WorldWideScience

Sample records for bladder outlet obstruction

  1. Female Bladder Outlet Obstruction.

    Science.gov (United States)

    Hoffman, Daniel S; Nitti, Victor W

    2016-04-01

    The non-specific symptoms the patients express upon the presentation of female bladder outlet obstruction make it a challenge to diagnose. There are subtle differences between the obstructed patient and those whose bladders are underactive and/or fail to mount a detrusor contraction. These disparities can be extracted through a thorough history and examination. At times, the clinician may utilize nomograms, non-invasive uroflow, and urodynamics with the addition of fluoroscopy to establish the diagnosis of obstruction. Management of the obstruction depends on the nature of the condition, whether functional or anatomical. The increase in the number of sling procedures performed to treat stress urinary incontinence has resulted in a rise in the number of iatrogenic obstructions. The temporal relationship between surgery and obstruction is the key to identifying the problem. PMID:26902625

  2. Effects of mild bladder outlet obstruction on rabbit bladder structure and function.

    Science.gov (United States)

    Kuo, H C

    1995-09-01

    Mild bladder outlet obstruction was created in 42 New Zealand white rabbits by placing a 5-mm inner diameter polyethylene tube around the urethra. Periods of obstruction lasted for 1 day (7 rabbits), 3 days (7 rabbits), 1 week (7 rabbits), 2 weeks (6 rabbits), 4 weeks (7 rabbits), 6 weeks (4 rabbits) and 8 weeks (4 rabbits). Whole bladder functional study was performed in control (5 rabbits) and the obstructed bladders. The obstructed bladders increased in weight two-to threefold. There was no significant difference in bladder weight after different periods of obstruction. Electric stimulation showed a diminished response after 3 days of obstruction. Pharmacologic stimulation with 500 microM carbachol revealed a decreased response after obstruction, but intravesical pressure returned to the control level at 6 and 8 weeks of obstruction. However, the bladder weight and the expelling function of the obstructed bladders remained the same as on day 1 of obstruction. Histologic study of control and obstructed bladders revealed that: 1) dense submucosal fibrous tissue developed after 3 days of obstruction, 2) detrusor muscle hypertrophy and hyperplasia were noted with intermuscular collagenous fiber deposition after 2 weeks of obstruction, 3) trabeculation of the bladder wall with hyperplasia of muscular bundles was noted after 2 weeks of obstruction, 4) acute edematous and inflammatory reaction were apparent after 3 days and 1 week of obstruction, but resolved later and 5) degenerative changes of muscular cells were noted at 8 weeks of obstruction. The results show that despite apparent morphologic changes after outlet obstruction, no significant difference was observed in bladder expelling between short-term and long-term infravesical mild outlet obstruction. The bladder contractile apparatus appears to have a compensatory ability after mild outlet obstruction. PMID:8696170

  3. Non-uniform changes in membrane receptors in the rat urinary bladder following outlet obstruction.

    OpenAIRE

    Zeng, Jianwen; Ekman, Mari; Jiang, Chonghe; Uvelius, Bengt; Swärd, Karl

    2015-01-01

    The aim of the present study was to investigate the expression and distribution of membrane receptors after bladder outlet obstruction (BOO). Partial bladder outlet obstruction (BOO) was induced in female rats and bladders were harvested after either 10 days or 6 weeks of BOO. The expression of different receptors was surveyed by microarrays and corroborated by immunohistochemistry and western blotting. A microarray experiment identified 10 membrane receptors that were differentially expresse...

  4. Mir-29 repression in bladder outlet obstruction contributes to matrix remodeling and altered stiffness.

    Directory of Open Access Journals (Sweden)

    Mari Ekman

    Full Text Available Recent work has uncovered a role of the microRNA (miRNA miR-29 in remodeling of the extracellular matrix. Partial bladder outlet obstruction is a prevalent condition in older men with prostate enlargement that leads to matrix synthesis in the lower urinary tract and increases bladder stiffness. Here we tested the hypothesis that miR-29 is repressed in the bladder in outlet obstruction and that this has an impact on protein synthesis and matrix remodeling leading to increased bladder stiffness. c-Myc, NF-κB and SMAD3, all of which repress miR-29, were activated in the rat detrusor following partial bladder outlet obstruction but at different times. c-Myc and NF-κB activation occurred early after obstruction, and SMAD3 phosphorylation increased later, with a significant elevation at 6 weeks. c-Myc, NF-κB and SMAD3 activation, respectively, correlated with repression of miR-29b and miR-29c at 10 days of obstruction and with repression of miR-29c at 6 weeks. An mRNA microarray analysis showed that the reduction of miR-29 following outlet obstruction was associated with increased levels of miR-29 target mRNAs, including mRNAs for tropoelastin, the matricellular protein Sparc and collagen IV. Outlet obstruction increased protein levels of eight out of eight examined miR-29 targets, including tropoelastin and Sparc. Transfection of human bladder smooth muscle cells with antimiR-29c and miR-29c mimic caused reciprocal changes in target protein levels in vitro. Tamoxifen inducible and smooth muscle-specific deletion of Dicer in mice reduced miR-29 expression and increased tropoelastin and the thickness of the basal lamina surrounding smooth muscle cells in the bladder. It also increased detrusor stiffness independent of outlet obstruction. Taken together, our study supports a model where the combined repressive influences of c-Myc, NF-κB and SMAD3 reduce miR-29 in bladder outlet obstruction, and where the resulting drop in miR-29 contributes to

  5. Mir-29 repression in bladder outlet obstruction contributes to matrix remodeling and altered stiffness.

    Science.gov (United States)

    Ekman, Mari; Bhattachariya, Anirban; Dahan, Diana; Uvelius, Bengt; Albinsson, Sebastian; Swärd, Karl

    2013-01-01

    Recent work has uncovered a role of the microRNA (miRNA) miR-29 in remodeling of the extracellular matrix. Partial bladder outlet obstruction is a prevalent condition in older men with prostate enlargement that leads to matrix synthesis in the lower urinary tract and increases bladder stiffness. Here we tested the hypothesis that miR-29 is repressed in the bladder in outlet obstruction and that this has an impact on protein synthesis and matrix remodeling leading to increased bladder stiffness. c-Myc, NF-κB and SMAD3, all of which repress miR-29, were activated in the rat detrusor following partial bladder outlet obstruction but at different times. c-Myc and NF-κB activation occurred early after obstruction, and SMAD3 phosphorylation increased later, with a significant elevation at 6 weeks. c-Myc, NF-κB and SMAD3 activation, respectively, correlated with repression of miR-29b and miR-29c at 10 days of obstruction and with repression of miR-29c at 6 weeks. An mRNA microarray analysis showed that the reduction of miR-29 following outlet obstruction was associated with increased levels of miR-29 target mRNAs, including mRNAs for tropoelastin, the matricellular protein Sparc and collagen IV. Outlet obstruction increased protein levels of eight out of eight examined miR-29 targets, including tropoelastin and Sparc. Transfection of human bladder smooth muscle cells with antimiR-29c and miR-29c mimic caused reciprocal changes in target protein levels in vitro. Tamoxifen inducible and smooth muscle-specific deletion of Dicer in mice reduced miR-29 expression and increased tropoelastin and the thickness of the basal lamina surrounding smooth muscle cells in the bladder. It also increased detrusor stiffness independent of outlet obstruction. Taken together, our study supports a model where the combined repressive influences of c-Myc, NF-κB and SMAD3 reduce miR-29 in bladder outlet obstruction, and where the resulting drop in miR-29 contributes to matrix remodeling and

  6. Positioning invasive versus noninvasive urodynamics in the assessment of bladder outlet obstruction

    NARCIS (Netherlands)

    M. Arnolds; M. Oelke

    2009-01-01

    Purpose of review To provide evidence of promising tests to noninvasively diagnose bladder outlet obstruction (800) in men with benign prostatic hyperplasia. Recent findings Pressure-flow studies are usually performed to prove BOO prior to prostatectomy. However, pressure-flow studies are invasive,

  7. Effect of long-term partial bladder outlet obstruction on caldesmon isoforms and their correlation with contractile function

    Institute of Scientific and Technical Information of China (English)

    Lin YANG; Da-lin Hei; Shu WANG; He-peng CHENG; Xin-yang WANG

    2008-01-01

    Aim: In the present study, we investigate the expression of caldesmon (CAD) isoforms in rabbit detrusor smooth muscles (DSM) during the progression of partial bladder outlet obstruction and relate them with the time course of obstruction. Methods: Detrusor samples were obtained from the bladders of rabbits with partial bladder outlet obstruction and sham-operated control rabbits after 1, 2, 4, and 8 weeks of obstruction. Contractile responses to field stimulation and carbachol were determined in the isolated bladder strips. Western blotting was used to determine the relative levels of CaD isoform expression at the protein levels. Results: The contractile responses decreased progressively over the course of obstruction. The expression of 1-CaD increased significantly to approximately the same extent as the 1-4-week obstructed groups and further in the 8-week ob-structed group. The expression of h-CaD increased in all of the obstructed bladders, but at significantly higher levels in the 1-2-week obstructed bladders compared to the control and 4-8-week obstructed bladders. Conclusions: The changes in the isoforms of CaD may be part of the molecular mechanism for bladder compensa-tion following partial bladder outlet obstruction. The overexpression of 1-CaD and the h-CaD/1-CaD ratio could be markers for the status of DSM remodeling and dysfunction.

  8. 5-Hydroxytryptamine-induced bladder hyperactivity via the 5-HT2A receptor in partial bladder outlet obstruction in rats.

    Science.gov (United States)

    Sakai, Takumi; Kasahara, Ken-ichi; Tomita, Ken-ichi; Ikegaki, Ichiro; Kuriyama, Hiroshi

    2013-04-01

    We investigated the effects of partial bladder outlet obstruction (BOO) on the function and gene expression of 5-hydroxytryptamine (5-HT) receptor subtypes in rat bladder. Isometric contractions of the isolated bladders from sham-operated control and BOO rats were examined. The contractile responses to 5-HT were significantly increased in BOO rat bladder strips, while the responses to KCl, carbachol, or phenylephrine were not different from the control. The 5-HT-induced hypercontraction in BOO rat bladder strips was inhibited by ketanserin, a 5-HT(2A) receptor antagonist. The contractile responses to 5-HT in bladder strips were not affected by urothelium removal from the intact bladder. The gene expression of 5-HT receptor subtypes in the bladders was analyzed by RT-PCR. The mRNA expression of the 5-HT(2A), 5-HT(2B), 5-HT(2C), 5-HT(4), and 5-HT(7) receptors was detected in both the control and BOO rat bladders. Quantitative RT-PCR analysis showed there was a significant increase of 5-HT(2A) receptor mRNA in the BOO rat bladder compared with the control bladder. On the other hand, the gene expression of the 5-HT(4) receptor was not changed in the BOO rat bladder. These results suggest that the increased contractile responses to 5-HT in BOO rat bladder may be partly caused by 5-HT(2A) receptor upregulation in the detrusor smooth muscles. PMID:23344575

  9. Work Capacity of the Bladder During Voiding: A Novel Method to Evaluate Bladder Contractile Function and Bladder Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Ning Liu

    2015-01-01

    Full Text Available Background: Work in voiding (WIV of the bladder may be used to evaluate bladder status throughout urination rather than at a single time point. Few studies, however, have assessed WIV owing to the complexity of its calculations. We have developed a method of calculating work capacity of the bladder while voiding and analyzed the associations of bladder work parameters with bladder contractile function and bladder outlet obstruction (BOO. Methods: The study retrospectively evaluated 160 men and 23 women, aged >40 years and with a detrusor pressure at maximal flow rate (P det Q max of ≥40 cmH 2 O in men, who underwent urodynamic testing. The bladder power integration method was used to calculate WIV; WIV per second (WIV/t and WIV per liter of urine voided (WIV/v were also calculated. In men, the relationships between these work capacity parameters and P det Q max and Abrams-Griffiths (AG number were determined using linear-by-linear association tests, and relationships between work capacity parameters and BOO grade were investigated using Spearman′s association test. Results: The mean WIV was 1.15 ± 0.78 J and 1.30 ± 0.88 J, mean WIV/t was 22.95 ± 14.45 mW and 23.78 ± 17.02 mW, and mean WIV/v was 5.59 ± 2.32 J/L and 2.83 ± 1.87 J/L in men and women, respectively. In men, WIV/v showed significant positive associations with P det Q max (r = 0.845, P = 0.000, AG number (r = 0.814, P = 0.000, and Schafer class (r = 0.726, P = 0.000. Conversely, WIV and WIV/t showed no associations with P det Q max or AG number. In patients with BOO (Schafer class > II, WIV/v correlated positively with increasing BOO grade. Conclusions: WIV can be calculated from simple urodynamic parameters using the bladder power integration method. WIV/v may be a marker of BOO grade, and the bladder contractile function can be evaluated by WIV and WIV/t.

  10. Work Capacity of the Bladder During Voiding: A Novel Method to Evaluate Bladder Contractile Function and Bladder Outlet Obstruction

    Institute of Scientific and Technical Information of China (English)

    Ning Liu; Li-Bo Man; Feng He; Guang-Lin Huang; Ning Zhou; Xiao-Fei Zhu

    2015-01-01

    Background: Work in voiding (WIV) of the bladder may be used to evaluate bladder status throughout urination rather than at a single time point.Few studies, however, have assessed WIV owing to the complexity of its calculations.We have developed a method of calculating work capacity of the bladder while voiding and analyzed the associations of bladder work parameters with bladder contractile function and bladder outlet obstruction (BOO).Methods: The study retrospectively evaluated 160 men and 23 women, aged >40 years and with a detrusor pressure at maximal flow rate (PdetQmax) of≥40 cmH2O in men, who underwent urodynamic testing.The bladder power integration method was used to calculate WIV;WIV per second (WIV/t) and WIV per liter of urine voided (WIV/v) were also calculated.In men, the relationships between these work capacity parameters and PdetQmax and Abrams-Griffiths (AG) number were determined using linear-by-linear association tests, and relationships between work capacity parameters and BOO grade were investigated using Spearman's association test.Results: The mean WIV was 1.15 ± 0.78 J and 1.30 ± 0.88 J, mean WIV/t was 22.95 ± 14.45 mW and 23.78 ± 17.02 mW, and mean WIV/v was 5.59 ± 2.32 J/L and 2.83 ± 1.87 J/L in men and women, respectively.In men, WIV/v showed significant positive associations with PdetQmax (r =0.845, P =0.000), AG number (r =0.814, P =0.000), and Schafer class (r =0.726, P =0.000).Conversely, WIV and WIV/t showed no associations with PdetQmax or AG number.In patients with BOO (Schafer class > Ⅱ), WIV/v correlated positively with increasing BOO grade.Conclusions: WIV can be calculated trom simple urodynamic parameters using the bladder power integration method.WIV/v may be a marker of BOO grade, and the bladder contractile function can be evaluated by WIV and WIV/t.

  11. Non-uniform changes in membrane receptors in the rat urinary bladder following outlet obstruction.

    Science.gov (United States)

    Zeng, Jianwen; Ekman, Mari; Jiang, Chonghe; Uvelius, Bengt; Swärd, Karl

    2015-09-01

    The aim of the present study was to investigate the expression and distribution of membrane receptors after bladder outlet obstruction (BOO). Partial bladder outlet obstruction (BOO) was induced in female rats and bladders were harvested after either 10 days or 6 weeks of BOO. The expression of different receptors was surveyed by microarrays and corroborated by immunohistochemistry and western blotting. A microarray experiment identified 10 membrane receptors that were differentially expressed compared to sham-operated rats including both upregulated and downregulated receptors. Four of these were selected for functional experiments on the basis of magnitude of change and relevance to bladder physiology. At 6 weeks of BOO, maximal contraction was reduced for neuromedin B and vasopressin (AVP), consistent with reductions of receptor mRNA levels. Glycine receptor-induced contraction on the other hand was increased and receptor mRNA expression was accordingly upregulated. Maximal relaxation by the β3-adrenergic receptor agonist CL316243 was reduced as was the receptor mRNA level. Immunohistochemistry supported reduced expression of neuromedin B receptors, V1a receptors and β3-adrenergic receptors, but glycine receptor expression appeared unchanged. Western blotting confirmed repression of V1a receptors and induction of glycine receptors in BOO. mRNA for vasopressin was detectable in the bladder, suggesting local AVP production. We conclude that changes in receptor expression following bladder outlet obstruction are non-uniform. Some receptors are upregulated, conferring increased responsiveness to agonist, whereas others are downregulated, leading to decreased agonist-induced responses. This study might help to select pharmacological agents that are effective in modulating lower urinary tract symptoms in BOO. PMID:26004535

  12. Role of intrathecal tachykinins for micturition in unanaesthetized rats with and without bladder outlet obstruction.

    OpenAIRE

    Ishizuka, O; Igawa, Y.; Lecci, A.; Maggi, C. A.; Mattiasson, A.; Andersson, K. E.

    1994-01-01

    1. The effects on micturition of RP 67,580, a selective NK1 receptor antagonist, and SR 48,968, a highly, potent antagonist at NK2 receptor sites, given intrathecally (i.t.) or intra-arterially (i.a.) near the bladder, were investigated in unanaesthetized rats with and without bladder outlet obstruction. 2. In normal rats, RP 67,580, given i.t. in doses of 2 and 20 nmol per rat, decreased micturition pressure, but did not change other cystometric parameters. After 20 nmol of RP 67,580, dribbl...

  13. Compensatory Paracrine Mechanisms That Define The Urothelial Response to Injury in Partial Bladder Outlet Obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Bassuk, James; Lendvay, Thomas S.; Sweet, Robert; Han, Chang-Hee; Soygur, Tarkan; Cheng, Jan-Fang; Plaire, J. Chadwick; Charleston, Jay S.; Charleston, Lynne B.; Bagai, Shelly; Cochrane, Kimberly; Rubio, Eric; Bassuk, James A.; Fuchs, Elaine

    2007-06-21

    Diseases and conditions affecting the lower urinary tract are a leading cause of dysfunctional sexual health, incontinence, infection, and kidney failure. The growth, differentiation, and repair of the bladder's epithelial lining are regulated, in part, by fibroblast growth factor (FGF)-7 and -10 via a paracrine cascade originating in the mesenchyme (lamina propria) and targeting the receptor for FGF-7 and -10 within the transitional epithelium (urothelium). The FGF-7 gene is located at the 15q15-q21.1 locus on chromosome 15 and four exons generate a 3.852-kb mRNA. Five duplicated FGF-7 gene sequences that localized to chromosome 9 were predicted not to generate functional protein products, thus validating the use of FGF-7-null mice as an experimental model. Recombinant FGF-7 and -10 induced proliferation of human urothelial cells in vitro and transitional epithelium of wild-type and FGF-7-null mice in vivo.To determine the extent that induction of urothelial cell proliferation during the bladder response to injury is dependent on FGF-7, an animal model of partial bladder outlet obstruction was developed. Unbiased stereology was used to measure the percentage of proliferating urothelial cells between obstructed groups of wild-type and FGF-7-null mice. The stereological analysis indicated that a statistical significant difference did not exist between the two groups, suggesting that FGF-7 is not essential for urothelial cell proliferation in response to partial outlet obstruction. In contrast, a significant increase in FGF-10 expression was observed in the obstructed FGF-7-null group, indicating that the compensatory pathway that functions in this model results in urothelial repair.

  14. Does bladder outlet obstruction affect distance between the ureteric orifices in patients with benign prostate hyperplasia?

    Directory of Open Access Journals (Sweden)

    Cüneyt Özden

    2009-01-01

    Full Text Available Objectives: Many morphological changes occur in the bladder due to bladder outlet obstruction (BOO in pa-tients with benign prostate hyperplasia (BPH. In the present study we evaluated the relationship between in-terureteric distance (IUD of the orifices and BOO in BPH patients.Materials and methods: Thirty-seven consecutive pa-tients with lower urinary tract symptoms at the urology polyclinic included in the study. Patients divided into 2 groups according to maximal flow rate (Qmax. The first group constituted of 18 patients with Qmax 15ml/s. The IUD measurement was performed with Doppler ultrasonography.Results: There was no significant difference between the groups regarding mean age and prostate volume. Mean IUD in the first group was 32.7±5.4 mm and mean IUD in the second group was 31.5±5.1 mm. There was no statistically significant difference between the groups regarding the IUD.Conclusions: Data obtained from the study revealed that measurement of IUD with Doppler ultrasonography not significantly related to BOO.

  15. Micturition in conscious rats with and without bladder outlet obstruction: role of spinal alpha 1-adrenoceptors.

    OpenAIRE

    Ishizuka, O; Persson, K.; Mattiasson, A.; Naylor, A; Wyllie, M.; Andersson, K.

    1996-01-01

    1. In normal rats and rats with bladder hypertrophy secondary to outflow obstruction, undergoing continuous cytometry, we examined the responses to the selective alpha 1-adrenoceptor antagonist doxazosin given intrathecally (i.t.) and intra-arterially (i.a.). In addition, we investigated the effects of the drug on L-dopa-induced bladder hyperactivity in normal, unobstructed rats. 2. Doxazosin 50 nmol (approximately 60 micrograms kg-1), given i.t., decreased micturition pressure in normal rats...

  16. Upregulation of heme oxygenase and collagen type III in the rat bladder after partial bladder outlet obstruction.

    Science.gov (United States)

    Inaba, Mitsuhiko; Ukimura, Osamu; Yaoi, Takeshi; Kawauchi, Akihiro; Fushiki, Shinji; Miki, Tsuneharu

    2007-01-01

    The objective of the study was to evaluate possible changes of the gene expression and localization of the enzymes, heme oxygenase and nitric oxide synthase (NOS), with reference to increase of collagen type III in response to the partial obstruction of the bladder. Following initial obstruction, whole rat bladders were removed for real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. Real-time RT-PCR demonstrated significantly enhanced expression of HO (p < 0.01) and collagen type III (p < 0.001) gene on postoperative day 14. Enhanced expression of NOS gene was seen only on postoperative day 4 (p < 0.01). Immunohistochemistry revealed that immunoreactivity to HO-1 had much in common in neural cells and fibers, although immunoreactivity to HO-2 and iNOS was relatively weak. This study suggested gene expression of HO, especially HO-1, was more dramatically changed than NOS, and was upregulated simultaneously with increase of collagen type III after obstruction. HO systems could be involved in the pathogenesis of bladder dysfunction related to increase of collagen type III after obstruction. PMID:17406140

  17. Influence of bladder outlet obstruction and detrusor contractility on residual urine in patients with benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    张鹏; 武治津; 高居忠

    2003-01-01

    Objective To study the relationship between the degree of bladder outlet obstruction (BOO), detrusor contractility and residual urine in patients suffering from benign prostatic hyperplasia (BPH).Methods In 181 patients with BPH, degree of BOO, detrusor contractility, residual urine caculated from cathetering combined with the difference between the filling and the voiding were recorded and analysized statistically using urodynamic technique.Results Residual urine increased when the detusor contractility was weakened (F=12.134, P=0.001). In patients wih severe BOO, there was no significant difference in residual urine (F=2.386, P=0.071).Conclusions Increased residual urine is mainly resulted from decreased detrusor contractility. BOO has no significant influence on residual urine. Some patients with normal or weakened detrusor contractility may have more residual urine

  18. Three-dimensional stereology as a tool for evaluating bladder outlet obstruction

    DEFF Research Database (Denmark)

    Wijk, J. Van der; Horn, T.; Nyengaard, J.R.;

    2008-01-01

    tract symptoms (LUTS) suggestive of BOO and five controls (mean age 48.6 years; range 43-53 years) without LUTS were studied. All participants underwent a full examination, including determination of the International Prostate Symptom Score, laboratory analysis and a urodynamic evaluation. A cold......). There was no relation between the Abrams-Griffiths number and either the interstitial fraction or the collagen fraction. Furthermore, the results suggest an age-associated effect of morphological changes in the bladder wall. The smooth muscle volume also showed no relationship with the severity of...

  19. Sodium Tanshinone IIA Sulfonate Ameliorates Bladder Fibrosis in a Rat Model of Partial Bladder Outlet Obstruction by Inhibiting the TGF-β/Smad Pathway Activation.

    Directory of Open Access Journals (Sweden)

    Xiaoxiao Jiang

    Full Text Available Transforming growth factor (TGF-β1 is known to play a pivotal role in a diverse range of biological systems including modulation of fibrosis in several organs. The precise role of TGF-β/Smad signaling in the progression of bladder fibrosis secondary to partial bladder outlet obstruction (PBOO is yet to be conclusively. Using a rat PBOO model, we investigated TGF-β1 expression and exaimined whether sodium tanshinone IIA sulfonate (STS could inhibit TGF-β/Smad signaling pathway activation and ameliorate bladder fibrosis. Forty-eight female Sprague-Dawley rats were randomly divided into three groups: sham operation group (n = 16, PBOO operation without STS treatment group (n = 16 and PBOO operation with STS treatment group (n = 16. Thirty-two rats underwent the operative procedure to create PBOO and subsequently received intraperitoneal injections of STS (10 mg/kg/d; n = 16 or vehicle (n = 16 two days after the surgery. Sham surgery was conducted on 16 rats, which received intraperitoneal vehicle injection two days later. In each of the three groups, an equal number of rats were sacrificed at weeks 4 and 8 after the PBOO or sham operation. The TGF-β/Smad signaling pathway was analyzed using western blotting, immunohistochemical staining and reverse transcriptase polymerase chain reaction (RT-PCR. One-way analysis of variance was conducted to draw statistical inferences. At 4 and 8 weeks, the expression of TGF-β1 and phosphorylated Smad2 and Smad3 in STS-treated PBOO rats was significantly lower than in the PBOO rats not treated with STS. Alpha smooth muscle actin (α-SMA, collagen I and collagen III expression at 4 and 8 weeks post PBOO was lower in STS-treated PBOO rats when compared to that in PBOO rats not treated with STS. Our findings indicate that STS ameliorates bladder fibrosis by inhibiting TGF-β/Smad signaling pathway activation, and may prove to be a potential therapeutic measure for preventing bladder fibrosis secondary to PBOO

  20. Blebbistain, a myosin II inhibitor, as a novel strategy to regulate detrusor contractility in a rat model of partial bladder outlet obstruction.

    Directory of Open Access Journals (Sweden)

    Xinhua Zhang

    Full Text Available Partial bladder outlet obstruction (PBOO, a common urologic pathology mostly caused by benign prostatic hyperplasia, can coexist in 40-45% of patients with overactive bladder (OAB and is associated with detrusor overactivity (DO. PBOO that induces DO results in alteration in bladder myosin II type and isoform composition. Blebbistatin (BLEB is a myosin II inhibitor we recently demonstrated potently relaxed normal detrusor smooth muscle (SM and reports suggest varied BLEB efficacy for different SM myosin (SMM isoforms and/or SMM vs nonmuscle myosin (NMM. We hypothesize BLEB inhibition of myosin II as a novel contraction protein targeted strategy to regulate DO. Using a surgically-induced male rat PBOO model, organ bath contractility, competitive and Real-Time-RT-PCR were performed. It was found that obstructed-bladder weight significantly increased 2.74-fold while in vitro contractility of detrusor to various stimuli was impaired ∼50% along with decreased shortening velocity. Obstruction also altered detrusor spontaneous activities with significantly increased amplitude but depressed frequency. PBOO switched bladder from a phasic-type to a more tonic-type SM. Expression of 5' myosin heavy chain (MHC alternatively spliced isoform SM-A (associated with tonic-type SM increased 3-fold while 3' MHC SM1 and essential light chain isoform MLC(17b also exhibited increased relative expression. Total SMMHC expression was decreased by 25% while the expression of NMM IIB (SMemb was greatly increased by 4.5-fold. BLEB was found to completely relax detrusor strips from both sham-operated and PBOO rats pre-contracted with KCl, carbachol or electrical field stimulation although sensitivity was slightly decreased (20% only at lower doses for PBOO. Thus we provide the first thorough characterization of the response of rat bladder myosin to PBOO and demonstrate complete BLEB-induced PBOO bladder SM relaxation. Furthermore, the present study provides valuable

  1. THE INFLUENCE OF MONTELUKAST ON THE ACTIVITY OF THE AUTONOMIC NERVOUS SYSTEM ESTIMATED BY HEART RATE VARIABILITY IN EXPERIMENTAL PARTIAL BLADDER OUTLET OBSTRUCTION IN RATS.

    Science.gov (United States)

    Dobrek, Łukasz; Skowron, Beata; Baranowska, Agnieszka; Zurowski, Daniel; Thor, Piotr Jan

    2016-01-01

    Due to their paracrine action, leukotrienes released from the urothelium are involved in control of the bladder function. Anti-leukotriene agents appear to exert an ameliorating effect in bladder overactivity. It is unknown, whether their possible, modulatory impact on the autonomic nervous system (ANS) activity may also contribute to the potentially beneficial effect of those compounds. Therefore, our aim was to indirectly estimate the ANS function using the heart rate variability (HRV) study in rats with experimental partial bladder outlet obstruction (PBOO), reflecting human benign prostatic hyperplasia (BPH), treated with leukotriene receptor antagonist - montelukast (MLKT). Twenty rats with surgically induced PBOO lasting for 14 days, divided into two groups: group 1 (10 control subjects) and group 2 (10 MLKT-treated rats; 2 mg/rat/day) were subjected to HRV recordings, preceded by daily urine collection and a subsequent cystectomy with histopathological evaluation of collected bladders. Standard HRV time and spectral parameters were calculated. MLKT-treated animals demonstrated an increase in power of non-normalized LF (low frequency) and HF (high frequency) components with no change of the total HRV power. Moreover, an increase and decrease in normalized nLF and nHF, respectively, were assessed in those animals compared to the control. Additionally, a decrease in daily diuresis measurement was demonstrated in MLKT-treated animals. Montelukast treatment resulted in the functional ANS status re-arrangement, with sympathetic overdrive and parasympathetic withdrawal. Those changes may contribute to alleviation of bladder overactivity symptoms, independently on leukotriene receptors blockade. PMID:27476297

  2. The use of ultrasound-estimated bladder weight in diagnosing bladder outlet obstruction and detrusor overactivity in men with lower urinary tract symptoms

    OpenAIRE

    Housami, Fadi; Drake, Marcus; Abrams, Paul

    2009-01-01

    Objectives: Measurement of bladder weight using ultrasound estimates of bladder wall thickness and bladder volume is an emerging clinical measurement technique that may have a role in the diagnosis of lower urinary tract dysfunction. We have reviewed available literature on this technique to assess current clinical status. Methods: A systematic literature search was carried out within PubMed and MedLine to identify relevant publications. These were then screened for relevance. Preliminary res...

  3. 耻骨后途径膀胱颈部分结扎与经尿道途径尿道部分结扎制作犬膀胱出口梗阻模型的比较∗%Comparison of Retropubic Bladder Neck Partial Ligation and Transurethral Urethral Partial Ligation in the Establishment of ;Bladder Outlet Obstruction Model in Dogs

    Institute of Scientific and Technical Information of China (English)

    李磊; 吴越; 张国飞; 邓玮; 陈安龙

    2016-01-01

    Objective To compare two methods for establishing an animal model of overactivity bladder caused by bladder outlet obstruction in beagle dogs. Methods Twenty-six healthy female beagles were randomly divided into three groups, which were group A ( n =10 ) , group B ( n =10 ) , and control group ( n =6 ) . The group A was given a retropubic approach midprostatic obstruction. The group B was given an urethral partial ligation through transurethral way. The control group underwent just exposure of the bladder neck without midprostatic obstruction through retropubic approach. Urodynamic study was carried out in these groups after 12 weeks. Results The operation time of the group B (10. 7 ± 3. 9 min) was shorter than the control group (15. 2 ± 2. 1) min, which was further shorter than the group A (18.4 ±3.2 min) (F=67.97, P=0.02). Urinary dynamics test showed no significant difference among the 3 groups before the operation of (P>0. 05). At 12 weeks after the operation, 8 dogs from the group A and 10 dogs from group B were found with detrusor contraction wave in urine storage period, while the control group did not appear. The detrusor pressure, maximum bladder capacity, residual urine in the group A and group B were significantly higher than the control group and before operation (P0. 05), and there was no significant difference in the control group between preoperation and postoperation (P>0. 05). Conclusions Both retropubic and transurethral approaches can be used to successfully establish bladder outlet obsteuction in female beagles. As compared to retropubic approach, the transurethral approach has advantages such as shorter operation time, better reproducibility and stability of the animal models, which is suitable for studying transurethral intracavitary treated by minimally invasive surgery.%目的:比较两种犬膀胱出口梗阻( bladder outlet obstruction,BOO)诱导膀胱过度活动症( overactivity bladder, OAB)模型制备方法的效果。方法将26

  4. Steroid responsive eosinophilic gastric outlet obstruction in a child

    Institute of Scientific and Technical Information of China (English)

    Richard Kellermayer; Nina Tatevian; William Klish; Robert J Shulman

    2008-01-01

    Gastric outlet obstruction is a rare complication of eosinophilic gastroenteritis, most commonly treated surgically. We report a case of eosinophilic gastric outlet obstruction in a child that responded to conservative medical management. A brief review of this clinical entity is also provided.

  5. Ultrasound assayed detrusor thickness may predict the bladder outlet obstruction in old men%超声测量逼尿肌厚度预测老年男性下尿路梗阻

    Institute of Scientific and Technical Information of China (English)

    张瑞莉; 文建国; 胡金华; 王庆伟; 王声政; 娄安锋; 张国贤; 姚亚雄

    2010-01-01

    目的 探讨老年良性前列腺增生(BPH)患者膀胱逼尿肌厚度与膀胱出口梗阻的相关性.方法 106例BPH患者行尿动力学检查,以尿动力学检查结果作为膀胱出口梗阻的诊断依据,梗阻标准:Abrams-Griffiths(A-G)指数≥40,LinPURR梗阻分级≥Ⅱ级.经腹B超在膀胱充盈量至150 ml时测定逼尿肌厚度.结果 最大尿流率和平均尿流率梗阻组[(10.1±3.0)ml/s、(5.5±2.2)ml/s]均明显低于非梗阻组[(17.4±3.1)ml/s、(11.2±2.2)ml/s](t=10.26和11.03,均P<0.01),而残余尿量、逼尿肌最大收缩压力梗阻组[(47.6±24.3)ml、(39.3±14.4)cm H2O]高于非梗阻组[(17.0±5.6)ml、(26.8±8.0)cm H2O,t=6.32和4.07,P<0.01和0.05].逼尿肌厚度与逼尿肌最大收缩压力呈正相关(r=0.419,P<0.01),与最大尿流率(r=-0.749,P<0.01)、平均尿流率(r=-0.853,P<0.01)和排尿量(r=-0.556,P<0.01)呈负相关.逼尿肌厚度梗阻组(3.0±0.2)mm,高于非梗阻组(2.5±0.2)mm(t=11.2,P<0.05).以逼尿肌厚度≥3.0 mm为标准诊断男性下尿路梗阻的灵敏度为90%,特异性为84.6%,阳性预测值93.1%,阴性预测值为78.6%.结论 逼尿肌厚度大于3 mm可预测老年男性膀胱出口梗阻.%Objective To evaluate the relationship between ultrasound-assayed detrusor thickness and bladder outlet obstruction (BOO) in old men with benign prostatic hyperplasia (BPH).Methods The 106 BPH patients underwent the urodynamic examination on which the diagnosis of BOO was dependent. The obstruction was defined as the Abrams-Griffiths nomogram (A-G index)≥40 and the grade of linear passive urethral resistance relation (LinPURR)≥Ⅱ . When bladder capacity reached 150 ml, the detrusor thickness was measured by abdominal ultrasound. Results Compared with unobstructed group, the maximum flow rate and average flow rate were both lower in obstructed group [(10.1±3.0) ml/s vs. (17.4±3.1) ml/s, (5.5±2.2) ml/s vs. (11.2±2.2) ml/s, t= 10.26and 11.03, both P<0.01]. And the residual urine volume and

  6. Update on endoscopic management of gastric outlet obstruction in children

    Science.gov (United States)

    Chao, Hsun-Chin

    2016-01-01

    Endoscopic balloon dilatation (EBD) and surgical intervention are two most common and effective treatments for gastric outlet obstruction. Correction of gastric outlet obstruction without the need for surgery is an issue that has been tried to be resolved in these decades; this management has developed with EBD, advanced treatments like local steroid injection, electrocauterization, and stent have been added recently. The most common causes of pediatric gastric outlet obstruction are idiopathic hypertrophic pyloric stenosis, peptic ulcer disease followed by the ingestion of caustic substances, stenosis secondary to surgical anastomosis; antral web, duplication cyst, ectopic pancreas, and other rare conditions. A complete clinical, radiological and endoscopic evaluation of the patient is required to make the diagnosis, with complimentary histopathologic studies. EBD are used in exceptional cases, some with advantages over surgical intervention depending on each patient in particular and on the characteristics and etiology of the gastric outlet obstruction. Local steroid injection and electrocauterization can augment the effect of EBD. The future of endoscopic treatment seems to be aimed at the use of endoscopic electrocauterization and balloon dilatations.

  7. 前列腺突入膀胱距离及逼尿肌厚度与膀胱出口梗阻的关系探讨%Correlation of intravesical prostatic protrusion and detrusor wall thickness with bladder outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    黄维; 刘励; 陈光勇; 龚丽媛; 冯颖慧

    2012-01-01

    目的 探讨前列腺突入膀胱距离(intravesical prostatic protrusion,IPP)及逼尿肌厚度(destrusor wall thickness,DWT)与良性前列腺增生(benign prostatic hyperplasia,BPH)所致膀胱出口梗阻(bladder outlet obstruction,BOO)的关系,旨在寻找一种简单、非侵入性诊断的方法.方法 选择前列腺增生有下尿路症状患者200例,予经腹超声检查及尿流动力学检查,测量参数包括:IPP、DWT、残余尿量(post-void residual urine,PVR)、前列腺体积(prostate volume,PV)、尿流动力学Schaefer分级;对数据进行统计分析并绘制相应ROC曲线.结果 IPP、DWT、PV与Schaefer分级相关[相关系数(r)分别为0.73、0.56、0.23,P值均<0.01];PVR与Schaefer分级无关;IPP、DWT、PV的ROC曲线下面积分别为0.80、0.84、0.60.结论 经腹超声测量DWT、IPP可以预测前列腺增生患者BOO程度,是一种简单、无创、有效的评估方法.%Objective To investigate the correlation of intravesical prostatic protrusion (IPP) and detrusor wall thickness (DWT) with bladder outlet obstruction (BOO) in patients with benign prostatic hyperpla-sia ( BPH) ,and to find a simple and noninvasive method to diagnose BOO. Methods A total of 200 men with lower urinary tract symptoms (LUTS) due to BPH were prospectively enrolled. The initial evaluation included DWT,IPP,post-void residual urine (PVR),prostate volume (PV) ,Schaefer obstruction class. These data were analyzed with statistic and produced a ROC curve. Results There are significant correlation between IPP,DWT and PV with the Schaefer obstruction class (r =0.73 ,0. 38,0. 23 ,respectively;P < 0.01). There were no correlation between PVR and the Schaefer obstruction class. The AUC for IPP,DWT,PV was 0. 80,0. 84,0. 60,respectively. Conclusion Trans-abdominal ultrasound of IPP and DWT can be used to predict patients with BOO due to BPD,and it is a simple,noninvasive,and effective method.

  8. Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

    Directory of Open Access Journals (Sweden)

    Abdulrahman Al-Hussaini

    2014-01-01

    Full Text Available Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

  9. Giant hepatic hemangioma presenting as gastric outlet obstruction.

    Science.gov (United States)

    Aydin, Cemalettin; Akbulut, Sami; Kutluturk, Koray; Kahraman, Aysegul; Kayaalp, Cuneyt; Yilmaz, Sezai

    2013-01-01

    Hemangioma, a most frequently encountered primary benign tumor of the liver, is generally determined incidentally during the course of radiologic tests for other reasons. Most lesions are less than 3 cm and a significant proportion of patients are asymptomatic, although the size and location of the lesion in some patients may be associated with the onset of symptoms. Pressure on the stomach and duodenum of giant hemagiomas developing in the left lobe of the liver, in particular, may result in the development of abdominal pain, nausea, vomiting, and feeling bloated, which are characteristic of a gastric outlet obstruction. A 42-year-old man presented with findings of gastric outlet obstruction and weight loss as a result of a giant hepatic hemangioma. PMID:23438272

  10. Female outlet obstruction constipation: assessment with MR defecography

    International Nuclear Information System (INIS)

    Objective: Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of' anterior and mid pelvic. Methods: One hundred and seven female patients, aged 20 to 84 years (average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool. Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results: In all the 107 cases, 70 (65.4%) presented rectocele on dynamic MRI; 28 (26.2%) presented anismus; 60 (56.1%) presented cystocele; 59 presented vaginal or cervical prolapse(55.1%); and, 54 (50.5%) presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion: MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic. (authors)

  11. GASTRIC OUTLET OBSTRUCTION CAUSED BY CYSTIC HETEROTOPIC PANCREAS

    Directory of Open Access Journals (Sweden)

    E. Târcoveanu

    2011-08-01

    Full Text Available Heterotopic (ectopic pancreas is relatively rare and is defined as abnormally situated pancreatic tissue has no contact with the normal pancreas and has its own ductal system and blood supply. It is usually an incidental finding in clinical practice. It most often occurs in the proximal gastrointestinal tract – gastric heterotopic pancreas. It may become clinically evident when complicated by pathological changes such as pancreatitis, cystic dystrophy with obstruction as especially gastric outlet obstruction. In this report a 29 – year old man with nausea, recurrent vomiting an abdominal pain is described. Gastroduodenal endoscopic examination, upper GI barium X-ray, ultrasonography revealed a submucosal tumor at the prepyloric area on the posterior wall of the stomach with gastric outlet obstruction. A degenerated gastrointestinal stromal tumor was suspected. Limitated distal antrectomy was performed and a histological diagnosis of gastric heterotopic pancreas was confirmed. The patient had an uneventful postoperative course and was discharged 5 days after operation and remains healthy and symptom-free in the follow-up of 6 months. This is a report of a case of gastric outlet obstruction resulting for pancreatic heterotopia in the gastric antrum with cystic dystrophy after acute pancreatitis in an adult man. The incidence of symptomatic heterotopic pancreas is low and preoperative diagnosis is difficult. Although endoscopy ultrasound is helpful for diagnosis, it is difficult to distinguish from stromal tumor. Frozen section should be taken so as to distinguish heterotopic pancreas from malignant tumors. Surgical excision by minimally invasive approach provides symptomatic relief and is recommended.

  12. TRICHOBEZOAR WITH GASTRIC OUTLET OBSTRUCTION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Nagendra Prasad

    2016-05-01

    Full Text Available Trichobezoar is collection of hairs forming a conglomerated mass. It is a very rare entity mimicking other common causes of gastric outlet obstruction. It is classically seen in adolescent females usually with psychiatric disturbances. Stomach is the most common site of occurrence. Occasionally, it may extend into small intestine (Rapunzel syndrome. Patients present with nonspecific symptoms such as loss of appetite, early satiety and vomiting. It may present as failure to thrive in small children. Diagnosis is frequently delayed due to paucity of symptoms. It is noticed as a slowly growing lump but occasionally may present with complications such as perforation, intestinal obstruction and pancreatitis. Abdominal ultrasonography is inconclusive and upper gastrointestinal endoscopy confirms the diagnosis. Laparotomy and extraction is the standard of treatment in spite of many new minimally invasive techniques. This is a case of gastric trichobezoar in a 16-year-old girl who presented with gastric outlet obstruction, which was successfully removed surgically. Recurrences are frequent due to associated psychiatric disturbances, hence psychiatric counselling must form an integral part of treatment.

  13. 经尿道铥激光前列腺切除术联合雄激素全阻断治疗晚期前列腺癌合并膀胱出口梗阻的疗效%Thulium laser resection of prostate and antiandrogen therapy in treatment of patients with advanced prostatic cancer accompanied by bladder outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    车建平; 黄建华; 彭波; 许云飞; 耿江; 罗明; 夏盛强; 刘丹; 郑军华

    2012-01-01

    目的 观察经尿道铥激光前列腺切除术联合雄激素全阻断治疗晚期前列腺癌合并膀胱出口梗阻的临床疗效.方法 选择2010年8月-2012年4月在同济大学附属第十人民医院行铥激光前列腺切除术联合雄激素全阻断治疗的晚期前列腺癌患者,观察患者手术前、后总前列腺特异性抗原(tPSA),最大尿流率(MFR),残余尿(RV),国际前列腺症状评分(IPSS)和生活质量评分(QOL)的变化或进展情况.结果 术后1、6、12个月,患者的tPSA水平、IPSS评分、QOL评分及RV均较术前显著降低(P值均<0.05),MFR较术前显著增高(P<0.05).术后12个月,患者的tPSA水平显著高于术后6个月(P<0.05),RV显著高于术后1、6个月(P<0.05).6例骨转移患者在随访期间均未出现新转移灶.1例患者随访至6个月,骨扫描提示T4椎体转移.结论 经尿道铥激光前列腺切除术联合雄激素全阻断治疗晚期前列腺癌合并膀胱出口梗阻简捷、安全、有效,是晚期前列腺癌姑息性治疗的一种重要方法.%Objective To investigate the efficacy of thulium laser resection combined with antiandrogen therapy in treatment of patients with advanced prostatic cancer accompanied by bladder outlet obstruction. Methods We retrospectively reviewed the clinical data of 49 patients diagnosed as advanced prostatic cancer accompanied by bladder outlet obstruction, who were treated in our hospital from August 2010 to April 2012 by thulium laser resection of prostate and antiandrogen therapy. The changes of total prostate specific antigen (Tpsa), maximum urinary flow rate (MFR), residual urine volume (RV), international prostate symptom score (IPSS), and quality of life (QOL) were observed before and after the operation. Results Compared with preoperative ones, Tpsa, IPSS, QOL score and RV were significantly decreased, and MFR were significantly increased 1, 6 and 12 months postoperatively (P<0. 05). Tpsa at 12 months posoperatively was

  14. Gastric outlet obstruction from duodenal lipoma in an adult

    Directory of Open Access Journals (Sweden)

    Promise N Wichendu

    2013-01-01

    Full Text Available The duodenum is a rare site for gastrointestinal lipoma with less than 230 cases reported in the literature. Although, peptic ulcer disease remains the most common benign cause of gastric outlet obstruction (GOO, duodenal lipomas remain a rare, but possible cause of GOO and could pose a diagnostic challenge, especially in countries where access to endoscopy and modern imaging techniques poses a challenge. The authors present a case of GOO in a 40-year-old male, secondary to a duodenal lipoma. It was successfully treated by a transduodenal resection through a midline laparotomy. The histology report confirmed it was a submucosal lipoma.

  15. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

    Directory of Open Access Journals (Sweden)

    Kurtkaya-Yapicier Ozlem

    2003-06-01

    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  16. Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

    Science.gov (United States)

    Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

    2015-06-01

    Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

  17. Rare causes of gastric outlet obstruction in children.

    Science.gov (United States)

    Feng, Jiexiong; Gu, Weizhong; Li, Minju; Yuan, Jiyan; Weng, Yizhen; Wei, Minfa; Zhou, Xuefeng

    2005-08-01

    Gastric outlet obstruction (GOO) presenting beyond the newborn period is a relatively rare condition, when infantile hypertrophic pyloric stenosis (IHPS) is excluded. This report describes the clinical features, evaluation and management of 18 patients with GOO which was not caused by IHPS. The sex, age, and main presenting features were recorded on admission. Hemoglobin estimation, serum chemistry and blood gas analysis were also assessed in these patients. The diagnosis was confirmed with gastrointestinal barium, B ultrasound, gastroscopy, or at surgery. Some of them underwent gastroscopy with biopsy sampling for rapid urease test or histologic examination with Giemsa stains for Helicobacter pylori. Thirteen patients had peptic ulcer disease, of which six were successfully treated with medications. While the other seven needed operative management which included Heineke-Mikulicz pyloroplasty, gastroduodenostomy or gastrojejunostomy, respectively. All the patients who had Heineke-Mikulicz pyloroplasty or gastrojejunostomy developed bile reflux gastritis that could be alleviated with omeprazol. None of the patients developed dumping syndrome, failing to thrive, or anemia. Three children with antral diaphragm recovered without any complications by diaphragm excision with Heineke-Mikulicz pyloroplasty. The pylorus was compressed by fibrotic band in one 30-month boy, and he recovered uneventfully with Heineke-Mikulicz pyloroplasty during 10-year follow-up. Gastric outlet obstruction secondary to ingestion of sulfuric acid was noted in one patient, and he was successfully treated with gastroduodenostomy. Our data suggests that the satisfactory results could be expected in children with GOO with different therapeutic modalities based on the specific cause and degree of obstruction. PMID:16041609

  18. Muscular structure at the male bladder outlet examined with successive colloid in-embedded slices

    Institute of Scientific and Technical Information of China (English)

    翟丽东; 张平

    2015-01-01

    Objective:To re-examine the detailed anatomy of the muscular system at the bladder neck and proximal urethra in the male and to explore its function in urinary continence and micturition further. Methods:The pelvic organs, including bladder, prostate, and rectum, were obtained from 20 formalin-fixed adult male ca-davers and were removed from the pelvic cavity and embedded in celloidin in their entirety. The embedded block was cut into successive slices with an immersing-alcohol microtome. Results:Circular muscle fibers of the detrusor at the bladder outlet consist of the anterior downward projected circular muscle fibers of the bladder outlet ( AD-PC) , the bilateral accumulated circular fibers, and the posterior circular fibers of the bladder outlet. Together, these fibers concentrically surround the internal urethral orifice and trigone muscle. The lower part of the ADPC surrounds the ventral surface of the proximal urethra. Longitudinal muscle fibers are radially inserted into the circu-lar muscle around the internal urethral orifice. Numerous fibers from the ventral longitudinal muscle are inserted in-to the lower part of the ADPC. The upper part of the trigone muscle exists in bladder cavity;the lower part extends into the proximal urethra to surround the posterior and posterolateral surface of the urethra. Conclusions:The AD-PC and the upward extension of the rhabdosphincter comprise the anterior fibromuscular stroma. The circular mus-cle of the bladder outlet may be responsible for closure; the longitudinal muscle of the bladder outlet may be re-sponsible for opening of the internal urethral orifice and proximal urethra.

  19. Use of transvaginal ultrasound in females with primary bladder neck obstruction. A preliminary study

    Directory of Open Access Journals (Sweden)

    Vikiela Galica

    2015-07-01

    Full Text Available Introduction and aim: The video-urodynamics study is the principal exam to establish a possible primary bladder neck obstruction (PBNO condition. While trans-rectal ultrasonography plays an important role in the evaluation of the low urinary tract symptoms (LUTS and the severity of bladder outlet obstruction (BOO in men, the use of the transvaginal ultrasound (TVUS in women with symptoms suggesting BOO remains unclear. We tried to check the utility of the TVUS in women with PBNO condition. Material and methods: We selected female patients which presented BOO without pelvic organ prolapse (POP. According to the data of the video-urodynamic exam we selected the patients with the suspicion of PBNO. A TVUS in basal and during micturition was performed before and after surgery. Results: TVUS showed a closed bladder neck bladder in basal condition and during micturition similarly to the fluoroscopic image during video-urodynamics. The mean distance from bladder neck to the vaginal mucosa resulted 1.3 cm in this patients. Conclusions: TVUS results worthy in the evaluation of patients with PBNO before and after surgery.

  20. Results of radiotherapy on ureteric obstruction in muscle-invasive bladder cancer

    DEFF Research Database (Denmark)

    Honnens De Lichtenberg, Mette; Miskowiak, J; Rolff, H

    1995-01-01

    To evaluate the effect of radiotherapy on ureteric obstruction due to muscle-invasive bladder cancer.......To evaluate the effect of radiotherapy on ureteric obstruction due to muscle-invasive bladder cancer....

  1. 经超声逼尿肌厚度测定在无创诊断女性膀胱出口梗阻中的应用%Ultrasound assessment of bladder detrusor wall thickness for non-invasive diagnosis of female bladder outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    李宁; 薛东炜; 刘春来; 刘屹立; 王平

    2012-01-01

    目的 探讨经超声逼尿肌厚度测定在女性膀胱出口梗阻诊断中的应用价值.方法 93例伴有LUTS的女性患者,行压力流率测定过程中,当膀胱容量为250 ml或最大膀胱容量的50%时,应用7.5 MHz高频线纵超声探头测定膀胱前壁逼尿肌厚度.以Qmax≤12 ml/s以及最大尿流率时逼尿肌压力≥25 cm H2O(1 cm H2O =0.098 kPa)作为诊断女性膀胱出口梗阻的标准,将患者分为梗阻及非梗阻两组,比较两组年龄、尿动力学参数及逼尿肌厚度的差异.应用相对工作特征曲线评价逼尿肌厚度测定作为诊断工具的价值. 结果 梗阻组42例,非梗阻组51例.两组年龄分别为(61.2±8.3)、(59.9±7.7)岁(P=0.44),最大膀胱灌注容量分别为(292.2±82.3)、(308.1±87.5)ml(P =0.37),组间比较差异均无统计学意义;两组最大逼尿肌压力[(43.1±11.2)、(16.2±7.1)cm H2O,P=0.00]、最大尿流率时逼尿肌压力[(34.3±8.2)、(13.1±7.8)cm H2O,P=0.00]、Qmax[(7.4±3.2)、(17.4±4.1)ml/s,P=0.00]、排尿量[(157.1±63.7)、(251.2±77.4)ml,P=0.00]、残余尿量[(117.5±71.3)、(37.7±18.1)ml,P=0.00]及逼尿肌厚度[(1.8±0.3)、(1.4±0.2)mm,P =0.00]比较差异均有统计学意义.当临界值≥1.9 mm时,特异性和阳性预测值均为100%,敏感性为38%,阴性预测值为62%.其曲线下面积为0.88±0.06. 结论 经超声逼尿肌厚度测定诊断女性膀胱出口梗阻具有无创、方便、可靠的特点.当临界值≥1.9 mm时,具有较高的特异度和阳性预测值,在一定程度上可取代压力流率测定.%Objective To evaluate the diagnostic accuracy of ultrasound bladder detrusor wall thickness (DWT) measurement for female bladder outlet obstruction (FBOO) and investigate the application of this non-invasive method for diagnosis of FBOO. Methods DWT was measured by linear ultrasound (7.5 MHz) either at a filling volume of 50% of cystometric capacity or at 250 ml filling in 93 women undergoing pressure flow study (PFS

  2. Bladder outlet reconstruction: fate of the silicone sheath.

    Science.gov (United States)

    Kropp, B P; Rink, R C; Adams, M C; Keating, M A; Mitchell, M E

    1993-08-01

    The placement of a 1.5 cm. wide silicone sheath around a newly constructed urethra/bladder neck to ensure maintenance of repair length and to facilitate future placement of a sphincter cuff was reported by our institution in 1985. We present our long-term followup and new recommendations for use of the silicone sheath. A total of 15 silicone sheaths was placed between March 1981 and July 1984. Of the sheaths 14 were placed at the time of urinary reconstruction around the Young-Dees-Leadbetter bladder neck repair and 1 was placed after erosion of an artificial urinary sphincter cuff. Of the 15 sheaths 10 have eroded into the urethra and 4 sheaths remain in situ. Another sheath was replaced 2 years after its original insertion with an artificial urinary sphincter cuff. Mean time to erosion was 48.2 months, with a range of 2 to 108 months. Long-term followup of 10 patients revealed that 4 ultimately required ligation of the bladder neck and construction of continent stoma after erosion, 1 is dry after placement of a bulbar artificial urinary sphincter, 2 remain dry after removal of the eroded sheath alone, 2 required bladder neck revision to achieve continence after erosion and the most recent patient remains diverted with a suprapubic tube. All 4 patients with sheaths still remaining are dry without evidence of erosion (mean duration 116 months). These long-term results using a silicone wrap around a newly constructed bladder neck reveal an unacceptably high rate of erosion. Therefore, we no longer recommend or support the use of the silicone sheath in the manner we have described for bladder neck reconstruction. PMID:8326628

  3. Surgical palliation of gastric outlet obstruction in advanced malignancy

    Science.gov (United States)

    Potz, Brittany A; Miner, Thomas J

    2016-01-01

    Gastric outlet obstruction (GOO) is a common problem associated with advanced malignancies of the upper gastrointestinal tract. Palliative treatment of patients’ symptoms who present with GOO is an important aspect of their care. Surgical palliation of malignancy is defined as a procedure performed with the intention of relieving symptoms caused by an advanced malignancy or improving quality of life. Palliative treatment for GOO includes operative (open and laparoscopic gastrojejunostomy) and non-operative (endoscopic stenting) options. The performance status and medical condition of the patient, the extent of the cancer, the patients prognosis, the availability of a curative procedure, the natural history of symptoms of the disease (primary and secondary), the durability of the procedure, and the quality of life and life expectancy of the patient should always be considered when choosing treatment for any patient with advanced malignancy. Gastrojejunostomy appears to be associated with better long term symptom relief while stenting appears to be associated with lower immediate procedure related morbidity. PMID:27648158

  4. Video-urodynamics study on female patients with bladder neck obstruction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Peng; YANG Yong; WU Zhi-jin; ZHANG Xiao-dong; ZHANG Chao-hua

    2012-01-01

    Background Pressure-flow study combined with cystourethroscopy were used as the major method to define female bladder neck obstruction in China.However,the definition of urodynamics for female bladder outlet obstruction (BOO) is not clear so far.Video-urodynamic study (VUDS) would provide more information to define the female BOO,but it is not used commonly due to the limitation of video-urodynamic equipment in China.We attempted to find a better way for diagnosis of female BOO by performing VUDS.Methods VUDS and cystourethroscopy were performed in 38 women with signs and symptoms of difficult voiding from March 2008 to April 2010 in Beijing Chao-Yang Hospital.Bladder neck obstruction was defined by radiological evidence of narrowing bladder neck,voiding pressure greater than 20 cmH2O and maximum flow rate (Qmax) less than 12 ml/s.Transurethral incision of bladder neck was then performed on those patients.Follow-up examination (Qmax and residual urine) was recorded 3 months after operation.Results The mean time from its onset to diagnosis was (18.1±9.1) months in 38 patients.Average patient age was 36.1 years (range from 19 to 79 years).The mean Qmax was (10.6±4.7) ml/s and residual urine was (81.5±42.4) ml.Three out of 38 patients had obvious distal urethral stricture,eight of them suffered from definitely bladder neck contracture and the remaining 27 patients did not show obvious abnormalities measured by cystourethroscopy examination.For the 35 patients without urethral stricture,the most frequent findings of VUDS were high-voiding pressure plus low-flow rate and narrow bladder neck during voiding on simultaneous fluoroscopy examination.With video-urodynamics definition,32 patients were diagnosed as bladder neck obstruction with mean Qmax of (10.8±3.7) ml/s,residual urine of (76.9±32.7) ml and detrusor pressure at maximum flow (PdetQmax) of (50.7±19.1) cmH2O.Other three patients were suffered from detrusor hypocontractility.All 32 patients including eight

  5. Impairment of ATP hydrolysis decreases adenosine A1 receptor tonus favoring cholinergic nerve hyperactivity in the obstructed human urinary bladder

    OpenAIRE

    Silva-Ramos, M.; Silva, I; Faria, M.; Magalhães-Cardoso, M. T.; Correia, J.; Ferreirinha, F; Correia-de-Sá, P.

    2015-01-01

    This study was designed to investigate whether reduced adenosine formation linked to deficits in extracellular ATP hydrolysis by NTPDases contributes to detrusor neuromodulatory changes associated with bladder outlet obstruction in men with benign prostatic hyperplasia (BPH). The kinetics of ATP catabolism and adenosine formation as well as the role of P1 receptor agonists on muscle tension and nerve-evoked [3H]ACh release were evaluated in mucosal-denuded detrusor strips from BPH patients (n...

