Sample records for traumatic posterior urethral

  1. Evaluation of early endoscopic realignment of post-traumatic complete posterior urethral rupture

    PubMed Central

    Abdelsalam, Yaser M; Abdalla, Medhat A; Safwat, Ahmad S; ElGanainy, Ehab O

    2013-01-01

    Introduction: to report our experience with 41 patients treated by early endoscopic realignment of complete post-traumatic rupture urethra. Materials and Methods: The study includes patients presented to our institute, between May 2004 and April 2009, with post-traumatic complete posterior urethral disruption. Preoperative retrograde urethrography, voiding cystourethrography and abdominopelvic CT were performed to evaluate the urethral defect length, the bladder neck competence, the prostate position, and the extent of the pelvic hematoma. Within the first week after trauma, antegrade and retrograde urethroscopy were performed to identify both urethral ends and insert urethral catheter. Patients were followed up by pericatheter retrograde urethrogram monthly postoperatively till catheter removal on disappearance of extravasation. Retrograde urethrography, voiding cystourethrography and urethroscopy were performed 1 month after the removal of the catheter. Follow-up abdominal ultrasound and uroflowmetry monthly till 6 months, bimonthly till 1 year, and every 3 months thereafter were encouraged. Urinary continence and postoperative erectile dysfunction were assessed by direct patient interview. Results: Forty one patients in the age group 17-61 years (mean 37.9) were treated. Patients were followed up for Conclusions: Early endoscopic realignment for complete posterior urethral rupture is a feasible technique with no or minimal intraoperative complications. The technique is successful as the definitive line of therapy in reasonable number of patients and seems to render further future interventions for inevitable urethral stricture easier. PMID:24082438

  2. Traumatic female urethral avulsion.

    PubMed

    Al-Asbahi, Walid A

    2015-03-01

    Traumatic female urethral avulsion in the absence of a pelvic fracture is an exceedingly rare entity, with no consensus on its' management. Here, we present a 35-year-old pregnant woman with severe anterior vaginal wall laceration and complete urethral avulsion secondary to straddle injury. Management consisted of primary urethral and vaginal repair. Saudi Med J 2015; Vol. 36 (3): 366-367doi: 10.15537/smj.2015.3.10399   PMID:25737183

  3. Urethral strictures after fulguration of posterior urethral valves.

    PubMed

    Lal, R; Bhatnagar, V; Mitra, D K

    1998-03-01

    This report discusses the incidence and predisposing factors for postfulguration urethral strictures in 82 boys with posterior urethral valves treated over 20 years and followed up for a period ranging from 1 to 21 years. A urethral stricture developed in three of the 82 patients (3.6%). All newborns and infants with small urethral caliber at presentation were treated on a temporary tubeless diversion, and fulguration of the valves was deferred until 9 to 12 months of age. A 9F resectoscope with a loop electrode was used to fulgurate at 5, 7, and 12 o'clock positions. A definite technical factor leading to a stricture could be identified in one of these three patients. Comparison of the "stricture" group with the "no stricture" group suggested that although dry fulguration did not have a definite correlation with stricture formation, it is best avoided. Refulguration and properly managed preoperative catheterization did not predispose to stricture formation. Meticulous surgical technique and avoiding oversized instrumentation were the most important factors for preventing this complication. PMID:9537571

  4. Minimally invasive surgical approach to treat posterior urethral diverticulum

    PubMed Central

    Alsowayan, Ossamah; Almodhen, Fayez; Alshammari, Ahmed

    2015-01-01

    Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. The mainstay treatment of posterior urethral diverticulum (PUD) is the open surgical approach. Here we discuss our minimally invasive surgical approach (MIS) in managing posterior urethral diverticulum.

  5. Late presentation of posterior urethral valves.

    PubMed

    Jalbani, Imran Khan; Biyabani, Syed Raziuddin

    2014-05-01

    Presence of posterior urethral valves (PUV) is the most common cause of urinary tract obstruction in the male neonate. Late presentation occurs in 10% of cases. We present a case of PUVs in an adult male who presented with history of obstructive lower urinary tract symptoms and hematuria. On evaluation, he was found to have raised serum creatinine level. A voiding cystourethrogram (VCUG) could not be completely performed because of narrowing in the posterior urethra. A rigid urethrocystoscopy was performed at which he was found to have type-I posterior urethral valve which were fulgurated. A repeat uroflowmetry revealed maximum flow rate of 12 ml/second. This case highlights that PUVs is not solely a disease of infancy but may also present late. VCUG is the radiological investigation of choice but the diagnosis may be missed. A urethrocystoscopy is advised if there is a high index of suspicion. PMID:24906275

  6. Multiple urethral anomalies: anterior urethral diverticulum, posterior urethral valves, and distal hypospadias.

    PubMed

    Ranawaka, Ravibindu; Dickson, Alan P

    2013-01-01

    We report an infant with antenatally detected bilateral hydroureteronephrosis and a penile cyst who was eventually diagnosed with an anterior urethral diverticulum (AUD), subcoronal hypospadias, and posterior urethral valves (PUV) after birth. To our knowledge, there are no reports where all three anomalies have been found to coexist. As per urethral catheterisation was difficult, cystoscopy-guided catheterisation was performed. On retracting the complete foreskin, a subcoronal hypospadias was identified. The AUD was resected partially, and during a cystoscopy for completion of AUD resection, a dilated anterior urethra was found collapsed, and thin PUV were identified and divided. He remains well at nine months with an improving renal cortical thickness. The vesicoureteric reflux had resolved. PMID:23331841

  7. Outcome of endoscopic fulguration of posterior urethral valves in children.

    PubMed

    Gupta, S D; Khatun, A A; Islam, A I; Shameem, I A

    2009-07-01

    Posterior urethral valves are the most common cause of congenital obstructive uropathy leading to renal failure in childhood. This study was undertaken to assess the outcome of endoscopic fulguration of posterior urethral valves based upon the clinical, radiological and laboratory findings. This prospective study was carried out on 50 male children with posterior urethral valves who were treated by endoscopic fulguration and came for routine follow-up. Diagnosis of posterior urethral valves (PUV) was confirmed by voiding cystourethrogram (VCUG). After valve ablation, urine R/M/E, urine for culture and sensitivity test, serum creatinine level, USG of KUB including PVR were done in all cases at 1,3,6,12 months and then at six months interval maximum up to 3 years. Mean age of the patients was 2 years ranging from 1 to 12 years old. Mean follow-up period was 30.48 months after valve ablation. At diagnosis mean serum creatinine +/-SD was 90.4+/-44.8 mumol/lit and it decreased to 56.3+/-11.1micromol/lit at the end of 3-years follow-up. Hydronephrotic changes decreased from 84% to 4%. Proteinuria decreased from 38% to 6% and urinary tract infections decreased from 58% to 4% at the end of final follow up. Although the techniques for posterior urethral valves ablation have been refined and the short-term management of patients with posterior urethral valves has improved remarkably, there is growing concern about the long-term outcome. At present endoscopic fulguration with observation is the treatment of choice for posterior urethral valves. In this study patients improved dramatically following fulguration of posterior urethral valves. Early diagnosis and appropriate therapy may arrest progressive damage and facilitate recovery. Further follow-up studies of longer duration are needed. PMID:19623154

