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61.
Laparoscopic colposuspension is one of many new operations for treating female urinary stress incontinence. With initially
reported success rates similar to those of the traditional open procedure, it appears to combine the advantages of laparoscopy
(such as minimal invasiveness and quicker return to normal activities) with the effectiveness of the standard procedure. Different
methods and approaches are used, but endoscopic suture techniques remain difficult and time-consuming. The use of endostapling
devices for fixation of alloplastic material has been a tempting alternative. We present a case during which laparoscopic
colposuspension was performed using staples and mesh. Incontinence did not improve, and the patient suffered severe chronic
pain for 18 months postoperatively. Removal of the alloplastic material and traditional abdominal resuspension led to complete
cure. 相似文献
62.
63.
JOOP KONSTEN COR G.M.I. BAETEN KAREL DEN DULK FRANK SPAANS† 《Pacing and clinical electrophysiology : PACE》1992,15(5):825-830
Electromagnetic fields and myopotentials from skeletal muscle may interfere with the function of a cardiac pacemaker. A 65-year-old woman with a unipolar DDD cardiac pacemaker underwent dynamic graciloplasty (transposition of the gracilis muscle around the anal canal and subsequent implantation of a bipolar pulse generator to stimulate the gracilis muscle), for the treatment of fecal incontinence. This gracilis pulse generator is turned "off" with an external magnet to allow defecation. Appropriate functioning of these two pulse generators (the cardiac pacemaker and the gracilis pulse generator) was tested during implantation of the gracilis pulse generator and afterwards. It was demonstrated that the combination could be used safely in this patient. 相似文献
64.
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
65.
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
66.
Summary Subjective symptoms related to autonomic dysfunction and quantitative non invasive tests measuring both sympathetic and parasympathetic functions of the autonomic nervous system were studied among a group of 41 chlorine-alkali workers with low long-term exposure to mercury (Hg') vapour and their matched referents. The test battery included measurements of pulse rate variation in normal and deep breathing, in the Valsalva manoeuvre and in vertical tilt as well as blood pressure responses during standing and isometric work. The exposure time had been 16 years on average, and the mean exposure to Hg vapour was estimated to have been about 30 g/m3 of air. Only a tendency for a subtle reduction of cardiovascular reflex responses and a slight increase of subjective symptoms were seen in the exposed group, but no significant autonomic dysfunction was associated with the low level of exposure. 相似文献
67.
Biochemical characterisation of para-aminophenol-induced nephrotoxic lesions in the F344 rat 总被引:5,自引:0,他引:5
Kevin P. R. Gartland Frank W. Bonner John A. Timbrell Jeremy K. Nicholson 《Archives of toxicology》1989,63(2):97-106
The acute biochemical effects of the nephrotoxin p-aminophenol (PAP) were studied in detail using a combination of conventional bioanalytical and 1H-NMR spectroscopic methods. Dosing PAP (25–100 mg/kg) to male F344 rats resulted in a dose-related proximal nephropathy with consequent elevations in urinary enzymes, glucose, and urine total protein as shown by conventional methodology. 1H-NMR spectroscopy at 400 MHz of urine from PAP-treated rats also revealed a characteristic glycosuria, with concomitant amino aciduria. The increased excretion of these compounds indicates functional defects in the proximal tubule and reduced solute reabsorption efficiency. In addition, 1H-NMR urinalysis and conventional enzymatic analysis showed a dose-related lactic aciduria. Other changes detected by 1H-NMR included a dose-related reduction in the excretion of citrate (confirmed by a conventional biochemical method) and an increase in the excretion of acetate. The degree of abnormalities shown by 1H-NMR urinalysis agreed well with histopathological observations and conventional biochemical indices of nephrotoxicity. 1H-NMR urinalysis therefore serves to highlight changes in the excretion of low MW urine components not routinely studied by conventional biochemical analysis.Abbreviations ALP
alkaline phosphatase
- APAP
paracetamol
- BUN
blood urea nitrogen
- GFR
glomerular filtration rate
- GOT
glutamate oxaloacetate transaminase
- LAP
leucine aminopeptidase
- LDH
lactate dehydrogenase
- MW
molecular weight
- NAG
N-acetyl--D-glucosaminidase
- PAP
p-aminophenol
- ppm
parts per million
- TMAO
trimethylamine N-oxide
- UFR
urine flow rate 相似文献
68.