  6. The location of obstruction predicts stent occlusion in malignant gastric outlet obstruction

    Science.gov (United States)

    Grunwald, Douglas; Cohen, Jonah; Bartley, Anthony; Sheridan, Jennifer; Chuttani, Ram; Sawhney, Mandeep S.; Pleskow, Douglas K.; Berzin, Tyler M.; Mizrahi, Meir

    2016-01-01

    Background: Gastric outlet obstruction (GOO) can occur with locally invasive or metastatic cancer involving the upper gastrointestinal tract at the pylorus or the duodenum. Endoscopic management with self-expanding metal stents (SEMSs) is often the preferred palliative approach. Stent occlusion is a common reason for failure and reintervention. We set out to determine whether the location of the malignant obstruction is associated with the angulation of the stent and can predict stent occlusion. Methods: We performed a retrospective review of consecutive patients who underwent successful duodenal stenting with SEMS for malignant GOO between 2006 and 2015 at a large advanced endoscopy referral center. We determined the location of obstruction, the stent angle, and the rate of technical and clinical success of stent placement. We then identified cases of subsequent stent occlusion confirmed by endoscopic evaluation. Results: A total of 100 consecutive patients were included in the study; 91 of these patients had enough data to evaluate SEMS occlusion. A total of 21 patients (23%) developed stent occlusion with a median time of 39 days. The risk of occlusion sequentially increased as the obstruction occurred more distally from the antrum to the third or fourth portion of the duodenum (p = 0.006). This relationship was maintained after controlling for stent angle (p = 0.05). Conclusions: A distal location of malignant GOO was strongly predictive of stent occlusion, independent of stent angle. This may be due to longer and more complex distal obstructions, along with foreshortening of the stent during placement and tumor infiltration. If replicated, these results will have implications for endoscopic practice and future device development. PMID:27803736

  7. Urethral obstruction from dislodged bladder Diverticulum stones: a case report

    Directory of Open Access Journals (Sweden)

    Okeke Linus I

    2012-11-01

    Full Text Available Abstract Background Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. Case presentation A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP and was lost to follow up. He re-presented with retained urethral catheter of 4months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury. Conclusions Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy.

  8. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial

    NARCIS (Netherlands)

    S.M. Jeurnink; E.W. Steyerberg; J.E. van Hooft; C.H.J. van Eijck; M.P. Schwartz; F.P. Vleggaar; E.J. Kuipers; P.D. Siersema

    2010-01-01

    BACKGROUND: Both gastrojejunostomy (GJJ) and stent placement are commonly used palliative treatments of obstructive symptoms caused by malignant gastric outlet obstruction (GOO). OBJECTIVE: Compare GJJ and stent placement. DESIGN: Multicenter, randomized trial. SETTING: Twenty-one centers in The Net

  9. Complete duplication of bladder and urethra: a case report.

    Science.gov (United States)

    Esham, W; Holt, H A

    1980-05-01

    A case of complete duplication of the bladder and urethra in a girl is reported, demonstrating outlet obstruction in the bladder on the left side. Associated anomalies and pertinent literature are reviewed.

  10. Impairment of ATP hydrolysis decreases adenosine A1 receptor tonus favoring cholinergic nerve hyperactivity in the obstructed human urinary bladder.

    Science.gov (United States)

    Silva-Ramos, M; Silva, I; Faria, M; Magalhães-Cardoso, M T; Correia, J; Ferreirinha, F; Correia-de-Sá, P

    2015-12-01

    This study was designed to investigate whether reduced adenosine formation linked to deficits in extracellular ATP hydrolysis by NTPDases contributes to detrusor neuromodulatory changes associated with bladder outlet obstruction in men with benign prostatic hyperplasia (BPH). The kinetics of ATP catabolism and adenosine formation as well as the role of P1 receptor agonists on muscle tension and nerve-evoked [(3)H]ACh release were evaluated in mucosal-denuded detrusor strips from BPH patients (n = 31) and control organ donors (n = 23). The neurogenic release of ATP and [(3)H]ACh was higher (P bladders. Relaxation of detrusor contractions induced by acetylcholine required 30-fold higher concentrations of adenosine. Despite VAChT-positive cholinergic nerves exhibiting higher A(1) immunoreactivity in BPH bladders, the endogenous adenosine tonus revealed by adenosine deaminase is missing. Restoration of A1 inhibition was achieved by favoring (1) ATP hydrolysis with apyrase (2 U mL(-1)) or (2) extracellular adenosine accumulation with dipyridamole or EHNA, as these drugs inhibit adenosine uptake and deamination, respectively. In conclusion, reduced ATP hydrolysis leads to deficient adenosine formation and A(1) receptor-mediated inhibition of cholinergic nerve activity in the obstructed human bladder. Thus, we propose that pharmacological manipulation of endogenous adenosine levels and/or A(1) receptor activation might be useful to control bladder overactivity in BPH patients. PMID:26521170

  11. GASTRIC OUTLET OBSTRUCTION CAUSED BY CYSTIC HETEROTOPIC PANCREAS

    OpenAIRE

    E. Târcoveanu; A. Vasilescu,; N. Vlad; Niculina Florea; C. Stanciu

    2011-01-01

    Heterotopic (ectopic) pancreas is relatively rare and is defined as abnormally situated pancreatic tissue has no contact with the normal pancreas and has its own ductal system and blood supply. It is usually an incidental finding in clinical practice. It most often occurs in the proximal gastrointestinal tract – gastric heterotopic pancreas. It may become clinically evident when complicated by pathological changes such as pancreatitis, cystic dystrophy with obstruction as especially gastric o...

  12. Cost comparison of gastrojejunostomy versus duodenal stent placement for malignant gastric outlet obstruction

    NARCIS (Netherlands)

    Jeurnink, S. M.; Polinder, S.; Steyerberg, E. W.; Kuipers, E. J.; Siersema, P. D.

    2010-01-01

    Gastrojejunostomy (GJJ) and stent placement are the most commonly used palliative treatments for malignant gastric outlet obstruction (GOO). In a recent randomized trial, stent placement was preferred in patients with a relatively short survival and GJJ in patients with a longer survival. As health

  13. Differences of urodynamic tests between patients of detrusor hyperactivity with impaired contractility with and without bladder outlet obstruction and effect of anticholinergic medications in these patients%DHIC和DHIC合并BOO患者在尿动力学检查的差异及抗胆碱能药物治疗的效果

    Institute of Scientific and Technical Information of China (English)

    刘宁; 何峰; 满立波; 黄广林; 王海东; 王海; 李贵忠; 王建伟

    2012-01-01

    Objective To explore the differences of urodynamic parameters and lower urinary symptoms between detrusor hyperactivity with impaired contractility (DHIC) patients and DHIC patients with bladder outlet obstruction (BOO) and evaluate the effects and risks of anticholinergic medications in these palients.Methods A retrospective analysis was performed in 56 DHIC patients at our hospital between February 2000 to February 2011.Among them,19 patients wcre complicated with BOO.Urodynamic studies were conducted and lower urinary symptoms assessed in all patients.Then the urodynamic parameters and lower urinary symptoms scores were compared between the DHIC and DHIC plus BOO patients.Among them,27 received anticholinergic medications and there were 11 BOO patients.After 2-month anticholinergic medications,the differences of lower urinary symptom score were analyzed and anticholinergic-induced retention was also investigated.Results As compared with the DHIC patients,the DHIC plus BOO patients had a higher post-voiding residual urine (70 (23-106)vs 20 (10-81) ml,P =0.02),higher total international prognostic scoring system (IPSS ) score (25.6 ± 3.9 vs 22.1 ± 4.1,P =0.00) and higher total voiding symptom score (15.3 ± 2.9 vs 1 1.8 ± 3.3,P =0.00).After 2-month anticholinergic medications,the IPSS score of DHIC plus BOO patients decreased from 25.7 ±4.6 to 23.6 ±4.9(P =0.01 ),2/11 patients developed urinary retention.The IPSS scores of DHIC patients decreased from 22.8±4.7 to 21.4 ±4.6(P=0.01)and none had urinary retention.Conclusions The DHIC plus BOO patients have more aggravated bladder empting and more severe lower urinary symptoms especially during voiding phase.Anticholinergic medications may alleviate the lower urinary symptoms in DHIC and DHIC plus BOO patients.But anticholinergic-induced retention is common among the DHIC plus BOOpatients.%目的 探讨逼尿肌过度活动伴收缩功能受损(DHIC)患者和DHIC合并膀胱出口梗阻(BOO)患者在尿动力

  14. A CLINICAL STUDY ON GASTRIC OUTLET OBSTRUCTION IN A SOUTH INDIAN TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sailaja

    2015-10-01

    Full Text Available Gastric outlet obstruction is defined as a clinical and patho - physiological consequence of any disease process that produces a mechanical impediment to gastric emptying which may be extrinsic or intrinsic. Gastric outlet obstruction can be a diagnostic and treatment dilemma. Endoscopy of upper gastrointestinal tract has been a sensitive and specific investigation to study the status of gastric outlet - the pylorus and has enabled early detection of lesions of both stomach a nd duodenum. We undertook a prospective clinical study regarding incidence, etiology, investigation and management of cases of Gastric outlet obstruction in adults in a period of three years. In our study the m ost common cause of GOO is Carcinoma stomach a ntral region 46.6% , duodenal ulcer 33.3% , corrosive acid ingestion sequel 8.3%, peri ampullary carcinoma 6.6%, Ca pancreas 3.3%% , cholangio Carcinoma 1.6%. Males are more commonly involved in a ratio of M: F=3:1. Surgical procedures done varied from defini tive resections to palliative bypass or feeding jejunostomy for enteral feeding

  15. Gastrojejunostomy followed by induction chemotherapy for incurable gastric cancer with outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    Yasuhiro; Okumura; Manabu; Ohashi; Souya; Nunobe; Tomohiro; Iwanaga; Tatsuo; Kanda; Yoshiaki; Iwasaki

    2010-01-01

    A 72-year-old male gastric cancer patient with outlet obstruction underwent laparoscopic exploration. The examination disclosed intraperitoneal free cancer cells with no overt peritoneal, lymphatic, or hepatic metastasis. The patient underwent laparoscopy-assisted gastroje-junostomy (LAGJ) and started chemotherapy with S-1 plus cisplatin on postoperative day 13. Three course of the chemotherapy shrank the tumor markedly. Then, the patient underwent gastrectomy with a curative intent. Laparotomy revealed no ...

  16. Isolated rectal diverticulum complicating with rectal prolapse and outlet obstruction: Case report

    Institute of Scientific and Technical Information of China (English)

    Chuang-Wei Chen; Shu-Wen Jao; Huang-Jen Lai; Ying-Chun Chiu; Jung-Cheng Kang

    2005-01-01

    The occurrence of rectal diverticula is very rare, with only sporadic reports in the literature since 1911. Symptomatic rectal diverticula are encountered even less frequently.Treatments of these complicated events range from conservative treatments to major surgical interventions.We present a hitherto unreported occurrence of isolated rectal diverticulum complicated with rectal prolapse and outlet obstruction. Delorme's procedure resulted in subsidence of symptoms and resolution of the diverticulum. It provides a minimal invasive surgical technique to successfully address the reported malady.

  17. Bouveret's syndrome as an unusual cause of gastric outlet obstruction: a case report

    Directory of Open Access Journals (Sweden)

    Joshi Deepak

    2007-08-01

    Full Text Available Abstract An 83 year old caucasian gentleman presented with vomiting and left sided abdominal pain. A subsequent upper GI endoscopy demonstrated a large smooth mass impacted within the duodenum. A cholecysto-duodenal fistula was discovered at laparotomy, with a large gallstone impacted in the duodenum. A diagnosis of Bouveret's syndrome was made. The management of this rare cause of gastric outlet obstruction is discussed.

  18. GASTRIC OUTLET OBSTRUCTION IN PROTON PUMP INHIBITOR ERA: A PROSPECTIVE STUDY OF FIFTY CASES IN TERTIARY HOSPITAL IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2016-01-01

    Full Text Available BACKGROUND Gastric Outlet Obstruction implies complete or incomplete obstruction of the distal stomach pylorus or proximal duodenum. (1 Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is no sufficient data on this subject in our setting. Studies throughout the world shows drastic reduction in peptic ulcer disease (PUD after Proton Pump Inhibitor (PPI era. (1 This study was undertaken to highlight the etiology and treatment of Duodenal Ulcer (DU and its most important complication, gastric outlet obstruction in Tertiary Hospital in South India. This study was done in SRM Medical College Hospital and Research Centre, Chennai, where in for all Gastric Ulcer (GU and Duodenal Ulcer (DU patients, eradication of H. Pylori has become a standard treatment. Surgical treatment is required for complications of peptic ulcer disease. (1 The aim of the study are two: first to analyze sex and age distribution of GU and DU and second to study the various types of management. MATERIALS AND METHODS This study on PUD and Gastric Outlet Obstruction (GOO is based on a study of 50 cases that were admitted in SRM Medical College Hospital and Research Centre during the period of October 2014 to September 2015. The patients were evaluated by routine investigations like upper gastrointestinal endoscopy and ultrasonography of the abdomen. Barium meal and CECT abdomen in selected cases. All cases were taken up for curative/palliative surgery and operated depending upon the causes. All patients with a clinical diagnosis of gastric outlet obstruction were included after informed consent for the study, consecutively enrolled into the study. Statistical data analysis was done using SPSS computer software version 17.0. RESULTS In 37 cases, carcinoma of antrum with gastric outlet obstruction was found. Males are 25 (68% and females are 12 in numbers (32%. In 12 cases of chronic duodenal

  19. Predictors of survival in patients with malignant gastric outlet obstruction: A patient-oriented decision approach for palliative treatment

    NARCIS (Netherlands)

    S.M. Jeurnink; E.W. Steyerberg; F.P. Vleggaar; C.H.J. van Eijck; J.E. van Hooft; M.P. Schwartz; E.J. Kuipers; P.D. Siersema

    2011-01-01

    Background: Gastrojejunostomy and stentplacement are the most commonly used treatments for malignant gastric outlet obstruction (GOO). The preference for either treatment largely depends on the expected survival. Our objective was to investigate predictors of survival in patients with malignant GOO

  20. International Consultation on Incontinence-Research Society (ICI-RS) Report on Non-Invasive Urodynamics: The Need of Standardization of Ultrasound Bladder and Detrusor Wall Thickness Measurements to Quantify Bladder Wall Hypertrophy

    NARCIS (Netherlands)

    M. Oelke

    2010-01-01

    Introduction: Ultrasonic measurements of urinary bladders are suitable to quantify bladder wall hypertrophy due to bladder outlet obstruction, detrusor overactivity, or neurogenic bladder dysfunction in adult men or women and in children. Quantification of bladder wall hypertrophy seems to be useful

  1. Treatment of gastric outlet and duodenal obstructions with uncovered expandable metal stents

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To investigate and evaluate the technical feasibility and clinical effectiveness of fluoroscopically guided peroral uncovered expandable metal stent placement to treat gastric outlet and duodenal obstructions. METHODS: Fifteen consecutive patients underwent peroral placement of WallstentTM Enteral Endoprosthesis to treat gastric outlet and duodenal obstructions (14 malignant, 1 benign). All procedures were completed under fluoroscopic guidance without endoscopic assistance. Follow-up was completed until the patients died or were lost, and the clinical outcomes were analyzed. RESULTS: The technique success rate was 100%, and the oral intake was maintained in 12 of 14 patients varying from 7 d to 270 d. Two patients remained unable to resume oral intake, although their stents were proven to be patent with the barium study. One patient with acute necrotizing pancreatitis underwent enteral stenting to treat intestinal obstruction, and nausea and vomiting disappeared. Ten patients died during the followup period, and their mean oral intake time was 50 d. No procedure-related complications occurred. Stent migration to the gastric antrum occurred in one patient 1 year after the procedure, a tumor grew at the proximal end of the stent in another patient 38 d post-stent insertion. CONCLUSION: Fluoroscopically guided peroral metal stent implantation is a safe and effective method to treat malignant gastrointestinal obstructions, and complications can be ignored based on our short-term study. Indications for this procedure should be discreetly considered because a few patients may not benefit from gastrointestinal insertion, but some benign gastrointestinal obstructions can be treated using this procedure.

  2. A newly designed big cup nitinol stent for gastric outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To find out whether a newly designed big cup nitinol stent is suitable for treatment of patients with gastric outlet obstruction resulting from gastric cancer.METHODS:The new stent is composed of a proximal big cup segment(20 mm in length and 48-55 mm in diameter),a middle part(60 mm in length and 20 mm in diameter)covered by a polyethylene membrane and a distal sphericity(20 mm in length and 28 mm in diameter).Half of the proximal big cup segment is also covered by a polyethlene membrane,which is adjac...

  3. Successful Multimodality Endoscopic Treatment of Gastric Outlet Obstruction Caused by an Impacted Gallstone (Bouveret's Syndrome

    Directory of Open Access Journals (Sweden)

    Jason N. Rogart

    2008-01-01

    Full Text Available Bouveret's syndrome is a rare condition of gastric outlet obstruction resulting from the migration of a gallstone through a choledochoduodenal fistula. Due to the large size of these stones and the difficult location in which they become impacted, endoscopic treatment is unsuccessful and most patients require surgery. We report the case of an elderly male who presented with nausea and hematemesis, and was found on CT scan and endoscopy to have an obstructing gallstone in his duodenal bulb. After several endoscopic sessions and the use of multiple instruments including a Holmium: YAG laser and electrohydraulic lithotripter, fragmentation and endoscopic removal of the stone were successful. We believe this to be the first case of Bouveret's syndrome successfully treated by endoscopy alone in the United States. We describe the difficulties encountered which necessitated varied and innovative therapeutic techniques.

  4. Distended bladder presenting with constipation and venous obstruction: a case report

    Directory of Open Access Journals (Sweden)

    Sharma Anu

    2012-01-01

    Full Text Available Abstract Introduction A distended urinary bladder has been known to cause venous obstruction or rarely bowel obstruction. We report the first case in the literature in which urinary bladder distension presented with both venous obstruction and constipation. This is an unusual presentation of urinary bladder distension and serves to broaden our differential diagnoses for a patient with clinical venous obstruction. Case presentation An 83-year-old man of African descent presented with constipation and bilateral lower limb edema. A huge abdominal mass was evident which was a large, distended urinary bladder confirmed by computed tomography. Promptly after urethral catheterization, both constipation and lower limb edema resolved. Conclusions To the best of our knowledge distended urinary bladder causing both constipation and lower limb edema has never previously been reported. Analysis of the literature revealed several factors resulting in the patient's presentation. A high level of suspicion for urinary bladder distension must be maintained for prompt diagnosis and to avoid improper management.

  5. Gastric outlet obstruction caused by heterotopic pancreas: A case report and a quick review

    Institute of Scientific and Technical Information of China (English)

    Li-Xin Jiang; Jie Xu; Xue-Wen Wang; Fu-Run Zhou; Wei Gao; Guo-Hua Yu; Zhong-Chuan Lv; Hai-Tao Zheng

    2008-01-01

    A 46-year-old Chinese woman presented with nausea,recurrent vomiting,and abdominal pain.Gastroduodenal endoscopic examination revealed an oval-shaped submucosal tumor at the prepyloric area on the posterior wall of the stomach.A degenerated gastrointestinal stromal tumor was suspected.Distal gastrectomy was performed and a histological diagnosis of heterotopic pancreas (HPs) was confirmed.The patient had an uneventful postoperative course and was discharged 7 d after operation.The patient remains healthy and symptom-free in the follow-up of 6 mo.This is a report of a case of gastric outlet obstruction resulting from pancreatic heterotopia in the gastric antrum in an adult woman.

  6. Unusual appearance for urinary bladder obstruction detected with 99mTc-MDP bone scintigraphy.

    Science.gov (United States)

    Wright, Chadwick L; Sharma, Akash

    2015-12-01

    Unanticipated but clinically significant nonosseous findings can be detected during routine bone scintigraphy. We present a case of an 83-year-old man who presented with a pathologic fracture of the right femur. Whole-body bone scintigraphy for osseous staging revealed intense radiotracer accumulation in the kidneys and ureters but no activity within the urinary bladder. The patient had not voided for 14 hours. A Foley catheter was inserted, and more than 2000 mL of urine was drained, most consistent with urinary bladder obstruction. Subsequent repeat images demonstrated marked reduction of the renal and ureteral activity with trace activity in the urinary bladder.

  7. Demographic and etiological patterns of gastric outlet obstruction in Kerala, South India

    Directory of Open Access Journals (Sweden)

    Vivek Sukumar

    2015-01-01

    Full Text Available Background: In the modern era, the major cause of gastric outlet obstruction (GOO is known to be a malignancy, especially in the developed world. Many books and articles do suggest that the benign causes continue to be the major cause of GOO in the developing world however, there is growing evidence proving the contrary. Males were (more commonly affected females and individuals in their fifth and sixth decade have been the predominant age group in the majority of studies. There is a minimal data of GOO from South India. Aims: A retrospective analysis of the endoscopic findings of patients presenting with features of GOO to determine the demographic and etiological patterns. Materials and Methods: A retrospective study of the endoscopic findings of patients with GOO from January 2005 to January 2014 was done. The diagnosis of GOO was based on clinical presentation, and an inability during the upper endoscopy to enter the second portion of the duodenum as documented in the endoscopy registers. Patients who have already been diagnosed with malignancy prior to the endoscopy were excluded from the study; so were the patients with gastroparesis. Results: A total of 342 patients with GOO underwent the endoscopy during the study period. The causes for benign obstruction were predominantly peptic ulcer disease. The major cause for malignant obstruction was carcinoma of stomach involving the distal stomach. The male to female ratio was 3.2:1. The patients with malignancy were older than patients with benign disorders. Most of the patients were in the sixth and seventh decade. The risk of malignancy was higher with increasing age, especially in women. A fourth of all carcinoma stomach presented with GOO. Conclusion: The study demonstrates that the cause for GOO in Kerala, South India is predominantly malignancy. The etiological and demographic patterns were similar to the studies conducted in the developed nations.

  8. Bilateral ureteral complete obstruction with huge spontaneous urinoma formation in a patient with advanced bladder cancer.

    Science.gov (United States)

    Jou, Yeong-Chin; Shen, Cheng-Huang; Cheng, Ming-Chin; Lin, Chang-Te; Chen, Pi-Che

    2012-02-01

    Spontaneous rupture of the collecting system with extravasation of urine and urinoma formation is usually associated with urinary tract obstruction by a ureteral calculus. Tumor growth is an extremely rare cause of urinary extravasation. Here we report a case of bilateral obstructive uropathy with a huge spontaneous left retroperitoneal urinoma caused by advanced infiltrative transitional cell carcinoma of the urinary bladder. The point of leakage was located in the left renal pelvis. The urinary leakage ceased after percutaneous nephrostomy drainage, and the patient subsequently underwent radical cystoprostatectomy. Histopathology revealed a high-grade urothelial carcinoma of the urinary bladder with pelvic lymph node metastasis. The patient refused any adjuvant treatment and expired 6 months after the operation from disseminated metastasis from bladder cancer.

  9. Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer

    Institute of Scientific and Technical Information of China (English)

    Tae Oh Kim; Dae Hwan Kang; Gwang Ha Kim; Jeong Heo; Geun Am Song; Mong Cho; Dong Heon Kim; Mun Sup Sim

    2007-01-01

    AIM: To ascertain clinical outcome and complications of self-expandable metal stents for endoscopic palliation of patients with malignant obstruction of the gastrointestinal (GI) tract.METHODS: A retrospective review was performed throughout August 2000 to June 2005 of 53 patients with gastric outlet obstruction caused by stomach cancer. All patients had symptomatic obstruction including nausea, vomiting, and decreased oral intake. All received self-expandable metallic stents.RESULTS: Stent implantation was successful in all 53 (100%) patients. Relief of obstructive symptoms was achieved in 43 (81.1%) patients. No immediate stent-related complications were noted. Seventeen patients had recurrent obstruction (tumor ingrowth in 14 patients, tumor overgrowth in 1 patient, and partial distal stent migration in 2 patients). The mean survival was 145 d. Median stent patency time was 187 d.CONCLUSION: Endoscopic placement of self-expandable metallic stents is a safe and effective treatment for the palliation of patients with inoperable malignant gastric outlet obstruction caused by stomach cancer.

  10. An Unusual Lesser Sac Collection Causing Gastric Outlet Obstruction with Coincidental Occurrence of Leriche's Syndrome: A Case Report.

    Science.gov (United States)

    Singla, Anand; Walia, Darshanjeet Singh; Kaur, Rishabhpreet

    2016-04-01

    Gastric outlet obstruction in adults is usually caused by pyloric stenosis secondary to peptic ulcer disease or malignancy. However, there are few other causes such as a foreign body and external compression due to pseudocyst pancreas. We present a rare aetiology of a large collection of pus in the lesser sac in our patient causing gastric outlet obstruction. A perforated peptic ulcer was suspected in our patient who had symptoms of sudden onset pain in epigastric region which was referred to back. This was followed by pain in upper abdomen, vomiting, constipation and fever for which patient was being managed conservatively before being referred to us. The CECT didn't show any leakage of contrast to the lesser sac making the possibility of healed perforation likely as all other causes were ruled out at the time of presentation to our hospital. The CECT scan ruled out other causes of gastric outlet obstruction with normal wall thickness of the stomach and duodenum along with normal looking liver, pancreas and no lymphadenopathy. The liver function tests and serum amylase were within normal limits. Along with this, there was another unrelated rare coincidental finding of aortoiliac occlusive disease termed as Leriche's syndrome. Ultrasound guided percutaneous drainage was done following which the patient's obstruction was relieved and patient was referred to the department of vascular surgery for the mangement of aortoiliac occlusive disease. PMID:27190892

  11. Treatment of gastric outlet obstruction that results fromunresectable gastric cancer: Current evidence

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Malignant gastric outlet obstruction (GOO) is a commoncondition that results from locally advanced malignanciesin the upper gastrointestinal tract, such aspancreatic, gastric, and other carcinomas. Two typesof procedures for malignant GOO, namely, gastrojejunostomy(GJ) with laparotomy or a laparoscopicapproach and endoscopic stenting (ES), are currentlyavailable. Although numerous previous reports haveclarified the benefits and drawbacks of each procedure,whether GJ or ES should be used in patients with GOOthat results from gastric cancer who may have a longerlife expectancy than patients with other malignancieshas not been determined. In this review, which focuseson gastric cancer-induced GOO, we analyzed the twosystematic reviews and a meta-analysis that comparedGJ and ES and outlined the current status of GOOtreatment. We also provide an updated review thatincludes laparoscopic GJ. Various data from 13 studiesin one review and 6 studies in another review wereanalyzed. Although the main results of the presentreview indicated that both GJ and ES were efficacioustreatments in patients with GOO that resulted fromgastric cancer, current evidence suggests that GJ maybe the preferable procedure given its good performancestatus and improved prognosis in gastric cancer patients.

  12. Late-onset hypertrophic pyloric stenosis with gastric outlet obstruction: case report and review of the literature.

    Science.gov (United States)

    Wolf, Lindsey L; Nijagal, Amar; Flores, Alejandro; Buchmiller, Terry L

    2016-10-01

    We report late-onset hypertrophic pyloric stenosis in a 17-year-old female. She presented with abdominal pain and an episode of upper gastrointestinal hemorrhage and subsequently developed gastric outlet obstruction. Work-up revealed circumferential pyloric thickening, delayed gastric emptying, and a stenotic, elongated pyloric channel. Biopsies showed benign gastropathy, negative for Helicobacter pylori, without eosinophilic infiltrates. Botulinum toxin injection provided limited relief. Diagnostic laparoscopy confirmed the hypertrophic pylorus and we performed laparoscopic pyloromyotomy. The patient tolerated the procedure well and had complete symptom resolution at 1-year follow-up. Hypertrophic pyloric stenosis is a rare cause of gastric outlet obstruction in adolescents and may be managed successfully with laparoscopic pyloromyotomy. PMID:27506212

  13. Treatment of female primary bladder neck obstruction with transurethral resection of bladder neck and pathological analysis%女性原发性膀胱颈梗阻的TURBN手术治疗及病理结果分析

    Institute of Scientific and Technical Information of China (English)

    张晓鹏; 胡浩; 张国喜; 王晓峰; 许克新

    2012-01-01

    目的 探讨经尿道膀胱颈切开术(TURBN)治疗女性原发性膀胱颈梗阻(PBNO)的疗效及病理结果分析.方法 22例PBNO患者术前进行体检、尿常规、美国泌尿外科学会(AUA)评分、尿动力学检查、超声检查和膀胱尿道镜检查.采用BlaivasGroutz计算图诊断膀胱出口梗阻,以Olympus标准电切镜行TURBN手术,术后留置尿管24~72 h.结果 在22例患者中,4例为重度梗阻,10例为中度梗阻,8例为轻度梗阻.膀胱尿道镜检查可发现膀胱颈后唇抬高,膀胱壁小梁样增生.术后12个月复查,主观症状和客观指标均显著改善.术后病理检查提示腺性膀胱炎、纤维组织增生和慢性炎症.结论 对于药物治疗效果不佳的PBNO患者建议采用TURBN手术治疗.%Objective To investigate the outcomes of female primary bladder neck obstruction ( PBNO) treated with transurethral resection of bladder neck (TURBN), and perform the pathological analysis. Methods Twenty-two women with PBNO were recruited, and preoperative examinations were conducted, including physical examination, urine routine, American Urological Association scoring, urodymamics, ultrasonography and cystoscopy. Bladder outlet obstruction was diagnosed according to Blaivas-Groutz nomogram, TURBIS was performed with Olympus standard resectoseope, and urinary catheter was retained for 24 to 72 h after operation. Results There were 4 patients with severe obstruction, 10 patients with moderate obstruction and 8 patients with mild obstruction. Elevated posterior lip of bladder neck and trabecula hyperplasia of bladder wall were observed through cystoscopy. Twelve months after operation, all the symptoms and parameters were improved. Pathological examinations revealed glandular cystitis, fibrous tissue hyperplasia and chronic inflammation. Conclusion TURBN is an effective and safe method in treatment of PBNO, especially for patients with unsuccessful pharmacotherapy.

  14. Bladder outflow obstruction caused by prostate metastasis in a young male

    Energy Technology Data Exchange (ETDEWEB)

    Unterweger, M.; Marincek, B.; Kubik-Huch, R.A. [UniversitaetsSpital Zuerich, Zurich (Switzerland). Inst. fuer Diagnostische Radiologie; Hailemariam, S. [Dept. of Pathology, University Hospital, Zurich (Switzerland); Reilly, I. [Clinic of Urology, University Hospital, Zurich (Switzerland)

    2001-10-01

    A 38-year-old male patient presented with symptoms of bladder outflow obstruction. Rectal palpation revealed a giant prostate. Sonography only confirmed the enlarged prostate. Magnetic resonance imaging showed, on both T1- and T2-weighted sequences, a large, inhomogenously hypointense, encapsulated prostate tumor encompassing the entire prostate. No capsular penetration or seminal vesicle invasion was seen. Transurethral biopsy of the prostate was performed. Histology demonstrated a prostate metastasis of colorectal carcinoma. (orig.)

  15. GASTRIC OUTLET OBSTRUCTION: AN OVERVIEW CLINICAL PRESENTATION AND ITS SURGICAL MANAGEMENT IN A TERTIARY CARE GOVERNMENT HOSPITAL

    Directory of Open Access Journals (Sweden)

    Nataraj Naidu

    2014-10-01

    Full Text Available INTRODUCTION: Gastric outlet obstruction (GOO mechanically impedes gastric emptying, normal emptying of the stomach. It is a diagnostic and therapeutic challenge for general surgeons in their daily practice. There is a paucity of publications regarding GOO in our setting. This paper highlights the etiology, clinical presentation and treatment outcome of GOO. METHODS: A Prospective study was conducted enrolling patients with GOO treated at Victoria hospital, Bangalore medical college during September 2008 to august 2010. Data was tabulated and analyzed using descriptive statistical methodology. RESULTS: carcinoma stomach with antral growth and cicatrized duodenal ulcer (both 41.5% were the most common cause of gastric outlet obstruction. Male were more affected than females (2.5:1. Most common symptom was vomiting and abdominal pain (noted among all, followed by loss of appetite (83% and loss of weight (82.35%. 94.1% patients of Cicatrized duodenal ulcer underwent truncal vagotomy with posterior gastrojejunostomy and 5.9% underwent truncal vagotomy with antrectomy. 58.8% patients of carcinoma stomach, underwent distal gastrectomy with ante-colic Roux-en-Y gastro- jejunostomy, 12.1% patients underwent subtotal gastrectomy with ante-colic and Roux-en-Y gastro jejunostomy and 4.8% patients underwent palliative gastrojejunostomy. In corrosive antral stricture Billroth I gastrectomy was done. Patients of pancreatic malignancy underwent palliative anterior gastrojejunostomy and pseudo- pancreatic cyst was treated by cystojejunostomy. The average hospital stay was 12-15 days and an overall mortality of 5.8% for malignant patients was noted. CONCLUSION: Study concludes that gastric outlet obstruction is an important and a common surgical condition in tertiary hospital. Malignancy and benign cicatrized duodenal ulcer being the most common cause. Early surgical intervention is of paramount importance to avoid the morbidity and mortality associated with GOO.

  16. Lateral sphincteromyotomy in patients with outlet obstruction after surgery for Hirschsprung's disease and short-segment disease

    DEFF Research Database (Denmark)

    Vorm, Hanne N; Jensen, Susanne I; Qvist, Niels

    2002-01-01

    The results of lateral sphincteromyotomy (LSM) including the external sphincter in patients with severe outlet obstruction (OO) and constipation refractory to medical treatment after surgery for Hirschsprung's disease (HD) or with short-segment disease were evaluated. The parents filled out...... a detailed questionnaire on the child's bowel habits prior to surgery and at follow-up 2-26 months after surgery. The postoperative questionnaire included a 10-grade visual analog scale (VAS) indicating the general effect of LSM on the child's bowel habits: grade 1 represented no change at all and 10...

  17. [Utility of the WallFlexTM duodenal stent for unresectable advanced gastric cancer related to gastric outlet obstruction].

    Science.gov (United States)

    Aoki, Taro; Hyuga, Satoshi; Kato, Aya; Chono, Teruhiro; Watanabe, Risa; Komori, Takamichi; Matsumoto, Takashi; Takachi, Kou; Nishioka, Kiyonori; Uemura, Yoshio; Kobayashi, Kenji

    2012-11-01

    Duodenal stenting for malignant disease related to gastric outlet obstruction(GOO) has been covered by health insurance in Japan since April 2010. We inserted WallFlexTM duodenal stents(WDS) in 4 patients with GOO caused by unresectable gastric cancer. WDS insertion was successful in all 4 cases. Duodenal perforation occurred in 1 case. One case each of stent obstruction and stent migration occurred. All patients could eat a soft-food diet for 3-6 months (median, 5.3 months). Survival time ranged between 5 and 14 months (median, 6 months). Three patients underwent S-1 combination chemotherapy. Duodenal stenting is expected to be effective for advanced gastric cancer related to GOO.

  18. Long-Term Palliative Effect of Stenting in Gastric Outlet Obstruction Due to Transarterial Chemoembolization with Yttrium-90 in a Patient with Metastatic Neuroendocrine Tumor

    Science.gov (United States)

    Caglar, Erkan; Doğusoy, Gulen; Kabasakal, Levent; Dobrucali, Ahmet

    2016-01-01

    Internal radioembolization with yttrium-90 is a promising treatment method, predominantly for liver tumors. However, the shifting of yttrium-90-loaded spherules into the arteries and veins that supply the duodenum and stomach, leading to ulceration, hemorrhage, perforation, and outlet obstruction of these organs, is one of the major undesirable consequences of this technique. We report a case of gastric outlet obstruction (GOO) due to antropyloric stenosis with ulceration, edema, and inflammation following transarterial yttrium-90 treatment for a metastatic neuroendocrine tumor in a 58-year-old man. Stenting was used for palliation in this case. GOO improved after stenting and recovery of oral intake was permanent after stent removal. PMID:27353368

  19. A challenging case of gastric outlet obstruction (Bouveret's syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Gelrud Andres

    2011-10-01

    Full Text Available Abstract Introduction Bouveret's syndrome is a clinically distinct form of gallstone ileus caused by the formation of a fistula between the biliary tract and duodenum. This case reinforces the need for early recognition and treatment of Bouveret's syndrome, as it is associated with high morbidity and mortality rates. Case presentation An 82-year-old Caucasian woman presented with signs and symptoms of small bowel obstruction. Her laboratory workup showed elevated alkaline phosphatase and amylase levels. Computed tomography of her abdomen revealed pneumobilia, a choledochoduodenal fistula and a gallstone obstructing her distal duodenum. The impacted gallstone could not be extracted endoscopically, so our patient underwent open enterolithotomy successfully. However, the postoperative course was complicated by myocardial infarction, respiratory failure and disseminated intravascular coagulation. She died 22 days after surgery, secondary to cardiopulmonary arrest. Conclusion This case clearly highlights the considerable morbidity and mortality associated with Bouveret's syndrome.

  20. What is the value of proctography for diagnostic of outlet obstruction?

    OpenAIRE

    Maria Auxiliadora Prolungatti Cesar; Wilmar Artur Klug; Jorge Alberto Ortiz; Chia Bin Fang; Peretz Capelhuchmik

    2011-01-01

    The diagnosis of constipation is complicated due to the multiplicity and complexity of the causes. Regarding diagnostic tests, proctography is the best choice because it provides information on functions and visualization of abnormalities. Objective: To measure the isolated value of proctography in patients with obstructed defecation. Method: We evaluated 40 constipated patients at the Coloproctology Clinic of Santa Casa de Misericórdia de São Paulo. The test was performed by introducing 120 ...

  1. Intermittent gastric outlet obstruction due to a gallstone migrated through a cholecysto-gastric fistula: A new variant of "Bouveret's syndrome"

    Institute of Scientific and Technical Information of China (English)

    Dimitry Arioli; Mario De Santis; Fabrizio Di Benedetto; Giorgio Enrico Gerunda; Maria Luisa Zeneroli; Ivo Venturini; Michele Masetti; Elisa Romagnoli; Antonella Scarcelli; Pietro Ballesini; Athos Borghi; Alessandro Barberini; Vincenzo Spina

    2008-01-01

    Bouveret's syndrome, defined as gastric outlet obstruction due to a large gallstone, is still one of the most dramatic biliary gallstone complications. Although new radiological and endoscopic techniques have made pre-surgical diagnosis possible in most cases and the death rate has dropped dramatically, "one-stage surgery" (biliary surgery carried out at the same time as the removal of the gut obstruction) should be still considered as the gold standard for the treatment of gallstone ileus. In this case, partial gastric outlet obstruction resulted in an atypical and insidious clinical presentation that allowed us to perform the conventional one-stage laparatomic procedure that completely solved the problem, thus avoiding any further complications.

  2. Treatment of malignant gastric outlet obstruction with endoscopically placed self-expandable metal stents

    Institute of Scientific and Technical Information of China (English)

    Jill KJ Gaidos; Peter V Draganov

    2009-01-01

    Malignant gastroduodenal obstruction can occur in up to 20% of patients with primary pancreatic, gastric or duodenal carcinomas. Presenting symptoms include nausea, vomiting, abdominal distention, pain and decreased oral intake which can lead to dehydration, malnutrition, and poor quality of life. Endoscopic stent placement has become the primary therapeutic modality because it is safe, minimally invasive, and a cost-effective option for palliation. Stents can be successfully deployed in the majority of patients. Stent placement appears to lead to a shorter time to symptomatic improvement, shorter time to resumption of an oral diet, and shorter hospital stays as compared with surgical options. Recurrence of the obstructive symptoms resulting from stent occlusion, due to tumor ingrowth or overgrowth, can be successfully treated with repeat endoscopic stent placement in the majority of the cases. Both endoscopic stenting and surgical bypass are considered palliative treatments and, to date, no improvement in survival with either modality has been demonstrated. A tailored therapeutic approach, taking into consideration patient preferences and involving a multidisciplinary team including the therapeutic endoscopist, surgeon, medical oncologist, radiation therapist, and interventional radiologist, should be considered in all cases.

  3. Multiscale Entropy Analysis of Surface Electromyographic Signals from the Urethral Sphincter as a Prognostic Indicator for Surgical Candidates with Primary Bladder Neck Obstruction

    OpenAIRE

    Hsien-Tsai Wu; Yuan-Hong Jiang; An-Bang Liu; Chun-Wei Liu; Yu-Nian Ou; Hann-Chorng Kuo; Cheuk-Kwan Sun

    2015-01-01

    To explore information hidden in the electromyographic (EMG) signals of the urethral sphincter that may be of prognostic significance for patients with primary bladder neck obstruction (PBNO), 41 patients with voiding difficulty were divided into four groups: 1) patients with primary bladder neck obstruction (PBNO) with successful (Group 1, n = 14) and 2) unsuccessful (Group 2, n = 8) surgical outcomes, 3) patients with detrusor overactivity (Group 3, n = 7), and 4) patients with detrusor-ext...

  4. What is the value of proctography for diagnostic of outlet obstruction?

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Prolungatti Cesar

    2011-09-01

    Full Text Available The diagnosis of constipation is complicated due to the multiplicity and complexity of the causes. Regarding diagnostic tests, proctography is the best choice because it provides information on functions and visualization of abnormalities. Objective: To measure the isolated value of proctography in patients with obstructed defecation. Method: We evaluated 40 constipated patients at the Coloproctology Clinic of Santa Casa de Misericórdia de São Paulo. The test was performed by introducing 120 mL of barium contrast in the rectum and by analyzing the different stages of evacuation. Three x-rays were performed in the lateral position: rest, anal contraction and evacuation. Results: The diagnoses were: rectocele: 2 (5.0%; anismus: 8 (20.0%; perineal descent: 13 (32.5%; sigmoidocele: 6 (15.0%; internal invagination: 10 (25.0%; rectocele + sigmoidocele 9 (22.5%; rectocele + internal invagination 11 (27.5%; rectocele + anismus: 18 (45.0%. Several patients presented multiple disorders. Conclusion: Constipation by obstructed defecation depends on multiple factors and it is important to have an accurate diagnosis. Proctography is essential, but insufficient as a single procedure. The other tests contribute with the diagnosis, therefore, they should be included in the investigation.O diagnóstico da constipação é difícil pela multiplicidade e complexidade das causas. Dos exames diagnósticos, a proctografia é preferida, fornecendo informações da função e visualização de anormalidades. Objetivo: Medir o valor isolado da proctografia, em pacientes com diagnóstico de defecação obstruída. Método: Avaliamos 40 pacientes com constipação intestinal do Ambulatório de Coloproctologia da Santa Casa de Misericórdia de São Paulo. O exame foi feito introduzindo-se 120 mL de contraste no reto e analisando-se as diferentes fases da evacuação. Foram realizadas três radiografias na posição lateral: repouso, contração anal e evacua

  5. Functional and molecular evidence for Kv7 channel subtypes in human detrusor from patients with and without bladder outflow obstruction.

    Directory of Open Access Journals (Sweden)

    Julie Svalø

    Full Text Available The aim of the study was to investigate whether Kv7 channels and their ancillary β-subunits, KCNE, are functionally expressed in the human urinary bladder. Kv7 channels were examined at the molecular level and by functional studies using RT-qPCR and myography, respectively. We found mRNA expression of KCNQ1, KCNQ3-KCNQ5 and KCNE1-5 in the human urinary bladder from patients with normal bladder function (n = 7 and in patients with bladder outflow obstruction (n = 3. Interestingly, a 3.4-fold up-regulation of KCNQ1 was observed in the latter. The Kv7 channel subtype selective modulators, ML277 (activator of Kv7.1 channels, 10 μM and ML213 (activator of Kv7.2, Kv7.4, Kv7.4/7.5 and Kv7.5 channels, 10 μM, reduced the tone of 1 μM carbachol pre-constricted bladder strips. XE991 (blocker of Kv7.1-7.5 channels, 10 μM had opposing effects as it increased contractions achieved with 20 mM KPSS. Furthermore, we investigated if there is interplay between Kv7 channels and β-adrenoceptors. Using cumulative additions of isoprenaline (β-adrenoceptor agonist and forskolin (adenylyl cyclase activator in combination with the Kv7 channel activator and blocker, retigabine and XE991, we did not find interplay between Kv7 channels and β-adrenoceptors in the human urinary bladder. The performed gene expression analysis combined with the organ bath studies imply that compounds that activate Kv7 channels could be useful for treatment of overactive bladder syndrome.

  6. Antepartum fetal bladder rupture leading to urinary ascitis: attempt to rescue by placement of peritoneo-amniotic shunt

    OpenAIRE

    Singh, Nilanchali; Tripathi, Reva; Tyagi, Shakun; Batra, Atul

    2013-01-01

    Fetal bladder rupture is a rare complication occurring due to bladder outlet obstruction, mostly posterior urethral valves. A 26-year-old primigravida presented to us at 27 weeks gestation with an ultrasound report showing gross fetal ascitis and mild oligohydramnios. A repeat scan was performed which showed fetal bladder rupture and urinary ascitis. In conjunction with paediatric surgeon, we performed ultrasound-guided placement of double-ended pigtail catheter connecting the fetal peritonea...

  7. Obstructive uropathy

    Science.gov (United States)

    ... suddenly, or be a long-term problem. Common causes of obstructive uropathy include: Bladder stones Kidney stones Benign prostatic hyperplasia (enlarged prostate) Bladder or ureteral cancer Colon cancer Cervical cancer Uterine cancer Any cancer ...

  8. Development of a duodenal gallstone ileus with gastric outlet obstruction (Bouveret syndrome four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis: a case report

    Directory of Open Access Journals (Sweden)

    Winnekendonk Guido

    2010-11-01

    Full Text Available Abstract Introduction Cases of gallstone ileus account for 1% to 4% of all instances of mechanical bowel obstruction. The majority of obstructing gallstones are located in the terminal ileum. Less than 10% of impacted gallstones are located in the duodenum. A gastric outlet obstruction secondary to a gallstone ileus is known as Bouveret syndrome. Gallstones usually enter the bowel through a biliary enteral fistula. Little is known about the formation of such fistulae in the course of gallstone disease. Case presentation We report the case of a 72-year-old Caucasian woman born in Germany with a gastric outlet obstruction due to a gallstone ileus (Bouveret syndrome, with a large gallstone impacted in the third part of the duodenum. Diagnostic investigations of our patient included plain abdominal films, gastroscopy and abdominal computed tomography, which showed a biliary enteric fistula between the gallbladder and the duodenal bulb. Our patient was successfully treated by laparotomy, duodenotomy, extraction of the stone, cholecystectomy, and resection of the fistula in a one-stage surgical approach. Histopathological examination showed chronic and acute cholecystitis, with perforated ulceration of the duodenal wall and acute purulent inflammation of the surrounding fatty tissue. Four months prior to developing a gallstone ileus our patient had been hospitalized for cholecystitis, a large gallstone in the gallbladder, cholangitis and a small obstructing gallstone in the common biliary duct. She had been treated with endoscopic retrograde cholangiopancreatography, endoscopic biliary sphincterotomy, balloon extraction of the common biliary duct gallstone, and intravenous antibiotics. At the time of her first presentation, abdominal ultrasound and endoscopic examination (including esophagogastroduodenoscopy and endoscopic retrograde cholangiopancreatography had not shown any evidence of a biliary enteral fistula. In the four months preceding the

  9. Successful treatment with a combination of endoscopic injection and irrigation with coca cola for gastric bezoar-induced gastric outlet obstruction.

    Science.gov (United States)

    Lin, Chen-Sheng; Tung, Chun-Fang; Peng, Yen-Chun; Chow, Wei-Keung; Chang, Chi-Sen; Hu, Wei-Hsiung

    2008-01-01

    We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola. A 73-year-old diabetic woman had a history of perforated peptic ulcer and had received pyloroplasty more than 20 years previously. She had been ingesting Pho Pu Zi (Cordia dichotoma Forst. f.) as an appetizer for 1 month. She presented with epigastric pain, nausea, and vomiting. Upper gastrointestinal endoscopy, performed at a local hospital, showed 2 gastric bezoars in the stomach, and 1 of them impacted at the pylorus. She was referred to our emergency department for removal of the gastric bezoars that were suspected to be causing gastric outlet obstruction. All attempts at endoscopic removal using a polypectomy snare, biopsy forceps and Dormia basket failed. We then injected Coca Cola directly into the bezoar mass, followed by irrigation with Coca Cola. Follow-up endoscopy was performed the next day, which revealed that the gastric bezoars had dissolved spontaneously.

  10. The fish-hook configuration of the distal ureter indicates bladder outlet obstruction due to benign prostatic hyperplasia

    OpenAIRE

    Mamoulakis, Charalampos; Herrmann, Thomas R.W.; Höfner, Klaus; Oelke, Matthias

    2010-01-01

    Purpose The aim of this retrospective study was to evaluate in a historical series of patients whether morphological changes of the urinary tract imaged on intravenous urography (IVU) are associated with clinical or urodynamic data. Methods During a 1-year period, every man 45 years or older with lower urinary tract symptoms suggestive of benign prostatic hyperplasia was systematically evaluated with multi-channel computer-urodynamic investigation and IVU. Men with urinary retention, known bl...

  11. Non-invasive diagnosis of bladder outlet obstruction (BOO) in male patients with lower urinary tract symptoms (LUTS)

    OpenAIRE

    Oelke, M.

    2016-01-01

    The thesis summarizes nine published articles and deals with the diagnostic value of morphological changes in the lower urinary tract in adult men with LUTS associated with BOO. Until recently, no morphological change of the lower urinary tract could safely diagnose BOO. Therefore, the value of ultrasound measurement of detrusor wall thickness (DWT) for the detection of BOO was investigated. The results of the studies demonstrate that suprapubic measurement of DWT should be performed at the a...

  12. Iatrogenic neonatal bladder perforation

    Directory of Open Access Journals (Sweden)

    Lilia Trigui

    2011-01-01

    Full Text Available Neonatal bladder rupture is rare as a complication of bladder obstruction due to abnormal anatomy or iatrogenic causes. The present study describes the case of a 3-day-old infant with ascites due to bladder perforation secondary probably to manual decompression of the bladder. The infant underwent successful surgical repair of the perforation.

  13. Gastric outlet obstruction due to adenocarcinoma in a patient with Ataxia-Telangiectasia syndrome: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Hammond Sue

    2009-03-01

    Full Text Available Abstract Background Ataxia-Telangiectasia syndrome is characterized by progressive cerebellar dysfunction, conjuctival and cutaneous telangiectasias, severe immune deficiencies, premature aging and predisposition to cancer. Clinical and radiographic evaluation for malignancy in ataxia-telangiectasia patients is usually atypical, leading to delays in diagnosis. Case presentation We report the case of a 20 year old ataxia-telangiectasia patient with gastric adenocarcinoma that presented as complete gastric outlet obstruction. Conclusion A literature search of adenocarcinoma associated with ataxia-telangiectasia revealed 6 cases. All patients presented with non-specific gastrointestinal complaints suggestive of ulcer disease. Although there was no correlation between immunoglobulin levels and development of gastric adenocarcinoma, the presence of chronic gastritis and intestinal metaplasia seem to lead to the development of gastric adenocarcinoma. One should consider adenocarcinoma in any patient with ataxia-telangiectasia who presents with non-specific gastrointestinal complaints, since this can lead to earlier diagnosis.

  14. Stereological study of collagen and elastic system in the detrusor muscle of bladders from controls and patients with infravesical obstruction

    Directory of Open Access Journals (Sweden)

    Mauricio Rubinstein

    2007-02-01

    Full Text Available OBJECTIVE: Compare detrusor muscle of normal and patients with infravesical obstruction, quantifying the collagen and elastic system fibers. MATERIALS AND METHODS: We studied samples taken from bladders of 10 patients whose ages ranged from 45 to 75 years (mean = 60 years, who underwent transvesical prostatectomy for treatment of BPH. Control material was composed of 10 vesical specimens, removed during autopsies performed in cadavers of accident victims, with ages between 18 and 35 years (mean = 26 years. RESULTS: The results of collagen and elastic fibers quantification (volumetric density demonstrated the following results in percentage (mean +/- standard deviation: collagen in BPH patients = 4.89 +/- 2.64 and 2.32 +/- 1.25 in controls (p < 0.0001, elastin in BPH patients = 10.63% +/- 2.00 and 8.94% +/- 1.19 in controls (p < 0.0001. CONCLUSION: We found that the components of connective tissue, collagen and elastic system fibers are increased in the detrusor muscle of patients with infravesical obstruction, when compared to controls.

  15. The novel β3-adrenoceptor agonist mirabegron reduces carbachol-induced contractile activity in detrusor tissue from patients with bladder outflow obstruction with or without detrusor overactivity

    DEFF Research Database (Denmark)

    Nordling, Jørgen; Bouchelouche, Kirsten; Andersson, Karl-Erik;

    2013-01-01

    prostatic hyperplasia undergoing cystoscopy and from patients undergoing radical prostatectomy/cystectomy (in total 33 donors). Detrusor contractility was evaluated by organ bath studies and strips were incubated with carbachol (1μM) to induce and enhance tension. Both mirabegron and isoprenaline reduced...... preparations from patients with bladder outflow obstruction (BOO) with and without detrusor overactivity (DO), and from patients with normal bladder function. We compared the effects to those of isoprenaline, a non-selective β-adrenoceptor agonist. Detrusor specimens were obtained from patients with benign...

  16. Unresectable gastric cancer with gastric outlet obstruction and distant metastasis responding to intraperitoneal and folfox chemotherapy after palliative laparoscopic gastrojejunostomy: report of a case

    Directory of Open Access Journals (Sweden)

    Park Joong-Min

    2010-12-01

    Full Text Available Abstract Background Gastric outlet obstruction (GOO caused by unresectable gastric cancer is a challenging aspect of patient care. There have been no reports involving patients with obstructing gastric cancer and several incurable factors curatively treated by multimodal treatments. Case presentation We report a case of 55-year-old man who was diagnosed with a poorly differentiated adenocarcinoma in the pre-pyloric antrum with GOO by gastroscopy. An abdominal computed tomography (CT scan revealed thickening of the gastric wall and adjacent fat infiltration, and a large amount of food in the stomach suggesting a passage disturbance, enlarged lymph nodes along the common hepatic and left gastric arteries, and multiple hepatic metastases. The serum carcinoembryonic antigen (CEA level was 343 ng/ml and the carbohydrate antigen (CA 19-9 level was within normal limits. The patient underwent a laparoscopic gastrojejunostomy for palliation of the GOO. On the 3rd and 12th days after surgery, he received intraperitoneal chemotherapy with 40 mg of docetaxel and 150 mg of carboplatin. Simultaneously, combined chemotherapy with 85 mg/m2 of oxaliplatin for the 1st day and 600 mg/m2 of 5-FU for 2 days (FOLFOX regimen was administered from the 8th post-operative day. After completion of nine courses of FOLFOX, the patient achieved a complete response (CR with complete disappearance of the primary tumor and the metastatic foci. He underwent a radical subtotal gastrectomy with D3 lymph node dissection 4 months after the initial palliative surgery. The pathologic results revealed no residual primary tumor and no lymph node metastasis in 43 dissected lymph nodes. He has maintained a CR for 18 months since the last operation. Conclusion Combination chemotherapy with systemic and intraperitoneal chemotherapy following laparoscopic bypass surgery showed marked efficacy in the treatment for unresectable advanced gastric cancer with GOO.

  17. Ultrasonographic evaluation of urinary bladder neoplasias

    Directory of Open Access Journals (Sweden)

    Nipa Patidar

    2015-12-01

    Full Text Available Background: Ultrasound has been shown to be a sensitive method for evaluating patients with chronic obstruction, bladder outlet obstruction, urinary tract infection, renal failure, renal and bladder neoplasm and renal transplants. It is now recommended as the method of choice for preliminary assessment and follow-up of several of these disorders. The objective of the study was to evaluate the specificity and sensitivity of ultrasonographic features of neoplastic lesions of urinary bladder. Methods: Clinical impression about the suspected abnormality was obtained from the case papers or from referring by clinical colleagues. Data was recorded under headings like clinical history, clinical examinations, investigations like urine analysis, serum creatinine and blood urea, X-ray of chest and Kidney Urinary Bladder, pelvic and abdominal Ultrasonography, and if require CT scan and guided biopsy. Results: out of total 35 cases 29 were Transitional Cell Carcinoma, 4 were Squamous Cell Carcinoma, One leiomyoma and one was secondary from bronchogenic carcinoma. Most of tumours were irregular in shape in both TCC and SCC patients. Most of tumour showed heterogeneous echo-texture in ultrasonography. While all SCC showed heterogeneous with calcification echo-texture. Most of the cases had residual urine volume was less than 100 cc. Conclusions: The primary advantage of ultrasound over the conventional study was found to be its ability to detect focal or diffuse bladder wall abnormalities in patients who presented with commonest complaint of painless hematuria. [Int J Res Med Sci 2015; 3(12.000: 3775-3778

  18. Clinical guidelines for male lower urinary tract symptoms associated with non-neurogenic overactive bladder

    Directory of Open Access Journals (Sweden)

    Chung-Cheng Wang

    2015-03-01

    Full Text Available The purpose of this guideline is to direct urologists and patients regarding how to identify overactive bladder (OAB in male patients with lower urinary tract symptoms (LUTS and to make an accurate diagnosis and establish treatment goals to improve the patients' quality of life (QoL. LUTS are commonly divided into storage, voiding, and postmicturition symptoms, and are highly prevalent in elderly men. LUTS can result from a complex interplay of pathophysiologic features that can include bladder dysfunction and bladder outlet dysfunction such as benign prostatic obstruction (BPO or poor relaxation of the urethral sphincter. Diagnosis of OAB in male LUTS leads to accurate diagnosis of pure OAB and bladder outlet-related OAB, and appropriate treatment in men with residual storage symptoms after treatment for LUTS.

  19. Chronic bladder ischemia and oxidative stress: new pharmacotherapeutic targets for lower urinary tract symptoms.

    Science.gov (United States)

    Nomiya, Masanori; Andersson, Karl-Erik; Yamaguchi, Osamu

    2015-01-01

    Chronic bladder ischemia is potentially a common cause of lower urinary tract symptoms in the elderly. Epidemiological studies have shown a close association between lower urinary tract symptoms and vascular risk factors for atherosclerosis, and investigations using transrectal color Doppler ultrasonography have shown a negative correlation between decreased lower urinary tract perfusion and International Prostate Symptom Score in elderly patients with lower urinary tract symptoms. Bladder blood flow is also known to decrease in men with bladder outlet obstruction as a result of benign prostatic hyperplasia. Studies in animal models suggest that chronic bladder ischemia and repeated ischemia/reperfusion during a micturition cycle might produce oxidative stress, leading to denervation of the bladder and the expression of tissue-damaging molecules in the bladder wall, which could be responsible for the development of bladder hyperactivity progressing to bladder underactivity. The effects of drugs with different mechanisms of action; for example, α1-adrenoceptor antagonists, phosphodiesterase type 5 inhibitors, free radical scavengers and β3-adrenoceptor agonist, have been studied in animal models of chronic bladder ischemia. The drugs, representing different treatment principles for increasing blood flow and decreasing oxidative stress, showed protective effects not only on urodynamic parameters, but also on negative effects on muscle contractility and on detrimental structural bladder wall changes. Improvement of lower urinary tract perfusion and control of oxidative stress can be considered new therapeutic strategies for treatment of bladder dysfunction induced by chronic ischemia. PMID:25339506

  20. Prostatic hyperplasia and congenital bladder diverticulum. A case report

    Directory of Open Access Journals (Sweden)

    Ciro Esteban Delgado Cantero

    2011-04-01

    Full Text Available Congenital diverticula in adults are typically associated with bladder outlet obstruction and their manifestation is most commonly by urinary sepsis. The case of a 69 years old male patient who attended consultation because of nocturia, thin urine stream, pushing, urgent urination and sense of incomplete emptying is presented. Through rectal examination grade I prostate with discrete grade I asymmetry consistent with right nodular lobe that did not rise to the surface was detected. During the physical examination tumor mass was palpated in the lower abdomen region. It was painless. Ultrasound and cystography showed giant bladder diverticulum with a narrow neck into the right lateral wall of the bladder. Cystoscopy confirmed the diagnosis and the patient was treated trough surgery. Histology revealed mucosal layers and muscle and adventitia in the wall, thus confirming congenital origin. Recovering after surgery was satisfactor.