  8. Posterior Urethral Valves; A single Center Experience

    PubMed Central

    Mirshemirani, Alireza; Khaleghnejad, Ahmad; Rouzrokh, Mohsen; Sadeghi, Afsaneh; Mohajerzadeh, Leila; Sharifian, Mustafa

    2013-01-01

    Objective Posterior urethral valves (PUV) are the most common cause of bladder outlet obstruction in infancy that impair renal and bladder function. This study was planned to evaluate and record the various clinical presentations and management, complications, and surgical management and long-term outcome of PUV. Methods In a retrospective study, 98 patients who have been treated for PUV are evaluated in Mofid Children's Hospital from January 2007 to December 2012. Detailed history taken and paraclinical examinations were performed in each patient and diagnosis was confirmed by voiding-cysto-urethrography (VCUG). PUV had been ablated in 62 patients by electric hook, and diversion was performed in 42 (42.85%) cases. Data were analyzed by SPSS software version18. Findings Totally 98 patients with mean age at diagnosis 62 (±13) days were included in this study. Fifty seven cases had been catheterized within one to 6 days of life (mean age one day), PUV was ablated in 62 patients by electric hook, and diversion was performed in 42 cases. The most common symptom in our group was dribbling poor stream 51% and urinary tract infection (UTI) 40.8%. There was vesico-ureteral-reflux (VUR) in 61.2%, and hydronephrosis in 82.6%. Most common associated anomaly was kidney anomalies (multicystic kidney disease and renal agenesis/dysplasia) in 8 (8.2%) patients. Twenty patients had prenatal diagnosis of PUV. Complication occurred in three (3.1%) patients. Mortality occurred in 5 (5.1%) patients. Mean follow-up period was 3.4±1.2 years (1.5 months to 5 years). Conclusion Urinary drainage by feeding tube in early days of infancy, followed by valve ablation is the best treatment in PUV, and urinary diversion improves the outcome. VCUG is still the gold-standard imaging modality for documenting PUVs. The factors like renal dysplasia and UTI have their role in final outcome. PMID:24800012

  9. Bilateral epididymitis in a child with undiagnosed posterior urethral valves.

    PubMed

    Kwong, Justin; Lorenzo, Armando J; DeMaria, Jorge; Braga, Luis H P

    2013-07-01

    Posterior urethral valves are most commonly detected in the early neonatal period, the diagnosis often antenatally suspected from ultrasound findings. Nevertheless, some cases might go undetected and become manifest later in life with lower urinary tract symptoms. We describe the unusual case of a 5-year-old boy with a 2-month history of bladder distension, urinary dribbling, and epididymitis. Cystourethrography revealed posterior urethral valves with reflux into the seminal vesicles, vas deferens, and epididymis, bilaterally. A review of the published data is provided in the context of this unusual presentation pattern. PMID:23477755

  10. Rare association of fetal posterior urethral valve with ureteric stricture

    PubMed Central

    Pradhan, Mandakini; Singh, Neeta; Singh, Asha Kumari; Kumari, Neeraj

    2012-01-01

    Background Amongst the various causes of obstructive uropathies, pelviureteric junction obstruction, bilateral ureterovesical junction obstruction and vesicoureteral reflux are common. The association of posterior urethral valve and ureteric stricture has not been reported so far. Case We report a rare case of fetal obstructive uropathy presenting as combination of ureteric stricture with posterior urethral valve and its consequences like cystic dysplastic kidneys and urinoma. Conclusion Combination of urinary malformation may be due to basic primary pathology and its secondary consequence at a distant site. PMID:22905302

  11. Incidence of urethral disruption in females with traumatic pelvic fractures.

    PubMed

    Carter, C T; Schafer, N

    1993-05-01

    According to the National Center for Health Statistics, in 1986 1.4 million female patients in the United States were admitted to inpatient and short-stay nonfederal hospitals as a result of injuries acquired secondary to trauma. Of these, 45,000 had traumatic pelvic fractures. Rupture of the urethra is the most important lower urinary tract injury associated with traumatic pelvic fracture because of the high incidence of serious complications, such as urethral stricture and incontinence. To our knowledge, there are no satisfactory studies in the English literature documenting the incidence of urethral disruption in females with traumatic pelvic fractures. The records of all women patients with pelvic fractures registered in the Latter Day Saints Hospital trauma registry between July 1, 1981 and August 31, 1987 were reviewed. Of 146 female patients with traumatic pelvic fractures who were hospitalized during this period, none was found to have an urethral injury. Two patients (1.4%) had bladder contusions, and one (.7%) had a bladder rupture. This was the first large series attempting to identify the true incidence of urethral disruption in females with traumatic pelvic fracture, and it was found to be a rare occurrence. PMID:8489661

  12. Urethritis

    MedlinePLUS

    ... urethritis into two categories: gonococcal urethritis, caused by gonorrhea bacteria, and nongonococcal urethritis, caused by bacteria other than gonorrhea. Gonococcal urethritis , commonly called clap, is caused by ...

  13. Posterior urethral valves presented at birth despite normal prenatal ultrasound scans.

    PubMed

    Moslehi, J; Herndon, C D; McKenna, P H

    2001-06-01

    Most patients with significant posterior urethral valves are identified antenatally. However, even with a normal antenatal ultrasound scan, posterior urethral valves may be detected after birth. We present a patient with significant upper urinary tract involvement identified 2 days after birth, despite a normal third-trimester antenatal ultrasound scan. PMID:11377342

  14. Urethritis

    MedlinePLUS

    ... E. coli ) and some sexually transmitted diseases ( chlamydia , gonorrhea ) can lead to urethritis. Viral causes of urethritis ... women only) Urinalysis and urine cultures Tests for gonorrhea , chlamydia , and other sexually transmitted illnesses (STI) Urethral ...

