Organic molecules in the Sheepbed Mudstone, Gale Crater, Mars.

The Sample Analysis at Mars (SAM) instrument on board the Mars Science Laboratory Curiosity rover is designed to conduct inorganic and organic chemical analyses of the atmosphere and the surface regolith and rocks to help evaluate the past and present habitability potential of Mars at Gale Crater. Central to this task is the development of an inventory of any organic molecules present to elucidate processes associated with their origin, diagenesis, concentration, and long-term preservation. This will guide the future search for biosignatures. Here we report the definitive identification of chlorobenzene (150-300 parts per billion by weight (ppbw)) and C2 to C4 dichloroalkanes (up to 70 ppbw) with the SAM gas chromatograph mass spectrometer (GCMS) and detection of chlorobenzene in the direct evolved gas analysis (EGA) mode, in multiple portions of the fines from the Cumberland drill hole in the Sheepbed mudstone at Yellowknife Bay. When combined with GCMS and EGA data from multiple scooped and drilled samples, blank runs, and supporting laboratory analog studies, the elevated levels of chlorobenzene and the dichloroalkanes cannot be solely explained by instrument background sources known to be present in SAM. We conclude that these chlorinated hydrocarbons are the reaction products of Martian chlorine and organic carbon derived from Martian sources (e.g., igneous, hydrothermal, atmospheric, or biological) or exogenous sources such as meteorites, comets, or interplanetary dust particles. KEY POINTS: First in situ evidence of nonterrestrial organics in Martian surface sediments Chlorinated hydrocarbons identified in the Sheepbed mudstone by SAM Organics preserved in sample exposed to ionizing radiation and oxidative condition.

GerOSS (German Obstetric Surveillance System). A Project to Improve the Treatment of Obstetric Rare Diseases and Complications Using a Web Based Documentation and Information Platform.

BACKGROUND: Severe and very rare obstetric complications (e.g. eclampsia, postpartum haemorrhage or uterine rupture), typically culminate in a chaotic, uncontrollable sequence of events. Outcome for mother and child depends on whether doctors and midwives are able to quickly take correct decisions and initiate optimal treatment. OBJECTIVES: GerOSS (German Obstetric Surveillance System) aims at generating deeper insight into relevant risk factors to improve diagnosis and treatment of severe complications during pregnancy and delivery. As such it is primarily conceived as a system for quality improvement and less as a register. Another focus is the provision of an information and communication platform for dissemination of these insights. Finally, incidences of selected rare obstetric events may be derived. METHODS: These rare events are monitored for two to five years in Lower Saxony, Bavaria and Berlin. Quantitative analyses of aggregate data are complemented with in depth case based anonymised evaluations by experts. The temporal sequence of measures taken as well as the management of care is inspected. Participants receive a feedback of comments on the synopsis of individual cases. Aggregate data results are published and made available through the GerOSS platform. A scientific advisory committee ensures the link with the professional scientific bodies. A comparison within INOSS (International Network of Obstetric Survey Systems) allows additional insights into the treatment of obstetric rare diseases and complications. More reliable estimates of the incidence of such events can be computed and compared within a larger database. RESULTS: Following the implementation in three federal states in Germany in 2010, participation in GerOSS-Project has increased to 100% of all hospitals with a delivery unit in Lower Saxony, 30% in Bavaria and 80% in Berlin. Feasibility of the project is shown by successful implementation of GerOSS. Quantitative analyses enable construction of risk profiles (e.g. for the prevalence of hysterectomies and uterine ruptures) such that tailored treatment algorithms may be derived. Age, body mass index and previous caesarean section are common risk factors when complications occur. Respective recommendations have not always been adhered to in the diagnosis and therapy of such cases. The presentation of initial GerOSS results has paved the path for first changes in obstetric care. CONCLUSIONS: The envisaged expansion of GerOSS to an interactive platform will allow dissemination of insights such that optimal obstetric care and transferal among all involved medical facilities may see future enhancements via the internet or even through smartphone applications.

