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Sample records for preoperative bladder outlet

  1. Giant bladder diverticulum: A rare cause of bladder outlet obstruction in children

    Directory of Open Access Journals (Sweden)

    William Appeadu-Mensah

    2012-01-01

    Full Text Available Giant bladder diverticula are rare causes of bladder outlet obstruction in children and have rarely been reported. [1] In this paper, we present three children with giant bladder diverticula who presented with bladder outlet obstruction within a year. Micturating cystourethrogram is important for investigating bladder outlet obstruction in children and was used to confirm the diagnosis in all the patients. The relationship between the diverticula and ureters varied, with the ureters running either through the wall of the diverticulum and opening directly into the bladder, or opening into the diverticulum. In one patient, there was a recurrence, which was excised successfully. Excision is important to reduce the risk of recurrence.

  2. Predictive factors of bladder outlet obstruction following the tension ...

    African Journals Online (AJOL)

    H. Elghamrawi

    risk factors for postoperative bladder outlet obstruction were evaluated: age, history ... Voiding dysfunction according to our definition developed in 24.7% of the ... and Petros described the midurethral support concept [3], however, ... or objective evidence of SUI. ... mean number of vaginal deliveries was 4.47 (range 2–11).

  3. Preoperative irradiation and cystectomy for bladder cancer.

    Science.gov (United States)

    Smith, J A; Batata, M; Grabstald, H; Sogani, P C; Herr, H; Whitmore, W F

    1982-03-01

    Between 1971 and 1974, 101 patients at Memorial Sloan-Kettering Cancer Center underwent planned integrated treatment for bladder cancer with 2000 rads by megavoltage delivered to the whole pelvis over five consecutive days followed by radical cystectomy within a week. The overall five-year survival rate was 39%; the hospital mortality rate was 2%. In the pelvis alone tumor recurred in 9% of the patients. These results support other studies demonstrating the efficacy of this and other regimens of preoperative irradiation and cystectomy.

  4. Involvement of STAT3 in Bladder Smooth Muscle Hypertrophy Following Bladder Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    Ogawa,Norio

    2006-12-01

    Full Text Available We examined the involvement of the signal transducer and activator of transcription 3 (STAT3 in bladder outlet obstruction (BOO-induced bladder smooth muscle hypertrophy using a rat in vivo and in vitro study. BOO induced increases in bladder weight and bladder smooth muscle thickness 1 week after the operation. By using antibody microarrays, 64 of 389 proteins blotted on the array met our selection criteria of an INR value between > or = 2.0 and < or = 0.5. This result revealed up-regulation of transcription factors, cell cycle regulatory proteins, apoptosis-associated proteins and so on. On the other hand, down-regulation (INR value < or = 0.5 of proteins was not found. In a profiling study, we found an increase in the expression of STAT3. A significant increase in nuclear phosphorylated STAT3 expression was confirmed in bladder smooth muscle tissue by immunohistochemistry and Western blot analysis. Cyclical stretch-relaxation (1 Hz at 120% elongation significantly increased the expression of STAT3 and of alpha-smooth muscle actin in primary cultured bladder smooth muscle cells. Furthermore, the blockade of STAT3 expression by the transfection of STAT3 small interfering RNA (siRNA significantly prevented the stretch-induced increase in alpha-smooth muscle actin expression. These results suggest that STAT3 has an important role in the induction of bladder smooth muscle hypertrophy.

  5. Urethrolysis with Martius labial fat pad graft for iatrogenic bladder outlet obstruction.

    Science.gov (United States)

    Carey, Jeffrey M; Chon, Joanna K; Leach, Gary E

    2003-04-01

    This article evaluates treatment outcomes of urethrolysis with the Martius labial fat pad graft for patients with outlet obstruction after incontinence surgery. A total of 23 women were diagnosed with iatrogenic bladder outlet obstruction by urinary retention, urodynamic criteria, physical examination findings, and/or temporal relation of voiding dysfunction to anti-incontinence surgery. The urodynamic definition of female outlet obstruction was a maximum flow rate 20 cm of water. Surgical treatment consisted of urethrolysis with complete circumferential urethral mobilization. A Martius labial fat pad graft was used to circumferentially wrap the urethra. No concurrent resuspension procedures were performed. Procedure efficacy was determined by retrospective review and phone interview. Mean patient age was 55 years (range, 37 to 85 years). Mean postoperative follow-up time was 15 months (maximum, 44 months). All patients related voiding dysfunction symptoms to their anti-incontinence surgery. In all, 17 of 23 (74%) patients had preoperative urinary retention requiring catheterization, and 63% of patients met urodynamic criteria for obstruction. After urethrolysis with a Martius labial fat pad graft, 20 of 23 (87%) patients had complete resolution of their obstruction; 3 patients required persistent catheterization. Postoperative stress incontinence was reported by 6 of 23 (13%) patients. Urodynamically documented detrusor instability occurred in 6 of 23 (26%) patients with de novo detrusor instability occurring in 3 of 15 (20%) patients.

  6. The NLRP3 Inflammasome Mediates Inflammation Produced by Bladder Outlet Obstruction.

    Science.gov (United States)

    Hughes, Francis M; Hill, Hayden M; Wood, Case M; Edmondson, Andrew T; Dumas, Aliya; Foo, Wen-Chi; Oelsen, James M; Rac, Goran; Purves, J Todd

    2016-05-01

    While bladder outlet obstruction is well established to elicit an inflammatory reaction in the bladder that leads to overactive bladder and fibrosis, little is known about the mechanism by which this is initiated. NLRs (NOD-like receptors) and the structures that they form (inflammasomes) have been identified as sensors of cellular damage, including pressure induced damage, and triggers of inflammation. Recently we identified these structures in the urothelium. In this study we assessed the role of the NLRP3 (NACHT, LRR and PYD domains-containing protein 3) inflammasome in bladder dysfunction resulting from bladder outlet obstruction. Bladder outlet obstruction was created in female rats by inserting a 1 mm outer diameter transurethral catheter, tying a silk ligature around the urethra and removing the catheter. Untreated and sham operated rats served as controls. Rats with bladder outlet obstruction were given vehicle (10% ethanol) or 10 mg/kg glyburide (a NLRP3 inhibitor) orally daily for 12 days. Inflammasome activity, bladder hypertrophy, inflammation and bladder function (urodynamics) were assessed. Bladder outlet obstruction increased urothelial inflammasome activity, bladder hypertrophy and inflammation, and decreased voided volume. Glyburide blocked inflammasome activation, reduced hypertrophy and prevented inflammation. The decrease in voided volume was also attenuated by glyburide mechanistically as an increase in detrusor contraction duration and voiding period. Results suggest the importance of the NLRP3 inflammasome in the induction of inflammation and bladder dysfunction secondary to bladder outlet obstruction. Arresting these processes with NLRP3 inhibitors may prove useful to treat the symptoms that they produce. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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

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    Ning Liu

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    翟丽东; 张平

    2015-01-01

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

  10. Urethral duplication with unusual cause of bladder outlet obstruction

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    Vivek Venkatramani

    2016-01-01

    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.

  11. Prostatic Cyst with Bladder Outlet Obstruction Symptoms. Case Report

    African Journals Online (AJOL)

    ADMIN

    reported a series of transrectal ultrasound on 704 patients with symptoms of bladder ... pelvic pain and prostatitis-like syndrome symptoms, but can rarely result in .... International Prostate Symptom Score (IPSS) was 20, and his quality of life ...

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mari Ekman

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

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

    DEFF Research Database (Denmark)

    Van Der Wijk, Jasper; Van Der Wijk, Jan; Horn, Thomas

    2008-01-01

    Objective. In a pilot study we evaluated whether implementation of a novel 3D stereologic technique can prove that bladder outlet obstruction (BOO) is associated with morphologic changes in the bladder wall. Material and methods. Ten males (mean age 69.7 years; range 58-84 years) with lower urinary...... tract symptoms (LUTS) suggestive of BOO and five controls (mean age 48.6 years; range 43-53 years) without LUTS were studied. All participants underwent a full examination, including determination of the International Prostate Symptom Score, laboratory analysis and a urodynamic evaluation. A cold....... Conclusions. This pilot study shows that, even with the implementation of subtle morphometric techniques, there seems to be no relationship between the severity of BOO and bladder wall morphology. It is possible that interstitial collagen in the bladder wall increases with age. It seems that bladder wall...

  15. Application of the Blaivas-Groutz bladder outlet obstruction nomogram in women with urinary incontinence.

    NARCIS (Netherlands)

    Massolt, E.T.; Groen, J.; Vierhout, M.E.

    2005-01-01

    AIMS: To test the applicability of the Blaivas-Groutz nomogram for female bladder outlet obstruction in urinary incontinent women presenting in a general gynecologic practice and to determine how the nomogram results related to the presence of obstructive symptoms according to a standardized questio

  16. Alpha-Blockade improves symptoms suggestive of bladder outlet obstruction but fails to relieve it.

    NARCIS (Netherlands)

    Rossi, C.; Kortmann, B.B.M.; Sonke, G.S.; Floratus, D.; Kiemeney, L.A.L.M.; Wijkstra, H.; Rosette, J.J.M.H.C. de la

    2001-01-01

    PURPOSE: We investigated the effect of the alpha-blockers alfuzosin, terazosin and tamsulosin on urodynamic parameters after 6 months of therapy. MATERIALS AND METHODS: Between February 1992 and June 1998, 163 patients with lower urinary tract symptoms suggestive of bladder outlet obstruction were t

  17. Botulinum toxin: An emerging therapy in female bladder outlet obstruction

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    Aditya A Pradhan

    2009-01-01

    Discussion: There is a gradual improvement in symptoms over time and the maximal effect occurred at 10-14 days. The duration of improvement was approximately 16.8 weeks. All patients were satisfied by the degree of improvement felt. Conclusions: Botulinum toxin proved successful in improving the voiding characteristics. It possibly acts at the zone of hypertonicity at the bladder neck or midurethra. The only disadvantage is the high cost of the drug.

  18. Preoperative balloon occluded arterial infusion chemotherapy for locally invasive bladder cancer. Accurate staging for bladder preservation

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    Hayashi, Norio; Arima, Kiminobu; Kawamura, Juichi [Mie Univ., Tsu (Japan). School of Medicine; Tochigi, Hiromi

    1999-02-01

    The possibility of bladder preservation by preoperative balloon occluded arterial infusion (BOAI) chemotherapy was studied in 111 patients with locally invasive bladder cancer. BOAI was performed by blocking the blood flow of the internal iliac artery and by performing intra-arterial infusion of adriamycin (50 mg/body) and cisplatin (100 mg/body). Before BOAI the clinical diagnosis was T2 in 36, T3a in 29, T3b in 27, T4 in 11 and after BOAI it was T0 in 1, T1 in 27, T2 in 25, T3a in 20, T3b in 20, and T4 in 10. Down staging was observed on diagnostic images in 46.6%. Thirty patients (27.0%) received transurethral resection of bladder tumor (TUR-Bt) and their bladder could be preserved. The 5-year cancer-specific survival rate was 100% in pT0 (n=9), 97.5% in pT1 (n=47), 79.9% in pT2 (n=21), 80.0% in pT3a (n=6), 39.9% in pT3b (n=18) and 51.9% in pT4 cases (n=9). For the bladder preservation, accurate staging diagnosis is required. Since 1992, endorectal magnetic resonance imaging (MRI) has been used in addition to imaging diagnosis for improving the accuracy of staging diagnosis. The accuracies of staging diagnosis with and without endorectal MRI were 62.5% and 44.0%, respectively. BOAI as a neoadjuvant chemotherapy has the possibility of bladder-preserving therapy in locally invasive bladder cancer. Also, the endorectal MRI can improve the accuracy of staging diagnosis, which is important for the bladder preservation. (author)

  19. Early effects of preoperative radiation therapy for invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Isaka, Shigeo; Igarashi, Tatsuo; Ito, Haruo

    1983-10-01

    22 patients with high grade invasive bladder cancer were treated with preoperative radiation therapy (910 rad by fast neutron or 3000 rad by X ray during 2 weeks) followed by radical cystectomy and urinary diversion. 62.5 % of patients showed reduction in tumor size more than 50% evaluated by cystogram. Stage down was observed in 38% of patients compared between clinical and pathological stage. Histopathological effect of GII or GIII, according to the criteria described by Ohboshi, was noticed in 79 % of the patients. Better effect seemed to be obtained in fast neutron treated group than in X ray group. 19 patients received curative surgery, and 18 patients were alive without recurrence after 10 months (mean observed term). One died from lung metastasis 4.5 months after surgery. 50% of the patients complained of side effects of irradiation although they were tolerable, and 32% of the patients had major complications of surgery.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  1. Testosterone Modifies Alterations to Detrusor Muscle after Partial Bladder Outlet Obstruction in Juvenile Mice

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    Andrew S. Flum

    2017-06-01

    Full Text Available Lower urinary tract symptoms secondary to posterior urethral valves (PUV arise in boys during adolescence. The reasons for this have previously been attributed to increased urine output as boys experience increased growth. Additionally, there are few choices for clinicians to effectively treat these complications. We formed the new hypothesis that increased androgen levels at this time of childhood development could play a role at the cellular level in obstructed bladders. To test this hypothesis, we investigated the role of testosterone on bladder detrusor muscle following injury from partial bladder outlet obstruction (PO in mice. A PO model was surgically created in juvenile male mice. A group of mice were castrated by bilateral orchiectomy at time of obstruction (CPO. Testosterone cypionate was administered to a group of castrated, obstructed mice (CPOT. Bladder function was assessed by voiding stain on paper (VSOP. Bladders were analyzed at 7 and 28 days by weight and histology. Detrusor collagen to smooth muscle ratio (Col/SM was calculated using Masson’s trichrome stain. All obstructed groups had lower max voided volumes (MVV than sham mice at 1 day. Hormonally intact mice (PO continued to have lower MVV at 7 and 28 days while CPO mice improved to sham levels at both time points. In accordance, PO mice had higher bladder-to-body weight ratios than CPO and sham mice demonstrating greater bladder hypertrophy. Histologically, Col/SM was lower in sham and CPO mice. When testosterone was restored in CPOT mice, MVV remained low at 7 and 28 days compared to CPO and bladder-to-body weight ratios were also greater than CPO. Histologic changes were also seen in CPOT mice with higher Col/SM than sham and CPO mice. In conclusion, our findings support a role for testosterone in the fibrotic changes that occur after obstruction in male mice. This suggests that while other changes may occur in adolescent boys that cause complication in boys

  2. Testosterone Modifies Alterations to Detrusor Muscle after Partial Bladder Outlet Obstruction in Juvenile Mice.

    Science.gov (United States)

    Flum, Andrew S; Firmiss, Paula R; Bowen, Diana K; Kukulka, Natalie; Delos Santos, Grace B; Dettman, Robert W; Gong, Edward M

    2017-01-01

    Lower urinary tract symptoms secondary to posterior urethral valves (PUV) arise in boys during adolescence. The reasons for this have previously been attributed to increased urine output as boys experience increased growth. Additionally, there are few choices for clinicians to effectively treat these complications. We formed the new hypothesis that increased androgen levels at this time of childhood development could play a role at the cellular level in obstructed bladders. To test this hypothesis, we investigated the role of testosterone on bladder detrusor muscle following injury from partial bladder outlet obstruction (PO) in mice. A PO model was surgically created in juvenile male mice. A group of mice were castrated by bilateral orchiectomy at time of obstruction (CPO). Testosterone cypionate was administered to a group of castrated, obstructed mice (CPOT). Bladder function was assessed by voiding stain on paper (VSOP). Bladders were analyzed at 7 and 28 days by weight and histology. Detrusor collagen to smooth muscle ratio (Col/SM) was calculated using Masson's trichrome stain. All obstructed groups had lower max voided volumes (MVV) than sham mice at 1 day. Hormonally intact mice (PO) continued to have lower MVV at 7 and 28 days while CPO mice improved to sham levels at both time points. In accordance, PO mice had higher bladder-to-body weight ratios than CPO and sham mice demonstrating greater bladder hypertrophy. Histologically, Col/SM was lower in sham and CPO mice. When testosterone was restored in CPOT mice, MVV remained low at 7 and 28 days compared to CPO and bladder-to-body weight ratios were also greater than CPO. Histologic changes were also seen in CPOT mice with higher Col/SM than sham and CPO mice. In conclusion, our findings support a role for testosterone in the fibrotic changes that occur after obstruction in male mice. This suggests that while other changes may occur in adolescent boys that cause complication in boys with PUV, the

  3. Autonomic nervous system activity assessement by heart rate variability in experimental bladder outlet obstruction 

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    Łukasz Dobrek

    2013-04-01

    Full Text Available A syndrome with urgency, with or without associated urine incontinence and usually accompanied by higher urinary frequency and nocturia has been named “overactive bladder; OAB”. OAB is an entity with complex pathophysiology, involving both myogenic and neurogenic (afferent / efferent bladder innervation disturbances. OAB symptoms accompany benign prostatic hypertrophy - BPH (“obstructive OAB”. The aim of the study was to estimate the autonomic nervous system activity (ANS in the experimental bladder outlet obstruction (BOO which was an animal model of the human BPH. The study was conducted using 30 female rats, divided into two groups: BOO animals (n=15, with surgically induced BOO (by partial ligation of the proximal urethra and control ones (n=15, which underwent sham procedure (without urethral ligation. Two weeks after the surgery, in both groups, ANS activity was estimated using time- and spectral analysis of the heart rate variability recordings. The bladder overactivity in BOO animals was confirmed using urodynamic recordings and bladder histological assessment, juxtaposed against the results of the control group. The key finding of our study was the development of autonomic disturbances in bladder outlet obstruction (BOO rats. Our study revealed that BOO animals were characterised by diminished rMSSD and spectral HRV parameters: TP, LF and HF, in comparison with the control group. The normalised nLF and nHF parameters did not differ significantly in both groups, although slight changes in the nLF (increased and nHF (decreased were noted in BOO group. The absolute VLF value was almost the same in both studied populations, however, the percentage part of this component in the appropriate HRV spectrum differed considerably in both studied groups. In BOO animals, VLF percentage amounted to about 90�20whereas in control animals this parameter reached only about 53�0of the total power spectrum.Thus, to sum up, our findings suggest

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-21

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

  5. Diagnosing bladder outlet obstruction can we do away with pressureflow studies?

    Directory of Open Access Journals (Sweden)

    Abraham Vinod Peedikayil

    2004-01-01

    Full Text Available Objective: To compare pressure-flow study on one hand with BWT, prostate volume, urine flow rate PVR and IPSS index in the other arm for diagnosis of BOO. Materials and methods: A prospective cross-sectional study was carried out in 48 men with lower urinary tract symptoms (LUTS. International prostate symptom score was completed by the patient who then underwent free urine flow study. Pressure-Flow study was performed as per recommendations of International continence Society. Abrams-Griffiths nomogram and number were used to diagnose BOO. Patients with diabetes, neurovesical dysfunction, acute urinary retention, prior pelvic surgery and known prostate cancer were excluded. Suprapubic ultrasonography was performed independently by a consultant radiologist, who was blinded to findings of Pressure-Flow study. Prevoid bladder volume, postvoid residue (PVR, prostate volume and bladder wall thickness (BWT were noted. Results: Based on objective evidence from Pressure-Flow study, 35 patients were obstructed, 13 were not. Multivariate analysis was performed using Backward Stepwise Logistic Regression Model. Bladder wall thickness, prostate volume and urine flow rate had statistically significant relationship with BOO. Their coefficients of correlation were +0.794, +0.084 and 0.393 respectively. Bladder outlet obstruction could be defined by using a mathematical formula as detailed in the text (Positive Predictive Value 96.97%. Post-void residue and IPSS index were statistically insignificant. Conclusion: In a select group of patients presenting with LUTS, it should be possible to diagnose BOO without the use of Pressure-Flow study.

  6. Sulforaphane Ameliorates Bladder Dysfunction through Activation of the Nrf2-ARE Pathway in a Rat Model of Partial Bladder Outlet Obstruction

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    Chong Liu

    2016-01-01

    Full Text Available Purpose. We evaluated the effect of sulforaphane (SFN treatment on the function and changes of expression of Nrf2-ARE pathway in the bladder of rats with bladder outlet obstruction (BOO. Materials and Methods. A total of 18 male Sprague-Dawley rats at age of 8 weeks were divided into 3 groups (6 of each: the sham operated group, the BOO group, and the BOO+SFN group. We examined histological alterations and the changes of oxidative stress markers and the protein expression of the Nrf2-ARE pathway. Results. We found that SFN treatment could prolong micturition interval and increase bladder capacity and bladder compliance. However, the peak voiding pressure was lower than BOO group. SFN treatment can ameliorate the increase of collagen fibers induced by obstruction. SFN treatment also increased the activity of SOD, GSH-Px, and CAT compared to the other groups. The level of bladder cell apoptosis was decreased in BOO rats with SFN treatment. Moreover, SFN could reduce the ratio of Bax/Bcl-2 expression. Furthermore, SFN could activate the Nrf2 expression with elevation of its target antioxidant proteins. Conclusions. The sulforaphane-mediated decrease of oxidative stress and activation of the Nrf2-ARE pathway may ameliorate bladder dysfunction caused by bladder outlet obstruction.

  7. Reliability of CT in preoperative evaluation of bladder carcinoma

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    Nurmi, M.; Puntala, P. (Univ. of Turku (Finland). Dept. of Surgery); Katevuo, K. (Univ. of Turku (Finland). Dept. of Radiology)

    1988-01-01

    Sixty patients with bladder carcinoma were examined by CT prior to radical cystectomy. CT indicated perivesical tumor growth or extension to neighboring organs correctly in 60 % of the cases. Overstaging was observed in 23% and understaging in 8 % of the cases. Most of the difficulties concerned assessment of tumors in the anterior bladder wall and identification of the plane between the bladder and the seminal vesicle. In most instances CT provided no supplementary information to clinical staging, but was useful when obesity or previous irradiation impeded clinical staging. (authors).

  8. Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction

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    Nishant D Patel

    2014-01-01

    Full Text Available Benign prostatic hyperplasia (BPH is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO; BOO may present as lower urinary tract symptoms (LUTS, infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors - including age, genetics and geography - play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies.

  9. Male bladder outlet obstruction : Time to re-evaluate the definition and reconsider our diagnostic pathway? ICI-RS 2015

    NARCIS (Netherlands)

    Rademakers, Kevin; Drake, Marcus J; Gammie, Andrew; Djurhuus, Jens C; Rosier, Peter F W M; Abrams, Paul; Harding, Christopher

    The diagnosis of bladder outlet obstruction (BOO) in the male is dependent on measurements of pressure and flow made during urodynamic studies. The procedure of urodynamics and the indices used to delineate BOO are well standardized largely as a result of the work of the International Continence

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

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    Cüneyt Özden

    2009-01-01

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

  11. Comparison between prostate volume and intravesical prostatic protrusion in detecting bladder outlet obstruction due to benign prostatic hyperplasia.

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    Hossain, A K M S; Alam, A K M K; Habib, A K M K; Rashid, M M; Rahman, H; Islam, A K M A; Jahan, M U

    2012-04-01

    The objectives of this study were to determine and compare the correlation of intravesical prostatic protrusion (IPP) and prostate volume (PV) with bladder outlet obstruction (BOO). This study was conducted in the department of urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2009 to September 2010. Fifty benign prostatic hyperplasia (BPH) patients were included in the study. Their evaluation consisted of history along with International Prostate Symptoms Score (IPSS), digital rectal examination (DRE), transabdominal ultrasonography to measure prostate volume, intravesical prostatic protrusion & post voidal residual (PVR) urine and pressure-flow studies to detect bladder outflow obstruction (BOO). Statistical analysis included Unpaired 't' test, Chi-square test and Spearman's Rank correlation test. Receiver Operator Characteristic (ROC) curves were used to compare the correlation of PV and IPP with BOO. Mean prostate volume was significantly larger in bladder outlet obstructed patients (PProstate volume & intravesical prostatic protrusion measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with bladder outlet obstruction in patients with benign prostatic hyperplasia and the correlation of IPP is much more stronger than that of prostate volume.

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

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    Fadi Housami

    2009-01-01

    Full Text Available Objectives: Measurement of bladder weight using ultrasound estimates of bladder wall thickness and bladder volume is an emerging clinical measurement technique that may have a role in the diagnosis of lower urinary tract dysfunction. We have reviewed available literature on this technique to assess current clinical status. Methods: A systematic literature search was carried out within PubMed and MedLine to identify relevant publications. These were then screened for relevance. Preliminary results from our clinical experiments using the technique are also included. Results: We identified 17 published papers concerning the technique which covered clinical studies relating ultrasound-estimated bladder wall thickness to urodynamic diagnosis in men, women, and children together with change in response to treatment of bladder outlet obstruction. The original manual technique has been challenged by a commercially available automated technique. Conclusion: Ultrasound-estimated bladder weight is a promising non-invasive technique for the categorization of storage and voiding disorders in both men and women. Further studies are needed to validate the technique and assess accuracy of diagnosis.

  13. Invasively estimated international continence society obstruction classification versus noninvasively assessed bladder outlet obstruction probability in treatment recommendation for LOTS suggestive of BPH

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    Boormans, Joost L.; van Venrooij, Ger E. P. M.; Boon, Tom A.

    2007-01-01

    OBJECTIVES To investigate the contribution of urodynamically proven presence or absence (International Continence Society classification) of bladder outlet obstruction (BOO) to treatment recommendations for lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia, and to invest

  14. Diagnostic value of urodynamic bladder outlet obstruction to select patients for transurethral surgery of the prostate: Systematic review and meta-analysis

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    Kim, Myong; Jeong, Chang Wook; Oh, Seung-June

    2017-01-01

    Purpose To investigate the diagnostic value of urodynamic bladder outlet obstruction (BOO) in the selection of patients for transurethral surgery of the prostate. Materials and methods We systematically searched online PubMed, Embase, and Cochrane Library databases from January 1989 to June 2014. Results A total of 19 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 2321 patients with a median number of 92 patients per study (range: 12–437). Of the 19 studies, 15 conducted conventional transurethral prostatectomy (TURP), and 7 used other or multiple modalities. In urodynamic bladder outlet obstruction (BOO) positive patients, the pooled mean difference (MD) was significant for better improvement of the International Prostate Symptom Score (IPSS) (pooled MD, 3.48; 95% confidence interval [CI], 1.72–5.24; p < 0.01; studies, 16; participants, 1726), quality of life score (QoL) (pooled MD, 0.56; 95% CI, 0.14–1.02; p = 0.010; studies, 9; participants, 1052), maximal flow rate (Qmax) (pooled MD, 3.86; 95% CI, 2.17–5.54; p < 0.01; studies, 17; participants, 1852), and post-void residual volume (PVR) (pooled MD, 32.46; 95% CI, 23.34–41.58; p < 0.01; studies, 10; participants, 1219) compared with that in non-BOO patients. Some comparisons showed between-study heterogeneity despite the strict selection criteria of the included studies. However, there was no clear evidence of publication bias in this meta-analysis. Conclusions Our meta-analysis results showed a significant association between urodynamic BOO and better improvements in all treatment outcome parameters. Preoperative UDS may add insight into postoperative outcomes after surgical treatment of benign prostatic hyperplasia. PMID:28241023

  15. Planned preoperative cisplatin and radiation therapy for locally advanced bladder cancer.

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    Herr, H W; Yagoda, A; Batata, M; Sogani, P C; Whitmore, W F

    1983-12-15

    Cisplatin (DDP) is an active agent in the treatment of disseminated bladder cancer. In addition to its direct tumor cytotoxicity, recent animal and clinical data suggest synergism with radiation therapy (RT). Since improved survival with preoperative RT is largely restricted to bladder cancer patients in whom radiation-induced downstaging (P less than T) may be recognized, the authors administered DDP + RT preoperatively to patients with locally advanced (T3, T4) bladder tumors selected for cystectomy. The aim was to evaluate the feasibility of such a combination in relation to surgical and hematologic complications, the immediate effect on tumor downstaging, disease progression, and survival. Two thousand rad (400 rad X 5 days) was delivered to the whole pelvis, followed by cystectomy in 2 days. DDP (70 mg/m2) was given intravenously on day 2 of the RT. Twenty-four patients received preoperative DDP + RT and underwent attempted cystectomy; however, six patients were nonresectable owing to extensive pelvic disease, and an additional five patients had resectable pelvic lymph node metastases. Pelvic complications developed in 3 of 24 (12%) patients, but none required reoperation. No patient had a wound dehiscence. Transient myelosuppression was similar to that induced by 2000 rad preoperative RT alone. Tumor downstaging (P less than T) was seen in 9 of 24 (38%) patients, and in 5 (21%) patients, no tumor was found in the surgical specimen (P0). Distant metastases alone have been detected in 4 of 18 (22%) patients who had a cystectomy (all 4 had nodal metastases). Disease-free survival at a median follow-up of 22 months (range, 12-34 months) is 60% (14/24) for all patients (89% for P less than T and 40% for P greater than or equal to T patients) and 78% (14/18) for the resected patients. Combined preoperative DDP + RT proved to be a safe and feasible regimen which resulted in a possibly greater recognition of radioresponsive bladder tumors, and after cystectomy, an

  16. A comparative study of two preoperative radiation regimens with cystectomy for bladder cancer.

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    Whitmore, W F; Batata, M A; Hilaris, B S; Reddy, G N; Unal, A; Ghoneim, M A; Grabstald, H; Chu, F

    1977-09-01

    This report surveys the results of two programs of preoperative irradiation with radical cystectomy for bladder cancer in 205 patients. Irradiating the true pelvis to 4000 rads in 4 weeks with radical cystectomy after 6 weeks was implemented in 119 patients (Group 1) from 1959 to 1965; 2000 rads given in 1 week to the true pelvis and radical cystectomy within the following week was implemented in 86 patients (Group 2) from 1966 to 1970. Determinate survival without evidence of recurrence at 5 years was 43% in Group 1 and 42% in Group 2. Mortality with recurrence of bladder cancer in 5 or more years was 44% in group 1 and 42% in group 2. Pelvic complications occurred in 13% of group 1 and 9% of group 2.

  17. AB298. SPR-25 NLRP3/IL-1β mediates denervation during bladder outlet obstruction in rats

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    Lutolf, Robin; Hughes, Francis M.; Purves, J. Todd

    2016-01-01

    Objective Bladder outlet obstruction (BOO) is a common condition resulting from benign prostatic hyperplasia, neurologic pathology, organ prolapse, etc. Long-term, obstruction is well-established to evoke denervation in the bladder which causes the detrusor to become hypocontractile, resulting in inefficient bladder emptying and consequent infections, continence issues or even renal failure. Recently, considerable attention has been paid to a role for inflammation in bladder deterioration during BOO and we have shown a central role for the NLRP3 inflammasome in triggering this inflammation. In the present study we explore a possible connection between this NLRP3-induced inflammation and bladder denervation. Methods Rats were divided into five groups: (I) control; (II) sham operated; (III) BOO + vehicle (1 mL, 40% ethanol in PBS, p.o.); (IV) BOO + glyburide (Gly, NLRP3 inhibitor; 10 mg/kg, p.o.); (V) BOO + anakinra (Ana, IL-1 receptor antagonist; 25 mg/kg, i.p.). BOO is constructed in female rats by inserting a 1 mm outer diameter transurethral catheter, tying a silk ligature around the urethra and removing the catheter. Medications were administered prior to surgery and once daily. At 12 days animals were sacrificed and the bladders processed for histological analysis. Transverse sections (5 µm) were stained for PGP9.5 expression (a pan-neuronal marker) using standard immunohistochemistry techniques. Entire sections were scanned, using a 10× objective, into TIFF files using Zen software (Zeiss Inc.). Images were imported into Elements software (Nikon Inc.) and the area of individual neurons designated as well as total bladder area (exclusive of the urothelium and lumen). The number of neurons and respective areas were used to calculate nerve density. Results Denervation in the bladder wall during BOO was significant, as measured by nerve density. This effect was attenuated by either preventing NLRP3 activation with Gly or blocking IL-1β’s action at its

  18. The analgesic effect of preoperative pregabalin in radical cystectomy for cancer bladder patients

    Institute of Scientific and Technical Information of China (English)

    Ayman A. Ghoneim; Mohammed M. Hegazy

    2013-01-01

    Objective: After the pregabalin has been approved for the treatment of neuropathic pain, preliminary clinical studies suggested a possible role in the perioperative period. To our knowledge, It has never been studied the perioperative analgesic effect of pregabalin in patients with cancer bladder. In this study, we hypothesized that cancer bladder patients undergoing radical cystectomy and received oral pregabalin 75 mg twice daily for ten days preoperatively would get their postoperative pain reduced. Methods: Sixty patients scheduled for elective radical cystectomy were randomly assigned to one of 2 groups (control group or pregabalin group). Patients in the pregabalin group received 75 mg pregabalin twice daily for ten days before surgery. Standard anesthesia protocol was applied to all patients. Pain intensity, opioid consumption, level of sedation and other side effects were regularly assessed for 48 h postoperative. Results: Mean time for the first request of analgesia was statistically longer in pregabalin group. Meanwhile, mean morphine consumption, VAS scores at rest (in the first 32 h postoperatively), VAS scores during movement (in the first 20 h postoperatively) were statistically significant lower in the pregabalin group than those in the control group. Patients in the pregabalin group were statistically more sedated in the first four hours postoperative than the control group. Conclusion: Preoperative pregabalin 75 mg twice daily for ten days resulted in 60% reduction in 24 h postoperative morphine requirements in patients undergoing radical cystectomy.

  19. Testosterone and 17β-estradiol induce glandular prostatic growth, bladder outlet obstruction, and voiding dysfunction in male mice.

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    Nicholson, Tristan M; Ricke, Emily A; Marker, Paul C; Miano, Joseph M; Mayer, Robert D; Timms, Barry G; vom Saal, Frederick S; Wood, Ronald W; Ricke, William A

    2012-11-01

    Benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO) are common in older men and can contribute to lower urinary tract symptoms that significantly impact quality of life. Few existing models of BOO and BPH use physiological levels of hormones associated with disease progression in humans in a genetically manipulable organism. We present a model of BPH and BOO induced in mice with testosterone (T) and 17β-estradiol (E(2)). Male mice were surgically implanted with slow-releasing sc pellets containing 25 mg T and 2.5 mg E(2) (T+E(2)). After 2 and 4 months of hormone treatment, we evaluated voiding patterns and examined the gross morphology and histology of the bladder, urethra, and prostate. Mice treated with T+E(2) developed significantly larger bladders than untreated mice, consistent with BOO. Some mice treated with T+E(2) had complications in the form of bladder hypertrophy, diverticula, calculi, and eventual decompensation with hydronephrosis. Hormone treatment caused a significant decrease in the size of the urethral lumen, increased prostate mass, and increased number of prostatic ducts associated with the prostatic urethra, compared with untreated mice. Voiding dysfunction was observed in mice treated with T+E(2), who exhibited droplet voiding pattern with significantly decreased void mass, shorter void duration, and fewer sustained voids. The constellation of lower urinary tract abnormalities, including BOO, enlarged prostates, and voiding dysfunction seen in male mice treated with T+E(2) is consistent with BPH in men. This model is suitable for better understanding molecular mechanisms and for developing novel strategies to address BPH and BOO.

  20. Bladder fibrosis during outlet obstruction is triggered through the NLRP3 inflammasome and the production of IL-1β.

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    Hughes, Francis Monty; Sexton, Stephanie J; Jin, Huixia; Govada, Vihasa; Purves, J Todd

    2017-06-07

    Bladder outlet obstruction (BOO) triggers inflammation in the bladder through the NLRP3 inflammasome. BOO also activates fibrosis, which is largely responsible for the decompensation of the bladder in the chronic state. Because fibrosis can be driven by inflammation, we have explored a role for NLRP3 (and IL-1β produced by NLRP3) in the activation and progression of BOO-induced fibrosis. Female rats were divided into 5 groups: 1) control, 2) sham, 3) BOO + Vehicle, 4) BOO + the NLRP3 inhibitor glyburide or 5) BOO + the IL-1β receptor antagonist anakinra. Fibrosis was assessed by Masson's Trichrome Stain, collagen secretion via Sirius Red, and protein localization by immunofluorescence. BOO increased collagen production in the bladder which was blocked by glyburide and anakinra, clearly implicating the NLRP3/IL-1β pathway in fibrosis. The collagen was primarily found in the lamina propria and the smooth muscle, while IL-1 receptor 1 and prolyl 4-hydroylase (an enzyme involved in the intracellular modification of collagen) both localized to the urothelium and the smooth muscle. Lysyl oxidase, the enzyme involved in the final extracellular assembly of mature collagen fibrils, was found to some extent in the lamina propria where its expression was greatly enhanced during BOO. In vitro studies demonstrated isolated urothelial cells from BOO rats secreted substantially more collagen than controls, and collagen expression in control cultures could be directly stimulated by IL-1β. In summary, NLRP3-derived IL-1β triggers fibrosis during BOO, most likely through an autocrine loop in which IL-1β acts on urothelia to drive collagen production. Copyright © 2017, American Journal of Physiology-Renal Physiology.

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

    Institute of Scientific and Technical Information of China (English)

    张鹏; 武治津; 高居忠

    2003-01-01

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

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

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    Xiaoxiao Jiang

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

  3. Simple Modification of the Bladder Outlet Obstruction Index for Better Prediction of Endoscopically-Proven Prostatic Obstruction: A Preliminary Study.

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    Jang Hee Han

    Full Text Available The bladder outlet obstruction index (BOOI, also known as the Abrams-Griffiths (AG number, is the most widely used index for predicting BOO. However, the obstructed prostatic urethra determined by the BOOI is often inconsistent with endoscopically-proven obstruction. We assessed abdominal straining pattern as a novel parameter for improving the prediction of BOO.We retrospectively reviewed the pressure-flow studies (PFS and cystourethroscopy in 176 BPH/LUTS patients who were unresponsive to medical therapy. During PFS, some groups of patients tried to urinate with abdominal straining, which can increases intravesical pressure and underestimate BOOI theoretically. Accordingly, the modified BOOI was defined as (PdetQmax+ΔPabd-2Qmax.Ultimately, 130 patients were eligible for the analysis. In PFS, ΔPabd (PabdQmax-initial Pabd was 11.81±13.04 cmH2O, and it was 0-9 cmH2O in 75 (57.7%, 10-19 cmH2O in 23 (17.7% and ≥20 cmH2O in 32 (24.6% patients. An endoscopically obstructed prostatic urethra in 92 patients was correctly determined in 47 patients (51.1% by the original BOOI versus 72 patients (78.3% based on the modified BOOI. Meanwhile, an "unobstructed" urethra according to the original BOOI was present in 11 patients (12.0%, whereas according to the modified BOOI, only 2 (2.1% would be labeled as "unobstructed". In receiver operating characteristic curves, the area under the curve was 0.906 using the modified BOOI number versus 0.849 in the original BOOI (p<0.05.The change in abdominal pressure was correlated with endoscopically-proven obstruction. Our simple modification of the BOOI on the basis of this finding better predicted bladder outlet obstruction and, therefore, should be considered when evaluating BOO in patients with LUTS/BPH.

  4. Preoperative whole pelvis versus true pelvis irradiation and/or cystectomy for bladder cancer

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    Batata, M.A.; Chu, F.C.H.; Hilaris, B.S.

    1981-10-01

    Between 1949 and 1974, 449 patients with bladder cancer were treated by radical cystectomy either alone (137 patients), or following three preoperative radiation schemes (312 patients). True pelvis irradiation was delivered either 4000 cGy (rad) over 4 weeks in 119 patients, or 2000 cGy over 1 week in 86 patients; radical cystectomy was performed after periods averaging 6 weeks and 2 days, respectively. Whole pelvic irradiation of 2000 cGy in 5 consecutive days was given to 107 patients who underwent cystectomy within 2 days later. Five-year survival rates for low-stage TIS-T/sub 2/ tumors of low histologic grade were 60-66% in the four treatment groups. The 5-year survival for high-stage tumors of high histologic grade, mainly in T/sub 3/ patients, was 9% in the cystectomy alone patients versus 24-32% in the preoperatively irradiated patients. The 5-year survival rates for high-stage low-grade and low-stage high-grade tumors, were 30% in the cystectomy alone group and 39-51% in the preoperative irradiation groups; the more favorable survival was noted in the whole pelvic irradiation group, which included 18% 5-year survivals for T/sub 4/ patients. Pelvic recurrence was reduced from 28% after cystectomy alone to 14-16% with true pelvis irradiation and 8% with whole pelvic irradiation. The reduced incidence of local recurrence, observed mainly in high stage or high grade tumors, was associated with tumor downstaging after irradiation. Extrapelvic metastases developed in 21-35% of the four treatment groups, underlining the inadequacy of the local radiation and surgical treatment in preventing subsequent distant spread.

  5. International Prostatic Symptom Score-voiding/storage subscore ratio in association with total prostatic volume and maximum flow rate is diagnostic of bladder outlet-related lower urinary tract dysfunction in men with lower urinary tract symptoms.

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    Yuan-Hong Jiang

    Full Text Available OBJECTIVES: The aim of this study was to investigate the predictive values of the total International Prostate Symptom Score (IPSS-T and voiding to storage subscore ratio (IPSS-V/S in association with total prostate volume (TPV and maximum urinary flow rate (Qmax in the diagnosis of bladder outlet-related lower urinary tract dysfunction (LUTD in men with lower urinary tract symptoms (LUTS. METHODS: A total of 298 men with LUTS were enrolled. Video-urodynamic studies were used to determine the causes of LUTS. Differences in IPSS-T, IPSS-V/S ratio, TPV and Qmax between patients with bladder outlet-related LUTD and bladder-related LUTD were analyzed. The positive and negative predictive values (PPV and NPV for bladder outlet-related LUTD were calculated using these parameters. RESULTS: Of the 298 men, bladder outlet-related LUTD was diagnosed in 167 (56%. We found that IPSS-V/S ratio was significantly higher among those patients with bladder outlet-related LUTD than patients with bladder-related LUTD (2.28±2.25 vs. 0.90±0.88, p1 or >2 was factored into the equation instead of IPSS-T, PPV were 91.4% and 97.3%, respectively, and NPV were 54.8% and 49.8%, respectively. CONCLUSIONS: Combination of IPSS-T with TPV and Qmax increases the PPV of bladder outlet-related LUTD. Furthermore, including IPSS-V/S>1 or >2 into the equation results in a higher PPV than IPSS-T. IPSS-V/S>1 is a stronger predictor of bladder outlet-related LUTD than IPSS-T.

  6. Evaluation of the effects of omega-3 & interferon alpha-2b administration on partial bladder outlet obstruction in a rat model

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    Firat, Fatih; Uluocak, Nihat; Erdemir, Fikret; Atilgan, Dogan; Markoc, Fatma; Parlaktas, Bekir Suha; Yasar, Adem

    2016-01-01

    Background & objectives: In bladder outlet obstruction-induced rat models, the transforming growth factor-beta (TGF-β) and collagen ratios have been shown to be increased. Increased TGF-β leads to fibrosis. In this study, the effect of omega-3 and interferon alpha-2b (IFN α-2b) was investigated on oxidative stress, inflammation and fibrosis in bladder structure in a partial bladder outlet obstruction (PBOO) rat model. Methods: A total of 35 male Wistar albino rats, weighing 300-350 g, were used in the study. The rats were randomly divided into five groups. At the end of the experimental period, bladders were harvested from all the rats, and pathological analysis of the rat bladder tissues was performed. In addition, investigations were carried out with enzymatic and non-enzymatic antioxidant systems to study the antioxidant properties of omega-3 fatty acid and IFN alpha-2b. Results: Increased bladder weight in the PBOO group, in comparison to the control group, was decreased by the administration of omega-3 and IFN α-2b (P=0.002). Significantly higher superoxide dismutase (SOD) levels were detected in group 2 in comparison to the control group. It was also detected that serum SOD, glutathione peroxidase and nitric oxide (NO) levels were significantly higher in group 2 when compared to the control group (P<0.05). In the pathologic evaluation, group 2 showed significantly increased inflammation and fibrosis compared to the control group. Omega-3 treatment significantly decreased inflammation. It was shown that IFN α-2b application partially decreased inflammation. Interpretation & conclusions: The results of the present study showed that in addition to the standard primary approaches to prevent the damage to the upper urinary tract secondary to PBOO, omega-3 fatty acid and IFN α-2b could be beneficial as adjunct treatment in clinical practice. However, this needs to be further investigated with prospective, randomized clinical trials with larger sample sizes

  7. Non-invasive clinical parameters for the prediction of urodynamic bladder outlet obstruction: analysis using causal Bayesian networks.

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    Myong Kim

    Full Text Available To identify non-invasive clinical parameters to predict urodynamic bladder outlet obstruction (BOO in patients with benign prostatic hyperplasia (BPH using causal Bayesian networks (CBN.From October 2004 to August 2013, 1,381 eligible BPH patients with complete data were selected for analysis. The following clinical variables were considered: age, total prostate volume (TPV, transition zone volume (TZV, prostate specific antigen (PSA, maximum flow rate (Qmax, and post-void residual volume (PVR on uroflowmetry, and International Prostate Symptom Score (IPSS. Among these variables, the independent predictors of BOO were selected using the CBN model. The predictive performance of the CBN model using the selected variables was verified through a logistic regression (LR model with the same dataset.Mean age, TPV, and IPSS were 6.2 (±7.3, SD years, 48.5 (±25.9 ml, and 17.9 (±7.9, respectively. The mean BOO index was 35.1 (±25.2 and 477 patients (34.5% had urodynamic BOO (BOO index ≥40. By using the CBN model, we identified TPV, Qmax, and PVR as independent predictors of BOO. With these three variables, the BOO prediction accuracy was 73.5%. The LR model showed a similar accuracy (77.0%. However, the area under the receiver operating characteristic curve of the CBN model was statistically smaller than that of the LR model (0.772 vs. 0.798, p = 0.020.Our study demonstrated that TPV, Qmax, and PVR are independent predictors of urodynamic BOO.

  8. Uroflowmetry, trans rectal ultra sonography and power doppler to develop a less invasive bladder outlet obstruction score in benign prostatic hyperplasia: A prospective analysis

    Directory of Open Access Journals (Sweden)

    Rajiv Goyal

    2006-01-01

    Full Text Available OBJECTIVE : To evaluate the ability of transrectal power doppler sonography (TRPDS in combination with conventional grey scale transrectal ultrasonography (TRUS, uroflowmetry and clinical parameters, to predict bladder outlet obstruction (BOO in benign prostatic hyperplasia (BPH. MATERIALS AND METHODS : Sixty-nine male patients with more than 50 years of age, presenting with lower urinary tract symptoms were evaluated prospectively for BOO secondary to BPH. TRUS was done to estimate prostate volume (PV, transition zone volume (TZV, median lobe projection in the bladder (ML and bladder wall thickness (BWT. TRPDS was done to measure resistive index (RI of transition zone vessels. All patients also underwent PFS and depending upon its results, the patients were divided into Group 1 [Abram-Griffiths (AG number 40. Mean values of TRUS and TRPDS parameters and uroflowmetry in the two groups were compared to identify predictive factors for BOO. RESULTS : Demographic profile of Group 1 (n= 42 was similar to that of Group 2 (n= 27. Significant independent factors for prediction of BOO were maximum flow rate, resistive index of transition zone, median lobe projection into the bladder and post void residue. BOO scoring system was developed based on these 4 factors, which showed a specificity of 77.8% and a sensitivity of 85.7%, with an overall predictive value of 82.6%. CONCLUSIONS : Transrectal power doppler ultrasonography (resistive index in combination with uroflowmetry, median lobe projection in bladder and post void residue measurement can predict BOO with a high specificity and sensitivity.

  9. Bladder outlet obstruction

    Science.gov (United States)

    ... failure. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 87. McNicholas TA, Speakman MJ, Kirby RS. Evaluation and nonsurgical management of benign prostatic ...

  10. Impact of preoperative thrombocytosis on pathological outcomes and survival in patients treated with radical cystectomy for bladder carcinoma.