  15. Vesicourethral fistula after retrograde primary endoscopic realignment in posterior urethral injury.

    PubMed

    Arora, Rajat; John, Nirmal Thampi; Kumar, Santosh

    2015-01-01

    A 22-year-old male patient presented with iatrogenic vesicourethral fistula after immediate retrograde endoscopic realignment of urethra after a posterior urethral injury associated with pelvic fracture. PMID:25440761

  16. Posterior urethral valve: Prognostic factors and renal outcome

    PubMed Central

    Bhadoo, Divya; Bajpai, Minu; Panda, Shasanka Shekhar

    2014-01-01

    Objective: The aim was to study the outcome of posterior urethral valve (PUV) cases treated by stepladder protocol and the prognostic factors affecting the outcome. Materials and Methods: Hospital records of all PUV patients treated by stepladder protocol between January 1992 and December 2013 were reviewed. The studied parameters were: Age at presentation, serum creatinine, types of surgical intervention, vesicoureteral reflux (VUR) on initial voiding cystourethrogram (VCUG), renal cortical scars, plasma renin activity (PRA), and glomerular filtration rate (GFR). Results: Of 396 PUV patients treated during the study period, 152 satisfied study criteria. The age at presentation ranged from 2 days to 15 years (mean 31.3 months). The mean follow-up period was 5 years (range: 2-18 years). Primary endoscopic valve ablation was the most common initial procedure. Chronic renal failure was seen in 42.7% patients at the last follow-up. Serum creatinine at presentation, initial PRA levels, initial GFR, and PRA levels at last follow-up were significant predictors of final renal outcome. Age at presentation (<1 vs. >1 year), presence/absence of VUR on initial VCUG and renal cortical scars had no significant correlation with ultimate renal function. Conclusion: Our study confirms the high prognostic significance of initial serum creatinine, PRA levels and GFR in cases with PUV. PRA also holds promise in long-term follow-up of these patients as a marker of progressive renal damage. PMID:25197189

  17. Posterior Urethral Valves: Prenatal Diagnostic Signs and Outcome

    Microsoft Academic Search

    Felicitas Eckoldt; K. S. Heling; R. Woderich; S. Wolke

    2004-01-01

    Introduction: Urethral valves can be of enormous clinical importance. Both the prognosis for an affected fetus and the indication for a prenatal therapeutic intervention depend to a high degree on the accuracy of the prenatal diagnosis. Patients and Methods: The sonographic findings and the results of the postnatal diagnostic workup of 24 boys treated for urethral valves in our institute

  18. Traumatic posterior atlantoaxial dislocation without associated fracture and neurological deficit

    Microsoft Academic Search

    Ping ZhenXu; Xu Lan; Li-Wei Yang

    2011-01-01

    Traumatic posterior atlantoaxial dislocation without related fractures of the odontoid process and anterior arch of the atlas\\u000a is exceedingly rare, with only ten published cases reported so far in English literature. We report on a 44-year-old man with\\u000a post-traumatic posterior displacement of the atlas with respect to the axis without any associated fractures and neurological\\u000a deficit caused by a crush

  19. [Post-traumatic cholesteatoma with posterior fossa invasion].

    PubMed

    Castillo-López, Irma Yolanda; Muñoz-Lozano, Adán G; Bonner-Osorio, Claudia B

    2011-01-01

    Post-traumatic cholesteatomas are an extremely rare variety of secondary cholesteatomas. We present a case of a 51-year-old male with post-traumatic cholesteatoma with posterior fossa invasion of 30-year evolution that initially manifested as acute otomastoiditis and headache. Its physiopathology and clinical manifestations are discussed. PMID:20557873

  20. Traumatic posterior atlantoaxial dislocation without associated fracture and neurological deficit.

    PubMed

    Zhen, Ping; Lan, Xu; Yang, Li-Wei

    2011-05-01

    Traumatic posterior atlantoaxial dislocation without related fractures of the odontoid process and anterior arch of the atlas is exceedingly rare, with only ten published cases reported so far in English literature. We report on a 44-year-old man with post-traumatic posterior displacement of the atlas with respect to the axis without any associated fractures and neurological deficit caused by a crush injury in earthquake. Radiographs, computed tomography and magnetic resonance imaging revealed posterior displacement of the atlas with the odontoid peg lying anterior and to the right of the anterior arch of the atlas. Partial odontoidectomy and posterior fixation with bone graft were performed in one-stage procedure after several unsuccessful attempts of closed reduction. The patient did not have neurological deterioration after operation. PMID:21207046

  1. A follow-up study of children with posterior urethral valve

    PubMed Central

    Uthup, S.; Binitha, R.; Geetha, S.; Hema, R.; Kailas, L.

    2010-01-01

    There are not many studies on long term follow up of children following surgery for posterior urethral valve in India. This study was done to assess the growth and renal function of children who had completed five years after surgery for posterior urethral valve at our hospital. Thirty children were included in this study. They were assessed retrospectively for the age and pattern of presentation, time of surgery and outcome. Outcomes measured were stunting, renal failure (GFR, tubular functions) and bladder functions. Fifty per cent of children were symptomatic five years after surgery with enuresis, dribbling, polyuria and recurrent urinary tract infection (UTI). GFR was <60 ml/m/1.73 m2 in 33%. Growth failure, according to the World Health Organization (WHO) definition, was present in one-third of children. A low GFR was associated with growth failure. Poor bladder function evidenced by history of dribbling and significant residual urine was seen in one-third of patients. Residual hydronephrosis was seen in 74%. The most common presenting symptoms of PUV were poor urinary stream followed by recurrent UTI, poor weight gain, renal failure and abdominal mass. Eighty per cent of the study population had undergone surgery in infancy. Five years after surgery, 50% children were symptomatic; 30% had stunting. 33% had a GFR <60 ml/m/1.73 m2 and a significantly greater degree of stunting than those with GFR >60 ml/m/1.73 m2. Sonologically normal kidneys on follow-up were associated with a GFR above 60 ml/m/1.73 m2. Poor bladder function was present in 30% of the children. Univariate analysis showed that statistically significant risk factors for decline in GFR in this study are oligohydramnios and surgery beyond the neonatal period. PMID:20835319

