair for POP necessitates ablation of the PM, proctectomy with a primary colo-rectal anastomosis, an omental patch interposition, and a temporary ileostomy.

Ouaissi, Mehdi; Cresti, Silvia; Giger, Urs; Sielezneff, Igor; Pirro, Nicolas; Berthet, Bruno; Grandval, Philippe; Consentino, Bernard; Sastre, Bernard

2010-01-01

277

Main routes of oxygen ingress through different closures into wine bottles.  

PubMed

The main routes of oxygen ingress into wine bottles through "technical" cork stoppers (Neutrocork), natural cork stoppers, and synthetic closures (Nomacorc) were investigated. A comparison was made among closures left uncovered (controls), closures with the closure-glass interface covered, and closures completely covered with a polyurethane impermeable varnish. The oxygen ingress into the bottles was measured by a nondestructive colorimetric method. Technical cork stoppers were essentially impermeable to atmospheric oxygen during the first 24 months of storage. Oxygen within natural corks diffused slowly but continuously into the bottles over the first 12 months of storage and in very tiny amounts through the cork-glass interface the 12 months thereafter. Nomacorc synthetic closures were permeable to atmospheric oxygen, mainly after the first month of storage. PMID:17542613

Lopes, Paulo; Saucier, Cédric; Teissedre, Pierre-Louis; Glories, Yves

2007-06-27

278

Impact of storage position on oxygen ingress through different closures into wine bottles.  

PubMed

Wine bottle aging is extremely dependent on the oxygen barrier properties of closures. Kinetics of oxygen ingress through different closures into bottles was measured by a nondestructive colorimetric method from 0.25 to 2.5 mL of oxygen. After 12, 24, and 36 months of storage, only the control (glass bottle ampule) was airtight. Other closures displayed different oxygen ingress rates, which were clearly influenced by the closure type and were independent of bottle storage position (upright, laid down) for most of the closures tested, at least during the first 24 months of the experiment under controlled conditions. The oxygen ingress rates into bottles were lowest in screw caps and "technical" corks, intermediate in conventional natural cork stoppers, and highest in the synthetic closures. PMID:16939334

Lopes, Paulo; Saucier, Cédric; Teissedre, Pierre-Louis; Glories, Yves

2006-09-01

279

21 CFR 884.5940 - Powered vaginal muscle stimulator for therapeutic use.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Powered vaginal muscle stimulator for therapeutic use. 884...Devices § 884.5940 Powered vaginal muscle stimulator for therapeutic use. (a) Identification. A powered vaginal muscle stimulator is an electrically...

2009-04-01

280

78 FR 19271 - Draft Guidance for Industry on Bioequivalence Recommendations for Metronidazole Vaginal Gel...  

Federal Register 2010, 2011, 2012, 2013

...Bioequivalence Recommendations for Metronidazole Vaginal Gel; Availability AGENCY...Bioequivalence Recommendations for Metronidazole Vaginal Gel.'' The guidance provides...new drug applications (ANDAs) for metronidazole vaginal gel. DATES: Although...

2013-03-29

281

Vaginal tumors in pregnancy. Case report and review of the literature.  

PubMed

A young patient with a vaginal tumor in early pregnancy is presented. The difficulty in diagnosis and subsequent management is discussed. Vaginal tumors with special reference to vaginal leiomyoma are reviewed and a differential diagnosis is presented. PMID:3425255

Sadan, O; Kruger, S; van Iddekinge, B

1987-01-01

282

76 FR 17444 - In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation  

Federal Register 2010, 2011, 2012, 2013

...Certain Vaginal Ring Birth Control Devices; Notice...certain vaginal ring birth control devices by reason...issue an exclusion order and cease and desist orders. ADDRESSES: The complaint...certain vaginal ring birth control devices...

2011-03-29

283

Successful management of a thick transverse vaginal septum with a vesicovaginal fistula by vaginal expansion and surgery.  

PubMed

We present a case of a thick transverse vaginal septum with a vesicovaginal fistula treated with vaginal expansion using dilators, followed by surgery. A 27-year-old woman was admitted to our hospital with vaginal atresia and cyclical hematuria. Urethroscopy and cystography showed a vesicovaginal fistula between the proximal vagina and bladder. The vaginal septum was 4 cm thick. Over a 6-month period, the distal vagina was expanded with the use of dilators and the septum was sufficiently thinned. Reconstruction using a transvaginal and transabdominal approach created a direct anastomosis between the proximal and distal vagina. No vaginal strictures or contractures in the anastomotic region have been observed during the 12 months following surgery. The combination of expansion and subsequent reconstructive surgery for the treatment of a thick transverse vaginal septum with a vesicovaginal fistula was less invasive than alternative surgical approaches and provided the desired outcome. PMID:22109703

Kashimura, Tsutomu; Takahashi, Satoru; Nakazawa, Hiroaki

2012-06-01

284

ACOG Committee Opinion No. 378: Vaginal "rejuvenation" and cosmetic vaginal procedures.  

PubMed

So-called "vaginal rejuvenation", "designer vaginoplasty", "revirgination", and "G-spot amplification" are vaginal surgical procedures being offered by some practitioners. These procedures are not medically indicated, and the safety and effectiveness of these procedures have not been documented. Clinicians who receive requests from patients for such procedures should discuss with the patient the reason for her request and perform an evaluation for any physical signs or symptoms that may indicate the need for surgical intervention. Women should be informed about the lack of data supporting the efficacy of these procedures and their potential complications, including infection, altered sensation, dyspareunia, adhesions, and scarring. PMID:17766626

2007-09-01

285

Mycoplasma genitalium infection among HIV-positive women: prevalence, risk factors and association with vaginal shedding.  

PubMed

This study examined the prevalence and factors associated with Mycoplasma genitalium (MG) infection among HIV-positive women and the association between MG and vaginal HIV-1 RNA shedding. HIV-positive women attending an outpatient clinic in New Orleans, Louisiana, USA, from 2002 to 2005 were examined for a battery of sexually transmitted infections (STIs) and underwent a behavioural survey. A selected subset had a measurement of vaginal shedding analysed. Of the 324 HIV-positive women, 32 (9.9%) were infected with MG. HIV-positive women with MG were more likely to be co-infected with Neisseria gonorrhoeae and Chlamydia trachomatis and to have had ?1 male sexual partners in the last month. In the subset (n = 164), no differences were found in the presence of detectable vaginal HIV-1 RNA between women infected and not infected with MG (30.8% versus 34.8% shedding; P = 0.69). While MG was a common co-STI in this sample of HIV-positive women, it was not associated with vaginal HIV shedding. PMID:21464453

Gatski, M; Martin, D H; Theall, K; Amedee, A; Clark, R A; Dumestre, J; Chhabra, P; Schmidt, N; Kissinger, P

2011-03-01

286

Mycoplasma genitalium infection among HIV-positive women: prevalence, risk factors and association with vaginal shedding  

PubMed Central

Summary: This study examined the prevalence and factors associated with Mycoplasma genitalium (MG) infection among HIV-positive women and the association between MG and vaginal HIV-1 RNA shedding. HIV-positive women attending an outpatient clinic in New Orleans, Louisiana, USA, from 2002 to 2005 were examined for a battery of sexually transmitted infections (STIs) and underwent a behavioural survey. A selected subset had a measurement of vaginal shedding analysed. Of the 324 HIV-positive women, 32 (9.9%) were infected with MG. HIV-positive women with MG were more likely to be co-infected with Neisseria gonorrhoeae and Chlamydia trachomatis and to have had ?1 male sexual partners in the last month. In the subset (n = 164), no differences were found in the presence of detectable vaginal HIV-1 RNA between women infected and not infected with MG (30.8% versus 34.8% shedding; P = 0.69). While MG was a common co-STI in this sample of HIV-positive women, it was not associated with vaginal HIV shedding.

Gatski, M; Martin, D H; Theall, K; Amedee, A; Clark, R A; Dumestre, J; Chhabra, P; Schmidt, N; Kissinger, P

2013-01-01

287

Effect of semen and seminal amyloid on vaginal transmission of simian immunodeficiency virus  

PubMed Central

Background Semen and semen-derived amyloid fibrils boost HIV infection in vitro but their impact on sexual virus transmission in vivo is unknown. Here, we examined the effect of seminal plasma (SP) and semen-derived enhancer of virus infection (SEVI) on vaginal virus transmission in the SIV/rhesus macaque (Macacca mulatta) model. Results A total of 18 non-synchronized female rhesus macaques (six per group) were exposed intra-vaginally to increasing doses of the pathogenic SIVmac239 molecular clone in the presence or absence of SEVI and SP. Establishment of productive virus infection was assessed by measuring plasma viral RNA loads at weekly intervals. We found that the first infections occurred at lower viral doses in the presence of SP and SEVI compared to the control group. Furthermore, the average peak viral loads during acute infection were about 6-fold higher after exposure to SP- and SEVI-treated virus. Overall infection rates after a total of 27 intra-vaginal exposures to increasing doses of SIV, however, were similar in the absence (4 of 6 animals) and presence of SP (5 of 6), or SEVI (4 of 6). Furthermore, the infectious viral doses required for infection varied considerably and did not differ significantly between these three groups. Conclusions Semen and SEVI did not have drastic effects on vaginal SIV transmission in the present experimental setting but may facilitate spreading of virus infection after exposure to low viral doses that most closely approximate the in vivo situation.

2013-01-01

288

Synthesis of Stable Force-Closure Grasps.  

National Technical Information Service (NTIS)

The thesis addresses the problem of synthesizing grasps that are force-closure and stable. The synthesis of force closure grasps constructs independent regions of contact for the fingertips, such that the motion of the grasped object is totally constraine...

V. D. Nguyen

1986-01-01

289

Emergent properties during dorsal closure in Drosophila morphogenesis  

NASA Astrophysics Data System (ADS)

Dorsal closure is an essential stage of Drosophila development that is a model system for research in morphogenesis and biological physics. Dorsal closure involves an orchestrated interplay between gene expression and cell activities that produce shape changes, exert forces and mediate tissue dynamics. We investigate the dynamics of dorsal closure based on confocal microscopic measurements of cell shortening in living embryos. During the mid-stages of dorsal closure we find that there are fluctuations in the width of the leading edge cells but the time-averaged analysis of measurements indicate that there is essentially no net shortening of cells in the bulk of the leading edge, that contraction predominantly occurs at the canthi as part of the process for zipping together the two leading edges of epidermis and that the rate constant for zipping correlates with the rate of movement of the leading edges. We characterize emergent properties that regulate dorsal closure, i.e., a velocity governor and the coordination and synchronization of tissue dynamics.

Peralta, X. G.; Toyama, Y.; Kiehart, D. P.; Edwards, G. S.

2008-03-01

290

Thermostat Closure for Point Vortices.  

National Technical Information Service (NTIS)

Using the point vortex flow on a disc as a prototype, we present a closure for incompressible ideal fluid flow in the form of a generalized thermostating device. The thermostat can model either an innite or nite reservoir. The thermostat variables are sto...

B. L. Leimkuhler J. E. Frank S. Dubinkina

2009-01-01

291

Endoscopic Closure of Gastrointestinal Leaks  

Microsoft Academic Search

Surgery has been the mainstay of therapy in patients with gastrointestinal perforations. This paradigm started to shift with the development of techniques for endoscopic closure of gastrointestinal perforations. A detailed review of the literature on this subject, along with a commentary on practical aspects in the management of patients with gastrointestinal leaks, is provided here.

Gottumukkala Subba Raju

2009-01-01

292

CIRSE Vascular Closure Device Registry  

SciTech Connect

Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0-14.5] for antegrade access and 1.8% (95% CI 1.1-2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only <0.5% of patients. Postdeployment bleeding occurred in 6.4%, and most these (51.5%) could be managed with light manual compression. During follow-up, other device-related complications were reported in 1.3%: seven false aneurysms, three hematoma >5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.

Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl [Academic Medical Center, Department of Radiology (Netherlands); Mueller-Huelsbeck, Stefan [Academic Hospitals, Department of Radiology (Germany); Libicher, Martin [University Clinics, Department of Radiology (Germany); Atar, Eli [Hasharon Hospital, Department of Radiology (Israel); Trentmann, Jens [University Clinics Schleswig-Holstein, Department of Radiology (Germany); Goffette, Pierre [University Clinics St. Luc, Department of Radiology (Belgium); Borggrefe, Jan [University Clinics Schleswig-Holstein, Department of Radiology (Germany); Zelenak, Kamil [University Hospital, Department of Radiology (Slovakia); Hooijboer, Pieter [Scheper Ziekenhuis, Department of Radiology (Netherlands); Belli, Anna-Maria [St. Georges Hospital, Department of Radiology (United Kingdom)

2011-02-15

293

Reynolds stress closures: Status and prospects  

NASA Technical Reports Server (NTRS)

The basic pattern of Reynolds closures and the reason they look as an attractive type of model for practical shear flow calculations is summarized. The relationship between the organized structures and Reynolds stress closures is discussed. An outline given of fundamental developments that are being introduced to extend the modest reliability of Reynolds stress closures.

Launder, B. E.

1980-01-01

294

Telemetric assessment of referred vaginal hyperalgesia and the effect of indomethacin in a rat model of endometriosis.  

PubMed

Symptoms of endometriosis (ENDO), among others, include pelvic/abdominal and muscle pain. Non-steroidal anti-inflammatory agents are first-line treatment for this pain. Similar to women, rats with surgically induced ENDO, but not its surgical control, exhibit vaginal hyperalgesia, which in rats is evidenced by a decreased threshold for the visceromotor response (VMR) induced by vaginal distention. Here we assess the VMR in rats with implanted probes that telemetrically transmit EMG activity from the abdominal muscle. The feasibility and sensitivity of this technique for monitoring the VMR threshold across the estrous cycle and the influence of Indomethacin on ENDO-induced vaginal hyperalgesia were evaluated. VMR thresholds in response to vaginal distention with an infusion pump were measured in different estrous stages. Indomethacin (5 or 10?mg/kg i.p. or s.c.) was injected in proestrus rats and 40-60?min later the VMR threshold was measured. The VMR threshold varied across the estrous cycle only in ENDO rats, being lowest in proestrus. Indomethacin increased this threshold in proestrus ENDO rats. These results show that telemetric assessment of the VMR is a sensitive tool, suitable for long-term studies in conscious rats. The results with this technique also suggest that ENDO-associated vaginal hyperalgesia involves COX activity, the feature that also underlies inflammatory pains. PMID:22969722

Dmitrieva, N; Faircloth, E K; Pyatok, S; Sacher, F; Patchev, V

2012-01-01

295

Telemetric Assessment of Referred Vaginal Hyperalgesia and the Effect of Indomethacin in a Rat Model of Endometriosis  

PubMed Central

Symptoms of endometriosis (ENDO), among others, include pelvic/abdominal and muscle pain. Non-steroidal anti-inflammatory agents are first-line treatment for this pain. Similar to women, rats with surgically induced ENDO, but not its surgical control, exhibit vaginal hyperalgesia, which in rats is evidenced by a decreased threshold for the visceromotor response (VMR) induced by vaginal distention. Here we assess the VMR in rats with implanted probes that telemetrically transmit EMG activity from the abdominal muscle. The feasibility and sensitivity of this technique for monitoring the VMR threshold across the estrous cycle and the influence of Indomethacin on ENDO-induced vaginal hyperalgesia were evaluated. VMR thresholds in response to vaginal distention with an infusion pump were measured in different estrous stages. Indomethacin (5 or 10?mg/kg i.p. or s.c.) was injected in proestrus rats and 40–60?min later the VMR threshold was measured. The VMR threshold varied across the estrous cycle only in ENDO rats, being lowest in proestrus. Indomethacin increased this threshold in proestrus ENDO rats. These results show that telemetric assessment of the VMR is a sensitive tool, suitable for long-term studies in conscious rats. The results with this technique also suggest that ENDO-associated vaginal hyperalgesia involves COX activity, the feature that also underlies inflammatory pains.

Dmitrieva, N.; Faircloth, E. K.; Pyatok, S.; Sacher, F.; Patchev, V.

2012-01-01

296

Need for Closure, Achievement Goals, and Cognitive Engagement in High School Students  

ERIC Educational Resources Information Center

The authors extend their understanding of learner motivation by addressing questions around the construct of classroom need for closure in a high school sample. First, they established that their classroom need for closure measure demonstrated adequate psychometric properties when used with high school students. Subsequently, they explored…

Harlow, Lea; DeBacker, Teresa; Crowson, H. Michael

2011-01-01

297

A new wireless biosensor for intra-vaginal temperature monitoring.  

PubMed

Wireless Body Sensors for medical purposes offer valuable contributions to improve patients' healthcare, including diagnosis and/or therapeutics monitoring. Body temperature is a crucial parameter in healthcare diagnosis. In gynecology and obstetrics it is measured at the skin's surface, which is very influenced by the environment. This paper proposes a new intra-body sensor for long-term intra-vaginal temperature collection. The embedded IEEE 802.15.4 communication module allows the integration of this sensor in a Wireless Sensor Network (WSN) for remote data access and monitoring. We present the sensor architecture, the construction of the corresponding testbed, and its performance evaluation. This sensor may be used in different medical applications, including preterm labor prevention and fertility and ovulation period detection. The features of the constructed testbed were validated in laboratory tests verifying its accuracy and performance. PMID:22163471

Caldeira, João M L P; Rodrigues, Joel J P C; Garcia, João F R; de la Torre, Isabel

2010-01-01

298

A New Wireless Biosensor for Intra-Vaginal Temperature Monitoring  

PubMed Central

Wireless Body Sensors for medical purposes offer valuable contributions to improve patients’ healthcare, including diagnosis and/or therapeutics monitoring. Body temperature is a crucial parameter in healthcare diagnosis. In gynecology and obstetrics it is measured at the skin’s surface, which is very influenced by the environment. This paper proposes a new intra-body sensor for long-term intra-vaginal temperature collection. The embedded IEEE 802.15.4 communication module allows the integration of this sensor in a Wireless Sensor Network (WSN) for remote data access and monitoring. We present the sensor architecture, the construction of the corresponding testbed, and its performance evaluation. This sensor may be used in different medical applications, including preterm labor prevention and fertility and ovulation period detection. The features of the constructed testbed were validated in laboratory tests verifying its accuracy and performance.

