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1

Posterior urethral polyp with type I posterior urethral valves: a rare association in a neonate.  

PubMed

Urethral polyp is a rare cause of bladder outlet obstruction, voiding dysfunction, and hematuria in the pediatric age group. Urethral polyps are rarely associated with other congenital urinary tract anomalies. In this study, we report a case of solitary posterior urethral polyp with type I posterior urethral valve in a 7-day-old neonate presented with urinary retention and deranged renal function. The polyp was diagnosed on cystoscopy. Transurethral resection of the polyp with posterior urethral valve fulguration was performed. Pathologic assessment revealed a fibroepithelial lesion, which was consistent with congenital posterior urethral polyp. PMID:24767515

Kesan, Krushnakumar V; Gupta, Rahul Kumar; Kothari, Paras; Gupta, Abhaya; Mudkhedkar, Kedar; Kamble, Ravikiran; Dikshit, K Vishesh

2014-06-01

2

Anterior urethral valve associated with posterior urethral valves.  

PubMed

The association of anterior urethral valve (AUV) with posterior urethral valve (PUV) is rare. A 7-month-old infant was presented at a district hospital with episodes of acute pyelonephritis. He was treated medically and a voiding cystourethrogram (VCUG) confirmed bilateral vesico-urethral reflux. The presence of concomitant AUV and PUV was not recognized. He underwent several surgical procedures, which failed. He had reflux recurrence following two antireflux procedures. He had urinary retention after each operation, which was managed by vesicostomy and perineal urethrostomy. At the age of 3.5 years, he was referred to our paediatric urology clinic. Noticing the AUV and PUV in the past VCUG, the valves were fulgurated. Urodynamic study before and 3 months after valve ablation showed a high voiding pressure. VCUG 6 months following ablation showed no reflux, but several uroflowmetric studies showed a staccato and interrupted pattern. Empirical treatment with an alpha-blocker was started. One year after treatment, a repeat VCUG showed no reflux. Uroflowmetry and urodynamic studies returned to normal. The perineal urethrostomy was closed. The child was asymptomatic after 9 months of follow up. PMID:18947585

Kajbafzadeh, A M; Jangouk, P; Ahmadi Yazdi, C

2005-12-01

3

A case of hypospadias, anterior and posterior urethral valves  

PubMed Central

This report outlines the case of a 3-year-old boy whose initial presentation was that of asymptomatic hypertension (lowest recording 148/90), found at preoperative check prior to stage 2-correction surgery for distal hypospadias. Upon diagnosis of true hypertension, an ultrasound of the child's renal tract showed evidence of marked hydronephrosis and calyceal dilatation. On the background of deteriorating renal function (Urea 25.5 and Creatinine 188), a Micturating Cystourethrogram was performed, demonstrating posterior urethral dilatation. With difficulties controlling blood pressure, the child was transferred to Urology care, where resection of a posterior urethral valve (PUV) was undertaken. Despite this, renal function deteriorated further and re-cystoscopy identified an anterior urethral valve (AUV), which was also resected. Renal function, although improved, remains poor and blood pressure is controlled with two anti-hypertensives. To the publisher's knowledge, the association between hypospadias, PUVs and AUVs is as yet undocumented. PMID:24964414

Carvell, James; Mulik, Roopa

2013-01-01

4

A case of hypospadias, anterior and posterior urethral valves.  

PubMed

This report outlines the case of a 3-year-old boy whose initial presentation was that of asymptomatic hypertension (lowest recording 148/90), found at preoperative check prior to stage 2-correction surgery for distal hypospadias. Upon diagnosis of true hypertension, an ultrasound of the child's renal tract showed evidence of marked hydronephrosis and calyceal dilatation. On the background of deteriorating renal function (Urea 25.5 and Creatinine 188), a Micturating Cystourethrogram was performed, demonstrating posterior urethral dilatation. With difficulties controlling blood pressure, the child was transferred to Urology care, where resection of a posterior urethral valve (PUV) was undertaken. Despite this, renal function deteriorated further and re-cystoscopy identified an anterior urethral valve (AUV), which was also resected. Renal function, although improved, remains poor and blood pressure is controlled with two anti-hypertensives. To the publisher's knowledge, the association between hypospadias, PUVs and AUVs is as yet undocumented. PMID:24964414

Carvell, James; Mulik, Roopa

2013-01-01

5

Single piece artificial urinary sphincter for secondary incontinence following successful repair of post traumatic urethral injury  

PubMed Central

Post traumatic urethral injury is uncommon in children. The management of this condition is dependent on the severity of injury. Initial suprapubic cystostomy with delayed repair is the conventional treatment. Successful reconstruction of urethral injury may be followed by urethral stricture, incontinence, impotence, and retrograde ejaculation. Successful repair of post traumatic urethral injury followed by secondary incontinence in children has not been well addressed in literature. We report the management of one such child, with satisfactory outcome with implantation of a new model of single piece artificial urinary sphincter in the bulbar urethra by perineal approach. PMID:24347870

Kandpal, D. K.; Rawat, S. K.; Kanwar, S.; Baruha, A.; Chowdhary, S. K.

2013-01-01

6

Technical note: Dynamic MRI in a complicated giant posterior urethral diverticulum  

PubMed Central

Congenital posterior urethral diverticulum is an uncommon anomaly, sometimes complicated by infection or calculi formation. A conventional voiding cystourethrogram (VCUG) is the most commonly used diagnostic modality. Dynamic magnetic resonance imaging (MRI) has not been frequently described in this entity. We describe a case of posterior urethral diverticulum complicated with secondary calculi, where the patient was evaluated using dynamic MRI and conventional VCUG. PMID:21423908

Kundum, Prasad R; Gupta, Arun K; Thottom, Prasad V; Jana, Manisha

2010-01-01

7

Urethritis  

MedlinePLUS

... papilloma virus (HPV), which causes venereal warts, and HIV Urethritis caused by injury or chemical irritation is diagnosed based on your medical history and the absence of an infectious cause. Expected ...

8

Delayed repair is the ideal management for posterior urethral injuries- FOR the motion  

PubMed Central

Posterior urethral injuries are seen in trauma cases with pelvic fracture. The time-tested and honored method of management is immediate supra-pubic diversion followed by delayed repair. Immediate alignment as a management option is not new. It was abandoned 30 years ago due to high incidence of incontinence and impotence. However, of late there is a tendency towards immediate management of these injuries with various endoscopic maneuvers. Unfortunately, there is little evidence supporting this. Even these evidences are of limited in number and of limited duration of follow-up. PMID:20877619

Philipraj, S. Joseph

2010-01-01

9

Endourologic reconstruction of post-traumatic obliterated urethral stricture in a young female: a point of technique  

Microsoft Academic Search

Introduction. A simple endourologic technique for reconstruction of a post-traumatic obliterated urethra in a young unmarried woman is described as an alternative management to complex open urethral reconstruction.Technical Considerations. A 20-year-old woman presented with a post-traumatic obliterated urethra after a road traffic accident. The cystogram at 6 weeks did not reveal a bladder neck or urethra. The examination under anesthesia

P. N Dogra; G Nabi

2001-01-01

10

Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap  

PubMed Central

Purpose We evaluated the preoperative clinical factors that affect the surgical outcome of posterior urethral anastomosis (PUA) with a gracilis muscle flap (GMF) to determine which factors predict benefit from the use of the GMF. Materials and Methods This was a retrospective analysis of 49 patients who underwent a delayed PUA with a GMF. A successful clinical outcome was defined as achieving a peak urinary flow rate greater than 15 mL/s at 3 and 12 months postoperatively without evidence of stricture recurrence on a retrograde urethrogram or cystourethroscopy at 3 months postoperatively. Multiple clinical factors were evaluated by use of univariate and multivariate analyses. Results The outcome of 21 of 49 patients (42.9%) was deemed successful. The mean age of the 49 patients was 37.2±13.5 years and the mean follow-up duration was 43.4±28.0 months. The length of the urethral defect was significantly shorter in patients with a successful outcome than in patients with an unsuccessful outcome (p=0.010). The outcome differed significantly depending on whether the patients had a previously successful urethroplasty (p=0.036) or whether they had suffered a pelvic bone injury (p=0.012). Multivariate logistic regression analyses revealed that a previous urethroplasty was the only preoperative clinical factor that significantly affected the surgical outcome in PUA with a GMF (odds ratio, 0.218; 95% confidence interval, 0.050 to 0.947; p=0.042). Conclusions A history of previous urethroplasty is a preoperative clinical factor that significantly affects the surgical outcome in PUA with a GMF; the procedure is more likely to be successful in patients who have not previously undergone urethroplasty. PMID:24175047

Hwang, Jin Ho; Kang, Moon Hyung; Lee, Young Tae; Park, Dong Soo

2013-01-01

11

Which Patients Are at Higher Risk for Residual Valves After Posterior Urethral Valve Ablation?  

PubMed Central

Purpose To find patients at high risk of obstructive remnant leaflets after valve ablation among boys with posterior urethral valve (PUV), we evaluated any possible relationship between preoperative findings in our patients and residual obstructive leaflets after valve ablation. Materials and Methods We retrospectively reviewed the medical records of 55 patients with PUV that was treated by the same surgeon between 2008 and 2012. Of these, 37 patients (67.3%) had no obstructive remnant leaflets (group A) and 18 patients (32.7%) had obstructive remnant leaflets (group B) in follow-up cystoscopy. Preoperative clinical and radiological findings were evaluated and compared between the groups. Results Among all the preoperative data we examined, the analysis revealed that age at the time of surgery (median age: group A, 15 months; group B, 7 months; p=0.017), echogenicity of kidneys (p<0.05), presence of vesicoureteral reflux (p<0.05), and grade of reflux (p<0.05) were significantly different between the groups. Method of valve ablation, anterior-posterior diameters of the renal pelvis, renal cortical thickness, bladder wall thickening, and scarring on the dimercaptosuccinic acid scan showed no significant differences between the two groups. Conclusions In our patients, younger age at surgery time, hyperechogenicity of renal parenchyma, presence of vesicoureteral reflux, and grade 4 or 5 reflux before surgery had a significant relationship with residual valves. More studies may result in enhanced management of patients at high risk of residual valves after PUV ablation, because the sooner the obstruction is resolved entirely, the better the outcome. PMID:24466400

Shirazi, Mehdi; Natami, Mohammad; Izadpanah, Kiomars; Malekahmadi, Amir; Khakbaz, Abbasali

2014-01-01

12

Arthroscopic anterior and posterior labral repair after traumatic hip dislocation: case report and review of the literature.  

PubMed

With the improvements in flexible instrumentation, hip arthroscopy is being increasingly used to treat a variety of hip pathology, including labral tears. However, up to this point, there has not been a case report of an anterior and a posterior labral tear successfully repaired arthroscopically. We present a case report of a 27-year-old male firefighter who presented to our institution with an anterior and posterior labral tear, as well as a cam lesion and loose body, following a traumatic hip dislocation. The purpose of this case report is to illustrate that both anterior and posterior labral tears can be repaired using hip arthroscopy. Anterior and posterior labral tears can be caused by a traumatic hip dislocation, and both can be successfully repaired using arthroscopic techniques. PMID:21886540

Cross, Michael B; Shindle, Michael K; Kelly, Bryan T

2010-09-01

13

Traumatic posterior hip dislocation and ipsilateral distal femoral fracture in a 22-month-old child: a case report.  

PubMed

Minor trauma may cause hip dislocation in young children because of physiologic hip joint laxity and the soft cartilaginous structure of the acetabulum. In this work, we report on a 22-month-old boy with right-sided traumatic posterior hip dislocation and ipsilateral distal femoral fracture because of an outdoor motor vehicle accident. The patient was treated with emergency closed reduction and one and a half hip spica under general anaesthesia. The femoral fracture and hip dislocation were healed smoothly without any complication. Traumatic hip dislocation is rare in children, which may occur after trivial trauma. Prognosis is better in younger patients with low-energy trauma and in cases treated early. PMID:25075766

Ciftdemir, Mert; Aydin, Deniz; Ozcan, Mert; Copuroglu, Cem

2014-11-01

14

Congenital giant male anterior urethral diverticulum with calculi.  

PubMed

Urethral diverticulum is a sac-like outpouching of urethral mucosa. It may be anterior or posterior according to anatomical locations. It is less common in men than in women. It can be congenital or acquired. Anterior urethral diverticula are usually congenital as compared to majority of posterior diverticula which are acquired. The most common aetiologies of male acquired diverticula are stricture, abscess, trauma or post-hypospadias repair. We report a case of congenital giant anterior urethral diverticulum with a calculus which has been managed successfully with surgical excision and repair in two layers. PMID:24567184

Kamal, Mir Reza; Jindal, Tarun; Sinha, Rajan Kumar; Karmakar, Dilip

2014-01-01

15

Traumatic Acute Subdural Hematoma Extending from the Posterior Cranial Fossa to the Cerebellopontine Angle  

PubMed Central

Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We present this case to emphasize that minor head trauma may lead to a posterior cranial fossa hematoma extending to the cerebellopontine angle and cause peripheral facial palsy in patients using aspirin (acetylsalicylic acid). In addition, partial evacuation and waiting for the resorption of the hematoma may help to prevent damage to the 7th and 8th cranial nerves. PMID:19844633

Sonmez, Erkin; Yilmaz, Cem; Altinors, Nur

2009-01-01

16

Treatment of traumatic radioulnar synostosis by excision, with interposition of a posterior interosseous island forearm flap  

Microsoft Academic Search

A 21-year-old man had proximal radioulnar synostosis 10 months after fracture of the proximal radius and the ulna. The bony bridge was excised and a direct posterior interosseous island flap was interposed as a biological barrier. One year after surgery, the range of forearm rotation was 65?. There was no radiographic evidence of recurrence.

M. Sugimoto; K. Masada; H. Ohno; T. Hosoya

1996-01-01

17

Traumatic posterior atlantoaxial dislocation without related fractures of C1-C2  

PubMed Central

Posterior dislocation without any associated fracture of odontoid is exceedingly rare and only 11 cases have been reported so far. A 32 year old male presented with pain, stiffness in neck, difficulty in breathing, associated lacerations on face and deformity of mandible and inability to open mouth. His plain radiographs, CT scan, MRI demonstrated a posterior dislocation of the atlas with respect of axis and a flake of bone from odontoid process on CT scan. He was successfully managed by closed reduction, C1C2 lateral mars pedicular screw stabilization and inter facetal fusion with synthetic bone graft substitute. At 10 months followup he had lost only 30° cervical rotation. The case is reported in view of rarity and to discuss the treatment rationale. PMID:24379471

Kambali, Maruti; Anand, HS Vijay; Priyamargavi, H; Varma, Ram Bhupal

2013-01-01

18

A new technique for closed reduction of traumatic posterior dislocations of the hip: the 'PGI technique'.  

PubMed

Many techniques have been described for closed reduction of posterior hip dislocations, but most require forceful and sustained traction, assistants to stabilise the pelvis and awkward positioning of the surgeon and/or the patient. We describe a new technique of closed reduction that does not need traction-countertraction or special positioning and can be safely and effectively performed by one surgeon.Fifteen patients, mean age 36.4 years, were subjected to reduction. There were five type I, four type II and six type III dislocations; ipsilateral injuries included one knee dislocation with patellar fracture, and two cases of tibia fracture. Closed reduction was achieved in 14 (93.3%) hips, with single attempt successful in 13 cases, while one needed two attempts. One hip could not be reduced due to incarceration of a posterior wall fragment and was managed by open reduction and internal fixation.Our new technique has proved to be a reliable, safe and effective alternative for closed reduction of posterior hip dislocations. It can be carried out by one surgeon, does not need traction and can be especially beneficial in polytrauma patients and also in those patients who have pelvic fractures and ipsilateral lower limb injuries. PMID:24817398

Sharma, Siddhartha; Kumar, Vishal; Dhillon, Mandeep S

2014-01-01

19

A Case of Post-radiotherapy Urethral Stricture with Spontaneous Bladder Rupture, Mimicking Obstructive Uropathy due to Cancer Metastasis  

PubMed Central

Non-traumatic, spontaneous urinary bladder rupture is a rare complication of urethral stricture. Furthermore, its symptoms are often nonspecific, and misdiagnosis is common. The authors experienced a case of urethral stricture with spontaneous bladder rupture and bilateral hydronephrosis, mimicking obstructive uropathy attributed to cancer metastasis. A 55-year-old woman was admitted with abdominal pain and distension, oliguria, and an elevated serum creatinine level. She had undergone radical hysterectomy for uterine cervical cancer and received post-operative concurrent chemoradiation therapy 13 years previously. Non-contrast enhanced computed tomography showed massive ascites and bilateral hydronephrosis. The initial diagnosis was acute kidney injury due to obstructive uropathy caused by malignant disease. After improvement of her renal function by bilateral percutaneous nephrostomy catheterization, contrast-enhanced computed tomography and a cytologic examination of ascites showed no evidence of malignancy. However, during retrograde pyelography, a severe urethral stricture was found, and subsequent cystography showed leakage of contrast into the peritoneal cavity and cystoscopy revealed a defect of the posterior bladder wall. After urethral dilatation and primary closure of the bladder wall, acute kidney injury and ascites were resolved. PMID:25061470

Shin, Jun Young; Yoon, Sang Min; Choi, Hyuck Jae; Lee, Si Nae; Kim, Hai Bong; Joo, Woo Chul; Song, Joon Ho; Kim, Moon-Jae

2014-01-01

20

Urethral obstruction from dislodged bladder Diverticulum stones: a case report  

PubMed Central

Background Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. Case presentation A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP) and was lost to follow up. He re-presented with retained urethral catheter of 4months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury. Conclusions Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy. PMID:23134722

2012-01-01

21

Parameatal urethral cyst.  

PubMed

Cyst formation in the parameatal area of the urethra is an uncommon entity. It was first reported in two male cases as recently as 1956 by Thompson and Lantin. Further reports have been rare. Herein, we report a case of a 21 year-old male having a spherical, cystic swelling 1 cm in size at the external urethral meatus. The diagnosis of parameatal urethral cyst was made and the cyst was excised. Histopathological examination revealed a monolocular cyst lined with transitional cells. The postoperative period was uneventful. PMID:18814338

Aggarwal, Kamal; Gupta, Sanjeev; Jain, Vijay Kumar; Goel, Ashish

2008-01-01

22

Traumatic pseudophacocele.  

PubMed

A 70-year-old man presented with blunt trauma to his pseudophacic eye, resulting in subconjunctival dislocation of the posterior chamber intra-ocular lens. This rare incidence of traumatic pseudophacocele, occurring 5 years after cataract surgery and how its management salvaged useful vision is reported here. PMID:15871363

Bandyopadhyay, Rakhi; Banerjee, Anita; Bhaduri, Gautam; Singh, Maneesh

2004-12-01

23

Evrim Bougie: A new instrument in the management of urethral strictures  

PubMed Central

Background In this study a new instrument and technique is described for the endoscopic treatment of complete posterior urethral strictures, which may result in serious complications and sometimes require troublesome treatments. Methods Three patients with complete posterior urethral obstruction were treated endoscopically with the guidance of a new instrument: Evrim Bougie. Evrim Bougie looks like a Guyon Bougie, has a curved end, which facilitates getting into the bladder through the cystostomy tract and with a built in channel of 1.5 mm in diameter for a sliding needle exiting at its tip. Having confirmed fluoroscopically and endoscopically that the sliding needle had passed across the strictured segment, the strictured segment was incised with internal urethrotomy, distal to the strictured segment, and urethral continuity was accomplished. At the end of the operation a Foley urethral catheter was easily placed into the bladder per urethra. Patients were instructed in self-catheterization after removal of the urethral catheter. All patients achieved normal voiding at postoperative 7th month follow-up evaluation. Conclusion Internal urethrotomy could be performed under the guidance of the sliding needle of Evrim Bougie advanced from above the posterior urethral strictures, which to our knowledge was described for the first time in the English literature. We also believe that there may be other possible indications of Evrim Bougie for different procedures in urethral surgery. PMID:11545678

Yilmaz, Ugur; Gunes, Ali; Soylu, Ahmet; Balbay, Mevlana Derya

2001-01-01

24

Current Management of Urethral Stricture  

PubMed Central

The surgical treatment of urethral stricture diseases is continually evolving. Although various surgical techniques are available for the treatment of anterior urethral stricture, no one technique has been identified as the method of choice. This article provides a brief updated review of the surgical options for the management of different sites and different types of anterior urethral stricture. This review also covers present controversies in urethral reconstruction. Among the various procedures available for treating urethral stricture, one-stage buccal mucosal graft urethroplasty is currently widely used. The choice of technique for urethroplasty for an individual case largely depends on the expertise of the surgeon. Therefore, urologists working in this field should keep themselves updated on the numerous surgical techniques to deal with any condition of the urethra that might surface at the time of surgery. PMID:24044088

Lee, Young Ju

2013-01-01

25

Adjunctive endourological technique for transurethral resection in patients with urethral stricture.  

PubMed

Attempts to dilate the urethra with metal sounds and to insert a resectoscope sheath with the metal obturator can be traumatizing in patients with urethral stricture or false passage. We describe a simple technique that uses endourological instruments to facilitate insertion of the resectoscope sheath and placement of the post-resection Foley catheter. PMID:2724436

Chiou, R K; O'Brien, W M; O'Connor, K P

1989-06-01

26

21 CFR 876.5520 - Urethral dilator.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5520 Urethral dilator. (a) Identification. A urethral dilator...

2013-04-01

27

21 CFR 876.5520 - Urethral dilator.  

Code of Federal Regulations, 2010 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5520 Urethral dilator. (a) Identification. A urethral dilator...

2010-04-01

28

21 CFR 876.5520 - Urethral dilator.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5520 Urethral dilator. (a) Identification. A urethral dilator...

2012-04-01

29

21 CFR 876.5520 - Urethral dilator.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5520 Urethral dilator. (a) Identification. A urethral dilator...

2014-04-01

30

21 CFR 876.5520 - Urethral dilator.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5520 Urethral dilator. (a) Identification. A urethral dilator...

2011-04-01

31

Selective control by posterior spinal nerve roots of micturition and erection in rats?  

PubMed Central

The posterior rootlets in L6 and S1 spinal cord of adult male Sprague-Dawley rats underwent electrostimulation. The bladder pressure, urethral perfusion pressure and intracavernous pressure were recorded. When some posterior rootlets of L6 and S1 were electrostimulated, the intracavernous pressure peaked rapidly, but the bladder pressure and the urethral perfusion pressure curve did not show great change. When other rootlets were stimulated, the bladder pressure changed greatly, but the urethral perfusion pressure and the intracavernous pressure did not show great change. When different rootlets were stimulated, the urethral perfusion pressure changed maximally, but there were no great changes in bladder pressure or intracavernous pressure. Furthermore, stimulation of some rootlets produced simultaneous changes in two or three different pressure measures mentioned above. The results demonstrate that regulation by L6 and S1 posterior rootlets of the rat bladder detrusor, external urethral sphincter and penis cavernous body are significantly distinct. Different rootlets can be distinguished by electrostimulation.

Wang, Wenting; Zhou, Mouwang; Zhu, Genying; Li, Tao; Liu, Nan

2012-01-01

32

Anterior Urethral Valves: Not Such a Benign Condition...  

PubMed Central

Purpose: Anterior urethral valves (AUVs) is an unusual cause of congenital obstruction of the male urethra, being 15–30 times less common than posterior urethral valves (PUVs). It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV, with less hydronephrosis, and a lower incidence of chronic renal insufficiency (5 vs. 30%). The long-term prognosis of AUVs is not clear in the literature. In this report we describe our experience and long-term follow up of patients with anterior urethral valve. Materials and Methods: We retrospectively identified 13 patients who presented with the diagnosis of AUVs in our institutions between January 1994 and June 2012. Two patients were excluded: one patient had no follow up after intervention; the other had a follow up <1?year. From the 11 patients included, we evaluated the gestational age, prenatal and postnatal ultrasound findings, voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine, and clinical follow up. Results: Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves. Of this group, 11 patients (7.3%) had AUVs and an adequate follow up. Mean follow up is 6.3?years (2.5–12?years). Five (45.4%) patients had prenatal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder. One patient showed a large perineal cystic mass, which was confirmed to be a dilated anterior urethra. The mean gestational age was 37.6?weeks (27–40 WGA). Postnatally, 90% had trabeculated bladder, 80% hydronephrosis, and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in five patients (45.4%), followed by weak urinary stream found in four patients (36.3%). The age at initial surgical intervention ranged between 7?days and 13?years. Seven (63.6%) patients had primary transurethral valve resection or laser ablation and three patients (27.2%) had primary vesicostomies. One boy (9.1%) had penile urethrostomy with excision of urethral diverticulum. Two (18.2%) patients developed end-stage renal disease. Conclusion: Anterior urethral valve is a rare congenital entity affecting the genitourinary system in males. Early urinary tract obstruction resulted in end-stage renal disease in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUVs we recommend long-term follow up and close evaluation of patient’s bladder and renal function. PMID:24400281

Cruz-Diaz, Omar; Salomon, Anahi; Rosenberg, Eran; Moldes, Juan Manuel; de Badiola, Francisco; Labbie, Andrew Scott; Gosalbez, Rafael; Castellan, Miguel Alfredo

2013-01-01

33

A radially expanding sheath for urethral dilation.  

PubMed

Urethral trauma caused by urethral dilation often leads to complications including gross hemorrhage and inflammation. The injury of the urethral mucosa is, in a large part, due to the shearing forces imposed on it during the introduction of dilation devices. In this article, a radially expanding sheath for urethral dilation is hypothesized by the authors. This device aims to reduce the axial forces during the insertion of dilators, thereby protecting the urethral mucosa from friction. When performing the endoscopy, the device could act as a barrier between urethral mucosa and the endoscope. Moreover, in the situation of encountering difficulties in catheterization, the sheath could also be used as a guide-wire to lead the catheter through its lumen course. Thus, it is proposed that this radially expanding sheath could be a potential powerful approach for reducing the risks and complications of urethral dilation. PMID:19589646

Hu, Zheng; Ma, Xin; Li, Hong-zhao; Wang, Chao; Ye, Da-wei; Gong, Dao-jing; Zhang, Xu

2009-10-01

34

Evaluation of healing at urethral anastomotic site by pericatheter retrograde urethrogram in patients with urethral stricture  

PubMed Central

Introduction: Stricture urethra has been always a surgical challenge. Different opinions regarding time require healing at anastomotic site after urethroplasty, so various strategies are there regarding time for post-operative catheter removal. In this study, healing was assessed by pericatheter retrograde urethrogram (PUG) before the catheter removal. Materials and Methods: Prospective study was conducted from January 2006 to December 2009. Twenty eight cases of short-segment urethral stricture (<2 cm) who underwent urethroplasty were included and divided into two groups depending upon etiology; post-traumatic group (road traffic accident/straddle type injury) and iatrogenic stricture group (due to prolong catheterization/after cystoscopy/Faulty Foleys balloon placement). Post-operative PUG was done on 14th post-operative day in all patients for healing assessment. Extravasation of dye on PUG was taken as anastomotic leak. If the patient had not showed extravasation, the catheter was removed. Otherwise it was kept further for next one week and again PUG was done for healing assessment. Results: Extravasation of dye was noted in 4 patients (33%) of iatrogenic group and 14 patients (87.5%) of the post-traumatic group on 14th post-operative day PUG. (P ? 0.05). The decision to remove catheter was depended upon PUG finding and it was safe, no complication was developed in any patient. Conclusion: Iatrogenic strictures have better healing than post-traumatic stricture in the post-operative period. PUG is a safe and simple procedure and can guide about safe removal of catheter in the post-operative period. PMID:25371610

Solanki, Shailesh; Hussain, Shabbir; Sharma, Deepti B.; Solanki, Fanindra S.; Sharma, Dhananjay

2014-01-01

35

Management of Traumatic Brain Injury  

Microsoft Academic Search

In the past years several recommendations have been published concerning the diagnostic work-up and treatment of patients with traumatic brain injury (TBI). They show that with regard to the surgical management of acute epidural hematomas, acute subdural hematomas, traumatic parenchymal lesions, posterior fossa mass lesions, as well as depressed skull fractures there is a lack of controlled studies, which would

Hans-Georg Imhof; Philipp M. Lenzlinger

2005-01-01

36

Urethral Diverticula and Other Periurethral Masses  

Microsoft Academic Search

Urethral diverticula may represent some of the more challenging diagnostic and reconstructive cases in urology. Women with\\u000a lower urinary tract symptoms, pelvic pain, or vaginal masses are often referred to a urologist or gynecologist as diagnostic\\u000a dilemmas. A portion of these patients are subsequently found to have urethral diverticula. However, urethral diverticula represent\\u000a only one of several types of pathologic

Eric S. Rovner; William I. Jaffe

37

Urinary abnormalities in non gonococcal urethritis.  

PubMed Central

The association between urinary abnormalities detected by the two-glass urine test and objective urethritis was investigated in a study of 221 male patients with non-gonococcal urethritis. A strong correlation existed between urinary threads and urethritis, but use of the test for diagnosis and in the assessment of cure is limited by its poor predictive value in both treated and untreated patients. PMID:7326552

Munday, P E; Altman, D G; Taylor-Robinson, D

1981-01-01

38

Tissue engineering in urethral reconstruction.  

PubMed

Urethral strictures are one of the most common urological problems, yet the natural limitations of wound healing and the physiologic demands on the anatomic structures combine to also make urethral strictures one of the most challenging urological problems to manage. Proper wound healing demands well approximated edges because prolonged inflammation and granulation, required to close large, deep wounds, will result in excess collagen production, fibrosis, and the formation of a scar or, in the urethra, a stricture. Biomaterials have successfully been used to approximate the ECM of several different tissue types and can define a three dimensional space suitable for the formation of new tissues with both appropriate structure and appropriate function. Biomaterials can be broadly categorized as either synthetic polymers or tissue matrices, each with their advantages and limitations. Recent studies utilizing cell seeded natural biomaterials in urethral repair has yielded some promising results. However, advancements in the use of alternative sources of cells for matrix seeding and cell-seeded synthetic materials hold the possibility of even better results in the future. PMID:24531669

Cui, Tao; Terlecki, Ryan; Atala, Anthony

2014-01-01

39

Novel approach for correction of urethral prolapse using a retropubic sling with urethral fixation.  

PubMed

We describe the novel management of a 68-year-old postmenopausal woman with urethral mucosal prolapse, stress urinary incontinence, and significant pelvic organ prolapse. Successful surgical management of her urethral prolapse was achieved using a retropubic suburethral sling with urethral fixation at the time of anti-incontinence and pelvic reconstructive surgery. PMID:19198753

Levin, Pamela; Harvie, Heidi S; Guerette, Nathan L

2009-08-01

40

Urethritis in women attending an STD clinic  

Microsoft Academic Search

Of an unselected group of 159 women attending a sexually transmitted diseases (STD) clinic 20% (32) had symptoms of urethritis. A positive correlation existed between the finding of more than 10 polymorphonuclear leucocytes (PMNL) per high-power field in the Gram-stained urethral smear and the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. Conversely, these organisms were rarely isolated if

J E Wallin; S E Thompson; A Zaidi; K H Wong

1981-01-01

41

Penile Fracture with Associated Urethral Rupture  

PubMed Central

Penile fracture of the erect penis is an uncommon but emergent urological trauma. Potential outcomes include erectile dysfunction, penile curvature, and urethral injury. Treatment is emergent surgical repair. We present the case of a 42-year-old man with a penile fracture complicated by a urethral rupture and subsequent repair. A discussion of the key aspects of this condition is presented. PMID:21076536

Boncher, Nicholas A.; Vricella, Gino J.; Jankowski, Jason T.; Ponsky, Lee E.; Cherullo, Edward E.

2010-01-01

42

Mycoplasma genitalium: a cause of male urethritis?  

PubMed Central

BACKGROUND--Male urethritis may be caused by mycoplasmas. Since Mycoplasma genitalium has previously been isolated from the urethra of two men with non-gonococcal urethritis (NGU), it was the aim of the study further to elucidate its role by measuring the prevalence of this organism in men with NGU. MATERIAL AND METHODS--The polymerase chain reaction was used. Two different sequences of the gene coding for the main adhesin MgPa were amplified. Urethral, rectal, and throat samples from 99 male sexually transmitted disease (STD) patients with and without urethritis were studied. RESULTS--M genitalium DNA was demonstrated in 17/99 (17%) of the urethral swabs, but in none of the rectal and throat swabs. Significantly more patients with urethritis (13/52) were positive for M genitalium DNA than were patients without urethritis (4/47) (p < 0.03). In those with urethritis M genitalium DNA was found more often in Chlamydia trachomatis negative NGU (12/34) than in those with chlamydial NGU (1/14) (p = 0.05). Attempts to culture M genitalium from the PCR positive specimens were unsuccessful. CONCLUSION--M genitalium DNA was found significantly more often in male STD patients with non-chlamydial NGU than in men with chlamydial urethritis (p = 0.05) and in men without urethritis (p = 0.003), suggesting that M genitalium may be a cause of NGU. M genitalium DNA was not demonstrated in any of the throat or rectal swabsindicating that the urogenital tract is probably the primary site of infection or colonisation of this species. PMID:7721285

Jensen, J S; Orsum, R; Dohn, B; Uldum, S; Worm, A M; Lind, K

1993-01-01

43

[Internal urethrotomy, a modern method in the treatment of urethral strictures].  

PubMed

The aim of this study was to evaluate the internal urethrotomy in the treatment of urethral strictures, by the retrospective analysis of 54 cases. The patients' age ranged between 18-92. 35 patients (64.8%) had iatrogenic strictures and 10 (18.5%) had traumatic ones. 35 patients presented with urinary infections before the procedure. Following internal urethrotomy, the medium hospital stay was 3.15 days. There were only 7 patients with postoperative fever and no death was recorded. The follow-up period was between 1-12 months with a medium of 9 months and only 2 patients required recurrent internal urethrotomy. Out of the 54 patients, 8 had recurrent urethral stricture disease and 6 of them had posttraumatic membranous urethral strictures. Optical internal urethrotomy appears to be the ideal therapeutic method of urethral strictures, because it has a low morbidity, it is safe to perform and the postoperative results are good. The hospitalization and the recovery periods are short, allowing a quick socio-professional reintegration. Most of the recurrencies occur with posttraumatic strictures. PMID:14756032

Gheorghiu, V; Radu, V D; Costache, C; Stef?nescu, R

2003-01-01

44

The urethral smear as a tool in diagnosing adenovirus-induced urethritis.  

PubMed

Adenovirus is a recognised cause of non-gonococcal urethritis, and is not uncommonly associated with extragenital signs and symptoms. This case report describes a patient with symptoms of conjunctivitis, meatitis and urethritis. The urethral smear revealed almost exclusively monocytes microscopically, raising the suspicion of a viral aetiology. Results confirmed the presence of adenovirus in both the eyes and urethra. Despite waning reliance on the urethral smear in sexual health clinics, it can still be an important diagnostic tool in assessing the aetiology of non-specific urethritis. Finding an obvious monocytic cell response in the urethral smear can indicate a viral cause and allow the clinician to optimise management, counsel appropriately, and potentially reduce unnecessary antibiotic use. PMID:24737883

Tønsberg, E; Hartgill, U

2014-12-01

45

Multiple Urethral Stones Causing Penile Gangrene  

PubMed Central

Penile urethral stones are a rare occurrence resulting from a number of causes including migration of stones within the urinary tract, urethral strictures, meatal stenosis, and obstructing tumours such as adenomatous metaplasia of the uroepithelium, hypospadias, urethral diverticulum, and very rarely primary fossa navicularis calculi. We report the case of a 54-year-old male presenting with penile gangrene and sepsis resulting from impaction of multiple stones within the penile urethra. This paper summarises the topic and discusses the pathophysiology of this unusual condition. PMID:24963438

Ramdass, Michael J.

2014-01-01

46

Nephrogenic adenoma in a urethral diverticulum.  

PubMed

Nephrogenic adenoma (NA) is a rare finding that represents metaplasia of the urothelium. We present a case of a 46-year-old woman who presented with a symptomatic anterior vaginal wall cyst that was found to be an NA within a urethral diverticulum. Although this remains an infrequently reported entity in the literature, prevalence has been shown to be higher in consecutive case series than what may be presumed by the rarity of case reports in clinical literature. Nephrogenic adenoma within a urethral diverticulum may represent an under-recognized entity which needs to be carefully distinguished from clear cell adenocarcinoma occurring within urethral diverticula. We discuss salient clinical features of NA occurring within a urethral diverticulum and describe a review of literature of published cases to date. PMID:25185615

Gujral, Harneet; Chen, Haiyang; Ferzandi, Tanaz R

2014-01-01

47

Mycoplasma genitalium: a cause of male urethritis?  

Microsoft Academic Search

BACKGROUND--Male urethritis may be caused by mycoplasmas. Since Mycoplasma genitalium has previously been isolated from the urethra of two men with non-gonococcal urethritis (NGU), it was the aim of the study further to elucidate its role by measuring the prevalence of this organism in men with NGU. MATERIAL AND METHODS--The polymerase chain reaction was used. Two different sequences of the

J S Jensen; R Orsum; B Dohn; S Uldum; A M Worm; K Lind

1993-01-01

48

Urethral malignant melanoma closely mimicking urothelial carcinoma.  

PubMed Central

Primary malignant melanoma of the urethra is very rare. In the male, the distal urethra is the most common site. The histopathology does not usually differ from that of melanoma at other body sites. This report describes a case of urethral malignant melanoma which closely resembled urethral carcinoma. It showed both papillary and solid growth, and the diagnosis only became apparent from special stains. Pathologists should be aware of this rare occurrence. Images PMID:9155678

Radhi, J M

1997-01-01

49

Male urethral strictures and their management  

PubMed Central

Male urethral stricture disease is prevalent and has a substantial impact on quality of life and health-care costs. Management of urethral strictures is complex and depends on the characteristics of the stricture. Data show that there is no difference between urethral dilation and internal urethrotomy in terms of long-term outcomes; success rates range widely from 8–80%, with long-term success rates of 20–30%. For both of these procedures, the risk of recurrence is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures. Analysis has shown that repeated use of urethrotomy is not clinically effective or cost-effective in these patients. Long-term success rates are higher for surgical reconstruction with urethroplasty, with most studies showing success rates of 85–90%. Many techniques have been utilized for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques. PMID:24346008

Hampson, Lindsay A.; McAninch, Jack W.; Breyer, Benjamin N.

2014-01-01

50

A case of parameatal urethral cyst with calculi.  

PubMed

Parameatal urethral cyst is very rare. Although 15 cases have been reported in Japan, no case of parameatal urethral cyst with calculi has previously been reported. We report the first case of parameatal urethral cyst with calculi in a 22-year-old female patient. PMID:8266865

Shibayama, T; Nakashima, J; Nakamura, S; Morinaga, S

1993-10-01

51

The thermal effect of urethral warming during cryosurgery  

Microsoft Academic Search

Summary The heating effect of urethral warming during cryosurgery has been investigated theoretically, via heat transfer simulations. Two warmer configurations have been considered: (i) the clinically available urethral warmer, which has a configuration of a counter flow fluid heat exchanger; (ii) a newly designed urethral warmer, based on a temperature controlled electrical heater, termed a \\

Yoed Rabin; Thomas F. Stahovich

52

[Overview of urethral strictures: etiology, epidemiology, physiopathology and classification. General principles of urethral repair].  

PubMed

In this article we present the causes of urethral stenosis in the adult male and review data about incidence. Regarding disease physiopathology we emphasize the inflammatory causes and, more specifically lichen sclerosus, as the clinical scenario that presents the greater difficulty for the management of urethral stenosis since we do not know its natural evolution. Regarding treatment of urethral stenosis we discuss the various options from excision and terminal-terminal anastomosis to oral mucosal graft augmentation urethroplasty, passing by two-step operations in more severe cases. Looking forward to the future a real gate opens with the application of tissue engineering to obtain oral mucosa. PMID:24531667

Llorente Abarca, Carlos; Hernández, Virginia; Díaz Goizueta, Francisco Javier

2014-01-01

53

Pathologic Outcomes following Urethral Diverticulectomy in Women  

PubMed Central

Purpose. Although most urethral diverticula in women are benign, there is a subset of patients who develop malignant changes. Limited studies report the pathologic findings associated with this relatively rare entity. We describe the clinicopathologic findings of women who underwent urethral diverticulectomy. Methods. A consecutive series of 29 women who underwent surgical resection of a urethral diverticulum were identified between 1992 and 2013. Clinical and radiographic data was collected by retrospective review of patient medical records. All pathological slides were rereviewed by a single urologic pathologist. Results. Of the 14 women with clinical data, 9 (64%) presented with urgency, 7 (50%) with urinary frequency, 3 (21%) with urinary incontinence, and 3 (21%) with dysuria. Mean diverticular size was 2.3 (±1.4) cm. Although one patient (3%) had invasive adenocarcinoma on final pathology, the remaining 28 cases (97%) demonstrated benign features. The most common findings were inflammation (55%) and nephrogenic adenoma (21%). Conclusions. Although most urethral diverticula in women are benign, there is a subset of patients who develop malignancy in association with the diverticulum. In this series, 97% of cases had a benign histology. These findings are important when counseling patients regarding treatment options. PMID:24860605

Laudano, Melissa A.; Jamzadeh, Asha E.; Lee, Richard K.; Robinson, Brian D.; Tyagi, Renuka; Kaplan, Steven A.; Te, Alexis E.

2014-01-01

54

Urethral response to latex and Silastic catheters.  

PubMed Central

The reaction of the urethral mucosa to latex and Silastic catheters was compared in two groups of patients undergoing prostatectomy. The bacteriologic response in the two groups differed little; however, Silastic catheters produced less cellular reaction than latex catheters. Images FIG. 1 PMID:1000441

Bruce, A. W.; Plumpton, K. J.; Willett, W. S.; Chadwick, P.

1976-01-01

55

Parameatal urethral cysts of the glans penis.  

PubMed

Parameatal urethral cysts are uncommon in the male. We have seen 9 cases and have reviewed these and the 35 cases reported in Japan between 1919 and 1984. The cysts recurred after rupture or aspiration in 3 cases and complete excision is recommended. PMID:2310917

Koga, S; Arakaki, Y; Matsuoka, M; Ohyama, C

1990-01-01

56

Urethral reconstruction with tissue-engineered human amniotic scaffold in rabbit urethral injury models.  

PubMed

Background Mitigating urethral injury remains a great challenge for urologists due to lack of ideal biomaterials for urethroplasty. The application of amniotic membranes (AM) over other synthetic materials make it a better potential source for urethral reconstruction. We separated the basement layer of AM to obtain denuded human amniotic scaffold (dHAS) and then inoculated primary rabbit urethral epithelial cells on the surface of dHAS to define whether this strategy minimize potential rejection and maximize the biocompatibility of human AM. Material and Methods After the successful acquisition of dHAS from AM, cell-seeded dHAS were prepared and characterized. Both cell-seeded dHAS and acellular dHAS were subcutaneously implanted. Immune responses were compared by histological evaluation and CD4 cell and CD8 cell infiltrations. Then they were applied as urethroplastic materials in the rabbit models of urethral injury to fully explore the feasibility and efficacy of tissue-engineered dHAS xenografts in urethral substitution application. Results Mild inflammatory infiltration was observed in cell-seeded dHAS grafts, as revealed by fewer accumulations of CD4 cells and CD8 cells (or neutrophils or other immune cells). Urethral defects of rabbits in the urethroplastic group with dHAS implantation (n=6) were completely resolved in one month, while there were one infection and one fistula in the control group with acellular dHAS patches (n=6). Histopathological analysis revealed mild immune response in cell-seeded dHAS group (P<0.05). Conclusions Tissue-engineered dHAS minimize potential rejection and maximize the biocompatibility of AM, which makes it a potential ideal xenograft for urethral reconstruction. PMID:25424000

Wang, Fuli; Liu, Tao; Yang, Lijun; Zhang, Geng; Liu, Heliang; Yi, Xiaomin; Yang, Xiaojian; Lin, Tzu-Yin; Qin, Weijun; Yuan, Jianlin

2014-01-01

57

FINITE ELEMENT SIMULATION OF MULTI-PROBE CRYOSURGERY WITH A URETHRAL WARMER  

E-print Network

warming tube is usually employed. The urethral warmer, technically, is a double-layer catheter, inside. A urethral warming tube extending to the bladder is used to protect the urethral lining (courtesy of Endo

Wan, Richard G.

58

Concomitant urethral triplication, bladder, and colon duplication.  

PubMed

The concomitant presence of urethral triplication and caudal duplication is extremely rare with no previous reported cases. We report a case of urethral triplication associated with bladder, sigmoid, and rectum duplication. The patient was initially referred with a history of fecaluria and recurrent urinary tract infection. Physical examination revealed 2 meatal opening on the glans penis. Further investigation revealed three distinct urinary streams, two terminating on the glans penis, and one in the rectum in voiding cystourethrography and retrograde urethrography. Computed tomography demonstrated the bladder divided into two compartments by a complete sagittal septum. The patient was managed by the excision of the rectal ending urethra and removal of the bladder sagittal septum during which, two sigmoidal and rectal segments (the right one filled with fecal) were revealed. The right sigmoid and rectum was resected. The two ventral urethras were kept intact. The postoperative course was uneventful. At his 4 month readmission for colostomy closure, the patient reported good urethral voiding with no complication and recurrence of urinary tract infection and the colostomy was closed with no major complication. PMID:21547464

Tourchi, Ali; Kajbafzadeh, Abdol-Mohammad; Khakpour, Mahshid; Mohammadi Nejad, Payam; Mousavian, Amir-Abbas; Kalantary, Mahdi

2012-02-01

59

Clinical and Functional Anatomy of the Urethral Sphincter  

PubMed Central

Continence and micturition involve urethral closure. Especially, insufficient strength of the pelvic floor muscles including the urethral sphincter muscles causes urinary incontinence (UI). Thus, it is most important to understand the main mechanism causing UI and the relationship of UI with the urethral sphincter. Functionally and anatomically, the urethral sphincter is made up of the internal and the external sphincter. We highlight the basic and clinical anatomy of the internal and the external sphincter and their clinical meaning. Understanding these relationships may provide a novel view in identifying the main mechanism causing UI and surgical techniques for UI. PMID:23094214

Ahn, Hyo Kwang; Huh, Youngbuhm

2012-01-01

60

21 CFR 876.4590 - Interlocking urethral sound.  

Code of Federal Regulations, 2010 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4590 Interlocking urethral sound. (a) Identification. An...

2010-04-01

61

21 CFR 876.4590 - Interlocking urethral sound.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4590 Interlocking urethral sound. (a) Identification. An...

2012-04-01

62

21 CFR 876.4590 - Interlocking urethral sound.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4590 Interlocking urethral sound. (a) Identification. An...

2014-04-01

63

21 CFR 876.4590 - Interlocking urethral sound.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4590 Interlocking urethral sound. (a) Identification. An...

2011-04-01

64

21 CFR 876.4590 - Interlocking urethral sound.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4590 Interlocking urethral sound. (a) Identification. An...

2013-04-01

65

Vascularisation of Urethral Repairs with the Gracilis Muscle Flap  

PubMed Central

Background The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. Methods We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. Results After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. Conclusions Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs. PMID:24086814

Kua, Ee Hsiang Jonah; Leo, Kah Woon; Ong, Yee Siang; Cheng, Christopher

2013-01-01

66

Amputation - traumatic  

MedlinePLUS

... accidents or from motor vehicle accidents. Natural disasters, war, and terrorist attacks can also cause traumatic amputations. ... plastic bag and place the bag in ice cold water. Do NOT directly put the body part ...

67

Vitrectomy for traumatic retinal incarceration.  

PubMed

Traumatic retinal incarceration into a scleral wound may prevent successful surgical rehabilitation of eyes with severe posterior segment injury. We managed 15 consecutive eyes with traumatic retinal incarceration and associated retinal detachment with vitrectomy techniques. We based our approach on the anteroposterior location of the incarceration site and the amount of retina incarcerated into the wound. Despite successful anatomic reattachment in six of seven eyes with retinal incarceration posterior to the vortex vein ampullae, only two of seven eyes achieved visual acuity of 5/200 or better. In eyes with more peripheral retinal incarceration, anatomic reattachment was achieved in five of eight eyes and visual acuity of 5/200 or better was achieved in four eyes. Overall, a visual acuity of 5/200 or better was achieved in six (40%) of 15 eyes with a minimum follow-up of six months. PMID:3358730

Han, D P; Mieler, W F; Abrams, G W; Williams, G A

1988-05-01

68

Parameatal urethral cysts: a review of 6 cases.  

