Immediate Effects of Different Trunk Exercise Programs on Jump Performance.

The aim of this study was to investigate the immediate effects of trunk stabilization exercise (SE) and conventional trunk exercise (CE) programs on jump performance. 13 adolescent male soccer players performed 2 kinds of jump testing before and immediate after 3 experimental conditions: SE, CE, and non-exercise (NE). The SE program consisted of the elbow-toe, hand-knee, and back bridge, and the CE program consisted of the sit-up, sit-up with trunk rotation and back extension. Testing of a countermovement jump (CMJ) and rebound jump (RJ) were performed to assess jump performance. Jump height of the CMJ and RJ-index, contact time, and jump height of the RJ were analyzed. The RJ index was improved significantly only after SE (p=0.017). However, contact time and jump height did not improve significantly in the SE condition. Moreover, no significant interaction or main effects of time or group were observed in the CMJ. Consequently, this study showed the different immediate effect on the RJ between the SE and CE, and suggested the possibility that the SE used in this study is useful as a warm-up program to improve the explosive movements.

A large ovarian leiomyoma discovered incidentally in a 76-year-old woman: case report.

BACKGROUND: Ovarian leiomyoma is very rare type of ovarian tumor. This benign tumor is seen in the pediatric age group to premenopausal women. CASE: A 76-year-old woman had a huge leiomyoma (19 x 11 x 10 cm) of the right ovary. The preoperative diagnosis was difficult to distinguish from a broad ligament leiomyoma or ovarian cancer. CONCLUSIONS: Although theses tumors are benign, its extreme rarity led us to report an additional and rather unusual case of ovarian leiomyoma, and to focus some attention on this type of tumor.

Premenstrual syndrome: management and pathophysiology.

Premenstrual syndrome (PMS) is triggered by hormonal events ensuing after ovulation. The symptoms can begin in the early, mid, or late luteal phase and are not associated with defined concentrations of any specific gonadal or non-gonadal hormone. Women with PMS experience affective or somatic symptoms that cause severe dysfunction in social or occupational realms. Although evidence for a hormonal abnormality has not been established, the symptoms of the premenopausal disorders are related to the production of progesterone by the ovary. The progesterone metabolites may bind to a neurosteroid-binding site on the membrane of the neurotransmitters. Thus, ovulation suppression is an area of focus for diagnostic and treatment options. Many treatment studies have focused on suppression of ovulation with gonadotropin-releasing hormone analogs (GnRHa), high doses of transdermal estrogen, and bilateral oophorectomy all have positive evidence as treatment options for prevention of PMS. However, because of these limitations and their substantial intensive care, these do not appear to be appropriate methods for conventional treatment of PMS. Serotonergic antidepressants, selective serotonin reuptake inhibitors, are well-established, highly effective, and first-line pharmacologic therapy.

Levonorgestrel-releasing intrauterine device used for dysmenorrhea: five-year literature review.

Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing IUD (LNG-IUD), originally designed for long-term contraceptives, is now recognized to provide non-contraceptive health benefits. These include severe dysmenorrhea and/or heavy menstrual bleeding associated with uterine myoma, endometriosis, and adenomyosis. This report aims to review the last five-year literature on the efficacy and safety of the LNG-IUD in women with dysmenorrhea. Dysmenorrhea has been reported to decrease in all women. LNG-IUD seems to be superior over copper-releasing IUD for improving dysmenorrhea. The LNG-IUD is beneficial for symptom recurrence and endometriotic cyst recurrence after conservative surgery for patients with severe pain related to endometriosis. There is also evidence to support its role in menstrual problems of severely obese adolescent females. Expulsion, one of the important factors for IUD acceptability, is rare but more common in women with distorted uterine cavity. In the treatment of dysmenorrhea, the LNG-IUD is equal or superior to treat with systemic progestins or oral contraceptives even in adolescent or menopausal women.

An autopsy case of acute aortic dissection during postpartum period.

BACKGROUND: Aortic dissection in young women without Marfan disease is related in most instances to pregnancy. This is a potentially catastrophic occurrence. CASE: An autopsy case of acute aortic dissection type B (Stanford classification), clinically undiagnosed during late puerperium period in a young woman with no discernible risk factors (e.g. family history and signs of connective tissue diseases) is presented. Autopsy with ancillary investigations revealed that knowledge of this albeit relatively rare complication of postpartum may assist the clinician in earlier diagnosis and referral of patients for surgical treatment. CONCLUSION: This case is presented to raise awareness and review the literature for the critical care of postpartum patients.

