Digital Commons Network^™

Can Urethral Retroresistance Pressures Predict Midurethral Sling Outcomes?, Patrick J. Culligan, Jennifer Lewis-Priestley, Linda Blackwell, Susan B. Tate

Jennifer L. Priestley

OBJECTIVE: To determine whether preoperative urethral resistance pressure (URP) measurements could predict success or failure of a tension-free vaginal tape (TVT) sling. METHODS: Subjects came from a previously published study comparing URP measurements to a validated urinary incontinence symptom survey (UISS). We contacted patients from that study to determine whether they had subsequently undergone TVT surgery. Within that cohort, we determined the “current” (i.e., postoperative) UISS and Sandvik urinary incontinence severity score. Success of a TVT sling in this group was defined in 4 ways: (1) postoperative UISS score < 3, (2) postoperative UISS score < 75% of the preoperative score, (3) …

A Randomized Clinical Trial Comparing Pelvic Floor Muscle Training To A Pilates Exercise Program For Improving Pelvic Muscle Strength, Patrick Culligan, Janet Scherer, Keisha Dyer, Jennifer Priestley, Geri Guingon-White, Donna Delvecchio, Margi Vangeli

Jennifer L. Priestley

Introduction and hypothesis The purpose of this study is to determine whether a Pilates exercise program and a pelvic floor muscle-training (PFMT) program could provide similar improvements in pelvic muscle strength. Methods Sixty-two women with little or no pelvic floor dysfunction were randomized to Pilates or PFMT. Each group had 24 biweekly 1-h sessions with either a physical therapist or Pilates instructor. Strength was measured via perineometry (cmH2O). Two questionnaires-pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7)-were also collected. Results At baseline, the Pilates and PFMT groups measured 14.9±12.5 and 12.5±10.4 cmH2O, respectively (p=0.41). Both the Pilates …

Evaluation Of A Transvaginal Mesh Delivery System For The Correction Of Pelvic Organ Prolapse: Subjective And Objective Findings At Least 1 Year After Surgery, Patrick Culligan, Paul Littman, Charbel Salamon, Jennifer Priestley, Amir Shariati

Jennifer L. Priestley

Objective: We sought to track objective and subjective outcomes ≥1 year after transvaginal mesh system to correct prolapse. Study Design: This was a retrospective cohort study of 120 women who received a transvaginal mesh procedure (Avaulta Solo, CR Bard Inc, Covington, GA). Outcomes were pelvic organ prolapse quantification values; Pelvic Floor Distress Inventory, Short Form 20/Pelvic Floor Impact Questionnaire, Short Form 7 scores; and a surgical satisfaction survey. “Surgical failure” was defined as pelvic organ prolapse quantification point >0, and/or any reports of vaginal bulge. Results: Of 120 patients, 116 (97%) were followed up for a mean of 14.4 months …

The Challenge Of Early Inpatient Postpartum Depression Screening, Elizabeth A. Berger Do, John C. Smulian Md, Mph, Joanne Quiñones Md, Msce, Rory L. Marraccini Md, Amy Wu Bs, Elizabeth A. Smulian Bs, Sandra L. Curet Md

John C Smulian MD, MPH

No abstract provided.

Participation In Perinatal Interventional Research: Which Characteristics Matter?, Hai-Yen T. Nguyen Md, Joanne Quiñones Md, Msce, Daniel G. Kiefer Md, Anita Kurt Phd, Rn, Felisa Saldutti, John C. Smulian Md, Mph

John C Smulian MD, MPH

No abstract provided.