PubMed

6 cases of parameatal urethral cysts are reported in 3 males and 3 females. The condition is considered to be rare. The aetiology is thought to be obstruction of the para-urethral ducts possibly due to infection. The treatment of choice is complete excision. PMID:912259

Hill, J T; Ashken, M H

1977-08-01

69

Traumatic Stress Substance Abuse  

E-print Network

Traumatic Stress and Substance Abuse Traumatic Stress and Substance Abuse H E L P I N G Y O U R T E E N C O P E W I T H Traumatic Stress and Substance Abuse #12;What is a traumatic event? A traumatic of traumatic stress and substance abuse. You'll find information about why these problems often occur simultane

Finzi, Adrien

70

Penile fracture with bilateral corporeal rupture without urethral involvement  

PubMed Central

Concomitant urethral injury is rare in penile fracture. We report the case of a 34-year-old male who presented to the emergency department 12 hours after a blunt self-injury of the penis. Physical examination revealed a swollen, ecchymotic, and deviated circumcised penis without blood at the meatus. The fracture line extending along the bilateral corpora without urethral involvement was seen intraoperatively. The fracture side was repaired primarily. The patient healed and recovered without complication. To our knowledge, this is the second reported case of bilateral corporeal rupture without urethral involvement. PMID:24454602

Yonguc, Tarik; Bozkurt, Ibrahim Halil; Ors, Bumin; Kozacioglu, Zafer; Arslan, Burak; Yonguc, Nilufer Goksin

2014-01-01

71

Management of urethral stricture disease: developing options for surgical intervention  

Microsoft Academic Search

Urethral strictures demand careful surgical management, and the authors from North Carolina describe the developing art of urethral surgery in the first of the mini-reviews in this issue. The non-surgical oncologists' role in managing advanced and metastatic TCC is of great importance, and as urologists increasingly adopt a multi-disciplinary approach to cancer, the next two mini-reviews in this section should

Andrew C. Peterson; George D. Webster

2004-01-01

72

Traumatic injury of the bladder and urethra  

MedlinePLUS

... urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption ... is uncommon. Only about 8 - 10% of pelvic fractures lead to bladder injury. Because the bladder is ...

73

Dorsal onlay vaginal graft urethroplasty for female urethral stricture  

PubMed Central

Introduction: Female urethral stricture is an underdiagnosed and overlooked cause of female bladder outlet obstruction. The possible etiologies may be infection, prior dilation, difficult catheterization with subsequent fibrosis, urethral surgery, trauma, or idiopathic. We present our technique and results of dorsal onlay full thickness vaginal graft urethroplasty for female urethral stricture. Materials and Methods: A retrospective review was performed on 16 female patients with mid-urethral stricture who underwent dorsal onlay vaginal graft urethroplasty from January 2007 to June 2011. Of these, 13 patients had previously undergone multiple Hegar dilatations, three had previous internal urethrotomies. The preoperative work up included detailed voiding history, local examination, uroflowmetry, calibration, and micturating cystourethrogram. Results: All patients had mid-urethral stricture. Mean age was 47.5 years. Mean Qmax improved from 6.2 to 27.6 ml/s. Mean residual volume decreased from 160 to 20 ml. Mean duration of follow-up was 24.5 months (6 months to 3 years). Only one patient required self-calibration for 6 months after which her stricture stabilized. None of the patient was incontinent. Conclusion: Dorsal vaginal onlay graft urethroplasty could be considered as an effective way to treat female urethral stricture. PMID:23956514

Singh, Manmeet; Kapoor, Rakesh; Kapoor, Deepa; Kapoor, Rohit; Srivastav, Alok; Chipde, Saurabh

2013-01-01

74

Posterior fossa malformations.  

PubMed

Understanding embryologic development of the cerebellum and the 4th ventricle is essential for understanding posterior fossa malformations. Posterior fossa malformations can be conveniently classified into those that have a large posterior fossa and those with normal or small posterior fossa. Disorders associated with a large posterior fossa include classic Dandy-Walker malformation, Blake's pouch cyst, mega cisterna magna, and posterior fossa arachnoid cyst. Disorders associated with normal or small posterior fossa include Dandy-Walker variant, Joubert syndrome, tecto-cerebellar dysraphia, rhombencephalosynapsis, the neocerebellar hypoplasias, and cerebellar atrophy. Neuro-imaging features should enable the imager to provide the referring physician a logical approach to these complex posterior fossa malformations. PMID:21596278

Shekdar, Karuna

2011-06-01

75

Female urethral diverticulum: cases report and literature  

PubMed Central

Introduction A female urethral diverticulum is an uncommon pathologic entity. It can manifest with a variety of symptoms involving the lower urinary tract. Our objective is to describe the various aspects of the diverticulum of the female urethra such as etiology, diagnosis and treatment. Cases presentation We report five female patients, without prior medical history. They had different symptoms: dysuria in four cases, recurrent urinary tract infection in three cases, stress incontinence in two cases and hematuria in two cases. All patients had dyspareunia. The physical exams found renitent mass located in the endovaginal side of urethra which drained pus in two cases. Urethrocystography found a diverticulum of urethra in all cases. Our five patients underwent diverticulotomy by endovaginal approach. The course after surgical treatment was favorable. The urinary catheter was withdrawn after ten days. Some recurrent symptoms were reported. Conclusion Evaluation of recurrent urinary complaints in young women can lead to the finding of a diverticulum of urethra. Urethrocystography can reveal this entity. Diverticulectomy by endovaginal approach is the best choice for treatment. PMID:24528809

2014-01-01

76

Arthroscopic stabilization of posterior shoulder instability.  

PubMed

Posterior shoulder instability is a rare and challenging condition with a complex patho-anatomy. The role of arthroscopic repair in the treatment remains poorly defined. The purpose of this study is to evaluate the result of arthroscopic stabilization procedures in patients with posterior shoulder instability. In this case series, we treated eighteen patients (19 shoulders) with posterior shoulder instability with either arthroscopic thermal capsular shrinkage (9 patients), capsulorrhaphy (3) or labral refixation (7). There were eight male and ten female patients with a mean age of 26 years. The study group included unidirectional (6 patients; PI), bi-directional (8; PII) and multidirectional posterior instability (5; MDI). The Rowe-score and DASH-score as well as subjective and objective evaluations of the patients function, range of motion, pain and instability were used as clinical outcome measurements. At a mean follow-up of 50 months, the Rowe-score improved significantly from 46 to 74 (P = 0.005). Four patients (21%) had recurrent instability after arthroscopic treatment (2 with generalized ligamentous laxity; 3 after thermal shrinkage). Analysis of postoperative DASH-scores showed a tendency toward inferior outcomes after thermal shrinkage and in patients with an a-traumatic origin of shoulder instability. We conclude that arthroscopic shoulder stabilization by either labral refixation or capsulorrhaphy is a safe and effective treatment for posterior shoulder instability. Thermal capsular shrinkage however showed poor results and should be abandoned for this indication. PMID:20411378

Engelsma, Y; Willems, W J

2010-12-01

77

Sonic hedgehog Signaling from the Urethral Epithelium Controls External Genital Development  

E-print Network

to a subset of cells. Transplantation of urethral epithelium, but not genital mesenchyme, to chick limbs results in mirror-image duplication of the digits. Moreover, when grafted to chick limbs, the urethral

Cohn, Martin

78

Anterior Urethral Valve and Diverticulum in a Neonate with Febrile Urinary Tract Infection  

PubMed Central

Anterior urethral valve is a rare congenital anomaly that can cause obstructive uropathy. Herein, we report a case of an anterior urethral valve that led to the development of febrile urinary tract infection in a neonate. PMID:22866225

Song, Jin Hyun; Lee, Min Ho; Lee, Ji Hye; Lee, Chang Ho; Jeon, Youn Soo; Lee, Nam Kyu

2012-01-01

79

[A case of polypoid form of parameatal urethral cyst].  

PubMed

A 45-year-old man first noticed a soft tumor on his left lip of the urethral meatus at the age of 15. The lesion had gradually been increasing in size during the last 10 years. He presented to our clinic with division of urinary stream which had been persisting for about nine months. The tumor was resected, and histopathological examination revealed that it was a mucous cyst. The cyst had an outer wall of stratified squamous epithelium and an inner wall of stratified columnar epithelium. Since the inner wall was covered with epithelium originating from the urethral mucosa and the lesion was located outside the urethral meatus, a diagnosis of parameatal urethral cyst was made. Recently, parameatal urethral cyst has rarely been reported since it is often clinically in significant and remains asymptomatic. In our patient, the tumor showed polyploid growth and caused difficulty in urination. The mechanism of its development is considered based on a review of the literature. PMID:11211811

Kawamura, S; Goto, Y; Goto, Y

2000-12-01

80

Management of urethral stricture in patients practising clean intermittent catheterization.  

PubMed

Clean intermittent catheterization (CIC) is used commonly to treat patients with impaired bladder emptying. We treated 6 male patients who were experiencing difficulty with intermittent catheterization. Retrograde urethrography demonstrated stricture of the urethra in all of them and a false passage as well in one patient. Treatment consisted of urethral dilatation using filiform and followers in 4 patients and optical internal urethrotomy in the remaining 2 patients followed by urethral stenting using a 16 Fr. Teflon Foley catheter in all. The stenting Foley catheter was removed after 2 weeks. Subsequently 5 of the 6 patients had resumed CIC regimen to empty their urinary bladder. The sixth patient with a false passage could not perform CIC and suprapubic cystostomy was performed. During a follow-up of 6 of 18 months, none of these five patients developed recurrence of urethral stricture and all are practising CIC without any difficulty. Analysis of our data revealed that forceful manipulation during catheter insertion and significant urethral bleeding during catheterization are important contributory factors for the development of urethral stricture in patients practising CIC. PMID:8276568

Mandal, A K; Vaidyanathan, S

1993-01-01

81

Anterior Urethral Strictures: A Brief Review of the Current Surgical Treatment  

Microsoft Academic Search

A review of the recent literature on the surgical management of anterior urethral stricture was performed. The literature was searched via PubMed using the search terms ‘urethral stricture’ and ‘urethroplasty’ from 1996 to 2009. The management of anterior urethral strictures is changing rapidly in the sense that the reconstructive procedures have evolved greatly. Penile skin, because of its location and

Onkar Singh; Shilpi Singh Gupta; Nand Kishore Arvind

2011-01-01

82

Acellular collagen matrix as a possible “off the shelf” biomaterial for urethral repair  

Microsoft Academic Search

Objectives. To determine whether a naturally derived collagen-based tissue substitute developed for urethral reconstruction would be suitable for urethral repair in an animal model. Several urethral conditions often require nongenital tissues for reconstruction, such as skin grafts or mucosal grafts from the bladder or buccal regions. However, the use of these tissues for urethroplasty may be associated with additional procedures

Fang Chen; James J Yoo; Anthony Atala

1999-01-01

83

Ureteral Cannulation as a Complication of Urethral Catheterization  

PubMed Central

Urinary catheterization is a common procedure, particularly among patients with neurogenic bladder secondary to spinal cord injury. Urethral catheterization is associated with the well-recognized complications of catheter-associated urinary tract infections and limited genitourinary trauma. Unintentional ureteral cannulation represents a rare complication of urethral catheterization and has been previously described in only eight cases within the literature. We describe two cases of aberrant ureteral cannulation involving two patients with quadriplegia. These cases along with prior reports identify the spastic, insensate bladder and altered pelvic sensorium found in upper motor neuron syndromes as major risk factors for ureteral cannulation with a urinary catheter.

Greenlund, Andrew C.

2014-01-01

84

Tissue engineering in urethral reconstruction--an update.  

PubMed

The field of tissue engineering is rapidly progressing. Much work has gone into developing a tissue engineered urethral graft. Current grafts, when long, can create initial donor site morbidity. In this article, we evaluate the progress made in finding a tissue engineered substitute for the human urethra. Researchers have investigated cell-free and cell-seeded grafts. We discuss different approaches to developing these grafts and review their reported successes in human studies. With further work, tissue engineered grafts may facilitate the management of lengthy urethral strictures requiring oral mucosa substitution urethroplasty. PMID:23042444

Mangera, Altaf; Chapple, Christopher R

2013-01-01

85

Post-Traumatic Stress Disorder  

MedlinePLUS

... might have post-traumatic stress disorder. What is post-traumatic stress disorder, or PTSD? PTSD is a ... Revised 2013 Share Find Publications About: Anxiety Disorders Post-Traumatic Stress Disorder Coping with Traumatic Events Related ...

86

Posterior fossa tumor  

MedlinePLUS

... and cause increased pressure on the brain and spinal cord. Most tumors of the posterior fossa are primary brain cancers . They start in the brain, rather than spreading from somewhere else ... Posterior fossa tumors have no known causes or risk factors.

87

Posterior instrumentation in scoliosis  

Microsoft Academic Search

The aims of posterior fusion and instrumentation in scoliosis are to achieve and maintain correction of the deformity and balance the spine in three planes, whilst keeping the fusion as short as possible and protecting the spinal cord. Harrington developed the first generation of posterior instrumentation, which considered only frontal plane correction. Since that time there has been an evolution

J. K. Webb; R. G. Burwell; A. A. Cole; I. Lieberman

1995-01-01

88

Comparative study of air and water measurements of peak and stabilized static urethral pressures.  

PubMed

Air and water were forced through female dogs' urethras to determine static urethral pressures. The cauda equina was sectioned to eliminate reflex responses to urethral manipulation, and the urethras were compressed circumferentially with inflatable Silastic cuffs. The peak and stabilized urethral pressures were recorded at flow rates between 20 and 150 ml./min. while cuff pressures were varied between 0 and 100 cm. of water. When the fluid recordings of static urethral pressure were compared with Millar transducer tip catheter measurements of urethral pressure, there were no statistically significant differences between the air cystometer, aneroid sphygmomanometer, and Millar catheter recordings of urethral pressure. At these high flow rates, the water recordings of urethral pressure were significantly higher than the Millar catheter determinations of static uretheral pressure. PMID:568841

Teague, C T; Merrill, D C

1978-10-01

89

Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty  

PubMed Central

Introduction: We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years. Methods: This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both. Results: In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success. Conclusion: In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk. PMID:24454595

Tinaut-Ranera, Javier; Arrabal-Polo, Miguel Angel; Merino-Salas, Sergio; Nogueras-Ocana, Mercedes; Lopez-Leon, Victor Manuel; Palao-Yago, Francisco; Arrabal-Martin, Miguel; Lahoz-Garcia, Clara; Alaminos, Miguel; Zuluaga-Gomez, Armando

2014-01-01

90

Primary proximal urethral adenocarcinoma: Case report and brief review  

PubMed Central

Primary urethral cancer in females is rare. It has a poor prognosis. The published data on this topic are limited, composed mostly of small case series. This paper presents a case of an advanced adenocarcinoma of the urethra, intestinal type, treated with anterior exenteration. PMID:23914268

Siosaki, Marcos Duarte; Machado, Roberto Dias; Souza, Ana Tarsila Fonseca; Magnabosco, Wesley Justino; Santos, Alexandre Cesar; Goncalves, Fernando Zapparoli; Pereira, Fernando Coutinho; de Araujo Silva, Carlos Flavio; Faria, Eliney Ferreira

2013-01-01

91

[Traumatic rupture of the corpus cavernosum].  

PubMed

Traumatic rupture of the corpus cavernosum is relatively frequent in the authors' experience. Based on the study of a series of 80 cases and a review of the literature, the authors analyse the diagnostic and therapeutic aspects and outcome of this disease. The patients in this series had a mean age of 30 years. Meticulous and intimate clinical interview demonstrated that the commonest mechanism is forced manipulation of the erect penis (68%). Clinical examination localized the site of the fracture (proximal: 57%, distal 43%). The fracture was unilateral (78 cases), rarely bilateral (2 cases) and associated with complete rupture of the urethra (1 case). Treatment was surgical in 79 patients. A distal semicircumferential incision was used in the case of bilateral rupture, distal rupture and associated urethral lesion (34 cases). A favourable course was observed in 86% of cases. However, 9 postoperative complications (12.5%) were observed (6 cases of fibrous plaques, 3 cases of chordee of the penis), due either to the extent of the haematoma or to the delay in treatment. Traumatic rupture of the corpus cavernosum is a disease of young adults, which requires early surgical treatment with an approach adapted to the type of lesions. PMID:9834519

Bennani, S; Dakir, M; Debbagh, A; Hafiani, M; el Moussaoui, A; el Mrini, M; Benjelloun, S

1998-09-01

92

Association of Mycoplasma genitalium with acute non-gonococcal urethritis in Russian men: a comparison with gonococcal and chlamydial urethritis.  

PubMed

Urethral specimens from 172 men who attended sexually transmitted disease clinics in the Moscow Oblast were examined for Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium by nucleic acid amplification tests. N. gonorrhoeae was detected in the urethra of 41 (24%) of the 172 men and C. trachomatis in 57 (33%). The latter occurred in 15 (36%) of the 41 men who were infected by N. gonorrhoeae and in 42 (32%) of 131 uninfected by gonococci. Of the 42 men uninfected by gonococci but chlamydia infected, 39 (93%) had symptoms and/or signs of urethritis. M. genitalium was detected in 45 (26%) of the 172 men, in nine (22%) of the 41 men infected with N. gonorrhoeae and in 12 (21%) infected with C. trachomatis. M. genitalium was detected alone in 25 (28%) of the 89 men uninfected by either gonococci or C. trachomatis. Of these 25 men, 24 (96%) had urethral symptoms and signs of inflammation, a proportion significantly more than experienced by the 64 men uninfected by any of the microorganisms. Of the 31 men who apparently had no symptoms or signs of urethritis, only three (10%) were infected by M. genitalium. The data provide evidence for the pathogenicity and frequent occurrence of M. genitalium in men in Moscow and presumably elsewhere in Russia. PMID:19304966

Taylor-Robinson, D; Renton, A; Jensen, J S; Ison, C A; Filatova, E; Dmitriev, G; Akovbian, V

2009-04-01

93

Mild Traumatic Brain Injury  

MedlinePLUS

... Frequently Asked Questions Glossary Contact Us mild Traumatic Brain Injury Click Here to Start VIDEO STORIES What ... Families & Friendships Spirituality Anger Work Adjustment mild Traumatic Brain Injury Sleep Featured Sites Defense Centers of Excellence ...

94

Post-traumatic endophthalmitis  

Microsoft Academic Search

ObjectiveTo establish risk factors for the occurrence of post-traumatic endophthalmitis, to observe the efficacy of prophylaxis, and to describe the clinical features of post-traumatic endophthalmitis.

Rohan W. Essex; Qing Yi; Patrick G. P. Charles; Penelope J. Allen

2004-01-01

95

The Treatment of Traumatic Posterior Sternoclavicular Joint Injuries  

Microsoft Academic Search

conclusion: Our experience suggests that closed reduction compares favorably with open reduction. 38% of patients evaluated, required only closed reduction as their defini- tive treatment. Moreover, once the joint has been reduced closed, it is usually stable. In the present series, early recognition of injury followed by closed reduction and figure-of- eight immobilization was highly successful, and obviated the risks

Michael A. Wirth; Gordon I. Groh; Charles A. Rockwood Jr.

96

Endoscopic management of urethral trauma in male spinal cord injury patients.  

PubMed

Spinal cord injury (SCI) patients with a neuropathic bladder are more prone to develop catheter-induced urethral trauma than occurs in the general population because many of the SCI patients are on indwelling urethral catheter drainage, or intermittent urethral catheterisation is performed either by them or by their carers. The presenting symptoms of improperly positioned Foley catheter in SCI patients may be at times, peculiar to the SCI patients and these include profuse sweating, bypassing of the catheter, increased spasms, or rarely, full fledged features of autonomic dysreflexia. With the availability of the flexible cystoscope, cystourethroscopy has been performed safely on SCI patients who had sustained catheter-induced urethral trauma, on the bedside, with an immediate, and accurate diagnosis of the extent of urethral trauma, and the presence of urethral false passage(s). Further, flexible cystoscopy has helped to treat the patients with urethral trauma by introducing a flexible tip guide wire under vision into the urinary bladder via the normal urethral channel and subsequently, passing a 12 Fr. Foley catheter over the guide wire, thus avoiding the false passage(s) in the urethra. With this technique, it was possible to avert the need for suprapubic urinary diversion in those SCI patients who had sustained acute urethral trauma. Such endoscopic management of acute urethral trauma in SCI patients is described with illustrative case reports of eight patients seen during a 15 month period. PMID:8918960

Vaidyanathan, S; Krishnan, K R; Soni, B M

1996-11-01

97

Posterior Tibial Tendon Dysfunction  

MedlinePLUS

... patients will notice some limitation in activity a er surgery. Anatomy The posterior tibial tendon is one ... the pain to last another 6 months a er treatment starts. Rest Decreasing or even stopping activities ...

98

Simultaneous avulsion fracture of the posterior medial and posterior lateral meniscus root: a case report and review of the literature.  

PubMed

Injuries of the meniscus roots are increasingly recognized as a serious knee joint pathology. An avulsion fracture of the meniscus root is a rare variant of this injury pattern. In this article, a case of a traumatic simultaneous avulsion fracture of both the posterior medial and posterior lateral meniscus root associated with a tear of the anterior cruciate ligament is presented. Both avulsion fractures were treated by indirect arthroscopic transtibial pullout fixation of the bony fragment. Based on the findings of our literature review, root avulsion fractures seem to be more common in young male patients after an acute trauma to the knee joint. PMID:24337588

Feucht, Matthias J; Salzmann, Gian M; Pestka, Jan M; Südkamp, Norbert P; Niemeyer, Philipp

2014-04-01

99

Anterior urethral valve in an adolescent with nocturnal enuresis.  

PubMed

The anterior urethral valve (AUV) is a rare congenital urethral anomaly that can lead to variable urinary tract symptoms. We report on a 13-year-old boy with AUV who was referred from a primary care physician for nocturnal enuresis. AUV was disclosed by videourodynamic study and confirmed by simultaneous retrograde cystourethroscopy and antegrade urethroscopy. The AUV was ablated by neodymium:yttrium-aluminum-garnet contact laser at the 5-o'clock and 7-o'clock directions. A postoperative videourodynamic study depicted a patent urethra, a good maximal flow rate, and improved bladder capacity. His nocturnal enuresis had completely subsided at a follow-up period of longer than 24 months. PMID:18068473

Wu, Chia Chang; Yang, Stephen Shei Dei; Tsai, Yao Chou

2007-11-01

100

Properties of urethral rhabdosphincter motoneurons and their regulation by noradrenaline  

PubMed Central

The urethral rhabdosphincter (URS), commonly known as the external urethral sphincter, facilitates urinary continence by constricting the urethra. Striated muscle fibres in the urethral rhabdosphincter are innervated by Onuf's nuclei motoneurons in the spinal cord. Although noradrenaline (NA) reuptake inhibitors are shown to increase URS tone preventing urinary leakage in incontinent patients, whether or how NA affects URS motoneurons is unknown. Properties of dye-labelled URS motoneurons were investigated by whole-cell patch-clamp recordings in isolated spinal cord slices prepared from neonatal female rats. As previously shown for adult sphincter motoneurons, neonatal URS motoneurons are more depolarized and possess higher input resistance than other spinal ?-motoneurons. These distinct properties make URS motoneurons more excitable than other ?-motoneurons. Moreover, bath application of noradrenaline (NA) significantly depolarizes URS motoneurons and in many cases evokes action potentials. NA also significantly increases input resistance and reduces rheobase. These changes are reversed with wash, are largely blocked by the ?1-adrenoceptor-selective antagonist prazosin, and are mimicked by the ?1-adrenoceptor-selective agonist phenylephrine. In addition, NA significantly reduces the amplitude of the afterhyperpolarization and increases action potential frequency. Both the increase in action potential frequency and the reduction in afterhyperpolarization are occluded by apamin, a small-conductance calcium-activated potassium (SKCa) channel blocker. In conclusion, NA effectively increases the excitability of URS motoneurons through multiple mechanisms. The NA-induced increase in excitability of urethral rhabdosphincter motoneurons could be a key mechanism by which NA reuptake inhibitors improve stress urinary incontinence. PMID:20974682

Yashiro, Koji; Thor, Karl B; Burgard, Edward C

2010-01-01

101

Acute urinary retention in a young woman by parameatal urethral cyst.  

PubMed

Parameatal urethral cysts are a rare pathology reported both in male and in female. The aethiology is not completely understood. Urography, urethroscopy and urethrography were described to diagnose parameatal urethral cysts. The treatment of choice is the complete excision of the cyst. A rare case of acute urinary retention in a 17-year-old woman by a parameatal urethral cyst is presented. PMID:16752886

Vecchioli Scaldazza, Carlo

2006-03-01

102

[Application of tissue engineering technology and stem cells in urethral reconstruction].  

PubMed

Urethral defects caused by congenital abnormality, injury, inflammation or tumor are common diseases in urology. Conventional surgery of urethral reconstruction may lead to many complications, and its application has been greatly limited by insufficient supply of donor materials. Tissue engineering technology and stem cells can be used to construct biological substitutes for maintaining and repairing damaged tissue and organ function, which offers a new prospect for the strategies of urethral reconstruction. PMID:22474996

Wang, Ying; Fu, Qiang

2012-03-01

103

Epidemiology, Etiology, Histology, Classification, and Economic Impact of Urethral Stricture Disease  

Microsoft Academic Search

\\u000a Urethral stricture is a common urologic problem, with the highest prevalence in underdeveloped countries. Urethral strictures\\u000a have a significant economic impact and burden. Economics and resource availability can influence stricture treatment. Detailed\\u000a here-in is the epidemiology of anterior urethral strictures as to demographics, incidence, and signs and symptoms. Histology\\u000a and pathology are addressed; in particular, the fibrotic process of spongiofibrosis

Steven B. Brandes

104

Electrical Stimulation of Afferent Neural Pathways for Suppression of Urethral Reflexes.  

E-print Network

?? Aberrant urethral reflexes following neurological injury or disease are a major component of voiding dysfunction, preventing micturition and leading to serious medical complications. Current… (more)

Mariano, Timothy Yu

2009-01-01

105

Posterior tracheal diverticulosis.  

PubMed

Multiple tracheal diverticulosis is a rare clinical entity. Tracheal diverticula are usually recognized radiologically as solitary right paratracheal air collections on thoracic computed tomography examination. They are usually asymptomatic but can occasionally present with persistent symptoms. We herein report the case of a 50-year-old male patient who underwent extensive evaluation for persistent cough. Multiple posterior right paratracheal air collections were recognized on thoracic multidetector computed tomography examination, which was confirmed as multiple-acquired posterior upper tracheal diverticula on flexible bronchoscopy. The patient improved with conservative medical management. PMID:25321454

Madan, Karan; Das, Chandan J; Guleria, Randeep

2014-10-01

106

SIU/ICUD Consultation on Urethral Strictures: The management of anterior urethral stricture disease using substitution urethroplasty.  

PubMed

In this systematic review of the literature, a search of the PubMed database was conducted to identify articles dealing with augmentation/substitution urethral reconstruction of the anterior urethral stricture. The evidence was categorized by stricture site, surgical technique, and the type of tissue used. The committee appointed by the International Consultation on Urological Disease reviewed this data and produced a consensus statement relating to the augmentation and substitution of the anterior urethra. In this review article, the background pathophysiology is discussed. Most cases of urethral stricture disease in the anterior urethra are consequent on an ischemic spongiofibrosis. The choice of technique and the surgical approach are discussed along with the potential pros and cons of the use of a graft vs a flap. There is research potential for tissue engineering. The efficacy of the surgical approach to the urethra is reviewed. Whenever possible, a 1-stage approach is preferable from the patient's perspective. In some cases, with complex penile urethral strictures, a 2-stage procedure might be appropriate, and there is an important potential role for the use of a perineal urethrostomy in cases where there is an extensive anterior urethral stricture or where the patient does not wish to undergo complex surgery, or medical contraindications make this hazardous. It is important to have accurate outcome measures for the follow-up of patients, and in this context, a full account needs to be taken of patients' perspectives by the use of appropriate patient-reported outcome measures. The use of symptoms and a flow rate can be misleading. It is well established that with a normally functioning bladder, the flow rate does not diminish until the caliber of the urethra falls below 10F. The most accurate means of following up patients after stricture surgery are by the use of endoscopy or visualization by urethrography. Careful consideration needs to be made of the outcomes reported in the world literature, bearing in mind these aforementioned points. The article concludes with an overview of the key recommendations provided by the committee. PMID:24411214

Chapple, Christopher; Andrich, Daniela; Atala, Anthony; Barbagli, Guido; Cavalcanti, André; Kulkarni, Sanjay; Mangera, Altaf; Nakajima, Yosuke

2014-03-01

107

STD\\/HIV control in Malawi and the search for affordable and effective urethritis therapy: a first field evaluation  

Microsoft Academic Search

OBJECTIVES--To evaluate gonococcal (GU) and nongonococcal urethritis (NGU), chlamydia antigen, and serostatus for syphilis and human immunodeficiency virus (HIV) among males attending a Malawian STD clinic with complaints of urethral discharge and\\/or dysuria. To collect demographic and behavioural data and to determine the effectiveness of five treatments for urethritis. METHODS--Urethritis was diagnosed using microscopy and culture for Neisseria gonorrhoeae. Sera

G Lule; F M Behets; I F Hoffman; G Dallabetta; H A Hamilton; S Moeng; G Liomba; M S Cohen

1994-01-01

108

Role of Striated Sphincter Muscle in Urethral Closure under Stress Conditions: An Experimental Study  

Microsoft Academic Search

The three-component mechanism for urethral closure under stress conditions is composed of urethral tension, passive pressure transmission and reflex pressure transmission. The reflex pressure transmission is regarded as a global result of the striated muscles of the urethra and the pelvic floor. In this experimental study, the question of what peak the reflex pressure reaches and which parts of the

H. Heidler; F. Casper; J. W. Thüroff

1987-01-01

109

Coexistence of urethritis with genital ulcer disease in South Africa: influence on provision of syndromic management  

Microsoft Academic Search

Objective: To assess whether syndromic management of genital ulcer disease was sound, if based on the premise that men with genital ulcers rarely have a concomitant urethral infection.Methods: Specimens were taken in 1998 from 186 mine workers in Carletonville, South Africa, who were seen consecutively with genital ulcers. The specimens comprised a swab from the ulcer, a urethral swab for

R C Ballard; H G Fehler; Y Htun; F Radebe; J S Jensen; D Taylor-Robinson

2002-01-01

110

Monitoring of Erectile and Urethral Sphincter Dysfunctions in a Rat Model Mimicking Radical Prostatectomy Damage  

E-print Network

1 Monitoring of Erectile and Urethral Sphincter Dysfunctions in a Rat Model Mimicking Radical post-RP urethral sphincter and erectile dysfunctions, and non-invasive methods to assess erectile of Sexual Medicine 2012;9(11):2827-37" DOI : 10.1111/j.1743-6109.2012.02905.x #12;2 Keywords: erectile

Paris-Sud XI, Université de

111

Comparison of Topical Anesthetics and Lubricants Prior to Urethral Catheterization in Males: A Randomized Controlled Trial  

Microsoft Academic Search

Although male urethral catheterization in the emergency department (ED) is both common and painful, few studies have evaluated the use of topical anesthesia prior to catheterization. Objectives: To determine whether pretreat- ment of the urethra with topical lidocaine reduces the pain associated with urethral catheterization. Methods: This was a prospective, double-blind, randomized clinical trial of 36 alert, cooperative male adult

John Siderias; Flavio Guadio; Adam J. Singer

2004-01-01

112

Bacterial Adhesion to Urethral Catheters: Role of Coating Materials and Immersion in Antibiotic Solution  

Microsoft Academic Search

Objective: To determine whether new coating materials (silver and hydrogel) or immersion in antibiotic solution may reduce or prevent bacterial adhesion to urethral catheters.Methods: Precut segment of Teflon–, silver– and hydrogel–coated urethral catheters were incubated with two uropathogenic bacterial strains with and without previous immersion in antibiotic solution. Tobramycin, ceftriaxone and ciprofloxacin solutions were used as these antibiotics are commonly

L. Cormio; P. La Forgia; D. La Forgia; A. Siitonen; M. Ruutu

2001-01-01

113

Squamous cell carcinoma on top of urethral stricture: case report and review of the literature  

PubMed Central

Introduction: Urethral stricture is a common urological condition, resulting from trauma or venereal infections. The aim of our study was to report a rare case of squamous cell carcinoma of the penis and pseudoepitheliomatous hyperplasia (PEH) of scrotal skin, on top of repeatedly managed urethral stricture which was of unknown aetiology. Methods: A Medline search of publications studying the association of urethral stricture with penile cancer was done. Results: Two case reports were identified that described two occurrences, which were separated by a few months. Conclusion: Repeated management of urethral stricture with visual urethrotomy or urethral dilation may result in a chronic inflammatory status, predisposing to PEH and squamous cell carcinoma of the genital organs. PMID:23589733

Kotb, Ahmed Fouad; Attia, Doaa; Ismail, Asmaa Mohamed; Elabbady, Ahmed

2013-01-01

114

Traumatic Brain Injury  

MedlinePLUS

... be affected. There may be changes to your personality and you may feel anxious, upset, irritable or depressed. You may have trouble controlling your impulses. In some cases, a severe traumatic brain injury can lead to coma or death. Diagnosis & Tests How is a traumatic brain injury diagnosed? At ...

115

Understanding Child Traumatic Stress  

MedlinePLUS

... Impact of Traumatic Stress on Development The Lessons of Traumatic Experiences Responding to Danger Before we discuss what is meant by ... human motivation and intent and struggle over issues of irresponsibility, malevolence, and human ... to Top Posttraumatic Stress Responses For reasons that are ...

116

Role of the urethral plate characters in the success of tubularized incised plate urethroplasty  

PubMed Central

Background: Today, tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid-penile hypospadias. Reports from different centers worldwide confirm its nearly universal applicability and low complications rate. Aim: Evaluation of the urethral plate characters and its effect on the outcome of TIP urethroplasty. Materials and Methods: Between 2010 and 2013, 100 children with primary distal penile hypospadias underwent TIP urethroplasty. Urethral plates were categorized as flat, cleft, and deeply grooved. Postoperatively, patients were followed-up for evaluation of meatal stenosis, fistula formation, and glandular dehiscence at 1st, 3rd and 6th months. Patients were followed-up for urethral calibration by urethral sound 8 Fr at 3rd and 6 months follow-up. Data were statistically analysed using Epi info program to correlate between the width, plate shape, and complications. Results: Mean age at surgery was 4.3 years. Patients were followed-up for an average period of 6.4 months. Pre-operative location of the meatus was reported as coronal in 46, subcoronal in 50 and anterior penile in 4 cases. Urethral plate characters were flat in 26 cases, cleft in 52, and deeply grooved in 22. Urethral plate width was >8 mm in 74 cases and <8 mm in 26. Patients with urethral plate <8 mm had a statistically significant higher fistula rate (P = 0.004) and failed 8 Fr calibrations in 26.9% (P = 0.01) compared with the patients with urethral plate >8 mm. In addition, we also founds higher fistula rate and failed 8 Fr calibrations in flat urethral plate. Conclusions: An adequate urethral plate width (>8 mm) is essential for successful TIP repair. Lower success rates with flat plates may need buccal mucosal augmentation to improve the results.

Aboutaleb, Hamdy

2014-01-01

117

Early Experience With a Thermo-Expandable Stent (Memokath) for the Management of Recurrent Urethral Stricture  

PubMed Central

Purpose To report our early experience with thermo-expandable urethral stents (Memokath) for the management of recurrent urethral stricture and to assess the efficacy of urethral stents. Materials and Methods Between March 2012 and February 2013, 13 patients with recurrent urethral stricture after several attempts with direct visual internal urethrotomy (DVIU) or failed urethroplasty underwent DVIU with thermally expandable, nickel-titanium alloy urethral stent (Memokath) insertion. Follow-up study time points were at 1, 3, 6, 9, and 12 months after stent insertion. Follow-up evaluation included uroflowmetry, retrograde urethrogram, plain radiography, and urinalysis. Results The mean patient age was 47.7 years (range, 18 to 74 years). The mean urethral stricture length was 5.54 cm (range, 1 to 12 cm). There were six patients with bulbar, four patients with proximal penile, one patient with distal penile, and two patients with whole penile urethral strictures, respectively. The overall success rate was 69% (9/13) and the mean postoperative peak flow rate was 17.7 mL/s (range, 6 to 28 mL/s). Major complications occurred in four patients including one patient (7.7%) with urethrocutaneous fistula induced by the stent and three patients with urethral hyperplasia. The mean follow-up duration was 8.4 months. Conclusions Our initial clinical experience indicates that thermo-expandable stents can be another temporary management option for recurrent urethral stricture patients who are unfit for or refuse urethroplasty. Distal or whole penile urethral stricture can be factors predicting poor results. PMID:24363867

Jung, Hyun Su; Kim, Joon Woo; Lee, Jun Nyung; Kim, Hyun Tae; Yoo, Eun Sang

2013-01-01

118

One-stage dorsal inlay oral mucosa graft urethroplasty for anterior urethral stricture  

PubMed Central

Background Anterior urethral stricture remains a great challenge. We reported our clinical technique and results by using inlay dorsal buccal mucosal graft urethroplasty for repair of anterior urethral stricture. Methods From January 2005 to July 2008, 87 male patients (range from 9 to 72 years old) with anterior urethral stricture have been treated by one-stage dorsal inlay oral mucosal graft (OMG) urethroplasty. All patients gave written informed consent for their participation. All patients showed that urethral plate had been either scarred or removed previously. In our surgery, the urethra was dissected dorsally and scar of the urethral plate was removed. The remnant urethral plate was split at midline and a buccal mucosa patch was inserted between the two parts. Neourethra was tubularized and covered with dartos flap. The pre-operative assessments included clinical data, urine analysis, uroflowmetry, retrograde and voiding cystogram, urethral ultrasonography and endoscopy. Postoperatively, the flow rate and void residual volume were analyzed by uroflowmetry and sonography. Any further instrumentation to assist voiding was considered as failure. Results After 12 to 48 months (mean: 25.8 months), 78 patients (89.66%) have shown good results by the one-stage urethroplasty. However, 9 patients (10.3%) required further treatment due to recurrence, while 6 patients (6.9%) had fistula. Conclusions This one-stage dorsal inlay approach using dorsal oral mucosal grafts is a reliable method to create a substitute urethral plate for tubularization. This approach represents a safe option for anterior urethral stricture patients especially with grossly scarred urethral plate. PMID:24885070

2014-01-01

119

Post-Traumatic Stress Disorder  

E-print Network

Post-Traumatic Stress Disorder It's natural to be afraid when you're in danger. It's natural or months later, it's time to talk with your doctor. You might have post-traumatic stress disorder. #12;Post-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a real illness. You can get PTSD

Bandettini, Peter A.

120

Characteristics of younger and older men with urethral chlamydial infection.  

PubMed

This study examined some characteristics of male clinic attenders with urethral chlamydial infection. The prevalence of urethral chlamydial infection among heterosexual men (men who have sex with women [MSW]) was 446 (17%) of 2684 men. Men aged 16-34 years were more likely to have chlamydiae than older men with only casual partners (chi2 = 16.08; P = 0.001). Infected younger men with casual partners had more partners than uninfected men (median 2.0 [interquartile range [IQR] 1.0] versus 1.0 [IQR 1.0]) (P<0.05). However, this was not true of older men (median number of partners 1.0 [IQR 1.0] versus 1.0 [IQR 1.0]) (P>0.05). Consistent condom use by younger but not by older men was associated with a lower prevalence of chlamydial infection compared with those whose use of condoms was inconsistent (chi2 = 19.75; P<0.001). Our results suggest that chlamydia testing should be offered to any MSW, irrespective of his age, who has had a new partner. PMID:16925900

Arnot, D J; Manavi, K; McMillan, A

2006-08-01

121

Treatment of urethral strictures with the KTP 532 laser  

NASA Astrophysics Data System (ADS)

The objective of this study was to evaluate and compare the safety and efficacy of the KTP 532 laser to direct vision internal urethrotomy (DVIU) in the management of urethral strictures. A total of 32 patients were randomized prospectively in this study, 14 DVIU and 18 KTP 532 laser. Patients were evaluated postoperatively with flowmetry and in the case of recurrence with cystourethrography at 3, 12, 24 weeks. With the KTP 532 laser complete symptomatic and urodynamic success was achieved in 15 (83%) patients at 12 and 24 weeks. Success rate was lower in the DVIU group with 9 (64%) patients at 12 weeks and 8 (57%) patients at 24 weeks. With the KTP mean preoperative peak-flow was improved from 6 cc/s to 20 cc/s at 3, 12 and 24 weeks. With DVIU mean preoperative peak-flow was improved from 5.5 cc/s to 20 cc/s at 3 weeks followed by a steady decrease to 13 cc/s at 12 weeks and to 12 cc/s 24 weeks. No complications were observed in either group of patients. Our results confirm that stricture vaporization with the KTP 532 laser is a safe and efficient procedure. It thus represents a valuable alternative in the endoscopic treatment of urethral strictures.

Schmidlin, Franz R.; Oswald, Michael; Iselin, Christoph E.; Jichlinski, Patrice; Delacretaz, Guy P.; Leisinger, Hans-Juerg; Graber, Peter

1997-05-01

122

Urethral Dysfunction in Female Mice with Estrogen Receptor ? Deficiency  

PubMed Central

Estrogen has various regulatory functions in the growth, development, and differentiation of the female urogenital system. This study investigated the roles of ER? in stress urinary incontinence (SUI). Wild-type (ER?+/+) and knockout (ER??/?) female mice were generated (aged 6–8 weeks, n?=?6) and urethral function and protein expression were measured. Leak point pressures (LPP) and maximum urethral closure pressure (MUCP) were assessed in mice under urethane anesthesia. After the measurements, the urethras were removed for proteomic analysis using label-free quantitative proteomics by nano-liquid chromatography–mass spectrometry (LC-MS/MS) analysis. The interaction between these proteins was further analysed using MetaCore. Lastly, Western blot was used to confirm the candidate proteins. Compared with the ER?+/+ group, the LPP and MUCP values of the ER??/? group were significantly decreased. Additionally, we identified 85 differentially expressed proteins in the urethra of ER??/? female mice; 57 proteins were up-regulated and 28 were down-regulated. The majority of the ER? knockout-modified proteins were involved in cell-matrix adhesion, metabolism, immune response, signal transduction, nuclear receptor translational regelation, and muscle contraction and development. Western blot confirmed the up-regulation of myosin and collagen in urethra. By contrast, elastin was down-regulated in the ER??/? mice. This study is the first study to estimate protein expression changes in urethras from ER??/? female mice. These changes could be related to the molecular mechanism of ER? in SUI. PMID:25275480

Chen, Yung-Hsiang; Chen, Chao-Jung; Yeh, Shuyuan; Lin, Yu-Ning; Wu, Yang-Chang; Hsieh, Wen-Tsong; Wu, Bor-Tsang; Ma, Wen-Lung; Chen, Wen-Chi; Chang, Chawnshang; Chen, Huey-Yi

2014-01-01

123

Acquired urinary incontinence in the bitch: update and perspectives from human medicine. Part 2: The urethral component, pathophysiology and medical treatment.  

PubMed

Various pathologies can affect the bladder and/or urethral contractility causing signs of urinary incontinence. In this second part of a three-part review, the pathophysiology of impaired urethral contractility (including urethral hyper- and hypotonicity) in the bitch and in women is discussed. Urethral sphincter mechanism incompetence (USMI) is the most common form of acquired urinary incontinence in bitches and is characterized by a decreased urethral tone. The pathophysiology and current recommended medical treatment options for USMI and cases of modified urethral tonicity due to a neurological disorder or functional outlet obstruction are discussed. Treatment options in human medicine in cases of impaired urethral contractility are described. PMID:20655776

Noël, Stéphanie; Claeys, Stéphanie; Hamaide, Annick

2010-10-01

124

The urethral pressure profile and ultrasound imaging of the lower urinary tract.  

PubMed

In a prospective study 105 patients with symptoms of stress incontinence underwent video-urodynamic testing, including resting urethral pressure profilometry and translabial ultrasound. The urethral pressure profile (UPP) included maximum urethral closure pressure (MUCP), functional length (FL) and area under the curve (AUC). Ultrasound parameters included urethral thickness, urethral rotation and bladder neck descent, as well as funneling/opening of the internal urethral meatus on Valsalva maneuver. Levator contraction strength was assessed measuring the cranioventral displacement of the internal meatus. Negative correlations between UPP data and age, parity and previous surgery were observed which were consistent with literature data. There was a positive correlation between the urethral AP diameter on ultrasound and the MUCP, which agrees with reports showing reduced sphincter thickness or volume in stress-incontinent women. Hypermobility on ultrasound did not correlate with UPP data. However, a lower MUCP correlated with extensive opening of the bladder neck. Finally, there was a trend towards poorer pelvic floor function with lower MUCP measurements. PMID:11294530

Dietz, H P; Clarke, B

2001-01-01

125

Docetaxel Inhibits Urethral Stricture Formation, an Initial Study in Rabbit Model  

PubMed Central

Introduction Urethral stricture, a frequent source of lower urinary tract disorders in men, is still a difficult problem for urologists. Based the anti-restenosis effect of paclitaxel on coronary artery, the role of docetaxel, a semi-synthetic analogue of paclitaxel, in limiting urethral stricture formation was studied. Methods Forty adult New Zealand male rabbits were involved in this study, which were randomly assigned into 3 groups, namely a high dose docetaxel (DH, 0.1 mg/d), a low dose docetaxel (DL, 0.01 mg/d) and a control (C) group, with 16, 16, 8 rabbits in each group, respectively. All animals underwent a 10 mm-long circumferential electrocoagulation of the bulbar urethra with a 13Fr pediatric resectoscope. Drugs were given by urethral irrigation daily and continuous for 28 days. Stricture formation was assessed by retrograde urethrography and videourethroscopy. Urethra pathology was evaluated by hematoxylin and eosin staining and Sirius red staining. Results At the end of this study, 15, 14 and 7 rabbits remained for evaluation in DH, DL and C group, respectively. Urethral diameters in DH, DL and C group were (7.17±1.63) mm, (6.55±0.62) mm, (3.23±1.36) mm, with a normal urethral diameter of (9.08±1.29) mm. Lumen reduction in DH, DL and C group were (36.93±11.58)%, (48.03±7.89)% and (84.66±14.95)%, respectively. Statistically difference could be found between every two groups (p<0.05) both in urethral diameters and in lumen reduction, except for compare of urethral diameters between DH and DL group. Histological examination confirmed mass fibrous tissue and collagen content at the stricture sit in C group, whereas less in docetaxel treated rabbits. Conclusions Docetaxel could limit urethral stricture formation, which may be due to inhibition of fibrous tissue and collagen expression. Docetaxel may become a new choice in the prevention of urethral stricture formation. PMID:25375859

Fu, Delai; Chong, Tie; Li, Hecheng; Zhang, Huibo; Wang, Ziming

2014-01-01

126

Minimal invasive transcaruncular optic canal decompression for traumatic optic neuropathy.  

PubMed

Abstract Traumatic optic neuropathy is a cause of loss of vision associated with head injuries. Treatment options include observation, steroids and decompression of the optic canal. We report a case where the optic canal decompression was performed using a transcaruncular approach under a regional block. The incision was made through the caruncle and the dissection was carried down to the periosteum down to the orbital apex where the optic nerve was seen exiting through the optic canal posterior to the posterior ethmoidal artery. The optic nerve was decompressed with good visualization. Hemostasis and wound closure was achieved using fibrin glue. Postoperatively visual acuity improved with minimal inflammation enabling early rehabilitation. PMID:25208226

Vaitheeswaran, Krishna; Kaur, Preetinder; Garg, Shalini

2014-12-01

127

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

PubMed Central

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

Stamatiou, Konstantinos; Papadatou, Aggeliki; Kornezos, Ioannis; Pavlis, Anargiros

2014-01-01

128

Erbium:YAG laser incision of urethral strictures: early clinical results  

NASA Astrophysics Data System (ADS)

Two cases involving Erbium:YAG laser incision of proximal bulbar urethral strictures are described. Erbium:YAG laser radiation with a wavelength of 2.94 ?m, pulse energy of 10 mJ, and a pulse repetition rate of 15 Hz, was delivered through a 2-m-long, 250-?m-core sapphire optical fiber in contact with tissue. Total laser irradiation time was 5 min. The first patient suffering from a virgin urethral stricture was treated and is stricture-free. The second patient suffering from a recurrent urethral stricture required further treatment. This case report describes the first clinical application of the Er:YAG laser in urology.

Munoz, John A.; Riemer, Jennifer D.; Hayes, Gary B.; Negus, Dan; Fried, Nathaniel M.

2007-02-01

129

Use of Cutting Balloon in the Treatment of Urethral Stricture: A Novel Technique  

SciTech Connect

The peripheral cutting balloon has been used to treat various nonvascular strictures as well as vascular stenosis. In this article, we describe for the first time the use of the cutting balloon in the treatment of patients with urethral stricture. Four patients with bulbar urethral stricture were included in the study. All strictures were successfully dilated with the cutting balloon, and patients were free of symptoms at 6-month follow-up. Cutting-balloon dilatation is a safe, easy-to-perform, and effective treatment for patients with tight urethral strictures.