  1. Multiscale Entropy Analysis of Surface Electromyographic Signals from the Urethral Sphincter as a Prognostic Indicator for Surgical Candidates with Primary Bladder Neck Obstruction

    Directory of Open Access Journals (Sweden)

    Hsien-Tsai Wu

    2015-12-01

    Full Text Available To explore information hidden in the electromyographic (EMG signals of the urethral sphincter that may be of prognostic significance for patients with primary bladder neck obstruction (PBNO, 41 patients with voiding difficulty were divided into four groups: 1 patients with primary bladder neck obstruction (PBNO with successful (Group 1, n = 14 and 2 unsuccessful (Group 2, n = 8 surgical outcomes, 3 patients with detrusor overactivity (Group 3, n = 7, and 4 patients with detrusor-external sphincter dyssynergia (Group 4, n = 12. All patients underwent baseline urodynamic studies (preoperative for Group 1 and Group 2 for comparison. The results demonstrated that, despite no significant difference in urodynamic parameters between Group 1 and Group 2, the large-scale multiscale entropy (MSE of preoperative EMG (i.e., MSELS(EMG of Group 1 was significantly higher than that of Group 2 without notable difference between Group 1 and Group 3 (i.e., patients with normal sphincter function. Moreover, the MSELS(EMG and small-scale MSE of preoperative EMG (i.e., MSESS(EMG of Group 2 were notably higher than those of Group 4 (i.e., patients with abnormal sphincter function, while both MSELS(EMG and MSESS(EMG of Group 3 were notably higher than those of Group 2. In conclusion, using MSE analysis for assessing preoperative urethral sphincter EMG signals successfully distinguished between PBNO patients with subsequent successful surgery from those with surgical failure possibly due to subtle functional impairment of the urethral sphincter that cannot be detected by routine urodynamic studies. The results, therefore, highlight the potential clinical significance of this analytical tool in guiding urologists regarding their choice of medical versus surgical treatment for this patient population.

  2. Therapeutic value of endoscopic metal pyloric stent implantation for gastric outlet obstruction%经内镜放置幽门金属支架对胃出口梗阻的治疗价值

    Institute of Scientific and Technical Information of China (English)

    朱静; 张杰; 陈婧; 郎海波; 于剑锋; 郝建宇

    2012-01-01

    目的 探讨经内镜放置幽门金属支架对胃出口梗阻的治疗价值.方法 对2008年1月至2012年1月因多种良恶性疾病引起胃出口梗阻而接受内镜下幽门金属支架植入术的21例患者的病例资料进行回顾性分析.结果 21例成功进行了幽门十二指肠支架置入术,14例24小时内症状明显缓解,1例于48小时后行CRE球囊扩张后缓解,总缓解率为71.4%.21例中有3例十二指肠壶腹部受累伴梗阻性黄疸的病例成功进行了双支架的置入治疗.3例出现术中出血,对症治疗后停止.1例良性狭窄病例使用覆膜支架发生移位,4例出现支架术后再堵塞,其中2例行二次支架置入.恶性肿瘤引起的狭窄术后生存时间平均为2.5个月.结论 对由于各种原因导致胃出口梗阻且无法手术或拒绝外科治疗的患者,幽门支架的置入可有效解除梗阻,改善患者生活质量.%Objective To evaluate the therapeutic value of endoscopic implantation of metal stent in gastric outlet obstruction. Methods Data of 21 patients who developed benign or malignant gastric outlet obstruction from January 2008 to January 2011 were retrospectively reviewed. Results Endoscopic metal pyloric stents were successfully placed in 21 patients. Symptoms were subsided in 14 patients. 1 patient subsided after CRE ballon in 48 hours. Response rate was 71.4%. 3 duodenal patients ampulla involvement with cases of obstructive jaundice successfully treated two-stent implantation. Bleeding occurred in 3 patients, 1 case of benign stenosis using stent occurred displacement , Obstruction occurred in 4 patients, and 2 of them received the second metal pyloric stent. The average survival time of obstruction patient with malignant was 2.5 months. Conclusion No chance of surgical treatment or refuse surgery patients because of some causes gastric outlet obstruction can effectively remove the obstruction and improve patients quality of life.

  3. Inflammasomes are important mediators of cyclophosphamide-induced bladder inflammation.

    Science.gov (United States)

    Hughes, Francis M; Vivar, Nivardo P; Kennis, James G; Pratt-Thomas, Jeffery D; Lowe, Danielle W; Shaner, Brooke E; Nietert, Paul J; Spruill, Laura S; Purves, J Todd

    2014-02-01

    Bladder inflammation (cystitis) underlies numerous bladder pathologies and is elicited by a plethora of agents such as urinary tract infections, bladder outlet obstruction, chemotherapies, and catheters. Pattern recognition receptors [Toll-like receptors (TLRs) and Nod-like receptors (NLRs)] that recognize pathogen- and/or damage-associated molecular patterns (PAMPs and/or DAMPs, respectively) are key components of the innate immune system that coordinates the production (TLRs) and maturation (NLRs) of proinflammatory IL-1β. Despite multiple studies of TLRs in the bladder, none have investigated NLRs beyond one small survey. We now demonstrate that NLRP3 and NLRC4, and their binding partners apoptosis-associated speck-like protein containing a COOH-terminal caspase recruitment domain (ASC) and NLR family apoptosis inhibitory protein (NAIP), are expressed in the bladder and localized predominantly to the urothelia. Activated NLRs form inflammasomes that activate caspase-1. Placement of a NLRP3- or NLRC4-activating PAMP or NLRP3-activating DAMPs into the lumen of the bladder stimulated caspase-1 activity. To investigate inflammasomes in vivo, we induced cystitis with cyclophosphamide (CP, 150 mg/kg ip) in the presence or absence of the inflammasome inhibitor glyburide. Glyburide completely blocked CP-induced activation of caspase-1 and the production of IL-1β at 4 h. At 24 h, glyburide reduced two markers of inflammation by 30-50% and reversed much of the inflammatory morphology. Furthermore, glyburide reversed changes in bladder physiology (cystometry) induced by CP. In conclusion, NLRs/inflammasomes are present in the bladder urothelia and respond to DAMPs and PAMPs, whereas NLRP3 inhibition blocks bladder dysfunction in the CP model. The coordinated response of NLRs and TLRs in the urothelia represents a first-line innate defense that may provide an important target for pharmacological intervention.

  4. Post-renal acute renal failure due to a huge bladder stone.

    Science.gov (United States)

    Celik, Orcun; Suelozgen, Tufan; Budak, Salih; Ilbey, Yusuf Ozlem

    2014-06-30

    A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN)/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography) scan showed a huge bladder stone (5 cm x 6 cm x 5 cm) with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine) decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure.

  5. Treatment of bladder dysfunction using stem cell or tissue engineering technique.

    Science.gov (United States)

    Kim, Jae Heon; Lee, Hong Jun; Song, Yun Seob

    2014-04-01

    Tissue engineering and stem cell transplantation are two important options that may help overcome limitations in the current treatment strategy for bladder dysfunction. Stem cell therapy holds great promise for treating pathophysiology, as well as for urological tissue engineering and regeneration. To date, stem cell therapy in urology has mainly focused on oncology and erectile dysfunction. The therapeutic potency of stem cells (SCs) was originally thought to derive from their ability to differentiate into various cell types including smooth muscle. The main mechanisms of SCs in reconstituting or restoring bladder function are migration, differentiation, and paracrine effects. Nowadays, paracrine effects of stem cells are thought to be more prominent because of their stimulating effects on stem cells and adjacent cells. Studies of stem cell therapy for bladder dysfunction have been limited to experimental models and have been less focused on tissue engineering for bladder regeneration. Bladder outlet obstruction is a representative model. Adipose-derived stem cells, bone marrow stem cells (BMSCs), and skeletal muscle-derived stem cells or muscle precursor cells are used for transplantation to treat bladder dysfunction. The aim of this study is to review stem cell therapy and updated tissue regeneration as treatments for bladder dysfunction and to provide the current status of stem cell therapy and tissue engineering for bladder dysfunction including its mechanisms and limitations.

  6. Activation of common signaling pathways during remodeling of the heart and the bladder.

    Science.gov (United States)

    Koeck, Ivonne; Burkhard, Fiona C; Monastyrskaya, Katia

    2016-02-15

    The heart and the urinary bladder are hollow muscular organs, which can be afflicted by pressure overload injury due to pathological conditions such as hypertension and bladder outlet obstruction. This increased outflow resistance induces hypertrophy, marked by dramatic changes in the organs' phenotype and function. The end result in both the heart and the bladder can be acute organ failure due to advanced fibrosis and the subsequent loss of contractility. There is emerging evidence that microRNAs (miRNAs) play an important role in the pathogenesis of heart failure and bladder dysfunction. MiRNAs are endogenous non-coding single-stranded RNAs, which regulate gene expression and control adaptive and maladaptive organ remodeling processes. This Review summarizes the current knowledge of molecular alterations in the heart and the bladder and highlights common signaling pathways and regulatory events. The miRNA expression analysis and experimental target validation done in the heart provide a valuable source of information for investigators working on the bladder and other organs undergoing the process of fibrotic remodeling. Aberrantly expressed miRNA are amendable to pharmacological manipulation, offering an opportunity for development of new therapies for cardiac and bladder hypertrophy and failure.

  7. Prostatic hyperplasia and congenital bladder diverticulum. A case report Hiperplasia de próstata y divertículo vesical congénito. Presentación de un caso

    OpenAIRE

    María Raquel Abreu Santana; Ciro Esteban Delgado Cantero

    2011-01-01

    Congenital diverticula in adults are typically associated with bladder outlet obstruction and their manifestation is most commonly by urinary sepsis. The case of a 69 years old male patient who attended consultation because of nocturia, thin urine stream, pushing, urgent urination and sense of incomplete emptying is presented. Through rectal examination grade I prostate with discrete grade I asymmetry consistent with right nodular lobe that did not rise to the surface was detected. During the...

  8. 恶性胆总管梗阻合并胃出口-十二指肠梗阻的内镜治疗价值分析%Value analysis of endoscopic management of malignant obstruction combined common bile duct and gastric outlet-duodenum obstruction

    Institute of Scientific and Technical Information of China (English)

    于剑锋; 郝建宇; 吴东方; 郎海波

    2013-01-01

    Objective To evaluate curative effects of treatment of malignant biliary and gastric outlet-duodenal obstruction with endoscopically placed self-expandable metal stents.Methods A retrospective analysis was performed in 17 patients who underwent enteral stenting after placement of the biliary stent.The success rate of insertion,the effective palliation of biliary and duodenal obstruction,the rate of complication,recurrent stent obstruction and the median patency were observed.Results In 17 patients,biliary stenting were all performed for obstructive jaundice and then enteral stents were inserted.The levels of tatal billirubin [from (263.4 ± 62.5) μmol/L to (157.6 ± 25.1) μmol/L],direct billirubin [from (1233.2 ±66.5) μmol/L to (130.9 ± 27.7) μmol/L] and alkaline phosphatase [from (233.2 ± 66.5) IU/L to (130.9 ±27.7)IU/L] decreased significantly (P <0.01),and the gastric outlet score increased significandy [from (0.9 ± 1.1) points to (2.1 ±0.7) points] (P <0.01).No serious complication in all patients.Lifetime of patients ranged from 70 days to 332 days,and the median survival time was 192 day.Conclusion Combined biliary and enteral stenting is an effective method for palliation of malignant biliary and gastric outlet-duodenal obstruction.%目的 探讨经内镜置入胆管及肠道支架联合治疗胆总管恶性梗阻合并胃出口-十二指肠梗阻的临床价值.方法 对17例同时存在胆管及胃出口-十二指肠梗阻的恶性肿瘤患者在完成胆管金属支架置入术后再行肠道金属支架置入.观察操作成功率、胆管及消化道梗阻缓解情况、并发症发生情况、支架再阻塞情况以及患者生存期.结果 17例患者经内镜下置入胆管支架和肠道支架,成功率100%;术后7天患者血清总胆红素[(263.4±62.5)μmol/L降至(157.6±25.1)μmol/L]、直接胆红素[(233.2±66.5)μmol/L降至(130.9±27.7) μmol/L]和碱性磷酸酶[(534.2±78.7)IU/L降至(216.3±23.3)IU

  9. Acute Urinary Tract Obstruction

    Directory of Open Access Journals (Sweden)

    Aleksic Djordje

    2015-09-01

    Full Text Available The kidneys are paired organs with the primary function of helping to remove toxins from the body and regulate water balance. They are vital to survival. After urine is produced in the kidneys, it must pass into the bladder, where it can be stored before being eliminated from the body through the urethra. Urinary tract obstruction is a common problem encountered by urologists, primary care physicians, and emergency medicine physicians. Urine can become obstructed at any point in this pathway. There are three groups of urinary tract obstructions: 1 obstruction of the urinary tract lumen; 2 obstruction of the urinary tract wall; and 3 extrinsic obstruction, which can press on the urinary tract lumen. An obstruction can be present from birth or develop later in life. The most common causes of obstruction include stones, strictures, tumours, and bladder dysfunction. These obstructions may result in the hydronephrosis of one or both kidneys, which, if left untreated, may lead to the deterioration of renal function. The goal of an initial treatment of urinary tract obstruction is to remove the obstruction. Later, we treat the cause that led to the obstruction. The bottom line is that all efforts should be made to preserve kidney function to avoid the need for dialysis or renal transplantation.

  10. Antepartum fetal bladder rupture leading to urinary ascitis: attempt to rescue by placement of peritoneo-amniotic shunt.

    Science.gov (United States)

    Singh, Nilanchali; Tripathi, Reva; Tyagi, Shakun; Batra, Atul

    2013-01-01

    Fetal bladder rupture is a rare complication occurring due to bladder outlet obstruction, mostly posterior urethral valves. A 26-year-old primigravida presented to us at 27 weeks gestation with an ultrasound report showing gross fetal ascitis and mild oligohydramnios. A repeat scan was performed which showed fetal bladder rupture and urinary ascitis. In conjunction with paediatric surgeon, we performed ultrasound-guided placement of double-ended pigtail catheter connecting the fetal peritoneal cavity with the amniotic cavity at 28 weeks gestation. Ultrasound performed 3 days after the placement of the catheter showed its correct placement. Unfortunately, 1 week after the procedure at 29 weeks gestation, the patient had premature rupture of membranes and later went into labour and delivered vaginally. The neonate could not be revived and expired after few hours of birth due to prematurity-related complications. The placement of the shunt could have probably precipitated preterm rupture of membranes. PMID:23946514

  11. 经内镜金属支架治疗胃出口梗阻的疗效评价%Endoscopic serf-expanded metal stent for gastric outlet obstruction:a ten-year experience

    Institute of Scientific and Technical Information of China (English)

    钟芸诗; 姚礼庆; 徐美东; 周平红

    2008-01-01

    目的 评价经内镜金属支架治疗胃出口梗阻的临床价值.方法 总结1999年3月至2008年1月间复旦大学附属中山医院内镜中心采用内镜金属支架治疗胃出口梗阻56例患者的临床资料.结果 56例患者中男33例、女23例.年龄(65±14)岁;晚期胃窦癌17例,胃癌术后复发15例(其中毕Ⅰ式吻合8例),十二指肠癌4例,壶腹周围癌7例,转移性肿瘤13例.支架置入成功率98.2%(55/56).49例患者(87.5%)在支架置入1~3(2±1)d后开始进流质饮食,进食半流质的时间为4~9(6±2)d;42例(76.4%)患者在支架置入10~16(13±3)d后开始进普通饮食.并发症发生率包括疼痛14.5%、支架移位1.8%和出血25.5%,无穿孔.截至2008年1月20日,53例(96.4%)接受了随访,生存期14~332(139±15)d,中位生存期135 d.支架通畅率94.3%(50/53),有3例患者分别在术后143 d、158 d和190 d出现了再狭窄,通过再次置入金属支架后好转.结论 内镜下金属支架引流术是治疗胃出口梗阻的一种微创、安全、有效的方法.%Objective To evaluate the efficacy of endoscopic self-expanded metal stent for the treatment of gastric outlet obstruction.Methods Fifty-six cases of gastric outlet obstruction, collected from March 1999 to January 2008, were treated by endoscopic self-expanded metal stents. The success rate, complication rate and survival were evaluated. Results Among the 56 cases, the male to female ratio was 33 to 23, and the average age was [65±14(24-86)] years. Seventeen cases were gastric cancer, 4 duodenal carcinoma, 7 peri-ampulla carcinoma, 13 metastasis cancer and 15 presented recurrence after operations. The success rate of stent implantation was 98.2% (55/56). Forty-nine cases(87.5%) could eat liquid food 1-3 days after operations and eat semifluid food 4-9 days later. Forty-two cases (76.4%)could eat normal food after 10-16 days. The main complications included 14.5% of eases with pain, 1.8% with stent shift, 25.5% with bleeding and

  12. Bladder Management

    Science.gov (United States)

    ... Catheterization • Urinary Tract Infections: Indwelling (Foley) Catheter Bladder Management [ Download this pamphlet: "Bladder Management" - (PDF, 499KB) ] The ... and medication or surgery may be helpful. Bladder Management Foley or Suprapubic Catheter A tube is inserted ...

  13. Bladder Dysfunction and Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    F. faizi

    2009-01-01

    , the internal pressure of the urethra should also increase. In women, the internal pressure of the urethra is short, and even if it has poorly developed they wet themselves when they cough. "nThe causes of BD: "nAs you see there are 17 causes, which 11 are related to the bladder. The bladder is responsible for retaining the urine and voiding. "nPathophysiology: "nThe bladder and sphincter should work in a coordinated manner: "nDuring the course of a day, an average person will void approximately 4-8 times. The urinary bladder is in storage mode for most of the day, allowing an individual to engage in more important activities than urination. "nNormal bladder function consists of 2 phases—filling and emptying. The normal micturition cycle requires the urinary bladder and the urethral sphincter working together as a coordinated unit to store and empty urine. During urinary storage, the bladder acts as a low-pressure receptacle, while the urinary sphincter maintains high resistance to urinary flow to keep the bladder outlet closed. During urine elimination, the bladder contracts to expel urine while the urinary sphincter opens (low resistance to allow unobstructed urinary flow and bladder emptying. "nFilling phase: "nDuring the filling phase, the bladder accumulates increasing volumes of urine while the pressure inside the bladder remains low. The pressure within the bladder must be lower than the urethral pressure during the filling phase. If the bladder pressure is greater than the urethral pressure (resistance, urine will leak out. "nThe filling of the urinary bladder depends on the intrinsic viscoelastic properties of the bladder and the inhibition of the parasympathetic nerves. Thus, bladder filling is primarily a passive event. "nSympathetic nerves also facilitate urine storage in the following ways: "nSympathetic nerves inhibit the parasympathetic nerves from triggering bladder contractions. "nSympathetic nerves directly cause relaxation and expansion of the

  14. Bladder Diseases

    Science.gov (United States)

    ... frequent, urgent urination Bladder cancer Doctors diagnose bladder diseases using different tests. These include urine tests, x- ... National Institute of Diabetes and Digestive and Kidney Diseases

  15. Urodynamic investigation of cyclophosphamide-induced overactive bladder in conscious rats

    Institute of Scientific and Technical Information of China (English)

    PAN Feng; LIU Di; HAN Xiao-min; LI Wen-cheng; PANG Zi-li; LI Bing; ZHANG Xiao-ping; XIAO Ya-jun; ZENG Fu-qing

    2012-01-01

    Background Overactive bladder (OAB) can be caused by many factors such as inflammation,bladder outlet obstruction,neurogenic factors.We performed an intraperitoneal (ip) injection of cyclophosphamide to induce cystitis in rats,which causes their detrusors to overact,to provide a valuable disease model for discussing OAB pathogenesis and to study effective curing methods.Methods Female Sprague-Dawley rats were induced to form cystitis by cyclophosphamide (200 mg/kg,ip).The day after the injection,two catheters were inserted into each rat's bladder to study its urodynamics.The BL-410 model bio-function experimental system was used to monitor bladder pressure while the rats were conscious.Unstable detrusor contractions appear in the urine storage period as a standard to determine OAB,and the positive rate was calculated.Urodynamic parameters such as bladder basal pressure (BP),maximum voiding pressure (MVP),intercontraction interval (ICI),spontaneous activity (SA),maximum cystometric capacity (MCC),and bladder compliance (BC) were recorded in each group,and a light microscope was used to observe the pathological changes in the rat bladder tissue.Results The detrusor instability rate of the model group was 83.33%.The MVP,MCC and BC of rats in the model group were lower than the control group (P <0.01),and the BP,ICI and SA of the model group rats were higher than the control group (P <0.01).The difference between the control group and the model group is statistically significant.The model group rats' bladder walls swelled and bled,the submucosa thickened and leukocyte infiltration became serious.Conclusions Acute cystitis and OAB symptoms can be induced by ip injections of cyclophosphamide in rats.This can provide a valuable animal model to study OAB in human beings.

  16. Gastric Duplication Cyst Causing Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Muna Al Shehi

    2012-07-01

    Full Text Available This is a case report of a newborn baby with gastric duplication cyst presented with non-bilious vomiting and upper abdominal distension. The diagnosis was suspected clinically and established by ultrasonography and computed tomography. The cyst was completely excised with uneventful recovery.

  17. Double outlet right ventricle

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007328.htm Double outlet right ventricle To use the sharing features on this page, please enable JavaScript. Double outlet right ventricle (DORV) is a heart disease that is ...

  18. A pelvic mass with obstructive uropathy in a 4-year old boy

    Directory of Open Access Journals (Sweden)

    Majid Malaki

    2013-01-01

    Full Text Available Cystic Echinococcosis is endemic in middle- East it may present in different sites mostly liver, but children show atypical signs in uncommon sites. A 4 years old boy presents with urinary retention, his imaging demonstrates a 6cm cystic mass displaced and compressed bladder outlet during survey another asymptomatic cyst found in chest but his liver was not involved. Retroperitoneal Cystic Echinococcosis is a rare event especially in children if present with urinary obstruction it may be due to rectum penetration and dislodged to lymphatic drainage head to chest. Cyst growth rapidity rate is 2-3 cm/year as our study.

  19. Bladder Health

    Science.gov (United States)

    ... life (the person’s level of health, comfort, and happiness). In fact, people with bladder problems may have a lower quality of life than people with diabetes, heart disease, or high blood pressure. Bladder problems ...

  20. Urinary Bladder

    Science.gov (United States)

    ... to the symphysis pubis, and below the parietal peritoneum . The size and shape of the urinary bladder ... outer layer of the bladder wall is parietal peritoneum. In all other regions, the outer layer is ...

  1. Bladder Retraining

    Science.gov (United States)

    ... a better voiding pattern around the clock. Do Kegel Exercises Help People with IC? Some bladder retraining programs recommend practicing Kegel exercises as part of bladder retraining. Kegel exercises ...

  2. Underground tank assembly with internal bladder

    Energy Technology Data Exchange (ETDEWEB)

    Strock, D.J.

    1987-03-10

    An underground tank assembly is described for storing motor fuels, such as gasoline or diesel fuel, comprising: a collapsible primary tank comprising a flexible bladder for containing a motor fuel, the primary tank being moveable from a collapsed generally empty position to an inflated generally full position; a substantially rigid secondary tank substantially surrounding and enclosing the primary tank for secondary containment of an leakage of motor fuel from the primary tank, the secondary tank having a top, a bottom, and end walls extending between and connecting the top and bottom; the bladder having a bottom portion positioned adjacent the bottom of the secondary tank; and conduit means extending through the top of the rigid secondary tank to a position in proximity to the bottom portion of the flexible bladder. The conduit means includes an inlet conduit with an inlet upright portion for filing the flexible bladder with motor fuel and an outlet conduit with an outlet upright portion for withdrawing the motor fuel from the flexible bladder. The outlet upright portion of the outlet conduit is positioned within the interior of and is substantially concentrically and coaxially surrounded by the inlet upright portion of the inlet conduit. The outlet conduit and the inlet conduit both are positioned in proximity to one of the end walls of the rigid secondary tank.

  3. Bladder exstrophy repair

    Science.gov (United States)

    Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy ... Bladder exstrophy repair involves two surgeries. The first surgery is to repair the bladder and the second one is to attach ...

  4. Neurogenic Bladder

    Directory of Open Access Journals (Sweden)

    Peter T. Dorsher

    2012-01-01

    Full Text Available Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

  5. Double Outlet Right Ventricle

    Science.gov (United States)

    ... closed during this surgery. Return to main topic: Congenital Heart Disease See on other sites: MedlinePlus https://medlineplus.gov/ency/article/007328.htm Double outlet right ventricle Texas Adult ...

  6. Thoracic outlet anatomy (image)

    Science.gov (United States)

    ... spinal vertebra to the rib. There may be pain in the neck and shoulders, and numbess in the last 3 fingers and inner forearm. Thoracic outlet syndrome is usually treated with physical therapy which helps ...

  7. Obstrução da via de saída de ventrículo esquerdo por prótese mitral: apresentação de seis casos Obstruction of the left ventricle outlet by mitral valve prosthesis: report of six cases

    Directory of Open Access Journals (Sweden)

    Pablo M. A Pomerantzeff

    1990-08-01

    Full Text Available De janeiro de 1982 a março de 1984, foram implantadas 170 biopróteses de pericárdio bovino e alto perfil, no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, com mortalidade hospitalar de 7,1%. Através do estudo anatomopatológico, foram identificados cinco casos em que ocorreu obstrução da via de saída do ventrículo esquerdo após substituição da valva mitral. Com base nessa experiência, a indicação de estudo hemodinâmico no 1º dia de pós-operatório em paciente em baixo débito, sem explicação, possibilitou identificar obstrução da via de saída do ventrículo esquerdo, com retroca valvar e boa evolução. Neste trabalho, são relatados detalhadamente os seis casos e discutidas as causas da obstrução da via de saída na substituição mitral.From January/1982 to March/1984, 170 high profile bovine pericardium bioprostheses were implanted in the INCOR (Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP. Hospital mortality amongst these patients was 7.1%. Anatomopathological studies identified five cases in which obstruction of the left ventricle outlet occurred after substitution of the mitral valve. Based on this experience, the indication of a hemodynamic study on the first postoperative day of a patient with an unexplained low cardiac output made it possible to identify obstruction of the left ventricle valve outlet in such patients, with resubstitution of the valve and a satisfactory evolution of the case. In this report we relate the six cases in detail and discuss the causes of the obstruction of the outlet in mitral valve substitutions.

  8. Tratamiento paliativo de la obstrucción tumoral del vaciamiento gástrico con prótesis metálicas autoexpandibles insertadas endoscópicamente Palliative management of malignant gastric outlet obstruction with endoscopically inserted self-expanding metal stents

    Directory of Open Access Journals (Sweden)

    J. García-Cano

    2008-06-01

    Full Text Available Antecedentes y objetivo: la inserción de prótesis metálicas autoexpandibles para paliar la obstrucción tumoral del vaciamiento gástrico es un procedimiento mínimamente invasivo, que cada vez se utiliza con más frecuencia. Presentamos la experiencia de esta técnica en un hospital de nivel II del Sistema Nacional de Salud. Pacientes y métodos: estudio retrospectivo de un periodo de cinco años (2003-2007, en los que se trató de resolver la obstrucción tumoral del vaciamiento gástrico en 27 ocasiones a 23 pacientes (media de 0,45 procedimientos por mes, mediante la inserción endoscópica de prótesis no recubiertas (Wallstent® y Wallflex®. Resultados: la inserción fue técnicamente posible en el 100% de los 27 intentos. Se obtuvo un buen resultado clínico en 25 ocasiones (92,5%. Se utilizó sólo endoscopia 10 (37% veces y en las otras 17 (63% también fluoroscopia. Tras la inserción de la prótesis se intervino a un paciente con intención curativa y a otro, en el que la prótesis no funcionó, para realizar una derivación paliativa. Cuatro prótesis se obstruyeron por crecimiento tumoral, recanalizándose mediante la inserción de nuevas prótesis. En tres ocasiones se produjo ictericia obstructiva en prótesis que cubrían la papila de Vater. No hubo otras complicaciones. Tampoco mortalidad derivada del procedimiento. La media de supervivencia fue de 104 días (rango 28-400, DE ± 94. Conclusiones: en nuestra experiencia, la inserción endoscópica de prótesis metálicas autoexpandibles parece un método seguro y eficaz en el tratamiento paliativo de la obstrucción tumoral del vaciamiento gástrico y puede llevarse a cabo con éxito en un centro de nuestras características.Aim and background: the insertion of self-expanding metal stents to palliate malignant gastric outlet obstruction is a minimally invasive procedure that is being increasingly used. We discuss experience with this technique in a level-II hospital in the

  9. Cross-sectional and longitudinal studies on interaction between bladder compliance and outflow obstruction in men with benign Prostatic hyperplasia%前列腺增生男性膀胱顺应性与流出道梗阻间相互关系的横截面与纵向研究

    Institute of Scientific and Technical Information of China (English)

    L.M.Liao; W.Schaefer

    2007-01-01

    Aim:To explore the interaction between bladder compliance (BC) and bladder outflow obstruction (BOO) in men with benign prostatic hyperplasia (BPH) using cross-sectional and longitudinal studies. Methods: A total of 181 men with BPH were recruited, and 100 of them were followed for one year. Cystometry was performed in a standing or a sitting position with 30 mL/min infusion. BC was manually corrected and defined. Obstruction coefficient (OCO), linear passive urethral resistance relation and international continence society (ICS) nomogram were used to diagnose BOO. The obstructed parameters were compared between the reduced BC group and the non-reduced group. BC was compared between the first investigation at the beginning of study and the second investigation at the end of study during the one-year follow-up period. Results: The group with reduced BC had increased OCO and linear passive urethral resistance relation. BC was significantly lower in the obstructed group (55.7 mL/cm water) than that in unobstructed and equivocal one (74.9 mL/cm water, P < 0.01). BC gradually reduced with the increased obstructed grade. There was a significantly weak negative correlation between BC and OCO (r = - 0.132, P<0.01).Over the one-year follow-up period in the longitudinal study, BC for all men changed from 54.4 to 48.8 mL/cm water (P > 0.05), and BC for the group with BOO fell from 58.4 ± 70.1 to 46.5 ± 38.7 mL/cm water (P > 0.05). Conclusion:In men with BPH, a significant systematic decrease occurred in BC in the obstructed group and a significant systematic increase with urethral resistance occurred in the low BC group. A longitudinal study of the tendency of BC reduction in a group with BOO is necessary in the future.

  10. 经超声逼尿肌厚度测定在可疑膀胱出口梗阻患者中的应用%Ultrasound measurement of detrusor wall thickness in equivocal bladder outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    李宁; 李永智; 宫雪; 刘屹立; 王平

    2011-01-01

    Objective To estimate the application of ultrasound measurement of detrusor wall thickness (DWT) in the assessment of curative effect after operation. Methods Detrusor thickness was measured by linear ultrasound (7. 5 MHz) either at a filling volume of 50% of cystometric capacity or at 250 ml filling in 86 patients, who were diagnosed equivocal BOO, during a pressure-flow study. All patients accepted transurethral resection of the prostate. At 3 months post-surgery, the patients were divided into two groups according to curative effect after operation. The volume of the prostate, age and DWT were compared between the two groups. Results There was no difference in either age or volume of the prostate between the two groups. DWT was significantly higher (P<0.01) in the more curative effect group (37 cases, DWT 2. 5±0.3 mm) compared to the less curative effect group (49 cases, 2.2±0. 3 mm). As a predictor of curative effect, DWT of 2. 8 mm or greater had a positive predictive value of 100%, a negative predictive value of 62%, specificity of 100% and sensitivity of 19%. Receiver operating characteristic analysis (ROC) revealed that DWT had a high predictive value for curative effect post-surgery with an AUC of 0. 84±0. 04. Conclusions In patients with equivocal BOO, ultrasonographically assessed detrusor thickness may have a predictive value for curative effect post-surgery. However, this cutoff value needs to be validated in a larger study population.%目的 分析可疑膀胱出口梗阻患者术前逼尿肌厚度,探讨逼尿肌厚度测定对可疑膀胱出口梗阻患者术后疗效的预测作用.方法 对可疑膀胱出口梗阻并行手术治疗的86例患者在行压力流率测定过程中,当膀胱容量为250 ml或灌注量为膀胱最大容量的50%时,应用7.5 MHz高频线纵超声探头行膀胱前壁逼尿肌厚度测定.术后3个月复查,将患者分为疗效显著组与疗效非显著组,比较2组患者年龄、前列腺体积及逼尿肌厚度.结果 疗效显著组(37例)与疗效非显著组(49例)患者年龄及前列腺体积差异无统计学意义(P>0.05).逼尿肌厚度差异有统计学意义[(2.5±0.3)和(2.2±0.3)mm,P<0.01].应用受试者工作特性曲线,当逼尿肌厚度≥2.8 mm时,逼尿肌厚度测定作为预测工作特异性和阳性预测值均为100%,而敏感性为19%,阴性预测值为62%.其曲线下面积为0.84±0.04.结论 逼尿肌测定预测可疑膀胱出口梗阻患者术后疗效可靠,但仍需要多中心、大样本的试验进一步确定临界值.

  11. 鼻肠管在伴有胃出口梗阻的胃癌病人营养和化疗中的应用%Clinical application of nasojejunal feeding tubes in the treatment of gastric outlet obstructive patients with neoadjuvant chemotherapy

    Institute of Scientific and Technical Information of China (English)

    王金晶; 汪志明; 王震龙; 刁艳青; 李宁

    2012-01-01

    Objective: To investigate the application and effect of enteral nutrition applied in gastric outlet obstructive patients with neoadjuvant chemotherapy by the nasojejunal feeding tubes placed endoscopically. Methods: Nasojejunal feeding tubes were placed in 16 gastric cancer patients with pyloric obstruction, followed by enteral nutrition support and neoadjuvant chemotherapy. The safety and efficiency of this procedure were recorded. Results: Tubes were successfully placed in 100% of the cases with an average time of (10. 8 ±3.6) min. No complications of this procedure were observed. Enteral nutrition, neoadjuvant chemotherapy and surgery were smoothly performed. Conclusion: The nasojejunal feeding tubes were easy to place endoscopically. And enteral nutrition support can improve the nutritional status of gastric cancer patients with pyloric obstruction during the neoadjuvant chemotherapy.%目的:探讨经内镜放置鼻肠管给予肠内营养(EN)在伴有胃出口梗阻的胃癌病人新辅助化疗中的应用及疗效.方法:对16例伴有胃出口梗阻的胃癌病人经内镜放置鼻肠管并给予EN,观察该方法的安全性和有效性.结果:16例病人均成功经内镜放置鼻肠管,平均置管时间为(10.8±3.6)min,未发生消化道穿孔和出血等严重并发症.所有病人均顺利完成新辅助化疗,并在化疗结束后接受了手术.结论:经内镜放置鼻肠管行EN,能改善伴有胃出口梗阻胃癌病人的营养状况,帮助其完成新辅助化疗.

  12. Analysis on Pathogenesis of 50 Cases of Bladder Proliferative Lesions

    Institute of Scientific and Technical Information of China (English)

    陈志强; 蓝儒竹; 叶章群; 杨为民

    2003-01-01

    In order to study the pathogenesis, clinical and pathological characteristics of prolifera-tive lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients withcomplaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy ofthe suspicious foci in the bladder. In combination with the symptoms, urine routine and urodynam-ics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of thelower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%)had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients withlower urinary tract obstruction were all complicated with infection. Three cases were associatedwith transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic exami-nation. Proliferative lesions of the bladder, especially those without other obvious mucosa changesunder cystoscopy, are common histological variants of urothelium in the patients with chronic in-flammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of thelower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested thatdifferent treatments should be applied according to the scope and histological type of the prolifera-tive lesions.

  13. Neurogenic bladder in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Al Taweel W

    2015-06-01

    Full Text Available Waleed Al Taweel, Raouf SeyamDepartment of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaAbstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.Keywords: neurogenic bladder, spinal cord injury, urodynamics, intestine, intermittent catheterization

  14. 车前番泻颗粒联合生物反馈治疗出口梗阻型便秘疗效评价%Effective Evaluation of Biofeedback Therapy Combined with Plantain-senna Granules in Patients with Outlet Obstructive Constipation

    Institute of Scientific and Technical Information of China (English)

    罗和生; 刘晓波; 童强; 郭艳

    2011-01-01

    目的:评价车前番泻颗粒联合生物反馈(BF)治疗出口梗阻型便秘(OCC)的疗效.方法:66例OCC患者BF治疗一个疗程后比较治疗前后直肠压力变化,按患者意愿分为继续BF治疗组和车前番泻颗粒联合治疗组,分组治疗2月后比较2组患者临床症状改善状况.结果:BF治疗前后比较患者直肠静息压、力排结果和直肠最大耐受量显著提高(P<0.05),肛管静息压、肛门直肠缩榨压、直肠初始感觉、初始欲望、强烈欲望均无改变(P>0.05);治疗2月后,BF组和联合组患者较治疗前症状均有显著改善,且联合组优于BF组(P<0.05).结论:BF联合车前番泻颗粒治疗方案改善患者临床症状优于单独BF治疗,是OCC的有效治疗方案.%Objective To evaluate the efficacy of biofeedback therapy combined with plantain-senna granules in treatment of patients with outlet obstructive constipation. Methods Sixty-six patients were underwent one course of biofeedback training, the change of rectal pressure before and after treatment were compared, then the patients were divided into BF group and combined group based on their own choices, the improvement of symptom were observed after treating for 2 months. Results After two weeks biofeedback training,the rectal resting pressure,force row results and maximum tolerated rectal volume were improved significantly(P0. 05). The symptoms of patients in both group were significantly improved after treating for two months, and the efficacy of combined group was more excellent than BF group( P<0.05). Conclusion The biofeedback therapy combined Plantain-senna granules could be effectively used for treatment of outlet obstructive constipation.

  15. DESIGN OF SEDIMENT FLUSHING OUTLETS

    Institute of Scientific and Technical Information of China (English)

    Prabhata K.SWAMEE

    2002-01-01

    Flushing pipe outlets are provided at the floor of sedimentation basins for flushing out of the deposited sediments. These outlets have to be positioned in such a way so as to remove the deposited sediments effectively. In the absence of rational method for the location, presently the outlets are located by judgment. A review of literature indicated that there is no judicious method available for obtaining the outlet diameter. Presented herein are the design equations for the flushing outlets. It is hoped that the equation will be useful to the design engineers.

  16. Overactive Bladder.

    Science.gov (United States)

    White, Nicola; Iglesia, Cheryl B

    2016-03-01

    Overactive bladder (OAB) is a condition affecting millions of individuals in the United States. Anticholinergics are the mainstay of treatment. Bladder botulinum toxin injections have shown an improvement in symptoms of OAB equivalent to anticholinergic therapy. Percutaneous tibial nerve stimulation can decrease symptoms of urinary frequency and urge incontinence. Sacral neuromodulation for refractory patients has been approved by the Food and Drug Administration for treatment of OAB, urge incontinence, and urinary retention. Few randomized, head-to-head comparisons of the different available alternatives exist; however, patients now have increasing options to manage their symptoms and improve their quality of life.

  17. Thoracic outlet syndrome.

    Science.gov (United States)

    Ozoa, Glenn; Alves, Daniel; Fish, David E

    2011-08-01

    Of the many clinical entities involving the neck region, one of the most intriguing is thoracic outlet syndrome (TOS). TOS is an array of disorders that involves injury to the neurovascular structures in the cervicobrachial region. A classification system based on etiology, symptoms, clinical presentation, and anatomy is supported by most physicians. The first type of TOS is vascular, involving compression of either the subclavian artery or vein. The second type is true neurogenic TOS, which involves injury to the brachial plexus. Finally, the third and most controversial type is referred to as disputed neurogenic TOS. This article aims to provide the reader some understanding of the pathophysiology, workup, and treatment of this fascinating clinical entity. PMID:21824588

  18. Bladder Cancer Advocacy Network

    Science.gov (United States)

    ... future bladder cancer research through the Patient Survey Network. Read More... The JPB Foundation 2016 Bladder Cancer ... 2016 Young Investigator Awardees The Bladder Cancer Advocacy Network (BCAN) has announced the recipients of the 2016 ...

  19. Giant Hepatic Hemangioma Presenting as Gastric Outlet Obstruction

    OpenAIRE

    Aydin, Cemalettin; Akbulut, Sami; Kutluturk, Koray; Kahraman, Aysegul; Kayaalp, Cuneyt; Yilmaz, Sezai

    2013-01-01

    Hemangioma, a most frequently encountered primary benign tumor of the liver, is generally determined incidentally during the course of radiologic tests for other reasons. Most lesions are less than 3 cm and a significant proportion of patients are asymptomatic, although the size and location of the lesion in some patients may be associated with the onset of symptoms. Pressure on the stomach and duodenum of giant hemagiomas developing in the left lobe of the liver, in particular, may result in...

  20. Obstructive Sleep Apnea

    Science.gov (United States)

    ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ...

  1. A New Outlet for Discount Shopping

    Institute of Scientific and Technical Information of China (English)

    S.E.CONGDON-MARTIN

    2004-01-01

    Shanghai Outlet Mall's flaming yellow and orange signage, featuring the word ‘outlet' in two-meter tall capital letters, shrieks, “I'm here!” A sprawling warehouse of discount clothes sold from regular stores and makeshift cubicles, Shanghai Outlet is the pioneer for outlet malls in the city, and one of the first in the country.

  2. Surgical treatment of double outlet ventricle: report on 72 cases

    Institute of Scientific and Technical Information of China (English)

    YANG Jin-fu; HU Dong-xu; HU Jian-guo; YIN Bang-liang; ZHOU Xin-min; ZHOU Wen-wu; TAN Si-chuang; YIN Ni

    2005-01-01

    @@ Double outlet ventricle (DOV) is defined as a congenital heart disease with: (1) both great arteries arising completely, or almost completely (≥90%), from a single ventricle (usually, right ventricle); (2) an aortic valve having no fibre connection with mitral valve; and (3) the only outlet of the other ventricle is a ventricular septal defect (VSD). The incidence of DOV accounts for 1% of all congenital heart disease.1 Clinically there are three common types: Fallot type or double outlet right ventricle (DORV) with subaortic VSD with pulmonary stenosis; Eisenmenger type or DORV with subaortic VSD without pulmonary stenosis and Taussig-Bing type or DORV with subpulmonary VSD. Operative techniques are different according to the position of the VSD and great arteries and the presence or absence of ventricular outflow tract obstruction. The operative difficulty increases in the presence of coronary artery malformation. Recently, our research centre has treated 72 cases of patients suffering from double outlet ventricle. This article is the report of the operative methods and the outcomes.

  3. The effect of a 6 Fr catheter in women: Are they obstructive?

    Science.gov (United States)

    Richard, Patrick; Ordonez, Nydia Icaza; Tu, Le Mai

    2013-01-01

    Objectives: Our objective was to evaluate the effect of a 6 Fr transurethral catheter on the uroflowmetry and to assess whether it potentially contributes to the bladder outlet obstruction (BOO) in women. Methods: We reviewed the charts of 1367 women who underwent an urodynamic study. We included patients with a non-invasive free-flow study (NIFFS) and pressure flow study (PFS) performed through a 6 Fr double lumen transurethral catheter. Results: In total, 120 women met the inclusion/exclusion criteria. Mean maximal flow rate (Qmax) was significantly higher (p 12 mL/s during the NIFFS. Of the 10 patients, only 2 reported obstructive symptoms. Conclusion: The presence of 6 Fr transurethral catheters alters the PFS and results in a significant reduction of the Qmax in patients who voided more than 250 mL. We believe that NIFFS should be performed in all patients before any urethral manipulation to lower a possible overdiagnosis of BOO and findings should always be correlated to clinical symptoms. PMID:23826045

  4. Outlets: the New Favorite of Apparel Industry

    OpenAIRE

    Yanhua Sun

    2009-01-01

    In recent years, along with the fast development of China retail industry, outlets, the brand-new retailing form has entered China. This paper briefly analyzes the advantages and disadvantages of outlets, and puts forward three tactics for its operation.

  5. Low-grade mucinous cystic tumor mimicking urinary bladder tumor: imaging-pathologic correlation.

    Science.gov (United States)

    Dohan, Anthony; Ferlicot, Sophie; Bessède, Thomas; Soyer, Philippe; Rocher, Laurence

    2013-05-01

    Mucin-producing cystitis glandularis is a rare proliferative and metaplastic change of the bladder mucosa that produces large amounts of mucus, thus taking a pseudotumoral pattern and resulting in urinary tract obstruction. We report a case of florid mucin-producing cystitis glandularis mimicking bladder carcinoma in a 77-year-old man that was documented by computed tomography and magnetic resonance imaging. Computed tomography showed diffuse, circumferential, irregular, and lobulated thickening of the bladder wall suggestive of urinary bladder carcinoma. Magnetic resonance imaging showed findings consistent with mucinous content and suggested the correct diagnosis preoperatively. PMID:23490529

  6. Factory Outlet Stores: Ein Trend in Deutschland?

    OpenAIRE

    Nufer, Gerd; Sieber, Dorothea

    2009-01-01

    Der Factory Outlet Store stellt einen neuen Vertriebskanal dar, der es Herstellern ermöglicht, Kunden Markenprodukte zu vergleichsweise günstige Preisen anzubieten. Der vorliegende Beitrag befasst sich mit dem Konzept Factory Outlet Store und der Frage, ob es sich hierbei um einen aktuellen Marketing-Trend handelt bzw. welche Mittel unternommen werden müssen, um Factory Outlet Stores nachhaltig zu etablieren. Hierzu werden Factory Outlet Stores aus der Marketing-Perspektive analysiert, bei de...

  7. Evaluation of female overactive bladder using urodynamics: relationship with female voiding dysfunction

    Directory of Open Access Journals (Sweden)

    Kang Jun Cho

    2015-08-01

    Full Text Available ABSTRACTPurpose:To investigate the role of urodynamic study (UDS in female patients with overactive bladder (OAB analyzing the relationship between OAB symptoms and female voiding dysfunction (FVD.Materials and Methods:We analyzed the clinical and urodynamic data of 163 women with OAB symptoms. OAB symptoms were categorized as dry and wet. FVD was described as detrusor underactivity (DUA, which was defined as a maximum flow rate (Qmax of ≤15mL/s associated with a detrusor pressure at Qmax (PdetQmax of ≤20cmH2O, along with bladder outlet obstruction (BOO, which was defined as a Qmax of ≤15mL/s with a PdetQmax of >20cmH2O. Clinical and urodynamic results were compared between patients with dry and wet symptoms and between those with and without FVD.Results:78 (47.9% had dry, and 85 (52.1% had wet symptoms. The entire group had a relatively low Qmax (15.1±6.6mL/s and relatively high number of BOO (42.9%, 70/163 and DUA (8.6%, 14/163. A significantly higher number of patients with wet symptoms had detrusor overactivity compared to those with dry, as detected by the UDS (p<0.05. No significant differences were found in BOO and DUA number between dry and wet groups. Further, the international prostate symptom score did not different significantly between patients with and without FVD.Conclusion:A significant number of women with OAB had voiding dysfunction. However, the OAB symptoms themselves were not useful for predicting the presence of FVD. Therefore, UDS may be necessary for accurate diagnosis in women with OAB symptoms.

  8. Urinary NGAL Levels Correlate with Differential Renal Function in Patients with Ureteropelvic Junction Obstruction Undergoing Pyeloplasty

    Science.gov (United States)

    Cost, Nicholas G.; Noh, Paul H.; Devarajan, Prasad; Ivancic, Vesna; Reddy, Pramod P.; Minevich, Eugene; Bennett, Michael; Haffner, Christopher; Schulte, Marion; DeFoor, W. Robert

    2014-01-01

    Purpose: Recent investigations described the use of NGAL, a sensitive biomarker for kidney injury, in the setting of ureteropelvic junction obstruction. We prospectively evaluated urinary NGAL levels in the affected renal pelvis and bladder of children with ureteropelvic junction obstruction undergoing unilateral dismembered pyeloplasty. Our hypothesis was that higher NGAL in the kidney and bladder would correlate with decreased ipsilateral differential function. Materials and Methods: We performed a prospective cohort study in patients treated with unilateral dismembered pyeloplasty from 2010 to 2012. Urine was obtained intraoperatively from the bladder and obstructed renal pelvis. A control population of unaffected children was recruited to provide a voided bladder specimen. Bladder NGAL levels were compared between the study and control populations. We tested our study hypothesis by correlating bladder and renal pelvic NGAL levels with the differential renal function of the affected kidney. Results: A total of 61 patients with a median age at surgery of 1.62 years (range 0.12 to 18.7) were enrolled in the study. Median bladder NGAL was 18.6 ng/mg (range 1.4-1,650.8) and median renal pelvic NGAL was 26.2 ng/mg (range 1.2-18,034.5, p = 0.004). Median bladder NGAL was significantly higher than in controls (p = 0.004). The correlation of bladder and renal pelvic NGAL with differential renal function was r = −0.359 (p = 0.004) and r = −0.383 (p = 0.002), respectively. Conclusions: Bladder NGAL is increased in children with ureteropelvic junction obstruction. Renal pelvic and bladder normalized urinary NGAL levels correlate inversely with the relative function of the affected kidney in cases of unilateral ureteropelvic junction obstruction. PMID:23791906

  9. SVC obstruction

    Science.gov (United States)

    ... Lymphoma Metastatic lung cancer (lung cancer that spreads) Testicular cancer Thyroid cancer Thymus tumor Superior vena cava obstruction ... Complications are serious and can sometimes be fatal. Prevention Prompt treatment of other medical disorders may reduce ...

  10. Intestinal obstruction

    Science.gov (United States)

    ... of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include: Bacteria or viruses that cause intestinal infections ( gastroenteritis ) Chemical, electrolyte, or mineral imbalances (such as decreased ...

  11. A rare case of recurrent urinary obstruction and acute renal failure from cystitis cystica et glandularis

    OpenAIRE

    Zhu, Justin X.G.; Gabril, Manal Y; Sener, Alp

    2012-01-01

    We report a rare case of recurrent florid cystitis cystica et glandularis (CCEG), common type, causing obstruction of the left ureterovesicle junction (UVJ) leading to renal colic and hydronephrosis. A 43-year-old man was admitted with renal colic, left UVJ obstruction, left hydronephrosis and azotemia. Cystoscopy showed a >4-cm bladder lesion compressing the left UVJ. Transurethral resection of the bladder tumour (TURBT) was performed and pathology revealed the lesion as CCEG. Two months lat...

  12. Mouse bladder wall injection.

    Science.gov (United States)

    Fu, Chi-Ling; Apelo, Charity A; Torres, Baldemar; Thai, Kim H; Hsieh, Michael H

    2011-07-12

    Mouse bladder wall injection is a useful technique to orthotopically study bladder phenomena, including stem cell, smooth muscle, and cancer biology. Before starting injections, the surgical area must be cleaned with soap and water and antiseptic solution. Surgical equipment must be sterilized before use and between each animal. Each mouse is placed under inhaled isoflurane anesthesia (2-5% for induction, 1-3% for maintenance) and its bladder exposed by making a midline abdominal incision with scissors. If the bladder is full, it is partially decompressed by gentle squeezing between two fingers. The cell suspension of interest is intramurally injected into the wall of the bladder dome using a 29 or 30 gauge needle and 1 cc or smaller syringe. The wound is then closed using wound clips and the mouse allowed to recover on a warming pad. Bladder wall injection is a delicate microsurgical technique that can be mastered with practice.

  13. URACHAL CARCINOMA IN BLADDER

    Institute of Scientific and Technical Information of China (English)

    薛丽燕; 吕宁; 何祖根; 林冬梅; 刘秀云

    2004-01-01

    Objective: To investigate the clinicopathologic features and diagnostic criteria of urachal carcinoma in the bladder.Methods: Seven cases of urachal carcinoma in the bladder were analyzed retrospectively. Results: All the tumors were found locating in the dome of bladder. Of them, 4 were mucinous adenocarcinoma, one was well differentiated papillary enteric adenocarcinoma, one was well differentiated squamous carcinoma, and one was neuroendocrine carcinoma. Cystomorphous urachal remnants were found in 4 cases. The main complaint was hematuria and all patients underwent partial excision of bladder and urachus. Conclusion: Mucinous adenocarcinoma is the main histo-pathological type, and cystomorphous urachal remnants are often accompanied with urachal carcinoma in the bladder. The key diagnostic criteria of urachal carcinoma in bladder are site and histopathology. And to examine the specimens carefully to find the urachal remnants is important.

  14. Treatment Option Overview (Bladder Cancer)

    Science.gov (United States)

    ... Cancer Treatment Bladder Cancer Screening Research Bladder Cancer Treatment (PDQ®)–Patient Version General Information About Bladder Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  15. Diabetic bladder dysfunction

    Institute of Scientific and Technical Information of China (English)

    Guiming Liu; Firouz Daneshgari

    2014-01-01

    Objective To review studies on diabetic bladder dysfunction (DBD),a common and bothersome complication of diabetes mellitus.Data sources We performed a search of the English literature through PubMed.The key words used were "diabetes" and "bladder dysfunction" or "cystopathy".Our own data and perspective are included in the discussion.Study selection Studies containing data relevant to DBD were selected.Because of the limited length of this article,we also referenced reviews that contain comprehensive amalgamations of relevant literature.Results The classic symptoms of DBD are decreased bladder sensation,increased bladder capacity,and impaired bladder emptying with resultant elevated post-void residual urine.However,recent clinical and experimental evidence indicate a strong presence of storage problems such as urge incontinence in diabetes.Recent studies of DBD in animal models of type 1 diabetes have revealed temporal effects of diabetes,causing an early phase of compensatory bladder function and a later phase of decompensated bladder function.The pathophysiology of DBD is multifactorial,including disturbances of the detrusor,urothelium,autonomic nerves,and urethra.Polyuria and hyperglycemia play important but distinctive roles in induction of bladder dysfunction in type 1 diabetes.Polyuria causes significant bladder hypertrophy in the early stage of diabetes,whereas oxidative stress in the bladder caused by chronic hyperglycemia may play an important role in the late stage failure of bladder function.Conclusions DBD includes time-dependent and mixed manifestations.The pathological alterations include muscle,nerve,and urothelium.Polyuria and hyperglycemia independently contribute to the pathogenesis of DBD.Treatments for DBD are limited.Future clinical studies on DBD in type 1 and type 2 diabetes should be investigated separately.Animal studies of DBD in type 2 diabetes are needed,from the natural history to mechanisms.Further understanding of the molecular

  16. Renal Papillary Necrosis Appearing as Bladder Cancer on Imaging.

    Science.gov (United States)

    Dagrosa, Lawrence M; Ghali, Fady; Gormley, Elizabeth Ann

    2016-01-01

    A 79-year-old woman with a history of diabetes mellitus and recurrent urinary tract infections (UTIs) presented with acute onset left lower quadrant pain, left-sided back pain, vomiting, and dysuria. Abdominopelvic CT scan revealed left hydroureteronephrosis to the level of the left ureterovesical junction (UVJ) where a bladder mass appeared to be obstructing the left ureteral orifice. The obstruction was ultimately found to be the result of a sloughed renal papilla lodged in the distal ureter, which created an inflammatory mass at the UVJ. Her history of diabetes and frequent UTIs likely predisposed her to the development of renal papillary necrosis (RPN) that resulted in sloughing of a renal papilla, distal ureteral obstruction with subsequent bladder inflammation that mimicked a bladder mass on imaging. RPN is a condition associated with many etiologies and likely represents a common final pathway of several diseases. Although several hypotheses exist, it is primarily thought to be ischemic in nature and is related to the underlying physiology of the renal papillae. We present a case of hydroureteronephrosis and bladder mass secondary to a sloughed renal papilla from RPN. PMID:27579408

  17. Stages of Bladder Cancer

    Science.gov (United States)

    ... red in color). Frequent urination. Pain during urination. Lower back pain. Tests that examine the urine and bladder are used to help detect (find) and diagnose bladder cancer. The following tests and ... left. Treatment given after surgery, to lower the risk that the cancer will come back, ...

  18. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has...

  19. Bladder dysfunction in children science fiction or [corrected] science fact: editorial comment.

    Science.gov (United States)

    Bägli, Darius J

    2012-08-01

    Functional bladder problems in children are often insidious and are frequently ignored by the child, by parents, and by many caregivers. Consideration of both the urinary and bowel outlets, and more recently, of the corticospinal tracts and brain reveal great complexity in this condition. In this article, the author addresses many of these issues in depth with a familiar personal experience derived from many years of dedicated consideration of these problems. Bladder dysfunction in the child is in many ways the pediatric urologist's hypertension diagnosis. Like antihypertensive therapy, bladder retraining strategies must be adhered to for life.

  20. Natural outlet of flue gases

    Science.gov (United States)

    Adámek, Karel; Kolář, Jan; Peukert, Pavel

    2016-06-01

    Many incidents of poisoning all the time became due to bad natural exhaust of burnt product from heating devices. The aim of this article is to simulate some reasons of it, therefore the content is focused on some influences, only - the vertical and horizontal shape of the outlet channel, the design of the chimney cap, situation of the surrounding walls, combined with the wind influence etc. It does not solve the possible bad maintaining of both chimney and device, bad supply of the combustion air etc. As main results of simulation there is presented an optimum cap shape of the chimney and an unsuitable influence of the unsteady starting of the flow just after the burner ignition.

  1. Paraganglioma of urinary bladder

    Directory of Open Access Journals (Sweden)

    Vinod Priyadarshi

    2015-01-01

    Full Text Available Paraganglioma of the urinary bladder are tumors of chromaffin tissue originating from the sympathetic innervations of the urinary bladder wall and are extremely rare. Being functional, in most of the cases they are recognized by their characteristic presentation of hypertensive crisis and postmicturition syncope. A silent presentation of a bladder paraganglioma is very unusual but quite dangerous as they are easily misdiagnosed and adequate peri-operative attention is not provided. Here, we are presenting one such silent paraganglioma in adult women who presented with only a single episode of hematuria and severe hypertensive crisis occur during its trans-urethral resection.

  2. Prostatic Adenocarcinoma Coexist with Transitional Cell Carcinoma of the Bladder and Prostate-A Case Report and Review of the Literature

    Institute of Scientific and Technical Information of China (English)

    TongZhang; YongXu; ShuminZhang

    2004-01-01

    Prostatic adenocarcinoma(PAC) with transitional cell carcinoma(TCC) of the bladder and prostate is a rare clinicopathological entity, presentation is usually late. We report a case with obstructive voiding symptoms and lumbago. Prostatic and cystic biopsy revealed PAC and TCC of bladder. Bone scan showed multiple bone metastases. He underwent transurethral resection of the prostate and bladder tumor and was found to have PAC with TCC of the bladder and prostate. We discuss the cases of PAC with TCC of the bladder and prostate.

