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91.
正位可控性去带盲结肠膀胱术的疗效观察 总被引:4,自引:1,他引:3
目的:探讨正位可控性去带盲结肠膀胱术的临床疗效.方法:对17例膀胱肿瘤患者行膀胱全切除术后,应用末段回肠及盲升结肠作贮尿囊行正位膀胱重建术.结果:17例中15例获随访6~24个月,平均14.5个月.全组无严重并发症,均无瘤生存;术后3周自主可控性排尿,日间排尿可控率为93.3%,1年夜间尿失禁22.2%.术后6个月尿动力学检查,膀胱容量336 ml、最大尿流率13.7 ml/s、剩余尿量42 ml,而充盈期膀胱压力明显低于尿道闭合压.输尿管反流1例,但无尿道、输尿管狭窄,肾功能正常.结论:正位可控性去带盲结肠膀胱术具有膀胱容量大、内压低,正位排尿,可控性好,且手术操作简单、并发症少等优点,患者易于接受,是一种较理想的尿流改道方式. 相似文献
92.
Obstructed voiding is a well recognized complication following a suburethral sling procedure. Current methods of transvaginal
and transabdominal urethrolysis have had variable success rates in relieving the obstruction, and do not restabilize the urethra
to prevent potential postoperative stress incontinence. We report on a procedure used in 4 cases which addresses both of these
issues. All patients had persistent urinary retention beyond 8 weeks after a suburethral sling procedure. An oupatient procedure
consisting of sling incision and associated tissue interposition (vaginal wall in three cases and fascia lata in one) was
successful in relieving the obstruction. Continence status was maintained in 3 of the 4 patients. There were no major complications
of this outpatient procedure. 相似文献
93.
Jonathan C. Craig Les M. Irwig James Christie Albert Lam Ella Onikul John F. Knight Premala Sureshkumar L. Paul Roy 《Pediatric nephrology (Berlin, Germany)》1997,11(4):455-459
Variability in the interpretation of micturating cystourethrography by paediatric radiologists for the diagnosis of vesicoureteric
reflux in children was evaluated. All 265 micturating cystourethrograms (MCUs) that were available from 304 consecutive children
aged 0.5 – 61 months – who were investigated after their first urine infection between 1993 and 1995 as part of a prospective
cohort study – were selected for interpretation. Three experienced paediatric radiologists from the same department independently
interpreted the MCUs according to the grading system of the International Reflux Study in Children, from grades 0 to V, with
the presence of intrarenal reflux also noted. Apart from being informed that urine infection was the indication for the MCU,
no other clinical information was given to the radiologists. The indices of variability used were the percentage of agreement
and the kappa statistic, expressed as a percentage. Both measures were weighted with integers representing the number of categories
from perfect agreement. Disagreement was analysed for children and kidneys. For the diagnosis of vesicoureteric reflux in
individual patients, including grade, the percentage of agreement was 96% – 97% (kappa 90% – 91%) and the weighted percentage
of agreement was 96% – 98% (weighted kappa 93% – 94%). The same high level of agreement was present for individual kidneys,
with a percentage of agreement of 97% – 98% (kappa 89% – 92%) and a weighted percentage of agreement of 98% – 99% (kappa 94% – 95%).
There was near perfect agreement in the interpretation of radiological micturating cystourethrography among three experienced
paediatric radiologists for the diagnosis and grade of vesicoureteric reflux. Any variations in the medical care of children
suspected of having vesicoureteric reflux are not explained by differences in the reporting of this diagnostic test.
Received June 19, 1996; received in revised form November 1, 1996; accepted December 6, 1996 相似文献
94.
Dörthe Andrea Kesper Christiana Stute Detlev Buttgereit Nina Kreisköther Smitha Vishnu Karl‐Friedrich Fischbach Renate Renkawitz‐Pohl 《Developmental dynamics》2007,236(2):404-415
During myogenesis in Drosophila embryos, a prominent adhesive structure is formed between precursor cells and fusion-competent myoblasts (fcms). Here, we show that Duf/Kirre and its interaction partners Rols7 (found in founder myoblasts and growing myotubes) and Sns (found in fcms) are organized in a ring-structure at the contact points of fcms with precursor cells, while cytoskeletal components like F-actin and Titin are centered in this ring in both cell types. The cytoplasmic protein Blow colocalizes with the actin plugs in fcms after cell adhesion. Furthermore, the requirement of additional as yet unidentified components was demonstrated by using mammalian C2C12 myoblasts. In this study, we propose that the fusion-restricted myogenic-adhesive structure (FuRMAS) is pivotal in linking cell adhesion as well as local F-actin assembly and dynamics to downstream events that ultimately lead to plasma membrane fusion. Moreover, we suggest that the FuRMAS may restrict the area of membrane breakdown. 相似文献
95.
改良Indiana膀胱术的远期疗效观察 总被引:1,自引:1,他引:0
目的:评价改良Indiana膀胱术的远期疗效.方法:对26例改良Indiana膀胱术术后患者的膀胱可控性、尿动力学、肾盂输尿管扩张、上尿路感染情况、血清电解质和肾功能进行随访.结果:26例随访1~7年,平均3年.白天可控率96.2%;贮尿囊容量为380~640 ml,平均542 ml;贮尿囊内压力为1.215~3.224 kPa,平均1.921 kPa.B超、IVP造影示3 例输尿管扩张,经随访无加重.血清电解质及肾功能正常.结论:改良Indiana膀胱术远期疗效可靠,并发症少,是一种较理想的尿路分流术式. 相似文献
96.
