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101.
尿道压监测下球部尿道悬吊术治疗男性获得性尿失禁 总被引:6,自引:2,他引:4
目的探讨尿道压监测下球部尿道悬吊术治疗男性获得性尿失禁的疗效。方法2000年lO月至2004年9月收治男性获得性尿失禁25例,年龄18~81岁,平均66岁。其中后尿道狭窄行尿道成形术后6例,根治前列腺切除术后4例,良性前列腺增生(BPH)行经尿道前列腺电切术(TURP)后6例,BPH行前列腺摘除术后9例。尿失禁病程1~12年,平均4年。完全性尿失禁8例,压力性尿失禁17例,需尿垫1~5块/d,平均3块/d。术前均经盆底肌锻炼无效。尿动力学检查平均最大尿道压52cm H2O(1cm H2O=0.098kPa)。平均功能性尿道长度1.4cm。均在尿道压监测下行球部尿道悬吊术。结果手术结束时平均尿道压96cm H2O,平均功能性尿道长度3.5cm。术后完全控尿21例,尿失禁改善3例,排尿困难1例,经膀胱颈部电切后排尿通畅。术后1个月B超检查剩余尿均〈20ml;23例平均最大尿流率15ml/s。随访1年以上22例,1例于术后2年死于脑溢血,2例于术后1年和2年压力性尿失禁复发,其余19例排尿和控尿良好。结论尿道压监测下球部尿道悬吊术是治疗男性尿失禁的有效方法。 相似文献
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104.
Recent evidence describing a suboptimal clinical outcome in women with
hydrosalpinges who undergo in-vitro fertilization (IVF) and embryo transfer
suggests a potential deleterious effect of this fluid on in- utero embryo
development. Consequently, we evaluated in-vitro mouse embryo development
in the presence of hydrosalpingeal fluid (HF) collected from 10 infertile
women of reproductive age. Chemical analyses showed both similarities and
differences of these fluids to reported values for fluids collected from
non-diseased Fallopian tubes. The HF had a significant deleterious effect
upon mouse embryo cleavage and development to the expanded and hatched
blastocyst stage, although the effect was variable among patients. Dilution
of HF to 30% concentration with culture medium failed to negate this
effect. This argues against the effect resulting from a relative lack of
critical, supportive component(s) in the HF. Additionally, further
experiments performed with cultures under an oil overlay significantly
reduced the embryotoxicity of the HF. This evidence suggests there may be a
lipophilic factor that can impair embryo development. The relatively poor
IVF-embryo transfer success in women with proximally patent hydrosalpinges
may be explained, at least in part, by reflux of a lipophilic embryotoxic
factor(s) into the uterine cavity.
相似文献
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106.
SANMIGUEL CP HAGIIKE M MINTCHEV MP DELA CRUZ R PHILLIPS E CUNNEEN SA CONKLIN JL SOFFER EE 《Neurogastroenterology and motility》2006,18(6):484-485
Background: Electrical stimulation (ES) of the stomach has been shown to modulate LESP. Electrical stimulation, using neural high frequency stimulation (NGES) can induce contractions of the smooth muscle of the gut. The purpose of this study was to determine if electrical stimulation of the LES can affect LESP. Methods: Four female hound dogs, weight: 20–25 kg, underwent an esophagostomy that allowed the introduction of a sleeve manometry catheter into the esophagus. They were also implanted with a pair of electrodes along the longitudinal axis of the LES. After 3 weeks of recovery, they underwent esophageal manometry recording during control and ES, performed randomly on separate days, using 4 different stimulations: 1‐Low frequency: freq: 6 cycles/min, pulse: 350 milisec, amp: 5 mAmp; 2 High‐frequency: freq: 50 Hz, pulse: 1 milisec, amp: 5 mAmp; 3‐ NGES: freq: 50 Hz, pulse:20 milisec, amp:10 volts; 4‐ High‐frequency, circular: freq: 20 Hz, pulse:1 milisec, amp:5 mAmp. All recordings were performed 1 hour after consumption of 3 ounces of canned dog food, to prevent fluctuations in LESP and under mild sedation (acepromazine 0.5 mg kg1). Tests consisted, during ES days, of 3 periods of 20 minutes each: control , stimulation and post stimulation. The effect of NGES was also tested under anesthesia and following administration of L‐NAME 50 mg kg1 IV. and also atropine 0.05 mg kg1 IV. Analysis: area under the curve (AUC) and pressure were compared among the 3 periods. Data shown as mean ± SD, ANOVA and t‐test, p < 0.05. Results: Sustained increase in LESP was observed during low frequency stimulation, 32.1 ± 12.8 vs. 42.4 ± 18.0 vs. 50.1 ± 23.6, control vs. stimulation vs. post stimulation respectively, p = 0.013. AUC also significantly increased during and after stimulation, 39,320.3 ± 15,722 vs. 51,294 ± 21,826 vs. 59,823.6 ± 28,198.4 mmHgxsec, control vs. stimulation vs. post stimulation respectively, p = 0.01. There was no significant change with other types of ES. NGES induced an initial rise in LESP followed within few seconds by relaxation with slow resumption of pressure over a 1 minute period. L‐NAME increased LESP and augmented the initial rise in LESP following NGES but markedly diminished or abolished the relaxation phase. Atropine lowered LESP and abolished the initial rise in LESP induced by NGES. Conclusions: Low frequency ES of the LES increases LESP in conscious dogs. NGES has dual effect on LESP: an initial stimulation, cholinergically mediated, followed by relaxation mediated by nitric oxide. 相似文献
107.
