Effect of neurogenic acupoint cupping on high sensitive C-reactive protein and pain perception in female chronic pelvic pain: A randomized controlled trial

Objectives:To determine the effect of neurogenic acupoint dry cupping therapy on high sensitive C-reactive protein (hs-CRP) level, pain perception & intensity, and life impact of pelvic pain in women with chronic pelvic pain (CPP), with regard to the biological and neurophysiological impacts of dry cupping on acupoint.Methods:Thirty women with CPP were randomly divided into two equal groups; the study group received dry cupping on neurogenic acupoints plus lifestyle modifications for 8 weeks (n=15), while the control group received only lifestyle modifications for 8 weeks (n=15). Women were assessed pre- and post-rehabilitation program with the hs-CRP blood test, the short-form McGill Pain Questionnaire (SF-MPQ), and the pelvic pain impact questionnaire (PPIQ).Results:Comparing both groups post-treatment revealed that there were significant reductions in levels of hs-CRP, and scores of SF-MPQ & PPIQ (p<0.05) in the study group compared with the control group. Also, there were significant positive correlations between hs-CRP and both SF-MPQ “Visual Analogue Scale (VAS), Present Pain Intensity (PPI) index & Pain Rating Index (PRI)” and PPIQ (p<0.05).Conclusion:Neurogenic acupoint cupping therapy had significantly improving effects on the degree of inflammation, pain perception & intensity, and life impact of pelvic pain in women with CPP.     

Adjustment of the fetal head and adult pelvis in modern humans

In nonhuman anthropoids, the anteroposterior (AP) diameters of the fetus are greater than the transverse (TR) diameters and the AP diameters of the pelvic planes are greater than the TR diameters: during labor, therefore, the fetus moves through the birth canal without changing position or orientation. In modern humans, the fetal head at term is encephalized and the fetal chest is flattened. The maternal pelvic inlet is flattened in an AP direction, the sacral promontory and the ischial spines are prominent. As a result, AP<TR at the inlet, but AP>TR at the midpelvis and outlet. In addition, the birth canal presents a marked sacral curvature in the AP direction. The human fetus successfully negotiates the birth canal because the three crucial fetal adaptations: (1) spheroidicity of the presenting part of the fetal head, which allows it to “roll” in the pelvis; (2) mobility of the head and chest in all directions; and (3) a capacity for cranial molding, which adapts fetal head dimensions to pelvic dimensions. The result is that the human fetal head and chest can perform multiple rotational movements in order to always present the greatest fetal diameters to the greatest pelvic diameters. Monkeys show a limited degree of encephalization and suffer from narrow TR pelvic diameters without any possibility of fetal adaptations as shown by humans. Apes also show some encephalization but, because of wider TR diameters in the pelvis, they achieve an easy delivery with no need of fetal adaptations.     

The impact of state of bladder fullness on tonic and phasic activation of the pelvic floor muscles in women

PurposeWe aimed to determine if state of bladder fullness affects pelvic floor muscle activation in healthy women without urogenital symptoms.Materials and methodsTwenty-three nulliparous, continent female participants were recruited to participate. Women were randomized to begin the protocol with either an empty (EF) or a full (FE) bladder. Tonic and maximal voluntary pelvic floor muscle electromyographic activity were measured in three states of bladder fullness (empty, full and uncomfortably full). Electromyographic signal amplitudes were compared among bladder states using separate two-way repeated-measures analyses of variance including bladder state and test order as main effects as well as the interaction between bladder state and test order.ResultsTonic activity of the pelvic floor muscles was significantly higher in the full and uncomfortably full bladder states compared to when the bladder was empty (p < 0.005). Maximum voluntary electromyographic activation was unaffected by state of bladder fullness (p = 0.713).ConclusionsConsistent with studies in which the bladder was filled through saline infusion, these results suggest that tonic activity of the PFMs is higher when the bladder is full compared to when it is empty. However once the bladder is moderately full, tonic PFM activity does not increase with increases in bladder volume.     

Problems and solutions in IGRT for cervical cancer

The contribution of Image-guided Radiotherapy (IGRT) to modern radiotherapy is undeniable, being the way to bring into daily practice the dosimetric benefits of Intensity-Modulated Radiotherapy (IMRT). Organ and target motion is constant and unpredictable at the pelvis, thus posing a challenge to the safe execution of IMRT. There are potential benefits of IMRT in the radical treatment of cervical cancer patients, both in terms of dose escalation and decrease of toxicity. But it is essential to find IGRT solutions to control the aspects that can lead to geographic miss targeting or organs at risk (OAR) overdose. This review seeks to describe the problems and possible solutions in the clinical implementation of IMRT/IGRT protocols to treat intact cervical cancer patients.     