  3. 自适应性生物反馈训练对出口梗阻型便秘患者临床疗效、心理状况和生命质量的影响%Impact of adaptive biofeedback training on clinical efficacy,psychological status and quality of life in patient with outlet obstruction constipation

    Institute of Scientific and Technical Information of China (English)

    李小平; 史久煜; Jiande DZ Chen; 徐月梅; 史池红

    2016-01-01

    Objective To explore the effects of adaptive biofeedback training(ABF)on efficacy of clinical efficacy,psychological status and life quality in patients with outlet obstruction constipation (OOC).Methods From June 2011 to October 2014,a total of 206 patients with OOC were enrolled. They were divided into ABF group and fixed biofeedback training (FBF)group.The clinical symptoms integral,clinical efficacy,psychological status and quality of life were observed before and eight weeks after treatment.Chi-square test or t-test was performed for statistical analysis.Results A total of 138 cases completed biofeedback training and were divided into ABF group (n=76)and FBF group (n=62). Before treatment,the total scores of clinical constipation symptoms of ABF and FBF groups were 10.95 ± 2.86 and 11 .20±2.23,respectively,which were 2.02±1 .10 and 2.98±1 .19 after treatment.The total scores of both groups decreased after treatment (t =2.60,2.45 ;both P 0.05).After treatment,the integral of each dimension of Chinese version of the MOS 36-item short form healtly survey (SF-36 )in ABF group and FBF group were both higher than those before treatment,and the differences were statistically significant (all P 0.05 ).Conclusions Both ABF and FBF can effectively improve clinical symptoms,psychological health and the quality of life in patients with OOC.However, ABF seems to be more effective and superior and more advantages.%目的:探讨自适应性生物反馈训练(ABF)对出口梗阻型便秘(OOC)患者临床症状疗效、心理状况和生命质量的改善程度。方法纳入2011年6月至2014年10月就诊的 OCC 患者206例,分成ABF 组和固定式生物反馈训练(FBF)组。观察治疗前和治疗后8周患者便秘临床症状、临床疗效、心理状态和生命质量情况。统计学分析采用卡方检验或 t 检验。结果共有138例完成了生物反馈治疗,其中ABF 组76例,FBF 组62例。ABF 组和 FBF 组治疗前便秘临

  4. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    OpenAIRE

    Bonasso, Patrick C.; Brandon Lucke-Wold; Uzer Khan

    2016-01-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  5. Small Bowel Obstruction Due to Suprapubic Catheter Placement

    Directory of Open Access Journals (Sweden)

    Patrick C. Bonasso

    2016-07-01

    Full Text Available Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection.

  6. Small Bowel Obstruction Due to Suprapubic Catheter Placement.

    Science.gov (United States)

    Bonasso, Patrick C; Lucke-Wold, Brandon; Khan, Uzer

    2016-07-01

    Suprapubic catheter placement has associated complications such as bowel injury, bladder injury, or bleeding. This case describes the management of an elderly patient who had suprapubic catheter placement complicated by small bowel obstruction. The catheter had continued production of urine. Further patient treatment required abdominal exploration and bowel resection. PMID:27335801

  7. Alcohol outlets and clusters of violence

    Directory of Open Access Journals (Sweden)

    Pridemore William

    2011-05-01

    Full Text Available Abstract Background Alcohol related violence continues to be a major public health problem in the United States. In particular, there is substantial evidence of an association between alcohol outlets and assault. However, because the specific geographic relationships between alcohol outlets and the distribution of violence remains obscured, it is important to identify the spatial linkages that may exist, enhancing public health efforts to curb both violence and morbidity. Methods The present study utilizes police-recorded data on simple and aggravated assaults in Cincinnati, Ohio. Addresses of alcohol outlets for Cincinnati, including all bars, alcohol-serving restaurants, and off-premise liquor and convenience stores were obtained from the Ohio Division of Liquor Control and geocoded for analysis. A combination of proximity analysis, spatial cluster detection approaches and a geographic information system were used to identify clusters of alcohol outlets and the distribution of violence around them. Results A brief review of the empirical work relating to alcohol outlet density and violence is provided, noting that the majority of this literature is cross-sectional and ecological in nature, yielding a somewhat haphazard and aggregate view of how outlet type(s and neighborhood characteristics like social organization and land use are related to assaultive violence. The results of the statistical analysis for Cincinnati suggest that while alcohol outlets are not problematic per se, assaultive violence has a propensity to cluster around agglomerations of alcohol outlets. This spatial relationship varies by distance and is also related to the characteristics of the alcohol outlet agglomeration. Specifically, spatially dense distributions of outlets appear to be more prone to clusters of assaultive violence when compared to agglomerations with a lower density of outlets. Conclusion With a more thorough understanding of the spatial relationships

  8. Obstructed uterus

    Energy Technology Data Exchange (ETDEWEB)

    Scott, W.W.; Rosenshein, N.B.; Siegelman, S.S.; Sanders, R.C.

    1981-12-01

    Eleven patients with an obstructed, fluid-filled uterus, due to carcinoma of the uterus or to its treatment by radiation therapy, were examined with computed tomography (CT) and/or ultrasound. It is important to recognize this abnormality to differentiate it from other causes of pelvic mass and to ensure prompt treatment of pyometra, should it develop. Both CT and ultrasound reliably identified this condition and differentiated it from other pelvic masses.

  9. Hypertension following primary bladder closure for vesical exstrophy.

    Science.gov (United States)

    Husmann, D A; McLorie, G A; Churchill, B M

    1993-02-01

    Since the initiation of staged reconstruction for bladder exstrophy, hypertension has been a known complication of the procedure. The etiology of the elevation in blood pressure was presumably secondary to ureteral dysfunction caused by edema at the ureterovesical junction and secondary renal obstruction. This report details the clinical course of three patients who developed significant hypertension following primary bladder closure with posterior iliac osteotomies and bony immobilization by skin traction. None of the patients had urinary obstruction and all had their hypertension alleviated by removal of the traction. The presumed etiology of the elevated blood pressure within these patients is similar to that experimentally produce by inappropriately applied traction resulting in tension on the sciatic nerve and reflex induced vasoconstriction. The need to maintain appropriately applied traction and the necessity of monitoring the postoperative blood pressure is stressed. PMID:8155094

  10. An Unexpected Foreign Body (a Thermometer in the Bladder: A Case Report

    Directory of Open Access Journals (Sweden)

    M. Dardamanis

    2014-03-01

    Full Text Available Foreign bodies in the bladder are rarely observed because of difficult access. These patients usually have a mental disorder, a background of intense sexual perversion, or inquisitiveness. A 48-year-old, deaf, and mentally retarded woman was referred to the nephrology clinic for severe anemia and impaired renal function. Imaging tests showed a mercury thermometer positioned in the bladder and a stone, 5 cm in diameter, around it. This had caused bilateral ureteral obstruction. The patient underwent an open cysteotomy. Obstructive uropathy is one of the causes of kidney failure; therefore, foreign bodies should be included in the differential diagnosis.

  11. Congenital urinary tract obstruction: the long view.

    Science.gov (United States)

    Chevalier, Robert L

    2015-07-01

    Maldevelopment of the collecting system resulting in urinary tract obstruction (UTO) is the leading identifiable cause of CKD in children. Specific etiologies are unknown; most cases are suspected by discovering hydronephrosis on prenatal ultrasonography. Congenital UTO can reduce nephron number and cause bladder dysfunction, which contribute to ongoing injury. Severe UTO can impair kidney growth in utero, and animal models of unilateral ureteral obstruction show that ischemia and oxidative stress cause proximal tubular cell death, with later development of interstitial fibrosis. Congenital obstructive nephropathy, therefore, results from combined developmental and obstructive kidney injury. Because of inadequacy of available biomarkers, criteria for surgical correction of upper tract obstruction are poorly established. Lower tract obstruction requires fetal or immediate postnatal intervention, and the rate of progression of CKD is highly variable. New biomarkers based on proteomics and determination of glomerular number by magnetic resonance imaging should improve future care. Angiotensin inhibitors have not been effective in slowing progression, although avoidance of nephrotoxins and timely treatment of hypertension are important. Because congenital UTO begins in fetal life, smooth transfer of care from perinatologist to pediatric and adult urology and nephrology teams should optimize quality of life and ultimate outcomes for these patients. PMID:26088076

  12. Tissue-engineered conduit using bladder acellular matrix and bladder epithelial cells for urinary diversion in rabbits

    Institute of Scientific and Technical Information of China (English)

    LIAO Wen-biao; SONG Chao; LI Yong-wei; YANG Si-xing; MENG Lin-chao; LI Xin-hui

    2013-01-01

    Background For muscle invasive bladder cancer,radical cystectomy is the most effective treatment now and urinary diversion is often necessary.The use of intestinal tissue for urinary diversion is frequently associated with complications.In this study,we aimed to make a tissue-engineered conduit (TEC) using bladder epithelial cells and bladder acellular matrix (BAM) for urinary diversion in rabbits.Methods Bladder epithelial cells of rabbit were cultivated and expanded in vitro,then seeded on BAM,and cultured for 7 days.Then cell-seeded graft was used to make TEC.In the experimental group,most of bladder of the rabbit was removed while bladder trigone was retained.The proximal end of TEC was anastomosed with bladder trigone and the distal end was anastomosed with the abdominal stoma.In the control group,TEC was made using unseeded BAM.Haematoxylin and eosin staining was conducted,respectively,at 1,2,4,and 8 weeks postoperatively.Immunohistochemistry was performed 8 weeks postoperatively.Intravenous urography,retrograde pyelography,and cystoscopy of TEC were made at 12 weeks postoperatively.Results All animals were alive in the experimental group.Haematoxylin and eosin staining showed epithelial coverage in TEC.Immunohistochemistry showed anti-cytokeratin AE1/AE3 antibody and anti-ZO1 antibody positive,confirming there were mature and functional epithelial cells on the lumen of TEC.Retrograde pyelography and intravenous urography showed that TEC developed well and that there was no obstruction.In the control group,four rabbits were dead within 2 weeks and scar formation,atresia,and severe hydronephrosis were found.Conclusions We successfully made TEC using BAM and bladder epithelial cells for urinary diversion in rabbits.The lumen of this new TEC covered mature epithelial cells and could prevent urinary extravasation.

  13. Spontaneous Bladder Perforation in an Infant Neurogenic Bladder: Laparoscopic Management

    Directory of Open Access Journals (Sweden)

    Daniel Cabezalí Barbancho

    2013-01-01

    Full Text Available Spontaneous bladder perforation is an uncommon event in childhood. It is usually associated with bladder augmentation. We are presenting a case of bladder rupture in an infant with neurogenic bladder without prior bladder surgery. Three days after lipomyelomeningocele excision the patient showed signs and symptoms of acute abdomen. The ultrasound exploration revealed significant amount of intraperitoneal free fluid and therefore a laparoscopic exploration was performed. A posterior bladder rupture was diagnosed and repaired laparoscopically. Currently, being 3 years old, she keeps successfully dry with clean intermittent catheterization. Neurogenic bladder voiding function can change at any time of its evolution and lead to complications. Early diagnosis of spontaneous bladder rupture is of paramount importance, so it is essential to think about it in the differential diagnosis of acute abdomen.

  14. Nerve Disease and Bladder Control

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... KB) Alternate Language URL Nerve Disease and Bladder Control Page Content On this page: What bladder control ...

  15. Socioeconomic Determinants of Exposure to Alcohol Outlets

    Science.gov (United States)

    Morrison, Christopher; Gruenewald, Paul J.; Ponicki, William R.

    2015-01-01

    Objective: Alcohol outlets tend to be located in lower income areas, exposing lower income populations to excess risks associated with alcohol sales through these establishments. The objective of this study was to test two hypotheses about the etiology of these differential exposures based on theories of the economic geography of retail markets: (a) outlets will locate within or near areas of high alcohol demand, and (b) outlets will be excluded from areas with high land and structure rents. Method: Data from the 2010 National Drug Strategy Household Survey were used to develop a surrogate for alcohol demand (i.e., market potential) at two census geographies for the city of Melbourne, Australia. Bayesian conditional autoregressive Poisson models estimated multilevel spatial relationships between counts of bars, restaurants, and off-premise outlets and market potential, income, and zoning ordinances (Level 1: n = 8,914). Results: Market potentials were greatest in areas with larger older age, male, English-speaking, high-income populations. Independent of zoning characteristics, greater numbers of outlets appeared in areas with greater market potentials and the immediately surrounding areas. Greater income excluded outlets in local and surrounding areas. Conclusions: These findings are consistent with the hypothesis that alcohol outlets are located in areas with high demand and are excluded from high-income areas. These processes appear to take place at relatively small geographic scales, encourage the concentration of outlets in specific low-income areas, and represent a very general economic process likely to take place in communities throughout the world. PMID:25978830

  16. Promotion in urinary bladder carcinogenesis.

    OpenAIRE

    Cohen, S M

    1983-01-01

    Aromatic amines, including 2-naphthylamine, 4-aminobiphenyl and benzidine, are known urinary bladder carcinogens in man and other species, but in rodents, aromatic amines and amides have usually induced liver tumors, occasionally also with tumors of the bladder and other tissues. Variations in organ specificity are related to differences in metabolism; for the production of bladder tumors, the rates of acetylation and deacetylation appear to be critical. Bladder specific carcinogens in rodent...

  17. Alcohol outlets, social disorganization, and robberies: accounting for neighborhood characteristics and alcohol outlet types.

    Science.gov (United States)

    Snowden, Aleksandra J; Freiburger, Tina L

    2015-05-01

    We estimated spatially lagged regression and spatial regime models to determine if the variation in total, on-premise, and off-premise alcohol outlet(1) density is related to robbery density, while controlling for direct and moderating effects of social disorganization.(2) Results suggest that the relationship between alcohol outlet density and robbery density is sensitive to the measurement of social disorganization levels. Total alcohol outlet density and off-premise alcohol outlet density were significantly associated with robbery density when social disorganization variables were included separately in the models. However, when social disorganization levels were captured as a four item index, only the association between off-premise alcohol outlets and robbery density remained significant. More work is warranted in identifying the role of off-premise alcohol outlets and their characteristics in robbery incidents. PMID:25769858

  18. CLINICO-PATHOLOGICAL STUDY OF CARCINOMA GALL BLADDER

    Directory of Open Access Journals (Sweden)

    Ravindra

    2015-12-01

    Full Text Available INTRODUCTION Gall bladder cancer is 5th most common cancer of GIT. It is associated with cholelithiasis in significant number of patients. Cholelithiasis is cause or effect of gall bladder cancer is still uncertain. There are many risk factors which are common to both gall stones and cancer. Preoperative diagnosis of gall bladder cancer is increased with better and new investigation facilities. AIM The study was aimed to assess clinicopathological behaviour, sociodemography, diagnostic modalities and treatment of cancer gall bladder. MATERIAL AND METHODS It was a type of prospective study which included 75 patients with clinical features suggestive of biliary disease. Various diagnostic modalities and treatment options were assessed along with sociodemography and clinical picture. RESULT Common clinical features were pain abdomen, obstructive jaundice and lump. Nearly one third of the patients were having anaemia and abnormal liver function tests. Majority had gall bladder fossa mass with liver extension and gall stones. The most common histopathological variety of carcinoma Gallbladder was Adenocarcinoma. CONCLUSION Carcinoma Gallbladder was found to affect predominantly the older female patients after the age of 40 years. Cholelithiasis was found in 69.3% patients of carcinoma Gallbladder. The most common clinical presentation was pain abdomen (90.7%. The most common histopathological variety of carcinoma Gallbladder was Adenocarcinoma. Majority of patients were treated with palliative measures.

  19. Acute colonic obstruction due to benign prostatic hypertrophy.

    LENUS (Irish Health Repository)

    Mac Giobuin, S

    2012-02-01

    A seventy two year old man presented to the Emergency Department with clinical features of colonic obstruction. Subsequent radiological investigations confirmed this impression and revealed the aetiology to be compression of the sigmoid colon against the sacrum by a massively distended urinary bladder. Chronic urinary retention due to benign prostatic hypertrophy is an extremely unusual cause of large bowel obstruction. Little in this patient\\'s clinical findings suggested this aetiology. We reviewed the literature in this area and highlight the benefits of CT scanning over contrast studies.

  20. A case of enterolith small bowel obstruction and jejunal diverticulosis

    Institute of Scientific and Technical Information of China (English)

    Buhussan Hayee; Hamed Noor Khan; Talib Al-Mishlab; John F Mcpartlin

    2003-01-01

    We reported a case of 79-year old woman with known large bowel diverticulosis presenting with small bowel obstruction due to stone impaction - found on plain abdominal X-ray.Contrast studies demonstrated small bowel diverticulosis.At laparotomy, the gall bladder was normal with no stones and no abnormal communication with small bowel - excluding the possibility of a gallstone ileus. Analysis of the stone revealed a composition of bile pigments and calcium oxalate.This was a rare case of small bowel obstruction due to enterolith formation - made distinctive by calcification (previously unreported in the proximal small bowel).

  1. Bladder neck contracture

    OpenAIRE

    Simhan, Jay; Ramirez, Daniel; Hudak, Steven J.; Morey, Allen F.

    2014-01-01

    Bladder neck contracture (BNC) is a well-described complication of the surgical treatment of benign and malignant prostate conditions. Nevertheless, etiologies of BNC development are highly dependent on the primary treatment modality undertaken with BNC also occurring after pelvic radiation. The treatment options for BNC can range from simple, office-based dilation procedures to more invasive, complex abdomino-perineal reconstructive surgery. Although numerous strategies have been described, ...

  2. Endoscopic Management of Bladder Diverticula.

    Science.gov (United States)

    Pham, Khanh N; Jeldres, Claudio; Hefty, Thomas; Corman, John M

    2016-01-01

    A 50-year-old man with benign prostatic hyperplasia and urinary retention had a very large diverticulum on the posterior wall of the bladder. The patient was managed with transurethral resection of the prostate and endoscopic fulguration of the bladder diverticulum mucosa using the Orandi technique. There was near-complete resolution of the bladder diverticulum following endoscopic management, obviating the need for bladder diverticulectomy. The patient now empties his bladder, with a postvoid residual < 50 mL and the absence of urinary tract infection after 6-month follow-up. We report the successful treatment of a large bladder diverticulum with endoscopic fulguration to near-complete resolution. This minimally invasive technique is a useful alternative in patients unfit for a more extensive surgical approach. PMID:27601971

  3. Contemporary Management of Bladder Cancer

    Science.gov (United States)

    Bell, David; Fradet, Yves

    1991-01-01

    Bladder cancer is currently the fifth most common cancer in Western society, and its incidence appears to be increasing. Important advances have recently occurred in both diagnostic and therapeutic approaches to bladder neoplasms. Presentation is not unique, and physician awareness is important to identify patients who are at risk for bladder neoplasia and consequently require further investigation. A diagnostic approach and contemporary management are discussed. ImagesFigure 1Figure 4 PMID:21229043

  4. Permeability and ultrastructure of human bladder epithelium

    DEFF Research Database (Denmark)

    Eldrup, J; Thorup, Jørgen Mogens; Nielsen, S L;

    1983-01-01

    Leakage of tight junctions as observed with electron microscopy and demonstration of solute transport across bladder epithelium was investigated in 13 patients with different bladder diseases: urinary retention and infection, bladder tumours and interstitial cystitis. The latter group showed cons...

  5. Treatment Options by Stage (Bladder Cancer)

    Science.gov (United States)

    ... Cancer Treatment Bladder Cancer Screening Research Bladder Cancer Treatment (PDQ®)–Patient Version General Information About Bladder Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on ...

  6. Intestinal obstruction repair

    Science.gov (United States)

    Repair of volvulus; Intestinal volvulus - repair; Bowel obstruction - repair ... Intestinal obstruction repair is done while you are under general anesthesia . This means you are asleep and DO NOT feel pain. ...

  7. Managing upper airway obstruction.

    Science.gov (United States)

    Innes, M H

    A complete respiratory obstruction can lead to death in 3 minutes. The first and constant duty of the nurse aider is to check that the person is breathing by looking, listening and feeling. Partial obstruction is no less serious than complete obstruction. The nurse aider, in any situation, should assess the problem and attempt to overcome the airway obstruction using the measures described. PMID:1490067

  8. Malignant duodenal obstructions: palliative treatment with covered expandable nitinol stent

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Chul; Jung, Gyoo Sik; Lee, Sang Hee; Kim, Sung Min; Oh, Kyung Seung; Huh, Jin Do; Cho, Young Duk [College of Medicine, Kosin Univ, Pusan (Korea, Republic of); Song, Ho Young [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2002-04-01

    To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was technically successful in ten patients, and no procedural complications occuured. In one of two patients in whom there was technical failure, and in whom the obstructions were located in part III, the stent was placed transgastrically. Stent migration occurred in one patient four days after the procedure, and treatment involved the palcement of a second, uncovered, nitinol stent. After stent placement, symptoms improved in all patients. During follow-up, obstructive symptoms due to stent stenosis (n=1), colonic obstruction (n=1), and multiple small bowel obstruction (n=1) recurred in three patients. Two of these were treated by placing additional stents in the duodenum and colon, respectively. One of the eight patients in whom a stent was placed in the second portion of the duodenum developed jaundice. The patients died a mean 14 (median, 9) weeks after stent placement. The placement of a polyurethane-covered expandable nitinol stent seems to be technically feasible, safe and effective for the palliative treatment of malignant

  9. Immunotherapy for bladder cancer.

    Science.gov (United States)

    Fuge, Oliver; Vasdev, Nikhil; Allchorne, Paula; Green, James Sa

    2015-01-01

    It is nearly 40 years since Bacillus Calmette-Guérin (BCG) was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment. As a better understanding of its mechanism of action and the clinical response to it have evolved, some of the questions around optimal dosing and treatment protocols have been answered. However, its potential for toxicity and failure to produce the desired clinical effect in a significant cohort of patients presents an ongoing challenge to clinicians and researchers alike. This review summarizes the evidence behind the established mechanism of action of BCG in bladder cancer, highlighting the extensive array of immune molecules that have been implicated in its action. The clinical aspects of BCG are discussed, including its role in reducing recurrence and progression, the optimal treatment regime, toxicity and, in light of new evidence, whether or not there is a superior BCG strain. The problems of toxicity and non-responders to BCG have led to development of new techniques aimed at addressing these pitfalls. The progress made in the laboratory has led to the identification of novel targets for the development of new immunotherapies. This includes the potential augmentation of BCG with various immune factors through to techniques avoiding the use of BCG altogether; for example, using interferon-activated mononuclear cells, BCG cell wall, or BCG cell wall skeleton. The potential role of gene, virus, or photodynamic therapy as an alternative to BCG is also reviewed. Recent interest in the immune check point system has led to the development of monoclonal antibodies against proteins involved in this pathway. Early findings suggest benefit in metastatic disease, although the role in superficial bladder cancer remains unclear. PMID:26000263

  10. Postmortem MRI of bladder agenesis

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Brendan R. [St George' s Hospital, Radiology Department, London (United Kingdom); Weber, Martin A. [Great Ormond Street Hospital for Children, Department of Histopathology, London (United Kingdom); Bockenhauer, Detlef [Great Ormond Street Hospital for Children, Department of Nephrology, London (United Kingdom); Hiorns, Melanie P.; McHugh, Kieran [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom)

    2011-01-15

    We report a 35-week preterm neonate with bladder agenesis and bilateral dysplastic kidneys. A suprapubic catheter was inadvertently inserted into one of the larger inferior cysts of the left dysplastic kidney. A postmortem MRI scan was performed with the findings being confirmed on autopsy. We are unaware of another postmortem MRI study demonstrating bladder agenesis. (orig.)

  11. Immunotherapy for bladder cancer

    Directory of Open Access Journals (Sweden)

    Fuge O

    2015-05-01

    Full Text Available Oliver Fuge,1 Nikhil Vasdev,1 Paula Allchorne,2 James SA Green2 1Department of Urology, Lister Hospital, Stevenage, UK; 2Department of Urology, Bartshealth NHS Trust, Whipps Cross Rd, London, UK Abstract: It is nearly 40 years since Bacillus Calmette–Guérin (BCG was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment. As a better understanding of its mechanism of action and the clinical response to it have evolved, some of the questions around optimal dosing and treatment protocols have been answered. However, its potential for toxicity and failure to produce the desired clinical effect in a significant cohort of patients presents an ongoing challenge to clinicians and researchers alike. This review summarizes the evidence behind the established mechanism of action of BCG in bladder cancer, highlighting the extensive array of immune molecules that have been implicated in its action. The clinical aspects of BCG are discussed, including its role in reducing recurrence and progression, the optimal treatment regime, toxicity and, in light of new evidence, whether or not there is a superior BCG strain. The problems of toxicity and non-responders to BCG have led to development of new techniques aimed at addressing these pitfalls. The progress made in the laboratory has led to the identification of novel targets for the development of new immunotherapies. This includes the potential augmentation of BCG with various immune factors through to techniques avoiding the use of BCG altogether; for example, using interferon-activated mononuclear cells, BCG cell wall, or BCG cell wall skeleton. The potential role of gene, virus, or photodynamic therapy as an alternative to BCG is also reviewed. Recent interest in the immune check point system has led to the development of monoclonal antibodies against proteins involved in this pathway. Early findings suggest

  12. Emerging Immunotargets in Bladder Cancer.

    Science.gov (United States)

    Massari, Francesco; Ciccarese, Chiara; Vau, Nuno; Santoni, Matteo; Montironi, Rodolfo; Cheng, Liang; Marques, Rita C; Scarpelli, Marina; Fonseca, Jorge; Matrana, Marc R; Holger, Moch; Cascinu, Stefano; Tortora, Giampaolo; Lopez-Beltran, Antonio

    2016-01-01

    Bladder cancer treatment, namely systemic therapy, was dominated in the last three decades due to the absence of newer therapeutic options other than chemotherapy regimens. Chemotherapy, by itself, both in first and second-line seems to have achieved the modest plateau of its possibilities at the cost of non-negligible toxicity. Targeted therapies, which changed the therapy of many different tumors, seem rather ineffective in bladder cancer. More recently, a new generation of Immunotherapy based regimens represent the most promising avenue for the future systemic treatment of bladder cancer. Checkpoint inhibition, namely PD1/PD-L1 pathway inhibition, showed impressive results in many other tumor types and are expected to become a major player in the treatment of bladder cancer. Other immunotherapy strategies such as fusion proteins represent distant, although promising, options. A brief overview of the current status of bladder cancer immunotherapy is presented.

  13. Alcohol outlet policies and practices concerning sales to underage people.

    Science.gov (United States)

    Wolfson, M; Toomey, T L; Murray, D M; Forster, J L; Short, B J; Wagenaar, A C

    1996-04-01

    Little is known about the relationship between alcohol outlet policies and practices in the United States and the likelihood that outlets will sell alcoholic beverages to persons under the legal drinking age. This study assessed the prevalence of such outlet-level policies and practices, and analyzed the relationships between outlet variables and outlets' actual propensity to sell alcoholic beverages to youth. The sample consisted of all outlets licensed for off-premise and a 40% random sample of outlets licensed for on-premise sale of alcoholic beverages in 15 small to medium-sized communities in Minnesota and Wisconsin (USA). Data on outlet characteristics, policies and practices were collected by a telephone survey of the owner or manager of each outlet. In addition, alcohol purchase attempts were conducted at each outlet by youthful-appearing study confederates. Generally, policies and practices that may reduce the likelihood of sales to youth were reported by a minority of outlets. Purchase success was found to be associated with a number of outlet characteristics, policies and practices. The implications of these findings for policy and future research are discussed. PMID:8857384

  14. 7 CFR 993.108 - Non-human consumption outlet.

    Science.gov (United States)

    2010-01-01

    ... CALIFORNIA Administrative Rules and Regulations Definitions § 993.108 Non-human consumption outlet. Non-human consumption outlet means any livestock feeder or manufacturer of inedible syrup, industrial alcohol, animal... 7 Agriculture 8 2010-01-01 2010-01-01 false Non-human consumption outlet. 993.108 Section...

  15. Analysis of the Sales Promotion in Choice Retail Outlet

    OpenAIRE

    HUMPOLCOVÁ, Michaela

    2010-01-01

    My bachelor thesis is aimed at sales promotion in a retail outlet. The main aim of this thesis is evaluate the current state of sales promotion in a selected retail outlet and based on the analysis of the current state of sales promotion in the outlet to try to propose some measures of improve.

  16. Alcohol Outlet Density and Intimate Partner Violence in a Nonmetropolitan College Town: Accounting for Neighborhood Characteristics and Alcohol Outlet Types.

    Science.gov (United States)

    Snowden, Aleksandra J

    2016-01-01

    There is a growing evidence of an ecological association between alcohol outlet density and intimate partner violence. It is reasonable to assume, however, that not all types of alcohol outlets contribute equally to criminal behavior, and to date, most ecological studies have been of large urban cities. Using Bloomington, Indiana, block groups as units of analysis and controlling for several structural characteristics associated with violence rates, I estimated spatially lagged regression models to determine if the variation in alcohol outlet density, including total outlets and disaggregating by on- and off-premise outlets, is related to intimate partner violence density. Results suggested that total alcohol outlet density and off-premise alcohol outlet density were significantly associated with intimate partner violence density. On-premise alcohol outlet density was not significantly associated with intimate partner violence density. These results not only extend the geographic scope of this relationship beyond large metropolitan areas but also have important policy implications.

  17. Familial aggregation of bladder cancer

    Directory of Open Access Journals (Sweden)

    Ilić Milena

    2011-01-01

    Full Text Available Background. Except for smoking and certain occupational exposures, the etiology of bladder cancer is largely unknown. Several case reports have described familial aggregation of transitional cell carcinoma of the bladder. Although the majority of patients with bladder cancer do not have family history of transitional cell carcinoma of the urinary tract, the study of familial transitional cell carcinoma may lead to the knowledge on the pathogenesis of this disease. The purpose of this study was to describe three cases of urinary bladder cancer in a single three-member family, i.e. in two generations (mother and son and a family member related by marriage (the patient’s wife. Case report. Three cases of urinary bladder cancer occurred in a three-member family within the interval of 5 years. The following common characteristics were detected in our patients: old age (over 60, working as farmers for more than 50 years, negative personal medical history on relevant health disorders, place of birth - village, place of residence - village, the same water supply, similar nutrition, positive family history on urinary bladder cancer or other malignant tumors, the first sign of illness was macroscopic hematuria in all the patients and the same pathohistological type of cancer - carcinoma papillare transitiocellulare. Conclusion. The stated common characteristics in our cases indicate, above all, the impact of exposure to external surrounding factors on the occurrence of urinary bladder cancer.

  18. Gallstone obstruction in anastomotic stricture: A very rare case

    Directory of Open Access Journals (Sweden)

    Burak Veli Ülger

    2015-03-01

    Full Text Available Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause of small bowel obstruction but it accounts up to 25% of non-strangulated small bowel obstructions in elderly. Obstruction usually occurs in the terminal ileum. Although the most frequent mechanism of gallstone ileus is migration of the gallstone through a gallbladder-duodenal fistula, there have been cases of bowel obstruction caused by gallstones without any findings of bilio-enteric fistula during the operation. The diagnosis is usually delayed due to nonspecific clinical signs and symptoms. Abdominal computerized tomography (CT scan is the optimal way to diagnose the gallstone ileus. It can identify the site and nature of the obstruction. The optimal surgical approach is a matter of debate. Enterolithotomy is the most performed operation. One stage operation should be performed in selected low risk patients. In this study, we report a 55 years old male patient who underwent surgical intervention due to gallstone ileus. During the operation, we observed that two individual gallstones lead to obstruction in anastomoticstricture which was due to the patient’s prior small bowel resection. Also, no fistula was found during the operation between the gall bladder and the gastrointestinal tract of patient. The gallstones were removed by enterolithotomy. Because there was no gallstone in the allbladder, we did not perform cholecystectomy. J Clin Exp Invest 2015; 6 (1: 72-74

  19. Bladder Diverticulitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Michael Silberman

    2011-01-01

    Full Text Available Bladder diverticulum, an outpouching of the mucosa through the muscular wall of the bladder, is a multifactorial disease process that can be either acquired or congenital. Although small diverticuli are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation. We describe the case of an elderly gentleman who presented to the emergency department with abdominal pain and was ultimately diagnosed with bladder diverticulitis, a disease not previously described in the literature.

  20. Underactive Bladder in Older Adults.

    Science.gov (United States)

    Chuang, Yao-Chi; Plata, Mauricio; Lamb, Laura E; Chancellor, Michael B

    2015-11-01

    Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies. PMID:26476113

  1. Experimental rat bladder urothelial cell carcinoma models

    OpenAIRE

    Arentsen, Harm C.; Hendricksen, Kees; Oosterwijk, Egbert; Witjes, J Alfred

    2009-01-01

    Bladder cancer is a major public health problem. Currently available therapeutic options seem to be unable to prevent bladder cancer recurrence and progression. To enable preclinical testing of new intravesical therapeutic agents, a suitable bladder tumor model that resembles human disease is highly desirable. The aim of this topic paper was to discuss the problems associated with current in vivo animal bladder tumor models, focusing on the orthotopic syngeneic rat bladder tumor model. In the...

  2. Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention

    Directory of Open Access Journals (Sweden)

    Amit Frenkel

    2015-01-01

    Full Text Available Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000. It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently, in men, it is usually associated with some degree of urinary retention. We present a 42-year-old man in whom herniation of the urinary bladder was the cause of urinary retention, and not vice versa. The patient was on tumor necrosis factor alpha antagonist (TNFA (Etanercept for severe Ankylosing spondylitis. Initially, the urinary retention was thought to be a side effect of the medication, but after the drug was discontinued, urinary retention persisted. CT and MRI demonstrated huge herniation of the urinary bladder into the inguinal canal. Immediately after the hernia was repaired, bladder function was restored. TNF treatment was restarted, and no further urinary symptoms were observed in the next two years of follow-up. In this case, the primary illness and its treatment were distracting barriers to early diagnosis and treatment. In younger patients with a large hernia who develop unexpected urinary retention, herniation of the urinary bladder should be highly considered in the differential diagnosis.

  3. Operativ behandling af thoracic outlet syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Stiasny, Jerzy

    2012-01-01

    We present three cases with longstanding true neurogenic thoracic outlet syndrome. All patients had aching pain in the shoulder, arm and ulnar border of the hand. On examination, we found atrophy of the hand muscles. Electromyography revealed signs of compromised function of the inferior trunk...... of the brachial plexus. At surgery, we found and severed a fibrous band that compressed the inferior trunk. Postoperatively, the pain subsided and fine hand movements improved. One patient had no cervical rib, however, in the two other cases we found rudimentary cervical ribs. Magnetic resonance imaging...

  4. Ct2 Bladder Cancer.

    Science.gov (United States)

    Soloway, Mark S

    2016-09-01

    The patient is an 80-year-old man who presented with gross hematuria. His past medical history indicates he was a cigarette smoker with 50 pack/years. He was successfully treated for carcinoma of the lung 7 years ago. He received chemotherapy, radiation, and surgery. He has mild COPD but has a good performance status. His laboratory studies do not indicate any abnormalities in terms of renal function. He does not have any significant cardiac disease. He has a medium build. He had prostate cancer and underwent a successful radical prostatectomy 10 years ago. His PSA is undetectable. He has some urinary incontinence and wears two pads/day. He underwent the appropriate investigations for gross hematuria. A CT scan of the abdomen and pelvis was normal with the exception of a 4-cm posterior mass in the bladder. There was no hydronephrosis and no enlarged lymph nodes. He underwent a transurethral resection of a solitary bladder tumor performed by another urologist. The tumor was described as large and sessile. It was located on the posterior wall and was approximately 4 cm. The bimanual examination did not reveal a mass. The pathology report stated that the tumor was a high-grade urothelial carcinoma with invasion into the muscularis propria. There was no lymphovascular invasion. I performed a reTURBT, and at that procedure, I did not identify any obvious tumor but the prior resection site was evident. I resected the prior tumor site quite extensively both in depth and width. The pathology revealed only focal carcinoma in situ. There was ample muscle in the specimen and there was some fat as well. As stated, they were free of any cancer. The patient is receptive to any treatment approach. PMID:27457483

  5. Intestinal Pseudo-Obstruction

    Science.gov (United States)

    ... underlying illness, stop the medication, or do both. Nutritional Support People with intestinal pseudo-obstruction often need nutritional support to prevent malnutrition and weight loss. Enteral nutrition ...

  6. Chronic obstructive pulmonary disease

    Science.gov (United States)

    ... airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... a protein called alpha-1 antitrypsin can develop emphysema. Other risk factors for COPD are: Exposure to ...

  7. Genetics Home Reference: bladder cancer

    Science.gov (United States)

    ... ND, Rubenstein JN, Eggener SE, Kozlowski JM. The p53 tumor suppressor gene and nuclear protein: basic science review and relevance in the management of bladder cancer. J Urol. 2003 Apr;169(4):1219-28. ...

  8. Nerve Disease and Bladder Control

    Science.gov (United States)

    ... Coordinating Committees NIDDK Advisory Council, Board of Scientific Advisors, and committees that coordinate research activities Research Areas ... bladder diary-a record of your fluid intake, trips to the bathroom, and episodes of urine leakage. ...

  9. Drugs Approved for Bladder Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for bladder cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  10. [Melanosis of the urinary bladder].

    Science.gov (United States)

    Wöllner, J; Janzen, J; Pannek, J

    2016-01-01

    Melanosis of the bladder is rare. Only 10 cases have been described in the literature. We present the case of an 80-year-old woman with neurogenic lower urinary tract dysfunction due to spinal paralysis. During the diagnostic work-up which included cystoscopy, black spots in the bladder wall were observed. Histopathological evaluation revealed a benign suburothelial melanosis. Thus, with cystoscopic suspicion of a malignancy (melanoma), a biopsy is mandatory and regular cystoscopic follow-up is recommended. PMID:26358438

  11. Bladder Dysfunction and Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Ulla Sillén

    2008-01-01

    Full Text Available In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB and the dysfunctional voiding (DV, have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could not support these results. Regarding the OAB, a prospective study with treatment of the bladder overactivity with anticholinergics, did not influence spontaneous resolution rate in children with a dysfunction including also the voiding phase, DV and DES (dysfunctional elimination syndrome, most studies indicate a negative influence on the resolution rate of VUR in children, both before and after the age for bladder control, both with and without treatment. However, a couple of uncontrolled studies indicate that there is a high short-term resolution rate after treatment with flow biofeedback. It should be emphasized that the voiding phase dysfunctions (DV and DES are more severe than the genuine filling phase dysfunction (OAB, with an increased frequency of UTI and renal damage in the former groups. To be able to answer the question if treatment of bladder dysfunction influence the resolution rate of VUR in children, randomized controlled studies must be performed.

  12. Procalcitonin is a strong predictor of urine culture results in patients with obstructing ureteral stones: A prospective, pilot study

    OpenAIRE

    Dimitri Papagiannopoulos; Patrick Whelan; Waseem Ahmad; James Rybak; Bala Hota; Leslie Deane; Ajay Nehra

    2016-01-01

    Purpose: The appropriate management of infected obstructing ureteral calculi is prompt genitourinary decompression. Urine cultures are the gold standard for confirming infection but often take 24–48 h to result. Although white blood cell (WBC) count is an important diagnostic laboratory test, it is a nonspecific inflammatory marker. Similarly, urinalysis (UA) can be misleading in the setting of a contaminated sample, bladder colonization, or in cases of a completely obstructed the upper urina...

  13. Obstructive sleep apnea therapy

    NARCIS (Netherlands)

    Hoekema, A.; Stegenga, B.; Wijkstra, P. J.; van der Hoeven, J. H.; Meinesz, A. F.; de Bont, L. G. M.

    2008-01-01

    In clinical practice, oral appliances are used primarily for obstructive sleep apnea patients who do not respond to continuous positive airway pressure (CPAP) therapy. We hypothesized that an oral appliance is not inferior to CPAP in treating obstructive sleep apnea effectively. We randomly assigned

  14. Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents

    Science.gov (United States)

    Peng, Chih-Wei; Chen, Jia-Jin Jason; Cheng, Chen-Li; Grill, Warren M.

    2008-06-01

    Urinary retention is the inability to empty the bladder completely, and may result from bladder hypocontractility, increases in outlet resistance or both. Chronic urinary retention can lead to several urological complications and is often refractory to pharmacologic, behavioral and surgical treatments. We sought to determine whether electrical stimulation of sensory fibers in the pudendal nerve could engage an augmenting reflex and thereby improve bladder emptying in an animal model of urinary retention. We measured the efficiency of bladder emptying with and without concomitant electrical stimulation of pudendal nerve afferents in urethane-anesthetized rats. Voiding efficiency (VE = voided volume/initial volume) was reduced from 72 ± 7% to 29 ± 7% following unilateral transection of the sensory branch of the pudendal nerve (UST) and from 70 ± 5% to 18 ± 4% following bilateral transection (BST). Unilateral electrical stimulation of the proximal transected sensory pudendal nerve during distention-evoked voiding contractions significantly improved VE. Low-intensity stimulation at frequencies of 1-50 Hz increased VE to 40-51% following UST and to 39-49% following BST, while high-intensity stimulation was ineffective at increasing VE. The increase in VE was mediated by increases in the duration of distention-evoked voiding bladder contractions, rather than increases in contraction amplitude. These results are consistent with an essential role for pudendal sensory feedback in efficient bladder emptying, and raise the possibility that electrical activation of pudendal nerve afferents may provide a new approach to restore efficient bladder emptying in persons with urinary retention.

  15. Antivortex Device for Multi-Outlet Liquid Reservoir

    Science.gov (United States)

    Grayson, Gary David (Inventor); Addison, Stephen Michael (Inventor)

    2016-01-01

    A liquid reservoir with a sump includes at least two outlet ports in fluid communication with a fluid conduit. An anti-vortex device includes a first plate extending across the at least two outlet ports and a second plate coupled to the first plate and extending substantially perpendicular to the first plate. The anti-vortex device is configured to disrupt formation of a vortex formed by liquid passing from the reservoir through said outlet ports.

  16. The Geography of Fast Food Outlets: A Review

    OpenAIRE

    Fraser, Lorna K; Edwards, Kimberly L.; Janet Cade; Clarke, Graham P

    2010-01-01

    The availability of food high in fat, salt and sugar through Fast Food (FF) or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity da...

  17. Trichobezoar – A Rare Cause of Abdominal Mass and Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Ana Couceiro

    2016-01-01

    Full Text Available The authors present the clinical case of a 14-year old girl with weight loss, anorexia, epigastric abdominal pain and postprandial vomiting with 5 months duration. There was a background of trichophagia for 2 years without evidence of alopecia or psychiatric history. The physical examination revealed an epigastric mass motionless, stony, with poorly defined limits, painful on palpation and about 7 cm diameter. Abdominal ultrasonography showed thickening of the gastric wall and antrum with gastric distension. The abdominal tomography scan and endoscopic examination revealed the presence of a bulky trichobezoar occupying almost the entire gastric lumen. It was decided to undergo gastrotomy and extraction of the bezoar. The postoperative period was uneventful.

  18. Partial gastric outlet obstruction caused by a huge submucosal tumor originating in the heterotopic pancreas

    OpenAIRE

    Jung, Gum O; Park, Dong Eun; Yun, Ki Jung; Chae, Kwon Mook

    2011-01-01

    A 21-year-old woman presented gastrointestinal manifestation showing intermittent abdominal pain, nausea, and vomiting. An upper endoscopic examination showed round, elevated mucosa at the antrum of the stomach anterior wall. After CT scanning, a huge degenerated gastrointestinal stromal tumor was suspected. Subtotal gastrectomy with Billroth II anastomosis was performed. Histologically, pseudocystic degeneration of the heterotopic pancreas was confirmed. The patient showed eventful postopera...

  19. Gastric outlet obstruction caused by heterotopic pancreas: A case report and a quick review

    OpenAIRE

    Jiang, Li-Xin; Xu, Jie; Wang, Xue-Wen; Zhou, Fu-Run; Gao, Wei; Yu, Guo-Hua; Lv, Zhong-Chuan; Zheng, Hai-Tao

    2008-01-01

    A 46-year-old Chinese woman presented with nausea, recurrent vomiting, and abdominal pain. Gastroduodenal endoscopic examination revealed an oval-shaped submucosal tumor at the prepyloric area on the posterior wall of the stomach. A degenerated gastrointestinal stromal tumor was suspected. Distal gastrectomy was performed and a histological diagnosis of heterotopic pancreas (HPs) was confirmed. The patient had an uneventful postoperative course and was discharged 7 d after operation. The pati...

  20. Malignant gastric outlet obstruction managed by endoscopic stenting: a prospective single-centre study

    DEFF Research Database (Denmark)

    Havemann, Maria Cecilie; Adamsen, Sven; Wøjdemann, Morten

    2008-01-01

    successful deployment, clinical effect, length of stay in hospital, survival, need for re-intervention and complications. Results. Forty-one patients (91%) were successfully stented. The mean pre-procedure GOOSS improved significantly from 0.39 (95% CI 0.22-0.56) to 2.29 (95% CI 2.01-2.58) after stenting (p......<0.0001). Twenty-six patients (63%) improved GOOSS at least one point, whereas 5 patients (12%) did not change GOOSS at all. Mean length of hospital stay was 13 days (95% CI 9-17 days). Mean survival was 121 days (95% CI 62-181 days). Two patients (4%; numbers 6 and 19) sustained perforation without...... fatalities. Three patients (7%) had stent migration. Procedure-related mortality was zero. Conclusions. Palliative stenting for advanced malignant upper GI-tract tumours at a tertiary Hepato-Pancreato-Biliary Unit is a safe, feasible and effective alternative to surgical bypass with a short hospital stay and...

  1. Recent Canyon Heads at the Bosphorus Outlet

    Science.gov (United States)

    Lericolais, G.; Le Drezen, E.; Nouze, H.; Gillet, H.; Ergun, M.; Cific, G.; Avci, M.; Dondurur, D.; Okay, S.

    2002-12-01

    The Black and Marmara Seas have witnessed increased scientific interest in last decade due to improved cooperation between the riparian countries and western scientific institutions but also due to the controversy existing about the origin of the reconnection of the Black Sea and Mediterranean seas after the last Glacial Maximum and its ensuing sea level rise. The Black Sea is linked to the global ocean only through the Bosphorus-Dardanelles system of straits. The Bosphorus is narrow (0.76 to 3.6 km wide) and shallow (32 m) at the sill, restricting the two-way water exchange between the brackish Black Sea and the very saline Mediterranean Sea. The Bosphorus sill was responsible for the behaviour of the Black Sea during the global glaciations and deglaciations, during which the Black Sea level followed the global sea level changes as long as they were higher than the sill. When global sea level was lower than the Bosphorus sill the variations of the Black Sea level reflected specific regional climate conditions without being coupled to the ocean changes. Recent studies suggest that a rapid flooding event may have occurred in the Black Sea during the Holocene. In 1998, a French-Romanian survey collected 4500 km of high-resolution seismic profiles, multibeam bathymetry, and sediment cores on the northern margin of the Black Sea where the shelf is sufficiently wide to preserve ancient shorelines in the vicinity of the shelf edge. If rapid flooding occurred through the Bosphorus Strait to drown these shorelines, it should have created a cataract. In August 2002, the French research vessel "Le Suroit" equipped with a EM 300 multibeam echosounder and a TritonElics Chirp Sonar mapped the Bosphorus outlet at the shelf edge. The results show a large retrogressive canyon deeply incised into the shelf which can be followed landward towards the Bosphorus outlet. Coring on the shelf and in the canyon revealed mega-ripples of shell debris of recent origin.

  2. Field Validation of Secondary Data Sources for Enumerating Retail Tobacco Outlets in a State without Tobacco Outlet Licensing

    OpenAIRE

    D’Angelo, Heather; Fleischhacker, Sheila; Rose, Shyanika W; Ribisl, Kurt M.

    2014-01-01

    Identifying tobacco retail outlets for U.S. FDA compliance checks or calculating tobacco outlet is difficult in the 13 states without tobacco retail licensing or where licensing lists are unavailable for research. This study uses primary data collection to identify tobacco outlets in three counties in a non-licensing state and validate two commercial secondary data sources. We calculated sensitivity and positive predictive values (PPV) to validate the secondary data sources, and conducted a g...

  3. [Occupational hazards and bladder cancer].

    Science.gov (United States)

    Nizamova, R S

    1991-01-01

    Occupational exposure to health hazards was studied in 258 industrial workers who had developed cancer of the bladder against 454 matched controls. All the test subjects and controls were residents of the Tambov Province centers of chemical industry. Statistical significance (relative risk-4.7) was established for exposure to aromatic amines. For those contacting with aniline dyes the relative risk (RR) made up 2.4. The risk to develop bladder cancer in powder shops (RR-3.2) was attributed to the hazards of dyes and diphenylamine. In leather-shoe and textile industry the exposure to dyes was not safe (RR-6.1), neither was it to chemicals, oil products, pesticides, overheating (RR-3.2, 1.6, 3.2 and 2.9, respectively). It is stated that in line with a significant risk to develop bladder cancer at exposure to aromatic amines there exist a number of occupational factors contributing to this risk.

  4. Tobacco Retail Outlets and Vulnerable Populations in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Michael O. Chaiton

    2013-12-01

    Full Text Available Interest has been increasing in regulating the location and number of tobacco vendors as part of a comprehensive tobacco control program. The objective of this paper is to examine the distribution of tobacco outlets in a large jurisdiction, to assess: (1 whether tobacco outlets are more likely to be located in vulnerable areas; and (2 what proportion of tobacco outlets are located close to schools. Retail locations across the Province of Ontario from Ministry of Health Promotion data were linked to 2006 Census data at the neighbourhood level. There was one tobacco retail outlet for every 1,000 people over age 15 in Ontario. Density of outlets varied by public health unit, and was associated with the number of smokers. Tobacco outlets were more likely to be located in areas that had high neighbourhood deprivation, in both rural and urban areas. Outlets were less likely to be located in areas with high immigrant populations in urban areas, with the reverse being true for rural areas. Overall, 65% of tobacco retailers were located within 500 m of a school. The sale of tobacco products is ubiquitous, however, neighbourhoods with lower socio-economic status are more likely to have easier availability of tobacco products and most retailers are located within walking distance of a school. The results suggest the importance of policies to regulate the location of tobacco retail outlets.

  5. 49 CFR 179.200-17 - Bottom outlets.

    Science.gov (United States)

    2010-10-01

    ... valve due to stresses or shocks incident to transportation. (5) Bottom outlet nozzle of interior valves... the root of the “V” be more than 1/4 inch. The outlet nozzle on interior valves or the valve body on... inside closure seat or plug. In no case may the nozzle wall thickness at the root of the “V” be more...

  6. Wrecks and Obstructions

    Data.gov (United States)

    Department of Homeland Security — In 1981, NOAA_s National Ocean Service (NOS) implemented the Automated Wreck and Obstruction Information System (AWOIS) to assist in planning hydrographic survey...

  7. Obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Although /sup 133/xenon ventilation studies and aerosol inhalation images have been shown to be more sensitive than other measurements of pulmonary function in detecting early airway disease, they fall short as ideal screening tests. In addition they do not distinguish between the different diseases of air flow obstruction. The diagnosis of the conditions discussed in this paper does not require studies of regional lung function. It is doubtful if further refinements in instrumentation or the introduction of other radioisotopes would really help in this matter. Chronic bronchitis, emphysema, and bronchial asthma are the major obstructive pulmonary disease. Cystic fibrosis and bronchiectasis, which are less common, are also accompanied by airway obstruction. Local obstruction of a bronchus may also occur as a result of a tumor or foreign body or a mucous plug

  8. Obstructive sleep apnea - adults

    Science.gov (United States)

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 100. Kimoff RJ. Obstructive sleep ... Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 88. Qaseem A, Holty JE, ...

  9. The Geography of Fast Food Outlets: A Review

    Science.gov (United States)

    Fraser, Lorna K.; Edwards, Kimberly L.; Cade, Janet; Clarke, Graham P.

    2010-01-01

    The availability of food high in fat, salt and sugar through Fast Food (FF) or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity. PMID:20623025

  10. The Geography of Fast Food Outlets: A Review

    Directory of Open Access Journals (Sweden)

    Lorna K. Fraser

    2010-05-01

    Full Text Available The availability of food high in fat, salt and sugar through Fast Food (FF or takeaway outlets, is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work. Thirty three studies were found that had assessed the geography of these outlets. Fourteen studies showed a positive association between availability of FF outlets and increasing deprivation. Another 13 studies also included overweight or obesity data and showed conflicting results between obesity/overweight and FF outlet availability. There is some evidence that FF availability is associated with lower fruit and vegetable intake. There is potential for land use policies to have an influence on the location of new FF outlets. Further research should incorporate good quality data on FF consumption, weight and physical activity.

  11. Coolant mixing in the LMFBR outlet plenum

    International Nuclear Information System (INIS)

    Small scale experiments involving water flows are used to provide mean flow and turbulence field data for LMFBR outlet plenum flows. Measurements are performed at Reynolds Number (Re) values of 33000 and 70000 in a 1/15-scale FFTF geometry and at Re = 35000 in a 3/80-scale CRBR geometry. The experimental behavior is predicted using two different turbulence model computer programs, TEACH-T and VARR-II. It is found that the qualitative nature of the flow field within the plenum depends strongly upon the distribution of the mean inlet velocity field, upon the degree of inlet turbulence, and upon the turbulence momentum exchange model used in the calculations. It is found in the FFTF geometry that the TEACH-T predictions are better than that of VARR-II, and in the CRBR geometry neither code provides a good prediction of the observed behavior. From the sensitivity analysis, it is found that the production and dissipation of turbulence are the dominant terms in the transport equations for turbulent kinetic energy and turbulent energy dissipation rate, and the diffusion terms are relatively small. From the same study a new set of empirical constants for the turbulence model is evolved for the prediction of plenum flows

  12. Zur Problematik des Thoracic Outlet-Syndroms

    Directory of Open Access Journals (Sweden)

    Mamoli B

    2008-01-01

    Full Text Available Das Thoracic Outlet-Syndrom (TOS ist ein äußerst kontrovers diskutiertes Engpasssyndrom, das für ca. 4 % aller nicht-traumatischen Paresen des Plexus brachialis verantwortlich ist [1]. Nach Wilbourn [2] wird zwischen einem neurogenen TOS (klassisches TOS und einem fraglichen (disputed TOS differenziert. Aus pathophysiologischer Sicht wird ein neurogenes (ca. 90 % aller TOS, ein arterielles und ein venöses TOS differenziert [3, 4]. Die einzelnen Formen können aufgrund unterschiedlicher Symptome gut voneinander abgegrenzt werden. Häufigste Ursachen sind abnorme anatomische Strukturen (fibröse Bänder etc. oder über Jahre ausgeübte muskuläre Tätigkeiten (z. B. Sportler, Musiker. Zur Diagnose werden klinische, lektrophysiologische, radiologische und Neuroimaging-Verfahren herangezogen. Wenngleich die neuen Techniken wie MRT, MRA und Sonographie die diagnostische Sicherheit erhöht haben, ähnelt die Diagnose eines TOS einem Indizienprozess und erfordert eine sorgfältige Analyse aller Daten. Therapeutisch ist bis heute der Wert der konservativen Therapie nicht durch kontrollierte Studien belegt. Die Therapieansätze basieren auf pathophysiologischen Überlegungen. Während beim vaskulären TOS ein rasches chirurgisches Eingreifen erforderlich ist, sollte beim neurogenen TOS, außer bei Progredienz der Symptomatik, zunächst ein konservativer Therapieversuch unternommen werden.

  13. A systematic review on the accuracy of diagnostic procedures for infravesical obstruction in boys.

    Directory of Open Access Journals (Sweden)

    Pauline M L Hennus

    Full Text Available BACKGROUND: Infravesical obstruction leads to kidney and bladder dysfunction in a significant proportion of boys. The aim of this review is to determine the value of diagnostic tests for ascertainment of infravesical obstruction in boys. METHODOLOGY: We searched PubMed and EMBASE databases until January 1, 2013, to identify papers that described original diagnostic accuracy research for infravesical obstruction in boys. We extracted information on (1 patient characteristics and clinical presentation of PUV and (2 diagnostic pathway, (3 diagnostic accuracy measures and (4 assessed risk of bias. PRINCIPAL FINDINGS: We retrieved 15 studies describing various diagnostic pathways in 1,189 boys suspected for infravesical obstruction. The included studies reflect a broad clinical spectrum of patients, but all failed to present a standardised approach to confirm the presence and severity of obstruction. The risk of bias of included studies is rather high due to work-up bias and missing data. CONCLUSIONS: As a consequence of low quality of methods of the available studies we put little confidence in the reported estimates for the diagnostic accuracy of US, VCUG and new additional tests for ruling in or ruling out infravesical obstruction. To date, firm evidence to support common diagnostic pathways is lacking. Hence, we are unable to draw conclusions on diagnostic accuracy of tests for infravesical obstruction. In order to be able to standardise the diagnostic pathway for infravesical obstruction, adequate design and transparent reporting is mandatory.

  14. Bladder Cancer Risk Prediction Models

    Science.gov (United States)

    Developing statistical models that estimate the probability of developing bladder cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  15. Microsatellite instability in bladder cancer

    DEFF Research Database (Denmark)

    Gonzalez-Zulueta, M; Ruppert, J M; Tokino, K;

    1993-01-01

    Somatic instability at microsatellite repeats was detected in 6 of 200 transitional cell carcinomas of the bladder. Instabilities were apparent as changes in (GT)n repeat lengths on human chromosome 9 for four tumors and as alterations in a (CAG)n repeat in the androgen receptor gene on the X...

  16. [Specific types of bladder cancer].

    Science.gov (United States)

    Bertz, S; Hartmann, A; Knüchel-Clarke, R; Gaisa, N T

    2016-02-01

    Bladder cancer shows rare variants and special subtypes with diverse prognostic importance and therefore may necessitate different therapeutic approaches. For pathologists it is important to histologically diagnose and specify such variants. Nested variants of urothelial carcinoma with inconspicuous, well-formed tumor cell nests present with an aggressive course. The plasmacytoid variant, which morphologically resembles plasma cells is associated with a shorter survival time and a high frequency of peritoneal metastasis. Micropapillary urothelial carcinoma with small papillary tumor cell islands within artificial tissue retraction spaces and frequent lymphovascular invasion also has a poor prognosis. Other important rare differential variants listed in the World Health Organization (WHO) classification are microcystic, lymphoepithelioma-like, sarcomatoid, giant cell and undifferentiated urothelial carcinomas. Additionally, there are three special types of bladder cancer: squamous cell carcinoma, adenocarcinoma and small cell neuroendocrine carcinoma of the bladder. These tumors are characterized by pure squamous cell or glandular differentiation and are sometimes less responsive to adjuvant (chemo)therapy. Small cell carcinoma of the bladder mimics the neuroendocrine features of its pulmonary counterpart, shows an aggressive course but is sensitive to (neo-)adjuvant chemotherapy. The morphology and histology of the most important variants and special types are discussed in this review. PMID:26782034

  17. Stem Cells in Functional Bladder Engineering

    Science.gov (United States)

    Smolar, Jakub; Salemi, Souzan; Horst, Maya; Sulser, Tullio; Eberli, Daniel

    2016-01-01

    Conditions impairing bladder function in children and adults, such as myelomeningocele, posterior urethral valves, bladder exstrophy or spinal cord injury, often need urinary diversion or augmentation cystoplasty as when untreated they may cause severe bladder dysfunction and kidney failure. Currently, the gold standard therapy of end-stage bladder disease refractory to conservative management is enterocystoplasty, a surgical enlargement of the bladder with intestinal tissue. Despite providing functional improvement, enterocystoplasty is associated with significant long-term complications, such as recurrent urinary tract infections, metabolic abnormalities, stone formation, and malignancies. Therefore, there is a strong clinical need for alternative therapies for these reconstructive procedures, of which stem cell-based tissue engineering (TE) is considered to be the most promising future strategy. This review is focused on the recent progress in bladder stem cell research and therapy and the challenges that remain for the development of a functional bladder wall.