Peptide YY producing strumal carcinoid tumor of the ovary.

BACKGROUND: Primary ovarian carcinoid tumor is uncommon and represents less than 0.1% of ovarian malignancies. The strumal carcinoid may be complicated by carcinoid syndrome induced by peptide YY (PYY). CASE REPORT: We describe a 45-year-old woman with a bilateral ovarian tumor diagnosed through periodical gynecological examination. She presented with severe constipation. Right ovarian cyst laparoscopically resected was diagnosed as a strumal carcinoid tumor; the left one was mature cystic teratoma. No metastatic findings were seen macroscopically on the ovarian surface and pelvic peritoneum. Constipation was drastically improved by resecting the tumor. The carcinoid tumor cells were positive for tumor-producing PYY by mRNA analysis. CONCLUSION: It is important to be aware of this entity in the pathological diagnosis of ovarian tumors, in the presence of any clinical indicator of carcinoid tumor/syndrome, as it carries a markedly better prognosis and clinical outcome in comparison with most other malignant ovarian tumors.

Novel [corrected] medical management of primary bladder endometriosis with dienogest: a case report.

BACKGROUND: Because of its low incidence, medical treatment of has not yet been well established although surgical excision is generally considered effective. We report the first case of primary bladder endometriosis successfully managed with a novel progestin dienogest. CASE: A 39-year-old woman, nulligravida, presented with lower urinary tract symptoms, especially during menstruation. Cystoscopy, with subsequent cold cup biopsy, revealed a solitary submucosal mass (2 x 2 cm) in the bladder on the posterior wall; histopathology revealed the diagnosis of extraperitoneal endometriosis. MRI and laparoscopy confirmed no peritoneal endometriosis implants or adenomyosis. She was treated with oral 2 mg/day dienogest for six months. The measurable lesion exhibited a remarkable reduction in its size, accompanied with immediate relief of the lesion-related symptoms. At one year after medication cessation, she is well and symptom-free. CONCLUSION: Dienogest may be a novel conservative alternative for bladder endometriosis, in particular for women who wish to avoid surgical intervention.

Relevance of level IIb neck dissection in patients with papillary thyroid carcinoma.

BACKGROUND: Cervical nodal metastasis is a key prognostic factor in patients with papillary thyroid carcinoma. The role of lymph nodes in papillary thyroid carcinoma management and prognosis remains controversial. METHODS: Level IIb lymph nodes obtained from 44 patients with papillary thyroid carcinoma were histopathologically examined retrospectively. Specimens were classified as ipsilateral or contralateral. The number of dissected nodes and prevalence of level IIb metastasis were compared according to pre-operative clinical nodal stage. RESULTS: In the node-negative neck, the prevalence of contralateral and ipsilateral IIb nodes was 0 out of 20 and 0 out of 3, respectively. In the node-positive neck, the prevalence of contralateral and ipsilateral IIb nodes was 1 out of 13 (7.70 per cent) and 3 out of 41 (7.32 per cent), respectively. Clinically determined and pathologically confirmed level IIb node negativity were significantly associated. Thirty-four patients (77.3 per cent) developed accessory nerve complications from level IIb dissection. CONCLUSION: Level IIb neck dissection for papillary thyroid carcinoma may be required if pre-operative examination reveals multilevel, level IIa or suspicious level IIb metastasis.

Cervical cancer metastasis to the scalp: case report and literature review.

BACKGROUND: Distant metastasis in carcinoma of the uterine cervix is a rare manifestation, with scalp metastasis being an exceptional event. CASE: We describe a 48-year-old woman with Stage IIb, squamous cell carcinoma of the cervix who was initially treated with radical hysterectomy and lymphadenectomy followed by concurrent chemoradiotherapy. The patient presented eight months later with swelling over the top of the scalp. The scalp was involved in the disease as the sole anatomic site of distant metastasis. CONCLUSION: A search of the literature revealed only seven cases of such distant metastatic involvement of the scalp from cervical cancer. More frequent reports and better understanding on these rare events may give new insight to clear strategies to prevent scalp metastases.

HMG-CoA reductase inhibitor lovastatin causes reversible cytoskeleton perturbation by RhoA signalling suppression in peritoneal cell line Met5A.