Is the Outcome Indicator "3rd/4th Degree Perineal Tear in Spontaneous Singleton Births" a Reliable Quality Parameter in Obstetrics?

Obstetric sphincter damage is the most common cause of fecal incontinence in women. Between one-third and two-thirds of women who sustain a recognized third-degree tear during delivery subsequently suffer from fecal incontinence. We should therefore try to reduce the rate of high-grade tears as much as possible. But this rate can only be used as an outcome indicator for the quality of obstetric departments if the recognition and classification of sphincter injury is similar across departments in different hospitals.

Mars atmosphere. The imprint of atmospheric evolution in the D/H of Hesperian clay minerals on Mars.

The deuterium-to-hydrogen (D/H) ratio in strongly bound water or hydroxyl groups in ancient martian clays retains the imprint of the water of formation of these minerals. Curiosity's Sample Analysis at Mars (SAM) experiment measured thermally evolved water and hydrogen gas released between 550° and 950°C from samples of Hesperian-era Gale crater smectite to determine this isotope ratio. The D/H value is 3.0 (±0.2) times the ratio in standard mean ocean water. The D/H ratio in this ~3-billion-year-old mudstone, which is half that of the present martian atmosphere but substantially higher than that expected in very early Mars, indicates an extended history of hydrogen escape and desiccation of the planet.

Volatile and organic compositions of sedimentary rocks in Yellowknife Bay, Gale crater, Mars.

H2O, CO2, SO2, O2, H2, H2S, HCl, chlorinated hydrocarbons, NO, and other trace gases were evolved during pyrolysis of two mudstone samples acquired by the Curiosity rover at Yellowknife Bay within Gale crater, Mars. H2O/OH-bearing phases included 2:1 phyllosilicate(s), bassanite, akaganeite, and amorphous materials. Thermal decomposition of carbonates and combustion of organic materials are candidate sources for the CO2. Concurrent evolution of O2 and chlorinated hydrocarbons suggests the presence of oxychlorine phase(s). Sulfides are likely sources for sulfur-bearing species. Higher abundances of chlorinated hydrocarbons in the mudstone compared with Rocknest windblown materials previously analyzed by Curiosity suggest that indigenous martian or meteoritic organic carbon sources may be preserved in the mudstone; however, the carbon source for the chlorinated hydrocarbons is not definitively of martian origin.

Volatile, isotope, and organic analysis of martian fines with the Mars Curiosity rover.

Samples from the Rocknest aeolian deposit were heated to ~835°C under helium flow and evolved gases analyzed by Curiosity's Sample Analysis at Mars instrument suite. H2O, SO2, CO2, and O2 were the major gases released. Water abundance (1.5 to 3 weight percent) and release temperature suggest that H2O is bound within an amorphous component of the sample. Decomposition of fine-grained Fe or Mg carbonate is the likely source of much of the evolved CO2. Evolved O2 is coincident with the release of Cl, suggesting that oxygen is produced from thermal decomposition of an oxychloride compound. Elevated δD values are consistent with recent atmospheric exchange. Carbon isotopes indicate multiple carbon sources in the fines. Several simple organic compounds were detected, but they are not definitively martian in origin.

Prevention of Labour-Associated Pelvic Floor Injuries - What is Known for Sure.

In order to avoid pelvic floor injuries a caesarean section is on the one hand often requested by the pregnant women and, on the other hand, offered by obstetric staff. For both forms of delivery, comprehensive risk-benefit analyses should be carried out before deciding in favour of the surgical procedure. The present brief review summarizes the current evidence on the avoidance of pelvic floor injuries.

[Gynecologic injuries, management]. / Gynäkologische Verletzungen, Versorgung.

Accidental trauma to the female perineum is relatively rare and occurs most often in the 4- to 12-year-old age group. Vulva and vaginal trauma are the result of straddle injuries, accidental penetration, intercourse, sexual abuse and motor vehicle accidents. Injuries to the genitalia require typical surgical repair and, in association with anogenital or urogenital injuries, a multidisciplinary approach.