  18. Prostatic hyperplasia and congenital bladder diverticulum. A case report Hiperplasia de próstata y divertículo vesical congénito. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    María Raquel Abreu Santana

    2011-04-01

    Full Text Available Congenital diverticula in adults are typically associated with bladder outlet obstruction and their manifestation is most commonly by urinary sepsis. The case of a 69 years old male patient who attended consultation because of nocturia, thin urine stream, pushing, urgent urination and sense of incomplete emptying is presented. Through rectal examination grade I prostate with discrete grade I asymmetry consistent with right nodular lobe that did not rise to the surface was detected. During the physical examination tumor mass was palpated in the lower abdomen region. It was painless. Ultrasound and cystography showed giant bladder diverticulum with a narrow neck into the right lateral wall of the bladder. Cystoscopy confirmed the diagnosis and the patient was treated trough surgery. Histology revealed mucosal layers and muscle and adventitia in the wall, thus confirming congenital origin. Recovering after surgery was satisfactor.Los divertículos congénitos en el adulto se detectan normalmente asociados a factores obstructivos a la salida vesical, se manifiestan mayormente por sepsis urinarias. Se presenta el caso de un paciente masculino de 69 años que asistió a consulta por nocturia, chorro fino, pujo, urgencia miccional y sensación de vaciamiento incompleto. Mediante tacto rectal se detectó próstata en grado I con asimetría discreta de la consistencia del lóbulo derecho en forma nodular que no se levantaba de la superficie; al examen físico se palpó masa tumoral en la región de hipogastrio, no dolorosa. El ultrasonido y la cistografía mostraron divertículo vesical gigante de cuello estrecho hacia la pared lateral derecha de la vejiga. Se confirmó mediante la cistoscopia y se procedió a la intervención quirúrgica. La histología reveló la existencia de capas mucosas, muscular y adventicia en su pared, corroborándose su origen congénito. El paciente evolucionó satisfactoriamente después de la operación.

  19. MRI findings in thoracic outlet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Aralasmak, Ayse; Sharifov, Rasul; Kilicarslan, Rukiye; Alkan, Alpay [Bezmialem Vakif University, Department of Radiology, Fatih/Istanbul (Turkey); Cevikol, Can; Karaali, Kamil; Senol, Utku [Akdeniz University, Department of Radiology, Antalya (Turkey)

    2012-11-15

    We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

  20. Prediction for Outlet Noise of Rolling Piston Comperssor

    Directory of Open Access Journals (Sweden)

    Zhang Tieshan

    2015-01-01

    Full Text Available An acoustic wave equation with considering small perturbation is presented first by use of the fluidic mechanics and aerodynamics, then a theoretical model for predicting the outlet noise of rolling piston compressors is investigated, and the sound pressure and sound power of the outlet noise are formulated based on the acoustic wave equation. The experimental data and simulation results for the outlet noise with different rotation velocities have been compared with the discrepancy less than 2.6%, which verifies the approach presented in this paper.

  1. Chronic obstructive pulmonary disease.

    Science.gov (United States)

    Barnes, Peter J; Burney, Peter G J; Silverman, Edwin K; Celli, Bartolome R; Vestbo, Jørgen; Wedzicha, Jadwiga A; Wouters, Emiel F M

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a common disease with high global morbidity and mortality. COPD is characterized by poorly reversible airway obstruction, which is confirmed by spirometry, and includes obstruction of the small airways (chronic obstructive bronchiolitis) and emphysema, which lead to air trapping and shortness of breath in response to physical exertion. The most common risk factor for the development of COPD is cigarette smoking, but other environmental factors, such as exposure to indoor air pollutants - especially in developing countries - might influence COPD risk. Not all smokers develop COPD and the reasons for disease susceptibility in these individuals have not been fully elucidated. Although the mechanisms underlying COPD remain poorly understood, the disease is associated with chronic inflammation that is usually corticosteroid resistant. In addition, COPD involves accelerated ageing of the lungs and an abnormal repair mechanism that might be driven by oxidative stress. Acute exacerbations, which are mainly triggered by viral or bacterial infections, are important as they are linked to a poor prognosis. The mainstay of the management of stable disease is the use of inhaled long-acting bronchodilators, whereas corticosteroids are beneficial primarily in patients who have coexisting features of asthma, such as eosinophilic inflammation and more reversibility of airway obstruction. Apart from smoking cessation, no treatments reduce disease progression. More research is needed to better understand disease mechanisms and to develop new treatments that reduce disease activity and progression. PMID:27189863

  2. Orthotopic ileal neobladder similar to original bladder

    Institute of Scientific and Technical Information of China (English)

    黄健; 许可慰; 姚友生; 郭正辉; 林天歆; 江春

    2003-01-01

    Objective To report the surgical techniques and results of an 8-year follow-up study of 42 patients with a modified orthotopic ileal neobladder restoring normal anatomical relationship.Methods Total cystoprostatectomy was performed extraperitoneally. A 45-50 cm segment of the ileal loop was isolated, detubularized, and reconfigured into an "M"-shape to form a pouch. Bilateral ureters were implanted by inserting 1 cm distal segment into the pouch. The bottom of pouch was opened and anastomosed with the urethra.Results Forty-two patients were followed up for 6 to 96 months,90.5% of whom were continent in the daytime, and 85.7% at night. Two patients had a difficulty in urination. The average volume of the pouch was (361±48) ml at 12 months postoperation. Urodynamic examination showed the average peak voiding pressure was (86.8±21.4) cmH2O. The average maximum flow rate (Qmax) was (18.4±6.1) ml/s. No remarkable ureter reflux and obstruction were found. No patient was detected to have urethral carcinoma.Conclusions Extraperitoneal cystectomy can avoid the tumor contamination of the abdomen and intestinal interference of the operative field. The ureter-inserting implantation technique is a simple anti-reflux anastomosis method with less ureter stenosis rate. Isolating the neobladder and ureters from the peritoneal cavity can reduce the postoperative complications, such as adhesive ileus, internal hernia, and urine leakage into the peritoneal cavity. The neobladder is similar to the original bladder in position, volume, shape and anti-reflux ureter connection.

  3. Exogenous glycosaminoglycans coat damaged bladder surfaces in experimentally damaged mouse bladder

    Directory of Open Access Journals (Sweden)

    Hurst Robert E

    2005-03-01

    Full Text Available Abstract Background Interstital cystitis is often treated with exogenous glycosaminoglycans such as heparin, chondroitin sulphate (Uracyst, hyaluronate (Cystistat or the semi-synthetic pentosan polysulphate (Elmiron. The mechanism of action is presumed to be due to a coating of the bladder surface to replace the normally present chondroitin sulphate and heparan sulphate lost as a result of the disease. This study used fluorescent labelled chondroitin sulphate to track the distribution of glycosaminoglycans administered intravesically to mouse bladder that had been damaged on the surface. Methods The surfaces of mouse bladders were damaged by 3 mechanisms – trypsin, 10 mM HCl, and protamine sulphate. Texas Red-labeled chondroitin sulphate was instilled into the bladders of animals with damaged bladders and controls instilled only with saline. Bladders were harvested, frozen, and sectioned for examination by fluorescence. Results The normal mouse bladder bound a very thin layer of the labelled chondroitin sulphate on the luminal surface. Trypsin- and HCl-damaged bladders bound the labelled chondroitin sulphate extensively on the surface with little penetration into the bladder muscle. Protamine produced less overt damage, and much less labelling was seen, presumably due to loss of the label as it complexed with the protamine intercalated into the bladder surface. Conclusion Glycosaminoglycan administered intravesically does bind to damaged bladder. Given that the changes seen following bladder damage resemble those seen naturally in interstitial cystitis, the mechanisms proposed for the action of these agents is consistent with a coating of damaged bladder.

  4. Metabolic phenotype of bladder cancer.

    Science.gov (United States)

    Massari, Francesco; Ciccarese, Chiara; Santoni, Matteo; Iacovelli, Roberto; Mazzucchelli, Roberta; Piva, Francesco; Scarpelli, Marina; Berardi, Rossana; Tortora, Giampaolo; Lopez-Beltran, Antonio; Cheng, Liang; Montironi, Rodolfo

    2016-04-01

    Metabolism of bladder cancer represents a key issue for cancer research. Several metabolic altered pathways are involved in bladder tumorigenesis, representing therefore interesting targets for therapy. Tumor cells, including urothelial cancer cells, rely on a peculiar shift to aerobic glycolysis-dependent metabolism (the Warburg-effect) as the main energy source to sustain their uncontrolled growth and proliferation. Therefore, the high glycolytic flux depends on the overexpression of glycolysis-related genes (SRC-3, glucose transporter type 1 [GLUT1], GLUT3, lactic dehydrogenase A [LDHA], LDHB, hexokinase 1 [HK1], HK2, pyruvate kinase type M [PKM], and hypoxia-inducible factor 1-alpha [HIF-1α]), resulting in an overproduction of pyruvate, alanine and lactate. Concurrently, bladder cancer metabolism displays an increased expression of genes favoring the pentose phosphate pathway (glucose-6-phosphate dehydrogenase [G6PD]) and the fatty-acid synthesis (fatty acid synthase [FASN]), along with a decrease of AMP-activated protein kinase (AMPK) and Krebs cycle activities. Moreover, the PTEN/PI3K/AKT/mTOR pathway, hyper-activated in bladder cancer, acts as central regulator of aerobic glycolysis, hence contributing to cancer metabolic switch and tumor cell proliferation. Besides glycolysis, glycogen metabolism pathway plays a robust role in bladder cancer development. In particular, the overexpression of GLUT-1, the loss of the tumor suppressor glycogen debranching enzyme amylo-α-1,6-glucosidase, 4-α-glucanotransferase (AGL), and the increased activity of the tumor promoter enzyme glycogen phosphorylase impair glycogen metabolism. An increase in glucose uptake, decrease in normal cellular glycogen storage, and overproduction of lactate are consequences of decreased oxidative phosphorylation and inability to reuse glucose into the pentose phosphate and de novo fatty acid synthesis pathways. Moreover, AGL loss determines augmented levels of the serine-to-glycine enzyme

  5. Rating of new outlet structures for MacFarlane Reservoir

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Memorandum explaining the new work on the outlet structure at MacFarlane Reservoir. Flow measurements were taken at different staff gage elevations and this data is...

  6. 7 CFR 987.55 - Outlets for restricted dates.

    Science.gov (United States)

    2010-01-01

    ... IN RIVERSIDE COUNTY, CALIFORNIA Order Regulating Handling Disposition of Other Than Free Dates § 987... countries as the Committee may approve or by diversion in product outlets described in § 987.43 which...

  7. TARGET MARKETS FOR RETAIL OUTLETS OF LANDSCAPE PLANTS

    OpenAIRE

    Turner, Steven C.; Dorfman, Jeffrey H.; Fletcher, Stanley M.

    1990-01-01

    Merchandisers of landscape plants can increase the effectiveness of their marketing strategies by identifying target markets. Using a full information maximum likelihood tobit procedure on a system of three equations, target markets for different types of retail outlets in Georgia were identified. The results lend support and empirical evidence to the premise that different retail outlet types have different target markets and thus should develop different market strategies. The estimated tar...

  8. Acute Alcohol Consumption, Alcohol Outlets, and Gun Suicide

    OpenAIRE

    Branas, Charles C; Richmond, Therese S.; Ten Have, Thomas R.; Wiebe, Douglas J.

    2011-01-01

    A case–control study of 149 intentionally self-inflicted gun injury cases (including completed gun suicides) and 302 population-based controls was conducted from 2003 to 2006 in a major US city. Two focal independent variables, acute alcohol consumption and alcohol outlet availability, were measured. Conditional logistic regression was adjusted for confounding variables. Gun suicide risk to individuals in areas of high alcohol outlet availability was less than the gun suicide risk they incurr...

  9. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Brøvig;

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures.......Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  10. Obstructive Uropathy in Sudanese Patients

    Directory of Open Access Journals (Sweden)

    El Imam M

    2006-01-01

    Full Text Available In this paper we describe the causes, patterns of presentation, and management of obstructive uropathy in Sudanese patients in a retrospective multi-center audit. All patients who presented with obstructive uropathy during 2005 were included in this study. All of the patients were subjected to serial investigations including imaging and tests of renal function. Diversion, stenting, and/or definitive surgery were performed in order to relieve the obstruction. Five hundred twenty patients were diagnosed with obstructive uropathy during this period; 345 (66% patients presented with chronic obstruction and 175 (34% with acute obstruction. Of the study patients, 210 (40% presented with significant renal impairment; 50 (23% of them required emergent dialysis. The patterns of clinical presentation of the obstructed patients included pain at the site of obstruction in 48%, lower urinary tract symptoms in 42%, urine retention in 36.5%, mass effect in 22%, and anuria in 4%. Patients in the pediatric age group constituted 4% of the total. The common causative factors of obstruction included congenital urethral valves, pelvi-ureteral junction obstruction, urolithiasis, and iatrogenic trauma, especially in the obstetric practice. Renal function was completely recovered with early management in 100% of patients with acute obstruction and was stabilized in 90% of patients with chronic obstruction. Four patients were diagnosed with end-stage renal failure; two of them were transplanted. The mortality rate in this study was less than 0.3%.

  11. Tube cystostomy for management of obstructive urolithiasis in ruminants

    Directory of Open Access Journals (Sweden)

    P. Tamilmahan

    2014-04-01

    Full Text Available Aim: The aim of this study was to evaluate the simple tube cystostomy procedure for management of urethral obstruction cases in ruminants. Materials and Methods: Tube cystostomy was used to treat a total of 58 ruminants, which included 35 buffalo calves and 23 goats. Diagnosis of the disease was made with the history of anuria, clinical signs, and physical examinations. Physical parameters like heart rate, respiratory rate, rectal temperature dehydration status of animals by skin tenting test, and intraoperative findings were compared. Results: Young ruminants were most commonly affected and the mean age was 4-5 months in both species. Only male were considered for the study in which buffalo calves were not castrated but in goat's 73.91% animal were castrated and 34.7% not castrated. Rupture of bladder was more common in buffalo calves as compared to goats. The confirmed cases of obstructive urolithiasis were selected for tube cystostomy with Foley's catheter. Postoperatively all cases were administered with broad spectrum antibiotic, anti-inflammatory agent, and caliculolytic agents like ammonium chloride. Postoperative complications recorded only in 10 animals and remaining 48 animals had an uneventful recovery. Conclusion: Tube cystostomy is a simple and effective procedure particularly in intact urinary bladder, which can be adopted at field level.

  12. Urothelial Bladder Cancer with Cavitary Lung Metastases

    OpenAIRE

    Anil Kurian; Jason Lee; Abraham Born

    2011-01-01

    Transitional cell carcinoma (TCC) of the bladder tends to remain superficial; however, in 5% to 20% of cases, it progresses to muscle invasion and, more rarely, can metastasize. TCC of the bladder primarily spreads via regional lymphatics. The most common sites of distant metastases of TCC are the liver, lung, mediastinum and bone. Long-term survival of patients with metastatic bladder cancer is rare. Patterns of pulmonary metastasis include multiple nodules, a solitary mass or interstitial m...

  13. Dietary factors associated with bladder cancer

    OpenAIRE

    Piyathilake, Chandrika

    2016-01-01

    It is biologically plausible for dietary factors to influence bladder cancer risk considering that beneficial as well as harmful components of a diet are excreted through the urinary tract and in direct contact with the epithelium of the bladder. However, studies that investigated the association between dietary factors and bladder cancer (BC) risk have largely reported inconsistent results. The macronutrient intake and risk of BC could have yield inconsistent results across studies because o...

  14. Ultrasound and Biomarker Tests in Predicting Cancer Aggressiveness in Tissue Samples of Patients With Bladder Cancer

    Science.gov (United States)

    2016-06-09

    Bladder Papillary Urothelial Carcinoma; Stage 0a Bladder Urothelial Carcinoma; Stage 0is Bladder Urothelial Carcinoma; Stage I Bladder Cancer With Carcinoma In Situ; Stage I Bladder Urothelial Carcinoma; Stage II Bladder Urothelial Carcinoma; Stage III Bladder Urothelial Carcinoma; Stage IV Bladder Urothelial Carcinoma

  15. What Are the Risk Factors for Bladder Cancer?

    Science.gov (United States)

    ... cancer Next Topic What causes bladder cancer? Bladder cancer risk factors A risk factor is anything that changes your ... make a person more likely to develop bladder cancer. Risk factors you can change Smoking Smoking is the most ...

  16. Evaluation of alcohol outlet density and its relation with violence

    Directory of Open Access Journals (Sweden)

    Ronaldo Laranjeira

    2002-08-01

    Full Text Available OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban São Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km; and the proportion of all properties that sold alcohol (1 in 12. CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.

  17. Evaluation of alcohol outlet density and its relation with violence

    Directory of Open Access Journals (Sweden)

    Laranjeira Ronaldo

    2002-01-01

    Full Text Available OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban São Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km; and the proportion of all properties that sold alcohol (1 in 12. CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.

  18. Experimental validation of tonal noise control from subsonic axial fans using flow control obstructions

    Science.gov (United States)

    Gérard, Anthony; Berry, Alain; Masson, Patrice; Gervais, Yves

    2009-03-01

    This paper presents the acoustic performance of a novel approach for the passive adaptive control of tonal noise radiated from subsonic fans. Tonal noise originates from non-uniform flow that causes circumferentially varying blade forces and gives rise to a considerably larger radiated dipolar sound at the blade passage frequency (BPF) and its harmonics compared to the tonal noise generated by a uniform flow. The approach presented in this paper uses obstructions in the flow to destructively interfere with the primary tonal noise arising from various flow conditions. The acoustic radiation of the obstructions is first demonstrated experimentally. Indirect on-axis acoustic measurements are used to validate the analytical prediction of the circumferential spectrum of the blade unsteady lift and related indicators generated by the trapezoidal and sinusoidal obstructions presented in Ref. [A. Gérard, A. Berry, P. Masson, Y. Gervais, Modelling of tonal noise control from subsonic axial fans using flow control obstructions, Journal of Sound and Vibration (2008), this issue, doi: 10.1016/j.jsv.2008.09.027.] and also by cylindrical obstructions used in the literature. The directivity and sound power attenuation are then given in free field for the control of the BPF tone generated by rotor/outlet guide vane (OGV) interaction and the control of an amplified BPF tone generated by the rotor/OGV interaction with an added triangular obstruction between two outlet guide vanes to enhance the primary non-uniform flow. Global control was demonstrated in free field, attenuation up to 8.4 dB of the acoustic power at BPF has been measured. Finally, the aerodynamic performances of the automotive fan used in this study are almost not affected by the presence of the control obstruction.

  19. Ileal bladder substitute: antireflux nipple or afferent tubular segment?

    Science.gov (United States)

    Studer, U E; Spiegel, T; Casanova, G A; Springer, J; Gerber, E; Ackermann, D K; Gurtner, F; Zingg, E J

    1991-01-01

    Spheroidal bladder substitutes made from double-folded ileal segments, similar to Goodwin's cup-patch technique, are devoid of major coordinated wall contractions. This, together with the reservoir's direct anastomosis to the membranous urethra, prevents major intraluminal pressure peaks and assures a residue-free voiding of sterile urine. In order to determine whether, under these conditions, an afferent tubular isoperistaltic ileal segment of 20-cm length protects the upper urinary tract as efficiently as an antireflux nipple, 60 male patients who were subjected to radical cystectomy were prospectively randomised to groups in which a bladder substitute was formed together with either of these 2 antireflux devices. An analysis of the results obtained in 20 patients from each group who could be followed for more than 1 year (median observation time 30 and 36 months) showed no differences between the groups in metabolic disturbances, kidney size, reservoir capacity, diurnal and nocturnal urinary continence, the incidence of urinary tract infection or episodes of acute pyelonephritis. Later than 1 year postoperatively, intravenous urograms of the renoureteral units of 25% of the patients with antireflux nipples showed persistent but generally slight dilatation of the upper urinary tracts. This observation was significantly more frequent than it was in patients with afferent tubular segments. Urodynamic and radiographic studies showed that the competence of the antireflux nipples was secured by the raised surrounding intravesical pressure. This, however, also resulted in a transient functional obstruction, and a gradual rise of the basal pressure in the upper urinary tracts was recorded. In patients with afferent ileal tubular segments, contrast medium could be forced upwards into the renal pelvis when the bladder substitutes were overfilled. However, despite raised intravesical pressures, peristalsis in the isoperistaltic afferent tubular segment gradually returned

  20. Bladder dysfunction in advanced Parkinson's disease

    DEFF Research Database (Denmark)

    Winge, Kristian; Nielsen, Kurt K

    2012-01-01

    Parkinson's disease (PD) patients often have lower urinary tract symptoms. Seventy-four percent of patients with early-to-moderate disease report more than one bladder disturbance symptom. Severe bladder symptoms are reported in 27-39% of PD patients. The aim of this study was to evaluate...

  1. Inflammatory myofibroblastic tumor of the urinary bladder

    OpenAIRE

    Yagnik Vipul; Chadha Amit; Chaudhari Sanjay; Patel Keyuri

    2010-01-01

    Inflammatory myofibroblastic tumor (IMT) of bladder is an uncommon benign tumor of bladder, which is of unknown neoplastic potential, characterized by spindle cell proliferation with characteristic fibroinflammatory and pseudosarcomatous appearance. Essential criteria for the diagnosis of IMT are: spindle myoepithelial cell proliferation and lymphocytic infiltrate. Complete surgical resection is the treatment of choice.

  2. Isolated Primary Schwannoma of Urinary Bladder

    Science.gov (United States)

    Bhat, Suresh; Paul, Fredrick

    2016-01-01

    Primary schwannoma of urinary bladder is a very rare tumour. It usually occurs in association with Von Recklinghausen’s disease. It arises from Schwann’s cells in the nerve sheath. We report here a very rare case of primary schwannoma of urinary bladder managed by complete transurethral resection. PMID:27437301

  3. Reversible bladder denervation in acute polyradiculitis

    DEFF Research Database (Denmark)

    Kamper, A L; Andersen, J T

    1982-01-01

    A case of reversible bladder denervation in acute polyradiculitis is presented, in which both motor and sensory bladder involvement could be demonstrated using cystometry and denervation-hypersensitivity testing. Attention is drawn to the differential diagnosis to cauda equina syndromes of other...

  4. The Molecular Pathogenesis of Bladder Cancer

    NARCIS (Netherlands)

    A.G. van Tilborg (Angela)

    2001-01-01

    textabstractThe bladder is a hollow organ in the small pelvis. It stores urine that is produced when the kidneys filter the blood. Four different layers, the epithelium, lamina propria, muscularis, and connective tissue, define the bladder wall. The epithelium consists of 7 to 10 cell layers and res

  5. SOX4 expression in bladder carcinoma

    DEFF Research Database (Denmark)

    Aaboe, Mads; Birkenkamp-Demtroder, Karin; Wiuf, Carsten;

    2006-01-01

    The human transcription factor SOX4 was 5-fold up-regulated in bladder tumors compared with normal tissue based on whole-genome expression profiling of 166 clinical bladder tumor samples and 27 normal urothelium samples. Using a SOX4-specific antibody, we found that the cancer cells expressed the...

  6. Bladder cancer documentation of causes: multilingual questionnaire, 'bladder cancer doc'.

    Science.gov (United States)

    Golka, Klaus; Abreu-Villaca, Yael; Anbari Attar, Rowshanak; Angeli-Greaves, Miriam; Aslam, Muhammad; Basaran, Nursen; Belik, Rouslana; Butryee, Chaniphun; Dalpiaz, Orietta; Dzhusupov, Keneshbek; Ecke, Thorsten H; Galambos, Henrieta; Galambos, Henrieta; Gerilovica, Helena; Gerullis, Holger; Gonzalez, Patricia Casares; Goossens, Maria E; Gorgishvili-Hermes, Lela; Heyns, Chris F; Hodzic, Jasmin; Ikoma, Fumihiko; Jichlinski, Patrice; Kang, Boo-Hyon; Kiesswetter, Ernst; Krishnamurthi, Kannan; Lehmann, Marie-Louise; Martinova, Irina; Mittal, Rama Devi; Ravichandran, Beerappa; Romics, Imre; Roy, Bidyut; Rungkat-Zakaria, Fransiska; Rydzynski, Konrad; Scutaru, Cristian; Shen, Jianhua; Soufi, Maria; Toguzbaeva, Karlygash; Vu Duc, Trinh; Widera, Agata; Wishahi, Mohamed; Hengstler, Jan G

    2012-06-01

    There is a considerable discrepancy between the number of identified occupational-related bladder cancer cases and the estimated numbers particularly in emerging nations or less developed countries where suitable approaches are less or even not known. Thus, within a project of the World Health Organisation Collaborating Centres in Occupational Health, a questionnaire of the Dortmund group, applied in different studies, was translated into more than 30 languages (Afrikaans, Arabic, Bengali, Chinese, Czech, Dutch, English, Finnish, French, Georgian, German, Greek, Hindi, Hungarian, Indonesian, Italian, Japanese, Kannada, Kazakh, Kirghiz, Korean, Latvian, Malay, Persian (Farsi), Polish, Portuguese, Portuguese/Brazilian, Romanian, Russian, Serbo-Croatian, Slovak, Spanish, Spanish/Mexican, Tamil, Telugu, Thai, Turkish, Urdu, Vietnamese). The bipartite questionnaire asks for relevant medical information in the physician's part and for the occupational history since leaving school in the patient's part. Furthermore, this questionnaire is asking for intensity and frequency of certain occupational and non-occupational risk factors. The literature regarding occupations like painter, hairdresser or miner and exposures like carcinogenic aromatic amines, azo dyes, or combustion products is highlighted. The questionnaire is available on www.ifado.de/BladderCancerDoc.

  7. Management of obstructed defecation

    OpenAIRE

    Podzemny, Vlasta; Pescatori, Lorenzo Carlo; Pescatori, Mario

    2015-01-01

    The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an “iceberg syndrome”, with “emerging rocks”, rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients ...

  8. Chronic obstructive pulmonary disease

    OpenAIRE

    NR Anthonisen

    2007-01-01

    The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD) in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are...

  9. Equine recurrent airway obstruction

    OpenAIRE

    Artur Niedźwiedź

    2014-01-01

    Equine Recurrent Airway Obstruction (RAO), also known as heaves or broken wind, is one of the most common disease in middle-aged horses. Inflammation of the airway is inducted by organic dust exposure. This disease is characterized by neutrophilic inflammation, bronchospasm, excessive mucus production and pathologic changes in the bronchiolar walls. Clinical signs are resolved in 3-4 weeks after environmental changes. Horses suffering from RAO are susceptible to allergens throughout their liv...

  10. Spectroscopic Imaging of Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Demos, S G; Gandour-Edwards, R; Ramsamooj, R; deVere White, R

    2003-01-01

    The feasibility of developing bladder cancer detection methods using intrinsic tissue optical properties is the focus of this investigation. In vitro experiments have been performed using polarized elastic light scattering in combination with tissue autofluorescence in the NIR spectral region under laser excitation in the green and red spectral regions. The experimental results obtained from a set of tissue specimens from 25 patients reveal the presence of optical fingerprint characteristics suitable for cancer detection with high contrast and accuracy. These photonic methods are compatible with existing endoscopic imaging modalities which make them suitable for in-vivo application.

  11. [Malignant biliary obstruction].

    Science.gov (United States)

    Hucl, Tomáš

    2016-01-01

    Pancreatic cancer and cholangiocarcinoma are the most common causes of malignant biliary obstruction. They are diseases of increasing incidence and unfavorable prognosis. Only patients with localized disease indicated for surgery have a chance of long-term survival. These patients represent less than 20 % of all patients, despite the progress in our diagnostic abilities.Locally advanced and metastatic tumors are treated with palliative chemotherapy or chemoradiotherapy; the results of such treatments are unsatisfactory. The average survival of patients with unresectable disease is 6 months and only 5-10 % of patients survive 5 years.Biliary drainage is an integral part of palliative treatment. Endoscopically or percutaneosly placed stents improve quality of life, decrease cholestasis and pruritus, but do not significantly improve survival. Biliary stents get occluded over time, possibly resulting in acute cholangitis and require repeated replacement.Photodynamic therapy and radiofrequency ablation, locally active endoscopic methods, have been increasingly used in recent years in palliative treatment of patients with malignant biliary obstruction. In photodynamic therapy, photosensitizer accumulates in tumor tissue and is activated 48 hours later by light of a specific wave length. Application of low voltage high frequency current during radiofrequency ablation results in tissue destruction by heat. Local ablation techniques can have a significant impact in a large group of patients with malignant biliary obstruction, leading to improved prognosis, quality of life and stent patency. PMID:26898789

  12. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model

    Science.gov (United States)

    Chai, Xiangfei; van Herk, Marcel; Betgen, Anja; Hulshof, Maarten; Bel, Arjan

    2012-06-01

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  13. Full-thickness endometriosis of the bladder

    DEFF Research Database (Denmark)

    Kjer, Jens Jørgen; Kristensen, Jens; Hartwell, Dorthe;

    2014-01-01

    OBJECTIVE: To draw attention to the rare condition of endometriosis in the bladder. This is correlated with symptoms not normally connected to endometriosis and therefore often remains underdiagnosed for years. DESIGN AND SETTING: Retrospective study in a university teaching hospital, one of two...... referral centres in Denmark for surgical treatment of stage III and IV endometriosis. POPULATION: Thirty-one women with deep infiltrating bladder endometriosis. METHODS: All women presenting in the Department of Obstetrics and Gynaecology with deep infiltrating bladder endometriosis between March 2002...... and March 2011. We included only patients with symptomatic full-thickness bladder detrusor endometriosis and mucosal involvement. All patients had had bladder symptoms for two to seven years. MAIN OUTCOME MEASURES: Symptoms after surgery and recurrence rate. RESULTS: The main preoperative symptom...

  14. Melting beneath Greenland outlet glaciers and ice streams

    Science.gov (United States)

    Alexander, David; Perrette, Mahé; Beckmann, Johanna

    2015-04-01

    Basal melting of fast-flowing Greenland outlet glaciers and ice streams due to frictional heating at the ice-bed interface contributes significantly to total glacier mass balance and subglacial meltwater flux, yet modelling this basal melt process in Greenland has received minimal research attention. A one-dimensional dynamic ice-flow model is calibrated to the present day longitudinal profiles of 10 major Greenland outlet glaciers and ice streams (including the Jakobshavn Isbrae, Petermann Glacier and Helheim Glacier) and is validated against published ice flow and surface elevation measurements. Along each longitudinal profile, basal melt is calculated as a function of ice flow velocity and basal shear stress. The basal shear stress is dependent on the effective pressure (difference between ice overburden pressure and water pressure), basal roughness and a sliding parametrization. Model output indicates that where outlet glaciers and ice streams terminate into the ocean with either a small floating ice tongue or no floating tongue whatsoever, the proportion of basal melt to total melt (surface, basal and submarine melt) is 5-10% (e.g. Jakobshavn Isbrae; Daugaard-Jensen Glacier). This proportion is, however, negligible where larger ice tongues lose mass mostly by submarine melt (~1%; e.g. Nioghalvfjerdsfjorden Glacier). Modelled basal melt is highest immediately upvalley of the grounding line, with contributions typically up to 20-40% of the total melt for slippery beds and up to 30-70% for resistant beds. Additionally, modelled grounding line and calving front migration inland for all outlet glaciers and ice streams of hundreds of metres to several kilometres occurs. Including basal melt due to frictional heating in outlet glacier and ice stream models is important for more accurately modelling mass balance and subglacial meltwater flux, and therefore, more accurately modelling outlet glacier and ice stream dynamics and responses to future climate change.

  15. Thoracic outlet syndrome after corrective surgery for pectus excavatum.

    Science.gov (United States)

    Donders, H P; Geelen, J A

    1988-02-01

    Two patients are described who developed a thoracic outlet syndrome (TOS) after undergoing Ravitch's operation for the correction of pectus excavatum. In one case the syndrome developed a few days after surgery, whereas in the second patient it manifested more gradually. A third patient presented with latent TOS and pectus excavatum. It is recommended that prior to the correction of pectus excavatum, the patient should be examined to detect signs of neurovascular compression due to latent thoracic outlet syndrome. After surgery the possibility of this complication should be kept in mind to avoid permanent lesions of the cervicobrachial plexus. PMID:3352940

  16. A possible variant of Bouveret's syndrome presenting as a duodenal stump obstruction by a gallstone after Roux-en-Y gastrectomy: a case report

    Directory of Open Access Journals (Sweden)

    Mittal Shruti

    2009-05-01

    Full Text Available Abstract Introduction Bouveret's syndrome is characterized by gastric outlet obstruction due to a gallstone in the duodenum, usually in association with a cholecystoduodenal fistula. Case presentation We report the case of a 69-year-old Caucasian man who developed duodenal stump obstruction due to an impacted gallstone after having previously undergone Roux-en-Y gastrectomy. Conclusions Duodenal stump obstruction after Roux-en-Y gastrectomy is rare, and may be difficult to manage. Patients who present with upper gastrointestinal or pancreatobiliary pathology after previous gastric surgery should be managed in centres with the availability of appropriate endoscopic and surgical experience.

  17. Lymphoma of the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Anthony Kodzo-Grey Venyo

    2014-01-01

    Full Text Available Background. Lymphoma of the urinary bladder (LUB is rare. Aims. To review the literature on LUB. Methods. Various internet databases were used. Results. LUB can be either primary or secondary. The tumour has female predominance; most cases occur in middle-age women. Secondary LUB occurs in 10% to 25% of leukemias/lymphomas and in advanced-stage systemic lymphoma. Less than 100 cases have been reported. MALT typically affects adults older than 60 years; 75% are female. Diffuse large B-cell lymphoma is also common and may arise from transformation of MALT. LUB presents with haematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. Macroscopic examination of LUBs show large discrete tumours centred in the dome or lateral walls of the bladder. Positive staining of LUB varies by the subtype of lymphoma; B-cell lymphomas are CD20 positive. MALT lymphoma is positively stained for CD20, CD19, and FMC7 and negatively stained for CD5, CD10, and CD11c. LUB stains negatively with Pan-keratin, vimentin, CK20, and CK7. MALT lymphoma exhibits t(11; 18(q21: 21. Radiotherapy is an effective treatment for the MALT type of LUB with no recurrence. Conclusions. LUB is diagnosed by its characteristic morphology and immunohistochemical characteristics. Radiotherapy is a useful treatment.

  18. OBSTRUCTIVE JAUNDICE: A CLINICAL STUDY

    OpenAIRE

    Antony,; Rasool Syed

    2016-01-01

    BACKGROUND Jaundice is a frequent manifestation of biliary tract disorders and evaluation of obstructive jaundice is a common problem faced by general surgeons. Obstructive jaundice of varied aetiology is one of the main cause of hospital admissions. Hence, comprehensive study of aetiology, clinical presentation, management of obstructive jaundice is important in management of these patients. AIMS AND OBJECTIVES  Study the clinical history and presentation of obstructiv...

  19. Complex bladder-exstrophy-epispadias management: Causes of failure of initial bladder closure

    Directory of Open Access Journals (Sweden)

    Kouame Dibi Bertin

    2014-01-01

    Full Text Available The success of the initial closure of the complex bladder-exstrophy remains a challenge in pediatric surgery. This study describes a personal experience of the causes of failure of the initial closure and operative morbidity during the surgical treatment of bladder-exstrophy complex. From April 2000 to March 2014, four patients aged 16 days to 7 years and 5 months underwent complex exstrophy-epispadias repair with pelvic osteotomies. There were three males and one female. Three of them had posterior pelvic osteotomy, one had anterior innominate osteotomy. Bladder Closure: Bladder closure was performed in three layers. Our first patient had initial bladder closure with polyglactin 4/0 (Vicryl ® 4/0, concerning the last three patients, initial bladder closure was performed with polydioxanone 4/0 (PDS ® 4/0. The bladder was repaired leaving the urethral stent and ureteral stents for full urinary drainage for three patients. In one case, only urethral stent was left, ureteral drainage was not possible, because stents sizes were more important than the ureteral diameter. Out of a total of four patients, initial bladder closure was completely achieved for three patients. At the immediate postoperative follow-up, two patients presented a complete disunion of the abdominal wall and bladder despite an appropriate postoperative care. The absorbable braided silk (polyglactin used for the bladder closure was considered as the main factor in the failure of the bladder closure. The second cause of failure of the initial bladder closure was the incomplete urine drainage, ureteral catheterisation was not possible because the catheters sizes were too large compared with the diameters of the ureters. The failure of the initial bladder-exstrophy closure may be reduced by a closure with an absorbable monofilament silk and efficient urine drainage via ureteral catheterisation.

  20. Using marine sediment archives to reconstruct past outlet glacier variability

    DEFF Research Database (Denmark)

    Andresen, Camilla Snowman; Straneo, Fiamma; Ribergaard, Mads;

    2013-01-01

    Ice-rafted debris in fjord sediment cores provides information about outlet glacier activity beyond the instrumental time period. It tells us that the Helheim Glacier, Greenland’s third most productive glacier, responds rapidly to short-term (3 to 10 years) climate changes....

  1. 49 CFR 179.220-18 - Bottom outlets.

    Science.gov (United States)

    2010-10-01

    ... closure is of the combination cap and valve type, the pipe connection to the valve shall be closed by a... thereto, must be provided with threaded cap closure arrangement or bolted flange closure arrangement having minimum 1-inch threaded pipe plug. (6) If outlet nozzle and its closure extends below the...

  2. Working with Media Outlets To Communicate with the Public.

    Science.gov (United States)

    Wallace, Mark L.

    2000-01-01

    Offers suggestions from a veteran public relations practitioner on how colleges can effectively use media resources to advertise academic programs, workforce training, and continuing education opportunities. Focuses on maximizing the benefits of using these five media outlets: newspapers, radio and TV, direct mail, the Internet, and cable…

  3. Gall bladder function test with Ceruletid

    Energy Technology Data Exchange (ETDEWEB)

    Schindler, G.

    1981-04-15

    Compared with the stimulating food given orally in the gall bladder function test the administration of the decapeptide Ceruletid which is related with Cholecystokinin has the advantage of avoiding resorption disturbances in the upper gastrointestinal tract. To 100 patients with positive peroral cholecystography, Ceruletid was injected i.m. in a dose of 0.4 ..mu..g/kg body weight. The contrasting of the main bile duct was thus increased from 10% to 86%. The oral stimulating food brings an increase to appr. 20%. A special importance is assigned to the frequent diagnosis of adenomyomatoses which, with 6%, lies significantly above the 0.8% achieved by means of the oral stimulating food. More contractile segments of the gall bladder wall can cause pain symptoms which are typical for the biliary tract. Adenomyomatoses in the region of the infundibulum of the gall bladder cause colicky pains and are, as generally accepted, an absolute indication for a surgical intervention. The finding of small gall bladder concrements is often connected with a strong diminution of the gall bladder in order to prevent the small concrements from being overlapped by the non-contrasting bladder bile. Therefore, the application of Ceruletid should be considered also within the frame of the intravenous cholegraphy, thinking of the large number of normal gall bladder findings which were obtained with the oral stimulating food as the only diagnostical help.

  4. Urinary bladder cancer: role of MR imaging.

    Science.gov (United States)

    Verma, Sadhna; Rajesh, Arumugam; Prasad, Srinivasa R; Gaitonde, Krishnanath; Lall, Chandana G; Mouraviev, Vladimir; Aeron, Gunjan; Bracken, Robert B; Sandrasegaran, Kumaresan

    2012-01-01

    Urinary bladder cancer is a heterogeneous disease with a variety of pathologic features, cytogenetic characteristics, and natural histories. It is the fourth most common cancer in males and the tenth most common cancer in females. Urinary bladder cancer has a high recurrence rate, necessitating long-term surveillance after initial therapy. Early detection is important, since up to 47% of bladder cancer-related deaths may have been avoided. Conventional computed tomography (CT) and magnetic resonance (MR) imaging are only moderately accurate in the diagnosis and local staging of bladder cancer, with cystoscopy and pathologic staging remaining the standards of reference. However, the role of newer MR imaging sequences (eg, diffusion-weighted imaging) in the diagnosis and local staging of bladder cancer is still evolving. Substantial advances in MR imaging technology have made multiparametric MR imaging a feasible and reasonably accurate technique for the local staging of bladder cancer to optimize treatment. In addition, whole-body CT is the primary imaging technique for the detection of metastases in bladder cancer patients, especially those with disease that invades muscle. PMID:22411938

  5. Hypertrophic obstructive cardiomyopathy (HOCM

    Directory of Open Access Journals (Sweden)

    B. Pojskić

    2006-02-01

    Full Text Available Hypertrophic cardiomyopathy (HOCM is an autosomal dominant inherited disease of myocardium. We have presented a case of an asymptomatic female patient with HOCM discovered during family screening for HOCM. At the first examination she had all criteria for HOCM, including echocardiography. The next examination was performed two years later and clear echocardiography progression of disease was found. Pathological findings, including increasing interventricular septum thickness, mitral insufficiency, left ventricular outflow obstruction gradient and narrowing of LV, encouraged us to start the drug the treatment, although patient was clinicaly asymptomatic.

  6. Experimental bladder defect in rabbit repaired with homologous bladder extracellular matrix graft

    Institute of Scientific and Technical Information of China (English)

    YANG Si-xing; SHEN Fu-jin; HU Yun-fei; JIN Hua-min; WANG Ling-long

    2005-01-01

    @@ Approximately 400 million people worldwide suffer from bladder disease such as congenital abnormalities, cancer, trauma, infection, iatrogenic injuries or other conditions which may lead to painful bladder damage or loss, so eventual bladder augmentation or substitution should be required. Gastrointestinal segments are commonly used as tissues for bladder replacement or repair, but have been associated with multiple complications such as infection, metabolic disturbances, increased mucus production, and malignancy.1 Because of the problems encountered with the use of gastrointestinal segments, several bladder substitutes have been attempted with both organic materials (skin, dura mater, peritoneum or fascia) and synthetics (such as poly vinyl, sponge, silicone). These attempts have usually failed due to mechanical, structural or biocompatibility problems. Permanent synthetic materials succumb to mechanical failure and urinary stone formation. Degradable materials lead to fibroblast deposition, scarring, and a reduced reservoir volume.2,3 It is evident that bladder tissue cannot be replaced easily due to its elastic properties and urothelial permeability function.

  7. Inflammatory pseudotumor of the urinary bladder.

    Science.gov (United States)

    Rosado, Elsa; Pereira, José; Corbusier, Florence; Demeter, Pieter; Bali, Maria Antonietta

    2015-01-01

    We report a case of an inflammatory pseudotumor of the urinary bladder in a 31 year-old woman. She presented at the emergency room with low abdominal pain and urinary symptoms. Abdominal ultrasound, computed tomography and magnetic resonance imaging were performed and revealed asymmetric thickening of the urinary bladder wall. Cystoscopy with urinary cytology revealed a benign nature of the process. The patient underwent partial cystectomy and the pathologic examination of the specimen revealed an inflammatory pseudotumor. We reviewed the clinical, imaging and pathological features of the inflammatory pseudotumor of the urinary bladder and discussed its differential diagnosis.

  8. Bladder exstrophy: current management and postoperative imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pierre, Ketsia [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Borer, Joseph [Boston Children' s Hospital, Department of Urology, Boston, MA (United States); Phelps, Andrew [University of California, San Francisco, Department of Pediatric Radiology, San Francisco, CA (United States); Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Boston Children' s Hospital, Department of Urology, Boston, MA (United States)

    2014-07-15

    Bladder exstrophy is a rare malformation characterized by an infra-umbilical abdominal wall defect, incomplete closure of the bladder with mucosa continuous with the abdominal wall, epispadias, and alterations in the pelvic bones and muscles. It is part of the exstrophy-epispadias complex, with cloacal exstrophy on the severe and epispadias on the mild ends of the spectrum. Bladder exstrophy is the most common of these entities and is more common in boys. The goal of this paper is to describe common methods of repair and to provide an imaging review of the postoperative appearances. (orig.)

  9. Increased Bladder Wall Thickness in Diabetic and Nondiabetic Women With Overactive Bladder

    OpenAIRE

    UZUN, Hakkı; Ogullar, Sabri; Şahin, Serap Baydur; Zorba, Orhan Ünal; Akça, Görkem; Sümer, Fatih; Güney, Ülkü Mete; Balık, Gülşah

    2013-01-01

    Purpose Bladder wall thickness has been reported to be associated with overactive bladder (OAB) in women. Diabetic women have an increased risk for OAB syndrome and may have an increased risk for bladder wall thickness. Methods A total of 235 female patients aged 40 to 75 years were categorized into four groups. The first group consisted of women free of urgency or urge urinary incontinence. The second group included nondiabetic women with idiopathic OAB. The third group consisted of women wi...

  10. CONGENITAL DUODENAL OBSTRUCTIONS

    Directory of Open Access Journals (Sweden)

    S.G. Aprodu

    2005-07-01

    Full Text Available The purpose of this study is to analyze a cohort of 46 cases of congenital duodenal obstruction, operated on between 1996 and 2002, 23 of them being diagnosed in neonatal period. In one case, the diagnosis was made antenatally, by ultrasonography. There were 15 males and 8 females, 17 with duodenal atresia and 6 with duodenal diaphragmatic stenosis. Surgery was performed in all cases, consisting in lateral duodeno-duodenal anastomosis in 5 cases and "diamond-shape" duodeno-duodenal anastomosis in 18 cases. The survival rate in this study was 69.5%. 12 cases (52,1% had other congenital pathologies: trisomy 21 (6 cases, multiple ileal atresia (2 cases, dextrocardy (2 cases, omphalocel (1 case, situs inversus (1 case. The complications of surgery were: anastomotic leaking with peritonitis, biliary fistula, intestional adhesions with occlusion. Congenital duodenal obstruction (midgut volvulus, atresia, stenosis remains a challenging issue for pediatric surgeons, especially in our country, due to limited possibilities of quick diagnosis and treatment of associated anomalies.

  11. CHEMOTHERAPY FOR MUSCLE INVASIVE BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Rusakov

    2014-08-01

    Full Text Available The paper considers treatment regimens for metastatic bladder cancer (MBC and gives the data of trials of the efficiency of using different chemotherapy schemes and regimens in patients with MBC.

  12. MANAGEMENT OF CARCINOMA BLADDER: A REVIEW LITERATURE

    Directory of Open Access Journals (Sweden)

    Gurinderjit Singh

    2014-12-01

    Full Text Available Carcinoma of the bladder is a disease of the elderly. Bladder cancer is three times more common in males than in females and more common in whites than in blacks. Patients with bladder cancer have a 1% to 4% incidence of synchronous or metachronous upper t ract urothelial tumors. There are many risk factors for urothelial cancer, classified into (1 Genetic (2 chemical exposure, and (3 chronic irritation. Genetic abnormalities associated with CIS include alterations in the retinoblastoma gene (Rb, p53, an d PTEN. Chemical exposure has the most epidemiologic evidence to support it as an inciting agent (Aromatic amines, aniline dyes, and nitrites and nitrates. Chronic irritants include catheters, recurrent urinary track infections, Schistosoma haematobium, a nd irradiation. There are many studies that suggest high water consumption, vitamin intake, and various diets that are beneficial in preventing bladder cancer. However, none of these have shown any clear benefit with respect to prevention.

  13. Transurethral microwave needle ablation for bladder cancer

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@To investigate the role of transurethral microwave needle ablation (TUMWNA) in the management of bladder cancer,TUMWNA was carried out in 24 patients with bladder cancer since 1989. From January 1989 to December 1997, 24 patients with bladder cancer were treated with TUMWNA. The 15 men and 9 women were 42 to 67 years old (mean, 58). There were 18 cases with a single tumor and 6 with multiple tumors (4 with 2 tumors, 1 with 3 and 1 with 4). Tumor diameter ranged from 0.3 to 2.5 cm. The lesions grew in different bladder regions: 13 tumors arose from the fundus, 3 tumors from the dome, 9 from the lateral wall, 5 from the anterior wall, 1 from the triangle region and 2 tumors were situated in the obturator nerve reflex sensitive region.

  14. Bladder Control: What Men Need to Know

    Science.gov (United States)

    ... about bladder control problems? Just changing some daily habits may help. For example, you could limit fluids at certain times of the day or plan regular trips to the bathroom to avoid an accident. Don’t be embarrassed ...

  15. SMP Bladder Tooling for Manufacturing Composites Project

    Data.gov (United States)

    National Aeronautics and Space Administration — CRG's shape memory polymer (SMP) Bladder Tooling is a cutting-edge manufacturing technology that can meet the manufacturing needs of the Ares launch vehicles. This...

  16. Bladder Diseases - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Bladder Diseases URL of this page: https://medlineplus.gov/languages/bladderdiseases.html Other topics A-Z A B ...

  17. Clinical Analysis of Parkinson' s Disease with Urinary Bladder Dysfunction: A Report of 64 Cases%64例帕金森病伴膀胱尿道功能障碍的临床分析

    Institute of Scientific and Technical Information of China (English)

    薛芃; 韩志兴; 王涛; 赵玉千

    2011-01-01

    目的 探讨帕金森病伴膀胱尿道功能障碍患者的治疗情况.方法 对伴有膀胱尿道功能障碍的64例帕金森病患者进行完善的尿动力学检查,并根据检查结果采取相应的治疗措施.结果逼尿肌反射亢进44例,采用治疗原发病、排尿功能锻炼、抗胆碱能药物治疗有效者28例;6例合并膀胱出口梗阻行经尿道前列腺电切术,2例术后呈明显尿失禁;10例无效者采用外部集尿器.逼尿肌功能受损及失代偿至急、慢性尿潴留20例,其中保留尿管患者14例.经口服α1受体阻滞剂坦索罗辛和/或非那雄胺逐渐恢复自行排尿或排尿症状明显改善者10例,行经尿道前列腺电切术3例,膀胱造瘘术3例,4例采取清洁间歇性自家导尿术.结论 结合尿动力学检查对帕金森病伴膀胱尿道功能障碍患者采取相应的治疗措施,以保护肾功能,提高患者生活质量.%Objective To investigate the treatment of Parkinson' s disease with urinary bladder dysfunction. Methods The urodynamic testing was carried out in 64 cases of Parkinson's disease with urinary bladder dysfunction,and the appropriate treatments were taken. Results There were 44 cases with detrusor hyperreflexia. In these patients ,28 cases were effective to the treatment of primary disease,urinary function exercise,anti-cholinergic drugs;6 cases with bladder outlet obstruction received the tran-surethral prostate resection;2 cases were with a postoperative urinary incontinence; 10 ineffective cases received external urine collection device. There were 20 cases with detrusor dysfunction and its decompensation leaded to acute or chronic urinary retention. 14 patients retained catheter. The voluntary micturition was recovered or improved in 10 cases after oralal-blocker tamsulo-sin and/or finasteride; 10 cases gradually returned to urinate or urinary symptoms improved in,Transurethral resection of prostate (TURP) was performed in 3 cases,cystostomy in 3 cases

  18. Narrow band imaging for bladder cancer

    OpenAIRE

    Thomas Y. Hsueh; Allen W. Chiu

    2016-01-01

    Narrow band imaging (NBI) is a newly developed technology aiming to provide additional endoscopic information for patients with bladder cancer. This review focuses on the diagnostic accuracy and treatment outcome using NBI cystoscopy for the treatment of non-muscle invasive bladder cancer. Current results showed improved sensitivity of NBI cystoscopy compared to conventional white light cystoscopy, although lower specificity and increased false-positive results were reported using NBI cystosc...

  19. Thulium laser treatment for bladder cancer

    OpenAIRE

    Wei Wang; Haitao Liu; Shujie Xia

    2016-01-01

    Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer. Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure. We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes. Literature evidence suggests that thulium laser te...

  20. Holmium laser lithotripsy of bladder calculi

    Science.gov (United States)

    Beaghler, Marc A.; Poon, Michael W.

    1998-07-01

    Although the overall incidence of bladder calculi has been decreasing, it is still a significant disease affecting adults and children. Prior treatment options have included open cystolitholapaxy, blind lithotripsy, extracorporeal shock wave lithotripsy, and visual lithotripsy with ultrasonic or electrohydraulic probes. The holmium laser has been found to be extremely effective in the treatment of upper tract calculi. This technology has also been applied to the treatment of bladder calculi. We report our experience with the holmium laser in the treatment of bladder calculi. Twenty- five patients over a year and a half had their bladder calculi treated with the Holmium laser. This study was retrospective in nature. Patient demographics, stone burden, and intraoperative and post-operative complications were noted. The mean stone burden was 31 mm with a range of 10 to 60 mm. Preoperative diagnosis was made with either an ultrasound, plain film of the abdomen or intravenous pyelogram. Cystoscopy was then performed to confirm the presence and determine the size of the stone. The patients were then taken to the operating room and given a regional or general anesthetic. A rigid cystoscope was placed into the bladder and the bladder stone was then vaporized using the holmium laser. Remaining fragments were washed out. Adjunctive procedures were performed on 10 patients. These included transurethral resection of the prostate, transurethral incision of the prostate, optic internal urethrotomy, and incision of ureteroceles. No major complications occurred and all patients were rendered stone free. We conclude that the Holmium laser is an effective and safe modality for the treatment of bladder calculi. It was able to vaporize all bladder calculi and provides a single modality of treating other associated genitourinary pathology.

  1. Sensory dysfunction of bladder mucosa and bladder oversensitivity in a rat model of metabolic syndrome.

    Directory of Open Access Journals (Sweden)

    Wei-Chia Lee

    Full Text Available PURPOSE: To study the role of sensory dysfunction of bladder mucosa in bladder oversensitivity of rats with metabolic syndrome. MATERIALS AND METHODS: Female Wistar rats were fed a fructose-rich diet (60% or a normal diet for 3 months. Based on cystometry, the fructose-fed rats (FFRs were divided into a group with normal detrusor function or detrusor overactivity (DO. Acidic adenosine triphosphate (ATP solution (5mM, pH 3.3 was used to elicit reflex micturition. Cystometric parameters were evaluated before and after drug administration. Functional proteins of the bladder mucosa were assessed by western blotting. RESULTS: Compared to the controls, intravesical acidic ATP solution instillation induced a significant increase in provoked phasic contractions in both FFR groups and a significant decrease in the mean functional bladder capacity of group DO. Pretreatment with capsaicin for C-fiber desentization, intravesical liposome for mucosal protection, or intravenous pyridoxal 5-phosphate 6-azophenyl-2',4'-disulfonic acid for antagonized purinergic receptors can interfere with the urodynamic effects of intravesical ATP in FFRs and controls. Over-expression of TRPV1, P2X(3, and iNOS proteins, and down-regulation of eNOS proteins were observed in the bladder mucosa of both fructose-fed groups. CONCLUSIONS: Alterations of sensory receptors and enzymes in the bladder mucosa, including over-expression of TRPV1, P2X(3, and iNOS proteins, can precipitate the emergence of bladder phasic contractions and oversensitivity through the activation of C-afferents during acidic ATP solution stimulation in FFRs. The down-regulation of eNOS protein in the bladder mucosa of FFRs may lead to a failure to suppress bladder oversensitivity and phasic contractions. Sensory dysfunction of bladder mucosa and DO causing by metabolic syndrome are easier to elicit bladder oversensitivity to certain urothelium stimuli.

  2. Automatic segmentation of bladder in CT images

    Institute of Scientific and Technical Information of China (English)

    Feng SHI; Jie YANG; Yue-min ZHU

    2009-01-01

    Segmentation of the bladder in computerized tomography (CT) images is an important step in radiation therapy planning of prostate cancer. We present a new segmentation scheme to automatically delineate the bladder contour in CT images with three major steps. First, we use the mean shift algorithm to obtain a clustered image containing the rough contour of the bladder, which is then extracted in the second step by applying a region-growing algorithm with the initial seed point selected from a line-by-line scanning process. The third step is to refine the bladder contour more accurately using the rolling-ball algorithm. These steps are then extended to segment the bladder volume in a slice-by-slice manner. The obtained results were compared to manual segmentation by radiation oncologists. The average values of sensitivity, specificity, positive predictive value, negative predictive value, and Hausdorff distance are 86.5%, 96.3%, 90.5%, 96.5%, and 2.8 pixels, respectively. The results show that the bladder can be accurately segmented.

  3. The role of imaging in pediatric bladder augmentation

    Energy Technology Data Exchange (ETDEWEB)

    Breen, Micheal; Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Phelps, Andrew [UCSF Benioff Children' s Hospital San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Estrada, Carlos [Boston Children' s Hospital, Department of Urology, Boston, MA (United States)

    2015-09-15

    Bladder augmentation (also called augmentation cystoplasty) refers to a number of surgical methods that increase the capacity and compliance of the urinary bladder. Imaging has an important role in the postoperative evaluation of bladder augmentation. The most common augmentation procedures utilize enteric segments to augment the bladder. The various types of bladder augmentation have characteristic appearances on different imaging modalities. Spontaneous bladder perforation is a complication that is seen in both early and late post-operative periods and it is one of the most important complications for radiologists to be aware of as it is life-threatening. We review the indications for bladder augmentation in children, the surgical techniques employed, the normal postoperative appearances on imaging studies and the role of imaging complications of bladder augmentation including delayed spontaneous bladder rupture, which is life-threatening. (orig.)

  4. Photoselective vaporization of the prostate in men taking clopidogrel

    Directory of Open Access Journals (Sweden)

    Daniel M.G Spernat

    2011-01-01

    Conclusions : PVP is a safe and efficacious in the treatment of high risk patients with bladder outlet obstruction. Further, the ability to continue therapeutic anticoagulation and anti-platelet agents, is a significant advantage over Holmium enucleation of the prostate and conventional transurethral resection of the prostate. Larger studies with greater numbers of patients are required prior to PVP becoming the gold standard for high-risk patients with bladder outlet obstruction.

  5. Radiological evaluation of double-outlet right ventricle - An analysis of cinecardioangiography in 44 cases -

    Energy Technology Data Exchange (ETDEWEB)

    Park, Cheong Hee; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    in 4, interrupted IVC in 1, obstructive VSD in 2, ASD in 4, PDA in 4, right aortic arch with levocardia in 5, and ectopic spleen with mesocardia in 1 case. 7. Biplane cinecardioangiogram must be performed in both ventricles to define the VSD and its relationship to the great arteries, and, if necessary, should also be performed in the aorta to rule out coarctation and coronary artery abnormalities, and in the pulmonary artery to visualize pulmonary venous return and mitral valve. Angiography is of crucial importance in differentiating double-outlet right ventricle from tetralogy of Fallot and complete transposition of the great arteries.

  6. Boundary conditions for free surface inlet and outlet problems

    KAUST Repository

    Taroni, M.

    2012-08-10

    We investigate and compare the boundary conditions that are to be applied to free-surface problems involving inlet and outlets of Newtonian fluid, typically found in coating processes. The flux of fluid is a priori known at an inlet, but unknown at an outlet, where it is governed by the local behaviour near the film-forming meniscus. In the limit of vanishing capillary number Ca it is well known that the flux scales with Ca 2/3, but this classical result is non-uniform as the contact angle approaches π. By examining this limit we find a solution that is uniformly valid for all contact angles. Furthermore, by considering the far-field behaviour of the free surface we show that there exists a critical capillary number above which the problem at an inlet becomes over-determined. The implications of this result for the modelling of coating flows are discussed. © 2012 Cambridge University Press.

  7. STILLING BASINS BELOW OUTLET WORKS – AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    H L Tiwari,

    2010-11-01

    Full Text Available A stilling basins are transition structures constructed to dissipate excess energy confined by high velocity flow at the outlet of conduit or tunnel so that the flow beyond the basin does not endanger the stability of bed and banks of downstream channel. In a stilling basin kinetic energy causes turbulences and it is ultimately lost as heat and sound energy. there are several types of stilling basins which are used in various hydraulic structures like dam, canal, culvert etc. The type of stilling basin most suitable at a particular location mainly depends upon initial Froude Number and initial velocity of flow. This paper covers design principles and features of various stilling basins used for outlet works.