The Association Between Hospital Obstetrical Volume And Maternal Postpartum Complications, Kathy Kyser, Xin Lu, Donna Santillan, Mark Santillan, Stephen Hunter, Alison Cahill, Peter Cram

Stephen K. Hunter

OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and …

A Select Issue In The Postpartum Period: Contraception, Whitney Cowman, Abbey Hardy-Fairbanks, Jill Endres, Colleen Stockdale

Abbey J Hardy-Fairbanks

One half of pregnancies in the United States are unintended and associated with adverse pregnancy outcomes. The postpartum period is an important, yet underutilized, time to initiate contraception. The U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 provides evidence-based guidelines for choosing a contraceptive method and an update in 2011 specifically addresses contraceptive method use in the puerperium. The variety of contraceptive methods include hormonal contraception, lactational amenorrhea, barrier contraception, natural family planning, and sterilization. Ideally, counseling about contraceptive choice should begin early in pregnancy care and continue postpartum; it should also include a variety of teaching modalities. Specifically we …

Effect Of Chlorhexidine Skin Prep And Subcuticular Skin Closure On Post-Operative Infectious Morbidity And Wound Complications Following Cesarean Section, Sara Tikkanen, Anna Button, Gideon Zamba, Abbey J. Hardy-Fairbanks

Abbey J Hardy-Fairbanks

Abstract:

Background: The obstetrical department at University of Iowa implemented several interventions at reducing post-operative infections and wound complication rates following a cesarean delivery. We implemented subcuticular closure of the skin following all cesarean sections in February of 2011 and switched from a povidone/iodine skin prep to a chlorhexidine-alcohol prep April 19th 2011. Based on prior studies, we hypothesized a 50% reduction in post cesarean wound complications

Objective:

To determine if changes in skin prep type and closure method decreases post-operative infectious morbidity and wound complications.

Methods:

The study reviewed charts of women who underwent a cesarean …

The Role Of Lef1 In Endometrial Gland Formation And Carcinogenesis, Dawne Shelton, Hubert Fornalik, Traci Neff, Soo Park, David Bender, Koen Degeest, Xiaoming Liu, Weiliang Xie, David Meyerholz, John Engelhardt, Michael Goodheart

David P Bender

No abstract provided.

Risk Of Early And Late Obstetric Complications In Women With Ivf-Conceived Pregnancies And Polycystic Ovary Syndrome (Pcos), N. Bagegni, J. Blaine, Bradley Van Voorhis, A. Dokras

Bradley J Van Voorhis

No abstract provided.

Expression And Localization Of Inducible And Endothelial Nitric Oxide Synthase In The Rat Ovary - Effects Of Gonadotropin Stimulation In Vivo, Bradley Van Voorhis, Kimberly Moore, Paul Strijbos, Scott Nelson, Sally Baylis, Dana Grzybicki, Carl Weiner

Bradley J Van Voorhis

No abstract provided.

Immunohistochemical Localization Of Prostaglandin-H Synthase In The Female Reproductive-Tract And Endometriosis, Bradley Van Voorhis, Phyllis Huettner, Martin Clark, Joseph Hill

Bradley J Van Voorhis

No abstract provided.

Prenatal Detection Of Congenital Heart Disease By Basic Ultrasonography At A Tertiary Care Center: What Should Our Expectations Be?, Kimberly Leslie, W. Persutte, J. Drose, R. Lenke, J. Hobbins, M. Manco-Johnson, E. Shaffer, J. Wiggins

Kimberly K. Leslie

No abstract provided.

Vascular Endothelial Growth Factor Pathway Blockade In Endometrial Cancer, Suzy Davies, Donghai Dai, Kimberly Leslie

Kimberly K. Leslie

No abstract provided.

