Sample records for maximal urethral closure

  1. The urethral closure function in continent and stress urinary incontinent women assessed by urethral pressure reflectometry.

    Saaby, Marie-Louise


    Stress urinary incontinence (SUI) occurs when the bladder pressure exceeds the urethral pressure in connection with physical effort or exertion or when sneezing or coughing and depends both on the strength of the urethral closure function and the abdominal pressure to which it is subjected. The urethral closure function in continent women and the dysfunction causing SUI are not known in details. The currently accepted view is based on the concept of a sphincteric unit and a support system. Our incomplete knowledge relates to the complexity of the closure apparatus and to inadequate assessment methods which so far have not provided robust urodynamic diagnostic tools, severity measures, or parameters to assess outcome after intervention. Urethral Pressure Reflectometry (UPR) is a novel method that measures the urethral pressure and cross-sectional area (by use of sound waves) simultaneously. The technique involves insertion of only a small, light and flexible polyurethane bag in the urethra and therefore avoids the common artifacts encountered with conventional methods. The UPR parameters can be obtained at a specific site of the urethra, e.g. the high pressure zone, and during various circumstances, i.e. resting and squeezing. During the study period, we advanced the UPR technique to enable faster measurement (within 7 seconds by the continuous technique) which allowed assessment during increased intra-abdominal pressure induced by physical straining. We investigated the urethral closure function in continent and SUI women during resting and straining by the "fast" UPR technique. Thereby new promising urethral parameters were provided that allowed characterization of the closure function based on the permanent closure forces (primarily generated by the sphincteric unit, measured by the Po-rest) and the adjunctive closure forces (primarily generated by the support system, measured by the abdominal to urethral pressure impact ratio (APIR)). The new parameters enabled

  2. Urethritis

    ... Sensitivity to the chemicals used in spermicides or contraceptive jellies, or foams Sometimes the cause is unknown. Risks for urethritis include: Being a female Being male, ages 20 to 35 Having many sexual partners ...

  3. [Magnetic urethral closure device. Negative outcome after implantation for the treatment of female urinary incontinence].

    Anding, R; van Ahlen, H; Müller, S C; Latz, S


    We report on a negative outcome after implantation of a magnetic urethral closure device, consisting of one part screwed into the pubic bone and one part as a vaginal cone, for the treatment of urinary stress incontinence grade III. Continence was never achieved for the patient. The urethra narrowed over time due to erosion and scarring and the patient started intermittent catheterization, because spontaneous micturition was not possible. The magnet was broken, the bladder neck was eroded, several fragments were found in the bladder, and numerous fragments were scattered throughout the small pelvis. Surgery consisted of removing most of the fragments, followed by bladder neck closure and suprapubic diversion.

  4. Effect of fesoterodine on urethral closure function in women with stress urinary incontinence assessed by urethral pressure reflectometry

    Klarskov, Niels; Darekar, Amanda; Scholfield, David


    INTRODUCTION AND HYPOTHESIS: The aim was to evaluate, using urethral pressure reflectometry (UPR), the effect of fesoterodine on urethral function in women with stress urinary incontinence (SUI). METHODS: Women aged 18 to 65 years were eligible for this randomised, double-blind, placebo-controlle......INTRODUCTION AND HYPOTHESIS: The aim was to evaluate, using urethral pressure reflectometry (UPR), the effect of fesoterodine on urethral function in women with stress urinary incontinence (SUI). METHODS: Women aged 18 to 65 years were eligible for this randomised, double-blind, placebo......-controlled, crossover study if they had had clinically significant SUI or SUI-predominant mixed urinary incontinence for >3 months. Each participant received fesoterodine 4 mg, fesoterodine 8 mg, and placebo once daily for 7 days, with a 7- to 10-day washout between treatments. UPR was performed at baseline and 4 to 8...... significant differences were seen between fesoterodine 4 mg or fesoterodine 8 mg and placebo in opening urethral pressure (primary endpoint) or other UPR endpoints. No statistically significant differences were seen between either fesoterodine dose and placebo in the change from baseline in the bladder diary...

  5. Measurement of urethral closure function in women with stress urinary incontinence

    Klarskov, N; Scholfield, D; Soma, K;


    , double-blind, placebo controlled, crossover study 17 women with stress urinary incontinence or mixed urinary incontinence received 4 mg esreboxetine or placebo for 7 to 9 days followed by a washout period before crossing over treatments. Urethral pressure reflectometry and urethral pressure profilometry...... esreboxetine patients had significantly fewer incontinence episodes and reported a treatment benefit (global impression of change) compared to placebo. CONCLUSIONS: The opening pressure measured with urethral pressure reflectometry was less variable compared to the parameters measured with urethral pressure...

  6. Effect of fesoterodine on urethral closure function in women with stress urinary incontinence assessed by urethral pressure reflectometry.

    Klarskov, Niels; Darekar, Amanda; Scholfield, David; Whelan, Laurence; Lose, Gunnar


    The aim was to evaluate, using urethral pressure reflectometry (UPR), the effect of fesoterodine on urethral function in women with stress urinary incontinence (SUI). Women aged 18 to 65 years were eligible for this randomised, double-blind, placebo-controlled, crossover study if they had had clinically significant SUI or SUI-predominant mixed urinary incontinence for >3 months. Each participant received fesoterodine 4 mg, fesoterodine 8 mg, and placebo once daily for 7 days, with a 7- to 10-day washout between treatments. UPR was performed at baseline and 4 to 8 h after the last dose in each treatment period. Participants completed a 3-day bladder diary before randomisation and during the last 3 days of each treatment period. Of the 22 women randomly assigned and treated, 17 met the criteria for the primary efficacy analyses. No statistically significant differences were seen between fesoterodine 4 mg or fesoterodine 8 mg and placebo in opening urethral pressure (primary endpoint) or other UPR endpoints. No statistically significant differences were seen between either fesoterodine dose and placebo in the change from baseline in the bladder diary variables (total urinary incontinence, SUI, or urgency urinary incontinence episodes per 24 h). Adverse events were reported by 8 participants taking fesoterodine 4 mg, 17 taking fesoterodine 8 mg, and 8 taking placebo. Fesoterodine did not affect urethral pressure or significantly decrease the number of incontinence episodes in women with SUI. The UPR parameters showed no placebo effect, while there was a placebo effect of 60 % based on the bladder diary.

  7. The impact of tension-free vaginal tape on the urethral closure function

    Saaby, Marie-Louise; Klarskov, Niels; Lose, Gunnar


    AIM: To investigate if the tension-free vaginal tape (TVT) works by increasing the abdominal to urethral pressure impact ratio (APIR). METHODS: Twenty one women with urodynamically proven stress urinary incontinence (SUI) were assessed by ICIQ-SF, pad-weighing test, incontinence diary and Urethral...

  8. Pressure/cross-sectional area probe in the assessment of urethral closure function. Reproducibility of measurement

    Lose, G; Schroeder, T


    -pressure zone and distally in the urethra. The in vitro study showed that cross sectional areas of 13-79 mm2 were determined with a SD of 1.4 mm2. In vivo measurements revealed that the urethral parameters: elastance, hysteresis, pressure and power of contraction during coughing and squeezing were fairly...

  9. Correlação entre a pressão de perda à manobra de Valsalva e a pressão máxima de fechamento uretral com a história clínica em mulheres com incontinência urinária de esforço Correlation of Valsalva leak point pressure and maximal urethral closure pressure with clinical history in women with stress urinary incontinence

    Paulo Cezar Feldner Jr


    Full Text Available Objetivo: analisar a relação entre a pressão de perda com manobra de Valsalva e a pressão máxima de fechamento uretral com a queixa clínica em mulheres com incontinência urinária de esforço. Métodos: estudo retrospectivo no qual foram incluídas 164 pacientes com diagnóstico de incontinência urinária de esforço ou mista atendidas no setor de Uroginecologia e Cirurgia Vaginal do Departamento de Ginecologia da UNIFESP/EPM. As pacientes submeteram-se à anamnese padronizada, exame físico e estudo urodinâmico. A pressão de perda foi mensurada sob manobra de Valsalva (Valsalva leak point pressure - VLPP, com volume vesical de 200 mL. O perfil uretral foi realizado utilizando-se cateter de fluxo número 8, sendo medida a pressão máxima de fechamento uretral (PMFU. As pacientes foram agrupadas conforme a queixa clínica de perda urinária aos esforços e realizou-se análise estatística por meio do teste de chi² para verificar a proporção entre as variáveis. Utilizou-se, a seguir, a análise de variância (ANOVA para verificar diferenças entre VLPP e PMFU com relação à gravidade subjetiva da incontinência. Resultados: a média de idade foi de 51,2 anos (19-82, sendo que 79 encontravam-se no menacme (48,2% e 85 (51,8% na pós-menopausa. A paridade média foi de 4,0 filhos (0-18. Houve correlação entre o número de pacientes com VLPP inferior a 60 cmH2O e a queixa clínica (pPurpose: to analyze the correlation between Valsalva leak point pressure and maximum urethral closure pressure and clinical symptoms in women with stress urinary incontinence. Methods: we analyzed retrospectively 164 patients with urodynamic diagnosis of stress and mixed urinary incontinence established by the Urogynecology and Vaginal Surgery Sector of UNIFESP/EPM. All patients were submmited to medical interview, physical examination and urodynamic study. Patients were divided into groups according to the subjective degree of stress urinary

  10. Intraoperative maximal urethral closing pressure measurement: a new technique of tape tension adjustment in transobturator sling surgery?

    Myung Beum Kang


    Full Text Available PURPOSE: Tape tension adjustment is an essential procedure in mid-urethral sling surgery. The goal of this study was to determine if intraoperative maximal urethral closing pressure (MUCP elevation could be used as a reference value for adequate tape tension adjustment and predict transobturator (TOT sling surgery outcome. MATERIALS AND METHODS: A prospective study was performed using MUCP measurements just before tape insertion and just after tension adjustment during surgery. Clinical data including preoperative urodynamic results were collected. The cure rate was determined by questionnaire. Patients were divided into two groups. The MUCP elevation group included patients with a MUCP elevation of more than 10 cmH2O before tape insertion; the others were regarded as the non-elevation group. The cure rate and pre- and postoperative clinical variables were compared between the two groups. RESULTS: A total of 48 patients had TOT surgery. The MUCP elevation group (n=19 and the non-elevation group (n=29 were similar with regard to patient characteristics and the preoperative parameters including age, mixed incontinence prevalence, Q-tip angle, peak flow rate, MUCP and the valsalva leak point pressure (VLPP. The mean follow-up period was nine months. The cure rate was significantly higher in the group with MUCP elevation than in the non-elevation group (84% vs. 52%, p=0.02. There was no significant difference in the mean postoperative peak flow rate between the two groups and there was no retention episode. CONCLUSIONS: MUCP elevation of more than 10 cmH2O just after tape insertion was a prognostic factor.

  11. Urethral Disorders

    ... or injury. They include Urethral cancer - a rare cancer that happens more often in men Urethral stricture - a narrowing of the opening of the urethra Urethritis - inflammation of the urethra, sometimes caused by ...

  12. Study on acupuncture and moxibustion therapy for female urethral syndrome.

    Zheng, H; Wang, S; Shang, J; Chen, G; Huang, C; Hong, H; Chen, S


    Among 180 patients with female urethral syndrome, 128 were treated by acupuncture and moxibustion and 52 by western medicine as controls. The short-term effective rate in the acupuncture and moxibustion group was 90.6% and the long-term effective rate, 80.4%; whereas the short-term effective rate of the control group was 26.9% (P acupuncture and moxibustion treatment (P 0.05). Sixty-nine cases from the acupuncture and moxibustion group and 39 from the control group were subjected before and after treatment to determinations of the maximal bladder pressure, maximal abdominal pressure, bladder-neck pressure, and maximal urethral closure pressure during urination. All these indexes were decreased remarkably in the acupuncture and moxibustion group, while no changes were observed in the control group.

  13. Urethral stricture

    Urethral stricture may be caused by inflammation or scar tissue from surgery, disease, or injury. Rarely, it may be caused by pressure from a growing tumor near the urethra. Other factors that increase the risk for this condition include: Sexually transmitted ...

  14. Closure

    Stigter, C.J.


    At least an easier task than I have carried out the previous hour when we discussed the preliminary conclusions and recommendations has, as a compensation I guess, been given to me as well. To say a few words as a closure of this symposium. The beginning of such a series of closing statements is mos

  15. Stages of Urethral Cancer

    ... Cancer Treatment Urethral Cancer Treatment (PDQ®)–Patient Version General Information About Urethral Cancer Go to Health Professional ... In men, the urethra also carries semen . Enlarge Anatomy of the male urinary system (left panel) and ...

  16. Treatment Options for Urethral Cancer

    ... Treatment Health Professional Urethral Cancer Treatment Urethral Cancer Treatment (PDQ®)–Patient Version General Information About Urethral Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  17. A Giant Urethral Calculus.

    Sigdel, G; Agarwal, A; Keshaw, B W


    Urethral calculi are rare forms of urolithiasis. Majority of the calculi are migratory from urinary bladder or upper urinary tract. Primary urethral calculi usually occur in presence of urethral stricture or diverticulum. In this article we report a case of a giant posterior urethral calculus measuring 7x3x2 cm in a 47 years old male. Patient presented with acute retention of urine which was preceded by burning micturition and dribbling of urine for one week. The calculus was pushed in to the bladder through the cystoscope and was removed by suprapubic cystolithotomy.

  18. Blocked Urethral Valves

    ... Blocked Urethral Valves Health Issues Listen Español Text Size Email Print Share Blocked Urethral Valves Page Content Article Body Urine leaves the bladder through a tube called the urethra, which in boys passes through the penis. Rarely, small membranes form across the urethra in ...

  19. Female urethral diverticulum presenting with acute urinary retention: Reporting the largest diverticulum with review of literature

    Manas Ranjan Pradhan


    Full Text Available Female urethral diverticulum is a rare entity with diverse spectrum of clinical manifestations. It is a very rare cause of bladder outlet obstruction and should be considered as a differential diagnosis in females presenting with acute urinary retention associated with a vaginal mass. Strong clinical suspicion combined with thorough physical examination and focused radiological investigations are vital for its diagnosis. Herein we report a case of giant urethral diverticulum presenting with acute urinary retention in a young female. It was managed by excision and urethral closure, and is the largest urethral diverticulum reported till date in the literature.

  20. General Information about Urethral Cancer

    ... Cancer Treatment Urethral Cancer Treatment (PDQ®)–Patient Version General Information About Urethral Cancer Go to Health Professional ... In men, the urethra also carries semen . Enlarge Anatomy of the male urinary system (left panel) and ...

  1. Posterior Urethral Valves

    Steve J. Hodges


    Full Text Available The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy are the goals for the care of children with posterior urethral valves[1].

  2. Urethral instability: current pathophysiological concept.

    Groenendijk, P.M.; Heesakkers, J.P.F.A.; Ouwerkerk, T.J.; Lycklama à Nijeholt, A.A.B.


    The role of urethral pressure variations during filling cystometry is seldom assessed as a potential cause of voiding dysfunction and/or storage disorders. In this article, we review current research in the field of urethral pressure variations and discuss the way of determining urethral pressure va

  3. Urethral instability: current pathophysiological concept.

    Groenendijk, P.M.; Heesakkers, J.P.F.A.; Ouwerkerk, T.J.; Lycklama à Nijeholt, A.A.B.


    The role of urethral pressure variations during filling cystometry is seldom assessed as a potential cause of voiding dysfunction and/or storage disorders. In this article, we review current research in the field of urethral pressure variations and discuss the way of determining urethral pressure va

  4. Parameatal urethral cyst

    Aggarwal Kamal


    Full Text Available Cyst formation in the parameatal area of the urethra is an uncommon entity. It was first reported in two male cases as recently as 1956 by Thompson and Lantin. Further reports have been rare. Herein, we report a case of a 21 year-old male having a spherical, cystic swelling 1 cm in size at the external urethral meatus. The diagnosis of parameatal urethral cyst was made and the cyst was excised. Histopathological examination revealed a monolocular cyst lined with transitional cells. The postoperative period was uneventful.

  5. Treatments of the posterior urethral injury by simplified urethral realignment


    Objective To discuss a simple, safe and effective management for the the posterior urethral injury after pelvic fracture.Methods: The patients were treated by the simplified urethral realignment with traction; in the operation, the two -way catheter with an inner metal frame was implanted by the guidance of forefinger. After the operation, urethral dilation was processed regularly. Results 41 cases have been followed up and 36 cases can midurate normally, so the curative rate was 87. 8%. ln those, impotence occurred 3 cases. Conclusions The proper application of the urethral realignment with tradion followed by regular urethral dilation has an effecf on the patients of the the posterior urethral injury in pelvic fracture.

  6. Anterior Urethral Valves

    Vidyadhar P. Mali


    Full Text Available We studied the clinical presentation and management of four patients with anterior urethral valves; a rare cause of urethral obstruction in male children. One patient presented antenatally with oligohydramnios, bilateral hydronephrosis and bladder thickening suggestive of an infravesical obstruction. Two other patients presented postnatally at 1 and 2 years of age, respectively, with poor stream of urine since birth. The fourth patient presented at 9 years with frequency and dysuria. Diagnosis was established on either micturating cystourethrogram (MCU (in 2 or on cystoscopy (in 2. All patients had cystoscopic ablation of the valves. One patient developed a postablation stricture that was resected with an end-to-end urethroplasty. He had an associated bilateral vesicoureteric junction (VUJ obstruction for which a bilateral ureteric reimplantation was done at the same time. On long-term follow-up, all patients demonstrated a good stream of urine. The renal function is normal. Patients are continent and free of urinary infections. Anterior urethral valves are rare obstructive lesions in male children. The degree of obstruction is variable, and so they may present with mild micturition difficulty or severe obstruction with hydroureteronephrosis and renal impairment. Hence, it is important to evaluate the anterior urethra in any male child with suspected infravesical obstruction. The diagnosis is established by MCU or cystoscopy and the treatment is always surgical, either a transurethral ablation or an open resection. The long-term prognosis is good.

  7. EAU Guidelines on Urethral Trauma.

    Martínez-Piñeiro, Luis; Djakovic, Nenad; Plas, Eugen; Mor, Yoram; Santucci, Richard A; Serafetinidis, Efraim; Turkeri, Levent N; Hohenfellner, Markus


    These guidelines were prepared on behalf of the European Association of Urology (EAU) to assist urologists in the management of traumatic urethral injuries. To determine the optimal evaluation and management of urethral injuries by review of the world's literature on the subject. A working group of experts on Urological Trauma was convened to review and summarize the literature concerning the diagnosis and treatment of genitourinary trauma, including urethral trauma. The Urological Trauma guidelines have been based on a review of the literature identified using on-line searches of MEDLINE and other source documents published before 2009. A critical assessment of the findings was made, not involving a formal appraisal of the data. There were few high-powered, randomized, controlled trials in this area and considerable available data was provided by retrospective studies. The Working Group recognizes this limitation. The full text of these guidelines is available through the EAU Central Office and the EAU website ( This article comprises the abridged version of a section of the Urological Trauma guidelines. Updated and critically reviewed Guidelines on Urethral Trauma are presented. The aim of these guidelines is to provide support to the practicing urologist since urethral injuries carry substantial morbidity. The diversity of urethral injuries, associated injuries, the timing and availability of treatment options as well as their relative rarity contribute to the controversies in the management of urethral trauma. Copyright © 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  8. A Method for Recording Urethral Pressure Profiles in Female Rats.

    Shengfei Xu

    Full Text Available Urethral pressure profile (UPP and leak-point pressure (LPP measurements as well as external urethral sphincter (EUS electromyography (EMG and videourodynamic analyses are the primary methods for evaluating urethral function in humans. However, UPP recording in female rats, a widely used animal model, is challenging due to their small body sizes. This study reports a novel method for recording UPP in female rats.Seventeen anesthetized female rats were studied. LPP data for 14 rats were included. The other 3 rats were excluded because of death or abnormal urogenital organs. UPP curves were recorded using a modified water-perfusion catheter system, with the lateral hole facing the 3-, 6-, 9-, and 12-o'clock positions in a randomized sequence. LPP, functional urethral length (FUL and maximum urethral closure pressure (MUCP were analyzed.The mean LPP was 64.39 ± 20.29 cm H2O. The mean FUL and MUCP values at the 3-, 6-, 9-, and 12-o'clock positions were 12.90 ± 1.20, 16.70 ± 1.95, 13.90 ± 2.42, and 11.60 ± 0.97 mm, respectively, and 38.70 ± 11.85, 33.90 ± 11.82, 37.40 ± 11.95, and 71.90 ± 23.01 cm H2O, respectively. The FUL at the 6-o'clock position and MUCP at the 12-o'clock position were significantly greater than those at the other 3 positions. The FUL and MUCP of repeated UPP recordings were not significantly different than those of the first recordings.UPP recording using a modified method based on a water-perfusion catheter system is feasible and replicable in female rats. It produces UPP curves that sensitively and appreciably reflect detailed pressure changes at different points within the urethra and thus provides opportunity to evaluate urethral structures, especially the urethral sphincter, in detail. These results may enhance the utility of female rat models in research of urinary sphincter mechanisms.

  9. Long-term urethral catheterisation.

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  10. Urethral function after cystectomy: a canine in vivo experiment.

    Hübner, W A; Trigo-Rocha, F; Plas, E G; Tanagho, E A


    To study the function of the pelvic floor and the isolated urethra after removal of the bladder, 5 male and 5 female mongrel dogs were used in an acute in vivo experiment. Urethral pressure changes secondary to unilateral stimulation of the pelvic and pudendal nerves were recorded. After baseline data of the intact system were documented, the following procedures were carried out: separation of the urethra from the bladder neck (prostate), nerve-sparing cystectomy (cystoprostatectomy), and cold-knife incision through the entire length of the proximal urethra. Pressure recordings were repeated after each step of surgery. Pudendal nerve stimulation resulted in rapid and large pressure rises in the distal urethra (reaction typical of striated muscle). This response remained unchanged after all three surgical steps. Pelvic nerve stimulation provoked pressure rises within the urethra of a pattern typical of smooth muscle. The findings persisted after separation of the urethra from the bladder neck (prostate) and after cystectomy, but were not observed after urethrotomy. Contractions secondary to pudendal nerve stimulation were inhibited by curare, which did not affect the reaction to pelvic nerve stimulation. Our experiments demonstrate that in the dog the continuity of bladder and urethra is not required for the function of urethral closure mechanisms. The contractile potency of the urethral smooth muscles remains intact after nerve-sparing cystectomy. We believe that problems with the baseline continence of surrogate bladders should mainly be ascribed to a lack of surgical caution in preserving the autonomic nerves of cystectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Indwelling urethral catheters in adults

    Calleja, Edward


    This article focuses on indwelling urethral catheters in adults, their indications for the short and long term use, the types of urinary catheters available in Malta, an overview of the basic structure of a catheter, and the complications of urinary catheter insertion and maintenance. An attempt has been made to address in some depth the most common complication of indwelling catheters – catheter associated urinary tract infection in terms of pathophysiology and its management. Simple but cru...

  12. Urethral sensitivity in incontinent women.

    Kinn, A-C; Nilsson, B Y


    The aim of this study was to ascertain whether frequent voiding and urge incontinence are associated with supersensitivity to electrical stimulation in the posterior urethra. Current perception thresholds (CPT) were tested at four stimulus frequencies (1, 3, 20, and 100 Hz; duration 0.5 ms) using a square-wave constant current electrical stimulator connected to ring electrodes on a urethral catheter. The strength of the current at the first tingling sensation was regarded as the CPT. CPT analysis and cystometry were performed on 61 women (ages 28-89 years). CPTs were significantly higher at lower than at elevated stimulus frequencies, and they were also generally higher in old than in younger patients. Seven women repeated the CPT test after two months, and the thresholds were unchanged. There were no significant differences in sensitivity between patient groups with stress incontinence, urge, or mixed symptoms. Moreover, CPT was not significantly related to bladder volume at first sensation of filling. Measuring CPT is an easy and reproducible method of testing urethral sensibility, but our results do not support the suspicion that urethral hypersensitivity is involved in increased voiding frequency and urge incontinence.

  13. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

    Kun-Woon Yoo


    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However,aesthetic and functional complications occur frequently at the donor site. The use of asuperficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages.Here, we report our case with a review of literature. A 69-year-old man visited our hospitalwith multiple contusions of the abdomen and genital amputation. After necrotic tissuedebridement, the length of the residual corpus carvernosum was 1.5 cm and that of thecorpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap andanterolateral thigh free flap was performed. The primary closure was performed at the donorsite. Three weeks postoperatively, the patient had a urethral foley catheter removed. Theneourethra was functioning well without stricture. Four months postoperatively, the patienthad no complications such as urethral stricture. A good recovery was also achieved withno aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction.Because of its proximity to the recipient sites, it makes surgical preparation easier and theprimary closure at the donor site available. It is also advantageous in that its location isalmost unnoticeable.

  14. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

    Kun-Woon Yoo


    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However, aesthetic and functional complications occur frequently at the donor site. The use of a superficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages. Here, we report our case with a review of literature. A 69-year-old man visited our hospital with multiple contusions of the abdomen and genital amputation. After necrotic tissue debridement, the length of the residual corpus carvernosum was 1.5 cm and that of the corpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap and anterolateral thigh free flap was performed. The primary closure was performed at the donor site. Three weeks postoperatively, the patient had a urethral foley catheter removed. The neourethra was functioning well without stricture. Four months postoperatively, the patient had no complications such as urethral stricture. A good recovery was also achieved with no aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction. Because of its proximity to the recipient sites, it makes surgical preparation easier and the primary closure at the donor site available. It is also advantageous in that its location is almost unnoticeable.

  15. The urethral closure function in continent and stress urinary incontinent women assessed by urethral pressure reflectometry

    Saaby, Marie-Louise


    . The technique involves insertion of only a small, light and flexible polyurethane bag in the urethra and therefore avoids the common artifacts encountered with conventional methods. The UPR parameters can be obtained at a specific site of the urethra, e.g. the high pressure zone, and during various...

  16. Anterior urethral diverticulum: A rare presentation

    Annavarupu Gopalkrishna


    Full Text Available Congenital anomalies of the urogenital tract are the most common anomalies found in the foetus, neonates and infants, but anterior urethral valves and diverticula are rare. Here, we present a case with congenital anterior urethral diverticulum associated with patent ductus arteriosus and polydactyly.

  17. Podophyllin induced urethral stricture in a young Nigerian male

    P.O. Areo


    Full Text Available Urethral stricture is an abnormal narrowing or loss of distensibility due to fibrosis in the peri-urethral tissues. Some substances can induce chemical urethritis severe enough to cause stricture. We present a case of long segment anterior urethral stricture in a young Nigerian patient cause by self-application of podophyllin for the treatment of genital warts.

  18. Urethral dysfunction in female mice with estrogen receptor β deficiency.

    Yung-Hsiang Chen

    Full Text Available Estrogen has various regulatory functions in the growth, development, and differentiation of the female urogenital system. This study investigated the roles of ERβ in stress urinary incontinence (SUI. Wild-type (ERβ(+/+ and knockout (ERβ(-/- female mice were generated (aged 6-8 weeks, n = 6 and urethral function and protein expression were measured. Leak point pressures (LPP and maximum urethral closure pressure (MUCP were assessed in mice under urethane anesthesia. After the measurements, the urethras were removed for proteomic analysis using label-free quantitative proteomics by nano-liquid chromatography-mass spectrometry (LC-MS/MS analysis. The interaction between these proteins was further analysed using MetaCore. Lastly, Western blot was used to confirm the candidate proteins. Compared with the ERβ(+/+ group, the LPP and MUCP values of the ERβ(-/- group were significantly decreased. Additionally, we identified 85 differentially expressed proteins in the urethra of ERβ(-/- female mice; 57 proteins were up-regulated and 28 were down-regulated. The majority of the ERβ knockout-modified proteins were involved in cell-matrix adhesion, metabolism, immune response, signal transduction, nuclear receptor translational regelation, and muscle contraction and development. Western blot confirmed the up-regulation of myosin and collagen in urethra. By contrast, elastin was down-regulated in the ERβ(-/- mice. This study is the first study to estimate protein expression changes in urethras from ERβ(-/- female mice. These changes could be related to the molecular mechanism of ERβ in SUI.

  19. Urethritis

    ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ...

  20. Urethral syndrome” in women

    Sławomir Dutkiewicz


    Full Text Available A contemporary overview of knowledge is presented on the subject of the so-called urethral syndrome in women, the causes of which have yet to be clearly identified. For practical reasons, the following three forms of the syndrome have been distinguished: interstitial cystitis, the “infectious” form and the “clean” form. In women who do not show symptoms of inflammation of the reproductive organs, bacterial urethritis should be distinguished from the urethral syndrome by evaluating the symptoms, the bacteriological tests and the risk of infection.

  1. Current management of urethral stricture disease

    Thomas G Smith


    Conclusions: Progress is being made toward consistent terminology, and nomenclature which will, in turn, help to standardize treatment within the field of urology. Treatment for urethral stricture and stenosis remains inconsistent between reconstructive and nonreconstructive urologists due to varying treatment algorithms and approaches to disease management. Tissue engineering appears to be future for reconstructive urethral surgery with reports demonstrating feasibility in the use of different tissue substitutes and grafts.

  2. Ultrasonic fragmentation in the treatment of male urethral calculi.

    Durazi, M H; Samiei, M R


    In the last 8 months, 7 patients have presented with acute retention of urine due to impacted urethral stones. Four stones were in the posterior urethra, 2 in the penile urethra and 1 proximal to the external urethral meatus. The patients were managed as emergencies. Stone fragmentation by ultrasound (US) through a 24F obliquely offset eyepiece nephroscope was achieved with minimal urethral trauma. Follow-up was for 6 months and no evidence of urethral stricture or recurrent stones was found. It was concluded that US fragmentation of urethral calculi is a safe and efficient procedure with minimal complications when used in the management of impacted urethral stones.

  3. Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes.

    Sangkum, P; Levy, J; Yafi, F A; Hellstrom, W J G


    Urethral stricture disease, pelvic fracture urethral injury (PFUI), and their various treatment options are associated with erectile dysfunction (ED). The etiology of urethral stricture disease is multifactorial and includes trauma, inflammatory, and iatrogenic causes. Posterior urethral injuries are commonly associated with pelvic fractures. There is a spectrum in the severity of both conditions and this directly impacts the treatment options offered by the surgeon. Many published studies focus on the treatment outcomes and the relatively high recurrence rates after surgical repair. This communication reviews the current knowledge of the association between ED and urethral stricture disease, as well as PFUI. The incidence, pathophysiology, and clinical ramifications of both conditions on sexual function are discussed. The treatment options for ED in those patients are reviewed and summarized. © 2015 American Society of Andrology and European Academy of Andrology.

  4. Urethralism concomitant with amphetamine abuse

    Bang-Ping Jiann


    Full Text Available Urethralism is a paraphilia disorder in which a person exhibits the habitual self-insertion of a foreign body into the urethra to achieve sexual gratification. We report a patient who habitually inserted a foreign body into his urethra and abused amphetamines to cope with stress. A 48-year-old man presented at the emergency room because of urine leakage from the penile base. Prior to this incident, he had been admitted to hospital 10 times from 2000 to 2005 for the removal of foreign bodies from the lower urinary tract. The patient also reported repeatedly inhaling a high dose of amphetamine to reach a “high” status prior to inserting a foreign body into his urethra. After the successful removal of the foreign bodies, the patient was referred to a psychiatrist for management in coping with stress and illicit drug withdrawal. Psychiatric support and treatment appeared to have a beneficial effect on his sexual behavior. In the management of a case involving recurrent insertion of a foreign body into the lower urinary tract, clinicians should enquire about a history of drug abuse and consult the psychiatry department regarding stress management and drug abstinence.

  5. Localized urethral cancer in women

    Mayer, R.; Fowler, J.E. Jr.; Clayton, M.


    The results of treatments for localized carcinoma of the urethra were assessed in 21 consecutive women treated at our institutions over a twenty year period. Only one of the tumors was confined to the distal urethra. Eighty-six percent invaded the periurethral tissues and 24% were known to be associated with regional lymph node metastases. Fifty-seven percent were adenocarcinomas. Five patients refused active therapeutic intervention and expired within one to 30 months following diagnosis. Sixteen patients were treated with extirpative surgery, radiation therapy, or combinations of the two. Four are free of disease at one, four, eleven, and 15 years after treatment. Nine developed pelvic recurrences, two developed pelvic recurrences and distant metastases and one developed distant metastases only from six to 72 months (mean, 19 months) after initial treatment. Eight of these 12 patients died at two to 13 months (mean, 8 months) after secondary treatment, two are alive with residual pelvic tumor, and two are clinically free of disease at 7 and 48 months. Only six patients were known to have distant metastases at the time of death and five of these six had adenocarcinomas. Advanced localized urethral cancer in women is difficult to eradicate and usually fatal.

  6. Urethral Cancer Treatment (PDQ®)—Patient Version

    Urethral cancer occurs in men and women and can spread quickly to lymph nodes near the urethra. Find out about risk factors, symptoms, tests to diagnose, prognosis, staging, and treatment for urethral cancer.

  7. The promise of urethral pressure reflectometry

    Khayyami, Yasmine; Klarskov, Niels; Lose, Gunnar


    pressure reflectometry (UPR), a method that measures pressure and the corresponding cross-sectional area along the entire length of the urethra continuously by means of acoustic reflectometry, have been performed. The studies have mainly been performed on patients with stress urinary incontinence (SUI......). METHODS: Our aim was to provide an overview of the studies conducted with UPR, establishing whether the method may be used in clinical practice. We reviewed all literature published on UPR. RESULTS: Urethral pressure reflectometry is easily performed with limited bother for the patient. The catheter...... measuring urethral pressure. UPR can discriminate patients with SUI from continent women and separate assessment of the sphincter function and support system is possible. Also, UPR has revealed statistically significant differences in urethral pressures after drug therapy for SUI. CONCLUSIONS: We conclude...

  8. 21 CFR 876.4590 - Interlocking urethral sound.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Interlocking urethral sound. 876.4590 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4590 Interlocking urethral sound. (a) Identification. An interlocking urethral sound is a device that consists of two metal sounds...

  9. Contemporary Management of Primary Distal Urethral Cancer.

    Traboulsi, Samer L; Witjes, Johannes Alfred; Kassouf, Wassim


    Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation therapy in women. There are no clear-cut indications for the choice of the most appropriate treatment modality. Organ-preserving modalities have shown effective and should be used whenever they do not compromise the oncological safety to decrease the physical and psychological trauma of dismemberment or loss of sexual/urinary function. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

    Katarzyna; Jadwiga; Macura; Richard; Eugene; Thompson; David; Alan; Bluemke; Rene; Genadry


    AIM: To define the magnetic resonance imaging(MRI) parameters differentiating urethral hypermobility(UH) and intrinsic sphincter deficiency(ISD) in women with stress urinary incontinence(SUI).METHODS: The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic(UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the highresolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI. For the functional imaging of the urethral support, we performed dynamic MRI with the pelvic phased array coil. We assessed the following MRI parameters in both the patient and thevolunteer groups:(1) urethral angle;(2) bladder neck descent;(3) status of the periurethral ligaments,(4) vaginal shape;(5) urethral sphincter integrity, length and muscle thickness at mid urethra;(6) bladder neck funneling;(7) status of the puborectalis muscle;(8) pubo-vaginal distance. UDs parameters were assessed in the patient study group as follows:(1) urethral mobility angle on Q-tip test;(2) Valsalva leak point pressure(VLPP) measured at 250 cc bladder volume; and(3) maximum urethral closure pressure(MUCP). The UH type of SUI was defined with the Q-tip test angle over 30 degrees, and VLPP pressure over 60 cm H2 O. The ISD incontinence was defined with MUCP pressure below 20 cm H2 O, and VLPP pressure less or equal to 60 cm H2 O. We considered the associations between the MRI and clinical data and UDs using a variety of statistical tools to include linear regression, multivariate logistic regression and receiver operating characteristic(ROC) analysis. All statistical analyses were performed using STATA version 9.0(Stata Corp LP, College Station, TX).RESULTS: In the incontinent group, 52% have history of vaginal delivery trauma as compared to none in control group(P < 0.001). There was no difference between the continent volunteers and incontinent

  11. Deferred endoscopic urethral realignment: Role in management of traumatic posterior urethral disruption

    M.A. Elgammal


    Conclusion: When early realignment is postponed for any reason, deferred endoscopic realignment is considered an adequate substitute because urethral continuity can be achieved in a group of patients without increase incidence of impotence and incontinence.

  12. Maximal trees

    Brendle, Joerg


    We show that, consistently, there can be maximal subtrees of P (omega) and P (omega) / fin of arbitrary regular uncountable size below the size of the continuum. We also show that there are no maximal subtrees of P (omega) / fin with countable levels. Our results answer several questions of Campero, Cancino, Hrusak, and Miranda.

  13. Advances in the Understanding and Treatment of Male Urethritis.

    Bachmann, Laura H; Manhart, Lisa E; Martin, David H; Seña, Arlene C; Dimitrakoff, Jordan; Jensen, Jørgen Skov; Gaydos, Charlotte A


    Neisseria gonorrhoeae and Chlamydia trachomatis are well-documented urethral pathogens, and the literature supporting Mycoplasma genitalium as an etiology of urethritis is growing. Trichomonas vaginalis and viral pathogens (herpes simplex virus types 1 and 2 and adenovirus) can cause urethritis, particularly in specific subpopulations. New data are emerging regarding the potential role of bacterial vaginosis-associated bacteria in urethritis, although results are inconsistent regarding the pathogenic role of Ureaplasma urealyticum in men. Mycoplasma hominis and Ureaplasma parvum do not appear to be pathogens. Men with suspected urethritis should undergo evaluation to confirm urethral inflammation and etiologic cause. Although nucleic acid amplification testing would detect N. gonorrhoeae and C. trachomatis (or T. vaginalis if utilized), there is no US Food and Drug Administration-approved clinical test for M. genitalium available in the United States at this time. The varied etiologies of urethritis and lack of diagnostic options for some organisms present treatment challenges in the clinical setting.

  14. Urethral diverticulo-rectal fistula in AIDS.

    Lee, W H; Yang, W J; Rha, K H; Chang, K H; Kim, J M; Lee, M S


    A 41-year-old heterosexual African man was evaluated for persistent urethral discharge, pneumaturia and watery diarrhea. Radiographic and endoscopic procedures established the diagnosis of a rectourethral fistula. The differential diagnosis of an acquired rectourethral fistula and the significance of AIDS are discussed.

  15. EAU guidelines on primary urethral carcinoma

    Gakis, G.; Witjes, J.A.; Comperat, E.; Cowan, N.C.; Santis, M. de; Lebret, T.; Ribal, M.J.; Sherif, A.M.


    CONTEXT: The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). OBJECTIVE: To review the curre

  16. EAU guidelines on primary urethral carcinoma

    Gakis, G.; Witjes, J.A.; Comperat, E.; Cowan, N.C.; Santis, M. de; Lebret, T.; Ribal, M.J.; Sherif, A.M.


    CONTEXT: The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). OBJECTIVE: To review the curre

  17. Incomplete urethral duplication in an adult male.

    Davis, N F


    Urethral duplication is a rare congenital anomaly with less than 200 cases reported. It predominantly occurs in males and is nearly always diagnosed in childhood or adolescence. It is defined as a complete second passage from the bladder to the dorsum of the penis or as an accessory pathway that ends blindly on the dorsal or ventral surface.

  18. Microscopy of Stained Urethral Smear in Male Urethritis; Which Cutoff Should be Used?

    Moi, Harald; Hartgill, Usha; Skullerud, Kristin Helene; Reponen, Elina J; Syvertsen, Line; Moghaddam, Amir


    The microscopical diagnosis of male urethritis was recently questioned by Rietmeijer and Mettenbrink, lowering the diagnostic criteria of the diagnosis to ≥2 polymorphonuclear leucocytes (PMNL) per high power field (HPF), and adopted by Centers for Disease Control and Prevention in their 2015 STD Treatment Guidelines. The European Non-Gonococcal Urethritis Guideline advocates a limit of ≥5 PMNL/HPF. To determine if syndromic treatment of urethritis should be considered with a cutoff value of ≥2 PMNL/HPF in urethral smear. The design was a cross-sectional study investigating the presence and degree of urethritis relative to specific infections in men attending an STI clinic as drop-in patients. The material included 2 cohorts: a retrospective study of 13,295 men and a prospective controlled study including 356 men. We observed a mean chlamydia prevalence of 2.3% in the 0-9 stratum, and a 12-fold higher prevalence (27.3%) in the strata above 9. Of the chlamydia cases, 89.8% were diagnosed in strata above 9. For Mycoplasma genitalium, the prevalence was 1.4% in the 0-9 stratum and 11.2% in the stratum ≥10, and 83.6% were diagnosed in strata above 9. For gonorrhea, a significant increase in the prevalence occurred between the 0-30 strata and >30 strata from 0.2% to 20.7%. The results of the prospective study were similar. Our data do not support lowering the cutoff to ≥2 PMNL/HPF. However, a standardization of urethral smear microscopy seems to be impossible. The cutoff value should discriminate between low and high prevalence of chlamydia, mycoplasma, and gonorrhea to include as many as possible with a specific infection in syndromic treatment, without overtreating those with few PMNL/HPF and high possibility of having nonspecific or no urethritis.

  19. A surface-modified biodegradable urethral scaffold seeded with urethral epithelial cells

    FU Wei-jun; ZHANG Xu; WANG Zhong-xin; LI Gang; ZHANG Bing-hong; ZHANG Lei; HU Kun; HONG Bao-fa; WANG Xiao-xiong; CUI Fu-zhai


    Background Efficient cell adhesion and proliferation is a central issue in cell-based tissue engineering, which offers great promise for repair of urethral defects or strictures. This study evaluated the adhesion and growth of rabbit uroepithelium on a surface-modified three-dimensional poly-L-lactic acid (PLLA) scaffold.Methods Urethral mucosa were harvested from male New Zealand rabbits and the urothelium were dissociated and then cultured. Immunocytochemistry on cultured uroepithelium for pancytokeratin and uroplakin Ⅱ and TE-7 confirmed pure populations. After in vitro proliferation, cells were seeded onto a surface-modified urethral scaffold with non-knitted filaments. The morphology and viability of the cells were examined by immunohistochemical and fluorescence staining.Inverted and scanning microscopes were used to document cell growth and adhesion.Results Three to five days after primary culture, the uroepithelial cells gradually became confluent, assuming a cobblestone pattern. The filaments of the urethral scaffold had excellent biocompatibility and allowed growth of the uroepithelium, without affecting viability. The uroepithelial cells adhered to and grew well on the scaffold. After 3-7 days,the cells grew vigorously and meshes of the scaffold were full of uroepitheliums.Conclusions The surface-modified urethral scaffold with non-knitted filaments allows the growth of uroepithelium and can serve as a carrier for the tissue engineering of urethra.

  20. Restaurant closures

    Novae Restauration


    Christmas Restaurant closures Please note that the Restaurant 1 and Restaurant 3 will be closed from Friday, 21 December at 5 p.m. to Sunday, 6 January, inclusive. They will reopen on Monday, 7 January 2013.   Restaurant 2 closure for renovation To meet greater demand and to modernize its infrastructure, Restaurant 2 will be closed from Monday, 17 December. On Monday, 14 January 2013, Sophie Vuetaz’s team will welcome you to a renovated self-service area on the 1st floor. The selections on the ground floor will also be expanded to include pasta and pizza, as well as snacks to eat in or take away. To ensure a continuity of service, we suggest you take your break at Restaurant 1 or Restaurant 3 (Prévessin).

  1. Urethral anatomy and semen flow during ejaculation

    Kelly, Diane


    Ejaculation is critical for reproductive success in many animals, but little is known about its hydrodynamics. In mammals, ejaculation pushes semen along the length of the penis through the urethra. Although the urethra also carries urine during micturition, the flow dynamics of micturition and ejaculation differ: semen is more viscous than urine, and the pressure that drives its flow is derived primarily from the rhythmic contractions of muscles at the base of the penis, which produce pulsatile rather than steady flow. In contrast, Johnston et al. (2014) describe a steady flow of semen through the crocodilian urethral groove during ejaculation. Anatomical differences of tissues associated with mammalian and crocodilian urethral structures may underlie these differences in flow behavior.

  2. Acupuncture Treatment of Female Urethral Syndrome

    ZHOU Yuan; HE Jia-yang; WANG Si-you


    Purpose To observe the curative effect of acupuncture on female urethral syndrome. Method A treatment group of 30 patients were treated with acupuncture at points Zhongji ( CV 3 ), Zusanli ( ST 36), Sanyinjiao ( SP 6), Shenshu ( BL 23 ), Pangguangshu ( BL28), Guanyuan (CV 4), Zhaohai (KI 6) and Zhonglushu ( BL 29). A control group of 28 patients were treated with capsule Norfloxacini and capsule Cystocaps.Results Of the treatment group, 26 patients had effectiveness and 4 had ineffectiveness; of the control group,2 patients had effectiveness and 26 had ineffectiveness.There was a significant difference in effective rate between the two groups (P<0.01). Conclusion The curative effect of acupuncture on female urethral syndrome is better than that of routine treatment.

  3. EAU guidelines on primary urethral carcinoma.

    Gakis, Georgios; Witjes, J Alfred; Compérat, Eva; Cowan, Nigel C; De Santis, Maria; Lebret, Thierry; Ribal, Maria J; Sherif, Amir M


    The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). To review the current literature on the diagnosis and treatment of patients with primary UC and assess its level of scientific evidence. A systematic literature search was performed to identify studies reporting urethral malignancies. Medline was searched using the controlled vocabulary of the Medical Subject Headings database, along with a free-text protocol. Primary UC is considered a rare cancer, accounting for EAU. It aims to increase awareness in the urologic community and provide scientific transparency to improve outcomes of this rare urogenital malignancy. Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  4. Entropy Maximization

    K B Athreya


    It is shown that (i) every probability density is the unique maximizer of relative entropy in an appropriate class and (ii) in the class of all pdf that satisfy $\\int fh_id_=_i$ for $i=1,2,\\ldots,\\ldots k$ the maximizer of entropy is an $f_0$ that is proportional to $\\exp(\\sum c_i h_i)$ for some choice of $c_i$. An extension of this to a continuum of constraints and many examples are presented.

  5. Female urethral syndrome. A female prostatitis?


    The cause of the female urethral syndrome has previously been obscure, as it has been associated by definition with a lack of objective findings but a plethora of subjective complaints of retropubic pressure, dyspareunia, urinary frequency, and dysuria. There is now strong evidence that the microscopic paraurethral glands connected to the distal third of the urethra in the prevaginal space are homologous to the prostate. They stain histologically for prostate-specific antigen and, like the pr...

  6. Urethral strictures incident to bicycle motocross racing.

    Delaney, Daniel P; Carr, Michael C


    A dramatic shift from traditional team to alternative or "extreme" sports has given rise to a new generation of nontraditional athletes and sports-related injuries in the pediatric population. We present a case of 2 brothers who developed urethral strictures believed incident to BMX racing. We address current demographics and the general presentation and course of treatment to aid both the pediatric urologist and the general practitioner in prompt and proper diagnosis.

  7. Electroacupuncture Treatment of 36 Patients with Female Urethral Syndrome

    LIU Lian; WANG Xiao-ming; WANG Si-you


    Purpose: To investigate a treatment for female urethral syndrome. Method: Electroacupuncture was used to treat 36 cases of female urethral syndrome,with medication for 42 cases as a control. Results: The total effective rate was 88.9% from electroacupuncture and 52.4% from medication. There was a significant difference in curative effect between the two groups (p<0.05). Conclusion: Electroacupuncture is an effective method for treatment of female urethral syndrome.

  8. [Clinical practice guideline. Traumatic urethral stenosis in males].

    Serrano-Brambila, Eduardo Alonso; Moreno-Alcázar, Othón Martino; Neri-Páez, Edgar; Sánchez-Martínez, Luis Carlos; Hernández-Ordóñez, Octavio Francisco; Morales-Morales, Arturo; Basavilvazo-Rodríguez, M Antonia; Torres-Arreola, Laura del Pilar; Valenzuela-Flores, Adriana Abigail; Hernández-Valencia, Marcelino


    The incidence of urethral stenosis in Mexico had not been documented. At the Centro Médico Nacional La Raza, during the year 2010, 629 patients with urethral stenosis were attended as outpatient consultation: 85 % with previous urethral stenosis and 15 % with urethral treatment complication. Urethral stenosis is a chronic illness, with multiple etiological origins and the handling is controversial. It has a great negative impact for the patients and the recurrence reaches 85 %. The treatment consisted of an invasive approach (urethral dilations, endoscopy procedure) and open surgery (urethroplasty). The World Health Organization and World Alliance take the world challenge about the urinary tract infections associated with the attention of patients, focused on urethral stenosis. The objective of the following clinical guide is to offer to the health professional a clinical tool for making decisions in the handling of the hardship or masculine urethral stenosis, based on the best available evidence, carrying out in systematized form with bibliographical research using validated terms of the MeSH: urethral structures, in the databases Trip database, PubMed, Guideline Clearinghouse, Cochrane Library and Ovid.

  9. SIU/ICUD Consultation on Urethral Strictures: Dilation, internal urethrotomy, and stenting of male anterior urethral strictures.

    Buckley, Jill C; Heyns, Chris; Gilling, Peter; Carney, Jeff


    Male urethral stricture is one of the oldest known urologic diseases, and continues to be a common and challenging urologic condition. Our objective was to review all contemporary and historial articles on the topic of dilation, internal urethrotomy, and stenting of male anterior urethral strictures. An extensive review of the scientific literature concerning anterior urethral urethrotomy/dilation/stenting was performed. Articles were included that met the criteria set by the International Consultation on Urological Diseases (ICUD) urethral strictures committee and were classified by level of evidence using the Oxford Centre for Evidence-Based Medicine criteria adapted from the work of the Agency for Health Care Policy and Research as modified for use in previous ICUD projects. Using criteria set forth by the ICUD, a committee of international experts in urethral stricture disease reviewed the literature and created a consensus statement incorporating levels of evidence and expert opinion in regard to dilation, internal urethrotomy, and stenting of male anterior urethral strictures.

  10. Reconstruction of rabbit urethra using urethral extracellular matrix

    杨嗣星; 姚颐; 胡云飞; 宋超; 王玲珑; 金化民


    Background Urethral reconstruction for both congenital and acquired etiologies remains a challenge for most urologic surgeons. Tissue engineering has been proposed as a strategy for urethral reconstruction. The purpose of This study was to determine whether a naturally derived extracellular matrix substitute developed for urethral reconstruction would be suitable for urethral repair in an animal model.Methods A urethral segmental defect was created in 20 male rabbits. The urethral extracellular matrix, obtained and processed from rabbit urethral tissue, was trimmed and transplanted to repair the urethral defect. Then, the regenerated segment was studied histologically by haematoxylin-eosin staining and Van Gieson staining at 10 days, 3 weeks, 6 weeks, and 24 weeks postoperation. Retrograde urethrography was used to evaluate the function of the regenerated urethras of 4 rabbits 10 and 24 weeks after the operation. The urodynamics of 4 rabbits from the experimental group and control group Ⅰ were assessed and compared. In addition, 4 experimental group rabbits were examined by a urethroscope 24 weeks after the operation.Results At 10 days after operation, epithelial cells had migrated from each side, and small vessels were observed in the extracellular matrix. The matrix and adjacent areas of the host tissue were infiltrated with inflammatory cells. The epithelium covered the extracellular matrix fully at 3 weeks postoperation. Well-formed smooth-muscle cells were first confirmed after 6 weeks, at which point the inflammatory cells had disappeared. At 24 weeks postoperation, the regenerated tissue was equivalent to the normal urethra. Urethrography and urodynamic evaluations showed that there was no difference between normal tissue and regenerated tissue.Conclusions Urethral extracellular matrix appears to be a useful material for urethral repair in rabbits. The matrix can be processed easily and has good characteristics for tissue handling and urethral function.

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

    Kouame Dibi Bertin


    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.

  12. Urethral dose and increment of international prostate symptom score (IPSS) in transperineal permanent interstitial implant (TPI) of prostate cancer

    Murakami, N.; Itami, J. [Dept. of Radiation Therapy and Oncology, International Medical Center of Japan, Tokyo (Japan); Div. of Radiation Therapy, National Cancer Center Hospital, Tokyo (Japan); Okuma, K.; Marino, H.; Ban, T.; Nakazato, M.; Kanai, K.; Naoi, K.; Fuse, M. [Dept. of Radiation Therapy and Oncology, International Medical Center of Japan, Tokyo (Japan); Nakagawa, K. [Dept. of Radiology, School of Medicine, Tokyo Univ. (Japan)


    Purpose: to find the factors which influence the acute increment of international prostate symptom score (IPSS) after transperineal permanent interstitial implant (TPI) using {sup 125}I seeds. Patients and methods: from April 2004 through September 2006, 104 patients with nonmetastatic prostate cancer underwent TPI without external-beam irradiation. Median patient age was 70 years with a median follow-up of 13.0 months. 73 patients (70%) received neoadjuvant hormone therapy. The increment of IPSS was defined as the difference between pre- and postimplant maximal IPSS. Clinical, treatment, and dosimetric parameters evaluated included age, initial prostate-specific antigen, Gleason Score, neoadjuvant hormone therapy, initial IPSS, post-TPI prostatic volume, number of implanted seeds, prostate V{sub 100}, V{sub 150}, D{sub 90}, urethral D{sub max}, and urethral D{sub 90}. In order to further evaluate detailed urethral doses, the base and apical urethra were defined and the dosimetric parameters were calculated. Results: the IPSS peaked 3 months after TPI and returned to baseline at 12-15 months. Multivariate analysis demonstrated a statistically significant correlation of post-TPI prostatic volume, number of implanted seeds, and the dosimetric parameters of the base urethra with IPSS increment. Conclusion: the base urethra appears to be susceptible to radiation and the increased dose to this region deteriorates IPSS. It remains unclear whether the base urethral dose relates to the incidence of late urinary morbidities. (orig.)