  8. Basal resistance for three of the largest Greenland outlet glaciers

    Science.gov (United States)

    Shapero, Daniel R.; Joughin, Ian R.; Poinar, Kristin; Morlighem, Mathieu; Gillet-Chaulet, Fabien

    2016-01-01

    Resistance at the ice-bed interface provides a strong control on the response of ice streams and outlet glaciers to external forcing, yet it is not observable by remote sensing. We used inverse methods constrained by satellite observations to infer the basal resistance to flow underneath three of the Greenland Ice Sheet's largest outlet glaciers. In regions of fast ice flow and high (>250 kPa) driving stresses, ice is often assumed to flow over a strong bed. We found, however, that the beds of these three glaciers provide almost no resistance under the fast-flowing trunk. Instead, resistance to flow is provided by the lateral margins and stronger beds underlying slower-moving ice upstream. Additionally, we found isolated patches of high basal resistivity within the predominantly weak beds. Because these small-scale (tested their robustness to different degrees of regularization.

  9. Airshuffler implementation at freezer air outlets for heat transfer enhancement

    Science.gov (United States)

    Ćerezci, Gökhan; Darka, Murat; Şenman, Ozan

    2016-06-01

    A study which is composed of computational simulation and experimental validation has been conducted for implementation of small, vane type geometries at freezer air outlets, similar to microvortex generators used in aircraft wings, in order to improve the heat transfer efficiency inside the freezer compartment by decreasing airside thermal resistance and improving the air distribution. Both simulation and experimental validation were performed in a loaded condition which was prepared according to `Household refrigerating appliances - characteristics and test methods - IEC 62552 [1]. Solutions for the incompressible K-epsilon (k-ɛ) turbulence model obtained for Bosch KDN 49 refrigerator freezer both with and without airshufflers at air outlets, which are similar to vane type microvortex generators with different geometric dimensions. The airshuffler dimensions were chosen with design of experiment (DOE) principles for finding the optimum geometry. The best combinations were tested according to cooling rate inside freezer compartment. Results were evaluated for feasibility of implementing of vortex generating surfaces (airshufflers) for cooling appliances.

  10. Turbofan gas turbine engine with variable fan outlet guide vanes

    Science.gov (United States)

    Wood, Peter John (Inventor); Zenon, Ruby Lasandra (Inventor); LaChapelle, Donald George (Inventor); Mielke, Mark Joseph (Inventor); Grant, Carl (Inventor)

    2010-01-01

    A turbofan gas turbine engine includes a forward fan section with a row of fan rotor blades, a core engine, and a fan bypass duct downstream of the forward fan section and radially outwardly of the core engine. The forward fan section has only a single stage of variable fan guide vanes which are variable fan outlet guide vanes downstream of the forward fan rotor blades. An exemplary embodiment of the engine includes an afterburner downstream of the fan bypass duct between the core engine and an exhaust nozzle. The variable fan outlet guide vanes are operable to pivot from a nominal OGV position at take-off to an open OGV position at a high flight Mach Number which may be in a range of between about 2.5-4+. Struts extend radially across a radially inwardly curved portion of a flowpath of the engine between the forward fan section and the core engine.

  11. Management of obstructed defecation.

    Science.gov (United States)

    Podzemny, Vlasta; Pescatori, Lorenzo Carlo; Pescatori, Mario

    2015-01-28

    The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an "iceberg syndrome", with "emerging rocks", rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients also has "underwater rocks" or occult disorders, such as anismus, rectal hyposensation and anxiety/depression, which mostly require conservative treatment. Rectal prolapse excision or obliterative suture, rectocele and/or enterocele repair, retrograde Malone's enema and partial myotomy of the puborectalis muscle are effective in selected cases. Laparoscopic ventral sacral colporectopexy may be an effective surgical option. Stapled transanal rectal resection may lead to severe complications. The Transtar procedure seems to be safer, when dealing with recto-rectal intussusception. A multidisciplinary approach to ODS provides the best results. PMID:25632177

  12. Childhood Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    R Dayal

    2014-03-01

    Full Text Available Obstructive sleep apnea (OSA is a common condition in childhood and can result insevere complications if left untreated. It is showing a rising trend in India. A significantassociation with obesity has been observed; however, some children with enlargedtonsils and/or adenoids may even be underweight. The patient usually presents withsnoring and other respiratory problems like mouth breathing, choking and gaspingepisodes in night. Poor school performance and neurocognitive deficits have beenreported. Pulmonary hypertension and cor pulmonale are seen in severe cases. Besidesthe history and clinical examination, for definitive diagnosis an overnightpolysomnographic evaluation is the gold standard. In all cases, the specific treatmentranges from simple lifestyle modifications and medications to surgeries likeadenotonsillectomy. Early diagnosis is vital.Key words: Childhood OSA, Obesity, adenotonsillar hypertrophy

  13. Embryonic Origin and Remodeling of the Urinary and Digestive Outlets

    OpenAIRE

    Chen Wang; JingYing Wang; Borer, Joseph G.; Xue Li

    2013-01-01

    Separating digestive and urinary outlets is a critical step during mammalian embryogenesis. However, the natural history of these structures is poorly studied, and little is known about their embryonic origin. Here, we show that peri-cloacal mesenchymal (PCM) progenitors are the major source of these structures. Surprisingly, PCM progenitors also contribute to perineum, a structural barrier separating the urinary and digestive tracts, suggesting a potential role of PCM progenitors in establis...

  14. Simulation of water flows in multiple columns with small outlets

    International Nuclear Information System (INIS)

    High-pressure die casting such as thixocasting and rheocasting is an effective process in the manufacturing automotive parts. Following the recent trend in the automotive manufacturing technologies, the product design subject to the die casting becomes more and more complex. Simultaneously the injection speed is also designed to be very high to establish a short cycle-time. Thus, the requirement of the die design becomes more demanding than ever before. In some cases the product's shape can have multiple slender manifolds. In such cases, design of the inlet and outlet parts of the die is very important in the whole manufacturing process. The main issues required for the qualified products are to attain gentle and uniform flow of the molten liquid within the passages of the die. To satisfy such issues, the inlet cylinder ('bed cylinder' in this paper) must be as large as possible and simultaneously the outlet opening at the end of each passage must be as small as possible. However these in turn obviously bring additional manufacturing costs caused by re-melting of the bed cylinder and increased power due to the small outlet-openings. The purpose of this paper is to develop effective simulation methods of calculation for fluid flows in multiple columns, which mimic the actual complex design, and to get some useful information which can give some contributions to the die-casting industry. We have used a commercial code CFX in the numerical simulation. The primary parameter involved is the size of the bed cylinder. We will show how the very small opening of the outlet can be treated with the aid of the porous model provided in the code. To check the validity of the numerical results we have also conducted a simple experiment by using water

  15. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  16. Alcohol Outlets and Substance Use among High Schoolers

    Science.gov (United States)

    Milam, Adam J.; Johnson, Sarah Lindstrom; Furr-Holden, C. Debra M.; Bradshaw, Catherine P.

    2016-01-01

    Few studies have considered the potential role of the built environment in increasing adolescent substance use. The current study explored the relationship between alcohol outlets, a potential malleable component of the neighborhood environment, and adolescent behavioral outcomes. Specifically, we investigated the relationship between alcohol outlet density, perceived alcohol, tobacco, and marijuana availability (ATOD), perception of substance use as a problem at the school, and self-reported ATOD use. Data come from Maryland Safe and Supportive Schools (MDS3) Initiative, a statewide project focused on measuring and improving school climate. The sample includes 25,308 adolescents from 58 high schools (9th–12th grade) across 12 counties. Multi-level path models indicated a positive relationship between the count of alcohol outlets and perceived availability of ATOD among girls but not boys. Perceived availability was associated with increased ATOD use at both the individual- and school-level, as well as other students’ ATOD use. Findings provide support for the potential role of the built environment in adolescent risk for substance use, particularly among girls. PMID:27574339

  17. Use of a self-designed bladder controller for restoring bladder function in paraplegic dogs

    Institute of Scientific and Technical Information of China (English)

    王诗波; 侯春林; 刁颖敏; 陈爱民; 张世民; 雷波; 尹承慧; 张伟

    2003-01-01

    Objective: To evaluate the results of a self-designed bladder controller for restoring micturition function in paraplegic dogs.Methods: The spinal cords of 4 dogs were transected above the cone. Electrodes were implanted in S2 bilaterally and connected to the subcutaneous receivers for external activation. Microsurgical technique was employed to perform dorsal rhizotomy of S1-3 intradurally. The dogs were stimulated daily to observe micturition. Urodynamic testing and vesicography were performed. Results: All the dogs acquired micturition under the control of electric stimulation, with urine volume 80-140 ml per time. The mode of micturition was post-stimulus voiding. Vesicography revealed that the bladder was filled well and the bladder neck was open in the micturition course of electric stimulation. Residual urine volume was 15-20 ml. Urodynamic testing found that the bladder pressure and intraurethral pressure increased simultaneously, but when the intraurethral pressure was greater than the bladder pressure, no micturition occurred. The pressure decreased to baseline rapidly and the bladder pressure decreased slowly between two bursts. Micturition occurred when the bladder pressure was greater than the intraurethral pressure.Conclusions: The self-designed bladder controller together with a sacral deafferentation procedure can restore micturition function of paraplegic dogs.

  18. Neighborhood Characteristics Associated with the Availability of Alcohol Outlets in Quebec, Canada

    OpenAIRE

    André Ngamini Ngui; Philippe Apparicio; Mathieu Philibert; Marie-Josée Fleury

    2015-01-01

    Objectives. The objectives of this study were to examine the spatial accessibility to alcohol outlets in Quebec and to assess the association between neighborhood level characteristics and availability of alcohol outlets. Methods. The Tobit Model was used to assess the association between neighborhood level characteristics and the availability of alcohol outlets within 500, 1000, 2000, and 3000 metres, respectively. Results. Alcohol outlets were found to be most available in the two largest m...

  19. Stenting in Malignant Biliary Obstruction.

    Science.gov (United States)

    Almadi, Majid A; Barkun, Jeffrey S; Barkun, Alan N

    2015-10-01

    Decompression of the biliary system in patients with malignant biliary obstruction has been widely accepted and implemented as part of the care. Despite a wealth of literature, there remains a significant amount of uncertainty as to which approach would be most appropriate in different clinical settings. This review covers stenting of the biliary system in cases of resectable or palliative malignant biliary obstruction, potential candidates for biliary drainage, technical aspects of the procedure, as well as management of biliary stent dysfunction. Furthermore, periprocedural considerations including proper mapping of the location of obstruction and the use of antibiotics are addressed. PMID:26431598

  20. Image-guided radiotherapy of bladder cancer: bladder volume variation and its relation to margins

    DEFF Research Database (Denmark)

    Muren, Ludvig; Redpath, Anthony Thomas; Lord, Hannah;

    2007-01-01

    : The correlation between the relative bladder volume (RBV, defined as repeat scan volume/planning scan volume) and the margins required to account for internal motion was first studied using a series of 20 bladder cancer patients with weekly repeat CT scanning during treatment. Both conformal RT (CRT) and IGRT......BACKGROUND AND PURPOSE: To control and account for bladder motion is a major challenge in radiotherapy (RT) of bladder cancer. This study investigates the relation between bladder volume variation and margins in conformal and image-guided RT (IGRT) for this disease. MATERIALS AND METHODS...... these patients were given fluid intake restrictions on alternating weeks during treatment. RESULTS: IGRT gave the strongest correlation between the RBV and margin size (R(2)=0.75; p10mm were required in only 1% of the situations when the RBV1, whereas isotropic margins >10...

  1. Transurethral en bloc resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    A. G. Martov

    2015-01-01

    Full Text Available Background. The high incidence of recurrent non-muscle-invasive bladder carcinoma (BC necessitates searches for new surgical methods. Objective: to comparatively evaluate the efficiency and safety of en block resection of bladder tumors versus transurethral resection (TUR. Subjects and methods. In January 2010 to June 2013, a total of 292 patients with primary and recurrent bladder tumor stages, cTa-T2, underwent transurethral endoscopic treatment (as TUR at the Unit of Minimally Invasive Urology, Moscow City Clinical Hospital Fifty-Seven. A major portion of these patients were included in the study of the efficiency and safety of en bloc TUR of bladder tumors. The criteria for study inclusion were primary or recurrent non-muscle-invasive bladder tumor measuring 1 to 3 cm, stage pTa-T1, signed informed consent to participate in the study and patients» readiness to undergo control examinations in inpatient setting for one year. The exclusion criteria were a confirmed or detected muscleinvasive tumor, multiple bladder involvement (> 3 tumors, as well as detected tumors spreading to the ureter, bladder neck, and prostatic urethra. The primary study endpoint was considered to be a recurrence of a tumor after TUR of the bladder (TURB. The secondary endpoint was the frequency of concealed bladder perforation, blood transfusions, recystoscopies for bladder tamponade, early recystoscopies to specify a BC stage, and the frequency of immediate intravesical injection of a chemical. For final analysis, the investigators selected 106 patients in a group where tumors were removed en bloc (a study group and 133 patients in a group where tumors were retrieved using traditional TURB (a control group. In the study group, the tumor was removed en bloc by a monopolar J-shaped electrode (sand wedge electrode in 45 patients, by a hook-like electrode in 14, by a hybrid procedure (hydropreparation and monopolar electrosurgery by a water-jet hybrid knife in 10, and by

  2. Transurethral en bloc resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    A. G. Martov

    2015-03-01

    Full Text Available Background. The high incidence of recurrent non-muscle-invasive bladder carcinoma (BC necessitates searches for new surgical methods. Objective: to comparatively evaluate the efficiency and safety of en block resection of bladder tumors versus transurethral resection (TUR. Subjects and methods. In January 2010 to June 2013, a total of 292 patients with primary and recurrent bladder tumor stages, cTa-T2, underwent transurethral endoscopic treatment (as TUR at the Unit of Minimally Invasive Urology, Moscow City Clinical Hospital Fifty-Seven. A major portion of these patients were included in the study of the efficiency and safety of en bloc TUR of bladder tumors. The criteria for study inclusion were primary or recurrent non-muscle-invasive bladder tumor measuring 1 to 3 cm, stage pTa-T1, signed informed consent to participate in the study and patients» readiness to undergo control examinations in inpatient setting for one year. The exclusion criteria were a confirmed or detected muscleinvasive tumor, multiple bladder involvement (> 3 tumors, as well as detected tumors spreading to the ureter, bladder neck, and prostatic urethra. The primary study endpoint was considered to be a recurrence of a tumor after TUR of the bladder (TURB. The secondary endpoint was the frequency of concealed bladder perforation, blood transfusions, recystoscopies for bladder tamponade, early recystoscopies to specify a BC stage, and the frequency of immediate intravesical injection of a chemical. For final analysis, the investigators selected 106 patients in a group where tumors were removed en bloc (a study group and 133 patients in a group where tumors were retrieved using traditional TURB (a control group. In the study group, the tumor was removed en bloc by a monopolar J-shaped electrode (sand wedge electrode in 45 patients, by a hook-like electrode in 14, by a hybrid procedure (hydropreparation and monopolar electrosurgery by a water-jet hybrid knife in 10, and by

  3. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  4. EFFECT OF GENERIC PROMOTION OF FLOWERS ON THE USE OF RETAIL FLOWER OUTLETS

    OpenAIRE

    Rimal, Arbindra; Ward, Ronald W.

    1998-01-01

    AIDs demand models are used to test if the generic promotion of fresh-cut flowers influenced the market shares for florists, supermarkets, and other retail outlets. Were the generic efforts outlet neutral? Generic promotions of fresh-cut flowers is shown to be outlet neutral while the brand advertising increased florists' market share.

  5. A Geospatial Statistical Analysis of the Density of Lottery Outlets within Ethnically Concentrated Neighborhoods

    Science.gov (United States)

    Wiggins, Lyna; Nower, Lia; Mayers, Raymond Sanchez; Peterson, N. Andrew

    2010-01-01

    This study examines the density of lottery outlets within ethnically concentrated neighborhoods in Middlesex County, New Jersey, using geospatial statistical analyses. No prior studies have empirically examined the relationship between lottery outlet density and population demographics. Results indicate that lottery outlets were not randomly…

  6. Successful treatment of lower urinary tract obstruction with peritoneal-amniotic and vesicoamniotic shunting

    Institute of Scientific and Technical Information of China (English)

    mit Korucuolu; Anl Iel Saygi; Yaam Kemal Akpak; zkanzdamar; Aydan Biri

    2014-01-01

    Lower urinary tract obstruction(LUTO) which is most commonly caused by posterior urethral valves or urethral atresia, is often associated with high perinatal mortality and morbidity and long-term childhood renal dysfunction or even renal failure.LUTO is an uncommon clinical entity that can be diagnosed by ultrasonographic examination and is particularly presented by enlarged bladder, hydronephrosis, hydroureter and oligohydramnios.Despite being a rare pathology of the genitourinary tract, detection rates of it is higher than other congenital abnormalities with ultrasonography.Moreover, ultrasonography has become the most widely used diagnostic tool in the diagnosis ofLUTO.Pulmonary hypoplasia resulting from severe oligohydramnios is the most common cause of death.Bladder drainage has a critical role on perinatal survival in fetuses withLUTO especially in those predicted to have a poor prognosis.Further interventions and observations of renal therapies may be required in childhood.

  7. Successful treatment of lower urinary tract obstruction with peritoneal-amniotic and vesicoamniotic shunting

    Directory of Open Access Journals (Sweden)

    Ümit Korucuoğlu

    2014-01-01

    Full Text Available Lower urinary tract obstruction (LUTO which is most commonly caused by posterior urethral valves or urethral atresia, is often associated with high perinatal mortality and morbidity and long-term childhood renal dysfunction or even renal failure. LUTO is an uncommon clinical entity that can be diagnosed by ultrasonographic examination and is particularly presented by enlarged bladder, hydronephrosis, hydroureter and oligohydramnios. Despite being a rare pathology of the genitourinary tract, detection rates of it is higher than other congenital abnormalities with ultrasonography. Moreover, ultrasonography has become the most widely used diagnostic tool in the diagnosis of LUTO. Pulmonary hypoplasia resulting from severe oligohydramnios is the most common cause of death. Bladder drainage has a critical role on perinatal survival in fetuses with LUTO especially in those predicted to have a poor prognosis. Further interventions and observations of renal therapies may be required in childhood.

  8. A rare case of renal vein thrombosis due to urinary obstruction.

    Science.gov (United States)

    Jana, Tanima; Orlander, Philip R; Molony, Donald A

    2015-08-01

    Renal vein thrombosis (RVT) is an uncommon condition in adults and may be caused by endothelial damage, stasis, or hypercoagulable states. RVT is commonly identified in patients with nephrotic syndrome or malignancy. We present the case of a 57-yearold man with no past medical history who presented with a 1-month history of abdominal pain, dysuria, and hematuria. Initial laboratory studies were consistent with acute kidney injury (AKI). Imaging revealed bladder distension, enlargement of the prostate, bilateral hydronephrosis, and left renal vein thrombosis extending into the inferior vena cava. His renal failure and presenting symptoms resolved with placement of a Foley catheter and ureteral stent. The patient was discharged on anticoagulation. Here, we report a rare case of RVT that appears to have occurred as a consequence of obstructive uropathy causing massive bladder distention resulting in compression of the renal vein.

  9. Somatic modulation of spinal reflex bladder activity mediated by nociceptive bladder afferent nerve fibers in cats.

    Science.gov (United States)

    Xiao, Zhiying; Rogers, Marc J; Shen, Bing; Wang, Jicheng; Schwen, Zeyad; Roppolo, James R; de Groat, William C; Tai, Changfeng

    2014-09-15

    The goal of the present study was to determine if supraspinal pathways are necessary for inhibition of bladder reflex activity induced by activation of somatic afferents in the pudendal or tibial nerve. Cats anesthetized with α-chloralose were studied after acute spinal cord transection at the thoracic T9/T10 level. Dilute (0.25%) acetic acid was used to irritate the bladder, activate nociceptive afferent C-fibers, and trigger spinal reflex bladder contractions (amplitude: 19.3 ± 2.9 cmH2O). Hexamethonium (a ganglionic blocker, intravenously) significantly (P < 0.01) reduced the amplitude of the reflex bladder contractions to 8.5 ± 1.9 cmH2O. Injection of lidocaine (2%, 1-2 ml) into the sacral spinal cord or transection of the sacral spinal roots and spinal cord further reduced the contraction amplitude to 4.2 ± 1.3 cmH2O. Pudendal nerve stimulation (PNS) at frequencies of 0.5-5 Hz and 40 Hz but not at 10-20 Hz inhibited reflex bladder contractions, whereas tibial nerve stimulation (TNS) failed to inhibit bladder contractions at all tested frequencies (0.5-40 Hz). These results indicate that PNS inhibition of nociceptive afferent C-fiber-mediated spinal reflex bladder contractions can occur at the spinal level in the absence of supraspinal pathways, but TNS inhibition requires supraspinal pathways. In addition, this study shows, for the first time, that after acute spinal cord transection reflex bladder contractions can be triggered by activating nociceptive bladder afferent C-fibers using acetic acid irritation. Understanding the sites of action for PNS or TNS inhibition is important for the clinical application of pudendal or tibial neuromodulation to treat bladder dysfunctions. PMID:25056352

  10. Treatment of ureteral calculus obstruction with laser lithotripsy in an Atlantic bottlenose dolphin (Tursiops truncatus).

    Science.gov (United States)

    Schmitt, Todd L; Sur, Roger L

    2012-03-01

    An adult female bottlenose dolphin (Tursiops truncatus) presented with acute anorexia secondary to progressive azotemia (blood urea nitrogen = 213 mg/dl, creatinine [Cr] = 9.5 mg/dl) and electrolyte abnormalities (K = 7.4 mEq/L). It was later diagnosed with postrenal obstruction secondary to bilaterally obstructing ureteral calculi seen on ultrasound. Treatment of the obstruction required two endoscopic procedures, cystoscopy for ureteral stent placement and ureteroscopy to perform intracorporeal lithotripsy on the obstructing calculi. Before the first procedure, the dolphin's azotemia was stabilized with aggressive fluid therapy, peritoneal dialysis, and treatment for acidosis. Diuresis subsequent to the fluid therapy enabled passage of the right obstructing urolith. For both endoscopic procedures, the dolphin was placed in left lateral recumbency due to the peritoneal dialysis catheter in the right retroperitoneal region. For the first procedure, a 12-French (Fr) flexible cystoscope was inserted retrograde into the bladder via the urethra, whereupon a calculus was seen obstructing the left ureteral orifice. A 4.8-Fr, 26-cm double-pigtail ureteral stent was placed up the left ureter to relieve the postrenal obstruction. Inadvertent proximal migration of the left ureteral stent occurred during the procedure. However, renal parameters (serum Cr = 5.8, K = 5.4) improved significantly by the next day. For the second procedure, 28 hr later, ureteroscopy was performed to treat the calculus and replace the existing stent with a longer stent. The left ureteral calculus was pulverized into tiny fragments by using a holmium:yttrium-aluminum-garnet laser inserted through a 6.9-Fr semirigid ureteroscope. The migrated stent was visualized in the distal left ureter and replaced with a 90-cm single-pigtail ureteral stent that was sutured exterior to the urogenital slit and removed 3 days later. Renal function normalized over the next several days, and the dolphin recovered over

  11. Treatment of ureteral calculus obstruction with laser lithotripsy in an Atlantic bottlenose dolphin (Tursiops truncatus).

    Science.gov (United States)

    Schmitt, Todd L; Sur, Roger L

    2012-03-01

    An adult female bottlenose dolphin (Tursiops truncatus) presented with acute anorexia secondary to progressive azotemia (blood urea nitrogen = 213 mg/dl, creatinine [Cr] = 9.5 mg/dl) and electrolyte abnormalities (K = 7.4 mEq/L). It was later diagnosed with postrenal obstruction secondary to bilaterally obstructing ureteral calculi seen on ultrasound. Treatment of the obstruction required two endoscopic procedures, cystoscopy for ureteral stent placement and ureteroscopy to perform intracorporeal lithotripsy on the obstructing calculi. Before the first procedure, the dolphin's azotemia was stabilized with aggressive fluid therapy, peritoneal dialysis, and treatment for acidosis. Diuresis subsequent to the fluid therapy enabled passage of the right obstructing urolith. For both endoscopic procedures, the dolphin was placed in left lateral recumbency due to the peritoneal dialysis catheter in the right retroperitoneal region. For the first procedure, a 12-French (Fr) flexible cystoscope was inserted retrograde into the bladder via the urethra, whereupon a calculus was seen obstructing the left ureteral orifice. A 4.8-Fr, 26-cm double-pigtail ureteral stent was placed up the left ureter to relieve the postrenal obstruction. Inadvertent proximal migration of the left ureteral stent occurred during the procedure. However, renal parameters (serum Cr = 5.8, K = 5.4) improved significantly by the next day. For the second procedure, 28 hr later, ureteroscopy was performed to treat the calculus and replace the existing stent with a longer stent. The left ureteral calculus was pulverized into tiny fragments by using a holmium:yttrium-aluminum-garnet laser inserted through a 6.9-Fr semirigid ureteroscope. The migrated stent was visualized in the distal left ureter and replaced with a 90-cm single-pigtail ureteral stent that was sutured exterior to the urogenital slit and removed 3 days later. Renal function normalized over the next several days, and the dolphin recovered over

  12. COPD (Chronic Obstructive Pulmonary Disease)

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is COPD? Español COPD, or chronic obstructive pulmonary (PULL-mun- ... can clog them. Normal Lungs and Lungs With COPD Figure A shows the location of the lungs ...

  13. CT of gastro-duodenal obstruction.

    Science.gov (United States)

    Millet, I; Doyon, F Curros; Pages, E; Faget, C; Zins, M; Taourel, P

    2015-10-01

    Gastro-duodenal obstruction encompasses a spectrum of benign and malignant disease. Historically, chronic peptic ulcer disease was the main cause of gastro-duodenal obstruction, whereas now malignant cause with gastric carcinomas for gastric obstruction and pancreatic tumors for duodenal obstruction predominate. This paper reviews the role of CT in diagnosing gastro-duodenal obstruction, its level, its cause by identifying intraluminal, parietal, or extrinsic process, and the presence of complication.

  14. Obstructive Jaundice in Chronic Pancreatitis

    OpenAIRE

    Hollands, M. J.; Little, J. M.

    1989-01-01

    Significant obstructive jaundice in chronic pancreatitis is generally considered to be rare. Eleven of 57 consecutive patients with proven chronic pancreatitis have developed significant obstructive jaundice of more than transient duration. Eight presented as jaundice complicating known pancreatitis and three as jaundice of unknown cause. Life table analysis showed a steady rise in the risk of developing jaundice up to the end of 10 years from the onset of chronic pancreatitis. Jaundice was f...

  15. Immunohistochemical diagnosis of urinary bladder tuberculosis

    Directory of Open Access Journals (Sweden)

    S. A. Semenov

    2014-01-01

    Full Text Available Diagnostics of urinary bladder tuberculosis bases on pathological verification. Standard histological staining (hematoxylin–eosin reveals glaucomatous inflammation, but cannot estimate its etiology.Aim of our study was to evaluate the role of complex immunohistochemical method in diagnostic of tuberculosis infection in bladder. Our study included 21 histological specimen of the resected bladder in case of nephrotuberculosis. Standard histological examination revealed specific changes in bladder tissue only in 2 cases, while immunohistochemical method with antibodies to Mycobacterium tuberculosis (MBT demonstrated positive reaction at 5 patients. Investigation of lower urinary tract function in late postoperative period showed that patients with positive anti-MBT reaction had clinically significant chronic urinary retention, as well as their degree of urinary disorders assessed using a questionnaire IPSS-Qol was higher. Thus, the use of IHC method in combination with standard histological examination improves diagnostics of urinary bladder tuberculosis, and it may serve the predictor of long-term results of surgical treatment of microcystis.

  16. Effects of urinary bladder distention on location of the urinary bladder and urethra of healthy dogs and cats

    International Nuclear Information System (INIS)

    Evaluation of the anatomic location of the distended and empty urinary bladders and urethras of healthy adult male and female dogs and cats by retrograde urethrocystography revealed substantial variations. In 15 dogs in lateral recumbency with empty bladder lumens, the caudal portion of the urinary bladder was within the pelvic canal in 5 of 7 male and 5 of 8 female dogs. In female dogs examined in ventrodorsal recumbency, only 4 of 8 had the empty urinary bladders in part within the pelvic canal. After luminal distention, 3 of 7 male and 3 of 8 female dogs, while in lateral recumbency, had the urinary bladders in part intrapelvically. However, when female dogs were placed in ventrodorsal recumbency, only 1 of 7 urinary bladders was in part within the pelvis. The urinary bladders of 14 cats were consistently within the abdominal cavity, irrespective of whether the bladder lumen was distended or empty. Urethral flexures occurred in dogs with intrapelvic bladders that were distended or empty. Urethral flexures were not found in cats. The urethras of dogs and cats in lateral recumbency were generally closer to the floor of the pelvis after urinary bladder distention than when the bladder was empty. The urethra of the dogs and cats in ventrodorsal recumbency was to the left or right of or on the midsagittal plane, whether the urinary bladder was empty or distended. A greater degree of lateral displacement was encountered in ventrodorsal recumbency after urinary bladder distention

  17. Bladder emptying by intermittent electrical stimulation of the pudendal nerve

    Science.gov (United States)

    Boggs, Joseph W.; Wenzel, Brian J.; Gustafson, Kenneth J.; Grill, Warren M.

    2006-03-01

    Persons with a suprasacral spinal cord injury cannot empty their bladder voluntarily. Bladder emptying can be restored by intermittent electrical stimulation of the sacral nerve roots (SR) to cause bladder contraction. However, this therapy requires sensory nerve transection to prevent dyssynergic contraction of the external urethral sphincter (EUS). Stimulation of the compound pudendal nerve trunk (PN) activates spinal micturition circuitry, leading to a reflex bladder contraction without a reflex EUS contraction. The present study determined if PN stimulation could produce bladder emptying without nerve transection in cats anesthetized with α-chloralose. With all nerves intact, intermittent PN stimulation emptied the bladder (64 ± 14% of initial volume, n = 37 across six cats) more effectively than either distention-evoked micturition (40 ± 19%, p 0.10), indicating that PN stimulation was not limited by bladder-sphincter dyssynergia. Intermittent PN stimulation holds promise for restoring bladder emptying following spinal injury without requiring nerve transection.

  18. Obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Steven D. Brass

    2011-11-01

    Full Text Available Obstructive sleep apnea (OSA affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  19. Obstructed Thickenings and Supermanifolds

    CERN Document Server

    Bettadapura, Kowshik

    2016-01-01

    Associated to any supermanifold is a filtration by spaces, referred to as thickenings. It is the objective of this paper to study them up to a certain equivalence and then up to isomorphism in the complex-analytic setting. We study them both in the presence and absence of a complex supermanifold and will be guided by the goal to clarify and address the question: when does a given thickening come from a supermanifold? Such a question was, in principle, first studied by Eastwood and LeBrun. In this paper we begin with a pedagogical account of their study, after which we further develop the theory of thickenings in the context of supergeometry. Our intent will be in recovering results reminiscent of those one finds in studies on deformation theory. As a complement to our study here, we comment on the moduli problem for complex supermanifolds and consider the analogous problem for thickenings. Finally, we conclude with some illustrations of obstructed thickenings on the complex projective plane.

  20. Posterior urethral obstruction: Prenatal sonographic findings and clinical outcome in 12 cases

    International Nuclear Information System (INIS)

    Twelve cases of fetal urethral obstruction were reviewed retrospectively. A dilated posterior urethra was identified in eight fetuses (67%) and an enlarged bladder in 11 (92%). Ureterectasis, pyelocalicectasis, increased renal echogenicity, and renal cysts suggest abnormal renal development. Ureterectasis was demonstrated in seven fetuses (58%) and pyelocalicectasis in ten (83%). Renal echogenicity was increased in eight of ten cases (80%) and renal cysts were identified in two cases. Decreased amniotic fluid volume complicated ten pregnancies (83%). There were six live births, but only two neonates survived more than 5 weeks. Pulmonary immaturity contributed to the four postnatal deaths

  1. Social stress induces changes in urinary bladder function, bladder NGF content, and generalized bladder inflammation in mice

    OpenAIRE

    Mingin, Gerald C.; Peterson, Abbey; Erickson, Cuixia Shi; Nelson, Mark T.; Vizzard, Margaret A.

    2014-01-01

    Social stress may play a role in urinary bladder dysfunction in humans, but the underlying mechanisms are unknown. In the present study, we explored changes in bladder function caused by social stress using mouse models of stress and increasing stress. In the stress paradigm, individual submissive FVB mice were exposed to C57BL/6 aggressor mice directly/indirectly for 1 h/day for 2 or 4 wk. Increased stress was induced by continuous, direct/indirect exposure of FVB mice to aggressor mice for ...

  2. Methylenetetrahydrofolate Reductase Polymorphisms at Familial Bladder Cancer: Case Report

    OpenAIRE

    Gulay Ceylan

    2016-01-01

    Bladder cancer is the seventh most common cancer in men in the world, it is the second most seen cancer after lung cancer and the first in urogenital tumours in Turkey. Many molecular epidemiologic studies have been reported to investigate the associations between the MTHFR C677T and A1298C polymorphisms and bladder cancer risk. In this report, a family with transitional bladder cancer have also MTHFR A1298C heterozygosity which supports the association between MTHFR variants and bladder canc...

  3. Impact of diabetes mellitus on bladder uroepithelial cells

    OpenAIRE

    Hanna-Mitchell, Ann T.; Ruiz, Giovanni W.; Daneshgari, Firouz; Liu, Guiming; Apodaca, Gerard; Birder, Lori A.

    2012-01-01

    Diabetic bladder dysfunction (DBD), a prevalent complication of diabetes mellitus (DM), is characterized by a broad spectrum of symptoms including urinary urgency, frequency, and incontinence. As DBD is commonly diagnosed late, it is important to understand the chronic impact of DM on bladder tissues. While changes in bladder smooth muscle and innervation have been reported in diabetic patients, the impact of DM on the specialized epithelial lining of the urinary bladder, the urothelium (UT),...

  4. Thoracic outlet syndrome: a neurological and vascular disorder.

    Science.gov (United States)

    Klaassen, Zachary; Sorenson, Edward; Tubbs, R Shane; Arya, Rahul; Meloy, Patrick; Shah, Rajnil; Shirk, Samuel; Loukas, Marios

    2014-07-01

    Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus as the structures travel from the thoracic outlet to the axilla. Despite the significant pathology associated with TOS, there remains some general disagreement among experts on the specific anatomy, etiology, and pathophysiology of the condition, presumably because of the wide variation in symptoms that manifest in presenting patients, and because of lack of a definitive gold standard for diagnosis. Symptoms associated with TOS have traditionally been divided into vascular and neurogenic categories, a distinction based on the underlying structure(s) implicated. Of the two, neurogenic TOS (nTOS) is more common, and typically presents as compression of the brachial plexus; primarily, but not exclusively, involving its lower trunk. Vascular TOS (vTOS) usually involves compression of the vessel, most commonly the subclavian artery or vein, or is secondary to thrombus formation in the venous vasculature. Any anatomical anomaly in the thoracic outlet has the potential to predispose a patient to TOS. Common anomalies include variations in the insertion of the anterior scalene muscle (ASM) or scalenus minimus muscle, the presence of a cervical rib or of fibrous and muscular bands, variations in insertion of pectoralis minor, and the presence of neurovascular structures, which follow an atypical course. A common diagnostic technique for vTOS is duplex imaging, which has generally replaced more invasive angiographic techniques. In cases of suspected nTOS, electrophysiological nerve studies and ASM blocks provide guidance when screening for patients likely to benefit from surgical decompression of TOS. Surgeons generally agree that the transaxillary approach allows the greatest field of view for first rib excision to relieve compressed vessels. Alternatively, a supraclavicular approach is favored for scalenotomies when the ASM impinges on surrounding

  5. PPOOLEX experiments with a modified blowdown pipe outlet

    Energy Technology Data Exchange (ETDEWEB)

    Laine, J.; Puustinen, M.; Raesaenen, A. (Lappeenranta Univ. of Technology, Nuclear Safety Research Unit (Finland))

    2009-08-15

    This report summarizes the results of the experiments with a modified blowdown pipe outlet carried out with the PPOOLEX test facility designed and constructed at Lappeenranta University of Technology. Steam was blown into the dry well compartment and from there through a vertical DN200 blowdown pipe to the condensation pool. Four reference experiments with a straight pipe and ten with the Forsmark type collar were carried out. The main purpose of the experiment series was to study the effect of a blowdown pipe outlet collar design on loads caused by chugging phenomena (rapid condensation) while steam is discharged into the condensation pool. The PPOOLEX test facility is a closed stainless steel vessel divided into two compartments, dry well and wet well. During the experiments the initial temperature level of the condensation pool water was either 20-25 or 50-55 deg. C. The steam flow rate varied from 400 to 1200 g/s and the temperature of incoming steam from 142 to 185 deg. C. In the experiments with 20-25 deg. C pool water, even 10 times higher pressure pulses were measured inside the blowdown pipe in the case of the straight pipe than with the collar. In this respect, the collar design worked as planned and removed the high pressure spikes from the blowdown pipe. Meanwhile, there seemed to be no suppressing effect on the loads due to the collar in the pool side in this temperature range. Registered loads in the pool were approximately in the same range (or even a little higher) with the collar as with the straight pipe. In the experiments with 50-55 deg. C pool water no high pressure pulses were measured inside the blowdown pipe either with the straight pipe or with the collar. In this case, more of the suppressing effect is probably due to the warmer pool water than due to the modified pipe outlet. It has been observed already in the earlier experiments with a straight pipe in the POOLEX and PPOOLEX facilities that warm pool water has a diminishing effect on

  6. Thoracic outlet syndrome: another cause for unilateral palmar hyperhidrosis.

    Science.gov (United States)

    Ozdemir, Oya; Ozçakar, Levent

    2007-08-01

    One of the most important therapeutic goal in hyperhidrosis treatment is to seek for the underlying cause and to tailor the treatment accordingly. A detailed history and prompt physical examination are needed to clarify the etiological factor. In this study, we report a 34-year-old woman with a diagnosis of thoracic outlet syndrome presenting with complaints of pain, numbness, and fatigue in her left arm and ipsilateral palmar hyperhidrosis. Thus, we want to highlight a specific potential cause of secondary hyperhidrosis, which can otherwise be easily overlooked, and furthermore, which has a completely different treatment strategy. PMID:16941200

  7. Supermarket and fast-food outlet exposure in Copenhagen

    DEFF Research Database (Denmark)

    Svastisalee, Chalida Mae; Jensen, Helene Nordahl; Glumer, Charlotte;

    2011-01-01

    . indicators of socio-economic status (percentage of recent immigrants, percentage without a high-school diploma, percentage of the population under 35 years of age and average household income in Euros) was performed using negative binomial analysis. Setting: Copenhagen, Denmark. Subjects: The unit...... of analysis was neighbourhood (n 400). Results: In the fully adjusted models, income was not a significant predictor for supermarket exposure. However, neighbourhoods with low and mid-low income were associated with significantly fewer fast-food outlets. Using backwise deletion from the fully adjusted models...

  8. PPOOLEX experiments with a modified blowdown pipe outlet

    International Nuclear Information System (INIS)

    This report summarizes the results of the experiments with a modified blowdown pipe outlet carried out with the PPOOLEX test facility designed and constructed at Lappeenranta University of Technology. Steam was blown into the dry well compartment and from there through a vertical DN200 blowdown pipe to the condensation pool. Four reference experiments with a straight pipe and ten with the Forsmark type collar were carried out. The main purpose of the experiment series was to study the effect of a blowdown pipe outlet collar design on loads caused by chugging phenomena (rapid condensation) while steam is discharged into the condensation pool. The PPOOLEX test facility is a closed stainless steel vessel divided into two compartments, dry well and wet well. During the experiments the initial temperature level of the condensation pool water was either 20-25 or 50-55 deg. C. The steam flow rate varied from 400 to 1200 g/s and the temperature of incoming steam from 142 to 185 deg. C. In the experiments with 20-25 deg. C pool water, even 10 times higher pressure pulses were measured inside the blowdown pipe in the case of the straight pipe than with the collar. In this respect, the collar design worked as planned and removed the high pressure spikes from the blowdown pipe. Meanwhile, there seemed to be no suppressing effect on the loads due to the collar in the pool side in this temperature range. Registered loads in the pool were approximately in the same range (or even a little higher) with the collar as with the straight pipe. In the experiments with 50-55 deg. C pool water no high pressure pulses were measured inside the blowdown pipe either with the straight pipe or with the collar. In this case, more of the suppressing effect is probably due to the warmer pool water than due to the modified pipe outlet. It has been observed already in the earlier experiments with a straight pipe in the POOLEX and PPOOLEX facilities that warm pool water has a diminishing effect on

  9. Botulinum Toxin to Treat Neurogenic Bladder.

    Science.gov (United States)

    Smith, Christopher P; Chancellor, Michael B

    2016-02-01

    Alteration in neural control from suprapontine areas to the nerves innervating the bladder can lead to bladder dysfunction and the development of a neurogenic bladder (NGB). Patients with NGB often suffer from urinary incontinence, which can lead to adverse events such as urinary tract infections and decubiti, in addition to creating a large care burden for family members or healthcare providers and significantly impairing patient quality of life. The common failure of anticholinergic medications has spurned the development of second-line treatments, including the use of botulinum toxin. OnabotulinumtoxinA (onaBoNT-A; BOTOX, Allergan, Inc.) was approved by the U.S. Food and Drug Administration (FDA) in 2011 to treat neurogenic detrusor overactivity in patients with urinary incontinence resulting from a NGB. In this review the authors summarize pertinent results from key trials leading to FDA approval of onaBoNT-A as well as more recent long-term data.

  10. Urothelial bladder cancer with cavitary lung metastases.

    Science.gov (United States)

    Kurian, Anil; Lee, Jason; Born, Abraham

    2011-01-01

    Transitional cell carcinoma (TCC) of the bladder tends to remain superficial; however, in 5% to 20% of cases, it progresses to muscle invasion and, more rarely, can metastasize. TCC of the bladder primarily spreads via regional lymphatics. The most common sites of distant metastases of TCC are the liver, lung, mediastinum and bone. Longterm survival of patients with metastatic bladder cancer is rare. Patterns of pulmonary metastasis include multiple nodules, a solitary mass or interstitial micronodule. When multiple nodules are present, they are round and well-circumscribed, without calcification or cavitation. An unusual case of rapidly metastatic TCC to the lung causing large cavitary masses and nodules is presented. Imaging performed after the patient began chemotherapy revealed widespread necrosis of the metastatic cavitary masses causing moderate volume hemoptysis. PMID:21766082

  11. Urothelial Bladder Cancer with Cavitary Lung Metastases

    Directory of Open Access Journals (Sweden)

    Anil Kurian

    2011-01-01

    Full Text Available Transitional cell carcinoma (TCC of the bladder tends to remain superficial; however, in 5% to 20% of cases, it progresses to muscle invasion and, more rarely, can metastasize. TCC of the bladder primarily spreads via regional lymphatics. The most common sites of distant metastases of TCC are the liver, lung, mediastinum and bone. Long-term survival of patients with metastatic bladder cancer is rare. Patterns of pulmonary metastasis include multiple nodules, a solitary mass or interstitial micronodule. When multiple nodules are present, they are round and well-circumscribed, without calcification or cavitation. An unusual case of rapidly metastatic TCC to the lung causing large cavitary masses and nodules is presented. Imaging performed after the patient began chemotherapy revealed widespread necrosis of the metastatic cavitary masses causing moderate volume hemoptysis.

  12. A Rare Case: Sporadic Bladder Paraganglioma

    Directory of Open Access Journals (Sweden)

    Hakan Ercil

    2013-08-01

    Full Text Available Paraganglioma is a rare tumor which originates from paraganglia tissue from neural crest. Bladder paraganglioma is suggested to be from crommaffin cells by the remains of the embryological cells. In this report, we aimed to discuss the literature by a case of bladder paraganglioma. A 39 year old male applied to our clinic with gross hematuria. A 2x2 cm mass was revealed in urinary ultrasound. Paraganglioma was found in the resection specimen and partial cystectomy was performed to the patient. A six month follow up revealed no recurrences. Even though bladder paraganglioma is a rare disease, it should be kept in mind for differential diagnosis. [Cukurova Med J 2013; 38(4.000: 794-799

  13. Optimizing systemic therapy for bladder cancer.

    Science.gov (United States)

    Pal, Sumanta K; Milowsky, Matthew I; Plimack, Elizabeth R

    2013-07-01

    Over the past several decades, few new systemic agents have been incorporated into the treatment paradigm for bladder cancer. Platinum-based therapy remains the cornerstone of treatment in the perioperative and metastatic settings. Despite level one evidence, use of cisplatin-based therapy in the neoadjuvant setting has been dismal. Second-line therapy for metastatic disease has only modest activity with no survival benefit. However, the elucidation and investigation of novel molecular targets, new therapeutics, and associated biomarkers with strong biologic rationale are actively changing the landscape in bladder cancer. Although the field is moving rapidly, no new drug approvals are currently pending and a need remains to continue to educate the medical oncology and urology communities on the optimal use of currently available treatments. This article outlines the evidence, including that from prospective studies and meta-analyses, providing the basis for the current recommendations from NCCN, and details previous and ongoing studies of targeted therapy for bladder cancer.

  14. Bladder cancer; Cancer de la Vessie

    Energy Technology Data Exchange (ETDEWEB)

    Pointreau, Y. [Service de radiotherapie, centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hpital Bretonneau, 37 - Tours (France); Universite Francois-Rabelais de Tours, GICC, 37 - Tours (France); CNRS, UMR 6239 -Genetique, Immunotherapie, Chimie et Cancer-, 37 - Tours (France); CHRU de Tours, laboratoire de pharmacologie-toxicologie, 37 - Tours (France); Denis, F. [Centre Jean-Bernard, 72 - Le Mans (France); Klotz, S.; Durdux, C. [Service d' oncologie-radiotherapie, hopital europeen Georges-Pompidou, 75 - Paris (France); Denis, F. [Centre Jean-Bernard, 72 - Le Mans (France)

    2010-07-01

    Bladder cancer is an urologic common tumor after prostate carcinoma. Radical treatment of localized invasive tumor is based on cystectomy. Surgical mutilation could be important when Bricker's urinary derivation is performed. Moreover, delayed metastasis frequently appeared in spite of radical surgery. Thus, chemoradiotherapy is a valid alternative treatment to cystectomy for selected patients. Cisplatin or derivatives are usually concurrently administered to radiation therapy up to 60 - 65 Gy. Patients undergo control cystoscopy at mid-time of treatment in order to select responders from non responders. For majority of cases, the empty bladder should be entirely treated with added margins (about 20 mm) to build the PTV. Control assessment could be improved by echography, cone beam imaging as well as bladder fiduciaries implantation before treatment. From a case report, this review summarizes the technical aspects of radiation therapy (GTV, CTV and PTV, organs at risk, planning) and main acute and late related toxicities. (authors)

  15. Contemporary management of low-risk bladder cancer

    NARCIS (Netherlands)

    Falke, J.; Witjes, J.A.

    2011-01-01

    Bladder cancer comprises a heterogeneous group of tumors, the majority of which are non-muscle-invasive bladder cancer (NMIBC) at initial presentation. Low-risk bladder cancer--defined as pTa low-grade papillary tumors--is the type of NMIBC with the most favorable oncologic outcome. Although the ris

  16. Xenon tissue/blood partition coefficient for pig urinary bladder

    DEFF Research Database (Denmark)

    Nielsen, K K; Bülow, J; Nielsen, S L;

    1990-01-01

    In four landrace pigs the tissue/blood partition coefficient (lambda) for xenon (Xe) for the urinary bladder was calculated after chemical analysis for lipid, water and protein content and determination of the haematocrit. The coefficients varied from bladder to bladder owing to small differences...

  17. Chronic phimosis as a cause of obstructive uropathy in an adult patient

    International Nuclear Information System (INIS)

    Phimosis is a rare cause of obstructive uropathy and renal failure. This report presents a case of a 22-year-old man with phimosis, resulting in such complications. The patient with incidentally revealed elevated serum creatinine level was subjected to ultrasonography, voiding cystourethrography and static fluid MR urography (sMRU), combined with conventional T1- and T2-weighted images. The urinary tract dilatation and the bladder diverticula were diagnosed with the use of imaging modalities. Two months after circumcision the degree of hydroureteronephrosis as well as creatinine level decreased. The obstructive uropathy involving the upper urinary tract and resulting in renal failure may develop on the basis of chronic phimosis. Completing of standard imaging techniques with MR urography significantly improved the possibility of the urinary tract evaluation in the presented case. (author)

  18. Bladder cancer and occupational exposure to leather.

    OpenAIRE

    Marrett, L D; Hartge, P; Meigs, J W

    1986-01-01

    A large case-control study of bladder cancer (2982 cases; 5782 controls) included information about occupational exposure to leather. Occupational histories of exposed white study subjects were reviewed and 150 were determined to have had "true" on the job exposure to leather. The odds ratio estimate (OR) of bladder cancer associated with such exposure in white subjects (n = 8063) was 1.4 (95% confidence limits = 1.0, 1.9) after adjustment for sex, age, and cigarette smoking. The risk was hig...

  19. Bladder Perforation Secondary to Primary Systemic Amyloidosis

    Directory of Open Access Journals (Sweden)

    Christopher J. Dru

    2014-01-01

    Full Text Available Amyloidosis is a disorder of protein folding characterized by extracellular aggregation and deposition of amyloid protein fibrils. Light-chain amyloidosis, also known as primary systemic amyloidosis, is the most common form of the disease. We present a case of an 84-year-old male with a history of systemic primary amyloidosis causing genitourinary, cardiac, and autonomic dysfunction who presented with hematuria and hypotension secondary to bladder perforation. He underwent open repair of a large extraperitoneal bladder defect. He ultimately died as a result of medical complications from his disease.

  20. Synchronous Rectovaginal, Urinary Bladder, and Pulmonary Endometriosis

    OpenAIRE

    Hilaris, Georgios E.; Payne, Christopher K.; Osias, Joelle; Cannon, Walter; Nezhat, Camran R.

    2005-01-01

    Background: Extragenital endometriosis is an uncommon condition that can affect almost any organ system and tissue in the human body. Disease involving multiple distant sites is extremely uncommon. Methods: We report a rare case of synchronous rectovaginal, urinary bladder, and pulmonary endometriosis. We performed a Medline literature search using keywords “endometriosis,” “rectovaginal,” “pulmonary,” “bladder,” “ureteral,” “bowel,” “extrapelvic,” and “extragenital” and were unable to find a...

  1. Bladder Pain Syndrome International Consultation on Incontinence

    DEFF Research Database (Denmark)

    Hanno, P.; Lin, A.; Nordling, J.;

    2010-01-01

    Aims of Study: The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature...... to the bladder with at least one urinary symptom, such as frequency not obviously related to high fluid intake, or a persistent urge to void should be evaluated for possible BPS. The initial assessment consists of a frequency/volume chart, focused physical examination, urinalysis, and urine culture. Urine...

  2. [TOS (thoracic outlet syndrome)--a challenge to conservative treatment].

    Science.gov (United States)

    Lindgren, K A

    1997-10-01

    Functional impairment and pain in the upper extremities may indicate a functional deficit in the thoracic outlet. Static work posture, trauma and whiplash injury may be predisposing factors. The younger generation who often spend long hours in front of a computer are in danger of becoming a future risk group. The primary care physician should be familiar with the syndrome which can be identified by careful clinical examination. Timely intervention can prevent much of the disabling symptomatology. Treatment is primarily conservative and should be aimed at the restoration of functional capacity. As in other disorders, the individual constellation of symptoms is dependent on circumstantial factors, an aspect meriting particular attention in treatment and follow-up. Optimisation of ergonomic conditions is important feature of treatment, and long-term follow-up is necessary. Transient exacerbation is not an indication for surgical treatment. If cervical and thoracic outlet function has normalised but the patient still has symptoms, then the differential diagnosis should be reconsidered. Examination and treatment of patients with pain in the upper extremities requires the collaboration of the physician and physical and occupational therapists. Treatment can be delivered in the primary care setting. PMID:9411397

  3. Technologies for Upgrading Light Water Reactor Outlet Temperature

    Energy Technology Data Exchange (ETDEWEB)

    Daniel S. Wendt; Piyush Sabharwall; Vivek Utgikar

    2013-07-01

    Nuclear energy could potentially be utilized in hybrid energy systems to produce synthetic fuels and feedstocks from indigenous carbon sources such as coal and biomass. First generation nuclear hybrid energy system (NHES) technology will most likely be based on conventional light water reactors (LWRs). However, these LWRs provide thermal energy at temperatures of approximately 300°C, while the desired temperatures for many chemical processes are much higher. In order to realize the benefits of nuclear hybrid energy systems with the current LWR reactor fleets, selection and development of a complimentary temperature upgrading technology is necessary. This paper provides an initial assessment of technologies that may be well suited toward LWR outlet temperature upgrading for powering elevated temperature industrial and chemical processes during periods of off-peak power demand. Chemical heat transformers (CHTs) are a technology with the potential to meet LWR temperature upgrading requirements for NHESs. CHTs utilize chemical heat of reaction to change the temperature at which selected heat sources supply or consume thermal energy. CHTs could directly utilize LWR heat output without intermediate mechanical or electrical power conversion operations and the associated thermodynamic losses. CHT thermal characteristics are determined by selection of the chemical working pair and operating conditions. This paper discusses the chemical working pairs applicable to LWR outlet temperature upgrading and the CHT operating conditions required for providing process heat in NHES applications.

  4. The soy phytoestrogens genistein and daidzein as neuroprotective agents against anoxia-glucopenia and reperfusion damage in rat urinary bladder.

    Science.gov (United States)

    Valeri, A; Fiorenzani, P; Rossi, R; Aloisi, A M; Valoti, M; Pessina, F

    2012-10-01

    Some bladder disorders, such as obstructive bladder and hyperactivity, may be caused partly by ischemia/reperfusion injury (I/R). The neuroprotective effects of estrogens were demonstrated in in vitro studies and a great interest in soy isoflavones (genistein and daidzein) as alternative to the synthetic estrogen receptor modulators for therapeutic use has been pointed out. The aim of this study was to investigate the effect of genistein and daidzein, on rat detrusor smooth muscle contractility and their possible neuroprotective role against I/R-like condition. Whole rat urinary bladders were subjected to in vitro anoxia-glucopenia (A-G) and reperfusion (R) in the absence or presence of drugs and response to electrical field stimulation (EFS) of intrinsic nerves evaluated. Furthermore rats were treated in vivo for 1 week with the phytoestrogens and the same in vitro protocol was applied to the ex vivo bladders. Antioxidant activity of genistein and daidzein on the A-G/R model was determined by measuring malonyldialdehyde (MDA). Moreover, hormones plasma levels were determined by radioimmunoassay. Genistein and daidzein administered either in vitro or in vivo showed significant neuroprotective effect and antioxidant activity. Testosterone and 17β-estradiol plasma levels were not modified by daidzein, while a significant decrease of testosterone in genistein treated rats was evident. Moreover both phytoestrogens significantly decreased detrusor contractions induced by EFS in a concentration-dependent manner. For being either neuroprotective and myorelaxant, genistein and daidzein could be considered a good lead for new therapeutic agents to protect the urinary bladder from hyperactivity and nerve damage. PMID:22743170

  5. HpD Photobiology And Photodynamic Therapy Of Bladder Carcinoma

    Science.gov (United States)

    Lin, Chi-Wei

    1988-02-01

    Bladder carcinoma is considered one of the most favorable targets for the application of photodynamic therapy (PDT) due to the accessibility of the bladder for light delivery. Examination of the bladder and surgical procedures are routinely performed by the insertion of an optical instrument called cystoscope through the urethra. Thus, the treatment of bladder cancer by PDT can be conducted through the cystoscope with minimal invasion. However, to achieve optimal results from this treatment, one must consider both the structure of the bladder and the nature of the carcinoma.

  6. Neurogenic Bladder Repair Using Autologous Mesenchymal Stem Cells.

    Science.gov (United States)

    Mahajan, Pradeep V; Subramanian, Swetha; Danke, Amit; Kumar, Anand

    2016-01-01

    The normal function of the urinary bladder is to store and expel urine in a coordinated, controlled fashion, the activity of which is regulated by the central and peripheral nervous systems. Neurogenic bladder is a term applied to a malfunctioning urinary bladder due to neurologic dysfunction or insult emanating from internal or external trauma, disease, or injury. This report describes a case of neurogenic bladder following laminectomy procedure and long-standing diabetes mellitus with neuropathy treated with autologous cellular therapy. The differentiation potential and paracrine effects of mesenchymal stem cells on bladder function have been highlighted. PMID:27656308

  7. Subcutaneous nephro-vesical bypass in the treatment of ureteral obstruction

    Directory of Open Access Journals (Sweden)

    Zhi-guo YANG

    2011-04-01

    Full Text Available Objective To sum up the experiences on treating ureteral obstruction in patients with terminal tumor by subcutaneous nephro-vesical bypass.Methods A total of 16 subcutaneous prosthetic ureters were percutaneously implanted into 12 patients(8 unilateral and 4 bilateral for the treatment of ureteral obstruction due to terminal tumor.The tube was inserted into the renal pelvis,tunnelled subcutaneously and introduced in the bladder through a small suprapubic incision.Serum creatinine and renal ultrasonography were evaluated during follow up.Results No operative or immediate postoperative death occurred.The patients were alive with the prosthesis without occurrence of encrustation,infection,or obstruction,and the renal function was normal.The serum creatinine level decreased significantly from 232.2±18.1μmol/L(preoperation to 115.2±17.1μmol/L(postoperation.Conclusions The subcutaneous urinary diversion using Ureteral Bypass Set is an efficient and minimally invasive way to bypass malignant obstructions of the ureters that otherwise would necessitate permanent nephrostomy drainage.With the operation patients may get a better quality of life due to increased independence and activity during their final stage of life.

  8. Bladder wall thickness and ultrasound estimated bladder weight in healthy adults with portative ultrasound device

    OpenAIRE

    Selcen Kanyilmaz; Funda Atamaz Calis; Yasemin Cinar; Yesim Akkoc

    2013-01-01

    Background: The aim of this study was to investigate bladder wall thickness (BWT) and ultrasound estimated bladder weight (UEBW) values in healthy population with a portative ultrasound device and their relationship with demographic parameters. Materials and Methods: The study was carried out in Neurorehabilitation Clinic of Ege University Hospital. Ninety-five subjects (48 women and 47 men) aged between 18 and 56 were included in the study. BWT and UEBW were determined non-invasively with a ...

  9. Noninvasive Evaluation of Bladder Wall Mechanical Properties as a Function of Filling Volume: Potential Application in Bladder Compliance Assessment.

    Directory of Open Access Journals (Sweden)

    Ivan Nenadic

    Full Text Available We propose a novel method to monitor bladder wall mechanical properties as a function of filling volume, with the potential application to bladder compliance assessment. The proposed ultrasound bladder vibrometry (UBV method uses ultrasound to excite and track Lamb waves on the bladder wall from which its mechanical properties are derived by fitting measurements to an analytical model. Of particular interest is the shear modulus of bladder wall at different volumes, which we hypothesize, is similar to measuring the compliance characteristics of the bladder.Three experimental models were used: 1 an ex vivo porcine model where normal and aberrant (stiffened by formalin bladders underwent evaluation by UBV; 2 an in vivo study to evaluate the performance of UBV on patients with clinically documented compliant and noncompliant bladders undergoing UDS; and 3 a noninvasive UBV protocol to assess bladder compliance using oral hydration and fractionated voiding on three healthy volunteers.The ex vivo studies showed a high correlation between the UBV parameters and direct pressure measurement (R2 = 0.84-0.99. A similar correlation was observed for 2 patients with compliant and noncompliant bladders (R2 = 0.89-0.99 undergoing UDS detrusor pressure-volume measurements. The results of UBV on healthy volunteers, performed without catheterization, were comparable to a compliant bladder patient.The utility of UBV as a method to monitor changes in bladder wall mechanical properties is validated by the high correlation with pressure measurements in ex vivo and in vivo patient studies. High correlation UBV and UDS in vivo studies demonstrated the potential of UBV as a bladder compliance assessment tool. Results of studies on healthy volunteers with normal bladders demonstrated that UBV could be performed noninvasively. Further studies on a larger cohort are needed to fully validate the use of UBV as a clinical tool for bladder compliance assessment.

