Trabalho prospectivo estudando a matriz extracelular da parede vesical em pacientes com extrofia vesical comparados ao grupo controle, pela microscopia óptica comum e luz polarizada com morfometria, quantificando-se as fibras colágenas e reticulínicas. Estudou-se 17 pacientes de ambos os sexos, biopsiando-se toda a parede vesical e empregando colorações HE, PS e Reticulina. Diferenças estatisticamente significantes foram notadas na análise quantitativa de fibras colágenas e reticulínicas o número de fibras colágenas foi significativamente maior e o número de fibras reticulínicas foi menor no grupo de pacientes com extrofia vesical quando comparado ao grupo controle. / A prospective study was done to evaluate the detrusor muscle\'s extracellular matrix in classical bladder exstrophy in comparison to a control group, by use of light microscopy and polarization method with morphometry, to quantify collagen and reticular fibers. Seventeen patients from both sexes were analysed and samples were obtained from the bladder and stained with Haematoxylin-eosin, Picrosirius red and the silver impregnation method. There were significant differences when comparing the quantity of collagen and reticular fibers. The collagen fibers were more abundant in the exstrophy bladders compared to controls, while the reticular fibers were present in smaller amounts.

INTRODUÇÃO E OBJETIVOS: Distúrbios miccionais são freqüentes em pacientes com doença de Parkinson, mas sua associação com parâmetros como idade do paciente, gênero, gravidade do comprometimento neurológico e duração da doença não é bem conhecida. Neste estudo, avaliamos prevalência e características dos sintomas miccionais em pacientes com doença de Parkinson e examinamos sua associação com parâmetros clínicos com potencial impacto sobre a disfunção miccional. MÉTODOS: Avaliamos prospectivamente 110 pacientes, incluindo 84 homens (76,4%) e 26 mulheres (23,6%), com idade média de 61,8 ± 9,6 anos. Os critérios de inclusão foram doença de Parkinson idiopática e idade acima de 40 anos. Pacientes com outras doenças neurológicas, história de cirurgia e radioterapia pélvica foram excluídos. A duração média da doença foi 12,3 ± 7,2 anos. O comprometimento neurológico foi avaliado pelas escalas Hoehn-Yahr (HY) e Escala Unificada de Avaliação da Doença de Parkinson (UPDRS). Os sintomas miccionais foram avaliados pelo questionário da Sociedade Internacional de Continência para Homens, incluindo uma questão de qualidade de vida relacionada a sintomas miccionais. Consideramos sintomáticos os pacientes que queriam tratamento para sua disfunção miccional. Estes foram avaliados com análise de urina, creatinina sérica, PSA, ultra-sonografia do aparelho urinário e urodinâmica. Avaliamos a associação da disfunção miccional com idade, gênero, tempo de duração da doença, grau de comprometimento neurológico, impacto na qualidade de vida e achados urodinâmicos. RESULTADOS: A avaliação neurológica demonstrou média de 3,0 ± 0,8 na escala de HY e 70,0 ± 31,1 na escala de UPDRS. A média do escore miccional foi de 11,9 ± 9,3 e os sintomas mais comuns foram noctúria em 89 (80,9%) pacientes, urgência em 40 (36,3%) e aumento da freqüência miccional em 39 (35,4%) pacientes. A duração média dos sintomas miccionais foi de 3,8 ± 3,4 anos. A prevalência da disfunção miccional aumentou significativamente com o aumento no grau de comprometimento neurológico, mas não com a idade nem com a duração da doença. A qualidade de vida relacionada aos sintomas miccionais foi afetada pela severidade da disfunção miccional e os sintomas de freqüência e noctúria são os de pior impacto na qualidade de vida. Sessenta e três pacientes (57,2%) eram sintomáticos e 54 (43 homens e 11 mulheres) completaram a avaliação. Os pacientes sintomáticos apresentaram disfunção neurológica mais severa (HY médio 3,2 ± 0,8 vs 2,8 ± 0,9 para os assintomáticos; p=0,035). A idade, a duração da doença e dos sintomas miccionais não diferiram entre sintomáticos e assintomáticos. O volume médio da próstata foi 30,3 ± 10,7 cc. Os achados urodinâmicos foram obstrução infravesical em 38 (70,3%) pacientes, hiperatividade