Caesarean section for the second twin after vaginal delivery of first.

Although caesarean section of a second twin after vaginal birth of the first twin is rare, it nevertheless has clinical importance as an acute emergency situation with high perinatal morbidity and mortality. We therefore found it appropriate to describe the obstetric management of such cases, including an overview of the literature and our own data. According to reports in the literature, 113 deliveries of second twins (3.4%) were carried out by section in 3342 twin births. At our department in Tubingen there were 497 twin births (1.9%) in 26 095 births. Of these the second twin was delivered by section in 11 cases (2.2%). This represents a statistical frequency of 0.04% of all births. As shown by case histories and our own study, the indications for abdominal delivery of the second twin were predominantly the prolapse of the umbilical cord or of small parts due to transverse or breech presentation, with simultaneous retraction of the cervix. Of our 11 births with emergency section, one child died postpartum. Because of above-mentioned risks the twin delivery must always be performed in a fully equipped facility, including facilities for intensive neonatal care.

[Uncomplicated obstetric injury as a risk factor for anal incontinence? Objective assessment of manometric measurements]. / Die unkomplizierte Geburtsverletzung als Risikofaktor analer Inkontinenz? Objektivierung durch manometrische Messungen.

The proximity of the anorectal sphincter apparatus and the vagina is a risk factor for faecal incontinence in women. To study the impact of the first delivery on anorectal continence, we evaluated 74 primiparae (41 women with midline episiotomy and 33 women with either intact perineum or Grade I tear only) and compared them to a control group of 18 nulliparous women. All subjects were examined by anorectal manometry and asked to complete a standardized questionnaire. Fourteen women of the primiparae group (eight patients with episiotomy, six pats. with intact perineum) had experienced incontinence of flatus, and 6 patients (8%, one pat. (3%) with intact perineum) had occasional incontinence of liquid or solid stool in the first weeks following delivery. We detected amongst those women who underwent episiotomy a significantly decreased maximum squeeze pressure and in women with an intact perineum a significantly decreased resting anal pressure. In all primiparae the anal canal length was significantly less when compared with control group. Even when the anal sphincter appears intact, the trauma of delivery causes detectable changes in the results of anorectal manometry, indicating a need for evaluation of the continence status at postpartum examination.

[Doppler ultrasound of uterine and fetoplacental circulation: placental laterality, normal values and reference curves]. / Dopplersonographie des utero- und fetoplazentaren Kreislaufs: Plazentalateralität, Normalwerte und Referenzkurven.

AIM: Doppler ultrasound assessment of blood flow velocity waveforms from the maternal and fetal sides of the placenta in normal pregnancies, taking into consideration placental location, in order to establish normal values and reference curves. METHOD: A cross sectional study of uneventful singleton pregnancies with gestational ages from 18 to 41 weeks and later on healthy newborns was performed by continuous-wave-Doppler ultrasound. Doppler flow signals from the uterine artery or the corresponding ascending branch and the umbilical arteries were analysed using the resistance index RI. The RI-values from the uterine circulation were classified according to the proximity of the placenta. Normal values and reference curves were established on the basis of centiles. RESULTS: After consideration of exclusion criteria, 757 pregnancies remained for evaluation. The resistance index reference curves of the uterine circulation were dependent on placental location, with proximal RI-values being lower, but with nearly constant course during the second half of pregnancy. In contrast, the umbilical artery RI-values were higher but showed a continuous decrease. CONCLUSION: In the second half of pregnancy, down stream flow resistance of the uterine circulation is very low and nearly constant but depends on placental location. The fetoplacental circulation shows high flow resistances which decrease with increasing gestational age. These reference curves are comparable with others where placental location is taken into consideration.

[Clinical effects of childbirth with median episiotomy and anal sphincter injury on fecal incontinence of primiparous women]. / Klinische Auswirkungen der Geburt mit medianer Episiotomie und analer Sphinkterverletzung auf die Stuhlkontinenz bei Primiparae.