  10. Small bowel obstruction- a surprise.

    Science.gov (United States)

    Mathew, Jeffrey Daniel; Cp, Ganesh Babu; M, Balachandar; M, Ramanathan

    2015-01-01

    Trans - omental hernia is very rare, accounting to 1-4% of all internal hernias which is an unusual cause of small bowel obstruction. Here we present a case report of a small bowel obstruction in a female due to trans - omental hernia presenting with central abdominal pain, distension and bilious vomiting. She had no previous history of trauma, surgery. Plain X-ray abdomen erect showed multiple air fluid levels with dilated small bowel loops. Emergency laparotomy revealed a segment of congested small bowel loop (ileum) through a defect in greater omentum. On table the herniated bowel loop was reduced and the defect in greater omentum was closed primarily. There was no necessity for bowel resection as it regained normal colour after reduction. Postoperative period was uneventful with complete resolution of symptoms. This case is presented for its rarity and its importance in clinical differential diagnosis of acute abdomen due to small bowel obstruction.

  11. Imaging of adenomyomatosis of the gall bladder.

    Science.gov (United States)

    Stunell, H; Buckley, O; Geoghegan, T; O'Brien, J; Ward, E; Torreggiani, W

    2008-04-01

    Adenomyomatosis is a relatively common abnormality of the gall bladder, with a reported incidence of between 2.8 and 5%. Although mainly confined to the adult study group, a number of cases have been reported in the paediatric study group. It is characterized pathologically by excessive proliferation of the surface epithelium and hypertrophy of the muscularis propria of the gall bladder wall, with invagination of the mucosa into the thickened muscularis forming the so-called 'Rokitansky-Aschoff' sinuses. The condition is usually asymptomatic and is often diagnosed as an incidental finding on abdominal imaging. The radiological diagnosis is largely dependent on the visualization of the characteristic Rokitansky-Aschoff sinuses. As the condition is usually asymptomatic, the importance of making a correct diagnosis is to prevent misinterpretation of other gall bladder conditions such as gall bladder cancer, leading to incorrect treatment. In the past, oral cholecystography was the main imaging method used to make this diagnosis. In most institutions, oral cholecystography is no longer carried out, and the diagnosis is now more commonly seen on cross-sectional imaging. In this review article, we describe the manifestations of adenomyomatosis on the various imaging methods, with an emphasis on more modern techniques such as magnetic resonance cholangiopancreatography. A brief section on oral cholecystography to aid readers familiar with this technique in understanding the comparable imaging features on more modern imaging techniques is included. PMID:18373800

  12. Traumatic injury of the bladder and urethra

    Science.gov (United States)

    ... been cut, a urological specialist can put a catheter in place. If this cannot be done, a tube will be inserted through the abdominal wall directly into the bladder. This is called a suprapubic tube. It will be left in place until ...

  13. Darifenacin for the treatment of overactive bladder

    NARCIS (Netherlands)

    B.F.M. Blok (Bertil); T. Corcos

    2007-01-01

    textabstractDarifenacin hydrobromide is a muscarinic receptor antagonist for once-daily treatment of overactive bladder (urinary urgency with or without urge incontinence, which may be associated with increased frequency of voiding and nocturia). Consistent with its high affinity for muscarinic M3 r

  14. Granular cell tumour of the urinary bladder

    Directory of Open Access Journals (Sweden)

    Christoph von Klot

    2012-04-01

    Full Text Available With only 16 cases reported in the literature, the mostly benign granular cell tumour of the urinary bladder is exceptionally rare. We present the case of a 68-year old patient with one of these lesions demonstrating our histological findings including several immunohistochemical stainings used to differentiate between other more common entities.

  15. Screening for Bladder and Other Urothelial Cancers

    Science.gov (United States)

    ... Using tobacco , especially smoking cigarettes. Having a family history of bladder cancer. Having certain changes in the genes . Being exposed to paints, dyes, metals or petroleum products in the workplace. Past treatment with radiation therapy to the pelvis or with certain anticancer drugs, ...

  16. Bladder cancer: molecular determinants of personalized therapy.

    Science.gov (United States)

    Lopez-Beltran, Antonio; Santoni, Matteo; Massari, Francesco; Ciccarese, Chiara; Tortora, Giampaolo; Cheng, Liang; Moch, Holger; Scarpelli, Marina; Reymundo, Carlos; Montironi, Rodolfo

    2015-01-01

    Several molecular and genetic studies have provided new perspectives on the histologic classification of bladder tumors. Recent developments in the field of molecular mutational pathway analyses based on next generation sequencing technology together with classic data derived from the description of mutations in the FGFR3 (fibroblast growth factor receptor 3) gene, mutations on TP53 gene, and cDNA technology profiling data gives support to a differentiated taxonomy of bladder cancer. All these changes are behind the use of non-traditional approach to therapy of bladder cancer patients and are ready to change our daily practice of uro-oncology. The observed correlation of some molecular alterations with tumor behavior and the identification of their targets at cellular level might support the use of molecular changes together with morphological data to develop new clinical and biological strategies to manage patients with urothelial cancer. The current review provides comprehensive data to support personalized therapy for bladder cancer based on an integrated approach including pathologic and clinical features and molecular biology.

  17. Bladder hyperactivity and increased excitability of bladder afferent neurons associated with reduced expression of Kv1.4 α-subunit in rats with cystitis

    OpenAIRE

    Hayashi, Yukio; Takimoto, Koichi; Chancellor, Michael B.; Erickson, Kristin A.; Erickson, Vickie L.; Kirimoto, Tsukasa; Nakano, Koushi; de Groat, William C.; Yoshimura, Naoki

    2009-01-01

    Hyperexcitability of C-fiber bladder afferent pathways has been proposed to contribute to urinary frequency and bladder pain in chronic bladder inflammation including interstitial cystitis. However, the detailed mechanisms inducing afferent hyperexcitability after bladder inflammation are not fully understood. Thus, we investigated changes in the properties of bladder afferent neurons in rats with bladder inflammation induced by intravesical application of hydrochloric acid. Eight days after ...

  18. Adhesive bowel obstruction? Not always

    Directory of Open Access Journals (Sweden)

    Mittapalli D

    2011-01-01

    Full Text Available A 58-year-old man presented acutely with features of post-surgical adhesive small bowel obstruction. Following an unsuccessful trial of conservative management, computed tomography (CT of the abdomen was performed. This revealed a mass in the ileocaecal region, for which he underwent a subsequent right hemicolectomy. Histology revealed diffuse B-cell Non-Hodgkin′s lymphoma of the terminal ileum. Confounding obstructive lesion of the intestine in patients with a history of previous laparotomy is extremely uncommon. Early high resolution imaging may predict diagnosis and consolidate clinical management plans.

  19. Probiotics, dendritic cells and bladder cancer.

    Science.gov (United States)

    Feyisetan, Oladapo; Tracey, Christopher; Hellawell, Giles O

    2012-06-01

    What's known on the subject? and What does the study add? The suppressor effect of probiotics on superficial bladder cancer is an observed phenomenon but the specific mechanism is poorly understood. The evidence strongly suggests natural killer (NK) cells are the anti-tumour effector cells involved and NK cell activity correlates with the observed anti-tumour effect in mice. It is also known that dendritic cells (DC) cells are responsible for the recruitment and mobilization of NK cells so therefore it may be inferred that DC cells are most likely to be the interphase point at which probiotics act. In support of this, purification of NK cells was associated with a decrease in NK cells activity. The current use of intravesical bacille Calmette-Guérin in the management of superficial bladder cancer is based on the effect of a localised immune response. In the same way, understanding the mechanism of action of probiotics and the role of DC may potentially offer another avenue via which the immune system may be manipulated to resist bladder cancer. Probiotic foods have been available in the UK since 1996 with the arrival of the fermented milk drink (Yakult) from Japan. The presence of live bacterial ingredients (usually lactobacilli species) may confer health benefits when present in sufficient numbers. The role of probiotics in colo-rectal cancer may be related in part to the suppression of harmful colonic bacteria but other immune mechanisms are involved. Anti-cancer effects outside the colon were suggested by a Japanese report of altered rates of bladder tumour recurrence after ingestion of a particular probiotic. Dendritic cells play a central role to the general regulation of the immune response that may be modified by probiotics. The addition of probiotics to the diet may confer benefit by altering rates of bladder tumour recurrence and also alter the response to immune mechanisms involved with the application of intravesical treatments (bacille Calmette

  20. Bladder perforation in a peritoneal dialysis patient.

    Science.gov (United States)

    Ounissi, M; Sfaxi, M; Fayala, H; Abderrahim, E; Ben Abdallah, T; Chebil, M; Ben Maiz, H; Kheder, A

    2012-05-01

    The dysfunction of the catheter in peritoneal dialysis (PD) is a frequent complication. However, perforation of organs are rare, particularly that of the urinary bladder. This requires an early diagnosis and prompt treatment of patients. We report here the case of a 38-year-old woman having end-stage renal disease due to autosomal-dominant polycystic kidney disease treated by PD since November 2000. Three years later, she was treated for Staphylococcal peritonitis. Four months later, she presented with a severe urge to urinate at the time of the fluid exchanges. The biochemical analysis of the fluid from the bladder showed that it was dialysis fluid. Injection of contrast through the catheter demonstrated the presence of a fistula between the bladder and the peritoneal cavity. She underwent cystoscopic closure of the fistulous tract and the PD catheter was removed. Subsequently, the patient was treated by hemodialysis. One month later, a second catheter was implanted surgically after confirming the closure of the fistula. Ten days later, she presented with pain at the catheter site and along the tunnel, which was found to be swollen along its track. The injection of contrast produced swelling of the subcutaneous tunnel but without extravasation of the dye. PD was withdrawn and the patient was put back on hemodialysis. Bladder fistula is a rare complication in PD and diagnosis should be suspected when patient complains of an urge to pass urine during the exchanges, which can be confirmed by contrast study showing presence of dye in the bladder. PD may be possible after the closure of the fistula, but recurrence may occur. PMID:22569443

  1. Bladder perforation in a peritoneal dialysis patient

    Directory of Open Access Journals (Sweden)

    M Ounissi

    2012-01-01

    Full Text Available The dysfunction of the catheter in peritoneal dialysis (PD is a frequent compli-cation. However, perforation of organs are rare, particularly that of the urinary bladder. This re-quires an early diagnosis and prompt treatment of patients. We report here the case of a 38-year-old woman having end-stage renal disease due to autosomal-dominant polycystic kidney disease treated by PD since November 2000. Three years later, she was treated for Staphylococcal peritonitis. Four months later, she presented with a severe urge to urinate at the time of the fluid exchanges. The biochemical analysis of the fluid from the bladder showed that it was dialysis fluid. Injection of contrast through the catheter demonstrated the presence of a fistula between the bladder and the peritoneal cavity. She underwent cystoscopic closure of the fistulous tract and the PD catheter was removed. Subsequently, the patient was treated by hemodialysis. One month later, a second catheter was implanted surgically after confirming the closure of the fistula. Ten days later, she presented with pain at the catheter site and along the tunnel, which was found to be swollen along its track. The injection of contrast produced swelling of the subcutaneous tunnel but without extravasation of the dye. PD was withdrawn and the patient was put back on hemodialysis. Bladder fistula is a rare complication in PD and diagnosis should be suspected when patient complains of an urge to pass urine during the exchanges, which can be confirmed by contrast study showing presence of dye in the bladder. PD may be possible after the closure of the fistula, but recurrence may occur.

  2. Integrating Tobacco Control and Obesity Prevention Initiatives at Retail Outlets.

    Science.gov (United States)

    Ribisl, Kurt M; D'Angelo, Heather; Evenson, Kelly R; Fleischhacker, Sheila; Myers, Allison E; Rose, Shyanika W

    2016-01-01

    Tobacco products are sold in approximately 375,000 US retail outlets, including convenience stores and pharmacies, which often sell energy-dense, low-nutrient foods and beverages. The Food and Drug Administration's (FDA's) increased authority over tobacco product sales and marketing, combined with declining smoking rates, provides an opportunity to transition tobacco retailers toward healthier retail environments. Unfortunately, research into improving consumer retail environments is often conducted in isolation by researchers working in tobacco control, nutrition, and physical activity. Interdisciplinary efforts are needed to transform tobacco retailers from stores that are dependent on a declining product category, to the sale and promotion of healthful foods and creating environments conducive to active living. The objective of this article is to describe the potential for interdisciplinary efforts to transition retailers away from selling and promoting tobacco products and toward creating retail environments that promote healthful eating and active living. PMID:26963859

  3. Availability of healthier options in traditional and nontraditional rural fast-food outlets

    OpenAIRE

    McIntosh Alex; Sharkey Joseph R; Creel Jennifer S; Anding Jenna; Huber J

    2008-01-01

    Abstract Background Food prepared away from home has become increasingly popular to U.S. families, and may contribute to obesity. Sales have been dominated by fast food outlets, where meals are purchased for dining away from home or in the home. Although national chain affiliated fast-food outlets are considered the main source for fast food, fast foods are increasingly available in convenience stores and supermarkets/grocery stores. In rural areas, these nontraditional fast-food outlets may ...

  4. Pengaruh Store Atmosphere Terhadap Keputusan Pembelian Pada Outlet Tivona International Fragrance Cabang Pasar Merah Medan

    OpenAIRE

    Harahap, Suci Annisaa Fitrieyanti

    2015-01-01

    This research is motivated by the sale of perfumes at Tivona International Fragrance outlet still fluctuated despite of repairing efforts store atmospheres at these outlets has made. This study aims to determine the effect instore and outstore atmosphere partially and store atmosphere on purchasing decisions in Tivona International Fragrance outlet. Store Atmosphere is the design environment through visual communication, lighting, colors, music and fragrances to design an emotional respons...

  5. Spatial patterning of supermarkets and fast food outlets with respect to neighborhood characteristics

    OpenAIRE

    Lamichhane, Archana P.; Warren, Joshua; Puett, Robin; Porter, Dwayne E.; Bottai, Matteo; Mayer-Davis, Elizabeth J.; Liese, Angela D.

    2013-01-01

    A large body of literature has reported differences in exposure to environments supporting either healthy (e.g. supermarkets) or unhealthy (e.g. fast food outlets) dietary choices by neighborhood characteristics. We explored the associations of both supermarkets and fast food outlets availability with neighborhood characteristics, and clustering of these two outlet types in a largely rural state. Compared to block groups without a supermarket, those with a supermarket had a significantly high...

  6. The ecology of domestic violence: the role of alcohol outlet density

    OpenAIRE

    Michael Livingston

    2010-01-01

    Studies have consistently found positive associations between the density of alcohol outlets and levels of violence in areas. Few studies have examined whether this relationship holds for domestic violence. This study assesses whether alcohol outlet density is related to domestic violence and whether this relationship is due to alcohol availability or to co-occurring economic disadvantage and social disorganisation. Cross-sectional data on family incidents, liquor outlets and socio-demographi...

  7. Access to alcohol outlets, alcohol consumption and mental health.

    Directory of Open Access Journals (Sweden)

    Gavin Pereira

    Full Text Available The objective of this study was to investigate residential exposure to alcohol outlets in relation to alcohol consumption and mental health morbidity (anxiety, stress, and depression. This was a cross-sectional study of 6,837 adults obtained from a population representative sample for the period 2006-2009 in Perth, Western Australia. The number of alcohol outlets was ascertained for a 1600 m service area surrounding the residential address. Zero-inflated negative binomial and logistic regression were used to assess associations with total alcohol consumption, harmful alcohol consumption (7-10 drinks containing 10 g of alcohol for men, 5-6 drinks for women and medically diagnosed and hospital contacts (for anxiety, stress, and depression, respectively. The rate ratio for the number of days of harmful consumption of alcohol per month and the number of standard drinks of alcohol consumed per drinking day was 1.06 (95% CI: 1.02, 1.11 and 1.01 (95% CI: 1.00, 1.03 for each additional liquor store within a 1600 m service area, respectively. The odds ratio of hospital contact for anxiety, stress, or depression was 1.56 (95% CI: 0.98, 2.49 for those with a liquor store within the service area compared to those without. We observed strong evidence for a small association between residential exposure to liquor stores and harmful consumption of alcohol, and some support for a moderate-sized effect on hospital contacts for anxiety, stress, and depression.

  8. Bladder cancer: The combination of chemotherapy and irradiation in the treatment of patients with muscle-invading tumors

    International Nuclear Information System (INIS)

    cystectomy series, adjuvant chemotherapy is given, and thus cystectomy patients are at risk for the same morbidity. A selective approach using combined modality therapy therefore represents one treatment option to be presented to patients with muscle invading bladder tumors. This approach is particularly attractive for patients with clinically staged T2 and T3a disease, especially those who can undergo visibly complete transurethral resections and those who did not have an obstructer ureter

  9. A bladder preservation regimen using intra-arterial chemotherapy and radiotherapy for invasive bladder cancer. A prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Miyanaga, Naoto; Akaza, Hideyuki [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Okumura, Toshiyuki [and others

    2000-02-01

    A prospective study was performed to investigate combined treatment with intra-arterial chemotherapy and radiation therapy for bladder preservation in locally invasive bladder cancer. Patients with invasive bladder cancer, stage T2-3N0M0, were included in the study. lntra-arterial chemotherapy was performed with three injections of methotrexate and cisplatin at 3-week intervals. Simultaneously, the patients underwent X-ray irradiation (40 Gy) of the small pelvic space. Where a post-treatment transurethral resection (TUR) biopsy showed no residual tumor, the tumor site was irradiated by a 30 Gy proton beam and the bladder was preserved. Where tumors remained, radical cystectomy was performed. Between 1990 and 1996, 42 patients were treated according to this protocol. Post-treatment TUR biopsy and urine cytology showed no residual tumors in 39 of 42 cases (93%). The bladder was preserved in accordance with the study protocol in 36 cases. A median follow-up of 38 months showed 3-year non-recurrence in 72% of bladder-preserved patients and the rate of bladder preservation was 84%. The nine recurrences included eight cases of superficial bladder recurrence. One cancer death occurred among the bladder-preservation patients, giving 3-year survival and cause-specific survival rates of 84% and 100%, respectively. Although bladder function decreased slightly in compliance, bladder capacity was retained in almost all cases. This regimen is useful for bladder preservation in T2-3 locally invasive bladder cancer. Information from more cases and the results of more long-term observations are needed, as is an evaluation of appropriate subject selection and factors associated with quality of life issues, particularly regarding bladder function. (author)

  10. Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.

    LENUS (Irish Health Repository)

    Glynn, Ronan W

    2012-02-01

    To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.

  11. Community organization moderates the effect of alcohol outlet density on violence.

    Science.gov (United States)

    Pridemore, William Alex; Grubesic, Tony H

    2012-12-01

    There is growing evidence from multiple disciplines that alcohol outlet density is associated with community levels of assault. Based on the theoretical and empirical literatures on social organization and crime, we tested the hypothesis that the association between alcohol outlet density and neighbourhood violence rates is moderated by social organization. Using geocoded police data on assaults, geocoded data on the location of alcohol outlets, and controlling for several structural factors thought to be associated with violence rates, we tested this hypothesis employing negative binomial regression with our sample of 298 block groups in Cincinnati. Our results revealed direct effects of alcohol outlet density and social organization on assault density, and these effects held for different outlet types (i.e., off-premise, bars, restaurants) and levels of harm (i.e., simple and aggravated assaults). More importantly, we found that the strength of the outlet-assault association was significantly weaker in more socially organized communities. Subsequent analyses by level of organization revealed no effects of alcohol outlet density on aggravated assaults in organized block groups, but significant effects in disorganized block groups. We found no association between social (dis)organization and outlet density. These results clarify the community-level relationship between alcohol outlets and violence and have important implications for municipal-level alcohol policies.

  12. Parametric study of containment emergency-sump performance: results of vertical-outlet sump tests

    International Nuclear Information System (INIS)

    This report presents the results of a test program designed to characterize the hydraulic performance of sumps with vertical outlets. The tests were performed for a wide range of geometric and flow variables typical of ECCS sumps. The work on vertical outlet sumps presented here supplements a broader test program characterizing sumps with horizontal outlets. In addition to a parametric evaluation of the operating characteristics of vertical outlet sumps under normal approach flow conditions, the effects of perturbations to the approach flow have been considered. The effectiveness of two vortex suppression devices was demonstrated

  13. Effects of outlets on cracking risk and integral stability of super-high arch dams.

    Science.gov (United States)

    Lin, Peng; Liu, Hongyuan; Li, Qingbin; Hu, Hang

    2014-01-01

    In this paper, case study on outlet cracking is first conducted for the Goupitan and Xiaowan arch dams. A nonlinear FEM method is then implemented to study effects of the outlets on integral stability of the Xiluodu arch dam under two loading conditions, i.e., normal loading and overloading conditions. On the basis of the case study and the numerical modelling, the outlet cracking mechanism, risk, and corresponding reinforcement measures are discussed. Furthermore, the numerical simulation reveals that (1) under the normal loading conditions, the optimal distribution of the outlets will contribute to the tensile stress release in the local zone of the dam stream surface and decrease the outlet cracking risk during the operation period. (2) Under the overloading conditions, the cracks initiate around the outlets, then propagate along the horizontal direction, and finally coalesce with those in adjacent outlets, where the yield zone of the dam has a shape of butterfly. Throughout this study, a dam outlet cracking risk control and reinforcement principle is proposed to optimize the outlet design, select the appropriate concrete material, strengthen the temperature control during construction period, design reasonable impounding scheme, and repair the cracks according to their classification. PMID:25152907

  14. Management of Obstructive Sleep Apnea

    OpenAIRE

    Vijayan, V.K.

    2014-01-01

    Obstructive Sleep Apnea (OSA) is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP), Bilevel positive airway pressure (BiPAP) and Oral Appliances (OA),pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP) treatmen...

  15. Extrinsic duodenal obstruction and halitosis.

    OpenAIRE

    Stephenson, B M; Rees, B. I.

    1990-01-01

    Two siblings with extrinsic duodenal obstruction caused by congenital peritoneal bands are reported. Attention is drawn to the unusual physical sign of halitosis as a presenting feature. It is suggested that this physical sign may be an indication for barium studies.

  16. Bladder wall thickness and ultrasound estimated bladder weight in healthy adults with portative ultrasound device

    Directory of Open Access Journals (Sweden)

    Selcen Kanyilmaz

    2013-01-01

    Full Text Available Background: The aim of this study was to investigate bladder wall thickness (BWT and ultrasound estimated bladder weight (UEBW values in healthy population with a portative ultrasound device and their relationship with demographic parameters. Materials and Methods: The study was carried out in Neurorehabilitation Clinic of Ege University Hospital. Ninety-five subjects (48 women and 47 men aged between 18 and 56 were included in the study. BWT and UEBW were determined non-invasively with a portative ultrasound device; Bladder Scan BVM 6500 (Verathon Inc., WA, USA at a frequency of 3.7 MHz at functional bladder capacity. These values were compared by gender, and their relation was assessed with age, body mass index (BMI and parity. Results: Mean BWT was 2.0 ± 0.4 mm and UEBW was 44.6 ± 8.3 g at a mean volume of 338.0 ± 82.1 ml. Although higher results were obtained in men at higher bladder volumes, the results did not differ significantly by gender. Correlation analyses revealed statistically significant correlation between UEBW and age (r = 0.32. BWT was negatively correlated with volume (r = -0.50 and bladder surface area (r = -0.57. Also, statistically significant correlations were observed between UEBW and volume (r = 0.36, bladder surface area (r = 0.48 and BWT (r = 0.25. Conclusion: Determined values of BWT and UEBW in healthy population are estimated with portative ultrasound devices, which are future promising, for their convenient, easy, non-invasive, time-efficient hand-held use for screening.

  17. Effect of hydrogen peroxide on rabbit urinary bladder citrate synthase activity in the presence and absence of a grape suspension

    Directory of Open Access Journals (Sweden)

    Vijay Venugopal

    2010-12-01

    Full Text Available PURPOSE: The etiology of obstructive bladder dysfunction includes free radical damage to mitochondria. Feeding rabbits a standardized grape suspension protects the ability of the bladder to contract and empty in part by preventing mitochondrial damage, thus maintaining smooth muscle and mucosal metabolism. The objective of the current study is to determine the direct effect of this grape suspension on the response of mitochondria to the oxidative effects of hydrogen peroxide. MATERIALS AND METHODS: Six male rabbits were anesthetized with sodium pentobarbital and the bladders excised. Four full thickness strips were obtained for contractile studies and the balance separated into smooth muscle and mucosa compartments by blunt dissection. The effect of hydrogen peroxide on the contractile response to field stimulation was quantitated. Each tissue was homogenized and the effects of increasing concentrations of hydrogen peroxide in the presence and absence of grape suspension on citrate synthase activity was determined. RESULTS: Citrate synthase activity was significantly higher in the mucosa than in the muscle. The grape suspension had no effect on control citrate synthase activity. However, the grape suspension provided significant protection of both smooth muscle and mucosal citrate synthase activity. CONCLUSIONS: These studies support the conclusion that the grape suspension provides direct protection of mitochondrial function.

  18. Adaptive radiotherapy for bladder cancer using deformable image registration of empty and full bladder

    DEFF Research Database (Denmark)

    Juneja, Prabhjot; Caine, H.; Hunt, P.;

    2015-01-01

    mm) for bladder planning target volume (PTV). The goal of this retrospective study is to define, evaluate and optimize new patient-specific anisotropic PTVs (a-PTVs) using deformable image registration (DIR) between empty and full bladder computed tomography (CT) scans. This will provide an ART...... that incorporates the extreme deformations of the bladder, and is applicable from the first day of treatment. Deformation vector fields (DVFs), measured from the deformable image registration between empty and full bladder CTs, were scaled and constrained to construct the a-PTVs. For each patient, four a-PTVs were...... bladder cancer patients and a total of 100 fractions. It was found that the smaller a-PTV, a-PTV4 and a-PTV3, were appropriate in 87% of the fractions, while a-PTV2 and a-PTV1 were required in 12% of the fractions respectively. The use of the a-PTVs reduced the PTV volume by 32% (28-36%) as compared...

  19. Bladder Smooth Muscle Cells Differentiation from Dental Pulp Stem Cells: Future Potential for Bladder Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Bing Song

    2016-01-01

    Full Text Available Dental pulp stem cells (DPSCs are multipotent cells capable of differentiating into multiple cell lines, thus providing an alternative source of cell for tissue engineering. Smooth muscle cell (SMC regeneration is a crucial step in tissue engineering of the urinary bladder. It is known that DPSCs have the potential to differentiate into a smooth muscle phenotype in vitro with differentiation agents. However, most of these studies are focused on the vascular SMCs. The optimal approaches to induce human DPSCs to differentiate into bladder SMCs are still under investigation. We demonstrate in this study the ability of human DPSCs to differentiate into bladder SMCs in a growth environment containing bladder SMCs-conditioned medium with the addition of the transforming growth factor beta 1 (TGF-β1. After 14 days of exposure to this medium, the gene and protein expression of SMC-specific marker (α-SMA, desmin, and calponin increased over time. In particular, myosin was present in differentiated cells after 11 days of induction, which indicated that the cells differentiated into the mature SMCs. These data suggested that human DPSCs could be used as an alternative and less invasive source of stem cells for smooth muscle regeneration, a technology that has applications for bladder tissue engineering.

  20. Tetrachloroethylene exposure and bladder cancer risk

    DEFF Research Database (Denmark)

    Vlaanderen, Jelle; Straif, Kurt; Ruder, Avima;

    2014-01-01

    BACKGROUND: In 2012, the International Agency for Research on Cancer classified tetrachloroethylene, used in the production of chemicals and the primary solvent used in dry cleaning, as "probably carcinogenic to humans" based on limited evidence of an increased risk of bladder cancer in dry...... cleaners. OBJECTIVES: We assessed the epidemiological evidence for the association between tetrachloroethylene exposure and bladder cancer from published studies estimating occupational exposure to tetrachloroethylene or in workers in the dry-cleaning industry. METHODS: Random-effects meta-analyses were...... carried out separately for occupational exposure to tetrachloroethylene and employment as a dry cleaner. We qualitatively summarized exposure-response data because of the limited number of studies available. RESULTS: The meta-relative risk (mRR) among tetrachloroethylene-exposed workers was 1.08 (95% CI...

  1. Carcinoma Gall Bladder: Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Ghosh Y

    2014-12-01

    Full Text Available Carcinoma gall bladder is a very aggressive disease with poor outcomes. Despite achievements in the field of advanced imaging techniques, there is a very high mortality rate of the disease Cancer is the second most common disease in India responsible for maximum mortality with about 0.3 million deaths per year. The magnitude of cancer problem in the Indian Sub-continent (sheer numbers is increasing due to poor to moderate living standards and inadequate medical facilities. Women are more commonly affected than men. The peak incidence occurs in people in their 60s, but the disease age range is from 29 to 90 years of age and there is great geographic and ethnic variation. Carcinoma gall bladder, a disease of old age, is now found in the younger age group and presents with greater ferocity.

  2. E-learning for neurological bladder management.

    Science.gov (United States)

    Rognoni, Carla; Fizzotti, Gabriella; Pistarini, Caterina; Mazzoleni, M Cristina

    2012-01-01

    Regarding the impact of visceral dysfunction on quality of life, bowel and bladder management is a very important problem. The management of the patient with neurological bladder is often a source of uncertainty for both patients and healthcare personnel. Since the need of specialized training is growing, two CME e-learning courses have been developed to provide physicians and nurses competencies for the enhancement of the daily life of the patients. The present study aims at evaluating courses attendance and outcomes. Attendance data confirm the interest for both courses. The results document a pretty good objective and subjective effectiveness of the e-learning courses but low attitude to exploit he support of an asynchronous tutor. The analysis of test results gives some hints for eventual quality improvement of the courses themselves. PMID:22874390

  3. Paraneoplastic retinopathy associated with occult bladder cancer

    Directory of Open Access Journals (Sweden)

    M Nivean

    2016-01-01

    Full Text Available The aim was to report the first case of cancer-associated retinopathy (CAR presenting before bladder cancer diagnosis. A 71-year-old woman with a history of bilateral vision loss underwent subsequent complete ophthalmic examination include a fluorescein angiography, full-field electroretinogram (ERG, serology including serum antibodies for CAR, and positron emission tomography-computed tomography (PET-CT scan. The patient was diagnosed with bladder carcinoma revealed by PET-CT. Timely recognition of this entity may be crucial for an increased patient survival thus adult onset progressive photoreceptor dysfunction, confirmed by ERG, should alert to a possible remote effect of known or occult malignancy. In the latter, PET-CT may be exploited as a powerful diagnostic tool.

  4. Combined therapy of urinary bladder radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Zaderin, V.P.; Polyanichko, M.F. (Rostovskij-na-Donu Nauchno-Issledovatel' skij Onkologicheskij Inst. (USSR))

    1982-01-01

    A scheme of therapy of radiation cystitis is suggested. It was developed on the basis of evaluation of literature and clinical data of 205 patients with radiation injury of the urinary bladder. The method is based on general and local therapy of damaged tissues by antiinflammatory drugs, anesthetics and stimulators of reparative regeneration. Severe ulcerative and incrustation cystites, refractory to conservative therapy, were treated by surgery, using antiseptics and reparation stimulators before, during and after operation. As a result, there were hardly any complications after reconstruction of the bladder with intestinal and peritoneal tissues. 104 patients (96.1%) were cured completely and ability to work was restored in 70 patients (76.9%).

  5. HLA class I expression in bladder carcinomas.

    Science.gov (United States)

    Cabrera, T; Pedrajas, G; Cozar, J M; Garrido, A; Vicente, J; Tallada, M; Garrido, F

    2003-10-01

    HLA class I molecules are frequently lost in a large variety of human carcinomas, possibly because of T-cell immune selection of major histocompatibility complex class I deficient tumor variants. We report that this phenomenon is also a frequent event in bladder carcinomas. Of a total of 72 bladder carcinomas, 72% of the tumors had at least one alteration in HLA class I expression. These altered HLA class I phenotypes were classified as total HLA class I loss (25%; phenotype I); HLA-A or/and HLA-B locus-specific loss (12%; phenotype III); and HLA class I allelic loss (35%; phenotype II or IV). Comparison of histopathological parameters with HLA class I expression showed a statistically significant relationship with the degree of differentiation and tumor recurrence.

  6. Spontaneous bladder rupture in acute alcohol intoxication

    Directory of Open Access Journals (Sweden)

    Bahjat Barakat

    2014-03-01

    Full Text Available Spontaneous bladder rupture is a rare condition that can be followed by an acute alcohol intoxication and can be associated with significant morbidity and mortality. We report a case diagnosed in a alcoholic young male who was admitted to our emergency room for epigastric pain. The case demonstrates the difficulties with diagnosis and the need for physicians who work in an emergency room to be aware of this condition.

  7. Paraneoplastic retinopathy associated with occult bladder cancer

    DEFF Research Database (Denmark)

    Nivean, M; Muttuvelu, Danson V; Afzelius, Pia Maria Tullia;

    2016-01-01

    The aim was to report the first case of cancer-associated retinopathy (CAR) presenting before bladder cancer diagnosis. A 71-year-old woman with a history of bilateral vision loss underwent subsequent complete ophthalmic examination include a fluorescein angiography, full-field electroretinogram ...... photoreceptor dysfunction, confirmed by ERG, should alert to a possible remote effect of known or occult malignancy. In the latter, PET-CT may be exploited as a powerful diagnostic tool....

  8. Primary posterior perineal herniation of urinary bladder

    Directory of Open Access Journals (Sweden)

    Kurumboor Prakash

    2013-01-01

    Full Text Available Primary perineal hernia is a rare clinical condition wherein herniation of viscera occurs through pelvic diaphragm. They are usually mistaken for sciatic hernia, rectal prolapse or other diseases in the perineum. Correct identification of the type of hernia by imaging is crucial for planning treatment. We present a case of primary posterior herniation of urinary bladder and rectal wall through levator ani repaired laparoscopically using a mesh repair.

  9. [Occlusion of the gastric outlet caused by a trichobezoar].

    Science.gov (United States)

    Cavuşoğlu, Z; Olcay, E; Dağoğlu, T; Akgün, E; Vural, S; Ateş, R

    1990-10-01

    Bezoars are concretions formed in the gastrointestinal tract. The trichobezoars are hairballs in the stomach or intestines composed of hair. They are usually found in young girls as in our case which we operated in April 1989 on Surgical Ward in Kartal State Hospital in Istanbul. The postgastrectomy state predisposes to bezoar formation. Persimmon peels or pits, orange or grapefruit pulp are the usual offenders. Bezoars are associated with vague upper gastrointestinal discomfort, nausea, and vomiting. The patients may complain of abdominal pain. Ulceration, bleeding, obstruction, and perforation are the most common complications. Treatment consist of mechanical fragmentation via the endoscope or operative extraction. Dissolution of the undigested bolus by ingestion of proteolytic enzymes such as papain may be tried. As prophylaxis the postgastrectomy patient must be warned of ingesting citrus fruits.

  10. Dynamics of liquid sloshing in upright and inverted bladdered tanks

    Science.gov (United States)

    Dodge, F. T.; Kana, D. D.

    A system identification methodology was used to examine the dynamics of liquid sloshing in the upright and inverted bladdered hydrazine tanks of the Tracking and Data Relay Satellite, (TDRS) and to evaluate the effects of bladder stiffness on the sloshing parameters. Mechanical models of the two systems were developed using the numerical values derived from static stability tests and from slosh frequency response tests of a full-size model tank fitted with a prototype bladder. For the upright tank (liquid below the bladder) a modified conventional pendulum was used. In the inverted tank (liquid above the bladder) where sloshing is unconventional due to the highly nonsymmetrical orientation of the liquid held by the bladder, a mechanical model using an inverted pendulum which is able to undergo small oscillations as well as large reorientations was necessary. Both thrusting and low-gravity conditions are considered.

  11. Oncolytic Viruses in the Treatment of Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Kyle G. Potts

    2012-01-01

    Full Text Available Bladder carcinoma is the second most common malignancy of the urinary tract. Up to 85% of patients with bladder cancer are diagnosed with a tumor that is limited to the bladder mucosa (Ta, T1, and CIS. These stages are commonly termed as non-muscle-invasive bladder cancer (NMIBC. Although the treatment of NMIBC has greatly improved in recent years, there is a need for additional therapies when patients fail bacillus Calmette-Guérin (BCG and chemotherapeutic agents. We propose that bladder cancer may be an ideal target for oncolytic viruses engineered to selectively replicate in and lyse tumor cells leaving normal cells unharmed. In support of this hypothesis, here we review current treatment strategies for bladder cancer and their shortcomings, as well as recent advancements in oncolytic viral therapy demonstrating encouraging safety profiles and antitumor activity.

  12. ILEOCYSTOPLASTY IN INVASIVE URINARY BLADDER CARCINOMA

    Directory of Open Access Journals (Sweden)

    V. N. Pavlov

    2009-01-01

    Full Text Available Objective: to assess the results of surgical treatment of patients with the intestinal urinary bladder, to characterize its early and late postoperative complications, and to develop their correction tactics.  Subjects and methods. The results of treatment in 198 patients who had undergone ileocystoplasty were analyzed.  Results. The developed diagnostic approach and the determined examination periods could reduce the number of late postoperative complications of ileocystoplasty: acute and chronic pyelonephritis from 19.4 to 7.6%, urolithiasis from 17.2 to 1.9%, bladder dysfunction from 25.8 to 7.6%, and metabolic acidosis from 4.3 to 1.9%, and prevent the development of ureterovesical anastomosis stricture.  Conclusion. Radical cystectomy with the ileoplasty using an isolated segment of the ileum in patients with invasive urinary bladder carcinoma has been the operation of choice no longer; it has become an essential surgical adjunct. This method permits overall 5-year survival to be achieved in 69.7% of patients.  

  13. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2012-02-01

    PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances. Early treatment with continuous positive airway pressure (CPAP) improves survival, reduces hospitalization and pulmonary hypertension, and also reduces hypoxemia. Evidence of systemic inflammation and oxidative stress in COPD and sleep apnea provides insight into potential interactions between both disorders that may predispose to cardiovascular disease. Long-term outcome studies of overlap patients currently underway should provide further evidence of the clinical significance of the overlap syndrome. SUMMARY: Studies of overlap syndrome patients at a clinical, physiological and molecular level should provide insight into disease mechanisms and consequences of COPD and sleep apnea, in addition to identifying potential relationships with cardiovascular disease.

  14. Impurity profiling of trinitrotoluene using vacuum-outlet gas chromatography-mass spectrometry

    NARCIS (Netherlands)

    Brust, H.; Willemse, S.; Zeng, T.; Asten, A. van; Koeberg, M.; Heijden, A.E.D.M. van der; Bolck, A.; Schoenmakers, P.

    2014-01-01

    In this work, a reliable and robust vacuum-outlet gas chromatography-mass spectrometry (GC-MS) method is introduced for the identification and quantification of impurities in trinitrotoluene (TNT). Vacuum-outlet GC-MS allows for short analysis times the analysis of impurities in TNT was performed in

  15. Dimensionless study on outlet flow characteristics of an air-driven booster

    Institute of Scientific and Technical Information of China (English)

    Yan SHI; Mao-lin CAI

    2012-01-01

    Air-driven boosters are widely used to obtain high-pressure gas.Through analysis of the boosting process of an air-driven booster,the basic mathematical model of working processes can be set up.By selecting the appropriate reference values,the basic mathematical model is transformed to a dimensionless expression.Using MATLAB/Simulink for simulation and studying the booster experimentally,the dimensionless outlet flow characteristics of the booster were obtained and the simulation results agree well with the experimental results.Through analysis,it can be seen that the dimensionless outlet flow of the booster is mainly determined by the dimensionless input pressure of the driving chamber,the dimensionless outlet condition pressure of the booster and the dimensionless area of the piston in the driving chamber.The dimensionless average outlet flow becomes larger with an increasing dimensionless input pressure of the driving chamber,but it becomes smaller with an increase in the dimensionless outlet condition pressure of the booster.Especially when the dimensionless outlet condition pressure is approximately 1.4,the dimensionless average outlet flow reaches zero.With an increase in the dimensionless area of the piston in the driving chamber,the dimensionless average outlet flow increases and peaks at approximately 1.89,and after this peak,it starts to decrease.This research can be referred to in the design of air-driven boosters.

  16. 12 CFR 7.1014 - Sale of money orders at nonbanking outlets.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Sale of money orders at nonbanking outlets. 7.1014 Section 7.1014 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY BANK ACTIVITIES AND OPERATIONS Bank Powers § 7.1014 Sale of money orders at nonbanking outlets. A national...

  17. Validation of presence of supermarkets and fast-food outlets in Copenhagen

    DEFF Research Database (Denmark)

    Svastisalee, Chalida M; Holstein, Bjørn E; Due, Pernille

    2012-01-01

    We examined the quality of food outlet addresses provided by secondary sources and determined whether they could be physically located in the field.......We examined the quality of food outlet addresses provided by secondary sources and determined whether they could be physically located in the field....

  18. 24 CFR 3280.813 - Outdoor outlets, fixtures, air-conditioning equipment, etc.

    Science.gov (United States)

    2010-04-01

    ... Electrical Systems § 3280.813 Outdoor outlets, fixtures, air-conditioning equipment, etc. (a) Outdoor.../or air conditioning equipment located outside the manufactured home, shall have permanently affixed, adjacent to the outlet, a metal tag which reads: This Connection Is for Air Conditioning Equipment Rated...

  19. Alcohol outlet density and alcohol consumption in Los Angeles county and southern Louisiana

    Directory of Open Access Journals (Sweden)

    Matthias Schonlau

    2008-11-01

    Full Text Available The objective of this study was to assess the relationship between alcohol availability, as measured by the density of off-premise alcohol outlets, and alcohol consumption in Los Angeles county and southern Louisiana, USA. Consumption information was collected through a telephone survey of 2,881 households in Los Angeles county and pre-Katrina southern Louisiana, nested within 220 census tracts. Respondents’ addresses were geo-coded and both neighbourhood (census tracts and buffers of varying sizes and individual (network distance to the closest alcohol outlet estimates of off-sale alcohol outlet density were computed. Alcohol outlet density was not associated with the percentage of people who were drinkers in either site. Alcohol outlet density was associated with the quantity of consumption among drinkers in Louisiana but not in Los Angeles. Outlet density within a one-mile buffer of the respondent’s home was more strongly associated with alcohol consumption than outlet density in the respondent’s census tract. The conclusion is that the relationship between neighbourhood alcohol outlet density and alcohol consumption is complex and may vary due to differences in neighbourhood design and travel patterns.

  20. Bladder cancer, a review of the environmental risk factors

    OpenAIRE

    Letašiová Silvia; Medveďová Alžbeta; Šovčíková Andrea; Dušinská Mária; Volkovová Katarína; Mosoiu Claudia; Bartonová Alena

    2012-01-01

    Abstract Background Many epidemiological studies and reviews have been performed to identify the causes of bladder cancer. The aim of this review is to investigate the links between various environmental risk factors and cancer of the bladder. Methods A systematic literature search was performed using PubMed, Science Direct, Scopus, Scholar Google and Russian Google databases to identify reviews and epidemiological studies on bladder cancer risk factors associated with the environment publish...

  1. Interstitial cystitis/bladder pain syndrome and glycosaminoglycans replacement therapy

    OpenAIRE

    Cervigni, Mauro

    2015-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic disease characterized by discomfort or recurrent abdominal and pelvic pains in the absence of urinary tract infections. Its symptomatology includes discomfort, increased bladder pressure, sensitivity and intense pain in the bladder and pelvic areas, increased voiding frequency and urgency, or a combination of these symptoms. For these reasons, this pathology has a very negative impact on quality of life. The etiolo...

  2. Complete transurethral bladder eversion 3 months after hemipelvectomy.

    Science.gov (United States)

    Lowe, Gregory; Mandalapu, Subbarao; Gilleran, Jason

    2010-02-01

    A 46-year-old white female underwent a left hemipelvectomy for chondrosarcoma. She presented with total incontinence and a bulging vaginal mass. Exam confirmed complete transurethral bladder eversion that was addressed with transvaginal multilayer bladder neck closure and suprapubic tube placement. Eventually she underwent abdominal hysterectomy, mesh sacral colpopexy, and catheterizable stoma creation. Patient is continent of urine 3 months postoperatively. We present the first reported case of bladder eversion after hemipelvectomy and propose possible pathophysiologic mechanisms. PMID:19629370

  3. Spontaneous Rupture of Bladder in Puerperium without Uterine Rupture

    Directory of Open Access Journals (Sweden)

    Subrat Panda

    2012-11-01

    Full Text Available Objective: we report a case of intraperitoneal urinary bladder rupture I week following normal delivery ina primigravida, who presented with huge urinary ascites, anuria and renal failure. Abdominalparacentesis and exploratory laparotomy was done and a diagnosis of intraperitoneal bladder rupturewas made. The rent was repaired in layers. This may be preventable if adequate precaution in the formof evacuating the bladder before the patient goes into second stage of labor is undertaken.

  4. Perioperative Challenges in Repeat Bladder Exstrophy Repair - Case Report

    Directory of Open Access Journals (Sweden)

    Otu Enenyi Etta

    2015-07-01

    Full Text Available Bladder exstrophy is a rare congenital malformation. It presents as leakage of urine in the anterior abdominal wall following defects in midline anterior abdominal wall skin and bladder. We report the use of combined general anaesthesia and caudal epidural analgesia in a 4yr old boy for repeat bladder exstrophy repair. Problems of prolonged surgery and the challenges of pain and sedation management in the post operative period are discussed.

  5. Neuromodulation attenuates bladder hyperactivity in a rat cystitis model

    OpenAIRE

    Su, Xin; Nickles, Angela; Nelson, Dwight E.

    2013-01-01

    Background We investigated the regulation of urinary bladder function by electrical stimulation of the L6 spinal nerve (SN) using cystometry in normal rats and in rats with cystitis induced by intravesical infusion of dilute acetic acid. Methods In anesthetized rats, a cannula was placed into the bladder dome for saline/acetic acid infusion and intravesical pressure monitoring. Threshold pressure (TP), basal pressure (BP) and inter-contraction interval (ICI) were measured from the bladder pre...

  6. Preventing Kidney Injury in Children with Neurogenic Bladder Dysfunction

    OpenAIRE

    Faezeh Javadi Larijani; Mastaneh Moghtaderi; Nilofar Hajizadeh; Farahnak Assadi

    2013-01-01

    The most common cause of neurogenic bladder dysfunction (NBD) in newborn infants is myelomeningocele. The pathophysiology almost always involves the bladder detrusor sphincter dyssynergy (DSD), which if untreated can cause severe and irreversible damage to the upper and lower urinary tracts. Early diagnosis and adequate management of NBD is critical to prevent both renal damage and bladder dysfunction and to reduce chances for the future surgeries. Initial investigation of the affected newbor...

  7. Bladder cancer and reproductive factors among women in Spain

    OpenAIRE

    Huang, An-Tsun; Kogevinas, Manolis; Silverman, Debra T.; Malats, Nủria; Rothman, Nathaniel; Tardón, Adonina; Serra, Consol; García-Closas, Reina; Carrato, Alfredo; Cantor, Kenneth P.

    2009-01-01

    Hormonal factors, possibly related to reproductive characteristics, may play a role in the risk of bladder cancer among women. To study this, we investigated the effects of reproductive factors on female bladder cancer risk. Information on reproductive and other risk factors was gathered in personal interviews from 152 female cases and 166 matched controls from 18 hospitals in five regions of Spain during 1998–2001. Logistic regression was used to estimate the association between bladder canc...

  8. Bladder dysfunction in distal autonomic neuropathy of acute onset.

    OpenAIRE

    Kirby, R S; Fowler, C J; Gosling, J A; Bannister, R

    1985-01-01

    A patient with cholinergic dysautonomia and a patient with pandysautonomia have each been investigated for disturbances of bladder and urethral function. Both patients suffered from an inability to develop or sustain a detrusor contraction, while retaining normal bladder sensation. Biopsy specimens of bladder muscle stained for acetylcholinesterase revealed a significant reduction in cholinergic nerves compared with controls; however, the prominent cholinergic subepithelial plexus was strikin...

  9. Bladder Bulge: Unifying Old and New Sonographic Bladder Wall Abnormalities in Ureterolithiasis

    Directory of Open Access Journals (Sweden)

    Scott Bomann

    2012-12-01

    Full Text Available As long as CT remains the first line imaging modality in suspected ureterolithiasis, emergency physicians will continue to perform the majority of renal colic ultrasound studies in a search for hydronephrosis. Hydronephrosis, however, is not always present and emergency physicians may not find it as useful as would be expected. Through this case series of seven patients, we present what we believe to be commonly present and easily acquired sonographic bladder wall findings in ureterolithiasis. These abnormalities are not routinely taught in emergency ultrasound and have not been reported in the emergency medicine literature. One variant, in fact, may be a novel finding unto itself. Due to their similar appearance, we propose to unify these findings under the name “bladder bulge.” This sign can be seen on axial views as an inward bulging or focal thickening of the bladder wall on the affected side, at the uretovesical junction.

  10. Chemotherapy for bladder cancer: treatment guidelines for neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and metastatic cancer

    DEFF Research Database (Denmark)

    Sternberg, Cora N; Donat, S Machele; Bellmunt, Joaquim;

    2007-01-01

    To determine the optimal use of chemotherapy in the neoadjuvant, adjuvant, and metastatic setting in patients with advanced urothelial cell carcinoma, a consensus conference was convened by the World Health Organization (WHO) and the Société Internationale d'Urologie (SIU) to critically review...... the published literature on chemotherapy for patients with locally advanced bladder cancer. This article reports the development of international guidelines for the treatment of patients with locally advanced bladder cancer with neoadjuvant and adjuvant chemotherapy. Bladder preservation is also discussed......, as is chemotherapy for patients with metastatic urothelial cancer. The conference panel consisted of 10 medical oncologists and urologists from 3 continents who are experts in this field and who reviewed the English-language literature through October 2004. Relevant English-language literature was identified...

  11. Well Water a Suspected Cause of Bladder Cancer in New England

    Science.gov (United States)

    ... a Suspected Cause of Bladder Cancer in New England Researchers believe arsenic exposure might contribute to higher- ... bladder cancer risk among people in three New England states, a new study suggests. Bladder cancer rates ...

  12. A novel bioreactor to simulate urinary bladder mechanical properties and compliance for bladder functional tissue engineering

    Institute of Scientific and Technical Information of China (English)

    WEI Xin; LI Dao-bing; XU Feng; WANG Yan; ZHU Yu-chun; LI Hong; WANG Kun-jie

    2011-01-01

    Background Bioreactors are pivotal tools for generating mechanical stimulation in functional tissue engineering study.This study aimed to create a bioreactor that can simulate urinary bladder mechanical properties, and to investigate the effects of a mechanically stimulated culture on urothelial cells and bladder smooth muscle cells.Methods We designed a bioreactor to simulate the mechanical properties of bladder. A pressure-record system was used to evaluate the mechanical properties of the bioreactor by measuring the pressure in culture chambers. To test the biocompatibility of the bioreactor, viabilities of urothelial cells and smooth muscle cells cultured in the bioreactor under static and mechanically changed conditions were measured after 7-day culture. To evaluate the effect of mechanical stimulations on the vital cells, urethral cells and smooth muscle cells were cultured in the simulated mechanical conditions. After that, the viability and the distribution pattern of the cells were observed and compared with cells cultured in non-mechanical stimulated condition.Results The bioreactor system successfully generated waveforms similar to the intended programmed model while maintaining a cell-seeded elastic membrane between the chambers. There were no differences between viabilities of urothelial cells ((91.90±1.22)% vs. (93.14±1.78)%, P >0.05) and bladder smooth muscle cells ((93.41±1.49)% vs.(92.61±1.34)%, P >0.05). The viability of cells and tissue structure observation after cultured in simulated condition showed that mechanical stimulation was the only factor affected cells in the bioreactor and improved the arrangement of cells on silastic membrane.Conclusions This bioreactor can effectively simulate the physiological and mechanical properties of the bladder.Mechanical stimulation is the only factor that affected the viability of cells cultured in the bioreactor. The bioreactor can change the growth behavior of urothelial cells and bladder smooth

  13. Effects of Inlet/Outlet Ducts on Acoustic Attenuation Characteristics of Circular Expansion Chambers

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-bo; GE Yun-shan; JI Zhen-lin; ZHANG Wen-ping; SONG Yan-rong; HAN Xiu-kun; ZHANG Xue-min

    2006-01-01

    The effect of coaxial, offset and extended inlet/outlet on the acoustic attenuation characteristics of circular expansion chambers are studied by the three-dimensional finite element method. The numerical results of transmission loss are compared with experiment results to verify the necessary of using three-dimensional methods. Maps of acoustic pressure level distribution inside of chambers and inlet/outlet ducts are given at a frequency to demonstrate the difference of acoustic wave propagation behavior caused by locations of inlet/outlet ducts. For the chambers of the same length, the chamber with extended inlet/outlet duct has higher attenuation ability than coaxial and offset inlet/outlet duct over middle frequencies.

  14. The Risk Factor and The Severity of Symptoms Relation in Women with Overactive Bladder

    Directory of Open Access Journals (Sweden)

    Tulga Egilmez

    2014-03-01

    Full Text Available Aim: To investigate whether risk factors for overactive bladder (OAB in women are associated with symptom severity and to assess the impact of symptom severity on the quality of life. Material and Method: Symptoms of 100 female patients (aged, 47.70 ± 12.34 years who were diagnosed with OAB were assessed using the Boyarsky symptom score (BSS. Data for age, educational status, body mass index (BMI, chronic disease, vaginal deliveries, constipation, smoking, consumption of alcohol, tea, coffee, or carbonated drinks and diets involving spicy food were recorded. Subcategories for each factor regarding quantity were established. The findings were statistically correlated with the BSS and with each urinary symptom individually. Each patient%u2019s quality-of-life (QoL scores were correlated with the severity of each symptom and the total, obstructive and irritative BSS. Results: Urgency was related with BMI, spicy food, vaginal deliveries, menopause, and advanced age. Nocturia had a relation with menopause and advanced age. Total BSS was significantly correlated with coffee consumption. Irritative BSS was correlated with menopause and advanced age and obstructive BSS was correlated with constipation. Total and irritative BSS were both positively correlated with the QoL score. Discusion: Risk factors can affect the severity of symptoms and these factors should be considered when planning therapy.

  15. Placenta Percreta With Invasion into the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Zachary L. Smith

    2014-01-01

    Full Text Available Placenta percreta is a rare condition, which can lead to significant morbidity and potentially mortality. We present a case of a 38-year-old woman who presented at 24 weeks gestation with vaginal bleeding and was found to have complete placenta previa with placenta percreta invading the urinary bladder. Her hospital course was complicated by bilateral pulmonary emboli. She underwent an exploratory laparotomy, repeat Caesarean section, and total abdominal hysterectomy. Because of placental invasion into the bladder, the procedure was complicated by bladder and ureteral injuries for which urology carried out repair. Postoperatively, the patient had a persistent bladder leak until postoperative day #39.

  16. A rat model with an isolated bladder in situ

    DEFF Research Database (Denmark)

    Thulesen, J; Olsen, P S; Grevstad, J U;

    1997-01-01

    This paper describes our method for producing a rat model with an isolated bladder in situ in which the bladder makes no contact with urine. First, the right kidney was removed, then an external catheter was placed in the right ureter for bladder infusions, and next the left ureter was anatomosed...... to the proximal part of the descending colon. The animals were treated with antibiotics, and saline was infused daily into the bladder in order to prevent atrophy. This in situ model is considered to be useful in studies investigating the influence of specific compounds, such as carcinogens, on the...

  17. Molecular profiling of ADAM12 in human bladder cancer

    DEFF Research Database (Denmark)

    Frolich, Camilla; Albrechtsen, Reidar; Andersen, Lars Dyrskjøt;

    2006-01-01

    staining on tissue arrays of bladder cancers. The presence and relative amount of ADAM12 in the urine of cancer patients were determined by Western blotting and densitometric measurements, respectively. RESULTS: ADAM12 mRNA expression was significantly up-regulated in bladder cancer, as determined...... could be detected in the urine by Western blotting; ADAM12 was present in higher levels in the urine from patients with bladder cancer compared with urine from healthy individuals. Significantly, following removal of tumor by surgery, in most bladder cancer cases examined, the level of ADAM12...

  18. A Very Long Foreign Body in the Bladder

    Directory of Open Access Journals (Sweden)

    Atsushi Imai

    2011-01-01

    Full Text Available In the urinary tract, foreign body is most commonly found in the urinary bladder. But it is anatomically very difficult for a man to self-insert a long object into the urinary bladder. Here we report a case of a 49-year-old Japanese man who has inserted a 140-cm vinyl tube in the bladder for masturbation. He could not retrieve it, and the bladder foreign body remained in this position for about two years. He was referred to our hospital and open surgery was performed.

  19. Bladder cancer arising in a spina bifida patient.

    Science.gov (United States)

    Game, X; Villers, A; Malavaud, B; Sarramon, J

    1999-11-01

    We report the case of a 52-year-old patient with spina bifida, neurologic bladder, and a history of recurrent urinary tract infections (UTIs) in whom a bladder cancer was incidentally discovered. Cytology, cystoscopy, and cystography showed nonspecific, extensive inflammatory lesions. Cystography demonstrated a complex of diverticulae and cellules. Pathologic examination of a diverticulectomy specimen revealed a grade III pT3b transitional and squamous cell carcinoma. Because of the similar disease causation (recurrent UTIs, stones, and indwelling catheterization), we suggest extension of the guidelines proposed for patients with spinal cord injuries (ie, annual serial bladder biopsies) to patients with nontraumatic neurogenic bladder. PMID:10754152

  20. Methylenetetrahydrofolate Reductase Polymorphisms at Familial Bladder Cancer: Case Report

    Directory of Open Access Journals (Sweden)

    Gulay Ceylan

    2016-02-01

    Full Text Available Bladder cancer is the seventh most common cancer in men in the world, it is the second most seen cancer after lung cancer and the first in urogenital tumours in Turkey. Many molecular epidemiologic studies have been reported to investigate the associations between the MTHFR C677T and A1298C polymorphisms and bladder cancer risk. In this report, a family with transitional bladder cancer have also MTHFR A1298C heterozygosity which supports the association between MTHFR variants and bladder cancer. This %uFB01nding should be further validated by prospective and larger studies with more diverse ethnic groups.

  1. Cervicomedullary neurocysticercosis causing obstructive hydrocephalus.

    Science.gov (United States)

    Wang, Doris D; Huang, Michael C

    2015-09-01

    We present a 45-year-old man with tussive headache and blurred vision found to have obstructive hydrocephalus from a neurocysticercal cyst at the cervicomedullary junction who underwent surgical removal of the cyst. We performed a suboccipital craniectomy to remove the cervicomedullary cyst en bloc. Cyst removal successfully treated the patient's headaches without necessitating permanent cerebrospinal fluid diversion. Neurocysticercosis is the most common parasite infection of the central nervous system causing seizures and, less commonly, hydrocephalus. Intraventricular cysts or arachnoiditis usually cause hydrocephalus in neurocysticercosis but craniocervical junction cysts causing obstructive hydrocephalus are rare. Neurocysticercosis at the craniocervical junction may cause Chiari-like symptoms. In the absence of arachnoiditis and leptomeningeal enhancement, surgical removal of the intact cyst can lead to favorable outcomes.