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

    PubMed Central

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

    2013-01-01

    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

  3. Outcome of Late Presentation of Posterior Urethral Valves in a Resource-Limited Economy: Challenges in Management

    PubMed Central

    Odetunde, Odutola Israel; Odetunde, Oluwatoyin Arinola; Ademuyiwa, Adesoji Oludotun; Okafor, Henrietta Uche; Ekwochi, Uchenna; Azubuike, Jonathan Chukwuemeka; Obianyo, Nene Elsie

    2012-01-01

    Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997–2009) was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days–13 years). The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91%) presented with urosepsis while 8 patients (36%) presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide. PMID:23050150

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

    PubMed Central

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

    2014-01-01

    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

  5. Study of prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves

    PubMed Central

    Bhadoo, Divya; Bajpai, M.; Abid, Ali; Sukanya, Gayan; Agarwala, Sandeep; Srinivas, M.; Deka, Deepika; Agarwal, Nutan; Agarwal, Ramesh; Kumar, Rakesh

    2015-01-01

    Aims: Study on prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves. Materials and Methods: Antenatally diagnosed hydronephrosis patients were included. Postnatally, they were divided into two groups, posterior urethral valve (PUV) and non-PUV. The studied parameters were: Gestational age at detection, surgical intervention, ultrasound findings, cord blood and follow up plasma renin activity (PRA) values, vesico-ureteric reflux (VUR), renal scars, and glomerular filtration rate (GFR). Results: A total of 25 patients were included, 10 PUV and 15 non-PUV. All infants with PUV underwent primary valve incision. GFR was less than 60 ml/min/1.73 m2 body surface area in 4 patients at last follow-up. Keyhole sign, oligoamnios, absent bladder cycling, and cortical cysts were not consistent findings on antenatal ultrasound in PUV. Cord blood PRA was significantly higher (P < 0.0001) in PUV compared to non-PUV patients. Gestational age at detection of hydronephrosis, cortical cysts, bladder wall thickness, and amniotic fluid index were not significantly correlated with GFR while PRA could differentiate between poor and better prognosis cases with PUV. Conclusions: Ultrasound was neither uniformly useful in diagnosing PUV antenatally, nor differentiating it from cases with non-PUV hydronephrosis. In congenital hydronephrosis, cord blood PRA was significantly higher in cases with PUV compared to non-PUV cases and fell significantly after valve ablation. Cord blood PRA could distinguish between poor and better prognosis cases with PUV.

  6. Non-traumatic posterior atlanto-occipital joint dislocation.

    PubMed

    Takechi, Yasuhiko; Iizuka, Haku; Sorimachi, Yasunori; Ara, Tsuyoshi; Nishinome, Masahiro; Takagishi, Kenji

    2011-07-01

    This report presents a case of non-traumatic posterior atlanto-occipital dislocation. A 36-year-old female was referred with a history of numbness of the extremities, vertigo and neck pain for 1 year. The patient had no history of trauma. The axial rotation of range of motion of the cervical spine was severely restricted. A lateral cervical radiograph in the neutral position demonstrated a posterior atlanto-occipital dislocation. A coronal view on a computed tomography (CT) reconstruction image showed a loss of angle of the bilateral atlanto-occipital joint, and a sagittal reconstruction view of CT images also demonstrated flatness of atlanto-occipital joint. Instrumented occipito-cervical fusion was performed after reduction. A lateral cervical radiograph in the neutral position 1 year after surgery showed the reduction of atlanto-occipital joint, moreover, it was maintained even in an extended position. The patient had neurologic improvement after surgery. Flatness of the bilateral atlanto-occipital joint may have induced this instability. Occipital-cervical fusion was chosen in the present case since the patient showed restricted axial rotation of the neck before surgery. The surgery improved the preoperative symptoms including the function of cervical spine evaluated by JOACMEQ. PMID:20549257

  7. Traumatic bilateral posterior hip dislocation in 10 year old male child

    PubMed Central

    Garg, Vipul; Singh, Ajay Pal; Singh, Arun Pal; Bajaj, P.S.

    2014-01-01

    Traumatic bilateral posterior hip dislocation in skeletally immature patient is reported very less in literature. We report a 10 yr old boy presented to us following farmyard injury with bilateral posterior hip dislocation, which was reduced manually under sedation with uneventful follow-up and complete hip range of motion at 2 year.

  8. One-stage penile\\/preputial island flap urethroplasty for difficult posterior urethral strictures

    Microsoft Academic Search

    J. K. M. Quartey

    1987-01-01

    Short traumatic strictures of the membranous urethra can be repaired by excision and end-to-end urethroprostatic anastomosis. Long membranous or bulbomembranous strictures with or without associated periurethral fibrosis, abscess or urinary fistulae require substitution urethroplasty. Tubed full-thickness skin grafts have a poor chance of survival in such circumstances. Scrotal flaps are hairy, but the penile\\/preputial island flap, which is relatively hairless,

  9. Treating Traumatic Lumbosacral Spondylolisthesis Using Posterior Lumbar Interbody Fusion with three years follow up

    PubMed Central

    Tang, Shujie

    2014-01-01

    Objective: To analyze the surgical outcome of traumatic lumbosacral spondylolisthesis treated using posterior lumbar interbody fusion, and help spine surgeons to determine the treatment strategy. Methods: We reviewed retrospectively five cases of traumatic lumbosacral spondylolisthesis treated in our hospital from May 2005 to May 2010. There were four male and one female patient, treated surgically using posterior lumbar interbody fusion. The patients’ data including age, neurological status, operation time, blood loss, follow-up periods, X- radiographs and fusion status were collected. Results: All the cases were treated using posterior lumbar interbody fusion to realize decompression, reduction and fusion. Solid arthrodesis was found at the 12-month follow-up. No shift or breakage of the instrumentation was found, and all the patients were symptom-free at the last follow-up. Conclusion: Traumatic lumbosacral spondylolisthesis can be treated using posterior lumbar interbody fusion to realize the perfect reduction, decompression, fixation and fusion. PMID:25225542

  10. The unexpected with ankle fracture: traumatic tibialis posterior tendon dislocation: a case report and literature review.