  13. A rare case of congenital Y-type urethral duplication

    Charu Tiwari


    Full Text Available Duplication of urethra is a rare congenital anomaly. We report a case of Y-type of urethral duplication with the accessory urethra arising from posterior urethra and opening in the perineum. The orthotopic urethra was normal. The accessory urethral tract was cored, transfixed and divided. At 1 year of follow-up, the patient has no urinary complaints

  14. Transurethral incision of urethral diverticulum in the female

    Miskowiak, J; Honnens de Lichtenberg, M


    A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time.......A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time....

  15. Anterior urethral recurrence of superficial bladder cancer: its clinical significance.

    Saika T


    Full Text Available The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6% had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9% had tumor progression and 149 (49.2% had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.

  16. Fiber types in the striated urethral and anal sphincters

    Schrøder, H D; Reske-Nielsen, E


    Seven normal human striated urethral and anal sphincters obtained by autopsy were examined using histochemical techniques. In both the urethral sphincter and the subcutaneous (s.c.) and superficial part of the anal sphincter a characteristic pattern with two populations of muscle fibers, abundant...... contractions and to react in stress conditions with fast increase in tension....

  17. Penile shaft sinus: A sequalae of circumcision in urethral duplication

    Lukman O Abdur-Rahman


    Full Text Available Urethral duplication (UD is rare congenital anomalies with varied presentation. Careful clinical evaluation of children by specialist would enhance diagnosis, adequate management and reduce occurrence of complication. We present a 12-year-old boy with chronic post circumcision ventral penile sinus that was successfully managed for urethral duplication.

  18. Design of closure works

    Verhagen, H.J.


    This chapter discusses the design aspects of estuary and river closures and those of reservoir dams and certain other hydraulic structures. The focus of this chapter is on closures, not on the situation after the closure has been completed.

  19. Urethral catheter knotting: an avoidable complication

    Ismail Burud


    Full Text Available Urethral catheterisation is a common andsafe procedure performed routinely. The small sizeof the urethra in a child necessitates the use of aninfant feeding tube (Size 5 to 8 F for catheterisation.Knotting within the bladder is a rare complication withsignificant morbidity often necessitating surgical orendoscopic removal. Insertion of an excessive lengthof tube contributes to coiling and knotting. We reportan instance of knotting of an infant feeding tube inthe proximal penile urethra of a 4 year-old male childrequiring urethrotomy to remove it. Awareness of therisk and proper technique can reduce this complication.

  20. Urethral catheters: can we reduce use?

    van den Akker-van Marle M Elske


    Full Text Available Abstract Background Indwelling urinary catheters are the main cause of healthcare-associated urinary tract infections. It can be expected that reduction of the use of urinary catheters will lead to decreased numbers of urinary tract infection. Methods The efficacy of an intervention programme to improve adherence to recommendations to reduce the use of urethral catheters was studied in a before-after comparison in ten Dutch hospitals. The programme detected barriers and facilitators and each individual facility was supported with developing their own intervention strategy. Outcome was evaluated by the prevalence of catheters, alternatives such as diapers, numbers of urinary tract infections, the percentage of correct indications and the duration of catheterization. The costs of the implementation as well as the catheterization were evaluated. Results Of a population of 16,495 hospitalized patients 3335 patients of whom 2943 were evaluable for the study, had a urethral catheter. The prevalence of urethral catheters decreased insignificantly in neurology (OR 0.93; 95% CI 0.77 - 1.13 and internal medicine wards (OR 0.97; 95% CI 0.83 - 1.13, decreased significantly in surgical wards (OR 0.84; 95% CI 0.75 - 0.96, but increased significantly in intensive care (IC and coronary care (CC units (OR 1.48; 95% CI 1.01 - 2.17. The use of alternatives was limited and remained so after the intervention. Duration of catheterization decreased insignificantly in IC/CC units (ratio after/before 0.95; 95% CI 0.78 - 1.16 and neurology (ratio 0.97; 95% CI 0.80 - 1.18 and significantly in internal medicine (ratio 0.81; 95% CI 0.69 - 0.96 and surgery wards (ratio 0.80; 95% CI 0.71 - 0.90. The percentage of correct indications on the day of inclusion increased from 50 to 67% (p Conclusion Targeted implementation of recommendations from an existing guideline can lead to better adherence and cost savings. Especially, hospitals which use a lot of urethral catheters or

  1. Haemophilus parainfluenzae urethritis among homosexual men.

    Hsu, Meng-Shiuan; Wu, Mei-Yu; Lin, Tsui-Hsien; Liao, Chun-Hsing


    Haemophilus parainfluenzae is a common inhabitant of the human upper respiratory tract of the normal oral microflora. We report three men who had been having unprotected sex with men (MSM) and subsequently acquired H. parainfluenzae urethritis, which was confirmed by 16S rRNA gene sequencing analysis. Two men were treated with ceftriaxone and doxycycline, and the third man was treated with clarithromycin. All three patients responded to treatment. This case series highlights the potential role of H. parainfluenzae as a sexually transmitted genitourinary pathogen.

  2. Aetiology of male urethritis in patients recruited from a population with a high HIV prevalence

    Sturm, P.D.J.; Moodley, P.; Khan, N.; Ebrahim, S.; Govender, K.; Connolly, C.E.; Sturm, A.W.


    The aetiology of urethritis, the significance of potential pathogens and the relation of urethritis to HIV infection were determined in 335 men (cases) with and 100 men (controls) without urethral symptoms. Urethral swab specimens were tested for different organisms by PCR or by culture for Neisseri

  3. 5α-Dihydrotestosterone negatively regulates cell proliferation of the periurethral ventral mesenchyme during urethral tube formation in the murine male genital tubercle.

    Suzuki, H; Matsushita, S; Suzuki, K; Yamada, G


    Androgen is an essential factor involved in masculinization of external genitalia. Failure of the exposure to 5α-dihydrotestosterone (DHT) causes a hypoplastic penile size and urethral abnormality. The main pathology of hypospadias is defective urethral closure on the ventral side of the penis. Hormone-dependent genes are suggested as the causative factors. However, the detailed mechanisms of DHT functions on urethral tube formation remain unknown. Androgen is both a positive and negative regulator of cell proliferation. The roles of locally converted DHT in cell proliferation at the periurethral mesenchyme have not been elucidated. We revealed the expression pattern of 5α-reductase type 2 mRNA (Srd5a2) and local DHT distribution by direct measurement in this study. We also analyzed periurethral mesenchymal cell proliferation status using systematic three-dimensional (3D) reconstruction analyses. A prominent Srd5a2 expression and localized DHT distribution on the ventral side of the genital tubercle were detected. Cell proliferation was reduced in this mesenchymal region during urethral formation. The current results suggest the presence of the possible negative regulation of cell proliferation by DHT. Moreover, cell proliferation related to urethral tube formation was revealed to be DHT dose dependent. These data are expected to contribute to the understanding of the mode of regulation of cell proliferation related to urethral tube formation by DHT. These findings may also offer insight into the understanding of human hypospadias and related hormone-dependent factors. © 2016 American Society of Andrology and European Academy of Andrology.

  4. One‑stage Anastomotic Urethroplasty for Traumatic Urethral ...

    occur in association with posterior urethral injuries in 10–20% of cases.[3,6,7] ... Department of Surgery, Urology Unit, Federal Teaching Hospital, Abakaliki, Ebonyi State, 1Department of Radiation. Medicine ..... urethro-cutaneous fistulae.

  5. Urethral catheterization:The need for adequate undergraduate ...

    E.V. Ezenwa


    Dec 26, 2016 ... There were 60 respondents who all graduated from medical schools in Nigeria except 2 .... effects of urethral catheterization (UC) taught by simulated training ... Outcomes and standards for under- graduate medical education.

  6. A novel cannulation technique for difficult urethral catheterization

    Mehmet Kaynar


    Full Text Available Introduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization.

  7. current concepts in the management of anterior urethral strictures


    urethral substitutes have been compared to other techniques of urethroplasty as seen over the. last decade. .... tube for 6 to 8 weeks to determine the tendency for such hydro dilated .... the urethra and penile curvature at erection 51. These.

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

    Okeke Linus I


    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.

  9. Transurethral resection of fibrotic scar tissue combined with temporary urethral stent placement for patients with in anterior urethral stricture

    Cheol Yong Yoon


    Full Text Available Introduction Fibrotic scar formation is a main cause of recurrent urethral stricture after initial management with direct vision internal urethrotomy (DVIU. In the present study, we devised a new technique of combined the transurethral resection of fibrotic scar tissue and temporary urethral stenting, using a thermo-expandable urethral stent (MemokathTM 044TW in patients with anterior urethral stricture. Materials and Methods As a first step, multiple incisions were made around stricture site with cold-cutting knife and Collins knife electrode to release a stricture band. Fibrotic tissue was then resected with a 13Fr pediatric resectoscope before deployment of a MemokathTM 044TW stent (40 – 60mm on a pre-mounted sheath using 0° cystoscopy. Stents were removed within 12 months after initial placement. Results We performed this technique on 11 consecutive patients with initial (n = 4 and recurrent (n = 7 anterior urethral stricture (April 2009 – February 2013. At 18.9 months of mean follow-up (12-34 months, mean Qmax (7.8±3.9ml/sec vs 16.8 ± 4.8ml/sec, p < 0.001, IPSS (20.7 vs 12.5, p = 0.001 , and QoL score (4.7 vs 2.2, p < 0.001 were significantly improved. There were no significant procedure-related complications except two cases of tissue ingrowth at the edge of stent, which were amenable by transurethral resection. In 7 patients, an average 1.4 times (1-5 times of palliative urethral dilatation was carried out and no patients underwent open surgical urethroplasty during the follow-up period. Conclusion Combined transurethral resection and temporary urethral stenting is a effective therapeutic option for anterior urethral stricture. Further investigations to determine the long-term effects, and safety profile of this new technique are warranted.

  10. Endoscopic removal of a proximal urethral stent using a holmium laser: Case report and literature review

    Francisco Botelho


    Full Text Available Urethral stents were initially developed for the management of urethral strictures and obstructive voiding disorders in select patients. Urethral stent complications are common and may require stent explantation, which is often quite challenging. We present our experience with endoscopic removal of an encrusted UroLume proximal urethral stent in a 72-year-old male using a holmium laser. The literature on various management options and outcomes for urethral stent removal is reviewed. Endoscopic removal of proximal urethral stents is feasible and safe and should be considered as the primary treatment option in patients requiring stent extraction.

  11. Closure Issues with Families.

    Craig, Steven E.; Bischof, Gary H.

    Closure of the counseling relationship constitutes both an ending and a beginning. Although closure signifies the ending of the present counseling relationship, many family counselors conceptualize closure as the start of a working relationship between counselor and family that may be summoned in future times of crisis or during a difficult life…

  12. Closure The Definitive Guide

    Bolin, Michael


    If you're ready to use Closure to build rich web applications with JavaScript, this hands-on guide has precisely what you need to learn this suite of tools in depth. Closure makes it easy for experienced JavaScript developers to write and maintain large and complex codebases -- as Google has demonstrated by using Closure with Gmail, Google Docs, and Google Maps. Author and Closure contributor Michael Bolin has included numerous code examples and best practices, as well as valuable information not available publicly until now. You'll learn all about Closure's Library, Compiler, Templates, tes

  13. Acute urinary retention in women due to urethral calculi: A rare case


    We present a case of a 51-year-old woman with acute urinary retention caused by a urethral calculus. Urethral calculi in women are extremely rare and are usually formed in association with underlying genitourinary pathology. In this case, however, no pathology was detected via thorough urological evaluation. We discuss the pathogenesis, clinical presentation and treatment of urethral calculi. To our knowledge, this is the second reported case of a primary urethral calculus in a female with an...

  14. The urethral glands of male mice in relation to depletion of secretory granules upon mating.

    Parr, M B; de França, L R; Kepple, L; Ying, L; Parr, E L; Russell, L D


    The present study describes the effects of mating on urethral gland acinar cells in male mice. Histological and morphometric analysis demonstrated that there was a depletion of secretory granules in the urethral glands during mating. However, no change occurred in the rough endoplasmic reticulum containing tubular elements. The results indicate that the urethral glands are functional during mating. The timing of their granule depletion suggests that urethral gland secretions may contribute to the formation of semen or the copulation plug.

  15. [Laser hair removal for urethral hair after hypospadias repair].

    Kaneko, Tomoyuki; Nishimatsu, Hiroaki; Ogushi, Tetsuo; Sugimoto, Masayuki; Asakage, Yasuyuki; Kitamura, Tadaichi


    A 56-year-old male was admitted for induration of ventral side of the penile shaft. Computed tomography showed a large urethral calculus in the distal urethra. About 50 years previously, he had undergone multi-staged urethroplasty for hypospadias. He had also suffered from recurrent urethral calculi managed by urethrolithotomy 5 and 2 years before the admission. Urethrolithotomy revealed hair-bearing urethral calculus. Instillation of depilating agent containing thioglycolate into the neourethra for preventing hair regrowth was ineffective. Transurethral laser hair removal of neourethra was subsequently performed. All the neourethral follicles were ablated with GaAlAs diode laser (wave length 810 nm; at a power of 15W for 2 seconds) through a side-firing laser fiber. Another three operations were performed for a few regrown hairs at a power of 20-30W. Convalescence was uneventful. The patient is free of hair regrowth except for a hair at five months of follow-up.


    Navkiran Kaur


    Full Text Available Multiple urethral stones are a rare occurrence commonly resulting from migration of renal stones and rarely arising de novo secondary to the other pathology such as urethral diverticulum, strictures, neurogenic bladder, meatal stenosis, and obstructing tumours such as adenomatous metaplasia of the uroepithelium and hypospadias. We report the case of a 47-year-old male presenting with difficulty in micturition resulting from impaction of multiple stones within the urethra. On retrograde urethrogram, meatal stenosis was also seen along with multiple urethral stones. On ultrasonography of patient, renal stones were also found. Patient was managed surgically and stones were extracted. This paper summarises the topic and discusses the radiological and its clinical implication of this unusual condition.

  17. Balanitis xerotica obliterans with urethral stricture after hypospadias repair.

    Uemura, S; Hutson, J M; Woodward, A A; Kelly, J H; Chow, C W


    Three cases of urethral stricture due to balanitis xerotica obliterans (BXO) after hypospadias repair are reported. The first patient showed white, dense scarring on the prepuce before the hypospadias repair and developed a stricture of the urethra after the operation. The second and the third were uneventful for 6 and 2 years, respectively, after the hypospadias repair, and then developed urethral strictures. Pathologic diagnosis of the stenotic lesion is essential. Complete excision of the affected urethra with topical steroid ointment or sublesional triamcinolone injection is recommended for this condition. Although the complication of BXO after hypospadias repair is rare (3 out of 796 cases with hypospadias in our series), surgeons need to be aware of this condition as a cause for late onset of urethral problems.

  18. Urethral triplication with meatuses terminating on the penis: a rare case presenting with bifid urinary stream

    Hirselj, Daniel A.; Jayanthi, Venkata R. [Nationwide Children' s Hospital, Department of Pediatric Urology, Columbus, OH (United States); Lowe, Gregory K. [The Ohio State University Medical Center, Department of Urology, Columbus, OH (United States)


    Urethral duplication is an uncommon clinical finding, and classification systems have been described to explain the clinical findings. Urethral triplication is an extremely uncommon diagnosis, with few published case reports. We present the rare case of an infant noted to have a bifid urinary stream and found to have urethral triplication on voiding cystourethrography. (orig.)

  19. Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015–2016

    Toh, Evelyn; Gangaiah, Dharanesh; Batteiger, Byron E.; Williams, James A.; Arno, Janet N.; Tai, Albert; Batteiger, Teresa A.


    At a clinic in Indianapolis, Indiana, USA, we observed an increase in Neisseria gonorrhoeae–negative men with suspected gonococcal urethritis who had urethral cultures positive for N. meningitidis. We describe genomes of 2 of these N. meningitidis sequence type 11 complex urethritis isolates. Clinical evidence suggests these isolates may represent an emerging urethrotropic clade. PMID:28098538

  20. Anterior urethral valves: not such a benign condition…

    Omar eCruz-Diaz


    Full Text Available Purpose: Anterior urethral valves (AUV is an unusual cause of congenital obstruction of the male urethra, being 15 to 30 times less common than posterior urethral valves (PUV. It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV.The long term prognosis of anterior urethral valves is not clear in the literature. In this report we describe our experience and long-term follow up of patients with AUV.Materials and methods: We retrospectively identified 13 patients who presented with the diagnosis of AUV in our institutions between 1994 and 2012. From the 11 patients included, we evaluated the gestational age, ultrasound and voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine and clinical follow up.Results: Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves, where 11 patients (7.3% had AUV and an adequate follow up. Mean follow up is 6.3 years. 5 patients (45.4% had pre-natal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder.The mean gestational age was 37.6 weeks. Postnatally, 90% had trabeculated bladder, 80% hydronephrosis and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in 5 patients (45.4%.7 patients (63.6% had primary transurethral valve resection or laser ablation and 3 patients (27.2% had primary vesicostomies. One boy (9.1% had urethrostomy with urethral diverticulum excision. 2 patients (18.2% developed end-stage renal disease (ESRD.Conclusions: Early urinary tract obstruction resulted in ESRD in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUV we recommend long-term follow up and close evaluation of patient’s bladder and renal function.

  1. Bleomycin induced urethral stricture in Hodgkin′s disease

    Ritesh Tapkire


    Full Text Available Bleomycin is a glycoprotein that is extensively used in combination with other anti-cancer agents because of its relative lack of hematological and gastrointestinal toxicity. However, pulmonary toxicity is common with bleomycin and limits its therapeutic utility. Urethral stricture as a result of bleomycin toxicity has not been reported in literature. In this case report, a young male patient who developed urethral stricture after bleomycin-based chemotherapy is described and the possible effects of bleomycin on the urethra are discussed.

  2. [Urogenital bleeding revealing urethral prolapse in a prepubertal girl].

    Ballouhey, Q; Abbo, O; Sanson, S; Cochet, T; Galinier, P; Pienkowski, C


    Urethral prolapse is a complete eversion of the distal urethral mucosa through the external meatus. It occurs primarily in prepubertal, primarly Black girls. Its pathophysiology has not been clearly identified. We report a case of a 5-year-old girl who came to the Emergency Department with a 1-day history of genital pain and "vaginal bleeding". Early recognition makes differential diagnosis with sexual abuse and staging allows prompt management under general anesthesic like prolapse reduction or surgical excision. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Non-surgical treatment of primary female urethral cancer

    Bernard F. Schneider


    Full Text Available Primary carcinomas of the female urethra are extremely rare, with an annual incidence of less than ten in one million. Currently, there is no consensus regarding management of this malignancy. However, there have been several case reports demonstrating the efficacy of chemoradiation in the treatment of female urethral cancer. In this report we present two cases of female primary urethral adenocar­cinoma that were treated by concomitant chemotherapy and external beam radiother­apy, followed by interstitial brachytherapy.

  4. Closure Operators and Closure Systems on Quantaloid-Enriched Categories

    Min LIU; Bin ZHAO


    In this paper,we introduce the fundamental notions of closure operator and closure system in the framework of quantaloid-enriched category.We mainly discuss the relationship between closure operators and adjunctions and establish the one-to-one correspondence between closure operators and closure systems on quantaloid-enriched categories.

  5. Impacted calculus within a urethral stent: A rare cause of urinary retention

    Shanmugasundaram Rajaian


    Full Text Available An elderly male presented to the emergency department with acute urinary retention. He had poor flow of urine associated with serosanguinous discharge per urethra for 3 days duration. Earlier he underwent permanent metallic urethral stenting for post TURP bulbar urethral stricture. Plain X-ray of Pelvis showed an impacted calculus within the urethral stent in bulbar urethra. Urethrolitholapaxy was done with semirigid ureteroscope. Urethral stent was patent and well covered. Subsequently he had an uneventful recovery. We describe a unique case of acute urinary retention due to calculus impaction within a urethral stent.

  6. Urethral stone presenting as a stop valve--a rare complication of balanitis xerotica obliterans.

    Dogra, P N; Singh, I; Khaitan, A


    Balanitis xerotic obliterans (BXO) is the genital subcategory of lichen sclerosis et atrophicus. The association of BXO with urethral stone causing interruption of the urinary stream and voiding by manual displacement of the urethral stone has not been described before. We describe one such case of a young boy with BXO and urethral stone who voided by manually displacing the stone for over a year. The case is reported to emphasize the ingenuity of the patient in continuing to void for over a year despite the association of the impacted urethral stone with urethral stricture and BXO.

  7. Profit maximization mitigates competition

    Dierker, Egbert; Grodal, Birgit


    We consider oligopolistic markets in which the notion of shareholders' utility is well-defined and compare the Bertrand-Nash equilibria in case of utility maximization with those under the usual profit maximization hypothesis. Our main result states that profit maximization leads to less price...... competition than utility maximization. Since profit maximization tends to raise prices, it may be regarded as beneficial for the owners as a whole. Moreover, if profit maximization is a good proxy for utility maximization, then there is no need for a general equilibrium analysis that takes the distribution...... of profits among consumers fully into account and partial equilibrium analysis suffices...

  8. The Triangle Closure is a Polyhedron

    Basu, Amitabh; Köppe, Matthias


    Recently, cutting planes derived from maximal lattice-free convex sets have been studied intensively by the integer programming community. An important question in this research area has been to decide whether the closures associated with certain families of lattice-free sets are polyhedra. For a long time, the only result known was the celebrated theorem of Cook, Kannan and Schrijver who showed that the split closure is a polyhedron. Although some fairly general results were obtained by Andersen, Louveaux and Weismantel [An analysis of mixed integer linear sets based on lattice point free convex sets, Math. Oper. Res. 35, (2010) pp. 233--256], some basic questions have remained unresolved. For example, maximal lattice-free triangles are the natural family to study beyond the family of splits and it has been a standing open problem to decide whether the triangle closure is a polyhedron. In this paper, we resolve this by showing that the triangle closure is indeed a polyhedron, and its number of facets can be ...

  9. Scrotal pop off in a congenital anterior urethral diverticulum.

    Abrol, N; Deshpande, A V; Berry, C S; Devasia, A


    Congenital anterior urethral diverticulum is a rare entity. This teaching video shows the scrotal pop-off mechanism for an anterior urethral diverticulum and the unique voiding pattern of a boy who empties his bladder by compression of his scrotum. The findings during urethroscopy and open reconstruction are also demonstrated. A four-year-old boy presented to the clinic with a poor urinary stream and scrotal swelling during voiding. Physical examination during voiding revealed a dumbbell-shaped anterior urethral diverticulum with scrotal pop off and preserved renal function. Open excision of the scrotal part of diverticulum was performed. Urethroplasty was conducted using a de-epithelialised diverticular wall flap from the penobulbar urethra. On follow up the boy voided with a good flow and resolution of symptoms. Scrotal pop off with completion of voiding by manual compression of the diverticulum may preserve bladder and renal function. The preferred treatment of anterior urethral diverticulum is open excision of the diverticulum and reconstruction. The wall of the diverticulum may be used to reinforce the repair ventrally, where the corpus spongiosum is deficient. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  10. Surgical Management of Prepubertal Urethral Prolapse: A report of 3 ...


    Department of Surgery, Lagos State University College of Medicine and Teaching ... Methods: Our series of 3 cases all presented with vaginal bleeding and all had primary ... Parents, caregivers and medical personnel in our ... recognition of urethral prolapse avoids unnecessary investigation and anxiety for the patients.

  11. Treatment of urethral strictures with balloon dilation: A forgotten tale

    Konstantinos Stamatiou


    Full Text Available Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization and dilation, urethroplasty and endoscopic internal urethrotomy as well. Although treatment option depends on the type, length and aetiology of stricture, the choice can be influenced to varying degrees by the simplicity of the method, the preferences of the patient the available accoutrements and the patient health condition. Both urethroplasty and endoscopic internal urethrotomy require anaesthesia and thus are not suitable for many elder and unfit for surgical treatment patients. On the other hand, dilations are easy to perform in every day clinical practice however they have been associated with iatrogenic urethral trauma. In contrast, balloon dilation under vision dilates by radial application of forces against the stricture, avoiding the potentially shearing forces associated with sequential rigid dilation. Since it reduces the possibility of an iatrogenic urethral trauma and the subsequent spongiofibrosis may lead into improved therapeutic outcomes. In this report we describe a technique for the treatment of urethral strictures with balloon dilation in elder and unfit for surgical treatment patients.

  12. Prostatic urethral lift vs transurethral resection of the prostate

    Gratzke, Christian; Barber, Neil; Speakman, Mark J


    OBJECTIVES: To compare prostatic urethral lift (PUL) with transurethral resection of the prostate (TURP) with regard to symptoms, recovery experience, sexual function, continence, safety, quality of life, sleep and overall patient perception. PATIENTS AND METHODS: A total of 80 patients with lower...

  13. Rosoxacin in the treatment of uncomplicated acute gonococcal urethritis.

    Vagaskar S


    Full Text Available A total of 112 male patients presenting with acute gonococcal urethritis were admitted to the hospital. The diagnosis was confirmed by smear, culture, oxidase reaction and sugar fermentation tests. The patients were treated with a single 300 mg capsule of rosoxacin. All patients except one showed adequate response to rosoxacin.

  14. Pudendal nerve stimulation induces urethral contraction and relaxation

    J. le Feber (Joost); E. van Asselt (Els)


    textabstractIn this study we measured urethral pressure changes in response to efferent pudendal nerve stimulation in rats. All other neural pathways to the urethra were transected, and the urethra was continuously perfused. We found fast twitch-like contractions, super

  15. Passive urethral resistance to dilation in healthy women

    Bagi, P; Thind, P; Nordsten, M


    at equilibrium, P alpha and P beta express the decline in pressure, and tau alpha and tau beta are time constants. The size of the pressure response proved highly dependent on velocity and size of dilation as well as urethral site of measurement, with the maximum values in the high pressure zone. The time...

  16. Management of anterior urethral strictures with buccal mucosa: Our ...

    Abdelwahab Elkassaby


    Mar 2, 2016 ... different uses of buccal mucosal graft as a reconstructive and replacement tool for anterior urethral .... of excessive mobilization and penile curvature. ... established that a strip of penile skin would inevitably form a tube if left in ...

  17. Urethral catheterization:The need for adequate undergraduate exposure

    E.V. Ezenwa


    Conclusion: Newly recruited interns have poor practical exposure to urethral catheterization. Efforts should be made to improve the quality of supervised training given to medical undergraduates so as to avoid complications that could arise if this procedure is not properly done when they qualify.

  18. Urethral catheter insertion forces: a comparison of experience and training

    Benjamin K. Canales


    Full Text Available Purpose: This study was undertaken to evaluate the insertion forces utilized during simulated placement of a urethral catheter by healthcare individuals with a variety of catheter experience. Materials and Methods: A 21F urethral catheter was mounted to a metal spring. Participants were asked to press the tubing spring against a force gauge and stop when they met a level of resistance that would typically make them terminate a catheter placement. Simulated catheter insertion was repeated fives times, and peak compression forces were recorded. Healthcare professionals were divided into six groups according to their title: urology staff, non-urology staff, urology resident/ fellow, non-urology resident/ fellow, medical student, and registered nurse. Results: A total of fifty-seven healthcare professionals participated in the study. Urology staff (n = 6 had the lowest average insertion force for any group at 6.8 ± 2.0 Newtons (N. Medical students (n = 10 had the least amount of experience (1 ± 0 years and the highest average insertion force range of 10.1 ± 3.7 N. Health care workers with greater than 25 years experience used significantly less force during catheter insertions (4.9 ± 1.8 N compared to all groups (p < 0.01. Conclusions: We propose the maximum force that should be utilized during urethral catheter insertion is 5 Newtons. This force deserves validation in a larger population and should be considered when designing urethral catheters or creating catheter simulators. Understanding urethral catheter insertion forces may also aid in establishing competency parameters for health care professionals in training.




    Full Text Available AIM OF THE STUDY: Effectiveness of Transpubic urethroplasty in recurrent (failed urethral strictures due to pelvic fracture urethral distraction defects. INTRODUCTION: Urethral distraction injuries occur upto 10% of pelvic fracture cases. The principle indication of Transpubic urethroplasty is length >3 c ms, recur rent (failed repairs of posterior urethral stricture. Though other procedures like primary anastomotic urethroplasty, rerouting of the urethra under the corporal body, urethral substitution with tubularised flaps, two stage urethroplasty are described, Tr anspubic urethroplasty is said to produce the best results especially when repeat procedures are required. MATERIALS & METHODS: This is a prospective study from 2004 to 2014 consisting of 17 patients having recurrent stricture urethra secondary to pelvic f racture urethral distraction defects (PFUDD. All the patients were males and their age ranged from 15year to 45 years. Pre - op evaluation included X - ray KUB, Ultrasound abdomen & pelvis, retrograde urethrogram (RGU, micturating cystourethrogram (MCU, up and down Cystoscopy, urine culture and renal biochemical parameters. Urethra was approched through progressive perineal and abdominal approach with total pubectomy, followed by excising fibrosed stricture and tension free end to end anastomosis. Post opera tively pericatheteral RGU was carried out after 4 weeks and Catheter removed if there was no leak. RGU, MCU uroflowmetry and PVR were done one month after removal of catheter. Subsequently UFR, PVR and obstructive symptoms were assessed periodically. RESUL TS: All 17 Cases were followed up for a period of 3 - 11 years. Out of 17patients, 14(80% patients maintained good uroflow (UFR and insignificant PVR and procedure was considered successful. In 3 patients procedure failed, of which 2 patients had pericathe ter leak and reduced urinary flow with significant PVR and were followed up with CIC and 1 patient remained on permanent

  20. Maximally incompatible quantum observables

    Heinosaari, Teiko, E-mail: [Turku Centre for Quantum Physics, Department of Physics and Astronomy, University of Turku, FI-20014 Turku (Finland); Schultz, Jussi, E-mail: [Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milano (Italy); Toigo, Alessandro, E-mail: [Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milano (Italy); Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Via Celoria 16, I-20133 Milano (Italy); Ziman, Mario, E-mail: [RCQI, Institute of Physics, Slovak Academy of Sciences, Dúbravská cesta 9, 84511 Bratislava (Slovakia); Faculty of Informatics, Masaryk University, Botanická 68a, 60200 Brno (Czech Republic)


    The existence of maximally incompatible quantum observables in the sense of a minimal joint measurability region is investigated. Employing the universal quantum cloning device it is argued that only infinite dimensional quantum systems can accommodate maximal incompatibility. It is then shown that two of the most common pairs of complementary observables (position and momentum; number and phase) are maximally incompatible.

  1. Eyelid closure at death

    A D Macleod


    Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

  2. Urethral pressure reflectometry in women with pelvic organ prolapse

    Khayyami, Yasmine; Lose, Gunnar; Klarskov, Niels


    INTRODUCTION AND HYPOTHESIS: The mechanism of continence in women with pelvic organ prolapse (POP) before and after surgery remains unknown. Urethral pressure reflectometry (UPR) separates women with stress urinary incontinence (SUI) from continent women by measuring urethral opening pressure...... at an abdominal pressure of 50 cmH2O (P O-Abd 50). UPR can help identify women with POP at risk of postoperative de novo SUI. The aim of this study was to investigate the reproducibility of UPR in women with POP. METHODS: Women with anterior or posterior vaginal wall prolapse were recruited for this prospective...... to determine the level of agreement between measurements. Paired t tests were used to estimate the difference; a two-tailed P value of prolapse and 11 women with posterior vaginal wall prolapse. There were...

  3. Aphallia with urethrorectal fistula, bladder and urethral calculi

    M Movarrekh


    Full Text Available Introduction: Aphallia is a very rare urogenital anomaly with incidence rate of 1 in 30,000,000. It usually coexists with other anomalies such as cardiovascular anomalies which are incompatible with normal life, and therefore infants are delivered stillbirth or live for a very short period of time. Methods: We present an 18 months old boy with aphallia associated with congenital urethrorectal fistula, bladder and urethral stones. All stones were removed endourologically, recto-urethral fistula was repaired and perincal urethrostomy was performed. Results: The stones were composed of calcium phosphate colonized by klebiella pneumonia and proteus mirabilis. Urethrorectal fistula repairment was confirmed by cystography. Patient was discharged without a urinary catheter. Conclusion: In developed countries, management of such patients is to raise them as females. However, we must consider socio-cultural conditions, parents preference and patients tendency in management of aphallia.

  4. Brachytherapy on urethral carcinoma; Braquiterapia no carcinoma da uretra

    Novaes, Paulo Eduardo R.S. [Fundacao Antonio Prudente, Sao Paulo, SP (Brazil). Hospital A.C. Camargo. Dept. de Radioterapia


    From 1954 to 1992 21 patients with primary urethral carcinoma were attended at A.C.Camargo Hospital - Fundacao Antonio Prudente - Sao Paulo. There were 17 female and 4 male with a median age of 58 years old. Eight patients received surgery, 8 radiation therapy and 5 were treated with palliative intention or were not treated. Patients treated by radiotherapy received 60 Gy to 80 Gy. Three patients were submitted to exclusive brachytherapy, 4 to the association of external beam and brachytherapy and 1 to external radiotherapy. Interstitial techniques were employed in 5 patients and intraluminal brachytherapy with special applicator in 2. Seven of 8 patients (87.5%) had local control and disease free survival with a minimum follow-up 4 years. Late effects were not observed. Primary urethral carcinoma is a curable disease by radiotherapy and the association of external irradiation and brachytherapy is the ideal approach. (author) 11 refs.

  5. Urethral tissue regeneration using collagen scaffold modified with collagen binding VEGF in a beagle model.

    Jia, Weisheng; Tang, He; Wu, Jianjian; Hou, Xianglin; Chen, Bing; Chen, Wei; Zhao, Yannan; Shi, Chunying; Zhou, Feng; Yu, Wei; Huang, Shengquan; Ye, Gang; Dai, Jianwu


    Extensive urethral defects have a serious impact on quality of life, and treatment is challenging. A shortage of material for reconstruction is a key limitation. Improving the properties of biomaterials and making them suitable for urethral reconstruction will be helpful. Previously, we constructed a fusion protein, collagen-binding VEGF (CBD-VEGF), which can bind to collagen scaffold, stimulate cell proliferation, and promote angiogenesis and tissue regeneration. We proposed that CBD-VEGF could improve the performance of collagen in reconstruction of extensive urethral defects. Our results showed that collagen scaffolds modified with CBD-VEGF could promote urethral tissue regeneration and improve the function of the neo-urethra in a beagle extensive urethral defect model. Thus, modifying biomaterials with bioactive factors provides an alternative strategy for the production of suitable biomaterials for urethral reconstruction.

  6. Acquired urethral diverticulum in a man with paraplegia presenting with a scrotal mass: a case report

    El Ammari Jalal Eddine


    Full Text Available Abstract Introduction Male urethral diverticula are rare. Patients with paraplegia may present with acquired diverticula as a result of prolonged catheterization. Diverticula may be asymptomatic or lead to lower urinary tract symptoms. Rarely, the diverticulum may initially present as a scrotal mass. Case presentation We report the case of a male 45-year-old Arab with paraplegia who presented with a mass in the peno-scrotal junction. He had in his medical history iterative prolonged urethral catheterizations associated with urine leakage through the urethral meatus upon applying compression. Diagnosis confirmation of urethral diverticula is obtained by retrograde urethrography. The patient underwent a diverticulectomy with urethroplasty. Conclusion Male acquired urethral diverticula can be found in patients who have a spinal cord injury because of prolonged urethral catheterization. Clinical presentations are different and sometimes can be misleading. Retrograde urethrography is the key to diagnosis and open surgery is the treatment of reference.

  7. Cholinergic urethral brush cells are widespread throughout placental mammals.

    Deckmann, Klaus; Krasteva-Christ, Gabriela; Rafiq, Amir; Herden, Christine; Wichmann, Judy; Knauf, Sascha; Nassenstein, Christina; Grevelding, Christoph G; Dorresteijn, Adriaan; Chubanov, Vladimir; Gudermann, Thomas; Bschleipfer, Thomas; Kummer, Wolfgang


    We previously identified a population of cholinergic epithelial cells in murine, human and rat urethrae that exhibits a structural marker of brush cells (villin) and expresses components of the canonical taste transduction signaling cascade (α-gustducin, phospholipase Cβ2 (PLCβ2), transient receptor potential cation channel melanostatin 5 (TRPM5)). These cells serve as sentinels, monitoring the chemical composition of the luminal content for potentially hazardous compounds such as bacteria, and initiate protective reflexes counteracting further ingression. In order to elucidate cross-species conservation of the urethral chemosensory pathway we investigated the occurrence and molecular make-up of urethral brush cells in placental mammals. We screened 11 additional species, at least one in each of the five mammalian taxonomic units primates, carnivora, perissodactyla, artiodactyla and rodentia, for immunohistochemical labeling of the acetylcholine synthesizing enzyme, choline acetyltransferase (ChAT), villin, and taste cascade components (α-gustducin, PLCβ2, TRPM5). Corresponding to findings in previously investigated species, urethral epithelial cells with brush cell shape were immunolabeled in all 11 mammals. In 8 species, immunoreactivities against all marker proteins and ChAT were observed, and double-labeling immunofluorescence confirmed the cholinergic nature of villin-positive and chemosensory (TRPM5-positive) cells. In cat and horse, these cells were not labeled by the ChAT antiserum used in this study, and unspecific reactions of the secondary antiserum precluded conclusions about ChAT-expression in the bovine epithelium. These data indicate that urethral brush cells are widespread throughout the mammalian kingdom and evolved not later than about 64.5millionyears ago.

  8. Idiopathic urethritis in children: Classification and treatment with steroids

    Sivasankar Jayakumar


    Full Text Available Background: Idiopathic urethritis [IU] in children is of unknown etiology and treatment options are limited. We propose a classification for IU based on cystourethroscopy findings and symptoms (Grade 1 - 4 and report our experience with use of topical and oral steroids in IU. Materials and Methods: Retrospective data collection of all male children (0-16 years diagnosed with IU over a period of 8 years between 2005 and 2012 at our institution. Data was collected on patient demographics, laboratory and radiological investigations, cystourethroscopy findings, management and outcomes. Results: A total of 19 male children were diagnosed with IU. The median age of the patients was 13(7-16 years. Presenting symptoms included dysuria in 12; hematuria in 9; loin pain in 6; and scrotal pain in 2 patients. Both patients with scrotal pain had previous left scrotal exploration that revealed epididymitis. Serum C-reactive protein and Full blood count was tested in 15 patients and was within normal limits in all of them. Cystourethroscopy revealed urethritis of grade-I in 2; grade-II in 11; and grade-III in 3 patients. There were 3 patients with systemic symptoms from extra-urethral extension of inflammation (grade-IV. Mean follow up was 18.9(1-74 months. All patients had steroid instillation at the time of cystourethroscopy. Three patients with IU grade IV required oral steroids (prednisolone in view of exacerbation of symptoms and signs despite steroid instillation. Complete resolution of symptoms and signs occurred in 18(94.7% patients. Significant improvement in symptoms and signs was noted in 1(5.3% patient who is still undergoing treatment. Conclusions: IU in male children can be successfully managed with steroid instillation, especially in grade I and II. Grade III, will need steroid instillation but treatment of scarring and stricture will necessitate longer duration of treatment. In children with IU and extra-urethral symptoms (grade IV, oral

  9. [Vesico-urethral lithiasis secondary to foreign body].

    Recasens Guinjuan, J R; Flores González, J J; Samsó Piñol, J M; Ribes Amoros, Y; Massó Badia, A


    We report a case of vesico-urethral litiasis secondary to foreign body (gauze) calcificated, left in prostatic cell during prostate open surgery of performed twelve years ago. In the related literature we observe that most of foreign urinals bodies are secondary to the introduction through the urethra of objects with autoerotic finality in normal patients or more often with psychiatric disorders, and only a small proportion are of iatrogenic origin, mainly in the last ten years.

  10. [Urethral diverticulum. Our casuistic and the literatura review].

    Ramírez Backhaus, M; Trassierra Villa, M; Broseta Rico, E; Gimeno Argente, V; Arlandis Guzmán, S; Alonso Gorrea, M; Jiménez Cruz, J F


    The possible etiopathogenic factors, symptoms, diagnostic methods, surgical management and complications of the urethral diverticula are reviewed. A retrospective study of the clinical charts with urethral diverticula diagnosis during the period 1986-2006 was carried out. In the last 20 years a total of 19 patients have been treated for this pathology: 15 females and 4 males. Five of the females started with a sensation of vaginal mass; the rest were diagnosed of micturitional (irritative) syndrome, urinary incontinence or urinary infection. In the case of males, 3 of them had a palpable tumour in the penis. The most used diagnostic method was retrograde and voiding cystourethrography; urethrography with double-occlusion balloon catheter was used in 5 cases and urethroscopy in 4 patients; other techniques of image diagnosis like magnetic resonance imaging were necessary for the most complex cases. The treatment was the excision of the diverticulum, except for one of the females who rejected the treatment. The evolution in all treated women was successful, according to follow up 2 years after the treatment. In males, two of them had complex recurrent diverticula. Urethral diverticula are nosologic entities of difficult diagnosis, due to their low prevalence and their unspecific clinic, therefore diagnosis is sometimes incidental. The etiopathogenity is acquired in most cases and its surgical treatment is more challenging in males than in females probably linked to the fact that diverticula appear in urethras with previous surgery, endourologic manipulation or associated injuries.

  11. Adenocarcinoma uretral em uma cadela Urethral adenocarcinoma in a bitch

    Marcia Cristina da Silva


    Full Text Available Tumores primários de uretra são raros em animais e há poucos relatos em cães. A ocorrência é maior em cadelas idosas, não havendo predileção por raça. Disúria, estrangúria e hematúria são sinais clínicos associados a esses tumores. É relatado um caso de adenocarcinoma primário de uretra em um cadela Poodle de 12 anos de idade que apresentava aumento de volume no membro pélvico esquerdo. Na necropsia, foram encontradas metástases na articulação femorotibial esquerda, na glândula adrenal e no rim.Urethral primary tumors are rare in animals and there are only few reports in dogs. They are more frequent in old bitches and have no breed predilection. Clinical signs associated with urethral primary tumors include dysuria, strangury and hematuria. We report a case of primary urethral adenocarcinoma in a 12-year-old female Poodle that was presented with localized volume enlargement in the left pelvic limb. At necropsy metastasis were found at the left femorotibial joint, adrenal gland and kidney.

  12. Somatomotor and sensory urethral control of micturition in female rats

    Cruz, Yolanda; Pastelín, César; Balog, Brian M.; Zaszczurynski, Paul J.


    In rats, axons of external urethral sphincter (EUS) motoneurons travel through the anastomotic branch of the pudendal nerve (ABPD) and anastomotic branch of the lumbosacral trunk (ABLT) and converge in the motor branch of the sacral plexus (MBSP). The aim of the present study was to determine in female rats the contribution of these somatomotor pathways and urethral sensory innervation from the dorsal nerve of the clitoris on urinary continence and voiding. EUS electromyographic (EMG) activity during cystometry, leak point pressure (LPP), and voiding efficiency (VE) were assessed in anesthetized virgin Sprague-Dawley female rats before and after transection of the above nerve branches. Transection of the MBSP eliminated EUS EMG, decreased LPP by 50%, and significantly reduced bladder contraction duration, peak pressure, intercontraction interval, and VE. Transection of the ABPD or ABLT decreased EUS EMG discharge and LPP by 25% but did not affect VE. Transection of the dorsal nerve of the clitoris did not affect LPP but reduced contraction duration, peak pressure, intercontraction interval, and VE. We conclude that somatomotor control of micturition is provided by the MBSP with axons travelling through the ABPD and ABLT. Partial somatomotor urethral denervation induces mild urinary incontinence, whereas partial afferent denervation induces voiding dysfunction. ABPD and ABLT pathways could represent a safeguard ensuring innervation to the EUS in case of upper nerve damage. Detailed knowledge of neuroanatomy and functional innervation of the urethra will enable more accurate animal models of neural development, disease, and dysfunction in the future. PMID:25339694

  13. Ruptured urinary bladder attributable to urethral compression by a haematoma after vertebral fracture in a bull

    Braun, U.; Trösch, L; Sydler, T.


    BACKGROUND: In male cattle, rupture of the urinary bladder is usually associated with urethral obstruction by uroliths. Less common causes include urethral compression or stricture. This case report describes the findings in a young Limousion breeding bull with rupture of the urinary bladder because of urethral compression by a haematoma after coccygeal fracture. CASE PRESENTATION: The bull had been introduced into a 40-head Red-Holstein herd one week before being injured. One week after intr...

  14. Relationship of nutritional factors to the cause, dissolution, and prevention of feline uroliths and urethral plugs.

    Osborne, C A; Polzin, D J; Kruger, J M; Lulich, J P; Johnston, G R; O'Brien, T D


    Feline lower urinary tract disease is often associated with uroliths and urethral plugs. Uroliths and urethral plugs are composed of variable quantities of matrix and a variety of minerals (including struvite, calcium oxalate, ammonium urate, calcium phosphate, and cystine). Knowledge of nutritional factors associated with the pathophysiology of uroliths and urethral plugs facilitates the modification of diets for the dissolution of several minerals contained within them.

  15. Management of male urethral polyps in children: Experience with four cases

    Eziyi Amogu


    Full Text Available Congenital urethral polyps area rare anomaly of the male urethra that may present with features of voiding dysfunction or obstruction. Although the exact incidence is unknown, they are important in the differential diagnosis of lower urethral obstruction in male children. Their diagnosis requires a high index of suspicion because of the variability of presentation. We present our experience with four cases of male urethral polyps in boys with discussion on the related literature.

  16. Paraexstrophy skin flaps for the primary closure of exstrophy in boys: outmoded or updated?

    Purves, J Todd; Gearhart, John P


    We evaluated the current application of Duckett paraexstrophy skin flaps for bladder exstrophy reconstruction. We reviewed the records of cases of classic exstrophy treated at our institution between September 1993 and March 2007. A total of 21 patients were identified in whom modified Duckett paraexstrophy skin flaps were used in bladder closure at our institution. Another 12 patients were referred during the same time after closure with complications with flap use. Of the 21 patients who underwent closure at our institution with our modified version of the Duckett flaps 1 (4%) had a complication, that is urethral stricture. This responded to internal urethrotomy and daily intermittent catheterization for 4 months, and the stricture stabilized. Four of the 12 referred patients responded to multiple urethral dilations, 3 underwent open repair with a buccal graft, 2 received a full-thickness skin graft and 3 underwent internal urethrotomy with daily intermittent catheterization for 4 months. Of our 21 patients with internal treatment 14 underwent bladder neck repair, 5 underwent epispadias repair and 2 were awaiting further reconstruction. Six of the 12 referred patients underwent bladder neck repair, 4 underwent epispadias repair and 2 were awaiting further reconstruction. By modifying our version of the Duckett paraexstrophy skin flaps we have lowered our complication rate significantly. While overall use of these flaps has continued to decrease, when they are required, these modifications help avoid complicating strictures and their sequelae in the bladder and upper urinary tract.

  17. Maximizers versus satisficers

    Parker, Andrew M.; Wandi Bruine de Bruin; Baruch Fischhoff


    Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007). Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al. (2002), we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decisions...

  18. The myth of closure.

    Boss, Pauline; Carnes, Donna


    Therapies for grief and loss have traditionally focused on the work of grieving. The goal was to reach an endpoint, now popularly called closure. There are, however, many people who, through no fault of their own, find a loss so unclear that there can be no end to grief. They have not failed in the work of grieving, but rather have suffered ambiguous loss, a type of loss that is inherently open ended. Instead of closure, the therapeutic goal is to help people find meaning despite the lack of definitive information and finality. Hope lies in increasing a family's tolerance for ambiguity, but first, professionals must increase their own comfort with unanswered questions. In this article, the authors, one a poet, the other a family therapist and theorist, offer a unique blending of theory, reflection, and poetry to experientially deepen the process of self-reflection about a kind of loss that defies closure. © FPI, Inc.

  19. On Maximal Injectivity

    Ming Yi WANG; Guo ZHAO


    A right R-module E over a ring R is said to be maximally injective in case for any maximal right ideal m of R, every R-homomorphism f : m → E can be extended to an R-homomorphism f' : R → E. In this paper, we first construct an example to show that maximal injectivity is a proper generalization of injectivity. Then we prove that any right R-module over a left perfect ring R is maximally injective if and only if it is injective. We also give a partial affirmative answer to Faith's conjecture by further investigating the property of maximally injective rings. Finally, we get an approximation to Faith's conjecture, which asserts that every injective right R-module over any left perfect right self-injective ring R is the injective hull of a projective submodule.

  20. Maximizers versus satisficers

    Andrew M. Parker


    Full Text Available Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007. Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al. (2002, we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decisions, more avoidance of decision making, and greater tendency to experience regret. Contrary to predictions, self-reported maximizers were more likely to report spontaneous decision making. However, the relationship between self-reported maximizing and worse life outcomes is largely unaffected by controls for measures of other decision-making styles, decision-making competence, and demographic variables.

  1. On Maximal Green Sequences

    Brüstle, Thomas; Pérotin, Matthieu


    Maximal green sequences are particular sequences of quiver mutations which were introduced by Keller in the context of quantum dilogarithm identities and independently by Cecotti-Cordova-Vafa in the context of supersymmetric gauge theory. Our aim is to initiate a systematic study of these sequences from a combinatorial point of view. Interpreting maximal green sequences as paths in various natural posets arising in representation theory, we prove the finiteness of the number of maximal green sequences for cluster finite quivers, affine quivers and acyclic quivers with at most three vertices. We also give results concerning the possible numbers and lengths of these maximal green sequences. Finally we describe an algorithm for computing maximal green sequences for arbitrary valued quivers which we used to obtain numerous explicit examples that we present.

  2. Achieving closure at Fernald

    Bradburne, John; Patton, Tisha C.


    When Fluor Fernald took over the management of the Fernald Environmental Management Project in 1992, the estimated closure date of the site was more than 25 years into the future. Fluor Fernald, in conjunction with DOE-Fernald, introduced the Accelerated Cleanup Plan, which was designed to substantially shorten that schedule and save taxpayers more than $3 billion. The management of Fluor Fernald believes there are three fundamental concerns that must be addressed by any contractor hoping to achieve closure of a site within the DOE complex. They are relationship management, resource management and contract management. Relationship management refers to the interaction between the site and local residents, regulators, union leadership, the workforce at large, the media, and any other interested stakeholder groups. Resource management is of course related to the effective administration of the site knowledge base and the skills of the workforce, the attraction and retention of qualified a nd competent technical personnel, and the best recognition and use of appropriate new technologies. Perhaps most importantly, resource management must also include a plan for survival in a flat-funding environment. Lastly, creative and disciplined contract management will be essential to effecting the closure of any DOE site. Fluor Fernald, together with DOE-Fernald, is breaking new ground in the closure arena, and ''business as usual'' has become a thing of the past. How Fluor Fernald has managed its work at the site over the last eight years, and how it will manage the new site closure contract in the future, will be an integral part of achieving successful closure at Fernald.

  3. Tank closure reducing grout

    Caldwell, T.B.


    A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr{sup 90}, the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel.

  4. Tissue Engineering for Human Urethral Reconstruction : Systematic Review of Recent Literature

    de Kemp, Vincent; de Graaf, Petra; Fledderus, Joost O.; Bosch, JLHR; de Kort, Laetitia


    Background Techniques to treat urethral stricture and hypospadias are restricted, as substitution of the unhealthy urethra with tissue from other origins (skin, bladder or buccal mucosa) has some limitations. Therefore, alternative sources of tissue for use in urethral reconstructions are considered

  5. A Rare Cause of Recurrent Urinary Tract Infections, Female Urethral Diverticulum: A Case Report

    Taha Numan Yikilmaz


    Full Text Available A female urethral diverticulum is an uncommon pathologic entity. The most presentation of urethral diverticule has been described as lower urinary tract symptoms and dyspareunia. The case of female is presented, who consult with a vaginal mass and dyspareunia and current literature was reviewed.

  6. Urethral sensory threshold and urethro-anal reflex latency in continent women.

    Cavalcanti, Geraldo de Aguiar; Bruschini, Homero; Manzano, Gilberto M; Giuliano, Lydia P; Nóbrega, João Antônio M; Srougi, Miguel


    The sensory evaluation of the lower urinary tract is summarized in the bladder proprioceptive sensitivity during cystometry. Experimental studies suggest that abnormalities of the urethral innervation and micturition reflex can be related to the presence of continence disturbances. This study aimed to measure the urethral sensory threshold and the urethro-anal reflex latency in healthy volunteers, establishing reading criteria, comparing the results and technique used with the literature and verifying the effect of physiological factors. Thirty healthy female volunteers were studied. They had an absence of genital or urinary complaints and had undergone no previous pelvic or vaginal procedures. The measurement of the urethral sensory threshold and urethro-anal reflex latency were performed as described. The determination of the urethral sensory threshold and urethro-anal reflex latency were obtained in 96.6% of the volunteers. The electrophysiological parameters did not correlate with age, parity or number of vaginal deliveries. There was a positive association of the urethral sensory threshold with height. Technical aspects were considered and compared with those in the literature as well as the advantages and limitations of the method. The measurement of the urethral sensory threshold and urethro-anal reflex latency presented consistent recordings. The urethral sensory threshold should be analyzed carefully in individuals with height above the population average. Subsequent observations are necessary to clarify their function in patients with continence disturbances and to measure the urethral function, but these values can be used as normal parameters for comparison.