无张力阴道吊带术治疗压力性尿失禁(附10例报告) 总被引:7,自引:0,他引:7
目的探讨无张力阴道吊带术(TVT)的手术方法、适应证及并发症的预防. 方法女性压力性尿失禁(SUI)患者10例,平均年龄52岁.漏尿病史平均7年,其中8例为轻中度SUI,加压期尿道压力>10 cmH2O,2例为重度SUI,加压期尿道压力<10 cmH2O.经阴道前壁行无张力阴道吊带术. 结果 10例SUI均得到满意的控尿效果.1例患者术后剩余尿100 ml,但主观评价明显改善.随访13~21个月,无SUI症状复发,无排尿困难及尿路感染. 结论 TVT是一种简便、快捷的SUI治疗方法,疗效满意,可以减少患者的痛苦和缩短住院时间. 相似文献
97.
98.
Rainer Hofmann Reynaldo Gomez Marshall L. Stoller Emil A. Tanagho Jack W. McAninch 《Urological research》1993,21(5):333-337
Summary Mechanisms for maintaining passive continence in the efferent limb of urinary diversions include compression of tissue, peristalsis, equilibration of pressure and use of valves. Motor activity and pressure in the ileum, ileocecal valve (ICV) and the colon were evaluated in dogs. Spontaneous activity and pressure were compared with stimulated pressure response and activity. Stimulation was performed at the pelvic nerve and the small nerves in the mesenterium, as well as direct neurostimulation of the bowel. Resting pressure at the ICV was 12.7±0.4 cmH2O rising to 26.4±2.2 cmH2O during spontaneous depolarization. Stimulation of the pelvic nerve resulted in increased colonic motor activity with unchanged pressure. Electric stimulation of small mesenterical nerves to the ICV increased pressure in the ICV to 35.0±4.1 cmH2O, while direct myoelectric stimulation of the ICV zone increased the intraluminal pressure to 75.0±3.2 cmH2O. Termination of the electric stimulation was followed by a slow decrease of pressure to the resting level a period of 30–45 s. Maintaining continence at the ICV with long-term constant or intermittent stimulation seems feasible. 相似文献
99.
Summary The surfaces of 32 encrusted urinary catheters were examined by scanning electron microscopy to investigate the association of bacteria with the encrusting deposits. Deposits consisted of struvite crystals surrounded by aggregates of very small crystallites of hydroxyapatite. Underneath these minerals there was a layer of closely packed bacteria. Impressions of bacteria were also observed in hydroxyapatite. Crystals were often engulfed by the bacterial layer, which thus appeared to bind the crystals to each other and to the catheter surface. This thick layer of bacteria associated with crystals may protect both the bacteria from antibiotics and the crystals from acidic bladder washout solutions intended to dissolve them. Furthermore, the existence of this sessile population explains why urease-producing bacteria are not invariably detected in the urine of patients with encrusted catheters. The observation of this bacterial layer (or biofilm) by scanning electron microscopy provided direct evidence for infection being implicated in catheter encrustation. 相似文献
100.
László Klujber Sándor Turi Ibolya Haszon Zsuzsa Baranyai Endre Sulyok 《Pediatric nephrology (Berlin, Germany)》1989,3(2):179-185
To assess the characteristics of connective tissue metabolism in chronic renal failure (CRF), urinary excretion of glycosaminoglycan (GAG) fractions and hydroxyproline (HYP) was determined in ten patients with CRF and in ten age-matched healthy children. CRF was found to be associated with elevated free HYP (19.9±6.1 vs 9.8±3.6 mol/day,P<0.05) and depressed peptide HYP excretion (33.1±13.5 vs 225.2±17.7 mol/day,P<0.01), a low rate of total GAG excretion (7.0±2.4 vs 16.1±1.9 mol uronic acid/day,P<0.05) with low chondroitin 4 — sulphate + chondroitin 6 — sulphate (Ch-Ss) (14.0±9.9 vs 65.0±22.1%) and a high proportion of non-sulphated or under-sulphated fractions, i.e. hyaluronic acid + chondroitin + heparan sulphate (HA+Ch+HS) (75.3±11.4 vs 31.5±5.7%). Urinary 3-methyl-histidine (3-met-HIS) excretion and plasma essential free amino acids did not differ in the two groups. In response to haemodialysis no consistent change occurred in urinary excretion of 3-met-HIS, peptide-bound HYP, total GAG or percentage distribution of individual GAG fractions. After haemodialysis all plasma amino acids decreased significantly, and there was a significant increase in urinary excretion of free HYP (P<0.05). We conclude that the alterations in urinary excretion of total and individual GAGs observed in CRF may reflect disturbed connective tissue metabolism which does not appear to be accounted for by protein malnutrition or enhanced protein breakdown and remains uninfluenced by haemodialysis therapy. 相似文献