    Science.gov (United States)

    Moschini, Marco; Suardi, Nazareno; Pellucchi, Federico; Rocchini, Lorenzo; La Croce, Giovanni; Capitanio, Umberto; Briganti, Alberto; Damiano, Rocco; Montorsi, Francesco; Colombo, Renzo

    2014-06-01

    To investigate the impact of preoperative platelet count on pathological findings at the time of Radical Cystectomy for Bladder Cancer and postoperative cancer-specific and overall survival. A total of 906 consecutive patients treated with Radical Cystectomy for Bladder Cancer between 1995 and 2012 at a tertiary referral Center were included in the study. Thrombocytosis was defined as >400,000 platelets/μl, in agreement with the standard assumed by the central laboratory of our Institution. Univariable and multivariable logistic regression analyses were used to investigate the impact of preoperative platelet count on pathological stage. Univariate and multivariate Cox regression analyses were also adopted to predict both cancer-specific and overall survival. The mean age at cystectomy was 67.25 years. The mean and median platelet counts were 242,100/μl and 227,500/μl. At a mean follow-up time of 41 months, the 2- and 5-year cancer-specific and overall survival were found to be 83.1% and 75.2% and 68.3 and 59.8%, respectively. At Univariable analysis, thrombocytosis count was significantly associated with adverse pathological disease stage (p ≤ 0.007) and lymph node invasion (p=0.05). Platelet count was significantly associated to patient survival at univariable analysis (Hazard Ratio=1.76 and 1.39 for overall survival and cancer specific survival, respectively; all p<0.05). At multivariate Cox regression analysis, platelet count was documented to be significantly related only to overall survival (Hazard Ratio=64,1.03-2.81; p=0.05). Preoperative platelet count should be taken into account as a factor predictive of postoperative oncological outcomes after radical cystectomy for bladder cancer and patients should be counseled accordingly. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Xinhua Zhang

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

  12. The influence of piroxicam, a non-selective cyclooxygenase inhibitor, on autonomic nervous system activity in experimental cyclophosphamide-induced hemorrhagic cystitis and bladder outlet obstruction in rats.

    Science.gov (United States)

    Dobrek, Łukasz; Baranowska, Agnieszka; Skowron, Beata; Thor, Piotr J

    2014-01-01

    Signs and symptoms of secondary overactive bladder (OAB) are observed both in course of infravesical obstruction of urine outflow in patients with benign prostatic hyperplasia, and as a result of development of hemorrhagic cystitis (HC) following administration of cyclophosphamide (CP). Non-steroidal antiinflammatory drugs (NSAIDs) alleviate symptoms of bladder overactivity reducing local synthesis of prostaglandins (PGs), but precise effects of those agents on functions of the autonomic nervous system (ANS) in course of OAB remain unknown. The purpose of this study was to evaluate the effect of piroxicam-induced prostaglandins (PGs) synthesis block on activity of the ANS in two experimental models of secondary OAB: bladder outlet obstruction (BOO) and cyclophosphamide-induced HC (CP-HC), by heart rate variability analysis (HRV). The experiment was performed on a group of rats with surgically induced 2-week BOO, and on a group of rats that were administered CP five times, with corresponding control groups. Study animals were given piroxicam (PRX) i.p. in two doses: 2 and 10 mg/kg b.w. In the BOO model, PRX in both doses revealed a trend for reduction of value of all non-normalized components of HRV. The lower PRX dose caused an increased nHF value, and PRX administered in the dose of 10 mg/kg b.w. caused an increase of the nLF value. In the CP-HC model, the lower PRX dose caused a trend for an increase of values of all non-normalized components, and the higher dose--for their decrease. Both doses of PRX in that model caused increase of the nLF value. Inhibition of PGs synthesis caused changes of ANS function in both models of OAB. Both in BOO and in CP-HC, PGs seem to be ANS-activating factors, responsible for maintenance of a high parasympathetic activity. In both models, inhibition of PGs synthesis with PRX administered at the dose of 10 mg/kg b.w. lead to functional reconstruction of ANS, with marked sympathetic predominance. That may contribute to reduction of

  13. Decline of seminal parameters in middle-aged males is associated with lower urinary tract symptoms, prostate enlargement and bladder outlet obstruction

    Directory of Open Access Journals (Sweden)

    Kristo Ausmees

    2013-09-01

    Full Text Available Purpose We aimed to compare the associations between semen quality, associated reproductive indicators and the main prostate-related parameters in middle-aged men. Materials and Methods: This is a prospective study on 422 middle-aged men who underwent the screening for prostate health. Their reproductive function, semen quality and prostate-related pathologies were investigated. Results Significant associations between semen quality and prostate-related parameters could be seen. Total sperm count and sperm density decreased along with the increase of the I-PSS score and total prostate volume. Also, the related lower urinary tract characteristics showed a negative correlation with main semen parameters for all investigated subjects. No significant differences in age, testicular size, and hormonal parameters were found between the subjects with or without lower urinary tract symptoms and prostate enlargement. Conclusions Our study suggests that altered seminal parameters in middle-aged men are associated with LUTS, prostate enlargement and/or bladder outlet obstruction. Although the assessments of prostate and lower urinary tract symptoms may not replace the semen parameters evaluating the male reproductive status, there is a need for further and more detailed investigations about the pathways behind these associations as well as possible related conditions.

  14. Diagnosis and treatment for female patients with bladder outlet obstruction combining bladder pain syndrome%以膀胱疼痛为特征的女性膀胱出口梗阻诊治体会

    Institute of Scientific and Technical Information of China (English)

    徐凌; 张鹏; 武治津; 张朝华; 杨勇; 张宁; 张小东

    2014-01-01

    目的 探讨以膀胱疼痛症状为特征的女性膀胱出口梗阻(BOO)患者的诊断及治疗.方法 2008年11月至2012年12月收治的21例以尿频、尿急、憋尿后耻骨上膀胱区疼痛为主诉的女性患者,经自由尿流率+残余尿检查联合影像尿动力学(VUD)检查明确存在BOO.治疗前平均Qmax(11.5±3.6) ml/s,平均PdetQmax(39.1±17.8)cmH2O(1 cmiH20=0.098 kPa).结合排尿期同步影像检查结果诊断为膀胱颈梗阻19例,尿道狭窄2例.本组21例均于硬膜外麻醉下行膀胱水扩张治疗,膀胱镜下观察均为红斑征阳性,均行膀胱黏膜活检,对膀胱颈梗阻患者行膀胱颈内切开术,尿道狭窄患者行尿道扩张术.于术后48个月采用O' Leary-Sant评分、QOL评分及盆腔疼痛和尿频、尿急症状(PUF)评分评价治疗前后患者膀胱疼痛症状的变化. 结果 本组21例膀胱黏膜活检病理结果均为膀胱黏膜急、慢性炎症.21例术后随访平均(6.7±5.9)个月,24h排尿次数由治疗前(24.3±11.8)次降至(13.0±5.9)次,平均夜尿次数由(6.5±2.7)次降至(3.3±1.6)次,O ' Leary-Sant评分由(24.6±7.3)分降至(14.7±7.4)分,PUF评分由(22.9±6.2)分降至(12.0±7.1)分,QOL评分由(5.0±0.8)分降至(2.9±1.5)分,差异均有统计学意义(P<0.05). 结论 尿流率+残余尿检查联合VUD检查对以膀胱疼痛症状为特征的女性BOO患者可以明确诊断.根据VUD检查结果解除梗阻后,与膀胱疼痛相关的症状会显著改善.%Objective To explore the diagnosis and treatment of female bladder outlet obstruction (BOO) with bladder pain as major symptom.Methods From November 2008 to December 2012,21 female patients suffered from urinary frequency,urgency,pain in suprapubic area during bladder filling phase were enrolled in the study.Video-urodynamics (VUD) study combined with free urinary flow rate andresidual urine were performed in all patients in order to make the diagnosis of BOO clearly.The mean maximum urinary flow rate was

  15. Effects of chronic administration of tamsulosin and tadalafil, alone or in combination, in rats with bladder outlet obstruction induced by chronic nitric oxide deficiency

    Directory of Open Access Journals (Sweden)

    Rommel Prata Regadas

    2014-08-01

    Full Text Available Purpose The aim of this study was to define if tadalafil causes detrusor muscle impairment and to observe the effect of combination of tadalafil with tamsulosin on the lower urinary tract of rats with bladder outlet obstruction (BOO induced by chronic nitric oxide deficiency. Materials and Methods Thirty-one male rats were randomized to following groups: 1 - control; 2 - L-Nitroarginine methyl ester (L-NAME; 3 - Tamsulosin + L-NAME, 4 Tadalafil+L-NAME; and 5 - Tamsulosin + Tadalafil + L-NAME. At the end of the treatment period (30 days, all animals were submitted to urodynamic study. Results The administration of L-NAME increased the number of non-voiding contractions (NVC (1.04 ± 0.22, volume threshold (VT (1.86 ± 0.35, and micturition cycle (MC (1.34 ± 0.11 compared with control (0.52 ± 0.06, 0.62 ± 0.06, and 0.67 ± 0.30, respectively. The administration of tamsulosin reduced the number of NVC (0.57 ± 0.42 and VT (0.76 ± 0.24 compared with L-NAME group. Co-treatment with tadalafil decreased the number of VT (0.85 ± 0.53 and MC (0.76 ± 0.22 compared with L-NAME group. The combination of tamsulosin with tadalafil improved the number of NVC (0.56 ± 0.18, VT (0.97 ± 0.52 and MC (0.68 ± 0.30 compared with L-NAME group. Conclusion In rats with BOO induced by chronic nitric oxide deficiency, tadalafil did not cause impairment in detrusor muscle and seems to have an addictive effect to tamsulosin because the combination decreased non voiding contractions as well the number of micturition cycles.

  16. AB279. SPR-06 Fibrosis in the bladder in response to outlet obstruction is triggered through the NLRP3 inflammasome and the production of IL-1β

    Science.gov (United States)

    Hughes, Francis M.; Govada, Vihasa; Sexton, Stephanie; Purves, J. Todd

    2016-01-01

    Objective Bladder outlet obstruction (BOO), most commonly created by benign prostatic hyperplasia, promotes an inflammatory state that produces voiding dysfunction. Recently, we have shown that the NLRP3 inflammasome triggers this inflammation. Over time, inflammation promotes fibrosis. In this study we explore the role of NLRP3 (and IL-1β produced by activated NLRP3) in BOO-induced fibrosis. Methods Rats were divided into 5 groups: (I) control, (II) sham, (III) BOO + Vehicle (Veh; 1 mL, 40% EtOH, p.o.), (IV) BOO + glyburide (Gly; NLRP3 inhibitor; 10 mg/kg, p.o.) or (V) BOO + Anakinra (Ana; IL-1 receptor antagonist; 25 mg/kg, i.p.). BOO is constructed by inserting a 1-mm transurethral catheter, tying a suture around the urethra and removing the catheter. Medications were given prior to surgery and once daily for 12 days. Hypertrophy was assessed by bladder weight, fibrosis by collagen staining (Masson’s Trichrome Stain), IL-1 receptor 1 (IL-1R1), prolyl 4-hydroylase (P4H) and lysyl oxidase (LOX) localization by immunofluorescence and collagen secretion by Sirius Red. Results BOO increased production of collagen in the bladder which was blocked by either preventing NLRP3 activation with glyburide or blocking IL-1β’s action at its receptor, clearly implicating the NLRP3/IL-1β pathway in fibrosis during BOO. IL-1β directly triggers collagen synthesis in other tissues and we found that recombinant IL-1β stimulated pro-collagen production in control urothelial cells placed in culture. Consistent with urothelia as a source of pro-collagen production, isolated urothelial cells from BOO rats secreted significantly more IL-1β than control cells. In control rats, the IL-1β receptor, IL-1R1, was highly expressed in the basal layer of the urothelia with less staining in the umbrella cells and detrusor and no staining in the interstitium. P4H (a marker of pro-collagen synthesis) exhibited similar staining, although enhanced expression in the basal urothelia was not

  17. Experimental model of bladder instability in rabbits

    Directory of Open Access Journals (Sweden)

    Balasteghin K.T.

    2003-01-01

    Full Text Available OBJECTIVE: Propose a new experimental model of bladder instability in rabbits after partial bladder obstruction. MATERIALS AND METHODS: Thirty North Folk male rabbits, weighting 1,700 to 2,820 g (mean: 2,162 g were studied. The animals were distributed in 2 experimental groups, formed by 15 rabbits each: Group 1 - clinical control. In this group there was no surgical intervention; Group 2 - bladder outlet obstruction. In this group, after anesthetizing the animal, urethral cannulation with Foley catheter 10F was performed and then an adjustable plastic bracelet was passed around the bladder neck. It was then adjusted in order to not constrict the urethra. The following parameters were studied in M1 - pre-operative period; M2 - 4 weeks post-operatively moments: 1- urine culture; 2- cystometric study; 3- serum creatinine and BUN. RESULTS: Bladder weight was 2.5 times larger in the group with obstruction than in the control group. Cystometric evaluation showed a significant increase in maximal vesical volume in the final moment at Group G2. However, there was no statistically significant difference among the groups studied. There was no statistically significant difference between maximal detrusor pressure and vesical compliance in the different moments or in the studied groups. There was an absence of uninhibited detrusor contractions in all the animals in group 1, and involuntary contractions were detected in 93% of group 2 animals. There was no significant variation in BUN and serum creatinine either among the groups or in the same group. CONCLUSIONS: We observed in the group with obstruction a bladder weight 2.5 higher than normal bladders. We detected involuntary contractions in 93% of the animals in group 2, establishing this experimental model as appropriate to secondary bladder instability and partial bladder outlet obstruction.

  18. Preoperative lymph-node staging of invasive urothelial bladder cancer with 18F-fluorodeoxyglucose positron emission tomography/computed axial tomography and magnetic resonance imaging

    DEFF Research Database (Denmark)

    Jensen, Thor Knak; Holt, Per; Gerke, Oke

    2011-01-01

    investigated the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed axial tomography (¹⁸F-FDG PET/CT) and magnetic resonance imaging (MRI) for preoperative N staging of bladder cancer. Material and methods. From June 2006 to January 2008, 48 consecutive patients diagnosed with bladder...... cancer were referred to preoperative staging including MRI and ¹⁸F-FDG PET/CT. Eighteen out of 48 patients underwent radical cystoprostatectomy including removal of lymph nodes for histology, and were included in the study. Values of ¹⁸F-FDG PET/CT and MRI for regional N staging were compared...... to histopathology findings, the gold standard. Results. ¹⁸F-FDG PET/CT and MRI were performed in 18 patients. The specificities for detection of lymph-node metastases for MRI and ¹⁸F-FDG PET/CT were 80% (n = 15) and 93.33% (n = 15), respectively. The negative predictive values were 80% (n = 15) and 87.5% (n = 16...

  19. The clinical efficacy of the therapy scheme of green light photoselective vaporization combined testicular resection plus anti-androgen on advanced prostate cancer and bladder outlet obstruction%绿激光汽化术联合睾丸切除加抗雄激素治疗晚期前列腺癌并膀胱出口梗阻的效果观察

    Institute of Scientific and Technical Information of China (English)

    贾文明; 郭建军

    2014-01-01

    Objective To evaluate the clinical efficacy of green light photoselective vaporization(PVP)combined testicular resection plus anti-androgen treatment on advanced prostate cancer and bladder outlet obstruction.Methods Twenty cases with PVP of advanced prostate cancer and bladder outlet obstruction were selected as our subjects,who underwent PVP testicular resection plus anti-androgen treatment.The clinical information was recorded.Results All patients were succeed through surgery.Maximum urinary flow rate (MFR) at the pre-operation was (2.0 ± 1.0) ml/s,and increased to (14.0 ± 4.5) ml/s after operation.Serum prostate specific antigen (PSA) was decreased from the preoperative (176.5 ± 160.5) μg/L to (2.0 ± 1.0)μg/L International prostate symptom score (IPSS) was from (25.0 ± 5.0) down to (8.0 ± 1.0) points.The quality of life (QOL) score was (4.0 ± 2.0) at pre-operation,higher than after operation (1.0 ± 1.0)points.There were significant differences between preoperative and postoperative (t =9.502,7.371,5.328,8.350,P <0.05).Every patient was followed up from 3 to 18 months.The improvements regarding of clinical symptoms were seen including voiding,and all patients survived with tumor.Conclusion Advanced prostate cancer associate with bladder outlet obstruction.The therapy plan of PVP joint testicular resection plus antiandrogen is proved to improve symptoms of urethral obstruction and patient quality of life.%目的 评估应用绿激光汽化术(PVP)联合睾丸切除加抗雄激素治疗晚期前列腺癌并膀胱出口梗阻的效果.方法 回顾性分析20例采用PVP联合睾丸切除加抗雄激素治疗晚期前列腺癌并膀胱出口梗阻患者的临床资料.结果 全部患者均手术治疗成功.最大尿流率从术前(2.0±1.0) ml/s升至(14.0±4.5) ml/s,血清前列腺特异性抗原从术前(176.5±160.5)μg/L降至(2.0±1.0)μg/L,国际前列腺症状评分从术前(25.0±5.0)分降至(8.0±1.0)分,生活质量评分从术前(4.0±2

  20. TURP联合雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻疗效观察%Effect Observation of TURP Combined with Androgen Blockade for Advanced Prostate Cancer with Bladder Outlet Obstruction

    Institute of Scientific and Technical Information of China (English)

    汪志顺; 刘修恒; 陈胜; 肖腾飞; 匡幼林

    2011-01-01

    successfully, only one patient received 400ml blood transfusion after operation and none of them had TURP syndrome, length of stay was (9 ±3.2)d, the operative time was 45 - 120 min, indwelling catheter time was 5 ~7 d. Preoperative prostate volume, QOL,IPSS, PSA, Qmax and RU were (87.53 ± 18.46)cm3, (3.54 ± 1.16) points, (18. 96 ± 3. 83)points, (76.32 ±20.47) jig/L, (9. 08 ±2. 76)ml/s, (142.53 ±34. 66) ml, after one month, prostate volume (46. 52 ± 13.43)cm3, QOL(2.15 ±1.30) points, IPSS( 12.78 ±3.34)points, PSA(1.82± 0.63)^1,, Qmax( 19.20 ±3.98) ml/s, RU (29.86 ±16.33)ml, respectively, all indicators were significant before and after operation (all/J<0.01) ; after3 months PSA was (0. 66 ±0.21)|ig/L (P<0.01). [Conclusion]TURP combined with androgen blockade for advanced prostate cancer with bladder outlet obstruction is safe and effective, with good short-term curative effect, can alleviate the urinary tract obstruction symptoms and improve the quality life of patients. However, the long-term effect deserves further research.

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

    Science.gov (United States)

    Esham, W; Holt, H A

    1980-05-01

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

  2. Advance in the effect of bladder outlet obstruction(BOO)on the signal transduction pathway in the detrusor cell%膀胱出口梗阻(BOO)与逼尿肌细胞力信号转导通路相关性的研究进展

    Institute of Scientific and Technical Information of China (English)

    杨渊峰; 王杭

    2013-01-01

    Benign prostatic hyperplasia(BPH)is one of the reasons which cause bladder outlet obstruction(BOO)in older men.BOO can cause changes in detrusor structure and function,such as bladder hypertrophy,detrusor overactivity,the occurrence of lower urinary tract symptom(LUTS)and a series of bladder dysfunction.In the urodynamics of bladder,trigger signal of overload mechanical tension cause these reactions.Further study showed that the mechanical tension signal might be provided by the susceptor of the mechanical induction in the detrusor cells.The induction had corresponding with force signal transduction pathway and turned the physical stimuli into cellular biochemical reactions.%良性前列腺增生(benign prostatic hyperplasia,BPH)是引起老年男性膀胱出口梗阻(bladder outletobstruction,BOO)的原因之一.BOO会导致逼尿肌结构和功能的改变,表现为膀胱逼尿肌代偿性肥大和过度活动,发生下尿路症状(lower urinary tract symptom,LUTS)及一系列膀胱的功能异常.在膀胱的尿动力学中,超负荷机械张力触发信号导致这些反应.进一步研究表明,机械张力信号可能通过逼尿肌细胞的机械性感受器感应,并与相应的力信号转导通路相关联,将物理刺激转变为细胞的生物化学反应.

  3. Double outlet right ventricle

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  5. Is [F-18]-fluorodeoxyglucose FDG-PET/CT better than CT alone for the preoperative lymph node staging of muscle invasive bladder cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Uttam, Mete; Pravin, Nayak; Anish, Bhattacharya; Nandita, Kakkar; Arup, Mandal, E-mail: uttam_mete@yahoo.com [PGIMER, Chandigarh, (India)

    2016-03-15

    Objective: To evaluate whether the use of [F-18]-FDG-PET/CT can accurately predict pelvic lymph node metastasis in patients with muscle invasive TCC of the bladder undergoing radical cystectomy. Materials and methods: Fifteen patients with muscle invasive bladder cancer had undergone FDG-PET/CT scan from the skull base to the mid-thighs after IV injection of 6.5MBq (Mega-Becquerel)/Kg of FDG. After intravenous hydration IV furosemide was given to overcome the difficulties posed by urinary excretion of {sup 18}F-FDG. PET/ CT data were analyzed as PET and CT images studied separately as well as fused PET/ CT images. The imaging findings were correlated with the histopathology of the nodes (gold standard). Results: CT and FDG-PET had demonstrated positive lymph nodes in 9 & 8 patients respectively. Among the 15 patients 3 had documented metastasis on histopathology. Both CT and PET could detect the nodes in all these 3 patients (100% sensitivity). Nodes were histologically negative amongst 6&5 patients who had node involvement by CT and PET respectively. Therefore, specificity, positive predictive value (PPV) & negative predictive value (NPV) for CT and PET/CT were 50%, 33.3%, 100% and 58.3%, 37.5%, 100% respectively. Conclusion: The theoretical advantage of this cutting edge technology for whole body imaging has not been translated into clinical practice as we found minimal advantage of combined FDG-PET/CT over CT alone for nodal staging of muscle invasive bladder cancer. This may be due to substantial overlap between standardized uptake values (SUVs) from active inflammatory processes with those of malignant lesion. (author)

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

    NARCIS (Netherlands)

    M. Oelke

    2010-01-01

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

  7. 经尿道前列腺切除联合去势治疗伴膀胱出口梗阻的晚期前列腺癌的临床进展%Transurethral Resection of the Prostate Combined Castration in the Treatment of Bladder Outlet Obstruction in Patients with Advanced Prostate Cancer Clinical Progress

    Institute of Scientific and Technical Information of China (English)

    赵富

    2012-01-01

      目的对临床上所采用的经尿道前列腺切除联合去势的方法针对膀胱出口梗阻的晚期前列腺癌的治疗效果进行分析与探讨,并且对此方法治疗晚期前列腺癌的可行性做出分析。方法对本院的晚期前列腺癌的患者临床资料进行回顾性总结与分析,和手术后的随访。这些患者均接受过本院实施的经尿道前列腺切除联合去势手术,并且这些患者的晚期前列腺癌均伴随有膀胱出口梗阻。结果进行手术的所有患者均取得了较好的治疗效果,在术后的随访过程中并没有发现患者的意外死亡。患者在接受手术之后排尿良好、并且没有出现尿失禁。结论伴膀胱出口梗阻的晚期前列腺癌的患者在经过经尿道前列腺切除联合去势治疗均取得了较好的康复效果。因此,这是一种具有良好效果,可以进行临床推广应用的手术方法。%  Objective Of clinical the transurethral resection of the prostate joint castrated method in the bladder outlet obstruction of advanced prostate cancer treatment effect of analysis and discussion, and the method is the treatment of advanced prostate cancer to the feasibility analysis. Methods Our hospital since 2004 through February to March 2006 were between the advanced prostate cancer patients with the clinical data were retrospectively summary and analysis, and postoperative fol ow-up.These patients are trained in this hospital implementation of the urethra prostate gland excision with castration surgery, and these patients with advanced prostate cancer are accompanied by a bladder outlet obstruction,and these patients with advanced prostate cancer are accompanied by a bladder outlet obstruction. Results Surgery al of the patients have achieved good results,in the process of the fol ow-up and found no patients accidental death.Patients undergoing surgery urination and did not appear after good urinary incontinence. Conclution

  8. Bladder Management

    Science.gov (United States)

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

  9. Bladder biopsy

    Science.gov (United States)

    Biopsy - bladder ... A bladder biopsy can be done as part of a cystoscopy . Cystoscopy is a telescopic examination of the inside of the ... informed consent form before you have a bladder biopsy. In most cases, you are asked to urinate ...

  10. Bladder Diseases

    Science.gov (United States)

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

  11. Neurogenic bladder

    Science.gov (United States)

    Neurogenic detrusor overactivity; NDO; Neurogenic bladder sphincter dysfunction; NBSD ... Disorders of the central nervous system commonly cause neurogenic bladder. These can include: Alzheimer disease Birth defects of ...

  12. Underground tank assembly with internal bladder

    Energy Technology Data Exchange (ETDEWEB)

    Strock, D.J.

    1987-03-10

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

  13. Brunn nests masquerading as bladder tumor: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Hee; Byun, Kyung Hwan; Jeon, Ji Min [College of Medicine, Pochon CHA University, Pochon (Korea, Republic of)

    2005-07-15

    Brunn nests are the most common proliferative lesions of the bladder uroepithelium, but exuberant proliferation can mimic bladder tumor on radiologic imaging and cystoscopy. We describe a case of pathologically proven Brunn nests in a 34-year-old man, misdiagnosed as bladder tumor on preoperative imaging studies.

  14. Understanding Thoracic Outlet Syndrome

    Directory of Open Access Journals (Sweden)

    Julie Freischlag

    2014-01-01

    Full Text Available The diagnosis of thoracic outlet syndrome was once debated in the world of vascular surgery. Today, it is more understood and surprisingly less infrequent than once thought. Thoracic outlet syndrome (TOS is composed of three types: neurogenic, venous, and arterial. Each type is in distinction to the others when considering patient presentation and diagnosis. Remarkable advances have been made in surgical approach, physical therapy, and rehabilitation of these patients. Dedicated centers of excellence with multidisciplinary teams have been developed and continue to lead the way in future research.

  15. Bladder exstrophy repair

    Science.gov (United States)

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

  16. Bladder Stones

    Science.gov (United States)

    ... does not include routine preventive screening for bladder cancer.If you do not treat bladder stones, you can have lasting damage. This includes repeat UTIs or injury to your bladder, kidney, or urethra. Questions to ask your doctor How do I ...

  17. AGU hydrology publication outlets

    Science.gov (United States)

    Freeze, R. Allan

    In recent months I have been approached on several occasions by members of the hydrology community who asked me which of the various AGU journals and publishing outlets would be most suitable for a particular paper or article that they have prepared.Water Resources Research (WRR) is the primary AGU outlet for research papers in hydrology. It is an interdisciplinary journal that integrates research in the social and natural sciences of water. The editors of WRR invite original contributions in the physical, chemical and biological sciences and also in the social and policy sciences, including economics, systems analysis, sociology, and law. The editor for the physical sciences side of the journal is Donald R. Nielson, LAWR Veihmeyer Hall, University of California Davis, Davis, CA 95616. The editor for the policy sciences side of the journal is Ronald G. Cummings, Department of Economics, University of New Mexico, Albuquerque, NM 87131

  18. Neurogenic Bladder

    Directory of Open Access Journals (Sweden)

    Peter T. Dorsher

    2012-01-01

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

  19. Bladder Retraining

    Science.gov (United States)

    ... Complicated IC Cases Promising IC Diagnostic Tests Wrong Diagnosis IC Treatment Guideline IC Treatments IC Diet & Self Management Physical Therapy Antidepressants Antihistamines Pentosan Polysulfate Sodium Bladder Instillations Immunosuppresants ...

  20. Effects of Different Preoperative Bowel Preparations on Intestinal Cleansing among Patients with Bladder Cancer%不同肠道准备方法对膀胱癌患者术前肠道清洁效果的影响

    Institute of Scientific and Technical Information of China (English)

    刘亚珍; 姜岩; 申海燕; 刘星

    2012-01-01

    目的 探讨术前不同肠道准备方法对腹腔镜下根治性膀胱切除联合全去带乙状结肠原位新膀胱术患者肠道清洁效果的影响.方法 便利抽样法选择2009年6月至2011年7月在南方医科大学珠江医院泌尿外科行腹腔镜下根治性膀胱切除联合全去带乙状结肠原位新膀胱术患者60例为研究对象,按随机数字表法将其分成对照组和观察组,每组均30例.观察组患者术前口服聚乙二醇电解质+蓖麻油后灌肠,对照组患者术前口服蓖麻油后灌肠.比较两组患者肠道的清洁度、不良反应以及患者服药依从性情况.结果 与对照组比较,观察组患者肠道清洁情况较好,不良反应发生少且依从性强,差异有均有统计学意义(均P<0.05).结论 口服聚乙二醇电解质+蓖麻油后灌肠能提高患者的肠道准备效果,可减少不良反应,更有利于保证手术的顺利进行.%Objective To discuss the effects of different preoperative bowel preparations on patients with intestinal cleaning for laparoscopic radical cystectomy with complete detenial sigmoid colon orthotopic neo-bladder reconstruction. Methods From Jun. 2009 to Jul. 2011,60 patients undergoing laparoscopic radical cystectomy with complete detenial sigmoid colon orthotopic neobladder reconstruction in the hospital were randomly divided into experimental group(n = 30) and control group(n = 30). The patients in the experi-mental group and in the control group were administrated with polyethylene glycol electrolytes powder±castor oil and castor oil+cleansing before enema respectively. The intestinal cleanliness,adverse reactions and compliance of the two groups were compared. Results Compared with the control group,significantly increased intestinal cleanliness,decreased adverse reactions and better compliance in the experimental group were observed(P<0. 05). Conclusion The bowel preparation method with polyethylene glycol electrolytes powder±castor oil before

  1. Core Outlet Temperature Study

    Energy Technology Data Exchange (ETDEWEB)

    Moisseytsev, A. [Argonne National Laboratory (ANL), Argonne, IL (United States); Hoffman, E. [Argonne National Laboratory (ANL), Argonne, IL (United States); Majumdar, S. [Argonne National Laboratory (ANL), Argonne, IL (United States)

    2008-07-28

    It is a known fact that the power conversion plant efficiency increases with elevation of the heat addition temperature. The higher efficiency means better utilization of the available resources such that higher output in terms of electricity production can be achieved for the same size and power of the reactor core or, alternatively, a lower power core could be used to produce the same electrical output. Since any nuclear power plant, such as the Advanced Burner Reactor, is ultimately built to produce electricity, a higher electrical output is always desirable. However, the benefits of the higher efficiency and electricity production usually come at a price. Both the benefits and the disadvantages of higher reactor outlet temperatures are analyzed in this work.

  2. Neurogenic bladder in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Al Taweel W

    2015-06-01

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

  3. Overactive Bladder

    Science.gov (United States)

    ... social interactions and everyday activities. Causes Normal bladder function The kidneys produce urine, which drains into your ... Sleep disturbances and interrupted sleep cycles Issues with sexuality Your doctor might recommend treatment of associated conditions, ...

  4. 应用前列腺B超参数替代尿动力学参数评估膀胱出口梗阻的可行性研究%Evaluation of Bladder Outlet Obstruction through Parameters of Prostate Ultrasound:A feasibility Study

    Institute of Scientific and Technical Information of China (English)

    刘丽欢; 钟东亮

    2014-01-01

    Objective To explore the correlation between prostatic meridians through ultrasound and parameters of urodynamics and its significance on bladder outlet obstruction (BOO) and to provide the basis for nursing assessment. Methods Totally 115 cases with BOO caused by benign prostatic hypertrophy (BPH), 34 cases with detrusor instability (DI) and 47 cases with overactive bladder syndrome (OAB) were detected by B-ultrasound. The correlation between the parameters of B-ultrasound and urodynamics was applied for the evaluation of the BOO. Results There were significant differences among PV, height, width and length of the prostate in BOO, DI and OAB group through by one-way ANOVA (P<0.05). There was positive relationship among age, pressure of the maximum urinary flow, maximum pressure of detrusor, parameters of BOO and the three dimensions of prostate(P<0.05). Conclusion It will be simple, noninvasive and objective to evaluate BOO when prostatic PV, three dimensions of prostate and residual urine are detected by B-ultrasound.%目的:探讨B超测定前列腺径线长度与尿动力学检测参数的相关性对临床判断膀胱出口梗阻的意义,为护理评估提供依据。方法分析良性前列腺增生引起膀胱出口梗阻115例患者,逼尿肌不稳定34例患者,膀胱过度活动症47例患者检测的前列腺B超参数与尿动力学参数的相关性,评估膀胱出口梗阻。结果膀胱出口梗阻组、逼尿肌不稳定组、膀胱过度活动症组的前列腺体积、上下径、左右径、前后径线,经单因素方差分析,差异有统计学意义(P<0.05)。年龄、最大尿流率时压力、最大逼尿肌压、膀胱出口梗阻系数,与膀胱出口梗阻组及膀胱过度活动症组前列腺三经线呈正相关(P<0.05)。结论根据B超提示前列腺体积、前列腺三径线长度、残余尿等参数,结合下尿路症状,能简便、无创、客观地评估膀胱出口梗阻患者的病情。

  5. Bladder Dysfunction and Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    F. faizi

    2009-01-01

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

  6. Study on the correlation between prostatitis and bladder outlet obstruction in patients with benign prostatic hyperplasia%良性前列腺增生患者合并前列腺炎与膀胱出口梗阻的相关性研究

    Institute of Scientific and Technical Information of China (English)

    余凯远; 祁旦巳; 王谦; 陈映鹤

    2013-01-01

    Objective To investigate the correlation between prostatitis and bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia.Methods From January 2008 to January 2012,Three hundred BPH patients were divided into two group according to whether had prostatitis determined by pathology.One hundred and thirty six patients with simple BPH and 164 patients with BPH combined with prostatitis were included with the median age of 69 years.PSA was (4.9 ± 8.3) μg/L and (7.0 ± 8.5)μg/L,the prostate volume was (41.4±18.1) ml and (48.7±20.7) ml,and IPSS was 21.9±7.0 and 27.5 ± 5.1 in BPH group and prostatitis group,respectively.The urodynamic parameters of bladder outlet obstruction between the two groups were analyzed.Results Qmax was (8.8 ± 4.8) ml/s and (6.3 ± 3.7)ml/s,Pdet.Qmax was (96.7 ± 33.0) cm H2O and (113.3 ± 39.8) cm H2O,AG value was 77.7 ± 31.9 and 93.9 ± 39.6,and Schafer grading value was 3.3 ± 1.5 and 4.4 ± 1.2 in BPH group and BPH combined with prostatitis group,respectively (P < 0.05).Logistic regression analysis showed that prostatitis (OR =2.66,P =0.002),PV (OR =1.37,P =0.000),and Qmax(OR =0.72,P =0.000) were positively correlated with Schafer grading value.Conclusions Prostatitis increased the degree of BOO in patients with BPH.%目的 探讨BPH患者合并前列腺炎与膀胱出口梗阻(BOO)的相关性.方法 选取2008年1月至2012年1月BPH患者300例.年龄47 ~ 93岁,平均69岁.按是否合并前列腺炎分为单纯BPH组136例,PSA(4.9±8.3) μg/L,前列腺体积(41.4±18.1)ml,IPSS评分(21.9 ±7.0)分;合并前列腺炎组164例,PSA(7.0±8.5) μg/L,前列腺体积(48.7±20.7) ml,IPSS评分(27.5±5.1)分.比较两组尿动力学检查梗阻指标的差异.结果 单纯BPH组与合并前列腺炎组的Qmax分别为(8.8±4.8)ml/s和(6.3±3.7) ml/s,差异有统计学意义(P<0.05);最大尿流率时逼尿肌压力分别为(96.7±33.0)cm H2O(1 cm H2O=0.098 kPa)和(113.2 ±39.8)cmH2O,差异有统计学意义(P<0

  7. Kidney transplantation in abnormal bladder

    Directory of Open Access Journals (Sweden)

    Shashi K Mishra

    2007-01-01

    Full Text Available Structural urologic abnormalities resulting in dysfunctional lower urinary tract leading to end stage renal disease may constitute 15% patients in the adult population and up to 20-30% in the pediatric population. A patient with an abnormal bladder, who is approaching end stage renal disease, needs careful evaluation of the lower urinary tract to plan the most satisfactory technical approach to the transplant procedure. Past experience of different authors can give an insight into the management and outcome of these patients. This review revisits the current literature available on transplantation in abnormal bladder and summarizes the clinical approach towards handling this group of difficult transplant patients. We add on our experience as we discuss the various issues. The outcome of renal transplant in abnormal bladder is not adversely affected when done in a reconstructed bladder. Correct preoperative evaluation, certain technical modification during transplant and postoperative care is mandatory to avoid complications. Knowledge of the abnormal bladder should allow successful transplantation with good outcome.

  8. Missed Iatrogenic Bladder Rupture Following Normal Vaginal Delivery.

    Science.gov (United States)

    Baheti, Vidyasagar H; Wagaskar, Vinayak G; Patwardhan, Sujata K

    2015-10-01

    Bladder rupture following caesarian section is well documented complications. Intraperitoneal bladder rupture following normal vaginal delivery is very rare. Hereby, we present a case report of intraperitoneal bladder rupture presented late following normal vaginal delivery. We report a case of spontaneous intraperitoneal urinary bladder rupture following uneventful outlet forceps delivery in a 22-year-old primi gravid woman with gestational diabetes mellitus and fetal macrosomia who presented with large urinary ascites, anuria and renal failure. Emergent exploratory laparotomy with repair of the intraperitoneal bladder rupture helped to prevent its potential complications. Postpartum patients who undergo episiotomy or perineal repair may land up in unnoticed urinary retention which may rarely terminate in spontaneous urinary bladder rupture. Awareness of its manifestations amongst emergency physician would help to initiate appropriate timely management.

  9. Overactive Bladder.

    Science.gov (United States)

    White, Nicola; Iglesia, Cheryl B

    2016-03-01

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

  10. Clinical value of urine flow acceleration and maximum urinary flow-rate in diagnosing bladder outlet obstruction of patients with benign prostate hyperplasia%尿流加速度和最大尿流率诊断膀胱出口梗阻的价值

    Institute of Scientific and Technical Information of China (English)

    文建国; 崔林刚; 孟庆军; 任川川; 李金升; 吕宇涛; 张艳

    2012-01-01

    目的 比较尿流加速度(UFA)和最大尿流率(Qmax)诊断膀胱出口梗阻(BOO)的价值. 方法 分别选取50例前列腺增生(BPH)患者和50例健康者进行前列腺体积、UFA和Qmax测定.以P-Q图梗阻区作为参考标准,比较UFA和Qmax诊断BOO的灵敏度和特异性. 结果 BPH组UFA明显低于非BPH组(P<0.05).以UFA<2 ml/s2和Qmax<10 ml/s作为诊断BOO参考标准,灵敏度和特异度分别为88%、75%与81%、63%,与参考标准P-Q图提示梗阻一致性分析Kappa值分别为0.55比0.35. 结论 UFA可以作为诊断BPH患者BOO的依据之一.%Objective To assess the value of the urine flow acceleration(UFA)versus maximum urinary flow rate (Qmax) for diagnosis of bladder outlet obstruction (BOO) in benign prostate hyperplasia (BPH).Methods A total of 50 men with BPH and 50 normal men were included in this study.Urodynamic examinations were performed in all patients according to the recommendations of the International Continence Society.Prostate volume,UFA and Qmax of each patient were analyzed and the results were compared between two groups.Results The UFA and Qmax of BPH group were much lower than that of the control group [(2.05±0.85)ml/s2 vs.(4.60±1.25)ml/s2 ; (8.50±1.05)ml/s vs.(13.00±3.35)ml/s,P<0.05].The prostate volume in BPH group was increased compared with control group [(28.6±9.8) ml vs.(24.2±7.6)ml,P<0.05].As diagnosis standard of UFA<2.05 ml/s2 and Qmax< 10 ml/s,the sensitivity and specificity of UFA and Qmax in diagnosing BOO were (88%,75 %)vs.(81%,63%).While compared with the result of P-Q chart,the Kappa values in correspondence analysis were 0.55 vs.0.35.The sensitivity,specificity and Kappa value of UFA in diagnosing BOO in BPHs were slightly higher than that of Qmax in comparison with the gold standard (BOO diagnosed by P-Q figure).Conclusions The UFA is a useful urodynamics parameter in diagnosing BOO of BPH.

  11. A New Outlet for Discount Shopping

    Institute of Scientific and Technical Information of China (English)

    S.E.CONGDON-MARTIN

    2004-01-01

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

  12. Bladder Cancer Advocacy Network

    Science.gov (United States)

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

  13. A case-control study on the association between bladder cancer and prior bladder calculus.

    Science.gov (United States)

    Chung, Shiu-Dong; Tsai, Ming-Chieh; Lin, Ching-Chun; Lin, Herng-Ching

    2013-03-15

    Bladder calculus is associated with chronic irritation and inflammation. As there is substantial documentation that inflammation can play a direct role in carcinogenesis, to date the relationship between stone formation and bladder cancer (BC) remains unclear. This study aimed to examine the association between BC and prior bladder calculus using a population-based dataset. This case-control study included 2,086 cases who had received their first-time diagnosis of BC between 2001 and 2009 and 10,430 randomly selected controls without BC. Conditional logistic regressions were employed to explore the association between BC and having been previously diagnosed with bladder calculus. Of the sampled subjects, bladder calculus was found in 71 (3.4%) cases and 105 (1.1%) controls. Conditional logistic regression analysis revealed that the odds ratio (OR) of having been diagnosed with bladder calculus before the index date for cases was 3.42 (95% CI = 2.48-4.72) when compared with controls after adjusting for monthly income, geographic region, hypertension, diabetes, coronary heart disease, and renal disease, tobacco use disorder, obesity, alcohol abuse, and schistosomiasis, bladder outlet obstruction, and urinary tract infection. We further analyzed according to sex and found that among males, the OR of having been previously diagnosed with bladder calculus for cases was 3.45 (95% CI = 2.39-4.99) that of controls. Among females, the OR was 3.05 (95% CI = 1.53-6.08) that of controls. These results add to the evidence surrounding the conflicting reports regarding the association between BC and prior bladder calculus and highlight a potential target population for bladder cancer screening.

  14. Gastric outlet obstruction secondary to Morgagni hernia: a case report.

    Science.gov (United States)

    Pallati, P K; Puri, V; Mittal, S K

    2008-04-01

    An 89-year old female presented to us with symptoms of gastric outlet obstruction which appeared to be secondary to gastric volvulus on preoperative work-up. On laparoscopy the stomach was found to be incarcerated in a right-sided Morgagni hernia with surrounding adhesions. The hernia was reduced after dissecting the adhesions and the diaphragmatic defect was repaired using a biologic mesh onlay patch (Surgisis GOLD, Cook Biotech Inc.). Her postoperative recovery was uneventful and she was doing well at three months follow-up.

  15. What Is Bladder Cancer?

    Science.gov (United States)

    ... of the bladder through a tube called the urethra . Start and spread of bladder cancer The wall of the bladder has several layers, ... called the renal pelvis ), the ureters, and the urethra. Patients with bladder cancer sometimes have other tumors in these places, so ...

  16. Functional properties of laser effects on morphology of liver, gall bladder and bile ducts in cholelithiasis

    National Research Council Canada - National Science Library

    Bakhtior Shamirzaev

    2012-01-01

    In 85 patients with calculous cholecystitis the preoperative preparation before laparoscopic cholecystectomy included irradiation of the area of gall bladder and epigastric puncture with low power magneto-infrared laser...

  17. Ultrasonographic evaluation of urinary bladder neoplasias

    Directory of Open Access Journals (Sweden)

    Nipa Patidar

    2015-12-01

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

  18. How frequent are overactive bladder symptoms in women with urodynamic verification of an overactive bladder?

    Science.gov (United States)

    Yeniel, Ahmet Özgür; Ergenoğlu, Mete Ahmet; Meseri, Reci; Aşkar, Niyazi; Itil, Ismail Mete

    2012-01-01

    To determine the relationship between overactive bladder symptoms and urodynamic verification of overactive bladder. Between June 2011 and November 2011, 159 patients underwent urodynamics (UDS) at our urogynecology unit in the Ege University Hospital. Of these, 95 patients who complained of urgency, did not have any overt neurological diseases, bladder outlet obstruction and did not take any medication affecting the lower urinary tract function were evaluated. SPSS (ver. 15.0) was used to evaluate the data and the chi-square test and t test for independent samples were used for analysis. The mean age was found to be 54.5±12. Frequency was the most frequent symptom in women with overactive bladder (OAB) (82.1%), nocturia (57.8%) and (57.8%) urgency urinary incontinence followed in frequency. Detrusor over activity incidence was found to be 38.9%. There was no significant relationship between the presence of detrusor over activity (DOA) and OAB symptoms. Leak at urodynamics was found in 46.3% and there is no significant association with detrusor overactivity. Total bladder capacity was found to be significantly lower in women who had DOA (p=0.000). It appears that overactive bladder symptoms do not predict detrusor over activity. Urodynamic investigation is not mandatory in the initial management of women with only OAB symptoms.

  19. Role of antioxidants in the treatment of obstruction-mediated rabbit urinary bladder dysfunction

    Directory of Open Access Journals (Sweden)

    Tasmina Hydery

    2011-02-01

    Full Text Available Benign prostatic hyperplasia (BPH is a common medical problem; more than 80% of males 50 years of age and older have some degree of bladder outlet obstruction secondary to BPH. In order to understand the effects of outlet obstruction on bladder structure and function, animal models have been developed using several species including rat, rabbit, guinea pig, and pig. Although there are marked differences in bladder size, capacity, compliance, physiology and pharmacology among these species, their responses to outlet obstruction have many common characteristics. Recent reviews have enumerated these responses of animal bladders to partial outlet obstruction; their relevance to progressive bladder dysfunction secondary to BPH in men. We have found that the rabbit is most similar to man in that the rabbit urinates between 3 and 5 times per day, we can evaluate bladder function through urodynamics performed similar to that used in man, and cystoscopy can be performed using a pediatric cystiscope. [J Exp Integr Med 2011; 1(1: 23-35

  20. Holmium laser lithotripsy of bladder calculi

    Science.gov (United States)

    Beaghler, Marc A.; Poon, Michael W.

    1998-07-01

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

  1. Left-sided gall bladder: Report of two cases

    Directory of Open Access Journals (Sweden)

    Chrungoo R

    2007-01-01

    Full Text Available Left-sided gall bladder without situs inversus viscerum is a rare albeit recognized clinical entity. We report our experience of two cases of left-sided gall bladder in two women aged 36 and 48 who underwent laparoscopic cholecystectomy for chronic calculous cholecystitis. Left-sided gall bladder may provide an unusual surprise to the surgeons during laparoscopy as routine pre-operative studies may not always detect the anomaly. Awareness of the unpredictable confluence of the cystic duct into the common bile duct (CBD and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual entity.

  2. Functional properties of laser effects on morphology of liver, gall bladder and bile ducts in cholelithiasis

    Directory of Open Access Journals (Sweden)

    Bakhtior Shamirzaev

    2012-05-01

    Full Text Available In 85 patients with calculous cholecystitis the preoperative preparation before laparoscopic cholecystectomy included irradiation of the area of gall bladder and epigastric puncture with low power magneto-infrared laser. The investigations performed revealed significant reduction of the liver and gall bladder changes both on the light optic and electron microscopic levels due to effects of low power laser irradiation.

  3. Functional properties of laser effects on morphology of liver, gall bladder and bile ducts in cholelithiasis

    OpenAIRE

    Bakhtior Shamirzaev

    2012-01-01

    In 85 patients with calculous cholecystitis the preoperative preparation before laparoscopic cholecystectomy included irradiation of the area of gall bladder and epigastric puncture with low power magneto-infrared laser. The investigations performed revealed significant reduction of the liver and gall bladder changes both on the light optic and electron microscopic levels due to effects of low power laser irradiation.

  4. Failure of conventional retrograde cystography to detect bladder ruptures in pelvic trauma

    OpenAIRE

    Berber, O.; Emeagi, C.; Perry, M; Rickman, M. S.

    2010-01-01

    Conventional retrograde cystography is often used to investigate patients with suspected bladder ruptures in pelvic trauma. Clinical indicators suggestive of a rupture include haematuria and suprapubic tenderness and should increase the suspicion of bladder and urinary tract injury and prompt the clinician to undertake further investigations. Two patients with high-energy pelvic fractures had bladder ruptures detected intraoperatively despite normal preoperative retrograde cystogram. Both pat...