  2. Hair Dye Use and Risk of Bladder Cancer in the New England Bladder Cancer Study

    OpenAIRE

    Koutros, Stella; Silverman, Debra T.; Baris, Dalsu; Zahm, Shelia Hoar; Lindsay M. Morton; Colt, Joanne S.; Hein, David W.; Moore, Lee E.; Johnson, Alison; Schwenn, Molly; Cherala, Sai; Schned, Alan; Doll, Mark A.; Rothman, Nathaniel; KARAGAS, MARGARET R.

    2011-01-01

    Aromatic amine components in hair dyes, and polymorphisms in genes that encode enzymes responsible for hair dye metabolism, may be related to bladder cancer risk. We evaluated the association between hair dye use and bladder cancer risk and effect modification by NAT1, NAT2, GSTM1, and GSTT1 genotypes in a population-based case-control study of 1,193 incident cases and 1,418 controls from Maine, Vermont, and New Hampshire enrolled between 2001 and 2004. Individuals were interviewed in person ...

  3. Sensory Dysfunction of Bladder Mucosa and Bladder Oversensitivity in a Rat Model of Metabolic Syndrome

    OpenAIRE

    Wei-Chia Lee; Po-Hui Chiang; You-Lin Tain; Chia-Ching Wu; Yao-Chi Chuang

    2012-01-01

    PURPOSE: To study the role of sensory dysfunction of bladder mucosa in bladder oversensitivity of rats with metabolic syndrome. MATERIALS AND METHODS: Female Wistar rats were fed a fructose-rich diet (60%) or a normal diet for 3 months. Based on cystometry, the fructose-fed rats (FFRs) were divided into a group with normal detrusor function or detrusor overactivity (DO). Acidic adenosine triphosphate (ATP) solution (5mM, pH 3.3) was used to elicit reflex micturition. Cystometric parameters we...

  4. Coagulability in Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Christina Liak

    2011-01-01

    Full Text Available BACKGROUND: Obstructive sleep apnea (OSA is a common disorder that affects both quality of life and cardiovascular health. The causal link between OSA and cardiovascular morbidity/mortality remains elusive. One possible explanation is that repeated episodes of nocturnal hypoxia lead to a hypercoagulable state that predisposes patients to thrombotic events. There is evidence supporting a wide array of hematological changes that affect hemostasis (eg, increased hematocrit, blood viscosity, platelet activation, clotting factors and decreased fibrinolytic activity.

  5. Chronic Intestinal Pseudo-Obstruction.

    Science.gov (United States)

    Panganamamula, Kashyap V; Parkman, Henry P

    2005-02-01

    Chronic intestinal pseudo-obstruction (CIP) is a gastrointestinal motility disorder characterized by chronic symptoms and signs of bowel obstruction in the absence of a fixed, lumen-occluding lesion. Radiographic findings consist of dilated bowel with air-fluid levels. Pseudo-obstruction is an uncommon condition and can result from primary or secondary causes. The management is primarily focused on symptom control and nutritional support to prevent weight loss and malnutrition. The principles of management of patients with CIP involve 1) establishing a correct clinical diagnosis and excluding mechanical obstruction; 2) differentiating between idiopathic and secondary forms; 3) performing a symptomatic and physiologic assessment of the parts of the gastrointestinal (GI) tract involved by manometric and whole gut transit scintigraphic studies; 4) careful assessment of nutritional status of the patient; and 5) developing a therapeutic plan addressing the patient's symptoms and nutritional status. Treatment of CIP includes frequent small meals with a low-fat, low-fiber diet, liquid nutritional supplements may be needed; prokinetic agents such as metoclopramide may help to reduce upper GI symptoms. Trials of drugs such as erythromycin, domperidone, cisapride, and tegaserod may be considered if there is no response. Subcutaneous octreotide may be helpful to improve small bowel dysmotility especially in patients with scleroderma. In patients with symptoms suggestive of bacterial overgrowth, courses of antibiotics such as metronidazole, ciprofloxacin, and doxycycline may be needed. Nutritional assessment and support is an important aspect of management. Enteral nutrition is usually preferred. In carefully selected patients, feeding jejunostomy with or without decompression gastrostomy may be tried. Long term parenteral nutrition should be reserved for patients who can not tolerate enteral nutrition. Complications associated with total parenteral nutrition include

  6. Obstructive sleep apnea and asthma*

    OpenAIRE

    Cristina Salles; Regina Terse-Ramos; Adelmir Souza-Machado; Cruz, Alvaro A

    2013-01-01

    Symptoms of sleep-disordered breathing, especially obstructive sleep apnea syndrome (OSAS), are common in asthma patients and have been associated with asthma severity. It is known that asthma symptoms tend to be more severe at night and that asthma-related deaths are most likely to occur during the night or early morning. Nocturnal symptoms occur in 60-74% of asthma patients and are markers of inadequate control of the disease. Various pathophysiological mechanisms are related to the worseni...

  7. Characterization of bladder sensory neurons in the context of myelination, receptors for pain modulators, and acute responses to bladder inflammation

    OpenAIRE

    Shelley L Forrest; Osborne, Peregrine B.; Keast, Janet R.

    2013-01-01

    Bladder sensation is mediated by lumbosacral dorsal root ganglion neurons and is essential for normal voiding and nociception. Numerous electrophysiological, structural and molecular changes occur in these neurons following inflammation. Defining which neurons undergo these changes is critical for understanding the mechanism underlying bladder pain and dysfunction. Our first aim was to define the chemical classes of bladder sensory neurons that express receptors for the endogenous modulators ...

  8. Effects of acute adult and early-in-life bladder inflammation on bladder neuropeptides in adult female rats

    Directory of Open Access Journals (Sweden)

    Ness Timothy J

    2011-08-01

    Full Text Available Abstract Background The purpose of the present study was to determine how acute adult and/or prior early-in life (EIL; P14-P16 exposure to bladder inflammation affects bladder content of calcitonin gene related peptide (CGRP and substance P (SP. Estrous cycle influences were also studied in the adult-treatment conditions. Methods In Experiment 1, intravesical zymosan or isoflurane anesthesia alone was administered to adult female rats. Bladders and serum were collected 24 hours later during each phase of the estrous cycle. In Experiment 2, zymosan or anesthesia alone was administered EIL and as adults, with bladder tissue collection 24 h later. Results In general, Experiment 1 showed that bladder content of both CGRP and SP was increased by inflammation. This effect was significant when data were collapsed across all phases of the estrous cycle, but was only significant during proestrus when individual comparisons were made during each phase of estrous. Also, adult bladder inflammation significantly reduced estradiol levels. In Experiment 2, bladder content of CGRP and SP was significantly increased in rats receiving EIL and/or adult inflammation. Bladder weights were also significantly increased by inflammation. Conclusions These data indicate that bladder CGRP and SP are maximally increased during the proestrus phase of the estrous cycle in inflamed adult female rats. EIL exposure to bladder inflammation alone can also produce an increase in CGRP and SP lasting into adulthood. Therefore, EIL experience with bladder inflammation may predispose an organism to experience a painful bladder disorder as an adult by increasing primary afferent content of CGRP and/or SP.

  9. Obstructive Sleep Apnea in MPS

    Directory of Open Access Journals (Sweden)

    Abhijit Ricky Pal MBBChir, MA, MD, FRCS(ORL-HNS

    2015-11-01

    Full Text Available The mucopolysaccharidoses (MPSs are a group of inherited, metabolic disorders characterized by progressive multisystem accumulation of partially degraded glycosaminoglycans. This manifests with multilevel airway obstruction, presenting with obstructive sleep apnea (OSA. We systematically reviewed the literature to determine the severity and prevalence of OSA in MPS based on polysomnography analysis. Fifteen studies with 294 participants met the inclusion criteria for review. The pretreatment prevalence of OSA in MPS was 81% with a mean apnea–hypopnea index (AHI of 10.4. Patients with MPS I are most significantly affected, with 75% suffering with moderate to severe OSA (mean AHI, 16.6. Enzyme replacement therapy (ERT results in an almost significant reduction in OSA in MPS I (P = .06, while adenotonsillar surgery significantly improves AHI (P = .002. Obstructive sleep apnea least affects MPS III. There is a lack of long-term post-ERT and hematopoietic stem cell transplant data relating to OSA outcomes in this population, with further prospective studies required to determine the ongoing response to treatment.

  10. Hypersensitive bladder: a solution to confused terminology and ignorance concerning interstitial cystitis.

    Science.gov (United States)

    Homma, Yukio

    2014-04-01

    Taxonomy or nomenclature concerning interstitial cystitis and its related symptom syndromes is in a state of confusion. After analyzing the reasons for confusion in regard to three components (disease name, symptoms, Hunner's lesion), I would like to propose a new term, "hypersensitive bladder", taking after overactive bladder, as a solution. Hypersensitive bladder symptoms are defined as "increased bladder sensation, usually associated with urinary frequency and nocturia, with or without bladder pain." The proposal of hypersensitive bladder is based on: (i) it does not appear a symptom syndrome, but a disease by ending with an organ name, "bladder"; (ii) it does not contain confusable symptom terms (pain and urgency), but indicates irritative symptoms including pain and urgency; and (iii) it suggests pathophysiological hyperactivity of sensory nerves. Interstitial cystitis is defined by three requirements: (i) hypersensitive bladder symptoms; (ii) bladder pathology; and (iii) no other diseases, where bladder pathology should be clearly stated either as Hunner's lesion or glomerulations after hydrodistention. Hypersensitive bladder can be used for the condition with hypersensitive bladder symptoms, but no obvious disease explaining hypersensitive bladder symptoms identified. Interstitial cystitis is a representative disease causing hypersensitive bladder symptoms, most typically with pain, but might be painless and indistinguishable from overactive bladder. Introducing hypersensitive bladder as a counter concept of overactive bladder into bladder dysfunction taxonomy will facilitate clinical practice and research progress, and attract considerable attention from the medical world. PMID:24807494

  11. Time-dependent bladder tissue regeneration using bilayer bladder acellular matrix graft-silk fibroin scaffolds in a rat bladder augmentation model.

    Science.gov (United States)

    Zhao, Yang; He, Yi; Zhou, Zhe; Guo, Jian-hua; Wu, Jia-sheng; Zhang, Ming; Li, Wei; Zhou, Juan; Xiao, Dong-dong; Wang, Zhong; Sun, Kang; Zhu, Ying-jian; Lu, Mu-jun

    2015-09-01

    With advances in tissue engineering, various synthetic and natural biomaterials have been widely used in tissue regeneration of the urinary bladder in rat models. However, reconstructive procedures remain insufficient due to the lack of appropriate scaffolding, which should provide a waterproof barrier function and support the needs of various cell types. To address these problems, we have developed a bilayer scaffold comprising a porous network (silk fibroin [SF]) and an underlying natural acellular matrix (bladder acellular matrix graft [BAMG]) and evaluated its feasibility and potential for bladder regeneration in a rat bladder augmentation model. Histological (hematoxylin and eosin and Masson's trichrome staining) and immunohistochemical analyses demonstrated that the bilayer BAMG-SF scaffold promoted smooth muscle, blood vessel, and nerve regeneration in a time-dependent manner. At 12weeks after implantation, bladders reconstructed with the BAMG-SF matrix displayed superior structural and functional properties without significant local tissue responses or systemic toxicity. These results demonstrated that the bilayer BAMG-SF scaffold may be a promising scaffold with good biocompatibility for bladder regeneration in the rat bladder augmentation model.

  12. Overactive bladder – 18 years – Part II

    Science.gov (United States)

    Truzzi, Jose Carlos; Gomes, Cristiano Mendes; Bezerra, Carlos A.; Plata, Ivan Mauricio; Campos, Jose; Garrido, Gustavo Luis; Almeida, Fernando G.; Averbeck, Marcio Augusto; Fornari, Alexandre; Salazar, Anibal; Dell’Oro, Arturo; Cintra, Caio; Sacomani, Carlos Alberto Ricetto; Tapia, Juan Pablo; Brambila, Eduardo; Longo, Emilio Miguel; Rocha, Flavio Trigo; Coutinho, Francisco; Favre, Gabriel; Garcia, José Antonio; Castaño, Juan; Reyes, Miguel; Leyton, Rodrigo Eugenio; Ferreira, Ruiter Silva; Duran, Sergio; López, Vanda; Reges, Ricardo

    2016-01-01

    ABSTRACT Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics – pillars of the overactive bladder pharmacotherapy – started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning – as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder – 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder. PMID:27176185

  13. Bladder exstrophy: An overview of the surgical management

    Directory of Open Access Journals (Sweden)

    Veereshwar Bhatnagar

    2011-01-01

    Full Text Available Background: The surgical management of urinary bladder exstrophy is challenging. This paper describes the personal experience in a tertiary care hospital over a period exceeding a quarter of a century. Methods: During the period 1984-2010, 248 patients of the epispadias-exstrophy complex have been treated. The cases of classical bladder exstrophy (n = 210 form the basis of this paper. The stages/procedures used in the surgical reconstruction of bladder exstrophy included bladder closure with anterior abdominal wall reconstruction, bladder neck repair, ureteric reimplantation, epispadias repair and augmentation colocystoplasty in various combinations. Some of these patients had their initial operations done prior to 1984 or in other hospitals. Evaluation methods included, amongst others, clinical evaluation and urodynamic assessment. Eight patients opted out of treatment; 15 patients underwent permanent urinary diversion by either ureterosigmoidostomy or colon conduit. The remaining 187 patients were treated with bladder reconstruction, and of these, 132 patients have had at least one attempt at bladder neck reconstruction with 56 of these patients having undergone an augmentation colocystoplasty. Results: A total of 105 patients had socially acceptable continence: 57 from the bladder neck reconstruction group and 48 from the bladder augmentation group. Further attempts at continence surgery have been offered to the inadequately continent patients. Conclusions: Surgical management of bladder exstrophy demands patience and perseverance. It is possible to provide all patients with socially acceptable continence with bladder neck division and catheterizable continent stoma as the last resort. Urodynamic assessment has emerged as an essential tool in the follow-up evaluation of these patients. Anticholinergic medication with imipramine or oxybutinin is a useful adjunct in the overall management.

  14. Asthma and chronic obstructive pulmonary disease overlap: asthmatic chronic obstructive pulmonary disease or chronic obstructive asthma?

    Science.gov (United States)

    Slats, Annelies; Taube, Christian

    2016-02-01

    Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another. However, especially in older patients (>55 years) it seems more difficult to differentiate between asthma and COPD. This has led to the definition of a new phenotype called asthma COPD overlap syndrome (ACOS). However, our understanding of ACOS is at a very preliminary stage, as most research has involved subjects with existing diagnoses of asthma or COPD from studies with different definitions for ACOS. This has led to different and sometimes opposing results between studies on several features of ACOS, also depending on the comparison with COPD alone, asthma alone or both, which are summarized in this review.We suggest not using the term ACOS for a patient with features of both asthma and COPD, but to describe a patient with chronic obstructive airway disease as completely as possible, with regard to characteristics that determine treatment response (e.g. eosinophilic inflammation) and prognosis (such as smoking status, exacerbation rate, fixed airflow limitation, hyperresponsiveness, comorbidities). This will provide a far more clinically relevant diagnosis, and would aid in research on treatment in more homogenous groups of patients with chronic airways obstruction. More research is certainly needed to develop more evidence-based definitions for this patient group and to evaluate biomarkers, which will help to further classify these patients, treat them more adequately and unravel the underlying pathophysiological mechanism. PMID:26596632

  15. Spirometry and Obstructive Lung Disease in Manitoba

    OpenAIRE

    NR Anthonisen; Dik, N; J Manfreda; LL Roos

    2001-01-01

    BACKGROUND: Spirometry, the measurement of forced expiratory volume in 1 s and forced vital capacity, is recommended in the diagnosis and management of the obstructive lung diseases asthma and chronic obstructive pulmonary disease (COPD). The present report describes spirometry use in Manitoba and tests the hypothesis that regional spirometry use correlates with the prevalence of physician-diagnosed obstructive lung diseases.METHODS: Spirometry is remunerated on a fee-for-service basis by Man...

  16. Quantitative Analysis of Differential Proteome Expression in Bladder Cancer vs. Normal Bladder Cells Using SILAC Method.

    Directory of Open Access Journals (Sweden)

    Ganglong Yang

    Full Text Available The best way to increase patient survival rate is to identify patients who are likely to progress to muscle-invasive or metastatic disease upfront and treat them more aggressively. The human cell lines HCV29 (normal bladder epithelia, KK47 (low grade nonmuscle invasive bladder cancer, NMIBC, and YTS1 (metastatic bladder cancer have been widely used in studies of molecular mechanisms and cell signaling during bladder cancer (BC progression. However, little attention has been paid to global quantitative proteome analysis of these three cell lines. We labeled HCV29, KK47, and YTS1 cells by the SILAC method using three stable isotopes each of arginine and lysine. Labeled proteins were analyzed by 2D ultrahigh-resolution liquid chromatography LTQ Orbitrap mass spectrometry. Among 3721 unique identified and annotated proteins in KK47 and YTS1 cells, 36 were significantly upregulated and 74 were significantly downregulated with >95% confidence. Differential expression of these proteins was confirmed by western blotting, quantitative RT-PCR, and cell staining with specific antibodies. Gene ontology (GO term and pathway analysis indicated that the differentially regulated proteins were involved in DNA replication and molecular transport, cell growth and proliferation, cellular movement, immune cell trafficking, and cell death and survival. These proteins and the advanced proteome techniques described here will be useful for further elucidation of molecular mechanisms in BC and other types of cancer.

  17. Neighborhood Characteristics Associated with the Availability of Alcohol Outlets in Quebec, Canada

    Science.gov (United States)

    Ngamini Ngui, André; Apparicio, Philippe; Philibert, Mathieu; Fleury, Marie-Josée

    2015-01-01

    Objectives. The objectives of this study were to examine the spatial accessibility to alcohol outlets in Quebec and to assess the association between neighborhood level characteristics and availability of alcohol outlets. Methods. The Tobit Model was used to assess the association between neighborhood level characteristics and the availability of alcohol outlets within 500, 1000, 2000, and 3000 metres, respectively. Results. Alcohol outlets were found to be most available in the two largest metropolitan areas of the province of Quebec (Montréal and Québec City). Within 1000 metres, alcohol outlets are more available in neighbourhoods with the following characteristics: highest concentration of men, least materially deprived highest concentration of persons aged 20 years or more, and location either in a metropolitan area or in a small town. Finally, the number of bars with video lottery terminals increases with the level of social and material deprivation. Conclusion. In Québec, there is no rule governing the location of alcohol outlets. Thus, there is an abundant literature indicating that the regulation of alcohol outlet density could be an effective means of controlling risk attributable to alcohol consumption. PMID:25810946

  18. Neighborhood Characteristics Associated with the Availability of Alcohol Outlets in Quebec, Canada

    Directory of Open Access Journals (Sweden)

    André Ngamini Ngui

    2015-01-01

    Full Text Available Objectives. The objectives of this study were to examine the spatial accessibility to alcohol outlets in Quebec and to assess the association between neighborhood level characteristics and availability of alcohol outlets. Methods. The Tobit Model was used to assess the association between neighborhood level characteristics and the availability of alcohol outlets within 500, 1000, 2000, and 3000 metres, respectively. Results. Alcohol outlets were found to be most available in the two largest metropolitan areas of the province of Quebec (Montréal and Québec City. Within 1000 metres, alcohol outlets are more available in neighbourhoods with the following characteristics: highest concentration of men, least materially deprived highest concentration of persons aged 20 years or more, and location either in a metropolitan area or in a small town. Finally, the number of bars with video lottery terminals increases with the level of social and material deprivation. Conclusion. In Québec, there is no rule governing the location of alcohol outlets. Thus, there is an abundant literature indicating that the regulation of alcohol outlet density could be an effective means of controlling risk attributable to alcohol consumption.

  19. Cystic lesions in abdomen: Prenatal and postnatal findings of ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Jong; Cho, Jeong Yeon; Lee, Young Ho; Han, Byoung Hee; Song, Mi Jin; Min, Jee Yeon; Lee, Soo Hyun; Kim, Jung Ah; Cho, Byung Jae [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2001-12-15

    Bladder outlet obstruction occurs secondary to a pathologic processes in the fetus and newborn. Although the overwhelming number of affected individuals are males, females also may demonstrate urethral obstruction. In males, posterior urethral valves are the most common cause. Sometimes, nonobstructive pathologies may suggest bladder outlet obstruction because vesicomegaly in observed. Cloacal dysgenesis has highly complicated embryologic origin simply stated, it is the result of failure of division of the primitive cloaca. There is convergence of the gastrointestinal and genitourinary tracts. There is usually a simple opening on the perineum, resulting in dilatation of genital and gastrointestinal tract.

  20. Cystic lesions in abdomen: Prenatal and postnatal findings of ultrasonography

    International Nuclear Information System (INIS)

    Bladder outlet obstruction occurs secondary to a pathologic processes in the fetus and newborn. Although the overwhelming number of affected individuals are males, females also may demonstrate urethral obstruction. In males, posterior urethral valves are the most common cause. Sometimes, nonobstructive pathologies may suggest bladder outlet obstruction because vesicomegaly in observed. Cloacal dysgenesis has highly complicated embryologic origin simply stated, it is the result of failure of division of the primitive cloaca. There is convergence of the gastrointestinal and genitourinary tracts. There is usually a simple opening on the perineum, resulting in dilatation of genital and gastrointestinal tract.

  1. Tuberculous biliary strictures: uncommon cause of obstructive jaundice

    International Nuclear Information System (INIS)

    Tuberculous biliary stricture is a very rare cause of obstructive jaundice. A case of a man who had had pulmonary tuberculosis 20 years ago is reported. He now presented with obstructive jaundice due to multiple strictures just below the confluence of the hepatic ducts and in the right hepatic duct. At surgery, these turned out to be tuberculous in origin. There was also tuberculous involvement of the gall bladder and cystic duct. The commonest differential diagnosis in such cases is cholangiocarcinoma (as in the present case). Imaging helps in defining the extent of bile duct obstruction. Suspicion of the disease and establishing a tissue diagnosis is very important in treating this potentially curable condition, especially with the worldwide resurgence of tuberculosis. Imaging modalities such as US and CT may be useful in demonstrating the dilated bile ducts. As there are no specific radiological features of tuberculous biliary strictures, the radiologist should search for any associated findings in abdominal imaging, especially focal hepatic lesions, abdominal lymphadenopathy and abdominal calcification. Tuberculous hepatic involvement can have miliary, nodular and solitary abscess forms. Solitary tuberculous abscesses may be readily detected by sectional imaging such as US, CT or MRI. Ultrasound appearances encountered include well-defined hypoechoic lesions, mixed hyper/hypoechoic masses or almost solid masses. On CT, tuberculous liver abscesses have been described as having a rosette appearance or being a hypodense mass. Magnetic resonance imaging of a tuberculous solitary mass has been described as hypointense on T1-weighted images and iso- or hypointense on T2-weighted images. However, none of these findings are specific or diagnostic of tuberculous origin and, therefore, the lesions have to be sampled percutaneously to arrive at the correct diagnosis. Abdominal lymphadenopathy (mainly periductal, hepatoduodenal ligament and at the porta hepatis) can be

  2. Availability of healthier options in traditional and nontraditional rural fast-food outlets

    Directory of Open Access Journals (Sweden)

    McIntosh Alex

    2008-11-01

    Full Text Available Abstract Background Food prepared away from home has become increasingly popular to U.S. families, and may contribute to obesity. Sales have been dominated by fast food outlets, where meals are purchased for dining away from home or in the home. Although national chain affiliated fast-food outlets are considered the main source for fast food, fast foods are increasingly available in convenience stores and supermarkets/grocery stores. In rural areas, these nontraditional fast-food outlets may provide most of the opportunities for procurement of fast foods. Methods Using all traditional and nontraditio nal fast-food outlets identified in six counties in rural Texas, the type and number of regular and healthiermenu options were surveyed using on-site observation in all food venues that were primarily fast food, supermarket/grocery store, and convenience store and compared with 2005 Dietary Guidelines. Results Traditional fast-food outlets represented 84 (41% of the 205 opportunities for procurement of fast food; 109 (53.2% were convenience stores and 12 (5.8% supermarkets/grocery stores. Although a s imilar variety of regular breakfast and lunch/dinner entrées were available in traditional fast-food outlets and convenience stores, the variety of healthier breakfast and lunch/dinner entrées was significantly greater in fast food outlets. Compared with convenience stores, supermarkets/grocery stores provided a greater variety of regular and healthier entrées and lunch/dinner side dishes. Conclusion Convenience stores and supermarkets/grocery stores more than double the potential access to fast foods in this rural area than traditional fast-food outlets alone; however, traditional fast food outlets offer greater opportunity for healthier fast food options than convenience stores. A complete picture of fast food environment and the availability of healthier fast food options are essential to understand environmental influences on diet and health

  3. Airflow obstruction in young adults in Canada

    DEFF Research Database (Denmark)

    Al-Hazmi, Manal; Wooldrage, Kate; Anthonisen, Nicholas R.;

    2007-01-01

    of airflow obstruction was elevated for subjects with past and current asthma, skin reactivity to allergens, elevated levels of total immunoglobulin E and bronchial hyper-responsiveness. Of the subjects with airflow obstruction, 21% were smokers with a history of asthma, 50% were smokers without asthma, 12......% were nonsmokers with asthma and 17% were nonsmokers with no history of asthma. Bronchial hyper-responsiveness increased the prevalence of airflow obstruction in each of these groups. CONCLUSION: Smoking and asthma, jointly and individually, are major determinants of obstructive disorders in young...

  4. P2X2 and P2X5 Receptors Mediate Bladder Hyperesthesia in ICC in Female Overactive Bladder.

    Science.gov (United States)

    Meng, Mingsen; Zheng, Ji; Yan, Junan; Li, Qianwei; Fang, Qiang; Li, Weibing

    2015-06-01

    This study was set to explore the role of P2X2 and P2X5 as the important molecules in sensory afferent of bladder in female overactive bladder (OAB) patients with the bladder hyperesthesia. Sixty-eight OAB patients admitted in Southwest Hospital affiliated to the Third Military Medical University during September, 2011-December, 2012 were selected and included in the experimental group (OAB group) and 30 healthy volunteers during the same period were included as the control group. We recorded voiding diary and urodynamic results, and immunohistochemistry analysis was used to detect P2X2 and P2X5 receptor in interstitial cell of Caja (ICC) in bladder tissue of female OAB patients and healthy volunteers, to tentatively explore the effect of P2X2 and P2X5 in bladder hyperesthesia. Urodynamic study has important diagnostic value in the diagnosis and differential diagnosis of OAB. P2X2 receptor was significantly up-regulated in bladder ICC in OAB group. The blockage of P2X2 receptor could significantly inhibit the contraction of bladder muscle strips, decrease the bladder pressure and the electric discharge of pelvic nerve. PET and urodynamic study showed that micturition desire sense in PAG area of pons in OAB patients was significantly increased compared with the control group. The up-regulation of P2X2 in ICC is an important factor to cause bladder hyperesthesia in OAB patients. PET and urodynamic study indicate that the bladder-originated nervous impulses are important cause of OAB. This study provides a basis for the study of P2X2 receptor in ICC in bladder hyperesthesia of OAB patients.

  5. Antibody conjugate radioimmunotherapy of superficial bladder cancer

    Directory of Open Access Journals (Sweden)

    Alan Perkins

    2002-09-01

    Full Text Available The administration of antibody conjugates for cancer therapy is now proving to be of clinical value. We are currently undertaking a programme of clinical studies using the monoclonal antibody C595 (IgG3 which reacts with the MUC1 glycoprotein antigen that is aberrantly expressed in a high proportion of bladder tumours. Radioimmunoconjugates of the C595 antibody have been produced with high radiolabelling efficiency and immunoreactivity using Tc-99m and In-111 for diagnostic imaging, and disease staging and the cytotoxic radionuclides Cu-67 and Re-188 for therapy of superficial bladder cancer. A Phase I/II therapeutic trail involving the intravesical administration of antibody directly into the bladder has now begun.A administração de anticorpos conjugados para o tratamento do câncer está agora provando ser de valor clínico. Nós estamos atualmente realizando um programa de estudos clínicos usando o anticorpo monoclonal C595 (IgG3 que reage com a glicoproteína MUC1 que está aberrantemente expressa numa alta proporção de tumores de bexiga. Tem sido produzidos radioimunoconjugados do anticorpo C595, com alta eficiência de radiomarcação e a imunoreatividade, usando-se o Tc-99m e In-111, para o diagnóstico por imagem e estagiamento de doenças. Tem sido produzidos, também, radionuclídeos citotóxicos (Cu-67 e Re-188 para o tratamento de cânceres superficiais de bexiga. A fase terapêutica I/II já se iniciou, envolvendo a administração intravesical do anticorpo diretamente na bexiga.

  6. Studies of experimental bladder tumors, 3

    International Nuclear Information System (INIS)

    Enzymatologic, histochemical and histologic investigations were performed on the effects of SLA, a β-glucoronidase inhibitor, and Linaic irradiation in an experimental BBN bladder tumor of rats. Bladder tumors were macroscopically thumb-head size in the cases with no treatment of with SLA application, but were shrunk by roentgen irradiation. The number of the rats with reduced tumor was respectively 3 in the group with roentgen irradiation. S-LDH activity of the cancer-carrying animals was markedly elevated as compared with that of the normal rat. SLA application caused no change in S-LDH activity of cancer-carrying animals, but roentgen irradiation resulted in a marked decrease in S-LDH activity of the similar animals with bladder tumors. The level of this decrease was dependent on the dosage of one time irradiation; no change was observed by 200, 300 and 500 rad, little decrease was seen by 750 rad, and marked decrease was observed after 1,000 and 1,500 rad radiation. Histological observation of the effects of irradiation could be summarized as follows. Histological changes were seen in the cases of macroscopic shrinkage by 3,000 rad irradiation. In this group, an individual variation was noticed not only macroscopically but microscopically. One time irradiation of 200, 300 and 500 rad resulted in no histological change, but that of 750, 1,000, and 1,500 rad caused a slight, but not marked, histological change. Tissue distribution of β-glucuronidase was examined by means of Naphthol-AS-BI-glucuronide method in the group without any treatment and the group with SLA administration. β-glucuronidase activity was noticed in the epithelial cells and interstitial stroma of the tumor tissue, but the effect of SLA on β-glucuronidase activity was not observed histochemically. (author)

  7. URINARY BLADDER CANCER WITH FOCUS ON OCCUPATIONAL DYE WORKERS

    Directory of Open Access Journals (Sweden)

    K.Revathi

    2015-11-01

    Full Text Available Benzidine based azo dyes are proven carcinogens, mutagens and have been linked to bladder cancer of human beings and laboratory animals. The textile and dyestuff manufacturing industry are the two major sources for releasing of azo dyes. Various research groups have started work on genotoxic effect of textile dyes in occupational workers of textile dye industry. Bladder cancer is the most common form of cancer in dye industries. Most of people between age 50 and 70 group of are diagnosed with bladder cancer. Men are more likely than the women to develop bladder cancer. Bladder cancer is a disease in which abnormal cells multiply without control in the bladder. The most common type of bladder cancer begins in cells lining the inside of the bladder and is called transitional cell carcinoma. Tumor markers are substances that can be found in the body when cancer is present. They are most often found in the blood or urine. The review deals about the impacts of the industry dyes on human health.

  8. Transitional Cell Carcinoma within a Portion of Inguinally Herniated Bladder

    Directory of Open Access Journals (Sweden)

    Matthew A. Uhlman

    2013-01-01

    Full Text Available Bladder herniation within the inguinal canal is a relatively uncommon finding. We report an even less-common occurrence of transitional cell carcinoma located within a portion of inguinally herniated bladder. Fewer than 20 reports exist in the literature describing this scenario.

  9. Morphology of the gas bladder in bumblebee catfishes (Siluriformes, Pseudopimelodidae).

    Science.gov (United States)

    Birindelli, José L O; Shibatta, Oscar A

    2011-07-01

    The gross morphology of the gas bladder is described and compared for representatives of all valid genera of Pseudopimelodidae (Siluriformes). Cephalosilurus albomarginatus and species of Batrochoglanis, and Microglanis have the most basic form: a large, cordiform gas bladder with a simple internal T-shaped septum. Cephalosilurus apurensis, C. fowleri, and C. nigricauda also have a large, cordiform gas bladder, but they have well-developed trabeculae associated with the internal T-shaped septum, and a pair of well-developed constrictor muscles inserted on the external wall; the latter feature is present in most species of Pimelodidae, but absent in all other catfishes. The monotypic Lophiosilurus alexandri also has well-developed constrictor muscles, and its gas bladder is moderately sized. The species of Pseudopimelodus and Cruciglanis have a diminutive gas bladder partially divided into two lateral sacs without internal communication, and lack constrictor muscles. The parapophysis of the fourth vertebra is a wide and long shelf connected to the dorsal surface of the gas bladder in most pseudopimelodid genera. However, in the species of Pseudopimelodus and Cruciglanis the parapophysis of the fourth vertebra is shorter and has its anterior ramus folded back, partially covering the gas bladder anteroventrally; and the tympanic opening is smaller than in species of the other genera. Five phylogenetic characters are proposed based on the morphology of the gas bladder and associated structures in species of Pseudopimelodidae, and the evolution of those characters in the family is discussed. J. Morphol., 2011. © 2011 Wiley-Liss, Inc. PMID:21538478

  10. Radical cystectomy for the treatment of T1 bladder cancer: the Canadian Bladder Cancer Network experience

    Science.gov (United States)

    Chalasani, Venu; Kassouf, Wassim; Chin, Joseph L.; Fradet, Yves; Aprikian, Armen G.; Fairey, Adrian S.; Estey, Eric; Lacombe, Louis; Rendon, Ricardo; Bell, David; Cagiannos, Ilias; Drachenberg, Darrell; Lattouf, Jean-Baptiste; Izawa, Jonathan I.

    2011-01-01

    Background: Radical cystectomy may provide optimal survival outcomes in the management of clinical T1 bladder cancer. We present our data from a large, multi-institutional, contemporary Canadian series of patients who underwent radical cystectomy for clinical T1 bladder cancer in a single-payer health care system. Methods: We collected a pooled database of 2287 patients who underwent radical cystectomy between 1993 and 2008 in 8 different centres across Canada; 306 of these patients had clinical T1 bladder cancer. Survival data were analyzed using Kaplan-Meier method and Cox regression analysis. Results: The median age of patients was 67 years with a mean follow-up time of 35 months. The 5-year overall, disease-specific and disease-free survival was 71%, 77% and 59%, respectively. The 10-year overall and disease-specific survival were 60% and 67%, respectively. Pathologic stage distribution was p0: 32 (11%), pT1: 78 (26%), pT2: 55 (19%), pT3: 60 (20%), pT4: 27 (9%), pTa: 16 (5%), pTis: 28 (10%), pN0: 215 (74%) and pN1-3: 78 (26%). Only 12% of patients were given adjuvant chemotherapy. On multivariate analysis, only margin status and pN stage were independently associated with overall, disease-specific and disease-free survival. Interpretation: These results indicate that clinical T1 bladder cancer may be significantly understaged. Identifying factors associated with understaged and/or disease destined to progress (despite any prior intravesical or repeat transurethral therapies prior to radical cystectomy) will be critical to improve survival outcomes without over-treating clinical T1 disease that can be successfully managed with bladder preservation strategies. PMID:21470529

  11. The main social media outlets used in business to business marketing : Case Study: Viexpo

    OpenAIRE

    Liuski, Emma

    2013-01-01

    This study was made in collaboration with a company called Viexpo, which operates in the field of internationalization. Also the author was employed at the firm. The aim of this thesis was to find out how B2B companies are utilizing social media marketing through the main social media outlets, such as Facebook and LinkedIn and how they are engaging their audience in these social media outlets. The results will help Viexpo perceive how these different social media outlets can be utilized in ma...

  12. The “School Foodshed”: schools and fast-food outlets in a London borough

    OpenAIRE

    Caraher, M.; S. Lloyd; Madelin, T.

    2014-01-01

    Purpose – The purpose of this paper is to explore the location of fast-food outlets around secondary schools and the influence of fast-food availability on the food choices of school children in an inner-London borough. Design/methodology/approach – A number of methods including: mapping of outlets relative to schools; sampling food; gathering data on secondary school food policies; observing food behaviour in fast food outlets and focus groups with young people. Findings were fed back t...

  13. IMMUNOHISTOCHEMICAL ANALYSIS OF UROTHELIAL BLADDER CANCERS

    Directory of Open Access Journals (Sweden)

    Katarina Bevizova

    2013-01-01

    Full Text Available Malignant cancers of urinary bladder are the second most common malignancy of the urinary tract and the fourth most common malignancy in general, especially in men. The aim of this study was a retrospective analysis of selected markers (p53, Ki-67 and E-cadherin of urinary bladder cancers from the Department of Urology in Bratislava, Slovak Republic between years 2007 and 2009. We analysed 244 patients (202 males, 42 females with diagnosed bladder cancer via cystoscopy and subsequent transurethral resection. Patients’ age varied from 36 to 98 years. Obtained samples were fixed by 10% buffered formalin for 24 to 48 h. Subsequently, they were dehydrated in ascending ethanol series and embedded in paraffin. The parafin sections of 5 µm were prepared by microtome and they were stained by haematoxylin and eosin. The antibodies against to p53, Ki-67 and E-cadherin were used in immunohistochemical analysis. Statistical evaluation was performed via SPSS using non-parametric Kruskal-Wallis test and p values<0.05 were considered statistically significant. No significant differences in the expression of selected markers were found between genders. Expression of p53 and Ki-67, in G1 and G2 of low grade tumours was lower in comparison to their expression in G3 tumors. Expression of E-cadherin was the opposite in this case. The expression of p53 and Ki-67 positively correlated with tumor’s depth of invasion, while the expression of E-cadherin significantly decreased. In case of T4 tumors, the expression of all markers exhibited consistently high values. When analysing tumor multiplicity, the expression of p53 and Ki-67 significantly decreased, while the expression of E-cadherin significantly increased. Based on the obtained results it can be concluded that the analysis of p53, Ki-67 and E-cadherin expression is essential for diagnostics and prognostics of bladder cancer and should be routinely used in daily practise together with

  14. Radical radiotherapy for urinary bladder cancer

    DEFF Research Database (Denmark)

    Fokdal, Lars; von der Maase, Hans; Høyer, Morten

    2006-01-01

    The exact value of radiotherapy in the treatment of muscle-invasive       bladder cancer is difficult to establish, as most studies exploring this       issue are retrospective with different procedures for selecting patients       for treatment, as well as varying treatment strategies. An estimate...... of the       5-year overall survival rate following radiotherapy is approximately 35%       in consecutive-selected patients and approximately 25% in       negative-selected patients...

  15. Placenta previa percreta with bladder invasion

    Directory of Open Access Journals (Sweden)

    Siniša Šijanović

    2011-02-01

    Full Text Available A 43- year old woman, with ten previous deliveries and history of two cesarean sections was admitted to our Department at 32 weeks of gestation with massive vaginal hemorrhage from an ultrasound diagnosed placenta previa. An emergency cesarean section with vertical abdominal incision was performed. A healthy 2300 g female infant was delivered. Attempts to manually remove the placenta caused massive hemorrhage. The lower uterine segment was widened due to placenta previa with suspicious placental invasion of the posterior wall of the bladder. Persistent hemorrhage demanded bilateral anterior internal iliac artery ligation and suture ligation of the bleeding vessels with supracervical hysterectomy done.

  16. Impact of proteomics on bladder cancer research

    DEFF Research Database (Denmark)

    Celis, Julio E; Gromova, Irina; Moreira, José Manuel Alfonso;

    2004-01-01

    Detecting bladder cancer at an early stage and predicting how a tumor will behave and act in response to therapy, as well as the identification of new targets for therapeutic intervention, are among the main areas of research that will benefit from the current explosion in the number of powerful...... technologies emerging within proteomics. The purpose of this article is to briefly review what has been achieved to date using proteomic technologies and to bring forward novel strategies - based on the analysis of clinically relevant samples - that promise to accelerate the translation of basic discoveries...

  17. 26 CFR 48.4071-3 - Imposition of tax on tires and tubes delivered to manufacturer's retail outlet.

    Science.gov (United States)

    2010-04-01

    ... to manufacturer's retail outlet. 48.4071-3 Section 48.4071-3 Internal Revenue INTERNAL REVENUE... § 48.4071-3 Imposition of tax on tires and tubes delivered to manufacturer's retail outlet. (a) General... a retail outlet of the manufacturer, the manufacturer is liable for tax in respect of the tire...

  18. Impact of remodeling and rehabilitation of irrigation outlets on water distribution of a canal in Punjab, Pakistan

    International Nuclear Information System (INIS)

    The study was undertaken to investigate water distribution along a distributary canal located in the southern part of the Punjab Province. It is a large size distributary having 353 cusecs of authorized discharge. This distributary was subjected to a series of problems including but not limited to (i) withdrawal of water by illegal means, (ii) design and construction flaws in the outlets, (iii) improper selection of the type of outlets and many others. The outlets were intentionally designed wrongly by using fictitious hydraulics data to provide undue benefits to the irrigators. During construction, setting of the outlets was also intentionally fixed at lower level than the designed. Investigations were carried out to evaluate hydraulic performance of all the outlets of the channel. Based on the observed data capacity statements of all the outlets were revised. The outlets were redesigned on the basis of actual hydraulic data of each outlet. Most of the non-modular outlets (Pipe and Scratchley) were converted to semi-modular outlets (OFRB and APM). With implementation of new and modified design of the outlets at the site, equity of water distribution has been improved. The results revealed that design of the outlets had a significant impact on equitable distribution of water along the distribution. (author)

  19. Severe Obstructive Sleep Apnea Due to Massive Cervical Lipohypertrophy.

    Science.gov (United States)

    Ugurlu, Alper Mete; Ersozlu, Tolga; Basat, Salih Onur; Ceran, Fatih

    2015-09-01

    Obstructive sleep apnea is a difficult problem to deal with. Many studies on the pathogenesis of obstructive sleep apnea were performed in the past, and we present cervical lipohypertrophy causing severe obstructive sleep apnea in this article.

  20. PIV measurement at the blowdown pipe outlet. [Particle Image Velocimetry

    Energy Technology Data Exchange (ETDEWEB)

    Puustinen, M.; Laine, J.; Raesaenen, A.; Pyy, L.; Telkkae, J. [Lappeenranta Univ. of Technology, Lappeenranta (Finland)

    2013-04-15

    This report summarizes the findings of the PIV measurement tests carried out in January - February 2013 with the scaled down PPOOLEX test facility at LUT. The main objective of the tests was to find out the operational limits of the PIV system regarding suitable test conditions and correct values of different adjustable PIV parameters. An additional objective was to gather CFD grade data for verification/validation of numerical models. Both water and steam injection tests were carried out. PIV measurements with cold water injection succeeded well. Raw images were of high quality, averaging over the whole measurement period could be done and flow fields close to the blowdown pipe outlet could be determined. In the warm water injection cases the obtained averaged velocity field images were harder to interpret, especially if the blowdown pipe was also filled with warm water in the beginning of the measurement period. The absolute values of the velocity vectors seemed to be smaller than in the cold water injection cases. With very small steam flow rates the steam/water interface was inside the blowdown pipe and quite stable in nature. The raw images were of good quality but due to some fluctuation in the velocity field averaging of the velocity images over the whole measured period couldn't be done. Condensation of steam in the vicinity of the pipe exit probably caused these fluctuations. A constant outflow was usually followed by a constant inflow towards the pipe exit. Vector field images corresponding to a certain phase of the test could be extracted and averaged but this would require a very careful analysis so that the images could be correctly categorized. With higher steam flow rates rapid condensation of large steam bubbles created small gas bubbles which were in front of the measurement area of the PIV system. They disturbed the measurements by reflecting laser light like seeding particles and therefore the raw images were of poor quality and they couldn

  1. Ultrasound Estimated Bladder Weight and Measurement of Bladder Wall Thickness-Useful Noninvasive Methods for Assessing the Lower Urinary Tract?

    NARCIS (Netherlands)

    E. Bright; M. Oelke; A. Tubaro; P. Abrams

    2010-01-01

    Purpose: In the last decade interest has arisen in the use of ultrasound derived measurements of bladder wall thickness, detrusor wall thickness and ultrasound estimated bladder weight as potential diagnostic tools for conditions known to induce detrusor hypertrophy. However, to date such measuremen

  2. Multidetector row computed tomography in bowel obstruction. Part 2. Large bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)]. E-mail: rakesh.sinha@uhl-tr.nhs.uk; Verma, R. [Department of Radiology, Glenfield Hospital, Leicester (United Kingdom)

    2005-10-01

    Large bowel obstruction may present as an emergency as high-grade colonic obstruction and can result in perforation. Perforated large bowel obstruction causes faecal peritonitis, which can result in high morbidity and mortality. Multidetector row computed tomography (MDCT) has the potential of providing an accurate diagnosis of large bowel obstruction. The rapid acquisition of images within one breath-hold reduces misregistration artefacts than can occur in critically ill or uncooperative patients. The following is a review of the various causes of large bowel obstruction with emphasis on important pathogenic factors, CT appearances and the use of multiplanar reformatted images in the diagnostic workup.

  3. Bladder Endometriosis Mimicking TCC - A Case Report.

    Science.gov (United States)

    Gupta, Asish; Bhatnagar, Atul; Seth, B N; Dang, Arbinder; Gupta, Vineeta

    2016-02-01

    Endometriosis is the ectopic presence of endometrial tissue outside the uterus. Though on its own endometriosis is not a rare lesion, the involvement of the urinary tract is rare but with the bladder being the most commonly affected organ. Endometriosis is usually seen in females between the ages of 30-40 years and may occur due to fluctuating levels of oestrogen and progesterone. Clinically the patient maybe asymptomatic or show symptoms of dysmenorrhea, irregular or heavy periods, pain in the pelvic area, lower abdomen or in the back. It has been suggested that ultrasonography should be done either before or during menstruation as the lesion becomes more evident and a biopsy taken during this period is a strong aid in reaching a final diagnosis. We report here an unusual case of bladder endometriosis where the patient came with severe pelvic pain and an endoluminal mass seen on the ultrasonographic report. Based on these findings a differential of transitional cell carcinoma was given which was ruled out based on the cystoscopic findings. PMID:27042525

  4. Granular cell tumors of the urinary bladder

    Directory of Open Access Journals (Sweden)

    Kayani Naila

    2007-03-01

    Full Text Available Abstract Background Granular cell tumors (GCTs are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies; they mostly follow a clinically benign course but are commonly mistaken for malignant tumors since they are solid looking, ulcerated tumors with ill-defined margins. Materials and methods We herein report two cases of GCTs, one benign and one malignant, presenting with gross hematuria in a 14- and a 47-year-old female, respectively. Results Histopathology revealed characteristic GCTs with positive immunostaining for neural marker (S-100 and negative immunostaining for epithelial (cytokeratin, Cam 5.2, AE/A13, neuroendocrine (neuron specific enolase, chromogranin A, and synaptophysin and sarcoma (desmin, vimentin markers. The benign tumor was successfully managed conservatively with transurethral resection alone while for the malignant tumor, radical cystectomy, hysterectomy with bilateral salpingo-oophorectomy, anterior vaginectomy, plus lymph node dissection was done. Both cases show long-term disease free survival. Conclusion We recommend careful pathologic assessment for establishing the appropriate diagnosis and either a conservative or aggressive surgical treatment for benign or localized malignant GCT of the urinary bladder, respectively.

  5. Bladder Endometriosis Mimicking TCC - A Case Report.

    Science.gov (United States)

    Gupta, Asish; Bhatnagar, Atul; Seth, B N; Dang, Arbinder; Gupta, Vineeta

    2016-02-01

    Endometriosis is the ectopic presence of endometrial tissue outside the uterus. Though on its own endometriosis is not a rare lesion, the involvement of the urinary tract is rare but with the bladder being the most commonly affected organ. Endometriosis is usually seen in females between the ages of 30-40 years and may occur due to fluctuating levels of oestrogen and progesterone. Clinically the patient maybe asymptomatic or show symptoms of dysmenorrhea, irregular or heavy periods, pain in the pelvic area, lower abdomen or in the back. It has been suggested that ultrasonography should be done either before or during menstruation as the lesion becomes more evident and a biopsy taken during this period is a strong aid in reaching a final diagnosis. We report here an unusual case of bladder endometriosis where the patient came with severe pelvic pain and an endoluminal mass seen on the ultrasonographic report. Based on these findings a differential of transitional cell carcinoma was given which was ruled out based on the cystoscopic findings.

  6. Creating Panoramic Images for Bladder Fluorescence Endoscopy

    Directory of Open Access Journals (Sweden)

    A. Behrens

    2008-01-01

    Full Text Available The medical diagnostic analysis and therapy of urinary bladder cancer based on endoscopes are state of the art in urological medicine. Due to the limited field of view of endoscopes, the physician can examine only a small part of the whole operating field at once. This constraint makes visual control and navigation difficult, especially in hollow organs. A panoramic image, covering a larger field of view, can overcome this difficulty. Directly motivated by a physician we developed an image mosaicing algorithm for endoscopic bladder fluorescence video sequences. In this paper, we present an approach which is capable of stitching single endoscopic video images to a combined panoramic image. Based on SIFT features we estimate a 2-D homography for each image pair, using an affine model and an iterative model-fitting algorithm. We then apply the stitching process and perform a mutual linear interpolation. Our panoramic image results show a correct stitching and lead to a better overview and understanding of the operation field. 

  7. Time-dependent effects of castration on the bladder function and histological changes in the bladder and blood vessels.

    Science.gov (United States)

    Magari, Tomohiro; Shibata, Yasuhiro; Arai, Seiji; Kashiwagi, Bunzo; Suzuki, Keiji; Suzuki, Kazuhiro

    2014-01-01

    We examined the effect of androgens on bladder blood flow (BBF), bladder function and histological changes in castrated male rats. Male Wistar rats were classified into unoperated group (control group), groups castrated at the age of 8 weeks (group 8wPC) and groups castrated at the age of 4 weeks (group 4wPC). Each rat was used at the age of 20 weeks. BBF was measured using fluorescent microspheres. Bladder cystometry was performed without anesthesia or restraint; the bladder was first irrigated with saline and then with 0.25% acetic acid (AA) solution. Maximum voiding pressure and voiding interval were measured. The bladder and iliac artery were histologically examined for differences in smooth muscle and quantity of collagen fiber to analyze the effect of castration on the smooth muscle content. No differences were noted in BBF following castration. The voiding intervals for all groups were shortened (P control group (Pcontrol group (Pblood vessels.

  8. Application of Bladder Acellular Matrix in Urinary Bladder Regeneration: The State of the Art and Future Directions

    Directory of Open Access Journals (Sweden)

    Marta Pokrywczynska

    2015-01-01

    Full Text Available Construction of the urinary bladder de novo using tissue engineering technologies is the “holy grail” of reconstructive urology. The search for the ideal biomaterial for urinary bladder reconstruction has been ongoing for decades. One of the most promising biomaterials for this purpose seems to be bladder acellular matrix (BAM. In this review we determine the most important factors, which may affect biological and physical properties of BAM and its regeneration potential in tissue engineered urinary bladder. We also point out the directions in modification of BAM, which include incorporation of exogenous growth factors into the BAM structure. Finally, we discuss the results of the urinary bladder regeneration with cell seeded BAM.

  9. Coolant mixing in LMFBR rod bundles and outlet plenum mixing transients. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Todreas, N.E.; Golay, M.W.; Wold, L.

    1981-02-01

    Four tasks are reported on: bundle geometry (wrapped and bare rods), subchannel geometry (bare rods), LMFBR outlet plenum flow mixing, and theoretical determination of local temperature fields in LMFBR fuel rod bundles. (DLC)

  10. 7 CFR 987.43 - Outlets and specifications for marketable dates.

    Science.gov (United States)

    2010-01-01

    ... MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE....12 to reflect new major outlets and regulatory requirements needed because of changes in marketing... processing, Export dates, and Product dates....

  11. Management of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available Obstructive Sleep Apnea (OSA is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP, Bilevel positive airway pressure (BiPAP and Oral Appliances (OA,pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP treatment reverses the repetitive upper airway obstruction of sleepapnea and associated daytime sleepiness and is the most effective treatment for OSA.However maintaining patient adherence to CPAP therapy is a challenge. Weight lossshould be recommended to overweight patients with OSA, as it has been shown thatweight reduction has additional health benefits. Treatment of underlying medicalconditions such as hypothyroidism or acromegaly has profound effect onapnea/hypopnea index. A subset of patients with OSA may benefit from supplementaloxygen and positional therapy. Presently, there are no effective pharmacotherapeuticagents for treatment of patients with OSA and the role of surgical treatment in OSA iscontroversial. However, pharmacological treatment of persisting residual sleepiness,despite adequate positive airway pressure therapy delivery and adherence, is indicatedand may improve daytime sleepiness.Key words : CPAP, Oral appliances, Modafinil, CPAP complianceUvulopalatopharyngoplasty, positional therapy

  12. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  13. 36 CFR 1004.13 - Obstructing traffic.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Obstructing traffic. 1004.13 Section 1004.13 Parks, Forests, and Public Property PRESIDIO TRUST VEHICLES AND TRAFFIC SAFETY § 1004.13 Obstructing traffic. The following are prohibited: (a) Stopping or parking a vehicle upon a Presidio...

  14. 36 CFR 4.13 - Obstructing traffic.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Obstructing traffic. 4.13... VEHICLES AND TRAFFIC SAFETY § 4.13 Obstructing traffic. The following are prohibited: (a) Stopping or... interfere with the normal flow of traffic....

  15. Obstructive sleep apnea in atrial fibrillation patients.

    Science.gov (United States)

    Arias, Miguel A; Alonso-Fernández, Alberto; García-Río, Francisco; Sánchez, Ana; López, Juana M; Pagola, Carlos

    2006-06-28

    A high prevalence of obstructive sleep apnea has been demonstrated in patients with atrial fibrillation. Our comments want to emphasize the importance of identifying and treating a large proportion of patients with atrial fibrillation who have undiagnosed obstructive sleep apnea as an additional preventive strategy for atrial fibrillation patients. PMID:16309764

  16. Whole-Pelvis or Bladder-Only Chemoradiation for Lymph Node–Negative Invasive Bladder Cancer: Single-Institution Experience

    International Nuclear Information System (INIS)

    Purpose: Whole-pelvis (WP) concurrent chemoradiation (CCRT) is the standard bladder preserving option for patients with invasive bladder cancer. The standard practice is to treat elective pelvic lymph nodes, so our aim was to evaluate whether bladder-only (BO) CCRT leads to results similar to those obtained by standard WP-CCRT. Methods and Materials: Patient eligibility included histopathologically proven muscle-invasive bladder cancer, lymph nodes negative (T2–T4, N−) by radiology, and maximal transurethral resection of bladder tumor with normal hematologic, renal, and liver functions. Between March 2005 and May 2006, 230 patients were accrued. Patients were randomly assigned to WP-CCRT (120 patients) and BO-CCRT (110 patients). Data regarding the toxicity profile, compliance, initial complete response rates at 3 months, and occurrence of locoregional or distant failure were recorded. Results: With a median follow-up time of 5 years (range, 3–6), WP-CCRT was associated with a 5-year disease-free survival of 47.1% compared with 46.9% in patients treated with BO-CCRT (p = 0.5). The bladder preservation rates were 58.9% and 57.1% in WP-CCRT and BO-CCRT, respectively (p = 0.8), and the 5-year overall survival rates were 52.9% for WP-CCRT and 51% for BO-CCRT (p = 0.8). Conclusion: BO-CCRT showed similar rates of bladder preservation, disease-free survival, and overall survival rates as those of WP-CCRT. Smaller field sizes including bladder with 2-cm margins can be used as bladder preservation protocol for patients with muscle-invasive lymph node–negative bladder cancer to minimize the side effects of CCRT.

  17. Optimized Design of Outlets Layout in Thermal Pressure Naturally Ventilated Rooms

    OpenAIRE

    Xuemin Sui; Jianping Ma; Yanling Guan

    2013-01-01

    Using thermal pressure ventilation principles to achieve passive ventilation in buildings is an important way to promote green and low consumption building strategy. The reasonable vents layout design can fully tap the potential of thermal pressure ventilation. Aimed to civil buildings with internal heating source, using Computational Fluid Dynamics (CFD) technology, the effects of outlets layout on thermal natural ventilation in rooms were studied. Three types of typical air outlets distribu...

  18. Alcohol outlets near schools in a midsize Romanian city : prevalence and characteristics

    OpenAIRE

    Hoof, van, P.A.M.; Reijlink, Lian M.J.; Dalen, van, J.A.

    2010-01-01

    Objective: alcohol availability is one of the strongest predictors of adolescent alcohol use, and subsequent harm. Alcohol outlets near schools are an important indicator of three types of availability related to adolescent alcohol use; physical (number), economic (price), and legal (compliance with age limits). Method: two teams with trained students (16 and 17 years old) visited all 37 schools in a 200,000 inhabitant Romanian city (Pitesti). On the spot all alcohol outlets were visited and ...

  19. Development of a solenoid actuated planar valveless micropump with single and multiple inlet–outlet arrangements

    Science.gov (United States)

    Kumar, N.; George, D.; Sajeesh, P.; Manivannan, P. V.; Sen, A. K.

    2016-07-01

    We report a planar solenoid actuated valveless micropump with multiple inlet–outlet configurations. The self-priming characteristics of the multiple inlet–multiple outlet micropump are studied. The filling dynamics of the micropump chamber during start-up and the effects of fluid viscosity, voltage and frequency on the dynamics are investigated. Numerical simulations for multiple inlet–multiple outlet micropumps are carried out using fluid structure algorithm. With DI water and at 5.0 Vp-p, 20 Hz frequency, the two inlet–two outlet micropump provides a maximum flow rate of 336 μl min‑1 and maximum back pressure of 441 Pa. Performance characteristics of the two inlet–two outlet micropump are studied for aqueous fluids of different viscosity. Transport of biological cell lines and diluted blood samples are demonstrated; the flow rate-frequency characteristics are studied. Viability of cells during pumping with multiple inlet multiple outlet configuration is also studied in this work, which shows 100% of cells are viable. Application of the proposed micropump for simultaneous pumping, mixing and distribution of fluids is demonstrated. The proposed integrated, standalone and portable micropump is suitable for drug delivery, lab-on-chip and micro-total-analysis applications.

  20. Influence of blade outlet angle on performance of low-specific-speed centrifugal pump

    Science.gov (United States)

    Cui, Baoling; Wang, Canfei; Zhu, Zuchao; Jin, Yingzi

    2013-04-01

    In order to analyze the influence of blade outlet angle on inner flow field and performance of low-specific-speed centrifugal pump, the flow field in the pump with different blade outlet angles 32.5° and 39° was numerically calculated. The external performance experiment was also carried out on the pump. Based on SIMPLEC algorithm, time-average N-S equation and the rectified k-ɛ turbulent model were adopted during the process of computation. The distributions of velocity and pressure in pumps with different blade outlet angles were obtained by calculation. The numerical results show that backflow areas exist in the two impellers, while the inner flow has a little improvement in the impeller with larger blade outlet angle. Blade outlet angle has a certain influence on the static pressure near the long-blade leading edge and tongue, but it has little influence on the distribution of static pressure in the passages of impeller. The experiment results show that the low-specific-speed centrifugal pump with larger blade outlet angle has better hydraulic performance.