Caldeira, Joao M. L. P.; Rodrigues, Joel J. P. C.; Garcia, Joao F. R.; de la Torre, Isabel

2010-01-01

299

Vaginal endosonography in the assessment of the anorectum.  

PubMed

Endosonography from within the anus has been used to image the anorectum and its associated musculature. A 5.0-MHz endovaginal probe was inserted vaginally, and longitudinal and cross-sectional views of the anorectum were obtained. We were able to measure rectal length and diameter, puborectalis thickness and angle, thickness of internal and external anal sphincter, and the curvature of the anal canal. We visualized defects in the internal and external anal sphincters. Suitable images were obtained from 70 subjects. Muscle thicknesses were within previously published ranges. Twenty-five of 70 subjects (36%) had defects of the internal anal sphincter, and 19 of 65 subjects (29%) had defects of the external anal sphincter. PMID:7501322

Sandridge, D A; Thorp, J M

1995-12-01

300

Women's preferences toward attributes of local estrogen therapy for the treatment of vaginal atrophy.  

PubMed

OBJECTIVES: Decreased estrogen production due to menopause is often associated with vaginal atrophy, and estrogen therapy is the most effective treatment for the management of this condition. This study investigated women's preferences relating to various aspects of local estrogen therapy (LET) for the treatment of postmenopausal vaginal atrophy. STUDY DESIGN: The study involved 423 women aged >50 years who were resident in Sweden, had experienced menopausal changes in and around the vagina, and had used LET for these changes. The women completed an online questionnaire. MAIN OUTCOME MEASURES: The questionnaire involved a discrete choice experiment to determine women's willingness to pay for different characteristics of therapy. Time of LET appliance, use of disposable applicators with small tablets compared with both dosing syringes with vaginal cream and vagitories, and therapy that did/did not cause smudges/leakage were all considered. RESULTS: The women had no significant preference as to the time of day LET should be used. However, quantifying other preferences suggested that respondents were willing to pay €66.58 or €60.32 per month extra for using disposable applicators with small tablets rather than dosing syringes with vaginal cream or vagitories, respectively, and to avoid smudges/leakage. CONCLUSIONS: This survey suggests that women may prefer using disposable applicators with small tablets to deliver LET and value therapy that does not cause smudges/leakage. It is possible that if women are able to use their preferred form of LET, improved uptake or adherence of such medication may enhance the management of postmenopausal vaginal atrophy. PMID:23312488

Mattsson, Lars-Åke; Ericsson, Asa; Bøgelund, Mette; Maamari, Ricardo

2013-01-01

301

Experimental investigation on the pressure characteristics of cavity closure region  

NASA Astrophysics Data System (ADS)

The most complicated component in cavitating flow and pressure distribution is the flow in the cavity closure line. The cavitating flow and pressure distribution provide critical aspects of flow field details in the region. The integral of pressure results of the hydrodynamic forces, indicate domination in the design of a supercavitating vehicle. An experiment was performed in a water tunnel to investigate the pressure characteristics of the cavity closure region. Ventilation methods were employed to generate artificial cavity, and the ventilation rate was adjusted accordingly to obtain the desired cavity length. An array of pressure transducers was laid down the cavity closure line to capture pressure distribution in this region. The experimental results show that there is a pressure peak in the cavity closure region, and the rise rate of pressure in space tends to be higher in the upwind side when the flow is non-axisymmetric. The transient pressure variations during the cavity formation procedure were also present. The method of measurement in this paper can be referenced by engineers. The result helps to study the flow pattern of cavity closure region, and it can also be used to analyze the formation of supercavitating vehicle hydrodynamics.

Wang, Yadong; Yuan, Xulong; Zhang, Yuwen

2012-12-01

302

Uterosacral Colpopexy at the Time of Vaginal Hysterectomy  

PubMed Central

OBJECTIVE To compare the risk of ureteral compromise and of recurrent vault prolapse following vaginal vs. laparoscopic uterosacral vault suspension at the time of vaginal hysterectomy. STUDY DESIGN In this retrospective, cohort study, uterosacral ligament suspension was performed using either a vaginal or laparoscopic approach. The primary outcome was intraoperative ureteral compromise; secondary outcomes were postoperative anatomic result and recurrent prolapse. The Canadian Task Force Classification was II-2. RESULTS One hundred eighteen patients were included: 96 patients in the vaginal group and 22 patients in the laparoscopic group. Ureteral compromise was identified intraoperatively in 4 (4.2%) cases in the vaginal group; no ureteral compromise was observed in the laparoscopic group (p = 0.33). Failure at the apex, defined as stage ? II for point C, was seen in 6.3% of patients in the vaginal group as compared with 0% in the laparoscopic group; this difference did not achieve statistical significance. Similarly, trends toward lower recurrent symptomatic vault prolapse (10% vs. 0%), any symptomatic prolapse recurrence (12.5% vs. 4.6%), and higher postoperative Pelvic Organ Prolapse Quantification point C were observed in the laparoscopic group (p > 0.05 for all). CONCLUSION Laparoscopic uterosacral vault suspension following vaginal hysterectomy is a safe alternative to the vaginal approach.

Rardin, Charles R.; Erekson, Elisabeth A.; Sung, Vivian W.; Ward, Renee M.; Myers, Deborah L.

2010-01-01

303

Vaginal Eroticism and Female Orgasm: A Current Appraisal  

Microsoft Academic Search

In the light of very recent studies, this paper reviews two controversial issues in the area of female sexuality: vaginal eroticism and female orgasm. From the available evidence, it is concluded that most (and probably all) women possess vaginal zones, mainly located on the anterior wall, whose tactile stimulation can lead to orgasm. The apparent contradiction between this finding and

Heli Alzate

1985-01-01

304

Treatment Options by Stage and Type of Vaginal Cancer  

MedlinePLUS

... it doesn't come back. Stage I Squamous cell cancers: Radiation therapy is used for most stage I vaginal cancers. ... for some patients with stage II vaginal squamous cell cancer if it is small ... already had radiation therapy for cervical cancer and who would not be ...

305

Nitroimidazole-resistant vaginal trichomoniasis treated with paromomycin  

Microsoft Academic Search

A 33-year old woman with nitroimidazole-resistant vaginal trichomoniasis is described. She was treated with intravaginal paromomycin (500mg daily for 2 days). This cured the trichomoniasis but resulted in severe local side effects. Paromomycin may be useful for difficult cases of nitroimidazole-resistant Trichomonas vaginalis vaginitis. The exact dosage still has to be determined.

Willy A. J. Poppe

2001-01-01

306

Vaginal hysterectomy is made easier with ERBE Biclamp forceps.  

PubMed

The ratio of vaginal hysterectomy to abdominal hysterectomy in the UK is 1:3. It is well known that patients who have had a vaginal hysterectomy recover better compared with abdominal hysterectomy. However, abdominal hysterectomy is the preferred method in most hospitals because it is deemed easier to do. With ERBE Biclamp diathermy forceps, vaginal hysterectomy could be safely and easily performed by gynaecologists. This study showed a different surgical technique for performing vaginal hysterectomy. It allowed easier and safer operations in patients with large uterus, fibroid uterus, where there was no uterine descent and narrow introitus. Also it allowed the adnexal appendages to be removed easily by the vaginal route. We compared 100 patients who had a vaginal hysterectomy performed using this method, with patients who had a vaginal hysterectomy performed by the conventional method using sutures. We found that we could safely perform vaginal hysterectomy with greater ease. Also, the need for postoperative analgesia was less and the patients were discharged earlier. Consequently, the patients' convalescence period was shorter and better. PMID:17999303

Chia, K V; Tandon, S; Moukarram, H

2007-10-01

307

An unusual cause of persistent postpartum vaginal discharge.  

PubMed

We describe the case of a 27-year-old woman with a three-month history of persistent green vaginal discharge following vaginal delivery of her first child. Group C ?-haemolytic streptococcus was ultimately isolated, which appears to be an uncommon cause of this clinical presentation. PMID:23970614

Parrott, Natasha; Asensio, Maria; Gupta, Nadi K

2013-10-01

308

Oral methotrexate and vaginal misoprostol for early abortion  

Microsoft Academic Search

Intramuscular methotrexate followed by vaginal misoprostol has been shown to be effective for abortion at ?49 days gestation. Oral dosing of the methotrexate may offer advantages over parenteral dosing. This pilot study was performed to evaluate if oral methotrexate would be effective when combined with vaginal misoprostol to effect abortion at ?49 days gestation. Twenty pregnant women were randomized to

Mitchell D. Creinin

1996-01-01

309

Oral or vaginal misoprostol for induction of labor  

Microsoft Academic Search

Objective: To compare vaginal versus oral misoprostol for induction of labor. Method: Induction of labor was carried out in 40 women near term in two equal and randomized groups (according to a computer generated table) using misoprostol. Group I received vaginal misoprostol (100 ?g) every 3 h while group II patients were given the same dose via the oral route.

M. K. Toppozada; M. Y. M. Anwar; H. A. Hassan; W. S. El-Gazaerly

1997-01-01

310

Spontaneous closure of congenital coronary artery fistulas  

PubMed Central

Six cases of full spontaneous closure of congenital coronary artery fistulas, and one case of near closure, as seen by colour Doppler echocardiography, are presented. It is worth reconsidering the classical view that nearly all cases of spontaneous closure are eligible for surgical or percutaneous correction to prevent the development of significant and potentially fatal complications. As the natural course of coronary artery fistulas is still poorly defined, asymptomatic patients, especially those under 7 years old with small shunts, should be periodically followed up by echocardiography rather than be subjected to operative closure, even by catheterisation.???Keywords: congenital heart disease; coronary artery disease; coronary artery fistula; spontaneous closure

Schleich, J; Rey, C; Gewillig, M; Bozio, A

2001-01-01

311

Update in management of vaginal mesh erosion.  

PubMed

Mesh erosion is one of the major complications of prolapse surgery conducted by transvaginal approach. Following the extensive use of meshes and warning about potential complications, a new classification of mesh-related adverse events has been proposed. Due to the wide scope of clinical features, no standardized approach has been proposed. Surgery is required after failure of conservative management, mostly based on mesh partial or total excision by transvaginal route, following the classic rules of re-do vaginal surgery. Complex cases are best managed in tertiary reference centers. PMID:23873511

Cornu, Jean-Nicolas; Peyrat, Laurence; Haab, François

2013-10-01

312

Pathology Case Study: Bloody Vaginal Discharge  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which an elderly woman experienced bloody vaginal discharge long after menopause. Visitors are given both the microscopic pap smear and biopsy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in gynecologic pathology.

Dickson, H.; Mahood, L.; Manlucu, E. D.; Nath, Manju E.

2008-10-28

313

Vaginal malignancies in childhood and adolescence.  

PubMed

Throughout the years 1978-1998, 13 patients, 9 months to 16 years of age, were treated for vaginal malignancy at the Medical City Hospital, Baghdad, Iraq. The majority were found to have an embryonal sarcoma, an endodermal sinus tumour or a clear cell adenocarcinoma. Most were treated by genital resection combined with triple cytotoxic therapy. We have eight survivors for more than 3 years following surgery. This study also illustrates the potential curability of these tumours with preservation of urinary function. PMID:15512636

Khunda, S S; Al-Omary, S K

2000-09-01

314

Update on nonoxynol-9 as vaginal spermicide.  

PubMed

Nonoxynol-9 (N-9) is a typical surfactant. For more than 30 years that very property of N-9 has been successfully exploited for its spermicidal action. It is available as an over-the-counter, locally acting vaginal spermicide. The suitability of N-9 as a spermicide is elaborated in this article. The reasons why N-9 may fail as a contraceptive are discussed. In spite of many drawbacks, which are mentioned in the article, N-9 is still often resorted to as a locally acting contraceptive. The review ends with suggestions to alter the molecular structure of N-9 and to adjust the dosages. PMID:19117251

Iyer, Vidya; Poddar, S S

2008-12-01

315

Monitoring Vaginal Epithelial Thickness Changes Noninvasively in Sheep Using Optical Coherence Tomography  

PubMed Central

Objective High-resolution optical coherence tomography (OCT), can be used noninvasively to evaluate vaginal morphologic features, including epithelial thickness, to assess this protective barrier in transmission of sexually transmitted infections and to monitor tissue response to topical medications and hormonal fluctuations. We examined the utility of OCT to measure epithelial thickness noninvasively before and after topical treatment with a drug that causes epithelial thinning. Study Design Twelve female sheep were treated with intravaginal placebo (n=4) or nonoxynol-9 (n=8). Vaginal OCT images were obtained before and 24 hours after treatment. Four sheep in the nonoxynol-9 group were also examined on days 3 and 7. Vaginal biopsies were obtained on the last exam day. Epithelial thickness was measured in OCT images and in H&E-stained histological sections from biopsies. Statistical analysis was performed using ANOVA (significance p<0.05). Results Baseline OCT epithelial thickness measurements were similar (85±19 ?m placebo, 78±20 ?m nonoxynol-9; p=0.52). Epithelial thinning was significant after nonoxynol-9 (32±22 ?m) compared to placebo (80±15 ?m) 24 hours after treatment (p<0.0001). In the four nonoxynol-9-treated sheep followed for 7 days, epithelial thickness returned to baseline by day 3, and increased significantly on day 7. Epithelial thickness measurements from histology were not significantly different than OCT (p=0.98 N-9, p=0.93 HEC). Conclusion Drug-induced changes in the epithelium were clearly detectable using OCT imaging. OCT and histology epithelial thickness measurements were similar, validating OCT as a noninvasive method for epithelial thickness measurement, providing an important tool for quantitative and longitudinal monitoring of vaginal epithelial changes.

VINCENT, Kathleen L.; VARGAS, Gracie; WEI, Jingna; BOURNE, Nigel; MOTAMEDI, Massoud

2013-01-01

316

Pap test--with or without vaginal smear?  

PubMed

The aim of this study was to evaluate medical and economic justification of vaginal smears as a part of primary screening for cervical carcinoma and its precursors. Study included 245.048 participants whose VCE (vaginal, cervical, endocervical) smears were examined at Department of clinical cytology of University Hospital Center Osijek from 2003 till 2008. There were 12.639 (5.2%) abnormal findings, and they were divided into three groups: abnormal cells found only in vaginal smear (V), abnormal cells found in vaginal and in at least one other smear (V+) and abnormal cells not found in vaginal smear (C/E). These three groups were analysed in respect to cytological differential diagnosis and age of participants. It was estimated how many women could be additionally included in the screening, if vaginal smear would be included in the Pap test only after 50 years of age. In 6.9% of cytologically diagnosed lesions abnormal cells were found exclusively in vaginal smears (0.35% of all findings). As for squamous cell lesions, 91.2% were mild lesions (ASC and LSIL). Invasive squamous cell carcinoma was not diagnosed exclusively by vaginal smear in either woman under 50 years of age, while in women over 50 years of age it was diagnosed in 2.3% of cases. Exclusively by vaginal smear was diagnosed 3.9% of all AGC and 6.3% of adenocarcinoma, while in 85.0% of glandular epithelium lesions abnormal cells were not found in vaginal smears. Two thirds of adenocarcinoma diagnosed exclusively by vaginal smears were endometrial adenocarcinoma, but that is only 10.3% of all endometrial carcinoma diagnosed by Pap test. Obtained results show that taking of vaginal smears along with cervical and endocervical smears as a part of primary screening for cervical carcinoma and its precursors in women under 50 years of age is not justifiable, since vaginal smear only has a role in detection of endometrial carcinoma that are extremely rare in younger age groups. If vaginal smear would be taken only in women over 50 years of age, additional 37.7% of women under 50, or 25.1% women over 50 years of age could be included in the screening. PMID:20437636

Milici?-Juhas, Valerija; Peri?, Marija; Pajtler, Marija; Prvulovi?, Ivana; Curzik, Darko

2010-03-01

317

Vaginal cleansing practices in HIV infected Zambian women.  

PubMed

Vaginal practices are a variety of behavioral techniques that women use to manage their sexual life and personal hygiene. Women perceive vaginal practices as a beneficial practice. However, vaginal cleansing has been identified as one of the main risk factors for bacterial vaginosis and is potentially implicated in Human Immune Deficiency Virus (HIV) and sexually transmitted infection transmission. This study examined the prevalence of vaginal practices and the types of practices used among a sample of HIV positive women living in Lusaka, Zambia. Over 90% of all women recruited engaged in vaginal practices. Certain practices, such as use of water or soap, were more frequently used for hygiene reasons. Herbs and traditional medicines were mainly used to please sexual partner. Strategies to decrease VP appear urgently needed in the Zambian community. PMID:22041932

Alcaide, Maria L; Mumbi, Miriam; Chitalu, Ndashi; Jones, Deborah

2013-03-01

318

The use of autologous buccal mucosa grafts in vaginal reconstruction.  

PubMed

Vaginal reconstruction can be challenging when there is a paucity of tissue, as the ideal donor source has yet to be determined. Many of the existing and commonly used techniques, such as vaginal replacement with skin grafts or bowel segments, have both advantages and disadvantages. A novel technique for vaginal replacement and reconstruction is with autologous buccal mucosa, an epithelium which is an excellent tissue match to the vagina. As urologists often have extensive experience with the use of oral mucosa for urethral reconstruction, it is fitting to apply these techniques to procedures where native vaginal tissue is lacking. This review presents the existing literature as well as the author's own experience with the use of autologous buccal mucosa for a variety of vaginal reconstructive procedures. PMID:24948036

Grimsby, Gwen M; Baker, Linda A

2014-08-01

319

Local Effects of Vaginally Administered Estrogen Therapy: A Review  

PubMed Central

The results of the Women’s Health Initiative (WHI) led to a distinct decline in the routine use of estrogen as preventive therapy for vasomotor symptoms, osteoporosis, and cardiovascular disease in postmenopausal women. Without estrogen replacement, one third of women experience symptoms of atrophic vaginitis including dryness, irritation, itching and or dyspareunia. Local application of estrogen has been shown to relieve these symptoms and improve quality of life for these women. In addition, local estrogen therapy may have a favorable effect on sexuality, urinary tract infections, vaginal surgery, and incontinence. This review examines the effects of vaginally applied estrogen on the vaginal epithelium, urethra and endometrium. An accompanying review examines the systemic effects of vaginally applied estrogen.