Yildirim, Erkan, E-mail: drerkany@yahoo.co [Baskent University Medical School Ankara, Department of Radiology (Turkey); Cicek, Tufan; Istanbulluoglu, Okan; Ozturk, Bulent [Baskent University Medical School Ankara, Department of Urology (Turkey)

2009-05-15

130

Traumatic Brain Injury  

MedlinePLUS

... Resources to Promote Psychological Health and Resilience in Military and Civilian Communities." Story National Plan Supports Veterans' ... and traumatic brain injury research efforts at the Military Health System Research Symposium. Story Maryland Nurses Learn ...

131

Traumatic Brain Injury  

MedlinePLUS Videos and Cool Tools

... service member refers to people serving in the military. This reference summary explains traumatic brain injuries. It ... are a common cause of TBIs in the military during wartime. Many service members have suffered from ...

132

Primary traumatic patellar dislocation  

PubMed Central

Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management. PMID:22672660

2012-01-01

133

Traumatic lumbar hernia: can't afford to miss.  

PubMed

We describe the radiological and surgical correlation of an uncommon case of a traumatic lumbar hernia in a 22-year-old man presenting to the emergency department following a motor vehicle accident. Computed tomography (CT) of the abdomen revealed a right-sided traumatic inferior lumbar hernia containing a small amount of fat through the posterior lateral internal oblique muscle with hematoma in the subcutaneous fat and adjacent abdominal wall musculature, which was repaired surgically via primary closure on emergent basis. The purpose of this article is to emphasize the importance of diagnosing traumatic lumbar hernia on CT and need for urgent repair to avoid potential complications of bowel incarceration and strangulation. PMID:24424984

Saboo, Sachin S; Khurana, Bharti; Desai, Naman; Juan, Yu-Hsiang; Landman, Wendy; Sodickson, Aaron; Gates, Jonathan

2014-06-01

134

Novel posterior fixation keratoprosthesis  

NASA Astrophysics Data System (ADS)

The keratoprosthesis is the last solution for corneally blind patients that cannot benefit from corneal transplants. Keratoprostheses that have been designed to be affixed anteriorly usually necessitate multi-step surgical procedures and are continuously subjected to the extrusion forces generated by the positive intraocular pressure; therefore, clinical results in patients prove inconsistent. We proposed a novel keratoprosthesis concept that utilizes posterior corneal fixation which `a priori' minimizes the risk of aqueous leakage and expulsion. This prosthesis is implanted in a single procedure thereby reducing the number of surgical complications normally associated with anterior fixation devices. In addition, its novel design makes this keratoprosthesis implantable in phakic eyes. With an average follow-up of 13 months (range 3 to 25 months), our results on 21 cases are encouraging. Half of the keratoprostheses were implanted in severe burn cases, with the remainder in cases of pseudo- pemphigus. Good visual results and cosmetic appearance were obtained in 14 of 21 eyes.

Lacombe, Emmanuel

1992-08-01

135

Uncontrolled epistaxis secondary to traumatic pseudoaneurysm of the maxillary artery.  

PubMed

We describe a rare case of traumatic pseudoaneurysm of the maxillary artery following a fall. The patient presented with epistaxis that could not be controlled with anterior and posterior nasal packing. She was urgently taken to the angiography suite for evaluation and ultimately underwent embolization of a left maxillary artery pseudoaneurysm with 500-700?micron Contour PVA followed by coiling with two 3?mm Tornado coils. Bleeding subsided after embolization, and the patient suffered no neurologic sequelae. PMID:22937363

Adil, Eelam; Setabutr, Dhave; Carr, Michele M

2011-01-01

136

A man with urethral polyembolokoilamania successfully treated with electroconvulsive therapy.  

PubMed

Polyembolokoilamania is the act of inserting foreign objects into bodily orifices and can be classified as a paraphilia if done for sexual pleasure. Although problematic sexual behaviors are common in dementia, the majority of case reports of urethral polyembolokoilamania in the elderly have occurred in the absence of dementia or cognitive impairment. Little empirical evidence exists for managing problematic sexual behaviors in the elderly and in dementia. Most evidence in the form of case reports demonstrates that behavioral, environmental, and pharmacological interventions can be effective. In this case report, we describe the management of sexually disinhibited behavior in the form of polyembolokoilamania in a 67-year-old man suffering from treatment-resistant depression, obsessive compulsive disorder, and early signs of frontotemporal dementia. The successful treatment included a course of electroconvulsive therapy. PMID:24569921

Ingves, Matthew V; Lau, Timothy; Fedoroff, J Paul; Levine, Sharon

2014-08-01

137

[Tissue equivalent for the closure of extended urethral defects].  

PubMed

The aim of the present work was to develop a method for culturing epidermal keratinocytes to be used in a tissue equivalent for the closure of extended urethral defects. The experiment was carried out using 15 rabbits. Skin biopsies were obtained from the inner surface of the ear. The tissue equivalent consisted of collagen gel with embedded fibroblasts and epidermal keratinocytes grown on its surface; lavsan-mesh endoprosthesis served as the framework. Prefabrication of the neourethral plate was performed on the superficial fascia of m. rectus abdominis. The neourethral tube was formed after engraftment which was complete in all 15 animals. A histological study revealed morphological similarity of the neourethral tube thus engineered and the normal urethra. PMID:21899087

Milanov, N O; Adamian, R T; Rogovaia, O S; Vasil'ev, A V; Zhidkov, I L; Lipski?, K B; Guliaev, I V; Suvorov, N A; Tagabilev, D G; Kiselev, I V; Terskikh, V V

2011-01-01

138

Urethral advancement procedure for reconstruction after excision of male parameatal melanoma in situ.  

PubMed

We successfully reconstructed the glans penis and external meatus by means of the urethral mobilization and advancement technique for an adult patient with a parameatal lesion of melanoma in situ. PMID:15756073

Kato, Haruaki; Hayashi, Koichi; Saida, Toshiaki; Kontani, Kazuhiko; Nishizawa, Osamu

2005-01-01

139

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

PubMed Central

Primary urethral carcinoma is extremely rare and is marked by a variety of clinical symptoms. Primary carcinoma of a urethral diverticulum is still rarer and clear cell adenocarcinoma of the urethra is particularly uncommon (Swartz et al., 2006). Such infrequency has led to inadequate management guidance in the literature for a disease that is often late in presentation and carries substantial morbidity and mortality. This treatable but grave disease deserves definitive curative treatment. We present the first published instance in which it was treated with robotic anterior exenteration. In our case, a 47-year-old female was referred to the urology service for investigation of recurring urinary tract infections. During the workup, the patient was found to have an advanced clear cell urethral adenocarcinoma originating in a urethral diverticulum. We discuss the natural history of this condition, its consequences, and the first instance of its treatment using robotic anterior pelvic exenteration. PMID:24454400

Ross, Curtis

2013-01-01

140

Is urethral mobility really being assessed by the pelvic organ prolapse quantification (POP-Q) system?  

Microsoft Academic Search

OBJECTIVE:To estimate the relationship between Q-tip measurement of urethral hypermobility and visual assessment of the urethrovesical junction as assessed by points Aa and Ba of the pelvic organ prolapse quantification (POP-Q) system.METHODS:A total of 274 patients with pelvic organ prolapse or urinary incontinence had preoperative Q-tip test straining angles and POP-Q staging measurements. By the Q-tip test, urethral hypermobility was

Stephanie L Cogan; Anne M Weber; Jeffrey P Hammel

2002-01-01

141

Suprapubic Bladder Aspiration or Urethral Catheterization: Which is More Painful in Uncircumcised Male Newborns?  

PubMed Central

Background: The aim was to compare the intensity of pain caused by suprapubic aspiration (SPA) and urethral catheterization for urine sampling in premature infants. Methods: A prospective randomized controlled design with 80 premature infants in Alzahra University Hospital, Isfahan, Iran was conducted. Premature newborns who needed urine samples for microbiologic analysis were randomly assigned into two groups: SPA group and urethral catheterization group. Newborn faces and upper parts of the body were videotaped during the study and the pain was assessed during urine collection using Premature Infant Pain Profile (PIPP) score. Furthermore, crying time compared between groups. Results: The mean crying time was significantly higher in SPA than urethral catheterization group (77 vs. 34.4 s) (P < 0.001). The PIPP score was significantly lower in urethral catheterization group (13.4) than SPA group (11.5) P < 0.001. The success rate of SPA was 53% compared with 71% success rate of urethral catheterization. Conclusions: SPA is more painful than urethral catheterization in premature male infants as assessed by PIPP score and is more likely leads to procedure failure.

Badiee, Zohreh; Sadeghnia, Alireza; Zarean, Noushin

2014-01-01

142

Coping with Traumatic Stress Reactions  

MedlinePLUS

... Guidelines Hospital Quality Data Medical Inspector Patient Safety Organizations Administrative Clinical Quick Links Enter ZIP code here Enter ZIP code here Coping with Traumatic Stress Reactions Coping with Traumatic Stress Reactions Available in ...

143

Post Traumatic Stress Disorder Research  

MedlinePLUS

... Disorder (OCD) (4 Items) Panic Disorder (2 Items) Post-Traumatic Stress Disorder (9 Items) Schizophrenia (2 Items) ... Disorder (OCD) (4 Items) Panic Disorder (2 Items) Post-Traumatic Stress Disorder (9 Items) Schizophrenia (2 Items) ...

144

Post-traumatic stress disorder  

MedlinePLUS

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder . It can occur after you have ... Parslow B. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev . ...

145

Posterior wall prolapse and repair.  

PubMed

Most posterior wall defects occur in combination with other pelvic support disorders. Some patients with rectoceles, the most common posterior wall defect, are asymptomatic, whereas others experience a range of symptoms from a sensation of lower pelvic fullness to defecatory and/or sexual dysfunction. If patients are symptomatic, rectoceles can be treated conservatively with pelvic floor physiotherapy, behavioral therapy, or pessaries. Surgically, the most common rectocele repair is a traditional posterior colporrhaphy which provides excellent cure rates of up to 95%. The studies published to date do not support the use of biologic or synthetic absorbable grafts in reconstructive surgical procedures of the posterior compartment as these repairs have not improved anatomic or functional outcomes over traditional posterior colporrhaphy. PMID:20142644

Kudish, Bela I; Iglesia, Cheryl B

2010-03-01

146

Post-Traumatic Stress Disorder  

E-print Network

Post-Traumatic Stress Disorder Large-print Version It's natural to be afraid when you're in danger stress disorder. #12;· · · · · · What is post-traumatic stress disorder, or PTSD? PTSD is a real illness afraid and upset weeks or months later, it's time to talk with your doctor.You might have post-traumatic

Bandettini, Peter A.

147

Classification of posterior vitreous detachment  

PubMed Central

Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT). By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD) or a partial posterior vitreous detachment (P-PVD). A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage) and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage). A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]). By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole. PMID:24376338

Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun

2014-01-01

148

A Case of Spontaneous Acute Subdural Haematoma in Traumatic Carotid- Cavernous Fistula  

PubMed Central

Summary We report a case of acute subdural haematoma in traumatic carotid-cavernous fistula. The patient had a history of head trauma four years ago. Postoperative study revealed CCF of dominant posterior drainage with giant pseudoaneurysm. Thereafter endovascular treatment using detachable balloons and detachable platinum micro-coils made successful occlusion of the fistula preserving the ICA. PMID:20667193

Fukui, K.; Miyachi, S.; Kato, M.; Miyazaki, M.

2000-01-01

149

Single dose treatment of gonococcal urethritis with augmentin in Ibadan.  

PubMed

Augmentin, a new orally absorbed broadspectrum antibacterial agent comprising of amoxycillin trihydrate and potassium clavulanate, was investigated in the treatment of gonococcal urethritis in Ibadan, Nigeria, where penicillinase producing Neisseria gonorrhoeae (PPNG) constitute about 80% of the circulating strains of gonococci. Two different formulations of the agent were employed in the study. The first formulation consisting of 3.0 g amoxycillin and 125 mg clavulanic acid, achieved a cure rate of 75% (i.e. eighteen out of twenty-four patients) among PPNG infections, but 100% cure rate among nine patients with non-PPNG infections. The second formulation consisting of 3.0 g amoxycillin and 250 mg clavulanic acid, had a cure rate of 86% (i.e. fifty-seven out of sixty-six patients) among PPNG infections, and 91% (i.e. ten out of eleven patients) among non-PPNG infections. Clavulanic acid appears to potentiate and enhance the activity of amoxycillin against the beta-lactamase produced by the gonococci. Augmentin seems to be a good and acceptable agent for the treatment of gonococcal infections, in this environment and further studies on its efficacy are therefore justified, such as the simultaneous administration of probenecid. PMID:3004176

Osoba, A O; Oyelese, A O; Ashiru, J O; Ekweozor, C C; Ochei, J

1985-01-01

150

Use of Martius flap in the complex female urethral surgery  

PubMed Central

Introduction Objectives were to evaluate safety and patient reported perception of the Martius fibroadipose flap for complex female urethra reconstruction. Material and methods Patients operated with a Martius flap were contacted again via telephone to rate their self–perception on cosmetic appearance, pain or numbness of the flap harvest site. Results 37 women (mean age of 46.8 yrs.) were operated with Martius flaps. Complications were limited to bleeding from the flap bed in 19% (7/37); hematomas – 5.4% (2/37); and lymphorrhea from the labial incision in 13.5% (5/37) and labial wound infection in 5.4% of cases (2/37). For self–perception 65% of patients (24/37) were phone interviewed (mean follow up – 54.2 months). Only 17% of women (4/24) complained to cosmetic problems. Two patients (8%) complained to a periodical mild pain. And 12.5% (3/24) of the women had decreased sensation or numbness at the labia. Conclusions Martius flap is safe and it is not causing significant complications during female urethral reconstruction. However, an informed consent for decreased sensation and numbness at the flap harvesting area should be obtained. PMID:25140241

Tupikina, Nataliya; Pushkar, Dmitry

2014-01-01

151

Transition after Traumatic Loss  

ERIC Educational Resources Information Center

Children experience grief when they suffer the loss of a close relationship. When that loss also traumatizes children, they experience additional emotional reactions. It is important that adults educate themselves and others who deal with children about typical, healthy grief reactions. Following a non-violent loss, the initial reactions of…

Kuban, Caelan

2011-01-01

152

Experimental traumatic brain injury  

Microsoft Academic Search

Traumatic brain injury, a leading cause of death and disability, is a result of an outside force causing mechanical disruption of brain tissue and delayed pathogenic events which collectively exacerbate the injury. These pathogenic injury processes are poorly understood and accordingly no effective neuroprotective treatment is available so far. Experimental models are essential for further clarification of the highly complex

Christiane Albert-Weissenberger; Anna-Leena Sirén

2010-01-01

153

Traumatic Brain Injury  

Microsoft Academic Search

Approximately 250 per 100,000 of the population sustain traumatic brain injury (TBI) annually (Cassidy et al., 2004), making it the most commonly occurring neurological condition. Of these 102 per 100,000 are hospitalised (Chesnut, Carney, Maynard, Patterson, Mann, & Helfand, 1998). Because of advances in trauma care these individuals are surviving injuries that would previously have been fatal (Klimczak, Donovick, &

Janet M. Leathem; Muriel Christianson

154

Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury  

Microsoft Academic Search

The prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for

RICHARD A. BRYANT; MARK CREAMER; MEAGHAN O’DONNELL; DERRICK SILOVE; C. RICHARD CLARK; ALEXANDER C. MCFARLANE

2009-01-01

155

Posterior cruciate ligament (PCL) injury  

MedlinePLUS

... extends from the top-rear surface of the tibia (bone between the knee and ankle) to the ... from posterior instability. This means it prevents the tibia from moving too much and going behind the ...

156

Preoperative CT Voiding Cystourethrography Using 16-Multidetector CT in Female Urethral Diverticulum  

PubMed Central

Purpose To evaluate the clinical usefulness of preoperative CT voiding cystourethrography (CT-VCUG) using 16-multidetector computed tomography for female urethral diverticula. Materials and Methods Preoperative CT-VCUG was performed in 15 consecutive patients who underwent urethral diverticulectomy from May 2004 to December 2012. The result of preoperative cystourethroscopy and surgical findings were recorded by a single surgeon and CT-VCUG findings including the location of osita were retrospectively reviewed by another urologist who was blinded to the surgical finding. The location of the ostium detected on CT-VCUG was compared descriptively with the intraoperative surgical and preoperative cystourethroscopic findings. Results A total of 14 consecutive patients who underwent preoperative CT-VCUG and urethral diverticulectomy were included in the analysis. Ostia were detected on CT-VCUG in all cases, whereas ostia were identified in 10 patients (71.4%) by cystourethroscopy. Ostia were located between the 4 and 8 o’clock direction. Mean distance from the bladder neck to the ostium was 24.2 mm. Circumferential and horseshoe shaped diverticula were observed in 6 and 4 patients, respectively. The surgical findings correlated well with the CT findings. Conclusions Preoperative CT-VCUG can be useful in identifying the ostia of urethral diverticula in patients scheduled for urethral diverticulectomy and can provide structural information, useful to establish surgical strategy. PMID:25216189

Lee, Young Ju; Son, Seung Jun; Paick, Jae-Seung; Kim, Soo Woong

2014-01-01

157

Long anterior urethral stricture: Reconstruction by dorsally quilted penile skin flap  

PubMed Central

Objectives: We’d like to present our experience in treating long (>5 cm) anterior urethral stricture by penile skin flap as dorsal on-lay in one-stage procedure. Patient and Methods: Between January 1998 and December 2010, 18 patients (aged from 28-65 years) presented with long urethral stricture, 5.6-13.2 cm, (penile in 6, bulbar in 2, and combined in 10 cases), those were repaired utilizing long penile skin flaps placed as dorsal on-lay flap in one-stage (Orandi flap 6 cm in 6 cases, circular flaps 7-10 cm in 8, and spiral flaps 10-15 cm in 4). Uroflowmetry and RUG were done following catheter removal and at 6 and 12 months. Results: The urethral patency was achieved in 77% of patients. The complications were fistula in 1 patient (5.5%), re-stricture occurred in 3 patients (16.6%) that required visual internal urethrotomy (VIU), and 2 patients (11%) showed curvature on erection that did not interfere with sexual intercourse. Diverticulum (penile urethra) was seen in 1 patient (5.5%) containing stones and was excised surgically. There was penile skin loss in 3 patients (16.6%). All patients completed at least one year follow-up period. Conclusion: Free penile skin flaps offer good results (functional and cosmetic) in long anterior urethral stricture. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long. PMID:24049378

Abdel-Kader, Mohammad Sayed; Gadelmoula, Mohamed; Elderwy, Ahmad; Elgammal, Mohammed; Abuzeid, Abdelmoneim Mohamed

2013-01-01

158

Recurrent villous adenoma with high-grade dysplasia arising in a urethral diverticulum.  

PubMed

Villous adenomas of the urinary tract are an uncommon, well-recognized entity, described in different locations. However, the occurrence of this lesion in the female urethral diverticulum is very unusual. We present the first case of a recurrent villous adenoma with high-grade dysplasia unassociated with adenocarcinoma, arising from a urethral diverticulum. A 75-year-old African-American female presented with urethral prolapse complaining of mild voiding difficulty, stress incontinence, and mild spotting of blood. Histological examination revealed a papillary lesion with finger-like processes lined by pseudostratified columnar epithelium with abundant goblet cells. There were focal areas with stratification to the luminal surface and loss of nuclear polarity and atypical mitoses, interpreted as villous adenoma with high-grade dysplasia. The lesion recurred at one year without evidence of malignant transformation. We also present a brief literature review of urothelial villous adenomas. PMID:19718251

Zarineh, Alireza; Bulakhtina, Elena; Olson, Peter R; Silverman, Jan F

2009-01-01

159

Clinical evaluation of Apamarga-Ksharataila Uttarabasti in the management of urethral stricture  

PubMed Central

Stricture urethra, though a rare condition, still is a rational and troublesome problem in the international society. Major complications caused by this disease are obstructed urine flow, urine stasis leading to urinary tract infection, calculi formation, etc. This condition can be correlated with Mutramarga Sankocha in Ayurveda. Modern medical science suggests urethral dilatation, which may cause bleeding, false passage and fistula formation in few cases. Surgical procedures have their own complications and limitations. Uttarabasti, a para-surgical procedure is the most effective available treatment in Ayurveda for the diseases of Mutravaha Strotas. In the present study, total 60 patients of urethral stricture were divided into two groups and treated with Uttarabasti (Group A) and urethral dilatation (Group B). The symptoms like obstructed urine flow, straining, dribbling and prolongation of micturation were assessed before and after treatment. The results of the study were significant on all the parameters. PMID:24250127

Reddy, K. Rajeshwar

2013-01-01

160

Isolated Posterior Fossa Involvement in Posterior Reversible Encephalopathy Syndrome  

PubMed Central

Summary Posterior reversible encephalopathy syndrome (PRES) is characterized by reversible vasogenic edema affecting the subcortical white matter of bilateral occipital and parietal lobes. We describe a case of isolated posterior fossa involvement of PRES which occurred during remission induction chemotherapy for T-cell acute lymphoblastic leukemia. Both the brainstem and cerebellum were extensively involved, but the supratentorial structures were completely spared. The follow-up magnetic resonance images revealed reversibility of most lesions. The knowledge of atypical radiological features of PRES is essential for prompt diagnosis. PMID:24199811

Shimizu, Yukie; Tha, Khin Khin; Iguchi, Akihiro; Cho, Yuko; Yoshida, Atsushi; Fujima, Noriyuki; Tsukahara, Akiko; Shirato, Hiroki; Terae, Satoshi

2013-01-01

161

Women and traumatic events.  

PubMed

Posttraumatic stress disorder (PTSD) gained the status of a psychiatric disorder in 1980, although the syndrome had already been recognized widely for many years. PTSD is distinguished by alternations between reexperiencing of the traumatic event that triggered the PTSD in the first place and avoidance and numbing. Increased arousal (e.g., exaggerated startle reaction) also forms part of the diagnosis. Although the majority of trauma victims recover spontaneously, more than 30% develop persistent PTSD symptoms, with women being twice as likely as men to suffer PTSD. To date, the most studied psychosocial treatments for PTSD are the cognitive-behavioral interventions. Exposure therapy (systematic exposure to the traumatic memory in a safe environment) has been demonstrated to be quite effective with adult women who were sexually or nonsexually assaulted in adulthood as well as with women who were sexually abused in childhood. Supportive counseling does not appear as effective as exposure therapy, but is better than no therapy. PMID:11495093

Foa, E B; Street, G P

2001-01-01

162

Traumatic Brain Injury  

Microsoft Academic Search

\\u000a Traumatic brain injury (TBI) is a serious public health problem, often referred to as a silent epidemic due to lack of public\\u000a awareness [1]. TBI is still the leading cause of mortality and morbidity in the world for individuals under the age of 45\\u000a [2]. In the United States alone, based on population data from 1995 to 2001, 1.4 million

Terri Morris

163

Traumatic brain injury  

PubMed Central

There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilcian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad. PMID:21149359

Risdall, Jane E.; Menon, David K.

2011-01-01

164

Abnormalities of the innervation of the urethral striated sphincter musculature in incontinence.  

PubMed

Perineal nerve and transcutaneous spinal cord stimulation have been used to study 17 patients with idiopathic neurogenic faecal incontinence, 12 of whom also had urinary incontinence. Significant increases in spinal, perineal and pudendal nerve motor latencies were demonstrated in all 17 patients. These results suggest that there is damage to the nerves innervating both the urethral and perianal sphincter musculature in these patients, including those with isolated faecal incontinence. There was evidence of both a distal (perineal nerve) and a proximal (sacral root) component to the damage to the nerve supply of the urethral striated sphincter muscle in half of the patients. PMID:6335972

Snooks, S J; Swash, M

1984-08-01

165

Primary myelolipoma in posterior mediastinum  

PubMed Central

Myelolipoma in posterior mediastinum is indeed rare. As a benign tumor, it consists of mature fat with scattered foci of haematopoietic elements resembling bone marrow. The computed tomography (CT) and magnetic resonance imaging (MRI) are effective methods to detect them, while the definite diagnosis still depends on pathological diagnosis. Up to now, there is no standard treatment for this disease. Surgery is thought to be the best choice in some literatures reports. In this paper, two patients with primary posterior mediastinal tumor are reported, both of whom were underwent Video-assisted thoracoscopic surgery (VATS). Postoperative pathological diagnosis was myelolipoma.

Xiong, Yan; Wang, Yong

2014-01-01

166

Primary myelolipoma in posterior mediastinum.  

PubMed

Myelolipoma in posterior mediastinum is indeed rare. As a benign tumor, it consists of mature fat with scattered foci of haematopoietic elements resembling bone marrow. The computed tomography (CT) and magnetic resonance imaging (MRI) are effective methods to detect them, while the definite diagnosis still depends on pathological diagnosis. Up to now, there is no standard treatment for this disease. Surgery is thought to be the best choice in some literatures reports. In this paper, two patients with primary posterior mediastinal tumor are reported, both of whom were underwent Video-assisted thoracoscopic surgery (VATS). Postoperative pathological diagnosis was myelolipoma. PMID:25276393

Xiong, Yan; Wang, Yong; Lin, Yidan

2014-09-01

167

Traumatic interhemispheric subdural haematoma: Study of 35 cases.  

PubMed

The clinical and radiological findings, management, and outcomes in 35 patients with traumatic interhemispheric subdural haematoma (ISH) were reviewed retrospectively. Twenty-five patients had favourable outcomes and 10 had poor outcomes. All patients were treated conservatively for ISH. Univariate analysis found that the Glasgow Coma Scale (GCS) score (p < 0.001), hypovolemic shock (p = 0.018), skull fracture (p = 0.008), convexity or posterior fossa subdural haematoma (p = 0.008), and subarachnoid haemorrhage (SAH) were correlated with outcome (p < 0.001). Multivariate analysis showed that GCS score (p = 0.031; odds ratio [OR], 0.6; 95% confidence interval [CI], 0.3-0.9) and the presence of SAH (p = 0.023; OR, 14.2; 95% CI, 1.5-138.2) were significantly related to poor outcome. This study provides important information on the clinicoradiological findings and prognoses in patients with traumatic ISH. PMID:20817537

Takeuchi, Satoru; Takasato, Yoshio; Masaoka, Hiroyuki; Hayakawa, Takanori; Yatsushige, Hiroshi; Sugawara, Takashi

2010-12-01

168

Post-traumatic Stress Disorder Following Traumatic Injuries in Adults  

Microsoft Academic Search

The residuals of traumatic injuries from home or workplace accidents, automobile accidents, physical assault, or other unintentional human error can affect victims both physically and psychologically. Symptoms of post-traumatic stress disorder (PTSD) are common among survivors of accidents and nonsex- ual assaults and can impede recovery. Early identifica- tion of PTSD and timely referrals to mental health providers can greatly

Jo M. Weis; Brad K. Grunert

169

Prevalence of genital Mycoplasma, Ureaplasma, Gardnerella , and human papillomavirus in Japanese men with urethritis, and risk factors for detection of urethral human papillomavirus infection  

Microsoft Academic Search

To analyze the risk factors for HPV infection in the urethra, we examined the prevalence of various microorganisms, for example\\u000a Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum, Gardnerella vaginalis, and human papillomavirus (HPV) in Japanese male patients with urethritis, and investigated their sexual backgrounds. Rubbed\\u000a samples obtained from the distal urethra and questionnaires regarding sexual

Shohei Kawaguchi; Toshiyuki Sasagawa; Keiichi Furubayashi; Masayoshi Shimamura; Yuji Maeda; Hiroyuki Konaka; Atsushi Mizokami; Eitetsu Koh; Mikio Namiki

170

Biocompatibility of posterior restorative materials.  

PubMed

Biocompatibility of dental materials is an important consideration for the patient, clinician, laboratory technician and manufacturer. This paper examines biocompatibility testing methods and the biocompatibility of posterior restorative materials, including amalgam, casting alloys, resin composites, dentin bonding agents, cements, porcelains and ceramics. PMID:9120609

Schuster, G S; Lefebvre, C A; Wataha, J C; White, S N

1996-09-01

171

Youth deception: Malingering traumatic stress  

Microsoft Academic Search

To explore how youths malinger symptoms of post-traumatic stress disorder (PTSD), college students completed the Trauma Symptom Inventory (TSI) under standard instructions (honest condition). Then, after learning the symptomatology of traumatic stress, they completed the TSI a second time attempting to fake symptoms of PTSD (deception condition). Motivation level was manipulated: 100 students were given course credits, allowing them to

DENNIS P. CARMODY; ANGELA M. CROSSMAN

2005-01-01

172

Post-Traumatic Stress Disorder  

E-print Network

Post-Traumatic Stress Disorder (PTSD) National Institute of Mental Health U.S. Department of HealtH anD HUman ServiceS · national institutes of Health #12;Contents What is post traumatic stress disorder treated? 5 Psychotherapy 5 Medications 6 Other medications 8 Treatment after mass trauma 8 What

Bandettini, Peter A.

173

Hypopituitarism after traumatic brain injury  

Microsoft Academic Search

Traumatic brain injury (TBI) is one of the main causes of death and disability in young adults, with consequences ranging from physical disabilities to long-term cognitive, behavioural, psychological and social defects. Post-traumatic hypopituitarism (PTHP) was recognized more than 80 years ago, but it was thought to be a rare occurrence. Recently, clinical evidence has demonstrated that TBI may frequently cause

Marta Bondanelli; Maria Rosaria Ambrosio; Maria Chiara Zatelli; Laura De Marinis

2005-01-01

174

Continent women have better urethral neuromuscular function than those with stress incontinence  

PubMed Central

Introduction and hypothesis The objective of this study is to describe urethral neuromuscular function using concentric needle electromyography (EMG) in stress incontinent (SUI) and asymptomatic women. Methods Following Institutional Review Board approval, we recruited SUI and asymptomatic women without urinary incontinence. Participants underwent quantitative urethral EMG and urodynamic testing. Results Sixty-seven women (37 SUI, 30 continent) with mean±SD age of 44±12 years participated. Nearly all EMG parameters showed significant differences between continent and SUI women consistent with better motor unit recruitment in continent women. Continent women had larger-amplitude, longer-duration motor unit action potentials (MUP) with increased turns and better MUP recruitment during bladder filling (P<.05). Increasing age was inversely correlated with nearly all MUP parameters (P<.05), suggesting MUP to be consistent with neuropathy. Conclusions We found significant differences in multiple MUP parameters in urethral sphincter between continent and stress incontinent women, suggesting continent women have better urethral innervation. We also found significant neuropathic MUP changes with advancing age, regardless of continence status. PMID:21979386

Mueller, Elizabeth; Brubaker, Linda

2012-01-01

175

[Urethral parameatal cysts. Report of two cases and review of the literature].  

PubMed

Two cases of parameatal urethral cysts in the male are reported. These round cysts don't interfere with sexual function but can determinate an alteration of the urinary flow (biforcation of the flow). The aetiology of these cysts is not completely understood, while the treatment is univoque and simple: complete excision but no aspiration or marsupialization. PMID:8815551

Di Cello, V; Saltutti, C; Dominici, A; Costanzi, A; Raugei, A; Abd-Ali, A

1995-09-01

176

[Parameatal urethral cyst: a report of 2 cases and review of 32 cases in Japan].  

PubMed

Two cases of parameatal urethral cyst were experienced in the past two years. In both cases, the parameatal cystic tumors had been noticed since childhood. A clinical survey, such as incidence, therapy and pathology was made on 32 cases reported in the Japanese literature between 1919 and 1983. PMID:6475689

Nakame, Y; Yoshida, K; Kaneoya, F; Negishi, T

1984-05-01

177

Y-type urethral duplication in children: Management strategy at our center  

PubMed Central

Aims: Report of seven children with Y-type urethral duplication (YUD). Materials and Methods: (A) Four staged operations were performed in patients having extensive perineal dissection (for rectourinary fistula separation and anterior mobilization of ventral urethra (VU)), tension rectocutaneous anastomosis, and children who were not toilet trained). These stages are (1) diversion sigmoid colostomy with anterior mobilization of VU as perineal urethrostomy via anterior sagittal approach; (2) Orthotopic urethral (OU) reconstruction; (3) anastomosis of OU and perineal urethra; (4) colostomy closure with management of complications. (B) The patients having VU onto the perineum underwent single stage urethral reconstruction. Results: The VU was urethrorectal/urethroanal in five and urethroperineal in two. Low anorectal malformation and upper urinary tract anomalies were present in 57.1% (4/7) and 14.7% (1/7) patients, respectively. Buccal mucosa free graft, transverse inner preputial flap, and perineal skin were tubularized for OU reconstruction. Mean age at 1st , 2nd , 3rd , and 4th surgery was 5 ± 0.78, 28 ± 0.78, 36 ± 0.78, 49 ± 0.78 months respectively. Three patients needed surgery for complications (urethrocutaneous fistula in two and urethral diverticulum in one) in a mean 3.12 ± 0.34 years of follow-up. Final uroflowmetry and fecal continence were good in all patients. Conclusions: The YUD is a difficult entity to manage. Although, staged procedure appears to be time consuming, but good and promising results can be achieved by staging the procedure. PMID:24019640

Singh, Sunita; Rawat, Jiledar

2013-01-01

178

Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome?  

Microsoft Academic Search

A potential association between abnormal electromyographic activity--that is, decelerating bursts and complex repetitive discharges--of the urethral sphincter and difficulty in voiding was examined in 57 women with urinary retention. Abnormal electromyographic activity was found in 33. Ultrasonography of the ovaries in 22 of the 33 women showed that 14 had polycystic ovaries. Of the other eight women, two had had

C. J. Fowler; T. J. Christmas; C. R. Chapple; H. F. Parkhouse; R. S. Kirby; H. S. Jacobs

1988-01-01

179

Evaluation of the biocompatibility and mechanical properties of naturally derived and synthetic scaffolds for urethral reconstruction.  

PubMed

The aim of this study was to evaluate the mechanical properties and biocompatibility of biomaterials, including bladder submucosa (BAMG), small intestinal submucosa (SIS), acellular corpus spongiosum matrix (ACSM), and polyglycolic acid (PGA), to identify the optimal scaffold for urethral tissue engineering. Tensile mechanical testing was conducted to evaluate mechanical properties of each scaffold. Rabbit corporal smooth muscle cells were cultured with the extracts of biomaterials and mitochondrial metabolic activity assay was used to determine the cytotoxicity of scaffold. The pore sizes of each scaffold were measured. Additionally, smooth muscle cells were seeded on biomaterials. Cell infiltration was evaluated. Mechanical evaluation showed that Young modulus, stress at break in ACSM were prior to those in other biomaterials (p < 0.05). MTT assay confirmed that all scaffolds supported normal cellular mitochondrial metabolic without inducing cytotoxic events. SEM demonstrated that PGA has the largest pore size (>200 microm). The ACSM has different pore sizes in urethral (<5 microm) and cavernosal surfaces (>10 microm). Widespread distribution of cells could be observed in PGA 14 days after seeding. Multilayer cellular coverage developed in BAMG and urethral surface of ACSM without any sign of cellular invasion. Moderated cellular penetration could be found in SIS and cavernosal surface of ACSM. Although each scaffold demonstrated suitable mechanical properties, which is similar to normal urethra, ACSM showed better response in some parameters than those in other biomaterials. It suggested that this scaffold may be an alternative for urethral reconstruction in the future. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010. PMID:20166222

Feng, Chao; Xu, Yue-Min; Fu, Qiang; Zhu, Wei-Dong; Cui, Lei; Chen, Jie

2010-07-01

180

Dorsal Onlay versus Ventral Onlay Urethroplasty for Anterior Urethral Stricture: A Meta-Analysis  

Microsoft Academic Search

Background: Ventral and dorsal sides of urethra were chosen to place grafts in free graft onlay urethroplasty. As the advantages and disadvantages of these two sites are still unclear, we systemically analyzed clinical articles reported in the literature. Materials and Methods: The literature till October 2007 regarding the use of ventral\\/dorsal graft urethroplasty in anterior urethral strictures was searched using

Kunjie Wang; Xunzhong Miao; Li Wang; Hong Li

2009-01-01

181

Implantation of autologous bone-marrow-derived cells reconstructs functional urethral sphincters in rabbits.  

PubMed

The purpose of this study was to determine if implantation of autologous bone-marrow-derived cells has the potential to treat stress urinary incontinence caused by intrinsic sphincter deficiency. Bone marrow cells harvested from femurs of New Zealand White rabbits were cultured for 10 days. Seven days before implantation, the urethral sphincters located at the internal urethral orifice were cryo-injured by spraying liquid nitrogen for 15?s. The cultured autologous bone-marrow-derived cells were implanted 7 days after cryo-injury. For controls, cell-free solutions were injected. At 7 and 14 days after implantation, leak point pressures were determined and the urethral sphincters were examined by immunohistochemistry. At 7 and 14 days, the cell-implanted regions contained numerous striated and smooth muscle-like cells expressing myoglobin and smooth muscle actin, respectively. The proportions of myoglobin- and smooth muscle actin-expressing areas in both the 7- and 14-day cell-implanted regions were significantly higher than in controls. By 14 days, these differentiated cells formed contacts with similar cells, creating layered muscle structures. At that time, the leak point pressure of the cell-implanted rabbits was significantly higher than that of the controls. In conclusion, autologous bone-marrow-derived cells can reconstruct functional urethral sphincters. PMID:21091339

Imamura, Tetsuya; Ishizuka, Osamu; Kinebuchi, Yoshiaki; Kurizaki, Yoshiki; Nakayama, Tsuyoshi; Ishikawa, Masakuni; Nishizawa, Osamu

2011-04-01

182

Enigma of urethral pain syndrome: why are there so many ascribed etiologies and therapeutic approaches?  

PubMed

Urethral pain syndrome has had several sobriquets, which have led to much confusion over the existence of this pathological condition and the useful options in the care of the afflicted patient. Our aim was to explore the proposed etiologies of this syndrome, and to provide a critical analysis of each proposed etiology and present a balanced argument on the plausibility of the proposed etiology and therapeutic approaches. We carried out an English language electronic search in the following databases: Medline, Embase, Amed, Cinahl, Pubmed, Cochrane Library, Trip Database and SUMSearch using the following search terms: urethral syndrome, urethral diseases, urethra, urologic diseases etiology/etiology, presentation, treatment, outcome, therapeutics and treatment from 1951 to 2011. In excess of 200 articles were recovered. With the clearly defined objectives of analyzing the proposed etiologies and therapeutic regimes, two author(s) (HP and IO) perused the abstracts of all the recovered articles, selecting those that addressed the etiologies and therapeutic approaches to treating the urethral pain syndrome. The number of articles was reduced to 25. The full text of all 25 articles were retrieved and reviewed. Through the present article, we hope to elucidate the most probable etiology of this condition whilst simultaneously, advance a logical explanation for the apparent success in the treatment of this condition using a range of different therapeutic modalities. We have carried out a narrative review, which we hope will reduce some of the confusion around this clinical entity by combining the known facts about the disease. PMID:24447292

Phillip, Harris; Okewole, Idris; Chilaka, Victor

2014-06-01

183

Anastomotic Urethroplasty in Female Urethral Stricture Guided by Cystoscopy – A Point of Technique  

PubMed Central

Purpose: During anastomotic urethroplasty for stricture urethra with false passage using standard technique, there remains a chance of anastomosis of normal distal urethra to proximal false lumen. Herein, we present a point of technique in which by using antegrade cystoscope, one cannot just identify and dissect normal anatomical proximal urethral lumen, but also perform some of the steps for anastomosis under direct vision. This will avoid making anastomosis to false lumen and thus leading to further complications. Materials and Methods: We report a case of 35-years-female who was presented to us with total mid-urethral stricture with false passage following multiple urethral dilatation attempts. We used antegrade cystoscopy during anastomotic urethroplasty to identify and dissect the proximal end of urethra thereby avoiding anastomosis to false tract. Results: We successfully performed anastomotic urethroplasty avoiding false passage. Post-operative Uroflow showed Q max of 18 ml/sec. Voiding cystourethrogram post-operatively showed anastomosis between normal anatomical lumens. Conclusion: This modification of using antegrade cystoscopy helps to identify proximal urethral end which in turn helps in avoiding anastomosis to false tract and ensures anastomosis between normal lumens. PMID:24741435

Patil, Sachin; Dalela, Deepansh; Dalela, Divakar; Goel, Apul; Sankhwar, Pushpalata; Sankhwar, Satya N.

2013-01-01

184

Surgical procedures for urethral diverticula in women in the United States, 1979–1997  

Microsoft Academic Search

The objective of this study was to describe national rates of surgery for urethral diverticula in women. Data from the National Hospital Discharge Survey (NHDS), a federal database that samples inpatient hospitals in the United States, were analyzed from 1979 to 1997 for diagnosis and procedure codes using the ICD-9-CM classification system. The difference between the median age-adjusted rates from

Lara J. Burrows; Nancy L. S. Howden; Leslie Meyn; Anne M. Weber

2005-01-01

185

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

PubMed

Congenital malformations or injuries of the urethra can be treated using existing autologous tissue, but these procedures are sometimes associated with severe complications. Therefore, tissue engineering may be advantageous for generating urethral grafts. We evaluated engineered high-density collagen gel tubes as urethral grafts in 16 male New Zealand white rabbits. The constructs were either acellular or seeded with autologous smooth muscle cells, isolated from an open bladder biopsy. After the formation of a urethral defect by excision, the tissue-engineered grafts were interposed between the remaining urethral ends. No catheter was placed postoperatively. The animals were evaluated at 1 or 3 months by contrast urethrography and histological examination. Comparing the graft caliber to the control urethra at 3 months, a larger caliber was found in the cell-seeded grafts (96.6% of the normal caliber) than in the acellular grafts (42.3%). Histology of acellular and cell-seeded grafts did not show any sign of inflammation, and spontaneous regrowth of urothelium could be demonstrated in all grafts. Urethral fistulae, sometimes associated with stenosis, were observed, which might be prevented by urethral catheter application. High-density collagen gel tubes may be clinically useful as an effective treatment of congenital and acquired urethral pathologies. PMID:22795859

Micol, Lionel A; Arenas da Silva, Luis F; Geutjes, Paul J; Oosterwijk, Egbert; Hubbell, Jeffrey A; Feitz, Wout F J; Frey, Peter

2012-10-01

186

Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic.  

PubMed

Between October 1974 and August 1997 in our Dizziness Clinic (n = 15,233), 2,523 patients were found to suffer from BPPV. All patients were assessed and followed up by the author. Patients (n = 337) having other ear or neurological diseases were excluded from this retrospective study. In 1644/2186 (75.21%) patients, the type of nystagmus was clinically identified in two opposite directions of gaze in the provocative head position. These patients were divided into two groups: i) idiopathic (n = 1,490) (no apparent cause); ii) post-traumatic (n = 154) (time of onset related to accident). It was found that in the idiopathic group men were older than women; women were more affected than men (2.3:1), and in the post-traumatic group there was no age difference between men and women; women and men were equally affected (1:1). In addition: i) patients were older in the idiopathic than the post-traumatic group. ii) BPPV of the posterior (PSC) was by far more prevalent than BPPV of the horizontal semicircular canal (HSC) in both groups, although there was no difference in prevalence between the two groups. iii) Bilateral involvement was more prevalent in the post-traumatic group. iv) All bilateral cases in both groups suffered from BPPV of the PSC. It is concluded that despite similarities, these two groups differ in a number of parameters. Thus the pathophysiology and the course of idiopathic vs post-traumatic BPPV may also be different. PMID:10687929

Katsarkas, A

1999-01-01

187

[Ossification of posterior longitudinal ligament].  

PubMed

Ossification of posterior longitudinal ligament (OPLL) is a hyperostotic disease of the spine associated with myelopathy which is occurred by an anterior compression to the spinal cord. OPLL was first reported by Key GA in 1838, and was previously considered specific to east Asian people, especially Japanese. However, now OPLL is recognized as a subtype of diffuse idiopathic skeletal hyperosteosis, which is detected in Europe and the United States. We discuss the etiology and natural history of OPLL in this review. PMID:24473355

Watanabe, Ryuichi; Miyamoto, Takeshi

2014-02-01

188

Neuroimaging of traumatic brain injury.  

PubMed

In this article, the neuroradiological evaluation of traumatic brain injury is reviewed. Different imaging strategies in the assessment of traumatic brain injury are initially discussed, and this is followed by a review of the imaging characteristics of both primary and secondary brain injuries. Computed tomography remains the modality of choice for the initial assessment of acute head injury because it is fast, widely available, and highly accurate in the detection of skull fractures and acute intracranial hemorrhage. Magnetic resonance imaging is recommended for patients with acute traumatic brain injury when the neurological findings are unexplained by computed tomography. Magnetic resonance imaging is also the modality of choice for the evaluation of subacute or chronic traumatic brain injury. Mild traumatic brain injury continues to be difficult to diagnose with current imaging technology. Advanced magnetic resonance techniques, such as diffusion-weighted imaging, magnetic resonance spectroscopy, and magnetization transfer imaging, can improve the identification of traumatic brain injury, especially in the case of mild traumatic brain injury. Further research is needed for other advanced imaging methods such as magnetic source imaging, single photon emission tomography, and positron emission tomography. PMID:19306377

Le, Tuong H; Gean, Alisa D

2009-04-01

189

Posterior asymmetry and idiopathic scoliosis  

E-print Network

Study design Are there neuro-anatomical abnormalities associated with idiopathic scoliosis (IS)? Posterior Basicranium (PBA) reflects cerebellum growth and contains vestibular organs, two structures suspected to be involved in scoliosis. Objective The aim of this study was to compare posterior basicranium asymmetry (PBA) in Idiopathic scoliosis (IS) and normal subjects. Method: To measure the shape of PBA in 3D, we defined an intra-cranial frame of reference based on CNS and guided by embryology of the neural tube. Measurements concerned three directions of space referred to a specific intra cranial referential. Data acquisition was performed with T2 MRI (G.E. Excite 1.5T, mode Fiesta). We explored a scoliosis group of 76 women and 20 men with a mean age of 17, 2 and a control group of 26 women and 16 men, with a mean age of 27, 7. Results: IS revealed a significant asymmetry of PBA (Pr>|t|<.0001) in 3 directions of space compared to the control group. This asymmetry was more pronounced in antero-posterior...

Rousie, D L; Berthoz, A

2009-01-01

190

Urethral Venous Malformation: An Unusual Cause of Recurrent Post-Coital Gross Haematuria in Association with Haematospermia  

PubMed Central

Three cases of recurrent post-coital haematuria are described. Extensive protracted investigations pinpointed urethral varicosities as the likely cause. All patients were successfully treated with diathermy fulguration. PMID:19558768

Gkougkousis, EG; Khan, M; Terry, TR; Mellon, JK

2009-01-01

191

Post-reduction stress urinary incontinence rates in posterior versus anterior pelvic organ prolapse: a secondary analysis  

PubMed Central

Introduction/hypothesis Stress incontinence with vaginal prolapse reduction is less common in women with posterior-predominant prolapse (rectocele) compared with those with anterior-predominant prolapse (cystocele). Methods This was a secondary analysis of a cohort of prospectively enrolled women with symptomatic pelvic organ prolapse at or beyond the hymen and prolapse-reduced stress urinary incontinence (SUI) testing. Subjects were included if they had anterior- or posterior-predominant prolapse with at least a 1 cm difference in pelvic organ prolapse quantification (POP-Q) points Ba and Bp (N=214). We evaluated the prevalence and risk factors of post-reduction SUI between the two groups. Results Comparing posterior (n=45) and anterior (n=169) prolapse groups, we identified similar rates of post-reduction SUI (posterior: 6/45, 13.3 %; anterior: 18/169, 10.7 %; p= 0.52) and SUI without reduction (posterior: 4.4 %; anterior: 11.2 %; p=0.26). Maximum prolapse size was slightly larger in anterior than in posterior patients (+3.1 vs +2.0 cm beyond the hymen, p=0.001), while a higher proportion of posterior subjects reported a prior hysterectomy (p=0.04). Among posterior subjects, lower maximum urethral closure pressure values (MUCP; p=0.02) were associated with post-reduction SUI. In contrast, among anterior-predominant prolapse, larger prolapse measured at POP-Q point Ba (p=0.003) and maximum POP-Q measurement (p=0.006) were each associated with higher rates of post-reduction SUI and were highly correlated with each other (R=0.90). Conclusions We observed similar rates of post-reduction SUI in women with anterior- and posterior-predominant pelvic organ prolapse. Factors affecting the anterior and posterior prolapse groups differed, suggesting different mechanisms of continence protection. These findings suggest that reduction incontinence testing for operative planning would be as relevant to posterior-predominant prolapses as it is to anterior prolapse. PMID:23306769

DeLancey, John O. L.; Fenner, Dee E.