  7. Outcomes of urethral calculi patients in an endemic region and an undiagnosed primary fossa navicularis calculus.

    Verit, Ayhan; Savas, Murat; Ciftci, Halil; Unal, Dogan; Yeni, Ercan; Kaya, Mete


    Urethral calculus is a rare form of urolithiasis with an incidence lower than 0.3%. We determined the outcomes of 15 patients with urethral stone, of which 8 were pediatric, including an undiagnosed primary fossa navicularis calculus. Fifteen consecutive male patients, of whom eight were children, with urethral calculi were assessed between 2000 and 2005 with a mean of 19 months' follow-up. All stones were fusiform in shape and solitary. Acute urinary retention, interrupted or weak stream, pain (penile, urethral, perineal) and gross hematuria were the main presenting symptoms in 7 (46.7%), 4 (26.7%), 3 (20%) and 1 (6.6%) patient, respectively. Six of them had accompanying urethral pathologies such as stenosis (primary or with hypospadias) and diverticulum. Two patients were associated with upper urinary tract calculi but none of them secondary to bladder calculi. A 50-year-old patient with a primary urethral stone disease had urethral meatal stenosis accompanied by lifelong lower urinary tract symptoms. Unlike the past reports, urethral stones secondary to bladder calculi were decreasing, especially in the pediatric population. However, the pediatric patients in their first decade are still under risk secondary to the upper urinary tract calculi or the primary ones.

  8. A faster urethral pressure reflectometry technique for evaluating the squeezing function

    Klarskov, Niels; Saaby, Marie-Louise; Lose, Gunnar


    Abstract Objective. Urethral pressure reflectometry (UPR) has shown to be superior in evaluating the squeeze function compared to urethral pressure profilometry. The conventional UPR measurement (step method) required up to 15 squeezes to provide one measure of the squeezing opening pressure and ...

  9. Persistent Urethritis and Prostatitis Due to Trichomonas vaginalis: A Case Report

    Alireza Abdolrasouli


    Full Text Available The present report describes a case of persistent urethritis accompanied by prostatitis due to Trichomonas vaginalis in a young male patient. The importance of the laboratory diagnosis of trichomoniasis in persistent or recurrent urethritis (ie, testing samples from multiple sites is highlighted, with the aim of improving the clinical recognition of this pathogen.

  10. Congenital urethral polyps: a report of two cases; Polipos uretrales congenitos. A proposito de dos casos

    Cano, D.; Vivas, I.; Torres, E.; Garcia, L.; Fernandez-Villa, T. [Clinica Universitaria de Navarra. Pamplona (Spain)


    Congenital urethral polyps are uncommon lesions, very few cases of which have been previously reported in the literature. We present two cases of congenital urethral polyps in children, describing the clinical and radiological features and the diagnostic method employed, as well as reviewing the literature. (Author) 6 refs.

  11. Case of a congenital urethral duplication being unmasked following circumcision for balanitis xerotica obliterans.

    Boyd, Matthew; Woodward, Mark; Lambert, Anthony


    We present the case of an 11-year-old boy diagnosed with an Effmann Type II A1 urethral duplication after routine circumcision for balanitis xerotica obliterans (BXO). We discuss the pathophysiology, investigation and management both of BXO and urethral duplication.

  12. Erectile function after anastomotic urethroplasty for pelvic fracture urethral injuries.

    El-Assmy, A; Harraz, A M; Benhassan, M; Nabeeh, A; Ibrahiem, El Hi


    There is an established association between ED and pelvic fracture urethral injuries (PFUIs). However, ED can occur after the injury and/or the urethral repair. To our knowledge, only one study of erectile function (EF) after urethroplasty for PFUIs used a validated questionnaire. This study was carried out to determine the impact of anastomotic posterior urethroplasty for PFUIs on EF. We retrospectively reviewed the computerized surgical records to identify patients who underwent anastomotic urethroplasty for PFUIs from 1998 to 2014. Those patients were contacted by phone or mail and were re-evaluated in the outpatient clinic by International Index of Erectile Function questionnaire; in unmarried men, the single-question self-report of ED was used for evaluation of EF, clinical examination and penile color Doppler ultrasonography (CDU) for men with ED. Overall, 58 patients were included in the study among whom 36 (62%) men were sexually active and the remaining 22 (38%) were single. The incidence of ED among our group is 72%. All patients developed ED after initial pelvic trauma and none of our patients had impaired EF after urethroplasty. The incidence of ED increased proportionally with severity of pelvic trauma. All patients with type-C pelvic fracture, associated symphysis pubis diastasis, sacroiliac joints diastasis and bilateral pubic ramus fractures had ED. Men with PFUIs had worse EF than men in other series with pelvic fractures without urethral injury. The majority (88%) of men with ED showed veno-occlusive dysfunction on penile CDU. So we concluded that men with PFUIs had a high incidence of ED up to 72%. Anastomotic posterior urethroplasty had no negative impact on EF and the development of ED after PFUIs was related to the severity of the original pelvic trauma. Veno-occlusive dysfunction is the commonest etiology of ED on penile CDU.

  13. Electrospun Poly(l-lactide)/Poly(ethylene glycol) Scaffolds Seeded with Human Amniotic Mesenchymal Stem Cells for Urethral Epithelium Repair

    Lv, Xiaokui; Guo, Qianping; Han, Fengxuan; Chen, Chunyang; Ling, Christopher; Chen, Weiguo; Li, Bin


    Tissue engineering-based urethral replacement holds potential for repairing large segmental urethral defects, which remains a great challenge at present. This study aims to explore the potential of combining biodegradable poly(l-lactide) (PLLA)/poly(ethylene glycol) (PEG) scaffolds and human amniotic mesenchymal cells (hAMSCs) for repairing urethral defects. PLLA/PEG fibrous scaffolds with various PEG fractions were fabricated via electrospinning. The scaffolds were then seeded with hAMSCs prior to implantation in New Zealand male rabbits that had 2.0 cm-long defects in the urethras. The rabbits were randomly divided into three groups. In group A, hAMSCs were grown on PLLA/PEG scaffolds for two days and then implanted to the urethral defects. In group B, only the PLLA/PEG scaffolds were used to rebuild the rabbit urethral defect. In group C, the urethral defect was reconstructed using a regular urethral reparation technique. The repair efficacy was compared among the three groups by examining the urethral morphology, tissue reconstruction, luminal patency, and complication incidence (including calculus formation, urinary fistula, and urethral stricture) using histological evaluation and urethral radiography methods. Findings from this study indicate that hAMSCs-loaded PLLA/PEG scaffolds resulted in the best urethral defect repair in rabbits, which predicts the promising application of a tissue engineering approach for urethral repair. PMID:27517902

  14. Electrospun Poly(l-lactide/Poly(ethylene glycol Scaffolds Seeded with Human Amniotic Mesenchymal Stem Cells for Urethral Epithelium Repair

    Xiaokui Lv


    Full Text Available Tissue engineering-based urethral replacement holds potential for repairing large segmental urethral defects, which remains a great challenge at present. This study aims to explore the potential of combining biodegradable poly(l-lactide (PLLA/poly(ethylene glycol (PEG scaffolds and human amniotic mesenchymal cells (hAMSCs for repairing urethral defects. PLLA/PEG fibrous scaffolds with various PEG fractions were fabricated via electrospinning. The scaffolds were then seeded with hAMSCs prior to implantation in New Zealand male rabbits that had 2.0 cm-long defects in the urethras. The rabbits were randomly divided into three groups. In group A, hAMSCs were grown on PLLA/PEG scaffolds for two days and then implanted to the urethral defects. In group B, only the PLLA/PEG scaffolds were used to rebuild the rabbit urethral defect. In group C, the urethral defect was reconstructed using a regular urethral reparation technique. The repair efficacy was compared among the three groups by examining the urethral morphology, tissue reconstruction, luminal patency, and complication incidence (including calculus formation, urinary fistula, and urethral stricture using histological evaluation and urethral radiography methods. Findings from this study indicate that hAMSCs-loaded PLLA/PEG scaffolds resulted in the best urethral defect repair in rabbits, which predicts the promising application of a tissue engineering approach for urethral repair.

  15. Electrospun Poly(l-lactide)/Poly(ethylene glycol) Scaffolds Seeded with Human Amniotic Mesenchymal Stem Cells for Urethral Epithelium Repair.

    Lv, Xiaokui; Guo, Qianping; Han, Fengxuan; Chen, Chunyang; Ling, Christopher; Chen, Weiguo; Li, Bin


    Tissue engineering-based urethral replacement holds potential for repairing large segmental urethral defects, which remains a great challenge at present. This study aims to explore the potential of combining biodegradable poly(l-lactide) (PLLA)/poly(ethylene glycol) (PEG) scaffolds and human amniotic mesenchymal cells (hAMSCs) for repairing urethral defects. PLLA/PEG fibrous scaffolds with various PEG fractions were fabricated via electrospinning. The scaffolds were then seeded with hAMSCs prior to implantation in New Zealand male rabbits that had 2.0 cm-long defects in the urethras. The rabbits were randomly divided into three groups. In group A, hAMSCs were grown on PLLA/PEG scaffolds for two days and then implanted to the urethral defects. In group B, only the PLLA/PEG scaffolds were used to rebuild the rabbit urethral defect. In group C, the urethral defect was reconstructed using a regular urethral reparation technique. The repair efficacy was compared among the three groups by examining the urethral morphology, tissue reconstruction, luminal patency, and complication incidence (including calculus formation, urinary fistula, and urethral stricture) using histological evaluation and urethral radiography methods. Findings from this study indicate that hAMSCs-loaded PLLA/PEG scaffolds resulted in the best urethral defect repair in rabbits, which predicts the promising application of a tissue engineering approach for urethral repair.

  16. Válvula de uretra anterior Anterior urethral valves

    Silvio Tucci Jr.


    Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

  17. Urethral duplication with unusual cause of bladder outlet obstruction

    Vivek Venkatramani


    Full Text Available A 12-year-old boy presented with poor flow and recurrent urinary tract infections following hypospadias repair at the age of 3 years. The evaluation revealed urethral duplication with a hypoplastic dorsal urethra and patent ventral urethra. He also had duplication of the bladder neck, and on voiding cystourethrogram the ventral bladder neck appeared hypoplastic and compressed by the dorsal bladder neck during voiding. The possibility of functional obstruction of the ventral urethra by the occluded dorsal urethra was suspected, and he underwent a successful urethro-urethrostomy.

  18. Retained Urethral Catheter Secondary to Placement in Proximal Ureter

    Thomas B. McGregor


    Full Text Available We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter.

  19. Retained Urethral Catheter Secondary to Placement in Proximal Ureter.

    McGregor, Thomas B; Sharda, Rajan


    We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter.

  20. Medical management of urethral and colonic perforation associated with urinary catheterization in a kitten.

    Whittemore, Jacqueline C; Zucca, Lynda


    A 6-week-old male kitten was evaluated because of stranguria and possible urethral blockage; a urinary catheter placed during general anesthesia penetrated the urethral and colonic walls and entered the colon. Treatment was conservative, with fluids administered i.v., administration of piperacillin, and supportive care. The kitten never became febrile or clinically ill and continued to thrive. There was no development of clinical signs consistent with stricture, diverticulum, or fistula formation. Complications from urethral perforation include infection and urethral stricture. Reconstructive surgery is considered the treatment of choice for traumatic urethral-colonic perforation. However, surgery may not be feasible or may be cost-prohibitive in certain situations. In such instances, medical management may provide a reasonable alternative to euthanasia.

  1. Mail Office annual closure


    On the occasion of the annual closure of CERN, there will be no mail distributed on Friday 20 December 2013 but mail will be collected in the morning. Nevertheless, you will still be able to bring your outgoing mail to Building 555-R-002 until 12 noon.  

  2. MNC Subsidiary Closure

    de Faria, Pedro; Preto, Miguel Torres; Sofka, Wolfgang


    We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. We ask to what degree the foreign knowledge that they were exposed to is valued in their new job. We argue theoretically that this foreign knowledge is both valuable and not readily available in the host...

  3. MNC Subsidiary Closure

    de Faria, Pedro; Sofka, Wolfgang; Torres Preto, Miguel

    We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. We ask to what degree the foreign knowledge that they were exposed to is valued in their new job. We argue theoretically that this foreign knowledge is both valuable and not readily available in the host...

  4. Ring closure in actin polymers

    Sinha, Supurna; Chattopadhyay, Sebanti


    We present an analysis for the ring closure probability of semiflexible polymers within the pure bend Worm Like Chain (WLC) model. The ring closure probability predicted from our analysis can be tested against fluorescent actin cyclization experiments. We also discuss the effect of ring closure on bend angle fluctuations in actin polymers.

  5. Once Again, Maxims

    Rudiger Bubner


    Full Text Available Even though the maxims' theory is not at thecenter of Kant's ethics, it is the unavoidable basis of the categoric imperative's formulation. Kant leanson the transmitted representations of modem moral theory. During the last decades, the notion of maxims has deserved more attention, due to the philosophy of language's debates on rules, and due to action theory's interest in this notion. I here by brietly expound my views in these discussions.

  6. Chlamydia trachomatis in cervicitis and urethritis in women.

    Paavonen, J; Vesterinen, E


    In the Scandinavian countries today, Chlamydia trachomatis seems to be the most important cause of sexually transmitted diseases. Although C. trachomatis is most prevalent in symptomatic women and in persons visiting venereal disease clinics, the asymptomatic carrier rate, particularly in young women, appears to be surprisingly high. In addition to young age and level of sexual activity, the use of oral contraceptives and the presence of cervical ectopy are important risk factors for chlamydial infection. Chlamydial cervicitis often is characterized by a hypertrophic follicular appearance, with severe edema, erythema, friability, and endocervical mucopurulent discharge. On colposcopy, an atypical transformation zone is frequently observed. Papanicolaou smears taken from C. trachomatis culture-positive patients often reveal benign atypias and dyskaryotic changes. C. trachomatis, therefore, being a venereally transmitted intracellular organism, may well play a role in the development of cervical intraepithelial neoplasia (CIN). Future studies on patients with cytological atypias, therefore, also should include tests for C. trachomatis. Prospective studies are needed to determine the natural history and outcome of C. trachomatis-associated atypias and their behavior after adequate therapy. A large proportion of C. trachomatis-infected women also are culture-positive from the urethra. The demonstration that C. trachomatis is a common causative agent of acute urethral syndrome (also called abacterial urethritis, dysuria-pyuria syndrome) in women has been a valuable contribution. The diagnosis of pyuria in a patient with abacterial dysuria is of critical importance, since it suggests a chlamydial etiology and thus is a potentially treatable condition.

  7. Outcome of children with posterior urethral valves: Prognostic factors

    R A Kukreja


    Full Text Available Posterior urethral valves present with a wide spectrum of renal and bladder pathology. These changes may per-sist despite successful treatment of the primary obstruc-tion, leading to a gradual progress towards renal insf ciency. This study reviews retrospectively a series of 70 children with posterior urethral valves who pre-sented at our institute over the last 10 years, with an aim to identify the prognostic factors and help in defining the end result and implicating the correct treatment proto-col. These included age at presentation and intervention (less than or more than 2 years, recurrent urosepsis, pres-ence of vesico-ureteric reflux, renal parenchymal dam-age as seen on ultrasound, vesical dysfunction and the nadir serum creatinine level. 29% of children had renal insufficiency at the end of 3-years′ follow-up. Factors important in the progression towards renal insufficiency were evaluated. Factors found to be statistically signifi-cant with a p value < 0.05 were age at intervention more than 2 years, recurrent urosepsis, bilateral high grade vesico-ureteric reflex, bilateral parenchymal damage as seen on ultrasonography and nadir serum creatinine of more than 0.8 mg%.

  8. Urethral metastasis of lung carcinoma with germinative cell features

    Tefilli Marcos V.


    Full Text Available INTRODUCTION: We present the case of a patient with urethral metastasis of a lung carcinoma with germinative cell features. CASE REPORT: A White, 57-year old man underwent urologic assessment due to gross hematuria. Patient was being treated with chemotherapy and radiotherapy during the past 3 months due to primary carcinoma of the lung with brain metastasis. Urethrocistoscopy and nuclear magnetic resonance imaging revealed a stenosing mass invading the bulbomembranous urethra. No other tumor was found. Biopsy specimens, obtained from the lung, brain and urethra tumors, revealed the same neoplasia, with definitive diagnosis being undifferentiated giant cell carcinoma of the lung with germinative features. Considering his clinical condition and poor prognosis, a decision was made to treat the patient only clinically. Clinical conditions deteriorated and the patient evolved to death within 3 months. COMMENTS: As far as we were able to access, urethral metastasis from lung carcinoma had never been described in the indexed literature. Due to the extremely limited experience with these tumors, there is not a defined treatment and the prognosis remains quite poor.

  9. A case against closure

    Olin, Doris


    Full Text Available Este artigo examina a objeção ao fechamento [dedutivo] que surge no contexto de certos paradoxos epistêmicos, paradoxos cuja conclusão é que a crença justificada pode ser inconsistente. É universalmente aceito que, se essa conclusão é correta, o fechamento deve ser rejeitado, para que se evite a crença justificada em enunciados contraditórios (P, ~P. Mas, mesmo que os argumentos desses paradoxos - o paradoxo da falibilidade (do prefácio e o paradoxo da loteria - seja mal sucedidos, eles, ainda assim, sugerem a existência de evidência independente para uma objeção mais direta contra o fechamento. O exame do argumento da falibilidade revela uma exigência de modéstia epistêmica que viola o fechamento a partir de múltiplas premissas. A reflexão sobre o paradoxo da loteria nos confronta com um dilema em que cada alternativa fornece um contra-exemplo ao fechamento a partir de uma única premissa. Seja ou não possível a inconsistência racional, há uma objeção contra o fechamento. This paper examines the case against closure that arises in the context of certain epistemic paradoxes, paradoxes whose conclusion is that it is possible for justified belief to be inconsistent. It is generally agreed that if this conclusion is correct, closure must be rejected in order to avoid justified belief in contradictory statements (P, ~P. But even if the arguments of these paradoxes – the fallibility (preface paradox and the lottery paradox – are unsuccessful, they nonetheless suggest independent grounds for a more direct case against closure. Examination of the fallibility argument reveals a requirement of epistemic modesty that violates multiple premise closure. Reflection on the lottery paradox presents us with a dilemma in which each alternative provides a counterexample to single premise closure. Whether or not rational inconsistency is possible, there is a case against closure.

  10. Summer season | Cafeteria closures


    Please note the following cafeteria closures over the summer season: Bldg. 54 closed from 29/07/2013 to 06/09/2013. Bldg. 13: closed from 13/07/2013 to 06/09/2013. Restaurant No. 2, table service (brasserie and restaurant): closed from 01/08/2013 to 06/09/2013. Bldg. 864: closed from 29/07/2013 to 06/09/2013. Bldg. 865: closed from 29/07/2013 to 06/09/2013.

  11. Summer season | Cafeteria closures


    Please note the following cafeteria closures over the summer season: Bldg. 54 closed from 29/07/2013 to 06/09/2013. Bldg. 13: closed from 13/07/2013 to 06/09/2013. Restaurant No. 2, table service (brasserie and restaurant): closed from 01/08/2013 to 06/09/2013. Bldg. 864: closed from 29/07/2013 to 06/09/2013. Bldg. 865: closed from 29/07/2013 to 06/09/2013.

  12. Overnight urethral stenting after tubularized incised plate urethroplasty for distal hypospadias.

    Ritch, Chad R; Murphy, Alana M; Woldu, Solomon L; Reiley, Elizabeth A; Hensle, Terry W


    The duration of urethral stenting after tubularized incised plate (TIP) urethroplasty for hypospadias varies among surgeons. Typically the catheter is left for up to 7 days with the goal of minimizing post-operative complications. We describe our experience with overnight stenting for distal TIP hypospadias repair. A retrospective chart review was performed on patients who underwent TIP hypospadias repair from 2003 to 2008. Patients who had their urethral catheter overnight were included in this analysis. Outcomes analyzed were the rates of: urethrocutaneous fistula, meatal stenosis, urethral stricture and urinary tract infections. A total of 64 patients underwent outpatient TIP hypospadias repair. Forty-nine patients had overnight urethral stenting with at least 12 months follow-up and were included in the analysis. Five of the 49 patients (10.2%) developed urethrocutaneous fistula. Of these five patients, two had undergone re-do hypospadias repair. The fistula rate in primary repairs was 3/45 (6.7%). There were no incidences of meatal stenosis, urinary tract infections or urethral strictures. In our experience, overnight urethral stenting for TIP hypospadias repair does not significantly affect the rates of urethrocutaneous fistula, meatal stenosis and urinary tract infections. Patients who have had a primary TIP hypospadias repair may have their urethral catheter removed safely on post-operative day one.

  13. RELAP-7 Closure Correlations

    Zou, Ling [Idaho National Lab. (INL), Idaho Falls, ID (United States); Berry, R. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Martineau, R. C. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Andrs, D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhang, H. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hansel, J. E. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Sharpe, J. P. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Johns, Russell C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    The RELAP-7 code is the next generation nuclear reactor system safety analysis code being developed at the Idaho National Laboratory (INL). The code is based on the INL’s modern scientific software development framework, MOOSE (Multi-Physics Object Oriented Simulation Environment). The overall design goal of RELAP-7 is to take advantage of the previous thirty years of advancements in computer architecture, software design, numerical integration methods, and physical models. The end result will be a reactor systems analysis capability that retains and improves upon RELAP5’s and TRACE’s capabilities and extends their analysis capabilities for all reactor system simulation scenarios. The RELAP-7 code utilizes the well-posed 7-equation two-phase flow model for compressible two-phase flow. Closure models used in the TRACE code has been reviewed and selected to reflect the progress made during the past decades and provide a basis for the colure correlations implemented in the RELAP-7 code. This document provides a summary on the closure correlations that are currently implemented in the RELAP-7 code. The closure correlations include sub-grid models that describe interactions between the fluids and the flow channel, and interactions between the two phases.

  14. Isolation of Haemophilus influenzae and Haemophilus parainfluenzae in urethral exudates from men with acute urethritis: a descriptive study of 52 cases.

    Deza, Gustavo; Martin-Ezquerra, Gemma; Gómez, Julià; Villar-García, Judit; Supervia, August; Pujol, Ramon M


    To describe the clinical characteristics and therapeutic outcomes from male patients diagnosed of Haemophilus spp urethritis. A chart review of patients who presented to our hospital from January 2013 to December 2014 with symptoms of acute urethritis in which Haemophilus spp was isolated in their urethral samples was performed. Haemophilus spp was isolated in 52 out of 413 urethral samples (12.6%) received in our laboratory from patients with symptoms of acute urethritis during the study period. Seven cases corresponded to Haemophilus influenzae and 45 cases to Haemophilus parainfluenzae. The most common clinical presentation was mucopurulent urethral discharge (71%). Eight per cent were HIV-infected patients, and 60% were men who have sex with men. Haemophilus spp was isolated as a single pathogen in 6.8% (28 of 413) of cases. Seventeen per cent of Haemophilus spp were β-lactamase producers. All patients reported having practiced unprotected insertive oral sex the month before consultation, and five of them denied having had another sexual contact apart from this exposure. In all cases in which follow-up was available, empirical treatment achieved a complete clinical resolution. Haemophilus spp was considered a pathogen in at least 6.8% of the patients from the evaluated area. It affected men regardless their sexual orientation or HIV status. Unprotected oral sex could play a role in its transmission. The limitations of the study (small sample size and lack of a representative control group) do not allow to prove the true pathogenic role of Haemophilus spp in acute urethritis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  15. One-stage urethral reconstruction using colonic mucosa graft:an experimental and clinical study

    Yue-Min Xu; Yong Qiao; Ying-Long Sa; Jiong Zhang; Hui-Zhen Zhang; Xin-Ru Zhang; Deng-Long Wu; Rong Chen


    AIM: To investigate the possibility of urethral reconstructionwith a free colonic mucosa graft and to present ourpreliminary experience with urethral substitution using a freegraft of colonic mucosa for treatment of 7 patients withcomplex urethral stricture of a long segment.METHODS: Ten female dogs underwent a procedure inwhich the urethral mucosa was totally removed andreplaced with a free graft of colonic mucosa. A urodynamicstudy was performed before the operation and sacrifice.The dogs were sacrificed 8 to 16 weeks after the operationfor histological examination of urethra. Besides, 7 patientswith complex urethral stricture of a long segment weretreated by urethroplasty with the use of a colonic mucosalgraft. The cases had undergone an average of 3 previousunsuccessful repairs. Urethral reconstruction with a freegraft of colonic mucosa ranged from 10 to 17 cm (mean13.1 cm). Follow-up included urethrography, urethroscopyand uroflowmetry.RESULTS: Urethral stricture developed in 1 dog. The resultsof urodynamic studies showed that the difference in themaximum urethral pressure between the pre-operation andpre-sacrifice in the remaining 9 dogs was not of significance(P>0.05). Histological examination revealed that the colonicfree mucosa survived inside the urethral lumen of the 10experimental dogs. Plicae surface and unilaminar cylindricepithelium of the colonic mucosa was observed in dogssacrificed 8 weeks after the operation. The plicae surfaceand unilaminar cylindric epithelium of the colonic mucosawas not observed, and metaplastic transitional epitheliumcovered a large proportion of the urethral mucosa in dogssacrificed 12 weeks after the operation. Clinically, the patientswere followed up for 3-18 months postoperatively (mean8.5 months). Meetal stenosis was developed in 1 patient 3months postoperatively and needed reoperation. The patientwas voiding very well with urinary peak flow 28.7 ml/s duringthe follow-up of 9 months after reoperation. The

  16. A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy

    Konstantinos Stamatiou


    Full Text Available Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization, urethroplasty, endoscopic internal urethrotomy, and dilation. Optical internal urethrotomy offers faster recovery, minimal scarring, and less risk of infection, although recurrence is possible. However, technical difficulties associated with poor visualization of the stenosis or of the urethral lumen may increase procedural time and substantially increase the failure rates of internal urethrotomy. In this report we describe a technique for urethral catheterization via a suprapubic, percutaneous approach through the urinary bladder in order to facilitate endoscopic internal urethrotomy.

  17. Parameatal urethral cyst of glans penis in children – a report of three cases

    Mrinal Gupta


    Full Text Available Parameatal urethral cysts are a rare benign condition usually seen in males. They are usually asymptomatic but may produce symptoms like difficulty in micturition, pain during intercourse, urinary retention and distortion of the urinary stream. We report three cases of parameatal urethral cyst in young males presenting as a spherical clear fluid filled cystic lesions over the external urethral meatus, causing distortion of the urinary stream and poor cosmesis. Histological examination of the excised cyst showed a monolocular cyst lined with pseudo-stratified epithelium with no evidence of inflammation. Complete surgical excision of the cysts was done and no recurrence was observed at follow-up.

  18. Urethral polyp in a 1-month-old child

    Beluffi, Giampiero [Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Section of Paediatric Radiology, Piazzale Golgi, 2, I-27100, Pavia PV (Italy); Berton, Francesca; Gola, Giada [University of Pavia, IRCCS Policlinico S. Matteo, Institute of Radiology, Pavia (Italy); Chiari, Giorgio; Romano, Piero; Cassani, Ferdinando [IRCCS Policlinico S. Matteo, Division of Paediatric Surgery, Pavia (Italy)


    Urethral polyps are a rare finding in children, particularly in the very young. They are suspected by the presence of various clinical signs such as obstruction, voiding dysfunction and haematuria. There is an association with other urinary tract congenital anomalies. They are usually benign fibro-epithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy. We report a 1-month-old boy with an antenatally diagnosed left ectopic pelvic kidney, postnatal urinary tract infection and no clinical signs of obstruction. Voiding cystourethrography to exclude vesico-ureteric reflux showed a trabeculated bladder and a mobile filling defect in the posterior urethra. Owing to its large size, cystotomy was necessary to remove the polyp successfully. (orig.)

  19. Urethral masturbation and sexual disinhibition in dementia: a case report.

    Rosenthal, Michal; Berkman, Pinhas; Shapira, Adi; Gil, Israel; Abramovitz, Jancu


    Urethral masturbation and sexual disinhibition as manifestations of behavioral and psychological symptoms of dementia (BPSD) are described in a 90-year-old patient who repeatedly self-inserted foreign bodies into his urethra. A diagnosis was made of late onset sexual disinhibition and hypersexuality in a patient with Dementia of the Alzheimer Type. Significant reduction of his sexual behavior was achieved with low doses of haloperidol. Similar symptoms are noted in Pick's disease, other fronto-temporal lesions, mania and following a seizure or treatment of Parkinson's disease, and have been described as Kluver-Busy-type. Clinicians should consider this diagnosis when investigating dysuria, cystitis, haematuria and urinary tract infections even in the very old.

  20. Female urethral diverticulum associated with a large urinary calculus

    Alexandre Oliveira Rodrigues


    Full Text Available The diverticula of female urethra are very uncommon, but more frequently found between the third and fifth decade of life. Diverticula area mostly relate to repeated urinary infections of the periurethral glands or urethra’s trauma. The diverticula may cause infection, calculus formation and rarely endometriosis or cancer. A case of a 65-year old Caucasian female with vaginal mass over six months is herein reported. There was no urinary loss, urethral secretion or urinary symptoms.    A cystourethrography showed diverticula with calculus inside. The patient was submitted to surgery and dismissed from the hospital on the first postoperative day. The pathologic examination revealed no malignancy. In six months of follow-up, the patient was continent with no complaints.

  1. [Diagnosis of urethritis in men. A 3-year review].

    Orellana, M A; Gómez, M l; Sánchez, M T; Fernández-Chacón, T


    The aim of this study is to know the prevalence and tendency of microorganisms producing urethritis, in men, in the City Centre of Madrid. Cross-sectional study. The urethral samples of 1.248 men were analyzed, for 3 years. The samples were studied for: GRAM stain, when secretion exists; culture in habitual plates; detection of C. trachomatis, U. urealyticum and M. hominis, when there was suspicious, study of T. vaginalis and when suspicious injuries exist, study of virus Herpes simplex. The percentage of positive samples was 22.60%. The isolated microorganisms were: U. urealyticum 7.61%, N. gonorrhoeae 6.33%, C. trachomatis 4.81%, M. hominis 0.24%, H. parainfluenzae 1.76%, H. influenzae 1.12%, Candida spp 0.48%, S. pyogenes 0.16% and Herpes virus simplex (2) 0.08%. Two or more microorganisms were isolated in 1.68%. The percentage of positive samples in 2003 was 17.41% and N. gonorrhoeae the most frequent microorganism (6.22%). In 2004 was 25.57% and the most frequent U. urealyticum (10.18%). In 2005 the 24.50% of the samples were positive and U. urealyticum the most frequent (7.92%). The 79.41% of N. gonorrhoeae were susceptible to all antibiotics tested. It is not found resistance to ceftriaxone, claritromicine and amoxicilline/clavulanic acid. The 11.76% were betalactamase- producing. The 26.47% of Haemophilus spp. were betalactamase- producing and all strains were susceptible to cefotaxime. The isolated microorganisms most frequently were: U. urealyticum, N. gonorrhoeae and C. trachomatis. There is an increase of 7% of prevalence between the years 2003 and 2005. Ceftriaxone, claritromicine and amoxicilline/clavulanic acid were susceptible to all the strains studied and cefotaxime to all Haemophilus spp.

  2. Uretritis meningocóccica masculina Male meningococcal urethritis

    Federico Díaz González


    Full Text Available

    Se presenta el caso de un hombre de 39 años que tuvo uretritis ocho días después de relación orogenital (felatio con una prostituta; de la secreción uretral se aisló Neisseria meningitidis, clasificada como del grupo B; la cepa no producía β lactamasa. El paciente fue tratado con ciprofloxacina y respondió satisfactoriamente; los controles ocho días después de terminar el tratamiento fueron negativos para Neisseria. La inmunofluorescencia para C. trachomatis fue negativa. Se hace una discusión del significado de la N. meningitidis en infecciones genitales.

    We report on the case of a 39 year-old white male who developed urethritis eight days after orogenital contact (fellatio with a prostitute. Group B N. meningitidis was recovered from the urethral secretion; the strain was negative for β lactamase production. Response to cyprofloxacin treatment was satisfactory. Control cultures for Neisseriawere negative eight days after completing treatment. At that moment direct immunofluorescence for Chlamydia trachomatis antigens were also negative. The significance of N. meningitidis in genital tract infections is discussed.

  3. Remote discovery of an asymptomatic bowel perforation by a mid-urethral sling.

    Elliott, Jason E; Maslow, Ken D


    Bowel perforation is a rare complication of mid-urethral sling procedures and is usually reported shortly after the surgery. We report a remotely discovered asymptomatic bowel injury found at the time of subsequent surgery. The patient with a history of several prior pelvic surgeries underwent an uneventful retropubic mid-urethral sling placement. Five years later, during an abdominal sacrocolpopexy procedure, mesh from the mid-urethral sling was found perforating the wall of the cecum and fixating it to the right pelvic sidewall. Cecal wedge resection was performed to excise the sling mesh. Asymptomatic bowel perforation by mid-urethral sling mesh has not been previously reported. Pelvic and abdominal surgeons should be aware of the possibility of finding this injury in patients with prior sling surgeries.

  4. Primary Clear Cell Adenocarcinoma of a Urethral Diverticulum Treated with Multidisciplinary Robotic Anterior Pelvic Exenteration

    Dane Scantling


    Full Text Available Primary urethral carcinoma is extremely rare and is marked by a variety of clinical symptoms. Primary carcinoma of a urethral diverticulum is still rarer and clear cell adenocarcinoma of the urethra is particularly uncommon (Swartz et al., 2006. Such infrequency has led to inadequate management guidance in the literature for a disease that is often late in presentation and carries substantial morbidity and mortality. This treatable but grave disease deserves definitive curative treatment. We present the first published instance in which it was treated with robotic anterior exenteration. In our case, a 47-year-old female was referred to the urology service for investigation of recurring urinary tract infections. During the workup, the patient was found to have an advanced clear cell urethral adenocarcinoma originating in a urethral diverticulum. We discuss the natural history of this condition, its consequences, and the first instance of its treatment using robotic anterior pelvic exenteration.

  5. Urethral pressure reflectometry before and after tension-free vaginal tape

    Saaby, Marie-Louise; Klarskov, Niels; Lose, Gunnar


    Urethral pressure reflectometry (UPR) is a new method for measuring pressure and cross-sectional area in the urethra. Our aim was to investigate if the UPR parameters at rest and during squeeze were unchanged after TVT....

  6. Reasons for the weak correlation between prostate volume and urethral resistance parameters in patients with prostatism

    R. Kranse (Ries); R. van Mastrigt (Ron); F.H. Schröder (Fritz); J.L.H.R. Bosch (Ruud)


    textabstractIn an attempt to increase our understanding of the clinical syndrome of benign prostatic hyperplasia (BPH) an analysis was made of the association between prostate volume as measured by transrectal ultrasound and several reported urodynamically determined urethral resis

  7. Maximally Atomic Languages

    Janusz Brzozowski


    Full Text Available The atoms of a regular language are non-empty intersections of complemented and uncomplemented quotients of the language. Tight upper bounds on the number of atoms of a language and on the quotient complexities of atoms are known. We introduce a new class of regular languages, called the maximally atomic languages, consisting of all languages meeting these bounds. We prove the following result: If L is a regular language of quotient complexity n and G is the subgroup of permutations in the transition semigroup T of the minimal DFA of L, then L is maximally atomic if and only if G is transitive on k-subsets of 1,...,n for 0 <= k <= n and T contains a transformation of rank n-1.

  8. Palliative Surgery for Rare Cases of Anterior Urethral Metastasis in Prostate Cancer

    Enrique Gómez Gómez


    Full Text Available Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature.

  9. Palliative Surgery for Rare Cases of Anterior Urethral Metastasis in Prostate Cancer

    Gómez Gómez, Enrique; Carrasco Aznar, Jose Carlos; Moreno Rodríguez, Maria del Mar; Valero Rosa, José; Requena Tapia, Maria José


    Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature. PMID:25161796

  10. Leiomioma uretral durante a gravidez: relato de caso Urethral leiomyoma during pregnancy: a case report

    Arlon Breno Figueiredo Nunes da Silveira


    Full Text Available The authors report a case of urethral leiomyoma diagnosed during pregnancy, which was conservatively treated up to the 38th week, when the pregnancy was interrupted. Thirty days after delivery, exeresis of the lesion was performed from the upper border of the urethral meatus and sutured with interrupted delayed-absorbable suture. The patient evolved favorably and presented no lesion recurrence during three months of follow up.

  11. A Study Of The Results Of "Urethral Advancement And Glanuloplasty" (UAGP) In Repairing Anterior Hypospadias


    Background: In this study, the results of "Urethral Advancement & Glanuloplasty" in repairing anterior hypospadias were considered. Hypospadias is a common urethral anomaly in boys. More than 65 percent of hypospadias cases are anterior (glanular, coronal and distal penil shaft). More than two hundreds original techniques have been applied to correct hypospadias. Each of these techniques has some complications. The most common complications of hypospadias repairing a...

  12. Guinea pig maximization test

    Andersen, Klaus Ejner


    Guinea pig maximization tests (GPMT) with chlorocresol were performed to ascertain whether the sensitization rate was affected by minor changes in the Freund's complete adjuvant (FCA) emulsion used. Three types of emulsion were evaluated: the oil phase was mixed with propylene glycol, saline with...... to the saline/oil emulsion. Placing of the challenge patches affected the response, as simultaneous chlorocresol challenge on the flank located 2 cm closer to the abdomen than the usual challenge site gave decreased reactions....

  13. 40 CFR 265.280 - Closure and post-closure.


    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure and post-closure. 265.280 Section 265.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES... location, topography, and surrounding land use, with respect to the potential effects of pollutant...


    Lane, J E; Scott, J E; Mathews, S E


    Lawrence Livermore National Laboratory of the University of California (LLNL) operates two Class II surface impoundments that store wastewater that is discharged from a number of buildings located on the Site 300 Facility (Site 300). The wastewater is the by-product of explosives processing. Reduction in the volume of water discharged from these buildings over the past several years has significantly reduced the wastewater storage needs. In addition, the impoundments were constructed in 1984, and the high-density polyethylene (HDPE) geomembrane liners are nearing the end of their service life. The purpose of this project is to clean close the surface impoundments and provide new wastewater storage using portable, above ground storage tanks at six locations. The tanks will be installed prior to closure of the impoundments and will include heaters for allowing evaporation during relatively cool weather. Golder Associates (Golder) has prepared this Final Closure Plan (Closure Plan) on behalf of LLNL to address construction associated with the clean closure of the impoundments. This Closure Plan complies with State Water Resources Control Board (SWRCB) Section 21400 of the California Code of Regulations Title 27 (27 CCR {section}21400). As required by these regulations and guidance, this Plan provides the following information: (1) A site characterization, including the site location, history, current operations, and geology and hydrogeology; (2) The regulatory requirements relevant to clean closure of the impoundments; (3) The closure procedures; and, (4) The procedures for validation and documentation of clean closure.

  15. Quantum-Inspired Maximizer

    Zak, Michail


    A report discusses an algorithm for a new kind of dynamics based on a quantum- classical hybrid-quantum-inspired maximizer. The model is represented by a modified Madelung equation in which the quantum potential is replaced by different, specially chosen 'computational' potential. As a result, the dynamics attains both quantum and classical properties: it preserves superposition and entanglement of random solutions, while allowing one to measure its state variables, using classical methods. Such optimal combination of characteristics is a perfect match for quantum-inspired computing. As an application, an algorithm for global maximum of an arbitrary integrable function is proposed. The idea of the proposed algorithm is very simple: based upon the Quantum-inspired Maximizer (QIM), introduce a positive function to be maximized as the probability density to which the solution is attracted. Then the larger value of this function will have the higher probability to appear. Special attention is paid to simulation of integer programming and NP-complete problems. It is demonstrated that the problem of global maximum of an integrable function can be found in polynomial time by using the proposed quantum- classical hybrid. The result is extended to a constrained maximum with applications to integer programming and TSP (Traveling Salesman Problem).

  16. Traumatic Posterior Urethral Fistula to the Hip Joint Following Gunshot Injury: A Case Report

    Mohammad Ghasemi-Rad


    Full Text Available Introduction: Fistula of the Urinary system to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury."nCase Presentation: A 37-year-old man was shot with firearm to the superior part of the right pelvis. He underwent delayed reconstruction surgery for urethral rupture. After 10 months of initial injury, he presented with inability to urinate, and history of progressive pain in the right hip joint accompanied by low-grade fever, which started two months after the initial injury. In retrograde urethrography and antegrade cystography, a 5 cm-long stricture and a fistula tract to the right hip joint were detected. Hip x-ray showed evidence of acetabular cavity and femoral head destruction diagnostic of complicated septic arthritis. The patient subsequently underwent reconstructive surgery for the urethral stricture and urethral fistula via a transperineal approach followed by total hip arthroplasty."nConclusion: Hip joint contamination with urine following urethro-acetabular fistula may lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should have these fistulas in mind as a complication of penetrating urethral injury; every attempt should be made for their early diagnosis and prompt treatment should be performed to prevent further complications."nKeywords: Urethral Fistula, Hip Joint, Gunshot Injury, Urethro-Acetabular Fistula, Trauma    

  17. Management of the stricture of fossa navicularis and pendulous urethral strictures

    Singh, Shrawan K.; Agrawal, Santosh K.; Mavuduru, Ravimohan S.


    Objective: Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods: The literature in English language was searched from the National Library of Medicine database, using the appropriate key words for the period 1985-2010. Out of 475 articles, 115 were selected for the review based on their relevance to the topic. Results: Etiology of stricture is shifting from infective to inflammatory and iatrogenic causes. Stricture of fossa navicularis is most often caused by lichen sclerosus et atrophicus and instrumentation. Direct visual internal urethrotomy is limited to selected cases in the management of pendulous urethral stricture. With experience and identification of various prognostic factors, conservative management by dilatation and internal urethrotomy is being replaced by various reconstructive procedures, using skin flaps and grafts with high success rates. Single-stage urethroplasty is preferred over the 2-stage procedure as the latter disfigures the penis and poses sexual problems temporarily. Conclusions: Flaps or grafts are useful for single-stage reconstruction of fossa navicularis and pendulous urethral strictures. The buccal and lingual mucosa serves as a preferred resource material for providing the inner lining of the urethra. Off-the-shelf materials, such as acellular collagen matrix, are promising. PMID:22022062

  18. Intermittent self-dilatation for urethral stricture disease in males.

    Jackson, Matthew J; Veeratterapillay, Rajan; Harding, Chris K; Dorkin, Trevor J


    Intermittent urethral self-dilatation is sometimes recommended to reduce the risk of recurrent urethral stricture. There is no consensus as to whether it is a clinically effective or cost-effective intervention in the management of this disease. The purpose of this review is to evaluate the clinical effectiveness and cost-effectiveness of intermittent self-dilatation after urethral stricture surgery in males compared to no intervention. We also compared different programmes of, and devices for, intermittent self-dilatation. . We searched the Cochrane Incontinence Group Specialised Register (searched 7 May 2014), CENTRAL (2014, Issue 4), MEDLINE (1 January 1946 to Week 3 April 2014), PREMEDLINE (covering 29 April 2014), EMBASE (1 January 1947 to Week 17 2014), CINAHL (31 December 1981 to 30 April 2014) OpenGrey (searched 6 May 2014), (6 May 2014), WHO International Clinical Trials Registry Platform (6 May 2014), Current Controlled Trials (6 May 2014) and the reference lists of relevant articles. Randomised and quasi-randomised trials where one arm was a programme of intermittent self-dilatation for urethral stricture were identified. Studies were excluded if they were not randomised or quasi-randomised trials, or if they pertained to clean intermittent self-catheterisation for bladder emptying. Two authors screened the records for relevance and methodological quality. Data extraction was performed according to predetermined criteria using data extraction forms. Analyses were carried out in Cochrane Review Manager (RevMan 5). The primary outcomes were patient-reported symptoms and health-related quality of life, and risk of recurrence; secondary outcomes were adverse events, acceptability of the intervention to patients and cost-effectiveness. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Eleven trials were selected for inclusion in the review, including a total of 776

  19. Planning for integrated mine closure

    Linda Starke (ed.)


    This document presents an Integrated Mine Closure Planning Toolkit for the mining and metals sector. The toolkit is intended to be used to promote a more disciplined approach to integrated closure planning and to increase the uniformity of good practices across the sector. The concepts apply equally well to both large and small companies. The document is not intended to be prescriptive; it provides a suite of tools that can be brought to bear in formulating well-considered decisions when planning for closure. It uses a risk and opportunity based process to guide the practitioner through the iterative process of preparing for planned closure. The first section, with head office and mine management personnel as the primary audience, describes the participants of effective closure planning. Sections 2 and 3 provide the frameworks for a conceptual closure plan and a detailed plan. The key audiences for these two sections are mine management and head office personnel, financial modellers and estimators, governments, academics and non-governmental organizations. The forth section addresses decommissioning and post closure planning, and Section 5 draws together the conclusions and outlines several unresolved issues. The five narrative sections are followed by Section 6 which outlines 13 tools, some of which are already available in earlier ICMM publications, member practices and other sector-affiliated publications. Others have been developed to cover identified gaps. These tools provide the practitioner with practical work processes, examples and contexts within which to apply closure planning discipline.

  20. Palladium interstitial implant in combination with external beam radiotherapy and chemotherapy for the definitive treatment of a female urethral carcinoma

    Hilary P. Bagshaw


    Full Text Available Primary urethral cancer is a rare diagnosis, especially in females. This report presents the utilization of a palladium interstitial implant and a review of the retrospective data published on the management of female urethral cancer. Excellent local control and survival has been obtained with the use of a palladium interstitial implant in combination with external beam radiotherapy and concurrent chemotherapy. This modality represents a novel and effective way to treat primary urethral cancer in females.

  1. Treatment of urethral strictures in balanitis xerotica obliterans (BXO) using circular buccal mucosal meatoplasy: Experience of 15 cases


    Objectives: Balanitis xerotica obliterans (BXO) related strictures involving the external urethral meatus. We reviewed our result with the use of circular mucosal graft in the reconstruction of strictures. Methods: Between March 1997 and January 2012, 15 patients underwent circular buccal mucosal urethroplasy for BXO related anterior urethral strictures. Urethral catheter was removed within 2 weeks. Follow-up included patient symptoms assessment, cosmetic outcome and uroflowmetry. Results: Me...

  2. Social group utility maximization

    Gong, Xiaowen; Yang, Lei; Zhang, Junshan


    This SpringerBrief explains how to leverage mobile users' social relationships to improve the interactions of mobile devices in mobile networks. It develops a social group utility maximization (SGUM) framework that captures diverse social ties of mobile users and diverse physical coupling of mobile devices. Key topics include random access control, power control, spectrum access, and location privacy.This brief also investigates SGUM-based power control game and random access control game, for which it establishes the socially-aware Nash equilibrium (SNE). It then examines the critical SGUM-b

  3. Maximizing Modularity is hard

    Brandes, U; Gaertler, M; Goerke, R; Hoefer, M; Nikoloski, Z; Wagner, D


    Several algorithms have been proposed to compute partitions of networks into communities that score high on a graph clustering index called modularity. While publications on these algorithms typically contain experimental evaluations to emphasize the plausibility of results, none of these algorithms has been shown to actually compute optimal partitions. We here settle the unknown complexity status of modularity maximization by showing that the corresponding decision version is NP-complete in the strong sense. As a consequence, any efficient, i.e. polynomial-time, algorithm is only heuristic and yields suboptimal partitions on many instances.

  4. Uerthral Obstruction By a Foregin Body:An Unusal Presentation of Ano-Rectal Malformation With Recto-Urethral Fistuala

    Nasib C.Digray,D.R.Thapa,H.L.Gowamy,Ratanakar Sharma


    Full Text Available A 16 months old male child with features of acute urinary and intestinal obstruction due toa vegetative foreign body (FB impacted in the anterior urethra is presented. The patient hadan untreated intermediate ano-rectal malformation (ARM with wide recto-urethral fistula(RUF. Multiple other congenital anomalies were, also, seen in this patient. The foreignbody was removed by an external urethral meatotomy, relieving recto-urethral obstruction.However, the child died of septicaemia 6 hours post-operativerly. To best ofOUt knowledge,this is the first case of ARM, presenting with urethral obstruction due to a foreign body.

  5. Maximizing without difficulty: A modified maximizing scale and its correlates

    Linda Lai


    This article presents several studies that replicate and extend previous research on maximizing. A modified scale for measuring individual maximizing tendency is introduced. The scale has adequate psychometric properties and reflects maximizers' aspirations for high standards and their preference for extensive alternative search, but not the decision difficulty aspect included in several previous studies. Based on this scale, maximizing is positively correlated with optimism, need for cogniti...

  6. Reinnervation of Urethral and Anal Sphincters With Femoral Motor Nerve to Pudendal Nerve Transfer

    Ruggieri, Michael R.; Braverman, Alan S.; Bernal, Raymond M.; Lamarre, Neil S.; Brown, Justin M.; Barbe, Mary F.


    Aims Lower motor neuron damage to sacral roots or nerves can result in incontinence and a flaccid urinary bladder. We showed bladder reinnervation after transfer of coccygeal to sacral ventral roots, and genitofemoral nerves (L1, 2 origin) to pelvic nerves. This study assesses the feasibility of urethral and anal sphincter reinnervation using transfer of motor branches of the femoral nerve (L2–4 origin) to pudendal nerves (S1, 2 origin) that innervate the urethral and anal sphincters in a canine model. Methods Sacral ventral roots were selected by their ability to stimulate bladder, urethral sphincter, and anal sphincter contraction and transected. Bilaterally, branches of the femoral nerve, specifically, nervus saphenous pars muscularis [Evans HE. Miller’s anatomy of the dog. Philadelphia: W.B. Saunders; 1993], were transferred and end-to-end anastomosed to transected pudendal nerve branches in the perineum, then enclosed in unipolar nerve cuff electrodes with leads to implanted RF micro-stimulators. Results Nerve stimulation induced increased anal and urethral sphincter pressures in five of six transferred nerves. Retrograde neurotracing from the bladder, urethral sphincter, and anal sphincter using fluorogold, fast blue, and fluororuby, demonstrated urethral and anal sphincter labeled neurons in L2–4 cord segments (but not S1–3) in nerve transfer canines, consistent with rein-nervation by the transferred femoral nerve motor branches. Controls had labeled neurons only in S1–3 segments. Postmortem DiI and DiO labeling confirmed axonal regrowth across the nerve repair site. Conclusions These results show spinal cord reinnervation of urethral and anal sphincter targets after sacral ventral root transection and femoral nerve transfer (NT) to the denervated pudendal nerve. These surgical procedures may allow patients to regain continence. PMID:21953679

  7. Balloon Cell Urethral Melanoma: Differential Diagnosis and Management

    M. McComiskey


    Full Text Available Introduction. Primary malignant melanoma of the urethra is a rare tumour (0.2% of all melanomas that most commonly affects the meatus and distal urethra and is three times more common in women than men. Case. A 76-year-old lady presented with vaginal pain and discharge. On examination, a 4 cm mass was noted in the vagina and biopsy confirmed melanoma of a balloon type. Preoperative CT showed no distant metastases and an MRI scan of the pelvis demonstrated no associated lymphadenopathy. She underwent anterior exenterative surgery and vaginectomy also. Histology confirmed a urethral nodular malignant melanoma. Discussion. First-line treatment of melanoma is often surgical. Adjuvant treatment including chemotherapy, radiotherapy, or immunotherapy has also been reported. Even with aggressive management, malignant melanoma of the urogenital tract generally has a poor prognosis. Recurrence rates are high and the mean period between diagnosis and recurrence is 12.5 months. A 5-year survival rate of less than 20% has been reported in balloon cell melanomas along with nearly 20% developing local recurrence. Conclusion. To the best of our knowledge, this case is the first report of balloon cell melanoma arising in the urethra. The presentation and surgical management has been described and a literature review provided.

  8. Posterior urethral valves: relationship between vesicoureteral reflux and renal function.

    Cozzi, Denis A; Morgante, Debora; Frediani, Simone; Iaconelli, Romina; Ceccanti, Silvia; Mele, Ermelinda; Cozzi, Francesco


    To investigate the relationship between renal function and vesicoureteral reflux before and after valve ablation in patients with posterior urethral valves. In these patients, back pressure may not be the only cause of renal damage. We conducted a retrospective review of 37 patients with valves consecutively treated between 1970 and 2002. Data were available for 31 patients, 19 of whom presented reflux at presentation. Grade of reflux was ascertained by voiding cystourethrography. Overall renal function was measured by serum creatinine, and split renal function was estimated by dimercaptosuccinic acid scan available for all patients but two. Before relief of obstruction, there was no correlation between split renal function and grade of reflux into 25 kidneys of the 17 patients (r = -.13; 95% CI, -.50 to .27; P = .51). High-grade reflux (grade IV-V) affected 6 of the 11 renal units, with split renal function >40% vs 11 of the 14 units with split renal function 40% vs 4 of the 14 units with split renal function <40% (P = .0005). The good renal function of more than half of the renal units with high-grade reflux at presentation, and the persistence of reflux mainly in nonfunctioning or poorly functioning kidneys after valve ablation, support the concept that in some patients with valves, reflux and renal damage are associated anomalies. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Characteristics of gonococci isolated from men with urethritis in Dubai.

