A safe and simple solution for intravesical tension-free vaginal tape erosion: removal by standard transurethral resection

OBJECTIVE: To report our experience with the successful removal of visible tension-free vaginal tape (TVT) by standard transurethral electroresection, as intravesical tape erosion after TVT is a rare complication, and removal can be challenging, with few cases reported. PATIENTS AND METHODS: Five patients presenting with TVT erosion into the bladder were treated at our institutions from December 2004 to July 2007; all had standard transurethral electroresection. Their records were reviewed retrospectively to retrieve data on presenting symptoms, diagnostic tests, surgical procedures and outcomes. RESULTS: The median (range) interval between the TVT procedure and the onset of symptoms was 17 (1-32) months. The predominant symptoms were painful micturition, recurrent urinary tract infection (UTI), urgency and urge incontinence. There were no complications during surgery. The storage symptoms and UTI resolved completely after removing the eroded mesh in all but one patient. Cystoscopy at 1 month after surgery showed complete healing of the bladder mucosa. CONCLUSION: Although TVT erosion into the bladder is rare, persistent symptoms, particularly recurrent UTIs, must raise some suspicion for this condition. Standard transurethral electroresection seems to be a safe, simple, minimally invasive and successful treatment option for TVT removal.

Mineralogy-based quantitative precipitation and temperature reconstructions from annually laminated lake sediments (Swiss Alps) since AD 1580

[1] We present quantitative autumn, summer and annual precipitation and summer temperature reconstructions from proglacial annually laminated Lake Silvaplana, eastern Swiss Alps back to AD 1580. We used X-ray diffraction peak intensity ratios of minerals in the sediment layers (quartz qz, plagioclase pl, amphibole am, mica mi) that are diagnostic for different source areas and hydro-meteorological transport processes in the catchment. XRD data were calibrated with meteorological data (AD 1800/1864–1950) and revealed significant correlations: mi/pl with SON precipitation (r = 0.56, p < 0.05) and MJJAS precipitation (r = 0.66, p < 0.01); qz/mi with MJJAS temperature (r = −0.72, p < 0.01)and qz/am with annual precipitation (r = −0.54, p < 0.05). Geological catchment settings and hydro-meteorological processes provide deterministic explanations for the correlations. Our summer temperature reconstruction reproduces the typical features of past climate variability known from independent data sets. The precipitation reconstructions show a LIA climate moister than today. Exceptionally wet periods in our reconstruction coincide with regional glacier advances.

Human–climate interactions in the central Mediterranean region during the last millennia: The laminated record of Lake Butrint (Albania)

Lake Butrint (39°47 N, 20°1 E) is a ca. 21 m deep, coastal lagoon located in SW Albania where finely-laminated sediments have been continuously deposited during the last millennia. The multi-proxy analysis (sedimentology, high-resolution elemental geochemistry and pollen) of a 12 m long sediment core, supported by seven AMS radiocarbon dates and 137Cs dating, enable a precise reconstruction of the environmental change that occurred in the central Mediterranean region during the last ∼4.5 cal kyrs BP. Sediments consist of triplets of authigenic carbonates, organic matter and clayey laminae. Fluctuations in the thickness and/or presence of these different types of seasonal laminae indicate variations in water salinity, organic productivity and runoff in the lake's catchment, as a result of the complex interplay of tectonics, anthropogenic forcing and climate variability. The progradation of the Pavllo river delta, favoured by variable human activity from the nearby ancient city of Butrint, led to the progressive isolation of this hydrological system from the Ionian Sea. The system evolved from an open bay to a restricted lagoon, which is consistent with archaeological data. An abrupt increase in mass-wasting activity between 1515 and 1450 BC, likely caused by nearby seismic activity, led to the accumulation of 24 homogenites, up to 17 cm thick. They have been deposited during the onset of finely laminated sedimentation, which indicates restricted, anoxic bottom water conditions and higher salinity. Periods of maximum water salinity, biological productivity, and carbonate precipitation coincide with warmer intervals, such as the early Roman Warm Period (RWP) (500 BC–0 AD), the Medieval Climate Anomaly (MCA) (800–1400 AD) and recent times (after 1800 AD). Conversely, lower salinity and more oxic conditions, with higher clastic input were recorded during 1400–500 BC, the Late Roman and the Early Medieval periods (0–800 AD) and during the Little Ice Age (1400–1800 AD). Hydrological fluctuations recorded in Butrint are in phase with most central and western Mediterranean records and correlate with NAO variability. In contrast, opposite hydrological patterns have been recorded in the Eastern Balkans and the Levant during the last millennium, emphasizing a complex spatial variability in the region. Phases of maximum settlement intensity in Butrint (Roman-Late Antique) coincide with warmer and/or stable climate periods (0–800 AD and MCA, respectively), indicating a long-term influence of climatic conditions on human activities. The Late Holocene sedimentary record of Lake Butrint demonstrates the complex interplay of climate variability, tectonics and human impact in the recent evolution of coastal Mediterranean regions.