Krause, Megan; Wheeler, Thomas L.; Snyder, Thomas E.; Richter, Holly E.

2011-01-01

320

Sustained Release of the CCR5 Inhibitors CMPD167 and Maraviroc from Vaginal Rings in Rhesus Macaques  

PubMed Central

Antiretroviral entry inhibitors are now being considered as vaginally administered microbicide candidates for the prevention of the sexual transmission of human immunodeficiency virus. Previous studies testing the entry inhibitors maraviroc and CMPD167 in aqueous gel formulations showed efficacy in the macaque challenge model, although protection was highly dependent on the time period between initial gel application and subsequent challenge. In this paper, we describe the sustained release of maraviroc and CMPD167 from matrix-type silicone elastomer vaginal rings both in vitro and in vivo. Both inhibitors were released continuously during 28 days from rings in vitro at rates of 100 to 2,500 ?g/day. In 28-day pharmacokinetic studies in rhesus macaques, the compounds were measured in the vaginal fluid and vaginal tissue; steady-state fluid concentrations were ?106-fold greater than the 50% inhibitory concentrations (IC50s) for simian human immunodeficiency virus 162P3 inhibition in macaque lymphocytes in vitro. Plasma concentrations for both compounds were very low. The pretreatment of macaques with Depo-Provera (DP), which is commonly used in macaque challenge studies, was shown to significantly modify the biodistribution of the inhibitors but not the overall amount released. Vaginal fluid and tissue concentrations were significantly decreased while plasma levels increased with DP pretreatment. These observations have implications for designing macaque challenge experiments and also for ring performance during the human female menstrual cycle.

Veazey, Ronald S.; Geer, Leslie; Lowry, Deborah; Fetherston, Susan M.; Murphy, Diarmaid J.; Boyd, Peter; Major, Ian; Shattock, Robin J.; Klasse, Per Johan; Doyle, Lara A.; Rasmussen, Kelsi K.; Goldman, Laurie; Ketas, Thomas J.; Moore, John P.

2012-01-01

321

Impact of Lane Closures on Roadway Capacity, Phase 2, Summary.  

National Technical Information Service (NTIS)

In a previous project (BD545-61), University of Florida researchers developed a simulation program, FlagSim, based on major factors that influence work zone performance measures for lane closures on two-way, two-lane roads. They also developed methods to ...

S. S. Washburn

2014-01-01

322

Collectivity-induced quenching of signatures for shell closures  

SciTech Connect

Mass differences are an often used as signature and measure for shell closure. Using the angular-momentum projected generator coordinate method and the Skyrme interaction SLy4, we analyze the modification of mass differences due to static deformation and dynamic fluctuations around the mean-field ground state.

Bender, M. [Universite Bordeaux, Centre d'Etudes Nucleaires de Bordeaux Gradignan, UMR5797, F-33175 Gradignan (France); CNRS/IN2P3, Centre d'Etudes Nucleaires de Bordeaux Gradignan, UMR5797, F-33175 Gradignan (France); Bertsch, G. F. [Department of Physics and Institute for Nuclear Theory, Box 351560, University of Washington, Seattle, Washington 98195 (United States); Heenen, P.-H. [Service de Physique Nucleaire Theorique, Universite Libre de Bruxelles, C.P. 229, B-1050 Bruxelles (Belgium); Physics Division, Argonne National Laboratory, 9700 S. Cass Avenue, Argonne, Illinois 60439 (United States)

2008-11-15

323

FIELD AND LABORATORY EVALUATION OF PETROLEUM LAND TREATMENT SYSTEM CLOSURE  

EPA Science Inventory

The objectives of the research were to measure and interpret the surface soil changes in relation to the quality of runoff water from petroleum refinery land treatment (LT) systems undergoing simulated closure. Waste/soils from four LT sites were studied for chemical transformati...

324

Association Between Tampon Use and Choosing the Contraceptive Vaginal Ring  

PubMed Central

Objective To estimate whether tampon users are more likely to select the contraceptive vaginal ring than combined oral contraceptive pills (OCPs). Methods The Contraceptive Choice Project is a longitudinal study of 10,000 St. Louis-area women promoting the use of long-acting, reversible methods of contraception and evaluating user continuation and satisfaction for all reversible methods. We performed univariable and multivariable analyses of the 311 women who were asked about tampon use at the time of enrollment and who chose the contraceptive vaginal ring or OCPs to assess the association of tampon use and choice of combined hormonal method. Results Among contraceptive vaginal ring and OCP users, 247 (79%) reported using tampons. Contraceptive vaginal ring users were not significantly different than OCP users in terms of age, race or ethnicity, marital status, insurance, BMI, and parity. Adjusted analysis indicates tampon users were more likely to choose the contraceptive vaginal ring instead of OCPs (adjusted RR=1.34; 95%CI: 1.01–1.78). Women with previous contraceptive vaginal ring experience were also more likely to choose the contraceptive vaginal ring (adjusted RR=1.96; 95%CI: 1.6–2.4). Recent OCP use did not influence method choice. Conclusion In our baseline analysis of the Contraceptive Choice Project, tampon users were more likely to choose the contraceptive vaginal ring than OCPs. Use of tampons could be considered an indicator for the initial acceptability of the contraceptive vaginal ring, but all women should be offered the contraceptive vaginal ring regardless of experience with tampon use.

Tepe, Melissa; Mestad, Renee; Secura, Gina; Allsworth, Jenifer E.; Madden, Tessa; Peipert, Jeffrey F.

2011-01-01

325

Vaginal Health: Insights, Views & Attitudes (VIVA) survey - Canadian cohort.  

PubMed

OBJECTIVE: To evaluate knowledge of vaginal atrophy among postmenopausal women (aged 55-65 years), using the Vaginal Health: Insights, Views & Attitudes (VIVA) survey. METHODS: An independent research organization conducted a quantitative Internet-based survey, to obtain information from 3520 women who were living in the UK, the USA, Canada, Sweden, Denmark, Finland or Norway. Findings from Canada are presented (n = 500). RESULTS: Almost half of Canadian respondents had experienced vaginal discomfort since they had stopped menstruating, most commonly (88%) vaginal dryness; over half (56%) reported having experienced symptoms for three years or longer. Seven percent would have attributed vaginal symptoms to vaginal atrophy. Eighty-two percent of women felt that vaginal discomfort would have a negative impact on various aspects of their lives, most notably sexual intimacy (72%), 'having a loving relationship with a partner' (39%) and 'overall quality of life' (30%). While the majority of women (66%) who had experienced vaginal atrophy eventually sought the assistance of a health-care professional, a considerable proportion (34%) did not. Most women (58%) had tried lubricating gels and creams to treat their symptoms, but many were less aware of specific means of treating the underlying cause. However, compared with systemic hormone replacement therapy, more women indicated that they would consider local estrogen therapy (e.g. vaginal tablets or creams). CONCLUSIONS: These data indicate that many postmenopausal women in Canada have a low understanding of vaginal atrophy. Medical practitioners should proactively initiate dialogue about this chronic condition with their patients, and discuss appropriate treatment options. PMID:23201626

Frank, Sheldon M; Ziegler, Cleve; Kokot-Kierepa, Marta; Maamari, Ricardo; Nappi, Rossella E

2012-11-30

326

Vaginal breech delivery: results of a prospective registration study  

PubMed Central

Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar?vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p?vaginal delivery group (p?vaginal group without long-term sequelae.

2013-01-01

327

Rats clearing a vaginal infection by Candida albicans acquire specific, antibody-mediated resistance to vaginal reinfection.  

PubMed Central

Oophorectomized, estrogen-treated rats were susceptible to experimental vaginal infection by Candida albicans. After spontaneous clearing of the primary infection, the animals were highly resistant to a second vaginal challenge with the fungus. The vaginal fluid of Candida-resistant rats contained antibodies directed against mannan constituents and secretory aspartyl proteinase(s) of C. albicans and was capable of transferring a degree of anti-Candida protection to naive, nonimmunized rats. This passive protection was mediated by the immunoglobulin fraction of the vaginal fluid and was substantially abolished by preabsorption of the vaginal fluid with C. albicans, but not with Saccharomyces cerevisiae, cells. Vaginal anti-mannan antibodies were also produced by active immunization with heat-killed cells of C. albicans or with a mannan extract when administered via the vaginal route. The protection conferred was comparable to that resulting from clearing of the primary infection. In summary, the data suggest that acquired anticandidal protection in this vaginitis model is mediated at least in part by antibodies, among which those directed against the mannan antigen(s) might play a dominant role.

Cassone, A; Boccanera, M; Adriani, D; Santoni, G; De Bernardis, F

1995-01-01

328

Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in The Gambia, West Africa  

PubMed Central

Background Bacterial vaginosis (BV) – a syndrome characterised by a shift in vaginal flora – appears to be particularly common in sub-Saharan Africa, but little is known of the pattern of vaginal flora associated with BV in Africa. We conducted a study aimed at determining the prevalence of BV and patterns of BV-associated vaginal micro-flora among women with vaginal discharge syndrome (VDS) in The Gambia, West Africa. Methods We enrolled 227 women with VDS from a large genito-urinary medicine clinic in Fajara, The Gambia. BV was diagnosed by the Nugent's score and Amsel's clinical criteria. Vaginal swabs were collected for T vaginalis and vaginal flora microscopy, and for Lactobacillus spp, aerobic organisms, Candida spp and BV-associated bacteria (Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma spp) cultures; and cervical swabs were collected for N gonorrhoeae culture and C trachomatis PCR. Sera were tested for HIV-1 and HIV-2 antibodies. Sexual health history including details on sexual hygiene were obtained by standardised questionnaire. Results BV prevalence was 47.6% by Nugent's score and 30.8% by Amsel's clinical criteria. Lactobacillus spp were isolated in 37.8% of women, and 70% of the isolates were hydrogen-peroxide (H202)-producing strains. Prevalence of BV-associated bacteria were: G vaginalis 44.4%; Bacteroides 16.7%; Prevotella 15.2%; Peptostretococcus 1.5%; Mobiluncus 0%; other anaerobes 3.1%; and Mycoplasma hominis 21.4%. BV was positively associated with isolation of G vaginalis (odds-ratio [OR] 19.42, 95%CI 7.91 – 47.6) and anaerobes (P = 0.001 [OR] could not be calculated), but not with M hominis. BV was negatively associated with presence of Lactobacillus (OR 0.07, 95%CI 0.03 – 0.15), and H2O2-producing lactobacilli (OR 0.12, 95% CI 0.05 – 0.28). Presence of H2O2-producing lactobacilli was associated with significantly lower prevalence of G vaginalis, anaerobes and C trachomatis. HIV prevalence was 12.8%. Overall, there was no association between BV and HIV, and among micro-organisms associated with BV, only Bacteroides spp. and Prevotella spp. were associated with HIV. BV or vaginal flora patterns were not associated with any of the factors relating to sexual hygiene practices (vaginal douching, menstrual hygiene, female genital cutting). Conclusion In this population, BV prevalence was higher than in corresponding populations in industrialised countries, but the pattern of vaginal micro-flora associated with BV was similar. BV or vaginal flora patterns were not associated with HIV nor with any of the vaginal hygiene characteristics.

Demba, Edward; Morison, Linda; van der Loeff, Maarten Schim; Awasana, Akum A; Gooding, Euphemia; Bailey, Robin; Mayaud, Philippe; West, Beryl

2005-01-01

329

Closure plan for Solid Waste Storage Area 6: Volume 1, Closure plan. Remedial investigation/feasibility study  

SciTech Connect

This Closure Plan for Solid Waste Storage Area 6 (SWSA 6) a disposal area for low-level radioactive wastes and hazardous materials, of the US Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) describes how portions of SWSA 6 will be closed under Resource Conservation and Recovery Act (RCRA) Interim Status per 40 CFR 265 Subpart G [TN Rule 1200-1-11-.05(7)]. An overview is provided of activities necessary for final closure and corrective measures for all of SWSA 6. Results of surface waters and groundwater sampling are provided.

Not Available

1988-09-01

330

Health Risk Assessment for Area 514 RCRA Closure  

SciTech Connect

Lawrence Livermore National Laboratory (LLNL) is a USDOE research and development institution for science and technology applied to national security. The specific area that is the subject of this document, Area 514, was the location of active LLNL waste treatment facilities until November 2003, and the operations there were authorized under interim status. The site is being closed pursuant to the requirements of the Resource Conservation Recovery Act. The DTSC-approved ''Closure Plan for Area 514 Treatment and Storage Facility, LLNL 2004'', states clean closure concentrations for certain organic compounds, metals and metalloids. if all soil samples contained measured concentrations less than these levels, it was agreed that the site would meet the requirements for clean closure. However, if the samples had measured concentrations greater than the clean closure levels, a more detailed risk assessment could be prepared to evaluate the potential effects of the actual measured levels. Soil samples collected from 33 locations in Area 514 were analyzed for 37 constituents of potential concern, as identified by the Closure Plan. Many of these compounds and elements were not detected. However, 10 metals or metalloids were present at levels above the clean closure requirements, and 19 organic compounds were identified as contaminants of potential concern. Following the guidance in the Closure Plan, a health risk assessment is presented in this document to demonstrate the low level of potential health effects from the remaining constituents and to support clean closure of the site. Three types of hypothetical receptors were identified: an intrusive construction worker conducting trenching in the area, a bystander worker in a nearby building, and a future resident. Of the worker receptors, the intrusive construction worker was found to have the greater overall chronic exposure, with a theoretical calculated carcinogenic risk of 4 x 10{sup -8}, a chronic hazard index of 8 x 10{sup -3}, and an acute hazard index of 9 x 10{sup -1}. The estimated incremental cancer risk for the residential receptor, 1 x 10{sup -6}, was calculated by adjusting contaminant concentrations to account for background levels of metals at the Livermore LLNL site. When no adjustments for background concentrations are made, the estimated incremental cancer risk is 3 x 10{sup -6}. The chronic hazard index for the residential receptor, 2 x 10{sup -1}, was developed without accounting for background concentrations of metals. These values are all below levels associated with health concerns, and support the conclusion that further cleanup of the area is not necessary.

Gallegos, G M; Hall, L C

2005-05-26

331

Surgical treatment of vaginal apex prolapse.  

PubMed

Pelvic organ prolapse is a common problem in women that increases with age and adversely affects quality of life and sexual function. If conservative treatments fail, surgery becomes the main option for symptom abatement. For uterovaginal prolapse, treatment with or without hysterectomy can be offered, and operations must include a specific apical support procedure to be effective. Operations for apical prolapse include transvaginal, open, and laparoscopic or robotic options; few clinical trials have compared the effectiveness and risk of these various surgeries. Grafts can be used selectively for apical suspensions and may improve cure rates but also increase risk of some complications. Slings should be added selectively to reduce postoperative stress incontinence. For women interested in future sexual activity who require apical prolapse surgery, we suggest using transvaginal apical repairs for older patients, those with primary or less severe prolapse, and those at increased surgical risk. We recommend sacral colpopexy with polypropylene mesh (preferably by minimally invasive route) in younger women, those with more severe prolapse or recurrences after vaginal surgery, and women with prolapsed, short vaginas. In older women with severe prolapse who are not interested in sexual activity, obliterative operations are very effective and have high satisfaction rates. An interactive consent process is mandatory, because many decisions-about route of surgery; use of hysterectomy, slings, and grafts; and vaginal capacity for sexual intercourse-require an informed patient's input. Selective referral to specialists in Female Pelvic medicine and Reconstructive Surgery can be considered for complex and recurrent cases. PMID:23344287

Walters, Mark D; Ridgeway, Beri M

2013-02-01

332

[Surgical management of congenital high vaginal atresia].  

PubMed

In the past 15 years five neonates and children have been treated for high vaginal atresia at the Surgical Unit of Department of Pediatrics, University Medical School, Pécs, Hungary. In three of the six patients distal atresia of the vagina was found (Type III). Two of the three were neonates and had a large hydrometrocolpos and the third, a 13-year-old girl, hematometrocolpos. In the fourth patient the vaginal atresia was associated with cloacal and anorectal malformation (Type V). In the fifth there was a duplication of uterus and vagina; however, only one of the two vaginas was atretic. In three patients a pull-through of the vagina was carried out, in one of them according to Pena, in another a transvesical approach, as suggested by Monfort, was used. Following repeated surgeries in the patient with cloacal malformation the vagina was replaced with large intestine. In the case of duplication of vagina and uterus one half of the duplication was removed. PMID:8464627

Alchihabi, N; Pintér, A

1993-04-01

333

REPAIR OF VESICO-VAGINAL FISTULA  

PubMed Central

One hundred and thirteen patients with vesico-vaginal fistula were seen at the University of California Hospital from 1932 through 1959. The most common cause of fistula was trauma associated with pelvic operation, and the operation most often involved was total abdominal hysterectomy. Malignant disease of the pelvic organs was the second most common cause, while radiation therapy and obstetrical causes were next in the order of frequency. Three fistulas healed spontaneously. Twelve bladder by-pass operations were done and 54 repairs were carried out in 46 patients. Thirty-eight patients (82.6 per cent) were cured after one or more repair operations. A variety of operative approaches were used, selected in accordance with the needs of the individual case. Bladder distention postoperatively, due to a plugged catheter, was held responsible for failure of the repair in three cases, and this complication was considered preventable. Close attention to surgical technique, the recognition of bladder injury, and proper repair at the time of operation are prime factors in the prevention of vesico-vaginal fistula.

Hill, Edward C.

1962-01-01

334

Repository Closure and Sealing Approach  

SciTech Connect

The scope of this analysis will be to develop the conceptual design of the closure seals and their locations in the Subsurface Facilities. The design will be based on the recently established program requirements for transitioning to the Site Recommendation (SR) design as outlined by ''Approach to Implementing the Site Recommendation Baseline'' (Stroupe 2000) and the ''Monitored Geologic Repository Project Description Document'' (CRWMS M&O 1999b). The objective of this analysis will be to assist in providing a description for the Subsurface Facilities System Description Document, Section 2 and finally to document any conclusions reached in order to contribute and provide support to the SR. This analysis is at a conceptual level and is considered adequate to support the SR design. The final closure barriers and seals for the ventilation shafts, and the north and south ramps will require these openings to be permanently sealed to limit excessive air and water inflows and prevent human intrusion. The major tasks identified with closure in this analysis are: (1) Developing the overall subsurface seal layout and identifying design and operational interfaces for the Subsurface Facilities. (2) Summarizing the general site conditions and general rock characteristic with respect to seal location and describing the seal selected. (3) Identify seal construction materials, methodology of construction and strategic locations including design of the seal and plugs. (4) Discussing methods to prevent human intrusion.