  5. L1椎体爆裂骨折合并脊髓圆锥损伤术后患者膀胱逼尿肌功能恢复的相关因素%Related factors of patient between the L1 burst fracture complicating conus medullaris injury with preoperative and postoperative detrusor muscle of bladder function recovery

    Institute of Scientific and Technical Information of China (English)

    谭俊铭; 来津; 王金鑫; 张颉峰; 申练兵; 王朝阳; 邢顺民; 陈德纯; 时国华; 廖腾; 苏加向; 何翔

    2013-01-01

    [ Objective ] To study related factors of the patients between the L1 burst fracture complicating conus medullaris injury with preoperative and postoperative detrusor muscle of bladder function recovery. [ Method ] Retrospective analysis clinical data with 35 cases with the L1 burst fracture complicating conus medullaris injuries were analyzed. According to imaging information and physical examinations, patients were performed selective operation with posterior or anterolateral decompression and stabilization and JOA score of bladder function were recorded before and after surgery. [ Result] All patients had perineum or saddle anesthesia. Of those, 25 cases had perineum or saddle hypesthesia, 10 cases had the saddle sensory deprivation. Bladder urine dynamics parameters were compared between the saddle hypesthesia group (25 cases) and sensory deprivation group(10 cases) ,such as the largest free urinary flow rate,automatic micturition rate,mean free urinary flow rate,independent urine output, residual urine volume, urinary flow rate with maximum detrusor pressure、detrusor maximum pressure of urinary flow rate、detrusor maximum pressure. With the saddle hypesthesia group was significantly superior to sensory deprivation group and had statistically significant difference ( P < 0. 05 ) . Two groups of patients in the follow-up of 2 years, hypesthesia group of 16 cases of 3 months relieve oneself returned to normal, 7 cases of postoperative 6 months to return to normal, 2 cases of postoperative recovery poor and need to catheterize. The sensory deprivation group recovery to normal proportion was significantly lower than the hypesthesia group (P < 0.05). [ Conclusion] Postoperative bladder detrusor function recovery of patient with the first lumbar spine burst fracture complicating conus medullaris injury is an important prognostic indicator, and the recovery of patients with preoperative perineum or saddle damage has an important relationship.%[目的]研究L1

  6. The paediatric neuropathic bladder

    African Journals Online (AJOL)

    spinal reflex arc that occurs when the bladder becomes autonomous from higher ... rise in the pressure v. time trace with bladder filling, representing a typical poorly .... reactions. Furthermore, new-generation anticholinergic agents, such.

  7. Ultrasound: Bladder (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Ultrasound: Bladder KidsHealth > For Parents > Ultrasound: Bladder A A A What's in this article? ... español Ultrasonido: vejiga What It Is A bladder ultrasound is a safe and painless test that uses ...

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

    Directory of Open Access Journals (Sweden)

    Chung-Cheng Wang

    2015-03-01

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

  9. Status of integrated irradiation and cystectomy for bladder cancer.

    Science.gov (United States)

    Whitmore, W F; Batata, M

    1984-11-01

    The rationale and representative results of integrated irradiation and cystectomy for bladder cancer are reviewed and an hypothesis regarding the mechanism and benefits of such treatment formulated. The basis for uncertainty regarding the value of preoperative irradiation is outlined and a perspective on the resolution of this uncertainty provided.

  10. Expanded PTFE bladder neck slings for incontinence in children: the long-term outcome.

    Science.gov (United States)

    Godbole, P; Mackinnon, A E

    2004-01-01

    To assess the long-term outcome of circumferential expanded PTFE (Gore-tex, WL Gore Associates, Scotland) bladder neck slings for achieving urethral continence in children with a neuropathic bladder. The records were reviewed of 19 children undergoing bladder reconstruction (most with a neuropathic bladder) who had a Gore-tex sling placed circumferentially at the bladder neck, over a 5-year period. Of these, seven had spina bifida; two each spinal dysraphism, surgery for anorectal anomalies and an idiopathic neuropathic bladder; five who developed a neuropathic bladder from other causes, and one born with bladder exstrophy. All children had an uncompliant bladder with a low urethral leak-point pressure on preoperative urodynamics. In all children conventional clean intermittent catheterization and pharmacotherapy had failed. Four had had previous augmentation surgery while 15 had concomitant bladder augmentation and formation of a Mitrofanoff stoma. The main outcome measure was achieving dryness. The original intention of the procedure was also to maintain urethral catheterization. Full details of the follow-up were available in 17 patients. Despite initial good short-term results, at a median follow up of 7 years, in 14 patients the sling had to be removed because of erosion, often with transient urethral leakage before the bladder neck subsequently closed. A bladder calculus was associated with each case of erosion except one. Although in the short term this technique had favourable results, it was not a useful technique in the long term.

  11. Socioeconomic determinants of exposure to alcohol outlets.

    Science.gov (United States)

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

    2015-05-01

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

  12. Noninvasive Methods to Evaluate Bladder Obstruction in Men

    Directory of Open Access Journals (Sweden)

    Dean S. Elterman

    2013-01-01

    Full Text Available Lower urinary tract symptoms (LUTS caused by benign prostatic hyperplasia (BPH commonly affect older men. Fifty percent of men in their sixties and 80% of men in their nineties will be affected. Many of these men will seek care for their bothersome symptoms and decreased quality of life. There is a poor association between LUTS and objective measures such as post void residual, voided volumes, or maximal flow. Pressure flow studies are considered the gold standard for detecting bladder outlet obstruction. These studies tend to be cumbersome, expensive, and have exposure to ionizing radiation. There are several techniques which may offer noninvasive methods of detecting bladder outlet obstruction (BOO in men.

  13. Alcohol outlets and clusters of violence

    Directory of Open Access Journals (Sweden)

    Pridemore William

    2011-05-01

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

  14. Complex Greenland outlet glacier flow captured

    Science.gov (United States)

    Aschwanden, Andy; Fahnestock, Mark A.; Truffer, Martin

    2016-02-01

    The Greenland Ice Sheet is losing mass at an accelerating rate due to increased surface melt and flow acceleration in outlet glaciers. Quantifying future dynamic contributions to sea level requires accurate portrayal of outlet glaciers in ice sheet simulations, but to date poor knowledge of subglacial topography and limited model resolution have prevented reproduction of complex spatial patterns of outlet flow. Here we combine a high-resolution ice-sheet model coupled to uniformly applied models of subglacial hydrology and basal sliding, and a new subglacial topography data set to simulate the flow of the Greenland Ice Sheet. Flow patterns of many outlet glaciers are well captured, illustrating fundamental commonalities in outlet glacier flow and highlighting the importance of efforts to map subglacial topography. Success in reproducing present day flow patterns shows the potential for prognostic modelling of ice sheets without the need for spatially varying parameters with uncertain time evolution.

  15. Report of two cases of double outlet left ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chul Soon; Lim, Tae Hwan; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1983-03-15

    Double outlet left ventricle (DOLV), even defined as origins or both great vessels from left ventricle, implies varieties of morphology in concern with loop pattern, location of ventricular septal defect, conotruncal anatomy, and presence or absence of pulmonary stenosis. With the improvement of surgical technique, corrective surgery of DOLV become possible, and preoperative diagnosis and determination of the accurate anatomical relationship between great vessels, ventricular septal defect, and ventricles is very important in surgical implication. Authors have recently experienced two cases of DOLV. The one is with subpulmonic conus, subpulmonic ventricular septal defect, patent ductus arteriosus, and preductal type coarctation of aorta. The other is with bilateral coni and subaortic ventricular septal defect. Loop patterns are [S, D, D]in both cases.

  16. Exposure to alcohol outlets in rural towns.

    Science.gov (United States)

    Morrison, Christopher

    2015-01-01

    Lower-income populations are exposed to excess risks related to the presence of greater concentrations of alcohol outlets in their communities. Theory from economic geography suggests this is due to dynamic processes that shape urban retail markets (as outlets are attracted to areas of higher population density due to the increased demand but are excluded from higher-income areas due to land and structure rents). This mechanism may explain increased exposure to alcohol outlets for lower-income populations in rural areas. This study tests the hypothesis that the distribution of outlets between rural towns will reflect these market dynamics, such that outlets are concentrated in towns with (i) greater resident and temporary populations, (ii) with lower income, and (iii) which are adjacent to towns with higher income. Bayesian conditional autoregressive Poisson models examined counts of bars, restaurants, and off-premise outlets within 353 discrete towns of rural Victoria, Australia (mean population = 4,236.0, SD = 15,754.1). Independent variables were each town's total resident population, net changes to population (due to commuter flow, visitors, and the flow of local residents to other towns [spatial interaction]), and income for the local and adjacent towns. Lower local income and increased income in adjacent towns were associated with more outlets of all types. Greater resident populations and greater net population due to commuters also predicted greater numbers of all outlets. Bars and restaurants were positively related to greater net population due to visitors and negatively related to spatial interaction. The economic geographic processes that lead to greater concentrations of alcohol outlets in lower-income areas are common to all retail markets. Lower-income populations are exposed to increased risk associated with the presence of additional outlets that service demand from nonresidents. In rural areas, these processes appear to operate between

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

    Science.gov (United States)

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

    2014-02-01

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

  18. Outpatient Preoperative Education Needs Identified by Nurses and Patients.

    Science.gov (United States)

    2007-11-02

    PREOPERATIVE EDUCATION NEEDS IDENTIFIED BY NURSES AND PATIENTS Cheryl Anne Reilly APPROVED: Supervising Prdessor Date APPROVED: / "Sanfor• Miller , P... anesthesiologist will visit them before 5 4 3 2 1 surgery to discuss what anesthesia would be used. 27. Their incision may pull, bum, or itch while it is 5 4...such as, giving me an injection & asking me to empty my bladder. 26. An anesthesiologist would visit me before Yes No 5 4 3 2 1 surgery to discuss

  19. Surgical treatment of thoracic outlet syndrome; by supraclavicular approach

    Directory of Open Access Journals (Sweden)

    Osman Abd Ellah Mohamed

    2012-01-01

    Full Text Available Background: Thoracic outlet syndrome comprises a wide spectrum of disorders with different compressive pathologies attributed to the neurovascular bundle passing from the root of the neck to supply the upper extremity. New concepts and advances in diagnosis and treatment are emerging. This study evaluates effectiveness and safety of the supraclavicular approach in management of neurovascular compression at the thoracic outlet. Materials and Methods: Twenty patients (15 females and 5 males with mean age of 20 years (ranging from 18 to 40 years underwent anterior neurovascular decompression procedures because of symptoms of lower plexus compression (C8 - T1. Preoperative plain radiography, MRI and nerve conduction velocity studies confirmed the clinical diagnosis. Nine patients had neck pain, all had sensory deficit and eight had motor deficit. Results: After 35 months of follow-up, 17 patients showed excellent results, two cases had good results and one case had fair results according to the visual analog scale, and nerve conduction velocities. Conclusions: We recommend nerve conduction velocity studies beside clinical assessment for diagnosis and follow-up, and supraclavicular approach in neurogenic decompression which is relatively safe and effective.

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

    Science.gov (United States)

    Bägli, Darius J

    2012-08-01

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

  1. Mouse bladder wall injection.

    Science.gov (United States)

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

    2011-07-12

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

  2. Biomatrices for bladder reconstruction.

    Science.gov (United States)

    Lin, Hsueh-Kung; Madihally, Sundar V; Palmer, Blake; Frimberger, Dominic; Fung, Kar-Ming; Kropp, Bradley P

    2015-03-01

    There is a demand for tissue engineering of the bladder needed by patients who experience a neurogenic bladder or idiopathic detrusor overactivity. To avoid complications from augmentation cystoplasty, the field of tissue engineering seeks optimal scaffolds for bladder reconstruction. Naturally derived biomaterials as well as synthetic and natural polymers have been explored as bladder substitutes. To improve regenerative properties, these biomaterials have been conjugated with functional molecules, combined with nanotechology, or seeded with exogenous cells. Although most studies reported complete and functional bladder regeneration in small-animal models, results from large-animal models and human clinical trials varied. For functional bladder regeneration, procedures for biomaterial fabrication, incorporation of biologically active agents, introduction of nanotechnology, and application of stem-cell technology need to be standardized. Advanced molecular and medical technologies such as next generation sequencing and magnetic resonance imaging can be introduced for mechanistic understanding and non-invasive monitoring of regeneration processes, respectively.

  3. URACHAL CARCINOMA IN BLADDER

    Institute of Scientific and Technical Information of China (English)

    薛丽燕; 吕宁; 何祖根; 林冬梅; 刘秀云

    2004-01-01

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

  4. Bladder augmentation with small intestinal submucosa leads to unsatisfactory long-term results.

    Science.gov (United States)

    Schaefer, M; Kaiser, A; Stehr, M; Beyer, H J

    2013-12-01

    To evaluate the use of small intestinal submucosa (SIS) for bladder augmentation in a series of select patients. Six patients (age 6.5-15.4, mean 9.8 years) underwent bladder augmentation with SIS: one after a cloacal exstrophy repair, one after multiple surgery of the bladder because of vesicoureteral reflux, two with spina bifida, two after bladder exstrophy repair. All suffered from a microbladder with a mean volume of 61.5 ml (range 15-120, 7-36% of expected bladder capacity for age). Preoperative bladder compliance ranged from 1.0 to 3.3 (mean 1.3) ml/cmH2O. Follow-up time ranged from 4.6 to 33.5 (mean 24.4) months. An increase of bladder volume was achieved in four patients (53-370 ml, 16-95% of expected bladder capacity for age). Bladder compliance postoperatively ranged from 0.9 to 5.6 (mean 3.0) ml/cmH2O. Histological examinations showed a complete conversion of SIS, leaving irregular urothelial lining and bladder wall containing muscular, vascular and relatively thick connective tissue in four patients and regular urothelium in two patients. Major complications were bladder stones in two patients and a bladder rupture in one patient. Bladder augmentation with SIS in humans failed to fulfill the hopes raised by animal studies. Due to the insufficient increase in bladder compliance and therefore failure to accomplish sufficient protection of the upper urinary tract, bladder augmentation with SIS cannot be recommended as a substitute for enterocystoplasty. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  5. Treatment Option Overview (Bladder Cancer)

    Science.gov (United States)

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

  6. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

    Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has ex...... can be challenging, and misdiagnosis as a psychological problem, overactive bladder, or chronic urinary infection has plagued patients with the problem....

  7. Overactive bladder is a negative predictor of achieving continence after robot-assisted radical prostatectomy.

    Science.gov (United States)

    Yamada, Yuta; Fujimura, Tetsuya; Fukuhara, Hiroshi; Sugihara, Toru; Miyazaki, Hideyo; Nakagawa, Tohru; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio

    2017-10-01

    To investigate predictors of continence outcomes after robot-assisted radical prostatectomy. Clinical records of 272 patients who underwent robot-assisted radical prostatectomy were investigated. Preoperative Overactive Bladder Symptom Score, International Prostate Symptom Score and clinicopathological factors were investigated, and relationships between factors and recovery of continence after robot-assisted radical prostatectomy were assessed. The presence of overactive bladder was defined as having urgency for more than once a week and having ≥3 points according to the Overactive Bladder Symptom Score. Age (≤66 years) was significantly associated with continence within 6 months after robot-assisted radical prostatectomy (P = 0.033). The absence of overactive bladder and lower Overactive Bladder Symptom Score (robot-assisted radical prostatectomy, Kaplan-Meier curves showed earlier recovery in "age ≤66 years," "prostate weight ≤40 g" and "overactive bladder symptom score robot-assisted radical prostatectomy. © 2017 The Japanese Urological Association.

  8. Diabetic bladder dysfunction

    Institute of Scientific and Technical Information of China (English)

    Guiming Liu; Firouz Daneshgari

    2014-01-01

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

  9. Bladder pain syndrome

    DEFF Research Database (Denmark)

    Hanno, Philip; Nordling, Jørgen; Fall, Magnus

    2011-01-01

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

  10. Preoperative preparation of children

    Directory of Open Access Journals (Sweden)

    Priya Reshma Aranha

    2017-01-01

    Full Text Available Surgery is a stressful and anxiety provoking experience for children. Millions of children undergo surgery every year. The majority of children experience significant preoperative anxiety which intern can affect their recovery. Preoperative anxiety may bring about physical and physiological changes in children, which can be particularly evident in terms of increased heart rate and blood pressure. To identify various strategies used to minimize the preoperative anxiety of children and update their clinical effectiveness among children undergoing surgery, the authors searched PubMed, MEDLINE, CINAHL, ScienceDirect, Google Scholar, Scopus, and Cochrane Library for identifying the relevant studies and retrieved available literature. It is concluded that utilization of the strategies available to reduce the preoperative anxiety of children will be a promising intervention to reduce anxiety, to promote relaxation, satisfaction, and speedy recovery. Many of these techniques are simple, cost-effective and can be easily carried out by nurses. It is essential to use the age appropriate and individualized methods in preparing children for surgery. Further research is required to strengthen the evidence.

  11. Pathological and morphological features of bladder neck sclerosis

    Directory of Open Access Journals (Sweden)

    Klochay V.V.

    2011-12-01

    Full Text Available The research goal is to estimate a condition of microcirculation in a bladder neck in patients with benign prostatic hyperplasia (BPH and its value in pathogenesis of bladder neck sclerosis. Materials and methods: Work basis included the analysis of treatment results of 1171 patients with BPH who carried complex examination, operative treatment and further supervision. The basic group was made up of 182 patients with BPH who developed bladder neck sclerosis in the postoperative period. The control group consisted of 200patients with BPH who did not develop the described pathology. clinico-anamnestic, laboratory methods and instrumental studies were used. Results: Disturbance of microcirculation in a bladder neck was considered to be a pathogenetic factor of sclerosis development as one of seri¬ous complications of operative treatment in case of BPH. The presence of microcirculatory disorders was confirmed by histological analysis. Inflammation in the bladder neck should be considered as an aggravating factor. Conclusion: The presence of microcirculatory disorders in the bladder neck in patients with BPH requires preoperative corrective therapy for prevention of sclerosis

  12. Posttraumatic Haematuria with Pseudorenal Failure: A Diagnostic Lead for Intraperitoneal Bladder Rupture

    Science.gov (United States)

    Vagholkar, Suvarna

    2016-01-01

    Bladder rupture is a very morbid injury following blunt or penetrating lower abdominal trauma. Prompt diagnosis is crucial to initiate optimal treatment. Intraperitoneal bladder rupture is associated with haematuria and biochemical features of renal failure. Cystogram is diagnostic. Immediate open surgical repair is the main stay of treatment. A case of intraperitoneal rupture diagnosed preoperatively by the presence of haematuria and pseudorenal failure is presented to highlight the association of posttraumatic haematuria and pseudorenal failure in such injuries. PMID:27547477

  13. Posttraumatic Haematuria with Pseudorenal Failure: A Diagnostic Lead for Intraperitoneal Bladder Rupture

    Directory of Open Access Journals (Sweden)

    Ketan Vagholkar

    2016-01-01

    Full Text Available Bladder rupture is a very morbid injury following blunt or penetrating lower abdominal trauma. Prompt diagnosis is crucial to initiate optimal treatment. Intraperitoneal bladder rupture is associated with haematuria and biochemical features of renal failure. Cystogram is diagnostic. Immediate open surgical repair is the main stay of treatment. A case of intraperitoneal rupture diagnosed preoperatively by the presence of haematuria and pseudorenal failure is presented to highlight the association of posttraumatic haematuria and pseudorenal failure in such injuries.

  14. Paraganglioma of urinary bladder

    Directory of Open Access Journals (Sweden)

    Vinod Priyadarshi

    2015-01-01

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

  15. Radical cystectomy at Roswell Park Memorial Institute. Preoperative and post operative observations.

    Science.gov (United States)

    Eisenkraft, S; Pontes, J E

    1984-01-01

    Between January 1979 and March 1983, 63 consecutive patients underwent cystectomy and urinary diversion for primary carcinoma of the bladder at Roswell Park Memorial Institute (RPMI). Fifty-five patients had transitional cell carcinoma, 6 squamous cell carcinoma and 2 adenocarcinoma of the bladder. Twelve patients with bladder cancer were found to have adenocarcinoma of the prostate on the pathological specimen. Preoperative radiation was given to 41 patients. Thirty-six patients received 4000 rads preoperatively followed by radical cystectomy, 5 patients received 2000 rads. Thirteen patients received 6000 rads as curative treatment and underwent salvage cystectomy and colon conduit because of failure. There was no operative mortality. Severe complications in the early postoperative period occurred in 19 instances, some patients having more than one complication. Late complications necessitating surgical correction occurred in 5 patients. Although radical cystectomy is effective in controlling the local disease, most patients still died of metastatic transitional cell carcinoma.

  16. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Møller, A; Villebro, N

    2005-01-01

    Smokers have a substantially increased risk of intra- and postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence. The preoperative period may be a well chosen time to offer smoking cessation interventions due to increased patient motivation....

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

    Science.gov (United States)

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

    2014-06-30

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

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

    Science.gov (United States)

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

    2014-04-01

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

  19. Failure of conventional retrograde cystography to detect bladder ruptures in pelvic trauma.

    Science.gov (United States)

    Berber, O; Emeagi, C; Perry, M; Rickman, M S

    2011-03-01

    Conventional retrograde cystography is often used to investigate patients with suspected bladder ruptures in pelvic trauma. Clinical indicators suggestive of a rupture include haematuria and suprapubic tenderness and should increase the suspicion of bladder and urinary tract injury and prompt the clinician to undertake further investigations. Two patients with high-energy pelvic fractures had bladder ruptures detected intraoperatively despite normal preoperative retrograde cystogram. Both patients had significant clinical indicators suggestive of underlying bladder and urinary tract injury. In both cases, a routine conventional retrograde cystogram was performed but failed to identify the full extent of the bladder injury. A possible reason for misdiagnosis in these cases is the delay between injury and investigation due to tertiary referral of care.

  20. Long neglected neurogenic bladder

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2011-01-01

    Full Text Available Urinary diversion is indicated for the management of the neurogenic bladder. However, there is a risk for developing pyocystitis in this type of patients. We present a case of young female who presented with a history of frequent urinary tract infection (UTI post urinary diversion for neurogenic bladder. Ever since she underwent simple cystectomy, there have been no further episodes of UTI.

  1. Double-outlet right ventricle revisited.

    Science.gov (United States)

    Ebadi, Ameneh; Spicer, Diane E; Backer, Carl L; Fricker, F Jay; Anderson, Robert H

    2017-08-01

    Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

  2. Two mathematical models explain the variation in cystometrograms of obstructed urinary bladders.

    Science.gov (United States)

    Damaser, M S; Lehman, S L

    1996-12-01

    Overdistension of the urinary bladder, secondary to outlet obstruction, causes cellular changes in the bladder wall, including hypertrophy of the smooth muscle cells, which increase bladder mass. To investigate the effects of increased mass on the cystometrogram (CMG), we have developed two mathematical models. In the first model, we assume that mass is added such that the largest bladder volume at zero transmural pressure, the zero pressure volume (ZPV), is constant, It predicts increased pressures and decreased compliance in the CMG. In the second model, we assume that both mass and ZPV increase proportionally. It predicts unchanged pressures, increased compliance, and increased capacity in the CMG. These results allow use to divide animal experiments in the literature into two groups. Cystometrograms performed on animals that have had outlet obstruction induced by a cuff method, inducing a small increase in mass, belong to the first group: hypertrophy with no change in ZPV. Cystometrograms performed on animals that have had outlet obstruction induced by a ligature method, inducing a large increase in mass, belong to the second group: hypertrophy with increased ZPV. We conclude that increased ZPV results from a more severe obstruction which is indicated by the increased capacity and compliance.

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

    Directory of Open Access Journals (Sweden)

    Daniel Cabezalí Barbancho

    2013-01-01

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

  4. Pre-operative anaemia.

    Science.gov (United States)

    Clevenger, B; Richards, T

    2015-01-01

    Pre-operative anaemia is a relatively common finding, affecting a third of patients undergoing elective surgery. Traditionally associated with chronic disease, management has historically focused on the use of blood transfusion as a solution for anaemia in the peri-operative period. Data from large series now suggest that anaemia is an independent risk associated with poor outcome in both cardiac and non-cardiac surgery. Furthermore, blood transfusion does not appear to ameliorate this risk, and in fact may increase the risk of postoperative complications and hospital length of stay. Consequently, there is a need to identify, diagnose and manage pre-operative anaemia to reduce surgical risk. Discoveries in the pathways of iron metabolism have found that chronic disease can cause a state of functional iron deficiency leading to anaemia. The key iron regulatory protein hepcidin, activated in response to inflammation, inhibits absorption of iron from the gastrointestinal tract and further reduces bioavailability of iron stores for red cell production. Consequently, although iron stores (predominantly ferritin) may be normal, the transport of iron either from the gastrointestinal tract or iron stores to the bone marrow is inhibited, leading to a state of 'functional' iron deficiency and subsequent anaemia. Since absorption from the gastrointestinal tract is blocked, increasing oral iron intake is ineffective, and studies are now looking at the role of intravenous iron to treat anaemia in the surgical setting. In this article, we review the incidence and impact of anaemia on the pre-operative patient. We explain how anaemia may be caused by functional iron deficiency, and how iron deficiency anaemia may be diagnosed and treated.

  5. Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Kari T. Syvänen

    2014-05-01

    Full Text Available Neoadjuvant chemotherapy (NAC in muscle-invasive bladder cancer was introduced several years ago. Despite the evidence supporting its use in clinical practice, only a minority of patients who undergo radical cystectomy receive preoperative chemotherapy. In addition, recommendations and methods to detect patients who would benefit the most from NAC are still unclear. The European Association of Urology (EAU guidelines panel on muscle-invasive and metastatic bladder cancer recommends the use of cisplatin-based NAC for T2-T4a, cN0 M0 bladder cancer if the patient has a performance status ≥2 and if the renal function is not impaired, but the American Urological Association, for example, does not have any guideline recommendations on this topic at all. In this review we describe the current literature supporting NAC in association with radical cystectomy in muscle-invasive urothelial carcinoma of the bladder. Evidence acquisition was made searching the Medline database for original articles published before 1st February 2014, with search terms: “neoadjuvant chemotherapy”, “radical cystectomy”, and “invasive bladder cancer”.

  6. Bladder Control Problems in Men

    Science.gov (United States)

    ... special sensors to measure bodily functions, such as muscle contractions that control urination. A video monitor displays the ... symptoms of urgency incontinence. Mirabegron suppresses involuntary bladder ... brain signals the muscular bladder wall to tighten, squeezing urine out of ...

  7. Giant Intradiverticular Bladder Tumor

    Science.gov (United States)

    Noh, Mohamad Syafeeq Faeez Md; Aziz, Ahmad Fuad Abdul; Ghani, Khairul Asri Mohd; Siang, Christopher Lee Kheng; Yunus, Rosna; Yusof, Mubarak Mohd

    2017-01-01

    Patient: Male, 74 Final Diagnosis: Giant intradiverticular bladder tumor with metastasis Symptoms: Hematuria Medication:— Clinical Procedure: — Specialty: Urology Objective: Rare disease Background: Intradiverticular bladder tumors are rare. This renders diagnosis of an intradiverticular bladder tumor difficult. Imaging plays a vital role in achieving the diagnosis, and subsequently staging of the disease. Case Report: A 74-year-old male presented to our center with a few months history of constitutional symptoms. Upon further history, he reported hematuria two months prior to presentation, which stopped temporarily, only to recur a few days prior to coming to the hospital. The patient admitted to having lower urinary tract symptoms. However, there was no dysuria, no sandy urine, and no fever. Palpation of his abdomen revealed a vague mass at the suprapubic region, which was non tender. In view of his history and the clinical examination findings, an ultrasound of the abdomen and computed tomography (CT) was arranged. These investigations revealed a giant tumor that seemed to be arising from a bladder diverticulum, with a mass effect and hydronephrosis. He later underwent operative intervention. Conclusions: Intradiverticular bladder tumors may present a challenge to the treating physician in an atypical presentation; thus requiring a high index of suspicion and knowledge of tumor pathophysiology. As illustrated in our case, CT with its wide availability and multiplanar imaging capabilities offers a useful means for diagnosis, disease staging, operative planning, and follow-up. PMID:28246375

  8. Hypoxia-increased expression of genes involved in inflammation, dedifferentiation, pro-fibrosis, and extracellular matrix remodeling of human bladder smooth muscle cells.

    Science.gov (United States)

    Wiafe, Bridget; Adesida, Adetola; Churchill, Thomas; Adewuyi, Esther Ekpe; Li, Zack; Metcalfe, Peter

    2017-01-01

    Partial bladder outlet obstruction (pBOO) is characterized by exaggerated stretch, hydrodynamic pressure, and inflammation which cause significant damage and fibrosis to the bladder wall. Several studies have implicated hypoxia in its pathophysiology. However, the isolated progressive effects of hypoxia on bladder cells are not yet defined. Sub-confluent normal human bladder smooth muscle cells (hbSMC) were cultured in 3% O2 tension for 2, 24, 48, and 72 h. RNA, cellular proteins, and secreted proteins were used for gene expression analysis, immunoblotting, and ELISA, respectively. Transcription of hypoxia-inducible factor (HIF)1α and HIF2α were transiently induced after 2 h of hypoxia (p inflammation, de-differentiation, pro-fibrotic changes, and increased extracellular matrix expression. This elucidates mechanisms of hypoxia-driven bladder deterioration in bladder cells, which is important in tailoring in vivo experiments and may ultimately translate into improved clinical outcomes.

  9. [Surgical treatment of superior thoracic outlet syndrome].

    Science.gov (United States)

    Gaibov, A D; Kakhorov, A Z; Sadriev, O N; Yunusov, Kh A

    2015-01-01

    The authors present immediate and long-term results of treatment of 117 patients with superior thoracic outlet syndrome (STOS). There were different reasons for compression of neu- rovascular fascicle in outlet of the thorax. The costaclavicular syndrome was a reason in 48 patients, additional cervical ribs had 36 patients. Skalenus syndrome was noted in 26 cases, rudimentary cervical ribs or hypertrophy of cervical vertebrae C7 had 7 patients. Raynaud's syndrome took place in 19 cases. The required volume of diagnostic procedures and surgical treatment of STOS were determined according to the cause of the syndrome. Differentiated approach to the different forms of STOS was used in relation to dominant symptoms of the disease and reasons for compression of neurovascular fascicle. This allowed getting positive results in majority of patients (90,4%) in long- term period.

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

    Science.gov (United States)

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

    2016-02-15

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

  11. Near-Infrared Spectroscopy of the Bladder: New Parameters for Evaluating Voiding Dysfunction

    Directory of Open Access Journals (Sweden)

    Andrew Macnab

    2011-01-01

    Full Text Available We describe innovative methodology for monitoring alterations in bladder oxygenation and haemodynamics in humans using near-infrared spectroscopy (NIRS. Concentrations of the chromophores oxygenated (O2Hb and deoxygenated (HHb haemoglobin and their sum (total haemoglobin differ during bladder contraction in health and disease. A wireless device that incorporates three paired light emitting diodes (wavelengths 760 and 850 nanometers and silicon photodiode detector collects data transcutaneously (10 Hz with the emitter/detector over the bladder during spontaneous bladder emptying. Data analysis indicates comparable patterns of change in chromophore concentration in healthy children and adults (positive trend during voiding, predominantly due to elevated O2Hb, but different changes in symptomatic subjects with characteristic chromophore patterns identified for voiding dysfunction due to specific pathophysiologies: bladder outlet obstruction (males, overactive bladder (females, and nonneurogenic dysfunction (children. Comparison with NIRS muscle data suggests altered bladder haemodynamics and/or oxygenation may underlie voiding dysfunction offering new insight into the causal physiology.

  12. Analysis of the Sales Promotion in Choice Retail Outlet

    OpenAIRE

    HUMPOLCOVÁ, Michaela

    2010-01-01

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

  13. 7 CFR 993.108 - Non-human consumption outlet.

    Science.gov (United States)

    2010-01-01

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

  14. Chapter 2: Pathophysiology of neurogenic detrusor overactivity and the symptom complex of "overactive bladder".

    Science.gov (United States)

    Chapple, Christopher

    2014-07-01

    It is now clearly recognized that the function of the lower urinary tract represents a complex interaction between the bladder and its outlet, acting under the control of the central nervous system. While in the past attention has principally focused on the motor (efferent) control of the bladder, sensory (afferent) innervation is now known to be an important therapeutic target. This change in emphasis is strongly supported by both basic science and clinical evidence demonstrating the efficacy of therapy directed at the afferent system. This chapter summarizes the neurophysiological control mechanism that underpins normal lower urinary tract function, emphasizing the importance of the afferent system as a potential therapeutic target.

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

    Science.gov (United States)

    Snowden, Aleksandra J

    2016-01-01

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

  16. Infraclavicular subpectoral lipoma causing thoracic outlet syndrome

    Directory of Open Access Journals (Sweden)

    Stefano Elia

    2015-01-01

    Conclusion: Although benign soft tissue tumors infraclavicular subpectoral lipomas may exert pressure on neurovascular surrounding structures during their progressive expansion and cause TOS. Therefore, a thorough preoperative study by radiological imaging such as MRI or neurophysiological test should always be performed in order to prevent unintentional lesions of the involved axillo-subclavicular plexus and plan correct surgical procedure.

  17. Surveillance of bladder cancer

    NARCIS (Netherlands)

    M.M.N. van der Aa (Madelon)

    2009-01-01

    textabstractThe urinary bladder together with the pyelum, ureters and urethra form the urinary tract system (figure 1.1); the system that is responsible for the excretion and collection of urine. With approximately 357,000 new cases per year worldwide, tumours of the urinary tract system contribute

  18. Structural alterations of the bladder induced by detrusor instability: experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Joao L. Amaro

    2005-12-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the histopathological and immunohistochemical alterations induced by detrusor instability in the bladder of rabbits submitted to partial bladder outlet obstruction. MATERIALS AND METHODS: Thirty male Norfolk rabbits were divided into 2 groups, a clinical control and a group with detrusor instability. Urine culture, cystometric study, histopathological and immunohistochemical analysis were performed in all animals prior to surgery (M1 and 4 weeks after-surgery (M2. RESULTS: Partial obstruction (G2 resulted in a 2.5 fold increment (p < 0.05 in bladder weight when compared to control (G1. Four weeks after surgery, 93% of animals in G2 developed cystitis. Partial obstruction resulted in detrusor instability at M2 and bladder capacity was significantly increased (p < 0.05 from M1 to M2. The incidence of mild to moderate mucosal and adventitious fibrosis at M2 was higher in G2 (p < 0.05 when compared to G1. Inflammatory reaction at M2 was statistically higher (p < 0.05 in G2. There was no difference in muscular hypertrophy between M1 and M2 in G1. However, 67% of G2 bladders showed a moderate to intense muscular hypertrophy at M2. Hyperplasia of the epithelium was also increased in G2 when M1 and M2 were compared (p < 0.05. CONCLUSION: Detrusor instability induced by partial bladder outlet obstruction caused significant histopathological and immunohistochemical alterations in the bladder of rabbits.

  19. Preoperative anxiety in neurosurgical patients.

    Science.gov (United States)

    Perks, Anna; Chakravarti, Sucharita; Manninen, Pirjo

    2009-04-01

    Anxiety is common in surgical patients, with an incidence of 60% to 92%. There is little information on the incidence and severity of preoperative anxiety in patients scheduled for neurosurgery. The aim of this study was to measure the level of preoperative anxiety in neurosurgical patients and to assess any influencing factors. After the Institutional Review Board approval and informed written consent, 100 patients booked for neurosurgery were interviewed preoperatively. Each patient was asked to grade their preoperative anxiety level on a verbal analog scale, Amsterdam Preoperative Anxiety and Information Scale, and a set of specific anxiety-related questions. The anxiety scores and the responses to the questions were compared between the sex, age, weight, diagnosis, and history of previous surgery. The mean age (+/-SD) was 50+/-13 years. The preoperative diagnosis was tumor (n=64), aneurysm (n=14), and other (n=22). Overall verbal analog scale was 5.2+/-2.7; the score was higher for female (5.8+/-2.8) than male patients (4.6+/-2.5) (PAmsterdam Preoperative Anxiety and Information Scale anxiety and knowledge scores were greater for surgery than for anesthesia. Questionnaire results showed that the most common anxieties were waiting for surgery, physical/mental harm, and results of the operation. In conclusion, our study showed that neurosurgical patients have high levels of anxiety, with a higher incidence in females. There was a moderately high need for information, particularly in patients with a high level of preoperative anxiety.

  20. POSSIBILITIES OF USING RADIODIAGNOSTIC METHODS IN THE STAGING OF URINARY BLADDER CANCER AND IN THE DETERMINATION OF ITS TREATMENT POLICY

    Directory of Open Access Journals (Sweden)

    S. A. Khudyashev

    2010-01-01

    Full Text Available The urgency of the study was determined by the unsolved problems in the radiation evaluation of the local extent (stage of a tumor and related surgical treatment policy. The results of a preoperative complex radiation study of 217 patients with urinary bladder cancer, including 134 men and 83 women, are presented. Based on the data of comprehensive preoperative examination, the authors define clear criteria for choosing a surgical treatment. A functional procedure for ultrasonography in varying urinary bladder filling is proposed to evaluate the degree of tumor invasion.

  1. Operativ behandling af thoracic outlet syndrome

    DEFF Research Database (Denmark)

    Birkeland, Peter; Stiasny, Jerzy

    2012-01-01

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

  2. Thoracic Outlet Syndrome Following Breast Implant Rupture

    Directory of Open Access Journals (Sweden)

    Raakhi Mistry, MBChB

    2015-03-01

    Full Text Available Summary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  3. Thoracic outlet syndrome following breast implant rupture.

    Science.gov (United States)

    Mistry, Raakhi; Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-03-01

    We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  4. Health-Related Quality of Life after Cystectomy and Urinary Diversion for Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Cheryl Shih

    2011-01-01

    Full Text Available With multiple options for urinary diversion after radical cystectomy for bladder cancer that have comparable cancer control and complication rates, health-related quality of life (HRQOL has become an important consideration. This article reviews the methods for defining HRQOL, the challenges in measuring HRQOL in bladder cancer, and the literature comparing HRQOL after various methods of urinary diversion. Recent contributions include the validation of HRQOL instruments specific to bladder cancer and the publication of several prospective studies measuring HRQOL outcomes after cystectomy and urinary diversion. There is no convincing evidence from existing literature that any particular method of urinary diversion offers superior HRQOL outcomes. Rather, there is growing evidence that good HRQOL can be achieved with patient education and consideration of each patient's clinical and psychosocial situation. Future research should utilize the validated bladder cancer specific HRQOL instruments and perhaps explore the impact of preoperative counseling on postoperative HRQOL.

  5. Health-Related Quality of Life after Cystectomy and Urinary Diversion for Bladder Cancer

    Science.gov (United States)

    Shih, Cheryl; Porter, Michael P.

    2011-01-01

    With multiple options for urinary diversion after radical cystectomy for bladder cancer that have comparable cancer control and complication rates, health-related quality of life (HRQOL) has become an important consideration. This article reviews the methods for defining HRQOL, the challenges in measuring HRQOL in bladder cancer, and the literature comparing HRQOL after various methods of urinary diversion. Recent contributions include the validation of HRQOL instruments specific to bladder cancer and the publication of several prospective studies measuring HRQOL outcomes after cystectomy and urinary diversion. There is no convincing evidence from existing literature that any particular method of urinary diversion offers superior HRQOL outcomes. Rather, there is growing evidence that good HRQOL can be achieved with patient education and consideration of each patient's clinical and psychosocial situation. Future research should utilize the validated bladder cancer specific HRQOL instruments and perhaps explore the impact of preoperative counseling on postoperative HRQOL. PMID:21826139

  6. Mechanical stretch upregulates proteins involved in Ca2+ sensitization in urinary bladder smooth muscle hypertrophy.

    Science.gov (United States)

    Boopathi, Ettickan; Gomes, Cristiano; Zderic, Stephen A; Malkowicz, Bruce; Chakrabarti, Ranjita; Patel, Darshan P; Wein, Alan J; Chacko, Samuel

    2014-09-15

    Partial bladder outlet obstruction (pBOO)-induced remodeling of bladder detrusor smooth muscle (DSM) is associated with the modulation of cell signals regulating contraction. We analyzed the DSM from obstructed murine urinary bladders for the temporal regulation of RhoA GTPase and Rho-activated kinase (ROCK), which are linked to Ca(2+) sensitization. In addition, the effects of equibiaxial cell stretch, a condition thought to be associated with pBOO-induced bladder wall smooth muscle hypertrophy and voiding frequency, on the expression of RhoA, ROCK, and C-kinase-activated protein phosphatase I inhibitor (CPI-17) were investigated. DSM from 1-, 3-, 7-, and 14-day obstructed male mice bladders and benign prostatic hyperplasia (BPH)-induced obstructed human bladders revealed overexpression of RhoA and ROCK-β at the mRNA and protein levels compared with control. Primary human bladder myocytes seeded onto type I collagen-coated elastic silicone membranes were subjected to cyclic equibiaxial stretch, mimicking the cellular mechanical stretch in the bladder in vivo, and analyzed for the expression of RhoA, ROCK-β, and CPI-17. Stretch caused a significant increase of RhoA, ROCKβ, and CPI-17 expression. The stretch-induced increase in CPI-17 expression occurs at the transcriptional level and is associated with CPI-17 promoter binding by GATA-6 and NF-κB, the transcription factors responsible for CPI-17 gene transcription. Cell stretch caused by bladder overdistension in pBOO is the likely mechanism for initiating overexpression of the signaling proteins regulating DSM tone.

  7. Gastric Outlet Obstruction Palliation: A Novel Stent-Based Solution

    Directory of Open Access Journals (Sweden)

    Natasha M. Rueth

    2010-06-01

    Full Text Available Gastric outlet obstruction (GOO after esophagectomy is a morbid outcome and significantly hinders quality of life for end-stage esophageal cancer patients. In the pre-stent era, palliation consisted of chemotherapy, radiation, tumor ablation, or stricture dilation. In the current era, palliative stenting has emerged as an additional tool; however, migration and tumor ingrowth are ongoing challenges. To mitigate these challenges, we developed a novel, hybrid, stent-based approach for the palliative management of GOO. We present a patient with esophageal cancer diagnosed with recurrent, metastatic disease 1 year after esophagectomy. She developed dehydration and intractable emesis, which significantly interfered with her quality of life. For palliation, we dilated the stenosis and proceeded with our stent-based solution. Using a combined endoscopic and fluoroscopic approach, we placed a 12-mm silicone salivary bypass tube across the pylorus, where it kinked slightly because of local tumor biology. To bridge this defect and ensure luminal patency, we placed a nitinol tracheobronchial stent through the silicone stent. Clinically, the patient had immediate relief from her pre-operative symptoms and was discharged home on a liquid diet. In conclusion, GOO and malignant dysphagia after esophagectomy are significant challenges for patients with end-stage disease. Palliative stenting is a viable option, but migration and tumor ingrowth are common complications. The hybrid approach presented here provides a unique solution to these potential pitfalls. The flared silicone tube minimized the chance of migration and impaired tumor ingrowth. The nitinol stent aided with patency and overcame the challenges of the soft tube. This novel strategy achieved palliation, describing another endoscopic option in the treatment of malignant GOO.

  8. Innovation in Bladder Cancer Immunotherapy.

    Science.gov (United States)

    Grossman, H Barton; Lamm, Donald L; Kamat, Ashish M; Keefe, Stephen; Taylor, John A; Ingersoll, Molly A

    2016-10-01

    Bladder cancer is understudied despite its high prevalence and its remarkable response to immunotherapy. Indeed, funding for studies to explore mechanisms of tumor immunity and novel new therapeutics is disproportionately lower for bladder cancer in comparison with malignancies of the breast, prostate, or lung. However, the recent successes of checkpoint blockade therapy suggest that new therapeutic strategies are on the horizon for bladder cancer. Here, we give a perspective into the evolution of bladder cancer therapy, focusing on strategies to treat high-risk nonmuscle invasive disease, followed by a discussion of recent advances in the treatment of muscle invasive bladder cancer and their potential applicability to lower stage disease. Finally, we explore immunotherapeutic strategies, which have been demonstrated to be successful in the treatment of other malignancies, for their potential to treat and cure patients with nonmuscle and muscle invasive bladder cancer.

  9. Permeability and ultrastructure of human bladder epithelium

    DEFF Research Database (Denmark)

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

    1983-01-01

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

  10. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  11. Impedance plethysmographic observations in thoracic outlet syndrome.

    Directory of Open Access Journals (Sweden)

    Nerurkar S

    1990-07-01

    Full Text Available Forty patients with symptoms of neuro-vascular compression in the upper extremities were subjected to impedance plethysmographic study using Parulkar′s method. Two patients recorded decreased blood flow (BFI in supine position and were diagnosed as having partial occlusion at subclavian level. Sixteen of the patients recorded decreased BFI on 90 degrees abduction and hyper-abduction. Twelve of these patients had radiological evidence of anomalous cervicle ribs. In remaining four patients extrinsic impression on the subclavian artery due to fibrous deposits was confirmed by arteriography. Remaining 22 patients recorded normal impedance plethysmograms. Impedance plethysmography thus provided a non-invasive modality for confirmation of vascular compression in thoracic outlet syndrome.

  12. Platelet Derived Growth Factor Has a Role in Pressure Induced Bladder Smooth Muscle Cell Hyperplasia and Acts in a Paracrine Way.

    Science.gov (United States)

    Preis, Laura; Herlemann, Annika; Adam, Rosalyn M; Dietz, Hans-Georg; Kappler, Roland; Stehr, Maximilian

    2015-12-01

    Bladder outlet obstruction is a finding in many urological disorders, leading to bladder wall hyperplasia. We investigated platelet derived growth factor and its receptor in human bladder smooth muscle cells and urothelial cells exposed to hydrostatic pressure or PDGF in vitro. Bladder smooth muscle cells and urothelial cells were exposed to elevated hydrostatic pressure for 1 hour. The expression of PDGF and PDGFR was evaluated using reverse transcriptase-polymerase chain reaction and Western blot analysis. Pressure or PDGF induced proliferation of bladder smooth muscle cells with or without pretreatment with lovastatin or imatinib was measured by enzyme-linked immunosorbent assay. PDGFRα was knocked down with siRNA. After hydrostatic pressure bladder smooth muscle cells showed increased PDGFRα and β expression. PDGF was not expressed in bladder smooth muscle cells. Urothelial cells showed no expression of PDGFR but PDGF expression was noted. Western blot analysis of bladder smooth muscle cells revealed a pressure induced increase in PDGFR in the membrane fraction. Phosphorylation of PDGFR occurred with pressure induction. Bladder smooth muscle cell proliferation was increased in pressure and PDGF mediated fashion. Pretreatment with lovastatin or imatinib prevented proliferation. There was no cell proliferation after PDGFRα knockdown. Increased expression and phosphorylation of PDGFR in bladder smooth muscle cells after hydrostatic pressure suggests a pivotal role of the PDGF pathway in pressure induced hyperplasia of bladder smooth muscle cells. PDGF expressed in urothelial cells may act in a paracrine way. Cholesterol depletion, inhibition of receptor tyrosine kinase activity and knockdown of PDGFRα in bladder smooth muscle cells prevent pressure and PDGF mediated cell proliferation. Targeting PDGFR seems a promising way to influence pressure induced bladder wall hyperplasia. Copyright © 2015 American Urological Association Education and Research, Inc

  13. Evidence for Bladder Urothelial Pathophysiology in Functional Bladder Disorders

    Directory of Open Access Journals (Sweden)

    Susan K. Keay

    2014-01-01

    Full Text Available Understanding of the role of urothelium in regulating bladder function is continuing to evolve. While the urothelium is thought to function primarily as a barrier for preventing injurious substances and microorganisms from gaining access to bladder stroma and upper urinary tract, studies indicate it may also function in cell signaling events relating to voiding function. This review highlights urothelial abnormalities in bladder pain syndrome/interstitial cystitis (BPS/IC, feline interstitial cystitis (FIC, and nonneurogenic idiopathic overactive bladder (OAB. These bladder conditions are typified by lower urinary tract symptoms including urinary frequency, urgency, urgency incontinence, nocturia, and bladder discomfort or pain. Urothelial tissues and cells from affected clinical subjects and asymptomatic controls have been compared for expression of proteins and mRNA. Animal models have also been used to probe urothelial responses to injuries of the urothelium, urethra, or central nervous system, and transgenic techniques are being used to test specific urothelial abnormalities on bladder function. BPS/IC, FIC, and OAB appear to share some common pathophysiology including increased purinergic, TRPV1, and muscarinic signaling, increased urothelial permeability, and aberrant urothelial differentiation. One challenge is to determine which of several abnormally regulated signaling pathways is most important for mediating bladder dysfunction in these syndromes, with a goal of treating these conditions by targeting specific pathophysiology.