    Al-Hattawi, K; Ison, C A


    Neisseria gonorrhoeae were collected from men attending out-patient clinics in Dubai. The susceptibility to a range of therapeutic antibiotics and their auxotype and serotype was determined. The plasmid content of all penicillinase-producing strains was also analysed. Thirty-six strains of N. gonorrhoeae were isolated from specimens collected from 79 patients over a 24-day period. Of the 36 isolates, 9(25%) were penicillinase-producing N. gonorrhoeae (PPNG) and 15 (42%) were chromosomally resistant N. gonorrhoeae (CMRNG). CMRNG exhibited higher levels of resistance to cefuroxime, chloramphenicol, tetracycline and erythromycin than PPNG. All isolates were susceptible to ceftriaxone and spectinomycin. Three (8%) isolates showed reduced susceptibility (MIC, > or = 0.25 mg/l) to ciprofloxacin. Six isolates of PPNG carried the 4.4 MD and three the 3.2 MD penicillinase encoding plasmid. The total gonococcal population was phenotypically diverse, with 12 serovars, 6 auxotypes and 21 A/S classes. Gonorrhoea was found to be a major cause of urethritis in Dubai and the strains exhibited high levels of resistance to penicillin.

  10. HEMI: Hyperedge Majority Influence Maximization

    Gangal, Varun; Narayanam, Ramasuri


    In this work, we consider the problem of influence maximization on a hypergraph. We first extend the Independent Cascade (IC) model to hypergraphs, and prove that the traditional influence maximization problem remains submodular. We then present a variant of the influence maximization problem (HEMI) where one seeks to maximize the number of hyperedges, a majority of whose nodes are influenced. We prove that HEMI is non-submodular under the diffusion model proposed.

  11. Guinea pig maximization test

    Andersen, Klaus Ejner


    Guinea pig maximization tests (GPMT) with chlorocresol were performed to ascertain whether the sensitization rate was affected by minor changes in the Freund's complete adjuvant (FCA) emulsion used. Three types of emulsion were evaluated: the oil phase was mixed with propylene glycol, saline...... with 30% (v/v) ethanol or saline, respectively. Relative viscosity was used as one measure of physical properties of the emulsion. Higher degrees of sensitization (but not rates) were obtained at the 48 h challenge reading with the oil/propylene glycol and oil/saline + ethanol emulsions compared...... to the saline/oil emulsion. Placing of the challenge patches affected the response, as simultaneous chlorocresol challenge on the flank located 2 cm closer to the abdomen than the usual challenge site gave decreased reactions....

  12. Closure report for N Reactor


    This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule.

  13. Urethral Pain Among Prostate Cancer Survivors 1 to 14 Years After Radiation Therapy

    Pettersson, Niclas, E-mail: [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden); Olsson, Caroline [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Alsadius, David; Wilderaeng, Ulrica [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden); Johansson, Karl-Axel [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden); Steineck, Gunnar [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden)


    Purpose: To investigate how treatment-related and non-treatment-related factors impact urethral pain among long-term prostate cancer survivors. Methods and Materials: Men treated for prostate cancer with radiation therapy at the Sahlgrenska University Hospital in Goeteborg, Sweden from 1993 to 2006 were approached with a study-specific postal questionnaire addressing symptoms after treatment, including urethral burning pain during urination (n=985). The men had received primary or salvage external-beam radiation therapy (EBRT) or EBRT in combination with brachytherapy (BT). Prescribed doses were commonly 70 Gy in 2.0-Gy fractions for primary and salvage EBRT and 50 Gy plus 2 Multiplication-Sign 10.0 Gy for EBRT + BT. Prostatic urethral doses were assessed from treatment records. We also recruited 350 non-pelvic-irradiated, population-based controls matched for age and residency to provide symptom background rates. Results: Of the treated men, 16% (137 of 863) reported urethral pain, compared with 11% (27 of 242) of the controls. The median time to follow-up was 5.2 years (range, 1.1-14.3 years). Prostatic urethral doses were similar to prescription doses for EBRT and 100% to 115% for BT. Fractionation-corrected dose and time to follow-up affected the occurrence of the symptom. For a follow-up {>=}3 years, 19% of men (52 of 268) within the 70-Gy EBRT + BT group reported pain, compared with 10% of men (23 of 222) treated with 70 Gy primary EBRT (prevalence ratio 1.9; 95% confidence interval 1.2-3.0). Of the men treated with salvage EBRT, 10% (20 of 197) reported urethral pain. Conclusions: Survivors treated with EBRT + BT had a higher risk for urethral pain compared with those treated with EBRT. The symptom prevalence decreased with longer time to follow-up. We found a relationship between fractionation-corrected urethral dose and pain. Among long-term prostate cancer survivors, the occurrence of pain was not increased above the background rate for prostatic urethral

  14. Bacterial Vaginosis–Associated Bacteria in Men: Association of Leptotrichia/Sneathia spp. With Nongonococcal Urethritis

    Manhart, Lisa E.; Khosropour, Christine M.; Liu, Congzhu; Gillespie, Catherine W.; Depner, Kevin; Fiedler, Tina; Marrazzo, Jeanne M.; Fredricks, David N.


    Background Approximately 45% of nongonococcal urethritis cases have no identified etiology. Novel bacteria recently associated with bacterial vaginosis (BV) in women may be involved. We evaluated the association of idiopathic nongonococcal urethritis and 5 newly described BV-associated bacteria (BVAB). Methods Heterosexual men 16 years or older attending a sexually transmitted disease clinic in Seattle, Washington, from May 2007 to July 2011 and negative for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, and Ureaplasma urealyticum–biovar2 were eligible. Cases had urethral discharge or 5 or more polymorphonuclear leukocytes per high-power field in urethral exudates. Controls had no urethral discharge and less than 5 polymorphonuclear leukocytes per high-power field. Urine was tested for Atopobium spp., BVAB-2, BVAB-3, Megasphaera spp., and Leptotrichia/Sneathia spp. using quantitative taxon-directed polymerase chain reaction. Results Cases (n = 157) and controls (n = 102) were of similar age, education, and income, and most were white. Leptotrichia/Sneathia spp. was significantly associated with urethritis (24/157 [15.3%] vs. 6/102 [5.9%], P = 0.03). BVAB-2 was more common in cases than in controls (7/157 [4.5%] vs. 1/102 [1.0%], P = 0.15), and BVAB-3 (n = 2) and Megasphaera spp. (n = 1) were only detected in men with urethritis, but these bacteria were found only in men who also had Leptotrichia/Sneathia spp. Atopobium spp. was not associated with urethritis. The quantity of bacteria did not differ between cases and controls. Among treated cases, doxycycline was more effective than azithromycin for clinical cure of men with Leptotrichia/Sneathia spp. (9/10 vs. 7/12, P = 0.16) and BVAB-2 (3/3 vs. 0/3, P = 0.10). Conclusions Leptotrichia/Sneathia spp. may be urethral pathogens or contribute to a pathogenic microbiota that can also include BVAB-2, BVAB-3, and Megasphaera spp. Doxycycline may be more effective than

  15. Docetaxel inhibits urethral stricture formation, an initial study in rabbit model.

    Delai Fu

    Full Text Available INTRODUCTION: Urethral stricture, a frequent source of lower urinary tract disorders in men, is still a difficult problem for urologists. Based the anti-restenosis effect of paclitaxel on coronary artery, the role of docetaxel, a semi-synthetic analogue of paclitaxel, in limiting urethral stricture formation was studied. METHODS: Forty adult New Zealand male rabbits were involved in this study, which were randomly assigned into 3 groups, namely a high dose docetaxel (DH, 0.1 mg/d, a low dose docetaxel (DL, 0.01 mg/d and a control (C group, with 16, 16, 8 rabbits in each group, respectively. All animals underwent a 10 mm-long circumferential electrocoagulation of the bulbar urethra with a 13Fr pediatric resectoscope. Drugs were given by urethral irrigation daily and continuous for 28 days. Stricture formation was assessed by retrograde urethrography and videourethroscopy. Urethra pathology was evaluated by hematoxylin and eosin staining and Sirius red staining. RESULTS: At the end of this study, 15, 14 and 7 rabbits remained for evaluation in DH, DL and C group, respectively. Urethral diameters in DH, DL and C group were (7.17±1.63 mm, (6.55±0.62 mm, (3.23±1.36 mm, with a normal urethral diameter of (9.08±1.29 mm. Lumen reduction in DH, DL and C group were (36.93±11.58%, (48.03±7.89% and (84.66±14.95%, respectively. Statistically difference could be found between every two groups (p<0.05 both in urethral diameters and in lumen reduction, except for compare of urethral diameters between DH and DL group. Histological examination confirmed mass fibrous tissue and collagen content at the stricture sit in C group, whereas less in docetaxel treated rabbits. CONCLUSIONS: Docetaxel could limit urethral stricture formation, which may be due to inhibition of fibrous tissue and collagen expression. Docetaxel may become a new choice in the prevention of urethral stricture formation.

  16. Evaluation of anterior urethral stricture using thick slab SSFSE MR urethrography.

    Park, Byung Kwan; Kim, Chan Kyo; Lee, Sung Won


    magnetic resonance urethrography (MRU) can be used for depicting not only anterior urethral strictures but also periurethral anatomy in order to produce a management plan. to determine if thick slab single-shot fast spin echo (SSFSE) MRU is useful for evaluating anterior urethral stricture compared to fast recovery fast spin echo (FRFSE) MRU. Ten patients with benign anterior urethral stricture underwent both thick slab SSFSE MRU and FRFSE MRU using sterile jelly for urethral distension before retrograde urethrography. The glans penis was tied at the time of MRU. The two types of MR image were compared regarding stricture length, scan time, and image quality. We also determined whether or not both of the two MR sequences could display an entire anterior urethra on one image. the stricture length on thick slab SSFSE and FRFSE MRU ranged from 4.0 to 71.3 mm (36.4 ± 21.8 mm) and from 4.0 to 67.5 mm (35.7 ± 20.8 mm), respectively (P > 0.05). The mean scan time for thick slab SSFSE and FRFSE sequences was 2 s and 194 s, respectively (P MRU was inferior to FRFSE MRU (P MRU displayed the entire anterior urethra on one image, while only five FRFSE MRU did so (P MRU can provide a concordant stricture length when compared to the FRFSE MRU and imaging of the entire length of the anterior urethral stricture with subjective reduced image quality and scan time.

  17. PCR for diagnosis of male Trichomonas vaginalis infection with chronic prostatitis and urethritis.

    Lee, Jong Jin; Moon, Hong Sang; Lee, Tchun Yong; Hwang, Hwan Sik; Ahn, Myoung-Hee; Ryu, Jae-Sook


    The aim of this study was to assess the usefulness of PCR for diagnosis of Trichomonas vaginalis infection among male patients with chronic recurrent prostatitis and urethritis. Between June 2001 and December 2003, a total of 33 patients visited the Department of Urology, Hanyang University Guri Hospital and were examined for T. vaginalis infection by PCR and culture in TYM medium. For the PCR, we used primers based on a repetitive sequence cloned from T. vaginalis (TV-E650). Voided bladder urine (VB1 and VB3) was sampled from 33 men with symptoms of lower urinary tract infection (urethral charge, residual urine sensation, and frequency). Culture failed to detect any T. vaginalis infection whereas PCR identified 7 cases of trichomoniasis (21.2%). Five of the 7 cases had been diagnosed with prostatitis and 2 with urethritis. PCR for the 5 prostatitis cases yielded a positive 330 bp band from bothVB1 and VB3, whereas positive results were only obtained from VB1 for the 2 urethritis patients. We showed that the PCR method could detect T. vaginalis when there was only 1 T. vaginalis cell per PCR mixture. Our results strongly support the usefulness of PCR on urine samples for detecting T. vaginalis in chronic prostatitis and urethritis patients.


    Widya Hanum Sari Pertiwi


    Full Text Available This study was qualitative research action that focuses to find out the flouting of Gricean maxims and the functions of the flouting in the tales which are included in collection of children literature entitled My Giant Treasury of Stories and Rhymes. The objective of the study is generally to identify the violation of maxims of quantity, quality, relevance, and manner in the data sources and also to analyze the use of the flouting in the tales which are included in the book. Qualitative design using categorizing strategies, specifically coding strategy, was applied. Thus, the researcher as the instrument in this investigation was selecting the tales, reading them, and gathering every item which reflects the violation of Gricean maxims based on some conditions of flouting maxims. On the basis of the data analysis, it was found that the some utterances in the tales, both narration and conversation, flouting the four maxims of conversation, namely maxim of quality, maxim of quantity, maxim of relevance, and maxim of manner. The researcher has also found that the flouting of maxims has one basic function that is to encourage the readers’ imagination toward the tales. This one basic function is developed by six others functions: (1 generating specific situation, (2 developing the plot, (3 enlivening the characters’ utterance, (4 implicating message, (5 indirectly characterizing characters, and (6 creating ambiguous setting. Keywords: children literature, tales, flouting maxims

  19. Closure and Sealing Design Calculation

    T. Lahnalampi; J. Case


    The purpose of the ''Closure and Sealing Design Calculation'' is to illustrate closure and sealing methods for sealing shafts, ramps, and identify boreholes that require sealing in order to limit the potential of water infiltration. In addition, this calculation will provide a description of the magma that can reduce the consequences of an igneous event intersecting the repository. This calculation will also include a listing of the project requirements related to closure and sealing. The scope of this calculation is to: summarize applicable project requirements and codes relating to backfilling nonemplacement openings, removal of uncommitted materials from the subsurface, installation of drip shields, and erecting monuments; compile an inventory of boreholes that are found in the area of the subsurface repository; describe the magma bulkhead feature and location; and include figures for the proposed shaft and ramp seals. The objective of this calculation is to: categorize the boreholes for sealing by depth and proximity to the subsurface repository; develop drawing figures which show the location and geometry for the magma bulkhead; include the shaft seal figures and a proposed construction sequence; and include the ramp seal figure and a proposed construction sequence. The intent of this closure and sealing calculation is to support the License Application by providing a description of the closure and sealing methods for the Safety Analysis Report. The closure and sealing calculation will also provide input for Post Closure Activities by describing the location of the magma bulkhead. This calculation is limited to describing the final configuration of the sealing and backfill systems for the underground area. The methods and procedures used to place the backfill and remove uncommitted materials (such as concrete) from the repository and detailed design of the magma bulkhead will be the subject of separate analyses or calculations. Post-closure

  20. Maximal equilateral sets

    Swanepoel, Konrad J


    A subset of a normed space X is called equilateral if the distance between any two points is the same. Let m(X) be the smallest possible size of an equilateral subset of X maximal with respect to inclusion. We first observe that Petty's construction of a d-dimensional X of any finite dimension d >= 4 with m(X)=4 can be generalised to show that m(X\\oplus_1\\R)=4 for any X of dimension at least 2 which has a smooth point on its unit sphere. By a construction involving Hadamard matrices we then show that both m(\\ell_p) and m(\\ell_p^d) are finite and bounded above by a function of p, for all 1 1 such that m(X) <= d+1 for all d-dimensional X with Banach-Mazur distance less than c from \\ell_p^d. Using Brouwer's fixed-point theorem we show that m(X) <= d+1 for all d-\\dimensional X with Banach-Mazur distance less than 3/2 from \\ell_\\infty^d. A graph-theoretical argument furthermore shows that m(\\ell_\\infty^d)=d+1. The above results lead us to conjecture that m(X) <= 1+\\dim X.

  1. Unified Maximally Natural Supersymmetry

    Huang, Junwu


    Maximally Natural Supersymmetry, an unusual weak-scale supersymmetric extension of the Standard Model based upon the inherently higher-dimensional mechanism of Scherk-Schwarz supersymmetry breaking (SSSB), possesses remarkably good fine tuning given present LHC limits. Here we construct a version with precision $SU(2)_{\\rm L} \\times U(1)_{\\rm Y} $ unification: $\\sin^2 \\theta_W(M_Z) \\simeq 0.231$ is predicted to $\\pm 2\\%$ by unifying $SU(2)_{\\rm L} \\times U(1)_{\\rm Y} $ into a 5D $SU(3)_{\\rm EW}$ theory at a Kaluza-Klein scale of $1/R_5 \\sim 4.4\\,{\\rm TeV}$, where SSSB is simultaneously realised. Full unification with $SU(3)_{\\rm C}$ is accommodated by extending the 5D theory to a $N=4$ supersymmetric $SU(6)$ gauge theory on a 6D rectangular orbifold at $1/R_6 \\sim 40 \\,{\\rm TeV}$. TeV-scale states beyond the SM include exotic charged fermions implied by $SU(3)_{\\rm EW}$ with masses lighter than $\\sim 1.2\\,{\\rm TeV}$, and squarks in the mass range $1.4\\,{\\rm TeV} - 2.3\\,{\\rm TeV}$, providing distinct signature...

  2. Etiology of male urethral strictures-Evaluation of temporal changes at a single center, and review of the literature

    C.F. Heyns


    Conclusions: Over the past 15 years there was an increase in education levels, illegal drug usage and number of sex partners in men with urethral strictures. There was a decrease in urethritis and external trauma, and an increase in iatrogenic trauma as stricture etiology.

  3. Challenges in the Diagnosis and Management of Acquired Nontraumatic Urethral Strictures in Boys in Yaoundé, Cameroon

    Mouafo Tambo, F. F.; Fossi kamga, G.; Kamadjou, C.; Mbouche, L.; Nwaha Makon, A. S.; Birraux, J.; Andze, O. G.; Angwafo, F. F.; Mure, P. Y.


    Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon. Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy. Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (n = 1), urethral dilatation (n = 1), vesicostomy (n = 2), and urethral catheterization (n = 3). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free. Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered. PMID:27239364

  4. Urethral glands of the male mouse contain secretory component and immunoglobulin A plasma cells and are targets of testosterone.

    Parr, M B; Ren, H P; Russell, L D; Prins, G S; Parr, E L


    The occurrence and possible functions of mucosal immunity in the male urogenital tract have not been extensively investigated. In this study we used immunolabeling to localize secretory component (SC) and immunoglobulin (Ig) A in the urogenital tract of the male mouse. SC was located in the ventral prostate, while SC and IgA plasma cells were both detected in the urethral glands in the pelvic and bulbous portions of the urethra. SC and IgA were not observed elsewhere in the urogenital tract. We also examined the ventral prostate and urethral glands of sham-castrated, oil-treated castrated, and testosterone-treated castrated mice. There was a striking reduction in the size of the ventral prostate and urethral glands in oil-treated castrates compared to the other two groups, based on gross and histological morphology. Morphometric analysis showed that the cell and nuclear sizes of the urethral gland acinar cells were reduced after castration and restored to normal size by testosterone treatment. Androgen receptors (AR) were localized in the nuclei of urethral gland cells by immunocytochemistry using anti-AR antibodies. Labeling of SC and IgA plasma cells was similar in the urethral glands and ventral prostates of sham- and testosterone-treated castrates, but was reduced or absent at these sites in oil-treated castrates. These studies show that the ventral prostate and urethral glands may be sites for secretory immunity in the male murine urogenital tract, and that the urethral glands are targets for testosterone.

  5. Retrospective study to characterize post-obstructive diuresis in cats with urethral obstruction.

    Francis, Brenda J; Wells, Raegan J; Rao, Sangeeta; Hackett, Timothy B


    Urethral obstruction is a common medical emergency in cats. Frequency of post-obstruction diuresis in cats following resolution of urethral obstruction is unknown. The objective of this study was to document frequency and associated clinical features of post-obstruction diuresis in cats. The records of 32 cats undergoing 33 admissions to the Colorado State University Veterinary Hospital for urethral obstruction were reviewed. Signalment, admission blood values, fluid therapy, and urine output were recorded. Diuresis was defined as urine output greater than 2ml/kg/h. Post-obstructive diuresis occurred in 46% (13/28) of cats within the first 6h of treatment. Occurrence of post-obstructive diuresis was statistically more likely in cats with venous pHdiuresis.

  6. [Can bladder catheterization in pediatrics cause complications? The case of a urethral dysuria cystograph].

    Alcázar García, A; Daviu Llorens, E; Daza Laguna, A; Durán Feliubadalo, C; Pons Torrents, X


    A urethral dysuria cystograph (CUMS (Cistografia Ureteral Miccional Seriada)) is the first diagnostic procedure, by means of x-rays, to evaluate bladder-urethral reflux. It consists of a bladder catheter to administer a radiopaque contrast dye through the ureter. To use the aforementioned technique without any asepsis measures and without knowledge about it can lead to possible complications. By means of a retrospective study using a sample of 181 patients, the authors have evaluated the incidence of possible complications and/or subsequent discomfort due to a urethral dysuria cystograph (CUMS). As final results, by means of an after test telephone call, the authors observed that 96.7% of the children who underwent this technique did not manifest any type of complication nor urinary discomfort.

  7. Fundamentals and clinical perspective of urethral sphincter instability as a contributing factor in patients with lower urinary tract dysfunction--ICI-RS 2014

    Kirschner-Hermanns, Ruth; Anding, Ralf; Rosier, Peter; Birder, Lori; Andersson, Karl Erik; Djurhuus, Jens Christian


    AIMS: Urethral pathophysiology is often neglected in discussions of bladder dysfunction. It has been debated whether "urethral sphincter instability," referred to based on observed "urethral pressure variations," is an important aspect of overactive bladder syndrome (OAB). The purpose of this report

  8. RCRA closure of mixed waste impoundments

    Blaha, F.J. [Doty and Associates (United States); Greengard, T.C.; Arndt, M.B. [Rockwell International (United States)


    A case study of a RCRA closure action at the Rocky Flats Plant is presented. Closure of the solar evaporation ponds involves removal and immobilization of a mixed hazardous/radioactive sludge, treatment of impounded water, groundwater monitoring, plume delineation, and collection and treatment of contaminated groundwater. The site closure is described within the context of regulatory negotiations, project schedules, risk assessment, clean versus dirty closure, cleanup levels, and approval of closure plans and reports. Lessons learned at Rocky Flats are summarized.

  9. 游离尿道板卷管尿道成形治疗尿道上裂%Tubularized urethral plate disassembly for epispadias repair

    徐卯升; 耿红全; 谢华; 徐国锋; 陈方


    目的 介绍和评价游离尿道板卷管尿道成形治疗男性尿道上裂.方法 2003年1月~2006年12月用游离尿道板卷管尿道成形治疗男性尿道上裂12例,年龄为1~20岁,其中单纯阴茎体尿道上裂10例,另2例为膀胱外翻曾在本院行骨盆截骨膀胱内翻关闭后.用Ransley法纠正阴茎背曲3例.结果 平均随访20个月(3~40个月),12例患儿阴茎头呈圆锥状,阴茎外观满意.1例患儿仍存在轻度阴茎背曲,1例患儿因术后尿瘘被再次手术修补.术后所有患儿阴茎勃起功能存在.结论 游离尿道板卷管尿道成形治疗尿道上裂方法简单,可达到恢复阴茎尿道正常的位置结构,使阴茎外观和功能接近正常.%Objective To evaluate the safety and efficacy of tabularized urethral plate disassembly for epispadias repair in boys.Methods From January 2003 through December 2006,12 boys aged between 1 to 20 years old,were performed tubularized urethral plate disassembly procedure to correct epispadias.Ten patients had isolated epispadias and the other 2 had bladder exstrophy who received exstrophy closure previously.The Ransley corporotomy was applied to correct persistent dorsal chordee in3 patients.Results The mean follow-up time was 20 months(ranged 3 to 40 months).All Datients had conical glans and good cosmetic appearance.Dorsal curvature was corrected in 11 cases.only one patient needed secondary repair because of fistula.All patients are potent postoperatively.Condusions The urethral plate disassembly allows tubularization and ventralization of the distal urethra.It is a simple procedure that can provide normal location and configuration of urethra and penile with satisfactory cosmetic and functional outcomes.

  10. Risk Factors for Urinary Tract Infection following Mid Urethral Sling Surgery.

    Vigil, Humberto R; Mallick, Ranjeeta; Nitti, Victor W; Lavallée, Luke T; Breau, Rodney H; Hickling, Duane R


    Mid urethral sling surgery is common. Postoperative urinary tract infection rates vary in the literature and independent risk factors for urinary tract infection are not well defined. We sought to determine the incidence of and risk factors for urinary tract infection following mid urethral sling surgery. A retrospective cohort of females who underwent sling surgery was captured from the 2006 to 2014 NSQIP® (National Surgical Quality Improvement Program®) database. Exclusion criteria included male gender, nonelective surgery, totally dependent functional status, preoperative infection, prior surgery within 30 days, ASA® (American Society of Anesthesiologists®) Physical Status Classification 4 or greater, concomitant procedure and operative time greater than 60 minutes. The primary outcome was the incidence of urinary tract infection within 30 days of mid urethral sling surgery. Risk factors for urinary tract infection were assessed by examining patient demographic, comorbidity and surgical variables. Logistic regression analyses were performed to estimate the ORs of individual risk factors. Multivariable logistic regression was then performed to adjust for confounding. A total of 9,022 mid urethral sling surgeries were identified. The urinary tract infection incidence was 2.6%. Factors independently associated with an increased infection risk included age greater than 65 years (OR 1.54, 95% CI 1.07-2.22), body mass index greater than 40 kg/m(2) (OR 1.89, 95% CI 1.23-2.92) and hospital admission (OR 2.06, 95% CI 1.37-3.11). Mid urethral sling surgery performed by urologists carried a reduced risk of infection compared to the surgery done by gynecologists (OR 0.52, 95% CI 0.40-0.69). The urinary tract infection risk following mid urethral sling surgery in NSQIP associated hospitals is low. Novel patient and surgical factors for postoperative urinary tract infection have been identified and merit further study. Copyright © 2017 American Urological Association

  11. Internal urethrotomy versus plasmakinetic energy for surgical treatment of urethral stricture

    Levent Ozcan


    Full Text Available Purpose: we aimed to compare the longterm outcome of surgical treatment of urethral stricture with the internal urethrotomy and plasmakinetic energy. Material and Methods: 60 patients, who have been operated due to urethral stricture were enrolled in our clinic. None of the patients had a medical history of urethral stricture. The urethral strictures were diagnosed by clinical history, uroflowmetry, ultrasonography and urethrography. The patients were divided two groups. Group 1 consisted of 30 patients treated with plasmakinetic urethrotomy and group 2 comprised 30 men treated with cold knife urethrotomy. Results: There were no statistically significant differences between two groups in terms of patient age, maximum flow rate (Qmax and quality of life score (Qol value. A statistical difference between the two groups was observed when we compared the 3rd-month uroflowmetry results. Group 1 patients had a mean postoperative Qmax value of 16,1 ± 2,3 ml/s, whereas group 2 had a mean postoperative Qmax value of 15,1 ± 2,2 ml/s (p < 0.05. In the cold knife group, 3 of 11 (27,7% recurrences appeared within the first 3 months, whereas in the plasmakinetic group zero recurrences appeared within the first 3 months in our study. The urethral stricture recurrence rate up to the 12 month period was statistically significant for group 1 (n = 7, 23% compared with group 2 (n = 11, 37% (p < 0.05. Conclusion: We believe that plasmakinetic surgery is better method than the cold knife technique for the treatment of urethral stricture.

  12. Advances in Surgical Reconstructive Techniques in the Management of Penile, Urethral, and Scrotal Cancer.

    Bickell, Michael; Beilan, Jonathan; Wallen, Jared; Wiegand, Lucas; Carrion, Rafael


    This article reviews the most up-to-date surgical treatment options for the reconstructive management of patients with penile, urethral, and scrotal cancer. Each organ system is examined individually. Techniques and discussion for penile cancer reconstruction include Mohs surgery, glans resurfacing, partial and total glansectomy, and phalloplasty. Included in the penile cancer reconstruction section is the use of penile prosthesis in phalloplasty patients after penectomy, tissue engineering in phallic regeneration, and penile transplantation. Reconstruction following treatment of primary urethral carcinoma and current techniques for scrotal cancer reconstruction using split-thickness skin grafts and flaps are described.

  13. Bacteriological finding in the urethra in men with and without non-gonococcal urethritis

    Tiodorović Jelica


    Full Text Available Background/Aim. Non-gonococcal urethritis (NGU is a very common sexually transmitted disease. The etiology of the disease is complex and not completely solved. The aim of this study was to determine the bacteriological finding in the urethra in men with and without non-gonococcal utethritis. Methods. The study group comprised 200 men with symptoms of urethritis. The control group consisted of 60 men without symptoms of urethritis. The diagnosis of nongonococcal infection was made by finding of an increased number of polymorphonuclear leukocytes (≥ 5 under the microscope in a sample of Gram-stain of urethral smear (× 1 000 and without evidence of Neisseria. gonorrhoeae in specimens (negative direct microscopy and cell culture. Bacteriological examination included: direct microscopy with the Gramstained and methylblue-stained smears of urethral discharges, and cultivation of specimens under the aerobic/unaerobic conditions. In addition to standard bacterial examination and performinig direct imunofluorescence test to detect Chlamydia trachomatis (bioMerieux, France, urethral smears were also examined for the presence of Ureaplasma urealyticum and Mycoplasma hominis by commercially available Mycofast Evolution 2 test (International Microbio, France. The finding of mycoplasmas ≥ 104 CCU/ml was positive. The data were statistically analyzed using Pearson χ2 and Student t test. Results. C. trachomatis was predominant bacterial species found in urethra in men with nongonococcal urethritis. It was isolated alone and/or mixed with mycoplasmas and/or other bacteria in 86 (43.0% of examinees. There was statistically significant difference in finding of C. trachomatis between the study group and the control group (p < 0.001. U. urealyticum was found in men with NGU: 30.2% were with C. trachomatis and 36.0% were without C. trachomatis (p > 0.05. In 16 (8.0% men with NGU, C. trachomatis was isolated alone, while in 13.0% examinees it occurred with U

  14. Maximal subgroups of finite groups

    S. Srinivasan


    Full Text Available In finite groups maximal subgroups play a very important role. Results in the literature show that if the maximal subgroup has a very small index in the whole group then it influences the structure of the group itself. In this paper we study the case when the index of the maximal subgroups of the groups have a special type of relation with the Fitting subgroup of the group.

  15. Finding Maximal Quasiperiodicities in Strings

    Brodal, Gerth Stølting; Pedersen, Christian N. S.


    of length n in time O(n log n) and space O(n). Our algorithm uses the suffix tree as the fundamental data structure combined with efficient methods for merging and performing multiple searches in search trees. Besides finding all maximal quasiperiodic substrings, our algorithm also marks the nodes......Apostolico and Ehrenfeucht defined the notion of a maximal quasiperiodic substring and gave an algorithm that finds all maximal quasiperiodic substrings in a string of length n in time O(n log2 n). In this paper we give an algorithm that finds all maximal quasiperiodic substrings in a string...

  16. Maximizing Entropy over Markov Processes

    Biondi, Fabrizio; Legay, Axel; Nielsen, Bo Friis


    computation reduces to finding a model of a specification with highest entropy. Entropy maximization for probabilistic process specifications has not been studied before, even though it is well known in Bayesian inference for discrete distributions. We give a characterization of global entropy of a process...... as a reward function, a polynomial algorithm to verify the existence of an system maximizing entropy among those respecting a specification, a procedure for the maximization of reward functions over Interval Markov Chains and its application to synthesize an implementation maximizing entropy. We show how...

  17. Maximizing entropy over Markov processes

    Biondi, Fabrizio; Legay, Axel; Nielsen, Bo Friis


    computation reduces to finding a model of a specification with highest entropy. Entropy maximization for probabilistic process specifications has not been studied before, even though it is well known in Bayesian inference for discrete distributions. We give a characterization of global entropy of a process...... as a reward function, a polynomial algorithm to verify the existence of a system maximizing entropy among those respecting a specification, a procedure for the maximization of reward functions over Interval Markov Chains and its application to synthesize an implementation maximizing entropy. We show how...

  18. [Laparotomy closure in advanced peritonitis].

    Bensman, V M; Savchenko, Yu P; Shcherba, S N; Golikov, I V; Triandafilov, K V; Chaykin, V V; Pyatakov, S N; Saakyan, A S; Saakyan, E A

    to improve the results of advanced peritonitis management. 743 patients with advanced peritonitis were studied. Patients were divided into 2 groups depending on treatment strategy. Programmed relaparotomy combined with removable draining musculoaponeurotic seams during laparotomy closure decreased mortality from 47.8±2.7% to 24.1±2.3% (pperitonitis management. Laparotomy closure with only cutaneous seams is indicated in case of persistent abdominal hypertension. Large eventration always requires abdominal wall repair. APACHE-III scale scores have significant prognostic value in patients with advanced peritonitis.

  19. Closure phase and lucky imaging.

    Rhodes, William T


    Since its introduction by Jennison in 1958, the closure-phase method for removing the effects of electrical path-length errors in radio astronomy and of atmospheric turbulence in optical astronomy has been based on the non-redundant-spacing triple interferometer. It is shown that through application of lucky imaging concepts it is possible to relax this condition, making closure-phase methods possible with redundantly spaced interferometer configurations and thereby widening their range of application. In particular, a quadruple-interferometer can, under lucky imaging conditions, be treated as though it were a triple interferometer. The slit-annulus aperture is investigated as a special case.

  20. Homogeneous orbit closures and applications

    Lindenstrauss, Elon


    We give new classes of examples of orbits of the diagonal group in the space of unit volume lattices in R^d for d > 2 with nice (homogeneous) orbit closures, as well as examples of orbits with explicitly computable but irregular orbit closures. We give Diophantine applications to the former, for instance we show that if x is the cubic root of 2 then for any y,z in R liminf |n|=0 (as |n| goes to infinity), where denotes the distance of a real number c to the integers.

  1. On w-maximal groups

    Gonzalez-Sanchez, Jon


    Let $w = w(x_1,..., x_n)$ be a word, i.e. an element of the free group $F =$ on $n$ generators $x_1,..., x_n$. The verbal subgroup $w(G)$ of a group $G$ is the subgroup generated by the set $\\{w (g_1,...,g_n)^{\\pm 1} | g_i \\in G, 1\\leq i\\leq n \\}$ of all $w$-values in $G$. We say that a (finite) group $G$ is $w$-maximal if $|G:w(G)|> |H:w(H)|$ for all proper subgroups $H$ of $G$ and that $G$ is hereditarily $w$-maximal if every subgroup of $G$ is $w$-maximal. In this text we study $w$-maximal and hereditarily $w$-maximal (finite) groups.

  2. Prevention of urethral stricture recurrence using clean intermittent self-catheterization

    Kjaergaard, B; Walter, S; Bartholin, J;


    OBJECTIVE: To investigate the effect of clean intermittent catheterization (CIC) on prevention of urethral stricture recurrence after internal urethrotomy. PATIENTS AND METHODS: Of 55 men who were randomly selected, 43 completed the investigation. Of these, 21 patients performed CIC weekly for 1...

  3. Long-term follow-up after urethral injection with polyacrylamide hydrogel for female stress incontinence

    Mouritsen, Lone; Lose, Gunnar; Møller-Bek, Karl


    Urethral injection therapy for treatment of stress urinary incontinence has been in use for years, but only a few long-term follow-up studies have been published. Twenty-five women, injected with polyacrylamide hydrogel 8 years earlier, were invited for follow-up. Twenty-four could be contacted; ...

  4. The effect of oral and intraurethral trimetazidine use on urethral healing

    Ali Ayyildiz


    Conclusion: TMZ increased urinary total oxidant level; while increasing serum TAC levels in the long-term. It also reduced serum TAC levels in urethral use and caused an increase in serum TOC levels with minimal effects on DNA injury and repair. No effect was detected on IL1 α and TNF, but partially reduced the effect on IL-1 β levels.

  5. Prospective, Randomized, Multinational Study of Prostatic Urethral Lift Versus Transurethral Resection of the Prostate

    Sønksen, Jens; Barber, Neil J; Speakman, Mark J


    BACKGROUND: Transurethral resection of the prostate (TURP) is considered the gold standard for male lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). However, TURP may lead to sexual dysfunction and incontinence, and has a long recovery period. Prostatic urethral...

  6. A large extra-abdominal prevesical pseudo-cyst in a newborn with posterior urethral valves.

    Binkhorst, M.; Gier, R.P.E. de


    A male newborn is described, in whom a large extra-abdominal prevesical pseudo-cyst as well as prune-belly features were present, both of which were supposedly secondary to posterior urethral valves. It is postulated that the subvesical obstruction caused pressure build-up in the urinary tract, foll

  7. Docetaxel grafted magnetic nanoparticles as dual-therapeutic agentia for targeting perfusion therapy of urethral carcinoma

    Huang, Xiao; Wang, Zhen [Chongqing University, Key Laboratory for Biorheological Science and Technology of Ministry of Education, College of Bioengineering (China); Dai, Hong [Chongqing Three Gorges Central Hospital, Department of Urology (China); Wang, Chunmei [Chongqing Three Gorges Central Hospital, Department of Orthopaedics (China); Xia, Bing [Guangzhou General Hospital of Guangzhou Military Command, Department of Medical Research (China); Chen, Lan; Pan, Jun, E-mail: [Chongqing University, Key Laboratory for Biorheological Science and Technology of Ministry of Education, College of Bioengineering (China)


    Although urethral carcinoma has a low incidence, it suffers from a poor curative rate for the low retention of medicine around urethra. In the present study, we developed a kind of magnetic targeting perfusion chemotherapy to detain the chemotherapeutic drugs. Docetaxel (TXT) grafted magnetic nanoparticles, of which size was around 40 nm, were obtained by the conjugation of TXT to amino-functionalized iron oxide (NH{sub 2}@Fe{sub 3}O{sub 4}). They have shown great potential to be targeted to and stayed in desired position of urethra under the externally applied magnetism through in vitro mimic urethral study. Furthermore, they have validly inhibited the growth of direct-contacted human urethral squamous carcinoma cells in vitro (up to 56.34 %) by the combination effects of TXT and NH{sub 2}@Fe{sub 3}O{sub 4}, however, less than 3 % of TXT released from the nanoparticles, which was very few to impair the adjacent normal cells and tissues. Therefore, this kind of novel agentia was expected to hold great potential in clinic urethral carcinoma therapy.

  8. Reasons for the weak correlation between prostate volume and urethral resistance parameters in patients with prostatism

    J.L.H.R. Bosch (Ruud); R. Kranse (Ries); R. van Mastrigt (Ron); F.H. Schröder (Fritz); W.K. Mebust (W.)


    textabstractIn an attempt to increase our understanding of the clinical syndrome of benign prostatic hyperplasia (BPH) an analysis was made of the association between prostate volume as measured by transrectal ultrasound and several reported urodynamically determined urethral resistance parameters.

  9. Female sexual function following mid-urethral slings for the treatment of stress urinary incontinence.

    Alwaal, A; Tian, X; Huang, Y; Zhao, L; Ma, L; Lin, G; Deng, D


    The aim of our study was to describe the impact of mid-urethral sling procedure for the treatment of stress urinary incontinence (SUI) on female sexual function. We used PubMed (updated March 2015) to conduct a literature electronic search that included peer-reviewed English language articles. We analyzed the studies about the impact of mid-urethral slings on female sexual function. There are different and contradictory results of the effects of mid-urethral sling on female sexual function. However, more papers show that women undergoing mid-urethral sling procedures report that their sexual function is improved or remains unchanged. The main mechanism of this improved sexuality is the complete relief from coital incontinence, reduction in anxiety and avoidance of sex, whereas the most common symptom related to worsened sexual activity is dyspareunia. Women undergoing sling procedures for SUI should be informed that their sexual activity is likely to remain unchanged or even improve after the operation, but that dyspareunia may occur.

  10. A Study Of The Results Of "Urethral Advancement And Glanuloplasty" (UAGP In Repairing Anterior Hypospadias

    Sadeghipottr roodsari S


    Full Text Available Background: In this study, the results of "Urethral Advancement & Glanuloplasty" in repairing anterior hypospadias were considered. Hypospadias is a common urethral anomaly in boys. More than 65 percent of hypospadias cases are anterior (glanular, coronal and distal penil shaft. More than two hundreds original techniques have been applied to correct hypospadias. Each of these techniques has some complications. The most common complications of hypospadias repairing are fistula and meatal stenosis."nMaterials and Methods: A total of 74 boys with anterior hypospadias underwent the procedure of "Urethral Advancement and Glanuloplasty" (UAGP in our medical centers from March 1994 to April 1999. The procedure included: degloving, correction of chordee, urethral mobilization and glans plasty. Cosmetic results were excellent in most patients. There was no fistula, and also meatal stenosis was not observed after applying V-Flap of the glans."nResults & Conclusions: In a 1 - 6 year follow - up (mean 3.15 years, SD ± 1.79 the results functionally and cosmetically, were satisfactory in all cases with no long-tem complication or chordee.

  11. Urethral pressure reflectometry; a novel technique for simultaneous recording of pressure and cross-sectional area

    Aagaard, Mikael; Klarskov, Niels; Sønksen, Jens;


    in several studies. But the technique, which was based on the field gradient principle, was never implemented in the clinical setting because of technical limitations. In 2005, urethral pressure reflectometry was introduced as a new technique in female urodynamics. The technique has been shown to be more...

  12. Mesonephroid adenocarcinoma in urethral diverticulum treated with diverticulectomy. Case report and review of the literature

    Jacobsen, F; Sørensen, Flemming Brandt; Nielsen, J B;


    A case of mesonephroid adenocarcinoma in an urethral diverticulum treated with diverticulectomy in a 53 year old female is reported. To our knowledge 26 cases of similar tumours have been reported in the literature. A review of symptoms, management and possible relationship to nephroid metaplasia...

  13. Management of complex urethral stricture disease: Algorithm and experience from a single institute

    Yu-Hua Shau


    Conclusion: Complex urethral strictures can be managed by a variety of surgical techniques according to specific stricture locations. However, a careful postoperative follow-up for recurrences is mandatory, since ∼40% of patients undergoing buccal mucosal graft-augmented urethroplasties were expected to have additional procedures after the index urethroplasty.

  14. In vitro fertilizing potential of urethral and epididymal spermatozoa collected from domestic cats (Felis catus).

    Prochowska, S; Niżański, W


    The aim of this study was to provide a comparative analysis of in vitro fertilizing potential of frozen-thawed urethral and epididymal feline spermatozoa. Both types of semen were collected from 7 cats and cryopreserved in liquid nitrogen. To perform in vitro fertilization, both urethral and epididymal samples from the same individual were thawed and spermatozoa were co-incubated with in vitro matured cat oocytes. Obtained embryos were cultured in vitro for 7 days in a commercial medium. Cleavage rate, morula rate and blastocyst rate were calculated. Experiment was run in 10 replicates. The examined parameters showed no significant differences between urethral and epididymal spermatozoa (p>0.05). Cleavage rate and embryo's development were highly variable between replicates, even for the different sperm samples collected from one individual. There was no significant correlation between fertilizing capacity of two types of spermatozoa collected from the same male. In this study we confirmed that cryopreserved urethral spermatozoa have equally good fertilizing potential as epididymal ones, and both can be successfully used for in vitro fertilization in cats with the use of commercial medium.

  15. Association of Cowper syringocele with posterior urethral valve: First case report with review of literature

    Samir Swain


    Full Text Available We are reporting a case of 12 year old boy presenting to us as with obstructive voiding accompanying urinary tract infection and diagnosed as a case of posterior urethral valve (PUV and Cowper syringocele. Up to our knowledge and search results from internet (pubmed, medline, there was no previous report in the literature regarding their association.

  16. Prune belly syndrome associated with bilateral multicystic dysplastic kidneys and urethral obstruction: A case report

    Arzu Akdag


    Full Text Available Prune belly syndrome is a rare congenital disorder defined by a characteristic clinical triad: Abdominal muscle deficiency, severe urinary tract abnormalities, and bilateral cryptorchidism. We describe a preterm neonate of Prune Belly syndrome who had abdominal muscle deficiency, multicystic dysplastic kidney, urethral hypoplasia and pulmonary hypoplasia. We presented this rare case with the data gathered from the literatüre.

  17. Microbial population diversity in the urethras of healthy males and males suffering from nonchlamydial, nongonococcal urethritis

    W.A. Riemersma; C.J. van der Schee; W.I. van der Meijden (Willem); H.A. Verbrugh (Henri); A.F. van Belkum (Alex)


    textabstractNonchlamydial, nongonococcal urethritis (NCNGU) is suggested to be a sexually transmitted disease in men. NCNGU patients were compared to control subjects with regard to the presence of potentially infectious bacteria in the first void urine. Patients' pre- and po

  18. Transrectal ultrasound of the prostatic urethra related to urodynamically assessed urethral resistance. A pilot study

    R. van Mastrigt (Ron); R. Kranse (Ries); H. Jansen


    textabstractIn this pilot study on 17 men who underwent urodynamic investigation for various dysuric complaints, real-time transrectal ultrasonography (TRUS) was performed. From the images anatomical parameters were identified that correlated with obstructive urodynamic findings and urethral resista

  19. Female urethral cavernous hemangioma - An unusual cause of hematuria: A rare case report

    Shivraj N Kanthikar


    Full Text Available Hemangiomas are benign vascular lesion, most commonly seen in liver and skin whereas rarely found in genitourinary system. Urethral hemangiomas are mostly found in males. To the best of our knowledge, in females only handful of case reports has been described in the literature. We report a case of urethral hemangioma in a 28-year-old female presented with history of intermittent hematuria. Cystourethroscopy examination revealed vascular mass of 2 cm Χ 2 cm at anterior urethral meatus. Surgical excision of mass with fulguration of base with diathermy was performed under general anesthesia. Final diagnosis on histopathology was given as cavernous type of urethral hemangioma. In spite of its benign nature, these lesions have a tendency to recur. In more extensive lesions or recurrence, open exploration with resection of involved tissue is always needed. Treatment of hemangiomas depends on size and site of the lesion and follow-up is needed to avoid recurrence. Histomorphological diagnosis of the lesion is always warranted in view of different treatment modalities.

  20. Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

    Emrullah Söğütdelen


    Full Text Available Urethral stricture is narrowing of the urethra due to inflammation that results in scarring. Prostatectomies for benign and malign prostatic diseases are common surgical procedures among men mainly after their fifties. Urethral stricture or bladder neck contraction following transurethral resection of the prostate (TURP is seen in up to 19% of men in different series. Urethral stricture after laser prostatectomy is less frequently reported than TURP, which is about 3.6%. Open prostatectomy for benign prostatic hyperplasia is the oldest technique, nonetheless, it is a reasonable alternative for patients with larger prostates. Urethral stricture is reported in 1.9-4.8% of patients after open prostatectomy. Radical prostatectomy (RP is the most common surgical procedure done worldwide for the treatment of localized prostate cancer. Contracture of the bladder neck at the level of the anastomosis is a well-recognized complication after RP occurring in 0.4-32% of patients. Strictures are mainly treated with endoscopic procedures. Rarely, urethroplasty with buccal mucosa grafts is needed for more complicated cases.

  1. Role of tubularization of urethral plate in development of urethrocutaneous fistula post hypospadias repair

    Basim S Alsaywid


    Conclusion: Incision of the urethral plate did not affect the fistula rate. In comparison to international literature, the incidence of fistula was significantly higher which could be explained by the fact that one-third of those patients had a previous hypospadias repair.

  2. Female urethral diverticulum. Clinical aspects and a presentation of 15 cases

    Jensen, L M; Aabech, J; Lundvall, F


    OBJECTIVE: Fifteen patients with female urethral diverticulum (FUD) were referred during nine years. In order to point out the symptomatology and findings and to evaluate the treatment we have reviewed these patients. METHODS: A retrospective analysis of 15 women treated with transvaginal diverti...

  3. Is there a need for smooth muscle cell transplantation in urethral reconstruction?

    Arenas da Silva, L.F.; Micol, L.; Tiemessen, D.; Kuppevelt, T.H. van; Frey, P.; Oosterwijk, E.; Geutjes, P.J.; Feitz, W.F.J.


    BACKGROUND: Hypospadias and urethral strictures are conditions requiring additional tissue for reconstruction. Due to a limited source of tissue, autologous skin and oral mucosa are frequently used. However, long-term follow-up studies demonstrated significant complications and diminished quality of

  4. A comparative study of different imaging modalities for successful percutaneous left atrial appendage closure.

    Chow, Danny Hf; Bieliauskas, Gintautas; Sawaya, Fadi J; Millan-Iturbe, Oscar; Kofoed, Klaus F; Søndergaard, Lars; De Backer, Ole


    Accurate sizing of the left atrial appendage (LAA) is essential when performing percutaneous LAA closure. This study aimed to compare different LAA imaging modalities and sizing methods in order to obtain successful LAA closure. Percutaneous LAA closure is an increasingly used treatment strategy to prevent stroke in patients with atrial fibrillation. LAA sizing has typically been done by 2D-transoesophageal echocardiography (TEE). Patients who had a preprocedural TEE and preprocedural and postprocedural multislice CT (MSCT) were identified. Preprocedural measurements of LAA ostia and landing zones by 2D-TEE, MSCT and angiography were collected and analysed for those patients with successful LAA closure - i.e. with no contrast leakage at 3-month follow-up MSCT. The study population (n=67) had a mean CHA2DS2-VASc score of 3.0 and HAS-BLED score of 2.7. Fifty-eight patients (87%) were identified to have successful LAA closure. Based on MSCT, 48 LAA sizings (83%) resulted in a correct LAA closure device size selection, whereas with 2D-TEE sizing, only 33 measurements (57%) would have resulted in a correct device size selection (pAmulet, WatchmanFLX), whereas the maximal diameter was the best parameter for the ‘open-end’ Watchman device. Preprocedural MSCT-based LAA closure device size selection proves to be a more accurate method than conventional 2D-TEE-based sizing. Depending on the LAA closure device design, perimeter-derived mean diameter or maximal diameter could be the better sizing method.

  5. Initial Experience of Transurethral Resection with Pediatric Resectoscope for Incomplete Anterior Urethral Stricture

    Won Seok Jang


    Full Text Available Purpose Endoscopic urethrotomy is an alternative method in treatment of urethral stricture. However, it have high recurrence rate because of the remained fibrotic tissue. Removal of the fibrotic tissue can maintain the patency of the urethral lumen after the procedure. We report the therapeutic efficacy of our initial experience using pediatric resectoscope for treating anterior urethral stricture in 16 cases. Materials and Methods From January 2009 to April 2011, transurethral resection with pediatric resectoscope was primarily performed on 16 patients with anterior urethral stricture. Retrograde urethrography, uroflowmetry, postvoid residual volume, IPSS score and QoL score were performed preoperatively. We used 11.5Fr pediatric resectoscope (Wolf and monopolar electrosurgical generator. The stricture was incised under vision at the 12 o'clock location or the site of maximum scar tissue or narrowing in asymmetric strictures for working space. After incision, transurethral resection with pediatric resectoscope was performed to all scar tissues. Monopolar cutting current was set on 45 watt and coagulation current was set on 30 watt, fulgurate mode. Postoperatively, drainage of the bladder was performed for 7 days using an 18F latex catheter. Patients were followed up by IPSS score, QoL score, uroflowmetry and postvoid residual volume. Results Successful results without recurrence were achieved in 11 of 16patients. Postoperative urethral dilation had been performed average 2.4 times (0∼6 times. When we classified the results by etiology, the number of successful results in strictures with a trauma, iatrogenic, or unknown cause was 5 (7/11, 3 (3/4 and 1 (1/1, respectively. In 5 patients who failed treatment, we repeated transurethral resection with pediatric resectoscope in 1 patient, and periodic urethral dilation in 4 patients. No operative complications occurred in any patients. Conclusions Transurethral resection with pediatric resectoscope

  6. TIMP-1 Induces α-Smooth Muscle Actin in Fibroblasts to Promote Urethral Scar Formation

    Yinglong Sa


    Full Text Available Background/Aims: Tissue inhibitor of metalloproteinases-1 (TIMP-1 has been reported to upregulate in urethral scar. However, the underlying molecular mechanisms remain undefined. Methods: Here, we studied levels of TIMP-1 and α-smooth muscle actin (α-SMA in the fibroblasts isolated from urethral scar tissues, compared to the fibroblasts isolated from normal urethra. Then we either overexpressed TIMP-1, or inhibited TIMP-1 by lentiviruses carrying a transgene or a short hairpin small interfering RNA for TIMP-1 in human fibroblasts. We examined the effects of modulation of TIMP-1 on α-SMA, and on epithelial-mesenchymal transition (EMT-related genes. We also studied the underlying mechanisms. Results: We detected significantly higher levels of TIMP-1 and α-smooth muscle actin (α-SMA in the fibroblasts isolated from urethral scar tissues, compared to the fibroblasts isolated from normal urethra. Moreover, the levels of TIMP-1 and α-SMA strongly correlated. Moreover, we found that TIMP-1 significantly increased levels of α-SMA, transforming growth factor β 1 (TGFβ1, Collagen I and some other key factors related to an enhanced EMT, suggesting that TIMP-1 may induce transformation of fibroblasts into myofibroblasts to promote tissue EMT to enhance the formation of urethral scar. Moreover, increases in TIMP-1 also induced an increase in fibroblast cell growth and cell invasion, in an ERK/MAPK-signaling-dependent manner. Conclusion: Our study thus highlights a pivotal role of TIMP-1 in urethral scar formation.