A.T. Watkins

2000-06-28

335

Particle Deposition During Airway Closure  

NASA Astrophysics Data System (ADS)

Inhaled aerosol particles deposit in the lung and may be from environmental, toxic, or medical therapy sources. While much research focuses on inspiratory deposition, primarily at airway bifurcations due to inertial impaction, there are other mechanisms that allow the particles to reach the airway surface, such as gravitational settling and diffusion depending on particle size. We introduce a new mechanism not previously studied, i.e. aerosol deposition from airway closure. The airways are lined with a liquid layer. Due to the surface tension driven instability, a liquid plug can form from this layer which blocks the airway. This process of airway closure tends to occur toward the end of expiration. In this study, the efficiency of the impaction of the particles during airway closure will be investigated. The particles will be released from the upstream of the airway and convected by the air flow and deposited onto the closing liquid layer. We solve the governing equations using a finite volume approach in conjunction with a sharp interface method for the interfaces. Once the velocity field of the gas flow is obtained, the path of the particles will be calculated and the efficiency of the deposition can be estimated.

Tai, Cheng-Feng; Halpern, David; Grotberg, James

2010-11-01

336

Particle Deposition During Airway Closure  

NASA Astrophysics Data System (ADS)

Inhaled aerosol particles deposit in the lung and may be from environmental, toxic, or medical therapy sources. While much research focuses on inspiratory deposition, primarily at airway bifurcations due to inertial impaction, there are other mechanisms that allow the particles to reach the airway surface, such as gravitational settling and diffusion depending on particle size. We introduce a new mechanism not previously studied, i.e. aerosol deposition from airway closure. The airways are lined with a liquid layer. Due to the surface tension driven instability, a liquid plug can form from this layer which blocks the airway. This process of airway closure tends to occur toward the end of expiration. In this study, the efficiency of the impaction of the particles during airway closure will be investigated. The particles will be released from the upstream of the airway and convected by the air flow and deposited onto the closing liquid layer. We solve the governing equations using a finite volume approach in conjunction with a sharp interface method for the interfaces. Once the velocity field of the gas flow is obtained, the path of the particles will be calculated and the efficiency of the deposition can be estimated.

Tai, Cheng-Feng; Halpern, David; Grotberg, James B.

2011-11-01

337

A clinical study to assess the effectiveness of a nonhormonal vaginal moisturizer in menopausal women  

Microsoft Academic Search

Objective: To assess the effectiveness of a vaginal moisturizer in menopausal women with external vaginal dryness. We studied a nonhormonal topically applied external vaginal moisturizer in women with external vaginal (vulvar) dryness to see if we could approach the results of a topically applied hormonal product.Methods: The 4-week clinical study included 30 subjects who were randomly divided into two groups

Lila E. Nachtigall; Margaret J. Nachtigall; Erika Jacob

2000-01-01

338

A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.  

PubMed

We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route. PMID:23919862

Agnaeber, K; Bodalal, Z

2013-08-01

339

Differential tissue-specific protein markers of vaginal carcinoma  

PubMed Central

The objective was to identify proteins differentially expressed in vaginal cancer to elucidate relevant cancer-related proteins. A total of 16 fresh-frozen tissue biopsies, consisting of 5 biopsies from normal vaginal epithelium, 6 from primary vaginal carcinomas and 5 from primary cervical carcinomas, were analysed using two-dimensional gel electrophoresis (2-DE) and MALDI-TOF mass spectrometry. Of the 43 proteins identified with significant alterations in protein expression between non-tumourous and tumourous tissue, 26 were upregulated and 17 were downregulated. Some were similarly altered in vaginal and cervical carcinoma, including cytoskeletal proteins, tumour suppressor proteins, oncoproteins implicated in apoptosis and proteins in the ubiquitin–proteasome pathway. Three proteins were uniquely altered in vaginal carcinoma (DDX48, erbB3-binding protein and biliverdin reductase) and five in cervical carcinoma (peroxiredoxin 2, annexin A2, sarcomeric tropomyosin kappa, human ribonuclease inhibitor and prolyl-4-hydrolase beta). The identified proteins imply involvement of multiple different cellular pathways in the carcinogenesis of vaginal carcinoma. Similar protein alterations were found between vaginal and cervical carcinoma suggesting common tumourigenesis. However, the expression level of some of these proteins markedly differs among the three tissue specimens indicating that they might be useful molecular markers.

Hellman, K; Alaiya, A A; Becker, S; Lomnytska, M; Schedvins, K; Steinberg, W; Hellstrom, A-C; Andersson, S; Hellman, U; Auer, G

2009-01-01

340

Rectal Colonization by Group B Streptococcus as a Predictor of Vaginal Colonization  

PubMed Central

Objective To describe rectal colonization by Group B Streptococcus (GBS) and its role in predicting vaginal colonization. Study Design In this prospective cohort of 1248 nonpregnant women, vaginal and rectal swabs for GBS culture were obtained at enrollment and three 4-month intervals. Generalized estimating equations were used to identify factors associated with colonization. Results Eight hundred fourteen (65%) women were colonized by GBS sometime during the observation period. Rectal GBS colonization was the strongest predictor of vaginal colonization (adjusted odds ratio = 14.3; 95% confidence interval: 11.9 to 17.1). Recent sexual intercourse, vaginal colonization with yeast, and a vaginal Nugent score ? 4 were also independent determinants of vaginal GBS colonization. Antimicrobial use decreased vaginal GBS colonization only among women lacking rectal colonization. Conclusions GBS in the gastrointestinal tract is a risk factor for vaginal GBS. Sexual activity and abnormal vaginal microflora are independent determinants of vaginal GBS colonization.

MEYN, Leslie A.; KROHN, Marijane A.; HILLIER, Sharon L.

2009-01-01

341

Magnitude of Interfractional Vaginal Cuff Movement: Implications for External Irradiation  

SciTech Connect

Purpose: To quantify the extent of interfractional vaginal cuff movement in patients receiving postoperative irradiation for cervical or endometrial cancer in the absence of bowel/bladder instruction. Methods and Materials: Eleven consecutive patients with cervical or endometrial cancer underwent placement of three gold seed fiducial markers in the vaginal cuff apex as part of standard of care before simulation. Patients subsequently underwent external irradiation and brachytherapy treatment based on institutional guidelines. Daily megavoltage CT imaging was performed during each external radiation treatment fraction. The daily positions of the vaginal apex fiducial markers were subsequently compared with the original position of the fiducial markers on the simulation CT. Composite dose-volume histograms were also created by summing daily target positions. Results: The average ({+-} standard deviation) vaginal cuff movement throughout daily pelvic external radiotherapy when referenced to the simulation position was 16.2 {+-} 8.3 mm. The maximum vaginal cuff movement for any patient during treatment was 34.5 mm. In the axial plane the mean vaginal cuff movement was 12.9 {+-} 6.7 mm. The maximum vaginal cuff axial movement was 30.7 mm. In the craniocaudal axis the mean movement was 10.3 {+-} 7.6 mm, with a maximum movement of 27.0 mm. Probability of cuff excursion outside of the clinical target volume steadily dropped as margin size increased (53%, 26%, 4.2%, and 1.4% for 1.0, 1.5, 2.0, and 2.5 cm, respectively.) However, rectal and bladder doses steadily increased with larger margin sizes. Conclusions: The magnitude of vaginal cuff movement is highly patient specific and can impact target coverage in patients without bowel/bladder instructions at simulation. The use of vaginal cuff fiducials can help identify patients at risk for target volume excursion.

Ma, Daniel J. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Michaletz-Lorenz, Martha [Department of Education and Training, Elekta, Maryland Heights, MO (United States); Goddu, S. Murty [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Grigsby, Perry W., E-mail: pgrigsby@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States)

2012-03-15

342

Uterus preserving vaginal surgery versus vaginal hysterectomy for correction of female pelvic organ prolapse.  

PubMed

(Full text is available at http://www.manu.edu.mk/prilozi). Aim. The objective of this study is to evaluate uterus preserving vaginal procedure of cervical amputation with uterosacral ligament plication (modified Manchester operation) and compare it to vaginal hysterectomy regard recurrence rate, duration of surgery, blood loses, intra and post-operative complications, duration of hospital stay. Methods: Consecutive women with pelvic organ prolapse who underwent either vaginal hyste-rectomy or a modified Manchester procedure were included. Assessments were made preoperatively and at 1-year follow-up, including physical examination with pelvic organ prolapse quantification standardized questionnaires. Results: 66 patients were included in the study with a one year follow-up. We found no significant difference in: recurrence of POP and reintervention (recurrence with required treatment n (%): 3(10) vs. 5(15), p = 0.28) and hospital stay (mean ± SD days: 5 ± 2 vs. 7 ± 2, p = 0.97). Significant less blood loses (250 ± 210 ml. vs. 360 ± 230 ml.) and shorter operation time (67 ± 20 min. vs 102 ± 22 min.) in modified Manchester group, but significant more urinary retention (cases: 8 vs 6) in modified Manchester group. The overall functional outcome was acceptable for both procedures. Conclusions: We found an excellent performance of both procedures regarding recurrences and intra and post-operative complications. A high degree of acceptance-satisfaction shows the modified Manchester operation and is good option for the treatment of uterine prolapse in younger women who wish to keep their uterus and in all cases of genital prolapse with elongation of uterine cervix (when there is not other uterine pathology). Shorter operation time and lower blood lose are another factors for stronger recommendation of the modified Manchester operation for patients with concomitant diseases and/or older age patients with elevated risk from anesthesia and/or surgery. Key worlds: vaginal, hysterectomy, prolapse, uterus. PMID:24802202

Iliev, V N; Andonova, I T

2014-01-01

343

Performing Vaginal Lavage, Crystal Violet Staining, and Vaginal Cytological Evaluation for Mouse Estrous Cycle Staging Identification  

PubMed Central

A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-?-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status.

McLean, Ashleigh C.; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A.L.

2012-01-01

344

Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy.  

PubMed

Vulvovaginal atrophy (VVA) and dryness are common symptoms of the decline in endogenous production of estrogen at menopause and often result in dyspareunia. Yet while 10% to 40% of women experience discomfort due to VVA, it is estimated that only 25% seek medical help. The main goals of treatment for vaginal atrophy are to improve symptoms and to restore vaginal and vulvar anatomic changes. Treatment choices for postmenopausal dyspareunia resulting from vulvovaginal atrophy will depend on the underlying etiology and might include individualized treatment. A number of forms of vaginal estrogen and manner of delivery are currently available to treat moderate to severe dyspareunia caused by VVA. They all have been shown to be effective and are often the preferred treatment due to the targeted efficacy for urogenital tissues while resulting in only minimal systemic absorption. Both healthcare professionals and patients often find it difficult to broach the subject of sexual problems associated with VVA. However, with minimal effort to initiate a conversation about these problems, healthcare providers can provide useful information to their postmenopausal patients in order to help them each choose the optimal treatment for their needs and symptoms. PMID:21072280

Kingsberg, Sa; Kellogg, S; Krychman, M

2010-01-01

345

Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy  

PubMed Central

Vulvovaginal atrophy (VVA) and dryness are common symptoms of the decline in endogenous production of estrogen at menopause and often result in dyspareunia. Yet while 10% to 40% of women experience discomfort due to VVA, it is estimated that only 25% seek medical help. The main goals of treatment for vaginal atrophy are to improve symptoms and to restore vaginal and vulvar anatomic changes. Treatment choices for postmenopausal dyspareunia resulting from vulvovaginal atrophy will depend on the underlying etiology and might include individualized treatment. A number of forms of vaginal estrogen and manner of delivery are currently available to treat moderate to severe dyspareunia caused by VVA. They all have been shown to be effective and are often the preferred treatment due to the targeted efficacy for urogenital tissues while resulting in only minimal systemic absorption. Both healthcare professionals and patients often find it difficult to broach the subject of sexual problems associated with VVA. However, with minimal effort to initiate a conversation about these problems, healthcare providers can provide useful information to their postmenopausal patients in order to help them each choose the optimal treatment for their needs and symptoms.

Kingsberg, SA; Kellogg, S; Krychman, M

2010-01-01

346

Performing vaginal lavage, crystal violet staining, and vaginal cytological evaluation for mouse estrous cycle staging identification.  

PubMed

A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-?-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status. PMID:23007862

McLean, Ashleigh C; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A L

2012-01-01

347

Colostrum in menopause effects on vaginal cytology/symptoms.  

PubMed

The aim of this study was to assess the effects of three weeks of daily colostrum cream on vaginal cytology and local symptoms related to menopause. Genito-urinary symptoms and cell morphology were analyzed at time 0 (T0) and after three weeks (16 +/- days since the end of treatment) at time 1 (T1). Dyspareunia, vaginal dryness, and maturation index (MI) reached a statistically significant difference between T0 and T1. The results proved to be an alternative treatment for vaginal distress caused by lack of hormones in patients in which hormonal treatment is contraindicated. PMID:23971242

Tucci, S; Mancini, R; De Vitis, C; Noto, A; Marra, E; Lukic, A; Giovagnoli, M R; Moscarini, M

2013-01-01

348

Transverse vaginal septum: case report and review of the literature.  

PubMed

A case of perforated complete transverse vaginal septum in the upper third of the vagina in a patient presenting at 19 years of age for evaluation of primary infertility. Diagnosis was made by hysterosalpingography. The patient was treated surgically and conceived 2 months after the procedure. The finding of transverse vaginal septum in an asymptomatic infertility patient is highly unusual. We reviewed the literature since 1966 and summarized 73 cases. The review confirms the benign characteristics of this rare anomaly and supports the embryonic origin of the transverse septum from the vaginal plate. PMID:9449593

Levy, G; Warren, M; Maidman, J

1997-01-01

349

Vaginal Myomectomy for a Thirteen-Centimeter Anterior Myoma  

PubMed Central

Vaginal myomectomy is an uncommon but advantageous approach for large interstitial uterine fibroids. Myomectomy is performed via laparotomy and laparoscopy; however, in selected cases, vaginal myomectomy has been proven to be a safe and an effective surgical procedure. We report the case of a 38-year-old para one woman with complaints of chronic lower abdominal pain. Preoperative workup revealed a thirteen-centimeter interstitial uterine myoma in the anterior wall. Successful myomectomy was performed via the vaginal route. We will share the preoperative images, operative technique, and postoperative images.

Deval, Bruno; Rousset, Pascal

2013-01-01

350

Intrapartum diagnosis and treatment of longitudinal vaginal septum.  

PubMed

Longitudinal vaginal septum is a rare Müllerian malformation that may be associated with dyspareunia, dysmenorrhea, primary amenorrhea, and infertility. In this report, the authors present a case of longitudinal vaginal septum in a 15-year-old patient with a full-term pregnancy whose diagnosis was only made during labor following bidigital vaginal and speculum examination. Septoplasty was performed during the second stage of labor. Both mother and child progressed satisfactorily and were discharged from hospital in good health. Six months later, ultrasonography, hysterosalpingography, and hysteroscopy were carried out and no other associated abnormality was found. PMID:24891963

de França Neto, Antonio Henriques; Nóbrega, Bianca Virgolino; Clementino Filho, Jessé; do Ó, Tiago Cavalcanti; de Amorim, Melania Maria Ramos

2014-01-01

351

Intrapartum Diagnosis and Treatment of Longitudinal Vaginal Septum  

PubMed Central

Longitudinal vaginal septum is a rare Müllerian malformation that may be associated with dyspareunia, dysmenorrhea, primary amenorrhea, and infertility. In this report, the authors present a case of longitudinal vaginal septum in a 15-year-old patient with a full-term pregnancy whose diagnosis was only made during labor following bidigital vaginal and speculum examination. Septoplasty was performed during the second stage of labor. Both mother and child progressed satisfactorily and were discharged from hospital in good health. Six months later, ultrasonography, hysterosalpingography, and hysteroscopy were carried out and no other associated abnormality was found.

de Franca Neto, Antonio Henriques; Nobrega, Bianca Virgolino; Clementino Filho, Jesse; do O, Tiago Cavalcanti; de Amorim, Melania Maria Ramos

2014-01-01

352

Pelviscopic Compared to Laparotomic and Vaginal Intrafascial Hysterectomy  

PubMed Central

Between 1993 and 1994, 368 women underwent hysterectomies for benign disorders at the University of Kiel. Of these, 58.7% were performed either by pelviscopic or by laparotomy Classic Intrafascial Supracervical Hysterectomy (CISH). Of the remaining, 14.8% were performed by abdominal hysterectomy, 13.6% by Intrafascial Vaginal Hysterectomy (IVH), 12.2% by Vaginal Hysterectomy (VH), and only 0.05% by Laparoscopic Assisted Vaginal Hysterectomy (LAVH). Comparative data of these six surgical techniques concerning patients characteristics, indications for operation, histological features, blood loss, operating time, hospital stay, uterine weights and postoperatively used analgesics are described.

Lutzewitsch, N.

1997-01-01

353

Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective  

PubMed Central

Vaginal bacterial communities are thought to help prevent sexually transmitted infections. Bacterial vaginosis (BV) is a common clinical syndrome in which the protective lactic acid–producing bacteria (mainly species of the Lactobacillus genus) are supplanted by a diverse array of anaerobic bacteria. Epidemiologically, BV has been shown to be an independent risk factor for adverse outcomes including preterm birth, development of pelvic inflammatory disease, and acquisition of sexually transmitted infections. Longitudinal studies of the vaginal microbiome using molecular techniques such as 16S ribosomal DNA analysis may lead to interventions that shift the vaginal microbiota toward more protective states.

Brotman, Rebecca M.

2011-01-01

354

Imperforate hymen and vaginal atresia and their associated anomalies.  