  14. [Plastic repair of the isolated bladder in exstrophy in children].

    Science.gov (United States)

    Derzhavin, V M; Kazachkov, S A; Bannikov, V M; Berulava, Z O

    1989-01-01

    Sigmoid colon segment was used to pass the urine through the intestine in 14 children with exstrophy of the bladder. Preoperative management of large intestine helped to reduce the number of operative stages from two to one. 12 patients were followed up from 1 to 3 yrs. Right ureterohydronephrosis of the upper urinary tract was observed in 1 patient. Urodynamic investigation of isolated sigmoid colon segment evidenced of its adequate contractile and peristaltic activity preventing the contact of feces with entero-ureteral anastomoses. To improve the closing ability of rectal sphincter in the above patients anal electrostimulation with diadynamic current can be recommended.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  16. Postmortem MRI of bladder agenesis

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-01-15

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

  17. Molecular Diagnosis in Bladder Cancer

    NARCIS (Netherlands)

    T.C.M. Zuiverloon (Tahlita)

    2013-01-01

    textabstractEpidemiologyBladder cancer (BC) is the most prevalent type of urothelial cancer and is associated with thehighest costs of all cancer types due to intensive patient surveillance. Because bladder tumorsfrequently recur, patients need to be monitored extensively [1-4]. Incidence increases

  18. Genetics Home Reference: bladder cancer

    Science.gov (United States)

    ... Cancer Survivorship ClinicalTrials.gov (1 link) ClinicalTrials.gov Scientific Articles on PubMed (1 link) PubMed OMIM (1 link) BLADDER CANCER Sources for This Page American Cancer Society: What Are the Key Statistics for Bladder Cancer? Bryan RT, Hussain SA, James ...

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

    Directory of Open Access Journals (Sweden)

    Michael O. Chaiton

    2013-12-01

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

  20. Steroid responsive eosinophilic gastric outlet obstruction in a child

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  1. Benign Strictures of the Esophagus and Gastric Outlet: Interventional Management

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Shin, Ji Hoon; Song, Ho Young [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2010-10-15

    Benign strictures of the esophagus and gastric outlet are difficult to manage conservatively and they usually require intervention to relieve dysphagia or to treat the stricture-related complications. In this article, authors review the non-surgical options that are used to treat benign strictures of the esophagus and gastric outlet, including balloon dilation, temporary stent placement, intralesional steroid injection and incisional therapy

  2. 49 CFR 179.200-17 - Bottom outlets.

    Science.gov (United States)

    2010-10-01

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

  3. Simple cyst of urinary bladder.

    Science.gov (United States)

    Bo, Yang

    2014-07-01

    Simple cysts are rare in the urinary bladder and can pose a diagnostic dilemma to both the urologist and the histopathologist. No case study was found in the database of Elsevier Science Direct, Spring-Link, or PubMed. We present two cases of subserous cyst in the bladder and discuss the diagnosis and treatment of the condition. The cystic lesion at bladder dome was detected by radiologic examination and confirmed by cystoscopy. In case 1, transurethral resection was first performed which was followed by partial cystectomy; In case 2, the cyst was removed with the urachus using laparoscopic surgery. The patients recovered uneventfully and the histopathology showed cysts in subserous layer of urinary bladder. The bladder cyst should be distinguished from urachal tumor, and laparoscopic partial cystectomy is the preferred operative procedure.

  4. Emerging Immunotargets in Bladder Cancer.

    Science.gov (United States)

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

    2016-01-01

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

  5. A CLINICAL STUDY ON GASTRIC OUTLET OBSTRUCTION

    Directory of Open Access Journals (Sweden)

    Latchu

    2015-11-01

    Full Text Available INTRODUCTION Gastric outlet obstruction (GOO is obstruction in the first part of duodenum secondary to cicatrised duodenal ulcer or proximally where the diagnosis of carcinoma is most probable. GOO can be a diagnostic and treatment dilemma. Once a mechanical obstruction is confirmed, differentiate between benign and malignant processes. Cicatrized duodenal ulcer was the most common cause of GOO. But with increased awareness, change in the dietary habits and availability of H2 receptor blockers and Proton Pump Inhibitors and H pylori kits all have resulted in decreased incidence of patients requiring surgery and also the complications like pyloric stenosis have reduced. At the same time the incidence of antral carcinoma of stomach producing GOO has comparatively increased, which may be due to increased early diagnosis of the condition with the help of flexible fibro optic endoscope. AIMS & OBJECTIVES To study and identify the cause of cases of GOO with respect to benign peptic ulcer and malignancy of stomach. MATERIALS AND METHODS An observational study comparing of 30 cases of GOO. An elaborate study of the cases with regard to history, clinical features, routine and special investigation, pre operative treatment, operative findings, post operative management and complications in the post operative period is done. Apart from routine surgical profile special investigations like serum electrolytes, barium meal study, Upper GI Endoscopy and ultrasound abdomen and pelvis will be carried. For peptic ulcer disease truncal vagotomy with posterior gastrojejunostomy was done and for carcinoma partial gastrectomy with Billroth II reconstruction or anterior GJ or palliative resection with anterior GJ were done. INCLUSION CRITERIA 1. Peptic ulcer disease 2. Carcinoma pyloric antrum, 3. Benign neoplasm of stomach. EXCLUSION CRITERIA 1. Carcinoma stomach with liver metastasis, ascites, peritoneal implantation, 2. Gastro duodenal tuberculosis. ETHICAL ISSUES

  6. Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome

    Directory of Open Access Journals (Sweden)

    Shu-Yu Wu

    2016-12-01

    Conclusion: There are obvious differences in bladder CT scans of patients with symptoms of bladder pain due to different etiology. Increased BWT was associated with increased pain scores and decreased bladder capacity in patients with KC and IC. BWT on a CT scan might be considered a marker for the severity of bladder inflammation.

  7. Alcohol Outlets and Violent Crime in Washington D.C.

    Directory of Open Access Journals (Sweden)

    Pan, William K

    2010-08-01

    Full Text Available Objective: Alcohol is more likely than any other drug to be involved in substance-related violence. In 2000 violence-related and self-directed injuries accounted for an estimated $37 billion and $33 billion in productivity losses and medical treatment, respectively. A review of emergency department data revealed violence and clinically identified trauma-related injuries have the strongest correlation among alcohol-dependent injuries. At the environmental level there is a relationship between alcohol outlet density and violent crime. A limited number of studies have examined the relationship between alcohol outlet type and the components of violent crime. The aim of this study is to examine the relationship between the aggregate components of violent crime and alcohol outlet density by type of outlet.Methods: For this study we used Washington, D.C. census tract data from the 2000 census to examine neighborhood characteristics. Alcohol outlet, violent crime, and population-level data for Washington, D.C. were drawn from various official yet publicly available sources. We developed an analytic database to examine the relationship between alcohol outlet category and four types of violent crime. After estimating spatial correlation and determining spatial dependence, we used a negative binomial regression analysis to assess the alcohol availability-violent crime association, while controlling for structural correlates of violence.Results: Independent of alternative structural correlates of violent crime, including the prevalence of weapons and illicit drugs, community-level alcohol outlet density is significantly associated with assaultive violence. Outlets were significantly related to robbery, assault, and sexual offenses. In addition, the relationship among on-premise and off-premise outlets varied across violent crime categories.Conclusion: In Washington, D.C., alcohol outlet density is significantly associated with the violent crimes. The

  8. Tissue engineering of the bladder--reality or myth? A systematic review.

    Science.gov (United States)

    Sloff, Marije; Simaioforidis, Vasileios; de Vries, Rob; Oosterwijk, Egbert; Feitz, Wout

    2014-10-01

    We systematically reviewed preclinical studies in the literature to evaluate the potential of tissue engineering of the bladder. Study outcomes were compared to the available clinical evidence to assess the feasibility of tissue engineering for future clinical use. Preclinical studies of tissue engineering for bladder augmentation were identified through a systematic search of PubMed and Embase™ from January 1, 1980 to January 1, 2014. Primary studies in English were included if bladder reconstruction after partial cystectomy was performed using a tissue engineered biomaterial in any animal species, with cystometric bladder capacity as an outcome measure. Outcomes were compared to clinical studies available at http://www.clinicaltrials.gov and published clinical studies. A total of 28 preclinical studies are included, demonstrating remarkable heterogeneity in study characteristics and design. Studies in which preoperative bladder volumes were compared to postoperative volumes were considered the most clinically relevant (18 studies). Bladder augmentation through tissue engineering resulted in a normal bladder volume in healthy animals, with the influence of a cellular component being negligible. Furthermore, experiments in large animal models (pigs and dogs) approximated the desired bladder volume more accurately than in smaller species. The initial clinical experience was based on seemingly predictive healthy animal models with a promising outcome. Unfortunately these results were not substantiated in all clinical trials, revealing dissimilar outcomes in different clinical/disease backgrounds. Thus, the translational predictability of a model using healthy animals might be questioned. Through this systematic approach we present an unbiased overview of all published preclinical studies investigating the effect of bladder tissue engineering on cystometric bladder capacity. Preclinical research in healthy animals appears to show the feasibility of bladder

  9. The Geography of Fast Food Outlets: A Review

    Directory of Open Access Journals (Sweden)

    Lorna K. Fraser

    2010-05-01

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

  10. The geography of Fast Food outlets: a review.

    Science.gov (United States)

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

    2010-05-01

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

  11. Chemoprevention of bladder cancer.

    Science.gov (United States)

    Kamat, Ashish M; Lamm, Donald L

    2002-02-01

    The data presented herein, although highly supportive for a protective role of various nutrients against bladder cancer, are far from definitive. Many authorities question the validity of current recommendations for nutritional chemoprevention against bladder cancer. The reason for the wide variations reported in epidemiologic studies lies in the nature of observational studies. Dietary studies are limited in their conclusions because the protection afforded by the consumption of a particular nutrient may be multifactorial, with different components of the food exerting potential chemopreventive effects. Furthermore, measuring levels of nutrients in the food intake of populations is confounded by factors that might affect these levels and also the incidence of cancer. For example, vitamin A can come from animal or vegetarian sources. Because animal fat has been identified as a potential carcinogen in man, depending on the source of the vitamin, varying levels of protection might be deduced. In addition, chemoprevention studies using dietary supplements are expected to have mild effects, and large studies would be required to confirm statistical significance. Even with agents such as intravesical chemotherapy, only half the studies achieve statistical significance [29]. Prospective randomized trials with a large sample size, longer follow-up, and an extended duration of treatment are needed to clarify the association between micronutrients and cancer protection. With these caveats in mind, several recommendations can be made. Simple measures, such as drinking more fluids (especially water), can have a profound impact on the incidence of bladder cancer. Vitamins are being extensively studied in chemopreventive trials for different cancers. There is strong evidence for a chemoprotective effect of vitamin A in bladder cancer. The authors recommend 32,000 IU/day of vitamin A initially, with lower doses (24,000 IU) for persons less than 50 kg. Because liver toxicity is a

  12. Coolant mixing in the LMFBR outlet plenum

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Y.B.; Golay, M.W.

    1977-06-01

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

  13. Zur Problematik des Thoracic Outlet-Syndroms

    Directory of Open Access Journals (Sweden)

    Mamoli B

    2008-01-01

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

  14. Duplication Cyst in the Third Part of the Duodenum Presenting with Gastric Outlet Obstruction and Severe Weight Loss

    Science.gov (United States)

    Shaheen, Osama; Sara, Samer; Safadi, Mhd Firas; Alsaid, Bayan

    2015-01-01

    Duodenal duplication is a rare developmental abnormality which is usually diagnosed in infancy and childhood, but less frequently in adulthood. We report a case of a 16-year-old female with a duplication cyst in the third part of the duodenum. The patient presented with symptoms of gastric outlet obstruction, including severe anorexia and weight loss. The diagnosis was made preoperatively by CT scan and upper endoscopy. The cyst was successfully treated by marsupialization on the duodenum using a GIA stapler. Duodenal duplication presents with a wide variety of symptoms. Although illusive, many cases can be properly diagnosed preoperatively by using the appropriate imaging modalities. Treatment choices are tailored according to the size and location of the cyst, in addition to its relation to adjacent structures. The outcomes are favorable in the majority of patients. PMID:26649220

  15. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2014-01-01

    : Randomized controlled trials that recruited people who smoked prior to surgery, offered a smoking cessation intervention, and measured preoperative and long-term abstinence from smoking or the incidence of postoperative complications or both outcomes. DATA COLLECTION AND ANALYSIS: The review authors......BACKGROUND: Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. OBJECTIVES: The objectives of this review...... are to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register in January 2014. SELECTION CRITERIA...

  16. Preoperative staging of rectal cancer.

    Science.gov (United States)

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials.

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

    Directory of Open Access Journals (Sweden)

    Vikiela Galica

    2015-07-01

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

  18. [The preliminary clinical results of laparoscopic ileum augmentation cystoplasty for low compliance bladder].

    Science.gov (United States)

    Qi, Xiaolong; Xu, Zhihui; Liu, Feng; Zhang, Dahong

    2015-08-01

    To study the effectiveness and safety of the laparoscopic ileal bladder augmentation treatment for low compliance bladder. A retrospective analysis was performed based on 36 cases admitted to the Zhejiang Provincial People's Hospital with highly reflective and low compliance bladder accepted laparoscopic ileal bladder augmentation surgical treatment from June 2011 to December 2013. In accordance with inclusion and exclusion criteria, 22 patients were enrolled in this study, including 13 males, 9 females who aged from 22 to 62 years with an average of 35.8 years. Among the selected sample, there were 15 cases of spinal cord injury, 4 cases of spinal cord dysplasia, and 3 cases of urinary tuberculosis. The duration of disease varied from 1 to 15 years, with an average of 8.5 years. For surgery, intraoperative and perioperative complications were observed, and preoperative serum creatinine in patients with postoperative at 3, 6, 12, 18, 24, 36 months, hydronephrosis, and glomerular filtration rate urodynamic parameters were used for univariate analysis of variance. All patients were successfully completed in laparoscopic surgery, the operative time were (105 ± 17) minutes (90-150 minutes), blood loss was (90 ± 26) ml (60-150 ml), postoperative intestinal function recovery time were (2.5 ± 0.7) d (2-5 d), and postoperative hospital stay was (15.0 ± 4.2) d (11-20 d), while postoperative anastomotic leakage, intestinal blockage, severe abdominal infection or sepsis and other complications did not occur. Patients were followed up for 6 to 36 months, with an average of 16.5 months, among which 17 patients were followed up for over 12 months. The bladder safety capacity increased from (103 ± 38) ml preoperatively to (405 ± 46) ml at the end of the follow-up (F = 381.7, P = 0.000), and bladder compliance increased from (10 ± 3) cmH₂O (1 cmH₂O = 0.098 kPa) preoperatively to (38 ± 4) cmH₂O (F = 678.1, P = 0.000); the average pressure within the bladder filling at

  19. Bladder diverticulitis: a case report.

    Science.gov (United States)

    Silberman, Michael; Jeanmonod, Rebecca

    2011-01-01

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

  20. Bladder Diverticulitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Michael Silberman

    2011-01-01

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

  1. Underactive Bladder in Older Adults.

    Science.gov (United States)

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

    2015-11-01

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

  2. Pathology of bilharzial bladder cancer.

    Science.gov (United States)

    Godwin, J T; Hanash, K

    1984-01-01

    Retrospective review of bladder carcinoma at this institution has revealed a high incidence of squamous cell carcinoma associated with bilharzia infection as has been found in other Mideast and African countries. Associated inflammatory and epithelial metaplastic changes were commonly noted and apparently represent early changes in the development of carcinoma, particularly in view of the progression from squamous metaplasia to in situ and infiltrating carcinoma observed in both bladder and ureter. The relationship between bilharzia infection and the development of bladder carcinoma has been postulated to be related to several factors; however, as yet the specific etiologic relationship and pathogenesis have not been defined.

  3. MRI findings in thoracic outlet syndrome

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  4. Anxiety in preoperative anesthetic procedures.

    Science.gov (United States)

    Valenzuela Millán, Jaquelyn; Barrera Serrano, José René; Ornelas Aguirre, José Manuel

    2010-01-01

    Preoperative anxiety is a common and poorly evaluated condition in patients who will undergo an anesthetic and surgical intervention. The objective of this study was to determine the prevalence of anxiety in a group of patients undergoing elective surgery, as assessed by the Amsterdam Anxiety Preoperative and Information (AAPI) scale. We studied 135 patients scheduled for elective surgery applying the AAPI scale 24 h before the surgical procedure to evaluate the presence of anxiety and patient characteristics. A descriptive analysis with mean +/- standard deviation for categorical variables was done. For intragroup differences, chi(2) test was used. Pearson correlation for the association between anxiety and postoperative complications was carried out. A value of p =0.05 was considered significant. One hundred six patients were surgically treated, 88% were female (average age 44 +/- 12 years). Some degree of preoperative anxiety was present in 72 patients (76%; p = 0.001) with a grade point average on the AAPI scale equal to 17 +/- 7 points, of which 95 (70%, OR = 5.08; p = 0.002) were females. Results of this study suggest the presence of high levels of preoperative anxiety in patients scheduled for elective surgery. The origin of the anxiety appears to be related to many factors that can be evaluated in pre-anesthetic consultation. Further study is needed to prevent the presence of this disorder.

  5. Prediction for Outlet Noise of Rolling Piston Comperssor

    Directory of Open Access Journals (Sweden)

    Zhang Tieshan

    2015-01-01

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

  6. Gall bladder ascariasis

    Directory of Open Access Journals (Sweden)

    Ranendra Hajong

    2013-01-01

    Full Text Available Hepatobiliary ascariasis is commonly reported from highly endemic regions like India, Bangladesh, Latin America, parts of Middle East and Africa. In humans, the usual habitat of Ascaris lumbricoides is the small intestine. When the worm load is high, going as high as more than 1000 worms, then the worms tend to migrate away from the usual site. Patients with hepatobiliary ascariasis may present with biliary colic due to obstruction caused by the worms in the gall bladder, common bile duct or as a result of obstructive symptoms caused by calcified worms or lithiasis, which is commonly found in patients with hepatobiliary ascariasis. Acute pancreatitis may also be caused by ascariasis. Management usually is conservative if it is still alive or can be extracted by endoscopic retrograde cholangio-pancreatography or surgery.

  7. THE RECURRENCE AFTER ORGAN-SAVING SURGERY OF PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    T. A. Sveklina

    2014-08-01

    Full Text Available The article represents the study of frequency and nature of the recurrence and survival rate (common, oncology-specific, disease-free after organ-saving surgery of patients with muscle-invasive bladder cancer stages T2b and T3a. Oncology-speсific and disease-free survival rates were much higher if full diagnosis of bladder mucosa, the adjuvant intravesical chemotherapy had been on pre-operative and intra-operative stages than in the absence of these diagnosis and therapy. Recurrentes of bladder cancer which appeared in the absence of diagnosis and combination therapy, statistically reliably occured at another location other than the zone of operation, stage of recurrentes and degree of differentiation of recurrents were less than the original tumor. This information confirms the existence of foci of cancer in situ which have not been identified on the diagnostic stage.

  8. Morphologic change of rectosigmoid colon using belly board and distended bladder protocol

    OpenAIRE

    2015-01-01

    Purpose This study investigates morphologic change of the rectosigmoid colon using a belly board in prone position and distended bladder in patients with rectal cancer. We evaluate the possibility of excluding the proximal margin of anastomosis from the radiation field by straightening the rectosigmoid colon. Materials and Methods Nineteen patients who received preoperative radiotherapy between 2006 and 2009 underwent simulation in a prone position (group A). These patients were compared to 1...

  9. Fundamentals of bladder tissue engineering

    African Journals Online (AJOL)

    W. Mahfouz

    Peer review under responsibility of Pan African Urological Surgeons'. Association ... Bladder scaffolds used must be able to support the adhesion and proliferation ... The ideal scaffold should be non-toxic, have the same mechanical properties ...

  10. Drugs Approved for Bladder Cancer

    Science.gov (United States)

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

  11. Neurogenic bladder in Hunter's syndrome.

    Science.gov (United States)

    Koyama, K; Moda, Y; Sone, A; Tanaka, H; Hino, Y

    1994-01-01

    We encountered a rare patient with Hunter's syndrome who exhibited urinary retention as a result of a neurogenic bladder, uninhibited detrusor contractions, and detrusor-sphincter dyssynergia. Neurological findings were consistent with cervical myelopathy and cervical MR imaging showed very narrow segments at the cord level C2-4. We speculate that this Hunter's syndrome patient has cervical myelopathy and that this neurological dysfunction causes the neurogenic bladder. PMID:8014981

  12. [Catheter-related bladder discomfort after urological surgery: importance of the type of surgery and efficiency of treatment by clonazepam].

    Science.gov (United States)

    Maro, S; Zarattin, D; Baron, T; Bourez, S; de la Taille, A; Salomon, L

    2014-09-01

    Bladder catheter can induce a Catheter-Related Bladder Discomfort (CRBD). Antagonist of muscarinic receptor is the gold standard treatment. Clonazepam is an antimuscarinic, muscle relaxing oral drug. The aim of this study is to look for a correlation between the type of surgical procedure and the existence of CRBD and to evaluate the efficiency of clonazepam. One hundred patients needing bladder catheter were evaluated. Sexe, age, BMI, presence of diabetes, surgical procedure and existence of CRBD were noted. Pain was evaluated with analogic visual scale. Timing of pain, need for specific treatment by clonazepam and its efficiency were noted. Correlation between preoperative data, type of surgical procedure, existence of CRBD and efficiency of treatment were evaluated. There were 79 men and 21 women (age: 65.9 years, BMI: 25.4). Twelve patients presented diabetes. Surgical procedure concerned prostate in 39 cases, bladder in 19 cases (tumor resections), endo-urology in 20 cases, upper urinary tract in 12 cases (nephrectomy…) and lower urinary tract in 10 cases (sphincter, sub-uretral tape). Forty patients presented CRBD, (pain 4.5 using VAS). This pain occurred 0.6 days after surgery. No correlation was found between preoperative data and CRBD. Bladder resection and endo-urological procedures were surgical procedures which procured CRBD. Clonazepam was efficient in 30 (75 %) out of 40 patients with CRBD. However, it was less efficient in case of bladder tumor resection. CRBD is frequent and occurred immediately after surgery. Bladder resection and endo-urology were the main surgical procedures which induced CRBD. Clonazepam is efficient in 75 %. Bladder resection is the surgical procedure which is the most refractory to treatment. 5. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Silo clogging reduction by placing an obstacle above the outlet

    Science.gov (United States)

    Lozano, C.; Zuriguel, I.; Janda, A.; Garcimartín, A.; Arévalo, R.; Maza, D.

    2013-06-01

    We present an experimental study of the effect that an obstacle above the outlet of a silo has on the clogging probability. Both, the size of the orifice and the obstacle position are varied for a chosen obstacle size and shape. If the position of the obstacle is properly selected the clogging probability can be importantly reduced. Indeed, as the outlet size is increased - and we approach the critical size above which there is not clogging - the obstacle effect is enhanced. For the largest outlet size studied, the clogging probability is reduced by a factor of more than one hundred. We will show, using numerical simulations, that the physical parameter behind the reduction of the silo clogging seems to be the decrease of the vertical pressure at the outlet proximities.

  14. Rating of new outlet structures for MacFarlane Reservoir

    Data.gov (United States)

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

  15. Supermarket and fast-food outlet exposure in Copenhagen

    DEFF Research Database (Denmark)

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

    2011-01-01

    Objective: To investigate whether exposure to fast-food outlets and supermarkets is socio-economically patterned in the city of Copenhagen. Design: The study was based on a cross-sectional multivariate approach to examine the association between the number of fast-food outlets and supermarkets...... and neighbourhood-level socio-economic indicators. Food business addresses were obtained from commercial and public business locators and geocoded using a geographic information system for all neighbourhoods in the city of Copenhagen (n 400). The regression of counts of fast-food outlets and supermarkets v......, such that neighbourhoods in the lowest income quartile had fewer fast-food outlets than higher-income neighbourhoods. These findings have similarities with studies conducted in the UK, but not in the USA. The results suggest there may be socio-economic factors other than income associated with food exposure in Europe....

  16. MALIGNANT TUMORS OF THE BLADDER

    Directory of Open Access Journals (Sweden)

    Boris Sedmak

    2003-12-01

    Full Text Available Background. The incidence of bladder cancer is rising in Slovenia and in most countries in the World. Increasing incidence is probably due to aging population and risk factors. Approximately 75–85% of patients present with disease confined to mucosa (Ta-Tis, or submucosa (T1 stage. The other 15–25% have muscle invasion or nodal disease (stages T2-T4, N+ at presentation.Conclusions. The diagnosis of bladder cancer ultimately depends on cystoscopic examination of the bladder and histopathological evaluation of resected lesion. After transuretral resection (TUR treatment of superficial bladder tumors (TaT1 will be directed towards the prevention of recurrence and progression with bladder instillation of vaccine for tuberculosis (bacillus Calmette-Guerin-BCG or chemotherapeutic agents. Tumors of T2 or higher category are infiltrating tumors and cystectomy is necessary in the majority of cases. Incontinent or continent urinary diversion is presently considered after radical cystectomy. Contra-indications for cystectomy are major co-morbidity and patients not willing to accept the surgery. Bladder preservation with chemo and radiotherapy can be an option in these selected cases.

  17. Bladder Dysfunction and Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Ulla Sillén

    2008-01-01

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

  18. Geoengineering Outlet Glaciers and Ice Streams

    Science.gov (United States)

    Wolovick, Michael

    2017-04-01

    Mass loss from Greenland and Antarctica is highly sensitive to the presence of warm ocean water that drives melting of ice shelves and marine terminated glaciers. This warm water resides offshore at depth and accesses the grounding line through deep but narrow troughs and fjords. Here, we investigate the possibility of blocking warm water transport through these choke points with an artificial sill. Using a simple width-averaged model of ice stream flow coupled to a buoyant-plume model of submarine melt, we find that grounding line retreat and sea level rise can be delayed or reversed for hundreds of years if warm water is prevented from accessing outlet glaciers and ice-shelf cavities. Glaciers with a floating shelf exhibit a strong response to the presence of the artificial sill regardless of our choice of calving law, while tidewater glaciers require a strong linkage between submarine melt and iceberg calving for the artificial sill to have an effect. As a result of this difference and as a result of differing degrees of overdeepening in the basal topography, Antarctica and Greenland present very different societal cost-benefit analyses. Intervention in Greenland would be low-cost and low-reward: the volume of the artificial sill is comparable to existing large public works projects such as the Dubai Islands or the Suez Canal, but the magnitude of averted sea-level rise is small, the success of the intervention depends on the choice of calving law, and the glaciers return to their non-geoengineered trajectories within one to two centuries. Intervention in Antarctica, on the other hand, would be high-cost and high-reward: the volume of the artificial sill is one to two orders of magnitude greater, but the averted sea level rise is much larger, the intervention is successful regardless of the choice of calving law, and the ice streams remain far from their non-geoengineered trajectories throughout the 1000 year duration of our model runs. In both cases, an

  19. Outcome of Trans-Axillary Approach for Surgical Decompression of Thoracic Outlet: A Retrospective Study in a Tertiary Care Hospital

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    Mohd Riyaz Lattoo

    2014-05-01

    Full Text Available Objective: The aim of this study was to evaluate the trans-axillary surgical approach in patients with thoracic outlet syndrome. Methods: This retrospective study is comprised of data acquired from January 1998 until Oct 2008. Case histories of all the patients were reviewed from the Medical Records Department of Sher-i-Kashmir Institute. Relevant information and follow-up of the patients was carried out by examining the relevant clinical notes available by telephone interviews and personal contact whenever possible. All data was compiled and analyzed statistically. Results: There were a total of 139 patients. The female: male ratio was about 6:1. Pain was the most common presenting symptom followed by weakness and parasthesia. Nerve conduction velocity was abnormal in 111 patients. Twenty-eight patients had abnormal Doppler study of subclavian vessels. Preoperative symptoms persisted in 13 patients. Overall, 126 patients showed improvement in symptoms and no recurrence or persistence of symptoms on follow-up examination. Conclusion: Trans-axillary approach provides a good exposure and cosmesis in patients with thoracic outlet syndrome. It should be considered as the gold standard in the management of thoracic outlet syndrome.

  20. [Preoperative fasting guidelines: an update].

    Science.gov (United States)

    López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J

    2015-03-01

    Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2010-01-01

    and keywords (surgery) or (operation) or (anaesthesia) or (anesthesia). MEDLINE, EMBASE and CINAHL were also searched, combining tobacco- and surgery-related terms. Most recent search April 2010. Selection criteria Randomized controlled trials that recruited people who smoked prior to surgery, offered......Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text...

  2. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, N.; Møller, Ann Merete;

    2010-01-01

    Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text......; pooled RR 10.76 (95% confidence interval (CI) 4.55 to 25.46, two trials) and RR 1.41 (95% CI 1.22 to 1.63, five trials) respectively. Four trials evaluating the effect on long-term smoking cessation found a significant effect; pooled RR 1.61 (95% CI 1.12 to 2.33). However, when pooling intensive...

  3. Recurrence patterns of bladder transitional cell carcinoma after radical cystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bohyun; Choi, Hyuck Jae; Kim, Mi-hyun; Cho, Kyung-Sik [Dept. of Radiology, Asan Medical Center, Univ. of Ulsan, Seoul (Korea, Republic of); E-mail: choihj@amc.seoul.kr

    2012-10-15

    Background Multidetector computed tomography (MDCT) is widely accepted as an effective imaging modality in monitoring for bladder cancer recurrence after radical cystectomy. Elucidating the pattern of bladder cancer recurrence on CT can increase the diagnostic accuracy. Purpose To evaluate the recurrence patterns of transitional cell carcinoma of the bladder and the factors associated with cancer recurrence. Material and Methods One hundred and forty-nine consecutive patients (mean age, 66.55 years; range, 32-86 years) who underwent preoperative contrast-enhanced CT and radical cystectomy were included in this study. The presence, site, and time of tumor recurrence were recorded retrospectively by two radiologists in a consensus fashion. The association of tumor recurrence and tumor factors (T stage, lymph node metastasis, nuclear grade, and tumor diameter) were also evaluated using multiple logistic regression analysis and Kaplan-Meier statistics. Results Tumor recurrence occurred in 60 patients (40.3%) with a mean time of 14 months (range, 1-64 months). The sites of recurrence included the operation site (n = 20), lymph node (n = 20), bone (n = 11), liver (n = 6), lung (n = 5), upper urinary tract (n = 4), colon (n = 3), adrenal gland (n = 2), peritoneum (n = 1), abdominal wall (n = 1), psoas muscle (n = 1), and penile skin (n = 1). Tumor recurrence was found to be associated with advanced T stage (P = 0.002) and lymph node metastasis (P < 0.001). Conclusion Transitional cell carcinomas of the bladder recur more frequently at the operation site and lymph node, and T-stage and lymph node metastasis are closely associated with tumor recurrence.

  4. Diagnosis and treatment of pheochromocytoma in urinary bladder

    Institute of Scientific and Technical Information of China (English)

    LIU Yong; DONG Sheng-guo; DONG Zhen; MAO Xin; SHI Xin-yan

    2007-01-01

    Objective:To study the diagnosis and treatment of pheochromocytoma in urinary bladder.Methods:Six cases of bladder pheochromocytoma were studied.Four cases showed hypertension,3 of which were paroxysmal hypertension during urination.Catecholamine (CA) was increased in a case,and vanillymandelic acid (VMA) was increased in 2 cases.Bladder submucosal mass was detected by B-ultrasound in 5 cases (5/5),computerized tomography (CT) in 3 cases (3/3),cystoscopy in 5cases (5/6).Four cases took α-receptor blocker for 2 weeks,1 case took β-receptor blocker to decrease heart rate.All patients were treated with surgical operation including 4 partial cystectomies,2 excavations.Results:Three cases had manifestations including headache,excessive perspiration and hypertension during cystoscopy.Four cases were confirmed before operation.Two cases showed hypertension during operation.All patients were pathologically diagnosed as pheochromocytoma postoperatively.In five cases followed up,blood pressure returned to normal.No patient had relapse and malignancy.Conclusions:Typical hypertension during urination comprised the main symptoms.We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound,CT,131I-MIBG (methyliodobenzylguanidine) and cystoscopy.The determination of CA in urine is valuable for qualitative diagnosis.The preoperative management of controlling blood pressure and expansion of the blood volume are very important.Surgical operation is a good method for effective treatment.Postoperative long-time followed up is necessary.

  5. Preoperative radiotherapy in rectal cancer treatment -- is it really a gold standard?

    Science.gov (United States)

    Pătraşcu, Tr; Doran, H; Mihalache, O

    2014-01-01

    Preoperative radiotherapy in the treatment of rectal cancer was thought to be an achievement of similar importance to total mesorectal excision (TME), for the therapeutic management of rectal malignancies. However, numerous criticisms have been discussed in this field lately. We have analysed the two main purposes of preoperative radiation: possible sphincter preservation and the conversion of a non-resectable tumor into a resectable one in a series of 31 consecutive patients, operated in our clinic. In 20 of them, preoperative radio chemoradiotherapy was applied, while 11 patients were firstly operated and then irradiated. The surgical procedure included total mesorectal excision in 30 patients, as part of a low anterior resection,in 13 cases and of an abdominal perineal resection, in the other 17 cases. We have found that preoperative radiotherapy improves the local recurrence rate but has no influence on the overall survival rate. However, we should not overlook the adverse effects of this method: toxicity of radiotherapy on the small bowel and the urinary bladder, the healing of the perineal wounds and the risk of anastomotic leaks. We concluded in favor of elective preoperative radiotherapy in selected cases: any T4 tumors, T3 tumors which threaten the mesorectal fascia on MRI, whenever there is a suspicion of nodal involvement and also for very low tumors. Celsius.

  6. Elective bladder-sparing treatment for muscle invasive bladder cancer.

    Science.gov (United States)

    Lendínez-Cano, G; Rico-López, J; Moreno, S; Fernández Parra, E; González-Almeida, C; Camacho Martínez, E

    2014-01-01

    Radical cystectomy is the standard treatment for localised muscle invasive bladder cancer (MIBC). We offer a bladder-sparing treatment with TURB +/- Chemotherapy+Radiotherapy to selected patients as an alternative. We analyze, retrospectively, 30 patients diagnosed with MIBC from March 1991 to October 2010. The mean age was 62.7 years (51-74). All patients were candidates for a curative treatment, and underwent strict selection criteria: T2 stage, primary tumor, solitary lesion smaller than 5cm with a macroscopic disease-free status after TURB, negative random biopsy without hydronephrosis. Staging CT evaluation was normal. Restaging TURB or tumor bed biopsy showed a disease-free status or microscopic muscle invasion. 14 patients underwent TURB alone, 13 TURB+Chemotherapy and 3 TURB+Chemotherapy+Radiotherapy. The mean follow up was 88.7 months (19-220). 14 patients remained disease free (46.6%), 10 had recurrent non-muscle invasive bladder cancer (33%). 81.3% complete clinical response. 71% bladder preserved at 5-years. Overall, 5-years survival rate was 79% and 85% cancer-specific survival rate. Although radical cystectomy is the standard treatment for localised MIBC, in strictly selected cases, bladder-sparing treatment offers an alternative with good long term results. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  7. Overactive bladder in children

    Science.gov (United States)

    Ramsay, Sophie; Bolduc, Stéphane

    2017-01-01

    Overactive bladder (OAB) is a highly prevalent disorder in the pediatric population. This condition is especially troublesome for pediatric patients and their families when associated with incontinence, since it negatively affects self-esteem and impairs children’s development. From the patient’s perspective, urgency and urge incontinence can have a significant impact, negatively affecting their quality of life. For a therapy to have true benefit, changes must not only be statistically significant, but must also be perceived as meaningful by the patient. A stepwise approach is favoured to treat this pathology, starting with behavioural therapy, followed by medical management, and eventually more invasive procedures. Antimuscarinic agents are the mainstay of medical treatment for OAB. Oxybutynin is the most commonly used antimuscarinic in the pediatric population. However, some patients have a suboptimal response to antimuscarinics and many experience bothersome side effects, which have been documented with all antimuscarinics to a significantly higher degree than placebo. Although there have been reports about the use of tolterodine, fesoterodine, trospium, propiverine, and solifenacin in children, to date, only oxybutynin has been officially approved for pediatric use by medical authorities in North America. This review will address alternative treatment options for pediatric patients presenting with OAB, from conservative measures to more invasive therapies. PMID:28265325

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

    Directory of Open Access Journals (Sweden)

    Ronaldo Laranjeira

    2002-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Laranjeira Ronaldo

    2002-01-01

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

  10. Alcohol outlet density and violence: A geographically weighted regression approach.

    Science.gov (United States)

    Cameron, Michael P; Cochrane, William; Gordon, Craig; Livingston, Michael

    2016-05-01

    We investigate the relationship between outlet density (of different types) and violence (as measured by police activity) across the North Island of New Zealand, specifically looking at whether the relationships vary spatially. We use New Zealand data at the census area unit (approximately suburb) level, on police-attended violent incidents and outlet density (by type of outlet), controlling for population density and local social deprivation. We employed geographically weighted regression to obtain both global average and locally specific estimates of the relationships between alcohol outlet density and violence. We find that bar and night club density, and licensed club density (e.g. sports clubs) have statistically significant and positive relationships with violence, with an additional bar or night club is associated with nearly 5.3 additional violent events per year, and an additional licensed club associated with 0.8 additional violent events per year. These relationships do not show significant spatial variation. In contrast, the effects of off-licence density and restaurant/café density do exhibit significant spatial variation. However, the non-varying effects of bar and night club density are larger than the locally specific effects of other outlet types. The relationships between outlet density and violence vary significantly across space for off-licences and restaurants/cafés. These results suggest that in order to minimise alcohol-related harms, such as violence, locally specific policy interventions are likely to be necessary. [Cameron MP, Cochrane W, Gordon C, Livingston M. Alcohol outlet density and violence: A geographically weighted regression approach. Drug Alcohol Rev 2016;35:280-288]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  11. Improving data accuracy of commercial food outlet databases.

    Science.gov (United States)

    Ohri-Vachaspati, Punam; Martinez, Diane; Yedidia, Michael J; Petlick, Nirvana

    2011-01-01

    PURPOSE. Assessing food environments often requires using commercially available data. Disparate methods used for classifying food outlets in these databases call for creating a classification approach using common definitions. A systematic strategy for reclassifying food stores and restaurants, as they appear in commercial databases, into categories that differentiate the availability of healthy options is described here. DESIGN AND SETTING. Commercially available data on food outlets including names, addresses, North American Industry Classification System codes, and associated characteristics was obtained for five New Jersey communities. ANALYSIS. A reclassification methodology was developed using criteria and definitions from the literature to categorize food outlets based on availability of healthy options. Information in the database was supplemented by systematic Internet and key word searches, and from phone calls to food outlets. RESULTS. The methodology resulted in 622 supermarket/grocery stores, 183 convenience stores, and 148 specialty stores in the original data to be reclassified into 58 supermarkets, 30 grocery stores, 692 convenience stores, and 115 specialty stores. Outlets from the original list of 1485 full-service restaurants and 506 limited-service restaurants were reclassified as 563 full-service restaurants and 1247 limited-service restaurants. Reclassification resulted in less than one-seventh the number of supermarkets and grocery stores, more than three times the number of convenience stores, and twice as many limited-service restaurants-a much less healthy profile than the one generated by using exclusively the commercial databases. CONCLUSION. An explicit and replicable strategy is proposed for reclassifying food outlets in commercial databases into categories that differentiate on the basis of healthy food availability. The intent is to contribute towards building a consensus among researchers on definitions used in public health

  12. Medical management of overactive bladder

    Directory of Open Access Journals (Sweden)

    Sarvpreet S Ubee

    2010-01-01

    Full Text Available Overactive bladder (OAB, as defined by the International Continence Society, is characterized by a symptom complex including urinary urgency with or without urge incontinence, usually associated with frequency and nocturia. OAB syndrome has an incidence reported from six European countries ranging between 12-17%, while in the United States; a study conducted by the National Overactive Bladder Evaluation program found the incidence at 17%. In Asia, the prevalence of OAB is reported at 53.1%. In about 75%, OAB symptoms are due to idiopathic detrusor activity; neurological disease, bladder outflow obstruction (BOO intrinsic bladder pathology and other chronic pelvic floor disorders are implicated in the others. OAB can be diagnosed easily and managed effectively with both non-pharmacological and pharmacological therapies. The first-line treatments are lifestyle interventions, bladder training, pelvic floor muscle exercises and anticholinergic drugs. Antimuscarinics are the drug class of choice for OAB symptoms; with proven efficacy, and adverse event profiles that differ somewhat.

  13. Molecular markers in bladder cancer.

    Science.gov (United States)

    Hussain, Syed A; James, Nicholas D

    2005-01-01

    Bladder cancer is one of the malignancies for which extensive information regarding molecular pathogenesis and genetic predictors of natural history as well as response to various modalities of treatment based on molecular profile is available. As more prognostic markers are being investigated in clinical trial settings, in the not very distant future we will be able to use these predictive markers in clinical decision-making. Bladder cancer is the second most common genitourinary tumor and is a significant cause of morbidity and mortality. A need for tumor markers that can be incorporated into clinical practice to add prognostic information and to refine the conventional TNM and grading systems in terms of treatment response and prognosis is crucial. Intravesical and systemic chemotherapy in bladder cancer are limited in their efficacy in the treatment of bladder cancer patients primarily when they are unable to induce apoptosis in bladder tumor cells. Understanding the apoptotic signals and the cascade of reactions that give pro-survival signals will go a long way in refining the treatments and will help in the future to individualize cancer therapies. It is imperative to study the role of these mechanisms in prospective clinical trials in a quest to find predictive markers that can help to tailor treatments, keeping in view the molecular heterogeneity.

  14. Do psychological interventions reduce preoperative anxiety?

    Science.gov (United States)

    Renouf, Tessa; Leary, Alison; Wiseman, Theresa

    The systematic review investigates whether, during preoperative assessments, nurse-delivered psychological interventions reduce anxiety levels preoperatively for patients undergoing elective surgery. Seventeen studies met the inclusion criteria for data extraction and in-depth critiquing. Of these, two were discarded due to lack of validity, while the remaining studies were organised thematically in a narrative synthesis, generating two principal results: patients' preoperative anxieties were lowered by nurse-delivered general preoperative psychological interventions; and patients valued individualised preoperative interventions delivered by nurses. However, the single oncology study in the review showed an elevation in preoperative anxiety, regardless of intervention, and highlights the need for more research in this under-reviewed area. In the meantime, the authors believe that service improvements should be implemented to ensure that, where possible, psychological preoperative interventions are individualised.

  15. Implantable Bladder Sensors: A Methodological Review.

    Science.gov (United States)

    Dakurah, Mathias Naangmenkpeong; Koo, Chiwan; Choi, Wonseok; Joung, Yeun-Ho

    2015-09-01

    The loss of urinary bladder control/sensation, also known as urinary incontinence (UI), is a common clinical problem in autistic children, diabetics, and the elderly. UI not only causes discomfort for patients but may also lead to kidney failure, infections, and even death. The increase of bladder urine volume/pressure above normal ranges without sensation of UI patients necessitates the need for bladder sensors. Currently, a catheter-based sensor is introduced directly through the urethra into the bladder to measure pressure variations. Unfortunately, this method is inaccurate because measurement is affected by disturbances in catheter lines as well as delays in response time owing to the inertia of urine inside the bladder. Moreover, this technique can cause infection during prolonged use; hence, it is only suitable for short-term measurement. Development of discrete wireless implantable sensors to measure bladder volume/pressure would allow for long-term monitoring within the bladder, while maintaining the patient's quality of life. With the recent advances in microfabrication, the size of implantable bladder sensors has been significantly reduced. However, microfabricated sensors face hostility from the bladder environment and require surgical intervention for implantation inside the bladder. Here, we explore the various types of implantable bladder sensors and current efforts to solve issues like hermeticity, biocompatibility, drift, telemetry, power, and compatibility issues with popular imaging tools such as computed tomography and magnetic resonance imaging. We also discuss some possible improvements/emerging trends in the design of an implantable bladder sensor.

  16. [Occupational hazards and bladder cancer].

    Science.gov (United States)

    Nizamova, R S

    1991-01-01

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

  17. Preoperative localization in primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sanson; Kitamura, Hiroyuki; Takagita, Shin-ichi; Maetani, Toshiki; Iwahashi, Yuka; Miyazaki, Masakazu; Yamamoto, Norio [Tenri Hospital, Nara (Japan)

    1998-04-01

    Between 1992 and 1996, 31 cases (8 men and 23 women) with primary hyperparathyroidism (PHPT) were treated in our department. In this study, we compared which of the preoperative localization methods was most useful in the detection of PHPT. The sensitivity for detection of abnormal parathyroid glands was 88.6% on ultrasonography (US), 76.9% on magnetic resonance imaging (MRI), 74.3% on Tl-Tc subtraction scintigraphy and 68.8% on computed tomography. We concluded that US should be performed first, with MRI as a supplementary method, for the detection of abnormal parathyroid glands and the evaluation of invasion within the body. (author)

  18. Preoperative Evaluation for Noncardiac Surgery.

    Science.gov (United States)

    Cohn, Steven L

    2016-12-06

    This issue provides a clinical overview of preoperative evaluation for noncardiac surgery, focusing on risk factors, elements of evaluation, medication management, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  19. [Rare cases of bladder stones].

    Science.gov (United States)

    Sampalmieri, Gregorio; Moretti, Antonello; Sampalmieri, Matteo

    2014-01-01

    We present here two special cases of urolithiasis. The first one shows a giant bladder lithiasis resulting in severe renal insufficiency in a 63-year-old patient, who had previously had nicturia (2-3 times), occasional episodes of urinary frequency and burning micturition, in the absence of renal colic, hematuria or interrupted urination. The second case referes to an 85-year-old man suffering from prostatic enlargement and bladder stones, hospitalized to undergo intervention of trans-vesical prostatic adenomectomy, during which two star-shaped stones were found without obvious symptoms.

  20. Hydrological Modeling of the Jezero Crater Outlet-Forming Flood

    Science.gov (United States)

    Fassett, Caleb I.; Goudge, Timothy A.

    2017-01-01

    Jezero crater is a site of prime scientific interest because it was a lake early in Mars history. Preserved clay- and carbonate-bearing sedimentary fans on Jezero's western and northwestern margin (Fig. 2) are accessible to future exploration. Geologic context [1] and stratigraphic analysis of the western fan strongly support the interpretation that these fans were deposited as deltas into the lake. This has helped establish Jezero as one of the final candidate landing sites for Mars 2020. The high level of certainty that Jezero was a lake results from the existence of its outlet valley, which required filling of the crater to form [e.g., 1,4]. Here, we specifically focus on how this outlet valley was carved by the dam breach flood that eroded the eastern crater rim. We have completed preliminary modeling in both 1D and 2D of the outlet's formation.