detrusora em 27 (50,0%), e hipocontratilidade detrusora em seis (11,1%) pacientes. O grau de comprometimento neurológico não se associou com nenhum padrão urodinâmico. Na comparação entre homens e mulheres sintomáticos a única diferença observada foi a maior gravidade dos sintomas de esvaziamento nos homens. CONCLUSÕES: A maior parte dos pacientes com doença de Parkinson apresenta disfunção miccional significativa e a gravidade da doença neurológica é o principal fator preditivo para a ocorrência de disfunção miccional. Obstrução infravesical e hiperatividade detrusora são os achados urodinâmicos mais comuns, mas não estão associados com o grau de comprometimento neurológico. Homens e mulheres são similarmente afetados pelos sintomas miccionais e não demonstraram distinção quanto aos achados urodinâmicos. / INTRODUCTION AND OBJECTIVES: Voiding dysfunction often occurs in patients with Parkinsons disease, but its association with patients age, gender, degree of neurological impairment, and disease duration is not fully known. In this study, we assessed the prevalence and characteristics of lower urinary tract symptoms (LUTS) in patients with Parkinson\'s disease and examined their association with those clinical parameters that could have an impact on voiding dysfunction. METHODS: We prospectively evaluated 110 patients, of which 84 were men (76.4%) and 26 were women (23.6%), with a mean age of 61.8 ± 9.6 years. The inclusion criteria were: idiopathic Parkinsons disease and age > 40 years. Patients with other neurological diseases and history of pelvic surgery and radiotherapy were excluded. Mean duration of the disease was 12.3 ± 7.2 years. The neurological impairment was assessed by the Hoehn-Yahr scale (HY) and the Unified Parkinson Disease Rating Scale (UPDRS). Lower urinary tract symptoms were assessed by the International Continence Society male questionnaire, which included a question about quality of life related to LUTS. Those patients who wanted to be treated for their voiding dysfunction were considered as symptomatic. They underwent urine analysis, serum creatinine measurement, PSA, urinary tract imaging and urodynamic study. We examined the association between voiding dysfunction and age, gender, disease duration, degree of neurological impairment, impact on quality of life, and urodynamic findings. RESULTS: The neurological assessment showed a mean HY score of 3.0 ± 0.8 and a mean UPDRS score of 70.0 ± 31.1. Mean LUTS score was 11.9 ± 9.3, and the most prevalent symptoms were nocturia in 89 (80.9%) patients, urgency in 40 (36.3%), and frequency in 39 (35.4%). Mean duration of LUTS was 3.8 ± 3.4 years. The prevalence of voiding dysfunction increased significantly with the degree of neurological impairment, but not with patients age or disease duration. Quality of life was affected by the severity of the voiding dysfunction, and the symptoms with the worst impact on quality of life were frequency and nocturia. Sixty-three patients (57.2%) were symptomatic and 54 (43 men and 11 women) concluded the evaluation. Symptomatic patients had more severe neurological dysfunction (mean HY 3.2 ± 0.8 vs 2.8 ± 0.9 for asymptomatic patients; p=0.035). Symptomatic and asymptomatic patients did not differ as to age, disease duration and LUTS. Mean prostate volume was 30.3 ± 10.7 cc. The urodynamic findings were bladder outlet obstruction in 38 (70.3%) patients, detrusor overactivity in 27 (50.0%), and detrusor underactivity in 6 (11.1%). The degree of neurological impairment was not associated with any urodynamic pattern. The only difference observed between symptomatic men and women was that the voiding symptoms were more severe in men. CONCLUSIONS: Most patients with Parkinsons disease have significant voiding dysfunction, and the severity of the neurological disease is the main predictive factor for the occurrence of voiding dysfunction. Bladder outlet obstruction and detrusor overactivity are the most common urodynamic findings, although not associated with the degree of neurological impairment. Men and women are equally affected by LUTS and show similar urodynamic findings.