PubMed Central

The presenting features and associated abnormalities of imperforate hymen and vaginal atresia were studied in 24 girls under the age of 16 years. Hydrocolpos or hydrometrocolpos occurred in 8 infants, 13 older girls developed haematocolpos, but 3 of the girls had no distension of the genital tract. Seven of the older girls were diagnosed as having appendicitis. Anorectal anomalies were present in 9 of the children. Intravenous pyelography was performed on 16 girls and was normal in only one. Urinary tract investigations are indicated in all girls with vaginal outlet obstruction, and the vaginal orifice should be inspected in all girls with anorectal abnormalities.

Shaw, L M; Jones, W A; Brereton, R J

1983-01-01

355

Therapeutic Mechanisms of Treatment in Cervical and Vaginal Cancer  

PubMed Central

Cervical and vaginal cancers remain serious health problems. Worldwide, more than 530,000 women annually are diagnosed with these diseases, with most new incident cases occurring in nations with limited health resources and underdeveloped screening programs. For women whose disease is too bulky or widespread for surgery, radiochemotherapy should be looked upon as the standard of care. Randomized clinical trials have indicated that radiochemotherapy strategies that disrupt the repair of damaged DNA are key to the management of advanced stage cervical and vaginal cancers. Here, from a viewpoint of cancer cell molecular biology, treatments for advanced stage cervical and vaginal cancers are discussed.

Kunos, Charles A

2012-01-01

356

Development of a novel synergistic thermosensitive gel for vaginal candidiasis: an in vitro, in vivo evaluation.  

PubMed

The singular aim of the proposed work is the development of a synergistic thermosensitive gel for vaginal application in subjects prone to recurrent vaginal candidiasis and other microbial infections. The dual loading of Itraconazole and tea tree oil in a single formulation seems promising as it would elaborate the microbial coverage. Despite being low solubility of Itraconazole in tea tree oil, a homogeneous, transparent and stable solution of both was created by co-solvency using chloroform. Complete removal of chloroform was authenticated by GC-MS and the oil solution was used in the development of nanoemulsion which was further translated into a gel bearing thermosensitive properties. In vitro analyses (MTT assay, viscosity measurement, mucoadhesion, ex vivo permeation, etc.) and in vivo studies (bioadhesion, irritation potential and fungal clearance kinetics in rat model) of final formulation were carried out to establish its potential for further clinical evaluation. PMID:23201748

Mirza, Mohd Aamir; Ahmad, Sayeed; Mallick, Md Nasar; Manzoor, Nikhat; Talegaonkar, Sushama; Iqbal, Zeenat

2013-03-01

357

Vesicovaginal fistula due to vaginal herb for primary infertility: could it be devastating?  

PubMed

Vesicovaginal fistula (VVF) is a very commonly encountered urogynaecological entity in developing countries such as India. The most common cause of VVF in developing counties is secondary to obstructive labour. We report a very unusual case of VVF in a young woman that developed due to insertion of an unknown vaginal herb for treatment of primary infertility. Cystoscopy showed a single trigonal fistula measuring 3×2 cm just near the bladder neck. Vaginoscopy revealed cicatrised less capacious vagina and unhealthy vaginal mucosa. She was treated with transvaginal VVF repair using Martius flap interposition which leaked on 10th postoperative day. She underwent re-evaluation and another transvaginal fistula repair for small trigonal residual fistula after 3 months. She is doing well during the follow-up of 2 years. She attained sexual activity after 3 months of surgical repair but could not conceive. PMID:24092608

Paul, Sagorika; Singh, Vishwajeet; Sinha, Rahul Janak; Kumar, Arvind

2013-01-01

358

The Effects of School Closures on Influenza Outbreaks and Pandemics: Systematic Review of Simulation Studies  

PubMed Central

Background School closure is a potential intervention during an influenza pandemic and has been investigated in many modelling studies. Objectives To systematically review the effects of school closure on influenza outbreaks as predicted by simulation studies. Methods We searched Medline and Embase for relevant modelling studies published by the end of October 2012, and handsearched key journals. We summarised the predicted effects of school closure on the peak and cumulative attack rates and the duration of the epidemic. We investigated how these predictions depended on the basic reproduction number, the timing and duration of closure and the assumed effects of school closures on contact patterns. Results School closures were usually predicted to be most effective if they caused large reductions in contact, if transmissibility was low (e.g. a basic reproduction number <2), and if attack rates were higher in children than in adults. The cumulative attack rate was expected to change less than the peak, but quantitative predictions varied (e.g. reductions in the peak were frequently 20–60% but some studies predicted >90% reductions or even increases under certain assumptions). This partly reflected differences in model assumptions, such as those regarding population contact patterns. Conclusions Simulation studies suggest that school closure can be a useful control measure during an influenza pandemic, particularly for reducing peak demand on health services. However, it is difficult to accurately quantify the likely benefits. Further studies of the effects of reactive school closures on contact patterns are needed to improve the accuracy of model predictions.

Jackson, Charlotte; Mangtani, Punam; Hawker, Jeremy; Olowokure, Babatunde; Vynnycky, Emilia

2014-01-01

359

On the Closure Properties of Robotic Grasping  

Microsoft Academic Search

The form--closure and force--closure properties of robotic grasping are investigated. Looselyspeaking, these properties are related to the capability of the robot to inhibit motions ofthe workpiece in spite of externally applied forces. In this paper, form--closure is consideredas a purely geometric property of a set of unilateral (contact) constraints, suchas those applied on a workpiece by a mechanical fixture, while

Antonio Bicchi

1995-01-01

360

Staple closure of the left atrial appendage.  

PubMed

Closure of the fibrillating left atrial appendage has been recommended during mitral valve repair or replacement to prevent systemic emboli postoperatively. Closure of the left atrial appendage has been accomplished in the past by direct intra-atrial suture or by external ligation. The authors have used the TA-55 automatic stapler in 40 patients to close the left atrial appendage during mitral valve surgery. In all patients the closure was effected successfully at the first attempt without complication. PMID:6704817

Landymore, R; Kinley, C E

1984-03-01

361

Oxidized Regenerated Cellulose Resembling Vaginal Cuff Abscess  

PubMed Central

Introduction: Application of oxidized regenerated cellulose is commonly performed in laparoscopy to achieve hemostasis during surgery. The appearance of an abscess resembles oxidized regenerated cellulose, causing imaging studies to be difficult to interpret. Case Description: We describe the cases of 3 patients who underwent oxidized regenerated cellulose placement during laparoscopic gynecologic surgery. They subsequently presented with signs and symptoms resembling an abscess. Computed tomographic imaging can be challenging to interpret in such cases; radiologic findings can be used to differentiate between the characteristics of oxidized regenerated cellulose and those of abscess formation on the vaginal cuff. Discussion: Oxidized regenerated cellulose has an appearance that often mimics postsurgical abscess formation. There are distinct characteristics that distinguish both findings. It is essential that patients' records accurately describe the presence and location of regenerated oxidized cellulose when placed intraoperatively, and this information must be relayed to the interpreting radiologist to facilitate medical diagnosis and guide clinical management.

Harkins, Gerald; Dykes, Thomas; Gockley, Allison; Davies, Matthew

2014-01-01

362

Improving Vaginal Examinations Performed by Midwives  

PubMed Central

A vaginal examination (VE) is an essential part of midwifery care, and is routinely performed when assessing the progress of labour. As evidence shows that during labour women may find VEs unpleasant, embarrassing and sometimes painful, the aim of this article is to review literature on the use of VEs during labour and to synthesise information from the available literature on how to provide an effective VE. The studies considered were retrieved from three databases (the Cumulative Index to Nursing and Allied Health Literature [CINAHL], SCOPUS and MEDLINE) using the following search terms: “VEs in labour”, “midwives and use of VEs” and “women experiences of VEs in labour”. The literature reviewed suggests that midwives are not careful about VEs. Therefore, a concerted effort is needed to pay attention to the frequency of VEs, the management of pain and distress, information-giving and the preferences of the patient, so that the patient can feel in control during a VE.

Muliira, Rhoda S.; Seshan, Vidya; Ramasubramaniam, Shanthi

2013-01-01

363

Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo  

SciTech Connect

Purpose: Vaginal balloon packing is a means to displace organs at risk during high dose rate brachytherapy of the uterine cervix. We tested the hypothesis that contrast-filled vaginal balloon packing reduces radiation dose to organs at risk, such as the bladder and rectum, in comparison to water- or air-filled balloons. Methods and Materials: In a phantom study, semispherical vaginal packing balloons were filled with air, saline solution, and contrast agents. A high dose rate iridium-192 source was placed on the anterior surface of the balloon, and the diode detector was placed on the posterior surface. Dose ratios were taken with each material in the balloon. Monte Carlo (MC) simulations, by use of the MC computer program DOSXYZnrc, were performed to study dose reduction vs. balloon size and contrast material, including commercially available iodine- and gadolinium-based contrast agents. Results: Measured dose ratios on the phantom with the balloon radius of 3.4 cm were 0.922 {+-} 0.002 for contrast/saline solution and 0.808 {+-} 0.001 for contrast/air. The corresponding ratios by MC simulations were 0.895 {+-} 0.010 and 0.781 {+-} 0.010. The iodine concentration in the contrast was 23.3% by weight. The dose reduction of contrast-filled balloon ranges from 6% to 15% compared with water-filled balloon and 11% to 26% compared with air-filled balloon, with a balloon size range between 1.4 and 3.8 cm, and iodine concentration in contrast of 24.9%. The dose reduction was proportional to the contrast agent concentration. The gadolinium-based contrast agents showed less dose reduction because of much lower concentrations in their solutions. Conclusions: The dose to the posterior wall of the bladder and the anterior wall of the rectum can be reduced if the vaginal balloon is filled with contrast agent in comparison to vaginal balloons filled with saline solution or air.

Saini, Amarjit S. [Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States); Zhang, Geoffrey G., E-mail: geoffrey.zhang@moffitt.org [Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States); Finkelstein, Steven E.; Biagioli, Matthew C. [Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States)

2011-07-15

364

Congenital vaginal obstructions: varied presentation and outcome.  

PubMed

Congenital obstructing lesions of vagina, hydrometrocolpos, and hematocolpos, present at a variable time during early childhood and adolescence to different medical and surgical specialties. Twenty-six cases presenting over an 18-years period (1987-2005) were divided into three groups; Group A: neonates (6), Group B: adolescents (18), and Group C: adults (2). Common presentations in neonates (Group A) were abdominal mass (5), neonatal sepsis (3), and respiratory distress (2); whereas abdominal pain (18), voiding dysfunctions (13), and backache (7) were prevalent in adolescents (Group B). Adults (Group C) presented with inability to consummate and infertility (2). Four patients received erroneous treatment; exploratory laparotomy (1) and appendectomy (3). Urinary symptoms and associated urinary abnormalities were present in more than 50% of cases, especially those with complex anomalies. Management included excision of imperforate hymen (16) and transverse vaginal septum (8) through perineal (20) and abdominoperineal approach (4). Patients with urogenital sinus (1) and cloacal malformation (1) had staged reconstruction at 2.5 years of age following preliminary vesicostomy and colostomy at birth. On follow up (range 1-15 years; mean 7) more than 60% patients have menstrual irregularity (11), endometriosis (5), and infertility (4). In conclusion, rarity and variable presentation of congenital vaginal obstructions can lead to delayed diagnosis and erroneous management. A high index of suspicion and cross-sectional imaging help in early diagnosis and associated renal anomalies. A comprehensive management is imperative to preserve the reproductive potentials, as significant proportion of patients may experience sexual difficulties, menstrual irregularity, and infertility. PMID:16871398

Nazir, Zafar; Rizvi, Raheela M; Qureshi, Rahat N; Khan, Zarrish Saeed; Khan, Zarak

2006-09-01

365

Comparison of abdominal muscle thickness with vaginal pressure changes in healthy women.  

PubMed

[Purpose] The purpose of this study was to verify the efficacy of a pelvic floor muscle exercise program by comparing subjects' muscle thickness with changes in vaginal pressure. [Subjects] Two groups of female participants without a medical history of pelvic floor muscle dysfunction were evaluated. The mean age of Group I was 33.5?years and that of Group II was 49.69?years. [Methods] The participants were instructed to perform a pelvic floor muscle contraction. While measuring the vaginal pressure of the pelvic floor muscle, biofeedback was given on five levels, and the thicknesses of the transversus abdominis, external oblique, and internal oblique muscles were measured with ultrasound. [Results] The thickness of the transversus abdominis muscle was significantly increased at 30 cmH2O in Group I, and at 20 cmH2O in Group II. The thickness of the internal oblique abdominal muscle significantly increased at maximum contraction in Group II. [Conclusion] Different abdominal muscles contracted depending on vaginal pressure. The result may be used to create and implement an exercise program that effectively strengthens the pelvic floor muscles. PMID:24707099

Kim, Bo-In; Hwang-Bo, Gak; Kim, Ha-Roo

2014-03-01

366

Management of angle closure glaucoma  

PubMed Central

Primary angle closure glaucoma (PACG) is equally prevalent in Indian in Asian population as the primary open angle glaucoma. Eighty-six percent of people with PACG are in Asia, with approximately 48.0% in China, 23.9% in India and 14.1% in southeast Asia. To understand PACG, it is mandatory to understand its classification and type of presentation with the underlying pathophysiology. The treatment options are medical, laser and/or surgical. The present article provides an overview of PACG.

See, Jovina L S; Aquino, Maria Cecilia D; Aduan, Joel; Chew, Paul T K

2011-01-01

367

Air quality impacts of a scheduled 36-h closure of a major highway  

NASA Astrophysics Data System (ADS)

Elevated concentrations of ultrafine particles (UFPs, <0.1 ?m) are commonly found near roadways. On the July 16-17, 2011 weekend, a section of a major Los Angeles freeway, the I-405, was closed for 36 h. We measured UFPs and other pollutants at two fixed locations, one upwind and one downwind, and at various distances from I-405 using a mobile measurement platform (MMP) on Fridays, Saturdays, and Sundays before, during, and after closure. On the closure Saturday on July 16, I-405 traffic flow was reduced by ˜90% relative to non-closure Saturday observations. Downwind of I-405, fixed-site measurements showed the following reductions: 83% of particle number concentration (PNC), 36% of PM2.5, and 62% of black carbon. Fixed-site measurements showed daily average UFP size distributions were bimodal for non-closure conditions (nucleation modes ˜20 nm, accumulation modes ˜60 nm), but only showed an accumulation mode ˜50 nm during closure. Spatial measurements from the MMP confirmed no nucleation mode was detected at any location 0-300 m downwind during closure. In 2011, non-closure particle emission factors were 5.0, 2.7, and 3.4 × 1013 particles vehicle-1 km-1 for Friday through Sunday respectively. After accounting for instrumental and traffic flow differences, weekday PNC in 2011 was 60% lower than 2001 at the same study location. During the closure event, regional freeway traffic was reduced compared to four selected control Saturdays. Eight stationary monitoring stations throughout the South Coast Air Basin showed PM2.5 was reduced between 18 and 36% relative to the same control days. The outcome of this natural experiment during the I-405 closure confirms that substantial traffic reduction can improve local and regional air quality in sprawled urban regions such as Los Angeles, CA.

Quiros, David C.; Zhang, Qunfang; Choi, Wonsik; He, Meilu; Paulson, Suzanne E.; Winer, Arthur M.; Wang, Rui; Zhu, Yifang

2013-03-01

368

Optical Coherence Tomography Compared With Colposcopy for Assessment of Vaginal Epithelial Damage: A Randomized Controlled Trial  

PubMed Central

Objective Colposcopy has been used to detect epithelial damage with vaginal microbicides. In animal models, optical coherence tomography (OCT) provided increased sensitivity over colposcopy in detecting epithelial injury. This randomized double-blinded clinical study compared OCT to colposcopy for the evaluation of epithelial injury in women using placebo or nonoxynol-9. Methods Thirty women aged 18–45 were randomized to use hydroxyethyl cellulose placebo or nonoxynol-9 vaginal gel twice daily for 5.5 days. Imaging with colposcopy and OCT was performed prior to product use, after the last dose, and 1 week later. Colposcopy was graded using standard criteria. OCT images were scored for epithelial integrity based on a published scoring system and measured for epithelial thickness. Results Colposcopy findings and OCT scores and epithelial thicknesses were similar between treatment groups at baseline. After treatment, there were significant differences between the nonoxynol-9 (1.37) and control group (1.15) OCT scores (p<0.001, indicating epithelial injury, and there was epithelial thinning in the nonoxynol-9 group (237?m) compared to the control group (292?m) (p=0.008). There were no significant posttreatment colposcopic differences in epithelial disruption between treatment groups, with only increased erythema noted after nonoxynol-9 use (p=0.02). Conclusion OCT detected epithelial disruption and thinning not identified by colposcopy. Vaginal epithelial thickness, a measure previously available only through biopsy, decreased after nonoxynol-9 use, a finding that may contribute to increased susceptibility to HIV after frequent use. OCT shows promise for the noninvasive clinical assessment of vaginal epithelial damage. Clinical Trial Registration UMIN Clinical Trials Registry, www.umin.ac.jp/ctr/index.htm, R000006186.

Vincent, Kathleen L.; Stanberry, Lawrence R.; Moench, Thomas R.; Breitkopf, Carmen Radecki; Loza, Melissa L.; Wei, Jingna; Grady, James; Paull, Jeremy; Motamedi, Massoud; Rosenthal, Susan L.