  1. Outcome of gall bladder polypoidal lesions detected by transabdominal ultrasound scanning: A nine year experience

    Institute of Scientific and Technical Information of China (English)

    D Chattopadhyay; R Lochan; S Balupuri; BR Gopinath; KS Wynne

    2005-01-01

    AIM: To determine the outcome of polypoidal lesions within the gall bladder (PLG) diagnosed by trans-abdominal scanning.METHODS: A nine-year (1993-2002) retrospective casenote review of all patients who underwent ultrasound scanning after referral to a single Upper GI Surgeon at a District General Hospital was conducted. Patients who were diagnosed with a PLG were included in our study. A database was constructed and patient details, investigations including ultrasound scan (USS) findings, treatment and histology and final diagnosis were recorded. RESULTS: Twenty-three (out of 651) patients were diagnosed pre-operatively by USS to have a polyp-likegall bladder lesion (PLG). Post cholecystectomy histological examination revealed 12 gallstones, 7 cholesterol polyps, 3 adenocarcinomas within polyps and 1 normal gall bladder. The specificity of USS in the diagnosis of PLG was 92.3%. All the true polyps were malignant. Overall USS had 66.66% sensitivity and 100% specificity in the pre-operative suspicion of malignancy. Using size greater than 10 mm as measured on USS as a cut-off, we find 100% sensitivity and 86.95% specificity with a positive predictive value of 50% in the diagnosis of malignancy in PLG.CONCLUSION: A large number of PLG are in fact calculi within diseased gall bladder. In cases of gall bladder polyps more then 10 mm in size on USS further imaging (crosssectional and/or EUS) is indicated prior to surgery. This will help in the optimal management of patients and avoid histological surprises.

  2. Preoperative fasting time in children.

    LENUS (Irish Health Repository)

    Adeel, S

    2012-02-01

    The aim of preoperative fasting is to prevent regurgitation and pulmonary aspiration while limiting potential problems of thirst, dehydration and hypoglycaemia. The American Society of Anaesthesiologists (ASA) has suggested guidelines for preoperative fasting for children undergoing elective surgery. We did a postal survey to determine the current practice regarding these guidelines amongst all specialist registrars in anaesthesia in Ireland. A questionnaire was sent to all specialist registrars in anaesthesia (90 in total), 60 (67%) were returned and analysed. The question asked was how long children should be kept fasting before elective surgery. The results of our survey suggest that most of the respondents are following the ASA guidelines for clear fluids and solids however there were differing opinion regarding the duration of fasting for formula milk and breast milk. In conclusion, we would recommend greater awareness and collaboration between anaesthetists, nurses and surgeons to ensure that fasting instructions are consistent with the ASA guidelines and that patient and their parents understand these directives as well.

  3. A Study on Consumer Behaviour at Organized Fish Retail Outlet

    OpenAIRE

    Mugaonkar, Pankajkumar Hanmantrao; Ananthan, P.S.; Samal, Suman Sekhar; Debnath, Biswajit

    2011-01-01

    Indian consumers have been buying fish from the unhygienic fish markets, but of late fish has become available at many of the multi-format retail outlets. Consumers’ behaviour at organized fish retail outlets in Mumbai has been studied. The majority of consumers are young (25-35 years) and belong to upper middle class. Fresh fish is the preferred choice and about 60 per cent consumers have emphasized on freshness rather than price of fish. About 97 per cent consumers have recently shifted t...

  4. Bladder Pneumatosis From a Catastrophic Vascular Event

    Directory of Open Access Journals (Sweden)

    Ian J. Cooke

    2016-09-01

    Full Text Available Air within the bladder wall, or bladder pneumatosis, is a very rare finding typically resulting from an infectious etiology, as in emphysematous cystitis (EC. However, there have been reports of bladder pneumatosis occurring without clear infectious origins. We present a case of a female patient found to have concurrent bladder and ileal pneumatosis secondary to a catastrophic vascular event. Prompt recognition of non-infectious etiologies of bladder pneumatosis is essential as this distinction may dramatically alter clinical decision-making.

  5. Obesity, Physical Activity and Bladder Cancer.

    Science.gov (United States)

    Noguchi, Jonathan L; Liss, Michael A; Parsons, J Kellogg

    2015-10-01

    While smoking and exposure to certain chemicals are well-defined risk factors for bladder cancer, there is no consensus as to the roles of modifiable lifestyle factors, notably physical activity, and obesity. We evaluated associations of obesity and physical activity with bladder cancer risk by performing a system-wide search of PubMed for cohort and case-control studies focused on obesity, exercise, and bladder cancer. A total of 31 studies were identified that evaluated the associations of obesity and physical activity with bladder cancer risk: 20 focused on obesity, eight on physical activity, and three on both. There was marked heterogeneity in population composition and outcomes assessment. Fifteen (65%) of the obesity studies used prevalence or incidence as the primary outcome and seven (30%) used bladder cancer mortality. Ten (44%) observed positive and 13 (56%) null associations of obesity with bladder cancer. Three (100%) of three studies also noted strong positive associations of obesity with bladder cancer progression or recurrence. Ten (91%) of the physical activity studies analyzed prevalence or incidence and one (9%) mortality. One (9%) study observed positive, seven (64%) null, and three (27%) negative associations of physical activity with bladder cancer. Study heterogeneity precluded quantitative assessment of outcomes. Obesity is potentially associated with an increased risk of bladder cancer, particularly for progression, recurrence, or death. Further studies of physical activity and bladder cancer are needed to validate these observations and elucidate the associations of exercise with bladder cancer progression and mortality.

  6. Stem Cells in Functional Bladder Engineering

    Science.gov (United States)

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

    2016-01-01

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

  7. Urinary markers in bladder cancer.

    NARCIS (Netherlands)

    Vrooman, O.P.; Witjes, J.A.

    2008-01-01

    OBJECTIVES: Many markers for the detection of bladder cancers have been tested. Almost all urinary markers reported are better than cytology with regard to sensitivity, but they score lower in specificity. The purpose of this review is to highlight the most important urinary biomarkers studied and

  8. Bladder Cancer Risk Prediction Models

    Science.gov (United States)

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

  9. Preoperative information management system using wireless PDAs.

    Science.gov (United States)

    Sawa, Tomohiro; Okahara, Masaharu; Santo, Masayuki; Schmidt, Ulrich; Nakata, Yoshinori; Morita, Shigeho; Ohno-Machado, Lucila

    2003-01-01

    Personal Digital Assistant (PDA) and wireless communication are currently available in clinical settings. We developed wireless PDA software that assists anesthesiologists in pre-operative patient assessment. The device communicates with the hospital information system through a wireless LAN and is equipped with pre-programmed data entry templates for pre-operative assessment. As a preliminary test of the device, we randomly assigned residents in preoperative assessment to an intervention and a control arm and compared the results.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Science.gov (United States)

    Chao, Hsun-Chin

    2016-01-01

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

  12. 49 CFR 179.220-18 - Bottom outlets.

    Science.gov (United States)

    2010-10-01

    ... Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... inner container may be equipped with a bottom outlet of approved design and an opening provided in the... valve body may be steam jacketed, in which case the breakage groove or its equivalent must be below the...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  14. Thoracic outlet syndrome in musicians - an approach to treatment.

    Science.gov (United States)

    Campbell, R M

    1996-01-01

    Thoracic outlet syndrome (TOS) can affect the skill of instrumental musicians. This paper details the way in which symptomatic TOS affects the musician and describes two cases of symptomatic TOS in a drummer and a violinist. Evaluation tools and treatment techniques are described.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  16. Food prices, access to food outlets and child weight.

    Science.gov (United States)

    Powell, Lisa M; Bao, Yanjun

    2009-03-01

    This study examines the importance of food prices and restaurant and food store outlet availability for child body mass index (BMI). We use the 1998, 2000 and 2002 waves of the child-mother merged files from the 1979 cohort of the National Longitudinal Survey of Youth combined with fruit and vegetable and fast food price data obtained from the American Chamber of Commerce Researchers Association and outlet density data on fast food and full-service restaurants and supermarkets, grocery stores and convenience stores obtained from Dun & Bradstreet. Using a random effects estimation model, we found that a 10% increase in the price of fruits and vegetables was associated with a 0.7% increase in child BMI. Fast food prices were not found to be statistically significant in the full sample but were weakly negatively associated with BMI among adolescents with an estimated price elasticity of -0.12. The price estimates were robust to whether we controlled for outlet availability based on a per capita or per land area basis; however, the association between food outlets and child BMI differed depending on the definition. The associations of fruit and vegetable and fast food prices with BMI were significantly stronger both economically and statistically among low- versus high-socioeconomic status children. The estimated fruit and vegetable and fast food price elasticities were 0.14 and -0.26, respectively, among low-income children and 0.09 and -0.13, respectively, among children with less educated mothers.

  17. Preoperative evaluation of oesophageal adenocarcinoma.

    Science.gov (United States)

    Khanna, Lauren G; Gress, Frank G

    2015-02-01

    The preoperative evaluation of oesophageal adenocarcinoma involves endoscopic ultrasound (EUS), computed tomography (CT), and positron emission tomography (PET). With routine Barrett's oesophagus surveillance, superficial cancers are often identified. EUS, CT and PET have a limited role in the staging of superficial tumours. Standard EUS has limited accuracy, but high frequency ultrasound miniprobes are valuable for assessing tumour stage in superficial tumours. However, the best method for determining depth of invasion, and thereby stage of disease, is endoscopic mucosal resection. In contrast, in advanced oesophageal cancers, a multi-modality approach is crucial. Accurate tumour staging is very important since the treatment of advanced cancers involves a combination of chemotherapy, radiation, and surgery. EUS is very useful for staging of the tumour and nodes. High frequency ultrasound miniprobes provide the ability to perform staging when the lesion is obstructing the oesophageal lumen. CT and PET provide valuable information regarding node and metastasis staging.

  18. Unexpected Small Urinary Bladder Pheochromocytoma: A Nonspecific Presentation

    Directory of Open Access Journals (Sweden)

    Faouzi Mallat

    2013-01-01

    Full Text Available Objectives. Pheochromocytoma of the urinary bladder is an extremely rare tumor that typically presents with a hypertensive crisis during micturition. Preoperatively, it may be misdiagnosed due to nonspecific symptomatology, physical, and radiologic findings. Method. We report a case of unsuspected small pheochromocytoma which was incidentally found by CT scan and confirmed by the histological aspects after transurethral resection in a 63-year-old woman. Here, we have described the clinical presentation, physical findings, laboratory investigations, and treatment provided in our case. We have also included radiological images and histopathology slides with input from both radiologists and pathologists. Surgical management and postoperative follow-up are discussed, as are details of previous published data. Results. After undergoing surgical treatment (transurethral resection, our patient is asymptomatic, with complete resolution of her pathology. Conclusion. Diagnosis is difficult before histopathological examination and should be considered in patients with no risk factors for usual bladder tumor. Our purpose is to raise clinician's awareness for this condition so that they will be more likely to diagnose it. This will facilitate prompt diagnosis and treatment and especially prevent complications due to pheochromocytoma which may be severe.

  19. [Synchronous male bladder cancer and breast cancer - a case report].

    Science.gov (United States)

    Yabe, Nobushige; Murai, Shinji; Kunugi, Chikara; Nakadai, Jyunpei; Oto, Ippei; Yoshikawa, Takahisa; Kitasato, Kenjiro; Shimizu, Hirotomo; Nakamura, Akihiko; Masuda, Aya; Miyazaki, Yasumasa; Ohashi, Masakazu; Jinno, Hiromitsu; Kitagawa, Yuko

    2014-11-01

    A 74-year-old man complained of blood in his urine over a 1-week period beginning in early October 2013, and was examined in the urology department of our hospital. A thorough examination revealed bladder cancer, and surgery was planned after two cycles of preoperative gemcitabine plus cisplatin chemotherapy. A chest computed tomography (CT) performed to evaluate the response to chemotherapy revealed a mass in the right breast. The patient had previously complained about the same site, and mammography and ultrasonography had suggested the possibility of a malignant mammary gland tumor. The results of aspiration cytology were Class V, and based on that finding, a diagnosis of cancer of the right breast was made. In February 2014, we performed a mastectomy, while preserving the pectoral muscles, along with sentinel node biopsy, total cystectomy, urethrectomy, pelvic lymph node dissection, and ureteroileal anastomosis. The histopathological diagnosis of the right breast tumor was invasive ductal carcinoma[scirrhous carcinoma, ly (+), v (-), g (+), f (+), s (+), nuclear grade 1=atypia 2+mitosis 1, EIC (-), ICT (-), NCAT (-)]. A micrometastatic tumor measuring approximately 1mm was observed in the sentinel lymph node. The breast disease was classified as pT1N1mi(sn)M0, Stage IIA, and the tumor was ER (+), PgR (+), HER2/neu (2+), and FISH (-). The bladder cancer was diagnosed as urothelial carcinoma, non-papillary, invasive G2>G3, pT2a; no pelvic lymph node metastases were detected, and it was classified as pT2aN0M0, Stage II. Synchronous male breast cancer and bladder cancer is a very rare condition, and we report the case with a review of the literature.

  20. [A case of small cell carcinoma in the urinary bladder responding to gemcitabine/cisplatin combination therapy as neoadjuvant chemotherapy].

    Science.gov (United States)

    Shirato, Akitomi; Shimamoto, Kenji; Ozawa, Akira; Tanji, Nozomu; Yokoyama, Masayoshi

    2006-12-01

    We report a case of primary small cell carcinoma of the urinary bladder. A 79-year-old man with the chief complaints of macrohematuria and pollakisuria was admitted to our hospital. Cystoscopy and computed tomography (CT) revealed a non-papillary broad-based bladder tumor. Histological diagnosis was small cell carcinoma of the urinary bladder, and he underwent 3 courses of neoadjuvant chemotherapy including gemcitabine and cisplatin with a preoperative diagnosis of cT3bN0M0. After the chemotherapy, cystoscopy and CT showed complete remission. Total cystectomy with ileal conduit was performed following 3 courses of chemotherapy. Microscopic examination revealed that the small cell carcinoma had disappeared and the converted squamous cell carcinoma remained only in a small part of the specimens. The patient was carefully followed for 10 months after operation, with no tumor recurrence.

  1. HAMLET treatment delays bladder cancer development.

    Science.gov (United States)

    Mossberg, Ann-Kristin; Hou, Yuchuan; Svensson, Majlis; Holmqvist, Bo; Svanborg, Catharina

    2010-04-01

    HAMLET is a protein-lipid complex that kills different types of cancer cells. Recently we observed a rapid reduction in human bladder cancer size after intravesical HAMLET treatment. In this study we evaluated the therapeutic effect of HAMLET in the mouse MB49 bladder carcinoma model. Bladder tumors were established by intravesical injection of MB49 cells into poly L-lysine treated bladders of C57BL/6 mice. Treatment groups received repeat intravesical HAMLET instillations and controls received alpha-lactalbumin or phosphate buffer. Effects of HAMLET on tumor size and putative apoptotic effects were analyzed in bladder tissue sections. Whole body imaging was used to study HAMLET distribution in tumor bearing mice compared to healthy bladder tissue. HAMLET caused a dose dependent decrease in MB49 cell viability in vitro. Five intravesical HAMLET instillations significantly decreased tumor size and delayed development in vivo compared to controls. TUNEL staining revealed selective apoptotic effects in tumor areas but not in adjacent healthy bladder tissue. On in vivo imaging Alexa-HAMLET was retained for more than 24 hours in the bladder of tumor bearing mice but not in tumor-free bladders or in tumor bearing mice that received Alexa-alpha-lactalbumin. Results show that HAMLET is active as a tumoricidal agent and suggest that topical HAMLET administration may delay bladder cancer development. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  2. Patient reported outcome measures in neurogenic bladder

    Science.gov (United States)

    Clark, Roderick

    2016-01-01

    Many interventions for neurogenic bladder patients are directed towards improving quality of life (QOL). Patient reported outcome measures (PROMs) are the primary method of evaluating QOL, and they provide an important quantification of symptoms which can’t be measured objectively. Our goal was to review general measurement principles, and identify and discuss PROMs relevant to neurogenic bladder patients. We identify two recent reviews of the state of the literature and updated the results with an additional Medline search up to September 1, 2015. Using the previous identified reviews, and our updated literature review, we identified 16 PROMs which are used for the assessment of QOL and symptoms in neurogenic bladder patients. Several are specifically designed for neurogenic bladder patients, such as the Qualiveen (for neurogenic bladder related QOL), and the Neurogenic Bladder Symptom Score (NBSS) (for neurogenic bladder symptoms). We also highlight general QOL measures for patients with multiple sclerosis (MS) and spinal cord injury (SCI) which include questions about bladder symptoms, and incontinence PROMs which are commonly used, but not specifically designed for neurogenic bladder patients. It is essential for clinicians and researchers with an interest in neurogenic bladder to be aware of the current PROMs, and to have a basic understanding of the principals of measurement in order to select the most appropriate one for their purpose. PMID:26904409

  3. Patient reported outcome measures in neurogenic bladder.

    Science.gov (United States)

    Clark, Roderick; Welk, Blayne

    2016-02-01

    Many interventions for neurogenic bladder patients are directed towards improving quality of life (QOL). Patient reported outcome measures (PROMs) are the primary method of evaluating QOL, and they provide an important quantification of symptoms which can't be measured objectively. Our goal was to review general measurement principles, and identify and discuss PROMs relevant to neurogenic bladder patients. We identify two recent reviews of the state of the literature and updated the results with an additional Medline search up to September 1, 2015. Using the previous identified reviews, and our updated literature review, we identified 16 PROMs which are used for the assessment of QOL and symptoms in neurogenic bladder patients. Several are specifically designed for neurogenic bladder patients, such as the Qualiveen (for neurogenic bladder related QOL), and the Neurogenic Bladder Symptom Score (NBSS) (for neurogenic bladder symptoms). We also highlight general QOL measures for patients with multiple sclerosis (MS) and spinal cord injury (SCI) which include questions about bladder symptoms, and incontinence PROMs which are commonly used, but not specifically designed for neurogenic bladder patients. It is essential for clinicians and researchers with an interest in neurogenic bladder to be aware of the current PROMs, and to have a basic understanding of the principals of measurement in order to select the most appropriate one for their purpose.

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

    Directory of Open Access Journals (Sweden)

    Hurst Robert E

    2005-03-01

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

  5. 膀胱前壁憩室并结石、憩室炎的超声检查%Ultrasound Analysis of the Anterior Wall of the Bladder Diverticulum with Calculi and Diverticulitis

    Institute of Scientific and Technical Information of China (English)

    李纯玉; 蔡梅; 谢美金

    2015-01-01

    Bladder diverticula are rare, much like a bag of the bladder wal is prominent, the anterior wal of the bladder diverticula calculus, diverticulitis and rare, comprehensive application of imaging examination is helpful to improve the preoperative diagnosis rate of the disease.%膀胱憩室较少见,多为膀胱壁的袋状突出,膀胱前壁腔内憩室并结石、憩室炎罕见,综合应用影像学检查有助于提高本病的术前正确诊断率。

  6. Metabolic phenotype of bladder cancer.

    Science.gov (United States)

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

    2016-04-01

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

  7. Preoperative Smoking Status and Postoperative Complications

    DEFF Research Database (Denmark)

    Grønkjær, Marie; Eliasen, Marie; Skov-Ettrup, Lise Skrubbeltrang;

    2014-01-01

    To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type.......To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type....

  8. 16 CFR Appendix F to Part 436 - Sample Item 20(5) Table-Projected New Franchised Outlets

    Science.gov (United States)

    2010-01-01

    ... Franchised Outlets F Appendix F to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION... 436—Sample Item 20(5) Table—Projected New Franchised Outlets Projected New Franchised Outlets As of... New Franchised Outlets in the Next Fiscal Year Column 4Projected New Company-Owned Outlets in...

  9. A pilot study of the use of fesoterodine in the management of men with refractory overactive bladder symptoms after surgery for bladder outlet obstruction

    Directory of Open Access Journals (Sweden)

    Bilal Chughtai

    2015-03-01

    Conclusion: Patients with persistent OAB symptoms after surgical treatment of BOO displayed possible reductions in the IPSS, IPSS irritative subscore, and mean number of nocturia events after 7 months of follow up, as well as trends for an increased quality of life when treated with fesoterodine. Larger trials are needed to help characterize the utility of fesoterodine in the treatment of persistent lower urinary tract symptoms after surgical treatment of benign prostatic hyperplasia.

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

    Science.gov (United States)

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

    2005-07-01

    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.

  11. Bladder Carcinoma Data with Clinical Risk Factors and Molecular Markers: A Cluster Analysis

    Directory of Open Access Journals (Sweden)

    Enrique Redondo-Gonzalez

    2015-01-01

    Full Text Available Bladder cancer occurs in the epithelial lining of the urinary bladder and is amongst the most common types of cancer in humans, killing thousands of people a year. This paper is based on the hypothesis that the use of clinical and histopathological data together with information about the concentration of various molecular markers in patients is useful for the prediction of outcomes and the design of treatments of nonmuscle invasive bladder carcinoma (NMIBC. A population of 45 patients with a new diagnosis of NMIBC was selected. Patients with benign prostatic hyperplasia (BPH, muscle invasive bladder carcinoma (MIBC, carcinoma in situ (CIS, and NMIBC recurrent tumors were not included due to their different clinical behavior. Clinical history was obtained by means of anamnesis and physical examination, and preoperative imaging and urine cytology were carried out for all patients. Then, patients underwent conventional transurethral resection (TURBT and some proteomic analyses quantified the biomarkers (p53, neu, and EGFR. A postoperative follow-up was performed to detect relapse and progression. Clusterings were performed to find groups with clinical, molecular markers, histopathological prognostic factors, and statistics about recurrence, progression, and overall survival of patients with NMIBC. Four groups were found according to tumor sizes, risk of relapse or progression, and biological behavior. Outlier patients were also detected and categorized according to their clinical characters and biological behavior.

  12. Management of congenital bladder diverticulum in children: A report of seven cases

    Directory of Open Access Journals (Sweden)

    Rachid Khemakhem

    2013-01-01

    Full Text Available Background: The purpose of the study is to present the author′s experience with congenital bladder diverticula in seven pediatric patients at a developing world tertiary care center. Materials and Methods: Records of seven patients diagnosed and treated as congenital bladder diverticulum, from January 1998 to December 2009 were retrospectively reviewed for age, sex, clinical symptoms, investigative work-up, operative notes, and postoperative follow-up. Results: All patients were males. Age at presentation ranged from six months to six years (mean three years and six months. All were manifested postnatally by urinary tract infection in four cases, bladder retention in three cases and abdominal pain in two cases. Diagnosis was suggested by ultrasound and confirmed by voiding cystourethrography (VCUG in all cases and urethrocystoscopy in three cases. Open surgical excision of diverticulum was done in all the patients associated with ureteral reimplantation in four patients with VCUG-documented high-grade vesicoureteral reflux (VUR. Average follow-up was four years; there is a resolution of symptoms and no diverticulum recurrence at the defined mean follow-up. Conclusion: Recurrent urinary tract infections and voiding dysfunction in pediatric population should always be evaluated for congenital bladder diverticulum. Investigations such as abdominal ultrasound, VCUG and nuclear renal scanning, form an important part of preoperative diagnostic work-up and postoperative follow up. Diverticulectomy with ureteral reimplantation in case of high-grade reflux, provides good results without recurrence.

  13. Bladder injuries frequently missed in polytrauma patients

    Directory of Open Access Journals (Sweden)

    Tanweer Karim

    2010-05-01

    Full Text Available Tanweer Karim, Margaret Topno, Vinod Sharma, Raymond Picardo, Ankur HastirSurgery, MGM Medical College, Kamothe, Navi Mumbai, IndiaAbstract: Bladder injuries are very common in patients who have had road traffic accidents. The method of diagnosis and management of such injuries is well established and accepted. However, trauma to the bladder can be associated with other life-threatening injuries which are frequently missed, and often diagnosed during laparotomy for other reasons. The aim of this study was to diagnose bladder injury in polytrauma patients as early as possible, taking into consideration the fact that these patients are hemodynamically unstable and require rapid evaluation and management. In order to achieve our objective, we used bedside sonography with retrograde instillation of normal saline to diagnose bladder injury in addition to use of the conventional retrograde cystogram.Keywords: bladder injury, bladder rupture, retrograde cystogram

  14. Scrotal Herniation of Bladder: A Case Report

    Directory of Open Access Journals (Sweden)

    Ali Hamidi Madani

    2013-03-01

    Full Text Available Inguinal bladder hernia is a rare clinical condition, with 1–3% of all inguinal hernias involving the bladder. Any portion of the bladder may herniate, from a small portion or a diverticulum to most of the bladder. We present a 55-year-old male with an intermittent right scrotal mass of 6 months’ duration. The mass lesion protruded through the right inguinal canal before voiding and reduced after that. Scrotal sonography revealed a hypoechoic lesion in the scrotum that stretched cranially to the intra-abdominal portion of the bladder. Excretory urography showed a duplicated system in the left kidney and deviation of the left orifice to the right side of the trigon. Finally, cystography illustrated herniation of the bladder to the right scrotum. Surgical repair of the hernia was done with mesh. Follow-up cystography one month postoperatively revealed no herniation.

  15. Bladder cancer: Present and future.

    Science.gov (United States)

    Martinez Rodriguez, Roberto Hugo; Buisan Rueda, Oscar; Ibarz, Luis

    2017-07-20

    Bladder cancer has a high incidence and involves high associated morbidity and mortality. Since its initial clinical suspicion, early diagnostic confirmation and multimodal treatment involve different medical specialties. For this reason, we consider it important to spread the current consensus for its management. Recent advances in immunology and Chemotherapy make it necessary to expose and reflect on future perspectives. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  16. Epitheloid hemangioendothelioma of urinary bladder

    Directory of Open Access Journals (Sweden)

    Narmada P Gupta

    2008-01-01

    Full Text Available Epitheloid hemangioendothelioma is an uncommon vascular neoplasm and has an unpredictable clinical behavior. It is characterized by round or spindle-shaped endothelial cells with cytoplasmic vacuolation. Most often, epitheloid hemangioendothelioma arise from the soft tissues of the upper and lower extremities and it has borderline malignant potential. We describe the first reported case of epitheloid hemangioendothelioma in the urinary bladder, which was treated by transurethral resection. The diagnosis was confirmed by immunohistochemistry.

  17. Epithelial abnormalities of urinary bladder.

    Science.gov (United States)

    Mostofi, F K; Davis, C J

    1984-01-01

    We have called attention to certain epithelial lesions of the bladder characterized as proliferative, metaplastic, and neoplastic. In the first group are included hyperplasia, von Brunn's nests, papillary cystitis, papilloma and inverted papilloma. The second category includes squamous metaplasia, mucous metaplasia, and tubular metaplasia. These two categories, while benign, are indicative of agitated sick mucosa and may progress to neoplasia. The neoplastic changes consist of carcinoma involving the surface epithelium, von Brunn's nests, papillary cystitis, and/or cystitis cystica.

  18. What Are the Risk Factors for Bladder Cancer?

    Science.gov (United States)

    ... bladder, is also a risk factor for bladder cancer. In countries where this parasite is common (mainly in Africa and the Middle East), squamous cell cancers of the bladder are seen much more often. ...

  19. Bladder calculi complicating intermittent clean catheterization.

    Science.gov (United States)

    Amendola, M A; Sonda, L P; Diokno, A C; Vidyasagar, M

    1983-10-01

    Eight male patients on clean intermittent catheterization programs for neurogenic bladder dysfunction developed vesical calculi around pubic hairs inadvertently introduced into the bladder, acting as a nidus for incrustation. In three patients, the radiographic appearance of serpentine calcifications in the pelvis was highly consistent with calcareous deposits on strands of hair. Familiarity with this radiologic appearance should suggest the diagnosis in the appropriate clinical setting and help avoid misinterpretation of these calcifications, atypical of usual bladder stones.

  20. Giant Leiomyosarcoma of the Urinary Bladder.

    Science.gov (United States)

    Ribeiro, José G A; Klojda, Carlos A B; Araújo, Claudio P De; Pires, Lucas A S; Babinski, Marcio A

    2016-05-01

    The bladder leiomyosarcoma is a rare and agressive mesenchymal tumour, and adult women of reproductive age have a higher incidence of developing the bladder leiomyosarcoma. The pathophysiology of the disease is not certain, and its main symptoms are hematuria, dysuria and abdominal pain. There are not a considerable amount of cases described in the literature. We report a case of a giant leiomyosarcoma of the urinary bladder in a 31-year-old woman.

  1. Implantable Bladder Sensors: A Methodological Review

    OpenAIRE

    Dakurah, Mathias Naangmenkpeong; Koo, Chiwan; Choi, Wonseok; Joung, Yeun-Ho

    2015-01-01

    The loss of urinary bladder control/sensation, also known as urinary incontinence (UI), is a common clinical problem in autistic children, diabetics, and the elderly. UI not only causes discomfort for patients but may also lead to kidney failure, infections, and even death. The increase of bladder urine volume/pressure above normal ranges without sensation of UI patients necessitates the need for bladder sensors. Currently, a catheter-based sensor is introduced directly through the urethra in...

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

    NARCIS (Netherlands)

    Oelke, M.

    2016-01-01

    The thesis summarizes nine published articles and deals with the diagnostic value of morphological changes in the lower urinary tract in adult men with LUTS associated with BOO. Until recently, no morphological change of the lower urinary tract could safely diagnose BOO. Therefore, the value of ultr

  3. Pharmacologic management of overactive bladder

    Directory of Open Access Journals (Sweden)

    Sum Lam

    2007-10-01

    Full Text Available Sum Lam1,2, Olga Hilas1,31St. John’s University, College of Pharmacy and Allied Health Professions, Department of Clinical Pharmacy Practice, Queens, New York, USA; 2Division of Geriatric Medicine, Winthrop University Hospital, Mineola, New York, USA; 3Department of Pharmacy, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USAAbstract: Overactive bladder (OAB is a prevalent and costly condition that can affect any age group. Typical symptoms include urinary urgency, frequency, incontinence and nocturia. OAB occurs as a result of abnormal contractions of the bladder detrusor muscle caused by the stimulation of certain muscarinic receptors. Therefore, antimuscarinic agents have long been considered the mainstay of pharmacologic treatment for OAB. Currently, there are five such agents approved for the management of OAB in the United States: oxybutynin, tolterodine, trospium, solifenacin and darifenacin. This article summarizes the efficacy, contraindications, precautions, dosing and common side effects of these agents. All available clinical trials on trospium, solifenacin and darifenacin were reviewed to determine its place in therapy.Keywords: overactive bladder, urinary incontinence, pharmacologic management, antimuscarinic agents, anticholinergics

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  5. Severe lower urinary tract symptoms due to anteriorly located midline prostatic cyst arising from the bladder neck in a young male: case report

    Directory of Open Access Journals (Sweden)

    Ali Gürağaç

    Full Text Available ABSTRACT CONTEXT: Prostatic cysts are uncommon. These cysts are usually asymptomatic and are diagnosed incidentally during ultrasonographic examination. On rare occasions, they may cause drastic symptoms. CASE REPORT: We report on a case of severely symptomatic anteriorly located prostatic cyst arising from the bladder neck in a 30-year-old man presenting with lower urinary tract symptoms, without clinical evidence of benign prostatic hyperplasia. Transrectal ultrasonography (TRUS, computed tomography (CT and cystourethroscopy demonstrated a projecting prostatic cyst that occupied the bladder neck at the precise twelve o'clock position. It was acting as a ball-valve, such that it obstructed the bladder outlet. Transurethral unroofing of the cyst was performed and the patient's obstructive symptoms were successfully resolved. Histopathological examination indicated a retention cyst. CONCLUSIONS: It should be borne in mind that midline prostate cysts can be a reason for bladder outlet obstruction in a young male. Such patients may have tremendous improvement in symptoms through transurethral unroofing of the cyst wall.

  6. Severe lower urinary tract symptoms due to anteriorly located midline prostatic cyst arising from the bladder neck in a young male: case report

    Energy Technology Data Exchange (ETDEWEB)

    Guragac, Ali; Demirer, Zafer; Alp, Bilal Firat; Aydur, Emin, E-mail: zaferdemirer@mynet.com, E-mail: zaferdemirer1903@gmail.com [Department of Urology, School of Medicine, Gulhane Military Medical Academy, Ankara (Turkey)

    2016-09-15

    Context: Prostatic cysts are uncommon. These cysts are usually asymptomatic and are diagnosed incidentally during ultrasonographic examination. On rare occasions, they may cause drastic symptoms. Case Report: We report on a case of severely symptomatic anteriorly located prostatic cyst arising from the bladder neck in a 30-year-old man presenting with lower urinary tract symptoms, without clinical evidence of benign prostatic hyperplasia. Transrectal ultrasonography (TRUS), computed tomography (CT) and cystourethroscopy demonstrated a projecting prostatic cyst that occupied the bladder neck at the precise twelve o’clock position. It was acting as a ball-valve, such that it obstructed the bladder outlet. Transurethral unroofing of the cyst was performed and the patient’s obstructive symptoms were successfully resolved. Histopathological examination indicated a retention cyst. Conclusions: It should be borne in mind that midline prostate cysts can be a reason for bladder outlet obstruction in a young male. Such patients may have tremendous improvement in symptoms through transurethral unroofing of the cyst wall. (author)

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    BACKGROUND AND PURPOSE: To control and account for bladder motion is a major challenge in radiotherapy (RT) of bladder cancer. This study investigates the relation between bladder volume variation and margins in conformal and image-guided RT (IGRT) for this disease. MATERIALS AND METHODS: The cor...

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

    Science.gov (United States)

    Ćerezci, Gökhan; Darka, Murat; Şenman, Ozan

    2016-06-01

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

  9. Boundary conditions for free surface inlet and outlet problems

    KAUST Repository

    Taroni, M.

    2012-08-10

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

  10. Modeling of Flow in Nuclear Reactor Fuel Cell Outlet

    Directory of Open Access Journals (Sweden)

    František URBAN

    2010-12-01

    Full Text Available Safe and effective load of nuclear reactor fuel cells demands qualitative and quantitative analysis of relations between coolant temperature in fuel cell outlet temperature measured by thermocouple and middle temperature of coolant in thermocouple plane position. In laboratory at Insitute of thermal power engineering of the Slovak University of Technology in Bratislava was installed an experimental physical fuel cell model of VVER 440 nuclear power plant with V 213 nuclear reactors. Objective of measurements on physical model was temperature and velocity profiles analysis in the fuel cell outlet. In this paper the measured temperature and velocity profiles are compared with the results of CFD simulation of fuel cell physical model coolant flow.

  11. Hydrological Modeling of the Jezero Crater Outlet-Forming Flood

    Science.gov (United States)

    Fassett, C. I.; Goudge, T. A.

    2017-01-01

    Abundant evidence exists for lakes on Mars both from orbital observations [e.g., 1-3] and in situ exploration [e.g., 4-5]. These lakes can be divided into two classes: those that were hydrologically closed, so their source valley(s) terminated at the basin [3], and those that were hydrologically open, where there was sufficient flow from inlet valley(s) to cause the lake to breach and form an outlet valley [2]. It is easier to be confident from orbital data alone that a standing body of water must have existed in open basins, because there is no other way for their perched outlet valleys to form. The majority of basins fed by valley networks, rather than by isolated inlet valleys, are open [6], with some important exceptions (e.g., Gale Crater). Jezero crater (Fig. 1) is one of the most well-studied open basin paleolakes on Mars, with a breach that re-mains well above the lowest part of the crater floor, and two sedimentary fans at its northwestern margin that are likely deltaic in origin [7-9]. CRISM observations of these sediments indicate they host a variety of alteration minerals [9-11], including smectite and carbonate, and both the mineralogy of the sediments and their settings suggest they have a strong potential for preserving organic materials [10]. As a result, Jezero is a strong candidate landing site for the Mars 2020 rover. Approximate formative discharges have been estimated for its well-preserved western fan (Q approximately 500m3/s) [7], but to our knowledge, no estimates for the dis-charges associated with formation and incision of its outlet valley have been presented. Indeed, only a few studies [e.g., 12-14] have attempted to reconstruct the formation of outlet breaches broadly similar to Jezero anywhere on Mars, despite the apparent commonality of basins with large outlets [e.g., 2]. The outlet valley formed as a dam breach when the lake overflowed. In such an event, the growth and incision of the breach is directly coupled to flood discharge

  12. Spinal accessory neuropathy, droopy shoulder, and thoracic outlet syndrome.

    Science.gov (United States)

    Al-Shekhlee, Amer; Katirji, Bashar

    2003-09-01

    Droopy shoulder has been proposed as a cause of thoracic outlet syndrome. Two patients developed manifestations of neurovascular compression upon arm abduction, associated with unilateral droopy shoulder and trapezius muscle weakness caused by iatrogenic spinal accessory neuropathies following cervical lymph node biopsies. The first patient developed a cold, numb hand with complete axillary artery occlusion when his arm was abducted to 90 degrees. The second patient complained of paresthesias in digits 4 and 5 of the right hand, worsened by elevation of the arm, with nerve conduction findings of right lower trunk plexopathy (low ulnar and medial antebrachial cutaneous sensory nerve action potentials). Spinal accessory nerve grafting (in the first patient) coupled with shoulder strengthening physical exercises in both patients resulted in gradual improvement of symptoms in 2 years. These two cases demonstrate that unilateral droopy shoulder secondary to trapezius muscle weakness may cause compression of the thoracic outlet structures.

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

    Directory of Open Access Journals (Sweden)

    Abdulrahman Al-Hussaini

    2014-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  15. Delayed presentation of traumatic intraperitoneal bladder rupture

    Energy Technology Data Exchange (ETDEWEB)

    Brown, D.; Magill, H.L.; Black, T.L.

    1986-03-01

    A child with urine ascites as a delayed manifestation of post-traumatic intraperitoneal bladder rupture is presented. The diagnosis was suggested by abdominal CT scan and confirmed with a cystogram. While uncommon, late presentation of intraperitoneal bladder rupture following trauma may occur from masking of a primary laceration or development of secondary rupture at the site of a hematoma in the bladder wall. Since CT may be a primary diagnostic study performed following abdominal trauma, the radiologist should be aware of CT findings suggesting bladder rupture and of the possibility of delayed presentation of this injury.

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

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Yong Kweon; Li, Zi Lu; Jeong, Jong Hyun; Lee, Jun Hee [Dong-A University, Busan (Korea, Republic of)

    2006-10-15

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

  17. Alcohol Outlets and Substance Use among High Schoolers

    Science.gov (United States)

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

    2016-01-01

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

  18. Occult Pelvic Lymph Node Involvement in Bladder Cancer: Implications for Definitive Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Goldsmith, Benjamin; Baumann, Brian C.; He, Jiwei; Tucker, Kai; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David; Keefe, Stephen M. [Department of Medical Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas; Malkowicz, S. Bruce [Department of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-03-01

    Purpose: To inform radiation treatment planning for clinically staged, node-negative bladder cancer patients by identifying clinical factors associated with the presence and location of occult pathologic pelvic lymph nodes. Methods and Materials: The records of patients with clinically staged T1-T4N0 urothelial carcinoma of the bladder undergoing radical cystectomy and pelvic lymphadenectomy at a single institution were reviewed. Logistic regression was used to evaluate associations between preoperative clinical variables and occult pathologic pelvic or common iliac lymph nodes. Percentages of patient with involved lymph node regions entirely encompassed within whole bladder (perivesicular nodal region), small pelvic (perivesicular, obturator, internal iliac, and external iliac nodal regions), and extended pelvic clinical target volume (CTV) (small pelvic CTV plus common iliac regions) were calculated. Results: Among 315 eligible patients, 81 (26%) were found to have involved pelvic lymph nodes at the time of surgery, with 38 (12%) having involved common iliac lymph nodes. Risk of occult pathologically involved lymph nodes did not vary with clinical T stage. On multivariate analysis, the presence of lymphovascular invasion (LVI) on preoperative biopsy was significantly associated with occult pelvic nodal involvement (odds ratio 3.740, 95% confidence interval 1.865-7.499, P<.001) and marginally associated with occult common iliac nodal involvement (odds ratio 2.307, 95% confidence interval 0.978-5.441, P=.056). The percentages of patients with involved lymph node regions entirely encompassed by whole bladder, small pelvic, and extended pelvic CTVs varied with clinical risk factors, ranging from 85.4%, 95.1%, and 100% in non-muscle-invasive patients to 44.7%, 71.1%, and 94.8% in patients with muscle-invasive disease and biopsy LVI. Conclusions: Occult pelvic lymph node rates are substantial for all clinical subgroups, especially patients with LVI on biopsy. Extended

  19. 16 CFR Appendix E to Part 436 - Sample Item 20(4) Table-Status of Company-Owned Outlets

    Science.gov (United States)

    2010-01-01

    ... RULES DISCLOSURE REQUIREMENTS AND PROHIBITIONS CONCERNING FRANCHISING Pt. 436, App. E Appendix E to Part... 5Outlets Reacquired From Franchisees Column 6Outlets Closed Column 7Outlets Sold to Franchisees...

  20. Gall bladder perforation and biliary peritonitis in a young pregnant lady.

    Science.gov (United States)

    Sharma, D K; Panwar, R S; Kumari, K

    2001-11-01

    A rare event of acute free perforation of gall bladder with biliary peritonitis in a case of calculous cholecystitis in a 28 years old pregnant lady occurring in the absence of the usual factors associated with gall stone disease is reported. The clinical features resembled acute appendicitis and a pre-operative diagnosis could not be made. It is suggested that a thorough attempt should be made to exclude conditions mimicking appendicitis, including those of the biliary system, on finding a normal appendix at emergency appendicectomy without hesitating to convert to full laparotomy if required.

  1. A fresh look at preoperative body washing

    Science.gov (United States)

    Tanner, Judith; Gould, Dinah; Jenkins, Philip; Hilliam, Rachel; Mistry, Neetesh; Walsh, Susannah

    2012-01-01

    National guidelines do not support preoperative body washing to reduce surgical site infections, instead recommending bathing or showering with soap. Yet preoperative body washing continues to be widely used in many hospitals across Europe. This paper suggests that existing trials of preoperative body washing, upon which guidelines are based, are dated and proposes a new investigation of preoperative body washing using modern definitions of surgical site infection with standardised patient follow up, modern surgical techniques and well designed trials. This paper provides a critique of existing guidelines and describes a randomised trial with 60 participants to compare the effect of soap and two antiseptic washing products on colony forming units (CFUs) for up to six hours. Chlorhexidine gluconate and octenidine were significantly more effective than soap in reducing CFUs in the underarm, and chlorhexidine was significantly more effective than soap in reducing CFUs in the groin. PMID:22448182

  2. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  3. Preoperative alcohol cessation prior to elective surgery

    DEFF Research Database (Denmark)

    Oppedal, Kristian; Møller, Ann Merete; Pedersen, Bolette

    2012-01-01

    Hazardous drinking has been associated with an increased postoperative complication rate after surgery. Common complications include postoperative infections, cardiopulmonary complications, and bleeding episodes. Preoperative abstinence may to some degree reverse alcohol-induced pathophysiological...

  4. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  5. The significance of radiotherapy in a multidisciplinary treatment approach of bladder cancer. Die Radiotherapie im interdisziplinaeren Behandlungskonzept des Harnblasenkarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Dunst, J. (Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik und Poliklinik)

    1991-10-01

    Bladder cancer accounts for approximately 3% of all malignancies. About 70% of bladder cancers are superficial tumors (Ta, Tis, T1), the remaining 30% are muscleinvasive (T2-4). Important prognostic factors include TNM-stage, histologic grade, multifocality, associated Tis, and residual tumor after TUR. Superficial cancers are managed by TUR and, if necessary, intravesical chemotherapy, and bladder preservation is possible. In case of T1 G3-cancers, we favour TUR plus irradiation with a moderate dose instead of cystectomy. Even advanced bladder cancers may be treated by an organ sparing approach. TUR plus radiotherapy or radiochemotherapy offer comparable survival figures and local control rate as compared to radical cystectomy. The 5-year survival rates are 60-70% for T1-2, 40% for T3, and 15% for T4-tumors. About 70% of long-term survivors maintain a functioning bladder. Radiochemotherapy (RCT) with platin compounds is equally effective but less toxic as compared to multi-agent chemotherapy or intraarterial administrations. We do not recommend preoperative radiotherapy or RCT with planned cystectomy because of the definitive organ loss. Optimal treatment results are achieved by complete TUR prior to irradiation. Persistent or recurrent tumor after radiotherapy requires salvage cystectomy. Intravesical recurrences in the spared bladder have a good prognosis. Adjuvant chemotherapy of bladder cancer is not established. Neoadjuvant chemotherapy may result in 20-30% complete remissions, but these figures are lower than those after radiotherapy or radiochemotherapy. Nevertheless, adjuvant treatment protocols are necessary because of the fact that even sophisticated local treatment with increased local control has not yet improved the overall survival rates. (orig./MG).

  6. Factors of prognostic and therapeutic significance in patients with bladder cancer. [X ray

    Energy Technology Data Exchange (ETDEWEB)

    Batata, M.A.; Chu, F.C.H.; Hilaris, B.S.; Kim, Y.S.; Lee, M.Z.; Chung, S.; Whitmore, W.F.

    1981-05-01

    In a two-decade period, 451 patients with bladder cancer were treated by external megavoltage irradiation and/or radical cystectomy at the Memorial Sloan-Kettering Cancer Center. Radical cystectomy alone was performed in 137 patients. One-hundred nine patients underwent radical cystectomy for cancer recurrence or persistence +- 1 year after radical irradiation averaging 6000 rad tumor dose in 6 weeks. Planned preoperative pelvic irradiation either 4000 rad in 4 weeks in 119 patients or 2000 rad in 1 week in 86 patients was followed by radical cystectomy after average intervals of 6 weeks and 2 days, respectively. Similarly more favorable 5-year survival results were observed with prior radical or preoperative conventional or shorter regimen irradiation than with cystectomy alone. The main pelvic complications from this treatment are discussed.

  7. Is transition zone index useful in assessing bladder outflow obstruction due to benign prostatic hyperplasia?: A prospective study

    Directory of Open Access Journals (Sweden)

    S L Sailo

    2006-01-01

    Full Text Available BACKGROUND: Benign prostatic enlargement (BPE is the commonest cause of bladder outlet obstruction in men above 50 years of age. Though pressure-flow study is the gold standard in establishing outlet obstruction, it is associated with definite morbidity. Several noninvasive parameters are described to diagnose outlet obstruction due to BPE and evaluate treatment efficacy. AIM: We studied the role of transitional zone index (TZI in assessing bladder outlet obstruction (BOO due to BPE. SETTING AND DESIGN: Prospective hospital-based cross-sectional diagnostic study. MATERIALS AND METHODS: Thirty-five men aged between 50 and 77 years with untreated lower urinary tract symptoms due to BPE were studied. Patients with prostate cancer, prostatitis, active UTI urethral stricture, neurovesical dysfunction and diabetes mellitus were excluded. All patients underwent a standard assessment using the American Urological Association (AUA symptom score, uroflow, pressure-flow (PF study and transrectal ultrasound (TRUS estimation of TZI. Investigators undertaking PF studies and TRUS were blinded to the investigation of others. From the PF studies, Abrams Griffith (AG number was calculated. Based on this, patients were grouped into obstructed (AG>40 and unobstructed (AG< 40 groups. STATISTICAL ANALYSIS: TZI was calculated and compared with PF studies using Mann-Whitney U test, logistic regression analysis and receiver operator characteristic curve (ROC. RESULTS: The mean age was 63.2 years (SD. The mean AUA scores and peak flow rate were 16.7 and 7.5 ml/sec, respectively. Of the 35 men, 21 were obstructed and 14 were unobstructed. TZI was not significantly different between the two groups, while the differences in age, AUA symptom score, prostate volume and TZ volume were statistically significant. Logistic regression model did not show any independent effect of TZI in predicting obstruction. ROC curve showed a poor overall accuracy in diagnosing obstruction due

  8. An unusual foreign body in the bladder.

    Directory of Open Access Journals (Sweden)

    Bakshi G

    2000-01-01

    Full Text Available In spite of its inaccessibility, every conceivable object has been inserted into the urinary bladder. Such patients may have a psychiatric disorder with a sexual perversion or inquisitiveness (as in children as the underlying cause. We report a case of an aluminum rod inserted into the urinary bladder by an adult male, which was removed successfully by surgery.

  9. Bladder dysfunction in advanced Parkinson's disease

    DEFF Research Database (Denmark)

    Winge, Kristian; Nielsen, Kurt K

    2012-01-01

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

  10. Bladder diverticulitis on PET/CT

    OpenAIRE

    Wosnitzer, Brian

    2015-01-01

    Diverticula are commonly seen in hollow viscous organs. One common complication of diverticula is infection, known as diverticulitis. Although diverticulitis has been extensively described with respect to the colon, not many cases describe diverticulitis of the urinary bladder. We report a case of diverticulitis of the bladder to emphasize the imaging findings on PET/CT and to discuss management and possible complications.