    PubMed

    Al Khudairy, A; Zafar, M M; Padinjarathala, B A

    2013-12-01

    Traumatic dislocation of tibialis posterior is infrequently reported in the literature. It is rare but potential cause of persistent pain that can be easily missed. Concomitant ankle fracture may obscure the clinical picture and if unsuspected, consequences such as iatrogenic injury to tibialis posterior tendon while fixing the medial malleolus may occur. We report our experience in the management of a tibialis posterior tendon dislocation associated with ankle fracture. A review of all English literature had been carried with a focus on treatment options. PMID:24026087

  11. Judo-related traumatic posterior sternoclavicular joint dislocation in a child.

    PubMed

    Galanis, Nikiforos; Anastasiadis, Prodromos; Grigoropoulou, Foteini; Kirkos, John; Kapetanos, George

    2014-05-01

    Judo is a combat sport with high risk of injury. We present a rare case of traumatic left posterior sternoclavicular (SC) joint dislocation, inflicted to a 12-year-old boy during a judo contest. An extensive literature review did not reveal any case of posterior SC joint dislocation in judo. The patient was treated with closed reduction under general anesthesia. At 2-year follow-up, his left upper extremity had full range of motion, and he did not complain of any residual symptoms. He decided to discontinue judo training; however, he participates in other physically demanding sports. Although not often encountered, posterior SC joint dislocation is a challenging and critical medical problem that can be fatal if not promptly diagnosed and treated on time and should be considered in the differential diagnosis of trauma-related anterior chest pain. PMID:24172655

  12. Fatal traumatic aneurysm of the posterior inferior cerebellar artery with delayed rupture.

    PubMed

    Purgina, Bibianna; Milroy, Christopher Mark

    2015-02-01

    Traumatic aneurysms of intracranial arteries are rare, forming less than 1% of all intracranial arteries. They may be associated with penetrating and non-penetrating trauma. Most cases are associated with fracturing of the skull. Rupture of traumatic aneurysms occur in up to 50% of cases and are typically delayed from days to weeks following the initiating trauma. We report a case of a 22-year-old man who was punched to the head. He was rendered unconscious but recovered and had a GCS of 14 on admission. CT scans showed subarachnoid hemorrhage. An initial angiogram was negative but on day 7 following the incident he was noted to have a 1 mm aneurysm of the posterior inferior cerebellar artery on CT angiogram. On day 9 he collapsed and was found to have new subarachnoid hemorrhage and to have a 4.0 mm × 3.7 mm. He did not recover and was declared brain dead on day 12. At autopsy, there was a 4.0 mm aneurysm of the left PICA just after the origin of the artery. Histological examination confirmed the presence of a traumatic false aneurysm in the left PICA. This case study shows sequential radiological imaging with pathologiocal correlation. PMID:25549847

  13. Posterior urethral valves: Persistent renin angiotensin system activation after valve ablation and role of pre-emptive therapy with angiotensin converting enzyme-inhibitors on renal recovery

    PubMed Central

    Bajpai, Minu; Chaturvedi, Pradeep K.; Bal, Chandra S.; Sharma, Meher C.; Kalaivani, Mani

    2013-01-01

    Aim: To study renin angiotensin system (RAS) activity after posterior urethral valve ablation and the role of early induction of angiotensin converting enzyme-inhibitors (ACE-I) on the outcome of renal function. Materials and Methods: Thirty four children underwent valve ablation in which therapy with ACE-I was started 40.5 ± 4.1 (range 32-47 months) formed the study group. Post-ACE-I data were collected after mean duration of 18.2 ± 4.0 (12-28 months). Plasma renin activity (PRA), urinary micro albumin, glomerular filtration rate (GFR), and serum creatinine, before and after therapy were monitored. Results: Therapy with ACE-I resulted in a fall in micro albuminuria by 45.7% and 42.0% in patients without and with vesico ureteral reflux, respectively, and improvement in split renal function by 6.6% and 5.9% GFR respectively. A similar response was noted in patients without and with renal scars. Conclusion: The decline in renal function after valve ablation is accompanied by activation of RAS reflected in a gradual rise in PRA. Therapy with ACE-I stabilizes and then improves renal function, thereby, retarding the pace of renal damage. PMID:23798811

  14. Maximizing the visual outcome in traumatic cataract cases: The value of a primary posterior capsulotomy and anterior vitrectomy

    PubMed Central

    Shah, Mehul A; Shah, Shreya M; Patel, Krunal D; Shah, Ashit H; Pandya, Jaimini S

    2014-01-01

    Objective: The objective was to provide evidence-based care for patients with traumatic cataracts, we assessed whether a posterior capsulotomy and anterior vitrectomy, as part of the primary surgical procedure, could be a positive predictor of final visual outcome. Materials and Methods: This is a prospective randomized control trial. Patients presenting at our hospital between January 2010 and December 2012 having ocular trauma and traumatic cataracts were enrolled, according to the inclusion criteria. We enrolled two groups: Those with and without primary posterior capsulotomy and vitrectomy. Information regarding demographic and ocular trauma were collected using the World Eye Trauma Registry form at the first visit and follow-up, and specific information was collected for both the group who underwent posterior capsulectomies and vitrectomies as a part of the primary procedure, and the control group. Data were analyzed to evaluate the predictive value of primary posterior capsulectomy and anterior vitrectomy. Results: We enrolled 120 cases, 60 in each group, comprising 31 females and 89 males. When all other variables were controlled for, the visual outcome (best corrected visual acuity) differed significantly (P < 0.001) between the groups. Conclusion: Performance of posterior capsulectomy and anterior vitrectomy as part of the primary procedure improves the final visual outcome. PMID:25494250

  15. Urethral stricture

    MedlinePLUS

    Augenbraun MH, McCormack WM. Urethritis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Churchill ...

  16. The Surgical Management of Traumatic Lower Cervical Spondylolisthesis with Posterior Percutaneous Pedicle Screw Fixation

    PubMed Central

    Luo, Peng; Ni, Wen-Fei; Wu, Yao-Sen; Wu, Ai-Min; Wang, Xiang-Yang; Xu, Hua-Zi

    2015-01-01

    We reported a technical report of traumatic lower cervical spondylolisthesisca used by bilateral pedicle fracture, without neurological compression. The patient was treated with the minimally invasive technique of percutaneous pedicle screw fixation. Fracture healing and normal cervical motion were confirmed by plain films and physical examinations on the 18-monthpostoperatively. The technique of percutaneous pedicle screw fixation might be an alternative strategy for the treatment of traumatic lower cervical spondylolisthesis with pedicle fracture.