  7. Evaluation of anterior urethral stricture using thick slab SSFSE MR urethrography

    Park, Byung Kwan; Kim, Chan Kyo (Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea)), e-mail:; Lee, Sung Won (Dept. of Urology, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea))


    Background: Magnetic resonance urethrography (MRU) can be used for depicting not only anterior urethral strictures but also periurethral anatomy in order to produce a management plan. Purpose: To determine if thick slab single-shot fast spin echo (SSFSE) MRU is useful for evaluating anterior urethral stricture compared to fast recovery fast spin echo (FRFSE) MRU. Material and Methods: Ten patients with benign anterior urethral stricture underwent both thick slab SSFSE MRU and FRFSE MRU using sterile jelly for urethral distension before retrograde urethrography. The glans penis was tied at the time of MRU. The two types of MR image were compared regarding stricture length, scan time, and image quality. We also determined whether or not both of the two MR sequences could display an entire anterior urethra on one image. Results: The stricture length on thick slab SSFSE and FRFSE MRU ranged from 4.0 to 71.3 mm (36.4 {+-} 21.8 mm) and from 4.0 to 67.5 mm (35.7 {+-} 20.8 mm), respectively (P > 0.05). The mean scan time for thick slab SSFSE and FRFSE sequences was 2 s and 194 s, respectively (P < 0.05). However, regarding image quality, thick slab SSFSE MRU was inferior to FRFSE MRU (P < 0.05). All the thick slab SSFSE MRU displayed the entire anterior urethra on one image, while only five FRFSE MRU did so (P < 0.05). Conclusion: Thick slab SSFSE MRU can provide a concordant stricture length when compared to the FRFSE MRU and imaging of the entire length of the anterior urethral stricture with subjective reduced image quality and scan time.

  8. The dose-dependence biological effect of laser fluence on rabbit fibroblasts derived from urethral scar.

    Yang, Yong; Yu, Bo; Sun, Dongchong; Wu, Yuanyi; Xiao, Yi


    Two-micrometer laser vaporization resection has been used in clinic for years, but some patients received the treatment are still faced with excessive and abnormal wound repair which leads to the recurrent of urethral stricture eventually. Fibroblasts play a key role in the processes of "narrow-expansion/operation-restenosis" recurring problems. Here, we investigated the effect of laser fluence biomodulation on urethral scar fibroblasts as well as the underlying mechanism. Urethral scar fibroblasts were isolated and cultured, and laser irradiation (2 μm) was applied at different laser fluence or doses (0, 0.125, 0.5, 2, 8, 32 J/cm(2)) with a single exposure in 1 day. The effect of 2-μm laser irradiation on cell proliferation, viability, and expression of scar formation related genes were investigated. Two-micrometer laser irradiation with intermediate dose (8 J/cm(2)) promoted scar fibroblasts proliferation and reactive oxygen species (ROS) production, while higher doses of 32 J/cm(2) are suppressive as it decreased the survival rate, viability, and proliferation of fibroblasts. In addition, qRT-PCR and Western blotting results both proven that collagen type I, collagen IV, MMP9, and CTGF display significant increase, yet the TGF-β1 expression was severely reduced at intermediate dose (8 J/cm(2)) group when compared with the others groups. Our findings suggest the scar formation-related genes are sensitive to intermediate laser irradiation dose, the most in scar fibroblasts. We revealed the bioeffect and molecular mechanism of 2-μm laser irradiation on rabbit urethral scar fibroblasts. Our study provides new insights into the mechanisms which involved in the excessive and abnormal wound repair of 2-μm laser vaporization resection. These results could potentially contribute to further study on biological effects and application of 2-μm laser irradiation in urethral stricture therapy.

  9. Maximizing without difficulty: A modified maximizing scale and its correlates

    Lai, Linda


    ... included in several previous studies. Based on this scale, maximizing is positively correlated with optimism, need for cognition, desire for consistency, risk aversion, intrinsic motivation, self-efficacy and perceived workload, whereas...

  10. Maximizing and customer loyalty: Are maximizers less loyal?

    Linda Lai


    Full Text Available Despite their efforts to choose the best of all available solutions, maximizers seem to be more inclined than satisficers to regret their choices and to experience post-decisional dissonance. Maximizers may therefore be expected to change their decisions more frequently and hence exhibit lower customer loyalty to providers of products and services compared to satisficers. Findings from the study reported here (N = 1978 support this prediction. Maximizers reported significantly higher intentions to switch to another service provider (television provider than satisficers. Maximizers' intentions to switch appear to be intensified and mediated by higher proneness to regret, increased desire to discuss relevant choices with others, higher levels of perceived knowledge of alternatives, and higher ego involvement in the end product, compared to satisficers. Opportunities for future research are suggested.

  11. Are maximizers really unhappy? The measurement of maximizing tendency,

    Dalia L. Diab


    Full Text Available Recent research suggesting that people who maximize are less happy than those who satisfice has received considerable fanfare. The current study investigates whether this conclusion reflects the construct itself or rather how it is measured. We developed an alternative measure of maximizing tendency that is theory-based, has good psychometric properties, and predicts behavioral outcomes. In contrast to the existing maximization measure, our new measure did not correlate with life (dissatisfaction, nor with most maladaptive personality and decision-making traits. We conclude that the interpretation of maximizers as unhappy may be due to poor measurement of the construct. We present a more reliable and valid measure for future researchers to use.

  12. Principles of maximally classical and maximally realistic quantum mechanics

    S M Roy


    Recently Auberson, Mahoux, Roy and Singh have proved a long standing conjecture of Roy and Singh: In 2-dimensional phase space, a maximally realistic quantum mechanics can have quantum probabilities of no more than + 1 complete commuting cets (CCS) of observables coexisting as marginals of one positive phase space density. Here I formulate a stationary principle which gives a nonperturbative definition of a maximally classical as well as maximally realistic phase space density. I show that the maximally classical trajectories are in fact exactly classical in the simple examples of coherent states and bound states of an oscillator and Gaussian free particle states. In contrast, it is known that the de Broglie–Bohm realistic theory gives highly nonclassical trajectories.

  13. Telephone switchboard closure | 19 December


    Exceptionally, the telephone switchboard will close at 4 p.m. on Friday, 19 December, instead of the usual time of 6 p.m., to allow time for closing all systems properly before the annual closure. Therefore, switchboard operator assistance to transfer calls from/to external lines will stop. All other phone services will run as usual.

  14. Abdominal wound closure: current perspectives

    Williams ZF


    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  15. Vacuum assisted closure in coloproctology

    Bemelman, W.A.


    Vacuum-assisted closure has earned its indications in coloproctology. It has been described with variable results in the treatment of large perineal defects after abdominoperineal excision, in the treatment of stoma dehiscence and perirectal abscesses. The most promising indication for

  16. Maximizing ROI with yield management

    Neil Snyder


    .... the technology is based on the concept of yield management, which aims to sell the right product to the right customer at the right price and the right time therefore maximizing revenue, or yield...

  17. Are CEOs Expected Utility Maximizers?

    John List; Charles Mason


    Are individuals expected utility maximizers? This question represents much more than academic curiosity. In a normative sense, at stake are the fundamental underpinnings of the bulk of the last half-century's models of choice under uncertainty. From a positive perspective, the ubiquitous use of benefit-cost analysis across government agencies renders the expected utility maximization paradigm literally the only game in town. In this study, we advance the literature by exploring CEO's preferen...

  18. Gaussian maximally multipartite entangled states

    Facchi, Paolo; Lupo, Cosmo; Mancini, Stefano; Pascazio, Saverio


    We introduce the notion of maximally multipartite entangled states (MMES) in the context of Gaussian continuous variable quantum systems. These are bosonic multipartite states that are maximally entangled over all possible bipartitions of the system. By considering multimode Gaussian states with constrained energy, we show that perfect MMESs, which exhibit the maximum amount of bipartite entanglement for all bipartitions, only exist for systems containing n=2 or 3 modes. We further numerically investigate the structure of MMESs and their frustration for n <= 7.

  19. All maximally entangling unitary operators

    Cohen, Scott M. [Department of Physics, Duquesne University, Pittsburgh, Pennsylvania 15282 (United States); Department of Physics, Carnegie-Mellon University, Pittsburgh, Pennsylvania 15213 (United States)


    We characterize all maximally entangling bipartite unitary operators, acting on systems A and B of arbitrary finite dimensions d{sub A}{<=}d{sub B}, when ancillary systems are available to both parties. Several useful and interesting consequences of this characterization are discussed, including an understanding of why the entangling and disentangling capacities of a given (maximally entangling) unitary can differ and a proof that these capacities must be equal when d{sub A}=d{sub B}.

  20. On the maximal diphoton width

    Salvio, Alberto; Strumia, Alessandro; Urbano, Alfredo


    Motivated by the 750 GeV diphoton excess found at LHC, we compute the maximal width into $\\gamma\\gamma$ that a neutral scalar can acquire through a loop of charged fermions or scalars as function of the maximal scale at which the theory holds, taking into account vacuum (meta)stability bounds. We show how an extra gauge symmetry can qualitatively weaken such bounds, and explore collider probes and connections with Dark Matter.

  1. 40 CFR 265.112 - Closure plan; amendment of plan.


    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure plan; amendment of plan. 265... DISPOSAL FACILITIES Closure and Post-Closure § 265.112 Closure plan; amendment of plan. (a) Written plan... have a written closure plan. Until final closure is completed and certified in accordance with §...




    Full Text Available Laparoscopic closure of perforated duodenal ulcer was first performed in the year 1990 . Due to its advantage of better view of the peritoneal cavity an opportunity for thorough lavage and avoidance of upper abdominal incision, with its related complication, especially in high – ri sk patients, this procedure has gained popularity all over the world. Approximately 10 - 20% of patients suffering from peptic ulcer develop perforation of stomach or duodenum in which, chemical peritonitis develop initially from gastric secretion and duoden al secretion the condition is life threatening. Early diagnosis and treatment is extremely important. Mortality will increase up if perforation exists more than 24 to 48 hours. Usually surgical intervention of simple closure with omental patch of the perforation is required. this study aims at evaluating efficacy , safety and outcome of laparoscopic surgery for perforated duodenal ulcer patients admitted during period Jan 2009 to Dec 2012 at tertiary hospital in north Karnataka A total of 61cases diagnosed as peritonitis secondary to duodenal ulcer perforation were involved in the study 30underwent open perforation closure and 31 cases underwent lap closure. Peptic ulcers are focal defects in the gastric or duodenal mucosa which extend into the sub mucosa or deeper. they may be acute or chronic and ultimately are caused by on imbalance between the action of peptic acid and mucosal defenses peptic ulcer remains a common outpatient diagnosis, but the number of elective operations for peptic ul cer disease have decreased dramatically over the past 30 decades due to the advent of H2 blockers However the incidence of emergency surgeries, and death rate associated with peptic ulcer are same

  3. Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture

    Sudhir Kumar Jain


    Conclusion: Both modalities are effective in providing immediate relief to patients with single and short segment (<2 cm long urethral strictures but more sustained response was attained with Cold knife urethrotomy.

  4. Toxic catheters and urethral strictures: A concern about types of catheters used in resource-poor countries

    A.A. Popoola


    Full Text Available Various reports in the literature have confirmed urethral toxicity caused by the use of catheters, mostly latex catheters and their coated versions, resulting in long-segment urethral strictures or strictures located in multiple areas of the urethra. Most catheters used in resource-poor countries, such as Nigeria, are latex catheters with various coatings, such as silicone. The reasons for the widespread use of these potentially toxic catheters are mainly non-availability and/or the high cost of less toxic catheters. We report three cases of urethral strictures following the use of siliconized latex catheters in order to highlight the potential urethral toxicity associated with the use of latex catheters and to draw the authorities’ attention to the need to regulate the types of catheters used in the country.

  5. In-vivo performance of high-density collagen gel tubes for urethral regeneration in a rabbit model.

    Micol, L.A.; Arenas da Silva, L.F.; Geutjes, P.J.; Oosterwijk, E.; Hubbell, J.A.; Feitz, W.F.J.; Frey, P.


    Congenital malformations or injuries of the urethra can be treated using existing autologous tissue, but these procedures are sometimes associated with severe complications. Therefore, tissue engineering may be advantageous for generating urethral grafts. We evaluated engineered high-density

  6. A case of clear cell adenocarcinoma arising from the urethral diverticulum: Utility of urinary cytology and immunohistochemistry

    Shin-ichi Nakatsuka


    Full Text Available Carcinomas rarely arise from the urethral diverticulum. In this report, we present a case of clear cell adenocarcinoma arising from the urethral diverticulum. A 42-year-old woman complained of bloody discharge and lower back pain. Imaging studies showed a tumor involving the region surrounding the urethra and cystourethroscopy showed papillary and villous tumors in the urethral diverticula. Cytology of the urine sediment showed papillary or spherical clusters of atypical cells, some of which had clear abundant cytoplasm and formed mirror ball-like clusters, suggesting adenocarcinoma. Although histological diagnosis was indeterminate by biopsy and transurethral resection (TUR because of absence of stromal invasion, surgically resected specimen via cysturethrectomy revealed that the tumor was clear cell carcinoma. Urinary cytological findings and immunohistochemical analysis for CD15, Ki-67, and p53 might be useful for accurate diagnosis of clear cell adenocarcinoma that arises from the urethral diverticulum when sufficient materials are not available by biopsy and TUR.

  7. Tubularised Incised Plate Urethroplasty is an Applicable Method for the Treatment of the Hypospadiac Type of Urethral Duplication

    Ömer Yılmaz


    Full Text Available Urethral duplication is a rare congenital anomaly usually seen in males. We present a case of urethral duplication treated by a tubularised incised plate urethroplasty (TIPU technique. A 5-year-old male boy was admitted to the clinic with the complaints of thin calibrated urinating and diurnal enuresis. We diagnosed distal penile hypospadias. During the operation, another urethral opening was found proximal to the previously seen hypospadiac meatus, localised on the coronary sulcus. We performed the TIPU procedure without excising the duplicated urethra. We only excised the common wall between the two urethras, and used the dorsal urethral plate of the duplicated urethra for tubularisation of the neourethra. The postoperative course was uneventful. A cystoscopy was done for suspected urogenital sinus. There was no further complaint at the third postoperative month. The TIPU technique can be successfully applied in such cases. The dorsal plate of the duplicated urethra can be used to form the neourethra.

  8. Trichomonas vaginalis infection: How significant is it in men presenting with recurrent or persistent symptoms of urethritis?

    Ng, Andrea; Ross, Jonathan D C


    Persistent or recurrent non-gonococcal urethritis has been reported to affect up to 10-20% of men attending sexual health clinics. An audit was undertaken to review the management of persistent or recurrent non-gonococcal urethritis in men presenting at Whittall Street Clinic, Birmingham, UK. Detection of Trichomonas vaginalis infection was with the newly-introduced nucleic acid amplification test. A total of 43 (8%) of 533 men treated for urethritis re-attended within three months with persistent or recurrent symptoms. Chlamydia trachomatis infection was identified in 13/40 (33%), T. vaginalis in 1/27 (4%) and Mycoplasma genitalium in 6/12 (50%). These findings suggest that the prevalence of T. vaginalis infection remains low in our clinic population and may not contribute significantly to persistent or recurrent non-gonococcal urethritis.

  9. Quality of life outcomes in peri-urethral calcium hydroxylapatite injection.

    Griffin, Meghan A; Janosek-Albright, Kirsten J C; Diaz-Insua, Mireya; Elshatanoufy, Solafa; Atiemo, Humphrey O


    Peri-urethral calcium hydroxylapatite injection is an established treatment for patients with stress urinary incontinence. Information is limited regarding calcium hydroxylapatite treatment and quality of life (QOL) outcomes. We hypothesize that patients might improve QOL after peri-urethral calcium hydroxylapatite injection, which was reflected in validated questionnaires. The peri-urethral calcium hydroxylapatite injection billing code was used to identify patients who underwent injection from 2011-2013. Female patients who completed the American Urological Association Symptom Score (AUASS), the AUASS QOL and Michigan Incontinence Symptom Index (M-ISI), and the bother score (M-ISI bother), or pad count at baseline and follow-up were included. Change in questionnaire scores and pads were assessed using the paired t test. Sixty patients underwent 1 (30), 2 (63) or 3 (7 %) peri-urethral calcium hydroxylapatite injections performed by a single surgeon. Thirty-seven patients provided questionnaires and 38 provided pad counts, all with a mean age of 75 years. The overall AUASS, AUASS QOL, and overall M-ISI scores improved in 67.6, 54.8, and 61.3 % respectively (4.5 ± 7.9, 1.3 ± 1.7 and 5.5 ± 8.6 respectively). The M-ISI bother score improved in 44.8 % with a mean improvement of 0.5 ± 2.9, but did not reach significance. There was a 1.7 ± 3.7 decrease in the mean number of pads used daily after the procedure (p = 0.006) and 19 % experienced transient urinary retention. Peri-urethral calcium hydroxylapatite injections can improve urinary QOL scores in patients with initial and recurrent stress urinary incontinence. This short-term retrospective analysis suggests that larger long-term studies focusing on QOL outcomes are needed to evaluate the effect of peri-urethral calcium hydroxylapatite has on incontinence-specific QOL.

  10. Congenital anterior urethral valves and diverticula: Diagnosis and management in six cases

    Rawat Jiledar


    Full Text Available Background: Anterior urethral valves (AUVs are rare congenital anomalies causing lower urinary tract obstruction in children. Although they are referred to as valves, these obstructive structures often occur in the form of a diverticulum. The urethra in these cases shows saccular or bulbar dilatation known as anterior urethral diverticulum (AUD. They typically occur where there is a defect in the corpus spongiosum, leaving a thin-walled urethra. This segment of the urethra balloons out during voiding, simulating a mass that is sometimes visible along the ventral wall of the penis. The swelling is fluctuant and urine dribbles from the meatus on compression. The present study highlights the clinical approach in identifying the condition and its treatment options, especially for those, presenting with urethral diverticula. Materials and Methods: We have studied children with congenital anterior urethral valves and diverticula. Six patients of AUVs with diverticula were admitted during the period of 2000-2007 and were prospectively evaluated. The mean age of presentation was 16 months (15 days to 4 years. Straining at micturition and a palpable penile swelling were the most common presenting features. The diagnosis was established by voiding cystourethrogram (VCUG and supported by ultrasonography (USG. All patients were treated with single-stage open surgical excision except one who died preoperatively due to urosepsis. Initial lay opening of the penoscrotal urethra and delayed repair were done in one patient. Results: The surgical outcome was successful in all but one patient, who died of delayed presentation with severe back pressure changes, urinary ascitis and urosepsis. On long-term follow-up, all patients demonstrated good stream of urine. The renal functions were normal and the patients had no evidence of urinary infections. Conclusion: We propose that, the patients of AUVs, if not excessively delayed for treatment are otherwise well in terms

  11. Stereological and biochemical analysis of the urethral edges in patients submitted to end-to-end anastomosis for bulbar urethral stricture

    Joao P. M. de Carvalho


    Full Text Available PURPOSE: To study the morphologic alterations in the proximal and distal urethral edges from patients submitted to end-to-end bulbar urethroplasty. MATERIALS AND METHODS: We analyzed 12 patients submitted to anastomotic urethroplasty to treat bulbar strictures less than 2.0 cm in length. After excision of the fibrotic segment to a 28Fr urethral caliber, we obtained biopsies from the spongious tissue of the free edges (proximal: PROX and distal: DIST. Controls included normal bulbar urethras obtained from autopsies of 10 age matched individuals. The samples were histologically processed for smooth muscle cells (SMC, elastic system fibers and collagen. Stereological analysis was performed to determine the volumetric density (Vv of each element. Also, a biochemical analysis was performed to quantify the total collagen content. RESULTS: Vv of SMC was reduced in PROX (31.48 ± 7.01 p < 0.05 and similar in DIST when compared to controls (55.65 ± 9.60% with no statistical difference. Elastic fibers were increased in PROX (25.70 ± 3.21%; p < 0.05 and were similar to controls in DIST (15.87 ± 4.26%. Total collagen concentration in PROX (46.39 �� 8.20 μg/mg, and DIST (47.96 ± 9.42 μg/mg did not differ from controls (48.85 ± 6.91 μg/mg. Type III collagen was similarly present in all samples. CONCLUSIONS: After excision of the stenotic segment to a caliber of 28Fr, the exposed and macroscopically normal urethral edges may present altered amounts of elastic fibers and SMC, but are free from fibrotic tissue. When excising the peri-stenotic tissue, the surgeon should be more careful in the proximal end, which is the most altered.

  12. Generalized Convective Quasi-Equilibrium Closure

    Yano, Jun-Ichi; Plant, Robert


    Arakawa and Schubert proposed convective quasi-equilibrium as a basic principle for closing their spectrum mass-flux convection parameterization. In deriving this principle, they show that the cloud work function is a key variable that controls the growth of convection. Thus, this closure hypothesis imposes a steadiness of the cloud work function tendency. This presentation shows how this principle can be generalized so that it can also encompasses both the CAPE and the moisture-convergence closures. Note that the majority of the current mass-flux convection parameterization invokes a CAPE closure, whereas the moisture-convergence closure was extremely popular historically. This generalization, in turn, includes both closures as special cases of convective quasi-equilibrium. This generalization further suggests wide range of alternative possibilities for convective closure. In general, a vertical integral of any function depending on both large-scale and convective-scale variables can be adopted as an alternative closure variables, leading to an analogous formulation as Arakawa and Schubert's convective quasi-equilibrium formulation. Among those, probably the most fascinating possibility is to take a vertical integral of the convective-scale moisture for the closure. Use of a convective-scale variable for closure has a particular appeal by not suffering from a loss of predictability of any large-scale variables. That is a main problem with any of the current convective closures, not only for the moisture-convergence based closure as often asserted.

  13. Maximization

    A. Garmroodi Asil


    To further reduce the sulfur dioxide emission of the entire refining process, two scenarios of acid gas or air preheats are investigated when either of them is used simultaneously with the third enrichment scheme. The maximum overall sulfur recovery efficiency and highest combustion chamber temperature is slightly higher for acid gas preheats but air preheat is more favorable because it is more benign. To the best of our knowledge, optimization of the entire GTU + enrichment section and SRU processes has not been addressed previously.

  14. Closure constraints for hyperbolic tetrahedra

    Charles, Christoph


    We investigate the generalization of loop gravity's twisted geometries to a q-deformed gauge group. In the standard undeformed case, loop gravity is a formulation of general relativity as a diffeomorphism-invariant SU(2) gauge theory. Its classical states are graphs provided with algebraic data. In particular closure constraints at every node of the graph ensure their interpretation as twisted geometries. Dual to each node, one has a polyhedron embedded in flat space R^3. One then glues them allowing for both curvature and torsion. It was recently conjectured that q-deforming the gauge group SU(2) would allow to account for a non-vanishing cosmological constant Lambda, and in particular that deforming the loop gravity phase space with real parameter q>0 would lead to a generalization of twisted geometries to a hyperbolic curvature. Following this insight, we look for generalization of the closure constraints to the hyperbolic case. In particular, we introduce two new closure constraints for hyperbolic tetrahe...

  15. Follow up of acute gonococcal urethritis in males treated with norfloxacin

    Chari KVR


    Full Text Available This subject was undertaken to confirm the efficacy of norfloxacin in acute gonorrhoea and to note the relapse if any during the follow up period of 3 months. 27 male patients suffering from acute gonorrhoea were treated with 800 mgs of norfloxacin as single oral dose. In all cases, gonococci disappeared from urethral smears by 8 hours, urethral discharge subsided by 72 hrs, urine on naked eye examination cleared in 4 days except in 1 case and burning micturition subsided by 7 days. Cure rate was 100% in the study. No relapse was found at the end of follow up of 3 months. No adverse reactions were observed to norfloxacin except headache in 2 cases. Norfloxacin was safe and effective in the treatment of acute gonorrhoea.

  16. A giant dumbbell shaped vesico-prostatic urethral calculus: a case report and review of literature.

    Prabhuswamy, Vinod Kumar; Tiwari, Rahul; Krishnamoorthy, Ramakrishnan


    Calculi in the urethra are an uncommon entity. Giant calculi in prostatic urethra are extremely rare. The decision about treatment strategy of calculi depends upon the size, shape, and position of the calculus and the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most of the previous reported cases, giant calculi were extracted via the transvesical approach and external urethrotomy. A 38-year-old male patient presented with complaints of lower urinary tract symptoms. Further investigations showed a giant urethral calculus secondary to stricture of bulbo-membranous part of the urethra. Surgical removal of calculus was done via transvesical approach. Two calculi were found and extracted. One was a huge dumbbell calculus and the other was a smaller round calculus. This case was reported because of the rare size and the dumbbell nature of the stone. Giant urethral calculi are better managed by open surgery.

  17. Comparative Study for the Effect of Tamsulosin on Biomarkers between Renal and Urethral Stone Lithotripsy

    Mohammed Khalid Abood


    Full Text Available Nephrolithiasis are multi-factorial diseases that result from the combined influence of epidemiological, biochemical and genetically risk factors. Defective drainage due to urinary tract obstruction at the narrowest part (ureterovesical junction, ureteropelvic junction, and near the pelvic brim via stones will eventually cause the agonizing renal colic pain. Therapeutic managements of nephrolithiasis to relief acute colic pain are the primary objective. Non-steroidal anti-inflammatory drugs are the most commonly used drugs as suggested by many studies. It is very important to consider side effects of the drugs used in the treatment of colic pain. In order to preserve renal function and to relief obstruction, medical expulsion therapy are used for urethral calculi as a conservative management. These medications will aid the passage urethral calculi, an area that currently seems to be a field for continuous investigation.

  18. Prevalence of Ureaplasma urealyticum in the urethra of men without urethritis in relation to clinical diagnosis.

    Hackel, H; Hartmann, A A; Elsner, P; Burg, G


    Ureaplasma urealyticum is one of the microorganisms possibly causing nongonococcal urethritis. In a prospective study, 606 men without urethritis presented to an STD clinic in a rural West German region were investigated for the prevalence of U. urealyticum in the urethra. The overall isolation rate of the organism was 21.3%. Analyzing patients grouped by clinical diagnoses, the isolation rate of U. urealyticum was significantly higher in the genital warts group (25%) and in the partner's control group (35%) than in the group of patients suffering from fertility disorder (15.2%) or balanitis (14%). These findings stress the importance and the difficulty to select the appropriate controls in clinical studies concerning the role of U. urealyticum in the male urethra.

  19. Hypospadias: the release of chordee without dividing the urethral plate and onlay island flap (92 cases)

    Mollard, P; Castagnola, C


    Standard teaching states that the correction of fibrous chordee requires division of the urethral plate. Subsequently, it is necessary to reconstruct the urethra using tubular urethroplasty, which carries a significant incidence of complications, for example stenosis. In fact, we have demonstrated that it is possible to release severe chordee associated with hypospadias simply by dissecting the urethral plate of the corpora rather than dividing it. Between 1989 and 1993 we operated on 101 patients with hypospadias with fibrous chordee. The release of chordee was achieved without dividing the plate in 92 patients (91%), including all 71 cases of penile hypospadias, 11 perineal hypospadias and 10 reoperations. A total of 92 urethroplasties was performed with an onlay flap and 19 complications occurred in 15 patients.

  20. [Urethral injuries secondary to implantation of penile prosthesis. Analysis of the causes, prevention and treatment].

    Vitarelli, Antonio; Divenuto, Lucia; Palminteri, Enzo; Lorusso, Giovanni; Pagliarulo, Arcangelo


    Urethral injuries due to penile prosthesis implant represent a rare complication of the intervention to position penile prosthesis, but unfortunately scientific literature about this is poor. This rare complication may occur during surgery and in the postoperative period, both early and late. It recognizes a variety of causes that may include anatomical or functional conditions, for example cavernosal fibrosis or outcomes of inflammations or previous urethral lesions and pathological sensibility due to diabetic neuropathy or other forms of neuropathy including those from spinal cord injury or myelopathy. This review evaluates the possible predisposing conditions, the clinical presentations, and the devices in the surgical procedures to use to minimize the risk of onset of this lesions and the measures to take if they occur.

  1. Fournier’s Gangrene in a Heterosexual Man: A Complication of Neisseria meningitidis Urethritis

    Tariq A. Khemees


    Full Text Available A 55-year-old heterosexual male presented to the emergency department with a symptomatology consistent with urethritis and Fournier’s gangrene. Urethral swab and operative tissue cultures were positive for coagulase-negative Staphylococcus and an intracellular Gram-negative diplococcus. The latter was initially thought to be Neisseria gonorrhea; however, DNA sequencing technique confirmed it to be Neisseria meningitidis. The patient required three separate surgical debridements to control widespread necrotizing infection. Following documentation of sterile wound healing with appropriate antibiotics, four reconstructive surgeries were necessary to manage the resultant wound defects. To our knowledge, Neisseria meningitidis as a causative organism in Fournier’s gangrene has not been reported in the literature.

  2. Algebraic curves of maximal cyclicity

    Caubergh, Magdalena; Dumortier, Freddy


    The paper deals with analytic families of planar vector fields, studying methods to detect the cyclicity of a non-isolated closed orbit, i.e. the maximum number of limit cycles that can locally bifurcate from it. It is known that this multi-parameter problem can be reduced to a single-parameter one, in the sense that there exist analytic curves in parameter space along which the maximal cyclicity can be attained. In that case one speaks about a maximal cyclicity curve (mcc) in case only the number is considered and of a maximal multiplicity curve (mmc) in case the multiplicity is also taken into account. In view of obtaining efficient algorithms for detecting the cyclicity, we investigate whether such mcc or mmc can be algebraic or even linear depending on certain general properties of the families or of their associated Bautin ideal. In any case by well chosen examples we show that prudence is appropriate.

  3. [Urethritis syndrome and atypical germ flora of the exterior female genitalia (author's transl)].

    Hofstetter, A; Schmiedt, E; Weissenbacher, E R; Frank, S


    A positive microbiological evidence could be obtained 54 times from the smear of the exterior genitals of 80 women suffering from complaints that were caused by urethritis, criteria of the examinations being sterile catheter specimen, negative cystoscopical findings, and missing indications to anatomical changes in the urethral region. Cytological examinations of these cases with regard to the vaginal epithelium had the following results:Group I:6 times; group II: 37 times; group IIW:8 times; group IIId: once; group IVa:twice. The cytological tests were carried out according to the method of papanicolaou as modified by Soost. Furthermore, we could state the following degrees of purity: Degree I: 8 times; degree II:16 times; degree III: 30 times. The cytological examinations of the urethral epithelium demonstrated, in 52 cases, an increased appearance of "nude" completely exposed epithelial cell nuclei--a fact corresponding to a degenerative autolysis (according to Wied). In the 26 women with missing atypical germ flora within the region of the exterior genitals, exclusively groups I (according to Papanicolaou and Soost) and degrees of purity I were stated. These persons also demonstrated remarkably grave psychical disturbances, especially in the intimate regions. In the cases of positive microbiological evidence, the following measures have proved satisfactory: Vaginal hygienization combined with a directly aimed antibacterial therapy, and the prescription of preparations containing lactic acid. A transitory discontinuation of contraceptives is being discussed. Our examination results are emphasizing the necessity of an analysis of the germ flora in cases of complaints arising from urethritis. Also psychical disturbances must be taken into consideration in cases of missing urological and gynaecological criteria of evidence.

  4. Urethral Fistula and Scrotal Abscess Associated with Colovesical Fistula Due to the Sigmoid Colon Cancer


    We report here a rare case of urethral fistula and scrotal abscess associated with colovesical fistula due to sigmoid colon cancer. An 84-year-old male was referred to our hospital complaining of macrohematuria, fecaluria, pneumaturia and micturitional pain. Computed tomography (CT) showed colovesical fistula. Other examinations, including colonoscopy and cystoscopy, did not reveal a clear cause for the colovesical fistula. Only an elevated serum level of the tumor marker CA19-9 suggested the...

  5. Urethroplasty by superficial membranous fascia for long urethral strictures: a new approach.

    Onu, P E


    36 patients has single-stage repair of severe bulbar urethral strictures using a superficial membranous fascia tubed flap. The length of follow-up varied from 9 months to 2 years (mean 15 months). Recurrence occurred in 1 case. Urodynamic studies in 35 cases before and after urethroplasty showed a marked improvement in urinary flow and voiding postoperatively. This procedure is safe, simple, economically preferable and has a no higher risk than other 1- and 2-stage procedures.

  6. Chlamydial infection of the cervix in contacts of men with nongonococcal urethritis.

    Tait, I A; Rees, E; Hobson, D.; Byng, R E; Tweedie, M C


    An investigation of chlamydial infection in sexual contacts of patients with nongonococcal urethritis (NGU) was carried out to determine the clinical signs of infection in the cervix, and their response to chemotherapy, and the incidence of cervical infection in the presence of ectopy and oral contraception. In 202 consecutive female contacts of NGU the isolation rate of Chlamydia trachomatis was 35%. Hypertrophic ectopy and endocervical mucopus were present in 19% and 37% of chlamydia-positi...

  7. Urethral stricture secondary to self-instrumentation due to delusional parasitosis: a case report.

    Ismail, Muhammad Fahmi; Cassidy, Eugene M


    Delusional parasitosis is a rare psychiatric disorder which often presents with dermatological problems. Delusional parasitosis, which involves urethral self-instrumentation and foreign body insertion, is exceptionally rare. This is the first case report to date that provides a detailed presentation of the urological manifestation of delusional parasitosis with complications associated with repeated self-instrumentation and foreign body insertion, resulting in stricture formation and requiring perineal urethrostomy. A 45-year-old Irish man was electively admitted for perineal urethrostomy with chronic symptoms of dysuria, haematuria, urethral discharge, and intermittent urinary retention. He reported a 4-year history of intermittent pain, pin-prick biting sensations, and burrowing sensations, and held the belief that his urethra was infested with ticks. He also reported a 2-year history of daily self-instrumentation, mainly injecting an antiseptic using a syringe in an attempt to eliminate the ticks. He was found to have urethral strictures secondary to repeated self-instrumentation. A foreign body was found in his urethra and was removed via cystoscopy. On psychiatric assessment, he displayed a fixed delusion of tick infestation and threatened to surgically remove the tick himself if no intervention was performed. The surgery was postponed due his mental state and he was started on risperidone; he was later transferred to an acute in-patient psychiatric unit. Following a 3-week admission, he reported improvement in his thoughts and distress. Delusional parasitosis is a rare psychiatric disorder. Self-inflicted urethral foreign bodies in males are rare and have high comorbidity with psychiatric disorders; hence, these patients have a low threshold for referral for psychiatric assessment. The mainstay treatment for delusional parasitosis is second-generation antipsychotic drugs.

  8. Long-term recording of external urethral sphincter EMG activity in unanesthetized, unrestrained rats


    The external urethral sphincter muscle (EUS) plays an important role in urinary function and often contributes to urinary dysfunction. EUS study would benefit from methodology for longitudinal recording of electromyographic activity (EMG) in unanesthetized animals, but this muscle is a poor substrate for chronic intramuscular electrodes, and thus the required methodology has not been available. We describe a method for long-term recording of EUS EMG by implantation of fine wires adjacent to t...

  9. Operative techniques of anastomotic posterior urethroplasty for traumatic posterior urethral strictures

    ZHOU Zhan-song; SONG Bo; JIN Xi-yu; XIONG En-qing; ZHANG Jia-hua


    Objective: To elucidate the details of operative technique of anastomotic posterior urethroplasty for traumatic posterior urethral strictures in attempt to offer a successful result.Methods: We reviewed the clinical data of 106 patients who had undergone anastomotic repair for posterior urethral strictures following traumatic pelvic fracture between 1979 and 2004. Patients' age ranged from 8 to 53 years (mean 27 years). Surgical repair was performed via perinea in 72 patients, modified transperineal repair in 5 and perineoabdominal repair in 29. Follow-up ranged from 1 to 23 years (mean 8 years).Results: Among the 77 patients treated by perineal approaches, 69 (95.8%) were successfully repaired and 27 out of the 29 patients (93.1%) who were repaired by perineoabdominal protocols were successful. The successful results have sustained as long as 23 years in some cases. Urinary incontinence did not happen in any patients while impotence occurred as a result of the anastomotic surgery.Conclusions: Three important skills or principles will ensure a successful outcome, namely complete excision of scar tissues, a completely normal mucosa ready for anastomosis at both ends of the urethra, and a tension-free anastomosis. When the urethral stricture is below 2.5 cm long, restoration of urethral continuity can be accomplished by a perineal procedure. If the stricture is over 2.5 cm long, a modified perineal or transpubic perineoabdominal procedure should be used. In the presence of a competent bladder neck, anastomotic surgery does not result in urinary incontinence. Impotence is usually related to the original trauma and rarely (5.7%) to urethroplasty.

  10. Introduction to Professor ZHENG Hui-tian's Clinical Experience in Treating Urethral Syndrome

    YUAN Ling-song; YUAN Shun-xing; HAUNG Guo-qi


    @@ Prof. ZHENG Hui-tian organized the project of "Acupuncture Treatment of Urethral Syndrome by the Method to Reinforce the Kidney and Warm Yang", which won the second prize for scientific achievements awarded by State Administration of Traditional Chinese Medicine and the second prize for the scientific achievements awarded by Shanghai Municipal Science Commission in 1996 and was introduced to the whole nation as a scientific achievement of traditional Chinese medicine in 1997.

  11. Extraperitoneal Pelvic laparoscopic disconnection of accessory urethra from normal urethra in a case of urethral duplication.

    Pant, Nitin; Aggarwal, Satish Kumar


    We report an extraperitoneal pelvic laparoscopic approach to disconnect accessory urethra from normal urethra in complete urethral duplication. First stage consisted of chordee correction, partial excision of the accessory urethra and glansplasty. In the second stage the remaining accessory urethra was disconnected from the normal urethra through a pre-peritoneal minimal access approach to the retropubic space. The remaining distal mucosa was ablated using monopolar cautery.

  12. Prefabricated partial distal urethral in 2-staged repair of proximal hypospadias with severe chordee

    Fan, Zhi-Qiang; Sun, Jian-Tao; Huangfu, Xue-Hun; Chen, Guo-Xiao; Hao, Jian-Wei; Liu, Zhong-Hua


    Purpose: To describe a new technique for staged hypospadias repair in which the urethral plate is divided and tubularized transverse island flap prefabricated partial distal urethral at the time of the first stage. Materials and methods: Sixteen patients with proximal hypospadias associated with severe chordee were operated on using a new staged technique. At the time of the first stage, the urethral plate was divided and chordee was corrected. Then tubularized transverse island flap was used to prefabricate partial distal urethra. The defective urethra was repaired using the Thiersch-Duplay principle at the second stage. Results: All participants have completed both stages of the operation. The mean follow-up duration was 18.4 months (range from 6 to 72 months). In the first-stage surgery, the modified tabularized transverse preputial island flap was performed on 6 patients, whereas the modified preputial double-faced island flap was performed on the other 10 patients. All of the prefabricated partial distal neourethras had no evidence of stenosis or scarring. The result of the second-stage procedure was a complete penis with integrated urethral. All patients were satisfied with cosmetic and functional results. Neither stricture nor diverticula was observed. A good urinary stream during the urination was attained in 12 (75.0%) patients. Four cases (25.0%) developed urethrocutaneous fistula after the second stage repair. Conclusions: In our preliminary series, this procedure improved functional and cosmetic results. It may be applicable to most cases of proximal hypospadias. Even when complications occur, they are less severe compared to those of the traditional staged approach. PMID:25932188

  13. Extraperitoneal Pelvic laparoscopic disconnection of accessory urethra from normal urethra in a case of urethral duplication

    Nitin Pant


    Full Text Available We report an extraperitoneal pelvic laparoscopic approach to disconnect accessory urethra from normal urethra in complete urethral duplication. First stage consisted of chordee correction, partial excision of the accessory urethra and glansplasty. In the second stage the remaining accessory urethra was disconnected from the normal urethra through a pre-peritoneal minimal access approach to the retropubic space. The remaining distal mucosa was ablated using monopolar cautery.

  14. Urethral inflammatory response to ureaplasma is significantly lower than to Mycoplasma genitalium and Chlamydia trachomatis.

    Moi, Harald; Reinton, Nils; Randjelovic, Ivana; Reponen, Elina J; Syvertsen, Line; Moghaddam, Amir


    A non-syndromic approach to treatment of people with non-gonococcal urethritis (NGU) requires identification of pathogens and understanding of the role of those pathogens in causing disease. The most commonly detected and isolated micro-organisms in the male urethral tract are bacteria belonging to the family of Mycoplasmataceae, in particular Ureaplasma urealyticum and Ureaplasma parvum. To better understand the role of these Ureaplasma species in NGU, we have performed a prospective analysis of male patients voluntarily attending a drop in STI clinic in Oslo. Of 362 male patients who were tested for NGU using microscopy of urethral smears, we found the following sexually transmissible micro-organisms: 16% Chlamydia trachomatis, 5% Mycoplasma genitalium, 14% U. urealyticum, 14% U. parvum and 5% Mycoplasma hominis. We found a high concordance in detecting in turn U. urealyticum and U. parvum using 16s rRNA gene and ureD gene as targets for nucleic acid amplification testing (NAAT). Whilst there was a strong association between microscopic signs of NGU and C. trachomatis infection, association of M. genitalium and U. urealyticum infections in turn were found only in patients with severe NGU (>30 polymorphonuclear leucocytes, PMNL/high powered fields, HPF). U. parvum was found to colonise a high percentage of patients with no or mild signs of NGU (0-9 PMNL/HPF). We conclude that urethral inflammatory response to ureaplasmas is less severe than to C. trachomatis and M. genitalium in most patients and that testing and treatment of ureaplasma-positive patients should only be considered when other STIs have been ruled out.

  15. Urethral Stricture Outcomes After Artificial Urinary Sphincter Cuff Erosion: Results From a Multicenter Retrospective Analysis.

    Gross, Martin S; Broghammer, Joshua A; Kaufman, Melissa R; Milam, Douglas F; Brant, William O; Cleves, Mario A; Dum, Travis W; McClung, Christopher; Jones, LeRoy A; Brady, Jeffrey D; Pryor, Michael B; Henry, Gerard D


    To evaluate the influence of both repair type and degree of cuff erosion on postoperative urethral stricture rate. Sparse literature exists regarding patient outcomes after artificial urinary sphincter (AUS) cuff erosion. Surgeons from 6 high-volume male continence centers compiled a comprehensive database of post-erosion patients to examine outcomes. This retrospective multi-institution study included 80 patients treated for AUS cuff erosions. Seventy-eight patients had specific information regarding post-cuff erosion urethral strictures. Erosion patients were categorized into 1 of 3 repair types at the time of explant surgery: catheter only, single-layer capsule-to-capsule repair (urethrorrhaphy), and formal urethroplasty. Operative notes and available medical records were extensively reviewed to collect study data. Twenty-five of 78 patients manifested a urethral stricture after AUS cuff erosion (32%). More strictures occurred among patients who underwent urethrorrhaphy (40% vs 29% for catheter only and 14% for urethroplasty). Stricture rates did not vary significantly by repair type (P = .2). Strictures occurred significantly more frequently in patients with complete cuff erosions (58%) as compared to partial erosions (25%, P = .037). A trend was detected regarding increased percentage of erosion correlating with increased stricture rate, but this did not reach statistical significance (P = .057). Partially eroded patients were more likely to undergo urethrorrhaphy repair (60%, P = .002). Urethral stricture was more likely to occur after complete cuff erosion as opposed to partial erosion in this multicenter retrospective population. Repair type, whether catheter only, urethrorrhaphy, or formal urethroplasty, did not appear to influence postoperative stricture rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Congenital Anterior Urethral Diverticulum in a Male Teenager: A Case Report and Review of the Literature

    Sadat Haider Quoraishi


    Full Text Available We present the case of a 13-year-old boy with a congenital anterior urethral diverticulum. This is a rare condition in males which can lead to obstructive lower urinary tract symptoms and urosepsis. Diagnosis is by urethroscopy and radiological imaging. Surgical treatment can be open or endoscopic. Long-term followup is required to check for reoccurrence of the obstruction.

  17. Sarcomatoid Carcinoma of Male Urethra with Bone and Lung Metastases Presenting as Urethral Stricture

    Niraj Badhiwala; Robert Chan; Hai-Jun Zhou; Steven Shen; Michael Coburn


    A 57-year-old man who presented with urinary retention was found to have a sarcomatoid carcinoma of the urethra. Evaluation with CT scan of the abdomen and pelvis revealed multiple pulmonary nodules and osteolytic lesions of left posterior ribs. After external beam radiation therapy and six cycles of systemic chemotherapy, patient underwent a surgical resection of the urethral cancer. After his surgery, patient was also found to have multiple brain metastases and underwent whole brain radiati...

  18. Single stage dorsal inlay buccal mucosal graft with tubularized incised urethral plate technique for hypospadias reoperations

    Wei-Jing Ye; Ping Ping; Yi-Dong Liu; Zheng Li; Yi-Ran Huang


    Aim: To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases. Methods: From May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old(average 11.62 ± 7.18 years) with failed previous hypospadias surgery were included in the present study. Indica- tions included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corporacavemosa. The neourethra was tubularized, and covered with subcutaneous (dartos) tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases. Results: The buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months (mean 22.6 months), the total complication rate was 15.1%, with five cases of fistula and three cases of stricture. Conclusion: Inlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations. (Asain J Androl 2008 Jul; 10: 682- 686)




    The authors study the singular integrals under the Hormander condition and the measure not satisfying the doubling condition. At first, if the corresponding singular integral is bounded from L2 to itseff, it is proved that the maximal singu lar integral is bounded from L∞ to RBMO except that it is infinite μ-a.e. on Rd. A sufficient condition and a necessary condition such that the maximal singular integral is bounded from L2 to itself are also obtained. There is a small gap between the two conditions.

  20. Stone risk after bladder substitution with the ileal-urethral Kock reservoir

    Osther, P J; Poulsen, A L; Steven, K


    OBJECTIVE: The study was carried out to compare urinary biochemical and physicochemical environments in patients who had undergone bladder substitution with the ileal-urethral Kock reservoir, and who had no actual urinary infection, with those of healthy subjects. MATERIAL AND METHODS: The partic......OBJECTIVE: The study was carried out to compare urinary biochemical and physicochemical environments in patients who had undergone bladder substitution with the ileal-urethral Kock reservoir, and who had no actual urinary infection, with those of healthy subjects. MATERIAL AND METHODS......: The participants were 23 male patients who had undergone bladder substitution with the ileal-urethral Kock reservoir and 25 healthy men. All subjects had sterile urine at the time of urine collection. Concentrations of calcium, magnesium, phosphorus, creatinine, citrate, oxalate, and ammonia in 24-h urine samples...... were measured. Estimates of ion activity products of calcium oxalate (CaOx), calcium phosphate (CaP), brushite (Bru), and magnesium ammonium phosphate (MAP) in urine were calculated according to Tiselius. RESULTS: There was no significant difference in 24-h urinary volume between patients...

  1. Novel Bioceramic Urethral Bulking Agents Elicit Improved Host Tissue Responses in a Rat Model

    Mann-Gow, Travis K.; King, Benjamin J.; El-Ghannam, Ahmed; Knabe-Ducheyne, Christine; Kida, Masatoshi; Dall, Ole M.; Krhut, Jan


    Objectives. To test the physical properties and host response to the bioceramic particles, silica-calcium phosphate (SCPC10) and Cristobalite, in a rat animal model and compare their biocompatibility to the current clinically utilized urethral bulking materials. Material and Methods. The novel bulking materials, SCPC10 and Cristobalite, were suspended in hyaluronic acid sodium salt and injected into the mid urethra of a rat. Additional animals were injected with bulking materials currently in clinical use. Physiological response was assessed using voiding trials, and host tissue response was evaluated using hard tissue histology and immunohistochemical analysis. Distant organs were evaluated for the presence of particles or their components. Results. Histological analysis of the urethral tissue five months after injection showed that both SCPC10 and Cristobalite induced a more robust fibroblastic and histiocytic reaction, promoting integration and encapsulation of the particle aggregates, leading to a larger bulking effect. Concentrations of Ca, Na, Si, and P ions in the experimental groups were comparable to control animals. Conclusions. This side-by-side examination of urethral bulking agents using a rat animal model and hard tissue histology techniques compared two newly developed bioactive ceramic particles to three of the currently used bulking agents. The local host tissue response and bulking effects of bioceramic particles were superior while also possessing a comparable safety profile. PMID:27688751

  2. Removal of retrievable self-expandable urethral stents: experience in 58 stents

    Shin, Ji Hoon; Song, Ho-Young; Kim, Jin Hyoung; Ko, Heung-Kyu; Kim, Yong Jae; Woo, Chul-Woong; Kim, Tae-Hyung; Ko, Gi-Young; Yoon, Hyun-Ki; Sung, Kyu-Bo [Asan Medical Center, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul (Korea); Park, Hyungkeun [Asan Medical Center, Department of Urology, University of Ulsan College of Medicine, Seoul (Korea)


    The purpose of this study was to retrospectively evaluate the safety and efficacy of removing retrievable self-expandable urethral stents using a retrieval hook wire. Under fluoroscopic guidance, the removal of 58 polyurethane or PTFE (polytetrafluoroethylene)-covered stents was attempted in 33 patients using a retrieval hook wire. Indications for removal were elective removal (n=21), stent migration (n=19), formation of tissue hyperplasia around or inside of the stent (n=14), stent deformity (n=3), and severe pain (n=1). The mean time the stents remained in place was 64.8{+-}42.9 days (range, 1-177 days). Fifty-six (97%) of the 58 stents were successfully removed using the retrieval hook wire despite the following difficulties; hook wire disconnection (n=2), untied drawstrings (n=3), and polyurethane membrane disruption/separation (n=4). The removal procedure using a retrieval hook wire failed in two stents (3%) which had migrated into the urinary bladder. One of the two stents with migration into the urinary bladder was removed using a snare through the cystostomy route. The overall complication rate was 14% (seven hematuria cases and one urethral tear case), and all were minor and spontaneously resolved without further treatment. In conclusion, removal of retrievable urethral stents using a retrieval hook wire was safe and effective despite some technical difficulties. It is a useful method for allowing temporary stent placement and solving various complications of stent use. (orig.)

  3. Hypothesis That Urethral Bulb (Corpus Spongiosum Plays an Active Role in Male Urinary Continence

    Peter Rehder


    Full Text Available The proximal urethral bulb in men is enlarged, surrounds the bulbous urethra, and extends dorsally towards the perineum. During intercourse engorgement takes place due to increased blood flow through the corpus spongiosum. Antegrade ejaculation is facilitated by contraction of the bulbospongiosus muscles during climax. Micturition during sexual stimulation is functionally inhibited. Supporting the bulb may indirectly facilitate continence in a certain subset of patients with postprostatectomy incontinence. During physical activity with increased abdominal pressure, reflex contraction of the pelvic floor muscles as well as the bulbospongiosus muscles occurs to support sphincter function and limit urinary incontinence. Operations to the prostate may weaken urinary sphincter function. It is hypothesized that the distal urinary sphincter may be supported indirectly by placing a hammock underneath the urethral bulb. During moments of physical stress the “cushion” of blood within the supported corpus spongiosum helps to increase the zone of coaptation within the sphincteric (membranous urethra. This may lead to urinary continence in patients treated by a transobturator repositioning sling in patients with postprostatectomy incontinence. This paper describes the possible role of the urethral bulb in male urinary continence, including its function after retroluminal sling placement (AdVance, AdVance XP® Male Sling System, Minnetonka, USA.

  4. Novel Bioceramic Urethral Bulking Agents Elicit Improved Host Tissue Responses in a Rat Model

    Travis K. Mann-Gow


    Full Text Available Objectives. To test the physical properties and host response to the bioceramic particles, silica-calcium phosphate (SCPC10 and Cristobalite, in a rat animal model and compare their biocompatibility to the current clinically utilized urethral bulking materials. Material and Methods. The novel bulking materials, SCPC10 and Cristobalite, were suspended in hyaluronic acid sodium salt and injected into the mid urethra of a rat. Additional animals were injected with bulking materials currently in clinical use. Physiological response was assessed using voiding trials, and host tissue response was evaluated using hard tissue histology and immunohistochemical analysis. Distant organs were evaluated for the presence of particles or their components. Results. Histological analysis of the urethral tissue five months after injection showed that both SCPC10 and Cristobalite induced a more robust fibroblastic and histiocytic reaction, promoting integration and encapsulation of the particle aggregates, leading to a larger bulking effect. Concentrations of Ca, Na, Si, and P ions in the experimental groups were comparable to control animals. Conclusions. This side-by-side examination of urethral bulking agents using a rat animal model and hard tissue histology techniques compared two newly developed bioactive ceramic particles to three of the currently used bulking agents. The local host tissue response and bulking effects of bioceramic particles were superior while also possessing a comparable safety profile.

  5. Using transurethral Ho:YAG-laser resection to treat urethral stricture and bladder neck contracture

    Bo, Juanjie; Dai, Shengguo; Huang, Xuyuan; Zhu, Jing; Zhang, Huiguo; Shi, Hongmin


    Objective: Ho:YAG laser had been used to treat the common diseases of urinary system such as bladder cancer and benign prostatic hyperplasia in our hospital. This study is to assess the efficacy and safety of transurethral Ho:YAG-laser resection to treat the urethral stricture and bladder neck contracture. Methods: From May 1997 to August 2004, 26 cases of urethral stricture and 33 cases of bladder neck contracture were treated by transurethral Ho:YAG-laser resection. These patients were followed up at regular intervals after operation. The uroflow rate of these patients was detected before and one-month after operation. The blood loss and the energy consumption of holmium-laser during the operation as well as the complications and curative effect after operation were observed. Results: The therapeutic effects were considered successful, with less bleeding and no severe complications. The Qmax of one month postoperation increased obviously than that of preoperation. Of the 59 cases, restenosis appeared in 11 cases (19%) with the symptoms of dysuria and weak urinary stream in 3-24 months respectively. Conclusions: The Ho:YAG-laser demonstrated good effect to treat the obstructive diseases of lower urinary tract such as urethral stricture and bladder neck contracture. It was safe, minimal invasive and easy to operate.