2011-01-01

369

Comparison of Blood Loss in Induced vs. Spontaneous Vaginal Delivery Using Specialized Blood Collection Bag  

PubMed Central

Objective: To compare third stage blood loss in induced vs. spontaneous vaginal deliveries and to correlate the amount of blood loss with the decrease in haemoglobin following deliveries. Setting: Department of Obstetrics and Gynaecology, Kasturba Hospital Manipal, Karnataka, India. Materials and Methods: Blood loss following placental deliveries was measured by using special collection bags in 150 pregnant ladies who delivered vaginally by labour induction and it was compared with that of another 50 women who had spontaneous vaginal deliveries. Haemoglobin values were recorded for each patient prior to labour and after delivery of child. Results: The mean blood loss in induced group was 30 mL more than that in spontaneous group (202 ± 117 mL vs. 172 ± 114 mL), but this was not statistically significant (p=0.12). However, when different methods of induction were compared, oxytocin group was found to have significantly higher blood loss (327 ± 140 mL) as compared to that in other types of labour inductions as well as spontaneous deliveries. Labour induction using prostaglandins did not produce more blood loss as compared that produced by spontaneous deliveries. Both induced and spontaneous delivery groups showed statistically significant drops in post-delivery haemoglobin values, but the drop was relatively more in induced group as compared to that in spontaneous vaginal delivery group (0.96gm/dL vs. 0.56gm/dL), which appeared to be statistically significant (p=0.002). Conclusion: Labour induction using prostaglandins is safe as compared to oxytocin usage. Accurate estimation of blood loss is important in all types of deliveries, in order to detect postpartum haemorrhage early, so that appropriate measures can be undertaken.

Rai, Lavanya; Mohan, Akshara

2014-01-01

370

40 CFR 265.1202 - Closure and post-closure care.  

Code of Federal Regulations, 2013 CFR

...post-closure care. (a) At closure of a magazine or unit which stored hazardous...closure, and financial responsibility for magazines or units must meet all of the requirements...service as a munitions or explosives magazine or storage unit. (b) If,...

2013-07-01

371

40 CFR 264.1202 - Closure and post-closure care.  

Code of Federal Regulations, 2013 CFR

...post-closure care. (a) At closure of a magazine or unit which stored hazardous...closure, and financial responsibility for magazines or units must meet all of the requirements...service as a munitions or explosives magazine or storage unit. (b) If,...

2013-07-01

372

Mucus-penetrating nanoparticles for vaginal and gastrointestinal drug delivery  

NASA Astrophysics Data System (ADS)

A method that could provide more uniform and longer-lasting drug delivery to mucosal surfaces holds the potential to greatly improve the effectiveness of prophylactic and therapeutic approaches for numerous diseases and conditions, including sexually transmitted infections and inflammatory bowel disease. However, the body's natural defenses, including adhesive, rapidly cleared mucus linings coating nearly all entry points to the body not covered by skin, has limited the effectiveness of drug and gene delivery by nanoscale delivery systems. Here, we investigate the use of muco-inert mucus-penetrating nanoparticles (MPP) for improving vaginal and gastrointestinal drug delivery. Conventional hydrophobic nanoparticles strongly adhere to mucus, facilitating rapid clearance from the body. Here, we demonstrate that mucoadhesive polystyrene nanoparticles (conventional nanoparticles, CP) become mucus-penetrating in human cervicovaginal mucus (CVM) after pretreatment with sufficient concentrations of Pluronic F127. Importantly, the diffusion rate of large MPP did not change in F127 pretreated CVM, implying there is no affect on the native pore structure of CVM. Additionally, there was no increase in inflammatory cytokine release in the vaginal tract of mice after daily application of 1% F127 for one week. Importantly, HSV virus remains adherent in F127-pretreated CVM. Mucosal epithelia use osmotic gradients for fluid absorption and secretion. We hypothesized that hypotonically-induced fluid uptake could be advantageous for rapidly delivering drugs through mucus to the vaginal epithelium. We evaluated hypotonic formulations for delivering water-soluble drugs and for drug delivery with MPP. Hypotonic formulations markedly increased the rate at which drugs and MPP reached the epithelial surface. Additionally, hypotonic formulations greatly enhanced drug and MPP delivery to the entire epithelial surface, including deep into the vaginal folds (rugae) that isotonic formulations failed to reach. However, hypotonic formulations caused free drugs to be drawn through the epithelium, reducing vaginal retention. In contrast, hypotonic formulations caused MPP to accumulate rapidly and uniformly on vaginal surfaces, ideally positioned for sustained drug delivery. Using a mouse model of vaginal genital herpes (HSV-2) infection, we found that hypotonic delivery of free drug led to improved immediate protection, but diminished longer-term protection. Minimally hypotonic formulations provided rapid and uniform delivery of MPP to the entire vaginal surface, thus enabling formulations with minimal risk of epithelial toxicity. We then describe an ex vivo method for characterizing particle transport on freshly excised mucosal tissues. By directly observing MPP transport on vaginal, gastrointestinal, and respiratory tissue, we were able to determine an innate difference in mucus mesh size at different anatomical locations. In addition, we were able to optimize particle size for gastrointestinal delivery in mice. As described here, there are numerous barriers to effective drug delivery in the gastrointestinal tract, including the mucus barrier. We go on to demonstrate that MPP can improve delivery in the gastrointestinal tract, both by rectal and oral administration. Finally, we describe the use of MPP for improving vaginal drug delivery. Incomplete drug coverage and short duration of action limit the effectiveness of vaginally administered drugs, including microbicides for preventing sexually transmitted infections. We show that MPP provide uniform distribution over the vaginal epithelium, whereas CP are aggregated by mouse vaginal mucus, leading to poor distribution. By penetrating into the deepest mucus layers in the rugae, more MPP were retained in the vaginal tract compared to CP. After 24 h, when delivered in a conventional vaginal gel, patches of a model drug remained on the vaginal epithelium, whereas the epithelium was coated with drug delivered by MPP. We then demonstrate that when administered 30 min prior to inoculum, anti-HSV-2 MPP protected

Ensign-Hodges, Laura

373

Management of Vaginal Atrophy: Implications from the REVIVE Survey.  

PubMed

Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA. PMID:24987271

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

374

Management of Vaginal Atrophy: Implications from the REVIVE Survey  

PubMed Central

Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women’s VIews of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA.

Wysocki, Susan; Kingsberg, Sheryl; Krychman, Michael

2014-01-01

375

A rare case of vaginal vault evisceration and its management  

PubMed Central

A 66 year old woman presented to A&E with per vagina bleeding and a mass protruding from the vagina. The patient was examined under anaesthesia, which revealed vaginal prolapse with evisceration of approximately 20-30 cm of bowel. The patient had received an abdominal hysterectomy 30 years ago for menorrhagia. In the last decade, the patient had experienced other recurrent episodes of prolapse (cystocoele and retrocoele). Vaginal vault evisceration is a recognised rare complication of hysterectomy and is a gynaecological emergency. This patient’s condition was rapidly recognised and surgically managed. The repair was achieved in two surgeries. Initially, the small bowel was re-inserted into the peritoneal cavity through the vaginal wall defect and the vaginal defect repaired. After sufficient time for healing, a sacrocolpopexy was performed to repair the prolapse.

Pereira, FD Alves; Rai, H

2012-01-01

376

Vaginal Estrogen Therapy for Patients with Breast Cancer  

PubMed Central

On account of the good prognosis for patients with breast cancer, improving or maintaining the quality of life in the aftercare period is becoming more and more important. In particular, the increasing usage of aromatase inhibitors in the past few years has led to an increased incidence of vaginal atrophy with symptoms such as vaginal dryness, petechial bleeding, dyspareunia and recurrent cystitis. And just these symptoms have a detrimental impact on the quality of life of breast cancer patients. Application of a topical estrogen therapy represents the most effective means to treat vaginal atrophy. The use of a systemic or, respectively, topical hormone therapy is, however, contraindicated for breast cancer patients. Further clinical trials are needed in order to assess the safety of vaginal estrogen therapy.

Moegele, M.; Buchholz, S.; Seitz, S.; Lattrich, C.; Ortmann, O.

2013-01-01

377

Vaginal Gel Might Prevent HIV Hours After Exposure  

MedlinePLUS

... please enable JavaScript. Vaginal Gel Might Prevent HIV Hours After Exposure Lab tests with monkeys look promising, ... from HIV, even if it is applied several hours after sex, animal research suggests. The antimicrobial gel ...

378

Female sexual dysfunction following vaginal surgery: myth or reality?  

PubMed

This article reviews the mechanisms by which vaginal surgery affects female sexual function and related pathophysiology to potential causes. The anatomy, neurovascular supply of the clitoris and introitus, and intrapelvic nerve supply are discussed as they apply to vaginal surgery. Methods to avoid neurovascular damage during pelvic floor surgery have been corroborated by supporting literature. The incidence of female sexual dysfunction after various transvaginal procedures for indications such as stress urinary incontinence and pelvic organ prolapse, anterior/posterior colporrhaphy, perineoplasty, and vaginal vault prolapse has been discussed. Current literature regarding female sexual dysfunction following other procedures such as vaginal hysterectomy, Martius flap interposition, and vesicovaginal and rectovaginal fistula repair also are reviewed. PMID:15461920

Tunuguntla, Hari S G R; Gousse, Angelo E

2004-10-01

379

Vaginal and Cervical Cytology of the Early Puerperium.  

National Technical Information Service (NTIS)

Cervical and vaginal smears were obtained from 160 women who had delivered one to eight days prior to cytologic examination. Preparations were examined for general morphology and graded for malignancy. The degree of cytologic abnormality was found to corr...

H. B. Soloway

1969-01-01

380

Higher order turbulence closure models  

NASA Technical Reports Server (NTRS)

Theoretical models are developed and numerical studies conducted on various types of flows including both elliptic and parabolic. The purpose of this study is to find better higher order closure models for the computations of complex flows. This report summarizes three new achievements: (1) completion of the Reynolds-stress closure by developing a new pressure-strain correlation; (2) development of a parabolic code to compute jets and wakes; and, (3) application to a flow through a 180 deg turnaround duct by adopting a boundary fitted coordinate system. In the above mentioned models near-wall models are developed for pressure-strain correlation and third-moment, and incorporated into the transport equations. This addition improved the results considerably and is recommended for future computations. A new parabolic code to solve shear flows without coordinate tranformations is developed and incorporated in this study. This code uses the structure of the finite volume method to solve the governing equations implicitly. The code was validated with the experimental results available in the literature.

Amano, Ryoichi S.; Chai, John C.; Chen, Jau-Der

1988-01-01

381

Accelerating cleanup: Paths to closure  

SciTech Connect

This document was previously referred to as the Draft 2006 Plan. As part of the DOE`s national strategy, the Richland Operations Office`s Paths to Closure summarizes an integrated path forward for environmental cleanup at the Hanford Site. The Hanford Site underwent a concerted effort between 1994 and 1996 to accelerate the cleanup of the Site. These efforts are reflected in the current Site Baseline. This document describes the current Site Baseline and suggests strategies for further improvements in scope, schedule and cost. The Environmental Management program decided to change the name of the draft strategy and the document describing it in response to a series of stakeholder concerns, including the practicality of achieving widespread cleanup by 2006. Also, EM was concerned that calling the document a plan could be misconstrued to be a proposal by DOE or a decision-making document. The change in name, however, does not diminish the 2006 vision. To that end, Paths to Closure retains a focus on 2006, which serves as a point in time around which objectives and goals are established.

Edwards, C.

1998-06-30

382

Optimized Dose Distribution of Gammamed Plus Vaginal Cylinders  

SciTech Connect

Endometrial carcinoma is the most common malignancy arising in the female genital tract. Intracavitary vaginal cuff irradiation may be given alone or with external beam irradiation in patients determined to be at risk for locoregional recurrence. Vaginal cylinders are often used to deliver a brachytherapy dose to the vaginal apex and upper vagina or the entire vaginal surface in the management of postoperative endometrial cancer or cervical cancer. The dose distributions of HDR vaginal cylinders must be evaluated carefully, so that clinical experiences with LDR techniques can be used in guiding optimal use of HDR techniques. The aim of this study was to optimize dose distribution for Gammamed plus vaginal cylinders. Placement of dose optimization points was evaluated for its effect on optimized dose distributions. Two different dose optimization point models were used in this study, namely non-apex (dose optimization points only on periphery of cylinder) and apex (dose optimization points on periphery and along the curvature including the apex points). Thirteen dwell positions were used for the HDR dosimetry to obtain a 6-cm active length. Thus 13 optimization points were available at the periphery of the cylinder. The coordinates of the points along the curvature depended on the cylinder diameters and were chosen for each cylinder so that four points were distributed evenly in the curvature portion of the cylinder. Diameter of vaginal cylinders varied from 2.0 to 4.0 cm. Iterative optimization routine was utilized for all optimizations. The effects of various optimization routines (iterative, geometric, equal times) was studied for the 3.0-cm diameter vaginal cylinder. The effect of source travel step size on the optimized dose distributions for vaginal cylinders was also evaluated. All optimizations in this study were carried for dose of 6 Gy at dose optimization points. For both non-apex and apex models of vaginal cylinders, doses for apex point and three dome points were higher for the apex model compared with the non-apex model. Mean doses to the optimization points for both the cylinder models and all the cylinder diameters were 6 Gy, matching with the prescription dose of 6 Gy. Iterative optimization routine resulted in the highest dose to apex point and dome points. The mean dose for optimization point was 6.01 Gy for iterative optimization and was much higher than 5.74 Gy for geometric and equal times routines. Step size of 1 cm gave the highest dose to the apex point. This step size was superior in terms of mean dose to optimization points. Selection of dose optimization points for the derivation of optimized dose distributions for vaginal cylinders affects the dose distributions.

Supe, Sanjay S. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)], E-mail: sanjayssupe@gmail.com; Bijina, T.K.; Varatharaj, C.; Shwetha, B.; Arunkumar, T.; Sathiyan, S.; Ganesh, K.M.; Ravikumar, M. [Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India)

2009-04-01

383

Markers of local immunity in cervico-vaginal secretions of HIV infected women: implications for HIV shedding  

PubMed Central

Objectives: To link local proinflammatory cytokines with HIV related nucleic acids in cervico-vaginal secretions and the factors associated with them. Methods: An observational study on 60 HIV positive women attending the department of obstetrics and gynaecology, University of Pavia, Italy. HIV-1 RNA in plasma, proviral HIV-1-DNA, cell associated and cell free HIV-1 RNA in cervico-vaginal secretions were evaluated by competitive polymerase chain reaction (c-PCR) and reverse transcriptase PCR (cRT-PCR). IL-1ß, IL-6, and TNF-? were measured by ELISA in cervico-vaginal lavages. Multiple regression analysis on ordinal categorical variables was used to test for the simultaneous associations of clinical and microbiological variables on quartiles of cytokine concentrations in lavage samples. Results: Proviral HIV-1 DNA, cell associated and cell free HIV-1 RNA were detected in 76.7% (46/60), 70% (42/60), and 71.7% (43/60) of the patients, respectively. IL-1ß concentration was directly correlated with proviral HIV-DNA (Spearman rho = 0.35, p = 0.01) and cell associated HIV-RNA levels (Spearman rho = 0.263, p = 0.05). IL-1ß concentration (153.9 pg/ml) was higher (p<0.05) among women with cytological squamous intraepithelial lesion (SIL) than negative controls (73.4 pg/ml). In women with vaginal infection both IL-1ß (41.7 pg/ml) and IL-6 (10.2 pg/ml) were lower (p<0.05) in comparison to negative controls (144.9 pg/ml and 23.7 pg/ml, respectively). Women receiving stable antiretroviral therapy had significantly lower TNF-? (34.4 pg/ml versus 44.4 pg/ml, p = 0.04) and higher IL-6 (24.0 pg/ml versus 1.4 pg/ml, p = 0.004) levels in lavage samples compared to untreated women. The associations between the presence of SIL, antiretroviral treatment, vaginal infection and cytokine concentrations in cervico-vaginal secretions were confirmed in multiple regression analysis. Conclusions: Local immune activation may modulate HIV-1 shedding in cervico-vaginal secretion with possible influence on vaginal physiology and host defence. Pharmacological agents lowering HIV-1 replication cause a shift to a pattern of cytokine production which seems less favourable to the transmission of the disease.

Zara, F; Nappi, R; Brerra, R; Migliavacca, R; Maserati, R; Spinillo, A

2004-01-01

384

Biological and Technical Variables Affecting Immunoassay Recovery of Cytokines from Human Serum and Simulated Vaginal Fluid: A Multicenter Study  

PubMed Central

The increase of proinflammatory cytokines in vaginal secretions may serve as a surrogate marker of unwanted inflammatory reaction to microbicide products topically applied for the prevention of sexually transmitted diseases, including HIV-1. Interleukin (IL)-1? and IL-6 have been proposed as indicators of inflammation and increased risk of HIV-1 transmission; however, the lack of information regarding detection platforms optimal for vaginal fluids and interlaboratory variation limit their use for microbicide evaluation and other clinical applications. This study examines fluid matrix variants relevant to vaginal sampling techniques and proposes a model for interlaboratory comparisons across current cytokine detection technologies. IL-1? and IL-6 standards were measured by 12 laboratories in four countries, using 14 immunoassays and four detection platforms based on absorbance, chemiluminescence, electrochemiluminescence, and fluorescence. International reference preparations of cytokines with defined biological activity were spiked into (1) a defined medium simulating the composition of human vaginal fluid at pH 4.5 and 7.2, (2) physiologic salt solutions (phosphate-buffered saline and saline) commonly used for vaginal lavage sampling in clinical studies of cytokines, and (3) human blood serum. Assays were assessed for reproducibility, linearity, accuracy, and significantly detectable fold difference in cytokine level. Factors with significant impact on cytokine recovery were determined by Kruskal?Wallis analysis of variance with Dunn’s multiple comparison test and multiple regression models. All assays showed acceptable intra-assay reproducibility; however, most were associated with significant interlaboratory variation. The smallest reliably detectable cytokine differences (P < 0.05) derived from pooled interlaboratory data varied from 1.5- to 26-fold depending on assay, cytokine, and matrix type. IL-6 but not IL-1? determinations were lower in both saline and phosphate-buffered saline as compared to vaginal fluid matrix, with no significant effect of pH. The (electro)chemiluminescence-based assays were most discriminative and consistently detected <2-fold differences within each matrix type. The Luminex-based assays were less discriminative with lower reproducibility between laboratories. These results suggest the need for uniform vaginal sampling techniques and a better understanding of immunoassay platform differences and cross-validation before the biological significance of cytokine variations can be validated in clinical trials. This investigation provides the first standardized analytic approach for assessing differences in mucosal cytokine levels and may improve strategies for monitoring immune responses at the vaginal mucosal interface.

2008-01-01

385

Biological and technical variables affecting immunoassay recovery of cytokines from human serum and simulated vaginal fluid: a multicenter study.  