Risk Of Early & Late Obstetric Complications In Women With Ivf- Conceived Pregnancies And Polycystic Ovary Syndrome (Pcos), N. A. Bagegni, J. Blaine, Bradley J. Van Voorhis, Anuja Dokras

Bradley J Van Voorhis

There is conflicting evidence on the association between PCOS and early and late obstetric complications. It is unclear if the reported risks are independent of BMI, preexisting hypertension and diabetes. We performed a retrospective chart review to examine the risk of early and late obstetrical complications after IVF in women with PCOS (n=130) compared to controls (n=130). The miscarriage rate was 17.7% in PCOS women and 15.4% in controls. PCOS was not associated with miscarriage independent of age and BMI. The prevalence of gestational DM (GDM) was similar in both groups (12% PCOS versus 11% controls). BMI was independently associated …

Barriers And Facilitators To Addressing Perinatal Depression In Obstetric Settings, Nancy Byatt, Kathleen Biebel, Liz Friedman, Gifty Debordes-Jackson, Jeroan J. Allison, Douglas M. Ziedonis

Kathleen Biebel

Background: Perinatal depression is common and can cause suffering for mother, fetus/child and family. The perinatal period is an ideal time to detect and treat depression due to regular contact between mothers and health professionals. Despite the opportune time and setting, depression is under-diagnosed and under-treated in the obstetric setting. Caring and committed providers are frustrated and confused, and mothers do not feel heard or understood by their providers.

Objectives: (1) Identify postpartum women’s perspective on how perinatal depression is addressed in obstetric settings; (2) Identify strategies for improvement of the delivery of depression care in OB/Gyn settings; and, (3) …

Developing An Artificial Fallopian Tube: Successful In Vitro Trials In Mice., Stephen Hunter, J. Neeld, J. Scott, D. Olsen, R. Urry, T. Cichocki

Stephen K. Hunter

This report describes the design and testing of an artificial fallopian tube for the treatment of tubal infertility. Within the device, mouse eggs incubated with sperm were fertilized and a microinfusion pump was used to transport the fertilized ova through the tube. Normal offspring resulted from transfer of the developing embryos into pseudopregnant recipients. These results provide encouraging evidence that an artificial fallopian tube warrants further investigation as a potential alternative to in vitro fertilization.

Molecular Weight Characterization Of Pre- And Postimplant Artificial Heart Polyurethane Materials., Stephen Hunter, D Gregonis, D Colman, J Andrade, T Kessler

Stephen K. Hunter

No abstract provided.

Single Umbilical Artery: Does Side Matter?, Mark Santillan, Donna Santillan, D. Fleener, B. Stegmann, G. Zamba, Stephen Hunter, J. Yankowitz

Stephen K. Hunter

INTRODUCTION: The aim of this study was to determine if laterality of an absent umbilical artery (AUA) is associated with specific sonographic findings, chromosomal defects or postpartum birth defects. MATERIALS AND METHODS: In this retrospective cohort study, ultrasound reports and medical records of patients who received an obstetric ultrasound at the University of Iowa Hospitals and Clinics with an identified laterality of the AUA from 1989 to 2007 (n = 405) were reviewed. Rates of sonographic abnormalities between fetuses with a right versus left AUA were compared using Fisher's exact test. Adjustments for confounding were made using logistic regression modeling. …

The Gamete And Embryo Compatibility Of Various Synthetic Polymers., Stephen Hunter, J. Scott, D. Hull, R. Urry

Stephen K. Hunter

Several popular and well-characterized polymeric materials were evaluated for their biocompatibility toward the cells unique to reproduction. To accomplish these studies, several in vitro tests were developed that evaluated biocompatibility between the polymers and spermatozoa, ova, and embryos. The data indicated significant differences between the materials with respect to their biocompatibility toward sperm motility, the sperm's ability to penetrate zona-free hamster eggs, and the ability of two-cell mouse embryos to divide. Polytetrafluoroethylene (PTFE-Teflon; PTFE, Chemplast Inc., Wayne, NJ), polyethylene glycol (PEG), and polyhydroxyethyl methacrylate (PHEMA) appear to be the most inert of the materials studied. Polyvinyl chloride (PVC; Tygon-Norton, Akron, …

Defining Normal Igg Changes Throughout Pregnancy, Jena Taylor, Jona Conklin, Stephen K. Hunter, Ryan Empey, Eric M. Tyler, Ashley Christensen, Katelyn M. Talcott, Zuhair K. Ballas, Donna A. Santillan, Mark K. Santillan