  6. Rat animal model for preclinical testing of microparticle urethral bulking agents.

    Mann-Gow, Travis K; Blaivas, Jerry G; King, Benjamin J; El-Ghannam, Ahmed; Knabe, Christine; Lam, Michael K; Kida, Masatoshi; Sikavi, Cameron S; Plante, Mark K; Krhut, Jan; Zvara, Peter


    To develop an economic, practical and readily available animal model for preclinical testing of urethral bulking therapies, as well as to establish feasible experimental methods that allow for complete analysis of hard microparticle bulking agents. Alumina ceramic beads suspended in hyaluronic acid were injected into the proximal urethra of 15 female rats under an operating microscope. We assessed overall lower urinary tract function, bulking material intraurethral integrity and local host tissue response over time. Microphotographs were taken during injection and again 6 months postoperatively, before urethral harvest. Urinary flow rate and voiding frequency were assessed before and after injection. At 6 months, the urethra was removed and embedded in resin. Hard tissue sections were cut using a sawing microtome, and processed for histological analysis using scanning electron microscopy, light microscopy and immunohistochemistry. Microphotographs of the urethra showed complete volume retention of the bulking agent at 6 months. There was no significant difference between average urinary frequency and mean urinary flow rate at 1 and 3 months postinjection as compared with baseline. Scanning electron microscopy proved suitable for evaluation of microparticle size and integrity, as well as local tissue remodeling. Light microscopy and immunohistochemistry allowed for evaluation of an inflammatory host tissue reaction to the bulking agent. The microsurgical injection technique, in vivo physiology and novel hard tissue processing for histology, described in the present study, will allow for future comprehensive preclinical testing of urethral bulking therapy agents containing microparticles made of a hard material. © 2015 The Japanese Urological Association.

  7. Understanding maximal repetitions in strings

    Crochemore, Maxime


    The cornerstone of any algorithm computing all repetitions in a string of length n in O(n) time is the fact that the number of runs (or maximal repetitions) is O(n). We give a simple proof of this result. As a consequence of our approach, the stronger result concerning the linearity of the sum of exponents of all runs follows easily.

  8. Dermal patch graft correction of severe chordee secondary to penile corporal body disproportion without urethral division in boys without hypospadias.

    Zaontz, M R; Dean, G E


    Historically, significant ventral penile curvature secondary to corporal body disproportion has been corrected either by dorsal plication or division of the urethral plate. In the rare situations where there is severe chordee in the face of an intact urethra with an orthotopic meatus, division of the urethral plate is commonly performed at the time of grafting the ventral defect created by incising the tunica albuginea. Subsequently, a staged procedure is necessary to reconnect the urethra at a later date. Herein the authors present a novel technique that shows it is possible to perform successful dermal patch orthoplasty without division of the urethra in patients with a normal orthotopic meatus and urethra via urethral mobilization. Three patients over the past 3 years with severe ventral chordee, orthotopic meati and normal urethral anatomy presented for correction. Two patients were 18 years old and one was 10 years old. All three boys were circumcised. The two older boys insisted on dorsal plication as a first approach which worked only temporarily for about 6 months while the younger boy had no prior surgery performed. Each boy underwent a circumcising incision, degloving of the shaft skin, extensive urethral mobilization and dermal patch graft orthoplasty to correct chordee. All surgeries were performed in an outpatient setting. No urinary drainage was used in any patient and a simple bio-occlusive dressing was employed in each case. Follow-up ranged from 11 months to 2 years (mean 1.5 years). All three boys have strong straight erections, full well directed urinary streams and no complications noted to date. Our conclusion based on this experience is that extensive urethral mobilization can allow for correction of severe ventral chordee without urethral division in a single operative setting in boys without hypospadias and a normal urethra. The accompanying movie herein describes the surgical technique.

  9. Sex-related penile fracture with complete urethral rupture: A case report and review of the literature

    Marco Garofalo


    Full Text Available Objective: To present the management of a patient with partial disruption of both cavernosal bodies and complete urethral rupture and to propose a non-systematic review of literature about complete urethral rupture. Material and method - Case report: A 46 years old man presented to our emergency department after a blunt injury of the penis during sexual intercourse. On physical examination there was subcutaneous hematoma extending over the proximal penile shaft with a dorsal-left sided deviation of the penis and urethral bleeding. Ultrasound investigation showed an hematoma in the ventral shaft of the penis with a discontinuity of the tunica albuginea of the right cavernosal corporum. The patient underwent immediate emergency surgery consisted on evacuation of the hematoma, reparation the partial defect of both two cavernosal bodies and end to end suture of the urethra that resulted completely disrupted. Results: The urethral catheter was removed at the 12-th postoperative day without voiding symptoms after a retrograde urethrography. 6 months postoperatively the patients was evaluated with uroflowmetry demonstrating a max flow rate of 22 ml/s and optimal functional outcomes evaluated with validated questionnaires. 8 months after surgery the patients was evaluated by dynamic magnetic resonance (MRI of the penis showing only a little curvature on the left side of the penile shaft. Conclusion: Penile fracture is an extremely uncommon urologic injury with approximately 1331 reported cases in the literature till the years 2001. To best of our knowledge from 2001 up today, 1839 more cases have been reported, only in 159 of them anterior urethral rupture was associated and in only 22 cases a complete urethral rupture was described. In our opinion, in order to prevent long term complications, in case of clinical suspicion of penile fracture, especially if it is associated to urethral disruption, emergency surgery should be the first choice of treatment.

  10. Closure constraints for hyperbolic tetrahedra

    Charles, Christoph; Livine, Etera R.


    We investigate the generalization of loop gravity's twisted geometries to a q-deformed gauge group. In the standard undeformed case, loop gravity is a formulation of general relativity as a diffeomorphism-invariant SU(2) gauge theory. Its classical states are graphs provided with algebraic data. In particular, closure constraints at every node of the graph ensure their interpretation as twisted geometries. Dual to each node, one has a polyhedron embedded in flat space {{{R}}3}. One then glues them, allowing for both curvature and torsion. It was recently conjectured that q-deforming the gauge group SU(2) would allow us to account for a non-vanishing cosmological constant Λ \

  11. 100-D Ponds closure plan. Revision 1

    Petersen, S.W.


    The 100-D Ponds is a Treatment, Storage, and Disposal (TSD) unit on the Hanford Facility that received both dangerous and nonregulated waste. This Closure Plan (Rev. 1) for the 100-D Ponds TSD unit consists of a RCRA Part A Dangerous Waste Permit Application (Rev. 3), a RCRA Closure Plan, and supporting information contained in the appendices to the plan. The closure plan consists of eight chapters containing facility description, process information, waste characteristics, and groundwater monitoring data. There are also chapters containing the closure strategy and performance standards. The strategy for the closure of the 100-D Ponds TSD unit is clean closure. Appendices A and B of the closure plan demonstrate that soil and groundwater beneath 100-D Ponds are below cleanup limits. All dangerous wastes or dangerous waste constituents or residues associated with the operation of the ponds have been removed, therefore, human health and the environment are protected. Discharges to the 100-D Ponds, which are located in the 100-DR-1 operable unit, were discontinued in June 1994. Contaminated sediment was removed from the ponds in August 1996. Subsequent sampling and analysis demonstrated that there is no contamination remaining in the ponds, therefore, this closure plan is a demonstration of clean closure.

  12. 40 CFR 264.112 - Closure plan; amendment of plan.


    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure plan; amendment of plan. 264... Closure and Post-Closure § 264.112 Closure plan; amendment of plan. (a) Written plan. (1) The owner or operator of a hazardous waste management facility must have a written closure plan. In addition,...

  13. Microwave Tissue Soldering for Immediate Wound Closure

    Arndt, G. Dickey; Ngo, Phong H.; Phan, Chau T.; Byerly, Diane; Dusl, John; Sognier, Marguerite A.; Carl, James


    A novel approach for the immediate sealing of traumatic wounds is under development. A portable microwave generator and handheld antenna are used to seal wounds, binding the edges of the wound together using a biodegradable protein sealant or solder. This method could be used for repairing wounds in emergency settings by restoring the wound surface to its original strength within minutes. This technique could also be utilized for surgical purposes involving solid visceral organs (i.e., liver, spleen, and kidney) that currently do not respond well to ordinary surgical procedures. A miniaturized microwave generator and a handheld antenna are used to deliver microwave energy to the protein solder, which is applied to the wound. The antenna can be of several alternative designs optimized for placement either in contact with or in proximity to the protein solder covering the wound. In either case, optimization of the design includes the matching of impedances to maximize the energy delivered to the protein solder and wound at a chosen frequency. For certain applications, an antenna could be designed that would emit power only when it is in direct contact with the wound. The optimum frequency or frequencies for a specific application would depend on the required depth of penetration of the microwave energy. In fact, a computational simulation for each specific application could be performed, which would then match the characteristics of the antenna with the protein solder and tissue to best effect wound closure. An additional area of interest with potential benefit that remains to be validated is whether microwave energy can effectively kill bacteria in and around the wound. Thus, this may be an efficient method for simultaneously sterilizing and closing wounds.

  14. Structural determinants of hospital closure.

    Longo, D R; Chase, G A


    In a retrospective case-control study, structural characteristics of hospitals that closed during the years 1976-1980 were contrasted with three comparison groups: hospitals that were acquired in a merger; hospitals that joined a multihospital system; and hospitals that remained autonomously opened, to investigate these characteristics as predictors of closure. Characteristics investigated included environmental, structural, and process variables. The independent variables were measured 5 years prior to outcome. Findings indicate that closed hospitals resemble hospitals acquired in a merger ("failure"), and likewise autonomous hospitals resemble hospitals that join a multihospital system ("success"). The most important predictors of hospital failure were the physician-to-population ratio, the East North Central and West North Central census regions, the level of diversification, low occupancy rate, location in a standard metropolitan statistical area, the chief executive officer's lack of affiliation in the American College of Hospital Administrators, profit status, bed size of less than 50, and presence in a state with a rate-setting agency. Surprisingly, this study shows the bed-to-population ratio to be unrelated to closure. In addition, the findings strongly support the open-system perspective, which, unlike the closed-system perspective, is concerned with the vulnerability of the organization to the uncontrollable and often unpredictable influences of the environment.

  15. Note on maximal distance separable codes

    YANG Jian-sheng; WANG De-xiu; JIN Qing-fang


    In this paper, the maximal length of maximal distance separable(MDS)codes is studied, and a new upper bound formula of the maximal length of MDS codes is obtained. Especially, the exact values of the maximal length of MDS codes in some parameters are given.

  16. Maximization, learning, and economic behavior.

    Erev, Ido; Roth, Alvin E


    The rationality assumption that underlies mainstream economic theory has proved to be a useful approximation, despite the fact that systematic violations to its predictions can be found. That is, the assumption of rational behavior is useful in understanding the ways in which many successful economic institutions function, although it is also true that actual human behavior falls systematically short of perfect rationality. We consider a possible explanation of this apparent inconsistency, suggesting that mechanisms that rest on the rationality assumption are likely to be successful when they create an environment in which the behavior they try to facilitate leads to the best payoff for all agents on average, and most of the time. Review of basic learning research suggests that, under these conditions, people quickly learn to maximize expected return. This review also shows that there are many situations in which experience does not increase maximization. In many cases, experience leads people to underweight rare events. In addition, the current paper suggests that it is convenient to distinguish between two behavioral approaches to improve economic analyses. The first, and more conventional approach among behavioral economists and psychologists interested in judgment and decision making, highlights violations of the rational model and proposes descriptive models that capture these violations. The second approach studies human learning to clarify the conditions under which people quickly learn to maximize expected return. The current review highlights one set of conditions of this type and shows how the understanding of these conditions can facilitate market design.

  17. 40 CFR 264.178 - Closure.


    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Use and Management of Containers § 264.178 Closure. At closure, all hazardous waste and hazardous waste residues must be removed...

  18. 40 CFR 264.351 - Closure.


    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Incinerators § 264.351 Closure. At closure the owner or operator must remove all hazardous waste and hazardous waste...

  19. 50 CFR 665.666 - Closures.


    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Closures. 665.666 Section 665.666 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION... § 665.666 Closures. (a) If the Regional Administrator determines that the harvest quota for any...

  20. Key financial ratios can foretell hospital closures.

    Lynn, M L; Wertheim, P


    An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent.

  1. Spontaneous closure of traumatic tympanic membrane perforations

    Jellinge, Marlene Ersgaard; Kristensen, S.; Larsen, K


    BACKGROUND: The treatment of traumatic tympanic membrane perforations varies in different investigations, ranging from observation to early surgical repair. The present study aimed to focus on the closure rate and the closure time in a group of patients treated with a watchful waiting policy. MET...

  2. Acute angle closure glaucoma following ileostomy surgery

    Mariana Meirelles Lopes


    Full Text Available Angle-closure glaucoma can be induced by drugs that may cause pupillary dilatation. We report a case of a patient that developed bilateral angle closure glaucoma after an ileostomy surgery because of systemic atropine injection. This case report highlights the importance of a fast ophthalmologic evaluation in diseases with ocular involvement in order to make accurate diagnoses and appropriate treatments.

  3. Periodic Closures as Adaptive Coral Reef Management in the Indo-Pacific

    Josh Cinner


    Full Text Available This study explores the social, economic, and ecological context within which communities in Papua New Guinea and Indonesia use adaptive coral reef management. We tested whether periodic closures had positive effects on reef resources, and found that both the biomass and the average size of fishes commonly caught in Indo-Pacific subsistence fisheries were greater inside areas subject to periodic closures compared to sites with year-round open access. Surprisingly, both long-lived and short-lived species benefited from periodic closures. Our study sites were remote communities that shared many socioeconomic characteristics; these may be crucial to the effectiveness of adaptive management of reef resources through periodic closures. Some of these factors include exclusive tenure over marine resources, a body of traditional ecological knowledge that allows for the rapid assessment of resource conditions, social customs that facilitate compliance with closures, relatively small human populations, negligible migration, and a relatively low dependence on fisheries. This dynamic adaptive management system, in which communities manage their resources among multiple social and ecological baselines, contrasts with western fisheries management practices, centered on maintaining exploited populations at stable levels in which net production is maximized.

  4. Land use-based landscape planning and restoration in mine closure areas.

    Zhang, Jianjun; Fu, Meichen; Hassani, Ferri P; Zeng, Hui; Geng, Yuhuan; Bai, Zhongke


    Landscape planning and restoration in mine closure areas is not only an inevitable choice to sustain mining areas but also an important path to maximize landscape resources and to improve ecological function in mine closure areas. The analysis of the present mine development shows that many mines are unavoidably facing closures in China. This paper analyzes the periodic impact of mining activities on landscapes and then proposes planning concepts and principles. According to the landscape characteristics in mine closure areas, this paper classifies available landscape resources in mine closure areas into the landscape for restoration, for limited restoration and for protection, and then summarizes directions for their uses. This paper establishes the framework of spatial control planning and design of landscape elements from "macro control, medium allocation and micro optimization" for the purpose of managing and using this kind of special landscape resources. Finally, this paper applies the theories and methods to a case study in Wu'an from two aspects: the construction of a sustainable land-use pattern on a large scale and the optimized allocation of typical mine landscape resources on a small scale.

  5. Anterior urethral valve, a rare cause of bilateral vesicoureteral reflux in a two year old boy: A case report and a review of the literature

    Amit Sharma


    Full Text Available Anterior urethral valve (AUV is a rare cause of obstructive uropathy in children. These are much rarer than posterior urethral valves. We report a case of a child with AUV and high grade bilateral vesicoureteric reflux. He was managed by transurethral laser ablation. The left sided reflux resolved after ablation. The right sided reflux persisted. The child is awaiting ureteric reimplantation.

  6. Intermittent acute angle closure glaucoma and chronic angle closure following topiramate use with plateau iris configuration

    Rajjoub LZ


    Full Text Available Lamise Z Rajjoub, Nisha Chadha, David A Belyea Department of Ophthalmology, The George Washington University, Washington, DC, USA Abstract: This is a case report describing recurrent intermittent acute angle closure episodes in the setting of topiramate use in a female suffering from migraines. Despite laser peripheral iridotomy placement for the pupillary block component, and the discontinuation of topiramate, the acute angle closure did not resolve in the left eye with chronic angle closure and the patient required urgent trabeculectomy. The right eye responded to laser peripheral iridotomy immediately and further improved after the cessation of topiramate. While secondary angle closure glaucoma due to topiramate use has been widely reported, its effects in patients with underlying primary angle closure glaucoma have not been discussed. Our report highlights the importance of recognizing the often multifactorial etiology of angle closure glaucoma to help guide clinical management. Keywords: angle closure glaucoma, plateau iris, topiramate, secondary glaucoma, drug-induced glaucoma


    Nischal Prasad Reddy


    Full Text Available OBJECTIVES: T he most common congenital anomaly is Posterior Urethral valve (PUV and has as incidence of 1 in 8000 male births. It is the most common obstructive cause of end stage renal disease in children. Vesicoureteric reflux, recurrent UTI, voiding dysfunction and late onset renal failure are the long term major problems in these children. There are few long term outcome studies of children with PUV from India. These studies mainly concentrate on the surgical aspects. The study is aimed to assess the long term impact of PUV on renal function and th e growth of these children. METHODS: The study was conducted at AJ hospital, Mangalore between July 2010 - June 2011. Thirty children, with posterior urethral valve, five years or more post - surgery were included in the study. The details of children were obtained from records regarding age, presenting symptoms serum creatinine, presence of or absence of vesicoureteric reflux. Outcomes measured were stunting, renal failure (GFR, tubular functions and bladder functions. Results were analysed. RESULTS: Thirt y children were analysed. The age at presentation varied from antenatal detection to six years. About 46.6% of patients presented between 0 - 1 month, 36.6% between one month to one year, 16.8% between one to six years. The median age at presentation was thr ee months. Primary surgery done in the neonatal period in 33% children. Of the 28 children who had antenatal ultrasound, 20 had normal USS and eight had antenatally detected hydronephrosis (28.6%. Five out of eight had associated oligohydramnios. All thes e five children had GFR <90 m/m/1.73m 2 at follow up. CONCLUSION: Poor bladder function was seen in one - third of patients. Interventions as and when needed on follow - up are important in the management of all children with posterior urethral valve. Comprehen sive care should be the rule by a team comprising paediatrician, pediatric surgeon and pediatric nephrologists

  8. A comparison of sonourethrography and retrograde urethrography in evaluation of anterior urethral strictures

    Choudhary, S. E-mail:; Singh, P.; Sundar, E.; Kumar, S.; Sahai, A


    AIM: This prospective study was undertaken to evaluate the abnormalities of the male anterior urethra using high-resolution ultrasound (sonourethrography) and to compare the efficacy with that of retrograde urethrography (RGU) using operative findings as the gold standard. MATERIALS AND METHODS: Seventy patients with symptoms of lower urinary tract obstruction underwent RGU followed by sonourethrography. The sonologist was blinded to the findings of RGU. The parameters studied were compared with the intra-operative findings as gold standard, and the sensitivity, specificity and overall accuracy for the procedures were calculated. Chi-square test and kappa statistics were used where appropriate. RESULTS: All patients found to have urethral stricture disease by RGU were also detected by sonourethrography and confirmed intra-operatively. In the estimation of stricture length, RGU showed a lower sensitivity (60-80%) for lengths 1-4 cm, compared with sonourethrography (73.3-100%). Spongiofibrosis was detected by sonourethrography with a sensitivity of 77.3-83.3%. All the false tracts and calculi detected at sonourethrography were confirmed at surgery, whereas RGU showed a low sensitivity in their detection. The complications encountered during the procedures were pain, urethral bleeding and contrast intravasation. The frequency of pain during RGU was greater (p<0.001); however, the difference in frequency of bleeding after the two procedures was not significant (p<0.5). CONCLUSION: RGU and sonourethrography are equally efficacious in detection of anterior urethral strictures. Further characterization of strictures in terms of length, diameter and periurethral pathologies, like spongiofibrosis and false tracts, is done with greater sensitivity using sonourethrography as compared with RGU, with the added benefit of lower incidence of complications.

  9. Observations on the Efficacy of Electroacupuncture plus TDP Irradiation for Treating Noninfectious Urethral Syndrome

    杨鹏飞; 朱函亭


    To investigate the efficacy of electroacupuncture plus TDP irradiation for treating noninfectious urethral syndrome. Method:Sixty patients with noninfectious urethral syndrome were randomly divided into an electroacupuncture plus TDP irradiation treatment group of 40 cases and a medication group of 20 cases as a control. Results:The effective rate was 85% in the treatment group and 35% in the control group. There was a significant difference in curative effect between the treatment and control groups(P<0.01). Conclusion:Treatment by electroacupuncture plus TDP irradiation has an exact effect on noninfectious urethral syndrome. Its curative effect was significantly better than that in the medication control group.%目的:观察电针力TDP照射治疗非感染性尿道综合征的疗效.方法:将60例非感染性尿道综合征患者随机分为以电针加TDP照射为治疗组40例,并设用药物治疗为对照组20例进行对比观察.结果:治疗组有效率为85%,对照组为35%,治疗组与对照组疗效相比有显著性差异(P<0.01).结论:电针加TDP照射治疗非感染性尿道综合征疗效确切,该方法疗效明显高于药物对照组.

  10. Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence

    Carlos H. Schaal


    Full Text Available OBJECTIVE: Description and early results of a new urethral sling technique for treatment of postprostatectomy urinary incontinence, which combines efficacy, low cost and technical simplicity. MATERIALS AND METHODS: From May 2003 to April 2004, 30 patients with moderate or total urinary incontinence, following radical prostatectomy or endoscopic resection of the prostate, underwent the new technique. The technique is based on the placement of a longitudinal-shaped sling in the bulbar urethra, measuring 4 cm in length by 1.8 cm in width, made of Dacron or polypropylene mesh, fixed by 4 sutures on each side, with 2 sutures passed with Stamey-Pereira needle by retropubic approach and 2 by prepubic approach, which are then tied over the pubis. Pressure control was determined by interrupting the loss of infused water through a suprapubic cystostomy 60 cm from the pubis level. RESULTS: Pre-operative assessment excluded vesical instability, urethral stenosis and urinary infection. Suprapubic cystostomy was removed when the patient was able to satisfactorily void with urinary residue lower than 100 mL, which occurred in 29 of the 30 cases. In 2 cases, there was infection of the prosthesis, requiring its removal. In 3 cases, there was the need to adjust the sling (increasing the tension, due to failure of the urinary continence. Overall, 20 of 30 (66.7% operated patients became totally continent, and did not require any kind of pads. Four of 30 (13.3% patients achieved partial improvement, requiring 1 to 2 pads daily and 6 of 30 (20% patients had minimal or no improvement. There was no case of urethral erosion. CONCLUSION: This new sling technique has shown highly encouraging preliminary results. Its major advantage over other surgical techniques for treatment of moderate or severe stress urinary incontinence is the simplicity for its execution and low cost. A long-term assessment, addressing maintenance of continence, detrusor function and preservation

  11. Development of a rabbit's urethral sphincter deficiency animal model for anatomical-functional evaluation

    M. Skaff


    Full Text Available OBJECTIVE: The aim of the study was to develop a new durable animal model (using rabbits for anatomical-functional evaluation of urethral sphincter deficiency. MATERIALS AND METHODS: A total of 40 New Zealand male rabbits, weighting 2.500 kg to 3.100 kg, were evaluated to develop an incontinent animal model. Thirty-two animals underwent urethrolysis and 8 animals received sham operation. Before and at 2, 4, 8 and 12 weeks after urethrolysis or sham operation, it was performed cystometry and leak point pressure (LPP evaluation with different bladder distension volumes (10, 20, 30 mL. In each time point, 10 animals (8 from the study group and 2 from the sham group were sacrificed to harvest the bladder and urethra. The samples were evaluated by H&E and Masson's Trichrome to determine urethral morphology and collagen/smooth muscle density. RESULTS: Twelve weeks after urethrolysis, it was observed a significant decrease in LPP regardless the bladder volume (from 33.7 ± 6.6 to 12.8 ± 2.2 cmH2O. The histological analysis evidenced a decrease of 22% in smooth muscle density with a proportional increase in the collagen, vessels and elastin density (p < 0.01. CONCLUSIONS: Transabdominal urethrolysis develops urethral sphincter insufficiency in rabbits, with significant decrease in LPP associated with decrease of smooth muscle fibers and increase of collagen density. This animal model can be used to test autologous cell therapy for stress urinary incontinence treatment.

  12. Characteristics of Idiopathic Urethral Strictures: A Link to Remote Perineal Trauma?

    Viers, Boyd R; Pagliara, Travis J; Rew, Charles A; Folgosa Cooley, Lauren; Shiang, Christine Y; Scott, Jeremy M; Morey, Allen F


    To characterize the physical features and reconstructive outcomes of a series of idiopathic urethral strictures (IUS) in an effort to elucidate the nature of this common yet poorly understood entity. We retrospectively reviewed our urethroplasty database to identify men undergoing initial urethral reconstruction from 2007 to 2014 at 1 of 3 hospitals (N = 514). Patients were stratified by stricture etiology, including IUS, acute trauma, iatrogenic, hypospadias, balanitis xerotica obliterans, and radiation. IUS that had a known history of subacute or repetitive blunt force to the perineum (horseback riding, avid cycling, motocross, etc.) were subclassified as subacute or repetitive perineal trauma (SRPT). Among 466 men undergoing initial reconstruction with available data, 215 (46%) were IUS cases. The median delay between IUS diagnosis and urethroplasty was 5.2 years, during which time men underwent a median of 2 endoscopic treatments. A total of 51 (24%) IUS cases recalled a distinct history of SRPT. Men with SRPT were slightly younger (median 43 vs 48 years, P = .01) but were remarkably similar in terms of urethral stricture length (2 vs 2 cm, P = .15), location (bulbar 96% vs 89%, P = .41), and treatment success (92% vs 88%; P = .61). Bulbar (-)SRPT and (+)SRPT IUS had similar clinical and morphometric features as those with known acute bulbar trauma with excellent 24-month stricture recurrence-free survival rates (93% vs 92% vs 97%, P = .19). IUS have clinical features suggesting that many may be related to unrecognized or repetitive perineal trauma. Although treatment tends to be delayed, IUS have excellent urethroplasty success because most are short bulbar strictures amenable to anastomotic urethroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Vestibular flap urethroplasty in women with recurrent distal intramural urethral pathology.

    Romman, Adam; Takacs, Liz; Gilleran, Jason; Zimmern, Philippe


    To report our experience with vestibular flap urethroplasty in case of recurrence of distal intramural urethral pathology (DIU) after unsuccessful urethral dilation under anesthesia. Following Independent Review Board approval, charts of non-neurogenic women who underwent urethroplasty for DIU were reviewed. Vestibular flap urethroplasty was offered to patients who failed one or two dilations. Success was defined as improvement on the single quality of life questionnaire (QoL, rated 1-10) with either a final score three or less, or a decrease of four QoL points from baseline and no related repeat procedure at any time during follow-up, with a minimum follow-up at 6 months. From 1998 to 2012, 28/30 patients had adequate follow-up and 19 met the criteria for success. Mean age at time of urethroplasty was 51 in both the success and failure groups. Mean follow-up was 52 ± 49 months in the success group and mean time to failure was 17 ± 20 months in the failure group. Mean QoL in the success group improved from 7.0 ± 2.1 preoperatively to 2.0 ± 1.7 postoperatively. Mean QoL in the failure group did not improve (from 7.0 ± 1.6 to 6.4 ± 1.5). Urethral wall fibrosis was confirmed in all tissue samples excised. No patient experienced new onset or exacerbation of stress urinary incontinence. Failure group was managed by repeat urethroplasty, clean intermittent catheterization or other methods. Vestibular flap urethroplasty is a viable long-term treatment option in women with DIU who have failed at least one dilation. © 2014 Wiley Periodicals, Inc.

  14. Preliminary experimental study of urethral reconstruction with tissue engineering and RNA interference techniques

    Chao Li; Yue-Min Xu; Hong-Bin Li


    This study investigated the feasibility of replacing urinary epithelial cells with oral keratinocytes and transforming growth factor-β1(TGF-β1) small interfering RNA (siRNA)-transfected fibroblasts seeded on bladder acellular matrix graft (BAMG) in order to reconstruct tissue-engineered urethra.Constructed siRNAs,which expressed plasmids targeting TGF-β1,were transfected into rabbit fibroblasts.The effective siRNA was screened out by RT-PCR and was transfected into rabbit fibroblasts again.Synthesis of type Ⅰ collagen in culture medium was measured by enzyme-linked immuno sorbent assay (ELISA).Autologous oral keratinocytes and TGF-β1siRNA-transfected fibroblasts were seeded onto BAMGs to obtain a tissue-engineered mucosa.The tissue-engineered mucosa was assessed morphologically and with the help of scanning electron microscopy.The TGF-β1 siRNA decreased the expression of fibroblasts synthesis type Ⅰ collagen.Oral keratinocytes and TGF-β1 siRNA-transfected fibroblasts were seeded onto sterilized BAMG to obtain a tissue-engineered mucosa for urethral reconstruction.The compound graft was assessed using scanning electron microscope.Oral keratinocytes and TGF-β1 siRNA-transfected fibroblasts had a good compatibility with BAMG.The downregulation of fibroblasts synthesis type Ⅰ collagen expression by constructed siRNA interfering TGF-β1 provided a potential basis for genetic therapy of urethral scar.Oral keratinocytes and TGF-β 1 siRNA-transfected fibroblasts had good compatibility with BAMG and the compound graft could be a new choice for urethral reconstruction.

  15. Treatment of urethral strictures in balanitis xerotica obliterans (BXO using circular buccal mucosal meatoplasy: Experience of 15 cases

    Abdulmuttalip Simsek


    Full Text Available Objectives: Balanitis xerotica obliterans (BXO related strictures involving the external urethral meatus. We reviewed our result with the use of circular mucosal graft in the reconstruction of strictures. Methods: Between March 1997 and January 2012, 15 patients underwent circular buccal mucosal urethroplasy for BXO related anterior urethral strictures. Urethral catheter was removed within 2 weeks. Follow-up included patient symptoms assessment, cosmetic outcome and uroflowmetry. Results: Median follow-up was 20.5 months (range 4 to 96. Mean postoperative peak urinary flow rate obtained 1 month after catheter removal was 22.4 ml per second. All patients had a normal meatus and none had recurrent stricture, chordee or erectile dysfunction. A functional and cosmetic outcome was achieved in 100% of the patients. Conclusions: Circular mucosal graft technique for treatment of meatal strictures is an efficient method for the restoration of a functional and cosmetic penis.

  16. Closure of Microcosm for refurbishment


    Since 1994, the Microcosm exhibition has given the opportunity to visitors of all ages and backgrounds to have a first glimpse into the secrets of physics.   To ensure that Microcosm can continue fulfilling its educational aims at the same level of quality for many years to come, it is closing for renovation work on 8 December 2014 and is expected to reopen during Summer 2015. During the closure, the “Fun with Physics” workshop will not take place, but the Universe of Particles exhibition in the Globe and the Passport to the Big Bang circuit will remain accessible to the public, free of charge and with no need to book in advance.  Guided tours of CERN are also available (advance booking required via this page).

  17. Closure for milliliter scale bioreactor

    Klein, David L.; Laidlaw, Robert D.; Andronaco, Gregory; Boyer, Stephen G.


    A closure for a microreactor includes a cap that is configured to be inserted into a well of the microreactor. The cap, or at least a portion of the cap, is compliant so as to form a seal with the well when the cap is inserted. The cap includes an aperture that provides an airway between the inside of the well to the external environment when the cap is inserted into the well. A porous plug is inserted in the aperture, e.g., either directly or in tube that extends through the aperture. The porous plug permits gas within the well to pass through the aperture while preventing liquids from passing through to reduce evaporation and preventing microbes from passing through to provide a sterile environment. A one-way valve may also be used to help control the environment in the well.

  18. Asymptotics of robust utility maximization

    Knispel, Thomas


    For a stochastic factor model we maximize the long-term growth rate of robust expected power utility with parameter $\\lambda\\in(0,1)$. Using duality methods the problem is reformulated as an infinite time horizon, risk-sensitive control problem. Our results characterize the optimal growth rate, an optimal long-term trading strategy and an asymptotic worst-case model in terms of an ergodic Bellman equation. With these results we propose a duality approach to a "robust large deviations" criterion for optimal long-term investment.

  19. Multivariate residues and maximal unitarity

    Søgaard, Mads; Zhang, Yang


    We extend the maximal unitarity method to amplitude contributions whose cuts define multidimensional algebraic varieties. The technique is valid to all orders and is explicitly demonstrated at three loops in gauge theories with any number of fermions and scalars in the adjoint representation. Deca-cuts realized by replacement of real slice integration contours by higher-dimensional tori encircling the global poles are used to factorize the planar triple box onto a product of trees. We apply computational algebraic geometry and multivariate complex analysis to derive unique projectors for all master integral coefficients and obtain compact analytic formulae in terms of tree-level data.

  20. Beeping a Maximal Independent Set

    Afek, Yehuda; Alon, Noga; Bar-Joseph, Ziv; Cornejo, Alejandro; Haeupler, Bernhard; Kuhn, Fabian


    We consider the problem of computing a maximal independent set (MIS) in an extremely harsh broadcast model that relies only on carrier sensing. The model consists of an anonymous broadcast network in which nodes have no knowledge about the topology of the network or even an upper bound on its size. Furthermore, it is assumed that an adversary chooses at which time slot each node wakes up. At each time slot a node can either beep, that is, emit a signal, or be silent. At a particular time slot...

  1. Maximal Congruences on Some Semigroups

    Jintana Sanwong; R.P. Sullivan


    In 1976 Howie proved that a finite congruence-free semigroup is a simple group if it has at least three elements but no zero elementInfinite congruence-free semigroups are far more complicated to describe, but some have been constructed using semigroups of transformations (for example, by Howie in 1981 and by Marques in 1983)Here, forcertain semigroups S of numbers and of transformations, we determine all congruences p on S such that S/p is congruence-free, that is, we describe all maximal congruences on such semigroups S.

  2. Surgical treatment of urethral obstruction due to urolithiasis in male cattle: a review of 85 cases.

    Gasthuys, F; Steenhaut, M; De Moor, A; Sercu, K


    Eighty-five male cattle with urethral obstruction due to urolithiasis were treated by surgery. In most cases local anaesthetic techniques combined with sedation were applied to the dorsally recumbent animals. The penis was transected and transposed in animals with a ruptured urethra. A ruptured bladder was repaired by a paramedian abdominal approach. The bladder was fistulated through the ventral abdominal wall when no alternative treatment was possible. Complications related to the different surgical interventions are described. Only 35.3 per cent of the animals recovered satisfactorily.

  3. Female urethral diverticulum containing a giant calculus: a CARE-compliant case report.

    Dong, ZhiLong; Wang, Hanzhang; Zuo, LinJun; Hou, MingLi


    Urethral diverticula with calculi have a low incidence as reported in the literature. Diverticulum of female urethra is rare, often discovered due to associated complications. We report a case of diverticulum of the female urethra containing giant calculi in a 62-year-old multiparous woman. She consulted with our office due to dysuria and a hard, painful periurethral mass in the anterior vagina wall. The diverticulum was approached surgically by a vaginal route, and local extraction of the calculi and subsequent diverticulectomy successfully treated the condition.Diagnosis of a complicated diverticulum can be easily achieved if one possesses a high degree of clinical symptoms.

  4. Missed diagnosis of anterior urethral valve complicated with a foreign body: A cause for concern

    Nayyar Rishi


    Full Text Available Anterior urethral valve (AUV is a long known but rare anomaly, which is occasionally encountered in boys with obstructive uropathy. We present a case of AUV with a diverticulum which was misdiagnosed at other center as neurogenic bladder resulting in chronic renal failure. The case was further complicated by breakage of tip of the catheter used for clean intermittent catheterization (CIC in the diverticulum presenting as a foreign body in the urethra. This article highlights the frequently missed diagnosis of AUV by most practitioners wrongly labeling it as neurogenic bladder, leading to improper management and renal failure in young boys.

  5. Urethral Stone Disease Leading to Retention After Hair-bearing Neophalloplasty

    Robert Viviano


    Full Text Available A 35-year-old male patient with a past history of traumatic penile amputation and subsequent penile reconstruction with a radial artery free flap phalloplasty presented to the urology clinic for urinary retention and complaint of a firm penile mass. The patient had been lost to follow-up for 2 years before this presentation. Patient had a suprapubic tube in place from initial surgery, with imaging showing 2 large uroliths encrusted around the end. Urethral stricture was suspected in the patient. On cystoscopy, an additional obstructing urolith was found in penile urethra, appearing to have formed in situ.

  6. Pressure-flow study as an evaluating method of neurogenic urethral relaxation failure.

    Sakakibara, R; Fowler, C J; Hattori, T; Hussain, I F; Swinn, M J; Uchiyama, T; Yamanishi, T


    Voiding difficulty is a common feature in neurological diseases, which can be attributed to dysfunction of the urethral sphincter and the detrusor. Electromyography (EMG)-cystometry can reveal the presence of detrusor-external sphincter dyssynergia (DESD), however, internal sphincter function on voiding is not easily evaluated. Pressure-flow study is widely used to diagnose benign outlet obstruction due to prostatic hypertrophy. We applied pressure-flow study in neurological patients in order to evaluate neurogenic urethral relaxation failure. We recruited 71 patients with neurological diseases. All were men under 60 years, with mean age of 44 years, ranging from 18 to 59 years. None had abnormal finding of digital examination or ultrasound echography of the prostate. Standard cystometry showed detrusor hyperreflexia in 33 patients and residual urine was noted in 36. DESD was noted in seven of 43 patients. Pressure-flow relation curve and a detrusor pressure (P(det)) at the point of maximum flow rate (Q(max)) (i.e., P(det)Q(max)) were obtained by urodynamic computers. The Abram-Griffiths (AG) number (P(det)Q(max)-2Q(max)), showing outlet obstruction particularly over 40, was also obtained. The points of P(det)Q(max) of the patients fell into three categories of the AG nomogram, showing obstruction in 19.7%, equivocal in 52.1% and unobstructed in 28.2%. Patients with DESD had AG number over 40 more commonly (57.1%) than those without DESD (8.4%) (p<0.05). The mean AG number was 46.4 in patients with DESD, which was larger than 17.1 in patients without DESD (p<0.01). Patients with detrusor hyperreflexia had AG number over 40 more commonly (42.4%) than those with normal cystometric curve (0%) (p<0.01). The mean AG number was 30.6 in patients with detrusor hyperreflexia, which was larger than 13.6 in patients with normal cystometric curve (p<0.01). The results showed that 19.7% of patients with neurological diseases had obstructive pattern (high pressure voiding

  7. Novel Bioceramic Urethral Bulking Agents Elicit Improved Host Tissue Responses in a Rat Model

    Mann-Gow, Travis K; King, Benjamin J; El-Ghannam, Ahmed;


    Objectives. To test the physical properties and host response to the bioceramic particles, silica-calcium phosphate (SCPC10) and Cristobalite, in a rat animal model and compare their biocompatibility to the current clinically utilized urethral bulking materials. Material and Methods. The novel...... agents using a rat animal model and hard tissue histology techniques compared two newly developed bioactive ceramic particles to three of the currently used bulking agents. The local host tissue response and bulking effects of bioceramic particles were superior while also possessing a comparable safety...

  8. Glans reconstruction with the use of an inverted urethral flap after distal penile amputation for carcinoma

    Salvatore Sansalone


    Full Text Available Restoration of adequate cosmesis and preservation of sexual and urinary function are the main goals of penile reconstructive surgery following amputation for carcinoma. Split thickness skin grafts and oral mucosa grafts have been widely used for the creation of a pseudoglans with excellent cosmetic and functional results. The main drawbacks associated with the use of grafts are donor site morbidity, the lack of engorgement of the pseudoglans and the risk of poor graft take, which may lead to contracture and poor cosmetic results. In the present series the long term cosmetic and functional outcomes of glans reconstruction with an inverted distal urethral flap are described.

  9. Sarcomatoid Carcinoma of Male Urethra with Bone and Lung Metastases Presenting as Urethral Stricture

    Niraj Badhiwala


    Full Text Available A 57-year-old man who presented with urinary retention was found to have a sarcomatoid carcinoma of the urethra. Evaluation with CT scan of the abdomen and pelvis revealed multiple pulmonary nodules and osteolytic lesions of left posterior ribs. After external beam radiation therapy and six cycles of systemic chemotherapy, patient underwent a surgical resection of the urethral cancer. After his surgery, patient was also found to have multiple brain metastases and underwent whole brain radiation therapy, nine months after his initial diagnosis. Sarcomatoid carcinomas of the genitourinary tract are extremely rare tumors that require a very aggressive, multimodal treatment approach.

  10. Closure of the Brewer Gold Mine by pit backfilling

    Lewis-Russ, A.; Lupo, J.F. [Titan Environmental Corp., Englewood, CO (United States); Bronson, J.M. [Titan Environmental Corp., Tempe, AZ (United States)] [and others


    Brewer Gold Mine, located in north-central South Carolina, is implementing an innovative reclamation plan that includes backfilling the main Brewer open pit with mine waste. The primary goals of the closure are to reduce acid rock drainage and minimize or eliminate long-term operation and maintenance requirements by restoring the site property to approximate pre-mining topography. The plan calls for consolidation of approximately 200 acres of waste into approximately 20 hectares (50 acres). Much of the material to be backfilled into the pit, including spent heap leach material and waste rock, has acid-generating potential. Therefore, the backfill design integrated geochemical properties of the backfill materials with expected post-closure conditions. A prime consideration was the final position of the water table. Since mining at the site started in the early 1800`s, no records exist of the original groundwater levels. Therefore, the design incorporates a large anoxic limestone drain to control the final groundwater level. Additional amendments are to be placed in targeted areas of the backfill to maximize their utilization. A low-permeability cap system that includes a GEOSYNTHETIC clay liner has been designed to limit infiltration into the backfill.

  11. Knowledge discovery by accuracy maximization.

    Cacciatore, Stefano; Luchinat, Claudio; Tenori, Leonardo


    Here we describe KODAMA (knowledge discovery by accuracy maximization), an unsupervised and semisupervised learning algorithm that performs feature extraction from noisy and high-dimensional data. Unlike other data mining methods, the peculiarity of KODAMA is that it is driven by an integrated procedure of cross-validation of the results. The discovery of a local manifold's topology is led by a classifier through a Monte Carlo procedure of maximization of cross-validated predictive accuracy. Briefly, our approach differs from previous methods in that it has an integrated procedure of validation of the results. In this way, the method ensures the highest robustness of the obtained solution. This robustness is demonstrated on experimental datasets of gene expression and metabolomics, where KODAMA compares favorably with other existing feature extraction methods. KODAMA is then applied to an astronomical dataset, revealing unexpected features. Interesting and not easily predictable features are also found in the analysis of the State of the Union speeches by American presidents: KODAMA reveals an abrupt linguistic transition sharply separating all post-Reagan from all pre-Reagan speeches. The transition occurs during Reagan's presidency and not from its beginning.

  12. Inapproximability of maximal strip recovery

    Jiang, Minghui


    In comparative genomic, the first step of sequence analysis is usually to decompose two or more genomes into syntenic blocks that are segments of homologous chromosomes. For the reliable recovery of syntenic blocks, noise and ambiguities in the genomic maps need to be removed first. Maximal Strip Recovery (MSR) is an optimization problem proposed by Zheng, Zhu, and Sankoff for reliably recovering syntenic blocks from genomic maps in the midst of noise and ambiguities. Given $d$ genomic maps as sequences of gene markers, the objective of \\msr{d} is to find $d$ subsequences, one subsequence of each genomic map, such that the total length of syntenic blocks in these subsequences is maximized. For any constant $d \\ge 2$, a polynomial-time 2d-approximation for \\msr{d} was previously known. In this paper, we show that for any $d \\ge 2$, \\msr{d} is APX-hard, even for the most basic version of the problem in which all gene markers are distinct and appear in positive orientation in each genomic map. Moreover, we provi...

  13. Maximal right smooth extension chains

    Huang, Yun Bao


    If $w=u\\alpha$ for $\\alpha\\in \\Sigma=\\{1,2\\}$ and $u\\in \\Sigma^*$, then $w$ is said to be a \\textit{simple right extension}of $u$ and denoted by $u\\prec w$. Let $k$ be a positive integer and $P^k(\\epsilon)$ denote the set of all $C^\\infty$-words of height $k$. Set $u_{1},\\,u_{2},..., u_{m}\\in P^{k}(\\epsilon)$, if $u_{1}\\prec u_{2}\\prec ...\\prec u_{m}$ and there is no element $v$ of $P^{k}(\\epsilon)$ such that $v\\prec u_{1}\\text{or} u_{m}\\prec v$, then $u_{1}\\prec u_{2}\\prec...\\prec u_{m}$ is said to be a \\textit{maximal right smooth extension (MRSE) chains}of height $k$. In this paper, we show that \\textit{MRSE} chains of height $k$ constitutes a partition of smooth words of height $k$ and give the formula of the number of \\textit{MRSE} chains of height $k$ for each positive integer $k$. Moreover, since there exist the minimal height $h_1$ and maximal height $h_2$ of smooth words of length $n$ for each positive integer $n$, we find that \\textit{MRSE} chains of heights $h_1-1$ and $h_2+1$ are good candidates t...

  14. Subsidence crack closure: rate, magnitude and sequence

    De Graff, J.V.; Romesburg, H.C.


    Tension cracks are a major surface disturbance resulting from subsidence and differential settlement above underground coal mines. Recent engineering studies of subsidence indicate that cracks may close where tensile stresses causing the cracks are reduced or relaxed. This stress reduction occurs as mining in the area is completed. Crack closure was confirmed by a study in the Wasatch Plateau coal field of central Utah. Cracks occurred in both exposed bedrock and regolith in an area with maximum subsidence of 3 m. Mean closure rate was 0.3 cm per week with individual crack closure rates between 0.2 cm and 1.0 cm per week. The mean crack closure magnitude was 80% with closure magnitudes varying between 31% and 100%. Actual magnitude values ranged from 0.6 cm to 6.5 cm with a mean value of 3.8 cm. Statistical analysis compared width change status among cracks over time. It was found that: 1) a 41% probability existed that a crack would exhibit decreasing width per weekly measurement, 2) closure state sequences seem random over time, and 3) real differences in closure state sequence existed among different cracks. (6 refs.) (In English)

  15. Analytic closures for M1 neutrino transport

    Murchikova, E. M.; Abdikamalov, E.; Urbatsch, T.


    Carefully accounting for neutrino transport is an essential component of many astrophysical studies. Solving the full transport equation is too expensive for most realistic applications, especially those involving multiple spatial dimensions. For such cases, resorting to approximations is often the only viable option for obtaining solutions. One such approximation, which recently became popular, is the M1 method. It utilizes the system of the lowest two moments of the transport equation and closes the system with an ad hoc closure relation. The accuracy of the M1 solution depends on the quality of the closure. Several closures have been proposed in the literature and have been used in various studies. We carry out an extensive study of these closures by comparing the results of M1 calculations with precise Monte Carlo calculations of the radiation field around spherically symmetric protoneutron star models. We find that no closure performs consistently better or worse than others in all cases. The level of accuracy that a given closure yields depends on the matter configuration, neutrino type and neutrino energy. Given this limitation, the maximum entropy closure by Minerbo on average yields relatively accurate results in the broadest set of cases considered in this work.

  16. Yucca Mountain Waste Package Closure System

    shelton-davis; Colleen Shelton-Davis; Greg Housley


    The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

  17. Yucca Mountain Waste Package Closure System

    Herschel Smartt; Arthur Watkins; David Pace; Rodney Bitsoi; Eric Larsen; Timothy McJunkin; Charles Tolle


    The current disposal path for high-level waste is to place the material into secure waste packages that are inserted into a repository. The Idaho National Laboratory has been tasked with the development, design, and demonstration of the waste package closure system for the repository project. The closure system design includes welding three lids and a purge port cap, four methods of nondestructive examination, and evacuation and backfill of the waste package, all performed in a remote environment. A demonstration of the closure system will be performed with a full-scale waste package.

  18. [Urethral Fistula and Scrotal Abscess Associated with Colovesical Fistula Due to the Sigmoid Colon Cancer].

    Nakazawa, Shigeaki; Uemura, Motohide; Miyagawa, Yasushi; Tsujimura, Akira; Nonomura, Norio


    We report here a rare case of urethral fistula and scrotal abscess associated with colovesical fistula due to sigmoid colon cancer. An 84-year-old male was referred to our hospital complaining of macrohematuria, fecaluria, pneumaturia and micturitional pain. Computed tomography (CT) showed colovesical fistula. Other examinations, including colonoscopy and cystoscopy, did not reveal a clear cause for the colovesical fistula. Only an elevated serum level of the tumor marker CA19-9 suggested the possibility of sigmoid colon cancer. Eleven days after hospitalization, bilateral scrotal contents had swollen rapidly to the size of a goose egg. CT suggested urethral fistula with scrotal abscess formation. Drainage of scrotal abscess and colostomy were performed. Intraoperatively, the fistula of the bulbar urethra was revealed. Because increased serum CA19-9 suggested a diagnosis of sigmoid colon cancer, cystectomy and sigmoid colectomy with right nephrectomy were performed. Pathological examination revealed adenocarcinoma of sigmoid colon with bladder invasion. His condition was improved with rehabilitation 6 months after operation.

  19. Comparison of terazosin and prazosin for treatment of vesico-urethral reflex dyssynergia in dogs.

    Haagsman, A N; Kummeling, A; Moes, M E; Mesu, S J; Kirpensteijn, J


    Nineteen dogs with vesico-urethral reflex dyssynergia (VURD) were treated with prazosin or terazosin 0.5 mg/kg twice daily to compare efficacy and side effects. Dogs were referred because of signs of (partial) urethral obstruction. Physical examination, abdominal ultrasonography, urinalysis and a radiographic contrast study of bladder and urethra (urethrocystography) were routinely performed. If no mechanical causes of obstruction or disease of the distal urinary tract were observed, the diagnosis VURD was presumed and the dogs were included in our study. Follow-up information was obtained from owners or referring veterinarians. Significantly more side effects were seen in the dogs treated with terazosin (n=14; 93 per cent) compared with the dogs treated with prazosin (n=5; 20 per cent; P=0.002). Effects of the treatment were comparable between prazosin and terazosin. Labradors and dogs that were castrated surgically had a significant better survival (P<0.01) compared with other breeds and animals that were castrated chemically. There was a moderate to good effect in 60 per cent of the dogs treated with prazosin, and in 64 per cent of the dogs treated with terazosin.

  20. Microwave prostatic hyperthermia: Interest of urethral and rectal applicators combination -- Theoretical study and animal experimental results

    Despretz, D.; Camart, J.C.; Michel, C.; Fabre, J.J. [Univ. des Sciences et Technologies de Lille, Villeneuve D`Ascq (France); Prevost, B. [Centre Oscar Lambret, Lille (France); Sozanski, J.P. [INSERM, Lille (France); Chive, M. [Univ. des Sciences et Technologies de Lille, Villeneuve D`Ascq (France)]|[INSERM, Lille (France)


    Microwave thermotherapy systems used for benign prostatic hyperplasia treatment generally operate with urethral or rectal applicator to deliver the microwave energy in the prostate. This technique does not allow an efficient heating of all the gland particularly in the case of large adenoma or when the treatment is limited to only one heating session. A solution to this problem is given by using simultaneously the rectal and urethral applicators. A complete 915-MHz microwave thermotherapy system is presented with two applicators which can operate independently or simultaneously to deliver the microwave energy in the prostate. Electromagnetic and thermal modeling have been developed for the applicator antenna optimization, to calculate the specific absorption rate (SAR) and the thermal pattern in the prostate for each applicator alone and when they operate together in phase. Different canine experiments have been performed to prove the interest of using the two applicators simultaneously as compared when they operate alone. Histological examination cuts of the prostate gland after heating have been carried out.

  1. Fabrication, Crosslinking and in vitro Biocompatibility of a Novel Degradable Nano-structure Urethral Tubular Scaffold

    WANG Xiao-qing; WANG Chun-xi; CHEN Qi-hui; HOU Yu-chuan; LU Zhi-hua; HU Jing-hai; ZHANG Hai-feng; HAO Yuan-yuan; ZHANG Long; GAO Zhan-tuan


    A degradable poly(lactic-co-glycolic acid,LA∶GA=80∶20)(PLGA) urethral tubular scaffold was fabricated by electrospinning.In order to enhance the mechanical properties,the scaffold was crosslinked with glutaraldehyde.The structure and properties of the crosslinked scaffolds were investigated by the mechanical property testing,scanning electron microscopy(SEM),degradability test in vitro and 3-(4,5)-dimethylthiahiazo(-z-yl)-3,5-diphenytetrazoliumromide(MTT).The results show that the scaffold has the nano-structure.The pore size and the porosity are suitable for cell seeding,growth and extracellular matrix production.Although influenced by the crosslinking slightly,the pore size and the porosity could still support cell proliferation and tissuse formation.The mechanical properties are remarkably increased by the crosslinking of glutaraldehyde,and it could meet the demands of a urethral stent.The scaffold could completely collapse within 70 d.The results of the biocompatibility test show that the PLGA scaffold had no cytotoxicity.

  2. Distribution of secretory inhibitor of platelet microbicidal protein among urethral isolates with its correlation with prostatitis

    Iuri B.Ivanov; Viktor A.Gritsenko; Michael D.Kuzmin


    Aim: To report the detection in vitro of secretory inhibitor of platelet microbicidal protein (SIPMP) phenotypes of urethral isolates along with a comparison with isolates from patients with or without chronic bacterial prostatitis (CBP). Methods: Urethral isolates of Staphylococcus spp. (n = 64), diphtheroids (n = 28), micrococci (n = 15),streptococci (n = 21), Enterobacteriaceae (n = 9) and Enterococcusfaecalis (n = 19) from patients with or without CBP were tested. SIPMP production was tested by inhibition of platelet microbicidal protein (PMP) bioactivity against Bacillus subtilis and was expressed as percentage of inhibition of PMP bactericidal activity. Results: A significantly higher proportion of CBP-strains (57.78% vs. 16.67%) reduced PMP-induced killing of Bacillus subtilis than non-CBP strains did (P < 0.01), SIPMP levels of staphylococci and Enterococcusfaecalis from the CBP group were significantly higher than those of the control group. Conclusion: These results suggest that SIPMP production is associated with the CBP source. Data from the present study might have significant implications for the understanding of the pathogenesis of CBP.