Cheung, Chun Wai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (leaves 111-128). / Abstracts in English and Chinese. / Acknowledgement --- p.ii / Abstract --- p.iv / 摘要 --- p.vii / Table of content --- p.ix / List of Figures --- p.xvii / List of Tables --- p.xix / Abbreviations --- p.xxi / Chapter Chapter 1. --- Introduction --- p.1 / Chapter 1.1 --- Complementary and Alternative Medicine (CAM) and Traditional Chinese Medicine (TCM) --- p.1 / Chapter 1.2 --- The development of Traditional Chinese Medicine --- p.2 / Chapter 1.3 --- Quality control of Traditional Chinese Medicine --- p.3 / Chapter 1.4 --- Problems of adulteration --- p.5 / Chapter 1.4.1 --- Confusion by common names --- p.5 / Chapter 1.4.2 --- Erroneous and intentional adulteration --- p.6 / Chapter 1.5 --- Authentication of Traditional Chinese Medicine using DNA techniques --- p.7 / Chapter 1.6 --- Crocodile meat --- p.10 / Chapter 1.6.1 --- Crocodile meat as Traditional Chinese Medicine --- p.10 / Chapter 1.6.2 --- Crocodile meat as exotic meat --- p.10 / Chapter 1.6.3 --- Effects of crocodile meat on mice --- p.12 / Chapter 1.6.4 --- Adulteration of crocodile meat in Hong Kong --- p.13 / Chapter 1.6.5 --- Authentication of crocodile meat --- p.14 / Chapter 1.6.5.1 --- SCAR analysis --- p.14 / Chapter 1.6.5.2 --- 12S and 16S ribosomal DNA --- p.14 / Chapter 1.7 --- Fish air-bladder --- p.15 / Chapter 1.7.1 --- Fish air-bladder as Traditional Chinese Medicine --- p.15 / Chapter 1.7.2 --- A case study --- p.16 / Chapter 1.7.3 --- Authentication of fish air-bladder --- p.17 / Chapter 1.8 --- Radix Stellariae --- p.18 / Chapter 1.8.1 --- Stellaria dichotoma L. var. lanceolata Bge --- p.18 / Chapter 1.8.2 --- Radix Stellariae as Traditional Chinese Medicine --- p.19 / Chapter 1.8.3 --- Chemicals in Radix Stellariae and their uses --- p.19 / Chapter 1.8.4 --- Adulteration of Radix Stellariae --- p.20 / Chapter 1.8.5 --- Authentication of Radix Stellariae --- p.21 / Chapter 1.8.5.1 --- Internal Transcribed Spacers (ITS) --- p.21 / Chapter 1.8.5.2 --- trnH-psbA intergenic spacer --- p.23 / Chapter 1.9 --- Objectives --- p.25 / Chapter Chapter 2. --- Materials and Methods --- p.26 / Chapter 2.1 --- Samples used in the study --- p.26 / Chapter 2.1.1 --- Crocodile and monitor lizard samples --- p.26 / Chapter 2.1.2 --- Sequence from NCBI database --- p.26 / Chapter 2.1.3 --- Fish air-bladder samples --- p.30 / Chapter 2.1.4 --- Radix Stellariae samples and samples of related species --- p.33 / Chapter 2.1.5 --- Sequences from NCBI database --- p.33 / Chapter 2.2 --- Reagents and equipments --- p.36 / Chapter 2.2.1 --- Sample preparation and DNA extraction --- p.36 / Chapter 2.2.2 --- Polymerase Chain Reaction --- p.38 / Chapter 2.2.3 --- Agarose gel electrophoresis and Gene Clean --- p.39 / Chapter 2.2.4 --- Cloning --- p.40 / Chapter 2.2.5 --- Cycle sequencing --- p.41 / Chapter 2.3 --- Experimental procedures --- p.42 / Chapter 2.3.1 --- Sample preparation --- p.42 / Chapter 2.3.2 --- DNA extraction --- p.42 / Chapter 2.3.3 --- Polymerase Chain Reaction --- p.44 / Chapter 2.3.4 --- Agarose gel electrophoresis --- p.47 / Chapter 2.3.5 --- Gene Clean --- p.47 / Chapter 2.3.6 --- Cloning --- p.48 / Chapter 2.3.7 --- Cycle sequencing and sequence analyses --- p.51 / Chapter Chapter 3. --- Crocodile meat - Results and Discussion --- p.54 / Chapter 3.1 --- Results --- p.54 / Chapter 3.1.1 --- SCAR analysis --- p.54 / Chapter 3.1.2 --- Sequence analyses --- p.55 / Chapter 3.1.3 --- The dendrograms --- p.56 / Chapter 3.2 --- Discussion --- p.60 / Chapter 3.2.1 --- SCAR as a quick and inexpensive method for the authentication of crocodile meat --- p.60 / Chapter 3.2.2 --- DNA sequencing - A useful tool to identify the source species of the crocodile meat --- p.61 / Chapter 3.2.3 --- Adulteration of crocodile meat in Hong Kong --- p.63 / Chapter 3.2.4 --- Source species of the genuine crocodile meats and the adulterants --- p.63 / Chapter 3.2.5 --- Regulation of labeling of food in Hong Kong --- p.69 / Chapter 3.2.6 --- Source species of the lizard head and tail from AFCD --- p.69 / Chapter 3.3 --- Summary --- p.70 / Chapter Chapter 4. --- Fish air-bladders - Results and Discussion --- p.72 / Chapter 4.1 --- Results --- p.72 / Chapter 4.1.1 --- Identities of sample BH and F1 --- p.73 / Chapter 4.1.2 --- Identity of sample BS --- p.74 / Chapter 4.1.3 --- Identities of samples GD and ZG --- p.74 / Chapter 4.1.4 --- Identity of sample GG --- p.74 / Chapter 4.1.5 --- "Identities of samples HB, HT and SH" --- p.75 / Chapter 4.1.6 --- Identity of sample JL --- p.75 / Chapter 4.1.7 --- Identity of sample MS --- p.76 / Chapter 4.1.8 --- Identity of sample RE --- p.76 / Chapter 4.2 --- Discussion --- p.77 / Chapter 4.2.1 --- Sample RE was confirmed to have originated from rabbit ears --- p.77 / Chapter 4.2.2 --- Identities of the dry fish air-bladders sold in Hong Kong --- p.79 / Chapter 4.2.3 --- Identities of the fresh fish air-bladders sold in Hong Kong --- p.82 / Chapter 4.2.4 --- Limitations of the use of DNA sequences for source species identification --- p.83 / Chapter 4.2.5 --- Variation in prices of fish air-bladders --- p.87 / Chapter 4.3 --- Summary --- p.88 / Chapter Chapter 5. --- Radix Stellariae - Results and Discussion --- p.89 / Chapter 5.1 --- Results --- p.89 / Chapter 5.1.1 --- Sequence analyses --- p.90 / Chapter 5.1.2 --- The dendrograms --- p.90 / Chapter 5.2 --- Discussion --- p.97 / Chapter 5.2.1 --- Identities of the samples obtained from the market --- p.97 / Chapter 5.2.2 --- Identity of sample Sdl4 --- p.97 / Chapter 5.2.3 --- Identities of samples Sd02R and Sd04 --- p.100 / Chapter 5.2.4 --- Myosoton aquaticum in the Stellaria-Myosoton clade --- p.104 / Chapter 5.2.5 --- Medicinal uses of the substitutes of Radix Stellariae --- p.105 / Chapter 5.3 --- Summary --- p.106 / Chapter Chapter 6. --- Conclusion --- p.107 / Reference --- p.111 / Appendix 1. 12S rDNA sequences of crocodilian and Varanus species obtained from NCBI database for sequence analyses --- p.129 / Appendix 2. 16S rDNA sequences of crocodilian and Varanus species obtained from NCBI database for sequence analyses --- p.130 / "Appendix 3. ITS sequences of the species in the genera Arenaria, Myosoton, Silene, and Stellaria obtained from NCBI database for sequence analyses" --- p.131 / Appendix 4. 7rnH-psbA intergenic spacer sequences of Silene species obtained from NCBI database for sequence analyses --- p.132 / Appendix 5. Sequence alignment of 12S rRNA gene sequences of crocodile and monitor lizard samples --- p.133 / Appendix 6. Sequence alignment of 16S rRNA gene sequences of crocodile and lizard samples --- p.141 / Appendix 7. Sequence alignment of coxl sequences of fish air-bladder samples --- p.149 / Appendix 8. Sequence alignment of 12S rRNA gene sequences of fish air-bladder samples --- p.151 / Appendix 9. Sequence alignment of 16S rRNA gene sequences of fish air-bladder samples --- p.153 / Appendix 10. Sequence alignment of coxl region of Vibrio parahaemolyticus and the coxl primers --- p.155 / Appendix 11. Sequence alignment of ITS sequences of Radix Stellariae and related samples --- p.156 / Appendix 12. Sequence alignment of trnH-psbA of Radix Stellariae and related samples --- p.163 / Appendix 13. Search results of coxl sequences of the fish air-bladder samples in BOLD-IDS --- p.167 / Appendix 14. Search results of coxl sequences of the fish air-bladder samples in NCBI nucleotide BLAST --- p.168 / Appendix 15. Search results of 12S rDNA sequences of the fish air-bladder samples in NCBI nucleotide BLAST --- p.169 / Appendix 16. Search results of 16S rDNA sequences of the fish air-bladder samples in NCBI nucleotide BLAST --- p.170 / Appendix 17. Sequence similarities (%) of coxl sequences of the fish air-bladder samples --- p.171 / Appendix 18. Sequence similarities (%) of 12S rDNA sequences of the fish air-bladder samples --- p.172 / Appendix 19. Sequence similarities (%) of 16S rDNA sequences of the fish air-bladder samples --- p.173

IINTRODUÇÃO: A Cistite Intersticial (CI) ou Síndrome da Bexiga Dolorosa (SBD) é uma síndrome crônica caracterizada pela presença de dor ou desconforto vesical ou pélvico e sintomas miccionais como urgência e aumento da frequência miccional diurna e noturna, na ausência de outra afecção identificável que justifique esses sintomas. Não existe até o momento nenhum teste diagnóstico ou marcador que defina a CI. Desta forma seu diagnóstico é predominantemente clínico, baseado nos sinais e sintomas e dependente da exclusão de outras doenças urológicas. A dificuldade no diagnóstico e no tratamento dessas pacientes reflete o pouco que se sabe sobre sua fisiopatologia e sobre as alterações genéticas presentes na doença. A identificação de marcadores pode proporcionar um melhor entendimento e manejo desses aspectos da síndrome. Na tentativa de identificar marcadores genéticos que possam estar associados a CI, avaliamos a presença de alguns polimorfismos genéticos, os polimorfismos de nucleotídeo único (SNP), no DNA de pacientes com os critérios diagnósticos de CI e comparamos sua prevalência entre as pacientes e também com um grupo