  11. Trigonalgia: An overlooked cause of bladder pain

    African Journals Online (AJOL)

    S. Aminu

    2015-12-04

    Dec 4, 2015 ... Trigonalgia: An overlooked cause of bladder pain. S. Aminu ... Bladder pain is a very important type of chronic pelvic pain syn- drome. .... in women: relevance and application of the fear-avoidance model of pain. Phys Ther ...

  12. Reversible bladder denervation in acute polyradiculitis

    DEFF Research Database (Denmark)

    Kamper, A L; Andersen, J T

    1982-01-01

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

  13. Tolerance and efficacy of preoperative intracavitary HDR brachytherapy in IB and IIA cervical cancer

    Science.gov (United States)

    Bialas, Brygida; Fijalkowski, Marek; Raczek-Zwierzycka, Katarzyna

    2009-01-01

    Purpose The aim of this work is to analyze the efficacy and tolerance of preoperative intracavitary HDR brachytherapy (HDR-BT) in patients with IB and IIA cervical cancer. Material and methods 139 patients with cervical cancer IB-IIA with preoperative HDR-BT, out of which 60 patients with cervical cancer IB (43.2%) and 79 with IIA (56.8%) were treated since 1996 to 2002. In preoperative BT total dose to point A ranged from 30-45 Gy in 6-9 fractions twice a week. The fraction dose was 4-5 Gy at point A. Six weeks after BT all patients underwent radical Wertheim-Meigs hysterectomy. Patients with disadvantageous risk factors or with positive specimen histology had a complementary therapy: external-beam radiotherapy (EBRT) given to the whole pelvic volume in daily fractions of 2 Gy up to total dose of 36-52 Gy (20 patients) or EBRT with cisplatin-based chemotherapy with the dose of 30-40 mg/m2 in 5-7 fractions given weekly (7 patients) or chemotherapy (6 patients). Acute and late radiation toxicity was evaluated according to EORTC/RTOG. Results In postoperative specimen histopathology the number of 114 women (82%) had tumor-free specimen within brachytherapy target (in cervix and cavity), 96 women (60.1%) had tumor-free specimen both in and outside brachytherapy target (lymph nodes, parametra, adnexis). The 5-year and 10-year DFS were 93.8% and 88% for IB and 89.7% and 64.7% for IIA respectively. 7.9% of patients developed acute toxicity both in rectum and bladder (only in I and II grade of EORTC/RTOG). Late severe complication occurred in rectum in 2.2% of patients and in bladder 1.4%. Conclusions 1. Preoperative HDR-BT in patients with IB and IIA cervical cancer is an effective and well tolerated therapy with acceptable rate of side effects. 2. Preoperative HDR-BT followed by surgery in a group without risk factors is a sufficient treatment option with no additional adjuvant therapy requirement.

  14. Preoperative education for lumbar surgery for radiculopathy

    OpenAIRE

    Louw, A; Louw, Q; L. Crous

    2009-01-01

    To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptive...

  15. Preoperative prediction of severe postoperative pain.

    Science.gov (United States)

    Kalkman, C J; Visser, K; Moen, J; Bonsel, G J; Grobbee, D E; Moons, K G M

    2003-10-01

    We developed and validated a prediction rule for the occurrence of early postoperative severe pain in surgical inpatients, using predictors that can be easily documented in a preoperative setting. A cohort of surgical inpatients (n=1416) undergoing various procedures except cardiac surgery and intracranial neurosurgery in a University Hospital were studied. Preoperatively the following predictors were collected: age, gender, type of scheduled surgery, expected incision size, blood pressure, heart rate, Quetelet index, the presence and severity of preoperative pain, health-related quality of life the (SF-36), Spielberger's State-Trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The outcome was the presence of severe postoperative pain (defined as Numeric Rating Scale > or =8) within the first hour postoperatively. Multivariate logistic regression in combination with bootstrapping techniques (as a method for internal validation) was used to derive a stable prediction model. Independent predictors of severe postoperative pain were younger age, female gender, level of preoperative pain, incision size and type of surgery. The area under the receiver operator characteristic (ROC) curve was 0.71 (95% CI: 0.68-0.74). Adding APAIS scores (measures of preoperative anxiety and need for information), but not STAI, provided a slightly better model (ROC area 0.73). The reliability of this extended model was good (Hosmer and Lemeshow test p-value 0.78). We have demonstrated that severe postoperative pain early after awakening from general anesthesia can be predicted with a scoring rule, using a small set of variables that can be easily obtained from all patients at the preoperative visit. Before this internally validated preoperative prediction rule can be applied in clinical practice to support anticipatory pain management, external validation in other clinical settings is necessary.

  16. Photodynamic management of bladder cancer

    Science.gov (United States)

    Johansson, A.; Stepp, H.; Beyer, W.; Pongratz, T.; Sroka, R.; Bader, M.; Kriegmair, M.; Zaak, D.; Waidelich, R.; Karl, A.; Hofstetter, A.; Stief, C.; Baumgartner, R.

    2009-06-01

    Bladder cancer (BC) is among the most expensive oncological diseases. Any improvement in diagnosis or therapy carries a high potential for reducing costs. Fluorescence cystoscopy relies on a selective formation of Protoporphyrin IX (PpIX) or more general photoactive porphyrins (PAP) in malignant urothelium upon instillation of 5-aminolevulinic acid (5-ALA) or its hexyl-derivative h-ALA. Fluorescence cystoscopy equipment has been developed with the aim to compensate for the undesired distortion caused by the tissue optical properties by displaying the red fluorescence simultaneously with the backscattered blue light. Many clinical studies proved a high sensitivity in detecting flat carcinoma in situ and small papillary malignant tumours. As a result, recurrence rates were significantly decreased in most studies. The limitation lies in a low specificity, caused by false positive findings at inflamed bladder wall. Optical coherence tomography (OCT) is currently being investigated as a promising tool to overcome this limitation. H-ALA-PDT (8 or 16 mM h-ALA in 50 ml instillation for 1-2 h, white light source, catheter applicator) has recently been investigated in a phase I study. 17 patients were applied 100 J/cm2 (3 patients received incrementing doses of 25 - 50 - 100 J/cm2) during approx. 1 hour irradiation time in 3 sessions, 6 weeks apart. PDT was performed without any technical complications. Complete photobleaching of the PpIX-fluorescence, as intended, could be achieved in 43 of 45 PDT-sessions receiving 100 J/cm2. The most prominent side effects were postoperative urgency and bladder pain, all symptoms being more severe after 16 mM h-ALA. Preliminary evaluation shows complete response assessed at 3 months after the third PDT-session (i.e. 6 months after first treatment) in 9 of 12 patients. 2 of these patients were free of recurrence until final follow-up at 84 weeks.

  17. Urinary Bladder Cancer in Yemen

    Science.gov (United States)

    Al-Samawi, Abdullah Saleh; Aulaqi, Saleh Mansoor

    2013-01-01

    Objectives The aims of this study are to highlight the clinicopathological features of urinary bladder cancer in Yemen, and to describe the histological grading of urothelial neoplasms according to the World Health Organization and International Society of Urologic pathology (WHO/ISUP 1998) classification. Methods This is a descriptive record-based study of 316 cases of bladder cancer diagnosed by two pathologists at the Department of pathology, Sana'a University from 1st January 2005 to 30th April 2009. The diagnoses were made on hematoxylin and eosin stained sections and categorized according to WHO/ISUP 1998 classification. Results Out of 316 urinary bladder cancers, 248 (78%) were urothelial neoplasms, 53 (17%) were squamous cell carcinoma, 7 (2%) were adenocarcinoma, and 3 (1%) were rhabdomyosarcoma. The remaining cases were metastatic carcinomas (n=3), small cell carcinoma (n=1), and non-Hodgkin's lymphoma (n=1). The urothelial neoplasms observed were carcinoma in situ 4 (2%), papilloma 7 (3%), papillary urothelial neoplasm of low malignant potential 26 (11%), papillary urothelial carcinoma of low grade 107 (43%), papillary urothelial carcinoma of high grade 18 (7%), and non-papillary urothelial carcinoma of high grade 85 (34%), with 60 years mean age for males and 58 years for females; along with a male to female ratio of 4:1. The peak incidence was observed in the 61-70 years age group. Conclusion This study documents a high frequency of urothelial neoplasms, mostly papillary urothelial carcinoma of low grade and non-papillary urothelial carcinoma of high grade with male preponderance and peak incidence in 6th decade of age. PMID:24044060

  18. Urinary Bladder Cancer in Yemen

    Directory of Open Access Journals (Sweden)

    Abdullah Saleh Al-Samawi

    2013-09-01

    Full Text Available Objectives: The aims of this study are to highlight the clinicopathological features of urinary bladder cancer in Yemen, and to describe the histological grading of urothelial neoplasms according to the World Health Organization and International Society of Urologic pathology (WHO/ISUP 1998 classification.Methods: This is a descriptive record-based study of 316 cases of bladder cancer diagnosed by two pathologists at the Department of pathology, Sana'a University from 1st January 2005 to 30th April 2009. The diagnoses were made on hematoxylin and eosin stained sections and categorized according to WHO/ISUP 1998 classification.Results: Out of 316 urinary bladder cancers, 248 (78% were urothelial neoplasms, 53 (17% were squamous cell carcinoma, 7 (2% were adenocarcinoma, and 3 (1% were rhabdomyosarcoma. The remaining cases were metastatic carcinomas (n=3, small cell carcinoma (n=1, and non-Hodgkin's lymphoma (n=1. The urothelial neoplasms observed were carcinoma in situ 4 (2%, papilloma 7 (3%, papillary urothelial neoplasm of low malignant potential 26 (11%, papillary urothelial carcinoma of low grade 107 (43%, papillary urothelial carcinoma of high grade 18 (7%, and non-papillary urothelial carcinoma of high grade 85 (34%, with 60 years mean age for males and 58 years for females; along with a male to female ratio of 4:1. The peak incidence was observed in the 61-70 years age group.Conclusion: This study documents a high frequency of urothelial neoplasms, mostly papillary urothelial carcinoma of low grade and non-papillary urothelial carcinoma of high grade with male preponderance and peak incidence in 6th decade of age.

  19. Availability of limited service food outlets surrounding schools in British Columbia.

    Science.gov (United States)

    Black, Jennifer L; Day, Meghan

    2012-06-05

    The purpose of this study was to provide a descriptive profile of the availability of limited service food outlets surrounding public schools in British Columbia, Canada. Data from the 2010 Canadian Business Data Files were used to identify limited service food outlets including fast food outlets, beverage and snack food stores, delis and convenience stores. The number of food outlets within 800 metres of 1,392 public schools and the distance from schools to the nearest food outlets were assessed. Multivariate regression models examined the associations between food outlet availability and school-level characteristics. In 2010, over half of the public schools in BC (54%) were located within a 10-12 minute walk from at least one limited service food outlet. The median closest distance to a food outlet was just over 1 km (1016 m). Schools comprised of students living in densely populated urban neighbourhoods and neighbourhoods characterized by lower socio-economic status were more likely to have access to limited service food outlets within walking distance. After adjusting for school-level median family income and population density, larger schools had higher odds of exposure to food vendors compared to schools with fewer students. The availability of and proximity to limited service food outlets vary widely across schools in British Columbia and school-level characteristics are significantly associated with food outlet availability. Additional research is needed to understand how food environment exposures inside and surrounding schools impact students' attitudes, food choices and dietary quality.

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

    Science.gov (United States)

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

    2012-06-01

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

  1. Urinary function following resection for rectal cancer with preoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Shirai, Yoshinori; Taniyama, Shinji; Arai, Tatsuo; Ono, Masato (National Cancer Center, Chiba (Japan). East Hospital); Nunomura, Masao; Sarashina, Hiromi; Saitoh, Norio; Nakajima, Nobuyuki

    1993-12-01

    Urinary function was evaluated after personal interview in 34 patients and after examination of the results of a urodynamic study in 15 of these, in whom resection for carcinoma of the rectum with preoperative irradiation therapy was performed. From the results of the personal interview, urinary urgency was found to have occurred in 19.2% when preoperative radiation was over. Urinary function after surgery was preserved in the group of patients who had undergone bilateral and unilateral pelvic plexus nerve preserving operations, whereas urinary dysfunction occurred in 66.7% of the group of patients who had undergone operations without pelvic plexus nerve preservation. Urinary dysfunction was recognized in 53.9% of the group of patients who had undergone abdominoperineal resection, but in none of the group of patients who had undergone low anterior resection. The urodynamic study showed that 21.4% had residual urinary output of more than 40 ml, 23.1% had the first desire to void at less than 100 ml, 15.4% had the maximum desire to void at less than 200 ml, 28.6% had compliance of the bladder at less than 20 ml/cmH[sub 2]O when preoperative irradiation was over, and these data became worse 1 month after surgery. However, these phenomena were improved 1 year after surgery. (author).

  2. Spectroscopic Imaging of Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-01-01

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

  3. Microsatellite instability in bladder cancer

    DEFF Research Database (Denmark)

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

    1993-01-01

    Somatic instability at microsatellite repeats was detected in 6 of 200 transitional cell carcinomas of the bladder. Instabilities were apparent as changes in (GT)n repeat lengths on human chromosome 9 for four tumors and as alterations in a (CAG)n repeat in the androgen receptor gene on the X...... chromosome for three tumors. Single locus alterations were detected in three tumors, while three other tumors revealed changes in two or more loci. In one tumor we found microsatellite instability in all five loci analyzed on chromosome 9. The alterations detected were either minor 2-base pair changes...

  4. The Danish Bladder Cancer Database

    Directory of Open Access Journals (Sweden)

    Hansen E

    2016-10-01

    Full Text Available Erik Hansen,1–3 Heidi Larsson,4 Mette Nørgaard,4 Peter Thind,3,5 Jørgen Bjerggaard Jensen1–3 1Department of Urology, Hospital of West Jutland-Holstebro, Holstebro, 2Department of Urology, Aarhus University Hospital, Aarhus, 3The Danish Bladder Cancer Database Group, 4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 5Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark Aim of database: The aim of the Danish Bladder Cancer Database (DaBlaCa-data is to monitor the treatment of all patients diagnosed with invasive bladder cancer (BC in Denmark. Study population: All patients diagnosed with BC in Denmark from 2012 onward were included in the study. Results presented in this paper are predominantly from the 2013 population. Main variables: In 2013, 970 patients were diagnosed with BC in Denmark and were included in a preliminary report from the database. A total of 458 (47% patients were diagnosed with non-muscle-invasive BC (non-MIBC and 512 (53% were diagnosed with muscle-invasive BC (MIBC. A total of 300 (31% patients underwent cystectomy. Among the 135 patients diagnosed with MIBC, who were 75 years of age or younger, 67 (50% received neoadjuvent chemotherapy prior to cystectomy. In 2013, a total of 147 patients were treated with curative-intended radiation therapy. Descriptive data: One-year mortality was 28% (95% confidence interval [CI]: 15–21. One-year cancer-specific mortality was 25% (95% CI: 22–27%. One-year mortality after cystectomy was 14% (95% CI: 10–18. Ninety-day mortality after cystectomy was 3% (95% CI: 1–5 in 2013. One-year mortality following curative-intended radiation therapy was 32% (95% CI: 24–39 and 1-year cancer-specific mortality was 23% (95% CI: 16–31 in 2013. Conclusion: This preliminary DaBlaCa-data report showed that the treatment of MIBC in Denmark overall meet high international academic standards. The database is able to identify Danish BC patients and

  5. Metastatic patterns of bladder carcinoma.

    Science.gov (United States)

    Tabbara, W S; Mehio, A R

    1984-01-01

    The authors reviewed 227 new bladder cancers from two main hospitals in Beirut Lebanon. They analyzed the morphologic features of these tumours, insisting particularly on the number, the size, the site, the grade, the stage, the mode of spread and the vascular permeation. The latter four factors appear to be directly related to the metastatic spread of these tumours. The metastatic patterns are summarized, regional lymph node metastases being the main problem because of therapeutic implications (radical surgery, radiotherapy and chemotherapy). The problems of generalized carcinoma, unusual lymph node metastases and solitary distant metastases are also considered.

  6. Breast metastasis from carcinoma of gall bladder

    Directory of Open Access Journals (Sweden)

    Ajaz Ahmad Malik

    2013-01-01

    Full Text Available Carcinoma of gall bladder has early lymphatic and haematogenous spread. Most common extra abdominal site of metastasis is the lung. Metastasis to breast from carcinoma of breast is very rare. Our case describes an interesting case of carcinoma of gall bladder metastising to breast. A 50-year-old female presented to our outpatient department with a small nodule on upper outer quadrant of left breast. Patient had a history of cholecystectomy done for symptomatic gall stones 2 years back. Histopathological examination of the gall bladder specimen showed adenocarcinoma of the gall bladder with invasion to lamina propria. No additional treatment was offered to the patient. The breast nodule was excised and sent for histopathological examination. Histopathological examination revealed metastising adenocarcinoma. Patient was subjected to palliative chemotherapy (Gamcitabine and carboplatin. However, patient died of hepatic encephalopathy after 5 months. Our case reports an unusual site of metastasis from carcinoma of gall bladder which is very rare.

  7. NOTCH pathway inactivation promotes bladder cancer progression.

    Science.gov (United States)

    Maraver, Antonio; Fernandez-Marcos, Pablo J; Cash, Timothy P; Mendez-Pertuz, Marinela; Dueñas, Marta; Maietta, Paolo; Martinelli, Paola; Muñoz-Martin, Maribel; Martínez-Fernández, Mónica; Cañamero, Marta; Roncador, Giovanna; Martinez-Torrecuadrada, Jorge L; Grivas, Dimitrios; de la Pompa, Jose Luis; Valencia, Alfonso; Paramio, Jesús M; Real, Francisco X; Serrano, Manuel

    2015-02-01

    NOTCH signaling suppresses tumor growth and proliferation in several types of stratified epithelia. Here, we show that missense mutations in NOTCH1 and NOTCH2 found in human bladder cancers result in loss of function. In murine models, genetic ablation of the NOTCH pathway accelerated bladder tumorigenesis and promoted the formation of squamous cell carcinomas, with areas of mesenchymal features. Using bladder cancer cells, we determined that the NOTCH pathway stabilizes the epithelial phenotype through its effector HES1 and, consequently, loss of NOTCH activity favors the process of epithelial-mesenchymal transition. Evaluation of human bladder cancer samples revealed that tumors with low levels of HES1 present mesenchymal features and are more aggressive. Together, our results indicate that NOTCH serves as a tumor suppressor in the bladder and that loss of this pathway promotes mesenchymal and invasive features.

  8. Spontaneous epigastric hernia causing gastric outlet obstruction: a case report.

    Science.gov (United States)

    Arowolo, O A; Ogundiran, T O; Adebamowo, C A

    2006-09-01

    Epigastric hernia, a rare form of ventral abdominal hernia, accounts for 0.4 - 1.5% of all abdominal wall hernias. It usually occurs in middle - aged individuals and is rarely large enough to admit more than a small amount of extra-peritoneal fat. In this case report, we present a 64 years old woman with 6 days history of sudden onset of painful epigastric swelling associated with acute gastric outlet obstruction. We did not find a previous report of a similar case in the medical literature.

  9. Gastric outlet obstruction from duodenal lipoma in an adult

    Directory of Open Access Journals (Sweden)

    Promise N Wichendu

    2013-01-01

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

  10. PPOOLEX experiments with a modified blowdown pipe outlet

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

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

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Kouame Dibi Bertin

    2014-01-01

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

  13. The Danish Bladder Cancer Database

    DEFF Research Database (Denmark)

    Hansen, Erik; Larsson, Heidi Jeanet; Nørgaard, Mette

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Bladder Cancer Database (DaBlaCa-data) is to monitor the treatment of all patients diagnosed with invasive bladder cancer (BC) in Denmark. STUDY POPULATION: All patients diagnosed with BC in Denmark from 2012 onward were included in the study. Results......-intended radiation therapy. DESCRIPTIVE DATA: One-year mortality was 28% (95% confidence interval [CI]: 15-21). One-year cancer-specific mortality was 25% (95% CI: 22-27%). One-year mortality after cystectomy was 14% (95% CI: 10-18). Ninety-day mortality after cystectomy was 3% (95% CI: 1-5) in 2013. One......-year mortality following curative-intended radiation therapy was 32% (95% CI: 24-39) and 1-year cancer-specific mortality was 23% (95% CI: 16-31) in 2013. CONCLUSION: This preliminary DaBlaCa-data report showed that the treatment of MIBC in Denmark overall meet high international academic standards. The database...

  14. Lymphoma of the Urinary Bladder

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    Anthony Kodzo-Grey Venyo

    2014-01-01

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

  15. Sigmoid colon cancer arising in a diverticulum of the colon with involvement of the urinary bladder: a case report and review of the literature

    Science.gov (United States)

    2014-01-01

    Background Colon cancer can arise from the mucosa in a colonic diverticulum. Although colon diverticulum is a common disease, few cases have been previously reported on colon cancer associated with a diverticulum. We report a rare case of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder, which presented characteristic radiographic images. Case presentation A 73-year-old man was admitted to our hospital for macroscopic hematuria. Computed tomography and magnetic resonance imaging revealed a sigmoid colon tumor that protruded into the urinary bladder lumen. The radiographs showed a tumor with a characteristic dumbbell-shaped appearance. Colonoscopy showed a type 1 cancer and multiple diverticula in the sigmoid colon. A diagnosis of sigmoid colon cancer with involvement of the urinary bladder was made based on the pathological findings of the biopsied specimens. We performed sigmoidectomy and total resection of the urinary bladder with colostomy and urinary tract diversion. Histopathological findings showed the presence of a colovesical fistula due to extramurally growing colon cancer. Around the colon cancer, the normal colon mucosa was depressed sharply with lack of the muscular layer, suggesting that the colon cancer was arising from a colon diverticulum. Conclusion The present case is the first report of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder. Due to an accurate preoperative radiological diagnosis, we were able to successfully perform a curative resection for sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder. PMID:24884743

  16. Influence of behavior modification on overactive bladder.

    Science.gov (United States)

    Burgio, Kathryn L

    2002-11-01

    Behavioral interventions have been used for decades to treat urge incontinence and other symptoms of overactive bladder. Perhaps the earliest form of treatment was the bladder drill, an intensive intervention designed to increase the interval between voids to establish a normal frequency of urination and normalization of bladder function. Bladder training is a modification of bladder drill that is conducted more gradually on an outpatient basis and has resulted in significant reduction of incontinence in older, community-dwelling women. Multicomponent behavioral training is another form of behavioral treatment that includes pelvic floor muscle training and exercise. This intervention focuses less on voiding habits and more on altering the physiologic responses of the bladder and pelvic floor muscles. Using biofeedback or other teaching methods, patients learn strategies to inhibit bladder contraction using pelvic floor muscle contraction and other urge suppression strategies. Although behavioral and drug therapies are known to be highly effective for reducing urge incontinence, few patients are cured with either treatment alone. Thus, future research should explore ways to enhance the effectiveness of these conservative therapies. Although the mechanisms by which behavioral treatments work have not been established, there is some evidence that behavioral and drug interventions may operate by different mechanisms, suggesting that they may have additive effects and that combining them may result in better outcomes. Future research needs to examine the mechanisms by which these therapies reduce incontinence and whether combining behavioral and drug treatment will result in better outcomes than either therapy alone.

  17. Fetal bladder wall regeneration with a collagen biomatrix and histological evaluation of bladder exstrophy in a fetal sheep model

    NARCIS (Netherlands)

    Roelofs, Luc A. J.; Eggink, Alex J.; de Kaa, Christina A. Hulsbergen-van; Wijnen, Rene M. H.; van Kuppevelt, Toin H.; van Moerkerk, Herman T. B.; Crevels, A. Jane; Hanssen, Alex; Lotgering, Fred K.; van den Berg, Paul P.; Feitz, Wout F. J.

    2008-01-01

    Objectives: To evaluate histological changes in an animal model for bladder exstrophy and fetal repair of the bladder defect with a molecular-defined dual-layer collagen biomatrix to induce fetal bladder wall regeneration. Methods: In 12 fetal lambs the abdominal wall and bladder were opened by a mi

  18. Technologies for Upgrading Light Water Reactor Outlet Temperature

    Energy Technology Data Exchange (ETDEWEB)

    Daniel S. Wendt; Piyush Sabharwall; Vivek Utgikar

    2013-07-01

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

  19. A CLINICAL STUDY OF GASTRIC OUTLET OBSTRUCTION IN ADULT POPULATION

    Directory of Open Access Journals (Sweden)

    Manju Singh

    2017-02-01

    Full Text Available BACKGROUND Gastric outlet obstruction (GOO also known as pyloric obstruction is not a single entity. It is the clinical & pathophysiological consequence of any disease process that produces a mechanical impediment to gastric emptying. MATERIALS AND METHODS 37 patients attending surgical out-patient department of Pt. J. N. M. Medical College, Raipur during the period of March 2015 to September 2016 of GOO with chief complaints of projectile vomiting, visible gastric peristalsis or palpable distended stomach were included in this study. Cases of functional non-mechanical cause of GOO were excluded. Only patients of 20 years & above were included in this study. Saline load test, upper gastro-intestinal endoscopy and routine laboratory investigations done in all cases. RESULTS Age group of 40-59 was maximum sufferer 27%, followed by age group 60-69 years (21.9%. Male-Female ratio was 1.2:1. Antral carcinoma (75.7% cases topped the list followed by cicatrised duodenal ulcer which was seen in 18.9% cases; only two case was due to duodenal adenoma. CONCLUSION This study is a clinical observational study of gastric outlet obstruction, but in vast majority of cases diagnosis can be established clinically. Males are more sufferers and antral carcinoma seems to be main causes of GOO, Proliferative lesion is common finding in UGI.

  20. TRICHOBEZOAR WITH GASTRIC OUTLET OBSTRUCTION: A CASE REPORT

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    Nagendra Prasad

    2016-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Kurtkaya-Yapicier Ozlem

    2003-06-01

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

  2. Methodological Approaches to Locating Outlets of the Franchise Retail Network

    Directory of Open Access Journals (Sweden)

    Grygorenko Tetyana M.

    2016-08-01

    Full Text Available Methodical approaches to selecting strategic areas of managing the future location of franchise retail network outlets are presented. The main stages in the assessment of strategic areas of managing the future location of franchise retail network outlets have been determined and the evaluation criteria have been suggested. Since such selection requires consideration of a variety of indicators and directions of the assessment, the author proposes a scale of evaluation, which allows generalizing and organizing the research data and calculations of the previous stages of the analysis. The most important criteria and sequence of the selection of the potential franchisees for the franchise retail network have been identified, the technique for their evaluation has been proposed. The use of the suggested methodological approaches will allow the franchiser making sound decisions on the selection of potential target markets, minimizing expenditures of time and efforts on the selection of franchisees and hence optimizing the process of development of the franchise retail network, which will contribute to the formation of its structure.

  3. Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

    Science.gov (United States)

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

    2015-06-01

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

  4. Photodynamic therapy: applications in bladder cancer and other malignancies.

    Science.gov (United States)

    Chang, S C; Bown, S G

    1997-11-01

    Photodynamic therapy (PDT) has gained popularity in the past 10 years because of advances in laser and pharmacokinetic technologies and the development of new photosensitizers. Early studies on PDT with focal illumination for papillary bladder cancer obtained reasonable response rates for small tumors but recurrence was common. Whole bladder irradiation, once a suitable light-delivery system had been developed, gave promising outcomes with acceptable rates of complications. PDT for prostate cancer is still at the experimental stage but initial results have been promising. Clinical trials of PDT for brain tumors have shown no significant complications but no improvement in survival rate compared with other treatment modalities. PDT is particularly useful for early superficial lung cancers that are localized to one or a few discrete sites; it is also safe to use in patients who are too sick to be treated with conventional therapies. Preoperative PDT has reduced the extent of surgery necessary in some patients. Clinical experience with PDT for gynecological cancer is limited and prospective studies are needed. In head and neck oncology, PDT should prove a useful option, but methodological problems need to be overcome. Good responses of esophageal cancer to PDT have led to governmental approval of Photofrin, a photosensitizer, in several countries for either palliative use or treatment of inoperable or recurrent cancer. The use of PDT for early gastric cancer has great potential but several technical problems remain. PDT has proven generally effective for skin cancer when hematoporphyrin derivative or Photofrin is used but more long-term follow-up data are required for PDT with 5-aminolevulinic acid. Overall, PDT is changing from a scientific curiousity into an accepted modality for the treatment of cancer, with an improved likelihood of finding further clinical applications.

  5. Preoperative education for lumbar surgery for radiculopathy

    Directory of Open Access Journals (Sweden)

    A. Louw

    2009-02-01

    Full Text Available To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptiveand inferential statistical tests. Results showed that 100% of the patients and 99% of therapists view preoperative education to be an important component for lumbar surgery for radiculopathy. The most important factors identifiedfor inclusion in preoperative educational programs were reason for surgery, risks associated with surgery, limitations following surgery and more education regarding pain. The preferred method of education delivery was verbal one-on-one education. This study demonstrates that there is a demand for preoperative education for patients who had lumbar surgery.

  6. [Preoperative assessment of lung disease patients.].

    Science.gov (United States)

    Ramos, Gilson; Ramos Filho, José; Pereira, Edísio; Junqueira, Marcos; Assis, Carlos Henrique C

    2003-02-01

    Lung complications are the most frequent causes of postoperative morbidity-mortality, especially in lung disease patients. So, those patients should be preoperatively carefully evaluated and prepared, both clinically and laboratorially. This review aimed at determining surgical risk and at establishing preoperative procedures to minimize peri and postoperative morbidity-mortality in lung disease patients. Major anesthetic-surgical repercussions in lung function have already been described. Similarly, we tried to select higher-risk patients, submitted or not to lung resection. To that end, clinical and laboratorial propedeutics were used. Finally, a proposal of a preoperative algorithm was presented for procedures with lung resection. Lung disease patients, especially those with chronic evolution, need to be preoperatively thoroughly evaluated. ASA physical status and Goldmans cardiac index are important risk forecasting factors for lung disease patients not candidates for lung resection. Adding to these criteria, estimated postoperative max VO2, FEV1 and diffusion capacity are mandatory for some patients submitted to lung resection. beta2-agonists and steroids should be considered in the preoperative period of these patients.

  7. Reconstructive bladder surgery in genitourinary tuberculosis

    Directory of Open Access Journals (Sweden)

    Narmada Prasad Gupta

    2008-01-01

    Full Text Available Genitourinary tuberculosis (GUTB occurs in 15-20% cases of pulmonary tuberculosis with a prevalence of 400 per 100,000 population. Reconstructive surgery for GUTB is required for cases with grossly distorted and dysfunctional anatomy that are unlikely to regress with chemotherapy alone. In the recent past, there has been a tremendous increase in the variety of reconstructive procedures for the urinary bladder, used in the management of GUTB. Augmentation cystoplasty includes the goals of increasing bladder capacity, while retaining as much of bladder as possible. Various bowel segments (from the stomach to the sigmoid colon have been used for bladder reconstruction. The choice of material for reconstruction is purely the surgeon′s prerogative--his skill, the ease, the mobility and length of mesentery (allowing bowel to reach the bladder neck without tension and maintaining an adequate blood supply. The presence or absence of concomitant reflux is of considerable importance. In the former, an ileocystoplasty with implantation of ureter to the proximal end of the isolated ileal loop and anastomosis of the distal end of the ileal loop to the bladder neck and trigone is advocated. In the latter case, the ureterovesical valve is preserved and colocystoplasty is preferred, wherein the sigmoid colon on being opened along its antimesentric border is joined to the trigone and bladder neck and then to itself to form a capacious pouch. Gastrocystoplasty reduces the risk of acidosis but is associated with complications like hypochloremic alkalosis and ′hematuria-dysuria′ syndrome. Orthotopic neobladder reconstruction is a feasible option, suitable in cases of tubercular thimble bladder with a markedly reduced capacity (as little as 15 ml, where an augmentation alone may be associated with anastomatic narrowing or poor relief of symptoms. In this article, we review the various bladder reconstruction options used for the surgical management of GUTB

  8. Duplex gall bladder associated with choledocholithiasis, cholecystitis, gall bladder rupture and septic peritonitis in a cat.

    Science.gov (United States)

    Moores, A L; Gregory, S P

    2007-07-01

    A 10-year-old cat was presented with a history of inappetence, pyrexia and weight loss. Clinical investigations showed anaemia, hyperbilirubinaemia, septic peritonitis and a double gall bladder with choleliths in an extrahepatic duct. Initial medical stabilisation was performed. At laparotomy, a duplex gall bladder with two separate cystic ducts was identified. The left gall bladder was thickened and had ruptured at the apex. Multiple choleliths were identified in the left cystic duct. The right gall bladder and cystic duct were grossly normal. The ruptured gall bladder was repaired, the gallstones were removed via a choledochotomy of the left cystic duct and a choledochoduodenostomy was created from the dilated left cystic duct. The cat remained depressed and anorexic, and it was euthanased 72 hours postoperatively at the owners' request. This is the first ante-mortem investigation of extrahepatic biliary disease associated with gall bladder duplication in the cat.

  9. Bladder exstrophy: current management and postoperative imaging

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

  10. Bladder rupture causing pseudo acute renal failure

    Directory of Open Access Journals (Sweden)

    Luciana Andrea Avena Smeili

    2011-09-01

    Full Text Available Bladder rupture is a rare condition associated with significant morbidityand mortality. It is classified into traumatic, nontraumatic or idiopathic andspontaneous. The nonspecific initial clinical presentation is followed bydiscomfort in the lower abdomen, oliguria, hematuria and ascitis. Laboratoryabnormalities simulate the picture of acute renal failure and occurs by amechanism called auto reverse dialysis, with absorption of excreta throughthe peritoneal membrane. The authors describe a case of bladder rupturein morphologically and functionally normal urinary bladder associated withalcohol intake in young healthy man, manifested by abdominal discomfort,pseudo renal failure and massive ascitis. The diagnosis was made by anabdominal multidetector computed tomography confirmed by the finding of7 cm laceration at laparotomy.

  11. Tetrachloroethylene exposure and bladder cancer risk

    DEFF Research Database (Denmark)

    Vlaanderen, Jelle; Straif, Kurt; Ruder, Avima

    2014-01-01

    -analysis demonstrates an increased risk of bladder cancer in dry cleaners, reported in both cohort and case-control studies, and some evidence for an exposure-response relationship. Although dry cleaners incur mixed exposures, tetrachloroethylene could be responsible for the excess risk of bladder cancer because...... it is the primary solvent used and it is the only chemical commonly used by dry cleaners that is currently identified as a potential bladder carcinogen. Relatively crude approaches in exposure assessment in the studies of "tetrachloroethylene-exposed workers" may have attenuated the relative risks....

  12. [Overactive bladder syndrome: etiology, pathogenesis, treatment].

    Science.gov (United States)

    Radchenko, V H

    2013-01-01

    The article analyzes the causes of hyperactive detrusory contractions, considered etiopathogenesis and treatment of patients with overactive bladder syndrome (OBS). Two groups of patients with overactive bladder syndrome were examined, analyzed etiology, pathogenesis and treatment. A new method for increasing the threshold sensitivity of spinal centers under the OBS by using the local lesions of the mucous membrane of the bladder by electrical coagulation or local microwave hyperthermia of the prostate are proposed. The high efficiency of these methods in dealing with OBS is shown.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    A common objective of various adaptive radiotherapy (ART) strategies for bladder cancer is to reduce irradiation of normal tissue, thereby reduce the risk of radiation induced toxicity, and maintain or improve the target coverage. Bladder radiotherapy, typically involves generous margins (up to 20...... that incorporates the extreme deformations of the bladder, and is applicable from the first day of treatment. Deformation vector fields (DVFs), measured from the deformable image registration between empty and full bladder CTs, were scaled and constrained to construct the a-PTVs. For each patient, four a-PTVs were...

  14. Morphometry of the outlet of the foramen magnum in crania with atlantooccipital fusion.

    Science.gov (United States)

    Tubbs, R Shane; Lancaster, Jeffrey R; Mortazavi, Martin M; Shoja, Mohammadali M; Chern, Joshua J; Loukas, Marios; Cohen-Gadol, Aaron A

    2011-07-01

    Assimilation of the atlas to the occiput may result in symptoms that are often compressive in nature around the outlet of the foramen magnum. The aim of the present study was to elucidate the morphological features of the bone through this foramen. Thirteen adult skulls with atlantooccipital fusion underwent morphometrical analysis of the outlet of the foramen magnum. All specimens but one were found to have a decreased area of the outlet of the foramen magnum. In those 12 specimens, a decrease of 15%-35% was seen. Fusions of the atlas that were based primarily along the anterior rim of the foramen magnum resulted in more obstruction of its outlet. In general, the horizontal diameters of the outlet of these foramina were more decreased from the normal range. These findings demonstrate that in the majority of cases, assimilation of the atlas to the occiput results in a compromised outlet of the foramen magnum.

  15. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children......Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  16. Lymphography and percutaneous fine needle node aspiration biopsy in the staging of bladder carcinoma.

    Science.gov (United States)

    Boccon-Gibod, L; Katz, M; Cochand, B; Le Portz, B; Steg, A

    1984-01-01

    Forty-two patients with infiltrating bladder tumor were submitted to pedal lymphography with percutaneous fine needle node aspiration biopsy on an out patient basis. Of 41 evaluable patients, 59% had a positive lymphangiogram. Adequate material was obtained in 81% of the patients. Of 12 patients with a normal lymphography, none had a positive aspiration whereas 40% of the positive lymphangiograms correlated with a positive aspiration. The high rate of positive lymphangiogram negative aspirate is attributed to inflammatory changes due to previous TUR of the tumor. Twenty-one patients were submitted to radical cystectomy: 12 negative aspirations correlated with 11 negative lymphadenectomies, and 4 positive aspirations with 4 positive lymphadenectomies. There was no mortality and only mild morbidity in this series. Lymphography with fine needle percutaneous node aspiration biopsy has a role in the pre-operative staging of bladder carcinoma. Positive pelvic wall lymph nodes upgrade bladder carcinoma from a local to a systemic disease that is no longer amenable to any form of local treatment. Nodal assessment is therefore critical to treatment planning in order to spare the N+ patients unnecessary radical surgery. Pelvic lymph nodes have been evaluated, in the past, radiologically by bipedal lymphography or C.A.T. scanning. The high false positive and negative rates of these procedures (Benson et al., 1981; Boccon-Gibod et al., 1982) preclude their routine use (Correa 1982; Walsh et al., 1980).(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Modeling ice front Dynamics of Greenland outlet glaciers using ISSM

    Science.gov (United States)

    Morlighem, M.; Bondzio, J. H.; Seroussi, H. L.; Rignot, E. J.

    2015-12-01

    The recent increase in the rate of mass loss from the Greenland Ice Sheet is primarily due to the acceleration and thinning of outlet glaciers along the coast. This acceleration is a dynamic response to the retreat of calving fronts, which leads to a loss in resistive stresses. These processes need to be included in ice sheet models in order to be able to accurately reproduce current trends in mass loss, and in the long term reduce the uncertainty in the contribution of ice sheets to sea level rise. Today, the vast majority of ice sheet models that include moving boundaries are one dimensional flow line and vertical flow band models, that are not adapted to the complex geometries of Greenland outlet glaciers, as they do not accurately capture changes in lateral stresses. Here, we use the level set method to track moving boundaries within a 2D plane view model of the Ice Sheet System Model (ISSM), and investigate the sensitivity of Store Glacier, in western Greenland, to the amount of melting occurring at its calving front. We explore different calving laws and obtain the best results with a new simple calving law adapted from von Mises yield criterion. We show that the ocean circulation near the front and the amount of runoff are able to trigger ice front advance and retreat depending on the amount of melting that they produce at the calving face, but the bed topography controls the stable positions of the ice front. The modeled calving front of Store Glacier, for which we have quality bed topography and sea floor bathymetry data, is particularly stable because of the presence of a large sill at the glacier terminus. If the ice front detaches from this stabilizing sill due to larger amounts of melting at the front or due to large calving events, the glacier front starts to retreat as the bed deepens inland, until it finds another stabilizing feature in the bed topography. The new bed topography maps based on mass conservation make it possible to model more

  18. Influencing factors and current studies of changes in bladder wall morphology%膀胱壁形态改变的影响因素及研究现状

    Institute of Scientific and Technical Information of China (English)

    贾磊; 段君程; 赵云; 杨小龙; 张烨

    2015-01-01

    膀胱壁形态改变除了受病理性因素的影响外,也受生理性因素的影响。在病理性因素方面,膀胱出口梗阻、神经源性膀胱、腺性膀胱炎、膀胱肿瘤膀胱壁的形态表现各有特点。在生理性因素方面,膀胱充盈量、年龄等因素与膀胱壁形态改变存在相关性。该文对膀胱壁形态改变的影响因素及相关的研究现状作一概述以引起同行们的重视,为早期规范化预防与治疗膀胱壁形态病理性改变提供参考。%The changes in the bladder wall morphology are not only affected by pathological factors, but also influenced by physiological factors.Regarding pathological factors,the morphological features of the bladder walls of bladder outlet obstruction,neurogenic bladder,glandular cystitis and bladder tumors vary con-siderably.In terms of physiological factors,the bladder filling and age are correlated with the changes in the morphology of the bladder wall.Herein,we summarize the influencing factors and correlation of the changes in the morphology of the bladder wall,aiming to arouse the attention from the physicians and provide clinical ref-erence for the early standard prevention and treatment of pathological changes in the bladder wall morphology.

  19. Media outlets and their moguls: why concentrated individual or family ownership is bad for editorial independence

    OpenAIRE

    HANRETTY, Chris

    2014-01-01

    This article investigates the levels of owner influence in 211 different print and broadcast outlets in 32 different European media markets. Drawing on the literature from industrial organisation, it sets out reasons why we should expect greater levels of influence where ownership of individual outlets is concentrated; where it is concentrated in the hands of individuals or families; and where ownership groups own multiple outlets in the same media market. Conversely, we should expect lower l...

  20. Spatial panel analyses of alcohol outlets and motor vehicle crashes in California: 1999–2008

    OpenAIRE

    Ponicki, William R.; Gruenewald, Paul J.; Remer, Lillian G.

    2013-01-01

    Although past research has linked alcohol outlet density to higher rates of drinking and many related social problems, there is conflicting evidence of density’s association with traffic crashes. An abundance of local alcohol outlets simultaneously encourages drinking and reduces driving distances required to obtain alcohol, leading to an indeterminate expected impact on alcohol-involved crash risk. This study separately investigates the effects of outlet density on (1) the risk of injury cra...

  1. [Intradiverticular bladder tumors. Three case reports].

    Science.gov (United States)

    Fekak, H; Rabu, R; Joual, A; Bennani, S; Moufid, K; Sarf, S; Debragh, A; el Mimu, M; Benjelloun, S

    2002-01-01

    The bladder tumours in vesical diverticula is rare, and the poor prognosis, because it was often with early invasion. We reported three cases of bladder tumours in vesical diverticula, with delay of diagnosis two, eight and twelve months respectively. The radiology exploration suspected the diagnosis and the histology biopsy confirmed a diagnosis of primary transitional cell carcinoma in two cases: PTa GI and T2 GII, and in an other case it was a invasive epidermoid carcinoma. The first patient was dead by urethral resection of the bladder tumour. The second required a cytoprototectomy and the last patient. The treatment consisted of radiotherapy and chemotherapy. We insisted of the particularity diagnosis, histology and therapeutic for bladder tumour in vesical diverticula and the early diagnosis in order to have a good prognosis.

  2. Probiotics, dendritic cells and bladder cancer

    National Research Council Canada - National Science Library

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

    2012-01-01

    What's known on the subject? and What does the study add? The suppressor effect of probiotics on superficial bladder cancer is an observed phenomenon but the specific mechanism is poorly understood...

  3. MANAGEMENT OF CARCINOMA BLADDER: A REVIEW LITERATURE

    Directory of Open Access Journals (Sweden)

    Gurinderjit Singh

    2014-12-01

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

  4. SMP Bladder Tooling for Manufacturing Composites Project

    Data.gov (United States)

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

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

    Science.gov (United States)

    Pridemore, William Alex; Grubesic, Tony H

    2012-12-01

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

  6. Socioeconomic area disparities in tobacco retail outlet density: a Western Australian analysis.

    Science.gov (United States)

    Wood, Lisa J; Pereira, Gavin; Middleton, Nick; Foster, Sarah

    2013-05-20

    To examine the association between tobacco outlet density and area socioeconomic status (SES) in Western Australia. Ecological cross-sectional study investigating the relationship between the area SES of, and the density of tobacco retail outlets in, WA suburbs and towns for the Perth metropolitan area, and at the regional and state level. SES was determined using the 2006 Australian Bureau of Statistics Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and classified into quartiles (very low, low, high and very high); tobacco outlet data were sourced from the WA Department of Health register of retailers licensed to sell tobacco at May 2011. Tobacco outlet density rate (per 10 000 residents). In WA overall, suburbs and towns with a very low IRSAD had more than four times the number of tobacco outlets compared with those with a very high IRSAD (P> number of tobacco outlets than those with a very high IRSAD (P> first Australian evidence of a strong relationship between area SES and tobacco outlet density. Findings are consistent with a number of United States studies that report higher tobacco outlet densities in lower SES or minority neighbourhoods. The results underscore the importance of policy approaches to limit the number of tobacco retail licences granted, and to reduce the geographic density of outlets in more disadvantaged suburbs and towns.

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

    LENUS (Irish Health Repository)

    Glynn, Ronan W

    2012-02-01

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

  8. [Symptomatic bladder calculi: diagnostic and therapeutic aspects].

    Science.gov (United States)

    Rabii, R; Fekak, H; Moufid, K; Mezz Our, H; Joual, A; el Mrini, M; Benjelloun, S

    2003-06-01

    The authors report the case of a 50 years old woman who consulted with bilateral lumbar pain and urinary infections. Intravenous Urography (IVU) showed bilateral renal and bladder stones. Treatment was by upper polary nephrectomy in the left kidney. Removing all urinary and bladder stone. We then the removed surgically renal stones in the right kidney. Using this case as an we discuss the diagnosis and therapeutic aspects of the hydrocalyx.

  9. Blindness in a bladder cancer patient.

    Science.gov (United States)

    Remón, J; Guardeño, R; Badía, A; Cardona, T; Picaza, J M; Lianes, P

    2007-02-01

    Blindness is an unusual symptom in the clinical course of cancer. When it appears it is necessary to differentiate between benign and malign causes. Brain metastases in bladder cancer are extremely rare. MRI is the best diagnostic option. We present a deaf-and-dumb male with subacute blindness, 12 months after the diagnosis of a metastatic bladder cancer. Computerised tomography scan and MRI revealed a mass into the pituitary gland and sella, probably of metastatic origin.

  10. Cystometric analysis of the transplanted bladder

    Science.gov (United States)

    Rocha, Jeová Nina

    2017-01-01

    ABSTRACT Objective Cystometric evaluation of the bladder after autotransplant and isogeneic transplant in female rats. Material and Methods Two groups were constituted: (A) bladder autotransplant with two subgroups: R1 – (control) and R2 – (bladder transplant); (B) isogeneic bladder transplant with three subgroups; T1 – (control); T2–T3, two subgroups observed for 30 and 60 days after transplant, respectively. All animals underwent cystometric evaluation. Afterwards, the bladders were removed for histological study. Results The transplanted bladders did not show significant changes in filling/storage and emptying/micturition functions after 30 and 60 days of evolution. Upon macroscopical evaluation, there was good revascularization and the tissue was well preserved. Cystometry results: Did not show significant differences in the micturition pressure in subgroups T2-T3, but did between subgroups R1−R2, T1−T2, and T1−T3. Significant differences were verified in the micturition interval between T1−T3, T2−T3, but not between R1−R2, T1−T2. There was significant difference in the micturition duration between T1−T3 but not between R1−R2, T1−T2 and T2−T3. No fistula was noted on the suture site nor leakage of urine in the abdominal cavity or signs of necrosis or retraction were observed. Conclusions Transplant of the bladder was shown to be a viable procedure. The results indicate that there was structural and functional regeneration of transplanted bladders, and these results indicate that it is possible that vascular endothelium growth and neurogenesis factors are involved and activated in the process of the preservation or survival of the transplanted organ. PMID:28124533

  11. The Integrative Physiology of the Bladder

    OpenAIRE

    Drake, Marcus John

    2007-01-01

    Normal bladder function is complex, resulting from the co-operative interaction of numerous regulatory cell types, of which the interstitial cells and the peripheral neurones are particularly interesting. Collectively, these comprise the myovesical plexus, which appears to confer structural and functional characteristics on the bladder loosely akin to those of the gut. These include functional modularity, which gives rise to the potential for localised and propagating peristalsis-like movemen...