Stephen K. Hunter

Immunoglobulin G (IgG) is the major serum immunoglobulin, accounting for roughly 75% of all immunoglobulin. IgG is the only class of immunoglobulin that crosses the placenta and it serves as the main immunologic barrier between the fetus and external environments. There has not been a clear consensus on what the normal values of IgG are throughout pregnancy. The aim of this study is to measure serum immunoglobulin G in each trimester of the pregnant female to determine a normal IgG profile throughout all trimesters in normal pregnancy.

Development And Characterization Of An Indoleamine 2,3-Dioxygenase (Ido) Deficient Mouse Model Of Preeclampsia, Mark Santillan, Christopher Pelham, Pimonrat Ketsawatsomkron, Donna Santillan, Baoli Yang, Stephen Hunter, Curt Sigmund

Stephen K. Hunter

No abstract provided.

Cell Encapsulation As A Potential Nondietary Therapy For Maternal Phenylketonuria, Donna Santillan, Mark Santillan, Stephen Hunter

Stephen K. Hunter

OBJECTIVE: The objective of this work was to determine whether cells overexpressing phenylalanine (Phe) hydroxylase (PAH) can significantly reduce Phe in vitro for potential use as a therapy for preventing maternal phenylketonuria. STUDY DESIGN: Human 293T and WRL68 cell lines were transiently and stably transfected to overexpress PAH. Cells were encapsulated within microspheres of sodium alginate. Timed measurements of Phe in media were performed using tandem mass spectrometry. RESULTS: Both nonencapsulated and encapsulated transiently transfected cells overexpressing PAH significantly reduced the Phe concentration in media by approximately 50% in comparison to mock-transfected cells. Cell line clones stably expressing PAH significantly …

T-Cell Specific Avian Tdt: Characterization Of The Cdna And Recombinant Enzyme., Baoli Yang, K. Gathy, M. Coleman

Baoli Yang

A cDNA clone coding for avian terminal deoxynucleotidyl transferase (TdT) has been isolated and sequenced. The size of this cDNA was 2545 bp with an open reading frame of 1521 bp and a predicted translation product of 58 kDa. Comparison of this TdT sequence with other known TdT sequences has revealed a very high degree of homology at both the DNA and predicted amino acid levels. The chicken TdT cDNA was expressed in a bacterial system and the protein was purified by affinity chromatography. The purified recombinant enzyme, with a specific activity of approximately 1700 U/mg protein, was significantly less …

Fetal Hemorrhage And Platelet Dysfunction In Slp-76-Deficient Mice., J. Clements, J. Lee, B. Gross, Baoli Yang, J. Olson, A. Sandra, S. Watson, S. Lentz, G. Koretzky

Baoli Yang

The adapter protein SLP-76 is expressed in T lymphocytes and hematopoietic cells of the myeloid lineage, and is known to be a substrate of the protein tyrosine kinases that are activated after ligation of the T-cell antigen receptor. Transient overexpression of SLP-76 in a T-cell line potentiates transcriptional activation after T-cell receptor ligation, while loss of SLP-76 expression abrogates several T-cell receptor-dependent signaling pathways. Mutant mice that lack SLP-76 manifest a severe block at an early stage of thymocyte development, implicating SLP-76 in signaling events that promote thymocyte maturation. While it is clear that SLP-76 plays a key role in …

Syntaxin 4 Heterozygous Knockout Mice Develop Muscle Insulin Resistance., C. Yang, K. Coker, J. Kim, S. Mora, D. Thurmond, A. Davis, Baoli Yang, R. Williamson, G. Shulman, J. Pessin