Mesothelial stomata overlying omental milky spots: Scanning electron microscopic study

Summary The presence in the rat omentum of intercellular pores (the classical stomata of von Recklinghausen) between the mesothelial cells overlying aggregates of lymphoreticular cells (the classical milky spots of Ranvier) and the apparent migration of lymphocytes through these stomata were recorded for the first time by scanning electron microscopy. Previous studies on passage of cells across the peritoneum and omentum used experimentally administered cells, while in the present study no cells were administered to the rats and their own lymphocytes were observed in situ. The possible role of lymphocytes in the peritoneal cavity is also briefly discussed.     

A dividing granule-containing cell in the pelvic ganglion of the guinea-pig

Summary A dividing granule-containing cell is described in the pelvic ganglion of the guinea-pig two days after pelvic nerve section. This appears to be the first report of a dividing granule-containing cell in adult tissue.     

Function and structure in the paired fins of scorpaeniform fishes

Synopsis The paired fins of the basic, ancestral type of free-swimming acanthopterygian teleost serve primarily in guiding the forward course of movement and in maneuvering within the water column. In various scorpaeniform fishes the paired fins have taken on a number of other functions associated with a bottom-living mode of life. Among these are: defense against predation, probing for food items, propping the forward part of the body away from the bottom, progressing over it, digging into it, and the development of a suction disc for attachment to it. The relationship between these developments and paired-fin structure is the subject of the paper.     

On the differences between two pelvises of Mousterian context from the Qafzeh and Kebara caves, Israel

Two pelvises from a similar archaeological context have been discovered in recent years in two different caves in Israel. The pelvis from the Qafzeh cave (Qafzeh 9) was dated by means of thermoluminescence at approximately 95 kyr BP. All available measurement values, the most significant being those of the diagnostic obturator region, fall within those of the modern range. The other pelvis emanates from the Kebara cave and differs fundamentally from modern pelvises and from the Qafzeh specimen, although the Kebara pelvis is 30,000 years younger than the latter. As in other remains of Neandertal pelvises, the superior pubic ramus of the Kebara hominid is extremely long and slender and exhibits a cross section unlike that of modern humans. The absolute height of the obturator region is very small. It is these measurements and proportions that set the Kebara pelvis apart from both modern pelvises and the specimen from Qafzeh. The morphological differences and the chronological relationship between the two fossil pelvises support the concept of two distinct evolutionary lineages for these hominids.     

Immunohistochemical properties and spinal connections of pelvic autonomic neurons that innervate the rat prostate gland

Autonomic innervation of the prostate gland supplies the acini, and non-vascular and vascular smooth muscle. The activity of each of these tissues is enhanced by sympathetic outflow, whereas the role of the parasympathetic nervous system in this organ is unclear. In the present study, a range of methods was applied in rats to determine the location of autonomic neurons supplying this gland, the immunohistochemical properties of these neurons, the spinal connections made with the postganglionic pathways and the distribution of various axon types within the gland. Injection of the retrograde tracer, FluoroGold, into the ventral gland visualised neurons within the major pelvic ganglion and sympathetic chain. Fluorescence immunohistochemical studies on the labelled pelvic neurons showed that most were noradrenergic (also containing neuropeptide Y, NPY), the others being non-noradrenergic and containing either vasoactive intestinal peptide (VIP) or NPY. Sympathetic dyelabelled neurons were identified by the presence of varicose nerve terminals stained for synaptophysin on their somata following lesion of sacral inputs. Parasympathetic innervation of dye-labelled neurons was identified by continued innervation after hypogastric nerve lesion. Most noradrenergic prostate-projecting neurons were sympathetic, as were many of the non-noradrenergic VIP neurons. Parasympathetic prostate-projecting neurons were largely non-noradrenergic and contained either VIP or NPY. All substances found in retrogradely labelled somata were located in axons within the prostate gland but had slightly different patterns of distribution. The studies have shown that there are a significant number of non-noradrenergic sympathetic prostate-projecting neurons, which contain VIP.