2014-01-01

192

Clinical measurement of posterior shoulder flexibility  

Microsoft Academic Search

The objectives of this study were to determine both the intra-rater reliability and the smallest real difference necessary to detect meaningful clinical changes over an 8–12 week period for three clinical measures of posterior shoulder flexibility. Posterior shoulder tightness has been associated with abnormal humeral head translations that narrow the subacromial space and contribute to impingement. Posterior shoulder stretching to

John D. Borstad; Krista M. Mathiowetz; Laura E. Minday; Bhakti Prabhu; Daisy E. Christopherson; Paula M. Ludewig

2007-01-01

193

[The role of human papilloma virus in development of chronic urethritis and vulvodynia in females: perspectives of immunomodulating therapy].  

PubMed

The article is devoted to combined affection of the lower urinary tracts and genitalia in women with human papilloma virus (HPV) infection which manifests with persistent recurrent urethritis, pelvic pain syndrome. The colposcopic and urethrocystoscopic features, disturbed microcirculation of urethral and vaginal mucosa in virus infection promoting recurrences and persistence of HPV are discussed. Immunomodulators (inosin pranobex-groprinosin) are recommended for more effective treatment. PMID:22876631

Ne?mark, A I; Shelkovnikova, N V; Ne?mark, B A; Sizovv, K A

2012-01-01

194

Post-Traumatic Stress Disorder  

MedlinePLUS

... examples of traumatic events are a natural disaster, rape, severe car crash or fighting in a war. ... or victims of war or combat Survivors of rape, domestic violence, physical assault such as a mugging ...

195

Understanding Traumatic Stress in Children  

MedlinePLUS

... acute traumatic stress and complex trauma. For each aspect of trauma, we describe the most common developmental ... Think of self-care as having three basic aspects: awareness, balance, and connection — the “ABC’s” of self- ...

196

Post-Traumatic Stress Disorder  

MedlinePLUS

... human-caused disasters, accidents, or military combat. For Consumers General Information Post-Traumatic Stress Disorder ( NIMH ) Anxiety Information Stress Information Depression Information St. John's Wort Information See more Research Spotlights Acupuncture May Help Symptoms of Posttraumatic Stress ...

197

Traumatic Fracture of Thin Pedicles Secondary to Extradural Meningeal Cyst  

PubMed Central

Spinal dural meningoceles and diverticula are meningeal cysts that have a myriad of clinical presentations and sequelae, secondary to local mass effect. Our objective is to report a technical case report, illustrating a traumatic spinal injury with multiple pedicle fractures, secondary to atrophic lumbar pedicles as well as the diagnostic workup and surgical management of this problem. Posterior lumbar decompression, resection of the meningeal cyst, ligation of the cyst ostium, instrumentation, and fusion were performed with the assistance of intraoperative isocentric fluoroscopy. The cyst's point of communication was successfully located with intraoperative fluoroscopy and the lesion was successfully excised. We suggest that patients with traumatic spinal injuries, having evidence of pre-existing anomalous bony architecture, undergo advanced imaging studies, to rule out intraspinal pathology. The positive clinical and radiographic results support the removal and closure of the pre-existing meningeal cyst at the time of treatment of traumatic spinal injury. Intraoperative isocentric fluoroscopy is a helpful tool in the operative management of these lesions. PMID:22022654

Yanni, Daniel S.; Mammis, Antonios; Thaker, Nikhil G.; Goldstein, Ira M.

2011-01-01

198

Anterior urethral valves without diverticulae: a report of two cases and a review of the literature.  

PubMed

Two unusual cases of anterior urethral valves (AUV) without diverticulae are presented. The first case is a male child born with prenatal diagnosis of bilateral hydronephrosis. On cystoscopy, iris-like diaphragm valves were encountered about 3?mm distal to the skeletal sphincter. In the second case, an 18-month-old male child was investigated for recurrent febrile urinary tract infections and obstructed urinary symptoms. Cystoscopy confirmed the presence of slit-like valves 5?mm distal to the skeletal sphincter. Fulguration of the AUVs was performed in both cases. It may be worthwhile to review all cases of anterior urethral obstruction collectively and re-categorize them appropriately to include the unusual AUVs without diverticulum in that classification. PMID:24118555

Singh, Dig Vijay; Taneja, Rajesh

2014-05-01

199

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

PubMed

We report an extraperitoneal pelvic laparoscopic approach to disconnect accessory urethra from normal urethra in complete urethral duplication. First stage consisted of chordee correction, partial excision of the accessory urethra and glansplasty. In the second stage the remaining accessory urethra was disconnected from the normal urethra through a pre-peritoneal minimal access approach to the retropubic space. The remaining distal mucosa was ablated using monopolar cautery. PMID:24741219

Pant, Nitin; Aggarwal, Satish Kumar

2014-04-01

200

Comparison of dose length, area, and volume histograms as quantifiers of urethral dose in prostate brachytherapy  

Microsoft Academic Search

Purpose: To determine the magnitude of the differences between urethral dose-volume, dose-area, and dose-length histograms (DVH, DAH, and DLH, respectively, or DgH generically).Methods and Materials: Six consecutive iodine-125 (125I) patients and 6 consecutive palladium-103 (103Pd) patients implanted via a modified uniform planning approach were evaluated with day 0 computed tomography (CT)-based dosimetry. The urethra was identified by the presence of

Wayne M Butler; Gregory S Merrick; Anthony T Dorsey; Brenda M Hagedorn

2000-01-01

201

Tubularized urethral replacement with unseeded matrices: what is the maximum distance for normal tissue regeneration?  

Microsoft Academic Search

Purpose  Complete urethral replacement using unseeded matrices has been proposed as a possible therapy in cases of congenital or acquired\\u000a anomalies producing significant defects. Tissue regeneration involves fibrin deposition, re-epithelialization, and remodeling\\u000a that are limited by the size of the defect. Scar formation occurs because of an inability of native cells to regenerate over\\u000a the defect before fibrosis takes place. We

Ryan P. Dorin; Hans G. Pohl; Roger E. De Filippo; James J. Yoo; Anthony Atala

2008-01-01

202

Posterior dynamic stabilization systems: DYNESYS.  

PubMed

Posterior dynamic stabilization systems have to neutralize injurious forces and restore painless function of the spine segments and protect the adjacent segments. Because degenerative disc disease has many clinical manifestations, pedicular screw systems and interspinous implants have their indications. A dynamic stabilization device has to provide stability throughout its lifetime, unless it activates or allows reparative processes with a reversal of the degenerative changes. Anchorage to the bone is crucial, at least for pedicular systems. This is a great demand on spinal implants and assumes rest and motion going together. Our experience with DYNESYS has shown that this method has limitations in elderly patients with osteoporotic bone or in patients with a severe segmental macro-instability combined with degenerative olisthesis and advanced disc degeneration. Such cases have an increased risk of failure. Only future randomized evaluations will be able to address the potential reduction of accelerated adjacent segment degeneration. The few posterior dynamic stabilization systems that have had clinical applications so far have produced clinical outcomes comparable with fusion. No severe adverse events caused by these implants have been reported. Long-term follow-up data and controlled prospective randomized studies are not available for most of the cited implants but are essential to prove the safety, efficacy, appropriateness, and economic viability of these methods. PMID:15950696

Schwarzenbach, Othmar; Berlemann, Ulrich; Stoll, Thomas M; Dubois, Gilles

2005-07-01

203

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

PubMed Central

Background In male cattle, rupture of the urinary bladder is usually associated with urethral obstruction by uroliths. Less common causes include urethral compression or stricture. This case report describes the findings in a young Limousion breeding bull with rupture of the urinary bladder because of urethral compression by a haematoma after coccygeal fracture. Case presentation The bull had been introduced into a 40-head Red-Holstein herd one week before being injured. One week after introduction to the herd, the bull had an acute onset of anorexia and he was referred to the clinic. There was marked abdominal distension, reduced skin turgor and enophthalmus. The serum concentration of urea and creatinine was increased. Ultrasonographic examination revealed severe ascites and abdominocentesis yielded clear yellow fluid with high urea and creatinine concentrations, which supported a diagnosis of uroperitoneum. The bull was euthanatized because of a poor prognosis. Postmortem examination revealed a comminuted fracture of the first two coccygeal vertebrae associated with a massive haematoma that obstructed entire pelvic cavity. The haematoma compressed the urethra thereby preventing outflow of urine, which resulted in a 5-cm tear ventrally at the neck of the bladder. It was assumed that the newly-introduced bull had sustained the vertebral fractures when he was mounted by a cow. Conclusions The present case study serves to expand the differential diagnosis of urinary bladder rupture. Therefore, in addition to obstructive urolithiasis, compression and stricture of the urethra might be considered in male cattle with uroperitoneum. PMID:24666697

2014-01-01

204

Urethral lift for benign prostatic hyperplasia: a comprehensive review of the literature.  

PubMed

Current treatments for benign prostatic hyperplasia (BPH) include watchful waiting, medical therapy, and interventional procedures. The post-surgical complication profile and the early discontinuation of medical therapy are significant drawbacks of the established approach and stimulate the search for less-invasive approaches. Our aim is to provide a comprehensive review all available literature on prostatic urethral lift (PUL), presenting an overview of safety, indications, surgical technique and results of the procedure, and to evaluate the potential role it could play in the treatment of BPH. A comprehensive search was conduct on PubMed and Scopus database to identify original articles in English dealing with PUL without any limit to publication date. Keywords used were prostatic urethral lift, urethral lifting, Urolift, benign prostatic hyperplasia and minimally invasive therapy. The PUL seems to offer a better IPSS improvement when compared to medical therapy, but the result is inferior when compared to surgical therapy. Published studies report an absence of degradation of erectile or ejaculatory function after treatment, which appears a noteworthy benefit of PUL. Additional advantages of the PUL are a better complication profile in comparison to other surgical therapies and the use of a local anesthesia, sometimes without postoperative catheterization. The PUL, a novel, minimally invasive treatment option for men affected by BPH, presents a promising potential although it is clear that PUL is not a substitute for traditional ablative surgical approach, as this procedure requires a scrupulous selection of the patient. PMID:23794125

Larcher, Alessandro; Broglia, Luigi; Lughezzani, Giovanni; Mistretta, Francesco; Abrate, Alberto; Lista, Giuliana; Fossati, Nicola; Sangalli, Mattia; Kuefner, Dana; Cestari, Andrea; Buffi, Nicolomaria; Lazzeri, Massimo; Guazzoni, Giorgio; Montorsi, Francesco

2013-12-01

205

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

PubMed

The purpose of this study was to retrospectively evaluate the safety and efficacy of removing retrievable self-expandable urethral stents using a retrieval hook wire. Under fluoroscopic guidance, the removal of 58 polyurethane or PTFE (polytetrafluoroethylene)-covered stents was attempted in 33 patients using a retrieval hook wire. Indications for removal were elective removal (n = 21), stent migration (n = 19), formation of tissue hyperplasia around or inside of the stent (n = 14), stent deformity (n = 3), and severe pain (n = 1). The mean time the stents remained in place was 64.8 +/- 42.9 days (range, 1-177 days). Fifty-six (97%) of the 58 stents were successfully removed using the retrieval hook wire despite the following difficulties; hook wire disconnection (n = 2), untied drawstrings (n = 3), and polyurethane membrane disruption/separation (n = 4). The removal procedure using a retrieval hook wire failed in two stents (3%) which had migrated into the urinary bladder. One of the two stents with migration into the urinary bladder was removed using a snare through the cystostomy route. The overall complication rate was 14% (seven hematuria cases and one urethral tear case), and all were minor and spontaneously resolved without further treatment. In conclusion, removal of retrievable urethral stents using a retrieval hook wire was safe and effective despite some technical difficulties. It is a useful method for allowing temporary stent placement and solving various complications of stent use. PMID:16528559

Shin, Ji Hoon; Song, Ho-Young; Park, Hyungkeun; Kim, Jin Hyoung; Ko, Heung-Kyu; Kim, Yong Jae; Woo, Chul-Woong; Kim, Tae-Hyung; Ko, Gi-Young; Yoon, Hyun-Ki; Sung, Kyu-Bo

2006-09-01

206

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

NASA Astrophysics Data System (ADS)

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.

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

2005-07-01

207

Urinary retention is uncommon after colpocleisis with concomitant mid-urethral sling.  

PubMed

The purpose of this study was to evaluate the effect of colpocleisis and concomitant mid-urethral sling on voiding function. This is an IRB-approved, retrospective case series of women who underwent a colpocleisis with concomitant synthetic mid-urethral sling for treatment of stress urinary incontinence (SUI) between January 2005 and September 2007. Thirty-eight women with pelvic organ prolapse and SUI symptoms were included. Thirty percent had a post-void residual (PVR) greater than 100 ml preoperatively. PVRs were normal in all but two women after surgery. Median prolapse and urinary subscales of the pelvic floor distress inventory improved significantly after surgery [75 (50-100) vs. 0 (0-38), p < 0.0001 and 44 (8-100) vs. 0 (0-50), p < .0001, respectively]. Colpocleisis with concomitant mid-urethral sling improves urinary symptoms without causing significant urinary retention. This combination may be offered to elderly women with SUI who are undergoing colpocleisis regardless of preoperative PVR. PMID:19002367

Abbasy, Shameem; Lowenstein, Lior; Pham, Thythy; Mueller, Elizabeth R; Kenton, Kimberly; Brubaker, Linda

2009-02-01

208

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

PubMed Central

This study investigated the feasibility of replacing urinary epithelial cells with oral keratinocytes and transforming growth factor-?1 (TGF-?1) small interfering RNA (siRNA)-transfected fibroblasts seeded on bladder acellular matrix graft (BAMG) in order to reconstruct tissue-engineered urethra. Constructed siRNAs, which expressed plasmids targeting TGF-?1, were transfected into rabbit fibroblasts. The effective siRNA was screened out by RT-PCR and was transfected into rabbit fibroblasts again. Synthesis of type I collagen in culture medium was measured by enzyme-linked immuno sorbent assay (ELISA). Autologous oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts were seeded onto BAMGs to obtain a tissue-engineered mucosa. The tissue-engineered mucosa was assessed morphologically and with the help of scanning electron microscopy. The TGF-?1 siRNA decreased the expression of fibroblasts synthesis type I collagen. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts were seeded onto sterilized BAMG to obtain a tissue-engineered mucosa for urethral reconstruction. The compound graft was assessed using scanning electron microscope. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts had a good compatibility with BAMG. The downregulation of fibroblasts synthesis type I collagen expression by constructed siRNA interfering TGF-?1 provided a potential basis for genetic therapy of urethral scar. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts had good compatibility with BAMG and the compound graft could be a new choice for urethral reconstruction. PMID:23542139

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

2013-01-01

209

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

PubMed

This study investigated the feasibility of replacing urinary epithelial cells with oral keratinocytes and transforming growth factor-?1 (TGF-?1) small interfering RNA (siRNA)-transfected fibroblasts seeded on bladder acellular matrix graft (BAMG) in order to reconstruct tissue-engineered urethra. Constructed siRNAs, which expressed plasmids targeting TGF-?1, were transfected into rabbit fibroblasts. The effective siRNA was screened out by RT-PCR and was transfected into rabbit fibroblasts again. Synthesis of type I collagen in culture medium was measured by enzyme-linked immuno sorbent assay (ELISA). Autologous oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts were seeded onto BAMGs to obtain a tissue-engineered mucosa. The tissue-engineered mucosa was assessed morphologically and with the help of scanning electron microscopy. The TGF-?1 siRNA decreased the expression of fibroblasts synthesis type I collagen. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts were seeded onto sterilized BAMG to obtain a tissue-engineered mucosa for urethral reconstruction. The compound graft was assessed using scanning electron microscope. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts had a good compatibility with BAMG. The downregulation of fibroblasts synthesis type I collagen expression by constructed siRNA interfering TGF-?1 provided a potential basis for genetic therapy of urethral scar. Oral keratinocytes and TGF-?1 siRNA-transfected fibroblasts had good compatibility with BAMG and the compound graft could be a new choice for urethral reconstruction. PMID:23542139

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

2013-05-01

210

Pefloxacin compared with cefotaxime for treating men with uncomplicated gonococcal urethritis.  

PubMed

In a randomized comparative study, 83 male patients suffering from acute uncomplicated gonococcal urethritis were treated with a single dose of either 0.8 g pefloxacin, given orally, or 1.0 g cefotaxime, given intramuscularly. The cure rates were 100% in both treatment groups four to seven days and 21 to 31 days, respectively, after therapy. The MICs of the isolated Neisseria gonorrhoeae ranged from 0.008 to 0.06 mg/l for pefloxacin and from 0.0005 to 0.03 mg/l for cefotaxime. Postgonococcal urethritis was found in 9% of the patients treated with pefloxacin and in 20% of the patients treated with cefotaxime. Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum were isolated from 15%, 7% and 22% of the patients, respectively, before therapy and from 22%, 11% and 20% of the patients, respectively, 21 to 31 days after therapy. Both antibiotics had no effect on the presence of these microorganisms. No side effects were recorded in either groups of patients except that 46% of the patients treated with cefotaxime reported mild pain at the injection site. In conclusion, pefloxacin and cefotaxime are safe and effective agents in the treatment of uncomplicated gonococcal urethritis in men. PMID:2124210

Tio, T T; Sindhunata, I R; Wagenvoort, J H; Angulo, A F; Habbema, L; Michel, M F; Stolz, E

1990-10-01

211

Traumatic Brain Injury, Neuroinflammation, and Post-Traumatic Headaches  

PubMed Central

Concussions following head and/or neck injury are common, and although most people with mild injuries recover uneventfully, a subset of individuals develop persistent post-concussive symptoms that often include headaches. Post-traumatic headaches vary in presentation and may progress to become chronic and in some cases debilitating. Little is known about the pathogenesis of post-traumatic headaches, although shared pathophysiology with that of the brain injury is suspected. Following primary injury to brain tissues, inflammation rapidly ensues; while this inflammatory response initially provides a defensive/reparative function, it can persist beyond its beneficial effect, potentially leading to secondary injuries because of alterations in neuronal excitability, axonal integrity, central processing, and other changes. These changes may account for the neurological symptoms often observed after traumatic brain injury, including headaches. This review considers selected aspects of the inflammatory response following traumatic brain injury, with an emphasis on the role of glial cells as mediators of maladaptive post-traumatic inflammation. PMID:24090534

Mayer, Cynthia L.; Huber, Bertrand R.; Peskind, Elaine

2014-01-01

212

Traumatic unilateral vasomotor rhinitis.  

PubMed

Vasomotor rhinitis (VMR) is a commonly encountered entity that may be difficult to diagnose. The classic symptoms are clear rhinorrhea and nasal congestion, commonly brought on by exercise, stress, heat, cold, and environmental irritants. The diagnosis is one of exclusion, and management usually involves avoidance of inciting agents and treatment with an anticholinergic nasal spray. We describe a case of VMR in a 22-year-old woman who presented with symptoms of clear, left-sided rhinorrhea and epiphora that had begun shortly after a motor vehicle accident approximately 1.5 years earlier, but which she had not reported at that time. The patient's left carotid canal had been fractured and the surrounding sympathetic plexus injured in the accident, resulting in an overactive parasympathetic system. Both exercise and heat exacerbated her symptoms. Allergy was excluded by negative allergy testing, and the patient did not respond to fluticasone nasal spray. Given the mechanism of injury, the unilaterality of symptoms, and the patient's lack of response to nasal steroids, it was thought that the VMR was due to the earlier traumatic injury, which had resulted in imbalance of the autonomic neural input. A trial of ipratropium was given to directly treat the parasympathetic overactivity. This treatment resulted in immediate improvement in both the nasal and lacrimal secretions. PMID:23288805

Harlor, Evan J; Greene, J Scott; Considine, Catherine

2012-11-01

213

Chronic traumatic encephalopathy.  

PubMed

Sports-related concussion has gained increased prominence, in part due to media coverage of several well-known athletes who have died from consequences of chronic traumatic encephalopathy (CTE). CTE was first described by Martland in 1928 as a syndrome seen in boxers who had experienced significant head trauma from repeated blows. The classic symptoms of impaired cognition, mood, behavior, and motor skills also have been reported in professional football players, and in 2005, the histopathological findings of CTE were first reported in a former National Football League (NFL) player. These finding were similar to Alzheimer's disease in some ways but differed in critical areas such as a predominance of tau protein deposition over amyloid. The pathophysiology is still unknown but involves a history of repeated concussive and subconcussive blows and then a lag period before CTE symptoms become evident. The involvement of excitotoxic amino acids and abnormal microglial activation remain speculative. Early identification and prevention of this disease by reducing repeated blows to the head has become a critical focus of current research. PMID:23314081

Yi, Juneyoung; Padalino, David J; Chin, Lawrence S; Montenegro, Philip; Cantu, Robert C

2013-01-01

214

Catheter induced urethral inflammatory reaction and urinary tract infection. An experimental and clinical study.  

PubMed

Urinary tract infections accounts for over 40% of all nosocomial infections, and almost all these infections are associated with indwelling catheters. The acquisition of urinary tract infections following urinary bladder catheterizations are associated with nearly a threefold increase in mortality among hospitalized patients. The economic impact of nosocomial urinary infections is difficult to assess. An estimate of the cost of these infections have shown that patients with hospital-acquired urinary tract infections secondary to indwelling catheters, spent an average of 2.4 additional days in the hospital. Bearing this in mind, even a marginal decrease in urinary tract infections may be cost-effective. In two randomized prospective clinical studies we have shown that coating urinary catheters with silver significantly reduces the infection rate during short-term catheterization (less than 7 days). We also showed that silver coating of urinary catheters prevented adherence and growth of Pseudomonas aeruginosa on the catheter material. Another risk from using indwelling catheters is an inflammatory reaction of the urethral mucosa leading to stricture formation. Several aetiological factors whereby indwelling catheters may cause a urethral stricture have been discussed. During the last years much attention has been paid to the catheter material as such, especially latex, and its role in stricture formation. Urinary catheters are made from a variety of materials combined with different chemicals. It seems as if these chemical substances can dissolve from the catheter material, causing inflammatory reactions. Using a cell culture technique with a mouse fibroblast cell line (BALBc/3T3), and an animal model with implantation of catheter material into the urethra, we assessed both in vitro cytotoxicity (IC50) and inflammatory reactions in vivo from different catheter materials. The studies confirmed that especially latex materials do not have both cytotoxic effects and cause considerable inflammation within the urethral mucosa. By coating the catheters with silver, the cytotoxicity could be significantly reduced as compared with pure latex and hydrogel coated latex catheters. Several studies have demonstrated a cytotoxic effect from catheter materials, indicating that this may be of importance in urethral inflammation. However, the exact mechanisms behind this phenomenon is not known. In an attempt to explain the inflammatory reaction within the urethra secondary to an indwelling catheter, we investigated the influence of the nervous system on experimentally induced urethral inflammation. Our findings indicate that an important part in catheter induced inflammation is played by neurogenic reactions. PMID:2633310

Liedberg, H

1989-01-01

215

Posterior Lamellar Keratoplasty in Perspective  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Posterior lamellar keratoplasty (PLK) offers many substantial benefits compared to penetrating keratoplasty (PK) including:\\u000a closed eye surgery elimination of both regular and irregular postoperative astigmatism leading to full visual rehabilitation\\u000a with spectacles within 3–6 months, elimination of postoperative corneal anaesthesia, and a reduced risk of postoperative globe\\u000a rupture.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Disadvantages of PLK compared to PK include: corneal stromal scarring

F Arnalich-Montiel; JKG Dart

216

Reconstruction of Posterior Trunk Defects  

PubMed Central

The posterior trunk roughly encompasses the upper back from the shoulders to the lumbar area above the iliac crests. Long-term outcomes in the treatment of defects of the spine and bony thorax have been proved superior if flaps were used. Many local muscle and fasciocutaneous flaps are available alternatives. A guideline, patterned according to arbitrary anatomic territories of the back, is suggested as a starting point for the selection of appropriate primary and secondary flap options. Depending on flap availability, the latissimus dorsi and trapezius muscles are the workhorse flaps for the upper back, whereas perforator flaps have become a useful alternative for the lumbar region in lieu of free flaps. PMID:22294946

Hallock, Geoffrey G.

2011-01-01

217

Post-traumatic stress disorder vs traumatic brain injury  

PubMed Central

Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) often coexist because brain injuries are often sustained in traumatic experiences. This review outlines the significant overlap between PTSD and TBI by commencing with a critical outline of the overlapping symptoms and problems of differential diagnosis. The impact of TBI on PTSD is then described, with increasing evidence suggesting that mild TBI can increase risk for PTSD. Several explanations are offered for this enhanced risk. Recent evidence suggests that impairment secondary to mild TBI is largely attributable to stress reactions after TBI, which challenges the long-held belief that postconcussive symptoms are a function of neurological insult This recent evidence is pointing to new directions for treatment of postconcussive symptoms that acknowledge that treating stress factors following TBI may be the optimal means to manage the effects of many TBIs, PMID:22034252

Bryant, Richard

2011-01-01

218

Sound and Fury: Understanding Post-Traumatic  

E-print Network

Sound and Fury: Understanding Post-Traumatic Stress Disorder Thursday, April 10, 2014 6:00 ­ 7:30 p is a recipient of the International Society for Traumatic Stress Studies' Award for Outstanding Scientific

Yellen, Gary

219

Postpartum Post-Traumatic Stress Disorder  

MedlinePLUS

... simply adjusting to life with a baby. Postpartum Post-Traumatic Stress Disorder Approximately 1-6% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth. Most often, ...

220

Post-traumatic stress disorder.  

PubMed

Post-traumatic stress disorder (PTSD) is an increasingly recognized and potentially preventable condition. Certain factors, especially the severity of the trauma, perceived lack of social support and peri-traumatic dissociation have been associated with its development. In recent years, a more robust evidence base regarding the management of individuals involved in traumatic events has emerged. Immediately after a traumatic event, simple practical, pragmatic support provided in a sympathetic manner by non-mental health professionals seems most likely to help. For individuals who develop persisting PTSD, trauma-focused cognitive behavioural therapy (TFCBT) may be beneficial within a few months of the trauma. For those who develop chronic PTSD, TFCBT and eye movement desensitization and reprocessing are best supported by the current evidence. Some anti-depressants appear to have a modest beneficial effect and are recommended as a second-line treatment. The current evidence base has allowed the development of guidelines that now require implementation. This has major implications in terms of planning and developing services that allow appropriately qualified and trained individuals to be available to cater adequately for the needs of survivors of traumatic events. PMID:17728312

Bisson, Jonathan I

2007-09-01

221

Effects of Concomitant Surgeries during Mid-Urethral Slings (MUS) on Post-operative Complications, Voiding Dysfunction, Continence Outcomes, and Urodynamic Variables  

PubMed Central

Objectives To determine whether concomitant surgeries affected outcomes in a randomized trial comparing retropubic (RMUS) versus transobturator midurethral slings (TOMUS). Methods Subjects (n=597) were stratified into 4 groups based on type of concomitant surgeries: Group I had anterior/apical with or without posterior repairs (n=79, 13%), Group II had posterior repairs or perineorrhaphy only (n=38, 6%), Group III had non-prolapse procedures (n=34, 6%) and Group IV had no concomitant surgeries (n=446, 75%). Complication rates, voiding dysfunction, objective and subjective surgical failure rates and changes in urodynamic (UDS) values (post-op minus pre-op) were assessed and compared in these 4 groups. Results There were no differences in complications, voiding dysfunction and subjective failure outcomes between these 4 groups. Group I had lower odds ratio (OR) of objective surgical failure compared to Group IV (OR 0.38, 95% CI 0.18–0.81, p=0.05). The OR of failure of all undergoing concomitant surgeries (Groups I–III) was lower than Group IV (OR 0.57, 95% CI 0.35–0.95, p=0.03). The change in Pdet@Qmax (from pressure-flow) was significantly higher in Group III versus IV (p=0.01). The change in Qmax (from uroflowmetry) was significantly less in Group I and II versus Group IV (p=0.046 and 0.04, respectively). Conclusions Concomitant surgeries did not increase complications. Subjects who underwent certain concomitant surgeries had lower failure rates than those undergoing slings only. These data support safety and efficacy of performing concomitant surgery at the time of mid-urethral slings. PMID:22542356

Chai, Toby C.; Kenton, Kimberly; Xu, Yan; Sirls, Larry; Zyczynski, Halina; Wilson, Tracey S.; Rahn, David D.; Whitcomb, Emily L.; Hsu, Yvonne; Gormley, Elizabeth A.

2012-01-01

222

Traumatic homonymous hemianopia  

PubMed Central

Objective To describe the characteristics of patients with homonymous hemianopia from traumatic brain injury (TBI) seen in our unit between 1989 and 2004. Methods Only patients with a history of TBI, who had detailed clinical information and results of neuroimaging, were included in our study. Demographic characteristics, clinical features, types of visual field defects, location of lesion and evolution of visual field defects were recorded. Results Of the 880 patients with homonymous hemianopia seen in our unit, 103 patients (112 with homonymous hemianopia) had TBI (74 men and 29 women, mean age 30.7 (SD 15.3)?years). Median time from injury to initial visual field testing was 5 (range 0.5–360)?months. In all, 64 (57.1%) patients sustained injuries that were motor vehicle?related; 19 (17%) violence?related; 17 (15.2%) due to falls; and 12 (10.7%) because of other blunt head trauma. Visual field defects included complete homonymous hemianopia in 44 (39.3%) patients and incomplete homonymous hemianopia in 68 (60.7%) patients. The lesion was occipital in 14 (12.5%) patients, associated with optic radiation in 26 (23.2%) and the optic tract in 12 (10.7%), and multiple in 60 (53.6%). Conclusion Most cases of homonymous hemianopia from TBI were motor vehicle?related. Patients were younger, more often male, and had multiple brain lesions more often than patients with homonymous hemianopia from causes other than TBI. A median delay of 5?months was observed before the documentation of the homonymous hemianopia, which may have a major effect on the success of rehabilitation and driving training in these young patients. PMID:16574725

Bruce, B B; Zhang, X; Kedar, S; Newman, N J; Biousse, V

2006-01-01

223

Rapid evaluation of gonococcal and nongonococcal urethritis in men with Limulus amoebocyte lysate and a chromogenic substrate.  

PubMed Central

A chromogenic substrate was used with Limulus amoebocyte lysate (LAL) and compared by parallel testing with the traditional gelation LAL method for the rapid evaluation of exudative urethritis in 125 male patients. Of these patients, 67 had positive cultures for Neisseria gonorrhoeae and 58 were negative. The corresponding prevalence of gonococcal urethritis was 53.6%. For assay, diluted urethral samples and chromogenic substrate were added directly to single-test LAL vials, and objective color endpoint determinations were made visually after a 10-min incubation period at 37 degrees C. Sensitivity and specificity were 98.5% and 93.1%, respectively, with an overall accuracy in predicting culture results of 96.0%. The predictive value of a positive LAL test was 94.3% in our patient population; in a population with a prevalence of gonococcal urethritis of only 10%, the predictive value would be 61.3%. Results were not statistically different from those obtained by the 30-min gelation LAL method or by Gram-stained smears read by experienced microscopists (P greater than 0.05). Unlike the delicate gel, the color endpoint was not prone to accidental mechanical disruption during incubation or reading. Thus, use of a chromogenic substrate greatly improved the utility and speed of the LAL assay for evaluating men with exudative urethritis while not affecting the accuracy of the test. PMID:6404928

Prior, R B; Spagna, V A

1983-01-01

224

Posterior Cruciate Ligament Removal Contributes to Abnormal Knee Motion during Posterior Stabilized Total Knee Arthroplasty  

E-print Network

Posterior Cruciate Ligament Removal Contributes to Abnormal Knee Motion during Posterior Stabilized Total Knee Arthroplasty Melinda J. Cromie,1,2 Robert A. Siston,1,2,3,4 Nicholas J. Giori,2,5 Scott L (20­608) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes

Delp, Scott

225

Mutation spectra of Kras and Tp53 in urethral and lung neoplasms in B6C3F1 mice treated with 3,3',4,4'-tetrachloroazobenzene.  

PubMed

3,3',4,4'-tetrachloroazobenzene (TCAB) is a contaminant formed during manufacture of various herbicide compounds. A recent National Toxicology Program study showed B6C3F1 mice exposed to TCAB developed a treatment-related increase in lung carcinomas in the high-dose group, and urethral carcinomas, an extremely rare lesion in rodents, in all dose groups. As the potential for environmental exposure to TCAB is widespread, and the mechanisms of urethral carcinogenesis are unknown, TCAB-induced urethral and pulmonary tumors were evaluated for alterations in critical human cancer genes, Kras and Tp53. Uroplakin III, CK20, and CK7 immunohistochemistry was performed to confirm the urothelial origin of urethral tumors. TCAB-induced urethral carcinomas harbored transforming point mutations in K-ras (38%) and Tp53 (63%), and 71% displayed nuclear TP53 expression, consistent with formation of mutant protein. Transition mutations accounted for 88% of Tp53 mutations in urethral carcinomas, suggesting that TCAB or its metabolites target guanine or cytosine bases and that these mutations are involved in urethral carcinogenesis. Pulmonary carcinomas in TCAB-exposed animals harbored similar rates of Tp53 (55%) and Kras (36%) mutations as urethral carcinomas, suggesting that TCAB may induce mutations at multiple sites by a common mechanism. In conclusion, TCAB is carcinogenic at multiple sites in male and female B6C3F1 mice through mechanisms involving Tp53 and Kras mutation. PMID:23703846

Bhusari, Sachin; Malarkey, David E; Hong, Hue-Hua; Wang, Yu; Masinde, Tiwanda; Nolan, Michael; Hooth, Michelle J; Lea, Isabel A; Vasconcelos, Daphne; Sills, Robert C; Hoenerhoff, Mark J

2014-01-01

226

Relationships between diagnoses of sexually transmitted infections and urinary tract infections among male service members diagnosed with urethritis, active component, U.S. Armed Forces, 2000-2013.  

PubMed

A previous MSMR report found that 42.8% of all incident (first-time) urinary tract infections (UTIs) in males, but only 0.4% of such UTIs in females, were diagnosed as "urethritis, unspecified" (ICD-9: 597.80). This study explored the possibility that many of the diagnoses of urethritis in males represented sexually transmitted infections (STIs), even though ICD-9: 597.80 is explicitly reserved for cases of urethritis that are deemed to not be sexually transmitted. Examined were relationships between diagnoses of urethritis, diagnoses of STIs, and recurrent diagnoses of UTIs. Male service members who received a diagnosis of "urethritis, unspecified" (ICD-9: 597.80) had an increased risk of a subsequent UTI diagnosis, especially of "urethritis, unspecified," compared to all male service members. Most service members who were diagnosed with "urethritis, unspecified" had no documented diagnoses of an STI in their Military Health System health records; however, recurrent UTIs were more common among service members who did have documented STIs. The most commonly diagnosed STIs in this study were "other non-gonococcal urethritis" (which includes that caused by Chlamydia trachomatis) and gonorrhea. PMID:25080332

2014-07-01

227

Surgical Reconstruction of the Urinary Sphincter after Traumatic Longitudinal Disruption  

PubMed Central

The question is whether the urethral sphincter may be reconstructed after longitudinal injury similar to anal sphincter injuries. Analogue to obstetric, anal sphincter repair, an approximation repair of the sphincter may be feasible. An overlap repair is possible in anal sphincter repair, but because of the little tissue available in the urethral sphincter this is not an option. We describe three cases of urethral sphincter injury of different aetiologies. All resulted in a total longitudinal disruption of the muscular components of the urethral sphincter complex. After making the diagnosis of urethral sphincter injury, a primary approximation repair was done. Follow-up of at least two and up to three years is promising with one male patient being completely continent and the two female patients needing one safety pad per day. Longitudinal disruption of the muscular elements of the sphincteric urethra may be primarily reconstructed with good success using an approximation technique with simple interrupted sutures. PMID:25258694

Rehder, Peter; Schillfahrt, Florian; Skradski, Viktor

2014-01-01

228

Epilepsy related to traumatic brain injury.  

PubMed

Post-traumatic epilepsy accounts for 10-20% of symptomatic epilepsy in the general population and 5% of all epilepsy. During the last decade, an increasing number of laboratories have investigated the molecular and cellular mechanisms of post-traumatic epileptogenesis in experimental models. However, identification of critical molecular, cellular, and network mechanisms that would be specific for post-traumatic epileptogenesis remains a challenge. Despite of that, 7 of 9 proof-of-concept antiepileptogenesis studies have demonstrated some effect on seizure susceptibility after experimental traumatic brain injury, even though none of them has progressed to clinic. Moreover, there has been some promise that new clinically translatable imaging approaches can identify biomarkers for post-traumatic epileptogenesis. Even though the progress in combating post-traumatic epileptogenesis happens in small steps, recent discoveries kindle hope for identification of treatment strategies to prevent post-traumatic epilepsy in at-risk patients. PMID:24554454

Pitkänen, Asla; Immonen, Riikka

2014-04-01

229

[Suprasegmental effects of selective posterior rhizotomy].  

PubMed

The occurrence of spasticity is most commonly attributed to the lack of presynaptic inhibition. Perinatal damage to the central nervous system, as it happens in cerebral palsy, leads to pathological reflex response both on segmental and polysegmental levels. It results not only in clinical signs typical for spasticity but also in alterations of brainstem function, such as dysarthria or congenital nystagmus. Selective posterior rhizotomy is a neurosurgical method, routinely used in the treatment of spasticity. The lumbosacral posterior roots are partially cut under perioperative neurophysiological control. The aim of the treatment is the reduction of afferentation for posterior horns resulting in a decrease of pathological reflex responses. Selective posterior rhizotomy consequently decreases lower limbs spasticity. The improvement of upper extremities fine skills, the improvement of speech and cognitive functions has been also observed after selective posterior rhizotomy. The possible pathophysiological explanations of these so-called suprasegmental effects are discussed in the article. PMID:15446453

Horínek, D; Tichý, M; Cerný, R; Vlková, J

2004-01-01

230

Comparative evaluation of the tube and microdilution Limulus lysate techniques for rapid presumptive diagnosis of gonococcal urethritis in men.  

PubMed Central

Eighty-one men with exudative urethritis were evaluated on initial visit for gonococcal urethritis by using the standard tube and newly developed microdilution Limulus amoebocyte lysate techniques. Serial dilutions of clinical specimens ranging from 1:100 to 1:102,400 were each tested, and results correlated with Gram stain and culture. Overall accuracy for predicting culture results was 98% for a dilution of 1:200 and 99% for a dilution of 1:400 for the tube and microdilution techniques, respectively. The microdilution technique predicted culture results in 98% of cases for dilutions ranging from 1:400 to 1:1,600, whereas the tube technique was as accurate for dilutions of only 1:100 and 1:200. The microdilution Limulus amoebocyte lysate technique was a rapid, reliable, sensitive, and economical diagnostic aid in the initial evaluation of exudative urethritis in men. PMID:7372797

Prior, R B; Spagna, V A

1980-01-01

231

Standard Treatment Regimens for Nongonococcal Urethritis Have Similar but Declining Cure Rates: A Randomized Controlled Trial  

PubMed Central

Background.?Azithromycin or doxycycline is recommended for nongonococcal urethritis (NGU); recent evidence suggests their efficacy has declined. We compared azithromycin and doxycycline in men with NGU, hypothesizing that azithromycin was more effective than doxycycline. Methods.?From January 2007 to July 2011, English-speaking males ?16 years, attending a sexually transmitted diseases clinic in Seattle, Washington, with NGU (visible urethral discharge or ?5 polymorphonuclear leukocytes per high-power field [PMNs/HPF]) were eligible for this double-blind, parallel-group superiority trial. Participants received active azithromycin (1 g) + placebo doxycycline or active doxycycline (100 mg twice daily for 7 days) + placebo azithromycin. Urine was tested for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Ureaplasma urealyticum biovar 2 (UU-2), and Trichomonas vaginalis (TV) using nucleic acid amplification tests. Clinical cure (<5 PMNs/HPF with or without urethral symptoms and absence of discharge) and microbiologic cure (negative tests for CT, MG, and/or UU-2) were determined after 3 weeks. Results.?Of 606 men, 304 were randomized to azithromycin and 302 to doxycycline; CT, MG, TV, and UU-2 were detected in 24%, 13%, 2%, and 23%, respectively. In modified intent-to-treat analyses, 172 of 216 (80%; 95% confidence interval [CI], 74%–85%) receiving azithromycin and 157 of 206 (76%; 95% CI, 70%–82%) receiving doxycycline experienced clinical cure (P = .40). In pathogen-specific analyses, clinical cure did not differ by arm, nor did microbiologic cure differ for CT (86% vs 90%, P = .56), MG (40% vs 30%, P = .41), or UU-2 (75% vs 70%, P = .50). No unexpected adverse events occurred. Conclusions.?Clinical and microbiologic cure rates for NGU were somewhat low and there was no significant difference between azithromycin and doxycycline. Mycoplasma genitalium treatment failure was extremely common. Clinical Trials Registration.?NCT00358462. PMID:23223595

Manhart, Lisa E.; Gillespie, Catherine W.; Lowens, M. Sylvan; Khosropour, Christine M.; Colombara, Danny V.; Golden, Matthew R.; Hakhu, Navneet R.; Thomas, Katherine K.; Hughes, James P.; Jensen, Nicole L.; Totten, Patricia A.

2013-01-01

232

Reconsidering Post-Traumatic Stress  

ERIC Educational Resources Information Center

This article serves to challenge the prevailing wisdom that suggests that most trauma is followed by post-traumatic stress disorder (PTSD), and is best treated with critical incident stress debriefing (CISD). Instead, recent evidence suggests that many individuals exposed to stress do not experience stress responses. Even those who do, however,…

Berman, Dene S.; Davis-Berman, Jennifer

2005-01-01

233

Management of traumatic aortic rupture.  

PubMed

A traumatic thoracic aortic injury is a severe and life-threatening clinical entity. Although largely fatal; if untreated, these injuries are amenable to surgical repair if appropriately diagnosed. Therefore, early triage of this condition is critically important. Unfortunately, aortic injuries rarely occur in isolation, and there has been no good cutoff value to help select the appropriate surgical strategy. Algorithms for the both diagnosis and treatment of traumatic thoracic aortic injury have undergone changes in recent years. There have been several case reports, retrospective series and registry data describing the treatment of patients with traumatic thoracic aortic rupture using endovascular treatment. Endovascular treatment is a less-invasive management option for polytraumatized patients. Because it is less invasive, without the need for thoracotomy or the use of heparin, endovascular repair can be performed even in acutely injured patients, without the risk of destabilizing pulmonary, head or abdominal traumatic lesions. Long-term follow-up especially in young patients is necessary after endovascular treatment. PMID:23338596

Watanabe, Ken-ichi; Fukuda, Ikuo; Asari, Yasushi

2013-12-01

234

Traumatic Brain Injury Inpatient Rehabilitation  

ERIC Educational Resources Information Center

Traumatic brain injuries (TBI) can cause multiple medical and functional problems. As the brain is involved in regulating nearly every bodily function, a TBI can affect any part of the body and aspect of cognitive, behavioral, and physical functioning. However, TBI affects each individual differently. Optimal management requires understanding the…

Im, Brian; Schrer, Marcia J.; Gaeta, Raphael; Elias, Eileen

2010-01-01

235

Evaluation after Traumatic Brain Injury  

ERIC Educational Resources Information Center

It is important to determine if a traumatic brain injury (TBI) has occurred when an individual is assessed in a hospital emergency room after a car accident, fall, or other injury that affects the head. This determination influences decisions about treatment. It is essential to screen for the injury, because the sooner they begin appropriate…

Trudel, Tina M.; Halper, James; Pines, Hayley; Cancro, Lorraine

2010-01-01

236

Understanding Traumatic Stress in Children  

ERIC Educational Resources Information Center

The unexpected loss of a loved one, a car accident, or exposure to a violent experience is familiar to many. Everyone reacts to such events, but the responses vary widely, ranging from numbness and withdrawal, to crying, nervousness, and agitation. Because traumatic events are prevalent, cause profound suffering, and may lead to life altering…

Bassuk, Ellen L.; Konnath, Kristina; Volk, Katherine T.

2006-01-01

237

Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review  

PubMed Central

Penile fracture is a rare injury most commonly sustained during sexual intercourse. We report the case of a 35-year-old man who presented with bilateral rupture of the corpora cavernosa and complete disruption of the urethra. A review of the literature on penile fracture is also presented. Urgent surgical exploration was performed and the injuries repaired primarily. In follow-up, the patient reported satisfactory erectile function. This case highlights the importance of early surgical repair and evaluation for concomitant urethral injuries in cases of penile fracture. PMID:21470546

Hoag, Nathan A.; Hennessey, Kiara; So, Alan

2011-01-01

238

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

PubMed

Anterior urethral valve (AUV) is a long known but rare anomaly, which is occasionally encountered in boys with obstructive uropathy. We present a case of AUV with a diverticulum which was misdiagnosed at other center as neurogenic bladder resulting in chronic renal failure. The case was further complicated by breakage of tip of the catheter used for clean intermittent catheterization (CIC) in the diverticulum presenting as a foreign body in the urethra. This article highlights the frequently missed diagnosis of AUV by most practitioners wrongly labeling it as neurogenic bladder, leading to improper management and renal failure in young boys. PMID:21478596

Nayyar, Rishi; Chavda, Sundeep; Singh, Prabhjot; Gupta, Narmada P

2011-01-01

239

[Necrotizing fasciitis and double bowel perforation after retropubic sub-urethral sling].  

PubMed

A 60-year-old woman without medical history developed after a Tension-free Vaginal Tape (TVT) procedure a necrotizing fasciitis and an abscess. After unadapted initial treatment, surgical procedure revealed 2 bowel perforations caused by the sling. Treatment was achieved by total mesh removal, bowel repair, necrosis excision and vacuum-assisted closure system. This is the first case report about the association of necrotizing fasciitis and double bowel perforations after TVT procedure. Any critical sepsis or with unsatisfactory evolution after retropubic sub-urethral sling has to make look for a digestive wound. PMID:24332737

Carassou-Maillan, A; Savary, D; Jacquetin, B

2014-10-01

240

A Retrospective Evaluation of Challenges in Urethral Stricture Management in a Tertiary Care Centre of a Poor Resource Community  

PubMed Central

Background Management of urethral stricture has evolved over the years with better understanding of the pathology, advancement in imaging, and introduction of several techniques of urethral reconstruction. In sub-Saharan Africa, advancement in management of urethral stricture may not be comparable with what obtained in most developed nations because of problems like late presentation and persistence of rare complications still reported in recent literature from the region. Objectives We set to evaluate the challenges faced by urologists involved in the management of urethral strictures in Osogbo, a poor resource community in south western Nigeria. Patients and Methods A retrospective study was performed in the urology unit of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria between July 2007 and July 2012. Information was retrieved from patients’ clinical notes and analyzed using statistical package for social sciences (SPSS) version 16.0. Results Eighty-four patients were treated during the period of study, their ages ranged between 19 and 89 years with the mean age of 52.3 years. The mean duration of symptoms before presentation was 3 years and 1 month. Inflammation resulting from sexually transmitted infection was the commonest etiology and more than 50% of the patients presented with complications. Sixteen patients (19.1%) received no treatment due to lack of fund. More than 90% were dependent, unemployed or underemployed. Single stage reconstruction by urethral substitution was the commonest form of repair with the restenosis rate of 4.4%. Conclusions Prevalent socio-cultural and economic situation in south western Nigeria have added some peculiar challenges to the management of urethral stricture in the region. PMID:24693504

Olajide, Abimbola Olaniyi; Olajide, Folakemi Olajumoke; Kolawole, Oladapo Adedayo; Oseni, Ismaila; Ajayi, Adewale Idowu

2013-01-01

241

Traumatic stress in acute leukemia  

PubMed Central

Objective Acute leukemia is a condition with an acute onset that is associated with considerable morbidity and mortality. However, the psychological impact of this life-threatening condition and its intensive treatment has not been systematically examined. In the present study, we investigate the prevalence and correlates of post-traumatic stress symptoms in this population. Methods Patients with acute myeloid, lymphocytic, and promyelocytic leukemia who were newly diagnosed, recently relapsed, or treatment failures were recruited at a comprehensive cancer center in Toronto, Canada. Participants completed the Stanford Acute Stress Reaction Questionnaire, Memorial Symptom Assessment Scale, CARES Medical Interaction Subscale, and other psychosocial measures. A multivariate regression analysis was used to assess independent predictors of post-traumatic stress symptoms. Results Of the 205 participants, 58% were male, mean age was 50.1 ± 15.4 years, 86% were recently diagnosed, and 94% were receiving active treatment. The mean Stanford Acute Stress Reaction Questionnaire score was 30.2 ± 22.5, with 27 of 200 (14%) patients meeting criteria for acute stress disorder and 36 (18%) for subsyndromal acute stress disorder. Post-traumatic stress symptoms were associated with more physical symptoms, physical symptom distress, attachment anxiety, and perceived difficulty communicating with health-care providers, and poorer spiritual well-being (all p <0.05). Conclusions The present study demonstrates that clinically significant symptoms of traumatic stress are common in acute leukemia and are linked to the degree of physical suffering, to satisfaction with relationships with health-care providers, and with individual psychological characteristics. Longitudinal study is needed to determine the natural history, but these findings suggest that intervention may be indicated to alleviate or prevent traumatic stress in this population. PMID:22081505

Rodin, Gary; Yuen, Dora; Mischitelle, Ashley; Minden, Mark D; Brandwein, Joseph; Schimmer, Aaron; Marmar, Charles; Gagliese, Lucia; Lo, Christopher; Rydall, Anne; Zimmermann, Camilla

2013-01-01

242

Penile necrosis requiring penectomy complicating recto-urethral fistula post prostate cancer external beam radiation and brachytherapy  

PubMed Central

Radiation therapy is a well-recognized treatment for unfavourable risk localized prostate cancer. Radiation induced recto-urethral fistulae are known rare complications particularly from brachytherapy. We report a case of a recto-urethral fistula 7 years post-external beam radiation and I-125 brachytherapy, which was complicated by a severe polymicrobial soft tissue infection. This infection required penectomy and pelvic exenteration with diverting colostomy, Indiana pouch urinary diversion and gracilis myo-cutaneuos flap closure of the perineum. PMID:24454604

Kinahan, John; Pai, Howard; Martens, Mildred; Gray, Jason; Biberdorf, Darren; Mihailovic, Alex; McAuley, Iain

2014-01-01

243

Posterior compartment prolapse: a urogynecology perspective.  