Obstetric damage of the anorectal continence organ can lead to impaired anal continence. To assess the effect of birth, either with or without direct injury of the anal sphincter, 123 primiparae were studied. 41 patients with a midline episiotomy and 82 patients with an additional injury of the anal sphincter were assessed at a median of 21 weeks postpartum and compared with 18 healthy volunteers. Anorectal manometry as well as a standardized questionnaire were employed. Patients with an additional injury of the anal sphincter reported persistent flatus incontinence significantly more often (p = 0.0069) than patients with a midline episiotomy only. Incontinence of solid or liquid stool occurred only transiently. Compared to nulliparae in all primiparae a significant shortening of anal canal and a decreased squeeze pressure were observed. In addition, a significantly reduced resting pressure was seen in patients with an anal sphincter injury. The rectoanal inhibitory reflex was absent significantly more often following anal sphincter tear (p = 0.0023). Vaginal delivery, both with and without anal sphincter injury, leads to early detectable changes in anorectal sphincter function.

Mapping of androgen, estrogen and progesterone receptors in the anal continence organ.

OBJECTIVE: To investigate the expression of androgen, estrogen and progesterone receptors (ARs, ERs, PRs) in the tissues of the anal continence organ using immunohistochemical techniques. STUDY DESIGN: Thirty-nine samples of anorectal tissue were obtained from 23 patients (seven men, seven premenopausal women and nine postmenopausal women). Immunostaining for ARs, ERs and PRs was performed by the ABC technique using 3,3'-diaminobenzidine tetrahydrochloride as the chromogen. RESULTS: Specific immunostaining for ARs, ERs and PRs was found exclusively over cell nuclei. ARs were found in the smooth muscle cells of the internal anal sphincter in all but one of the females (10/11) and all males (7/7), ERs were found in 12/12 females and 4/7 males, and PRs were found in 4/10 females and 1/7 males. The squamous epithelium exhibited a similar pattern of immunostaining. The nuclei of the striated muscle fibers expressed none of the sex steroid receptors investigated. CONCLUSION: The intense expression of ARs, ERs and, in some cases, PRs in the tissues of the anal continence organ at all ages and in both sexes indicates that this organ is a target for sex steroid hormones.

Inhibition of minK protein induced K+ channels in Xenopus oocytes by estrogens.

Previously it was shown that minK protein expression in uterus is regulated by estrogen. In the present study, we were interested in putative direct effects of estrogen on minK protein induced K+ currents (IminK) in Xenopus oocytes. Superfusion with 17-beta-estradiol (1 microM) resulted in an inhibition of minK-induced currents, but had no appreciable effects on the delayed rectifier and inward rectifier K+ channels Kv1.1 and Kir2.1, respectively. The inhibition of IminK by 17-beta-estradiol was concentration-dependent, with an IC50 of approximately 0.5 microM. In the presence of 17-beta-estradiol, the conductance-voltage relationship was shifted to more depolarized potentials. IminK inhibition occurred also in the presence of the estrogen-receptor antagonist tamoxifen, suggesting that a mechanism independent of estrogen receptors is involved. The synthetic estrogen diethylstilbestrol (DES) also inhibited IminK but with a lower affinity (IC50 of 4.5 microM), while cortisol and progesterone had only weak effects on IminK. In summary, the results indicate that estrogens directly inhibit IminK.

Immunohistochemical assessment of steroid hormone receptors in tissues of the anal canal. Implications for anal incontinence?