PubMed

The increase of proinflammatory cytokines in vaginal secretions may serve as a surrogate marker of unwanted inflammatory reaction to microbicide products topically applied for the prevention of sexually transmitted diseases, including HIV-1. Interleukin (IL)-1beta and IL-6 have been proposed as indicators of inflammation and increased risk of HIV-1 transmission; however, the lack of information regarding detection platforms optimal for vaginal fluids and interlaboratory variation limit their use for microbicide evaluation and other clinical applications. This study examines fluid matrix variants relevant to vaginal sampling techniques and proposes a model for interlaboratory comparisons across current cytokine detection technologies. IL-1beta and IL-6 standards were measured by 12 laboratories in four countries, using 14 immunoassays and four detection platforms based on absorbance, chemiluminescence, electrochemiluminescence, and fluorescence. International reference preparations of cytokines with defined biological activity were spiked into (1) a defined medium simulating the composition of human vaginal fluid at pH 4.5 and 7.2, (2) physiologic salt solutions (phosphate-buffered saline and saline) commonly used for vaginal lavage sampling in clinical studies of cytokines, and (3) human blood serum. Assays were assessed for reproducibility, linearity, accuracy, and significantly detectable fold difference in cytokine level. Factors with significant impact on cytokine recovery were determined by Kruskal-Wallis analysis of variance with Dunn's multiple comparison test and multiple regression models. All assays showed acceptable intra-assay reproducibility; however, most were associated with significant interlaboratory variation. The smallest reliably detectable cytokine differences ( P < 0.05) derived from pooled interlaboratory data varied from 1.5- to 26-fold depending on assay, cytokine, and matrix type. IL-6 but not IL-1beta determinations were lower in both saline and phosphate-buffered saline as compared to vaginal fluid matrix, with no significant effect of pH. The (electro)chemiluminescence-based assays were most discriminative and consistently detected <2-fold differences within each matrix type. The Luminex-based assays were less discriminative with lower reproducibility between laboratories. These results suggest the need for uniform vaginal sampling techniques and a better understanding of immunoassay platform differences and cross-validation before the biological significance of cytokine variations can be validated in clinical trials. This investigation provides the first standardized analytic approach for assessing differences in mucosal cytokine levels and may improve strategies for monitoring immune responses at the vaginal mucosal interface. PMID:18484740

Fichorova, Raina N; Richardson-Harman, Nicola; Alfano, Massimo; Belec, Laurent; Carbonneil, Cedric; Chen, Silvia; Cosentino, Lisa; Curtis, Kelly; Dezzutti, Charlene S; Donoval, Betty; Doncel, Gustavo F; Donaghay, Melissa; Grivel, Jean-Charles; Guzman, Esmeralda; Hayes, Madeleine; Herold, Betsy; Hillier, Sharon; Lackman-Smith, Carol; Landay, Alan; Margolis, Leonid; Mayer, Kenneth H; Pasicznyk, Jenna-Malia; Pallansch-Cokonis, Melanie; Poli, Guido; Reichelderfer, Patricia; Roberts, Paula; Rodriguez, Irma; Saidi, Hela; Sassi, Rosaria Rita; Shattock, Robin; Cummins, James E

2008-06-15

386

Predictive value for infection of febrile morbidity after vaginal surgery  

Microsoft Academic Search

Objective: To determine the screening value of febrile morbidity for detecting infections after vaginal surgery.Methods: A cohort of 431 consecutive women had vaginal surgery at the M. S. Hershey Medical Center from September 1988 through June 1995. Outcomes of febrile morbidity and infection were analyzed.Results: Fifty-four of 431 patients (12.5%) had febrile morbidity. Thirty-five infections (8.1%) were identified, of which

D. Paul Shackelford; M. K Hoffman; M. F Davies; P. F Kaminski

1999-01-01

387

Small bowel obstruction associated with tension-free vaginal tape  

Microsoft Academic Search

A 73-year-old woman with stress urinary incontinence and uterine prolapse underwent vaginal hysterectomy followed by tension-free vaginal tape (TVT) placement. Postoperatively, she presented with low-grade fever and abdominal distension. Abdominal computed tomography revealed bowel distension and abrupt cutoff of the distended small bowel and normal bowel caliber. Transperitoneal laparotomy demonstrated perforation of the mesentery by the TVT without other injury.

Line Leboeuf; Luis E. Mendez; Angelo E. Gousse

2004-01-01

388

Vaginal vault prolapse following cystectomy: transvaginal reconstruction by mesh interposition.  

PubMed

The present study aims to introduce a transvaginal interposition of polypropylene mesh as a reproducible procedure for women with vaginal vault prolapse following cystectomy due to bladder carcinoma. No recurrent prolapse occurred in two cases 16 and 4 months after the operation. With apical fixation of the mesh, vaginal length can be maintained. No perioperative complications appeared. Performing the technique in a reproducible way seems feasible irrespective of differing anatomical conditions. PMID:22955251

Graefe, Flora; Beilecke, Kathrin; Tunn, Ralf

2013-08-01

389

Robotic removal of eroded vaginal mesh into the bladder.  

PubMed

Vaginal mesh erosion into the bladder after midurethral sling procedure or cystocele repair is uncommon, with only a few cases having been reported in the literature. The ideal surgical management is still controversial. Current options for removal of eroded mesh include: endoscopic, transvaginal or abdominal (either open or laparoscopic) approaches. We, herein, present the first case of robotic removal of a large eroded vaginal mesh into the bladder and discuss potential benefits and limitations of the technique. PMID:23600850

Macedo, Francisco Igor B; O'Connor, Jeffrey; Mittal, Vijay K; Hurley, Patrick

2013-11-01

390

Vaginal microflora in healthy women with Gardnerella vaginalis  

Microsoft Academic Search

In order to find the vaginal prevalence of Gardnerella vaginalis in a normal female population, we determined the incidence of G. vaginalis in relation to that of other bacterial genera and species in the vagina. Two-hundred and thirty-nine healthy women were the\\u000a subjects of this study. Vaginal discharge was collected and bacteriological studies were performed. The mean total aerobe\\u000a count

Hiroshige Mikamo; Yasumasa Sato; Yoh Hayasaki; Yin Xiang Hua; Teruhiko Tamaya

2000-01-01

391

Obstetric and gynecological diseases and complications resulting from vaginal dysbacteriosis.  

PubMed

Accurate knowledge of the composition and ecology of vaginal microbial environment of a healthy woman is necessary for the understanding of normal flora and how to reduce the risk for diseases. Vagina and its microflora form a balanced ecosystem in which dominated bacteria are vaginal lactobacilli. There are dynamic changes in this ecosystem having structure and composition depending on many factors. The term dysbacteriosis defines any movement outside the normal range for the given biotope of obligate and/or facultative microflora. Such a change in the quantity and quality of the respective microbial balance is fraught with danger and requires correction and recovery. The purpose of this overview is to examine obstetric and gynecological diseases that can cause vaginal impaired microbial balance. Vaginal dysbacteriosis is a cause, predecessor, and often also consequence of vaginal infections. In essence, any vaginal infection can be seen as dysbacteriosis, developed to the most severe extent. Here, there is a dominant microorganism other than lactic acid bacteria in the vagina (clinically manifested or not, respectively), depletion of defense mechanisms of the vagina associated with the shift of lactobacilli from their dominant role in the vaginal balance, decrease in their number and species diversity, and a resulting change in the healthy status of the vagina. Vaginal dysbacteriosis can be found in pathogenetic mechanism, whereby many obstetric and gynecological diseases develop. Most of these diseases lead directly to increased maternal and infant morbidity and mortality, so it is important to understand the reasons for them and the arrangements for their prevention. PMID:24711012

Kovachev, Stefan Miladinov

2014-08-01

392

Transverse vaginal septum: Case report and review of the literature  

Microsoft Academic Search

A case of perforated complete transverse vaginal septum in the upper third of the vagina in a patient presenting at 19 years\\u000a of age for evaluation of primary infertility. Diagnosis was made by hysterosal-pingography. The patient was treated surgically\\u000a and conceived 2 months after the procedure. The finding of transverse vaginal septum in an asymptomatic infertility patient\\u000a is highly unusual.

G. Levy; M. Warren; J. Maidman

1997-01-01

393

Management of Vaginal Erosion of Polypropylene Mesh Slings  

Microsoft Academic Search

PurposeThe SPARC (American Medical Systems, Minneapolis, Minnesota) polypropylene sling has recently been introduced as an alternative delivery system to TVT (Ethicon, New Brunswick, New Jersey) tension-free vaginal tape for placement of a tension-free mid urethral sling. Erosion must always be considered a risk of synthetic materials. We present 4 cases of vaginal erosion of polypropylene mesh placed with this system

KATHLEEN C. KOBASHI; FRED E. GOVIER

2003-01-01

394

Longitudinal vaginal septum: a retrospective study of 202 cases  

Microsoft Academic Search

Objective: To assess issues and management of longitudinal vaginal septum.Study design: The charts of 202 patients referred for a longitudinal vaginal septum over a 24 year period were reviewed.Results: The most common septa were complete and high partial. Associated uterine malformations were frequent (87.8% of the cases), especially in complete or partial high septum (99.4%). The septum was asymptomatic in

Bassam Haddad; Christine Louis-Sylvestre; Philippe Poitout; Bernard-Jean Paniel

1997-01-01

395

Factors influencing women's decisions to self-treat vaginal symptoms  

Microsoft Academic Search

PURPOSE: To review the research on women's self-treatment of vaginal symptoms, describe factors influencing this phenomenon, identify evidence-based interventions, and suggest strategies for nurse practitioners (NPs) to promote safe and effective self-treatment decisions by women.\\u000aDATA SOURCES: Research articles identified through Medline and CINAHL databases.\\u000aCONCLUSIONS: The primary factors influencing women's decisions to self-treat vaginal symptoms were personal (attitudes, beliefs,

Rosemary T. Theroux

2005-01-01

396

Diversity of vaginal ecosystem on women in Southern China  

Microsoft Academic Search

In this study, we analyzed the diversity of vaginal microbiota in 9 bacterial vaginosis (BV) positive and 11 healthy women from the metropolitan area of Guangzhou in Southern China using full-length 16S rDNA. Our data confirmed that a shift in the abundance of bacterial species present in the vaginal environment comparing the BV and non-BV groups. Each sequence read was

Wenbo Hao; Yongzheng Peng; Weiwen Xu; Xiaoqing Liao; Ming Li; Shuhong Luo

2011-01-01

397

RASTREAMENTO DE CANDIDOSE VAGINAL DURANTE A PREVENÇÃO DO CÂNCER CÉRVICO-UTERINO SCREENING OF VAGINAL CANDIDOSIS DURING THE PREVENTION OF UTERINE CERVIX CANCER  

Microsoft Academic Search

Introduction: vaginal candidosis is one of the most prevalent infection of the lower genital tract around the world. Lately a huge increase in inciden- ce accounted for ranking this disease as the second more frequent vaginal infection in Brazil. These reasons led some authors to indicate the scree- ning of vaginal discharge in gynecology clinics. Objective: the aim of this

Vânia LN Cavalcante; Aldine T Miranda; Glenda MP Portugal

398

Colpocleisis and Tension-Free Vaginal Tape Sling for Severe Uterine and Vaginal Prolapse and Stress Urinary Incontinence under Local Anesthesia  

Microsoft Academic Search

Study ObjectiveTo describe the technique, complications, and outcomes of vaginal repair of concomitant advanced uterine and vaginal prolapse and stress urinary incontinence using colpocleisis and tension-free vaginal tape (TVT) and pubovaginal sling under intravenous sedation and local anesthesia in elderly and\\/or medically compromised patients.

Robert D. Moore; John R. Miklos

2003-01-01

399

Biomarkers of leukocyte traffic and activation in the vaginal mucosa.  

PubMed

Development of novel vaginal spermicides and anti-human immunodeficiency virus (HIV) microbicides requires careful assessment of their potential to recruit and activate CD4+ HIV-1 host cells in the female genital tract mucosa, two events that facilitate HIV-1 infection. Leukocyte traffic and activation are mediated by proinflammatory cytokines and chemokines, e.g. interleukin (IL)-1, IL-6 and IL-8, which have been detected in vaginal secretions in association with epithelial damage and infections. These proinflammatory mediators, however, have bidirectional, destructive as well as beneficial, effects on the mucosal barrier, and may be counterbalanced by endogenous inhibitors. Here we propose additional biomarkers for the evaluation of compound-induced cervicovaginal mucosal inflammation. Displaying different temporal patterns of detection, the levels of soluble E-selectin, vascular adhesion molecule-1, CD14 and myeloperoxidase in vaginal secretions reflected the mucosal leukocyte reaction to proinflammatory compounds being evaluated for safety in an improved rabbit vaginal irritation model. These biomarkers, which were also detected in human vaginal secretions, may be used to enhance the characterization of mucosal safety of vaginally applied compounds, both in animal as well as clinical studies. PMID:17852080

Trifonova, Radiana T; Bajpai, Malini; Pasicznyk, Jenna-Malia; Chandra, Neelima; Doncel, Gustavo F; Fichorova, Raina N

2007-01-01

400

What has Changed about Vaginal Douching among African American Mothers and Daughters?  

PubMed Central

Objectives To explore African American mothers’ and daughters’ practices and influences related to vaginal douching. Design and Sample Our overall study used a sequential mixed-method design with 3 phases. Phase 1, the focus of this report, used grounded theory methods and in-depth, semistructured individual interviews. Two generations of African American girls and women: 24 girls (“daughters”) aged 14–18 and 17 women (“mothers” or “mother figures”) aged 22–43, recruited from 1 adolescent health clinic in Baltimore, MD. Measures In-depth interviews were taped and transcribed and data analysis used the constant comparison method. Results Daughters were much less likely to douche or to have been exposed to douching information than mothers. Many mothers and daughters were influenced by health care providers and/or family members to not initiate, to decrease, or to stop douching. Women who currently douche often do so because of the perception of improved smell and cleanliness around menstruation and sexual intercourse. Conclusions These data indicate that although some women continue to believe that vaginal douching has therapeutic value, others have been influenced to stop or not start douching by family and health care providers. Health care providers should continue efforts to educate patients on the risks of vaginal douching.

Mark, Hayley; Sherman, Susan G.; Nanda, Joy; Chambers-Thomas, Tracey; Barnes, Mathilda; Rompalo, Anne

2010-01-01

401

Supplementary health benefits of linoleic Acid by improvement of vaginal cornification of ovariectomized rats.  

PubMed

Purpose: This study aimed to evaluate the possible estrogenic activity of some ingredients of Nigella sativa including Linoleic acid and Gama-Linolenic acid by vaginal cornification assay. Methods: Forty ovariectomized (OVX) rats, aged 16 weeks were allotted randomly to five groups: negative control (taking 1 ml olive oil/ day); positive control (taking 0.2 mg/kg/day Conjucated Equine Estrogen-CEE); experimental groups (taking 50 mg/kg/day Linoleic acid or 10 mg/kg/day Gamma Linolenic acid or 15mg/kg/day Thymoquinone ). All of supplements administered via intragastric gavage for 21 consecutive days. To assess estrogen like activity, vaginal smear was examined daily and serum estradiol was measured at baseline, after 10 days and at the end of experiment. Results: The significant occurrence of vaginal cornification cell (p<0.05) after Linoleic acid supplementation indicated estrogenic activity of Linoleic acid which was in consistency with serum estradiol level, but this effect was not as much as CEE. Gama-Linolenic acid also exist a few cornified cell in smear which was not significantly differ from those control group. Conclusion: Linoleic acid showed the beneficial effects on OVX rats' reproductive performance, thereby indicating its beneficial role in the treatment of the postmenopausal symptoms. PMID:24312809

Parhizkar, Saadat; Latiff, Latiffah A

2013-01-01

402

Finite Element and Experimental Analysis of Closure and Contact Bonding of Pores During Hot Rolling of Steel  

NASA Astrophysics Data System (ADS)

The closure and contact bonding behavior of internal pores in steel slabs during hot rolling was studied using experiments and the finite element method (FEM). Effects of pore size and shape were investigated, and three different cases of pore closure results were observed: no closure, partial closure, and full closure. The FEM results well reproduced various closure events. Bonding strengths of unsuccessfully closed pores, measured by tensile tests, showed critical effects. Also, there was a difference in bonding strengths of several fully closed pores. Fracture surfaces showed that welded regions could be divided into three (not, partially, and perfectly) welded regions. The pressure-time curves obtained from the FEM results indicate that pore surface contact time and deformed surface length are important parameters in pore welding. Pore size, pore shape, time of pressure contact, and deformed surface length should be considered to completely eliminate pores in final products.

Joo, Soo-Hyun; Jung, Jaimyun; Chun, Myung Sik; Moon, Chang Ho; Lee, Sunghak; Kim, Hyoung Seop

2014-05-01

403

Definitive radiotherapy in the management of isolated vaginal recurrences of endometrial cancer  

SciTech Connect

Purpose: The aim of our study was to assess prognostic factors and overall survival after salvage radiotherapy for patients who had endometrial carcinoma and who experienced an isolated vaginal recurrence. Methods and Materials: We reviewed the records of 50 patients treated at our institution between 1967 and 2003 for an isolated vaginal recurrence of endometrial carcinoma. Initial treatment for endometrial carcinoma was definitive surgery in 49 patients and definitive radiotherapy in 1 patient. The median time from initial diagnosis of endometrial carcinoma to recurrence was 25 months (range, 4-179 months). Three patients (6%) received external-beam radiotherapy alone, 8 patients (16%) received brachytherapy only, and 39 patients (78%) received combined external-beam radiation therapy and brachytherapy. Median dose of radiation to the recurrence was 60 Gy (range, 16-85 Gy). Overall survival was calculated by the Kaplan-Meier method. Endpoints were measured from the date of diagnosis of the vaginal recurrence. Median follow-up of survivors after recurrence was 53 months (range, 8-159 months). Results: The 5-year and 10-year disease-free and overall survivals were 68% and 55%, and 53% and 40%, respectively. On multivariate analysis, age (p = 0.0242), Grade 1 or 2 vs. Grade 3 tumor (p = 0.002), and size of recurrence (p < 0.001) were significant predictors of overall survival. All patients who had Grade 3 disease were dead by 3.6 years from the time of recurrence. Five patients experienced a Grade 3 or 4 complication. Conclusions: Patients treated with radiotherapy for an isolated vaginal recurrence can be cured in over 50% the cases. Radiotherapy is well tolerated, with a low risk of complications. Factors predictive of overall survival include tumor grade, patient age at recurrence, and tumor size.