PubMed

Posterior compartment prolapse is often caused by a defect in the rectovaginal septum, also known as Denonvillier's fascia. Patients with symptomatic posterior compartment prolapse can present with bulge symptoms as well as defecatory dysfunction, including constipation, tenesmus, splinting, and fecal incontinence. The diagnosis can successfully be made on clinical examination. Treatment of posterior prolapse includes pessaries and surgery. Both traditional colporrhaphy and site-specific defect repair have excellent success rates. Complications from surgery can include sexual dysfunction, de novo dyspareunia, and defecatory dysfunction. Compared with native tissue repair, biological and synthetic grafting has not improved overall anatomic and subjective outcomes. PMID:22877719

Richardson, Monica L; Elliot, Christopher S; Sokol, Eric R

2012-08-01

244

Sickle cell disease and posterior reversible leukoencephalopathy.  

PubMed

Sickle cell disease can present with neurological manifestations. One such presentation is with posterior reversible leukoencephalopathy also known as reversible posterior leukoencephalopathy. The condition is classically described as reversible over time; it commonly presents with oedematous changes involving the white matter of the occipital and parietal regions. Only a few patients with the association between sickle cell disease and posterior reversible leukoencephalopathy have been described in the adult literature. We present two patients from our institutions to emphasise the association between the two conditions and summarise the published cases in the literature. PMID:24656986

Geevasinga, Nimeshan; Cole, Catherine; Herkes, Geoffrey K; Barnett, Yael; Lin, Jamie; Needham, Merrilee

2014-08-01

245

Epidemiology of traumatic hip dislocation in patients treated in Cear?, Brazil  

PubMed Central

OBJECTIVE: To describe the epidemiological profile of patients with traumatic hip dislocation treated in our Institute from November/2012 to July/2013. METHODS: A descriptive cross-sectional study based on interviews and involving 43 patients who suffered traumatic hip dislocation was conducted. RESULTS: The mean age of patients was 34.4 years old and 90.7% were male. Regarding the mechanism of injury, 95% involved traffic accidents. The posterior dislocation of the hip was the most common injury (93%). Associated lesions were observed in 74.4% of patients, hip fractures being the most frequent. The time span between accident and dislocation reduction was less than 6 hours in 37.2% of patients, between 6 and 12 hours in 32.5% and over 12 hours in 30.3%, ranging from 1 hour to 15 days. A fraction of 90.7% of patients was submitted to closed reduction. CONCLUSION: Traumatic hip dislocation affected mostly young adults, victims of traffic accidents. The posterior dislocation of the hip was the most frequent injury and closed reduction was performed in 90.7% of patients. The time span between accident and dislocation reduction was less than 12 hours in most patients. Level of Evidence III, Study of Nonconsecutive Patients. PMID:25061422

Lima, Luciana Cascao; do Nascimento, Robson Alves; de Almeida, Victor Monte Tenorio; Facanha, Fernando Antonio Mendes

2014-01-01

246

Recreational urethral sounding is associated with high risk sexual behaviour and sexually transmitted infections  

PubMed Central

OBJECTIVE To determine whether men who perform recreational sounding are at increased risk of engaging in unsafe sexual behaviours, developing sexually transmitted infections (STIs) and lower urinary tract symptoms (LUTS). SUBJECTS AND METHODS In a cross-sectional, international, internet-based survey of the sexual practices of >2000 men who have sex with men, subjects were asked if they had engaged in urethral sounding for sexual gratification. We compared ethnodemographic and health-related variables between the sounding and non-sounding populations. The International Prostate Symptom Score and a modified validated version of the International Index of Erectile Function were used to quantify LUTS and erectile dysfunction (ED) in both populations. RESULTS There were 2122 respondents with complete data, 228 (10.7%) of whom had engaged in recreational sounding. Men who had engaged in sounding were more likely to report certain high risk sexual behaviours (e.g. multiple sexual partners and sex with partners who were not well known) and had increased odds of reporting STIs. Men who had engaged in sounding had a slight but statistically significant increase in LUTS but no significant difference in prevalence of ED. CONCLUSIONS Urethral sounding is a sexual practice that is associated with higher risk sexual behaviour and carries the potential for morbidity. Research on means for risk reduction for men who choose to engage in recreational sounding requires further study. PMID:22221824

Breyer, Benjamin N.; Shindel, Alan W.

2013-01-01

247

Three-year outcomes of Uretex Urethral Support System for treatment of stress urinary incontinence.  

PubMed

To assess the medium-term performance of the Uretex Urethral Support System, patients were evaluated by the 1-h pad test, cough stress test (CST), Valsalva leak-point pressure test (VLPP), and validated questionnaires. Seventy-five patients were enrolled; median follow-up was 3.6 years (range, 3.1-4.3 years). All patients had a negative CST, 65 (87%) had no leakage during VLPP, and 62 of 72 patients (86%) had a negative 1-h pad test. Compared with baseline values of 50.0 and 28.6, median Urogenital Distress Inventory and Incontinence Impact Questionnaire-7 scores at 3-year follow-up were 16.7 and 0, respectively (P<0.001). Observed medium-term morbidity included de novo urgency in four (5%), frequency in three (4%), and urge incontinence in one (1%). No patients reported graft erosion. The Uretex Urethral Support System is highly effective (both objectively and subjectively) for treatment of stress urinary incontinence and improves quality of life in women with minimal adverse sequelae. PMID:18305884

Gebhart, John B; Dixon, Deborah A; Trabuco, Emanuel C; Klingele, Christopher J; Bagniewski, Stephanie M; Weaver, Amy L

2008-08-01

248

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

SciTech Connect

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

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

1996-10-01

249

??Severe indwelling urinary catheter-associated urethral erosion in four elderly men.  

PubMed

?Medical devices often are overlooked as a potential cause of pressure ulcers. Indwelling urinary catheters have been described as a cause of urethral erosion. In men, the resultant partial-thickness or full-thickness wound can involve a small area of the glans penis or cleave the glans or penile shaft, requiring reconstructive surgery or urinary diversion. During a 3-month period, four elderly men, all residing in one unit of a long-term care facility, were referred to the wound specialist for erosive urethral injuries. All were observed to have a history of improper securement of a rigid style silicone catheter. As part of creating a latex-free environment, the facility had recently replaced the (softer) latex-containing catheters with new silicone catheters. In addition to providing meticulous catheter care and comfort measures for the patients, all securement procedures were reviewed and different silicone catheters were evaluated for their potential to cause pressure ulcers. This case series highlights the importance of careful evaluation of catheter materials and securement devices before selecting them for widespread patient use and emphasizes the need for research focused on catheter composition and pressure injury risk. PMID:21205992

Bell, Mary Ann

2010-12-01

250

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

PubMed Central

Detailed knowledge of the anatomy of the rhabdosphincter and adjacent tissues is mandatory during urologic surgery to ensure reliable oncologic and functional outcomes. To characterize the levator ani (LA) function for the urethral sphincter, we described connective tissue morphology between the LA and urethral rhabdosphincter. The interface tissue between the LA and rhabdosphincter area in males contained abundant irregularly arrayed elastic fibers and smooth muscles. The male rhabdosphincter was positioned alongside the LA to divide the elevation force and not in-series along the axis of LA contraction. The male perineal membrane was thin but solid and extends along the inferior margin or bottom of the rhabdosphincter area. In contrast, the female rhabdosphincter, including the compressor urethrae and urethrovaginal sphincter muscles, was embedded in the elastic fiber mesh that is continuous with the thick, multilaminar perineal membrane. The inferomedial edge of the female LA was attached to the upper surface of the perineal membrane and not directly attached to the rhabdosphincter. We presented new diagrams showing the gender differences in topographical anatomy of the LA and rhabdosphincter. PMID:24877147

Hinata, Nobuyuki; Murakami, Gen

2014-01-01

251

Bitter triggers acetylcholine release from polymodal urethral chemosensory cells and bladder reflexes.  

PubMed

Chemosensory cells in the mucosal surface of the respiratory tract ("brush cells") use the canonical taste transduction cascade to detect potentially hazardous content and trigger local protective and aversive respiratory reflexes on stimulation. So far, the urogenital tract has been considered to lack this cell type. Here we report the presence of a previously unidentified cholinergic, polymodal chemosensory cell in the mammalian urethra, the potential portal of entry for bacteria and harmful substances into the urogenital system, but not in further centrally located parts of the urinary tract, such as the bladder, ureter, and renal pelvis. Urethral brush cells express bitter and umami taste receptors and downstream components of the taste transduction cascade; respond to stimulation with bitter (denatonium), umami (monosodium glutamate), and uropathogenic Escherichia coli; and release acetylcholine to communicate with other cells. They are approached by sensory nerve fibers expressing nicotinic acetylcholine receptors, and intraurethral application of denatonium reflexively increases activity of the bladder detrusor muscle in anesthetized rats. We propose a concept of urinary bladder control involving a previously unidentified cholinergic chemosensory cell monitoring the chemical composition of the urethral luminal microenvironment for potential hazardous content. PMID:24843119

Deckmann, Klaus; Filipski, Katharina; Krasteva-Christ, Gabriela; Fronius, Martin; Althaus, Mike; Rafiq, Amir; Papadakis, Tamara; Renno, Liane; Jurastow, Innokentij; Wessels, Lars; Wolff, Miriam; Schütz, Burkhard; Weihe, Eberhard; Chubanov, Vladimir; Gudermann, Thomas; Klein, Jochen; Bschleipfer, Thomas; Kummer, Wolfgang

2014-06-01

252

Acute traumatic central cord syndrome: a comprehensive review.  

PubMed

Acute traumatic central cord syndrome (ATCCS) is the most common type of incomplete spinal cord injury, characterized by predominant upper extremity weakness, and less severe sensory and bladder dysfunction. ATCCS is thought to result from post-traumatic centro-medullary hemorrhage and edema, or, as more recently proposed, from a Wallerian degeneration, as a consequence of spinal cord pinching in a narrowed canal. Magnetic Resonance Imaging is the method of choice for diagnosis, showing a typical intramedullary hypersignal on T2 sequences. Non-surgical treatment relies on external cervical immobilization, maintenance of a sufficient systolic blood pressure, and early rehabilitation, and should be reserved for patients suffering from mild ATCCS. Surgical management of ATCCS consists of posterior, anterior or combined approaches, in order to achieve spinal cord decompression, with or without stabilization. The benefits of early surgical decompression in the setting of ATCCS remain controversial due to the lack of clinical randomized trials; recent studies suggest that early surgery (less than 72hours after trauma) appears to be safe and effective, especially for patients with evidence of focal anatomical cord compression. PMID:24613283

Molliqaj, G; Payer, M; Schaller, K; Tessitore, E

2014-01-01

253

Traumatic brain injury among Indiana state prisoners.  

PubMed

Research on traumatic brain injury among inmates has focused on comparing the rate of traumatic brain injury among offenders to the general population, but also how best to screen for traumatic brain injury among this population. This study administered the short version of the Ohio State University Traumatic Brain Injury Identification Method to all male inmates admitted into Indiana state prisons were screened for a month (N = 831). Results indicate that 35.7% of the inmates reported experiencing a traumatic brain injury during their lifetime and that these inmates were more likely to have a psychiatric disorder and a prior period of incarceration than those without. Logistic regression analysis finds that a traumatic brain injury predicts the likelihood of prior incarceration net of age, race, education, and psychiatric disorder. This study suggests that brief instruments can be successfully implemented into prison screenings to help divert inmates into needed treatment. PMID:24588316

Ray, Bradley; Sapp, Dona; Kincaid, Ashley

2014-09-01

254

45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.  

Code of Federal Regulations, 2011 CFR

...Eligibility criteria: Traumatic brain injury. 1308.16 Section...Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF...Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose...

2011-10-01

255

45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.  

Code of Federal Regulations, 2012 CFR

...Eligibility criteria: Traumatic brain injury. 1308.16 Section...Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF...Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose...

2012-10-01

256

45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.  

Code of Federal Regulations, 2013 CFR

...Eligibility criteria: Traumatic brain injury. 1308.16 Section...Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF...Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose...

2013-10-01

257

Abuse, Post-Traumatic Stress Disorder and Migraine  

MedlinePLUS

... Traumatic Stress Disorder and Migraine Print Email Abuse, Post Traumatic Stress Disorder and Migraine ACHE Newsletter Sign ... by entering your e-mail address below. Abuse, Post-Traumatic Stress Disorder and Migraine Gretchen E. Tietjen, ...

258

Models of Traumatic Cerebellar Injury  

Microsoft Academic Search

Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Studies of human TBI demonstrate that\\u000a the cerebellum is sometimes affected even when the initial mechanical insult is directed to the cerebral cortex. Some of the\\u000a components of TBI, including ataxia, postural instability, tremor, impairments in balance and fine motor skills, and even\\u000a cognitive deficits, may be

Matthew B. Potts; Hita Adwanikar; Linda J. Noble-Haeusslein

2009-01-01

259

Apathy following traumatic brain injury.  

PubMed

Traumatic brain injury (TBI) may result in significant emotional and behavioral changes, such as depression, impulsivity, anxiety, aggressive behavior, and posttraumatic stress disorder. Apathy has been increasingly recognized as a relevant sequela of TBI, with a negative impact on the patients' quality of life as well as their participation in rehabilitation activities. This article reviews the nosologic and phenomenological aspects of apathy in TBI, diagnostic issues, frequency and prevalence, relevant comorbid conditions, potential mechanisms, and treatment. PMID:24529426

Starkstein, Sergio E; Pahissa, Jaime

2014-03-01

260

Microwave prostatic hyperthermia: interest of urethral and rectal applicators combination-theoretical study and animal experimental results  

Microsoft Academic Search

Microwave thermotherapy systems used for benign prostatic hyperplasia treatment generally operate with urethral or rectal applicator to deliver the microwave energy in the prostate. This technique does not allow an efficient heating of all the gland particularly in the case of large adenoma or when the treatment is limited to only one heating session. A solution to this problem is

D. Despretz; J.-C. Camart; C. Michel; J.-J. Fabre; B. Prevost; J.-P. Sozanski; M. Chive

1996-01-01

261

Fluid perfused urethral pressure profilometry and Valsalva leak point pressure: a comparative study in a biophysical model of the urethra.  

PubMed

In patient studies the correlation between maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (LPP) is meagre at best (r = 0.22-0.50). We therefore studied the relation between MUCP and LPP in a flexible and extensible model urethra. We applied differently sized pressure zones and different degrees of resistance to a biophysical model urethra by stepwise inflating three types of blood pressure cuff placed around the model. At each degree of resistance we measured detrusor LPP, an in vitro equivalent of Valsalva LPP. Subsequently, we recorded the Urethral Pressure Profile using a water-perfused 5F end-hole catheter at four withdrawal rates and five perfusion rates and calculated MUCP. We tested the dependence of LPP on pressure zone length and MUCP on perfusion rate, withdrawal rate and pressure zone length using analysis of variance. We tested the correlation between LPP and MUCP using Pearson's correlation coefficient and Linear Regression. LPP did not significantly depend on the pressure zone length (P = 0.80) and increased linearly with increasing cuff pressure. MUCP also increased with increasing cuff pressure, however, MUCP significantly depended (P < 0.01) on perfusion rate, withdrawal rate and pressure zone length. MUCP increased with increasing perfusion rate, and decreased with increasing withdrawal rate. In our model urethra MUCP only accurately reflected urethral resistance for a very limited number of combinations of perfusion rate and withdrawal rate. LPP reflected urethral resistance independent of the type of pressure zone. PMID:17576565

Idzenga, Tim; Pel, Johan J M; van Mastrigt, Ron

2007-08-01

262

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

PubMed

Injectable urethral bulking agents composed of synthetic and biological biomaterials are minimally invasive treatment options for stress urinary incontinence (SUI). The development of an ideal urethral bulking agent remains challenging because of clinical concerns over biocompatibility and durability. Herein, the mechanical and biological features of injectable urethral biomaterials are investigated, with particular emphasis on their future potential as primary and secondary treatment options for SUI. A literature search for English language publications using the two online databases was performed. Keywords included "stress urinary incontinence", "urethral bulking agent" and "injectable biomaterial". A total of 98 articles were analysed, of which 45 were suitable for review based on clinical relevance and importance of content. Injectable biomaterials are associated with a lower cure rate and fewer postoperative complications than open surgery for SUI. They are frequently reserved as secondary treatment options for patients unwilling or medically unfit to undergo surgery. Glutaraldehyde cross-linked bovine collagen remains the most commonly injected biomaterial and has a cure rate of up to 53 %. Important clinical features of an injectable biomaterial are durability, biocompatibility and ease of administration, but achieving these requirements is challenging. In carefully selected patients, injectable biomaterials are feasible alternatives to open surgical procedures as primary and secondary treatment options for SUI. In future, higher cure rates may be feasible as researchers investigate alternative biomaterials and more targeted injection techniques for treating SUI. PMID:23224022

Davis, Niall F; Kheradmand, F; Creagh, T

2013-06-01

263

HIV infection associated post-traumatic stress disorder and post-traumatic growth – A systematic review  

Microsoft Academic Search

The phenomenon of post-traumatic stress has been well documented in the literature as a lasting mental health condition associated with exposure to traumatic life events. The diagnosis and experience of human immunodeficiency virus (HIV) disease may be such a trauma. On the other hand, the phenomenon of post-traumatic growth (PTG) has been described, whereby people show positive mental health growth

Lorraine Sherr; Navneet Nagra; Grace Kulubya; Jose Catalan; Claudine Clucas; Richard Harding

2011-01-01

264

Traumatic experiences and post-traumatic stress disorder in the New Zealand police  

Microsoft Academic Search

Police duties place many officers at risk of traumatic stress and subsequent development of symptoms of post-traumatic stress disorder (PTSD). A survey of 527 New Zealand Police officers was carried out to investigate the prevalence of PTSD and its relationship with traumatic experiences, both on and off the job. The results showed that the prevalence of PTSD in the New

Christine Stephens; Ian Miller

1998-01-01

265

Anatomical Posterior Cruciate Ligament TransplantationA Biomechanical Analysis  

Microsoft Academic Search

Background: Although current techniques of posterior cruciate ligament reconstruction may successfully stabilize the posterior cruciate ligament-deficient knee, no studies have demonstrated restoration of intact-knee kinematics.Hypothesis: Posterior cruciate ligament transplantation will successfully restore posterior stability and kinematics to the posterior cruciate ligament-deficient knee.Study Design: Controlled laboratory study.Methods: Seven pairs (donor\\/recipient) of size-matched cadaveric knees underwent a novel technique for posterior cruciate

Daniel K. Davis; David H. Goltz; Donald C. Fithian; Darryl D’Lima

2006-01-01

266

Post-traumatic pulmonary pseudocyst with hemopneumothorax following blunt chest trauma: a case report  

PubMed Central

Introduction Post-traumatic pulmonary pseudocyst is an uncommon cavitary lesion of the lung and develops after blunt chest trauma and even more rarely following penetrating injuries. It is generally seen in young adults presenting with cough, chest pain, hemoptysis, and dyspnea. Post-traumatic pulmonary pseudocyst should be included in the differential diagnosis of cavitary pulmonary lesions. We describe the case of a 60-year-old Caucasian Greek woman who sustained traumatic pulmonary pseudocyst with hemopneumothorax due to a blunt chest trauma after a traffic accident. Case presentation After a traffic accident, a 60-year-old Caucasian Greek woman sustained a hemopneumothorax due to a blunt chest trauma. There was evidence of an extensive contusion in the posterior and lateral segments of the right lower lobe, a finding that was attributed to an early sign of a cavitation, and the presence of a thin-walled air cavity was detected on the anterior segment of the right lower lobe in the control computed tomography taken 24 hours after admission. Our patient was treated by catheter aspiration, and the findings of computed tomography evaluation about one month later showed complete resolution of one of the two air-filled cavitary lesions. The second pseudocyst also disappeared completely, as shown by the control computed tomography scan performed six months later. Conclusions Traumatic pulmonary pseudocyst is a rare complication of blunt chest trauma, and computed tomography is a more valuable imaging technique than chest radiograph for early diagnosis. PMID:23083130

2012-01-01

267

Acute tibialis posterior tendon rupture associated with a distal tibial fracture.  

PubMed

Tibialis posterior tendon ruptures associated with closed medial malleolar fractures are rare. This article describes the association of tibialis posterior tendon ruptures with closed, high-energy, distal tibia fractures. Tendon ruptures are likely to be identified intraoperatively or missed if clinical evaluation at acute injury is limited. A high index of suspicion is required to diagnose this injury. The consequences of an unrecognized tibialis posterior tendon rupture include progressive, painful pes planus deformities due to the unopposed action of the peroneus brevis muscle and lack of support of the medial longitudinal arch. Secondary operative intervention may be required. This article describes an intraoperative tenodesis technique between the tibialis posterior and flexor digitorum longus tendons when direct repair is not possible.A 48-year-old woman sustained a closed AO/Orthopaedic Trauma Association type 43A right lower-extremity distal tibia fracture and a traumatic left knee arthrotomy. Temporary stabilization with an external fixator was performed, followed by open reduction and internal fixation of the distal tibial fracture 6 days later. A periarticular nonlocking medial plate was applied, and the tibialis posterior tendon was shortened. We performed a direct tenodesis to the flexor digitorum longus tendon. At 1-year follow-up, the patient had made excellent progress, with no detectable muscle weakness, and was able to perform a single-leg toe raise.A review of the literature suggested which features of radiological evidence of tendon rupture should be examined, which may be useful in the current era considering most high-energy distal tibia or pilon fractures undergo examination with computed tomography. PMID:22495868

Jarvis, Hannah C; Cannada, Lisa K

2012-04-01

268

International Society for Traumatic Stress Studies  

MedlinePLUS

... Mission Statement ISTSS is an international, interdisciplinary professional organization that promotes advancement and exchange of knowledge about traumatic stress. This knowledge includes: Understanding the scope and consequences ...

269

Posterior approach white line advancement ptosis repair: the evolving posterior approach to ptosis surgery  

Microsoft Academic Search

IntroductionWe describe a surgical technique for ptosis correction in moderate to good levator function involving advancement of the levator aponeurosis via a transconjunctival posterior approach without resection of Müller's muscle. We present our experience of and the results from this method, and review the evolution of posterior approach ptosis surgery.PurposeTo assess the efficacy and predictability of posterior approach white line

Vikesh Patel; Aysha Salam; Raman Malhotra

2010-01-01

270

Posterior horn instability of the medial meniscus a sign of posterior meniscotibial ligament insufficiency  

Microsoft Academic Search

Purpose  In longstanding chronic anterior cruciate ligament (ACL) insufficiency, we identified an abnormal movement of the posterior\\u000a medial meniscal horn, likely due to insufficiency of the posteromedial meniscotibial ligament. Passing from extension to flexion\\u000a or vice versa, the medial posterior horn slides below the posterior rim of the tibia exposing the tibial plateau. Fixation\\u000a with suture anchors of the meniscotibial ligament

P. P. Mariani

2011-01-01

271

[Factors influencing prolonged hospital stays by elderly patients: problems in medical management including use of urethral catheters].  

PubMed

Fifty-nine elderly patients who had been hospitalized more than six months in five hospitals in the city of Mino in Osaka Prefecture, were studied to clarify the factors influencing prolonged hospital stays by the elderly. Their mean age was 82.2 years, and women accounted for 86% of the patients. One-third had suffered a stroke. As for ADL, 44% were completely dependent when walking, eating, bathing and dressing. Moreover, 36% had severe dementia, 19% suffered from decubitus ulcers, 66% were undergoing rehabilitation, 58% were receiving venous infusion therapy, 36% used a urethral catheter, and 10% were receiving tube feeding. The subjects were divided into two groups according to the likelihood of discharge assessed by the doctors in charge: one group consisted of 27 patients who might be discharged and the other of 32 patients with an ongoing need for inpatient care. Multivariate analyses using Hayashi's quantification method II indicated that use of a urethral catheter and not undergoing rehabilitation were the main factors associated with the need for inpatient care, while being a woman, being of advanced age and not having one's own room at home were the non-medical factors which made it difficult for the patients to be discharged from the hospital. As use of a urethral catheter was the factor most strongly related to prolonged hospital stay, multivariate analyses were applied to the 45 patients with urinary incontinence, who were divided into one group of 21 patients with, and one of 24 without a urethral catheter. The factors associated with use of a urethral catheter were then investigated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1464952

Kuroda, K; Tatara, K; Zhao, L; Takatorige, T; Shinsho, F

1992-10-01

272

Traumatic obturator hip dislocation in a 9-year-old boy.  

PubMed

Traumatic hip dislocation is a rare but potentially devastating injury in a child. Although most hip dislocations are posterior, other variants have been described. An anterior dislocation in the pediatric population is uncommon and, to our knowledge, this is the first case of anterior-inferior (obturator) dislocation (ie, the femoral head lies in the obturator foramen), to be reported in the English-language literature. In this article, we describe the case of a young boy with a traumatic obturator hip dislocation treated conservatively with closed reduction and followed closely for 1 year. The patient did not develop any sequelae throughout the follow-up year. This case report, along with a review of the literature, will help guide clinicians in the care of patients with this rare injury. PMID:24078972

Avery, Daniel M; Carolan, Gregory F

2013-09-01

273

Bone regeneration with plasma-rich-protein following enucleation of traumatic bone cyst  

PubMed Central

Traumatic bone cyst is an uncommon non-epithelium lined cavity and is seen frequently in young individuals. The lesion occurs more commonly in the mandible, involving the posterior region. It is generally asymptomatic and is diagnosed on routine radiographic examination. The cystic cavity is usually empty and there is scanty material for histological examination. Surgical curettage is usually done and recurrence is rare. A case of traumatic bone cyst occurring in the anterior region of mandible in a young boy is presented. Following surgical intervention, plasma-rich-protein was placed in the cystic cavity. The lesion showed progressive resolution and bone regeneration of the cystic cavity within a short period of time. PMID:24926221

Subramaniam, Priya; Kumar, Krishna; Ramakrishna, T.; Bhadranna, Abhishek

2013-01-01

274

Human amniotic fluid stem cell injection therapy for urethral sphincter regeneration in an animal model  

PubMed Central

Background Stem cell injection therapies have been proposed to overcome the limited efficacy and adverse reactions of bulking agents. However, most have significant limitations, including painful procurement, requirement for anesthesia, donor site infection and a frequently low cell yield. Recently, human amniotic fluid stem cells (hAFSCs) have been proposed as an ideal cell therapy source. In this study, we investigated whether periurethral injection of hAFSCs can restore urethral sphincter competency in a mouse model. Methods Amniotic fluids were collected and harvested cells were analyzed for stem cell characteristics and in vitro myogenic differentiation potency. Mice underwent bilateral pudendal nerve transection to generate a stress urinary incontinence (SUI) model and received either periurethral injection of hAFSCs, periurethral injection of Plasma-Lyte (control group), or underwent a sham (normal control group). For in vivo cell tracking, cells were labeled with silica-coated magnetic nanoparticles containing rhodamine B isothiocyanate (MNPs@SiO2 (RITC)) and were injected into the urethral sphincter region (n = 9). Signals were detected by optical imaging. Leak point pressure and closing pressure were recorded serially after injection. Tumorigenicity of hAFSCs was evaluated by implanting hAFSCs into the subcapsular space of the kidney, followed two weeks later by retrieval and histologic analysis. Results Flow activated cell sorting showed that hAFSCs expressed mesenchymal stem cell (MSC) markers, but no hematopoietic stem cell markers. Induction of myogenic differentiation in the hAFSCs resulted in expression of PAX7 and MYOD at Day 3, and DYSTROPHIN at Day 7. The nanoparticle-labeled hAFSCs could be tracked in vivo with optical imaging for up to 10 days after injection. Four weeks after injection, the mean LPP and CP were significantly increased in the hAFSC-injected group compared with the control group. Nerve regeneration and neuromuscular junction formation of injected hAFSCs in vivo was confirmed with expression of neuronal markers and acetylcholine receptor. Injection of hAFSCs caused no in vivo host CD8 lymphocyte aggregation or tumor formation. Conclusions hAFSCs displayed MSC characteristics and could differentiate into cells of myogenic lineage. Periurethral injection of hAFSCs into an SUI animal model restored the urethral sphincter to apparently normal histology and function, in absence of immunogenicity and tumorigenicity. PMID:22906045

2012-01-01

275

Urethral Trauma  

MedlinePLUS

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276

Urethral Diverticulum  

MedlinePLUS

... January 2011 You are leaving UrologyHealth.org. The Urology Care Foundation has no control over the content of this site. Click OK to proceed. Urology A - Z A Adrenal Gland Disorders Adrenal Medulla ...

277

Hypospadias and genes related to genital tubercle and early urethral development  

PubMed Central

Purpose We determined whether variants in genes associated with genital tubercle (the anlage for the penis) and early urethral development were associated with hypospadias in humans. Materials and Methods We examined 293 relatively common tagSNPs in BMP4, BMP7, FGF8, FGF10, FGFR2, HOXA13, HOXD13, HOXA4, HOXB6, SRY, WT1, WTAP, SHH, GLI1, GLI2, and GLI3. The analysis included 624 cases (81 mild, 319 moderate, 209 severe, 15 undetermined severity) and 844 population-based non-malformed male controls born in California from 1990-2003. Results There were 28 SNPs for which any of the comparisons (i.e., overall or for a specific severity) had a p-value <0.01. The homozygous variant genotypes for four SNPs in BMP7 were associated with at least 2-fold increased risk of hypospadias, regardless of severity. Five SNPs for FGF10 were associated with 3- to 4-fold increased risks, regardless of severity; for four of them, results were restricted to whites. For GLI1, GLI2 and GLI3, there were 12 associated SNPs but results were inconsistent by severity and race-ethnicity. For SHH, one SNP was associated with 2.4-fold increased risk of moderate hypospadias. For WT1, six SNPs were associated with approximately 2-fold increased risks, primarily for severe hypospadias. Conclusions This study provides evidence that SNPs in several genes that contribute to genital tubercle and early urethral development are associated with hypospadias risk. PMID:23727413

Carmichael, Suzan L.; Ma, Chen; Choudhry, Shweta; Lammer, Edward J.; Witte, John S.; Shaw, Gary M.

2014-01-01

278

Microbial Population Diversity in the Urethras of Healthy Males and Males Suffering from Nonchlamydial, Nongonococcal Urethritis  

PubMed Central

Nonchlamydial, nongonococcal urethritis (NCNGU) is suggested to be a sexually transmitted disease in men. NCNGU patients were compared to control subjects with regard to the presence of potentially infectious bacteria in the first void urine. Patients' pre- and post-antibiotic-treatment urine samples and two samples obtained 2 weeks apart from healthy volunteers, who did not receive antibiotic therapy, were analyzed with broad-spectrum PCR tests aiming at eubacterial small subunit rRNA genes. Restriction fragment length polymorphism analysis of the amplicons cloned from the mixtures of PCR products revealed that many different species of microorganisms were found to be colonizing the male urethra. We document here clear differences in the composition of the resident urethral flora between samples obtained from various individuals and between samples obtained at various points in time for a single individual. No major changes in population complexity were found upon antimicrobial treatment. In two of five patients a previously suggested pathogen (Mycoplasma genitalium or Haemophilus parainfluenzae) was accurately identified on the basis of DNA sequencing. No ubiquitous, azithromycin-sensitive organism was identified as a common pathogen in all patients, but up to 40% of all clones represented as-yet-unclassified bacterial species. Relatively often Pseudomonas spp. or Pseudomonas-like organisms were identified in the bacterial flora of patients. Interestingly, an as-yet-uncharacterized microbial species was identified as a negative predictor of NCNGU. This species was identified in all control subjects and was absent from all of the patient' samples (5 of 5 versus 0 of 5, P = 0.0079). This suggests that NCNGU might also be diagnosed by assessing the absence rather than the presence of certain bacterial species. PMID:12734237

Riemersma, W. A.; van der Schee, C. J. C.; van der Meijden, W. I.; Verbrugh, H. A.; van Belkum, A.

2003-01-01

279

The Trial of Mid-Urethral Slings (TOMUS): Design and Methodology  

PubMed Central

Objective Mid-urethral slings (MUS) are increasingly common surgical procedures for the treatment of stress urinary incontinence (SUI) in women. There are currently no adequately powered trials with sufficient length of follow-up comparing the efficacy or safety of the transobturator and retropubic MUS. As a result, no selection criteria are available to guide surgeons or patients. This article describes the methodology and rationale for the Trial Of Mid-Urethral Slings (TOMUS). Patients and Methods The primary aims of this randomized controlled trial is to compare subjective and objective success rates for urinary incontinence (UI) at 12 and 24 months following retropubic and transobturator MUS procedures. Secondary aims are to compare the resolution of overall and stress-specific UI, morbidity, the time to adequate voiding, satisfaction, and quality of life in the two groups. TOMUS will also assess the clinical utility of pre-operative urodynamics in women undergoing MUS procedures. The primary outcome will be obtained at 12 months and 24 months. The definition of treatment success is two-fold. Objective treatment success is defined by a negative stress test, a negative 24-hour pad test and no retreatment for SUI. Subjective treatment success is defined by no self-reported leakage on 3-day diary and no self-reported SUI symptoms. Enrollment began April 2006 and is expected to be complete in 2 years. Conclusions The TOMUS trial is designed to provide outcome and safety information to pelvic surgeons and their patients on the two most commonly performed MUS techniques. PMID:24772006

2013-01-01

280

A de-epithelialised 'turnover dartos flap' in the repair of urethral fistula.  

PubMed

We report our experience in the management of urethrocutaneous fistulae following hypospadias repair by using a turnover, de-epithelialiszed dartos flap. From May 2003 to June 2007 we operated on 10 patients with urethral fistulae following hypospadias repair. Their ages ranged from 4 to 25 years (mean: 7 years). Four of these patients had their urethroplasty done elsewhere and reported for fistula repair alone. These four patients had no record of the urethroplasty procedure that was used. A solitary fistula was located at the corona in two patients, on the mid-shaft in three patients, and proximal penile in one patient. Two patients had multiple fistulae on the shaft, one patient had two fistulae on the shaft, and one patient had a long fistula from the proximal penile to peno-scrotal region. The technique involves using a circumscribing incision around the fistula and closing the inner skin edges by an inverting subcuticular stitch to form the urethral layer. A flap is marked on the skin adjacent to the circumscribing incision and de-epithelialised. It is raised with underlying dartos fascia/muscle and turned over the first layer of closure and secured. The vascular supply to the flap is based on a hinge of tissue around the defect. A long skin flap developed from shaft or the scrotum is approximated over this layer to complete the repair. Alternatively, the skin is closed in a 'pants over vest' technique. An indwelling catheter is placed for 3-4 days. Nine patients healed without complications, and one patient with multiple fistulae on the shaft had a residual tiny pin-point fistula which closed spontaneously. Thus, the success rate with this technique was 100%. Although dartos flaps have been used for many years as a waterproofing layer in urethroplasties or while repairing urethrocutaneous fistulae, their use as a 'de-epithelialised turnover flap' provides another reliable tool in the surgical repertoire. PMID:18640885

Ahuja, Rajeev B

2009-03-01

281

Post-traumatic stress: Attributional aspects  

Microsoft Academic Search

Although exposure to a traumatic event is thought to be the main aetiological factor in the development of post-traumatic stress disorder (PTSD: APA, 1987), a large amount of individual variance in the chronicity and severity of symptoms remains unaccounted for. In this paper, evidence will be reviewed for the possible mediating role of causal attributions and attributional style. It is

Stephen Joseph; William Yule; Ruth Williams

1993-01-01

282

Traumatic Brain Injury: A Challenge for Educators  

ERIC Educational Resources Information Center

In this article, the authors provide information designed to enhance the knowledge and understanding of school personnel about traumatic brain injury (TBI). The authors specifically define TBI and enumerate common characteristics associated with traumatic brain injury, discuss briefly the growth and type of services provided, and offer some…

Bullock, Lyndal M.; Gable, Robert A.; Mohr, J. Darrell

2005-01-01

283

Psychosocial research in traumatic stress: An update  

Microsoft Academic Search

This report presents an update of psychosocial research in the traumatic stress field, presenting an overview of recent studies in several areas: the epidemiology of traumatic events and of PTSD in the general adult population, other diagnoses associated with trauma exposure and PTSD, the course and longevity of PTSD symptomatology, and risk factors for the diagnosis. Other areas of increasing

Bonnie L. Green

1994-01-01

284

Traumatic pericardial rupture with skeletonized phrenic nerve  

Microsoft Academic Search

BACKGROUND: Traumatic pericardial rupture is a rare presentation. Pericardial rupture itself is asymptomatic unless complicated by either hemorrhage or herniation of the heart through the defect. Following diagnosis surgical repair of the pericardium is indicated because cardiac herniation may result in vascular collapse and sudden death. OBJECTIVES: Here we present a case of traumatic, non-herniated pericardial rupture with complete skeletonization

Zain Khalpey; Taufiek K Rajab; Jan D Schmitto; Philipp C Camp

2011-01-01

285

Post-traumatic demoralization syndrome (PTDS)  

Microsoft Academic Search

Demoralization appears to be a key dimension of patients' presenting complaints to therapists today. This is especially true when the patient has gone through psychological traumatization; for example, rape, war, natural disaster, incest, or technological or occupational accidents. This article is to alert clinicians to this pervasive malady in patients, as it focuses on the dynamics and components of “post-traumatic

Erwin Randolph Parson

1990-01-01

286

Secondary Traumatic Stress in Substance Abuse Treatment  

ERIC Educational Resources Information Center

The terms secondary traumatic stress (STS), vicarious traumatization (VT), and compassion fatigue (CF) have all been used, sometimes interchangeably, to refer to the observation that those who provide clinical services to trauma survivors may themselves experience considerable emotional disruption, becoming indirect victims of the trauma.…

Bride, Brian E.; Walls, Erin

2006-01-01

287

The Effects of Traumatic and Abusive Relationships  

ERIC Educational Resources Information Center

The present study aimed to understand what constitutes a traumatic relationship experience for adults in abusive intimate relationships and what effects, losses, and coping strategies were the most salient for these participants. A total of 101 individuals (42 males, 59 females) who reported experiencing an abusive or traumatic relationship…

Orzeck, Tricia L.; Rokach, Ami; Chin, Jacqueline

2010-01-01

288

The Effects of Traumatic and Abusive Relationships  

Microsoft Academic Search

The present study aimed to understand what constitutes a traumatic relationship experience for adults in abusive intimate relationships and what effects, losses, and coping strategies were the most salient for these participants. A total of 101 individuals (42 males, 59 females) who reported experiencing an abusive or traumatic relationship participated. A mixed-method content analysis approach was used to derive the

Tricia L. Orzeck; Ami Rokach; Jacqueline Chin

2010-01-01

289

Post-traumatic symptoms in abused children  

Microsoft Academic Search

A variety of symptoms have been described as sequelae of physical and sexual abuse in childhood. This review suggests that some of these symptoms can be understood as developmentally mediated manifestations of post-traumatic disorders. Like traumatized combat or concentration camp survivors, severely abused children develop anxiety, compulsive repetitions, sleep disturbances and depression, ego constriction, and disturbed expressions of anger. The

Jean Goodwin

1988-01-01

290

Comparison of the Combined Anterior-Posterior Approach versus Posterior-Only Approach in Scoliosis Treatment  

PubMed Central

Study Design This is descriptive analytical study. Purpose The present study aims at comparing treatment results found between the two groups comprising of patients who underwent posterior spinal fusion using thoracic pedicle screws and the ones who underwent combined anterior-posterior method, respectively. Overview of Literature There was controversy about surgical techniques including anterior, posterior, or a combined anterior-posterior approaches are applied to treat non-congenital scoliosis with surgical indications. Methods Medical records of 50 patients suffering from thoracic non-congenital scoliosis with curves exceeding 70° were reviewed. In this study, 25 patients who underwent posterior spinal fusion using thoracic pedicle screws were compared with 25 patients who underwent combined anterior-posterior method. Results Patients treated through posterior-only and combined approaches were respectively hospitalized for 11.84±5.18 and 26.5±5.2 days (p=0.001). There was a significant difference between these two groups considering intensive care unit admission duration (p=0.001), correction in sagittal view of X-ray (p=0.01), and number of days the patients underwent traction (0.001). Finally, coronal view was corrected without any significant difference (p=0.2). Conclusions According to our findings, it is hypothesized that posterior-only method is associated with some significant advantages and is an advisable method in patients with severe scoliosis over than 70°. PMID:24596599

Pourfeizi, Hossein Hojjat; Sales, Jafar Ganjpour; Borran, Ghanbar; Alavi, Sahar

2014-01-01

291

Post-traumatic Stress Disorder.  

PubMed

Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with severely ill patients, journalists and their families, and audiences who witness serious trauma and war at higher risk of PTSD.The intensity of trauma, pre-trauma demographic variables, neuroticism and temperament traits are the best predictors of the severity of PTSD symptoms. About 84% of those suffering from PTSD may have comorbid conditions including alcohol or drug abuse; feeling shame, despair and hopeless; physical symptoms; employment problems; divorce; and violence which make life harder. PTSD may contribute to the development of many other disorders such as anxiety disorders, major depressive disorder, substance abuse/dependency disorders, alcohol abuse/dependence, conduct disorder, and mania. It causes serious problems, thus its early diagnosis and appropriate treatment are of paramount importance. PMID:23022845

Javidi, H; Yadollahie, M

2012-01-01

292

Spinal stenosis and posterior lumbar interbody fusion.  

PubMed

One hundred forty-two patients with the common types of spinal stenosis were treated by posterior lumbar interbody fusion (PLIF). The majority of the patients had one or more decompressive procedures prior to PLIF. The results were excellent or good in 78%. A review of the literature concerning long-term results of decompressive procedures indicates a short-term failure rate of 15%-20% and about 50% failure by ten or more years after the operation. Anterior fusion in primary disc lesions produces admirable results but is of little value in spinal stenosis. Long-term reports of the success rates of posterior lumbar interbody fusion indicate that this operation combines the success rate of an anterior interbody fusion with the benefits of posterior decompression. PMID:3971609

Hutter, C G

1985-03-01

293

Large vocabulary decoding and confidence estimation using word posterior probabilities  

Microsoft Academic Search

The paper investigates the estimation of word posterior probabilities based on word lattices and presents applications of these posteriors in a large vocabulary speech recognition system. A novel approach to integrating these word posterior probability distributions into a conventional Viterbi decoder is presented. The problem of the robust estimation of confidence scores from word posteriors is examined and a method

G. Evermann; P. C. Woodland

2000-01-01

294

Traumatic hyphema (continuing education credit).  

PubMed

1. The successful treatment of patients with hyphemas depends on identification of risk factors, proper medical management, and prompt surgical intervention when indicated. 2. There are a number of management issues that the ophthalmologist deals with in treating traumatic hyphemas. These include inpatient versus outpatient treatment, limiting activity, weighing the advantages/disadvantages of Amicar to control secondary hemorrhages, and treating secondary glaucoma. 3. Two indications for surgical management include uncontrolled IOP or the development of corneal blood staining. 4. Hyphema patients require long-term, yearly follow-up to monitor for secondary glaucoma. PMID:7699726

Spires, R

1995-01-01

295

Early traumatic events in psychopaths.  

PubMed

The relationship between diverse early traumatic events and psychopathy was studied in 194 male inmates. Criminal history transcripts were revised, and clinical interviews were conducted to determine the level of psychopathy using the Psychopathy Checklist-Revised (PCL-R) Form, and the Early Trauma Inventory was applied to assess the incidence of abuse before 18 years of age. Psychopathic inmates presented a higher victimization level and were more exposed to certain types of intended abuse than sociopathic inmates, while the sum of events and emotional abuse were associated with the PCL-R score. Our studies support the influence of early adverse events in the development of psychopathic offenders. PMID:23550705

Borja, Karina; Ostrosky, Feggy

2013-07-01

296

Posterior-compartment repair: a urology perspective.  

PubMed

The prevalence of posterior-compartment prolapse (rectocele) is not known. The authors have found that operative repair symptomatically improved a majority of patients with impaired defecation associated with a large rectocele, but this improvement was likely related at least in part to factors other than the size of the rectocele. Multiple surgical techniques are available for rectocele repair, and the literature is not clear regarding indications for each type of surgical intervention. This article reviews the literature regarding various types of posterior-compartment repair, and draws conclusions regarding their absolute efficacy and relative efficacy in comparison with one another. PMID:22877720

Gomelsky, Alex; Dmochowski, Roger R

2012-08-01

297

Arthroscopic management of shoulder instabilities: anterior, posterior, and multidirectional.  

PubMed

Arthroscopy is considered a relatively new technique for the surgical repair of an unstable shoulder. Shoulder arthroscopy has grown in popularity and is considered the gold standard for treating carefully selected patients. Despite its increasing popularity, the procedure has a significant learning curve and has resulted in early higher recurrence rates when compared with patients treated with open techniques. With the addition of newer instrumentation, the refinement of techniques, and additional capsular plication and tensioning, outcomes for patients treated with shoulder arthroscopy should continue to improve. A major distinguishing feature in selecting appropriate candidates for shoulder arthroscopy is whether there have been significant bone changes resulting from dislocation recurrence. Recurrent anterior dislocation may create an anterior glenoid rim fracture, erosion loss from multiple recurrences, and an impression defect on the posterior aspect of the humeral head. The loss of contact area between the "ball and cup" may compromise the results of techniques that restore the anatomic restraints of soft tissues. Early intervention is becoming recognized as an important factor in patient selection for arthroscopic treatment. Imaging studies after traumatic injuries include radiographs, CT scans, possible articular contrast studies, and MRIs. These studies can identify and quantify rim fractures and the remaining articular contact in patients with recurrent subluxations, allowing for earlier appropriate intervention. Patients with significant bone loss may be best treated with an open procedure that allows grafting of the deficiency. Arthroscopic techniques to repair fractures or graft deficiencies continue to evolve. Rim fractures can be anatomically repaired with a suture anchor technique when recognized early. Rim erosion from chronic recurrent dislocations may require a combination of soft-tissue reattachment and coracoid grafting. Humeral head defects may require either soft-tissue or bone grafting to avoid engagement with the anterior edge of the glenoid. These techniques require arthroscopic skill and experience and are currently being performed as open procedures. In the future, it is likely that arthroscopy will be involved in the entire spectrum of treatment for shoulder instability. PMID:20415377

Abrams, Jeffrey S; Bradley, James P; Angelo, Richard L; Burks, Robert

2010-01-01

298

Bladder dysfunction changes from underactive to overactive after experimental traumatic brain injury.  

PubMed

Although bladder dysfunction is common after traumatic brain injury (TBI), few studies have investigated resultant bladder changes and the detailed relationship between TBI and bladder dysfunction. The goal of this study was to characterize the effects of TBI on bladder function in an animal model. Fluid-percussion injury was used to create an animal model with moderate TBI. Female Sprague-Dawley rats underwent TBI, sham TBI or were not manipulated (naïve). All rats underwent filling cystometry while bladder pressure and external urethral sphincter electromyograms were simultaneously recorded 1 day, 1 week, 2 weeks, and 1 month after injury. One day after injury, 70% of the animals in the TBI group and 29% of the animals in the sham TBI group showed no bursting activity during urination. Compared to naïve rats, bladder function was mainly altered 1 day and 1 week after sham TBI, suggesting the craniotomy procedure affected bladder function mostly in a temporary manner. Compared to either naïve or sham TBI, bladder weight was significantly increased 1 month after TBI and collagen in the bladder wall was increased. Bladder function in the TBI group went from atonic 1 day post-TBI to overactive 1 month post-TBI, suggesting that TBI significantly affected bladder function. PMID:23178579

Jiang, Hai-Hong; Kokiko-Cochran, Olga N; Li, Kevin; Balog, Brian; Lin, Ching-Yi; Damaser, Margot S; Lin, Vernon; Cheng, Julian Yaoan; Lee, Yu-Shang

2013-02-01

299

NIMH Fact Sheet Post-Traumatic Stress Disorder Research  

E-print Network

NIMH Fact Sheet Post-Traumatic Stress Disorder Research What is Post-Traumatic Stress Disorder? Post-traumatic stress disorder (PTSD) is an anxiety disorder that some people develop after seeing PTSD, please see the NIMH Post-Traumatic Stress Disorder booklet. You can also find a list of places

Bandettini, Peter A.