controle representativo da população geral. A correlação desses polimorfismos considerando a CI e a intensidade de dor nessas pacientes ainda não foi estudada na literatura. OBJETIVOS: Analisar a presença de polimorfismos (SNP) em amostras de sangue de pacientes com CI e correlacionar a presença dos polimorfismos com o quadro de dor crônica. MÉTODOS: Foram selecionadas 34 pacientes do sexo feminino com diagnóstico de CI de acordo com os critérios do NIDDK e 23 pacientes do grupo controle (mulheres saudáveis apenas com incontinência urinária de esforço). As pacientes com o diagnóstico de CI foram estratificadas em dois grupos de acordo com o grau dos sintomas de dor crônica. Foram selecionados 20 polimorfismos para análise: rs1800871, rs1800872, rs1800896, rs1800471, rs1800629, rs361525, rs1800497, rs6311, rs6277, rs6276, rs6313, rs2835859, rs11127292, rs2243248, rs6887695, rs3212227, rs1799971, rs12579350, rs3813034, rs6746030. A genotipagem foi realizada através da técnica de PCR em tempo real (q-PCR) e correlacionada com o diagnóstico de CI e com a intensidade dos sintomas álgicos. RESULTADOS: O alelo polimórfico (T) do SNP rs11127292 foi mais frequente nas pacientes com CI em relação ao grupo controle (p:0,01). O alelo polimórfico (T) do SNP rs6311 foi significativamente mais frequente nas pacientes com dor mais intensa (p:0,03). A frequência do alelo selvagem (A) do SNP rs1799971 foi maior em pacientes com dor leve a moderada (p:0,04). CONCLUSÕES: Foram identificadas algumas diferenças na frequência dos polimorfismos nas pacientes estudadas, o que sugere a existência de um papel relevante dos SNP associados tanto à CI quando na intensidade dos sintomas de dor crônica nestas pacientes / INTRODUCTION: Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a chronic syndrome characterized by the presence of bladder/pelvic pain or discomfort and voiding symptoms such as urgency and increased urinary waking and night-time frequency in the absence of another identifiable cause to justify these symptoms. So far, there is no diagnostic test or marker to establish the presence of IC. Thus, the diagnosis is predominantly clinical, based on signs and symptoms and dependent on the exclusion of other urological diseases. The difficulty in the diagnosis and treatment of these patients reflects the little that is known about IC physiopathology and about the genetic background of the disease. The identification of new markers may provide a better understanding and management of the syndrome. As an attempt to identify genetic markers that may be associated with IC, we evaluated the presence of some genetic polymorphisms, single nucleotide polymorphisms (SNPs), in the DNA of patients with the diagnostic criteria of IC, and we compared their prevalence among IC patients and with a control group representative of the general population. The correlation of these polymorphisms considering IC and pain intensity in these patients has not been studied in the literature. OBJECTIVES: To assess the presence of polymorphisms (SNPs) in blood samples from IC patients and to correlate the presence of polymorphisms with chronic pain. METHODS: Thirty-four female patients with a diagnosis of IC according to the NIDDK criteria and 23 control subjects (healthy women with stress urinary incontinence) were selected. Patients with the diagnosis of IC were stratified into two groups according to the degree of symptoms of chronic pain. We selected 20 polymorphisms for analysis: rs1800871, rs1800876, rs1800471, rs1800629, rs361525, rs1800497, rs6311, rs6277, rs6276, rs6313, rs2835859, rs11127292, rs2243248, rs6887695, rs3212227, rs1799971, rs12579350, rs3813034, rs6746030. Genotyping was performed using the real-time PCR technique (q-PCR) and correlated with the diagnosis of IC and intensity of pain symptoms. RESULTS: The polymorphic allele (T) of the SNP rs11127292 occurred with more frequency in patients with IC compared to the control group (p= 0.01). The polymorphic allele (T) of SNP rs6311 occurred with more frequency in patients with severe pain (p= 0.03). The frequency of wild-type (A) SNP rs1799971 was higher in patients with mild to moderate pain (p= 0.04). CONCLUSION: The results indicated differences in polymorphism frequency in the patients studied, suggesting the existence of a relevant role of SNPs associated with both IC and intensity of chronic pain symptoms in these patients