Increasing evidence indicates that statins increase peritoneal fibrinolysis through RhoA-linked pathway and may play a role in the prevention of postoperative adhesion. This study investigated whether lovastatin perturbs cytoskeletons and cell morphology by RhoA suppression in peritoneal Met5A cells. Subcellular distributions of RhoA protein and actin were assessed by immunocytochemical staining. Exposure to lovastatin caused actin filament reorganisation, decrease in the active (membrane-bound) form of RhoA and subsequently cellular shrinkage in Met5A cells. These lovastatin-induced changes were significantly overcome by the addition of geranylgeranyl pyrophosphate (downstream intermediate of HMG-CoA pathway). A RhoA protein inhibitor C3 transferase mimicked the effects of lovastatin on the Met5A cells. The effects of lovastatin on cytoskeleton alterations were correlated well with inhibition of the membrane localisation of RhoA. These results suggest that lovastatin induced reversible cytoskeleton reorganisation and cellular retraction through the reduction of RhoA geranylgeranylation, which in turn suppressed RhoA signalling-associated cellular events.

Uterovaginal duplication with blind hemivagina and ipsilateral renal agenesis: review of unusual presentation.

Congenital abnormalities of the Müllerian duct system can result in various urogenital anomalies, including uterus didelphys with blind hemivagina and ipsilateral renal agenesis (Herlyn-Werner-Wunderlich syndrome). It usually presents after the menarche with progressive pelvic pain during periods secondary to haematocolpos. However, rarely presentation is unusual with consequent diagnostic delay. This paper attempts to review the medical literature for rare presentations that make diagnosis and treatment difficult, including our cases. Clinicians must be aware of the importance of this rare congenital anomaly of the female genital tract, especially many years after the menarche. This condition should be considered to prevent misdiagnosis or suboptimal treatment.

Sequential methotrexate treatment with and estrogen and progestin in a retained adhesive placenta.

BACKGROUND: Hysterectomy is the definite and recommended treatment of a retained adhesive placenta. CASE: A 33-year-old woman at 38 weeks plus one day of gestation had a cesarean delivery due to previous history of myomectomy. On ultrasound placental retention was noted thus curettage was attempted two weeks postpartum but it induced moderate fresh bleeding. A contrast-enhanced computed tomography scan depicted the multiple vessels within the intrauterine mass and the absence of deep myometrial invasion. The patient received four doses of 50 mg of methotrexate intramuscularly every other day, alternating with four doses of 15 mg of folic acid. An attempt to evacuate the necrotic tissue along with withdrawal bleeding was successful after three courses of sequential conjugated estrogen (0.25 mg)-progestin (5 mg) therapy. CONCLUSION: The use of estrogen and progestogen together with methotrexate in combination may be simple and potentially effective for placenta accreta and placenta increta.

Ovarian torsion; early diagnosis by MRI to prevent irreversible damage.

BACKGROUND: Early diagnosis of ovarian torsion can help prevent irreversible damage to the adnexal structures in women desiring to maintain fertility. CASE: The patient was transferred by ambulance for a six-hour history of severe lower abdominal pain. Magnetic resonance imaging (MRI) revealed bilateral enlarged ovaries measuring 5 x 6 cm (right) and 4 x 5 cm (left) with a right twisted and thickened peduncle. Ultrasonography failed to detect the peduncle changes. At surgery, the right adnexa was twisted 180 degrees in a clockwise direction with no findings suggestive of gangrenous change, hemorrhagic infarction or ischemic change. Detorsion of the twisted ovary was performed. CONCLUSION: Detection of tube torsion at MRI may be useful in the preoperative evaluation for surgical detorsion of twisted adnexa encountered in enlarged ovaries.

The Effects of Aluminablasting on Bond Durability Between Universal Adhesives and Tooth Substrate.