300

The Spectrum of Disease in Chronic Traumatic Encephalopathy  

ERIC Educational Resources Information Center

Chronic traumatic encephalopathy is a progressive tauopathy that occurs as a consequence of repetitive mild traumatic brain injury. We analysed post-mortem brains obtained from a cohort of 85 subjects with histories of repetitive mild traumatic brain injury and found evidence of chronic traumatic encephalopathy in 68 subjects: all males, ranging…

McKee, Ann C.; Stein, Thor D.; Nowinski, Christopher J.; Stern, Robert A.; Daneshvar, Daniel H.; Alvarez, Victor E.; Lee, Hyo-Soon; Hall, Garth; Wojtowicz, Sydney M.; Baugh, Christine M.; Riley, David O.; Kubilus, Caroline A.; Cormier, Kerry A.; Jacobs, Matthew A.; Martin, Brett R.; Abraham, Carmela R.; Ikezu, Tsuneya; Reichard, Robert Ross; Wolozin, Benjamin L.; Budson, Andrew E.; Goldstein, Lee E.; Kowall, Neil W.; Cantu, Robert C.

2013-01-01

301

Traumatic and nontraumatic brain injury.  

PubMed

The neurological consequences of an acquired brain injury (ABI), of traumatic or nontraumatic origin, are caused by an alteration of neuronal activity that compromises physical integrity or function of one or more areas of the brain. Impairments resulting from an ABI often affect cognitive function, as well as language, memory, attention, and information processing faculties, leading to partial or total disability that is likely to prevent people's functional and psychosocial recovery even in the long term. This situation has harmful clinical, social, and economic effects. Social costs caused by a patient's death or acquired disability are extremely high, and costs to healthcare systems rank among the top three in Europe. One of the main considerations when dealing with traumatic or nontraumatic brain injury is the complexity of the rehabilitation process. Many variables must be taken into account because of the great variety of clinical features that may occur, involving damage etiology, severity level, and health complications. Great advancements have been achieved over the past 10-15 years in the treatment of ABI, but new basic and clinical research must be encouraged and financially supported. Many challenging issues still occur when evaluating patients with ABI due to the lack of appropriate assessment measures and reliable prognostic indexes that could support clinical observation. Furthermore, researcher authors need to create a network of rehabilitation services that responds to the needs - medical, emotional, and social - of all brain-injured patients and their families, from initial hospitalization to reintegration into the community. PMID:23312659

Giustini, Alessandro; Pistarini, Caterina; Pisoni, Camilla

2013-01-01

302

Imaging of traumatic adrenal injury.  

PubMed

Traumatic adrenal injury is a relatively rare event, reported in 0.15 to 4 % of blunt abdominal trauma cases. The location of the adrenal glands, protected deeply within the retroperitoneum, accounts for the rarity of adrenal trauma. These injuries are unilateral in 75 to 90 % of cases and most commonly afflict the right adrenal gland. While no specific clinical symptoms or signs point directly to adrenal injury, and isolated adrenal injury is rare, the presence of adrenal injury can be an indicator of severe trauma. In fact, mortality rates in series of adrenal injuries range from 7 to 32 %. The most common associated injuries affect the liver, ribs, kidney, or spleen. Three theories of adrenal injury from blunt trauma have been proposed: (1) acute rise in intra-adrenal venous pressure due to compression of the IVC during impact, (2) crushing between the spine and surrounding organs, and (3) deceleration forces shearing the small adrenal arterioles. The most common imaging features include a 2-3-cm oval hematoma, irregular hemorrhage obliterating the adrenal gland, periadrenal hemorrhage or fat stranding, and uniform adrenal swelling with increased attenuation. The differential diagnosis of adrenal abnormalities on trauma CT includes adenoma, carcinoma, myelolipoma, metastases, pheochromocytoma, and tuberculosis. Preexisting adrenal disorders can predispose the adrenal to injury with minor trauma. Most adrenal traumatic injuries are managed conservatively. PMID:22895661

To'o, Katherine J; Duddalwar, Vinay A

2012-12-01

303

[Posterior longitudinal ligament ossification: case report].  

PubMed

Posterior longitudinal ligament ossification of cervical spine is a rare condition among caucasians. A 42 years old japanese patient with progressive walking difficulty was diagnosed with this pathology by CT scan and MRI and treated surgically by an anterior approach with arthrodesis. Pathophysiology, racial prevalence, clinical picture, radiological characteristics and surgical approaches options are revised. PMID:16622577

Tella, Oswaldo Inácio de; Herculano, Marco Antonio; Paiva Neto, Manoel Antonio; Faedo Neto, Atílio; Crosera, João Francisco

2006-03-01

304

Extralobar pulmonary sequestration simulates posterior neurogenic tumor  

Microsoft Academic Search

We report a case of 19-year-old asymptomatic man with posterior mediastinal mass thought to be of neurogenic origin on computed tomography scan. During video-assisted thoracic surgery the mass appeared to be an extralobar pulmonary sequestration. Surgery was straightforward by division of vascular pedicle. Histopathology confirmed diagnosis.

Ryszard W Lupinski; Thirugnanam Agasthian; Chong Hee Lim; Yeow Leng Chua

2004-01-01

305

Vision through nuclear and posterior subcapsular cataract  

Microsoft Academic Search

We have developed a new set of tests for evaluation of visual function through media opacities, based on vernier acuity measurements (hyperacuity). In this paper, results of one of these tests, the ‘gap test’, are compared in patients with posterior subcapsular (PSC) cataract versus nuclear cataract (NC). Patients with PSC cataract often report multiple images or significant ‘star burst’ effects.

Patrizia Baraldi; Jay M. Enoch; Sylvan Raphael

1986-01-01

306

Assessing Traumatic Event Exposure: Comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for "DSM-IV"  

ERIC Educational Resources Information Center

Post-traumatic stress disorder (PTSD) diagnosis requires first identifying a traumatic event, but very few studies have evaluated methods of potential traumatic event assessment and their impact on PTSD diagnosis. The authors compared a behaviorally specific comprehensive multiple-item traumatic event measure with a single-item measure to…

Peirce, Jessica M.; Burke, Christopher K.; Stoller, Kenneth B.; Neufeld, Karin J.; Brooner, Robert K.

2009-01-01

307

Acute Posterior Ischemic Optic Neuropathy Mimicking Posterior Cerebral Artery Stroke Visualized by 3-Tesla MRI  

PubMed Central

Acute ischemic lesions of the posterior optic nerve and optic tract can produce a variety of visual field defects. A 71-year-old woman presented with acute hemianopia, which led to rt-PA thrombolysis for suspected posterior cerebral artery ischemia. 3-Tesla cMRI, however, revealed the cause to be an acute posterior ischemic optic neuropathy. Cases like this may be more common than thought and quite regularly overlooked in clinical practice, especially when there is no high-resolution MRI available. This case strengthens the importance of repeat MR imaging in patients with persistent visual field defects. PMID:23185170

Menzel, Tilman; Kern, Rolf; Griebe, Martin; Hennerici, Michael; Fatar, Marc

2012-01-01

308

Chlamydia trachomatis serovar distribution and other concurrent sexually transmitted infections in heterosexual men with urethritis in Italy  

Microsoft Academic Search

The distribution of Chlamydia trachomatis serovars among 157 heterosexual male patients with urethritis and the presence of coinfections with other sexually transmitted\\u000a infections were studied. One hundred seventeen (74.5%) patients, with a mean age of 33.7 years, were Italians, whereas 40\\u000a (25.5%) were immigrants coming from eastern European countries, Africa, and South America. All the immigrants and 82 (70.0%)\\u000a Italian patients

M. Donati; A. Di Francesco; A. D’Antuono; S. Pignanelli; A. Shurdhi; A. Moroni; R. Baldelli; R. Cevenini

2009-01-01

309

Epithelial-differentiated adipose-derived stem cells seeded bladder acellular matrix grafts for urethral reconstruction: an animal model.  

PubMed

The limited amount of available epithelial tissue is considered a main cause of the high rate of urethral reconstruction failures. The aim of this study was to investigate whether epithelial-differentiated rabbit adipose-derived stem cells (Epith-rASCs) could play a role of epithelium in vivo functionally and be a potential substitute of urothelium. Substitution urethroplasty was performed to repair an anterior urethral defect in male New Zealand rabbits using Epith-rASCs seeded bladder acellular matrix grafts (BAMGs) after 5-bromo-2'-deoxyuridine (BrdU) labeling, based on the in vitro epithelial induction system we previously described. Urethroplasty with cell-free BAMGs and with undifferentiated rASCs (Und-rASCs) seeded BAMGs were performed as controls. After surgery, a notable amelioration of graft contracture and recovery of urethral continuity were observed in the Epith-rASCs/BAMG group by retrograde urethrograms and macroscopic inspection. Immunofluorescence revealed that the BrdU-labeled Epith-rASCs/Und-rASCs colocalized with cytokeratin 13 or myosin. Consistent with the results of western blotting, at early postimplantation stage, the continuous epithelial layer with local multilayered structure was observed in the Epith-rASCs/BAMG group, whereas no significant growth and local monolayer growth profile of epithelial cells were observed in the BAMG and Und-rASCs/BAMG group, respectively. The results showed that Epith-rASCs could serve as a potential substitute of urothelium for urethral tissue engineering and be available to prevent lumen contracture and subsequent complications including recurrent stricture. PMID:24329501

Li, Hongbin; Xu, Yuemin; Xie, Hong; Li, Chao; Song, Lujie; Feng, Chao; Zhang, Qin; Xie, Minkai; Wang, Ying; Lv, Xiangguo

2014-02-01

310

Treatment of urethral stricture disease by internal urethrotomy followed by intermittent 'low-friction' self-catheterization: preliminary communication.  

PubMed Central

The aim of this study was to determine whether the natural course of urethral stricture disease could be modified following urethrotomy by teaching patients intermittent self-catheterization. Preliminary results in 42 patients show that postoperative urine flow rates can be maintained if this method of 'low-friction' catheterization is adopted. The technique has been well received by an elderly group of patients and can be recommended for wider use. Images p138-a p138-b PMID:3357154

Lawrence, W T; MacDonagh, R P

1988-01-01

311

[Technique of the urethral anastomosis in orthotopic neo-bladder following robot-assisted radical cystectomy (RARC)].  

PubMed

The urethral anastomosis in extracorporeally constructed orthotopic neo-bladder following robot-assisted radical cystectomy (RARC) remains a challenge. In principle either pre-posi-tioned single sutures or robotic continuous suture techniques can be applied. In the literature the different techniques are most often not described in detail. In the present work one example for each technique is given and the advantages and disadvantages of both methods are discussed. PMID:23446632

Horstmann, M; Kurz, M; Padevit, C; Horton, K; John, H

2013-03-01

312

Attributions for Different Types of Traumatic Events and Post-Traumatic Stress Among Women  

Microsoft Academic Search

This study investigated the relationship of attributions to post-traumatic stress symptoms among women exposed to different types of traumatic events. Participants were 424 female undergraduates who previously experienced a serious accident, natural disaster, child abuse, or adult interpersonal violence. Path analysis indicated a significant indirect pathway from event type to post-traumatic stress through global attributions. Interpersonal-violence survivors exhibited the highest

Heidi M. Zinzow; Joan L. Jackson

2009-01-01

313

Development of a CFD urethral model to study flow-generated vortices under different conditions of prostatic obstruction.  

PubMed

A novel, non-invasive method to diagnose bladder outlet obstruction involves the recording of noise with a contact microphone pressed against the perineum (between anus and scrotum). This noise results from flow-generated vortices caused by prostatic obstruction. We developed a computational fluid dynamic (CFD) urethral model including urethral geometry to study the relation between generated noise and the degree of obstruction. This model comprised a bladder, bladder neck, prostate and urethra. Calculations were carried out at four bladder pressures, five degrees of obstruction and three obstruction shapes. For each of the sixty simulations, the velocity and pressure distributions along the urethra were calculated including wall shear stresses to localize flow transition from disturbed to normal. Negative pressures at the obstruction outlet induced recirculation of flow. The location of transition was independent of the applied bladder pressure, but it depended primarily on the degree and secondarily on the shape of the obstruction. Based on the presented results, we hypothesize that the location of the maximum amplitude of perineal noise mainly depends on the degree and shape of the prostatic obstruction. Our future aim is to test our hypothesis in male patients and to extend the presented model to 3D with a viscoelastic urethral wall to calculate the fluid-wall interaction. PMID:17151416

Pel, Johan J M; van Mastrigt, Ron

2007-01-01

314

Arthroscopic Posterior Labral Repair and Capsular Shift With a Lateralized Posterior Portal  

PubMed Central

Arthroscopic techniques for posterior shoulder subluxation with labral injuries in athletes have shown good results. The difficulty with the procedure is gaining appropriate access to the posteroinferior quadrant of the glenoid at a steep enough angle that allows for safe anchor placement. Various portals have been described that can be used as accessory portals for anchor placement. Although the use of additional portals to create appropriate access to the joint is always encouraged, preoperative planning can minimize the need for their use. The video shows a simple technique for posterior labral repair with capsular plications through a lateralized posterior portal in the lateral decubitus position. This technique allows the surgeon to address posterior labral tears and capsular laxity without the need for accessory portals. PMID:24400175

Ciccone, William J.

2013-01-01

315

Plasma copeptin level predicts acute traumatic coagulopathy and progressive hemorrhagic injury after traumatic brain injury.  

PubMed

Higher plasma copeptin levels correlate with poor clinical outcomes after traumatic brain injury. Nevertheless, their links with acute traumatic coagulopathy and progressive hemorrhagic injury are unknown. Therefore, we aimed to investigate the relationship between plasma copeptin levels, acute traumatic coagulopathy and progressive hemorrhagic injury in patients with severe traumatic brain injury. We prospectively studied 100 consecutive patients presenting within 6h from head trauma. Progressive hemorrhagic injury was present when the follow-up computerized tomography scan reported any increase in size or number of the hemorrhagic lesion, including newly developed ones. Acute traumatic coagulopathy was defined as an activated partial thromboplastic time greater than 40s and/or international normalized ratio greater than 1.2 and/or a platelet count less than 120×10(9)/L. We measured plasma copeptin levels on admission using an enzyme-linked immunosorbent assay in a blinded fashion. In multivariate logistic regression analysis, plasma copeptin level emerged as an independent predictor of progressive hemorrhagic injury and acute traumatic coagulopathy. Using receiver operating characteristic curves, we calculated areas under the curve for progressive hemorrhagic injury and acute traumatic coagulopathy. The predictive performance of copeptin was similar to that of Glasgow Coma Scale score. However, copeptin did not obviously improve the predictive value of Glasgow Coma Scale score. Thus, copeptin may help in the prediction of progressive hemorrhagic injury and acute traumatic coagulopathy after traumatic brain injury. PMID:24905622

Yang, Ding-Bo; Yu, Wen-Hua; Dong, Xiao-Qiao; Du, Quan; Shen, Yong-Feng; Zhang, Zu-Yong; Zhu, Qiang; Che, Zhi-Hao; Liu, Qun-Jie; Wang, Hao; Jiang, Li; Du, Yuan-Feng

2014-08-01

316

Traumatically ruptured globes in children.  

PubMed

This retrospective study was designed to document the etiology of traumatically ruptured globes in children and to determine the prognostic value of several clinical parameters with respect to visual outcome. Forty-six children 16 years of age and under seen in the emergency room over a 2-year period were found to have full thickness penetration of the globe. Fifty-nine percent of injuries occurred during recreational activities, and 59% occurred outside of the home. Boys outnumbered girls by a 6:1 ratio. For children, initial visual acuity proved to be less valuable as a prognostic indicator with regard to final vision than has been reported in adults. Smaller corneal wounds offered better visual outcomes. Four eyes were enucleated. Ten ruptures (22%) were related to activity involving guns. Four of six BB gun injuries were the result of a ricocheted BB. Visual outcomes in gun-related injuries were particularly poor. PMID:7837018

Rudd, J C; Jaeger, E A; Freitag, S K; Jeffers, J B

1994-01-01

317

A patient with traumatic chylothorax  

PubMed Central

Chylothorax refers to the accumulation of chyle in the pleural cavity. Although rare, it is the most frequent cause of pleural effusion in the neonatal period. Its incidence is estimated at one in 15,000 neonates. The causes of chylothorax are multiple, and there are several major types of chylothorax defined by origin, ie, traumatic (and iatrogenic) chylothorax, medical (spontaneous) chylothorax, and congenital chylothorax. A case of neonatal chylothorax following surgery for esophageal atresia and our therapeutic approach to this entity are presented. Conservative therapy with total enteral nutrition and drainage were sufficient. Treatment for chylothorax is essentially medical, ie, pleural drainage, removal of dietary fats, treatment of any medical cause, and use of drugs to reduce production of chyle. In the event of failure or reappearance of a large effusion, surgical treatment is needed. PMID:23049269

Barkat, Amina; Benbouchta, Ilham; Karboubi, Lamia; Ghanimi, Zineb; Kabiri, Meryem

2012-01-01

318

Hypopituitarism after traumatic brain injury.  

PubMed

Traumatic brain injury (TBI) is one of the main causes of death and disability in young adults, with consequences ranging from physical disabilities to long-term cognitive, behavioural, psychological and social defects. Post-traumatic hypopituitarism (PTHP) was recognized more than 80 years ago, but it was thought to be a rare occurrence. Recently, clinical evidence has demonstrated that TBI may frequently cause hypothalamic-pituitary dysfunction, probably contributing to a delayed or hampered recovery from TBI. Changes in pituitary hormone secretion may be observed during the acute phase post-TBI, representing part of the acute adaptive response to the injury. Moreover, diminished pituitary hormone secretion, caused by damage to the pituitary and/or hypothalamus, may occur at any time after TBI. PTHP is observed in about 40% of patients with a history of TBI, presenting as an isolated deficiency in most cases, and more rarely as complete pituitary failure. The most common alterations appear to be gonadotropin and somatotropin deficiency, followed by corticotropin and thyrotropin deficiency. Hyper- or hypoprolactinemia may also be present. Diabetes insipidus may be frequent in the early, acute phase post-TBI, but it is rarely permanent. Severity of TBI seems to be an important risk factor for developing PTHP; however, PTHP can also manifest after mild TBI. Accurate evaluation and long-term follow-up of all TBI patients are necessary in order to detect the occurrence of PTHP, regardless of clinical evidence for pituitary dysfunction. In order to improve outcome and quality of life of TBI patients, an adequate replacement therapy is of paramount importance. PMID:15879352

Bondanelli, Marta; Ambrosio, Maria Rosaria; Zatelli, Maria Chiara; De Marinis, Laura; degli Uberti, Ettore C

2005-05-01

319

Symptoms of Post-traumatic Stress Disorder  

E-print Network

Previous studies have indicated a possible relationship between Post-traumatic Stress Disorder (PTSD) resulting from exposure to a trauma and other measures of functioning, such as attachment style and substance use. The sample for this study...

Hall, Christy Ann

2013-02-22

320

Persisting insomnia following traumatic brain injury.  

PubMed

Persisting insomnia secondary to traumatic brain injury, rarely reported and documented, is described in an adult male following head injury. The neuronal mechanisms underlying this sleep disorder as well as the neuropsychological concomitants and therapeutic approaches are discussed. PMID:10570765

Tobe, E H; Schneider, J S; Mrozik, T; Lidsky, T I

1999-01-01

321

Animal models of external traumatic wound infections  

PubMed Central

Background: Despite advances in traumatic wound care and management, infections remain a leading cause of mortality, morbidity and economic disruption in millions of wound patients around the world. Animal models have become standard tools for studying a wide array of external traumatic wound infections and testing new antimicrobial strategies. Results: Animal models of external traumatic wound infections reported by different investigators vary in animal species used, microorganism strains, the number of microorganisms applied, the size of the wounds and for burn infections, the length of time the heated object or liquid is in contact with the skin. Methods: This review covers experimental infections in animal models of surgical wounds, skin abrasions, burns, lacerations, excisional wounds and open fractures. Conclusions: As antibiotic resistance continues to increase, more new antimicrobial approaches are urgently needed. These should be tested using standard protocols for infections in external traumatic wounds in animal models. PMID:21701256

Dai, Tianhong; Kharkwal, Gitika B; Tanaka, Masamitsu; Huang, Ying-Ying; Bil de Arce, Vida J

2011-01-01

322

Shining a light on posterior cortical atrophy.  

PubMed

Posterior cortical atrophy (PCA) is a clinicoradiologic syndrome characterized by progressive decline in visual processing skills, relatively intact memory and language in the early stages, and atrophy of posterior brain regions. Misdiagnosis of PCA is common, owing not only to its relative rarity and unusual and variable presentation, but also because patients frequently first seek the opinion of an ophthalmologist, who may note normal eye examinations by their usual tests but may not appreciate cortical brain dysfunction. Seeking to raise awareness of the disease, stimulate research, and promote collaboration, a multidisciplinary group of PCA research clinicians formed an international working party, which had its first face-to-face meeting on July 13, 2012 in Vancouver, Canada, prior to the Alzheimer's Association International Conference. PMID:23274153

Crutch, Sebastian J; Schott, Jonathan M; Rabinovici, Gil D; Boeve, Bradley F; Cappa, Stefano F; Dickerson, Bradford C; Dubois, Bruno; Graff-Radford, Neill R; Krolak-Salmon, Pierre; Lehmann, Manja; Mendez, Mario F; Pijnenburg, Yolande; Ryan, Natalie S; Scheltens, Philip; Shakespeare, Tim; Tang-Wai, David F; van der Flier, Wiesje M; Bain, Lisa; Carrillo, Maria C; Fox, Nick C

2013-07-01

323

Posterior reversible encephalopathy syndrome following measles vaccination.  

PubMed

Due to recent domestic measles outbreaks in Japan, the Japanese government has mandated measles vaccination at ages 14 and 17 since April 2008. Since then, the number of people receiving measles vaccination has increased in Japan. Measles vaccination may cause serious neurological complications including encephalopathy, although the incidence is very low. We report here an adult case of posterior reversible encephalopathy syndrome (PRES) and myeloradiculoneuropathy following measles vaccination. Brain MRI demonstrated typical findings of PRES, high intensity signals in the occipital lobes on FLAIR imaging, isointensity signals on diffusion weighted imaging, with an increase in the apparent diffusion coefficient (ADC). Vasoconstriction mainly in the posterior cerebral arteries was detected by MRA. Physicians should keep in mind the possible occurrence of PRES and myeloradiculoneuropathy following measles vaccination. PMID:20850135

Hamano, Tadanori; Takeda, Tomoko; Morita, Hiroshi; Muramatsu, Tomoko; Yoneda, Makoto; Kimura, Hirohiko; Kuriyama, Masaru

2010-11-15

324

Pseudoexfoliation material on posterior chamber intraocular lenses  

PubMed Central

The presence of pseudoexfoliation material on the surface of an intraocular lens (IOL) is a rare finding. We report a series of seven cases with different patterns of pseudoexfoliation material deposition on the posterior chamber IOLs, recognized 2–20 years after cataract surgery. Six patients had an IOL implanted in the capsular bag and one in the ciliary sulcus. Two patients had undergone posterior capsulotomy. Although the pathophysiological mechanisms and clinical significance of this finding remain unknown, the careful follow-up of pseudophakic patients with known or suspected pseudoexfoliation syndrome is essential to monitor the development or progression of glaucoma, since deposition of pseudoexfoliation material continues even after cataract surgery. PMID:25143707

da Rocha-Bastos, Ricardo António; Silva, Sérgio Estrela; Prézia, Flávio; Falcão-Reis, Fernando; Melo, António B

2014-01-01

325

[Traumatic thrombosis of the inferior vena cava].  

PubMed

Traumatic thrombosis of vena cava is rare. Thrombosis of the inferior vena cava diagnosed by uroscanner after blunt abdominal trauma involving the kidney is reported. The Doppler exam confirmed the floating character of the clot. Three days after the initiation of anticoagulant therapy, the thrombus disappeared without any clinical or radiological signs of pulmonary embolism. Fifteen cases of traumatic thrombosis of the inferior vena cava have been described in the literature. Mechanisms, clinical pictures and the management are discussed. PMID:15324965

Mouaffak, Y; Mikou, M M; Benyacob, A; Mosaddek, A; Faroudy, M; Ababou, A; Lazreq, C; Sbihi, A

2004-07-01

326

Pediatric brainstem hemorrhages after traumatic brain injury.  

PubMed

Traumatic brain injuries afflict a large number of pediatric patients. The most severe injuries lead to increased intracranial pressure and herniation, with resultant changes in the brainstem. Traumatic brainstem hemorrhages have previously been associated with poor neurological outcome and fatality. However, this report discusses 2 pediatric patients who sustained severe head trauma with subsequent brainstem hemorrhages, and yet experienced good neurological outcome; the possible mechanism is described. PMID:25105513

Beier, Alexandra D; Dirks, Peter B

2014-10-01

327

The posterior palatal seal. A review.  

PubMed

The posterior palatal seal area is described and its anatomical borders are defined. The methods used to achieve a seal are (1) scraping the cast, (2) a selective loading impression technique, and (3) a physiological impression technique. Each method is described and its problems are discussed. It is believed by the authors that the physiological impression technique using wax requires the least amount of skill and experience to master competently. PMID:7004416

Ettinger, R L; Scandrett, F R

1980-08-01

328

Cyclosporine-related reversible posterior leukoencephalopathy: MRI  

Microsoft Academic Search

Three patients aged 48, 11 and 40 years, two of whom were recent recipients of renal transplants and one of a bone marrow\\u000a transplant, developed seizures, with cortical blindness in two cases. All were immunosuppressed with cyclosporine and were\\u000a hypertensive at the onset of symptoms. MRI showed predominantly posterior signal changes in all three cases. The abnormalities\\u000a were more conspicuous

J. M. Jarosz; D. C. Howlett; T. C. S. Cox; J. B. Bingham

1997-01-01

329

Indocyanine green angiography in posterior uveitis  

PubMed Central

Literature review for indocyanine green angiography and evaluate the role of indocyanine green angiogram (ICGA) in patients with posterior uveitis seen at a tertiary referral eye care centre. Detailed review of the literature on ICGA was performed. Retrospective review of medical records of patients with posterior uveitis and dual fundus and ICGA was done after institutional board approval. Eighteen patients (26 eyes) had serpiginous choroiditis out of which 12 patients had active choroiditis and six patients had healed choroiditis, six patients (12 eyes) had ampiginous choroiditis, six patients (12 eyes) had acute multifocal posterior placoid pigment epitheliopathy, eight patients (10 eyes) had multifocal choroiditis, four patients (eight eyes) had presumed ocular histoplasmosis syndrome, four patients (eight eyes) had presumed tuberculous choroiditis, two patients (four eyes) had multiple evanescent white dot syndrome and two patients (four eyes) had Vogt Koyanagi Harada (VKH) syndrome. The most characteristic feature noted on ICGA was the presence of different patterns of hypofluorescent dark spots, which were present at different stages of the angiogram. ICGA provides the clinician with a powerful adjunctive tool in choroidal inflammatory disorders. It is not meant to replace already proven modalities such as the fluorescein angiography, but it can provide additional information that is useful in establishing a more definitive diagnosis in inflammatory chorioretinal diseases associated with multiple spots. It still needs to be determined if ICGA can prove to be a follow up parameter to evaluate disease progression. PMID:23685486

Agrawal, Rupesh V; Biswas, Jyotirmay; Gunasekaran, Dinesh

2013-01-01

330

Treatment of posterior skull base tumors.  

PubMed

Surgery for posterior skull base tumors may be associated with high morbidity and mortality because of the complex anatomy, irregular bony topography, and vital neurovascular structures in this region. We experienced three benign posterior skull base tumors. These were petroclival and foramen magnum meningiomas and a jugular formen neurinoma. Three dimensional computed tomography (3 D-CT) in addition to the conventional CT, magnetic resonance imaging (MRI), and cerebral angiography were performed preoperatively. Preoperative embolizations for the tumors were also done, and intraoperative neurophysiological monitorings were performed. The tumors could be subtotally removed with no damage to the brainstem, cranial nerves, and vessels. No newly developed postoperative neurological symptoms were observed. As to the remaining tumors, gamma knife (gamma-knife) therapy was planned. 3 D-CT was very useful in the preoperative evaluation of the surgical approach, and the intraoperative neurophysiological monitoring was considered to be necessary to prevent permanent damage. gamma-knife after direct approach was recommended for the benign posterior skull base tumors. PMID:9755601

Lin, C; Node, Y; Teramoto, A

1998-08-01

331

Clinical Trials of a Urethral Dose Measurement System in Brachytherapy Using Scintillation Detectors  

SciTech Connect

Purpose: To report on the clinical feasibility of a novel scintillation detector system with fiberoptic readout that measures the urethral dose during high-dose-rate brachytherapy treatment of the prostate. Methods and Materials: The clinical trial enrolled 24 patients receiving high-dose-rate brachytherapy treatment to the prostate. After the first 14 patients, three improvements were made to the dosimeter system design to improve clinical reliability: a dosimeter self-checking facility; a radiopaque marker to determine the position of the dosimeter, and a more robust optical extension fiber. Results: Improvements to the system design allowed for accurate dose measurements to be made in vivo. A maximum measured dose departure of 9% from the calculated dose was observed after dosimeter design improvements. Conclusions: Departures of the measured from the calculated dose, after improvements to the dosimetry system, arise primarily from small changes in patient anatomy. Therefore, we recommend that patient response be correlated with the measured in vivo dose rather than with the calculated dose.

Suchowerska, Natalka, E-mail: natalka@email.cs.nsw.gov.a [Radiation Oncology, Royal Prince Alfred Hospital, New South Wales (Australia); School of Physics, University of Sydney, New South Wales (Australia); Jackson, Michael [Radiation Oncology, Prince of Wales Hospital, New South Wales (Australia); Department of Medicine, University of Sydney, New South Wales (Australia); Lambert, Jamil; Yin, Yong Bai [School of Physics, University of Sydney, New South Wales (Australia); Hruby, George [Radiation Oncology, Royal Prince Alfred Hospital, New South Wales (Australia); Department of Medicine, University of Sydney, New South Wales (Australia); McKenzie, David R. [School of Physics, University of Sydney, New South Wales (Australia)

2011-02-01

332

Multiple Pudendal Sensory Pathways Reflexly Modulate Bladder and Urethral Activity in Persons with Spinal Cord Injury  

PubMed Central

Purpose Electrical stimulation of pudendal afferents can evoke reflex bladder contractions with relaxation of the external urethral sphincter in cats. This voiding reflex is mediated by pudendal sensory fibers innervating the penile and prostatic urethra that engage either a spinal or spinobulbospinal micturition pathway, respectively. However, the clinical translation of this potential therapy in persons with spinal cord injury (SCI) is limited by the lack of evidence demonstrating analogous reflex mechanisms in humans. Materials and Methods We investigated the presence of excitatory pudendal-to-bladder reflexes in seven individuals with chronic SCI. The isovolumetric bladder pressure and perineal electromyogram (EMG) were recorded in response to intraurethral (IU) electrical stimulation at varying amplitudes and frequencies. Results Selective electrical stimulation of the proximal and distal segments of the urethra evoked sustained reflex bladder contractions in different subsets of participants: 24.9 ± 13.9 cmH2O (n = 3) and 23.3 ± 16.1 cmH2O (n = 3), respectively. In contrast, the corresponding reflex perineal EMG exhibited a differential activation pattern between proximal and distal IU stimulation (normalized EMG, p < 0.05): 1.3 ± 0.2 and 0.3 ± 0.1, respectively. Conclusions This study presents the first clinical evidence of two independent excitatory pudendal-to-bladder reflex pathways that can, in turn, differentially modulate efferent pudendal output. Both reflex mechanisms involve a complex interaction of multiple sensory inputs and may provide a neural substrate for restoring micturition following SCI. PMID:21168860

Yoo, Paul B.; Horvath, Eric E.; Amundsen, Cindy L.; Webster, George D.; Grill, Warren M.

2011-01-01

333

Urethral Exudates of Men with Neisseria gonorrhoeae Infections Select a Restricted Lipooligosaccharide Phenotype During Transmission  

PubMed Central

Neisseria gonorrhoeae lipooligosaccharides (LOSs) induce immunoglobulin G that protects men from experimental infection. This raises the possibility that an LOS vaccine might prevent gonorrhea. Gonococci make different LOS molecules, depending on whether 3 genes, lgtA, lgtC, and lgtD, are in frame (IF) or out of frame (OOF). Mispairing of polymeric guanine (polyG) tracts within each gene determines its frame during replication. We amplified lgtA, lgtC, and lgtD from diagnostic slides of urethral exudates and sequenced their polyG tracts. We found that lgtA in exudative bacteria is IF and that lgtC is OOF. The frame of lgtD varied widely: it was OOF in most but not all cases. This genotype would result in synthesis of polylactosamine ? chains that could be sialylated. Polylactosamine ? chains would enhance virulence, and their sialylation would enable gonococci to survive within polymorphonuclear cells; however, an active LgtD in a few bacteria could provide a survival advantage in other sites of infection. PMID:22904337

McLaughlin, Stephanie E.; Cheng, Hui; Ghanem, Khalil G.; Yang, Zhijie; Melendez, Johan; Zenilman, Jonathan; Griffiss, J. McLeod

2012-01-01

334

Default-Mode Network Disruption in Mild Traumatic Brain Injury  

PubMed Central

Purpose: To investigate the integrity of the default-mode network (DMN) by using independent component analysis (ICA) methods in patients shortly after mild traumatic brain injury (MTBI) and healthy control subjects, and to correlate DMN connectivity changes with neurocognitive tests and clinical symptoms. Materials and Methods: This study was approved by the institutional review board and complied with HIPAA regulations. Twenty-three patients with MTBI who had posttraumatic symptoms shortly after injury (<2 months) and 18 age-matched healthy control subjects were included in this study. Resting-state functional magnetic resonance imaging was performed at 3 T to characterize the DMN by using ICA methods, including a single-participant ICA on the basis of a comprehensive template from core seeds in the posterior cingulate cortex (PCC) and medial prefrontal cortex (MPFC) nodes. ICA z images of DMN components were compared between the two groups and correlated with neurocognitive tests and clinical performance in patients by using Pearson and Spearman rank correlation. Results: When compared with the control subjects, there was significantly reduced connectivity in the PCC and parietal regions and increased frontal connectivity around the MPFC in patients with MTBI (P < .01). These frontoposterior opposing changes within the DMN were significantly correlated (r = ?0.44, P = .03). The reduced posterior connectivity correlated positively with neurocognitive dysfunction (eg, cognitive flexibility), while the increased frontal connectivity correlated negatively with posttraumatic symptoms (ie, depression, anxiety, fatigue, and postconcussion syndrome). Conclusion: These results showed abnormal DMN connectivity patterns in patients with MTBI, which may provide insight into how neuronal communication and information integration are disrupted among DMN key structures after mild head injury. © RSNA, 2012 PMID:23175546

Zhou, Yongxia; Milham, Michael P.; Lui, Yvonne W.; Miles, Laura; Reaume, Joseph; Sodickson, Daniel K.; Grossman, Robert I.

2012-01-01

335

Electrocardiographic diagnosis of remote posterior wall myocardial infarction using unipolar posterior lead V9  

SciTech Connect

The accuracy of four electrocardiographic criteria for diagnosing remote posterior myocardial infarction was assessed prospectively in 369 patients undergoing exercise treadmill testing with thallium scintigraphy. Criteria included the following: (1) R-wave width greater than or equal to 0.04 s and R-wave greater than or equal to S-wave in V1; (2) R-wave greater than or equal to S-wave in V2; (3) T-wave voltage in V2 minus V6 greater than or equal to 0.38 mV (T-wave index); (4) Q-wave greater than or equal to 0.04 s in left paraspinal lead V9. Twenty-seven patients (7.3 percent) met thallium criteria for posterior myocardial infarction, defined as a persistent perfusion defect in the posterobase of the left ventricle. Sensitivities for the four criteria ranged from 4 to 56 percent, and specificities ranged from 64 to 99 percent. Posterior paraspinal lead V9 provided the best overall predictive accuracy (94 percent), positive predictive value (58 percent), and ability to differentiate patients with and without posterior myocardial infarction of any single criterion (p less than .0001). Combining the T-wave index with lead V9 further enhanced the diagnostic yield: the sensitivity for detecting posterior infarction by at least one of these criteria was 78 percent, and when both criteria were positive, specificity was 98.5 percent. It is concluded that a single, unipolar posterior lead in the V9 position is superior to standard 12-lead electrocardiographic criteria in diagnosing remote posterior myocardial infarction, and that combining V9 with the T-wave index maximizes the diagnostic yield.

Rich, M.W.; Imburgia, M.; King, T.R.; Fischer, K.C.; Kovach, K.L. (Jewish Hospital Washington University Medical Center, St. Louis (USA))

1989-09-01

336

Gender Differences in Traumatic Events and Rates of Post-Traumatic Stress Disorder among Homeless Youth  

ERIC Educational Resources Information Center

In the present report we describe patterns of traumatic events and Post-traumatic Stress Disorder (PTSD), both partial and full, among homeless youth and those at risk for homelessness, with an emphasis on gender differences. Participants were 85 homeless and at-risk youth (49% female) recruited from a drop-in center in New York City in 2000.…

Gwadz, Marya Viorst; Nish, David; Leonard, Noelle R.; Strauss, Shiela M.

2007-01-01

337

Stress and Traumatic Stress: How Do Past Events Influence Current Traumatic Stress among Mothers Experiencing Homelessness?  

ERIC Educational Resources Information Center

The purpose of this research was to evaluate the relationship between past traumatic events and the level of current traumatic stress among mothers experiencing homelessness. The data for this study were gathered from 75 homeless mothers between May 2006 and October 2006 using a cross-sectional survey design with purposive sampling. All mothers…

Williams, Julie K.; Hall, James A.

2009-01-01

338

Rat posterior parietal cortex: topography of corticocortical and thalamic connections  

Microsoft Academic Search

Anatomical and functional findings support the contention that there is a distinct posterior parietal cortical area (PPC) in the rat, situated between the rostrally adjacent hindlimb sensorimotor area and the caudally adjacent secondary visual areas. The PPC is distinguished from these areas by receiving thalamic afferents from the lateral dorsal (LD), lateral posterior (LP), and posterior (Po) nuclei, in the

R. L. Reep; H. C. Chandler; V. King; J. V. Corwin

1994-01-01

339

A study of posterior palatal seals with varying palatal forms.  

PubMed

A study was carried out to determine the depth and width of posterior palatal seals in different shapes of palates. Four different methods of developing the posterior palatal seal were utilized on each patient. The width of the posterior palatal seal area was compared with original models which were produced by plaster impressions. PMID:1104808

Nikoukari, H

1975-12-01

340

Comparison of plasmakinetic transurethral resection of the prostate with monopolar transurethral resection of the prostate in terms of urethral stricture rates in patients with comorbidities  

PubMed Central

Purpose To compare urethral stricture rates in comorbid patients undergoing plasmakinetic transurethral resection of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for benign prostatic hyperplasia. Methods The data of 317 patients with comorbidities undergoing either PK-TURP or M-TURP from September 2008 to December 2012 were retrospectively evaluated. Preoperative and postoperative 12-month International Prostate Symptom Score, maximal flow rate, postoperative International Index of Erectile Function scores, and urethral stricture rates were evaluated. Results A total of 154 patients underwent M-TURP and 163 patients underwent PK-TURP. Urethral stricture rates were 6/154 in the M-TURP treatment arm and 17/163 in the PK-TURP treatment arm (P=0.000). In the presence of hypertension and/or coronary artery disease and/or diabetes mellitus, the risk of urethral stricture complication was significantly higher in the PK-TURP group than in the M-TURP group (P=0.000). Conclusions The risk of urethral stricture increases with PK-TURP in elderly patients with a large prostate and concomitant hypertension and/or coronary artery disease and/or diabetes mellitus. Therefore, PK-TURP should be performed cautiously in this group of benign prostatic hyperplasia patients. PMID:25325023

Sinanoglu, Orhun; Ekici, Sinan; Balci, MB Can; Hazar, A Ismet; Nuhoglu, Baris

2014-01-01

341

Neurological outcome in a series of 58 patients operated for traumatic thoracolumbar spinal cord injuries  

PubMed Central

Background: Traumatic thoracolumbar spinal fractures represent approximately 65% of all traumatic spinal fractures and are frequently associated to permanent disability with significant social and economic impact. These injuries create severe physical limitations depending on neurological status, level of fracture, severity of injury, patient age and comorbidities. Predicting neurological improvement in patients with traumatic spinal cord injuries (SCIs) is very difficult because it is related to different preoperative prognostic factors. We evaluated the neurological improvement related to the preoperative neurological conditions and the anatomic level of spinal cord injury. Methods: From January 2004 to June 2010, we operated 207 patients for unstable thoracolumbar spinal fractures. We carried out a retrospective analysis of 69 patients with traumatic SCIs operated on by a posterior fixation performed within 24 hours from the trauma. The preoperative neurological conditions (ASIA grade), the type of the fracture, the anatomic level of spinal cord injury and the postoperative neurological improvement were evaluated for each patient. Results: The ASIA grade at admission (P = 0,0005), the fracture type according to the AO spine classification (P = 0,0002), and the anatomic location of the injury (P = 0,0213) represented predictive factors of neurological improvement at univariate analysis. The preoperative neurological status (P = 0,0491) and the fracture type (P = 0,049) confirmed a positive predictive value also in the multivariate analysis. Conclusions: Our study confirms that the preoperative neurological status, the fracture type and the anatomic location of the fracture are predictive factors of the neurological outcome in patients with spinal cord injury.

Dobran, Mauro; Iacoangeli, Maurizio; Di Somma, Lucia Giovanna Maria; Di Rienzo, A.; Colasanti, Roberto; Nocchi, Niccolo; Alvaro, Lorenzo; Moriconi, Elisa; Nasi, Davide; Scerrati, Massimo

2014-01-01

342

Unrecognized pediatric partial achilles tendon injury followed by traumatic completion: a case report and literature review.  

PubMed

Achilles tendon ruptures are a relatively common athletic injury but are exceedingly rare in the pediatric population. We describe the case of a 10-year-old ice hockey player who experienced an Achilles tendon injury from a laceration to the posterior leg from a skate blade that led to a partial tendon laceration. This tendon injury was initially unrecognized despite an emergency department evaluation. The patient continued to complain of weakness and paresthesia after the skin laceration had healed. A traumatic dorsiflexion injury while running several weeks later led to a traumatic complete tendon rupture. The clinical, operative, and physical therapy records were reviewed to complete the history, treatment, and rehabilitation progress. The initial laceration injury had occurred 6 weeks before presentation, and the traumatic dorsiflexion injury had occurred 2 days before referral to an acute orthopedics clinic. Open repair was performed several days after the traumatic completion of the laceration, and the patient was immobilized in a cast for 5 weeks. The patient had weaned off crutches by 10 weeks postoperatively and had returned to some activities and light skating at 5.5 months. A full return to running and ice hockey had been achieved by 8 months postoperatively. The optimal repair for this injury has not been well established in published studies. We have concluded that laceration injuries have the potential to mask tendon injuries and that prolonged symptoms after a laceration should suggest occult pathologic features. Open tendon repair is a viable treatment option in the pediatric patient with Achilles tendon ruptures. A return to activities within a reasonable period can be expected with robust physical therapy. PMID:24713492

Vasileff, William Kelton; Moutzouros, Vasilios

2014-01-01

343

The role of the posterior cingulate cortex in cognition and disease.  

PubMed

The posterior cingulate cortex is a highly connected and metabolically active brain region. Recent studies suggest it has an important cognitive role, although there is no consensus about what this is. The region is typically discussed as having a unitary function because of a common pattern of relative deactivation observed during attentionally demanding tasks. One influential hypothesis is that the posterior cingulate cortex has a central role in supporting internally-directed cognition. It is a key node in the default mode network and shows increased activity when individuals retrieve autobiographical memories or plan for the future, as well as during unconstrained 'rest' when activity in the brain is 'free-wheeling'. However, other evidence suggests that the region is highly heterogeneous and may play a direct role in regulating the focus of attention. In addition, its activity varies with arousal state and its interactions with other brain networks may be important for conscious awareness. Understanding posterior cingulate cortex function is likely to be of clinical importance. It is well protected against ischaemic stroke, and so there is relatively little neuropsychological data about the consequences of focal lesions. However, in other conditions abnormalities in the region are clearly linked to disease. For example, amyloid deposition and reduced metabolism is seen early in Alzheimer's disease. Functional neuroimaging studies show abnormalities in a range of neurological and psychiatric disorders including Alzheimer's disease, schizophrenia, autism, depression and attention deficit hyperactivity disorder, as well as ageing. Our own work has consistently shown abnormal posterior cingulate cortex function following traumatic brain injury, which predicts attentional impairments. Here we review the anatomy and physiology of the region and how it is affected in a range of clinical conditions, before discussing its proposed functions. We synthesize key findings into a novel model of the region's function (the 'Arousal, Balance and Breadth of Attention' model). Dorsal and ventral subcomponents are functionally separated and differences in regional activity are explained by considering: (i) arousal state; (ii) whether attention is focused internally or externally; and (iii) the breadth of attentional focus. The predictions of the model can be tested within the framework of complex dynamic systems theory, and we propose that the dorsal posterior cingulate cortex influences attentional focus by 'tuning' whole-brain metastability and so adjusts how stable brain network activity is over time. PMID:23869106

Leech, Robert; Sharp, David J

2014-01-01

344

Peer relationships of children with traumatic brain injury.  

PubMed

This study examined peer relationships in children with traumatic brain injury (TBI) relative to children with orthopedic injuries (OI), and explored whether differences in peer relationships correlated with white matter volumes. Classroom procedures were used to elicit peer perceptions of social behavior, acceptance, and friendships for eighty-seven 8- to 13-year-old children, 15 with severe TBI, 40 with complicated mild/moderate TBI, and 32 with OI. Magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) were used to investigate volumetric correlates of peer relationship measures. Children with severe TBI were rated higher in rejection-victimization than children with OI, and were less likely than children with OI to have a mutual friendship in their classroom (47% vs. 88%). Children with TBI without a mutual friend were rated lower than those with a mutual friend on sociability-popularity and prosocial behavior and higher on rejection-victimization, and had lower peer acceptance ratings. Mutual friendship ratings were related to white matter volumes in several posterior brain regions, but not to overall brain atrophy. Severe TBI in children is associated with detrimental peer relationships that are related to focal volumetric reductions in white matter within regions of the brain involved in social information-processing. PMID:23340166

Yeates, Keith Owen; Gerhardt, Cynthia A; Bigler, Erin D; Abildskov, Tracy; Dennis, Maureen; Rubin, Kenneth H; Stancin, Terry; Taylor, H Gerry; Vannatta, Kathryn

2013-05-01

345

Dexmedetomidine sedation in painful posterior segment surgery  

PubMed Central

Purpose To present a case series on the use of dexmedetomidine (Precedex) sedation in painful posterior segment surgery performed under topical anesthesia, similar to its use in cataract surgery. Methods A prospective review of cases that had posterior segment surgery under topical anesthesia and that needed sedation. Dexmedetomidine-loading infusion was 1 mcg/kg over 10 minutes, followed by a maintenance infusion (0.5 mcg/kg/h). Results Nine patients were operated on under topical anesthesia: two scleral buckle, five cryopexy, one scleral laceration, and one pars plana vitrectomy with very dense laser therapy in an albinotic fundus; six patients had retinal detachment. General or local anesthesia were not possible due to medical or ocular morbidities, use of anticoagulants, or the surgery plan changed intraoperatively when new pathologies were discovered. The surgeon achieved good surgical control in eight of nine cases, with one patient having ocular and bodily movements that were disturbing. Six patients had no pain, while three patients reported mild pain. No adverse effects were noted and all patients had successful surgical outcomes. Heart rate, blood pressure, and oxygen saturation were well controlled throughout the procedures. The most frequent adverse reactions of dexmedetomidine reported in the literature in less than 5% (hypotension, bradycardia, and dry mouth) were not recorded in the present study. Conclusion When a surgeon has planned to do a pars plana vitrectomy under topical anesthesia and the surgical situation dictates the addition of cryopexy, scleral buckle, or intense laser retinopexy, then sedation with dexmedetomidine can help in the control of ocular pain in the majority of cases, with good intraoperative and immediate postoperative hemodynamic control with the possibility of supplemental rescue analgesia. Dexmedetomidine, a sedative analgesic, is devoid of respiratory depressant effects, and its use in posterior segment surgery under topical anesthesia is reported here for the first time. PMID:23271889

Mansour, Ahmad; Taha, Samar

2012-01-01

346

Neurostimulation for traumatic brain injury.  