  12. North Atlantic warming and the retreat of Greenland's outlet glaciers.

    Science.gov (United States)

    Straneo, Fiammetta; Heimbach, Patrick

    2013-12-05

    Mass loss from the Greenland ice sheet quadrupled over the past two decades, contributing a quarter of the observed global sea-level rise. Increased submarine melting is thought to have triggered the retreat of Greenland's outlet glaciers, which is partly responsible for the ice loss. However, the chain of events and physical processes remain elusive. Recent evidence suggests that an anomalous inflow of subtropical waters driven by atmospheric changes, multidecadal natural ocean variability and a long-term increase in the North Atlantic's upper ocean heat content since the 1950s all contributed to a warming of the subpolar North Atlantic. This led, in conjunction with increased runoff, to enhanced submarine glacier melting. Future climate projections raise the potential for continued increases in warming and ice-mass loss, with implications for sea level and climate.

  13. Complete vaginal outlet stenosis in a patient with Sheehan's syndrome.

    Science.gov (United States)

    Choo, Minji; Park, Hana; Yi, Kyong Wook

    2016-11-01

    We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan's syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.

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

    Science.gov (United States)

    D’Angelo, Heather; Evenson, Kelly R.; Fleischhacker, Sheila; Myers, Allison E.; Rose, Shyanika W.

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gavin Pereira

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

  16. Rare causes of gastric outlet obstruction in children.

    Science.gov (United States)

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

    2005-08-01

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

  17. Clinical Observation of Acupuncture in Treating Contracted Pelvic Outlet Syndrome

    Institute of Scientific and Technical Information of China (English)

    王茵萍

    2008-01-01

    Objective: To observe the clinical efficacy of acupuncture in the treatment of contracted pelvic outlet syndrome. Methods: Fifty subjects were randomized in visit sequence into two groups; treatment group in which 27 cases were treated by anatomical needling at Ashi points and control group in which 23 cases were treated by electroacupuncture at Ashi points, Chengfu (BL 50), Chengshan (BL 57) and Yanglingquan (GB 34); the treatment was given once a day and 5 treatments made up one course; the clinical efficacy was observed after 1-2 courses. Results: The first pain-easing effects and clinical efficacy were better in treatment group than in control group (P<0.05). Conclusion: Anatomical acupuncture has more advantages over electroacupuncture in the treatment of contracted pelvic outlet syndrome.%目的:观察解剖针刺法治疗盆腔出口狭窄综合征的临床疗效.方法:50例患者按就诊顺序分为治疗组27例和对照组23例.治疗组选阿是穴,采用多针、多层次或多角度的解剖针刺法;对照组选阿是穴、承扶、承山、阳陵泉,进针得气后接电针.每天治疗1次,治疗5次为一个疗程,治疗1~2个疗程后比较疗效.结果:治疗组首次镇痛效果及总体效果均优于对照组,P<0.05.结论:解剖针刺法治疗盆腔出口狭窄综合征比电针更有优势.

  18. The role of imaging in pediatric bladder augmentation

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  19. Histopathological study of cystoscopic bladder biopsies

    Directory of Open Access Journals (Sweden)

    R Baidya

    2015-03-01

    Full Text Available Background: Urinary bladder diseases constitute an important source of clinical signs and symptoms which are more disabling than lethal. The prevalence of bladder tumor in developed countries is approximately six times higher compared with that in developing countries. The aim of this study was to find out various lesions in urinary bladder biopsies and its frequencies.Materials and Methods: This was a five year retrospective study from January 2008 to December 2013, carried out at B&B Hospital, Lalitpur. All the relevant data of 324 patients who had undergone cystoscopic biopsy of urinary bladder were included in the study. All blocks were retrieved and stained with Hematoxylin and Eosin stain and examined under light microscope.Results: The spectrum of pathological lesions included inflammations and tumors. Non-neoplastic lesions were predominant (61.11% followed by Transitional cell tumors accounted for 124 cases (38.27%. Non-neoplastic lesions comprises of cystitis and tuberculosis. Papillary urothelial neoplasms was the most common tumors seen in this study with 55 low grade, and 54 high grade Papillary urothelial carcinoma according to recent WHO grading. Single cases each of adenocarcinoma and paraganglioma were diagnosed.Conclusion: Cystoscopic biopsies help in the early diagnosis and treatment of various bladder lesions. Analysis of cystoscopic biopsies was done to ascertain the type of urinary bladder lesions in our country.Journal of Pathology of Nepal (2015 Vol. 5, 717-719

  20. Virtual computed tomography cystoscopy in bladder pathologies

    Directory of Open Access Journals (Sweden)

    Halil Arslan

    2006-04-01

    Full Text Available OBJECTIVE: Assessed the usefulness of virtual cystoscopy performed with multidetector computed tomography (CT in patients with different urinary bladder pathologies compared to the conventional cystoscopy. MATERIALS AND METHODS: Eighteen patients with different bladder pathologies, which consisted of 11 tumors, 3 diverticula, 2 trabecular changes and 2 stones, were assessed with conventional cystoscopy and virtual CT cystoscopy. The results of virtual CT cystoscopy were compared with the findings of conventional cystoscopy. We determined the detection rate and positive predictive value of CT imaging based virtual cystoscopy in the diagnosis of urinary bladder lesions. RESULTS: CT scanning was well tolerated by all patients, and no complications occurred. Images in 16 (88% of the 18 virtual cystoscopic examinations were either of excellent or good quality. All tumors except one, 2 trabecular changes and 2 stones were characterized with similar findings in the both of methods. The masses ranged from 0.4 to 7.0 cm in diameter. While conventional cystoscopy could not evaluate interior part of the diverticulum, virtual CT cystoscopy could demonstrate clearly within it. There were no false-positive findings in our series. CONCLUSION: Virtual CT cystoscopy is a promising technique to be used in the detection of bladder lesions. It should be considered especially at the evaluation of bladder diverticula. In the future, it may be possible or even advantageous to incorporate into the imaging algorithm for evaluation of bladder lesion.

  1. Virtual computed tomography cystoscopy in bladder pathologies

    Energy Technology Data Exchange (ETDEWEB)

    Arslan, Halil; Ceylan, Kadir; Harman, Mustafa; Yilmaz, Yuksel; Temizoz, Osman; Can, Saban [Yuzuncu Yil University School of Medicine, Van (Turkey). Dept. of Radiology and Urology]. E-mail: drhalilarslan@hotmail.com

    2006-03-15

    Objective: assessed the usefulness of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with different urinary bladder pathologies compared to the conventional cystoscopy.Materials and methods: eighteen patients with different bladder pathologies, which consisted of 11 tumors, 3 diverticula, 2 trabecular changes and 2 stones, were assessed with conventional cystoscopy and virtual CT cystoscopy. The results of virtual CT cystoscopy were compared with the findings of conventional cystoscopy. We determined the detection rate and positive predictive value of CT imaging based virtual cystoscopy in the diagnosis of urinary bladder lesions. Results: CT scanning was well tolerated by all patients, and no complications occurred. Images in 16 (88%) of the 18 virtual cystoscopic examinations were either of excellent or good quality. All tumors except one, 2 trabecular changes and 2 stones were characterized with similar findings in the both of methods. The masses ranged from 0.4 to 7.0 cm in diameter. While conventional cystoscopy could not evaluate interior part of the diverticulum, virtual CT cystoscopy could demonstrate clearly within it. There were no false-positive findings in our series. Conclusion: virtual CT cystoscopy is a promising technique to be used in the detection of bladder lesions. It should be considered especially at the evaluation of bladder diverticula. In the future, it may be possible or even advantageous to incorporate into the imaging algorithm for evaluation of bladder lesion. (author)

  2. Automatic segmentation of bladder in CT images

    Institute of Scientific and Technical Information of China (English)

    Feng SHI; Jie YANG; Yue-min ZHU

    2009-01-01

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

  3. PREOPERATIVE ENDOSCOPIC MARKING OF UNPALPABLE COLONIC TUMORS

    Directory of Open Access Journals (Sweden)

    A. L. Goncharov

    2013-01-01

    Full Text Available The identification of small colon lesions is one of the major problems in laparoscopic colonic resection.Research objective: to develop a technique of visualization of small tumors of a colon by preoperative endoscopic marking of a tumor.Materials and methods. In one day prior to operation to the patient after bowel preparation the colonoscopy is carried out. In the planned point near tumor on antimesentery edge the submucous infiltration of marking solution (Micky Sharpz blue tattoo pigment, UK is made. The volume of entered solution of 1–3 ml. In only 5 months of use of a technique preoperative marking to 14 patients with small (the size of 1–3 cm malignant tumors of the left colon is performed.Results. The tattoo mark was well visualized by during operation at 13 of 14 patients. In all cases we recorded no complications. Time of operation with preoperative marking averaged 108 min, that is significantly less in comparison with average time of operation with an intra-operative colonoscopy – 155 min (р < 0.001.Conclusions. The first experience of preoperative endoscopic marking of non palpable small tumors of a colon is encouraging. Performance of a technique wasn't accompanied by complications and allowed to reduce significantly time of operation and to simplify conditions of performance of operation.

  4. Preoperative exercise training to improve postoperative outcomes

    NARCIS (Netherlands)

    Valkenet, K.

    2017-01-01

    It is common knowledge that better preoperative physical fitness is associated with better postoperative outcomes. However, as a result of aging of the population and improved surgical and anaesthesia techniques, the proportion of frail patients with decreased physical fitness levels undergoing majo

  5. Preoperational test report, primary ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  6. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from

  7. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  8. Preoperational test report, vent building ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  9. Preoperative and intraoperative continuous use of ...

    African Journals Online (AJOL)

    2016-09-13

    Sep 13, 2016 ... in clinics to improve patient safety and effectiveness with. Introduction ... and control group according to different use of drugs. The two ... Key words: Anesthesia, dexmedetomidine, effect, intervention, preoperative, recovery, remifentanil .... will lead to postoperative pain in patients and severe agitation after ...

  10. Preoperational test, vent building ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T., Westinghouse Hanford

    1996-08-20

    Preoperational Test Procedure for Vent Building Ventilation System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The Vent Building ventilation system provides ventilation, heating, cooling, and zone confinement control for the W-030 Project Vent Building. The tests verify correct System operation and correct indications displayed by the central Monitor and Control system.

  11. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from preo

  12. [Giant prostatic calculus with neurogenic bladder disease and prostate diverticulum: a case report and review of the literature].

    Science.gov (United States)

    Li, Xiao-Shi; Quan, Chang-Yi; Li, Gang; Cai, Qi-Liang; Hu, Bin; Wang, Jiu-Wei; Niu, Yuan-Jie

    2013-02-01

    To study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum. We retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 -20/HPF, RBC 12 - 15/HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus. The patient underwent TURP and transurethral lithotripsy with holmium-YAG laser. The prostatic calculus was carbonate apatite in composition. Urinary dynamic images at 2 weeks after surgery exhibited significant improvement in the highest urine flow rate and residual urine volume. Seventeen months of postoperative follow-up showed dramatically improved urinary incontinence and thicker urine stream. Prostate diverticulum with prostatic giant calculus is very rare, and neurogenic bladder may play a role in its etiology. Cystoscopy is an accurate screening method for its diagnosis. For the young patients and those who wish to retain sexual function, TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.

  13. Construction of tissue-engineered urinary bladder using biodegradable polymer matrices as cell scaffolds

    Institute of Scientific and Technical Information of China (English)

    WANG Changyong; WANG Shen-guo; SHI Gui-xin; CAI Qing; YAN Quan-jian; HOU Wei-ping; GUO Xi-min; ZHAO Qiang; DUAN Cui-mi; SHAO Guo-xing; YE Ben-lan; BEI Jian-zhong

    2001-01-01

    @@ INTRODUCTIONApproximately 400 million persons worldwide suffer from bladder disease. Individuals with end-stage bladder disease often require bladder replacement or repair.Several bladder substitutes have been attempted with both organic materials and synthetics.

  14. Recurrent urinary tract infection and risk of bladder cancer in the Nijmegen bladder cancer study

    NARCIS (Netherlands)

    Vermeulen, S.; Hanum, N.; Grotenhuis, A.J.; Castano-Vinyals, G.; Heijden, A.G. van der; Aben, K.K.H.; Mysorekar, I.U.; Kiemeney, L.A.L.M.

    2015-01-01

    BACKGROUND: Controversy exists on whether urinary tract infection (UTI) is a risk factor for urinary bladder cancer (UBC). Here, the association is investigated using data from one of the largest bladder cancer case-control studies worldwide. METHODS: Information on (i) history and age at onset of r

  15. Neurophysiological modeling of bladder afferent activity in the rat overactive bladder model

    NARCIS (Netherlands)

    Choudhary, M. (Mahipal); E. van Asselt (Els); R. van Mastrigt (Ron); F. Clavica (Francesco)

    2015-01-01

    textabstractThe overactive bladder (OAB) is a syndrome-based urinary dysfunction characterized by “urgency, with or without urge incontinence, usually with frequency and nocturia”. Earlier we developed a mathematical model of bladder nerve activity during voiding in anesthetized rats and found that

  16. Out-of-home food outlets and area deprivation: case study in Glasgow, UK

    Directory of Open Access Journals (Sweden)

    Cummins Steven

    2005-10-01

    Full Text Available Abstract Background There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas. Methods We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways, and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles. Results The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2 and lowest in the second most deprived quintile (Q4. Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32–0.84 in Q1, 0.50 (CI 0.31 – 0.80 in Q4 and 0.61 (CI 0.38 – 0.98 in Q5. Outlets were located in the City Centre, West End, and along arterial roads. Conclusion In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

  17. Morphologic change of rectosigmoid colon using belly board and distended bladder protocol

    Science.gov (United States)

    Cho, Yeona; Chang, Jee Suk; Kim, Mi Sun; Lee, Jaehwan; Byun, Hwakyung; Kim, Nalee; Park, Sang Joon; Keum, Ki Chnag

    2015-01-01

    Purpose This study investigates morphologic change of the rectosigmoid colon using a belly board in prone position and distended bladder in patients with rectal cancer. We evaluate the possibility of excluding the proximal margin of anastomosis from the radiation field by straightening the rectosigmoid colon. Materials and Methods Nineteen patients who received preoperative radiotherapy between 2006 and 2009 underwent simulation in a prone position (group A). These patients were compared to 19 patients treated using a belly board in prone position and a distended bladder protocol (group B). Rectosigmoid colon in the pelvic cavity was delineated on planning computed tomography (CT) images. A total dose of 45 Gy was planned for the whole pelvic field with superior margin of the sacral promontory. The volume and redundancy of rectosigmoid colon was assessed. Results Patients in group B had straighter rectosigmoid colons than those in group A (no redundancy; group A vs. group B, 10% vs. 42%; p = 0.03). The volume of rectosigmoid colon in the radiation field was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009). In dose volume histogram analysis, the mean irradiated volume was lower in patients in group B (V45 27.2 vs. 18.2 mL; p = 0.004). In Pearson correlation coefficient analysis, the in-field volume of rectosigmoid colon was significantly correlated with the bladder volume (R = 0.86, p = 0.003). Conclusion Use of a belly board and distended bladder protocol could contribute to exclusion of the proximal margin of anastomosis from the radiation field. PMID:26157683

  18. Morphologic change of rectosigmoid colon using belly board and distended bladder protocol

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Yeo Na; Chang, Jee Suk; Kim, Mi Sun; Lee, Jae Hwan; Byun, Hwa Kyung; Kim, Na Lee; Park, Sang Joon; Keum, Ki Chang; Koom, Woong Sub [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul (Korea, Republic of)

    2015-06-15

    This study investigates morphologic change of the rectosigmoid colon using a belly board in prone position and distended bladder in patients with rectal cancer. We evaluate the possibility of excluding the proximal margin of anastomosis from the radiation field by straightening the rectosigmoid colon. Nineteen patients who received preoperative radiotherapy between 2006 and 2009 underwent simulation in a prone position (group A). These patients were compared to 19 patients treated using a belly board in prone position and a distended bladder protocol (group B). Rectosigmoid colon in the pelvic cavity was delineated on planning computed tomography (CT) images. A total dose of 45 Gy was planned for the whole pelvic field with superior margin of the sacral promontory. The volume and redundancy of rectosigmoid colon was assessed. Patients in group B had straighter rectosigmoid colons than those in group A (no redundancy; group A vs. group B, 10% vs. 42%; p = 0.03). The volume of rectosigmoid colon in the radiation field was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009). In dose volume histogram analysis, the mean irradiated volume was lower in patients in group B (V45 27.2 vs. 18.2 mL; p = 0.004). In Pearson correlation coefficient analysis, the in-field volume of rectosigmoid colon was significantly correlated with the bladder volume (R = 0.86, p = 0.003). Use of a belly board and distended bladder protocol could contribute to exclusion of the proximal margin of anastomosis from the radiation field.

  19. Transurethral en bloc resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    A. G. Martov

    2015-01-01

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

  20. Transurethral en bloc resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    A. G. Martov

    2015-03-01

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

  1. Fesoterodine for the treatment of overactive bladder.

    Science.gov (United States)

    Tzefos, Maria; Dolder, Christian; Olin, Jacqueline L

    2009-12-01

    To review pharmacologic, pharmacokinetic, efficacy, and safety data for fesoterodine and determine its role in the treatment of overactive bladder. A MEDLINE search (1966-July 2009) was conducted using the key words fesoterodine, tolterodine, muscarinic receptor antagonist, anticholinergic, overactive bladder, urge incontinence, efficacy, safety, adverse effect, pharmacology, pharmacokinetic, and receptor binding. All articles written in English that were identified from the data sources were evaluated, prioritizing randomized, controlled trials with human data. The references of published articles that we identified were examined for any additional studies appropriate for the review. Fesoterodine, a competitive muscarinic receptor antagonist, is converted to its active metabolite, 5-hydroxymethyltolterodine, by nonspecific esterases, bypassing the cytochrome P450 system. Two randomized controlled Phase 3 trials examined the safety and efficacy of fesoterodine in the treatment of overactive bladder. Fesoterodine was found to produce significant improvements in the treatment of overactive bladder symptoms compared with placebo. Post hoc analysis of these trials demonstrated significant improvements in health-related quality of life in patients with overactive bladder. Only one study included tolterodine, and direct comparisons between fesoterodine and tolterodine were not conducted. The most common treatment-emergent adverse effects associated with fesoterodine included dry mouth, constipation, urinary tract infection, and headache. Fesoterodine appears to be effective and generally safe for the treatment of overactive bladder. The efficacy and safety of fesoterodine in overactive bladder treatment seem to be at least similar to that of tolterodine. Although additional comparative trials are needed, based on available data, it does not appear that fesoterodine provides a substantial advantage over extended-release tolterodine in either efficacy or safety.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

    In this work, a reliable and robust vacuum-​outlet gas chromatog.-​mass spectrometry (GC-​MS) method is introduced for the identification and quantification of impurities in trinitrotoluene (TNT)​. Vacuum-​outlet GC-​MS allows for short anal. times; the anal. of impurities in TNT was performed in 4

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  6. A systematic approach to preventing chilled-food waste at the retail outlet

    NARCIS (Netherlands)

    Tromp, Seth Oscar; Haijema, René; Rijgersberg, Hajo; Vorst, van der Jack G.A.J.

    2016-01-01

    The objective of this paper is to develop a systematic overview of interventions for preventing chilled-food waste at retail outlets, and to assess the impact of these interventions for a particular case of fresh-cut iceberg lettuce at a Dutch retail outlet. The structure of the simulation model as

  7. 24 CFR 3280.813 - Outdoor outlets, fixtures, air-conditioning equipment, etc.

    Science.gov (United States)

    2010-04-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Yan SHI; Mao-lin CAI

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Matthias Schonlau

    2008-11-01

    Full Text Available The objective of this study was to assess the relationship between alcohol availability, as measured by the density of off-premise alcohol outlets, and alcohol consumption in Los Angeles county and southern Louisiana, USA. Consumption information was collected through a telephone survey of 2,881 households in Los Angeles county and pre-Katrina southern Louisiana, nested within 220 census tracts. Respondents’ addresses were geo-coded and both neighbourhood (census tracts and buffers of varying sizes and individual (network distance to the closest alcohol outlet estimates of off-sale alcohol outlet density were computed. Alcohol outlet density was not associated with the percentage of people who were drinkers in either site. Alcohol outlet density was associated with the quantity of consumption among drinkers in Louisiana but not in Los Angeles. Outlet density within a one-mile buffer of the respondent’s home was more strongly associated with alcohol consumption than outlet density in the respondent’s census tract. The conclusion is that the relationship between neighbourhood alcohol outlet density and alcohol consumption is complex and may vary due to differences in neighbourhood design and travel patterns.

  10. Preoperative staging of perforated diverticulitis by computed tomography scanning

    NARCIS (Netherlands)

    M.P.M. Gielens; I.M. Mulder (Irene); E. van der Harst (Erwin); M.P. Gosselink (Martijn Pieter); K.J. Kraal; H.T. Teng; J.F. Lange (Johan); J. Vermeulen (Jefrey)

    2012-01-01

    textabstractBackground: Treatment of perforated diverticulitis depends on disease severity classified according to Hinchey's preoperative classification. This study assessed the accuracy of preoperative staging of perforated diverticulitis by computerized tomography (CT) scanning. Methods: All patie

  11. The Amsterdam Preoperative Anxiety and Information Scale (APAIS)

    National Research Council Canada - National Science Library

    Moerman, N; Dam, van, F.S.A.M; Muller, M.J; Oosting, H

    1996-01-01

    ... phase.During routine preoperative screening, 320 patients were asked to assess their anxiety and information requirement on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS...

  12. A CLINICAL STUDY OF GASTRIC OUTLET OBSTRUCTION IN ADULTS

    Directory of Open Access Journals (Sweden)

    Sushruta

    2015-05-01

    Full Text Available From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but is more often placed immediately proximal to the sphincter where the diagnosis of carcinoma is most probable or more dista lly in the duodenal bulb where the cause is almost invariably a duodenal ulcer. This study has been taken up to review the changes in presentation of gastric outlet obstruction in view of changing trends in the aetiology analysing the occurrence of benign and malignant causes, signs and symptoms, investigatory modalities, management and their results. The present study is an observational study a total of 50 cases were studied with Cicatrised duodenal ulcer and carcinoma pyloric antrum being the major cause s. Clinical profile, investigations and treatment outcomes were analysed. The majority of patients had malignant gastric outlet obstruction with 32[64%] patients presenting with Gastric cancer and 18[36%] patients presenting with cicatrised duodenal ulcer. In this study most patients were in the fifth and seventh decades of life. Men outnumbered women by 3: 1. The clinical presentation is not different from those in other studies with non - bilious vomiting being common to all the patients with dehydration. V isible gastric peristalsis and succussion splash were more prominent in Cicatrised Duodenal Ulcer. All cases were subjected to serum electrolyte estimation. Out of them 20 cases [40%] showed electrolyte imbalance barium meal, ultrasound abdomen pelvis and CT scan abdomen being the other investigating tools. Blood group ‘O’ was common in cicatrized duodenal ulcer patients [77.7%] followed by blood group ‘A’ [11.1%]. Upper GI endoscopy was done in all cases [100%]. 32[64%] cases had pyloric antral Carcinoma i n which 23 cases had fungating growth and the rest 9 had ulcerative growth and 18[36%] had cicatrized duodenal ulcer. 100

  13. Duodenal stenting for malignant gastric outlet obstruction:Prospective study

    Institute of Scientific and Technical Information of China (English)

    Eduardo Guimar(a)es Hourneaux Moura; Flávio Coelho Ferreira; Spencer Cheng; Diogo Turiani Hourneaux Moura; Paulo Sakai; Bruno Zilberstain

    2012-01-01

    AIM:To evaluate the results of duodenal stenting for palliation of gastroduodenal malignant obstruction by using a gastric outlet obstruction score (GOOS).METHODS:A prospective,non-randomized study was performed at a tertiary center between August 2005 and April 2010.Patients were eligible if they had malignant gastric outlet obstruction (GOO) and were not candidates for surgical treatment.Medical history and patient demographics were collected at baseline.Scheduled interviews were made on the day of the procedure and 15,30,90 and 180 d later or unscheduled as necessary.RESULTS:Fifteen patients (6 male,9 female; median age 61 years) with GOO who had undergone duodenal stenting were evaluated.Ten patients had metastasis at baseline (66.6%) and 14 were unable to accept oral intake (93.33%),including 7 patients who were using a feeding tube.Laboratory data showed biliary obstruction in eight cases (53.33%); all were submitted to biliary drainage.Two patients developed obstructive symptoms due to tumor ingrowth after 30 d and another due to tumor overgrowth after 180 d.Two cases of stent migration occurred.A good response to treatment was observed,with a mean time of approximately 1 d (19 h) until toleration of a liquid diet and slightly more than 2 d for both soft solids (51 h) and a solid food/normal diet (55 h).The mean time to first failure to maintain liquid intake (GOOS ≥ 1) was 93 d.During follow-up,the mean time to first failure to maintain the previously achieved GOOS of 2-3 (solid/semi-solid food),considered technical failure,was 71 d.On the basis of oral intake a GOOS is defined:0 for no oral intake; 1 for liquids only; 2 for soft solids only; 3 for lowresidue or full diet.CONCLUSION:Enteral stenting to alleviate gastroduodenal malignant obstruction improves quality of life in patients with limited life expectancy,which can be evaluated by using a GOO scoring system.

  14. The relationships between preoperative urodynamic parameters and clinical outcomes in urinary stress incontinence

    Directory of Open Access Journals (Sweden)

    Yaşar Bozkurt

    2008-12-01

    Full Text Available The aim of present study was to evaluate the influence of urodynamic parameters on preoperative and postoperative clinical pictures in stress incontinence.Charts of patients, who were operated for stress incontinence using autologous rectus fascia sling between March 1999 and January 2005 in Tepecik Training and Research Hospital Urology Clinic, were evaluated retrospectively.A total of 41 patients were divided into two subgroups as, pure (10 patients and mixed stress incontinence (31 patients groups. Mean age of patients was 50.4 (33-70 years. Fifteen patients had intrinsic sphincter insufficiency (ISI. Mixed incontinence group had lower volume for first sensation and more detrusor overactivity than pure group. ISI did not alter the success of operation. Urodynamically no relationship was found between detrusor pressure and postoperative postvoiding residual urine (P>0.05.In conclusion, urodynamic evaluation before surgery was not related to preoperative and postoperative clinical picture of patients, but first sensation of bladder is only predictive for the success in fascial sling surgery.

  15. Effects of Inlet/Outlet Ducts on Acoustic Attenuation Characteristics of Circular Expansion Chambers

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-bo; GE Yun-shan; JI Zhen-lin; ZHANG Wen-ping; SONG Yan-rong; HAN Xiu-kun; ZHANG Xue-min

    2006-01-01

    The effect of coaxial, offset and extended inlet/outlet on the acoustic attenuation characteristics of circular expansion chambers are studied by the three-dimensional finite element method. The numerical results of transmission loss are compared with experiment results to verify the necessary of using three-dimensional methods. Maps of acoustic pressure level distribution inside of chambers and inlet/outlet ducts are given at a frequency to demonstrate the difference of acoustic wave propagation behavior caused by locations of inlet/outlet ducts. For the chambers of the same length, the chamber with extended inlet/outlet duct has higher attenuation ability than coaxial and offset inlet/outlet duct over middle frequencies.

  16. Bladder tumors:dynamic contrast-enhanced axial imaging, multiplanar reformation, three-dimensional reconstruction and virtual cystoscopy using helical CT

    Institute of Scientific and Technical Information of China (English)

    王东; 张挽时; 熊明辉; 喻敏; 徐家兴

    2004-01-01

    Background There have been few studies to evaluate the effects of helical CT on bladder tumor. This study was to evaluate the clinical applications of helical CT dynamic contrast-enhanced axial imaging, multiplanar reformation (MPR), three-dimensional (3D) reconstruction and virtual cystoscopy (CTVC) in bladder tumors. Methods The precontrast and four-phase postcontrast helical CT scans were performed in 42 patients with bladder tumors confirmed by conventional cystoscopy and pathology. MPR, 3D and CTVC images were generated from the volumetric data of the excretory phase. The results were then compared with the findings of conventional cystoscopy and surgery in a double-blinded mode. Results The sensitivity of the axial, 3D and CTVC images in detecting the bladder tumors were 90.8%, 76.9% and 95.4% respectively. The dynamic contrast-enhanced axial images could provide excellent intramural and extravesical information, and the accuracy in preoperative tumor staging was 87.7%. MPR could directly demonstrate the origin and extravesical invasions of the tumors and their relation to the ureter. 3D and CTVC images were useful for displaying the surface morphology of the tumor and the relationship between the tumor and the ureteric orifices, whereas CTVC could depict the tumors smaller than 5 mm that were not seen on the axial images.Conclusions The combination of axial, MPR, 3D and CTVC images with helical CT can provide comprehensive information on bladder tumor.

  17. [Preoperative assessment of patients with diabetes mellitus].

    Science.gov (United States)

    Takeda, Kiyoshi

    2010-07-01

    The perioperative morbidity of diabetic patients is related to preoperative end-organ damage. Due to the microvascular pathology, autonomic neuropathy is common and cardiovascular abnormalities such as hypertension, painless myocardial ischemia, and orthostatic hypotension may predispose patients to perioperative cardiovascular instability. Autonomic dysfunction also contributes to delayed gastric emptying, and preoperative administration of a histamine antagonist and a gastric emptying agent is needed. Chronic hyperglycemia leads to glycosylation of tissue proteins and the accumulation of abnormal collagen can cause stiff joint syndrome resulting in difficult tracheal intubation. The primary goal of pre and intraoperative blood glucose control is to avoid hypoglycemia and ketosis. Moreover, the tight glycemic control has been reported to improve survival in critically ill patients who were treated in the intensive care unit.

  18. Preoperatively diagnosed mucocele of the appendix.

    Science.gov (United States)

    Rojnoveanu, Gh; Ghidirim, Gh; Mishin, I; Vozian, M; Mishina, A

    2014-01-01

    Mucocele of the appendix is an infrequent entity, characterized by distension of the lumen due to accumulation of mucoid substance and is rarely diagnosed preoperatively. If untreated, mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The type of surgical treatment is related to the dimensions and the histology of the mucocele. Appendectomy is used for simple mucocele or for cystadenoma. Right hemi-colectomy is recommended for cystadeno carcinoma. In this paper, we report a case of an asymptomatic 37-year-old woman in whom mucocele was found on a routine ultrasound examination and preoperative computed tomography scan. Surgery revealed a big appendix measuring 84 mm in length and 40 mm in diameter. The final pathologic diagnosis was simple mucocele. Celsius.

  19. Expression and Significance of Oct4 in Bladder Cancer

    Institute of Scientific and Technical Information of China (English)

    XU Kai; ZHU Zhaohui; ZENG Fuqing; DONG Jihua

    2007-01-01

    In order to detect the expression of Oct4 in bladder cancer tissue and cell line BIU-87, immunohistochemistry was used in 49 bladder cancer biopsy samples and immunofluorescence and reverse transcription-PCR were performed on bladder cancer cell line BIU-87. Forty of 49 bladdercancer samples showed the expression of Oct4 in about 0.6% cancer cells. The positive rate and den-sity of Oct4 expression had no obvious relationship with the grade, recurrence or metastasis of blad-der cancer (P0.05). A few Oct4 positive cells were found in bladder cancer cell line BlU-87, which was also confirmed by RT-PCR. This study indicated the existence of few Oct4 positive cells in bladder cancer, which may be the bladder cancer stem cells. This study may provide the foundation for isolation and identification of bladder cancer stem cells.

  20. Bladder Infection (Urinary Tract Infection - UTI) in Adults

    Science.gov (United States)

    ... It Works Urologic Diseases A-Z Bladder Infection (Urinary Tract Infection—UTI) in Adults View or Print All Sections ... Bladder infections are the most common type of urinary tract infection (UTI), but any part of your urinary tract ...

  1. Continent cutaneous diversion for bladder exstrophy in adults

    Directory of Open Access Journals (Sweden)

    J.E. Mensah

    2013-06-01

    Conclusion: Bladder neck closure in conjunction with continent cutaneous diversion is a reliable and safe method for achieving continence in adults presenting with bladder exstrophy. Total continence can be achieved without resorting to multiple complex and expensive surgeries.

  2. Immunohistochemical diagnosis of urinary bladder tuberculosis

    Directory of Open Access Journals (Sweden)

    S. A. Semenov

    2014-01-01

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

  3. Preoperative Alcohol Consumption and Postoperative Complications

    DEFF Research Database (Denmark)

    Eliasen, Marie; Grønkjær, Marie; Skov-Ettrup, Lise Skrubbeltrang

    2013-01-01

    .30-2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18-1.31), and admission to intensive care unit (RR = 1.29; 95% CI: 1.03-1.61). Clearly defined high alcohol consumption was associated with increased risk of postoperative mortality (RR = 2.68; 95% CI: 1.50-4.78). Low to moderate preoperative alcohol...... complications, prolonged stay at the hospital, and admission to intensive care unit....

  4. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  5. Citrus aurantium blossom and preoperative anxiety.

    Science.gov (United States)

    Akhlaghi, Mahmood; Shabanian, Gholamreza; Rafieian-Kopaei, Mahmoud; Parvin, Neda; Saadat, Mitra; Akhlaghi, Mohsen

    2011-01-01

    Reducing anxiety is very important before operation. Preoperative visit and use of premedication are popular methods to achieve this goal, but the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication. Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossomon preoperative anxiety. We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1) Citrus aurantium blossom distillate 1mL.kg(-1) (C-group); 2) Saline solution 1mL.kg(-1) as placebo (P-group). Anxiety was measured before and after premedication using the Spielberger state-trait anxiety inventory (STAI-state) and the Amsterdam preoperative anxiety and information scale (APAIS) before operation. After premedication, both the STAI-state and the APAIS scales were decreased in C-group (ppreoperative anxiety before minor operation. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

  6. Preoperative imaging diagnosis of carotid body tumors.

    Science.gov (United States)

    Pacheco-Ojeda, Luis A; Martínez-Viteri, Miguel A

    2010-01-01

    Carotid body tumors (CBTs) are relatively frequent lesions encountered at high altitudes, such in as the Andean Mountains. A correct preoperative diagnosis is essential for surgical planning and performance. For this reason, we have reviewed the evolution of our experience in the imaging diagnosis of these tumors. Between 1980 and June 2008, 160 CBTs were diagnosed. A total of 138 tumors were operated on, 4 are waiting for surgery, and 18 were not operated on because of age, medical conditions, or patient refusal. We have reviewed retrospectively the modalities of imaging diagnosis in our patients who underwent operation. Among the 138 tumors operated on, a correct preoperative diagnosis was done in 127 cases (92%). The preoperative diagnosis of the remaining 11 patients was unspecified benign tumor for 6 patients and neck lymph node for 5 patients. The imaging methods performed by different radiologists were conventional ultrasound, color Doppler ultrasound, carotid conventional angiography (CA), axial tomography, magnetic resonance and magnetic resonance angiography, and computed tomographic angiography (CTA). Most patients had more than one image study. Review of radiologist reports revealed a correct diagnosis in all carotid CA, magnetic resonance studies, and CTA. Additionally, CTA appeared to be a valuable method to predict the Shamblin group. Clinical suspicion and current image techniques permit a correct diagnosis in practically all cases of CBT.

  7. Implications of preoperative hypoalbuminemia in colorectal surgery

    Institute of Scientific and Technical Information of China (English)

    Adam Truong; Mark H Hanna; Zhobin Moghadamyeghaneh; Michael J Stamos

    2016-01-01

    Serum albumin has traditionally been used as a quantitative measure of a patient’s nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient’s chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery.

  8. Combustor cap having non-round outlets for mixing tubes

    Science.gov (United States)

    Hughes, Michael John; Boardman, Gregory Allen; McConnaughhay, Johnie Franklin; Arguinzoni, Carlo Antonio

    2016-12-27

    A system includes a a combustor cap configured to be coupled to a plurality of mixing tubes of a multi-tube fuel nozzle, wherein each mixing tube of the plurality of mixing tubes is configured to mix air and fuel to form an air-fuel mixture. The combustor cap includes multiple nozzles integrated within the combustor cap. Each nozzle of the multiple nozzles is coupled to a respective mixing tube of the multiple mixing tubes. In addition, each nozzle of the multiple nozzles includes a first end and a second end. The first end is coupled to the respective mixing tube of the multiple mixing tubes. The second end defines a non-round outlet for the air-fuel mixture. Each nozzle of the multiple nozzles includes an inner surface having first and second portions, the first portion radially diverges along an axial direction from the first end to the second end, and the second portion radially converges along the axial direction from the first end to the second end.

  9. [Anatomy and embriology of double outlet right ventricle (author's transl)].

    Science.gov (United States)

    Angelini, P; Leachman, R D

    1978-01-01

    After formulating the definition of double outlet right ventricle (DORV) as the persistence origin of the trunco-conal structures from the right ventricle, 64 autopsy cases meeting this definition were reviewed. A wide spectrum of anatomic variations of DORV were found. A classification is proposed based upon the type of relationship between the great vessels and upon the presence and type of ventricular septal defect. Twenty-five cases had normally crossed great arteries (13 of which had pulmonic stenosis), nine cases had transposed vessels and 23 cases had a double muscular conus and a side-by-side arrangement of the great vessels in the frontal view, a relationship called "partial distortion" or atypical transposition. Seven cases had absent trunco-conal septum (common truncus). Only one case had intact ventricular septum. Anterior ventricular septal defect was found only in cases with partial distortion or common truncus. Angiographic and surgical correlations are presented. Because of their great heterogeneity, the need for detailed description of the anatomy of the individual case of DORV is emphasized.

  10. Surgical palliation of gastric outlet obstruction in advanced malignancy

    Science.gov (United States)

    Potz, Brittany A; Miner, Thomas J

    2016-01-01

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

  11. [Neurological Signs and Symptoms of True Neurogenic Thoracic Outlet Syndrome].

    Science.gov (United States)

    Higashihara, Mana; Konoeda, Fumie; Sonoo, Masahiro

    2016-05-01

    Thoracic outlet syndrome (TOS) is a well-known disorder, but many aspects of its pathology, including its definition, has been disputed. True neurogenic TOS (TN-TOS) is a rare but well-defined clinical condition. TN-TOS results from the compression of the C8/T1 roots (dominant for the T1 root) or the proximal lower trunk of the brachial plexus by a fibrous band. The band extends from the first rib to either the tip of an elongated C7 transverse process or a rudimentary cervical rib. The most common presenting symptoms of TN-TOS are insidious-onset atrophy and weakness of the intrinsic hand muscles, predominantly in the thenar eminence and radial digit flexors. Nerve conduction studies demonstrate pathognomonic findings: severely attenuated compound muscle action potential of the abductor pollicis brevis muscle, and usually, loss of the sensory nerve action potential of the medial antebrachial cutaneous nerve. Numbness and sensory loss are typically observed, mainly in the medial forearm, although they are usually mild, and may be absent in some patients. Severe pain or paresthesia proximal to the elbow is not observed. The classical concept of TOS underlie nonspecific neurogenic TOS. It has been primarily diagnosed using provocative maneuvers. However, there is controversy regarding its pathological conceptualization and existence, as objective evidence of the disease is still lacking.

  12. Electronic Cigarette Retail Outlets and Proximity to Schools.

    Science.gov (United States)

    Hahn, Ellen J; Begley, Kathy; Gokun, Yevgeniya; Johnson, Andrew O; Mundy, Monica E; Rayens, Mary Kay

    2015-01-01

    To compare the retail distribution and density per population of electronic and conventional cigarettes in smoke-free communities with and without e-cigarette restrictions. A cross-sectional study with field observations of retail tobacco stores. Two Central Kentucky counties with 100% smoke-free workplace regulations; counties selected on the basis of whether e-cigarette use was restricted. Fifty-seven tobacco retailers in two counties, including conventional retailers and stand-alone e-cigarette stores. Type and location of store and products sold; addresses of stores and schools geocoded with ArcGIS. Bivariate comparisons between counties, rates and confidence intervals for frequency of tobacco retailers and e-cigarette stores per population. Fifty-three percent of tobacco retailers sold e-cigarettes. E-cigarette availability did not differ by whether smoke-free regulation covered e-cigarettes. Rates of tobacco retailers and e-cigarette distributors per 10,000 were 8.29 and 4.40, respectively, in the two-county area. Of the 40 schools, 88% had a tobacco retailer and 68% had an e-cigarette distributor within 1 mile. In this exploratory study, e-cigarette use restriction was not related to store availability. For a relatively new product, e-cigarettes were readily available in retail outlets and close to schools.

  13. [Bladder stone surrounding a foreign body: a case report].

    Science.gov (United States)

    Fekak, H; Rabii, R; Moufid, K; Guessous, H; Joual, A; Bennani, S; Elmrini, M; Benjeloun, S

    2003-04-01

    The bladder can be the site of various foreign bodies. We report one case of bladder stone including a foreign body in a 24 years old man with a psychomotor deficiency who was admitted for pyuria, block miction and bladder symptoms. The pelvic X-Ray film showed a bladder stone including a sewing needle. We analysed the diagnosis, aspect and therapeutic management of this case.

  14. Paediatric bladder augmentation and substitution: From diversions to tissue engineering.

    Science.gov (United States)

    Pike, John Grant

    2002-10-01

    To review the evolution of urinary diversion, bladder augmentation and bladder replacement in the paediatric population over the past century and to outline the possible direction of future management. Original and review articles obtained from a PubMed search of English language publications dating from 1970 to 2001. The search terms were "bladder augmentation", "bladder substitution", "bladder autoaugmentation", "ureterocystoplasty" and "bladder engineering". The age group was "all child 0-18". Articles selected were those with relevance to the scope of the topic. The articles were analyzed with the primary focus being the problems encountered with various forms of urinary diversion, bladder augmentation and bladder replacement, and the subsequent evolution of materials and techniques. Bladder tissue may need to be replaced in the paediatric population because of congenital malformation, disease or trauma. The unique structure and function of urothelium and bladder muscle make this a challenging task. Management has evolved from a mindset of attempting to divert urine from the bladder completely to that of trying to preserve what is salvageable of the organ. Historically and contemporarily, the gastrointestinal tract has provided the raw material for urinary diversion, bladder augmentation and bladder substitution. Experience, however, has highlighted the potential complications inherent in the use of the bowel in the urinary tract including mucus production, stone disease, metabolic abnormalities, growth retardation, spontaneous perforation and malignancy. However, despite these drawbacks, the bowel is the gold standard in terms of functional utility and longevity. In efforts to develop alternatives, research has focused on the use of both natural and synthetic materials. With these materials, a whole new list of potential problems has been characterized. Tissue engineering may hold promise in resolving the issues of bladder replacement or repair by providing

  15. Neoadjuvant Chemotherapy in Neuroendocrine Bladder Cancer: A Case Report

    OpenAIRE

    Prelaj, Arsela; Rebuzzi, Sara Elena; Magliocca, Fabio Massimo; Speranza, Iolanda; Corongiu, Emanuele; Borgoni, Giuseppe; Perugia, Giacomo; Liberti, Marcello; Bianco, Vincenzo

    2016-01-01

    Patient: Male, 71 Final Diagnosis: Neuroendocrine cancer bladder Symptoms: Dysuria • haematuria Medication: — Clinical Procedure: Transurethral resection of the bladder tumor Specialty: Oncology Objective: Rare disease Background: Small cell carcinoma of the urinary bladder is a rare and aggressive form of bladder cancer that mainly presents at an advanced stage. As a result of its rarity, it has been described in many case reports and reviews but few retrospective and prospective trials, sho...

  16. Tissue engineering of rat bladder using marrow-derived mesenchymal stem cells and bladder acellular matrix.

    Directory of Open Access Journals (Sweden)

    Daniel L Coutu

    Full Text Available Bladder replacement or augmentation is required in congenital malformations or following trauma or cancer. The current surgical solution involves enterocystoplasty but is associated with high complication rates. Strategies for bladder tissue engineering are thus actively sought to address this unmet clinical need. Because of the poor efficacy of synthetic polymers, the use of bladder acellular matrix (BAM has been proposed. Indeed when cellular components are removed from xenogenic or allogeneic bladders, the extracellular matrix scaffold thus obtained can be used alone or in combination with stem cells. In this study, we propose the use of BAM seeded with marrow-derived mesenchymal stem cells (MSCs for bladder tissue engineering. We optimized a protocol for decellularization of bladder tissue from different species including rat, rabbit and swine. We demonstrate the use of non-ionic detergents followed by nuclease digestion results in efficient decellularization while preserving the extracellular matrix. When MSCs were seeded on acellular matrix scaffold, they remained viable and proliferative while adopting a cellular phenotype consistent with their microenvironment. Upon transplantation in rats after partial cystectomy, MSC-seeded BAM proved superior to unseeded BAM with animals recovering nearly 100% normal bladder capacity for up to six months. Histological analyses also demonstrated increased muscle regeneration.

  17. Transurethral front-firing Greenlight bladder autoaugmentation for bladder contracture: technique and clinical outcomes.

    Science.gov (United States)

    Bao, Ji-Ming; Tan, Wan-Long; Wang, Bing-Wei; Qiu, Xiao-Fu; Liu, Bai-Chuan; Zhong, Rui-Lun; Li, Gao-Yuan; Yang, Guo-Sheng

    2016-04-01

    To describe a novel transurethral front-firing Greenlight bladder autoaugmentation for the treatment of bladder contracture and report initial clinical outcomes. Between April 2014 and August 2015, five patients diagnosed with contracted bladder were all refractory to conservative treatment and received novel transurethral autoaugmentation. CT scan and urodynamics examination were conducted before operation for disease assessment. Mucosal and muscular layers of bladder wall in fundus were incised vertically and horizontally with front-firing Greenlight laser to enlarge bladder capacity in the operation. Imaging examination and periodical urodynamics study were performed to evaluate the clinical outcomes of the procedure in postoperative follow-up. Transurethral front-firing Greenlight bladder autoaugmentation was performed successfully on all the patients. The mean operative time was 59 min (range 52-65 min) with no significant blood loss. Urodynamic parameters of these patients after operation improved significantly compared with those before operation. Average maximum cystometric capacity (Vmax) increased from 91.2 to 333 ml (p < 0.01), average maximum flow rate (Qmax) ascended from 12.6 to 18.62 ml/min (p < 0.01), and average flow rate (Q(ave)) also increased from 5.74 to 13.18 ml/min (p < 0.01). At the last follow-up, all the patients could void spontaneously with good bladder emptying and their symptoms improved significantly. Our novel transurethral front-firing Greenlight bladder autoaugmentation is a safe and effective treatment for contracted bladders. Future studies with larger sample size and long-term follow-up are needed to confirm our findings.

  18. Transcriptional repression of Caveolin-1 (CAV1) gene expression by GATA-6 in bladder smooth muscle hypertrophy in mice and human beings.

    Science.gov (United States)

    Boopathi, Ettickan; Gomes, Cristiano Mendes; Goldfarb, Robert; John, Mary; Srinivasan, Vittala Gopal; Alanzi, Jaber; Malkowicz, S Bruce; Kathuria, Hasmeena; Zderic, Stephen A; Wein, Alan J; Chacko, Samuel

    2011-05-01

    Hypertrophy occurs in urinary bladder wall smooth muscle (BSM) in men with partial bladder outlet obstruction (PBOO) caused by benign prostatic hyperplasia (BPH) and in animal models of PBOO. Hypertrophied BSM from the rabbit model exhibits down-regulation of caveolin-1, a structural and functional protein of caveolae that function as signaling platforms to mediate interaction between receptor proteins and adaptor and effector molecules to regulate signal generation, amplification, and diversification. Caveolin-1 expression is diminished in PBOO-induced BSM hypertrophy in mice and in men with BPH. The proximal promoter of the human and mouse caveolin-1 (CAV1) gene was characterized, and it was observed that the transcription factor GATA-6 binds this promoter, causing reduced expression of caveolin-1. Furthermore, caveolin-1 expression levels inversely correlate with the abundance of GATA-6 in BSM hypertrophy in mice and human beings. Silencing of GATA6 gene expression up-regulates caveolin-1 expression, whereas overexpression of GATA-6 protein sustains the transcriptional repression of caveolin-1 in bladder smooth muscle cells. Together, these data suggest that GATA-6 acts as a transcriptional repressor of CAV1 gene expression in PBOO-induced BSM hypertrophy in men and mice. GATA-6-induced transcriptional repression represents a new regulatory mechanism of CAV1 gene expression in pathologic BSM, and may serve as a target for new therapy for BPH-induced bladder dysfunction in aging men.