  17. Traumatic posterior atlantoaxial dislocation without related fractures of C1-C2

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

    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

    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

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

    PubMed

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

    2014-06-01

    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

  20. Female Urethral Adenocarcinoma Arising from Urethritis Glandularis

    Microsoft Academic Search

    Yik-Ming Chan; Danny Ka-Leung Cheng; Annie Nga-Yin Cheung; Hextan Yuen-Sheung Ngan; Ling-Chui Wong

    2000-01-01

    Introduction. Female urethral adenocarcinoma is extremely rare and more than one tissue of origin has been suggested other than the Skene's gland. Immunohistochemistry with cytokeratins (CK) 7 and 20 is used to define the origin of the tumor.Case report. A 72-year-old woman presented with a 2-cm polypoid tumor at the external urethral meatus and bleeding. Wide local excision and bilateral

  1. Treatment Options for Urethral Cancer

    MedlinePLUS

    ... nodes by the time it is diagnosed . A history of bladder cancer can affect the risk of urethral ... for urethral cancer include the following: Having a history of bladder cancer . Having conditions that cause chronic inflammation ...

  2. [Posterior epispadias with unknown complete duplicated urethra].

    PubMed

    Aubert, D; Rigaud, P; Destuynder, O; Zoupanos, G

    1992-04-01

    The authors report a case of posterior epispadias associated with complete ventral urethra only discovered during the urethroplasty phase of the operation. This malformation is a rare form of urethral duplication and should be considered in any case of apparently isolated posterior epispadias. PMID:1302070

  3. Steroid Treatment for Recurrent Epididymitis Secondary to Idiopathic Urethritis and Urethrovasal Reflux

    PubMed Central

    Ninan, G. K.; Bhishma, Preethi; Patel, Ramnik

    2013-01-01

    We describe a case of recurrent left-sided epididymitis secondary to severe idiopathic posterior urethritis extending to left seminal vesicle and vas deference with associated urethrovasal reflux (UVR). Cystourethroscopy and micturating cystourethrogram were essential for the diagnosis. Following cystourethroscopy, intravesical, and urethral instillation of topical steroid triamcinolone, patient had a full recovery. Idiopathic urethritis in association with veru montentitis, utriculitis leading to left-sided UVR, inflammation of the seminal vesicle, and vas deference causing secondary epididymitis is rare. We report the first such rare case presenting as recurrent acute scrotum and response to innovative treatment we used.

  4. Current Management of Urethral Stricture

    PubMed Central

    Lee, Young Ju

    2013-01-01

    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

  5. Management of urethral strictures

    PubMed Central

    Mundy, A R

    2006-01-01

    Controlled clinical trials are unusual in surgery, rare in urology, and almost non?existent as far as the management of urethral stricture is concerned. What data there are come largely from so called “expert opinion” and the quality of this is variable. None the less, the number of so called experts, past and present, is comparatively small and in broad principle their views more or less coincide. Although this review is therefore inevitably biased, it is unlikely that expert opinion will take issue with most of the general points raised here. PMID:16891437

  6. KTP-532 laser ablation of urethral strictures

    NASA Astrophysics Data System (ADS)

    Malloy, Terrence R.

    1991-07-01

    In 1988, the KTP-532 laser was used to ablate a series of benign urethral strictures. Rather than using a single incision, as in urethrotomy, strictures were treated with a 360$DEG contact photoradiation. Thirty-one males, average age 53.2 years, received 37 treatments. Six patients underwent a second laser treatment. Stricture etiology was commonly iatrogenic (32%), traumatic (16%), and post-gonococcal (10%). Stricture location included mainly bulbar (49%), membranous (20%), and penile (12%) areas. The surgical technique consisted of a circumferential ablation followed by foley catheter placement (mean 10 days). Follow-up on 29 of 31 patients ranged from 1 to 16 months (mean 9.7) Complete success occurred in 17 patients (59%) who had no further symptoms or instrumentation. Partial success was seen in 6 patients (20.5%) with symptoms but no stricture recurrence. Six patients (20.5%) failed therapy requiring additional surgery or regular dilatations. No complications were encountered. Although longer assessment is required, KTP-532 laser ablation of urethral strictures appears efficacious.

  7. Congenital megalourethra associated with urethral duplication and imperforate anus

    Microsoft Academic Search

    A. Savanelli; A. Schiano; C. Esposito; S. Russo; H. Dolezalova

    1998-01-01

    A newborn with a prenatal diagnosis of right hydroureteronephrosis and enlarged penis is presented. At birth, the baby had\\u000a an imperforate anus (IA) with a megalourethra; radiologic and ultrasonographic studies showed a left?polycystic kidney and\\u000a right hydroureteronephrosis, right vesicoureteral reflux, and an incomplete urethral duplication with dilatation of the posterior\\u000a urethra. The IA was corrected on the 1st day of

  8. General Information about Urethral Cancer

    MedlinePLUS

    ... nodes by the time it is diagnosed . A history of bladder cancer can affect the risk of ... for urethral cancer include the following: Having a history of bladder cancer . Having conditions that cause chronic ...

  9. [Chlamydia urethritis in nephrologic practice].

    PubMed

    Stanojci?, A; Peri?, J; Radmilovi?, A

    1996-01-01

    Chlamydia trachomatis is an ubiquitous bacterium, strictly intracellular organism. The D-K serovars urethritis, cervicitis, endometritis, salpingitis, periappendicitis and perihepatitis, in women, urethritis, prostatitis, epididymitis and Reiter's syndrome in 1-2% of cases in men. Sterility is the most serious complication in both sexes. Chlamydial infections are sexually transmitted diseases, often asymptomatic, prone to recurrences. Cure occurs only when both sexual partners are treated simultaneously. We treated 40 patients, 24 women and 16 men, from 1991-1994, who presented in nephrologic offices with symptoms of chlamydial urethritis. Detection of Chlamydia trachomatis was performed by direct fluorescent antibody stain. All patients had positive urethral swab, six women had chlamydial cervicitis too, one man had Reiter's syndrome, one man orchiepididymitis, and five men prostatitis. Optimal therapy for Chlamydia trachomatis infections consists of a 10-14 day regimen of quinolone, of tetracycline, and macrolides. We used sulfonamide rarely. Because of very serious sequelae of initial infection with Chlamydia trachomatis, every patient with urethritis should be examined by urethral swab for Chlamydia testing. Both partners should be examined and treated simultaneously. PMID:9102910

  10. 21 CFR 876.5520 - Urethral dilator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...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...

  11. 21 CFR 876.5520 - Urethral dilator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  12. 21 CFR 876.5520 - Urethral dilator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...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...

  13. 21 CFR 876.5520 - Urethral dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...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...

  14. 21 CFR 876.5520 - Urethral dilator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...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...