Purpose To evaluate the pelvic floor health knowledge base and presence of pelvic floor dysfunction (PFD) in women working in an office environment, and whether this knowledge significantly increases following a pelvic floor health education session and a re-education session. To assess whether this knowledge-acquisition leads to significant decrease in PFD. Participants Female volunteers (N=161), ages 18-69 years, were randomly allocated to Groups A, B or C. Methods Online surveys were completed by all groups on three occasions and included validated tools (Prolapse and Incontinence Knowledge Quiz, Pelvic Floor Distress Inventory-20, Pelvic Floor Impact Questionnaire-7) plus sexual function and pelvic floor muscle (PFM) exercise items. On completion of the baseline survey, an education session was given to Groups A and B only (Group C represented the controls). Following this, all participants completed the second survey. Two months later, to allow time for efficacy for the PFM exercises, a re-education presentation was given to Group A only, followed by the final survey administered to all. Analysis Of the 161 volunteers, 16 failed to complete all study requirements, leaving 145 questionnaires (Groups A and B n=48, Group C n=49) available for analysis using ANOVA and Descriptive Analysis. Results The knowledge base of the participants receiving the education showed highly significant improvement compared to the control group, and again for those receiving the re-education session. Although only 14% stated that they had PFD, the surveys revealed that 96% of the participants had PFD. The groups receiving the PFM exercise education and strategies to encourage healthier bladder and bowel habits showed significant decrease in PFD symptoms and increase in QoL. Education was successful in producing highly significant increases in knowledge, importance and commitment toward PFM exercise. Conclusion This study is unique as it evaluated pelvic floor health knowledge and presence of PFD of presumably healthy women within an office setting in contrast to patients seeking PFD medical attention. While further research is required, it is clear that low pelvic floor health knowledge was associated with high prevalence of PFD. Further, as knowledge/awareness significantly increased following education, so did QoL, while PFD significantly decreased.

Purpose To evaluate the pelvic floor health knowledge base and presence of pelvic floor dysfunction (PFD) in women working in an office environment, and whether this knowledge significantly increases following a pelvic floor health education session and a re-education session. To assess whether this knowledge-acquisition leads to significant decrease in PFD. Participants Female volunteers (N=161), ages 18-69 years, were randomly allocated to Groups A, B or C. Methods Online surveys were completed by all groups on three occasions and included validated tools (Prolapse and Incontinence Knowledge Quiz, Pelvic Floor Distress Inventory-20, Pelvic Floor Impact Questionnaire-7) plus sexual function and pelvic floor muscle (PFM) exercise items. On completion of the baseline survey, an education session was given to Groups A and B only (Group C represented the controls). Following this, all participants completed the second survey. Two months later, to allow time for efficacy for the PFM exercises, a re-education presentation was given to Group A only, followed by the final survey administered to all. Analysis Of the 161 volunteers, 16 failed to complete all study requirements, leaving 145 questionnaires (Groups A and B n=48, Group C n=49) available for analysis using ANOVA and Descriptive Analysis. Results The knowledge base of the participants receiving the education showed highly significant improvement compared to the control group, and again for those receiving the re-education session. Although only 14% stated that they had PFD, the surveys revealed that 96% of the participants had PFD. The groups receiving the PFM exercise education and strategies to encourage healthier bladder and bowel habits showed significant decrease in PFD symptoms and increase in QoL. Education was successful in producing highly significant increases in knowledge, importance and commitment toward PFM exercise. Conclusion This study is unique as it evaluated pelvic floor health knowledge and presence of PFD of presumably healthy women within an office setting in contrast to patients seeking PFD medical attention. While further research is required, it is clear that low pelvic floor health knowledge was associated with high prevalence of PFD. Further, as knowledge/awareness significantly increased following education, so did QoL, while PFD significantly decreased.