The aim of this study was to determine the effect of aluminablasting on the bond durability of universal adhesives and adherent surface characteristics. Adhese Universal (Ivoclar Vivadent), All-Bond Universal (Bisco), Bondmer Lightless (Tokuyama Dental), G-Premio Bond (GC), and Scotchbond Universal (3M ESPE) were used in self-etch mode. The prepared bovine enamel and dentin specimens were divided into two groups based on whether they received an aluminablasting prior to application of the universal adhesives. The resin composite bonded specimens were stored in distilled water at 37°C for 24 hours, following which the shear bond strength (SBS) of half of the specimens was measured (24-hour group). The other half was subjected to 30,000 thermal cycles between 5 and 55°C before SBS measurement (TC group). Surface roughness (Ra) and surface free energy (SFE) of the adherent surfaces were also measured, and scanning electron microscopy observation and scanning electron microscopy/energy-dispersive X-ray analysis were carried out. Most of the adhesives did not show any significant differences in enamel SBS values between the two pretreatment groups, regardless of the storage condition. However, the dentin SBS values were significantly lower in specimens that underwent aluminablasting compared with those that did not, irrespective of their storage conditions. Significantly higher Ra and SFE values were observed in the enamel and dentin of specimens that underwent aluminablasting. Although aluminablasting increased the Ra and SFE values of enamel and dentin, its effect on the SBS value was dependent on the tooth substrate. In addition to C, O, Na, Mg, P, and Ca, the element Al was detected in the enamel and dentin of samples that had undergone aluminablasting. These results suggest that although aluminablasting of the tooth surface is thought to be effective for modification of the adherent surface, it may not enhance enamel bond performance and may also adversely affect the dentin bond effectiveness of the universal adhesives.

Effects of Finishing and Polishing Methods on the Surface Roughness and Surface Free Energy of Bulk-fill Resin Composites.

The purpose of this study was to determine the influence of finishing and polishing methods on surface properties of bulk-fill resin composites through surface roughness (Ra) and surface free energy (SFE) measurements, and scanning electron microscopy (SEM) observations. Three bulk-fill resin composites, Tetric EvoCeram Bulk Fill (TB), Filtek Bulk Fill (FB), and Filtek Bulk Fill Flowable Restorative (FF), and two conventional resin composites, Clearfil AP-X (AP) and Estelite ∑ Quick (EQ) were used. Seventy cured specimens of each resin composite were prepared and divided into seven groups of 10 specimens. Ra, SFE measurements, and SEM observations were conducted after finishing and polishing procedures. Three groups of specimens were finished with a fine grit diamond bur (FDB), and three with a tungsten carbide bur (CBB). After finishing, one group from each type of finishing was polished with aluminum oxide flexible disks (SSD) and one group from each type of finishing was polished with diamond particles embedded in a silicone point (CMP). A baseline group of samples that were neither finished nor polished after removing the translucent strips from the surface was examined. Although the baseline group showed significantly lower Ra values than the other groups, most resin composites showed lower Ra values with CBB+SSD than with the other finishing and polishing groups. Among the tested resin composites, EQ showed significantly lower Ra values than the other resin composites, regardless of the finishing and polishing methods. On the other hand, AP showed significantly higher Ra values than the other resin composites in all finishing and polishing groups, apart from FB with FDB. For the finished specimens, most resin composites showed higher SFE values with CBB than with FDB. For the polished specimens, all the tested resin composites with CMP showed lower γS values than those with SSD, regardless of the finishing method. The baseline groups of TB and FB showed significantly lower SFE values than the other finished and polished groups. In the SEM observations, all the examined resin composites showed rougher surfaces after finishing with FDB than with CBB. However, when comparing the different polishing methods (CMP and SSD), surface smoothness appeared to be material dependent.

Optokinetic stimulation induces illusory movement of both out-of-the-body and on-the-body hand-held visual objects.

The coding of body part location may depend upon both visual and proprioceptive information, and allows targets to be localized with respect to the body. The present study investigates the interaction between visual and proprioceptive localization systems under conditions of multisensory conflict induced by optokinetic stimulation (OKS). Healthy subjects were asked to estimate the apparent motion speed of a visual target (LED) that could be located either in the extrapersonal space (visual encoding only, V), or at the same distance, but stuck on the subject's right index finger-tip (visual and proprioceptive encoding, V-P). Additionally, the multisensory condition was performed with the index finger kept in position both passively (V-P passive) and actively (V-P active). Results showed that the visual stimulus was always perceived to move, irrespective of its out- or on-the-body location. Moreover, this apparent motion speed varied consistently with the speed of the moving OKS background in all conditions. Surprisingly, no differences were found between V-P active and V-P passive conditions in the speed of apparent motion. The persistence of the visual illusion during the active posture maintenance reveals a novel condition in which vision totally dominates over proprioceptive information, suggesting that the hand-held visual stimulus was perceived as a purely visual, external object despite its contact with the hand.

Leiomyoma and rhabdomyoma of the vagina . Vaginal myoma.