Late-glacial and Holocene vegetation history and dynamics as shown by pollen and plant macrofossil analyses in annually laminated sediments from Soppensee, central Switzerland

The palynostratigraphy of two sediment cores from Soppensee, Central Switzerland (596 m asl) was correlated with nine regional pollen assemblage zones defined for the Swiss Plateau. This biostratigraphy shows that the sedimentary record of Soppensee includes the last 15 000 years, i.e. the entire Late-glacial and Holocene environmental history. The vegetation history of the Soppensee catchment was inferred by pollen and plant-macrofossil analyses on three different cores taken in the deepest part of the lake basin (27 m). On the basis of a high-resolution varve and calibrated radiocarbonchronology it was possible to estimate pollen accumulation rates, which together with the pollen percentage data, formed the basis for the interpretation of the past vegetation dynamics. The basal sediment dates back to the last glacial. After reforestation with juniper and birch at ca. 12 700 B.P., the vegetation changed at around 12 000 B.P. to a pine-birch woodland and at the onset of the Holocene to a mixed deciduous forest. At ca. 7000 B.P., fir expanded and dominated the vegetation with beech becoming predominant at ca. 50014C-years later until sometime during the Iron Age. Large-scale deforestation, especially during the Middle Ages, altered the vegetation cover drastically. During the Late-glacial period two distinct regressive phases in vegetation development are demonstrated, namely, the Aegelsee oscillation (equivalent to the Older Dryas biozone) and the Younger Dryas biozone. No unambiguous evidence for Holocene climatic change was detected at Soppensee. Human presence is indicated by early cereal pollen and distinct pulses of forest clearance as a result of human activity can be observed from the Neolithic period onwards.

Fatty acids and intact polar lipids of laminated microbial sediments from St. Peter Ording, German Wadden Sea

Hidden for the untrained eye through a thin layer of sand, laminated microbial sediments occur in supratidal beaches along the North Sea coast. The inhabiting microbial communities organize themselves in response to vertical gradients of light, oxygen or sulfur compounds. We performed a fine-scale investigation on the vertical zonation of the microbial communities using a lipid biomarker approach, and assessed the biogeochemical processes using a combination of microsensor measurements and a 13C-labeling experiment. Lipid biomarker fingerprinting showed the overarching importance of cyanobacteria and diatoms in these systems, and heterocyst glycolipids revealed the presence of diazotrophic cyanobacteria even in 9 to 20 mm depth. High abundance of ornithine lipids (OL) throughout the system may derive from sulfate reducing bacteria, while a characteristic OL profile between 5 and 8 mm may indicate presence of purple non-sulfur bacteria. The fate of 13C-labeled bicarbonate was followed by experimentally investigating the uptake into microbial lipids, revealing an overarching importance of cyanobacteria for carbon fixation. However, in deeper layers, uptake into purple sulfur bacteria was evident, and a close microbial coupling could be shown by uptake of label into lipids of sulfate reducing bacteria in the deepest layer. Microsensor measurements in sediment cores collected at a later time point revealed the same general pattern as the biomarker analysis and the labeling experiments. Oxygen and pH-microsensor profiles showed active photosynthesis in the top layer. The sulfide that diffuses from deeper down and decreases just below the layer of active oxygenic photosynthesis indicates the presence of sulfur bacteria, like anoxygenic phototrophs that use sulfide instead of water for photosynthesis.

Benthic foraminifera in Neogene laminated diatom ooze of ODP Hole 138-844C

Several widely correlatable intervals of laminated Thalassiothrix diatom mat deposits occur in Neogene sediments recovered from the eastern equatorial Pacific Ocean. The presence of laminated sediments in extensive areas of the deep open ocean floor raises fundamental questions concerning the cause of preservation of the laminations and the nature of the benthic environment during episodes of mat deposition. Traditional explanations for the preservation of laminations have centered on restriction of dissolved oxygen. Studies of benthic foraminifers through the laminated intervals show no evidence for an increase in absolute or relative abundance of species characteristic of a low oxygen environment, but rather a decrease in relative abundance of infaunal forms attesting to the impenetrability of the diatom meshwork formed by the interlocking Thalassiothrix frustules. These results support evidence from coring of the high tensile strength of the Thalassiothrix laminations suggesting that the diatom meshwork was of sufficient tensile strength and impenetrability to suppress infaunal benthic activity. Comparison of the relative abundances of foraminifers in the enclosing ôbackgroundö sediment of foraminifer nannofossil ooze and the laminated diatom oozes shows that some epifaunal species (e.g., Cibicides spp.) increase in relative abundance within the laminated sediment, whereas others (e.g., Epistominella exigua) show a marked decrease in relative abundance. Other species show more complex changes in abundance related to the occurrence of the laminated sediments, which may indicate a combination of controls that include the physical nature of the substrate and the amount of organic flux.

Krapp's Last Tape, un recorrido por las metáforas de la memoria

A partir de la obra de Samuel Beckett Krapp's Last Tape, el presente artículo se propone presentar y revisar críticamente las metáforas de la memoria. A lo largo de la historia, los diferentes pensadores que se refirieron a la memoria hicieron uso de esta figura retórica para explicar su funcionamiento. En la crítica se verá que las metáforas poseen sus limitaciones, si bien pueden sugerir cómo se dan los procesos de almacenamiento y sus funciones, resultan insuficientes ante la cuestión del sentido que brinda la memoria. Así, y a partir de esas críticas, quedará abierto el lugar de la imaginación en nuestra relación con el pasado