PubMed

Traumatic brain injury (TBI) remains a significant public health problem and is a leading cause of death and disability in many countries. Durable treatments for neurological function deficits following TBI have been elusive, as there are currently no FDA-approved therapeutic modalities for mitigating the consequences of TBI. Neurostimulation strategies using various forms of electrical stimulation have recently been applied to treat functional deficits in animal models and clinical stroke trials. The results from these studies suggest that neurostimulation may augment improvements in both motor and cognitive deficits after brain injury. Several studies have taken this approach in animal models of TBI, showing both behavioral enhancement and biological evidence of recovery. There have been only a few studies using deep brain stimulation (DBS) in human TBI patients, and future studies are warranted to validate the feasibility of this technique in the clinical treatment of TBI. In this review, the authors summarize insights from studies employing neurostimulation techniques in the setting of brain injury. Moreover, they relate these findings to the future prospect of using DBS to ameliorate motor and cognitive deficits following TBI. PMID:25170668

Shin, Samuel S; Dixon, C Edward; Okonkwo, David O; Richardson, R Mark

2014-11-01

347

Traumatic bilateral vertebral artery dissection.  

PubMed

Traumatic vertebral artery dissection is not often seen by forensic pathologists, and cases investigated are scarce in the forensic literature. We present the case of a 40-year-old woman cyclist who was struck by a car while wearing a helmet, and was neurologically near normal immediately thereafter at Emergency. She presented 48 h later with acute right hemiparesis, decreasing level of consciousness, and unsteadiness. CT revealed massive cerebellar infarction. CT angiography was normal. The patient died in coma 7 days after injury and autopsy revealed bilateral edematous cerebellar infarction and bilateral vertebral artery dissection. Rotational neck injury and mural tear in the wall of the Atlantic parts of both vertebral arteries is suggested as the possible mechanism of the arterial injury. Head and neck injuries are reported as a precipitating cause of vertebral artery injury. The possible influence of trauma may be further underestimated if longer intervals between vessel dissection and ischemia occur. The current case illustrates that "talk-and-die" syndrome may be due to occult vertebral artery dissection, possibly bilateral. In forensic cases of delayed death after mild trauma to the head and neck, the vertebral arteries should be examined for the cause of death. PMID:21798679

Galtés, Ignasi; Borondo, Juan Carlos; Cos, Mònica; Subirana, Mercè; Martin-Fumadó, Carles; Martín, Carles; Castellà, Josep; Medallo, Jordi

2012-01-10

348

Endoscopic treatment of posterior ankle pain  

Microsoft Academic Search

Purpose  The aim of this study is to describe the indications for two-portal hindfoot endoscopy in the treatment of posterior ankle\\u000a compartment pathologies and to express the effectiveness of this technique by short- to mid-term outcomes on 59 consecutive\\u000a patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In our institute, between 2003 and 2009, patients operated by single surgeon with hindfoot endoscopy were enrolled. The American\\u000a Orthopaedic Foot

Tahir Ogut; Egemen Ayhan; Kaan Irgit; Abdullah Ilker Sarikaya

2011-01-01

349

A Short History of Posterior Dynamic Stabilization  

PubMed Central

Interspinous spacers were developed to treat local deformities such as degenerative spondylolisthesis. To treat patients with chronic instability, posterior pedicle fixation and rod-based dynamic stabilization systems were developed as alternatives to fusion surgeries. Dynamic stabilization is the future of spinal surgery, and in the near future, we will be able to see the development of new devices and surgical techniques to stabilize the spine. It is important to follow the development of these technologies and to gain experience using them. In this paper, we review the literature and discuss the dynamic systems, both past and present, used in the market to treat lumbar degeneration. PMID:23326674

Gomleksiz, Cengiz; Sasani, Mehdi; Oktenoglu, Tunc; Ozer, Ali Fahir

2012-01-01

350

Posterior optic buttonholing prevents intraocular pressure peaks after cataract surgery with primary posterior capsulorhexis  

Microsoft Academic Search

Background  The performance of a primary posterior capsulorhexis (PPC) with and without posterior optic buttonholing (POBH) may significantly\\u000a influence the intraocular pressure (IOP) after cataract surgery in age-related cataract patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The prospective randomized clinical study was performed at the department of Ophthalmology, Medical University of Vienna,\\u000a Austria. Thirty consecutive cataract patients with bilateral same-day cataract surgery (60 eyes) under topical anesthesia

Eva Stifter; Rupert Menapace; Katharina Kriechbaum; Alexandra Luksch

2010-01-01

351

External Urethral Sphincter Pressure Measurement: An Accurate Method for the Diagnosis of Detrusor External Sphincter Dyssynergia?  

PubMed Central

Background Combined pelvic floor electromyography (EMG) and videocystourethrography (VCUG) during urodynamic investigation are the most acceptable and widely agreed methods for diagnosing detrusor external sphincter dyssynergia (DESD). Theoretically, external urethral sphincter pressure (EUSP) measurement would provide enough information for the diagnosis of DESD and could simplify the urodynamic investigation replacing combined pelvic floor EMG and VCUG. Thus, we evaluated the diagnostic accuracy of EUSP measurement for DESD. Patients & Methods A consecutive series of 72 patients (36 women, 36 men) with neurogenic lower urinary tract dysfunction able to void spontaneously was prospectively evaluated at a single university spinal cord injury center. Diagnosis of DESD using EUSP measurement (index test) versus combined pelvic floor EMG and VCUG (reference standard) was assessed according to the recommendations of the Standards for Reporting of Diagnostic Accuracy Initiative. Results Using EUSP measurement (index test) and combined pelvic floor EMG and VCUR (reference standard), DESD was diagnosed in 10 (14%) and in 41 (57%) patients, respectively. More than half of the patients presented discordant diagnosis between the index test and the reference standard. Among 41 patients with DESD diagnosed by combined pelvic floor EMG and VCUR, EUSP measurement identified only 6 patients. EUSP measurement had a sensitivity of 15% (95% CI 5%–25%), specificity of 87% (95% CI 76%–98%), positive predictive value of 60% (95% CI 30%–90%), and negative predictive value of 56% (95% CI 44%–68%) for the diagnosis of DESD. Conclusions For diagnosis of DESD, EUSP measurement is inaccurate and cannot replace combined pelvic floor EMG and VCUR. PMID:22701539

Gregorini, Flavia; Birnbock, Dorothee; Kozomara, Marko; Mehnert, Ulrich; Kessler, Thomas M.

2012-01-01

352

External urethral sphincter motoneuron properties in adult female rats studied in vitro.  

PubMed

The external urethral sphincter (EUS) muscle plays a crucial role in lower urinary tract function: its activation helps maintain continence, whereas its relaxation contributes to micturition. To determine how the intrinsic properties of its motoneurons contribute to its physiological function, we have obtained intracellular current-clamp recordings from 49 EUS motoneurons in acutely isolated spinal cord slices from adult female rats. In all, 45% of EUS motoneurons fired spontaneously and steadily (average rate = 12-27 pulses/s). EUS motoneurons were highly excitable, having lower rheobase, higher input resistance, and smaller threshold depolarization than those of rat hindlimb motoneurons recorded in vitro. Correlations between these properties and afterhyperpolarization half-decay time are consistent with EUS motoneurons having characteristics of both fast and slow motor unit types. EUS motoneurons with a slow-like spectrum of properties exhibited spontaneous firing more often than those with fast-like characteristics. During triangular current ramp-induced repetitive firing, recruitment typically occurred at lower current levels than those at derecruitment, although the opposite pattern occurred in 10% of EUS motoneurons. This percentage was likely underestimated due to firing rate adaptation. These findings are consistent with the presence of a basal level of persistent inward current (PIC) in at least some EUS motoneurons. The low EUS motoneuron current and voltage thresholds make them readily recruitable, rendering them well suited to their physiological role in continence. The expression of firing behaviors consistent with PIC activation in this highly reduced preparation raises the possibility that in the intact animal, PICs contribute to urinary function not only through neuromodulator-dependent but also through neuromodulator-independent mechanisms. PMID:20573976

Carp, Jonathan S; Tennissen, Ann M; Liebschutz, Jennifer E; Chen, Xiang Yang; Wolpaw, Jonathan R

2010-09-01

353

External Urethral Sphincter Motoneuron Properties in Adult Female Rats Studied In Vitro  

PubMed Central

The external urethral sphincter (EUS) muscle plays a crucial role in lower urinary tract function: its activation helps maintain continence, whereas its relaxation contributes to micturition. To determine how the intrinsic properties of its motoneurons contribute to its physiological function, we have obtained intracellular current-clamp recordings from 49 EUS motoneurons in acutely isolated spinal cord slices from adult female rats. In all, 45% of EUS motoneurons fired spontaneously and steadily (average rate = 12–27 pulses/s). EUS motoneurons were highly excitable, having lower rheobase, higher input resistance, and smaller threshold depolarization than those of rat hindlimb motoneurons recorded in vitro. Correlations between these properties and afterhyperpolarization half-decay time are consistent with EUS motoneurons having characteristics of both fast and slow motor unit types. EUS motoneurons with a slow-like spectrum of properties exhibited spontaneous firing more often than those with fast-like characteristics. During triangular current ramp-induced repetitive firing, recruitment typically occurred at lower current levels than those at derecruitment, although the opposite pattern occurred in 10% of EUS motoneurons. This percentage was likely underestimated due to firing rate adaptation. These findings are consistent with the presence of a basal level of persistent inward current (PIC) in at least some EUS motoneurons. The low EUS motoneuron current and voltage thresholds make them readily recruitable, rendering them well suited to their physiological role in continence. The expression of firing behaviors consistent with PIC activation in this highly reduced preparation raises the possibility that in the intact animal, PICs contribute to urinary function not only through neuromodulator-dependent but also through neuromodulator-independent mechanisms. PMID:20573976

Tennissen, Ann M.; Liebschutz, Jennifer E.; Chen, Xiang Yang; Wolpaw, Jonathan R.

2010-01-01

354

Outcomes following vaginal Prolapse repair and mid Urethral Sling (OPUS) trial  

PubMed Central

Background Many women without preexisting stress urinary incontinence (SUI) who undergo vaginal surgery to correct pelvic organ prolapse will develop symptoms of SUI. A concomitant prophylactic anti-incontinence procedure may prevent SUI symptom development in women undergoing vaginal prolapse surgery. Purpose To present the rationale, design and methodology of a randomized controlled surgical trial (RCT), the Outcomes Following Vaginal Prolapse Repair and Mid Urethral Sling (OPUS) Trial. The primary aims of this RCT are to determine (1) whether the prevalence of post-operative urinary incontinence (UI) differs between stress continent women receiving vaginal prolapse repair with concomitant tension-free vaginal tape (TVT®; a sling procedure commonly used to treat SUI) and those with only sham incisions at 3 months post surgery (2) whether it is more cost-effective to place a TVT prophylactically than to treat the SUI symptoms postoperatively as they occur over a 12 month period after the index surgery.. The study also incorporates a patient preference trial (PPT). Methods Primary outcome, defined as signs (positive cough stress test), symptoms (per validated questionnaire) and/or need for treatment of SUI and its associated cost, at 3 and 12 months post-operatively. Secondary outcomes consist of group differences in lower urinary tract and prolapse symptoms, health related quality of life, measures of vaginal anatomy, and surgical complications. Limitations Given the invasive nature of surgical intervention trials, some individuals may be reluctant to agree with random assignment, potentially impacting result generalizability. To evaluate the magnitude and direction of non-participation bias, the PPT will enroll a sample of those who decline participation in the RCT but are otherwise eligible. Conclusion This sham-controlled RCT will provide important information for patients and surgeons regarding both the short- and long-term optimal treatment approach for stress continent women undergoing a vaginal surgery for prolapse. Non-participation bias will be estimated. PMID:19342469

Wei, John T.; Nygaard, Ingrid; Richter, Holly E.; Brown, Morton B; Barber, Matthew D.; Xu, Xiao; Kenton, Kim; Nager, Charles W.; Schaffer, Joseph; Visco, Anthony; Weber, Anne

2010-01-01

355

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

PubMed

The external urethral sphincter muscle (EUS) plays an important role in urinary function and often contributes to urinary dysfunction. EUS study would benefit from methodology for longitudinal recording of electromyographic activity (EMG) in unanesthetized animals, but this muscle is a poor substrate for chronic intramuscular electrodes, and thus the required methodology has not been available. We describe a method for long-term recording of EUS EMG by implantation of fine wires adjacent to the EUS that are secured to the pubic bone. Wires pass subcutaneously to a skull-mounted plug and connect to the recording apparatus by a flexible cable attached to a commutator. A force transducer-mounted cup under a metabolic cage collected urine, allowing recording of EUS EMG and voided urine weight without anesthesia or restraint. Implant durability permitted EUS EMG recording during repeated (up to 3 times weekly) 24-h sessions for more than 8 wk. EMG and voiding properties were stable over weeks 2-8. The degree of EUS phasic activity (bursting) during voiding was highly variable, with an average of 25% of voids not exhibiting bursting. Electrode implantation adjacent to the EUS yielded stable EMG recordings over extended periods and eliminated the confounding effects of anesthesia, physical restraint, and the potential for dislodgment of the chronically implanted intramuscular electrodes. These results show that micturition in unanesthetized, unrestrained rats is usually, but not always, associated with EUS bursting. This methodology is applicable to studying EUS behavior during progression of gradually evolving disease and injury models and in response to therapeutic interventions. PMID:24990895

LaPallo, Brandon K; Wolpaw, Jonathan R; Chen, Xiang Yang; Carp, Jonathan S

2014-08-15

356

A new surgery for recurrent or persist stress urinary incontinence in females after primary mid-urethral slings  

PubMed Central

Objective: To retrospectively evaluate the efficacy of a new complementary mid-urethral sling surgery (Tong’s hammock anterior, THA) in treatment of recurrent or persist stress urinary incontinence (SUI) in females after primary synthetic mid-urethral slings (MUSs). Methods: THA was performed in 27 females with recurrent or persist SUI after primary MUSs from June 2005 and July 2010. These patients were followed up for one year, and clinical data including main complaints, operation duration, blood loss, efficacy and complications were reviewed. Results: All 27 SUI patients were treated with THA surgery, a trans-vaginal mid-urethral sling on the descending pubic ramus. The average operation time was 39 min (range: 25-70 min), average blood loss was 70 ml (range: 20-120 ml). After urinary catheter removal, all patients could micturate and their average residual urine was 25.2 ml (range: 0-80 ml). The average hospital stay was 4.7 days (rage: 3-7 days). SUI symptom was persistent in 2 patients after THA surgery and the effective rate reached 92.5%. At 3 months, 6 months and 1 year after surgery, the effective rate was 92.5% (25/27), 92% (23/25) and 87.5% (21/24), respectively. 6 months after THA surgery, 2 were lost to follow up; 1 had recurrent SUI at 1 year and 1 had mesh erosion, 1 died of other diseases, and operative complications were absent after surgery. Conclusions: THA surgery is an effective method for treating recurrent or persistent SUI after primary MUSs. It is cheap, efficient, and easy to handle. PMID:24482697

Fan, Bo-Zhen; Xia, Hong; Li, Huai-Fang; Ouyang, Yi-Qin; Yang, Xiang; Tong, Xiao-Wen

2014-01-01

357

Selective Management of Posterior Stab Wounds  

PubMed Central

Selective management of 473 patients with stab wounds limited to the posterior abdomen was reviewed. This group was composed of predominantly young, healthy men. Laporotomy was based primarily on clinical findings. Tenderness, not localized to the area of injury, or absent or rare bowel sounds best identified patients with serious injuries. Omental protrusion was frequently associated with significant organ injury. Peritoneal lavage and local wound exploration were used infrequently. All patients with fatal injuries were operated on or died within four hours of admission. Diagnosis was delayed in five serious injuries: one diaphragmatic, three retroperitoneal colon perforations and one duodenal injury, all of which were identified and treated successfully in the initial hospital admission without any complications. Seventy-six percent of the patients never required surgery. Sixteen percent of all patients had significant organ injury, and six percent had “nonessential” laporotomy. Overall morbidity was 12 percent and mortality was 1.1 percent. The colon, liver, diaphragm, and kidneys were the most common organs injured. Thus, clinical assessment alone is a reliable means of selectively managing patients with posterior abdominal stab wounds. PMID:3573058

Ocampo, H.; Yamaguchi, M.; Mackabee, J.; Ordog, G.; Fleming, A.

1987-01-01

358

Sampling Networks from Their Posterior Predictive Distribution  

PubMed Central

Recent research indicates that knowledge about social networks can be leveraged to increase efficiency of interventions (Valente, 2012). However, in many settings, there exists considerable uncertainty regarding the structure of the network. This can render the estimation of potential effects of network-based interventions difficult, as providing appropriate guidance to select interventions often requires a representation of the whole network. In order to make use of the network property estimates to simulate the effect of interventions, it may be beneficial to sample networks from an estimated posterior predictive distribution, which can be specified using a wide range of models. Sampling networks from a posterior predictive distribution of network properties ensures that the uncertainty about network property parameters is adequately captured. The tendency for relationships among network properties to exhibit sharp thresholds has important implications for understanding global network topology in the presence of uncertainty; therefore, it is essential to account for uncertainty. We provide detail needed to sample networks for the specific network properties of degree distribution, mixing frequency, and clustering. Our methods to generate networks are demonstrated using simulated data and data from the National Longitudinal Study of Adolescent Health. PMID:25339990

Goyal, Ravi; De Gruttola, Victor; Blitzstein, Joseph

2014-01-01

359

Posterior consistency in conditional distribution estimation  

PubMed Central

A wide variety of priors have been proposed for nonparametric Bayesian estimation of conditional distributions, and there is a clear need for theorems providing conditions on the prior for large support, as well as posterior consistency. Estimation of an uncountable collection of conditional distributions across different regions of the predictor space is a challenging problem, which differs in some important ways from density and mean regression estimation problems. Defining various topologies on the space of conditional distributions, we provide sufficient conditions for posterior consistency focusing on a broad class of priors formulated as predictor-dependent mixtures of Gaussian kernels. This theory is illustrated by showing that the conditions are satisfied for a class of generalized stick-breaking process mixtures in which the stick-breaking lengths are monotone, differentiable functions of a continuous stochastic process. We also provide a set of sufficient conditions for the case where stick-breaking lengths are predictor independent, such as those arising from a fixed Dirichlet process prior. PMID:25067858

Pati, Debdeep; Dunson, David B.; Tokdar, Surya T.

2014-01-01

360

Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions  

ERIC Educational Resources Information Center

This article presents a review of creative interventions that can be helpful in facilitating the resolution of traumatic grief in children and adolescents. Traumatic grief is conceptualized as a condition in which a person loses a close loved one (e.g., a parent or a sibling) in a traumatic manner, and ensuing trauma-related symptoms disrupt the…

Edgar-Bailey, Meredith; Kress, Victoria E.

2010-01-01

361

A Computational Agent Model for Post-Traumatic Stress Disorders  

E-print Network

A Computational Agent Model for Post-Traumatic Stress Disorders Sebastien NAZE and Jan TREUR VU-based training or in gaming or virtual stories. Keywords: Post-Traumatic Stress Disorder (PTSD), computational agent model Introduction A Post-Traumatic Stress Disorder (PTSD) may occur when a person undergoes

Treur, Jan

362

Post-Traumatic Stress Disorder: Opportunities & Challenges for Computing Technology  

E-print Network

Post-Traumatic Stress Disorder: Opportunities & Challenges for Computing Technology Brian M. Landry of the experience of Post- Traumatic Stress Disorder, including recognizing the pre-trauma disposition for PTSD Design, Human Factors Keywords Post-Traumatic Stress Disorder, PTSD, healthcare, mental health, mental

Anderson, Richard

363

Differential effects of trauma on spouses of traumatized households  

Microsoft Academic Search

The responses of 60 households subjected to varying degrees of traumatic events were examined. Specific attention was given to the differential effect that traumatic events have on spouses, especially in terms of general anxiety, state anxiety, trait anxiety, depression, and other symptoms related to trauma. The findings showed that degree of traumatization was proportional to number and intensity of stress

Ahmad M. Baker; Nadera S. Kevorkian

1995-01-01

364

[The post-traumatic pancreatitis: about four cases].  

PubMed

The post-traumatic pancreatitis is the main reason of mortality in the traumatisms of the pancreas, its concurrence is related to the lesions of the pancreatic channels. It represents only 1% of the pancreatitis. In a descriptive retrospective study, four cases of post-traumatic pancreatitis are described. PMID:16546346

Faroudy, M; Mosadik, A; Mouelhi, S; Ababou, A; Lazreq, C; Sbihi, A

2006-06-01

365

Comparison of posterior dynamic and posterior rigid transpedicular stabilization with fusion to treat degenerative spondylolisthesis.  

PubMed

This article describes the clinical and radiological outcomes of a comparison of posterior dynamic transpedicular stabilization and posterior rigid transpedicular stabilization with fusion after decompression in the treatment of degenerative spondylolisthesis. This prospective clinical and radiologic study was conducted between 2004 and 2007 and included 46 patients, of whom 33 were women (71.7%) and 13 were men (28.3%). Mean patient age was 61.67+/-10.80 years (range, 45-89 years). Twenty-six patients who underwent lumbar decompression and posterior dynamic transpedicular stabilization were followed for a mean of 38 months (range, 24-55 months). In the fusion group, 20 patients who underwent lumbar decompression and rigid stabilization with fusion were followed for a mean of 44 months (range, 26-64 months). The intervertebral space measurements of the dynamic group at the preoperative examination and at 12 and 24 months postoperatively were statistically significantly higher than the intervertebral space measurements of the fusion group (P<.05). In the dynamic group, complications occurred in 2 patients; the first was a screw malposition, which was improved with revision surgery within 1 month of the initial surgery, and the second was a fusion performed in the second year in 1 patient because the patient reported continued pain. In the fusion group, adjacent segment disease was observed in 1 patient, with subsequent reoperation. Lumbar decompression and posterior dynamic transpedicular stabilization yield satisfactory results in the treatment of degenerative lumbar spondylolisthesis and can be considered a valid alternative to fusion. PMID:20506953

Kaner, Tuncay; Dalbayrak, Sedat; Oktenoglu, Tunc; Sasani, Mehdi; Aydin, Ahmet Levent; Ozer, Ali Fahir

2010-05-01

366

Treatment for traumatic memories: review and recommendations.  

PubMed

The aim of this article is to provide recommendations concerning the use of exposure-based therapy for reduction of emotional responding to traumatic memories. Background for these recommendations consists of a summary of the literature on traumatic stress and symptoms of posttraumatic stress disorder (PTSD); an overview of biological, cognitive, and behavioral models for traumatic memory; and a selective review of evidence for the effectiveness of therapeutic exposure as a treatment for trauma memories and PTSD. The recommendations themselves demonstrate how clinical decision making during the course of treatment might be informed by empirical evidence and theoretical models concerning human memory, as well as ethical and legal considerations that mark this topic. PMID:9885771

Leskin, G A; Kaloupek, D G; Keane, T M

1998-12-01

367

Endocannabinoids and traumatic brain injury  

PubMed Central

Traumatic brain injury (TBI) represents the leading cause of death in young individuals. It triggers the accumulation of harmful mediators, leading to secondary damage, yet protective mechanisms are also set in motion. The endocannabinoid (eCB) system consists of ligands, such as anandamide and 2-arachidonoyl-glycerol (2-AG), receptors (e.g. CB1, CB2), transporters and enzymes, which are responsible for the ‘on-demand’ synthesis and degradation of these lipid mediators. There is a large body of evidence showing that eCB are markedly increased in response to pathogenic events. This fact, as well as numerous studies on experimental models of brain toxicity, neuroinflammation and trauma supports the notion that the eCB are part of the brain's compensatory or repair mechanisms. These are mediated via CB receptors signalling pathways that are linked to neuronal survival and repair. The levels of 2-AG, the most highly abundant eCB, are significantly elevated after TBI and when administered to TBI mice, 2-AG decreases brain oedema, inflammation and infarct volume and improves clinical recovery. The role of CB1 in mediating these effects was demonstrated using selective antagonists or CB1 knockout mice. CB2 were shown in other models of brain insults to reduce white blood cell rolling and adhesion, to reduce infarct size and to improve motor function. This review is focused on the role the eCB system plays as a self-neuroprotective mechanism and its potential as a basis for the development of novel therapeutic modality for the treatment of CNS pathologies with special emphasis on TBI. LINKED ARTICLES This article is part of a themed issue on Cannabinoids in Biology and Medicine. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21418185

Shohami, Esther; Cohen-Yeshurun, Ayelet; Magid, Lital; Algali, Merav; Mechoulam, Raphael

2011-01-01

368

Traumatic Endophthalmitis due to Cellulosimicrobium cellulans  

PubMed Central

Purpose. To report a case of traumatic endophthalmitis due to Cellulosimicrobium cellulans. Design. Case report. Methods. Retrospective chart review. Results. To our knowledge, this is the first report of traumatic endophthalmitis due to C. cellulans, which did not respond to intravitreal antibiotics or repeat vitrectomy and ultimately led to the discovery of an occult intraocular foreign body. Conclusions. C. cellulans is a rare cause of endophthalmitis. Greater awareness of this bacterium in the ophthalmic literature as a cause of endophthalmitis and its association with foreign bodies may allow earlier and more purposeful intervention in future cases. PMID:22606461

Jaru-ampornpan, Pimkwan; Agarwal, Anita; Midha, Narinder K.; Kim, Stephen J.

2011-01-01

369

Traumatic Endophthalmitis due to Cellulosimicrobium cellulans.  

PubMed

Purpose. To report a case of traumatic endophthalmitis due to Cellulosimicrobium cellulans. Design. Case report. Methods. Retrospective chart review. Results. To our knowledge, this is the first report of traumatic endophthalmitis due to C. cellulans, which did not respond to intravitreal antibiotics or repeat vitrectomy and ultimately led to the discovery of an occult intraocular foreign body. Conclusions. C. cellulans is a rare cause of endophthalmitis. Greater awareness of this bacterium in the ophthalmic literature as a cause of endophthalmitis and its association with foreign bodies may allow earlier and more purposeful intervention in future cases. PMID:22606461

Jaru-Ampornpan, Pimkwan; Agarwal, Anita; Midha, Narinder K; Kim, Stephen J

2011-01-01

370

Engagement and Vicarious Traumatization in rescue workers  

Microsoft Academic Search

Purpose  The aims of this study are (1) to investigate the incidence of the symptoms of Vicarious Traumatization in a group of rescue\\u000a workers; (2) to explore some of the main predictors of Engagement and Vicarious Traumatization; and (3) to identify the individual\\u000a and organizational factors able to improve the state of well-being of those working in the helping professions.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A

Piergiorgio Argentero; Ilaria Setti

2011-01-01

371

76 FR 75458 - Servicemembers' Group Life Insurance Traumatic Injury Protection Program-Genitourinary Losses  

Federal Register 2010, 2011, 2012, 2013

...or urethral sphincter muscle(s) that requires permanent...lifetime of the member. GU losses may be combined with...term total and permanent loss of urinary system function...or urethral sphincter muscle(s) that requires urinary...For losses listed in...

2011-12-02

372

Electroclinical characteristics of posterior lateral temporal epilepsy.  

PubMed

The current study aimed to investigate the electroclinical differences between mesial temporal lobe epilepsy (MTLE) and posterior lateral temporal lobe epilepsy (PLTLE). All patients had Engel class I outcomes after surgery for at least one year. In MTLE patients, the epileptogenic zone was inside the boundary of a standard temporal lobectomy, whereas in PLTLE, the epileptogenic zone was behind the boundary of a standard temporal lobectomy. Febrile convulsion, history of psychic aura, oroalimentary automatism, and diffuse interictal epileptiform discharges were more frequent in MTLE. Theta wave and increasing heart rate were more evident at the seizure onset in MTLE, whereas an ictal onset fast rhythm was more evident in PLTLE. Tonic head turning was more frequent in PLTLE. Distinguishing between MTLE and PLTLE was easier than distinguishing MTLE from lateral TLE (LTLE), which may be helpful in planning epilepsy surgery. Combinations of these manifestations and signs can provide vital clues to distinguish between MTLE and PLTLE. PMID:23200534

Wang, Fang; Liu, Xingzhou; Pan, Sipei; Wang, Mengyang; Chen, Shuhua

2013-01-01

373

Posterior restorations--a clinical view.  

PubMed

This paper examines the state-of-the-art in the direct restoration of posterior teeth. The existing paradigms for the management of caries are questioned and some existing methods of cavity preparation are reviewed. Dental restorations need to be durable but able to adapt to a changing environment brought about by wear of the adjacent tooth substance and by fatigue processes within the tooth itself. The wear of restorative materials needs to be matched to that of the tooth, otherwise differential loss of either the restorative material or the enamel may destabilize the occlusion. Esthetic instability due to natural darkening of the tooth with age, punctuated by clinical intervention with bleaching procedures, adds a further dimension to the concept of a permanent restoration. Clinical methods that minimize the disruptive effects of dental restorations upon the remaining tooth structure are a continuing challenge. PMID:11317380

Jedynakiewicz, N M; Martin, N

2001-01-01

374

Asymptomatic posterior mediastinal teratoma diagnosed incidentally.  

PubMed

We present a young patient with occasional chest pain and an incidentally found posterior mediastinal mass on radiology which was confirmed as mature teratoma on histopathology. The gross specimen received in the department of pathology was globular measuring 9.0×7.0×5.5 cm and varying in consistency from soft cystic to firm. Cut surface showed numerous hair entangled in pultaceous material. Representative sections were taken and stained with H&E stain. Histopathology revealed haphazardly distributed mature derivatives of all the three germ layers comprising of epidermis, pilo sebaceous units, nerve bundles (ectodermal), cartilage, bone, salivary gland clusters, blood vessels, muscle bundles, fibrous tissue infiltrated by foreign body giant cells, lymphoid follicles (mesodermal) and pseudostratified columnar epithelium (mesodermal), thus establishing the diagnosis of mature teratoma. PMID:24654248

Jaiswal, Riddhi; Rani, Poonam; Devenraj, Vijayant

2014-01-01

375

Objective autorefraction in posterior chamber pseudophakia.  

PubMed Central

Automated refraction with the Canon RK-1 Autoref keratometer was evaluated in 110 eyes (110 patients) six to eight weeks after they had undergone extracapsular cataract extraction with posterior chamber intraocular lens implantation and achieved a best corrected visual acuity of at least 6/12. Autorefraction readings were obtained in 100 (91%) of these eyes. The agreement between autorefraction and clinical refraction data was 98% for spherical equivalence less than 0.51 dioptres (D), 95% for sphere power less than 0.51D, 94% for cylinder power less than 0.51D, and 85% for cylinder axis less than 11 degrees. Autorefraction can provide acceptably accurate postoperative refraction values in pseudophakic eyes. Images PMID:2275935

Raj, P S; Akingbehin, T; Levy, A M

1990-01-01

376

Multiple hypoplastic duplicated urethral hydrodistension and simple end-to-end anastomosis to penoscrotal hypospadias: a novel technique.  

PubMed

Complete urethral duplication is a rare congenital genitourinary anomaly with various symptoms. Since anatomical place of urethra greatly varies between cases, surgical management of the patients is personalized according to the type of the duplication and requires a careful workup before planning for any intervention. In this case report, a 4-year-old boy with finding of complete proximal hypospadiac urethral duplication is presented with double-stream voiding. He was passing a normal stream of urine through the hypospadiac tract, while a thin stream came out from the normal meatal site. Examination revealed a hypoplastic orthotopic urethra with an accessory penoscrotal hypospadiac urethra. The patient was successfully managed with hydrodistension technique which was used to resolve the stricture of hypoplastic dorsal urethra followed by end-to-end anastomosis to penoscrotal hypospadias. This approach gives an insight that the technique could be possibly considered as a simple alternative to avoid proximal hypospadias repair which is comparatively a challenging surgical task. PMID:24859321

Mazaheri, Tina; Rad, Mona Vahidi; Fareghi, Mehdi; Kajbafzadeh, Abdol-Mohammad

2014-09-01

377

Postoperative acetabular retroversion causes posterior osteoarthritis of the hip  

PubMed Central

We retrospectively reviewed 68 hips in 62 patients with acetabular dysplasia who underwent curved periacetabular osteotomy. Among the 68 hips, 33 had acetabular retroversion (retroversion group) and 35 had anteversion (control group) preoperatively. All hips were evaluated according to the Harris hip score. Radiographic evaluations of acetabular retroversion and posterior wall deficiency were based on the cross-over sign and posterior wall sign, respectively. The clinical scores of the two groups at the final follow-up were similar. In the retroversion group, 12 hips had anteverted acetabulum postoperatively. The posterior wall sign disappeared in these hips, but remained in 21 hips with retroverted acetabulum postoperatively. Among the 21 hips with retroverted acetabulum, posterior osteoarthritis of the hip developed postoperatively in five hips. When performing corrective osteotomy for a dysplastic hip with acetabular retroversion, it is important to correct the acetabular retroversion to prevent posterior osteoarthritis of the hip due to posterior wall deficiency. PMID:18157533

Naito, Masatoshi; Shiramizu, Kei; Shinoda, Tsuyoshi

2007-01-01

378

Membrane properties of external urethral and external anal sphincter motoneurones in the cat.  

PubMed Central

1. Intracellular recordings were made from external urethral sphincter (EUS) and external anal sphincter (EAS) motoneurones in the cat spinal cord under pentobarbitone anaesthesia. EUS and EAS motoneurones were located in segments S1 and S2 in the lateral part of the ventral horn corresponding to column Y of Romanes in the cat or group X of Onuf in man. 2. The axonal conduction velocity of sphincter motoneurones, calculated from the latency of the antidromic action potential and the conduction distance, ranged from 16 to 80 ms-1, much slower than that of hindlimb motoneurones. The duration of the spike after-hyperpolarization (AHP) was in a similar range to that of hindlimb motoneurones. The antidromic latency, the duration of the action potential and the duration of the AHP were positively correlated with one another. 3. The input resistance ranged from 2.6 to 9.0 M omega and was positively correlated with the latency of the antidromic spike. The plots of input resistance versus conduction velocity in sphincter motoneurones were distributed around the extrapolated regression line determined for hindlimb motoneurones, indicating that there is a common correlation amongst conduction velocity, input resistance, and size of motoneurones regardless of the muscle type innervated by a motoneurone. 4. The regression line relating AHP duration and input resistance in sphincter motoneurones was quite different from that in hindlimb motoneurones in its slope, indicating that the AHP duration does not depend solely on the size of the motoneurone. 5. The voltage responses to injection of steps of hyperpolarizing current developed a time-dependent depolarizing 'sag' at higher current levels. The delay in onset and the time constant of decay of this depolarizing sag depended upon the peak amplitude of the hyperpolarizing response. The slope resistance in the I-V curve decreased in the hyperpolarizing direction in all neurones examined, indicating the existence of anomalous rectification analogous to the Q current IQ. In some sphincter motoneurones, an increase of slope resistance in the I-V curve was observed when the membrane was further hyperpolarized. 6. The membrane time constant was positively correlated with input resistance, suggesting that motoneurones with high input resistance have high specific membrane resistivity. The dendritic-to-soma conductance ratio (p) and electrotonic length of dendrite (L) were estimated according to Rall's model. p was smaller than that of hindlimb motoneurones, suggesting less developed dendritic arborization. L was similar to that of hindlimb motoneurones. 7. No differences were observed, in any of the above characteristics of motoneurones, between EUS and EAS. PMID:1804967

Sasaki, M

1991-01-01

379

Thoracolumbar fracture dislocations treated by posterior reduction, interbody fusion and segmental instrumentation  

PubMed Central

Background: Literature describing the application of modern segmental instrumentation to thoracic and lumbar fracture dislocation injuries is limited and the ideal surgical strategy for this severe trauma remains controversial. The purpose of this article was to investigate the feasibility and efficacy of single-stage posterior reduction with segmental instrumentation and interbody fusion to treat this type of injury. Materials and Methods: A retrospective review of 30 patients who had sustained fracture dislocation of the spine and underwent single stage posterior surgery between January 2007 and December 2011 was performed. All the patients underwent single stage posterior pedicle screw fixation, decompression and interbody fusion. Demographic data, medical records and radiographic images were reviewed thoroughly. Results: Ten females and 20 males with a mean age of 39.5 years were included in this study. Based on the AO classification, 13 cases were Type B1, 4 cases were B2, 4 were C1, 6 were C2 and 3 cases were C3. The average time of the surgical procedure was 220 min and the average blood loss was 550 mL. All of the patients were followed up for at least 2 years, with an average of 38 months. The mean preoperative kyphosis was 14.4° and reduced to -1.1° postoperatively. At the final followup, the mean kyphosis was 0.2°. The loss of correction was small (1.3°) with no significant difference compared to postoperative kyphotic angle (P = 0.069). Twenty seven patients (90%) achieved definitive bone fusion on X-ray or computed tomography imaging within 1 year followup. The other three patients were suspected possible pseudarthrosis. They remained asymptomatic without hardware failure or local pain at the last followup. Conclusion: Single stage posterior reduction using segmental pedicle screw instrumentation, combined with decompression and interbody fusion for the treatment of thoracic or lumbar fracture-dislocations is a safe, less traumatic and reliable technique. This procedure can achieve effective reduction, sagittal angle correction and solid fusion.

Wang, Xiao-Bin; Yang, Ming; Li, Jing; Xiong, Guang-Zhong; Lu, Chang; Lu, Guo-Hua

2014-01-01

380

Posterior cranial vault distraction with resorbable distraction devices.  

PubMed

Posterior cranial vault distraction is recognized as a viable initial approach to patients with syndromic craniosynostosis. It offers advantages to initial anterior vault surgery and to traditional 1-stage advancements. Reports of posterior vault distraction have thus far focused on the use of standard titanium distractors. We present a case of posterior vault distraction with resorbable distraction devices, obviating the need for a second surgery and anesthetic for distractor removal. Distraction was performed successfully without complications or device-related issues. PMID:25006906

Maurice, Samuel M; Gachiani, John M

2014-07-01

381

Evaluation of posterior fossa lesions by computer assisted tomography (CAT).  

PubMed

Valuable neuroradiologic information can be obtained with routine examination of the posterior fossa by computer assisted tomography (CAT). The diagnosis can be difficult in the posterior fossa due to the relatively small size of the compartment and its proximities to large bony masses and air in the mastoid cells. However, many lesions can be accurately diagnosed when close attention is given to anatomic detail and the frequent use of contrast enhancement. We introduced a new CAT classification of posterior fossa neoplasms. PMID:877637

Lott, T; El Gammal, T; Volcan, I

1977-07-01

382

Posterior Thigh Muscle Injuries in Elite Track and Field Athletes  

Microsoft Academic Search

Introduction: Posterior thigh muscle injuries in athletes are common, and prediction of recovery time would be of value.Hypothesis: Knee active range of motion deficit 48 hours after a unilateral posterior thigh muscle injury correlates with time to full recovery.Study Design: Cohort study (prognosis); Level of evidence, 2.Methods: One hundred sixty-five track and field athletes with acute, first-time, unilateral posterior thigh

Nikolaos Malliaropoulos; Emmanuel Papacostas; Olga Kiritsi; Agapi Papalada; Nikolaos Gougoulias; Nicola Maffulli

2010-01-01

383

Traumatic events and post-traumatic stress symptoms among adolescents in Ibadan.  

PubMed

Little empirical data exist on the rates of exposure to traumatic events and its sequelae especially in adolescents. This study was designed to determine the lifetime prevalence of exposure to traumatic events and posttraumatic stress symptoms among adolescents in Ibadan, Nigeria. A sample of 786 boys and girls from 10 senior secondary schools located within Ibadan were interviewed using an adapted version of the Schedule for Affective Disorders and Schizophrenia (KSADS) to ascertain the prevalence of exposure to traumatic events and posttraumatic stress symptoms. Irrespective of gender, more than 40% reported lifetime exposure to at least one traumatic event. Commonly reported events were: receiving news of sudden injury, death or illness in a close family member or friend, being a victim or witness to a violent crime and physical abuse. About 2.4% of the sample met diagnostic criteria for posttraumatic stress disorder (PTSD). Female sex, exposure to more than one traumatic event, and sexual abuse were associated with increased risk for PTSD. The results of this study highlights the substantial risk for experiencing serious traumatic events by adolescents within the community, and a need for professionals involved in the care of adolescents to be more vigilant in screening for trauma related distress. PMID:21834258

Oladeji, B D; Morakinyo, J J; Gureje, O

2011-03-01

384

38 CFR 9.20 - Traumatic injury protection.  

Code of Federal Regulations, 2012 CFR

...xxviii) The term permanent loss of use of both ovaries is...The term total and permanent loss of urinary system function...bladder, or urethral sphincter muscle(s) that requires urinary...member. (f) Schedule of Losses. For losses listed in...

2012-07-01

385

38 CFR 9.20 - Traumatic injury protection.  

Code of Federal Regulations, 2013 CFR

...xxviii) The term permanent loss of use of both ovaries is...The term total and permanent loss of urinary system function...bladder, or urethral sphincter muscle(s) that requires urinary...member. (f) Schedule of Losses. For losses listed in...

2013-07-01

386

38 CFR 9.20 - Traumatic injury protection.  

...The term total and permanent loss of urinary system function is defined as damage to the urethra, ureter(s), both kidneys, bladder, or urethral sphincter muscle(s) that requires urinary diversion and/or hemodialysis, either of which is...

2014-07-01

387

Posterior Circulation Stroke: Animal Models and Mechanism of Disease  

PubMed Central

Posterior circulation stroke refers to the vascular occlusion or bleeding, arising from the vertebrobasilar vasculature of the brain. Clinical studies show that individuals who experience posterior circulation stroke will develop significant brain injury, neurologic dysfunction, or death. Yet the therapeutic needs of this patient subpopulation remain largely unknown. Thus understanding the causative factors and the pathogenesis of brain damage is important, if posterior circulation stroke is to be prevented or treated. Appropriate animal models are necessary to achieve this understanding. This paper critically integrates the neurovascular and pathophysiological features gleaned from posterior circulation stroke animal models into clinical correlations. PMID:22665986

Lekic, Tim; Ani, Chizobam

2012-01-01

388

Clinical significance of acute traumatic intracranial pneumocephalus  

Microsoft Academic Search

Among 1142 patients with head injuries hospitalized in the Neurosurgery Department of Gazi University Medical School during the period between 1979 and 1992, 583 had initial CT scans. A retrospective analysis of these initial CT images revealed intracranial air on admission in only 21 cases. These were classified as acute traumatic intracranial pneumocephalus: a potentially serious complication of head injury.

Semih Keskil; Kemali Baykaner; Necdet Çeviker; Sedat I?ik; Mustafa Çengel; Toygun Orbay

1998-01-01

389

Prevention of post-traumatic stress disorders  

Microsoft Academic Search

This article deals with issues which are helpful in designing preventive outreach programs for victims of traumatic stress. The first part outlines a theoretical approach to the process of coping with serious life events. The second part analyzes the various aspect of mental assistance after such events. Aims of psychological intervention and different components of intervention programs are discussed. Finally

D. Brom; R. J. Kleber

1989-01-01

390

Treatment of Acute Traumatic Stress Reactions  

Microsoft Academic Search

This paper calls for a broadening of the context within which we study responses to traumatic stress, the course of recovery, components of effective interventions, and assessments of outcome. Acute stress reactions to trauma as a spectrum include anxiety, dissociative, and depressive symptoms. The course of these symptoms may vary, with fluctuations between intrusion (“positive”) and avoidance\\/ numbing\\/dissociative (“negative”) symptoms

David Spiegel

2005-01-01

391

Functional MRI and Outcome in Traumatic Coma  

PubMed Central

Advances in task-based functional MRI (fMRI), resting-state fMRI (rs-fMRI), and arterial-spin labeled (ASL) perfusion MRI have occurred at a rapid pace in recent years. These techniques for measuring brain function have great potential to improve the accuracy of prognostication for civilian and military patients with traumatic coma. In addition, fMRI, rs-fMRI, and ASL have provided novel insights into the pathophysiology of traumatic disorders of consciousness, as well as mechanisms of recovery from coma. However, functional neuroimaging techniques have yet to achieve widespread clinical use as prognostic tests for patients with traumatic coma. Rather, a broad spectrum of methodological hurdles currently limits the feasibility of clinical implementation. In this review, we discuss the basic principles of fMRI, rs-fMRI and ASL and their potential applications as prognostic tools for patients with traumatic coma. We also discuss future strategies for overcoming the current barriers to clinical implementation. PMID:23881623

Giacino, Joseph T.; Wu, Ona

2013-01-01

392

[A man with severe traumatic brain injury].  

PubMed

We present a 41-year-old man with severe traumatic brain injury. Cranial imaging studies revealed cerebral contusion and a longitudinal fracture of the temporal bone. Several days later brain herniated into the left external auditory canal. Imaging studies showed the known skull fracture with a direct connection between the external acoustic meatus and the intracranial structures. PMID:23388139

Oudeman, Eline A; Martins Jarnalo, Carine O; van Ouwerkerk, Willem J R

2013-01-01

393

Imaginal Flooding of Traumatized Children and Adolescents.  

ERIC Educational Resources Information Center

Considerable research has been conducted since posttraumatic stress disorder (PTSD) was included in the American Psychiatric Association's taxonomy of mental disorders. Most studies have involved adults. Whereas different treatment modalities have been applied with different degrees of efficacy with traumatized youth, this article considers…

Saigh, Philip A.

1996-01-01

394

Adolescent Post-Traumatic Stress Disorder  

ERIC Educational Resources Information Center

Based on over a decade of work in the area of PTSD, including a longitudinal study of PTSD among adolescents, Dr. Yule provides an introduction to post-traumatic stress disorder as it occurs in youth. This includes a look at the manifestations of stress reactions, the incidence and prevalence of PTSD, and the relationship between levels of…

Yule, William

2003-01-01

395

Post-traumatic stress reactions in children  

Microsoft Academic Search

Surprisingly, far less is known of the manifestations of post-traumatic stress reactions in children than in adults. Research over the past 10 years has begun to describe phenomena very similar to PTSD in adults, particularly among young adolescents. This paper will briefly review recent research and will describe our own experiences working with children who survived the Herald of Free

William Yule; Ruth M. Williams

1990-01-01

396

Working with Students with Traumatic Brain Injury  

ERIC Educational Resources Information Center

The participation of a student with Traumatic Brain Injury (TBI) in general physical education can often be challenging and rewarding for the student and physical education teacher. This article addresses common characteristics of students with TBI and presents basic solutions to improve the education of students with TBI in the general physical…

Lucas, Matthew D.

2010-01-01

397

Psychiatric disorders and traumatic brain injury  

PubMed Central

Psychiatric disorders after traumatic brain injury (TBI) are frequent. Researches in this area are important for the patients’ care and they may provide hints for the comprehension of primary psychiatric disorders. Here we approach epidemiology, diagnosis, associated factors and treatment of the main psychiatric disorders after TBI. Finally, the present situation of the knowledge in this field is discussed. PMID:19043523

Schwarzbold, Marcelo; Diaz, Alexandre; Martins, Evandro Tostes; Rufino, Armanda; Amante, Lucia Nazareth; Thais, Maria Emilia; Quevedo, Joao; Hohl, Alexandre; Linhares, Marcelo Neves; Walz, Roger

2008-01-01

398

Physiatric Management of Mild Traumatic Brain Injury  

Microsoft Academic Search

Mild traumatic brain injury (MTBI) is a common condition, afflicting as many as 1.5 million Americans yearly. Most individuals sustain MTBI as a result of motor vehicle collisions, but it may also occur as a result of falls, physical assault or sporting accidents. Problems related to MTBI include various pain syndromes, cognitive impairments, disorders of affect, cranial nerve dysfunction, and

STEVEN FLANAGAN

1999-01-01

399

Traumatic Brain Injury: Perspectives from Educational Professionals  

ERIC Educational Resources Information Center

This article reports the outcomes from 2 focus groups conducted to ascertain professional educators' perceptions regarding their (a) level of preparedness for working with students with traumatic brain injury (TBI), (b) ideas regarding ways to improve support to students and families, and (c) concerns about meeting the diverse needs of children…

Mohr, J. Darrell; Bullock, Lyndal M.

2005-01-01

400

Understanding Traumatic Brain Injury: An Introduction  

ERIC Educational Resources Information Center

This article is the first of a multi-part series on traumatic brain injury (TBI). Historically, TBI has received very limited national public policy attention and support. However since it has become the signature injury of the military conflicts in Iraq and Afghanistan, TBI has gained the attention of elected officials, military leaders,…

Trudel, Tina M.; Scherer, Marcia J.; Elias, Eileen

2009-01-01

401

Traumatic Brain Injury and Personality Change  

ERIC Educational Resources Information Center

Traumatic brain injury (TBI) is the leading cause of death and lifelong disability in the United States for individuals below the age of 45. Current estimates from the Center for Disease Control (CDC) indicate that at least 1.4 million Americans sustain a TBI annually. TBI affects 475,000 children under age 14 each year in the United States alone.…

Fowler, Marc; McCabe, Paul C.