Lin, Lilie L. [Department of Radiation Oncology, Washington University Medical School, St. Louis, MO (United States); Grigsby, Perry W. [Department of Radiation Oncology, Washington University Medical School, St. Louis, MO (United States) and Alvin J. Siteman Cancer Center, St. Louis, MO (United States)]. E-mail: pgrigsby@wustl.edu; Powell, Matthew A. [Alvin J. Siteman Cancer Center, St. Louis, MO (United States); Division Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University Medical School, St. Louis, MO (United States); Mutch, David G. [Alvin J. Siteman Cancer Center, St. Louis, MO (United States); Division Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University Medical School, St. Louis, MO (United States)

2005-10-01

404

PREVALENCE AND CORRELATES OF RECENT VAGINAL DOUCHING AMONG AFRICAN AMERICAN ADOLESCENT FEMALES  

PubMed Central

Study objective To describe the prevalence and correlates of vaginal douching among urban African American adolescents and to examine the association between douching and STI status. Design: Demographic, psychosocial, and behavioral data were collected through cross-sectional, self-administered surveys. Self-collected vaginal swabs were assayed using NAAT for trichomoniasis, Chlamydia, and gonorrhea. Setting Sexual health clinic in a large metropolitan area of the Southeast Participants African American females (N=701) ages 14 to 20 participating in an HIV prevention intervention Main outcome measure The outcome of interest was the association between vaginal douching (lifetime, past 90 days, and past 7 days) with demographic characteristics (e.g. age, education, and socioeconomic status), physical and mental health status, STI status, sexual behavior (e.g. number of vaginal sexual partners, age of sex partners, consistent condom use in the past 90 days, sex while self/partner was high on drugs or alcohol), and psychosocial characteristics (e.g. sexual adventurism, social support, peer norms, sexual happiness, self-efficacy for sex refusal, self-esteem, relationship power, risk avoidance). Results Forty-three percent reported ever douching, and 29% reported douching in the past 90 days. In bivariate analyses, recent douching was associated with demographic, behavioral, and psychosocial variables, but not current STI status. In multivariate analyses, recent douching was associated with age (AOR=1.13, CI=1.02–1.25), lower socio-economic status (AOR=1.25, CI=1.05–1.47), and having sex with much older partners (AOR=1.87, CI=1.22–2.86). Conclusion Increased age, lower socioeconomic status, and older partners may be salient risk factors for douching behavior among African American young women.

DiClemente, RJ; Young, AM; Painter, JL; Wingood, GM; Rose, E; Sales, JM

2011-01-01

405

Variations on the Closure of a Set  

ERIC Educational Resources Information Center

The author observes that checking the closure property is redundant for most number systems and therefore hard for students to understand. He defines several systems which are not closed, develops two concepts related to closure, and provides many related examples. (SD)

Francis, Richard L.

1975-01-01

406

Boolean Matrix Multiplication and Transitive Closure  

Microsoft Academic Search

Arithmetic operations on matrices are applied to the problem of finding the transitive closure of a Boolean matrix. The best transitive closure algorithm known, due to Munro, is based on the matrix multiplication method of Strassen. We show that his method requires at most O(n? ¿ P(n)) bitwise operations, where ? = log27 and P(n) bounds the number of bitwise

Michael J. Fischer; Albert R. Meyer

1971-01-01

407

Key financial ratios can foretell hospital closures.  

PubMed

An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent. PMID:10145901

Lynn, M L; Wertheim, P

1993-11-01

408

Spontaneous closure of traumatic macular hole  

Microsoft Academic Search

PURPOSE : To report eight cases of spontaneous closure of traumatic macular hole.DESIGN : Consecutive observational case series.PATIENTS AND METHODS : In a consecutive series of 18 eyes of 18 patients with traumatic macular hole, eight patients achieved spontaneous closure of traumatic macular hole. Clinical records of the eight eyes of eight patients were reviewed, together with the results of

Takehiro Yamashita; Akinori Uemara; Eisuke Uchino; Norihito Doi; Norio Ohba

2002-01-01

409

Surgical technique for closure of difficult abdomen.  

PubMed

Abdominal dehiscence reported to occur with a frequency of one per cent even under the best circumstances, is a dreaded complication. Closure of the dehisced abdominal wall under adverse conditions like local infection and wound edge retraction may be difficult. We describe a new technique which is a modification of classical retention sutures for the abdominal wall closure. PMID:12914378

Abbasoglu, O; Nursal, T

2003-06-01

410

Fascial Closure Following Percutaneous Endovascular Aneurysm Repair  

Microsoft Academic Search

IntroductionThere are potential benefits of percutaneous over open femoral access for endovascular aneurysm repair (EVAR). Subsequent arterial closure using percutaneous devices is costly, whilst open repair risks potential wound complications and delayed discharge. The technique of fascial closure has perceived advantages but its efficacy is unclear. The aim of this study was to assess the safety and durability of fascial

G. J. Harrison; D. Thavarajan; J. A. Brennan; S. R. Vallabhaneni; R. G. McWilliams; R. K. Fisher

2011-01-01

411

40 CFR 146.73 - closure care.  

Code of Federal Regulations, 2010 CFR

...I Hazardous Waste] [Sec. 146.73 Financial Responsibility for Post - closure care...2009-07-01 false 146.73 Sec. 146.73 Financial responsibility for post PROTECTION...Class I Hazardous Waste Sec. 146.73 Financial responsibility for post-closure...

2009-07-01

412

50 CFR 635.28 - Fishery closures.  

Code of Federal Regulations, 2013 CFR

...may be possessed in or from the Atlantic Ocean north of 5° N. lat. or landed...closure may be possessed in the Atlantic Ocean north of 5 N. lat. or landed...fishing after the closure in the Atlantic Ocean north of 5 N. lat., and...

2013-10-01

413

Long-term results of transvaginal colposuspension for the treatment of genuine stress incontinence combined with vaginal hysterectomy.  

PubMed

We assessed the long-term efficacy of a modified transvaginal needle bladder neck suspension, combined with vaginal hysterectomy, for the treatment of female stress incontinence. Thirty-two women who underwent this procedure were followed up clinically and urodynamically 1 and 5 years postoperatively. A total of 27 women (84.4%) were cured 1 year postoperatively. Of the 29 women who were followed up 5 years postoperatively, 21 (72.4%) had a satisfactory result (p = 0.157). No significant differences were observed in maximum urine flow rate, residual volume of urine, and functional length of the urethra. On the contrary, the maximum urethral closure pressure was significantly decreased (p = 0.004). Although the results of our study show a decline in success rate by time, the overall long-term efficacy of this technique is undoubtedly satisfactory. This technique is promising as an easy and minimally invasive surgical procedure for bladder neck suspension. PMID:12845259

Athanasopoulos, A; Barlas, P; Perimenis, P; Dimitrakopoulos, S; Markou, S; Gianitsas, K; Gyftopoulos, K; Hatzipapas, J; Barbalias, G

2003-01-01

414

PLAN FOR CLOSURE OF HANFORDS CENTRAL PLATEAU  

SciTech Connect

This paper summarizes an approach to reduce risk to the public and environment through accelerated closure of Hanford's Central Plateau, based on a plan developed by Fluor Hanford and submitted to the Department of Energy (DOE)-Richland Office, for consideration, in September, 2004. This plan provides a framework and starting point for discussions with regulators and further planning for closure activities on the Plateau. The closure strategy and approach required developing a full inventory of items needing closure as well as identifying and defining technical and regulatory approaches that were compatible with current regulatory processes, reduce risks, and met DOE objectives. This effort, and the paper that follows, integrates closure activities among several contractors and two DOE field offices.

AUSTIN, B.A.

2004-12-15

415

Statistical closure and the logistic map  

SciTech Connect

We consider the chaotic logistic map with stochastic initial conditions. All initial conditions assume a Gaussian distribution centered in the unit interval with a small dispersion. We show that the system exhibits behavior characterized by three different regimes (called initial, transient, and final). The initial interval is characterized by the Gaussian closure being accurate and the evolution of the system dominated by the evolution of the mean. The transient interval is characterized by rapid growth of all cumulants and a breakdown of Gaussian closure. We identify this period as the Suzuki scaling regime. An alternative closure scheme based on the beta distribution is also introduced. We find that the evolution equations for the mean and dispersion based on a beta distribution closure give accurate predictions over all iterations. This type of closure assumes nothing about the vanishing of higher-order cumulants (in fact, cumulants of all order are nonvanishing). The possible relevance of these results to clump kinetics is also addressed.

Bauer, J.D.; Graziani, F.R. (University of California, Lawrence Livermore National Laboratory, Livermore, California 94550 (United States))

1994-01-01

416

Phenotypic and Functional Characterization of Vaginal Dendritic Cells in a Rat Model of Candida albicans Vaginitis  

PubMed Central

This study analyzes the phenotype of vaginal dendritic cells (VDCs), their antigenic presentation and activation of T-cell cytokine secretion, and their protective role in a rat model of Candida vaginitis. Histological observation demonstrated a significant accumulation of OX62+ VDCs in the mucosal epithelium of Candida albicans-infected rats at the third round of infection. We identified two subsets of OX62+ VDCs differing in the expression of CD4 molecule in both noninfected and Candida-infected rats. The OX62+ CD4+ subset of VDCs displayed a lymphoid cell-like morphology and expressed the T-cell antigen CD5, whereas the OX62+ CD4? VDC subset exhibited a myeloid morphology and was CD5 negative. Candida infection resulted in VDC maturation with enhanced expression of CD80 and CD134L on both CD4+ and CD4? VDC subsets at 2 and 6 weeks after Candida infection. CD5? CD4? CD86? CD80? CD134L+ VDCs from infected, but not noninfected, rats spontaneously released large amounts of interleukin-12 (IL-12) and tumor necrosis factor alpha, whereas all VDC subsets released comparable levels of IL-10 and IL-2 cytokines. Furthermore, OX62+ VDCs from infected rats primed naïve CD4+ T-cell proliferation and release of cytokines, including gamma interferon, IL-2, IL-6, and IL-10, in response to staphylococcal enterotoxin B stimulation in vitro. Adoptive transfer of highly purified OX62+ VDCs from infected rats induced a significant acceleration of fungal clearance compared with that in rats receiving naive VDCs, suggesting a protective role of VDCs in the anti-Candida mucosal immunity. Finally, VDC-mediated protection was associated with their ability to rapidly migrate to the vaginal mucosa and lymph nodes, as assessed by adoptive transfer of OX62+ VDCs labeled with 5 (and 6-)-carboxyfluorescein diacetate succinimidyl ester.

De Bernardis, Flavia; Lucciarini, Roberta; Boccanera, Maria; Amantini, Consuelo; Arancia, Silvia; Morrone, Stefania; Mosca, Michela; Cassone, Antonio; Santoni, Giorgio

2006-01-01

417

Phenotypic and functional characterization of vaginal dendritic cells in a rat model of Candida albicans vaginitis.  

PubMed

This study analyzes the phenotype of vaginal dendritic cells (VDCs), their antigenic presentation and activation of T-cell cytokine secretion, and their protective role in a rat model of Candida vaginitis. Histological observation demonstrated a significant accumulation of OX62(+) VDCs in the mucosal epithelium of Candida albicans-infected rats at the third round of infection. We identified two subsets of OX62(+) VDCs differing in the expression of CD4 molecule in both noninfected and Candida-infected rats. The OX62(+) CD4(+) subset of VDCs displayed a lymphoid cell-like morphology and expressed the T-cell antigen CD5, whereas the OX62(+) CD4(-) VDC subset exhibited a myeloid morphology and was CD5 negative. Candida infection resulted in VDC maturation with enhanced expression of CD80 and CD134L on both CD4(+) and CD4(-) VDC subsets at 2 and 6 weeks after Candida infection. CD5(-) CD4(-) CD86(-) CD80(-) CD134L(+) VDCs from infected, but not noninfected, rats spontaneously released large amounts of interleukin-12 (IL-12) and tumor necrosis factor alpha, whereas all VDC subsets released comparable levels of IL-10 and IL-2 cytokines. Furthermore, OX62(+) VDCs from infected rats primed naïve CD4(+) T-cell proliferation and release of cytokines, including gamma interferon, IL-2, IL-6, and IL-10, in response to staphylococcal enterotoxin B stimulation in vitro. Adoptive transfer of highly purified OX62(+) VDCs from infected rats induced a significant acceleration of fungal clearance compared with that in rats receiving naive VDCs, suggesting a protective role of VDCs in the anti-Candida mucosal immunity. Finally, VDC-mediated protection was associated with their ability to rapidly migrate to the vaginal mucosa and lymph nodes, as assessed by adoptive transfer of OX62(+) VDCs labeled with 5 (and 6-)-carboxyfluorescein diacetate succinimidyl ester. PMID:16790803

De Bernardis, Flavia; Lucciarini, Roberta; Boccanera, Maria; Amantini, Consuelo; Arancia, Silvia; Morrone, Stefania; Mosca, Michela; Cassone, Antonio; Santoni, Giorgio

2006-07-01

418

Efficacy of rifaximin vaginal tablets in treatment of bacterial vaginosis: a molecular characterization of the vaginal microbiota.  

PubMed

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV. PMID:22585228

Cruciani, Federica; Brigidi, Patrizia; Calanni, Fiorella; Lauro, Vittoria; Tacchi, Raffaella; Donders, Gilbert; Peters, Klaus; Guaschino, Secondo; Vitali, Beatrice

2012-08-01

419

Efficacy of Rifaximin Vaginal Tablets in Treatment of Bacterial Vaginosis: a Molecular Characterization of the Vaginal Microbiota  

PubMed Central

Bacterial vaginosis (BV) is a common vaginal disorder characterized by an alteration of the vaginal bacterial morphotypes, associated with sexually transmitted infections and adverse pregnancy outcomes. The purpose of the present study was to evaluate the impact of different doses of rifaximin vaginal tablets (100 mg/day for 5 days, 25 mg/day for 5 days, and 100 mg/day for 2 days) on the vaginal microbiota of 102 European patients with BV enrolled in a multicenter, double-blind, randomized, placebo-controlled study. An integrated molecular approach based on quantitative PCR (qPCR) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) was used to investigate the effects of vaginal tablets containing the antibiotic. An increase in members of the genus Lactobacillus and a decrease in the BV-related bacterial groups after the antibiotic treatment were demonstrated by qPCR. PCR-DGGE profiles confirmed the capability of rifaximin to modulate the composition of the vaginal microbial communities and to reduce their complexity. This molecular analysis supported the clinical observation that rifaximin at 25 mg/day for 5 days represents an effective treatment to be used in future pivotal studies for the treatment of BV.

Cruciani, Federica; Brigidi, Patrizia; Calanni, Fiorella; Lauro, Vittoria; Tacchi, Raffaella; Donders, Gilbert; Peters, Klaus; Guaschino, Secondo

2012-01-01

420

Composition of the Vaginal Microbiota in Women of Reproductive Age - Sensitive and Specific Molecular Diagnosis of Bacterial Vaginosis Is Possible?  

PubMed Central

Background and Objective Bacterial vaginosis (BV) is the most common vaginal disorder, characterized by depletion of the normal lactobacillus-dominant microbiota and overgrowth of commensal anaerobic bacteria. This study aimed to investigate the composition of the vaginal microbiota in women of reproductive age (healthy women and women with BV), with the view of developing molecular criteria for BV diagnosis. Materials and Methods Vaginal samples from 163 women (79 control, 73 BV and 11 intermediate (Lactobacillary grade II flora) cases) were analyzed using 454 pyrosequencing of the hypervariable regions V3–V4 of the 16S rRNA gene and 16 quantitative bacterial species/genus-specific real-time PCR assays. Sensitivities and specificities of potential BV markers were computed using the Amsel criteria as reference standard for BV. The use of quantitative thresholds for prediction of BV, determined for both relative abundance measured with 454 pyrosequencing and bacterial load measured with qPCR, was evaluated. Results Relative to the healthy women, the BV patients had in their vaginal microbiota significantly higher prevalence, loads and relative abundances of the majority of BV associated bacteria. However, only Gardnerella vaginalis, Atopobium vaginae, Eggerthella, Prevotella, BVAB2 and Megasphaera type 1 detected at or above optimal thresholds were highly predictable for BV, with the best diagnostic accuracy shown for A. vaginae. The depletion of Lactobacillus species combined with the presence of either G. vaginalis or A. vaginae at diagnostic levels was a highly accurate BV predictor. Conclusions Quantitative determination of the presence of G. vaginalis, A. vaginae, Eggerthella, Prevotella, BVAB2 and Megasphaera type 1 as well as the depletion of Lactobacillus was highly accurate for BV diagnosis. Measurements of abundance of normal and BV microbiota relative to total bacteria in vaginal fluid may provide more accurate BV diagnosis, and be used for test-of-cure, rather than qualitative detection or absolute counts of BV related microorganisms.

Shipitsyna, Elena; Roos, Annika; Datcu, Raluca; Hallen, Anders; Fredlund, Hans; Jensen, J?rgen S.; Engstrand, Lars; Unemo, Magnus

2013-01-01

421

Closure for milliliter scale bioreactor  

DOEpatents

A closure for a microreactor includes a cap that is configured to be inserted into a well of the microreactor. The cap, or at least a portion of the cap, is compliant so as to form a seal with the well when the cap is inserted. The cap includes an aperture that provides an airway between the inside of the well to the external environment when the cap is inserted into the well. A porous plug is inserted in the aperture, e.g., either directly or in tube that extends through the aperture. The porous plug permits gas within the well to pass through the aperture while preventing liquids from passing through to reduce evaporation and preventing microbes from passing through to provide a sterile environment. A one-way valve may also be used to help control the environment in the well.

Klein, David L. (Palo Alto, CA); Laidlaw, Robert D. (Albany, CA); Andronaco, Gregory (Palo Alto, CA); Boyer, Stephen G. (Moss Beach, CA)

2010-12-14

422