Trabalho prospectivo estudando a matriz extracelular da parede vesical em pacientes com extrofia vesical comparados ao grupo controle, pela microscopia óptica comum e luz polarizada com morfometria, quantificando-se as fibras colágenas e reticulínicas. Estudou-se 17 pacientes de ambos os sexos, biopsiando-se toda a parede vesical e empregando colorações HE, PS e Reticulina. Diferenças estatisticamente significantes foram notadas na análise quantitativa de fibras colágenas e reticulínicas o número de fibras colágenas foi significativamente maior e o número de fibras reticulínicas foi menor no grupo de pacientes com extrofia vesical quando comparado ao grupo controle. / A prospective study was done to evaluate the detrusor muscle\'s extracellular matrix in classical bladder exstrophy in comparison to a control group, by use of light microscopy and polarization method with morphometry, to quantify collagen and reticular fibers. Seventeen patients from both sexes were analysed and samples were obtained from the bladder and stained with Haematoxylin-eosin, Picrosirius red and the silver impregnation method. There were significant differences when comparing the quantity of collagen and reticular fibers. The collagen fibers were more abundant in the exstrophy bladders compared to controls, while the reticular fibers were present in smaller amounts.

IINTRODUÇÃO: A Cistite Intersticial (CI) ou Síndrome da Bexiga Dolorosa (SBD) é uma síndrome crônica caracterizada pela presença de dor ou desconforto vesical ou pélvico e sintomas miccionais como urgência e aumento da frequência miccional diurna e noturna, na ausência de outra afecção identificável que justifique esses sintomas. Não existe até o momento nenhum teste diagnóstico ou marcador que defina a CI. Desta forma seu diagnóstico é predominantemente clínico, baseado nos sinais e sintomas e dependente da exclusão de outras doenças urológicas. A dificuldade no diagnóstico e no tratamento dessas pacientes reflete o pouco que se sabe sobre sua fisiopatologia e sobre as alterações genéticas presentes na doença. A identificação de marcadores pode proporcionar um melhor entendimento e manejo desses aspectos da síndrome. Na tentativa de identificar marcadores genéticos que possam estar associados a CI, avaliamos a presença de alguns polimorfismos genéticos, os polimorfismos de nucleotídeo único (SNP), no DNA de pacientes com os critérios diagnósticos de CI e comparamos sua prevalência entre as pacientes e também com um grupo controle representativo da população geral. A correlação desses polimorfismos considerando a CI e a intensidade de dor nessas pacientes ainda não foi estudada na literatura. OBJETIVOS: Analisar a presença de polimorfismos (SNP) em amostras de sangue de pacientes com CI e correlacionar a presença dos polimorfismos com o quadro de dor crônica. MÉTODOS: Foram selecionadas 34 pacientes do sexo feminino com diagnóstico de CI de acordo com os critérios do NIDDK e 23 pacientes do grupo controle (mulheres saudáveis apenas com incontinência urinária de esforço). As pacientes com o diagnóstico de CI foram estratificadas em dois grupos de acordo com o grau dos sintomas de dor crônica. Foram selecionados 20 polimorfismos para análise: rs1800871, rs1800872, rs1800896, rs1800471, rs1800629, rs361525, rs1800497, rs6311, rs6277, rs6276, rs6313, rs2835859, rs11127292, rs2243248, rs6887695, rs3212227, rs1799971, rs12579350, rs3813034, rs6746030. A genotipagem foi realizada através da técnica de PCR em tempo real (q-PCR) e correlacionada com o diagnóstico de CI e com a intensidade dos sintomas álgicos. RESULTADOS: O alelo polimórfico (T) do SNP rs11127292 foi mais frequente nas pacientes com CI em relação ao grupo controle (p:0,01). O alelo polimórfico (T) do SNP rs6311 foi significativamente mais frequente nas pacientes com dor mais intensa (p:0,03). A frequência do alelo selvagem (A) do SNP rs1799971 foi maior em pacientes com dor leve a moderada (p:0,04). CONCLUSÕES: Foram identificadas algumas diferenças na frequência dos polimorfismos nas pacientes estudadas, o que sugere a existência de um papel relevante dos SNP associados tanto à CI quando na intensidade dos sintomas de dor crônica nestas pacientes / INTRODUCTION: Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a chronic syndrome characterized by the presence of bladder/pelvic pain or discomfort and voiding symptoms such as urgency and increased urinary waking and night-time frequency in the absence of another identifiable