  3. The Urethral Rhabdosphincter, Levator Ani Muscle, and Perineal Membrane: A Review

    Nobuyuki Hinata


    Full Text Available Detailed knowledge of the anatomy of the rhabdosphincter and adjacent tissues is mandatory during urologic surgery to ensure reliable oncologic and functional outcomes. To characterize the levator ani (LA function for the urethral sphincter, we described connective tissue morphology between the LA and urethral rhabdosphincter. The interface tissue between the LA and rhabdosphincter area in males contained abundant irregularly arrayed elastic fibers and smooth muscles. The male rhabdosphincter was positioned alongside the LA to divide the elevation force and not in-series along the axis of LA contraction. The male perineal membrane was thin but solid and extends along the inferior margin or bottom of the rhabdosphincter area. In contrast, the female rhabdosphincter, including the compressor urethrae and urethrovaginal sphincter muscles, was embedded in the elastic fiber mesh that is continuous with the thick, multilaminar perineal membrane. The inferomedial edge of the female LA was attached to the upper surface of the perineal membrane and not directly attached to the rhabdosphincter. We presented new diagrams showing the gender differences in topographical anatomy of the LA and rhabdosphincter.

  4. The maximal D = 4 supergravities

    Wit, Bernard de [Institute for Theoretical Physics and Spinoza Institute, Utrecht University, Postbus 80.195, NL-3508 TD Utrecht (Netherlands); Samtleben, Henning [Laboratoire de Physique, ENS Lyon, 46 allee d' Italie, F-69364 Lyon CEDEX 07 (France); Trigiante, Mario [Dept. of Physics, Politecnico di Torino, Corso Duca degli Abruzzi 24, I-10129 Turin (Italy)


    All maximal supergravities in four space-time dimensions are presented. The ungauged Lagrangians can be encoded in an E{sub 7(7)}-Sp(56; R)/GL(28) matrix associated with the freedom of performing electric/magnetic duality transformations. The gauging is defined in terms of an embedding tensor {theta} which encodes the subgroup of E{sub 7(7)} that is realized as a local invariance. This embedding tensor may imply the presence of magnetic charges which require corresponding dual gauge fields. The latter can be incorporated by using a recently proposed formulation that involves tensor gauge fields in the adjoint representation of E{sub 7(7)}. In this formulation the results take a universal form irrespective of the electric/magnetic duality basis. We present the general class of supersymmetric and gauge invariant Lagrangians and discuss a number of applications.

  5. Maximizing profit using recommender systems

    Das, Aparna; Ricketts, Daniel


    Traditional recommendation systems make recommendations based solely on the customer's past purchases, product ratings and demographic data without considering the profitability the items being recommended. In this work we study the question of how a vendor can directly incorporate the profitability of items into its recommender so as to maximize its expected profit while still providing accurate recommendations. Our approach uses the output of any traditional recommender system and adjust them according to item profitabilities. Our approach is parameterized so the vendor can control how much the recommendation incorporating profits can deviate from the traditional recommendation. We study our approach under two settings and show that it achieves approximately 22% more profit than traditional recommendations.

  6. The maximal D=5 supergravities

    de Wit, Bernard; Trigiante, M; Wit, Bernard de; Samtleben, Henning; Trigiante, Mario


    The general Lagrangian for maximal supergravity in five spacetime dimensions is presented with vector potentials in the \\bar{27} and tensor fields in the 27 representation of E_6. This novel tensor-vector system is subject to an intricate set of gauge transformations, describing 3(27-t) massless helicity degrees of freedom for the vector fields and 3t massive spin degrees of freedom for the tensor fields, where the (even) value of t depends on the gauging. The kinetic term of the tensor fields is accompanied by a unique Chern-Simons coupling which involves both vector and tensor fields. The Lagrangians are completely encoded in terms of the embedding tensor which defines the E_6 subgroup that is gauged by the vectors. The embedding tensor is subject to two constraints which ensure the consistency of the combined vector-tensor gauge transformations and the supersymmetry of the full Lagrangian. This new formulation encompasses all possible gaugings.

  7. Constraint Propagation as Information Maximization

    Abdallah, A Nait


    Dana Scott used the partial order among partial functions for his mathematical model of recursively defined functions. He interpreted the partial order as one of information content. In this paper we elaborate on Scott's suggestion of regarding computation as a process of information maximization by applying it to the solution of constraint satisfaction problems. Here the method of constraint propagation can be interpreted as decreasing uncertainty about the solution -- that is, as gain in information about the solution. As illustrative example we choose numerical constraint satisfaction problems to be solved by interval constraints. To facilitate this approach to constraint solving we formulate constraint satisfaction problems as formulas in predicate logic. This necessitates extending the usual semantics for predicate logic so that meaning is assigned not only to sentences but also to formulas with free variables.

  8. Systematization of a set of closure techniques.

    Hausken, Kjell; Moxnes, John F


    Approximations in population dynamics are gaining popularity since stochastic models in large populations are time consuming even on a computer. Stochastic modeling causes an infinite set of ordinary differential equations for the moments. Closure models are useful since they recast this infinite set into a finite set of ordinary differential equations. This paper systematizes a set of closure approximations. We develop a system, which we call a power p closure of n moments, where 0≤p≤n. Keeling's (2000a,b) approximation with third order moments is shown to be an instantiation of this system which we call a power 3 closure of 3 moments. We present an epidemiological example and evaluate the system for third and fourth moments compared with Monte Carlo simulations.

  9. Entropy production and collisionless fluid closure

    Sarazin, Y; Zarzoso, D; Garbet, X; Ghendrih, Ph; Grandgirard, V [CEA, IRFM, F-13108 Saint-Paul-lez-Durance (France); Dif-Pradalier, G, E-mail: yanick.sarazin@cea.f [Center for Astrophysics and Space Science, U.C.S.D., La Jolla, CA 92093 (United States)


    A novel method is proposed to construct collisionless fluid closures accounting for some kinetic properties. The idea consists in optimizing the agreement between the fluid and kinetic quasi-linear entropy production rates, so as to constrain the closure coefficients. This procedure is applied to the slab branch of the ion temperature gradient driven instability. Focusing on the kinetic regime characterized by slow waves, the closure proposed by Hammett and Perkins (Hammett and Perkins 1990 Phys. Rev. Lett. 64 3019) naturally emerges from the systematic identification of the kinetic and fluid entropy production rates. This closure is revealed to be extremely powerful well beyond the kinetic regime. Besides, it reconciles the fluid and kinetic linear stability diagrams in the two-dimensional space of the density and temperature gradient lengths. Such a method is systematic and generic. As such, it is applicable to other models and classes of instabilities.

  10. Entropy production and collisionless fluid closure

    Sarazin, Y.; Dif-Pradalier, G.; Zarzoso, D.; Garbet, X.; Ghendrih, Ph; Grandgirard, V.


    A novel method is proposed to construct collisionless fluid closures accounting for some kinetic properties. The idea consists in optimizing the agreement between the fluid and kinetic quasi-linear entropy production rates, so as to constrain the closure coefficients. This procedure is applied to the slab branch of the ion temperature gradient driven instability. Focusing on the kinetic regime characterized by slow waves, the closure proposed by Hammett and Perkins (Hammett and Perkins 1990 Phys. Rev. Lett. 64 3019) naturally emerges from the systematic identification of the kinetic and fluid entropy production rates. This closure is revealed to be extremely powerful well beyond the kinetic regime. Besides, it reconciles the fluid and kinetic linear stability diagrams in the two-dimensional space of the density and temperature gradient lengths. Such a method is systematic and generic. As such, it is applicable to other models and classes of instabilities.

  11. Testing turbulent closure models with convection simulations

    Snellman, J E; Mantere, M J; Rheinhardt, M; Dintrans, B


    Aims: To compare simple analytical closure models of turbulent Boussinesq convection for stellar applications with direct three-dimensional simulations both in homogeneous and inhomogeneous (bounded) setups. Methods: We use simple analytical closure models to compute the fluxes of angular momentum and heat as a function of rotation rate measured by the Taylor number. We also investigate cases with varying angles between the angular velocity and gravity vectors, corresponding to locating the computational domain at different latitudes ranging from the pole to the equator of the star. We perform three-dimensional numerical simulations in the same parameter regimes for comparison. The free parameters appearing in the closure models are calibrated by two fit methods using simulation data. Unique determination of the closure parameters is possible only in the non-rotating case and when the system is placed at the pole. In the other cases the fit procedures yield somewhat differing results. The quality of the closu...

  12. Reliability assessment of underground shaft closure

    Fossum, A.F. [RE/SPEC, Inc., Rapid City, SD (United States); Munson, D.E. [Sandia National Labs., Albuquerque, NM (United States)


    The intent of the WIPP, being constructed in the bedded geologic salt deposits of Southeastern New Mexico, is to provide the technological basis for the safe disposal of radioactive Transuranic (TRU) wastes generated by the defense programs of the United States. In determining this technological basis, advanced reliability and structural analysis techniques are used to determine the probability of time-to-closure of a hypothetical underground shaft located in an argillaceous salt formation and filled with compacted crushed salt. Before being filled with crushed salt for sealing, the shaft provides access to an underground facility. Reliable closure of the shaft depends upon the sealing of the shaft through creep closure and recompaction of crushed backfill. Appropriate methods are demonstrated to calculate cumulative distribution functions of the closure based on laboratory determined random variable uncertainty in salt creep properties.

  13. Cyanoacrylate for Intraoral Wound Closure: A Possibility?

    Parimala Sagar


    Full Text Available Wound closure is a part of any surgical procedure and the objective of laceration repair or incision closure is to approximate the edges of a wound so that natural healing process may occur. Over the years new biomaterials have been discovered as an alternate to conventional suture materials. Cyanoacrylate bioadhesives are one among them. They carry the advantages of rapid application, patient comfort, resistance to infection, hemostatic properties, and no suture removal anxiety. Hence this study was undertaken to study the effect of long chain cyanoacrylate as an adhesive for intraoral wound closure and also to explore its hemostatic and antibacterial effects. Isoamyl-2-cyanoacrylate (AMCRYLATE was used as the adhesive in the study. In conclusion isoamyl cyanoacrylate can be used for intraoral wound closure, as an alternative to sutures for gluing the mucoperiosteum to bone, for example, after impaction removal, periapical surgeries, and cleft repair. Its hemostatic and antibacterial activity has to be further evaluated.

  14. [Percutaneous closure of patent ductus arteriosus: results and costs compared to surgical closure].

    Vieu, T; Beaurain, S; Angel, C; Leriche, H; Petit, J; Conso, J F; Planché, C; Losay, J


    The comparison of the clinical results and costs of the two methods of closure of patient ductus arteriosus was undertaken in two comparable groups of 40 patients treated in the same period in the same hospital. After transcatheter closure there was a 9% residual shunt rate at 3 years, the 2 patients with a residual continuous murmur being operated secondarily. The only complication was severe haemolysis which regressed after transcatheter ablation of the prosthesis. After surgical closure, there were no residual shunt. Some postoperative complications were observed in 20% of cases, usually benign (ventilatory problems, dysphonia or urinary infection), but occasionally more serious (peroperative lesion of the pulmonary artery). Morbidity, inherent to the technique of closure, was very different and much less in catheter closure. The average cost (daily cost x average length of hospital stay) was much less with transcatheter closure 38,558 francs versus 11,240 francs. On the other hand, the direct cost of transcatheter closure was greater than that of surgery: 32,798 francs versus 20,903 francs, the difference being related to the actual price of the prosthesis. The authors conclude that the 3 year results of transcatheter closure of patent ductus arterious make this technique a reasonable therapeutic alternative to surgery. From the safety point of view, the two techniques are comparable bu patient confort is greater with transcatheter closure for an increase in cost of the initial procedure which should decrease in relation to the types and prices of the prosthesis used.

  15. Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis

    Satoshi Takahashi


    Full Text Available To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011–2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33. The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43 and 37.2% (16/43, respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50. The microbiological eradication rates for the pathogens were 90.9% (30/33 for Neisseria gonorrhoeae, 91.5% (43/47 for Chlamydia trachomatis, 71.4% (5/7 for Mycoplasma genitalium, and 100% (13/13 for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120. The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.

  16. Injectable biomaterials for the treatment of stress urinary incontinence: their potential and pitfalls as urethral bulking agents.

    Davis, Niall F


    Injectable urethral bulking agents composed of synthetic and biological biomaterials are minimally invasive treatment options for stress urinary incontinence (SUI). The development of an ideal urethral bulking agent remains challenging because of clinical concerns over biocompatibility and durability. Herein, the mechanical and biological features of injectable urethral biomaterials are investigated, with particular emphasis on their future potential as primary and secondary treatment options for SUI. A literature search for English language publications using the two online databases was performed. Keywords included "stress urinary incontinence", "urethral bulking agent" and "injectable biomaterial". A total of 98 articles were analysed, of which 45 were suitable for review based on clinical relevance and importance of content. Injectable biomaterials are associated with a lower cure rate and fewer postoperative complications than open surgery for SUI. They are frequently reserved as secondary treatment options for patients unwilling or medically unfit to undergo surgery. Glutaraldehyde cross-linked bovine collagen remains the most commonly injected biomaterial and has a cure rate of up to 53 %. Important clinical features of an injectable biomaterial are durability, biocompatibility and ease of administration, but achieving these requirements is challenging. In carefully selected patients, injectable biomaterials are feasible alternatives to open surgical procedures as primary and secondary treatment options for SUI. In future, higher cure rates may be feasible as researchers investigate alternative biomaterials and more targeted injection techniques for treating SUI.

  17. A rare case of male pelvic squamous cell carcinoma of unknown primary origin presenting as perineal abscess and urethral stenosis

    Massimiliano Creta


    Full Text Available Carcinomas of unknown primary origin (CUP represent a diagnostic and therapeutic challenge. Squamous cell CUP located in the male pelvis are very rare. We describe a case of a locally advanced squamous cell CUP occurring in the male pelvis presenting as perineal abscess and urethral stenosis and diagnosed by means of transperineal needle biopsy.

  18. Prevalence of Trichomonas vaginalis, Mycoplasma genitalium and Ureaplasma urealyticum in men with urethritis attending an urban sexual health clinic.

    Khatib, N; Bradbury, C; Chalker, V; Koh, G C K W; Smit, E; Wilson, S; Watson, J


    We conducted a study to determine the prevalence of Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) in men with urethritis, attending an urban sexual health clinic, in order to inform screening and treatment policies. Men attending an urban sexual health clinic between June 2011 and January 2012 were evaluated. Urine samples were collected from men with urethritis and tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and TV using transcription-mediated amplification and for MG and UU using polymerase chain reaction. Eighty-three samples were analysed. The prevalence of CT was 33.7% (28/83), GC was 16.8% (14/83), TV was 3.6% (3/83), MG was 12.0% (10/83) and UU was 4.8% (4/83). Fifteen men had recurrent urethritis. Of these, three were found to have had TV, five to have had MG and none to have had UU, at initial presentation. Given the prevalence of MG in this study, there is an urgent need for further larger studies looking at optimal treatment regimens and screening strategies in urethritis.

  19. Efficacy and perioperative safety of synthetic mid-urethral slings in obese women with stress urinary incontinence

    Weltz, V; Guldberg, R; Lose, G


    INTRODUCTION AND HYPOTHESIS: Obesity is associated with an increased prevalence of female stress urinary incontinence (SUI). Mid-urethral polypropylene sling is considered the surgical gold standard for treatment of SUI. We reviewed the current literature on efficacy at 1 year (or more) and perio...

  20. Prevention of urethral blockage following semen collection in two species of lemur, Varecia variegata variegata and Lemur catta.

    Chatfield, Jenifer; Penfold, Linda


    Lemurs are a diverse group of primates comprised of five families, all of which are found only on Madagascar and the Comoro Islands. Of the 60 known species, 17 are endangered and 5 of these are considered critically endangered. The effects of inbreeding on population health and viability have been well described; though negative inbreeding effects can be ameliorated through the introduction of new genetic material. Introduction of new individuals into a population can be extremely challenging because of the highly social nature of lemurs. Semen collection in lemur species is notoriously challenging, as the ejaculate forms a coagulum. During normal breeding, the coagulum forms a copulatory plug in the female. However, this coagulum can present a life-threatening situation when retained in the urethra abnormally following electroejaculation. This study investigates the use of ascorbic acid in preventing urethral blockage in two lemur species during semen collection, demonstrates successful collection of semen by electroejaculation from two species of lemur during the breeding season, and discusses removal of urethral plugs subsequent to semen collection. Semen was collected successfully from all animals. Urethral plugs formed during each collection and were abnormally retained in 2/11 collections. Both plugs were successfully and immediately removed with the use of retropulsion through a urethral catheter. Although the results of this study are encouraging, more investigation is required to establish whether or not this procedure can be safely performed in the field.

  1. Does patterned afferent stimulation of sacral dermatomes suppress urethral sphincter reflexes in individuals with spinal cord injury?

    McCoin, Jaime L; Bhadra, Narendra; Brose, Steven W; Gustafson, Kenneth J


    Dyssynergic contractions of the external urethral sphincter prevent efficient bladder voiding and lead to numerous health concerns. Patterned electrical stimulation of the sacral dermatomes reduces urethral sphincter spasms and allows functional bladder emptying in cats after chronic SCI. Reflex suppression in animals is strongly dependent on stimulus location and pattern. The purpose of this study was to determine whether the stimulation patterns and locations effective in animals suppress urethral sphincter spasms in humans with SCI. Ten subjects with chronic SCI underwent bladder filling to elicit distention-evoked contractions. During reflex contractions patterned electrical stimulation was applied to the S2 or S3 dermatome in random 25-sec intervals. Bladder and sphincter pressures were simultaneously recorded and compared between control and afferent stimulation periods. Six of the 10 subjects demonstrated both reflex bladder and sphincter contractions with bladder filling. No significant reduction in urethral pressure was observed during stimulation for any stimulus locations and patterns tested. Stimulation parameters and locations effective in SCI animals did not suppress reflex sphincter activity in these human subjects. It is likely that a broader set of stimulus patterns and dermatome locations will need to be tested to find the effective combination in humans. © 2014 Wiley Periodicals, Inc.

  2. Short- and long-term transfer of urethral catheterization skills from simulation training to performance on patients

    Todsen, Tobias; Henriksen, Mikael V.; Kromann, Charles B.


    Inexperienced interns are responsible for most iatrogenic complications after urethral catheterization (UC). Although training on simulators is common, little is known about the transfer of learned skills to real clinical practice. This study aimed to evaluate the short- and long-term effects of UC...

  3. A comparative study of various electrodes in electromyography of the striated urethral and anal sphincter in children

    Nielsen, K K; Kristensen, E S; Qvist, N


    The series comprised 41 children aged 6 to 14 years consecutively referred with recurrent urinary tract infection and/or enuresis. Carbon dioxide cystometry was carried out in the supine and the erect position and combined with simultaneous electromyography (EMG). The external urethral sphincter...

  4. Urethral pressure reflectometry. A method for simultaneous measurements of pressure and cross-sectional area in the female urethra

    Klarskov, Niels


    A novel technique for simultaneous measurements of pressure and cross-sectional area (CA) in the female urethra, denoted Urethral Pressure Reflectometry (UPR), was devised. A very thin and highly flexible polyurethane-bag was placed in the urethra. A pump applied increasing and decreasing pressur...

  5. Avoidable iatrogenic complications of urethral catheterization and inadequate intern training in a tertiary-care teaching hospital.

    Thomas, Arun Z


    To examine the magnitude of potentially avoidable iatrogenic complications of male urethral catheterization (UC) within a tertiary-care supra-regional teaching hospital, and to evaluate risk factors and subjective feeling of interns in our institution on the adequacy of training on UC.

  6. A comparitive study of buccal mucosa graft and penile pedical flap for reconstruction of anterior urethral strictures

    SA Ying-long; XU Yue-min; QIAN Yong; JIN San-bo; FU Qiang; ZHANG Xin-ru; ZHANG Jiong; GU Baojun


    @@ Anterior urethral strictures, where the length is more than 2 cm, are best treated by substitution urethroplasy with either preputial/penile skin flaps or free grafts.~1 The use of dartos pedicled flaps has many advantages in terms of increased survival thanks to its own vascularization. Recently, buccal mucosa has become increasingly popular among urologists for urethral replacement when local penile skin is unavailable.~2 Both penile skin flaps and buccal mucosa grafts have emerged as reliable urethral substitutes with comparable long-term results.~(3,4) These urethral substitutes are traditionally placed on the ventral aspect of the stricture and have a success rate of about 85%.~5 Recently, dorsal placement of the free graft has been described, allowing the skin patch/buccal mucosa to be spread and fixed on the tunica albuginea of the corporal bodies overlying the strictured segment of the urethra.~6 This location offers a better outcome. We reviewed our experience with dorsal and ventral onlay substitution urethroplasty using free buccal mucosa and pedicled penile/preputial flaps to determine the outcome and particular problems associated with each technique.

  7. Primary closure for postoperative mediastinitis in children.

    Ohye, Richard G; Maniker, Robert B; Graves, Holly L; Devaney, Eric J; Bove, Edward L


    Mediastinitis affects approximately 1% of children undergoing median sternotomy. Conventional therapy involves debridement followed by open wound care with delayed closure, days to weeks of closed suction or antimicrobial irrigation, and vacuum-assisted closure or muscle flap closure. We hypothesized that primary closure without prolonged suction or irrigation is an effective, less traumatic treatment for mediastinitis in children. From January 1986 to July 2002, 6705 procedures involving median sternotomy were performed at the C. S. Mott Children's Hospital, resulting in 57 cases of mediastinitis (0.85%). Cases were divided into 2 groups, with 42 cases treated with primary closure and 15 cases treated with delayed or muscle flap closure. The 42 cases of primary closure comprised the primary study group of this institutional review board-approved, retrospective analysis. Patient demographics, surgical variables, mediastinitis-related parameters, and outcomes were evaluated. One patient had recurrent mediastinitis for an overall infection eradication rate of 97% (40/41). Three patients (7%) required re-exploration for suspected ongoing infection. Of these re-explorations, 1 patient had evidence of continued mediastinitis. The remaining 2 patients with sepsis of unclear cause had no clinical or culture evidence of recurrent infection. One of these patients ultimately died of sepsis without active mediastinitis for a hospital survival of 97% (41/42). No significant differences could be detected between the treatment successes and failures in this small cohort of patients. Simple primary closure is an effective means to treat selected cases of postoperative mediastinitis in children. The results compare favorably with other more lengthy or debilitating treatments.

  8. Exceptional closure of UNIQA office at CERN

    HR Department


    The UNIQA office at CERN will be closed from Wednesday 18 February to Friday 20 February due to painting work. During this closure, the Headquarters of UNIQA in Geneva will remain at the disposal of the members. See details The CERN office will re-open on Monday 23 February according to the normal schedule. We apologise for any inconvenience caused by this closure.

  9. Left ventricle expands maximally preceding end-diastole. Radionuclide ventriculography study

    Horinouchi, Osamu [Kagoshima Univ. (Japan). Faculty of Medicine


    It has been considered that left ventricle (LV) expands maximally at the end-diastole. However, is it exactly coincident with this point? This study was aimed to determine whether the maximal expansion of LV coincides with the peak of R wave on electrocardiogram. Thirty-three angina pectoris patients with normal LV motion were examined using radionuclide ventriculography. Data were obtained from every 30 ms backward frame from the peak of R wave. All patients showed the time of maximal expansion preceded the peak of R wave. The intervals from the peak of R wave and the onset of P wave to maximal expansion of LV was 105{+-}29 ms and 88{+-}25 ms, respectively. This period corresponds to the timing of maximal excurtion of mitral valve by atrial contraction, and the centripetal motion of LV without losing its volume before end-diastole may be interpreted on account of the movement of mitral valve toward closure. These findings suggest that LV expands maximally between P and R wave after atrial contraction, preceding the peak of R wave thought conventionally as the end-diastole. (author)

  10. Non-inferiority of short-term urethral catheterization following fistula repair surgery: study protocol for a randomized controlled trial

    Barone Mark A


    Full Text Available Abstract Background A vaginal fistula is a devastating condition, affecting an estimated 2 million girls and women across Africa and Asia. There are numerous challenges associated with providing fistula repair services in developing countries, including limited availability of operating rooms, equipment, surgeons with specialized skills, and funding from local or international donors to support surgeries and subsequent post-operative care. Finding ways of providing services in a more efficient and cost-effective manner, without compromising surgical outcomes and the overall health of the patient, is paramount. Shortening the duration of urethral catheterization following fistula repair surgery would increase treatment capacity, lower costs of services, and potentially lower risk of healthcare-associated infections among fistula patients. There is a lack of empirical evidence supporting any particular length of time for urethral catheterization following fistula repair surgery. This study will examine whether short-term (7 day urethral catheterization is not worse by more than a minimal relevant difference to longer-term (14 day urethral catheterization in terms of incidence of fistula repair breakdown among women with simple fistula presenting at study sites for fistula repair service. Methods/Design This study is a facility-based, multicenter, non-inferiority randomized controlled trial (RCT comparing the new proposed short-term (7 day urethral catheterization to longer-term (14 day urethral catheterization in terms of predicting fistula repair breakdown. The primary outcome is fistula repair breakdown up to three months following fistula repair surgery as assessed by a urinary dye test. Secondary outcomes will include repair breakdown one week following catheter removal, intermittent catheterization due to urinary retention and the occurrence of septic or febrile episodes, prolonged hospitalization for medical reasons, catheter blockage, and

  11. Beeping a Maximal Independent Set

    Afek, Yehuda; Bar-Joseph, Ziv; Cornejo, Alejandro; Haeupler, Bernhard; Kuhn, Fabian


    We consider the problem of computing a maximal independent set (MIS) in an extremely harsh broadcast model that relies only on carrier sensing. The model consists of an anonymous broadcast network in which nodes have no knowledge about the topology of the network or even an upper bound on its size. Furthermore, it is assumed that an adversary chooses at which time slot each node wakes up. At each time slot a node can either beep, that is, emit a signal, or be silent. At a particular time slot, beeping nodes receive no feedback, while silent nodes can only differentiate between none of its neighbors beeping, or at least one of its neighbors beeping. We start by proving a lower bound that shows that in this model, it is not possible to locally converge to an MIS in sub-polynomial time. We then study four different relaxations of the model which allow us to circumvent the lower bound and find an MIS in polylogarithmic time. First, we show that if a polynomial upper bound on the network size is known, it is possi...

  12. Maximal switchability of centralized networks

    Vakulenko, Sergei; Morozov, Ivan; Radulescu, Ovidiu


    We consider continuous time Hopfield-like recurrent networks as dynamical models for gene regulation and neural networks. We are interested in networks that contain n high-degree nodes preferably connected to a large number of N s weakly connected satellites, a property that we call n/N s -centrality. If the hub dynamics is slow, we obtain that the large time network dynamics is completely defined by the hub dynamics. Moreover, such networks are maximally flexible and switchable, in the sense that they can switch from a globally attractive rest state to any structurally stable dynamics when the response time of a special controller hub is changed. In particular, we show that a decrease of the controller hub response time can lead to a sharp variation in the network attractor structure: we can obtain a set of new local attractors, whose number can increase exponentially with N, the total number of nodes of the nework. These new attractors can be periodic or even chaotic. We provide an algorithm, which allows us to design networks with the desired switching properties, or to learn them from time series, by adjusting the interactions between hubs and satellites. Such switchable networks could be used as models for context dependent adaptation in functional genetics or as models for cognitive functions in neuroscience.

  13. A Maximally Supersymmetric Kondo Model

    Harrison, Sarah; Kachru, Shamit; Torroba, Gonzalo; /Stanford U., Phys. Dept. /SLAC


    We study the maximally supersymmetric Kondo model obtained by adding a fermionic impurity to N = 4 supersymmetric Yang-Mills theory. While the original Kondo problem describes a defect interacting with a free Fermi liquid of itinerant electrons, here the ambient theory is an interacting CFT, and this introduces qualitatively new features into the system. The model arises in string theory by considering the intersection of a stack of M D5-branes with a stack of N D3-branes, at a point in the D3 worldvolume. We analyze the theory holographically, and propose a dictionary between the Kondo problem and antisymmetric Wilson loops in N = 4 SYM. We perform an explicit calculation of the D5 fluctuations in the D3 geometry and determine the spectrum of defect operators. This establishes the stability of the Kondo fixed point together with its basic thermodynamic properties. Known supergravity solutions for Wilson loops allow us to go beyond the probe approximation: the D5s disappear and are replaced by three-form flux piercing a new topologically non-trivial S3 in the corrected geometry. This describes the Kondo model in terms of a geometric transition. A dual matrix model reflects the basic properties of the corrected gravity solution in its eigenvalue distribution.

  14. Causative Role of Ureaplasma Urealyticum and other Sexually Transmitted Infections in the Urethral Meatus Polyp Development in Women

    Tatyana S. Taranina


    Full Text Available The objective of this study was the investigation of the influence of ureaplasmal infection on the development of urethral meatus polyps in women. The article presents the results of the examination of women with chronic cystitis and urethritis over a 0.5- to 5-year duration, complicated by the presence of urethral meatus polyps and associated with concomitant Ureaplasma urealyticum and other sexually transmitted infections (STI. This was based on the culture analysis of the cervical and urethral content, and PCR-diagnostics of STI, as well as a complex pathomorphologic study of the resected polyps, including electron microscopy. In this study, 98 women between 45 and 60 years (52.5±4.9 years were examined, who had undergone radiowave resection of the polyps: 52 women were infected by STI, including Ureaplasma urealyticum, Mycoplasma genitalium, Mycoplasma hominis, Chlamydia trachomatis and Trichomonas vaginalis, while the remaining 46 women had been diagnosed as not having STI. According to the culture results in the women with STI, U. urealyticum was identified as a monoinfection in 69% of cases, while in the remaining 31% of cases it was evident in the form of mixed infections, mainly in association with Mycoplasma hominis (17.5% and Trichomonas vaginalis (13.5%. Pathomorphological examination of the urethral meatus polyps of the women with U. urealyticum and other STI demonstrated the proliferative character of the remodeling of the surface epithelium with hyperplasia, acanthosis, and keratinization of the stratified squamous epithelium and synchronous changes in the underlying connective tissue - impaired microcirculation and the diffuse inflammatory cell infiltrates with transepithelial leukopedesis. Using electron microscopy in the fibroblasts and plasma cells of the resected polyps the markers of U. urealyticum were detected in patients with negative results of the bacteriological diagnostic methods.

  15. Vaginal-sparing ventral buccal mucosal graft urethroplasty for female urethral stricture: A novel modification of surgical technique

    Gani, Johan; Chee, Justin


    Purpose To present a novel modification of surgical technique to treat female urethral stricture (FUS) by a vaginal-sparing ventral buccal mucosal urethroplasty. Recurrent FUS represents an uncommon, though difficult clinical scenario to manage definitively. A variety of surgical techniques have been described to date, yet a lack of consensus on the optimal procedure persists. Materials and Methods We present a 51-year-old female with urethral stricture involving the entire urethra. Suspected etiology was iatrogenic from cystoscopy 17 years prior. Since then, the patient had undergone at least 25 formal urethral dilations and periods of self-dilation. In lithotomy position, the urethra was dilated to accommodate forceps, and ventral urethrotomy carried out sharply, exposing a bed of periurethral tissue. Buccal mucosa was harvested, and a ventral inlay technique facilitated by a nasal speculum, was used to place the graft from the proximal urethra/bladder neck to urethral meatus without a vaginal incision. Graft was sutured into place, and urethral Foley catheter inserted. Results The vaginal-sparing ventral buccal mucosal graft urethroplasty was deemed successful as of last follow-up. Flexible cystoscopy demonstrated patency of the repair at 6 months. At 10 months of follow-up, the patient was voiding well, with no urinary incontinence. No further interventions have been required. Conclusions This case describes a novel modification of surgical technique for performing buccal mucosal urethroplasty for FUS. By avoiding incision of the vaginal mucosa, benefits may include reduced: morbidity, urinary incontinence, and wound complications including urethro-vaginal fistula. PMID:27437540

  16. 105-DR Large Sodium Fire Facility closure activities evaluation report

    Adler, J.G.


    This report evaluates the closure activities at the 105-DR Large Sodium Fire Facility. The closure activities discussed include: the closure activities for the structures, equipment, soil, and gravel scrubber; decontamination methods; materials made available for recycling or reuse; and waste management. The evaluation compares these activities to the regulatory requirements and closure plan requirements. The report concludes that the areas identified in the closure plan can be clean closed.

  17. NPAR- products, applications and closure

    Vora, J.P.


    Almost a decade ago the Office of Nuclear Regulatory Research (RES) developed and implemented a comprehensive research program (NUREG-1144) widely known as NPAR or Nuclear Plant Aging Research. The NPAR program is a structured research program specifically oriented to understanding significant age-related degradation mechanisms and their long term effects on properties and performance of important components and systems and ways to mitigate detrimental effects of aging. It provided a road map and a phased approach to research that is applicable to any structure, system, or component of interest. This hardware-oriented engineering research program led the industry worldwide and communicated a need to understand and manage age-related degradation effects in selected but important structures and components. At the conclusion (1995) of the NPAR program, 22 electrical and mechanical components, 13 safety-related systems, and 10 special topics will have been studied and results summarized in 160 technical reports. This reference library of information listed and summarized in NUREG-1377, Rev. No. 4 provides a foundation upon which individual programs can be built for the specific needs of a utility, a regulator, or equipment manufacturers. During the life of the NPAR program, it has provided technical bases and support for license renewal, codes and standards, resolution of generic safety issues, information notices, regulatory guides and the standard Review Plan, as well as the Office of Nuclear Reactor Regulation and The NRC Regions. All ongoing NPAR activities will either be completed or terminated by the end of 1995. No new initiative will be undertaken. This paper summarizes NPAR products and accomplishments, application of the research results, and its status and closure.

  18. Accelerating cleanup: Paths to closure



    This report describes the status of Environmental Management`s (EM`s) cleanup program and a direction forward to complete achievement of the 2006 vision. Achieving the 2006 vision results in significant benefits related to accomplishing EM program objectives. As DOE sites accelerate cleanup activities, risks to public health, the environment, and worker safety and health are all reduced. Finding more efficient ways to conduct work can result in making compliance with applicable environmental requirements easier to achieve. Finally, as cleanup activities at sites are completed, the EM program can focus attention and resources on the small number of sites with more complex cleanup challenges. Chapter 1 describes the process by which this report has been developed and what it hopes to accomplish, its relationship to the EM decision-making process, and a general background of the EM mission and program. Chapter 2 describes how the site-by-site projections were constructed, and summarizes, for each of DOE`s 11 Operations/Field Offices, the projected costs and schedules for completing the cleanup mission. Chapter 3 presents summaries of the detailed cleanup projections from three of the 11 Operations/Field Offices: Rocky Flats (Colorado), Richland (Washington), and Savannah River (South Carolina). The remaining eight Operations/Field Office summaries are in Appendix E. Chapter 4 reviews the cost drivers, budgetary constraints, and performance enhancements underlying the detailed analysis of the 353 projects that comprise EM`s accelerated cleanup and closure effort. Chapter 5 describes a management system to support the EM program. Chapter 6 provides responses to the general comments received on the February draft of this document.

  19. Urethral Injuries

    ... Commentary Recent News Scientists Working on Solar-Powered Prosthetic Limbs Exercise a Great Prescription to Help Older Hearts Bavencio Approved for Rare Skin Cancer Older Mothers May Raise Better-Behaved ... a catheter placed directly into the bladder through the skin over the lower abdomen. The urethra is repaired surgically after all ...

  20. Human amniotic fluid stem cell injection therapy for urethral sphincter regeneration in an animal model

    Kim Bum


    Full Text Available Abstract Background Stem cell injection therapies have been proposed to overcome the limited efficacy and adverse reactions of bulking agents. However, most have significant limitations, including painful procurement, requirement for anesthesia, donor site infection and a frequently low cell yield. Recently, human amniotic fluid stem cells (hAFSCs have been proposed as an ideal cell therapy source. In this study, we investigated whether periurethral injection of hAFSCs can restore urethral sphincter competency in a mouse model. Methods Amniotic fluids were collected and harvested cells were analyzed for stem cell characteristics and in vitro myogenic differentiation potency. Mice underwent bilateral pudendal nerve transection to generate a stress urinary incontinence (SUI model and received either periurethral injection of hAFSCs, periurethral injection of Plasma-Lyte (control group, or underwent a sham (normal control group. For in vivo cell tracking, cells were labeled with silica-coated magnetic nanoparticles containing rhodamine B isothiocyanate (MNPs@SiO2 (RITC and were injected into the urethral sphincter region (n = 9. Signals were detected by optical imaging. Leak point pressure and closing pressure were recorded serially after injection. Tumorigenicity of hAFSCs was evaluated by implanting hAFSCs into the subcapsular space of the kidney, followed two weeks later by retrieval and histologic analysis. Results Flow activated cell sorting showed that hAFSCs expressed mesenchymal stem cell (MSC markers, but no hematopoietic stem cell markers. Induction of myogenic differentiation in the hAFSCs resulted in expression of PAX7 and MYOD at Day 3, and DYSTROPHIN at Day 7. The nanoparticle-labeled hAFSCs could be tracked in vivo with optical imaging for up to 10 days after injection. Four weeks after injection, the mean LPP and CP were significantly increased in the hAFSC-injected group compared with the control group. Nerve regeneration and

  1. Safety and efficacy of laser and cold knife urethrotomy for urethral stricture

    JIN Tao; LI Hong; JIANG Li-hai; WANG Li; WANG Kun-jie


    Background Endoscopic treatment for urethral stricture, including cold knife and laser, poses a major challenge to clinical practice. Both the benefits and drawbacks of these two treatments remain controversial. This article aimed to compare the efficacy and safety of laser and cold knife urethrotomy for urethral stricture.Methods We searched PubMed (1966-2009), Embase (1980-2009), Cochrane Central Register of Controlled Trials (CCRCT, 2009 No.1) and Chinese Biomedical Literature Database (CBM) for laser and cold knife urethrotomy as treatment for male urethral stenosis, looking in the English literatures. Two reviewers independently screened the literatures and extracted information. Chi-square test was used for statistical analysis with SPSS15.0.Results A total of 44 articles, including of 3230 cases was retrieved. Success rate of patients treated with laser was 74.9% compared with 68.5% for cold knife, with very similar clinical results despite a statistically significant difference (P=0.004). The trend in success rate at a different follow-up time was similar between the two groups. No significant difference in success rate was found between the groups of repeat operation for recurrence cases, first P=0.090 and second P=0.459. The shorter the stricture length was (<1 cm), the higher the success rate was (P <0.0001). No significant difference in success rate between the laser and cold knife groups was found in neither bulbar nor membranous urethra, bulbar P=0.660 and membranous P=0.477. The rates of urinary incontinence, urinary extravasation, and urinary tract infection showed no significant difference (P=0.259, P=0.938, P=0.653, respectively).Conclusions Success rates for laser and cold knife were very similar despite being statistically different, with the groups having a similar trend in success rates at different follow-up time. Stricture location and history of endoscopic intervention did impact treatment outcome but was not significantly different. The

  2. Posterior urethral valves: Morphological normalization of posterior urethra after fulguration is a significant factor in prognosis

    Menon Prema


    Full Text Available Aim: To assess the changes in urethral morphology 3 months post fulguration of posterior urethral valves (PUVs on micturating cystourethrogram (MCUG and correlate these changes with the overall clinical status of the patient. Materials and Methods: A total of 217 children, managed for PUVs during a period of 6 years in a single surgical unit were prospectively studied. The ratio of the diameters of the prostatic and bulbar urethras (PU/BU was calculated on the pre- and post-fulguration MCUG films. They were categorized into three groups based on the degree of normalization of posterior urethra (post-fulguration PU/BU ratio. Results: Group A: Of the 133 patients, 131 had normal urinary stream and 4 (3% had nocturnal enuresis. Vesicoureteral reflux (VUR, initially seen in 83 units (31% units, regressed completely at a mean duration of 6 months in 41 units (49%. Of the 152 non-VUR, hydroureteronephrosis (HUN units, 11 were poorly functioning kidneys. Persistent slow but unobstructed drainage was seen in 23 units (16% over a period of 1.5-5 years (mean 2.5 years. Group B: All the 11 patients had a normal stream. Four (36.4% had daytime frequency for a mean duration of 1 year and one (9% had nocturnal enuresis for 1 year. Grade IV-V VUR was seen in five patients (three bilateral, which regressed completely by 3 months in five units (62.5%. In the non-VUR, HUN patients, slow (but unobstructed drainage was persistent in two units (14% at 3 years. Group C: Of the 16 patients, only 5 (31.3% were asymptomatic. Six patients (nine units had persistent VUR for 6 months to 3 years. Of the 20 units with HUN, 17 (85% were persistent at 1-4 years (mean 2 years. Eight patients (50% required a second fulguration while 3 (18.7% required urethral dilatation for stricture following which all parameters improved. Conclusions: Adequacy of fulguration should be assessed by a properly performed MCUG. A postop PU/BU ratio >3 SD (1.92 should alert to an incomplete

  3. An eddy closure for potential vorticity

    Ringler, Todd D [Los Alamos National Laboratory


    The Gent-McWilliams (GM) parameterization is extended to include a direct influence in the momentum equation. The extension is carried out in two stages; an analysis of the inviscid system is followed by an analysis of the viscous system. In the inviscid analysis the momentum equation is modified such that potential vorticity is conserved along particle trajectories following a transport velocity that includes the Bolus velocity in a manner exactly analogous to the continuity and tracer equations. In addition (and in contrast to traditional GM closures), the new formulation of the inviscid momentum equation results in a conservative exchange between potential and kinetic forms of energy. The inviscid form of the eddy closure conserves total energy to within an error proportional to the time derivative of the Bolus velocity. The hypothesis that the viscous term in the momentum equation should give rise to potential vorticity being diffused along isopycnals in a manner analogous to other tracers is examined in detail. While the form of the momentum closure that follows from a strict adherence to this hypothesis is not immediately interpretable within the constructs of traditional momentum closures, three approximations to this hypothesis results in a form of dissipation that is consistent with traditional Laplacian diffusion. The first two approximations are that relative vorticity, not potential vorticity, is diffused along isopyncals and that the flow is in approximate geostrophic balance. An additional approximation to the Jacobian term is required when the dissipation coefficient varies in space. More importantly, the critique of this hypothesis results in the conclusion that the viscosity parameter in the momentum equation should be identical to the tradition GM closure parameter {Kappa}. Overall, we deem the viscous form of the eddy closure for potential vorticity as a viable closure for use in ocean circulation models.

  4. Urethral patterns on micturition cystourethrography in adult males with subvesical obstruction

    Manoliu, R.A.


    Reexamination of the micturition cystourethrograms in 289 adult male patients with subvesical obstruction proved that the cause of the narrowing can be accurately diagnosed on the pattern of the urethral lumen. The radiologic and the final urologic diagnoses coincided in 87,5 per cent of all cases. The narrowing localized to the bladder outlet associated with short supracollicular urethra correlated well with the urologic diagnosis of bladder neck contracture. In this group 37,9 per cent of the cases presented evidence for an inflammatory etiology. 19 per cent of the same group had patterns which resembled very much nodular hyperplasia. Other possible etiologies for the bladder neck contracture did not appear to produce characteristic patterns.

  5. Penile Urethral Hypospadias with Two Fistulae and Diverticulum in a Saanen Kid

    Areeg Mohamed Almubarak


    Full Text Available Hypospadias is a rare congenital defect reported in most animal species and humans. This case study reports a hypospadiac case in a goat kid with urethral diverticulum diagnosed in Sudan for the first time. A 45-day-old male kid was presented to the Veterinary Teaching Hospital, College of Veterinary Medicine, Sudan University of Science and Technology (SUST, with a history of an increasing prescrotal swelling. At presentation in the clinic the kid was bright and alert and the vital parameters were within the normal physiological range. Ultrasonography was performed to assess the integrity of the urinary system using (3.5–5 MHz curvilinear probe and it revealed normal kidneys and a distended urinary bladder. The kid was referred to surgery and two hypospadiac urinary fistulae were found. One fistula was sutured and the other was not corrected due to catheterization failure.




    Full Text Available INTRODUCTION: Mid Urethral Slings is the main stay of therapy in the management of stress urinary incontinence in the female, w e evaluated the effect of TVT on sexual function in women who are from the rural backward districts of Rayalaseema districts of Andhra Pradesh. MATERIALS & METHODS: 30 Women with a mean age of 44 yrs with SUI were evaluated before TVT procedure and then every 3months for 1yr for sexual health using NSF - 9 questionnaire . RESULTS: The sexual function in all the domains including desire, frequency ar ousal , orgasm remained the same as before surgery in more than 80% pts. The satisfaction rate was better in pts who were leaking during sex before surgery in six out of ten patients. CONCLUSIONS: TVT surgery does not have any significant impact on sexual function Sexual function is not an important issue for the female beyond the age of 40 yrs in the perimenopau s e/ post menopause period

  7. Prostatic urethral lift: A minimally invasive treatment for benign prostatic hyperplasia.

    Garcia, Cindy; Chin, Peter; Rashid, Prem; Woo, Henry H


    Prostatic urethral lift (PUL) is a minimally invasive procedure for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. The procedure may be performed under local, spinal, or general anesthesia. The PUL procedure involves the delivery of implants that retract obstructing prostate lobes. Unlike other benign prostatic hyperplasia treatment options including pharmacological therapy, and the current invasive gold-standard transurethral resection of the prostate, the PUL procedure achieves quantifiable improvements in functional outcomes and quality of life, in the absence of major adverse events. Furthermore, improvement in LUTS may be attained while preserving erectile and ejaculatory function. Adverse effects associated with the PUL procedure are mild to moderate, and are transient in nature. The PUL procedure provides an alternative for men seeking treatment for bothersome LUTS, with fewer side-effects.

  8. Periurethral muscle-derived mononuclear cell injection improves urethral sphincter restoration in rats.

    Turco, Marcelo Pitelli; de Souza, Alex Balduino; de Campos Sousa, Isida; Fratini, Paula; Veras, Mariana Matera; Rodrigues, Marcio Nogueira; de Bessa, José; Brolio, Marina Pandolphi; Leite, Katia Ramos Moreira; Bruschini, Homero; Srougi, Miguel; Miglino, Maria Angélica; Gomes, Cristiano Mendes


    Investigate the effect of a novel cell-based therapy with skeletal muscle-derived mononuclear cells (SMDMCs) in a rat model of stress urinary incontinence. Male Wistar-Kyoto rats' hind limb muscles were enzymatically dissociated, and SMDMCs were isolated without needing expansion. The cell population was characterized. Twenty female rats underwent urethrolysis. One week later, 10 rats received periurethral injection of 10(6) cells (SMDMC group), and 10 rats received saline injections (Saline group). Ten rats underwent sham surgery (Sham group). Four weeks after injection, animals were euthanized and the urethra was removed. The incorporation of SMDMCs in the female urethra was evaluated with fluorescence in situ hybridization for the detection of Y-chromosomes. Hematoxylin and eosin, Masson's trichrome staining, and immunohistochemistry for actin and myosin were performed. The muscle/connective tissue, actin and myosin ratios were calculated. Morphological evaluation of the urethral diameters and fractional areas of the lumen, mucosa, and muscular layer was performed. SMDMCs population was consistent with the presence of muscle cells, muscle satellite cells, perivascular cells, muscle progenitor cells, and endothelial cells. SMDMCs were incorporated into the urethra. A significant decrease in the muscle/connective tissue ratio was observed in the Saline group compared with the SMDMC and Sham groups. The proportions of actin and myosin were significantly decreased in the Saline group. No differences were observed in the morphometric parameters. SDMSC were incorporated into the rat urethra and promoted histological recovery of the damaged urethral sphincter, resulting in decreased connective tissue deposition and increased muscle content. © 2017 Wiley Periodicals, Inc.

  9. Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

    Negar Taleschian-Tabrizi


    Full Text Available Background It is believed that healthcare staff play an important role in minimizing complications related to urethral catheterization. The purpose of this study was to determine whether or not healthcare staff complied with the standards for urethral catheterization. Methods This study was conducted in Imam Reza teaching hospital, Tabriz, Iran, from July to September 2013. A total of 109 catheterized patients were selected randomly from surgical and medical wards and intensive care units (ICUs. A questionnaire was completed by healthcare staff for each patient to assess quality of care provided for catheter insertion, while catheter in situ, draining and changing catheter bags. Items of the questionnaire were obtained from guidelines for the prevention of infection. Data analysis was performed with SPSS 16. Results The mean age of the patients was 50.54 ± 22.13. Of the 109 patients, 56.88% were admitted to ICUs. The mean duration of catheter use was 15.86 days. Among the 25 patients who had a urinalysis test documented in their hospital records, 11 were positive for urinary tract infection (UTI. The lowest rate of hand-washing was reported before bag drainage (49.52%. The closed drainage catheter system was not available at all. Among the cases who had a daily genital area cleansing, in 27.63% cases, the patients or their family members performed the washing. In 66.35% of cases, multiple-use lubricant gel was applied; single-use gel was not available. The rate of documentation for bag change was 79%. Conclusion The majority of the guideline statements was adhered to; however, some essential issues, such as hand hygiene were neglected. And some patients were catheterized routinely without proper indication. Limiting catheter use to mandatory situations and encouraging compliance with guidelines are recommended.

  10. The Assessment of Bladder and Urethral Function in Spinal Cord Injury Patients

    Zhong CHEN; Shuangquan SUN; Rongjin DENG; Dan CAI; Xiaoyi YUAN; Guanghui DU; Weimin YANG; Zhangqun YE


    The correlation between the anatomic site of spinal cord injury and real-time conditions of bladder and urethral function was assessed in order to provide a reasonable basis for the clinical treat-ment of neurogenic bladder. A total of 134 patients with spinal cord injuries (105 males, 29 females;averaged 34.1 years old) were involved in this retrospective analysis, including urodynamic evaluation,clinical examination and imaging for anatomical position, and Bors-Comarr classification. The associa-tions between the levels of injury and urodynamic findings were analyzed. The results showed that mean follow-up duration was 16.7 months (range 8-27 months). Complete spinal cord injuries occurred in 21 cases, and incomplete spinal cord injuries in 113 cases. Of the 43 patients with upper motor neu-ron (UMN) injuries, hyperreflexia and (or) detmsor sphincter dyssynergia were demonstrated in 30 (69.8%), 31 (72.1%) suffered low bladder compliance (less than 12.5 mL/cmH2O), 28 (65.1%) had high detrusor leak point pressures (greater than 40 cmH2O), and 34 (79.1%) had residual urine. Of the 91 pa-tients with lower motor neuron (LMN) injuries, areflexia occurred in 78 (85.7%), high compliance in 75 (82.4%), low leak point pressures in 80 (87.9%), and residual urine in 87 (95.6%), respectively. The as-sociations between the anatomical site of spinal cord injury and urodynamic findings were ill defined. In patients with spinal cord injury, this study revealed a significant association between the level of injury and the type of voiding dysfunction. The anatomical site of spinal cord injury can not be predicted in real-time condition of bladder and urethral function. Management of neurogenic bladder in patients with spinal cord injury must be based on urodynamic findings rather than inferences from the neurologic evaluation.

  11. In-vivo laser induced urethral stricture animal model for investigating the potential of LDR-brachytherapy

    Sroka, Ronald; Lellig, Katja; Bader, Markus; Stief, Christian; Weidlich, Patrick; Wechsel, G.; Assmann, Walter; Becker, R.; Fedorova, O.; Khoder, Wael


    Purpose: Treatment of urethral strictures is a major challenge in urology. For investigation of different treatment methods an animal model was developed by reproducible induction of urethral strictures in rabbits to mimic the human clinical situation. By means of this model the potential of endoluminal LDR brachytherapy using β-irradiation as prophylaxis of recurrent urethral strictures investigated. Material and Methods: A circumferential urethral stricture was induced by energy deposition using laser light application (wavelength λ=1470 nm, 10 W, 10 s, applied energy 100 J) in the posterior urethra of anaesthetized New Zealand White male rabbits. The radial light emitting fiber was introduced by means of a children resectoscope (14F). The grade of urethral stricture was evaluated in 18 rabbits using videourethroscopy and urethrography at day 28 after stricture induction. An innovative catheter was developed based on a β-irradiation emitting foil containing 32P, which was wrapped around the application system. Two main groups (each n=18) were separated. The "internal urethrotomy group" received after 28days of stricture induction immediately after surgical urethrotomy of the stricture the radioactive catheter for one week in a randomized, controlled and blinded manner. There were 3 subgroups with 6 animals each receiving 0 Gy, 15 Gy and 30 Gy. In contrast animals from the "De Nuovo group" received directly after the stricture induction (day 0) the radioactive catheter also for the duration of one week divided into the same dose subgroups. In order to determine the radiation tolerance of the urethral mucosa, additional animals without any stricture induction received a radioactive catheter applying a total dose of 30 Gy (n=2) and 15 Gy (n=1). Cystourethrography and endoscopic examination of urethra were performed on all operation days for monitoring treatment progress. Based on these investigation a classification of the stricture size was performed and

  12. High-pressure balloon dilation for male anterior urethral stricture:single-center experience

    Shi-cheng YU; Hai-yang WU; Wei WANG; Li-wei XU; Guo-qing DING; Zhi-gen ZHANG; Gong-hui LI‡


    题目:高压球囊扩张治疗男性前尿道狭窄:单中心的临床经验  目的:评估高压球囊扩张治疗男性前尿道狭窄的有效性和安全性。  创新点:既往高压球囊扩张技术已成熟应用于输尿管狭窄的临床治疗,我们将这一技术拓宽应用于男性前尿道狭窄的治疗,并证明高压球囊扩张治疗前尿道狭窄同样安全、有效。  方法:采用回顾性病例对照研究,收集并分析了31例接受高压球囊扩张和25例接受直视下尿道内切开术治疗的前尿道患者的病例资料,比较两组患者的手术时间、手术难易程度、术后并发症(出血和感染)、术后1年狭窄复发率和术后3年狭窄复发率等相关指标。  结论:高压球囊扩张组的手术时间和术后并发症发生率要优于直视下尿道内切开术组,两组患者的远期尿道狭窄复发率无统计学差异,但高压球囊扩张组的术后1年狭窄复发率明显低于直视下尿道内切开术组。高压球囊扩张治疗男性前尿道狭窄是安全、有效的,且近期疗效要优于传统腔内治疗方式。%Objectives: We retrospectively reviewed the urethral stricture cases treated in our tertiary center, and assessed the safety and feasibility of the high-pressure baloon dilation (HPBD) technique for anterior urethral stricture. Methods: From January 2009 to December 2012, a total of 31 patients with anterior urethral strictures underwent HPBD at our center, while another 25 cases were treated by direct vision internal urethrotomy (DVIU). Patient de-mographics, stricture characteristics, surgical techniques, and operative outcomes were assessed and compared between the two groups. The Kaplan-Meier survival analysis was applied to evaluate the stricture-free rate for the two surgical techniques. Results: The operation time was much shorter for the HPBD procedure than for the DVIU ((13.19±2.68) min vs. (18.44±3.29) min,P<0

  13. Maximal inequalities for demimartingales and their applications

    WANG XueJun; HU ShuHe


    In this paper,we establish some maximal inequalities for demimartingales which generalize and improve the results of Christofides.The maximal inequalities for demimartingales are used as key inequalities to establish other results including Doob's type maximal inequality for demimartingales,strong laws of large numbers and growth rate for demimartingales and associated random variables.At last,we give an equivalent condition of uniform integrability for demisubmartingales.

