The Safe Labiaplasty: A Study of Nerve Density in Labia Minora and Its Implications.

BACKGROUND: Surgical techniques to alleviate labia minora hypertrophy are gaining popularity. Due to the rapidly growing number of labiaplasties performed around the world, there is concern for the safety of these procedures with respect to maintaining sensitivity to the genitalia and/or implications for sexual arousal. OBJECTIVES: An anatomic study aimed at identifying the nerve density distribution of the labia minora was performed to provide unique insight into performing labiaplasty while preserving sensation. METHODS: Four fresh tissue cadaver labia minora were analyzed. Each labia minora was divided into 6 anatomic areas. The samples from each of the 6 anatomic locations were analyzed for presence of nerve bundles using both a routine hematoxylin and eosin (H&E) stain and a confirmatory immunohistochemical staining for S100 protein. Nerve density was analyzed under light microscopy, counted, and then expressed as percentage nerve density as well as number of bundles per square millimeter. RESULTS: Upon gross analysis, the raw data reveal that labia minora have a heterogeneous population of sensory nerves. When looking at percent nerve density, the data do not reveal any statistical differences between the anatomic locations. CONCLUSIONS: Most labiaplasty techniques can be performed safely and are unlikely to cause loss of sensation as the nerve density distribution in labia minora is heterogeneous.

Mixed pulmonary infection with Strongyloides stercoralis and Blastomyces dermatitidis.

We report the first case of mixed pulmonary infection with Strongyloides stercoralis and Blastomyces dermatitidis. Histopathology from the lung biopsy showed structures consistent with B. dermatitidis and S. stercoralis. A parasitology exam from a bronchi alveolar lavage yielded an immature rhabditiform larva and female worm. Fungal cultures grew B. dermatitidis.

Increased Expression but Reduced Activity of Antioxidant Enzymes in Alzheimer's Disease.

A growing body of data suggests that free radicals are involved in the pathogenesis of Alzheimer's disease (AD). Increased expression of antioxidant enzymes, such as superoxide dismutase (SOD), and their co-localization to senile plaques and dystrophic neurites have established a firm association between free-radical mediated injury and the disease neuropathology. While several studies have confirmed these findings, there is conflicting information regarding the activity of some of the enzymes. In the current report, we assayed the activity of superoxide dismutase (SOD), catalase and glutathione peroxidase (GSH-Px) from the same areas of the tissue showing increased expression of SOD1 and SOD2 (parallel sequential slices). Nine brains with neuropathologically confirmed AD and six neuropathologically normal, age-matched, controls were examined. Despite marked increased expression of SOD1 and SOD2 within senile plaques in all the cases studied, the activities of SOD, GSH-Px and catalase were significantly lower in AD than in control brains. The difference was most profound in the case of catalase followed by GSH-Px and SOD. These data are in qualitative agreement with that of several laboratories, and support a decrease rather than an increase, in antioxidant enzyme activity. The findings suggest two main possibilities. On one hand, the observed reduced activity along with antigenically increased expression may be consistent with inactivation of excess protein that has been synthesized under conditions of high oxidative stress. Increased protein oxidation coupled with enzyme inactivation is a documented, aging-associated phenomenon. Alternatively, the increased immuno-reactivity may reflect a redistribution phenomenon as the enzymes become more concentrated at the sites of increased oxidative stress, despite an over all reduction in their activity.