  19. Experimental electrical stimulation of the bladder using a new device

    DEFF Research Database (Denmark)

    Petersen, T; Christiansen, P; Nielsen, B

    1986-01-01

    Repeated bladder contractions were evoked during a six month period in three unanaesthetized female minipigs by using unipolar carbon fiber electrodes embedded in the bladder wall adjacent to the ureterovesical junction. In contrast to bipolar and direct bladder muscle stimulation unipolar electr...

  20. Contemporary management of low-risk bladder cancer

    NARCIS (Netherlands)

    Falke, J.; Witjes, J.A.

    2011-01-01

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

  1. A rat model with an isolated bladder in situ

    DEFF Research Database (Denmark)

    Thulesen, J; Olsen, P S; Grevstad, J U

    1997-01-01

    This paper describes our method for producing a rat model with an isolated bladder in situ in which the bladder makes no contact with urine. First, the right kidney was removed, then an external catheter was placed in the right ureter for bladder infusions, and next the left ureter was anatomosed...

  2. Progress in Personalizing Chemotherapy for Bladder Cancer

    Directory of Open Access Journals (Sweden)

    James S. Chang

    2012-01-01

    Full Text Available Platinum-based chemotherapy is commonly used for the treatment of locally advanced and metastatic bladder cancer. However, there are currently no methods to predict chemotherapy response in this disease setting. A better understanding of the biology of bladder cancer has led to developments of molecular biomarkers that may help guide clinical decision making. These biomarkers, while promising, have not yet been validated in prospective trials and are not ready for clinical applications. As alkylating agents, platinum drugs kill cancer cells mainly through induction of DNA damage. A microdosing approach is currently being tested to determine if chemoresistance can be identified by measuring platinum-induced DNA damage using highly sensitive accelerator mass spectrometry technology. The hope is that these emerging strategies will help pave the road towards personalized therapy in advanced bladder cancer.

  3. Laparoscopic gastrocystoplasty for tuberculous contracted bladder

    Directory of Open Access Journals (Sweden)

    Manickam Ramalingam

    2017-01-01

    Full Text Available The stomach is the preferred augmentation option for a contracted bladder in a patient with renal failure. A 49-year-old female presented with right solitary functioning kidney with tuberculous lower ureteric stricture and contracted bladder. Her creatinine was 2.8 mg%. By laparoscopic approach, right gastroepiploic artery based gastric flap was isolated using staplers and used for augmentation and ureteric replacement. At 6-month follow-up, her creatinine was 1.9 mg%, and bladder capacity was 250 ml. She had mild hematuria, which settled with proton pump inhibitors. Laparoscopic gastrocystoplasty is feasible and effective augmentation option in those with renal failure, giving the benefits of minimally invasive approach.

  4. Unusual presentation of metastatic gall bladder cancer

    Directory of Open Access Journals (Sweden)

    Piyush Shukla

    2014-01-01

    Full Text Available To report the first case of rare isolated breast metastasis from carcinoma gall bladder. Single patient case report. A 35-year-old pre-menopausal female presented with 2 FNx01 2 cm right upper outer quadrant breast lump. Post-mastectomy, histology confirmed it to be metastatic adenocarcinoma positive for both Cytokeratin (CK 7 and CK20. Past history as told by the patient revealed that 2 years back, cholecystectomy was performed for gall stones, of which no histology reports were present; she had a port site scar recurrence which showed it to be adenocarcinoma. Adjuvant chemotherapy and radiotherapy was advised which the patient did not complete. This is probably the first case reported of isolated breast metastasis from gall bladder carcinoma, diagnosed retrospectively. It also highlights the importance of adjuvant treatment in gall bladder malignancy.

  5. Perioperative management of classic bladder exstrophy

    Directory of Open Access Journals (Sweden)

    Massanyi EZ

    2013-03-01

    Full Text Available Eric Z Massanyi,1 John P Gearhart,1 Sabine Kost-Byerly2 1Division of Pediatric Urology, Department of Urology, James Buchanan Brady Urological Institute, 2Division of Pediatric Anesthesia, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital and Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA Abstract: The exstrophy-epispadias complex is a rare congenital malformation of the genitourinary system, abdominal wall muscles, and pelvic structures. Modern surgical repairs focus on reconstruction of the bladder and its adjacent structures, with the goal of achieving urinary continence, a satisfactory cosmetic result, and a high quality of life. Complex surgery in neonates and young children, as well as a prolonged postoperative course require close collaboration between surgeons, anesthesiologists, intensivists, pediatricians, and an experienced nursing staff. This article will review the spectrum of bladder exstrophy anomalies, the surgical repair, and the perioperative interdisciplinary management. Keywords: bladder exstrophy, infant, newborn, surgery, anesthesia

  6. Bladder cancer; Cancer de la Vessie

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-01

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

  7. A Rare Case: Sporadic Bladder Paraganglioma

    Directory of Open Access Journals (Sweden)

    Hakan Ercil

    2013-08-01

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

  8. Optimizing systemic therapy for bladder cancer.

    Science.gov (United States)

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

    2013-07-01

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

  9. Bladder carcinoma: MDCT cystography and virtual cystoscopy.

    Science.gov (United States)

    Panebianco, Valeria; Sciarra, Alessandro; Di Martino, Michele; Bernardo, Silvia; Vergari, Valeria; Gentilucci, Alessandro; Catalano, Carlo; Passariello, Roberto

    2010-06-01

    Bladder carcinoma is the most common tumor among the low urinary tract, accounting for 90% of cancer cases. Conventional cystoscopy represents the gold standard for diagnosis and local management of bladder carcinoma. As the prevalence of transitional cell carcinoma is four-fold greater in men than in women, the endoscopic procedure presents objective difficulties related to the length and bending of male urethra. The most important problems are represented by intense discomfort for the patient and bleeding; furthermore, the high cost, invasivity, and local complications such as infections and mechanical lesions are well-known drawbacks. Additionally, conventional cystoscopy does not provide information about extravescical extensions of the tumor. CT cystography, combined with virtual cystoscopy, is mandatory for TNM staging of the tumor and also is useful when conventional cystoscopy is inconclusive or cannot be performed. We presents the CT cystography findings with virtual endoscopy correlation and bladder carcinoma appearance.

  10. Botulinum Toxin to Treat Neurogenic Bladder.

    Science.gov (United States)

    Smith, Christopher P; Chancellor, Michael B

    2016-02-01

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

  11. MOLECULAR PROGNOSTIC MARKERS OF URINE BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    V. N. Pavlov

    2012-01-01

    Full Text Available Bladder cancer (BC remains a current problem in oncourology. Despite that bladder cancer risk factors have been studied and described in the literature, new molecular and genetic mechanisms have been identified that predisposes to the disease development. There are numerous cellular processes involve in BC pathogenesis. The less-aggressive, non-invasive slow progressing bladder cancer types are defined by Ras-MAPK system activation. Tumors that are more aggressive and have low cancer-specific survival rate are characterized by changes in retinoblastoma genes and p53. Attempts are made to develop prognostic tests to predict tumor behavior, targeted treatment. perspectively, BC patients will be treated using molecular genetic markers allowing the accurate prediction of the patient’s tumor behavior and fitting the treatment tactics on the individual basis.

  12. Cases of a Borderline Pathology That Can Mimic Bladder Cancer: Primary Amyloidosis of Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Cemal Selçuk İşoğlu

    2015-06-01

    Full Text Available Amyloidosis is a disease characterised by accumulation of a fibrillar protein called amyloid in the extracellular space. The kidneys, ureters and the bladder can be affected in the urinary tract. However, primary amyloidosis of bladder is a rare entity. Macroscopic hematuria could be the first and only symptom of primary amyloidosis of the bladder; therefore, it has similar findings with urinary tract malignancies. Histopathological evaluation is mandatory for the diagnosis. Follow-up should always include cystoscopic evaluation as recurrence is expected in the natural course.

  13. Iron therapy for pre-operative anaemia.

    Science.gov (United States)

    Ng, Oliver; Keeler, Barrie D; Mishra, Amitabh; Simpson, Alastair; Neal, Keith; Brookes, Matthew J; Acheson, Austin G

    2015-12-22

    Pre-operative anaemia is common and occurs in up to 76% of patients. It is associated with increased peri-operative allogeneic blood transfusions, longer hospital lengths of stay and increased morbidity and mortality. Iron deficiency is one of the most common causes of this anaemia. Oral iron therapy has traditionally been used to treat anaemia but newer, safer parenteral iron preparations have been shown to be more effective in other conditions such as inflammatory bowel disease, chronic heart failure and post-partum haemorrhage. A limited number of studies look at iron therapy for the treatment of pre-operative anaemia. The aim of this Cochrane review is to summarise the evidence for use of iron supplementation, both enteral and parenteral, for the management of pre-operative anaemia. The objective of this review is to evaluate the effects of pre-operative iron therapy (enteral or parenteral) in reducing the need for allogeneic blood transfusions in anaemic patients undergoing surgery. We ran the search on 25 March 2015. We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic and EMBASE (Ovid), CINAHL Plus (EBSCO), PubMed, clinical trials registries, conference abstracts, and we screened reference lists. We included all randomised controlled trials (RCTs) which compared pre-operative iron monotherapy to placebo, no treatment, standard of care or another form of iron therapy for anaemic adults undergoing surgery. Anaemia was defined by haemoglobin values less than 13 g/dL for males and 12 g/dL for non-pregnant females. Data were collected by two authors on the proportion of patients who receive a blood transfusion, amount of blood transfused per patient (units) and haemoglobin measured as continuous variables at pre-determined time-points: pre

  14. Bladder Perforation Secondary to Primary Systemic Amyloidosis

    Directory of Open Access Journals (Sweden)

    Christopher J. Dru

    2014-01-01

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

  15. Inflammatory pseudotumor of the bladder: case report

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Jeung Hee; Nam, Eun Sook [Hallym University College of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    Inflammatory pseudotumor of the urinary bladder is a rare benign lesion. Because it is difficult to differentiate from other tumors clinically and pathologically, histopathologic confirmation is needed, and to avoid unnecessary cystectomy, it should be included in the differential diagnosis. A 47-year-old male presented with hematuria and voiding difficulty. IVP revealed a triangular filling defect in the urinary bladder, and CT demonstrated the presence there of a strongly enhancing mass. We deseribe this case, in which inflammatory pseudotumor was diagnosed, and review literature.

  16. [Bladder primitive lymphoma. Report of a case].

    Science.gov (United States)

    Rakototiana, A F; Rakoto-Ratsimba, H N; Hunald, F A; Ralahy, F; Ezra, J; Rabarioelina, L

    2008-03-01

    Lymphoma is an uncommon tumor of bladder. We report herein one case in a 58 year-old man aiming to show diagnosis and treatment difficulties in our practice. This patient had medical history of nephritic colic, haematuria and cystitis. Imagery revealed tissular mass with orange-like dimension in the right bladder corn. There was no kidney function alteration. Complete mass excision was performed and histological examination diagnosed low grade lymphoma with lymphoplasmocytary type. After chemotherapy, complete remission was obtained after 10 months follow-up.

  17. Actinomycosis of urinary bladder - a rare entity

    Directory of Open Access Journals (Sweden)

    Chaman Lal Gupta

    2003-01-01

    Full Text Available Actinomycosis is considered the most misdiagnosed dis-ease usually involving the cervico fascial region, thorax, abdomen and occasionally also the pelvis, usually in case of the females using intra-uterine devices. The involve-ment of the urinary tract is rare and primary actinomyco-sis of urinary bladder is still rarer. The disease is usually diagnosed by demonstration of the discharged sulphur granules. In our case this was not the usual presentation and the patient was first diagnosed as having appendicu-lar mass and then bladder malignancy. The excised mass demonstrated features suggestive of actinomycosis.

  18. Urinary Tract Infection and Neurogenic Bladder.

    Science.gov (United States)

    McKibben, Maxim J; Seed, Patrick; Ross, Sherry S; Borawski, Kristy M

    2015-11-01

    Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options. Multiple prevention methods are used but evidence-based practices are few. Prevention and treatment of symptomatic UTI requires a multimodal approach that focuses on bladder management as well as accurate diagnosis and appropriate antibiotic treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Magnetic resonace appearance of Gall Bladder Ascariasis

    Directory of Open Access Journals (Sweden)

    Arya Prafull

    2005-05-01

    Full Text Available Ascariasis is a common disease in many developing countries and is a common cause of biliary and pancreatic diseases in endemic areas. Numerous studies have been published on biliary tract ascariasis. All these have documented ultrasonography as the primary imaging modality for biliary tract ascariasis. Magnetic Resonance Cholangiopancreatography (MRCP has been the latest entrant for the study of bilary tract. MRCP findings of biliary tract ascariasis have been scarcely documented. MRCP is a unique non-invasive investigation for demonstrating ascariasis in Gall bladder and bilary tract clearly. We present MR appearances of Gall bladder and biliary tract in a proven case of biliary ascariasis.

  20. Calcifying nanoparticles associated encrusted urinary bladder cystitis.

    Science.gov (United States)

    Jelic, Tomislav M; Roque, Rod; Yasar, Uzay; Tomchin, Shayna B; Serrato, Jose M; Deem, Samuel G; Tierney, James P; Chang, Ho-Huang

    2008-01-01

    Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder mucosa and frequently associated with mucosal ulcers. It is a very rare disease of controversial etiology. Our transmission electron microscopy of the calcified plaques of encrusted cystitis has revealed that the smallest formed particles (elementary units) of these calcifications are electron-dense shells surrounding an electron lucent core, diagnostic of calcifying nanoparticles (previously called nanobacteria). We pioneer the notion that calcifying nanoparticles are the causative agents of encrusted urinary bladder cystitis.

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

    Directory of Open Access Journals (Sweden)

    André Ngamini Ngui

    2015-01-01

    Full Text Available Objectives. The objectives of this study were to examine the spatial accessibility to alcohol outlets in Quebec and to assess the association between neighborhood level characteristics and availability of alcohol outlets. Methods. The Tobit Model was used to assess the association between neighborhood level characteristics and the availability of alcohol outlets within 500, 1000, 2000, and 3000 metres, respectively. Results. Alcohol outlets were found to be most available in the two largest metropolitan areas of the province of Quebec (Montréal and Québec City. Within 1000 metres, alcohol outlets are more available in neighbourhoods with the following characteristics: highest concentration of men, least materially deprived highest concentration of persons aged 20 years or more, and location either in a metropolitan area or in a small town. Finally, the number of bars with video lottery terminals increases with the level of social and material deprivation. Conclusion. In Québec, there is no rule governing the location of alcohol outlets. Thus, there is an abundant literature indicating that the regulation of alcohol outlet density could be an effective means of controlling risk attributable to alcohol consumption.

  2. Tobacco advertising and sales practices in licensed retail outlets after the Food and Drug Administration regulations.

    Science.gov (United States)

    Frick, Ryan G; Klein, Elizabeth G; Ferketich, Amy K; Wewers, Mary Ellen

    2012-10-01

    To assess retailer compliance with Food and Drug Administration (FDA) regulations on tobacco sales and advertising practices, including point-of-sale advertisements, in two distinct Columbus, Ohio neighborhood groups by income. Data were gathered from a random sample of 129 licensed tobacco retailers, which included data on both exterior and interior advertisements as well as sales practices. Descriptive analyses compared retail outlets by high and low income neighborhood locations. Compliance with FDA regulations was high in the random sample of urban tobacco retail outlets. None of the retail outlets sold loose cigarettes or offered free items with purchase. Less than 10% of the outlets surveyed offered self-service access to cigarettes or smokeless tobacco products. From all surveyed retail outlets 95% had cigarette, 57% had smokeless, and 57% had cigar advertisements at the point-of-sale. There were no significant differences in compliance by income, but the mean number of advertisements on the building and self-service access to cigars was significantly different by neighborhood income. There was a high degree of compliance with the new FDA regulation on tobacco marketing and sales practices in urban retail tobacco outlets in Columbus, Ohio. Tobacco advertising and marketing remain highly prevalent in retail outlets, with some significant differences between high and low income neighborhoods.

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

    Science.gov (United States)

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

    2008-01-01

    Background Food prepared away from home has become increasingly popular to U.S. families, and may contribute to obesity. Sales have been dominated by fast food outlets, where meals are purchased for dining away from home or in the home. Although national chain affiliated fast-food outlets are considered the main source for fast food, fast foods are increasingly available in convenience stores and supermarkets/grocery stores. In rural areas, these nontraditional fast-food outlets may provide most of the opportunities for procurement of fast foods. Methods Using all traditional and nontraditio nal fast-food outlets identified in six counties in rural Texas, the type and number of regular and healthiermenu options were surveyed using on-site observation in all food venues that were primarily fast food, supermarket/grocery store, and convenience store and compared with 2005 Dietary Guidelines. Results Traditional fast-food outlets represented 84 (41%) of the 205 opportunities for procurement of fast food; 109 (53.2%) were convenience stores and 12 (5.8%) supermarkets/grocery stores. Although a s imilar variety of regular breakfast and lunch/dinner entrées were available in traditional fast-food outlets and convenience stores, the variety of healthier breakfast and lunch/dinner entrées was significantly greater in fast food outlets. Compared with convenience stores, supermarkets/grocery stores provided a greater variety of regular and healthier entrées and lunch/dinner side dishes. Conclusion Convenience stores and supermarkets/grocery stores more than double the potential access to fast foods in this rural area than traditional fast-food outlets alone; however, traditional fast food outlets offer greater opportunity for healthier fast food options than convenience stores. A complete picture of fast food environment and the availability of healthier fast food options are essential to understand environmental influences on diet and health outcomes, and identify

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

    Directory of Open Access Journals (Sweden)

    McIntosh Alex

    2008-11-01

    Full Text Available Abstract Background Food prepared away from home has become increasingly popular to U.S. families, and may contribute to obesity. Sales have been dominated by fast food outlets, where meals are purchased for dining away from home or in the home. Although national chain affiliated fast-food outlets are considered the main source for fast food, fast foods are increasingly available in convenience stores and supermarkets/grocery stores. In rural areas, these nontraditional fast-food outlets may provide most of the opportunities for procurement of fast foods. Methods Using all traditional and nontraditio nal fast-food outlets identified in six counties in rural Texas, the type and number of regular and healthiermenu options were surveyed using on-site observation in all food venues that were primarily fast food, supermarket/grocery store, and convenience store and compared with 2005 Dietary Guidelines. Results Traditional fast-food outlets represented 84 (41% of the 205 opportunities for procurement of fast food; 109 (53.2% were convenience stores and 12 (5.8% supermarkets/grocery stores. Although a s imilar variety of regular breakfast and lunch/dinner entrées were available in traditional fast-food outlets and convenience stores, the variety of healthier breakfast and lunch/dinner entrées was significantly greater in fast food outlets. Compared with convenience stores, supermarkets/grocery stores provided a greater variety of regular and healthier entrées and lunch/dinner side dishes. Conclusion Convenience stores and supermarkets/grocery stores more than double the potential access to fast foods in this rural area than traditional fast-food outlets alone; however, traditional fast food outlets offer greater opportunity for healthier fast food options than convenience stores. A complete picture of fast food environment and the availability of healthier fast food options are essential to understand environmental influences on diet and health

  5. Totally Endoscopic (VATS) First Rib Resection for Thoracic Outlet Syndrome.

    Science.gov (United States)

    George, Robert S; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

    2017-01-01

    Thoracic outlet syndrome (TOS) causes neurologic symptoms in 95% of cases and vascular symptoms in 5% of cases. Surgical resection is curative. Endoscopic-assisted transaxillary first rib resection has been previously reported. In this study we report a totally endoscopic video-assisted thoracoscopic surgery (VATS) approach using tailored endoscopic instruments. Ten patients (8 women; average age, 32.3 ± 5.6 years) with TOS underwent VATS first rib resection following failure of symptom improvement with physiotherapy. Symptoms were: unilateral neurogenic (n = = 7), bilateral neurogenic (n = = 2), and bilateral arterial compression (n = = 1). Three standard VATS ports were utilized. The parietal pleura and periosteum overlying the first rib were stripped avoiding injury to the neurovascular bundle. The rib was transected with an endoscopic rib cutter and resected completely in a piecemeal fashion using endoscopic bone nibblers. All periosteal remnants were trimmed releasing the neurovascular bundle completely. Patients were discharged within 72 hours following surgery. One patient had the contralateral side treated 18 months later and another patient is awaiting the second surgery. At follow-up, 9 patients had complete resolution of their main symptoms. One patient with neurogenic TOS developed mild functional and sensational loss of the non-dominant hand that improved within 8 months with physiotherapy. VATS first rib resection for TOS provides, unlike the classic approaches, a superior, magnified, and well-illuminated view of the thoracic inlet. It allows good posterior trimming of the first rib, release of brachial plexus, and an aesthetically pleasing result, especially in female patients. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Boundary layer models for calving marine outlet glaciers

    Directory of Open Access Journals (Sweden)

    C. Schoof

    2017-10-01

    Full Text Available We consider the flow of marine-terminating outlet glaciers that are laterally confined in a channel of prescribed width. In that case, the drag exerted by the channel side walls on a floating ice shelf can reduce extensional stress at the grounding line. If ice flux through the grounding line increases with both ice thickness and extensional stress, then a longer shelf can reduce ice flux by decreasing extensional stress. Consequently, calving has an effect on flux through the grounding line by regulating the length of the shelf. In the absence of a shelf, it plays a similar role by controlling the above-flotation height of the calving cliff. Using two calving laws, one due to Nick et al. (2010 based on a model for crevasse propagation due to hydrofracture and the other simply asserting that calving occurs where the glacier ice becomes afloat, we pose and analyse a flowline model for a marine-terminating glacier by two methods: direct numerical solution and matched asymptotic expansions. The latter leads to a boundary layer formulation that predicts flux through the grounding line as a function of depth to bedrock, channel width, basal drag coefficient, and a calving parameter. By contrast with unbuttressed marine ice sheets, we find that flux can decrease with increasing depth to bedrock at the grounding line, reversing the usual stability criterion for steady grounding line location. Stable steady states can then have grounding lines located on retrograde slopes. We show how this anomalous behaviour relates to the strength of lateral versus basal drag on the grounded portion of the glacier and to the specifics of the calving law used.

  7. Obesity-promoting food environments and the spatial clustering of food outlets around schools.

    Science.gov (United States)

    Day, Peter L; Pearce, Jamie

    2011-02-01

    The increasing prevalence of overweight and obesity in school-aged children is potentially linked to contextual influences such as the food environment around schools. The proximity of fast-food and convenience stores to schools may enhance access to unhealthy foods and have a negative impact on diet. This study used spatial cluster analysis to determine whether food outlets are clustered around schools and evaluated the extent of food outlet clustering by school and school neighborhood sociodemographic characteristics. The locations in 2008 of all schools, fast-food outlets, and convenience stores in five urban regions across New Zealand were geocoded. Using GIS analysis conducted in 2009, the number and proportion of outlets within 400-m and 800-m road distance around each school was calculated. The spatial clustering of food outlets within 1.5 km of schools was determined using a multi-type K-function. Food outlet type, school level, SES, the degree of population density, and commercial land use zoning around each school were compared. Primary/intermediate schools had a total proportion of 19.3 outlets per 1000 students within 800 m compared to 6.6 for secondary schools. The most socially deprived quintile of schools had three times the number and proportion of food outlets compared to the least-deprived quintile. There was a high degree of clustering of food outlets around schools, with up to 5.5 times more outlets than might be expected. Outlets were most clustered up to 800 m from schools and around secondary schools, socially deprived schools, and schools in densely populated and commercially zoned areas. Food environments in New Zealand within walking proximity to schools are characterized by a high density of fast-food outlets and convenience stores, particularly in more-socially deprived settings. These obesogenic environments provide ready access to obesity-promoting foods that may have a negative impact on student diet and contribute to inequalities in

  8. 16 CFR Appendix D to Part 436 - Sample Item 20(3) Table-Status of Franchise Outlets

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Sample Item 20(3) Table-Status of Franchise Outlets D Appendix D to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES... Item 20(3) Table—Status of Franchise Outlets Status of Franchise Outlets For years 2004 to 2006...

  9. 16 CFR Appendix C to Part 436 - Sample Item 20(2) Table-Transfers of Franchised Outlets

    Science.gov (United States)

    2010-01-01

    ... Franchised Outlets C Appendix C to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION... 436—Sample Item 20(2) Table—Transfers of Franchised Outlets Transfers of Franchised Outlets from Franchisees to New Owners (other than the Franchisor) For years 2004 to 2006 Column 1State Column 2Year...

  10. Solitary Fibrous Tumor in Bladder:A Case Report

    Institute of Scientific and Technical Information of China (English)

    王涛; 陈瑞宝; 乔建坤; 胡涛; 刘继红; 杨为民; 叶章群

    2010-01-01

    Solitary fibrous tumor(SFT) in bladder is extremely rare.In this study,we reported one case of bladder SFT and reviewed the only ten cases of the disease that had been reported so far.The patient suffered from residual urine sensation and urethral pain.Cystoscopy revealed a 7-cm protruding mass at the dome of the bladder,and bladder mucosa biopsy showed normal differentiation of the bladder mucosa with a small amount of inflammatory cells.Radical resection of the tumor was performed in this patient.Patholog...

  11. BCG Induced Necrosis of the Entire Bladder Urothelium

    Directory of Open Access Journals (Sweden)

    Malte Krönig

    2015-09-01

    Full Text Available Instillation therapy with attenuated tuberculosis bacteria (BCG can significantly reduce rates of recurrence of non-muscle invasive bladder cancer. Local and systemic side effects such as dysuria, irritative voiding symptoms or partial bladder contracture and systemic inflammation were reported. A 75 year-old male patient with recurrent non muscle invasive bladder cancer developed necrosis of the entire bladder urothelium more than six years after BCG instillation immunotherapy. The resulting irritative voiding symptoms and low bladder capacity required radical cystectomy. BCG instillation can cause severe side effects, which develop gradually and eventually need radical surgical therapy such as cystectomy without tumor recurrence.

  12. Effects of morphine in the isolated mouse urinary bladder.

    Science.gov (United States)

    Acevedo, C G; Tamayo, L; Contreras, E

    1986-01-01

    Acute morphine increased the responses to acetylcholine of the isolated mouse urinary bladder. A chronic morphine treatment did not change the responses of the urinary bladder to acetylcholine or ATP. The acute administration of morphine did not modify the contractile response to ATP in the urinary bladders from untreated or chronically morphine treated mice. Methadone and ketocyclazocine decreased the responses to the electrical stimulation of the urinary bladder. These depressant effects were not modified by naloxone. The results suggest the nonexistence of opiate receptors in the mouse urinary bladder and the lack of direct effects of morphine on the neuroeffector junction.

  13. HpD Photobiology And Photodynamic Therapy Of Bladder Carcinoma

    Science.gov (United States)

    Lin, Chi-Wei

    1988-02-01

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

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

    Science.gov (United States)

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

    2014-09-15

    The goal of the present study was to determine if supraspinal pathways are necessary for inhibition of bladder reflex activity induced by activation of somatic afferents in the pudendal or tibial nerve. Cats anesthetized with α-chloralose were studied after acute spinal cord transection at the thoracic T9/T10 level. Dilute (0.25%) acetic acid was used to irritate the bladder, activate nociceptive afferent C-fibers, and trigger spinal reflex bladder contractions (amplitude: 19.3 ± 2.9 cmH2O). Hexamethonium (a ganglionic blocker, intravenously) significantly (P irritation. Understanding the sites of action for PNS or TNS inhibition is important for the clinical application of pudendal or tibial neuromodulation to treat bladder dysfunctions. Copyright © 2014 the American Physiological Society.

  15. Preoperative urinary tract obstruction in scoliosis patients.

    Science.gov (United States)

    Suzuki, Shigeru; Kotani, Toshiaki; Mori, Kazuetsu; Kawamura, Ken; Ohtake, Akira

    2017-01-01

    While the association between scoliosis and cardiac and respiratory function impairments has been well characterized in clinical practice and research, the potential effect of scoliosis on urinary tract structure and renal function has received little attention. Therefore, the purpose of this study was to evaluate the preoperative clinical characteristics of urinary tract structure and renal function in pediatric patients with idiopathic scoliosis, using a combination of blood tests, urinalysis, and imaging. Preoperative measures of urinary tract structure and renal function were obtained for 16 patients, 13-17 years old, scheduled for corrective surgery for idiopathic scoliosis. Preoperative assessment included blood test and urinalysis, combined with structural imaging on ultrasound (US), magnetic resonance imaging (MRI), magnetic resonance urography (MRU), and radioisotope tracing (RI), using technetium-99 m mercaptoacetyltriglycine ((99m) Tc-MAG3). Differences in blood and urine tests between patients with and without urinary tract obstruction (UTO) were evaluated for significance using Mann-Whitney U test. For all 16 patients, blood tests and MRU were within normal limits. Dilatation of the renal pelvis was identified on US in eight patients (50.0%). UTO was identified on RI in six patients (37.5%). UTO was associated with elevated β2-microglobulin concentration. Urinary β2-microglobulin concentration >0.7 μg/mg Cr differentiated patients with UTO from those without UTO, with a sensitivity of 100% and specificity of 70%. β2-Microglobulin concentration may be a useful marker to screen for asymptomatic UTO in patients with idiopathic scoliosis. © 2016 Japan Pediatric Society.

  16. Simplified bladder training augments the effectiveness of tolterodine in patients with an overactive bladder.

    OpenAIRE

    Mattiasson, Anders; Blaakaer, J; Høye, K; Wein, A J

    2003-01-01

    OBJECTIVES To compare the efficacy of tolterodine plus simplified bladder training (BT) with tolterodine alone in patients with an overactive bladder. PATIENTS AND METHODS In a multicentre, single-blind study at 51 Scandinavian centres, 505 patients aged >= 18 years with symptoms of urinary frequency (>= 8 micturitions/24 h) and urgency, with or without urge incontinence, were randomized to oral treatment with either tolterodine 2 mg twice daily plus simplified BT o...

  17. [Staging urinary bladder cancer with dynamic MR imaging].

    Science.gov (United States)

    Tsuda, K; Narumi, Y; Nakamura, H; Nonomura, I; Okuyama, A

    2000-11-01

    This article reviews the magnetic resonance (MR) staging of bladder cancer. The multiplanar and soft-tissue characterization capabilities of MR imaging make it a valuable diagnostic tool to image the urinary bladder. Recent advances of MR imaging such as fast imaging, pelvic phased array coil, and dynamic imaging improve the image quality and diagnostic accuracy for staging bladder cancer. Some patient-related factors are also important for optimal imaging of the urinary bladder, especially motion artifacts from the gastrointestinal tract and the degree of bladder distension. An anticholinergic agent should be used for suppressing the motion artifacts. Optimal bladder filling can be achieved by asking patients to void and drink water 1 hour before examinations. Scanning perpendicular to the bladder wall is necessary for optimal evaluation for staging bladder cancer. Oblique scanning is needed in cases when a tumor is not located on the dome, base, anterior wall, posterior wall, or lateral walls. The early phase image of dynamic imaging is most useful for staging tumors. Better contrast between tumor and bladder wall on dynamic images provides high staging accuracy, especially in differentiation between superficial tumors and tumors with muscle invasion. MR imaging is comparable to computed tomography (CT) in the evaluation of lymph nodes. Although MR imaging currently is not appropriate for screening for bladder cancer and detecting small tumors, it has been proved to be most useful in the staging of bladder cancer.

  18. Preoperative Evaluation: Estimation of Pulmonary Risk.

    Science.gov (United States)

    Lakshminarasimhachar, Anand; Smetana, Gerald W

    2016-03-01

    Postoperative pulmonary complications (PPCs) are common after major non-thoracic surgery and associated with significant morbidity and high cost of care. A number of risk factors are strong predictors of PPCs. The overall goal of the preoperative pulmonary evaluation is to identify these potential, patient and procedure-related risks and optimize the health of the patients before surgery. A thorough clinical examination supported by appropriate laboratory tests will help guide the clinician to provide optimal perioperative care. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A preoperative checklist in esthetic plastic surgery

    OpenAIRE

    Anger,Jaime; Letizio,Nelson; Orel,Maurício; Souza Junior,José Leão de; Santos,Márcio Martines dos

    2011-01-01

    The authors present a checklist to be used at the last stage of a preoperative visit for esthetic plastic surgery composed of 29 yes/no questions, four blank spaces for entering data, and one question for ranking the level of risk of deep vein thrombosis. The criteria are divided into three tables relating to three areas: anesthesia, psychological aspects, and clinical risk factors. The answers are framed in four colors that identify the level of risk and suggest the degree of attention warra...

  20. Preoperational test report, recirculation ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-11

    This represents a preoperational test report for Recirculation Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102 and supports the ability to exhaust air from each tank. Each system consists of a valved piping loop, a fan, condenser, and moisture separator; equipment is located inside each respective tank farm in its own hardened building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  1. Preoperational test report, raw water system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-10-29

    This represents the preoperational test report for the Raw Water System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system supplies makeup water to the W-030 recirculation evaporative cooling towers for tanks AY1O1, AY102, AZ1O1, AZ102. The Raw Water pipe riser and associated strainer and valving is located in the W-030 diesel generator building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  2. Migrated Mesh Plug Masquerading as a Bladder Tumor

    Science.gov (United States)

    Dajani, Daoud; Aron, Monish

    2017-01-01

    Abstract Background: The purpose of this case presentation is to demonstrate how erosion of mesh into the bladder can initially present with the same symptoms as bladder malignancy. Case Presentation: A 62-year-old Hispanic male presented with 2 years of hematuria along with imaging concerning for a bladder tumor. The patient underwent cystoscopy with biopsy of a lesion at the anterior bladder. It was ultimately determined that a mesh plug from a prior hernia repair had migrated into the bladder. The mesh plug was excised using the Da Vinci Si robot, which allowed for efficient mobilization of the bladder and other anatomic structures, as well as rapid recovery. Conclusion: Our case demonstrates the need to consider mesh erosion as a cause of hematuria and, furthermore, shows how the robotic approach can help facilitate excision of migrated mesh into the bladder. PMID:28164159

  3. Impact of behaviour and lifestyle on bladder health.

    Science.gov (United States)

    Burgio, K L; Newman, D K; Rosenberg, M T; Sampselle, C

    2013-06-01

    Bladder conditions, including UTI, UI, and bladder cancer, are highly prevalent and affect a wide range of populations. There are a variety of modifiable behavioral and lifestyle factors that influence bladder health. Some factors, such as smoking and obesity, increase the risk or severity of bladder conditions, whereas other factors, such as pelvic floor muscle exercise, are protective. Although clinical practice may be assumed to be the most appropriate ground for education on behavioral and lifestyle factors that influence bladder health, it is also crucial to extend these messages into the general population through public health interventions to reach those who have not yet developed bladder conditions and to maximize the prevention impact of these behaviors. Appropriate changes in these factors have the potential for an enormous impact on bladder health if implemented on a population-based level.

  4. Long-term outcomes of cutaneous vesicostomy in patients with neuropathic bladder caused by spina bifida.

    Science.gov (United States)

    Dönmez, M İrfan; Carrasco, Alonso; Saltzman, Amanda F; Vemulakonda, Vijaya; Wilcox, Duncan T

    2017-06-16

    To evaluate the outcomes of patients who underwent cutaneous vesicostomy for management of neuropathic bladder secondary to spina bifida. We hypothesize that vesicostomy, in select patients, is beneficial to prevent upper urinary tract deterioration (UTD), reduce febrile urinary tract infections (UTIs), and preserve renal function. We performed a retrospective chart review on patients with spina bifida who underwent cutaneous vesicostomy at our institution between 2000 and 2016. Demographic information, indication for vesicostomy, pre and postoperative laboratory/radiologic studies, incidence of febrile UTIs, and urodynamic findings were abstracted. A total of 14 patients (eight females and six males) were identified. The indication for vesicostomy was UTD in four, recurrent febrile UTIs in five, parental request in two, both UTD and recurrent febrile UTIs in two, and both UTI and parental request in one patient. Seven patients had a median of three (range one to five) febrile UTI prior to surgery for cutaneous vesicostomy. Median creatinine level before surgery was 0.26 mg/dL (range 0.16-0.97). Either unilateral or bilateral ≥SFU Grade 2 hydronephrosis was present in six patients. Median age at vesicostomy creation was 26.5 months (range 4-96). Mean functional bladder capacity assessed during preoperative urodynamic studies was 107 mL (range 20-279), and detrusor sphincter dysynergia was present in all patients. High-grade vesicoureteral reflux (grade ≥3) was present in three patients, all with UTD. Mean follow-up after vesicostomy was 62.4 ± 39.3 months. After vesicostomy, only two of the seven patients with history of febrile UTIs experienced an additional febrile UTI. The median serum creatinine level was 0.36 mg/dL (range 0.2-0.58) at last follow-up. Moreover, 11/14 patients had no hydronephrosis and just two patients had unilateral SFU grade 1 hydronephrosis (Table). Worsening UTD, recurrent febrile UTIs, and high-pressure bladder despite maximal

  5. Full-thickness endometriosis of the bladder

    DEFF Research Database (Denmark)

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

    2014-01-01

    was urinary frequency. All patients had significant relief of symptoms after operation, and none had recurrence of the bladder endometriosis judged by ultrasound or reported symptoms. Twenty-six (87%) patients had endometriosis in another location as well. Eight had nodules in the recto-vaginal septum...

  6. Pelvic organ prolapse and overactive bladder.

    NARCIS (Netherlands)

    Boer, T.A. de; Salvatore, S.; Cardozo, L.; Chapple, C.; Kelleher, C.; Kerrebroeck, P. van; Kirby, M.G.; Koelbl, H.; Espuna-Pons, M.; Milsom, I.; Tubaro, A.; Wagg, A.; Vierhout, M.E.

    2010-01-01

    AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms

  7. Darifenacin for the treatment of overactive bladder

    NARCIS (Netherlands)

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

    2007-01-01

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

  8. [Primary nontransitional neoplasms of the bladder].

    Science.gov (United States)

    Varo Solís, C; Soto Delgado, M; Hens Pérez, A; Baez Perea, J M; Estudillo González, F; Juárez Soto, A; Bachiller Burgos, J; Beltrán Aguilar, V

    1999-01-01

    Revision of all primitive tumours of the bladder diagnosed in our Service between July 1990 and July 1998. Among a total of 703 neoplasms of the bladder only 14 were non-transitional primitive tumours, accounting for just 1.98%. Eleven were malignant neoplasms with a diagnosis of epidermoid carcinoma in nine cases, one adenocarcinoma and one bladder adenocarcinoma. The other three were benign tumours: one haemangioma and two leiomyomas. From a clinical perspective, the predominant symptom was haematuria, followed by irritative symptoms. The two leiomyomas were accidental findings during a gynaecological examination (ultrasound) and a diagnostic examination for a nephritic colic (urography). The diagnostic means used and the extension studies were the same as used for transitional neoplasms. In general, treatment of benign neoplasms was partial cystectomy or transurethral resection while it was radical surgery for the malignant tumours when the existing criteria were an indication for that type of surgery (cystoprostatectomy with bypass), since there are no definite criteria with regards to therapy due to the low incidence of these tumours. Only three of the 11 patients with malignant neoplasms are still alive. All the others died within one year of diagnosis, an evidence of the aggressiveness of these tumours. These cases were considered primitive bladder tumours once it was concluded that there was no relation with any previous or simultaneous transitional neoplasms and that there had been no primitive tumour in a different organ.

  9. Embryogenesis of bladder exstrophy: A new hypothesis

    Directory of Open Access Journals (Sweden)

    Kulkarni Bharati

    2008-01-01

    Full Text Available Aims and Objective: To postulate a hypothesis to explain the embryogenesis of exstrophy bladder based on our clinical observations. Materials and Methods: In 27 cases of exstrophy, we measured the distance between the lowermost inguinal skin crease to the root of the penis (clitoris (B and the distance between the penis (clitoris and the scrotum (labia majora (C. These were compared with age, height and XP distance (distance between xiphisternum and symphysis pubis matched control group of normal children. The distance between the lowermost inguinal skin crease and the penis (clitoris (A was measured in control group. Results: The observation was A = B + C. This implies that in exstrophy bladder, the position of the penis (clitoris has moved cephalad from the lower border of A to the junction of B and C. Conclusion: Based on the observations, we postulate that abnormal origin of genital tubercle may be the cause of exstrophy bladder. The abnormal origin of primordia of the genital tubercle in more cephalad direction than normal causes wedge effect, which will interfere with the medial migration of the mesoderm as well as the midline approximation of mesodermal structures in the lower abdominal wall, thereby resulting in the exstrophy of bladder.

  10. Bladder calculus presenting as excessive masturbation.

    Science.gov (United States)

    De Alwis, A C D; Senaratne, A M R D; De Silva, S M P D; Rodrigo, V S D

    2006-09-01

    Masturbation in childhood is a normal behaviour which most commonly begins at 2 months of age, and peaks at 4 years and in adolescence. However excessive masturbation causes anxiety in parents. We describe a boy with a bladder calculus presenting as excessive masturbation.

  11. Pelvic organ prolapse and overactive bladder.

    NARCIS (Netherlands)

    Boer, T.A. de; Salvatore, S.; Cardozo, L.; Chapple, C.; Kelleher, C.; Kerrebroeck, P. van; Kirby, M.G.; Koelbl, H.; Espuna-Pons, M.; Milsom, I.; Tubaro, A.; Wagg, A.; Vierhout, M.E.

    2010-01-01

    AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms d

  12. Granular cell tumour of the urinary bladder

    Directory of Open Access Journals (Sweden)

    Christoph von Klot

    2012-04-01

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

  13. Radical radiotherapy for urinary bladder cancer

    DEFF Research Database (Denmark)

    Fokdal, Lars; von der Maase, Hans; Høyer, Morten

    2006-01-01

    The exact value of radiotherapy in the treatment of muscle-invasive       bladder cancer is difficult to establish, as most studies exploring this       issue are retrospective with different procedures for selecting patients       for treatment, as well as varying treatment strategies. An estima...

  14. Impact of proteomics on bladder cancer research

    DEFF Research Database (Denmark)

    Celis, Julio E; Gromova, Irina; Moreira, José Manuel Alfonso

    2004-01-01

    Detecting bladder cancer at an early stage and predicting how a tumor will behave and act in response to therapy, as well as the identification of new targets for therapeutic intervention, are among the main areas of research that will benefit from the current explosion in the number of powerful ...

  15. Bladder cancer: molecular determinants of personalized therapy.

    Science.gov (United States)

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

    2015-01-01

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

  16. Bladder sensory desensitization decreases urinary urgency

    Directory of Open Access Journals (Sweden)

    Avelino António

    2007-06-01

    Full Text Available Abstract Background Bladder desensitization has been investigated as an alternative treatment for refractory detrusor overactivity. Most open and controlled clinical trials conducted with intravesical RTX showed that desensitization delays the appearance of involuntary detrusor contractions during bladder filling and decreases the number of episodes of urgency incontinence. Urgency is being recognised as the fundamental symptom of overactive bladder (OAB, a symptomatic complex which recent epidemiological studies have shown to affect more than 10% of the Western population. As anti-muscarinic drugs, the first line treatment for OAB, are far from being able to fully control urgency, the opportunity to test other therapeutic approaches is created. The present work was, therefore, designed as an exploratory investigation to evaluate the effect of bladder desensitization on urinary urgency. Methods Twenty-three OAB patients with refractory urgency entered, after given informed consent, a 30 days run-in period in which medications influencing the bladder function were interrupted. At the end of this period patients filled a seven-day voiding chart where they scored, using a 0–4 scale, the bladder sensations felt before each voiding. Then, patients were instilled with 100 ml of 10% ethanol in saline (vehicle solution and 30 days later a second seven-day voiding chart was collected. Finally, patients were instilled with 100 ml of 50 nM RTX in 10% ethanol in saline. At 1 and 3 months additional voiding charts were collected. At the end of the vehicle and 3 months period patients were asked to give their subjective impression about the outcome of the treatment and about the willingness to repeat the previous instillation. Results At the end of the run-in period the mean number of episodes of urgency per week was 71 ± 12 (mean ± SEM. After vehicle instillation, the mean number of episodes of urgency was 56 ± 11, but only 4 patients (17% considered

  17. Outlet plenum flow stratification studies for the Clinch River Breeder Reactor Plant

    Energy Technology Data Exchange (ETDEWEB)

    Novendstern, E.H.; Woods, M.D.; Andreychek, T.S.; Flannigan, L.J.; Carr, J.A.

    1976-01-01

    The transient temperature behavior during a simulated reactor trip was studied in a 1/3 sector, 0.55 scale model of the reactor outlet plenum of the CRBRP. Buoyancy effects were simulated using water and salt solution. Effects of variations in Richardson Number (ratio of buoyancy/inertia forces) and Froude Number (ratio of inertia/viscous forces) were evaluated. Effects of geometrical changes of a component in the outlet plenum called the Upper Internals Structure on transient temperature response were studied; both height of the structure and leakage under this component were experimentally varied. The test results confirm that flow stratification occurs in the outlet plenum following a reactor trip. The colder, denser fluid issuing from the core assemblies during the transient fills the lower portion of the plenum while the hotter fluid is trapped in the region above the outlet nozzles.

  18. Evaluation of microbial contents of table eggs at retail outlets in ...

    African Journals Online (AJOL)

    ADEYEYE

    2015-02-23

    Feb 23, 2015 ... Keywords: Bacterial isolation, Microbial contents, Retail outlets, Sokoto, Table eggs. Received: ... very nutritious and a cheap source of protein. (Blumenthal ... The possible transmission of such toxic residues to edible eggs.

  19. 7 CFR 987.43 - Outlets and specifications for marketable dates.

    Science.gov (United States)

    2010-01-01

    ... MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE....12 to reflect new major outlets and regulatory requirements needed because of changes in marketing... processing, Export dates, and Product dates....

  20. Genetics of Bladder Malignant Tumors in Childhood

    Science.gov (United States)

    Zangari, Andrea; Zaini, Johan; Gulìa, Caterina

    2016-01-01

    Bladder masses are represented by either benign or malignant entities. Malignant bladder tumors are frequent causes of disease and death in western countries. However, in children they are less common. Additionally, different features are found in childhood, in which non epithelial tumors are more common than epithelial ones. Rhabdomyosarcoma is the most common pediatric bladder tumor, but many other types of lesions may be found, such as malignant rhabdoid tumor (MRT), inflammatory myofibroblastic tumor and neuroblastoma. Other rarer tumors described in literature include urothelial carcinoma and other epithelial neoplasms. Rhabdomyosarcoma is associated to a variety of genetic syndromes and many genes are involved in tumor development. PAX3-FKHR and PAX7-FKHR (P-F) fusion state has important implications in the pathogenesis and biology of RMS, and different genes alterations are involved in the pathogenesis of P-F negative and embryonal RMS, which are the subsets of tumors most frequently affecting the bladder. These genes include p53, MEF2, MYOG, Ptch1, Gli1, Gli3, Myf5, MyoD1, NF1, NRAS, KRAS, HRAS, FGFR4, PIK3CA, CTNNB1, FBXW7, IGF1R, PDGFRA, ERBB2/4, MET, BCOR. Malignant rhabdoid tumor (MRT) usually shows SMARCB1/INI1 alterations. Anaplastic lymphoma kinase (ALK) gene translocations are the most frequently associated alterations in inflammatory myofibroblastic tumor (IMT). Few genes alterations in urothelial neoplasms have been reported in the paediatric population, which are mainly related to deletion of p16/lnk4, overexpression of CK20 and overexpression of p53. Here, we reviewed available literature to identify genes associated to bladder malignancies in children and discussed their possible relationships with these tumors. PMID:27013922