Project Details
Abstract
Aging, birth trauma and extensive pelvic surgery are the causes
known to cause advanced pelvic organ prolaspe, fecal as well as urinary
incontinence. Surgical treatment is the last resort to manage the
abovementioned
clinical manifestations of pelvic floor disorders except
the subject is too frail to receive operation.
In order to facilitate the reconstructive pelvic surgery, reinforcement
with synthetic mesh or biological material is the modern trend in pelvic
repair. Unfortunately no prosthesis including synthetic or biological is
ideal because vaginal erosion with mesh extrusion which is the subject of
this proposal and other complications were reported continuously. As per
the literature, the rate for mesh vaginal extrusion ranged between 2.4 and
17% when polypropylene which is the most popular synthetic material
used for the midurethral
sling or pelvic reconstructive surgery to date.
The causes of this complication are still controversial which include
rejection, poor quality of tissue, surgical artifact, material of mesh and
etc.
A prospective controlled study for the investigation of the cause for
mesh vaginal erosion was conducted and the results revealed evidences of
immune reactivity after mesh implantation, albeit the evidence was not
solid. As per the pilot study initially done by us to determine the
biofilmrelatedinfection,
we have found bacterial biofilm could adhere to
surfaces and interfaces, i.e. bacteria located in the cells just beneath the
contacting surfaces in the electron microscopic (EM) analyses. In
addition, soon after bacteria infection, proteins in biofilm undergo
conformational changes, making them immunogenic and triggers a
typical inflammatory response leading to activation of the complement
system. Thus, we plan to use CD (clusters of differentiation) antigens – 4,
8, 20, 25, 40, 68 and quantitative analysis of FoxP3 to determine the
function of regulatory T cells in the immune response. In addition,
bacterial culture and subuquent EM analysis for the bacteria biofilm will
be performed.
Project IDs
Project ID:PC9706-1019
External Project ID:NSC96-2314-B182-015-MY2
External Project ID:NSC96-2314-B182-015-MY2
Status | Finished |
---|---|
Effective start/end date | 01/08/08 → 31/07/09 |
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