2011-01-01

402

Assessment of Students with Traumatic Brain Injury  

ERIC Educational Resources Information Center

The incidence of brain injuries, as well as their impact on individuals who sustain them, has received growing attention from American media in recent years. This attention is likely the result of high profile individuals suffering brain injuries. Greater public awareness of traumatic brain injuries (TBIs) has also been promoted by sources such as…

Chesire, David J.; Buckley, Valerie A.; Canto, Angela I.

2011-01-01

403

Traumatic Brain Injury: Looking Back, Looking Forward  

ERIC Educational Resources Information Center

This article is the eighth of a multi-part series on traumatic brain injury (TBI). Historically, TBI has received limited national attention and support. However, since it is the signature injury of the military conflicts in Iraq and Afghanistan, TBI has gained attention of elected officials, military leaders, policymakers, and the public. The…

Bartlett, Sue; Lorenz, Laura; Rankin, Theresa; Elias, Eileen; Weider, Katie

2011-01-01

404

Traumatic Brain Injury. Quick Turn Around (QTA).  

ERIC Educational Resources Information Center

This brief paper summarizes information concerning use of the traumatic brain injury (TBI) disability classification by states and the nature of state-level activities related to the education of children and youth with TBI. It notes addition of the TBI disability category to the Individuals with Disabilities Education Act in 1990 and provides the…

Markowitz, Joy; Linehan, Patrice

405

Narrative Language in Traumatic Brain Injury  

ERIC Educational Resources Information Center

Persons with traumatic brain injury (TBI) often show impaired linguistic and/or narrative abilities. The present study aimed to document the features of narrative discourse impairment in a group of adults with TBI. 14 severe TBI non-aphasic speakers (GCS less than 8) in the phase of neurological stability and 14 neurologically intact participants…

Marini, Andrea; Galetto, Valentina; Zampieri, Elisa; Vorano, Lorenza; Zettin, Marina; Carlomagno, Sergio

2011-01-01

406

Resource Guide on Traumatic Brain Injury  

ERIC Educational Resources Information Center

The purpose of this resource guide on traumatic brain injury (TBI) is to provide assistance to educators, families, and professionals who may be striving to increase their knowledge and understanding of brain injury. This guide will hopefully become an initial resource. It provides: a glossary of TBI Terms; contact information for and brief…

Monfore, Dorothea

2005-01-01

407

Reality Lessons in Traumatic Brain Injury  

ERIC Educational Resources Information Center

This article goes beyond the typical guidance on how to address the educational needs of students with traumatic brain injury (TBI). A survivor of TBI and his parent advocate describe real-life encounters in the education arena and offer ways to respond to the problems depicted in the situations. Their candor enhances educator awareness of the…

Adams, Elaine Parker; Adams, Albert A., Jr.

2008-01-01

408

Clinimetric measurement in traumatic brain injuries  

PubMed Central

Abstract Traumatic brain injury is a leading cause of death and disability worldwide. Every year, about 1.5 million affected people die and several millions receive emergency treatment. Most of the burden (90%) is in low and middle-income countries. The costs of care depend on the level of disability. The burden of care after traumatic brain injury is caused by disability as well as by psychosocial and emotional sequelae of injury. The final consequence of brain injury is the reduction of quality of life. It is very difficult to predict the outcome after traumatic brain injury. The basic clinical model included four predictors: age, score in Glasgow coma scale, pupil reactivity, and the presence of major extracranial injury. These are the neuroradiological markers of recovery after TBI (CT, MRI and PET) and biomarkers: genetic markers of ApoE Gene, ectoenzyme CD 38 (cluster of differentiation 38), serum S100B, myelin basic protein (MBP), neuron specific endolase (NSE), and glial fibrillary acidic protein (GPAP). These are many clinimetric scales which are helpful in prognosing after head injury. In this review paper, the most commonly used scales evaluating the level of consciousness after traumatic brain injury have been presented. PMID:25408714

Opara, N; Ma?ecka, I; Szczygiel, M

2014-01-01

409

Traumatic brain injury: initial resuscitation and transfer  

Microsoft Academic Search

Traumatic brain injury (TBI) is a major cause of mortality and morbidity in the young adult population. Targeted resuscitation with the aim of avoiding hypoxia and hypotension – two of the most important determinants of secondary brain injury – can produce significant improvements in outcome. Guidelines exist to aid the structured conduct of this resuscitation and then to aid the

Ian Appleby

2008-01-01

410

Traumatic brain injury in children – clinical implications  

Microsoft Academic Search

Traumatic brain injury (TBI) is the leading cause of death in childhood; however only very few studies focusing on the specific pathophysiology and treatment have been published to date. Head trauma is more likely in young children than in adults given the same deceleration of the body due to their large and heavy heads and weak cervical ligaments and muscles.

Ruediger Noppens; Ansgar M. Brambrink

2004-01-01

411

Correlation of Head Trauma and Traumatic Aneurysms  

PubMed Central

Summary Subarachnoid hemorrhage following severe trauma to the head is relatively common. In most cases the bleed originates from superficial veins and occasionally from arteries. Following the replacement of cerebral angiography with CT in the diagnostic evaluation of head traumas fewer traumatic aneurysms have been observed. This may indicate that some traumatic aneu-rysms are missed if angiographic procedures are not performed in patients with severe head injury. Trauma patients admitted to our institution are submitted to CT including a bone algorithm. In case of subarachnoid hemorrhage, especially in the basal cisterns, CT- angiography is performed. Digital subtraction angiography is performed as well in cases with uncertain interpretations. During one year 81 patients were admitted with subarachnoid hemorrhage following head trauma. Thirteen (16%) of them underwent CT-angiography and in five (6.2%) with SAH in the basal cistern traumatic aneurysms were found. Four of these cases had a skull base fracture including fractures through the clivus. Four cases were embolized and one very small extradural aneurysm is still not treated. One small pericallosal aneurysm was operated. A traumatic aneurysm should always be suspected n patients with skull base fractures and subarachnoid hemorrhage in the basal cisterns. PMID:20557783

Nakstad, P.Hj.; Gjertsen, Ø.; Pedersen, H.Kr.

2008-01-01

412

Traumatic brain injury and posttraumatic stress disorder.  

PubMed

Given the upsurge of research in posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), much of which has focused on military samples who served in Iraq and Afghanistan, the purpose of this article is to review the literature published after September 11th, 2001 that addresses the epidemiology, pathophysiology, evaluation, and treatment of PTSD in the context of TBI. PMID:24529423

Bahraini, Nazanin H; Breshears, Ryan E; Hernández, Theresa D; Schneider, Alexandra L; Forster, Jeri E; Brenner, Lisa A

2014-03-01

413

Management of traumatic macular holes: case report.  

PubMed

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months. PMID:18797673

Brasil, Oswaldo Ferreira Moura; Brasil, Oswaldo Moura

2008-01-01

414

Pediatric Traumatic Brain Injury: Quo Vadis?  

Microsoft Academic Search

In this review, five questions serve as the framework to discuss the importance of age-related differences in the pathophysiology and therapy of traumatic brain injury (TBI). The following questions are included: (1) Is diffuse cerebral swelling an important feature of pediatric TBI and what is its etiology? (2) Is the developing brain more vulnerable than the adult brain to apoptotic

Patrick M. Kochanek

2006-01-01

415

Substance P Mediates Reduced Pneumonia Rates After Traumatic Brain Injury  

PubMed Central

Objectives Traumatic brain injury results in significant morbidity and mortality and is associated with infectious complications, particularly pneumonia. However, whether traumatic brain injury directly impacts the host response to pneumonia is unknown. The objective of this study was to determine the nature of the relationship between traumatic brain injury and the prevalence of pneumonia in trauma patients and investigate the mechanism of this relationship using a murine model of traumatic brain injury with pneumonia. Design Data from the National Trauma Data Bank and a murine model of traumatic brain injury with postinjury pneumonia. Setting Academic medical centers in Cincinnati, OH, and Boston, MA. Patients/Subjects Trauma patients in the National Trauma Data Bank with a hospital length of stay greater than 2 days, age of at least 18 years at admission, and a blunt mechanism of injury. Subjects were female ICR mice 8–10 weeks old. Interventions Administration of a substance P receptor antagonist in mice. Measurements and Main Results Pneumonia rates were measured in trauma patients before and after risk adjustment using propensity scoring. In addition, survival and pulmonary inflammation were measured in mice undergoing traumatic brain injury with or without pneumonia. After risk adjustment, we found that traumatic brain injury patients had significantly lower rates of pneumonia compared to blunt trauma patients without traumatic brain injury. A murine model of traumatic brain injury reproduced these clinical findings with mice subjected to traumatic brain injury demonstrating increased bacterial clearance and survival after induction of pneumonia. To determine the mechanisms responsible for this improvement, the substance P receptor was blocked in mice after traumatic brain injury. This treatment abrogated the traumatic brain injury–associated increases in bacterial clearance and survival. Conclusions The data demonstrate that patients with traumatic brain injury have lower rates of pneumonia compared to non–head-injured trauma patients and suggest that the mechanism of this effect occurs through traumatic brain injury–induced release of substance P, which improves innate immunity to decrease pneumonia. PMID:25014065

Yang, Sung; Stepien, David; Hanseman, Dennis; Robinson, Bryce; Goodman, Michael D.; Pritts, Timothy A.; Caldwell, Charles C.; Remick, Daniel G.; Lentsch, Alex B.

2014-01-01

416

An anatomic investigation of the serratus posterior superior and serratus posterior inferior muscles  

Microsoft Academic Search

In classical anatomy textbooks the serratus posterior superior muscle was said to elevate the superior four ribs, thus increasing\\u000a the AP diameter of the thorax and raising the sternum. However, electromyographic and other studies do not support its role\\u000a in respiration. In order to help resolve this controversy and provide some insight into their possible functionality, the\\u000a present study aimed

Marios Loukas; Robert G. Louis Jr; Christopher T. Wartmann; R. Shane Tubbs; Ankmalika A. Gupta; Nihal Apaydin; Robert Jordan

2008-01-01

417

Urethral reconstruction of critical defects in rabbits using molecularly defined tubular type I collagen biomatrices: key issues in growth factor addition  

Microsoft Academic Search

Tubular type I collagen biomatrices with and without growth factors (GFs) were constructed and evaluated in a rabbit model for critical urethral defects. Porous tubular biomatrices with an inner diameter of 3 mm were prepared using highly purified collagen fibrils and were crosslinked with or without heparin. Heparinized biomatrices were supplemented with the heparin-binding GFs vascular endothelial GF, fibroblast GF-2,

Jody E. Nuininga; Martin J. W. Koens; Dorien M. Tiemessen; Egbert Oosterwijk; Willeke F. Daamen; Paul J. Geutjes; A. H. M. S. M. van Kuppevelt; Wout F. J. Feitz

2010-01-01

418

Hippocampal Network Connectivity and Activation Differentiates Post-Traumatic Stress Disorder From Generalized Anxiety Disorder  

PubMed Central

Anxiety disorders are a diverse group of clinical states. Post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD), eg, share elevated anxiety symptoms, but differ with respect to fear-related memory dysregulation. As the hippocampus is implicated in both general anxiety and fear memory, it may be an important brain locus for mapping the similarities and differences among anxiety disorders. Anxiety and fear also functionally associate with different subdivisions of the hippocampus along its longitudinal axis: the human posterior (rodent dorsal) hippocampus is involved in memory, through connectivity with the medial prefrontal-medial parietal default-mode network, whereas the anterior (rodent ventral) hippocampus is involved in anxiety, through connectivity with limbic-prefrontal circuits. We examined whether differential hippocampal network functioning may help account for similarities and differences in symptoms in PTSD and GAD. Network-sensitive functional magnetic resonance imaging-based resting-state intrinsic connectivity methods, along with task-based assessment of posterior hippocampal/default-mode network function, were used. As predicted, in healthy subjects resting-state connectivity dissociated between posterior hippocampal connectivity with the default-mode network, and anterior hippocampal connectivity to limbic-prefrontal circuitry. The posterior hippocampus and the associated default-mode network, across both resting-state connectivity and task-based measures, were perturbed in PTSD relative to each of the other groups. By contrast, we found only modest support for similarly blunted anterior hippocampal connectivity across both patient groups. These findings provide new insights into the neural circuit-level dysfunctions that account for similar vs different features of two major anxiety disorders, through a translational framework built on animal work and carefully selected clinical disorders. PMID:23673864

Chen, Ashley C; Etkin, Amit

2013-01-01

419

Short-Term Results of Total Knee Arthroplasty with Anterior-Posterior Glide LCS Mobile-Bearing System  

PubMed Central

Purpose To evaluate the clinical and radiological results of total knee arthroplasty (TKA) using the anterior-posterior glide (APG) low contact stress (LCS) mobile-bearing system. Materials and Methods We evaluated 130 knees in 117 patients who had undergone TKA with APG LCS mobile-bearing system between September 2005 and July 2007 and could be followed over 5 years. The mean follow-up period was 68 months. The clinical and radiological results were evaluated using the American Knee Society Scoring System, Oxford knee score and the American Knee Society Roentgenographic Evaluation and Scoring System. And we analyzed short-term postoperative complications. Results The average range of motion of the knee joint was 107.9° (range, 70° to 135°) preoperatively and 125.2° (range, 90° to 135°) at the last follow-up. The average knee and functional scores were improved from 39.1 and 42.0 to 71.2 and 75.6, respectively, between the preoperative and last follow-up evaluation. The Oxford knee score was decreased from 42.9 preoperatively to 23.1 at the last follow-up. The femoro-tibial angle (anatomical axis) changed from 10.1° varus preoperatively to 3.3° valgus at the last follow-up. Radiolucency was observed in 14% of all cases. There were 1 case of traumatic dislocation of the polyethylene liner, 1 case of aseptic loosening and 6 cases of posterior instability because of posterior cruciate ligament (PCL) insufficiency. Conclusions TKA with APG LCS mobile-bearing system demonstrated relatively good short-term clinical and radiological results. However, further considerations for posterior instability associated with PCL insufficiency are needed.

Kim, Kyung Taek; Kang, Min Soo; Lim, Young Hoon; Park, Jin Woo

2014-01-01

420

Posterior regeneration in Isodiametra pulchra (Acoela, Acoelomorpha)  

PubMed Central

Introduction Regeneration is a widespread phenomenon in the animal kingdom, but the capacity to restore damaged or missing tissue varies greatly between different phyla and even within the same phylum. However, the distantly related Acoelomorpha and Platyhelminthes share a strikingly similar stem-cell system and regenerative capacity. Therefore, comparing the underlying mechanisms in these two phyla paves the way for an increased understanding of the evolution of this developmental process. To date, Isodiametra pulchra is the most promising candidate as a model for the Acoelomorpha, as it reproduces steadily under laboratory conditions and is amenable to various techniques, including the silencing of gene expression by RNAi. In order to provide an essential framework for future studies, we report the succession of regeneration events via the use of cytochemical, histological and microscopy techniques, and specify the total number of cells in adult individuals. Results Isodiametra pulchra is not capable of regenerating a new head, but completely restores all posterior structures within 10 days. Following amputation, the wound closes via the contraction of local muscle fibres and an extension of the dorsal epidermis. Subsequently, stem cells and differentiating cells invade the wound area and form a loosely delimited blastema. After two days, the posterior end is re-patterned with the male (and occasionally the female) genital primordium being apparent. Successively, these primordia differentiate into complete copulatory organs. The size of the body and also of the male and female copulatory organs, as well as the distance between the copulatory organs, progressively increase and by nine days copulation is possible. Adult individuals with an average length of 670 ?m consist of approximately 8100 cells. Conclusion Isodiametra pulchra regenerates through a combination of morphallactic and epimorphic processes. Existing structures are “re-modelled” and provide a framework onto which newly differentiating cells are added. Growth proceeds through the intercalary addition of structures, mirroring the embryonic and post-embryonic development of various organ systems. The suitability of Isodiametra pulchra for laboratory techniques, the fact that its transcriptome and genome data will soon be available, as well as its small size and low number of cells, make it a prime candidate subject for research into the cellular mechanisms that underlie regeneration in acoelomorphs. PMID:24160844

2013-01-01

421

Vision through nuclear and posterior subcapsular cataract.  

PubMed

We have developed a new set of tests for evaluation of visual function through media opacities, based on vernier acuity measurements (hyperacuity). In this paper, results of one of these tests, the 'gap test', are compared in patients with posterior subcapsular (PSC) cataract versus nuclear cataract (NC). Patients with PSC cataract often report multiple images or significant 'star burst' effects. We hypothesized the presence of 'multi-prismatic' and/or high frequency spurious resolution phenomena due to PSC cataract characteristic substructure. We were able to minimize these effects by using a pinhole held close to the eye, a large (adapting) background field of white light superimposed on the vernier test targets, a low-pass spatial filter applied to the targets. When the particular problems associated with PSC cataract are not present or are adequately addressed and when patients are matched for visual acuity, the hyperacuity 'gap test' shows less functional effect due to the opacity for PSC cataract than NC in all the cases we have tested. These findings, moreover, indicate that visual acuity provides an insufficient description of the effects of intraocular scattering on image formation. The results emphasize the importance and the necessity of developing models that better clarify the specific effects of different types of ocular media opacities. PMID:3721717

Baraldi, P; Enoch, J M; Raphael, S

1986-05-01

422

Automatic quantification of posterior capsule opacification  

NASA Astrophysics Data System (ADS)

After Cataract surgery where a plastic implant lens is implanted into the eye to replace the natural lens, many patients suffer from cell growth across a membrane situated at the back of the lens which degrades their vision. The cell growth is known as Posterior Capsule Opacification (or PCO). It is important to be able to quantify PCO so that the effect of different implant lens types and surgical techniques may be evaluated. Initial results obtained using a neural network to detect PCO from implant lenses are compared to an established but less automated method of detection, which segments the images using texture segmentation in conjunction with co- occurrence matrices. Tests show that the established method performs well in clinical validation and repeatability trials. The requirement to use a neural network to analyze the implant lens images evolved from the analysis of over 1000 images using the established co-occurrence matrix segmentation method. The work shows that a method based on neural networks is a promising tool to automate the procedure of calculating PCO.

Barman, Sarah A.; Uyyanonvara, Bunyarit; Boyce, James F.; Sanguinetti, Giorgia; Hollick, Emma J.; Meacock, William R.; Spalton, David J.; Paplinski, Andrew P.

2000-06-01

423

Decoding Trajectories from Posterior Parietal Cortex Ensembles  

PubMed Central

High-level cognitive signals in the posterior parietal cortex (PPC) have previously been used to decode the intended endpoint of a reach, providing the first evidence that PPC can be used for direct control of a neural prosthesis (Musallam et al., 2004). Here we expand on this work by showing that PPC neural activity can be harnessed to estimate not only the endpoint but also to continuously control the trajectory of an end effector. Specifically, we trained two monkeys to use a joystick to guide a cursor on a computer screen to peripheral target locations while maintaining central ocular fixation. We found that we could accurately reconstruct the trajectory of the cursor using a relatively small ensemble of simultaneously recorded PPC neurons. Using a goal-based Kalman filter that incorporates target information into the state-space, we showed that the decoded estimate of cursor position could be significantly improved. Finally, we tested whether we could decode trajectories during closed-loop brain control sessions, in which the real-time position of the cursor was determined solely by a monkey’s neural activity in PPC. The monkey learned to perform brain control trajectories at 80% success rate(for 8 targets) after just 4–5 sessions. This improvement in behavioral performance was accompanied by a corresponding enhancement in neural tuning properties (i.e., increased tuning depth and coverage of encoding parameter space) as well as an increase in off-line decoding performance of the PPC ensemble. PMID:19036985

Mulliken, Grant H.; Musallam, Sam; Andersen, Richard A.

2009-01-01

424

Posterior likelihood methods for multivariate survival data.  

PubMed

This article deals with the semiparametric analysis of multivariate survival data with random block (group) effects. Survival times within the same group are correlated as a consequence of a frailty random block effect. The standard approaches assume either a parametric or a completely unknown baseline hazard function. This paper considers an intermediate solution, that is, a nonparametric function that is reasonably smooth. This is accomplished by a Bayesian model in which the conditional proportional hazards model is used with a correlated prior process for the baseline hazard. The posterior likelihood based on data, as well as the prior process, is similar to the discretized penalized likelihood for the frailty model. The methodology is exemplified with the recurrent kidney infections data of McGilchrist and Aisbett (1991, Biometrics 47, 461-466), in which the times to infections within the same patients are expected to be correlated. The reanalysis of the data has shown that the estimates of the parameters of interest and the associated standard errors depend on the prior knowledge about the smoothness of the baseline hazard. PMID:9883545

Sinha, D

1998-12-01

425

Posterior infectious crystalline keratopathy with Staphylococcus epidermidis.  

PubMed

Two cases of infectious crystalline keratopathy located in the posterior stroma after penetrating keratoplasty are presented. Topical steroids and suture removal were risk factors in both cases. In the first case, a moderate anterior chamber reaction was present. Crystalline infiltrates persisted on topical and systemic steroid therapy. In the second case, deep corneal ulceration, hypopyon, and vitreitis were noted. A vitreous aspirate showed rare gram-positive cocci in pairs. The corneal ulceration and crystalline keratopathy persisted despite intravitreal and topical antibiotics. Therapeutic penetrating keratoplasty was performed in both cases. Staphylococcus epidermidis sensitive to vancomycin was isolated from corneal tissue. Light microscopy documented aggregates of gram-positive bacteria anterior to Descemet's membrane, with an overlying keratitis. Electron microscopy in the second case showed all bacteria within stromal keratocytes. No clinical recurrence was seen using topical vancomycin. As demonstrated in the cases presented, infectious crystalline keratopathy can occur exclusively in the deeper layers of the cornea. Isolation of S. epidermidis, associated inflammation, and intraocular spread of organisms are rare findings. PMID:2255518

Lubniewski, A J; Houchin, K W; Holland, E J; Weeks, D A; Wessels, I F; McNeill, J I; Cameron, J D

1990-11-01

426

Accurate Approximations for Posterior Moments and Marginal Densities  

Microsoft Academic Search

This article describes approximations to the posterior means and variances of positive functions of a real or vector-valued parameter, and to the marginal posterior densities of arbitrary (i.e., not necessarily positive) parameters. These approximations can also be used to compute approximate predictive densities. To apply the proposed method, one only needs to be able to maximize slightly modified likelihood functions

Luke Tierney; Joseph B. Kadane

1986-01-01

427

Establishing the posterior palatal seal during the final impression stage.  

PubMed

A procedure for adding a posterior palatal seal at the final impression stage with green stick modeling compound is described. The location and degree of tissue displacement of the posterior palatal seal area are controlled by the dentist. This procedure is suggested to be more accurate than the arbitrary scraping of the master cast. PMID:9297652

Ansari, I H

1997-09-01

428

Establishing the posterior palatal seal during the final impression stage  

Microsoft Academic Search

A procedure for adding a posterior palatal seal at the final impression stage with green stick modeling compound is described. The location and degree of tissue displacement of the posterior palatal seal area are controlled by the dentist. This procedure is suggested to be more accurate than the arbitrary scraping of the master cast. (J Prosthet Dent 1997;78: 324-6.)

Izharul Haque Ansari

1997-01-01

429

Combined posterior and transaxillary approach for neurogenic thoracic outlet syndrome  

Microsoft Academic Search

Background: Incomplete removal of the first rib in operations intended to decompress the thoracic outlet is often seen after the single transaxillary approach (often leaving a posterior stump) or supraclavicular techniques (leaving an anterior stump). The former may also cause neurogenic and vascular injuries because the exposure is often poor in attempting complete removal of the first rib posteriorly and

J. Ernesto Molina

1998-01-01

430

Traumatic burst fracture with spinal channel involvement augmentation with bioactive strontium-hydroxyapatite cement.  

PubMed

In November 2011 a 75-year-old man was admitted to our emergency department with a low back pain caused by a traumatic L1 vertebral collapse with backward projection of posterior wall superior third. The indication for neurosurgical instrumentation was placed, although he refused the treatment. Hence he was treated conservatively without a significant improvement up to January 2012 when, still refusing surgery, he accepted to undergo percutaneous vertebroplasty with a novel bioactive injectable strontium-hydroxyapatite cement. Vertebroplasty was performed without complications. A CT scan, performed the day after the procedure, ruled out extravertebral cement leakage. Pain improvement was significant (preprocedure VAS 10, one-week VAS 4) with a gradual decrease up to three months when it stabilized at 2. CT examination after 1 year showed a good cement osseointegration with osteophytic spurs bridging the superior endplate of the level involved to the inferior one of the level above. The new bone ingrowing property of the strontium-hydroxyapatite containing cement permits to extend the treatment indication also to unstable collapses in which the risk of pseudoarthrosis is very high. In this reported case we evaluated the potential role of percutaneous vertebroplasty in traumatic burst fracture with spinal channel involvement. PMID:23984142

Masala, S; Calabria, E; Nano, G; Iundusi, R; Greco, L; Di Trapano, R; Tarantino, U; Simonetti, G

2013-01-01

431

Traumatic Burst Fracture with Spinal Channel Involvement Augmentation with Bioactive Strontium-Hydroxyapatite Cement  

PubMed Central

In November 2011 a 75-year-old man was admitted to our emergency department with a low back pain caused by a traumatic L1 vertebral collapse with backward projection of posterior wall superior third. The indication for neurosurgical instrumentation was placed, although he refused the treatment. Hence he was treated conservatively without a significant improvement up to January 2012 when, still refusing surgery, he accepted to undergo percutaneous vertebroplasty with a novel bioactive injectable strontium-hydroxyapatite cement. Vertebroplasty was performed without complications. A CT scan, performed the day after the procedure, ruled out extravertebral cement leakage. Pain improvement was significant (preprocedure VAS 10, one-week VAS 4) with a gradual decrease up to three months when it stabilized at 2. CT examination after 1 year showed a good cement osseointegration with osteophytic spurs bridging the superior endplate of the level involved to the inferior one of the level above. The new bone ingrowing property of the strontium-hydroxyapatite containing cement permits to extend the treatment indication also to unstable collapses in which the risk of pseudoarthrosis is very high. In this reported case we evaluated the potential role of percutaneous vertebroplasty in traumatic burst fracture with spinal channel involvement. PMID:23984142

Masala, S.; Calabria, E.; Nano, G.; Iundusi, R.; Greco, L.; Di Trapano, R.; Tarantino, U.; Simonetti, G.

2013-01-01

432

Efficacy of various single-dose regimens of ceftriaxone in uncomplicated acute gonococcal urethritis in adult males.  

PubMed

The therapeutic efficacy of single intramuscular doses of ceftriaxone (Rocephin; Roche) (62.5, 125 and 250 mg), administered without probenecid, was evaluated in 167 adult males with uncomplicated acute gonococcal urethritis. Cure rates of 100% were achieved at 62.5 mg and 250 mg. In the 125 mg dose group, Neisseria gonorrhoeae was isolated from 1 patient at follow-up after therapy. Reinfection was suspected, since this patient returned on day 10 and admitted to sexual contact 2 days previously. Side-effects were minimal, and patient acceptance was better for ceftriaxone dissolved in lignocaine than in sterile water. Chlamydia trachomatis was detected at follow-up in 14.4% patients, confirming that ceftriaxone has no significant effect on chlamydial infection and additional treatment is necessary for patients with coexistent infection. PMID:2116670

Hoosen, A A; O'Farrell, N; Coetzee, K D; van den Ende, J

1990-08-18

433

Selective posterior rhizotomy for lower extremity spasticity: how much and which of the posterior rootlets should be cut?  

Microsoft Academic Search

BACKGROUNDIt is well known that selective posterior rhizotomy is effective for relieving spasticity associated with cerebral palsy. However, there is significant variation between surgeons in terms of how much and which of the posterior rootlets should be cut for the improvement of ambulatory function without causing adverse effects.METHODSThe study population was composed of 200 CP patients who underwent SPR more

Dong-Seok Kim; Joong-Uhn Choi; Kook-Hee Yang; Chang-Il Park; Eun-Sook Park

2002-01-01

434

Posterior fossa syndrome after cerebellar stroke.  

PubMed

Posterior fossa syndrome (PFS) due to vascular etiology is rare in children and adults. To the best of our knowledge, PFS due to cerebellar stroke has only been reported in patients who also underwent surgical treatment of the underlying vascular cause. We report longitudinal clinical, neurocognitive and neuroradiological findings in a 71-year-old right-handed patient who developed PFS following a right cerebellar haemorrhage that was not surgically evacuated. During follow-up, functional neuroimaging was conducted by means of quantified Tc-99m-ECD SPECT studies. After a 10-day period of akinetic mutism, the clinical picture developed into cerebellar cognitive affective syndrome (CCAS) with reversion to a previously learnt accent, consistent with neurogenic foreign accent syndrome (FAS). No psychometric evidence for dementia was found. Quantified Tc-99m-ECD SPECT studies consistently disclosed perfusional deficits in the anatomoclinically suspected but structurally intact bilateral prefrontal brain regions. Since no surgical treatment of the cerebellar haematoma was performed, this case report is presumably the first description of pure, "non-surgical vascular PFS". In addition, reversion to a previously learnt accent which represents a subtype of FAS has never been reported after cerebellar damage. The combination of this unique constellation of poststroke neurobehavioural changes reflected on SPECT shows that the cerebellum is crucially implicated in the modulation of neurocognitive and affective processes. A decrease of excitatory impulses from the lesioned cerebellum to the structurally intact supratentorial network subserving cognitive, behavioural and affective processes constitutes the likely pathophysiological mechanism underlying PFS and CCAS in this patient. PMID:23575947

Mariën, Peter; Verslegers, Lieven; Moens, Maarten; Dua, Guido; Herregods, Piet; Verhoeven, Jo

2013-10-01

435

Aspheric versus Spherical Posterior Chamber Intraocular Lenses  

PubMed Central

Purpose To compare spherical aberration and contrast sensitivity function following implantation of four different foldable posterior chamber intraocular lenses (IOLs), namely Sensar, Akreos AO, Tecnis, and AcrySof IQ. Methods In this randomized clinical trial, 68 eyes of 68 patients with senile cataracts underwent phacoemulsification and IOL implantation with Sensar (n=17), Akreos AO (n=17), Tecnis (n=17), or AcrySof IQ (n=17). Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), spherical aberration and contrast sensitivity function (CSF) were compared among the study groups, 3 months after surgery. Results There was no significant difference between the study groups in terms of age (P = 0.21). Mean postoperative BSCVA with Sensar, Akreos AO, Tecnis, and AcrySof IQ was 0.15±0.10, 0.12±0.9, 0.08±0.08, and 0.08±0.07 logMAR, respectively (P=0.08). Spherical aberration measured over a 4 mm pupil was significantly higher with Sensar and Akreos AO than the two other IOLs. The difference between Tecnis and AcrySof IQ was significantly in favor of the former IOL. Over a 6 mm pupil, spherical aberrations were comparable with Sensar and Akreos AO, furthermore spherical aberration was also comparable among eyes implanted with Akreos AO, AcrySof IQ, and Tecnis. Sensar yielded significantly inferior results as compared to Acrysof IQ and Tecnis. CSF with Sensar was inferior to the three aspheric IOLs at the majority of spatial frequencies. Tecnis yielded significantly better mesopic CSF at 1.5 and 3 cycles per degree spatial frequencies. Conclusion Tecnis and AcrySof IQ provided significantly better visual function as compared to Sensar and Akreos AO, especially with smaller pupil size. However, this difference diminished with increasing pupil size. PMID:22737364

Jafarinasab, Mohammad-Reza; Feizi, Sepehr; Baghi, Ahmad-Reza; Ziaie, Hossein; Yaseri, Mehdi

2010-01-01

436

Phonological decoding involves left posterior fusiform gyrus.  

PubMed

Aloud reading of novel words is achieved by phonological decoding, a process in which grapheme-to-phoneme conversion rules are applied to "sound out" a word's spoken representation. Numerous brain imaging studies have examined the neural bases of phonological decoding by contrasting pseudoword (pronounceable nonwords) to real word reading. However, only a few investigations have examined pseudoword reading under both aloud and silent conditions, task parameters that are likely to significantly alter the functional anatomy of phonological decoding. Subjects participated in an fMRI study of aloud pseudoword, aloud real word, silent pseudoword, and silent real word reading. Using this two-by-two design, we examined effects of word-type (real words vs. pseudowords) and response-modality (silent vs. aloud) and their interactions. We found 1) four regions to be invariantly active across the four reading conditions: the anterior aspect of the left precentral gyrus (Brodmann's Area (BA) 6), and three areas within the left ventral occipitotemporal cortex; 2) a main effect of word-type (pseudowords > words) in left inferior frontal gyrus and left intraparietal sulcus; 3) a main effect of response-modality (aloud > silent) that included bilateral motor, auditory, and extrastriate cortex; and 4) a single left hemisphere extrastriate region showing a word-type by response-modality interaction effect. This region, within the posterior fusiform cortex at BA 19, was uniquely modulated by varying phonological processing demands. This result suggests that when reading, word forms are subject to phonological analysis at the point they are first recognized as alphabetic stimuli and BA 19 is involved in processing the phonological properties of words. PMID:15934062

Dietz, Nicole A E; Jones, Karen M; Gareau, Lynn; Zeffiro, Thomas A; Eden, Guinevere F

2005-10-01

437

Urethral stricture vaporization with the KTP laser provides evidence for a favorable impact of laser surgery on wound healing  

NASA Astrophysics Data System (ADS)

The objective of this study was to evaluate and compare the safety and efficacy of the KTP 532 laser to direct vision internal urethrotomy (DVIU) in the management of urethral strictures. A total of 32 patients were randomized prospectively in this study, 14 DVIU and 18 KTP 532 laser. Patients were evaluated postoperatively with flowmetry and in the case of recurrence with cystourethrography at 3, 12, 24 weeks. With the KTP 532 laser complete symptomatic and uredynamic success was achieved in 15 (83%) patients at 12 and 24 weeks. Success rate was lower in the DVIU group with 9 (64%) patients at 12 weeks and 8 (57%) patients at 24 weeks. Mean preoperative peak-flow was improved from 6 cc/s to 20 cc/s at 3, 12 and 24 weeks with the KTP laser. With DVIU mean preoperative peak-flow was improved from 5.5 cc/s to 20 cc/s at 3 weeks followed by a steady decrease to 13 cc/s at 12 weeks and to 12 cc/s 24 weeks. No complication was observed in either group of patients. Our results confirm that stricture vaporization with the KTP 532 laser is a safe and efficient procedure. The better results after laser surgery make it also a valuable alternative in the endoscopic treatment of urethral strictures. These findings suggest a favorable influence of laser surgery on wound healing with less wound contraction and scarring. The lack of contraction of laser wounds might be related to the absence and the lack of organization of myofibroblasts in laser induced lesions.

Schmidlin, Franz R.; Venzi, Giordano; Jichlinski, Patrice; Oswald, Michael; Delacretaz, Guy P.; Gabbiani, Giulio; Leisinger, Hans-Juerg; Graber, Peter

1997-12-01

438

Dose perturbation due to the presence of a prostatic urethral stent in patients receiving pelvic radiotherapy: an in vitro study.  

PubMed

Temporary metallic intraprostatic stent is a new alternative treatment for patients with urinary obstructive syndrome caused by prostate cancer. Definitive radiotherapy is a treatment of choice for localized prostate cancer. This study evaluates in vitro the effect of a urethral intraprostatic metallic stent on the dose absorbed by the surrounding tissue. The study was designed to mimic the conditions under which the prostatic stent is placed in the body during pelvic irradiation. A urethral stent composed of a 50% nickel-50% titanium alloy (Uracoil-InStent) was imbedded in material mimicking normal tissue (bolus) at a simulated body depth of 10 cm. The distribution of the absorbed dose of irradiation was determined by film dosimetry using Kodak X-Omat V film. Irradiation was done in a single field at the isocenter of a 6 MV linear accelerator with a field size of 7 x 7 cm. The degree of film blackening was in direct proportion to the absorbed dose. The measurements showed an increase in dose of up to 20% immediately before the stent and a decrease of up to 18% immediately after the stent. These changes occurred within a range of 1-3 mm from both sides of the stent. In practice, irradiation in prostate cancer is given by two pairs of opposed co-axial fields; a total of four fields (Box Technique). The dose perturbations are partly cancelled in a pair of opposed beams resulting in a net variation of +/- 4%; therefore, the presence of the intraprostatic stent should not influence radiotherapy planning for prostate cancer. PMID:9243465

Gez, E; Cederbaum, M; Yachia, D; Bar-Deroma, R; Kuten, A

1997-01-01

439

Retention of clinical trial participants in a study of nongonococcal urethritis (NGU), a sexually transmitted infection in men.  

PubMed

Nongonococcal urethritis (NGU), an inflammation of the urethra not caused by gonorrhea, is the most common urethritis syndrome seen in men in the United States. It is a sexually transmitted infection commonly caused by Chlamydia trachomatis, a pathogen which occurs more frequently in African-American men compared to white men. The purpose of this study was to investigate factors related to retention of study participants in a randomized, double-blinded clinical trial that evaluated four treatment regimens for the treatment of NGU. After the one-week treatment period, follow-up visits were scheduled during days 15-19 and days 35-45. Participants were phoned prior to scheduled appointments to encourage attendance, and contacted after missed appointments to reschedule their clinic visits. Of the 305 male study participants, 298 (98%) were African-American, 164 (54%) were 25 years of age or younger, and 80 (31%) had a post-secondary school education. The overall retention rate was 75%. Factors associated with study completion were educational level attained and clinical center. Participants with higher levels of education were more likely to complete the study. Clinical centers with the highest retention rates also provided the highest monetary incentives for participation. The retention rate for this study suggests that strategies are needed for improving the proportion of study participants that complete a clinical trial among young men with a sexually transmitted disease. These strategies may include increasing contacts with study participants to remind them of scheduled study visits using text messaging or social media and the use of financial incentives. PMID:22261236

Lee, Jeannette Y; Lensing, Shelly Y; Schwebke, Jane R

2012-07-01

440

Traumatic injuries caused by hazing practices.  

PubMed

Hazing is defined as committing acts against an individual or forcing an individual into committing an act that creates a risk for harm in order for the individual to be initiated into or affiliated with an organization. Hazing is an enduring activity with roots that date back to the ancient and medieval eras. It has become increasingly prevalent in fraternities and sororities, high school and college athletic organizations, the military, professional sports teams, and street gangs. Scant information is available in the medical literature regarding hazing. This article reviews the history of hazing, provides statistics regarding its prevalence, presents information on specific hazing practices and consequent traumatic injuries, and assesses alcohol's influence on hazing. It also offers recommendations on how to recognize victims of hazing in the Emergency Department and proposes guidelines for their treatment. Current legislation and information on the prevention of traumatic injuries from hazing are discussed. PMID:11992345

Finkel, Michelle A

2002-05-01

441

Retinal detachment associated with traumatic chorioretinal rupture.  

PubMed

Traumatic chorioretinal rupture, also known as sclopetaria, is a full-thickness break of the choroid and retina caused by a high-velocity projectile striking or passing adjacent to, but not penetrating, the globe. Previous reports have emphasized that retinal detachment seldom occurs, and observation alone has been the recommended management strategy. However, the authors present herein a series of consecutive patients with retinal detachment associated with sclopetaria and provide a literature review of the topic. They recommend that patients with traumatic chorioretinal rupture be monitored closely for the development of retinal detachment during the first few weeks after the injury. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:451-455.]. PMID:25153657

Papakostas, Thanos D; Yonekawa, Yoshihiro; Wu, David; Miller, John B; Veldman, Peter B; Chee, Yewlin E; Husain, Deeba; Eliott, Dean

2014-09-01

442

Position statement: definition of traumatic brain injury.  

PubMed

A clear, concise definition of traumatic brain injury (TBI) is fundamental for reporting, comparison, and interpretation of studies on TBI. Changing epidemiologic patterns, an increasing recognition of significance of mild TBI, and a better understanding of the subtler neurocognitive neuroaffective deficits that may result from these injuries make this need even more critical. The Demographics and Clinical Assessment Working Group of the International and Interagency Initiative toward Common Data Elements for Research on Traumatic Brain Injury and Psychological Health has therefore formed an expert group that proposes the following definition: In this article, we discuss criteria for considering or establishing a diagnosis of TBI, with a particular focus on the problems how a diagnosis of TBI can be made when patients present late after injury and how mild TBI may be differentiated from non-TBI causes with similar symptoms. Technologic advances in magnetic resonance imaging and the development of biomarkers offer potential for improving diagnostic accuracy in these situations. PMID:21044706

Menon, David K; Schwab, Karen; Wright, David W; Maas, Andrew I

2010-11-01

443

New mechanics of traumatic brain injury.  

PubMed

The prediction and prevention of traumatic brain injury is a very important aspect of preventive medical science. This paper proposes a new coupled loading-rate hypothesis for the traumatic brain injury (TBI), which states that the main cause of the TBI is an external Euclidean jolt, or SE(3)-jolt, an impulsive loading that strikes the head in several coupled degrees-of-freedom simultaneously. To show this, based on the previously defined covariant force law, we formulate the coupled Newton-Euler dynamics of brain's micro-motions within the cerebrospinal fluid and derive from it the coupled SE(3)-jolt dynamics. The SE(3)-jolt is a cause of the TBI in two forms of brain's rapid discontinuous deformations: translational dislocations and rotational disclinations. Brain's dislocations and disclinations, caused by the SE(3)-jolt, are described using the Cosserat multipolar viscoelastic continuum brain model. PMID:19031012

Ivancevic, Vladimir G

2009-09-01

444

Current management of traumatic thoracic aortic injury.  

PubMed

Traumatic aortic rupture is a devastating injury that is difficult to manage because of the need to approach aortic repair, often in concert with management of complex associated injuries to nonvascular organ systems. Traditional open repair, while effective in the long-term, is associated with a periprocedural mortality between 10% and 20%, along with a 5% risk of stroke and up to a 5% risk of spinal chord ischemia. The advent of endovascular stent graft repair has allowed single centers to cut periprocedural mortality in half and decrease the risk of major neurologic events to <2%. It is unlikely that a multicenter prospective randomized trial will ever be performed to evaluate these two procedures. However, several large meta-analyses have been published recently, along with a clinical practice guideline from the Society for Vascular Surgery. The purpose of this article is to review the trends and current concepts in the management of traumatic rupture of the thoracic aorta. PMID:21194638

Kwolek, Christopher J; Blazick, Elizabeth

2010-12-01

445

77 FR 32397 - Servicemembers' Group Life Insurance Traumatic Injury Protection Program-Genitourinary Losses  

Federal Register 2010, 2011, 2012, 2013

...RIN 2900-AO20 Servicemembers' Group Life Insurance Traumatic Injury Protection Program...regulations governing the Servicemembers' Group Life Insurance Traumatic Injury Protection...that expanded the Servicemembers' Group Life Insurance Traumatic Injury...

2012-06-01

446

Pharmacotherapy of Post-Traumatic Stress Disorder  

Microsoft Academic Search

\\u000a Post-traumatic stress disorder (PTSD) is a prevalent psychiatric disorder that may result in significant social and occupational\\u000a debilitation unless symptoms are recognized and treated appropriately. Considerable research effort has been devoted over\\u000a the last 20years to developing effective pharmacological treatments for this illness. At this time, the bulk of the agents\\u000a investigated include antidepressants, anticonvulsants, atypical antipsychotics, benzodiazepines, and antiadrenergic

Lakshmi N. Ravindran; Murray B. Stein

447

Traumatic Events and Posttraumatic Stress in Childhood  

Microsoft Academic Search

Results: More than two thirds of children reported at least 1 traumatic event by 16 years of age, with 13.4% of thosechildrendevelopingsomePTSsymptoms.FewPTS symptoms or psychiatric disorders were observed for in- dividuals experiencing their first event, and any effects were short-lived. Less than 0.5% of children met the cri- teria for full-blown DSM-IV PTSD. Violent or sexual trauma were associated with

William E. Copeland; Gordon Keeler; Adrian Angold; E. Jane Costello

2007-01-01

448

The Process of Transcending a Traumatic Childhood  

Microsoft Academic Search

This study used a qualitative, exploratory approach to develop a conceptual framework that illustrated the process by which\\u000a spirituality emerged as one of the processes that helped people transcend a traumatic childhood. Ninety people described how\\u000a they survived and transcended the difficult time. This article outlines the stages of the developmental process that culminated\\u000a for many in a deeper spiritual

Linda Skogrand; Archana Singh; Scot Allgood; John DeFrain; Nikki DeFrain; Jean E. Jones

2007-01-01

449

Foreign accent syndrome following traumatic brain injury.  

PubMed

Foreign accent syndrome (FAS) is a very rare disorder, caused by lesions of the dominant brain hemisphere and defined as a loss of normal phonetic contrast when using the mother language. The pronunciation is perceived by native speakers as compromised by a foreign accent. This study reports about a 35-years old woman, with a FAS following a brain injury with a traumatic left temporal haemorrhage, who experienced excellent remission after 2 years. PMID:16243750

Lippert-Gruener, M; Weinert, U; Greisbach, T; Wedekind, C

2005-10-01

450

Burnout, Secondary Traumatic Stress, and Social Support  

Microsoft Academic Search

The current study examines the extent to which selected work-related variables differentially predict burnout and secondary\\u000a traumatic stress (STS) and the degree to which social support mitigates both of these occupational stress syndromes. Multiple\\u000a regression performed on responses from 331 professional chaplains found that: (1) the number of years worked in the same employment\\u000a position was positively associated with burnout

Kathleen Galek; Kevin J. Flannelly; Paul B. Greene; Taryn Kudler

451

Suicidal behavior after a traumatic event.  

PubMed

This article reviews the literature on the psychosocial and psychiatric consequences (such as a diagnosis of posttraumatic stress disorder and elevated suicide risk) for a range of traumatic life experiences, including military combat, criminal victimization, interpersonal and domestic violence, child abuse and neglect, sexual retraumatization, natural disasters, torture, and the Holocaust. Possible mechanisms mediating the relationship between trauma and suicide are presented along with suicide risk assessment implications for trauma nurses. PMID:19543020

Krysinska, Karolina; Lester, David; Martin, Graham

2009-01-01

452

Traumatic dislocation of testes and bladder rupture.  

PubMed

Traumatic dislocation of the testes with bladder rupture occurred in 2 multiply injured patients with pelvic fracture. One had a history of retractile testes and the other of previous testicular dislocation. Surgical correction was performed after closed reduction failed. These injuries must be recognized and treated promptly to maximize the likelihood of testicular salvage. If early intervention is not possible, duplex ultrasonography and pulsed Doppler analysis are the optional valuative studies. PMID:1466102

Lee, J Y; Cass, A S; Streitz, J M

1992-12-01

453

Cognitive Control Impairments in Traumatic Brain Injury  

Microsoft Academic Search

The componential nature of impaired cognitive control following traumatic brain injury (TBI) remains uncertain. We examined regulative and evaluative components of cognitive control in mild and moderate-to-severe (M\\/S) TBI patients and demographically-matched comparison participants using the AX-CPT task. We also examined relationships of cognitive control impairment to ratings of cognitive, behavioral, and affective symptomatology on the Dysexecutive Questionnaire (DEX). Results

Michael J. Larson; William M. Perlstein; Jason A. Demery; David A. Stigge-Kaufman

2006-01-01

454

Psychotic disorder caused by traumatic brain injury.  

PubMed

Psychosis is a rare and severe sequela of traumatic brain injury (TBI). This article assists clinicians in differential diagnosis by providing literature-based guidance with regard to use of the Diagnostic and Statistical Manual for Mental Disorders 5 criteria for this condition. This article also describes potential relationships between TBI and the development of a psychosis within the conceptualization of psychosis as a neurobehavioral syndrome. PMID:24529427

Fujii, Daryl E; Ahmed, Iqbal

2014-03-01

455

Post-traumatic stress disorder in veterans.  

PubMed

Over 2000 general practice encounters per year (2.3%) in BEACH are with repatriation health card holders, referred to here as veterans. The patients are veterans of Australia's defence force or war widows, widowers or dependent children. We compared the rate at which post-traumatic stress disorder (PTSD) was managed among veterans and non-veterans from April 2009 to June 2014. PMID:25393458

Charles, Janice; Harrison, Christopher; Britt, Helena

2014-11-01

456

Treatment of traumatic brain injury in pediatrics  

Microsoft Academic Search

Opinion statement  The primary goal in treating any pediatric patient with severe traumatic brain injury (TBI) is the prevention of secondary\\u000a insults such as hypotension, hypoxia, and cerebral edema. Despite the publication of guidelines, significant variations in\\u000a the treatment of severe TBI continue to exist, especially in regards to intracranial pressure (ICP)-guided therapy. This variability\\u000a in treatment results mainly from a

Andranik Madikians; Christopher C. Giza

2009-01-01