  15. Evaluation and Treatment of Urethral Stricture Disease

    Microsoft Academic Search

    Leo R. Doumanian

    2010-01-01

    Any process causing trauma to the urethral tissue or underlying corpus spongiosum can lead to urethral stricture disease.\\u000a The traditional treatment algorithm for urethral strictures, also known as the reconstructive ladder, begins with minimally invasive interventions, including urethral dilation and endoscopic urethrotomy. Inevitably, endoscopic\\u000a incision and dilation fails, resulting in stricture recurrence. After the expenditure of valuable time and resources,

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

    PubMed Central

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

    2013-01-01

    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

  17. Management of Traumatic Brain Injury

    Microsoft Academic Search

    Hans-Georg Imhof; Philipp M. Lenzlinger

    2005-01-01

    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

  18. Buccal mucosa urethroplasty for adult urethral strictures

    PubMed Central

    Zimmerman, W. Britt; Santucci, Richard A.

    2011-01-01

    Urethral strictures are difficult to manage. Some treatment modalities for urethral strictures are fraught with high patient morbidity and stricture recurrence rates; however, an extremely useful tool in the armamentarium of the Reconstructive Urologist is buccal mucosal urethroplasty. We like buccal mucosa grafts because of its excellent short and long-term results, low post-operative complication rate, and relative ease of use. We utilize it for most our bulbar urethral stricture repairs and some pendulous urethral stricture repairs, usually in conjunction with a first-stage Johanson repair. In this report, we discuss multiple surgical techniques for repair of urethral stricture disease. Diagnosis, evaluation of candidacy, surgical techniques, post-operative care, and complications are included. The goal is to raise awareness of buccal mucosa grafting for the management urethral stricture disease. PMID:22022061

  19. Hinging the urethral plate in hypospadias meatoplasty.

    PubMed

    Rich, M A; Keating, M A; Snyder, H M; Duckett, J W

    1989-12-01

    A technique is described for creation of a cosmetically normal, vertical slit-like urethral meatus in conjunction with common hypospadias reconstructions that preserve the urethral plate. The distal portion of the urethral plate is incised longitudinally in the midline. This incision allows the flat and rigid urethral plate to be folded or hinged during glans plasty, molding it into an anatomically correct vertical slit configuration. This modification has been applied successfully to a variety of meatal-based flap and onlay island flap urethroplasties with no increased morbidity and a significant improvement in meatal cosmetic results. PMID:2685370

  20. Male Urethral Diverticulum Having Multiple Stones

    PubMed Central

    Mohanty, D; Garg, PK; Jain, BK; Bhatt, S

    2014-01-01

    Congenital diverticulum of male urethra is an uncommon entity. Neglected management complicates the process in the form of calculi formation and recurrent urinary infection. A 10-year-old boy presented with urinary voiding disturbances and development of a painless hard lump at the penoscrotal junction. Imaging demonstrated presence of anterior urethral diverticulum with contained calculi in it. Open urethral diverticulectomy, extraction of multiple calculi, and primary urethral reconstruction over a Foley catheter was carried out. Early diagnosis and individualized surgical management of congenital male urethral diverticulum is the key to a successful outcome. PMID:25031909

  1. Delayed vaginal and urethral mesh exposure: 10 years after TVT surgery.

    PubMed

    Khanuengkitkong, Siwatchaya; Lo, Tsia-Shu; Dass, Anil Krishna

    2013-03-01

    Delayed mesh exposure after tension-free vaginal tape (TVT) procedure is rare. We report a case of mesh exposure into the vagina and urethra that developed 10 years after TVT surgery. A 58-year-old postmenopausal woman presented with mixed urinary incontinence. She was investigated, and her stress urinary incontinence was cured with a TVT procedure 10 years ago. She was then scheduled follow-up annually. Two years postsurgery, a granulation tissue was observed and excised at the vaginal incision site. Vaginal examination 10 years postsurgery showed vaginal mesh erosion 0.5 cm from urethral meatus. Cystoscopy revealed concomitant urethral erosion at the posterior urethral wall. Mesh excision was performed, and urethra and vagina were repaired in layers. Postoperative recovery was uneventful. This finding shows that, although rare, complications can occur even after 10 years of TVT surgery. PMID:22736034

  2. Multiple Urethral Stones Causing Penile Gangrene

    PubMed Central

    Ramdass, Michael J.

    2014-01-01

    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

  3. SIU/ICUD Consultation On Urethral Strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries.

    PubMed

    Latini, Jerilyn M; McAninch, Jack W; Brandes, Steven B; Chung, Jae Yong; Rosenstein, Daniel

    2014-03-01

    This committee reviewed and evaluated published data, and recommended standardized terminology relating to the epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries, as well as their surgical management. A literature search using Medline, PubMed (U.S. National Library of Medicine and the National Institutes of Health), Embase, online acronym databases, and abstracts from scientific meetings was performed from 1980-2010. Articles were evaluated using the Levels of Evidence adapted by the International Consultation on Urological Diseases (ICUD) from the Oxford Centre for Evidence-Based Medicine. Recommendations were based on the level of evidence and discussed among the committee to reach a consensus. There is expert opinion to support standards regarding the epidemiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries. There is level 3 evidence regarding the epidemiology and etiology of urethral stenoses, urethral strictures, and pelvic fracture urethral injuries. The literature regarding the epidemiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries are sparse and generally of a low level of evidence. The proposed ICUD system does not readily apply to these areas. Further research is needed so that stronger levels of evidence can be developed leading to recommendations regarding the accuracy of the data. To improve future research and promote effective scientific progress and communication, a standardized nomenclature and anatomy regarding the urethra and urethral surgery is detailed herein. PMID:24210733

  4. Steroid Instillation for Idiopathic Urethritis in Children: An 8-Year experience.

    PubMed

    Jayakumar, Sivasankar; Ninan, George Kaithayil; Pringle, Kirsty

    2015-04-01

    Purpose?Idiopathic urethritis (IU) in children is of unknown etiology and treatment options are limited. We aim to report our experience with steroid instillation in IU in children. Methods?Retrospective data collection of all male children diagnosed with IU over a period of 8 years. Patients with balanitis xerotica obliterans (BXO) and positive urine culture at presentation were excluded from the study. Data were collected on patient demographics, laboratory and radiological investigations, cystoscopy findings, management, and outcomes. Results?A total of 16 male children were diagnosed with IU. The mean age was 11.6 (7-16) years. Presenting symptoms included dysuria in 10; frank hematuria in 7; loin pain in 5; and scrotal pain in 2 patients. Serum C-reactive protein and full blood count was tested in 13 patients and was within normal limits in all of them. Endoscopy findings included posterior urethritis in 12, anterior urethritis in 2, and urethral stricture with inflammation in 2 patients. Ten patients required more than one episode of steroid instillation. Mean follow-up was 19.4 (1-74) months. Complete resolution of symptoms and signs occurred in 15 (93.6%) patients and improvement of symptoms and signs noted with ongoing treatment in 1 (6.4%) patient. Conclusion?IU in children can be successfully managed with steroid instillation. In our series, 93.6% of children had complete resolution of symptoms. PMID:24683102