Mr N. Ishikawa S. Suda T. Sasaki T. Yamanishi H. Hosaka K. Yasuda H. Ito 《Medical & biological engineering & computing》1998,36(6):704-710
A system composed of a functional continuous magnetic stimulator (FCMS) and a saddle-type coil has been developed for non-invasive
treatment of urinary incontinence, especially stress incontinence and urge incontinence. The FCMS conditions were as follows:
2 kW maximum electrical power consumption, 800 V maximum capacitor voltage, 720 μs pulsewidth (180 μs rise time), and 5–30
Hz frequency. A frequency between 5 and 10 Hz is used to treat urge incontinence and a frequency between 25 Hz and 30 Hz is
used to treat urge incontinence. The coil (120 mm long, 90 mm wide and 50 mm thick) fits the most suitable region for this
treatment, the region from the anus to the perineum. The coil is cooled to maintain a coil temperature between 20 and 25°C
so that it can be used efficiently and safely. In experiments with anaesthetised dogs, it was confirmed that the urethral
pressure increased when the circumference of the perineum received continuous magnetic stimulation of 720 μs pulsewidth (180
μs rise time), 10Hz frequency and about 520 V capacitor voltage. This result suggests that magnetic stimulation can be effective
as a urinary incontinence therapy. 相似文献
69.
P. Vogelaere G. Savourey G. Deklunder J. Lecroart M. Brasseur S. Bekaert J. Bittel 《European journal of applied physiology》1992,64(3):244-249
Summary Classically, cold induced plasma volume reduction is explained by an increased diuresis which is generated by an inhibition of antidiuretic hormone release. However, most of the haemoconcentration appears to be reversible during rewarming. This observation weakens the former statement. The aim of this study was to clarify the mechanisms involved in the reversal of the cold induced haemoconcentration. Six young males, resting in a dorsal reclining position, were exposed successively to a thermoneutral environment (30 min), a cold environment (1° C; cold) or thermoneutrality (control) for 120 min, and during a 60-min recovery period in thermoneutral conditions. During cold stress, a reduction of 15% (i.e. 510 ml) of the plasma volume was observed, and osmolality was unchanged. After the 60-min recovery under thermoneutral conditions, plasma volume variation between the Cold and the Control experiments was reduced and reached 3% (i.e. 100 ml). This volume equalled the increased amount of urine production observed during the cold stress experiment. Haemoconcentration cannot be explained by increased urinary water loss (± 100 ml) alone. Therefore a transient shift of plasma water from vascular to interstitial spaces, due to an increase of blood pressure, could be involved in the reduction of plasma volume. 相似文献
70.
Christoph Olbricht June Mason Toshikazu Takabatake Gero Hohlbrugger Klaus Thurau Sigrid Pätz 《Pflügers Archiv : European journal of physiology》1977,372(3):251-258
Summary Experiments were designed to determine whether leakage of substances across the tubular epithelium, which are impermeant in the normal kidney, falsifies the measurement of glomerular filtration rate in acute renal failure. Permeability to those substances most commonly used for filtration rate determination, polyfructosan, inulin and ferrocyanide, was estimated by measuring their recoveries following perfusion through various nephron segments in haeme pigment, ischaemic and nephrotoxic models of actue renal failure. Late proximal recovery of14C ferrocyanide was only marginally decreased compared to controls, by a maximum of 6%. Distal recovery of polyfructosan,14C and3H inulin were depressed somewhat more, by a maximum of 11%. Urinary recovery of14C inulin was reduced by only 15% in kidneys showing severely restricted renal function. It is concluded that tubular leakage is not a feature of significance in the early phase of moderate acute renal failure, that ferrocyanide and inulin are reliable markers for the determination of nephron filtration rate and water reabsorption, and that the reduction in whole kidney inulin or polyfructosan clearance reflects primarily a reduction in glomerular filtration rate. 相似文献