cause to justify these symptoms. So far, there is no diagnostic test or marker to establish the presence of IC. Thus, the diagnosis is predominantly clinical, based on signs and symptoms and dependent on the exclusion of other urological diseases. The difficulty in the diagnosis and treatment of these patients reflects the little that is known about IC physiopathology and about the genetic background of the disease. The identification of new markers may provide a better understanding and management of the syndrome. As an attempt to identify genetic markers that may be associated with IC, we evaluated the presence of some genetic polymorphisms, single nucleotide polymorphisms (SNPs), in the DNA of patients with the diagnostic criteria of IC, and we compared their prevalence among IC patients and with a control group representative of the general population. The correlation of these polymorphisms considering IC and pain intensity in these patients has not been studied in the literature. OBJECTIVES: To assess the presence of polymorphisms (SNPs) in blood samples from IC patients and to correlate the presence of polymorphisms with chronic pain. METHODS: Thirty-four female patients with a diagnosis of IC according to the NIDDK criteria and 23 control subjects (healthy women with stress urinary incontinence) were selected. Patients with the diagnosis of IC were stratified into two groups according to the degree of symptoms of chronic pain. We selected 20 polymorphisms for analysis: rs1800871, rs1800876, rs1800471, rs1800629, rs361525, rs1800497, rs6311, rs6277, rs6276, rs6313, rs2835859, rs11127292, rs2243248, rs6887695, rs3212227, rs1799971, rs12579350, rs3813034, rs6746030. Genotyping was performed using the real-time PCR technique (q-PCR) and correlated with the diagnosis of IC and intensity of pain symptoms. RESULTS: The polymorphic allele (T) of the SNP rs11127292 occurred with more frequency in patients with IC compared to the control group (p= 0.01). The polymorphic allele (T) of SNP rs6311 occurred with more frequency in patients with severe pain (p= 0.03). The frequency of wild-type (A) SNP rs1799971 was higher in patients with mild to moderate pain (p= 0.04). CONCLUSION: The results indicated differences in polymorphism frequency in the patients studied, suggesting the existence of a relevant role of SNPs associated with both IC and intensity of chronic pain symptoms in these patients

A prosthetic socket worn by an amputee must serve a wide variety of functions, from stationary support to the transfer of forces necessary to move. Fit and comfort are important factors in determining the therapeutic effectiveness of a socket. A socket that does not fit the subject well will cause movement problems and potentially long-term health issues. Because a subject's residual limb changes volume throughout the day, it is desirable that the socket adapt to accommodate volume changes to maintain fit and comfort. This thesis presents research to manufacture adaptive sockets using selective laser sintering (SLS). This additive manufacturing process allows freedom to design a socket that has both compliant areas that can adapt to changes to the residual limb, as well as rigid regions to provide necessary support for the limb. A variety of concepts are discussed that are intended for manufacture by SLS, and that feature flexible inner membranes in various configurations. For each concept the membrane will be inflated or deflated to match the limb’s change in volume and the thesis also presents a study to determine SLS machine parameters for optimal build results. A series of experiments was created to understand the ability of SLS manufactured plastics to be inflated and the possible performance. / text

Work on sound production of deep-sea fishes has been limited to anatomy, and no sounds from identified species have been recorded on the continental slope. Here I examined the sonic muscles of six species in the family Macrouridae by depth (Coelorhincus carminatus, Nezumia bairdii, Coryphaenoides rupestris, Nezumia equalis, Coryphaenoides armatus, Coryphaenoides carapinus,). Due to increasingly limited food with depth, I hypothesized that sonic muscle development would decrease with depth. Sonic muscles were intrinsic and occurred in males and females. Swimbladder and sonic muscle dimensions increased linearly with fish size, but there were no clear differences with depth suggesting sound production remains important in deeper species.