BACKGROUND: A prerequisite for a hormonal influence on anal continence in women is the presence of hormone receptors in the tissues of the anal canal. Using immunohistochemical techniques, we demonstrated and localized estrogen and progesterone receptors (ER, PR) in tissue sections of the anal canal. METHODS: Thirty-five specimens of the anorectal region from 21 patients (14 women, seven men) were examined histologically for smooth muscle (present in specimens from ten females and in seven males), striated muscle (present in three females and five males), and perimuscular connective tissue (present in 12 females and seven males). Immunostaining for ER and PR was then performed by incubating with primary anti-ER and anti-PR antibody and visualization of specific antibody binding by the ABC technique with DAB as chromogen. RESULTS: Positive staining for ER and PR was seen exclusively over cell nuclei. Estrogen receptors were found in the smooth muscle cells of the internal sphincter of all females (10/10) and in four of the seven males. Staining for ER was detected in the perimuscular connective tissue of all females (12/12) and in four of the seven males. No specific staining for ER or PR was found in the nuclei of striated muscle cells of the external sphincter in males or females (n = 8). In females, about 50% of the ER-positive tissues were also found to be positive for PR. Amongst the male patients, only one exhibited staining for PR, and this was confined to the smooth muscle. CONCLUSIONS: Expression of ER is a constitutional feature of the connective tissue and smooth muscle cells of the anal continence organ. Estrogen receptors and PR are not detectable in the striated muscle fibers of the external anal sphincter in either sex. The presence of ER in the stroma and smooth muscles of the anal canal suggests that these tissues are targets for estrogen. This constitutes a theoretical basis for the beneficial effects of estrogen and progestin replacement on anal continence in postmenopausal women.

De novo direct tandem duplication of a small segment of the short arm of chromosome 7 (p21.22-->22.1).

We report a boy with duplication of a small segment of the short arm of chromosome 7 (46,XY, dir dup (7) (p21.2-->22.1). The boy presented with supravalvular pulmonary stenosis, atrial septum defect and mental retardation. The origin of the additional material from chromosome 7 was confirmed by fluorescence in situ hybridization. This technique in combination with the use of single-copy DNA probes may in future help to delineate the phenotype/karyotype correlation.

Circulatory Doppler parameters in fetal hypoxaemia.

A 32-year-old pregnant woman (gravida 1, para 0) was delivered at 27 weeks of gestation by elective Caesarean section because of regular fetal heart rate (FHR) decelerations. Doppler ultrasound assessment of the middle cerebral artery (MCA) and the ductus venosus (DV) showed pathological results, whereas the umbilical artery waveforms were normal. Blood gas analysis of the umbilical cord obtained at Caesarean section indicated fetal hypoxaemia. The discrepancy between abnormal Doppler findings in the central circulation and normal Doppler in the umbilical artery suggests that a detailed Doppler assessment may be necessary in order to clarify abnormal FHR tracings.

[Pelvic floor reconstruction after traumatic childbirth damage]. / Beckenbondenrekonstruktion nach geburtstraumatischen Schäden.

Vaginal delivery can result in direct injury to the anterior part of the anal sphincter. The goal of its repair is to restore the separated sphincters and connective tissue to their anatomical positions in order to achieve continence. The results are best when an anal sphincter rupture is repaired immediately following delivery, when the vascularity of the perineum and perivaginal tissues favours healing.

[Infiltrating tubo-ovarian abscess in IUD-associated actinomycosis]. / Infiltrierender Tuboovarialabszess bei IUP-assoziierter Aktinomykose.

We report on a case of a 55-year old patient with a great adnexal tumour (10 x 5 x 8 cm), on the left side with infiltration of the bladder and the pelvis with recurring urinary retention in the kidney. Histological examination revealed an intrauterine device-associated actinomycosis. Following a 6-month high dose penicillin therapy, the abdominal hysterectomy with adnexectomy and partial resection of the bladder with new implantation of the ureter (Boari) was performed. The postoperative period was uneventful, the urogram normal.

[Gaucher disease and pregnancy]. / Morbus Gaucher und Schwangerschaft.

Up to date, initial or recurrent pregnancy has been reported in 46 patients suffering from Gaucher's disease. In the present review of the literature, potential complications and therapeutic concepts are outlined and a case report of a 22-year-old primipara is presented.