Baoli Yang

To investigate the physiological function of syntaxin 4 in the regulation of GLUT4 vesicle trafficking, we used homologous recombination to generate syntaxin 4-knockout mice. Homozygotic disruption of the syntaxin 4 gene results in early embryonic lethality, whereas heterozygous knockout mice, Syn4(+/-), had normal viability with no significant impairment in growth, development, or reproduction. However, the Syn4(+/-) mice manifested impaired glucose tolerance with a 50% reduction in whole-body glucose uptake. This defect was attributed to a 50% reduction in skeletal muscle glucose transport determined by 2-deoxyglucose uptake during hyperinsulinemic-euglycemic clamp procedures. In parallel, insulin-stimulated GLUT4 translocation in skeletal muscle was also …

The Ubiquitin Ligase Adaptor Ndfip1 Regulates T Cell-Mediated Gastrointestinal Inflammation And Inflammatory Bowel Disease Susceptibility., H. Ramon, C. Riling, J. Bradfield, Baoli Yang, H. Hakonarson, P. Oliver

Baoli Yang

Nedd4 family interacting protein 1 (Ndfip1) is an adaptor protein that regulates Itch, an E3 ubiquitin ligase that ubiquitylates JunB, thereby preventing interleukin (IL)-4 and IL-5 production. Mice lacking Ndfip1 or Itch develop T helper type 2 (T(H)2)-mediated inflammation in the skin and lungs and die prematurely. In this study we show that Ndfip1-/- mice also develop inflammation in the gastrointestinal tract. Inflammation is characterized by infiltration of eosinophils and T cells and is accompanied by a failure to gain weight. T cells are both necessary and sufficient for eosinophil recruitment and inflammation. This is because Ndfip1-/- T cells become …

Appropriate Tissue- And Cell-Specific Expression Of A Single Copy Human Angiotensinogen Transgene Specifically Targeted Upstream Of The Hprt Locus By Homologous Recombination., B. Cvetkovic, Baoli Yang, R. Williamson, C. Sigmund

Baoli Yang

Development of experimental models by genetic manipulation in mice has proven to be very useful in determining the significance of particular genes in the development of or susceptibility to hypertension. Advances in molecular genetics, transgenic mouse technology, and physiological measurements in mice provided an opportunity to go a step further and develop models to analyze the physiological significance of specific gene variants potentially causing hypertension. In this report, we describe the development of a human angiotensinogen transgenic mouse model generated by targeting the human angiotensinogen gene upstream of the mouse HPRT locus by homologous recombination. The main benefit of this …

Regulation Of Terminal Deoxynucleotidyl Transferase Gene Expression In Mice And Men., M. Coleman, Baoli Yang, D. Sorscher

Baoli Yang

A nontemplate directed DNA polymerase, terminal deoxynucleotidyl transferase (terminal transferase) is expressed in a tissue-specific and development stage-specific manner. Its enzymatic properties and tissue localization have implicated the protein in development of normal immune function. Significant progress has been made in understanding the enzymology and important domains of this protein. More recently, studies have focused on regulation of the gene that codes for the protein in mice and humans. The murine gene has yielded to these studies more readily than the human gene. A murine basal promoter element has been identified along with several trans-acting protein factors that may regulate …

Mutational Analysis Of Residues In The Nucleotide Binding Domain Of Human Terminal Deoxynucleotidyl Transferase., Baoli Yang, K. Gathy, M. Coleman

Baoli Yang

Human terminal deoxynucleotidyl transferase (TdT) was overexpressed in a baculovirus system. The pure recombinant enzyme was identical in size, activity, kinetic constants, and metal effects to native enzyme. Three amino acids, within either the putative nucleotide binding domain and part of a DNA polymerase consensus sequence, YGDTDSLF, or a TdT consensus sequence, GGFRRGK, were altered by site-directed mutagenesis. The four mutant forms of terminal transferase were also overexpressed in the baculovirus expression system and purified from Trichoplusia ni larvae by a monoclonal antibody affinity column and compared with wild-type enzyme with respect to thermostabilities, secondary structure, metal effects, and kinetic …