  14. Maximal inequalities for demimartingales and their applications


    In this paper, we establish some maximal inequalities for demimartingales which generalize and improve the results of Christofides. The maximal inequalities for demimartingales are used as key inequalities to establish other results including Doob’s type maximal inequality for demimartingales, strong laws of large numbers and growth rate for demimartingales and associated random variables. At last, we give an equivalent condition of uniform integrability for demisubmartingales.


    A. Chelli


    Full Text Available We provide a complete theory of the phase closure of a binary system in which a small, feeble, and unresolved companion acts as a perturbing parameter on the spatial frequency spectrum of a dominant, bright, resolved source. We demonstrate that the in uence of the companion can be measured with precision by measuring the phase closure of the system near the nulls of the primary visibility function. In these regions of phase closure nulling, frequency intervals always exist where the phase closure signature of the companion is larger than any systematic error and can thus be measured. We show that this technique allows retrieval of many astrophysically relevant properties of faint and close companions such as ux, position, and in favorable cases, spectrum. As a proof of concept, using the AMBER/VLTI instrument with 3 auxiliary telescopes of 1.8 m and only 15 minutes of on-sky integration, we detected the ve magnitudes fainter companion of HD 59717 at only 3.5 stellar radii distance from the primary. This is one of the highest contrast detected by interferometry between a companion and its parent star. We conclude by a rapid study of the potentialities of phase closure nulling observations with current interferometers and explore the requirements for a new type of dedicated instrument.

  16. Space Station evolution study oxygen loop closure

    Wood, M. G.; Delong, D.


    In the current Space Station Freedom (SSF) Permanently Manned Configuration (PMC), physical scars for closing the oxygen loop by the addition of oxygen generation and carbon dioxide reduction hardware are not included. During station restructuring, the capability for oxygen loop closure was deferred to the B-modules. As such, the ability to close the oxygen loop in the U.S. Laboratory module (LAB A) and the Habitation A module (HAB A) is contingent on the presence of the B modules. To base oxygen loop closure of SSF on the funding of the B-modules may not be desirable. Therefore, this study was requested to evaluate the necessary hooks and scars in the A-modules to facilitate closure of the oxygen loop at or subsequent to PMC. The study defines the scars for oxygen loop closure with impacts to cost, weight and volume and assesses the effects of byproduct venting. In addition, the recommended scenarios for closure with regard to topology and packaging are presented.

  17. Task-oriented maximally entangled states

    Agrawal, Pankaj; Pradhan, B, E-mail: agrawal@iopb.res.i, E-mail: bpradhan@iopb.res.i [Institute of Physics, Sachivalaya Marg, Bhubaneswar, Orissa 751 005 (India)


    We introduce the notion of a task-oriented maximally entangled state (TMES). This notion depends on the task for which a quantum state is used as the resource. TMESs are the states that can be used to carry out the task maximally. This concept may be more useful than that of a general maximally entangled state in the case of a multipartite system. We illustrate this idea by giving an operational definition of maximally entangled states on the basis of communication tasks of teleportation and superdense coding. We also give examples and a procedure to obtain such TMESs for n-qubit systems.

  18. Inflation in maximal gauged supergravities

    Kodama, Hideo [Theory Center, KEK,Tsukuba 305-0801 (Japan); Department of Particles and Nuclear Physics,The Graduate University for Advanced Studies,Tsukuba 305-0801 (Japan); Nozawa, Masato [Dipartimento di Fisica, Università di Milano, and INFN, Sezione di Milano,Via Celoria 16, 20133 Milano (Italy)


    We discuss the dynamics of multiple scalar fields and the possibility of realistic inflation in the maximal gauged supergravity. In this paper, we address this problem in the framework of recently discovered 1-parameter deformation of SO(4,4) and SO(5,3) dyonic gaugings, for which the base point of the scalar manifold corresponds to an unstable de Sitter critical point. In the gauge-field frame where the embedding tensor takes the value in the sum of the 36 and 36’ representations of SL(8), we present a scheme that allows us to derive an analytic expression for the scalar potential. With the help of this formalism, we derive the full potential and gauge coupling functions in analytic forms for the SO(3)×SO(3)-invariant subsectors of SO(4,4) and SO(5,3) gaugings, and argue that there exist no new critical points in addition to those discovered so far. For the SO(4,4) gauging, we also study the behavior of 6-dimensional scalar fields in this sector near the Dall’Agata-Inverso de Sitter critical point at which the negative eigenvalue of the scalar mass square with the largest modulus goes to zero as the deformation parameter s approaches a critical value s{sub c}. We find that when the deformation parameter s is taken sufficiently close to the critical value, inflation lasts more than 60 e-folds even if the initial point of the inflaton allows an O(0.1) deviation in Planck units from the Dall’Agata-Inverso critical point. It turns out that the spectral index n{sub s} of the curvature perturbation at the time of the 60 e-folding number is always about 0.96 and within the 1σ range n{sub s}=0.9639±0.0047 obtained by Planck, irrespective of the value of the η parameter at the critical saddle point. The tensor-scalar ratio predicted by this model is around 10{sup −3} and is close to the value in the Starobinsky model.

  19. 男性尿道癌3例报告%Urethral carcinoma of male: a report of 3 cases

    闵立贵; 王英刚


    Objective To investigate the clinical feature, diagnosis and treatment of carcinoma of male urethral carcinoma. Methods The data of 3 cases of urethral carcinoma of male, diagnosed and treated in our hospital from 2000 to 2008, were summarized and discussed. Results The 3 cases included 2 cases of urethral squamous cancer and 1 case of transitional Cell carcinoma. One patient with urcthral squamous cancer, who died because of myocardial infarction 2 years after operation. underwent radical cystectomy, prostatovesiculectomy. phallectomy, pubis ablation, pelvic lymphadenectomy and ileum conduit urinary diversion. The other patient underwent the same operation but is still alive. The patient with transitional cell carcinoma was treated with transurethral electrocision of postcrior urethral carcinoma and partial resection of prostate,died half a year after operation because of sudden death. Conclusions Surgery is the primary treatment for male patients with urethral carcinoma. while radiotherapy combined with chemotherapy is secondary. Long-term survival is related to tumor position , clinical classification and pathological grade. The prognosis of distal urethral carcinoma is more favorable than that of bulbar and membranous urechral carcinoma.%目的 探讨男性尿道癌临床特点和诊治措施.方法 总结本院2000~2008年诊治的3例男性尿道癌的临床资料,并结合文献讨论.结果 男性尿道鳞癌2例,移行细胞癌1例.1例尿道鳞癌行膀胱、前列腺、精囊、阴茎全切和盆腔淋巴结清扫术及回肠膀胱术,术后2年死于心肌梗死.1例尿道鳞癌行膀胱、前列腺、精囊、阴茎全切、耻骨部分切除和盆腔淋巴结清扫术以及回肠膀胱术,存活至今.1例尿道移行细胞癌行姑息性经尿道后尿道肿瘤电切和前列腺部分电切,术后半年患者死于心肺疾病.结论 男性尿道癌以手术治疗为主,辅助化疗和放疗,其预后与肿瘤部位、临床分级和病理分级

  20. A congenital anterior urethral diverticulum associated with obstructive urinary symptoms in a 1-year-old male child: A case report and review of the literature

    Mehmet Hanifi Okur


    Full Text Available Congenital anterior urethral diverticula are rarely found in children. We present the case of a 1-year-old male child with a congenital anterior urethral diverticulum. This condition can lead to obstructive lower urinary tract symptoms and urosepsis. The clinical presentation, diagnosis, and management of this rare condition are discussed in this report. The diagnosis was made using retrograde urethrography. Patient was treated with open diverticulectomy and urethroplasty

  1. Median sternotomy closure: review and update research

    Hua Kun; Yang Xiubin


    Cardiac surgery is a very common operation nowadays all over the world. Median stemotomy is a routine procedure required for cardiac access during open heart surgery. The complications of this procedure after the cardiac surgery range from 0.7% to 1.5% of all cases, and bear a high mortality rate if they occur. Every individual surgeon must pay great attention on every detail during the sternal closure. This article shows the details as to conventional information and updated progress on median sternotomy closure. The update contents involve in biomechanics, number of wires twists, biomaterial and so on.According to our experience, we recommend four peristernal single/double steel wires for sternal closure as our optimal choice.

  2. Biological constraints do not entail cognitive closure.

    Vlerick, Michael


    From the premise that our biology imposes cognitive constraints on our epistemic activities, a series of prominent authors--most notably Fodor, Chomsky and McGinn--have argued that we are cognitively closed to certain aspects and properties of the world. Cognitive constraints, they argue, entail cognitive closure. I argue that this is not the case. More precisely, I detect two unwarranted conflations at the core of arguments deriving closure from constraints. The first is a conflation of what I will refer to as 'representation' and 'object of representation'. The second confuses the cognitive scope of the assisted mind for that of the unassisted mind. Cognitive closure, I conclude, cannot be established from pointing out the (uncontroversial) existence of cognitive constraints.

  3. Hanford Patrol Academy demolition sites closure plan


    The Hanford Site is owned by the U.S. Government and operated by the U.S. Department of Energy, Richland Operations Office. Westinghouse Hanford Company is a major contractor to the U.S. Department of Energy, Richland Operations Office and serves as co-operator of the Hanford Patrol Academy Demolition Sites, the unit addressed in this paper. This document consists of a Hanford Facility Dangerous Waste Part A Permit Application, Form 3 (Revision 4), and a closure plan for the site. An explanation of the Part A Form 3 submitted with this closure plan is provided at the beginning of the Part A section. This Hanford Patrol Academy Demolition Sites Closure Plan submittal contains information current as of December 15, 1994.

  4. Adapting MARSSIM for FUSRAP site closure.

    Johnson, Robert; Durham, L; Rieman, C


    The Multi-Agency Radiation Survey and Site Investigation Manual (MARSSIM) provides a coherent, technically defensible process for establishing that exposed surfaces satisfy site cleanup requirements. Unfortunately, many sites have complications that challenge a direct application of MARSSIM. Example complications include Record of Decision (ROD) requirements that are not MARSSIM-friendly, the potential for subsurface contamination, and incomplete characterization information. These types of complications are typically the rule, rather than the exception, for sites undergoing radiologically-driven remediation and closure. One such site is the Formerly Utilized Sites Remedial Action Program (FUSRAP) Linde site in Tonawanda, New York. Cleanup of the site is currently underway. The Linde site presented a number of challenges to designing and implementing a closure strategy consistent with MARSSIM. This paper discusses some of the closure issues confronted by the U.S. Army Corps of Engineers Buffalo District at the Linde site and describes how MARSSIM protocols were adapted to address these issues.

  5. Computing Maximally Supersymmetric Scattering Amplitudes

    Stankowicz, James Michael, Jr.

    This dissertation reviews work in computing N = 4 super-Yang--Mills (sYM) and N = 8 maximally supersymmetric gravity (mSUGRA) scattering amplitudes in D = 4 spacetime dimensions in novel ways. After a brief introduction and overview in Ch. 1, the various techniques used to construct amplitudes in the remainder of the dissertation are discussed in Ch. 2. This includes several new concepts such as d log and pure integrand bases, as well as how to construct the amplitude using exactly one kinematic point where it vanishes. Also included in this chapter is an outline of the Mathematica package on shell diagrams and numerics.m (osdn) that was developed for the computations herein. The rest of the dissertation is devoted to explicit examples. In Ch. 3, the starting point is tree-level sYM amplitudes that have integral representations with residues that obey amplitude relations. These residues are shown to have corresponding residue numerators that allow a double copy prescription that results in mSUGRA residues. In Ch. 4, the two-loop four-point sYM amplitude is constructed in several ways, showcasing many of the techniques of Ch. 2; this includes an example of how to use osdn. The two-loop five-point amplitude is also presented in a pure integrand representation with comments on how it was constructed from one homogeneous cut of the amplitude. On-going work on the two-loop n-point amplitude is presented at the end of Ch. 4. In Ch. 5, the three-loop four-point amplitude is presented in the d log representation and in the pure integrand representation. In Ch. 6, there are several examples of four- through seven-loop planar diagrams that illustrate how considerations of the singularity structure of the amplitude underpin dual-conformal invariance. Taken with the previous examples, this is additional evidence that the structure known to exist in the planar sector extends to the full theory. At the end of this chapter is a proof that all mSUGRA amplitudes have a pole at

  6. 2401-W Waste storage building closure plan

    LUKE, S.M.


    This plan describes the performance standards met and closure activities conducted to achieve clean closure of the 2401-W Waste Storage Building (2401-W) (Figure I). In August 1998, after the last waste container was removed from 2401-W, the U.S. Department of Energy, Richland Operations Office (DOE-RL) notified Washington State Department of Ecology (Ecology) in writing that the 2401-W would no longer receive waste and would be closed as a Resource Conservation and Recovery Act (RCRA) of 1976 treatment, storage, and/or disposal (TSD) unit (98-EAP-475). Pursuant to this notification, closure activities were conducted, as described in this plan, in accordance with Washington Administrative Code (WAC) 173-303-610 and completed on February 9, 1999. Ecology witnessed the closure activities. Consistent with clean closure, no postclosure activities will be necessary. Because 2401-W is a portion of the Central Waste Complex (CWC), these closure activities become the basis for removing this building from the CWC TSD unit boundary. The 2401-W is a pre-engineered steel building with a sealed concrete floor and a 15.2-centimeter concrete curb around the perimeter of the floor. This building operated from April 1988 until August 1998 storing non-liquid containerized mixed waste. All waste storage occurred indoors. No potential existed for 2401-W operations to have impacted soil. A review of operating records and interviews with cognizant operations personnel indicated that no waste spills occurred in this building (Appendix A). After all waste containers were removed, a radiation survey of the 2401-W floor for radiological release of the building was performed December 17, 1998, which identified no radiological contamination (Appendix B).

  7. Final Clean Closure Report Site 300 Surface Impoundments Closure Lawrence Livermore National Laboratory Livermore, California

    Haskell, K


    Lawrence Livermore National Laboratory operated two Class II surface impoundments that stored wastewater that was discharged from a number of buildings located on the Site 300 Facility (Site 300). The wastewater was the by-product of explosives processing. Reduction in the volume of water discharged from these buildings over the past several years significantly reduced the wastewater storage needs. In addition, the impoundments were constructed in 1984, and the high-density polyethylene (HDPE) geomembrane liners were nearing the end of their service life. The purpose of this project was to clean close the surface impoundments and provide new wastewater storage using above ground storage tanks at six locations. The tanks were installed and put into service prior to closure of the impoundments. This Clean Closure Report (Closure Report) complies with State Water Resources Control Board (SWRCB) Section 21400 of the California Code of Regulations Title 27 (27 CCR section 21400). As required by these regulations and guidance, this Closure Report provides the following information: (1) a brief site description; (2) the regulatory requirements relevant to clean closure of the impoundments; (3) the closure procedures; and (4) the findings and documentation of clean closure.

  8. Impacted anterior urethral calculus complicated by a stone-containing diverticulum in an elderly man: outcome of transurethral lithotripsy without resection of the diverticulum.

    Zhou, Tie; Chen, Guanghua; Zhang, Wei; Peng, Yonghan; Xiao, Liang; Xu, Chuangliang; Sun, Yinghao


    The prevalence of lower urinary tract symptoms (LUTS) is about 20% in men aged 40 or above. Other than benign prostatic hyperplasia (BPH), urethral diverticulum or calculus is not uncommon for LUTS in men. Surgical treatment is often recommended for urethral diverticulum or calculus, but treatment for an impacted urethral calculus complicated by a stone-containing diverticulum is challenging. An 82-year-old man had the persistence of LUTS despite having undergone transurethral resection of prostate for BPH. Regardless of treatment with broad spectrum antibiotics and an α-blocker, LUTS and post-void residual urine volume (100 mL) did not improve although repeated urinalysis showed reduction of WBCs from 100 to 10 per high power field. Further radiology revealed multiple urethral calculi and the stone configuration suggested the existence of a diverticulum. He was successfully treated without resecting the urethral diverticulum; and a new generation of ultrasound lithotripsy (EMS, Nyon, Switzerland) through a 22F offset rigid Storz nephroscope (Karl Storz, Tuttingen, Germany) was used to fragment the stones. The operative time was 30 minutes and the stones were cleanly removed. The patient was discharged after 48 hours with no immediate complications and free of LUTS during a 2 years follow-up. When the diverticulum is the result of a dilatation behind a calculus, removal of the calculus is all that is necessary. Compared with open surgery, ultrasound lithotripsy is less invasive with little harm to urethral mucosa; and more efficient as it absorbs stone fragments while crushing stones.

  9. A comparison of surgical outcomes of perineal urethrostomy plus penile resection and perineal urethrostomy in twelve calves with perineal or prescrotal urethral dilatation

    M.A. Marzok


    Full Text Available The clinical diagnosis, ultrasonographic findings, surgical management, outcome, and survival rate of perineal or prescrotal urethral dilatation in 12 male calves are described. All calves were crossbred and intact males. The most noticeable clinical presentations were perineal (n= 10 or prescrotal (n= 2 swellings and micturition problems. The main ultrasonographic findings were oval shaped dilatation of the urethra in all animals with dimensions of 40-75 X 30-62 mm. The calves with perineal urethral dilatation were treated by perineal urethrostomy (n= 4 and partial penile transection including the dilated urethra and urethral fistulation (n= 6. Prescrotal urethral dilatations were treated by penile transection proximal to the dilatation site (n= 2. Cystitis and stricture of the urethra were recorded postoperatively for two of the calves that underwent perineal urethrostomy. Nine animals were slaughtered at normal body weight approximately 6-8 months after the surgical treatment. Three animals were slaughtered after approximately three to four months, two of them having gained insufficient body weight. Our study shows that ultrasonography is a useful tool for the diagnosis of urethral dilatation in bovine calves. Our study also shows that the partial penile transection may be a suitable and satisfactory choice of surgical treatment for correcting the urethral dilatation in bovine calves.

  10. Closure properties of Watson-Crick grammars

    Zulkufli, Nurul Liyana binti Mohamad; Turaev, Sherzod; Tamrin, Mohd Izzuddin Mohd; Azeddine, Messikh


    In this paper, we define Watson-Crick context-free grammars, as an extension of Watson-Crick regular grammars and Watson-Crick linear grammars with context-free grammar rules. We show the relation of Watson-Crick (regular and linear) grammars to the sticker systems, and study some of the important closure properties of the Watson-Crick grammars. We establish that the Watson-Crick regular grammars are closed under almost all of the main closure operations, while the differences between other Watson-Crick grammars with their corresponding Chomsky grammars depend on the computational power of the Watson-Crick grammars which still need to be studied.

  11. The effect of plant closure on crime

    Rege, Mari; Skarðhamar, Torbjørn; Telle, Kjetil; Votruba, Mark


    We estimate the effect of exposure to plant closure on crime using an individual-level panel data set containing criminal charges for all unmarried and employed Norwegian men below the age of 40. Men originally employed in plants that subsequently closed are 14 percent more likely to be charged of a crime than comparable men in stable plants. There is no difference in charge rates prior to closure, supporting a causal interpretation of our result. Within crime categories, we find no effect of...

  12. Straight line closure of congenital macrostomia

    Schwarz Richard


    Full Text Available The results of patients operated on by Nepal Cleft Lip and Palate Association (NECLAPA surgeons for congenital macrostomia were prospectively studied between January 2000 and December 2002. There were four males and three females with a median age of 10 years. Three had an associated branchial arch syndrome. In all patients an overlapping repair of orbicularis oris was done. Six patients had a straight line closure with excellent cosmetic results and one a Z-plasty with a more obvious scar. All had a normal appearing commissure. Overlapping orbicularis repair with straight line skin closure for this rare congenital anomaly is recommended.

  13. Are all maximally entangled states pure?

    Cavalcanti, D; Terra-Cunha, M O


    In this Letter we study if all maximally entangled states are pure through several entanglement monotones. Our conclusions allow us to generalize the idea of monogamy of entanglement. Then we propose a polygamy of entanglement, which express that if a general multipartite state is maximally entangled it is necessarily factorized by any other system.

  14. Sampling and Representation Complexity of Revenue Maximization

    Dughmi, Shaddin; Han, Li; Nisan, Noam


    We consider (approximate) revenue maximization in auctions where the distribution on input valuations is given via "black box" access to samples from the distribution. We observe that the number of samples required -- the sample complexity -- is tightly related to the representation complexity of an approximately revenue-maximizing auction. Our main results are upper bounds and an exponential lower bound on these complexities.

  15. New Maximal Two-distance Sets

    Lisonek, Petr


    our classifications confirmthe maximality of previously known sets, the results in E^7 and E^8are new. Their counterpart in dimension larger than 10is a set of unit vectors with only two values of inner products in the Lorentz space R^{d,1}.The maximality of this set again follows from a bound due...

  16. An ethical justification of profit maximization

    Koch, Carsten Allan


    In much of the literature on business ethics and corporate social responsibility, it is more or less taken for granted that attempts to maximize profits are inherently unethical. The purpose of this paper is to investigate whether an ethical argument can be given in support of profit maximizing b...

  17. Alternative trailer configurations for maximizing payloads

    Jason D. Thompson; Dana Mitchell; John Klepac


    In order for harvesting contractors to stay ahead of increasing costs, it is imperative that they employ all options to maximize productivity and efficiency. Transportation can account for half the cost to deliver wood to a mill. Contractors seek to maximize truck payload to increase productivity. The Forest Operations Research Unit, Southern Research Station, USDA...

  18. Cohomology of Weakly Reducible Maximal Triangular Algebras

    董浙; 鲁世杰


    In this paper, we introduce the concept of weakly reducible maximal triangular algebras φwhich form a large class of maximal triangular algebras. Let B be a weakly closed algebra containing 5φ, we prove that the cohomology spaces Hn(φ, B) (n≥1) are trivial.

  19. Inclusive fitness maximization: An axiomatic approach.

    Okasha, Samir; Weymark, John A; Bossert, Walter


    Kin selection theorists argue that evolution in social contexts will lead organisms to behave as if maximizing their inclusive, as opposed to personal, fitness. The inclusive fitness concept allows biologists to treat organisms as akin to rational agents seeking to maximize a utility function. Here we develop this idea and place it on a firm footing by employing a standard decision-theoretic methodology. We show how the principle of inclusive fitness maximization and a related principle of quasi-inclusive fitness maximization can be derived from axioms on an individual׳s 'as if preferences' (binary choices) for the case in which phenotypic effects are additive. Our results help integrate evolutionary theory and rational choice theory, help draw out the behavioural implications of inclusive fitness maximization, and point to a possible way in which evolution could lead organisms to implement it. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Maximal Hypersurfaces in Spacetimes with Translational Symmetry

    Bulawa, Andrew


    We consider four-dimensional vacuum spacetimes which admit a free isometric spacelike R-action. Taking a quotient with respect to the R-action produces a three-dimensional quotient spacetime. We establish several results regarding maximal hypersurfaces (spacelike hypersurfaces of zero mean curvature) in quotient spacetimes. First, we show that complete noncompact maximal hypersurfaces must either be flat cylinders S^1 x R or conformal to the Euclidean plane. Second, we establish a positive mass theorem for certain maximal hypersurfaces. Finally, while it is meaningful to use a bounded lapse when adopting the maximal hypersurface gauge condition in the four-dimensional (asymptotically flat) setting, it is shown here that nontrivial quotient spacetimes admit the maximal hypersurface gauge only with an unbounded lapse.

  1. Urethral pressure reflectometry. A method for simultaneous measurements of pressure and cross-sectional area in the female urethra

    Klarskov, Niels


    per second. The examinations were performed with the women supine relaxing, supine squeezing, and standing relaxing. The examination provided measures of the opening pressure (the pressure exactly needed to open the urethra), the closing pressure (the pressure where the urethra closes again after......A novel technique for simultaneous measurements of pressure and cross-sectional area (CA) in the female urethra, denoted Urethral Pressure Reflectometry (UPR), was devised. A very thin and highly flexible polyurethane-bag was placed in the urethra. A pump applied increasing and decreasing pressures...... the hysteresis were decreased in stress urinary incontinent (SUI) women compared to continent women. Thus the parameters seem to be relevant regarding SUI. UPR examination was performed before and after urethral bulking and from these examinations a mechanism of action of the bulking procedure was proposed...

  2. Urethral pressure reflectometry, a novel technique for simultaneous recording of pressure and cross-sectional area in the prostatic urethra

    Aagaard, Mikael; Klarskov, Niels; Sønksen, Jens


    OBJECTIVE: Urethral pressure reflectometry (UPR) was introduced in 2005, for simultaneous measurement of pressure and cross-sectional area in the female urethra. It has shown to be more reproducible than conventional pressure measurement. Recently, it has been tested in the anal canal...... and the prostatic urethra. The primary aim of this study was to describe UPR in men without bothersome lower urinary tract symptoms. MATERIAL AND METHODS: The study investigated 18 men, median age 59 (range 50-77) with UPR and pressure-flow analyses (PQ), the International Prostate Symptom Score and the Danish...... version of Prostate Symptom Score, flow rate, residual urine measurements, transrectal ultrasound, urethral pressure profilometry and visual analogue scale (Discomfort). UPR parameters measured were opening and closing pressure, opening and closing elastance and hysteresis, from the bladder neck...

  3. Curative Effect of Special Acupuncture Techniques on Female Urethral Syndrome and its Relationship with the Course of Treatment

    WANG Si-you; CHEN Guo-mei; CUI Yi-jun; ZHANG Shu-jing; ZHANG Gen-feng


    Purpose To observe the curative effect of special acupuncture techniques on female urethral syndrome and its relationship with the course of treatment.Method Four abdominal and four sacral empirical points were acupunctured with special techniques and electricity. A difference in curative effect was investigated between different numbers of treatments. Results The clinical cure rate reached 15.2% just after ≤ 10 (7.3 ± 1.3) treatments. The curative effect was significantly better after 20-40 (32.1 ± 5.8) treatments than after ≤ 10 (7.3± 1.3) treatments (χ2 = 10.086, P <0.05). The clinical cure rate reached 43.5% in the former. Conclusion Special acupuncture techniques have a good clinical effect on female urethral syndrome. The curative effect improves with an increase in the number of treatments.

  4. A Case of Urethral Metastasis from Sigmoid Colon Cancer Diagnostically and Prognostically Indicated by F 18 FDG PET/CT

    Seo, Han Seok; Kim, Eun Sil; Kim, Soyon; Im, Su Jin; Park, Yong Hyun; Lee, Ju Hyoung; Hur, So Chong [National Police Hospital, Seoul (Korea, Republic of)


    Urethral metastasis from colorectal cancer is rare and is known to have a poor prognosis. A 72 year old man with a history of colectomy and colostomy due to sigmoid colon cancer was admitted to the emergency room with bowel distension, rectal bleeding and urinary symptoms. Computed tomography of the abdominopelvis showed sigmoid colon cancer with multiple metastases involving the liver. Positron emission tomography with F 18 fluorodeoxyglucose (FDG) showed multiple hypermetabolic foci in the liver, penis and pubic bone, which otherwise could not be diagnosed. The lesions revealed no improvement with chemotherapy and urological surgery on follow up F 18 FDG PET/CT. We present a case of urethral metastasis of sigmoid colon cancer diagnostically and prognostically indicated by F 18 FDG PET/CT.

  5. Role of tissue engineered buccal mucosa for treatment of urethral stricture

    Vaddi S


    Full Text Available Cell based therapies in Urology: Cell based therapy for tissue engineering in urology, like in other branches of medicine uses the principles of cell transplantation, materials science, and biomedical engineering to develop biologic substitutes that can restore and maintain function of the damaged or lost genitourinary organs. Most current strategies for tissue engineering depend on a sample of autologous cells from the diseased organ of the host. However in cases where primary autologous cells cannot be expanded, pluripotent stem cells are an ideal source. Biomaterials play a major role in genitourinary tissue engineering. They are used to replace biologic and mechanical functions of the native extracellular matrix. Three classes of biomaterials have been used for the engineering of genitourinary tissues: naturally derived materials, such as collagen and alginate; acellular tissue matrices, such as bladder submucosa and synthetic polymers, such as polyglycolic acid [1]. A lot of research is ongoing in urethral regeneration by tissue engineering and cell based therapy. Tubularized collagen matrices seeded with autologous cells are used to regenerate the urethra [2]. Urinary Bladder reconstruction is possible with bladder shaped biodegradable scaffold seeded with autologous urothelial cells and smooth muscle cells [3]. Ureteral acellular tubular grafts have been used to replace ureteral loss but with poor functional results [4]. Cell-seeded biodegradable polymer scaffolds have been used with more success to reconstruct ureteral tissues [3]. The kidney is the most challenging organ in the genitourinary system to reconstruct because of its complex structure and function. Cell based therapies are used for creation of functional renal structures in vivo. Renal tubular cells have been harvested, expanded in culture and seeded on to a tubular device to function as nephron [5]. The expansion of this system to larger three-dimensional structures is the

  6. Successful Treatment of Uncomplicated Gonococcal Urethritis in HIV-Infected Patients with Single-Dose Oral Cefpodoxime

    George Psevdos


    Full Text Available Fluoroquinolones are no longer recommended for the treatment of gonococcal infections in the United States. Cephalosporins – ceftriaxone and cefixime – are the treatment of choice, as suggested by the Centers for Disease Control and Prevention (USA. There are limited data on the efficacy of cefpodoxime for the treatment of uncomplicated gonococcal infections. Two cases of HIV-infected homosexual men who were successfully treated with cefpodoxime for urethritis caused by Neisseria gonorrhoeae are described in the present study.

  7. Urethral reconstruction with a 3D porous bacterial cellulose scaffold seeded with lingual keratinocytes in a rabbit model.

    Huang, Jian-Wen; Lv, Xiang-Guo; Li, Zhe; Song, Lu-Jie; Feng, Chao; Xie, Min-Kai; Li, Chao; Li, Hong-Bin; Wang, Ji-Hong; Zhu, Wei-Dong; Chen, Shi-Yan; Wang, Hua-Ping; Xu, Yue-Min


    The goal of this study was to evaluate the effects of urethral reconstruction with a three-dimensional (3D) porous bacterial cellulose (BC) scaffold seeded with lingual keratinocytes in a rabbit model. A novel 3D porous BC scaffold was prepared by gelatin sponge interfering in the BC fermentation process. Rabbit lingual keratinocytes were isolated, expanded, and seeded onto 3D porous BC. BC alone (group 1, N  =  10), 3D porous BC alone (group 2, N  =  10), and 3D porous BC seeded with lingual keratinocytes (group 3, N  =  10) were used to repair rabbit ventral urethral defects (2.0   ×   0.8 cm). Scanning electron microscopy revealed that BC consisted of a compact laminate while 3D porous BC was composed of a porous sheet buttressed by a dense outer layer. The average pore diameter and porosity of the 3D porous BC were 4.23   ±   1.14 μm and 67.00   ±   6.80%, respectively. At 3 months postoperatively, macroscopic examinations and retrograde urethrograms of urethras revealed that all urethras maintained wide calibers in group 3. Strictures were found in all rabbits in groups 1 and 2. Histologically, at 1 month postoperatively, intact epithelium occurred in group 3, and discontinued epithelium was found in groups 1 and 2. However, groups 2 and 3 exhibited similar epithelial regeneration, which was superior to that of group 1 at 3 months (p  3D porous BC seeded with lingual keratinocytes enhanced urethral tissue regeneration. 3D porous BC could potentially be used as an optimized scaffold for urethral reconstruction.

  8. Urodynamic evaluation of fesoterodine metabolite, doxazosin and their combination in a rat model of partial urethral obstruction

    Fuellhase, Claudius; Soler, Roberto; Gratzke, Christian; Brodsky, Marina; Christ, George J.; Andersson, Karl-Erik


    OBJECTIVETo evaluate the urodynamic effects of fesoterodine, a new antimuscarinic agent, alone and combined with doxazosin, in a rat model of partial urethral obstruction (PUO), as 35-83% of men with bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH) have overactive bladder (OAB) syndrome, and as the combination of alpha(1)-adrenoceptor- and muscarinic-receptor antagonists has been proposed to be beneficial for these patients.MATERIALS and METHODSThirty-seven mal...

  9. Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

    Tao, Huang; Jiang, Yu Yong; Jun, Qi; Ding, Xu; Jian, Duan Liu; Jie, Ding; Ping, Zhu Yu


    ABSTRACT Purpose: To determine risk factors of postoperative urethral stricture (US) and vesical neck contracture (BNC) after transurethral resection of prostate (TURP) from perioperative parameters. Materials and Methods: 373 patients underwent TURP in a Chinese center for lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO), with their perioperative and follow-up clinical data being collected. Univariate analyses were used to determine variables which had correlation with the incidence of US and BNC before logistic regression being applied to find out independent risk factors. Results: The median follow-up was 29.3 months with the incidence of US and BNC being 7.8% and 5.4% respectively. Resection speed, reduction in hemoglobin (ΔHb) and hematocrit (ΔHCT) levels, incidence of urethral mucosa rupture, re-catheterization and continuous infection had significant correlation with US, while PSA level, storage score, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), resection time and resected gland weight had significant correlation with BNC. Lower resection speed (OR=0.48), urethral mucosa rupture (OR=2.44) and continuous infection (OR=1.49) as well as higher storage score (OR=2.51) and lower TPV (OR=0.15) were found to be the independent risk factors of US and BNC respectively. Conclusions: Lower resection speed, intraoperative urethral mucosa rupture and postoperative continuous infection were associated with a higher risk of US while severer storage phase symptom and smaller prostate size were associated with a higher risk of BNC after TURP. PMID:27256185

  10. Spinal stimulation of the upper lumbar spinal cord modulates urethral sphincter activity in rats after spinal cord injury.

    Abud, Edsel M; Ichiyama, Ronaldo M; Havton, Leif A; Chang, Huiyi H


    After spinal cord injury (SCI), the neurogenic bladder is observed to develop asynchronous bladder and external urethral sphincter (EUS) contractions in a condition known as detrusor-sphincter dyssnergia (DSD). Activation of the EUS spinal controlling center located at the upper lumbar spinal cord may contribute to reduce EUS dyssynergic contractions and decrease urethral resistance during voiding. However, this mechanism has not been well studied. This study aimed at evaluating the effects of epidural stimulation (EpS) over the spinal EUS controlling center (L3) in combination with a serotonergic receptor agonist on EUS relaxation in naive rats and chronic (6-8 wk) T8 SCI rats. Cystometrogram and EUS electromyography (EMG) were obtained before and after the intravenous administration of 5HT-1A receptor agonist and antagonist. The latency, duration, frequency, amplitude, and area under curve of EpS-evoked EUS EMG responses were analyzed. EpS on L3 evoked an inhibition of EUS tonic contraction and an excitation of EUS intermittent bursting/relaxation correlating with urine expulsion in intact rats. Combined with a 5HT-1A receptor agonist, EpS on L3 evoked a similar effect in chronic T8 SCI rats to reduce urethral contraction (resistance). This study examined the effect of facilitating the EUS spinal controlling center to switch between urine storage and voiding phases by using EpS and a serotonergic receptor agonist. This novel approach of applying EpS on the EUS controlling center modulates EUS contraction and relaxation as well as reduces urethral resistance during voiding in chronic SCI rats with DSD. Copyright © 2015 the American Physiological Society.

  11. Ultrastructure and morphometry of the urethral glands in normal, castrated, and testosterone-treated castrated male mice.

    Parr, M B; Ren, H P; Kepple, L; Parr, E L; Russell, L D


    Recent studies of the urethral glands in the male mouse and rat have suggested that they are testosterone-dependent glands that may be potential sites for secretory immunity in the male genital tract. In the present study we describe the ultrastructural features of these glands in normal mice and provide quantitative data on the sizes of the acinar cells and their organelles in sham-, oil-, and testosterone-treated castrated mice. Acinar cells in urethral glands from normal mice contain numerous secretory granules, prominent Golgi complexes, elongated mitochondria, and an abundance of rough endoplasmic reticulum (RER) with large and dilated cisternae, all of which are features characteristic of secretory cells. In some acinar cells the cisternae of the RER were filled with closely packed, unbranched, straight, tubular structures that were oriented parallel to one another, that radiated from aggregates of dense material, or that were randomly arranged. In other acinar cells the cisternae of the RER showed a network of branching and anastomosing vesicular-like structures whose limiting membranes were occasionally seen in continuity with the membranes of the RER. Secretory acini showed large, unbranched tubules in the acinar lumen. When cut at right angles the large tubules exhibited a distinct fuzzy outer coat with fine projections radiating outwards. The ultrastructure of the acinar cells and the presence of tubules in the lumen suggests that they are engaged in secretion of a tubular protein. Morphometric analysis of acinar cells in the urethral glands showed that the mean volumes of nuclei, cytoplasm, secretory granules, vacuoles, and mitochondria were significantly reduced in castrated mice in comparison to either normal or testosterone-treated castrated mice. This confirms earlier observations that the urethral glands are targets of testosterone.

  12. 78 FR 20625 - Extension of Hearing Record Closure Date


    ... From the Federal Register Online via the Government Publishing Office DEFENSE NUCLEAR FACILITIES SAFETY BOARD Extension of Hearing Record Closure Date AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Extension of hearing record closure date. SUMMARY: The Defense Nuclear Facilities Safety...

  13. 77 FR 65871 - Extension of Hearing Record Closure Date


    ... From the Federal Register Online via the Government Publishing Office DEFENSE NUCLEAR FACILITIES SAFETY BOARD Extension of Hearing Record Closure Date AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Extension of hearing record closure date. SUMMARY: The Defense Nuclear Facilities Safety...

  14. Seeding cell approach for tissue-engineered urethral reconstruction in animal study: A systematic review and meta-analysis.

    Xue, Jing-Dong; Gao, Jing; Fu, Qiang; Feng, Chao; Xie, Hong


    We systematically reviewed published preclinical studies to evaluate the effectiveness of cell-seeded tissue engineering approach for urethral reconstruction in an animal model. The outcomes were summarized by success factors in the animal experiments, which evaluate the possibility and feasibility of a clinical application in the future. Preclinical studies of tissue engineering approaches for urethral reconstruction were identified through a systematic search in PubMed, Embase, and Biosis Previews (web of science SP) databases for studies published from 1 January 1980 to 23 November 2014. Primary studies were included if urethral reconstruction was performed using a tissue-engineered biomaterial in any animal species (with the experiment group being a cell-seeded scaffold and the control group being a cell-free scaffold) with histology and urethrography as the outcome measure. A total of 15 preclinical studies were included in our meta-analysis. The histology and urethrography outcome between the experimental and control groups were considered to be the most clinically relevant. Through this systematic approach, our outcomes suggested that applying the cell-seeded biomaterial in creating a neo-urethra was stable and effective. And multi-type cells including epithelial cells as well as smooth muscle cells or fibroblasts seemed to be a better strategy. Stem cells, especially after epithelial differentiation, could be a promising choice for future researches. © 2016 by the Society for Experimental Biology and Medicine.

  15. The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013.

    Hamasuna, Ryoichi; Yasuda, Mitsuru; Ishikawa, Kiyohito; Uehara, Shinya; Hayami, Hiroshi; Takahashi, Satoshi; Matsumoto, Tetsuro; Yamamoto, Shingo; Minamitani, Shinichi; Watanabe, Akira; Iwata, Satoshi; Kaku, Mitsuo; Kadota, Junichi; Sunakawa, Keisuke; Sato, Junko; Hanaki, Hideaki; Tsukamoto, Taiji; Kiyota, Hiroshi; Egawa, Shin; Tanaka, Kazushi; Arakawa, Soichi; Fujisawa, Masato; Kumon, Hiromi; Kobayashi, Kanao; Matsubara, Akio; Naito, Seiji; Kuroiwa, Kentaro; Hirayama, Hideo; Narita, Harunori; Hosobe, Takahide; Ito, Shin; Ito, Kenji; Kawai, Shuichi; Ito, Masayasu; Chokyu, Hirofumi; Matsumura, Masaru; Yoshioka, Masaru; Uno, Satoshi; Monden, Koichi; Takayama, Kazuo; Kaji, Shinichi; Kawahara, Motoshi; Sumii, Toru; Kadena, Hitoshi; Yamaguchi, Takamasa; Maeda, Shinichi; Nishi, Shohei; Nishimura, Hirofumi; Shirane, Takeshi; Yoh, Mutsumasa; Akiyama, Kikuo; Imai, Toshio; Kano, Motonori


    Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 μg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 μg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 μg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 μg/ml.

  16. An unusual cause of urinary incontinence: Urethral coitus in a case of Mayer-Rokitansky-Kuster-Hauser syndrome.

    Sharifiaghdas, Farzaneh; Daneshpajooh, Azar; Sohbati, Samira; Mirzaei, Mahboubeh


    Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare anomaly in women and is characterized by congenital aplasia of the uterus and vagina, with normal development of secondary sexual characteristics and a normal karyotype. We report a case of a 38-year-old women with MRKH syndrome that had experienced urethral sex for many years. She presented with urinary incontinence and dyspareunia. The patient's secondary sexual characteristics were normal, and examination revealed a widely open incompetent megalourethra and an absent vagina. Laboratory studies confirmed a 46, XX karyotype. Imaging included ultrasonography and magnetic resonance imaging, which indicated bilateral normal ovaries and a rudimental bicornuate uterus. After confirming the diagnosis of MRKH, the patient underwent urethroplasty by urethral plication, antiincontinence surgery by autologous fascial sling of the bladder neck, and the creation of a neo-vagina using a urethral flap. After 3 months, voiding cystourethrography and uroflowmetry confirmed normal voiding. There were no postoperative symptoms of urinary incontinence, and the patient was completely satisfied.

  17. Outcome of Late Presentation of Posterior Urethral Valves in a Resource-Limited Economy: Challenges in Management

    Odutola Israel Odetunde


    Full Text Available Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997–2009 was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days–13 years. The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91% presented with urosepsis while 8 patients (36% presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide.

  18. In vitro resistance to human platelet microbicidal protein among urethral staphylococcal and enterococcal isolates with its correlation with prostatitis

    Ivanov I


    Full Text Available The study was carried out to test the in vitro activity of human platelet microbicidal protein (hPMP on most commonly isolated urethral pathogens and compare the same with clinical isolates from cases of chronic prostatitis (CP. Urethral isolates of Staphylococcus aureus (n=19, coagulase negative staphylococci (n=40 and Enterococcus faecalis (n=16 from patients with or without CP were tested. The hPMP susceptibility of bacterial strains was determined by exposing bacterial cells to serial dilutions of hPMP. A significantly higher proportion of CP-strains of coagulase negative staphylococci (91.3% vs 5.88% was resistant to hPMP than was that of non-CP strains (P < 0.001. Among CP-strains of S.aureus studied, 77.8% were considered resistant to the bactericidal action of hPMP. All nine CP-strains of E.faecalis were highly resistant to hPMP. Most non-CP urethral isolates of S.aureus , coagulase negative staphylococci and E.faecalis were susceptible to the bactericidal action of hPMP, while CP isolates of all species were significantly more resistant to hPMP. Data from the present study may have significant implications in understanding the pathogenesis of CP.

  19. 33 CFR 154.520 - Closure devices.


    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Closure devices. 154.520 Section 154.520 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED... devices. (a) Except as provided in paragraph (b) of this section, each facility to which this part...

  20. Rural Primary School Closures in England.

    Whitfield, Richard C.

    A three-phase interdisciplinary effort between educators and environmental planners is focusing on the social effects of rural primary school reorganization now occuring in England as a result of a declining birth rate and the resulting need for school closure. A questionnaire mailed nationally to rural Local Education Authorities, cross-community…

  1. The Story of a Charter School Closure.

    Flynn, Susan L.; Arguelles, Lourdes


    The story of a charter school closure is told from the perspectives of students, parents, teachers, and community members, who felt that the sponsoring district revoked the charter for political reasons despite broad local support. The experience underscores the necessity of publicly subjecting the relationship of the public school system and the…

  2. Parallel hierarchical evaluation of transitive closure queries

    Houtsma, M.A.W.; Cacace, F.; Ceri, S.


    Presents a new approach to parallel computation of transitive closure queries using a semantic data fragmentation. Tuples of a large base relation denote edges in a graph, which models a transportation network. A fragmentation algorithm is proposed which produces a partitioning of the base relation

  3. End-of-year closure - Mail Office

    GS Department


    On the occasion of the annual closure of CERN, there will be no mail distributed on Tuesday 21 December 2010, but mail will be collected in the morning. Nevertheless, it will be possible for you to bring your mail for the departure until 12:00 at building 555-R-002. Mail Office

  4. 300 Area Process Trenches Closure Plan

    Luke, S.N.


    Since 1987, Westinghouse Hanford Company has been a major contractor to the US Department of Energy, Richland Operations Office and has served as co-operator of the 300 Area Process Trenches, the waste management unit addressed in this closure plan. For the purposes of the Resource Conservation and Recovery Act, Westinghouse Hanford Company is identified as ``co-operator.`` The 300 Area Process Trenches Closure Plan (Revision 0) consists of a Resource Conservation and Recovery Act Part A Dangerous Waste Permit Application, Form 3 and a Resource Conservation and Recovery Act Closure Plan. An explanation of the Part A Permit Application, Form 3 submitted with this document is provided at the beginning of the Part A Section. The closure plan consists of nine chapters and six appendices. The 300 Area Process Trenches received dangerous waste discharges from research and development laboratories in the 300 Area and from fuels fabrication processes. This waste consisted of state-only toxic (WT02), corrosive (D002), chromium (D007), spent halogenated solvents (F001, F002, and F003), and spent nonhalogented solvent (F005). Accurate records are unavailable concerning the amount of dangerous waste discharged to the trenches. The estimated annual quantity of waste (item IV.B) reflects the total quantity of both regulated and nonregulated waste water that was discharged to the unit.

  5. Opening up closure. Semiotics across scales



    The dynamic emergence of new levels of organization in complex systems is related to the semiotic reorganization of discrete/continuous variety at the level below as continuous/discrete meaning for the level above. In this view both the semiotic and the dynamic closure of system levels is reopened to allow the development and evolution of greater complexity.

  6. Individual Consequences of Plant Closures and Cutbacks

    Andersen, Steen


    This thesis describes the segment of unemployment which has its origin in major closures and cutbacks. The argument for this is to make it possible to describe and to analyse a flow into and a flow out of a population of unemployed. Given a major dismissal the following questions are to be answer...

  7. Primary closure of equine laryngotomy incisions

    Lindegaard, C.; Karlsson, L.; Ekstrøm, C. T.;


    The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy inc...

  8. Parallel hierarchical evaluation of transitive closure queries

    Houtsma, M.A.W.; Houtsma, M.A.W.; Cacace, F.; Ceri, S.


    Presents a new approach to parallel computation of transitive closure queries using a semantic data fragmentation. Tuples of a large base relation denote edges in a graph, which models a transportation network. A fragmentation algorithm is proposed which produces a partitioning of the base relation

  9. 50 CFR 648.141 - Closure.


    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Closure. 648.141 Section 648.141 Wildlife... inaction of one or more states will cause the applicable target exploitation rate specified in § 648.140(a... state has been remedied by that state without causing the applicable specified target exploitation...

  10. Synthesis of azaphenanthridines via anionic ring closure

    Hansen, Henriette Møller; Lysén, M.; Begtrup, M.;


    A new and convergent synthesis of azaphenanthridines via an anionic ring closure is reported. Ortho-lithiation/in situ borylation of cyanopyridines produces the corresponding cyanopyridylboronic esters, which undergo a Suzuki-Miyaura cross-coupling to give the key intermediates. Addition of lithium...

  11. 50 CFR 635.28 - Closures.


    ... for the shark species or complexes specified in § 635.27(b)(1) will remain open. (2) When NMFS..., provided the harvesting vessel does no fishing after the closure in the Atlantic Ocean north of 5 N. lat., and reports positions with a vessel monitoring system, as specified in § 635.69. Additionally,...

  12. Are all maximally entangled states pure?

    Cavalcanti, D.; Brandão, F. G. S. L.; Terra Cunha, M. O.


    We study if all maximally entangled states are pure through several entanglement monotones. In the bipartite case, we find that the same conditions which lead to the uniqueness of the entropy of entanglement as a measure of entanglement exclude the existence of maximally mixed entangled states. In the multipartite scenario, our conclusions allow us to generalize the idea of the monogamy of entanglement: we establish the polygamy of entanglement, expressing that if a general state is maximally entangled with respect to some kind of multipartite entanglement, then it is necessarily factorized of any other system.

  13. An ethical justification of profit maximization

    Koch, Carsten Allan


    In much of the literature on business ethics and corporate social responsibility, it is more or less taken for granted that attempts to maximize profits are inherently unethical. The purpose of this paper is to investigate whether an ethical argument can be given in support of profit maximizing...... behaviour. It is argued that some form of consequential ethics must be applied, and that both profit seeking and profit maximization can be defended from a rule-consequential point of view. It is noted, however, that the result does not apply unconditionally, but requires that certain form of profit (and...

  14. Robust utility maximization in a discontinuous filtration

    Jeanblanc, Monique; Ngoupeyou, Armand


    We study a problem of utility maximization under model uncertainty with information including jumps. We prove first that the value process of the robust stochastic control problem is described by the solution of a quadratic-exponential backward stochastic differential equation with jumps. Then, we establish a dynamic maximum principle for the optimal control of the maximization problem. The characterization of the optimal model and the optimal control (consumption-investment) is given via a forward-backward system which generalizes the result of Duffie and Skiadas (1994) and El Karoui, Peng and Quenez (2001) in the case of maximization of recursive utilities including model with jumps.

  15. Permanent Closure of the TAN-664 Underground Storage Tank

    Bradley K. Griffith


    This closure package documents the site assessment and permanent closure of the TAN-664 gasoline underground storage tank in accordance with the regulatory requirements established in 40 CFR 280.71, 'Technical Standards and Corrective Action Requirements for Owners and Operators of Underground Storage Tanks: Out-of-Service UST Systems and Closure.'

  16. 25 CFR 573.6 - Order of temporary closure.


    ... or a customer. (7) A management contractor operates for business without a contract that the Chairman... 25 Indians 2 2010-04-01 2010-04-01 false Order of temporary closure. 573.6 Section 573.6 Indians... ENFORCEMENT § 573.6 Order of temporary closure. (a) When an order of temporary closure may issue...

  17. Pulmonary edema following transcatheter closure of atrial septal defect

    Singhi Anil


    Full Text Available Pulmonary edema after device closure of atrial septal defect (ASD is a rare complication. We present illustrative images of a case of pulmonary edema after device closure of ASD in a 53 year old adult. Older patients undergoing ASD closure can benefit from their left atrial and left ventricular end diastolic pressures measurement before and after temporary balloon occlusion of ASD.

  18. A Simple Method for Thoracotomy Closure Avoiding Intercostal Nerve Damage

    Ufuk Cagirici


    Full Text Available It is well known that intercostal nerve damage during thoracotomy closure causes severe postoperative pain. A simple closure technique is proposed for intercostal nerve-sparing during thoracotomy opening and closure. We think that this maneuver may avoid intercostal nerve compression.

  19. 27 CFR 28.102 - Bottles to have closures affixed.


    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Bottles to have closures... Transportation to a Manufacturing Bonded Warehouse § 28.102 Bottles to have closures affixed. Every bottle containing distilled spirits to be withdrawn under the provisions of this subpart shall have a closure...

  20. 78 FR 1206 - Second Extension of Hearing Record Closure Date


    ... SAFETY BOARD Second Extension of Hearing Record Closure Date AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Second extension of hearing record closure date. SUMMARY: The Defense Nuclear Facilities... closure date to January 2, 2013 (77 FR 65871). Extension of Time: The Board now extends the period of...