Vaginal fibromyomas (leiomyomas and rhabdomyomas) are rare; approximately 300 cases have been reported in the literature. They usually present as a mass per vaginum or dyspareunia or pressure symptoms on the urinary tract. However, they sometimes have an unusual presentation that is largely responsible for the relative difficulty in preoperative diagnosis. Preoperative imaging and careful examination may help to rule out malignancy. Recurrence occurs infrequently but the practical approach entails immediate careful excision. Surgical excision through the vaginal route has been the traditional approach, but abdominoperineal route may be necessary for huge tumours.

Partial Cystectomy of Paraganglioma of the Urinary Bladder Before Living Kidney Transplantation: Case Report.

BACKGROUND: Paraganglioma (extra-adrenal pheochromocytoma) of the bladder is a very rare disease, accounting for 0.06% of all bladder tumors. Optimal management of bladder paraganglioma before kidney transplantation is unknown. We report a case of partial cystectomy for urinary bladder paraganglioma before living kidney transplantation. CASE PRESENTATION: A 59-year-old man with a 27-year history of hemodialysis was referred to our department for further examination of a bladder tumor detected during pre-transplantation testing. Cystoscopy revealed a submucosal tumor on the right side of the bladder. The patient experienced a hypertensive crisis during transurethral resection of the bladder tumor. Endocrinologic and pathologic examinations confirmed the diagnosis of paraganglioma in the urinary bladder. A partial cystectomy was performed before kidney transplantation. Nine months after partial cystectomy, the patient underwent AB0-incompatible living kidney transplantation from his spouse. No disease recurrence or graft rejection was observed 12 months after the transplantation. CONCLUSIONS: To our knowledge, this is the 1st report on the management of paraganglioma in the urinary bladder before living kidney transplantation. Kidney transplantation after partial cystectomy is an option that may be considered in patients with paraganglioma of the urinary bladder, with careful observations of bladder function and vesicoureteral reflux to the grafts.

Condyloma Acuminata of the Urethra in a Male Renal Transplant Recipient: A Case Report.

BACKGROUND: Condyloma acuminatum (CA) is a common sexually transmitted disease associated with human papilloma virus (HPV). CA occurring in the urethra is rare and has not been reported in male renal transplant recipients. In addition, despite immunosuppressive conditions and increased risk of HPV-related malignant neoplasms in transplant recipients, HPV testing in male transplant recipients has been uncommon. Here we report a case of urethral CA in a male deceased donor renal transplantation recipient and discuss the importance of HPV testing in male transplant recipients. CASE PRESENTATION: A 33-year-old male deceased donor renal transplant recipient presented with miction pain 5 years after the transplantation. He reported repeated urinary tract infections with no sexual contact since the renal transplantation. Multiple papillary tumors in his penile urethra were detected by cystoscopy, and a biopsy sample was pathologically diagnosed with CA. Transurethral tumor resection was performed, and the tumors were completely resected. Additional HPV risk type screening with a urethral smear sample showed the prevalence of low-risk HPV. Although tacrolimus was switched to everolimus and imiquimod cream was administered, the tumors recurred 6 months after the resection, and a second resection was performed. No further recurrence has been observed for 1 year to date. CONCLUSION: As the urethral CA was possibly related to immunosuppressive conditions and a risk for HPV-related malignant neoplasm, the case required careful diagnosis, including HPV risk type. The methodology of sampling for HPV testing in men has not been established. This case suggests the necessity for further discussion about HPV testing in male transplant recipients.

Budgets of major ionic species and nutrients on a dam reservoir in forested watershed.

To evaluate the role of a dam reservoir in the runoff of pollutant loadings from a forested watershed, the input-output budgets in the Ikuno dam reservoir had been investigated for eight years since 1996. The T-N, T-P, TOC and major ionic species in the bulk precipitation, stream water, and outflow were measured. The residence time calculated by using the data of the inflow and outflow was 0.3 year. The average precipitation was 1,772 mm during the investigation period (1996-2004). The direct deposition to water surface was less than one percentage to total loadings of nutrients and major ionic species. The ratios of output to input of TOC, TN, and TP were 1.04 to 1.42, and those of major ionic species were from 0.83 to 0.99 except for NO3(-), which was 1.12. However, the ratios of output to input of major ionic species except for NO3(-) at the Ikuno dam reservoir will be larger, and those of NO3(-), TOC, TN, and TP will be smaller, if we also include rain events. These results suggested that the dam reservoir played a role as a sink for pollutants in forested watershed, and that the pollutant loadings to downstream may decrease.