本实验采用性腺摘除或经假摘除手术的两性SD大鼠,其中部分动物分别予以睾酮(T)或雌二醇(E_2),观察它们在急性饥饿或非饥饿状态下血清T_4、TSH与T浓度变化。结果提示急性饥饿可使雄鼠甲状腺合成或分泌T_4和性腺分泌睾酮减少,从而不完全地抑制了雄激素所介导的对垂体TSH分泌的兴奋作用。外源性T替代虽然可以使去势雄鼠血清T浓度恢复正常,但却无兴奋TSH分泌的作用;饥饿组去势雄鼠接受外源性T后血清TSH更为减少。提示外源性T可抑制此组雄鼠垂体TSH合成及(或)释放。 相似文献
108.
EDWARD B. DIETHRICH M.D. DIOGO IVENS FERRAZ. DA CUNHA E SA M.D. ILHAN. BAHADIR M.D. OSVALDO. SANTIAGO M.D. 《Journal of interventional cardiology》1990,3(3):145-156
The proliferation of sophisticated endovascular interventions is mandating more definitive and comprehensive documentation of atherosclerotic lesions and the results of the interventional devices used in their removal. A technique with a potential to fulfill these goals, intravascular ultrasound imaging (IVUS), was evaluated against pressure gradients, arteriography, and femoral-radial indices in 11 patients with stenotic iliac lesions. The two-dimensional, real-time scans were useful in measuring pre-and posttreatment cross-sectional diameters and luminal areas for procedural assessment. Furthermore, the ultrasound scans clearly identified arterial wall calcifications, iliac veins, soft plague formations, dissections, synthetic graft anastomoses, and intravascular stents, often with definition superior to arteriography. The IVUS technique was useful in selecting interventional therapies, in particular, the need for stent implantation to control intimal flaps. Further, IVUS demonstrated its ability as a substitute for contrast arteriography in a twelfth patient with an iliac stent in whom a protocol-dictated follow-up arteriogram was contraindicated. 相似文献
109.
The authors present two cases of percutaneous cecostomy performed with a modified approach previously described for percutaneous gastrostomy and cholecystostomy. T-fastener devices were used to affix the cecum to the anterior abdominal wall; thus, the potential problem of fecal spillage was prevented. In both cases, adequate fecal drainage was provided without complication. 相似文献
110.
神经外科中高渗盐注射液应用研究进展 总被引:1,自引:0,他引:1
控制脑水肿和颅内压(ICP)升高是神经外科围手术期治疗的重要组成部分.颅脑创伤、动脉梗塞、静脉高压/梗塞、大脑内出血、蛛网膜下腔出血、肿瘤和术后脑组织水肿的治疗过程中ICP的控制都是决定患者预后的关键因素.虽然利用渗透压脱水药物是控制ICP的最基础的工具,但却缺乏前瞻性研究以指导其运用,高渗盐被认为是甘露醇的替代物,早期的数据表明每种药的用药指征最终取决于ICP的病因.在这篇综述中,我们总结了有关高渗盐(HS)治疗颅内高压的相关数据,以及这些数据和我们有关HS的经验是如何指导目前的ICP治疗的. 相似文献