  5. Acute traumatic L5–S1 spondylolisthesis: a case report

    Microsoft Academic Search

    M. Reinhold; C. Knop; M. Blauth

    2006-01-01

    Study Design: Case report of a patient treated surgically 2 months after sustaining a misdiagnosed acute traumatic lumbosacral dislocation is presented. Objectives: The aims is to report in full about an uncommon case of anterior traumatic L5–S1 spondylolisthesis treated successfully with combined posterior stabilization and anterior fusion. Summary of background data: Review of literature shows that traumatic lumbosacral dislocations and its

  6. Lower Urinary Tract Pain and Anterior Urethral Stricture Disease: Prevalence and Effects of Urethral Reconstruction

    PubMed Central

    Bertrand, Laura A.; Warren, Gareth J.; Voelzke, Bryan B.; Elliott, Sean P.; Myers, Jeremy B.; McClung, Christopher D.; Oleson, Jacob J.; Erickson, Bradley A.

    2015-01-01

    Purpose Anterior urethral stricture disease most commonly presents as urinary obstruction. Lower urinary tract pain is not commonly reported as a presenting symptom. We prospectively characterized lower urinary tract pain in association with urethral stricture disease and assessed the effects of urethroplasty on this pain. Materials and Methods Men (18 years old or older) with anterior urethral stricture disease were prospectively enrolled in a longitudinal, multi-institutional, urethral reconstruction outcomes study from June 2010 to January 2013 as part of TURNS (Trauma and Urologic Reconstruction Network of Surgeons). Preoperative and postoperative lower urinary tract pain was assessed by the validated CLSS. Voiding and sexual function was assessed using validated patient-reported measures, including I-PSS. Results Preoperatively 118 of 167 men (71%) reported urethral pain and 68 (41%) reported bladder pain. Age was the only predictor of urethral pain with men 40 years or younger reporting more pain than those 60 years old or older (81% vs 58%, p = 0.0104). Lower urinary tract pain was associated with worse quality of life and overall voiding symptoms on CLSS and I-PSS (each p <0.01). Postoperatively lower urinary tract pain completely resolved in 64% of men with urethral pain and in 73.5% with bladder pain. There were no predictive factors for changes in lower urinary tract pain after urethral reconstruction. Conclusions Lower urinary tract pain is common in urethral stricture disease, especially in younger men. It is associated with worse quality of life and voiding function. In most men lower urinary tract pain resolves after urethral reconstruction. PMID:25046621

  7. Male urethral strictures and their management

    PubMed Central

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

    2014-01-01

    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

  8. Male urethral strictures and their management.

    PubMed

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

    2014-01-01

    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

  9. Bladder and urethral responses to isolated sacral motor root stimulation.

    PubMed

    McGuire, E J; Herlihy, E

    1978-11-01

    After complete intradural lumbosacral rhizotomy and cord transection in 40 cats, parasympathetic discharge was induced by electrical stimulation of the second and third sacral roots. Isolation of the stimulus to the preganglionic motor fiber resulted in bladder contraction and reciprocal urethral pressure loss. The threshold for the urethral response was lower than that of the bladder and the urethral response findings strongly suggest that urethral adrenoreceptor activity can be modified peripherally by a primary parasympathetic stimulus. PMID:568606

  10. Urethral duplication: Experience of four cases

    PubMed Central

    Ramareddy, Raghu S.; Alladi, Anand; Siddappa, O. S.

    2012-01-01

    Aim: Our experience of 4 cases of urethral duplication is reported here. Materials and Methods: A retrospective chart review. Results: The age at presentation varied from newborn to 10 years. The clinical presentation ranged from prepubic sinus to diphallus urethra. There were 2 each incomplete duplication with only external openings (Type IA) and complete duplication of Effmann Type IIA2. All underwent complete excision of accessory urethra and corrections of associated anomalies. Conclusions: Urethral duplications have a varied presentation. At follow up, all are asymptomatic with good cosmetic result. PMID:22869976

  11. Sexually transmitted Escherichia coli urethritis and orchiepididymitis.

    PubMed

    Dan, Michael; Gottesman, Tamar; Schwartz, Orna; Tsivian, Alexander; Gophna, Uri; Rokney, Assaf

    2012-01-01

    We describe herein a case of uropathogenic Escherichia coli urethritis and orchiepididymitis in a heterosexual man, which he had acquired sexually from his girlfriend. The identity of the genital isolates from both partners was confirmed by pulsed-field gel electrophoresis. PMID:22183838

  12. Aggressive vaginal angiomyxoma mimicking urethral tumor

    Microsoft Academic Search

    Lucio F. Gonzaga; Fernando C. M. Freitas; Jose M. Tavares

    2005-01-01

    This is a case report of a 32-year-old female patient with a neoplasia mimicking a urethral tumor. Following anterior pelvic exanteration, vulvectomy, bilateral inguinal lymphadenectomy, the pathological study established the diagnosis of aggressive vaginal angiomyxoma, CD-34 labeled.

  13. Multiple prostatic abscesses presenting with urethral discharge

    Microsoft Academic Search

    S K Gill; R J Gilson; D Rickards

    1991-01-01

    Prostatic abscess has become less common, is now usually related to urinary tract infection, and is a rare cause of urethral discharge. The case is described of a man with prostatic abscesses caused by Staphylococcus aureus possibly related to recent skin abrasions. Transrectal ultrasound was used to make the diagnosis and to facilitate repeated drainage with a successful outcome.

  14. Utilization of urethral plate in hypospadias surgery

    PubMed Central

    Snodgrass, Warren T.

    2008-01-01

    Purpose Recognition the urethral plate comprises tissues that normally should have created the urethra was an important milestone in hypospadias surgery, giving rise to new operative repairs - most notably the tubularized incised plate technique. This article reviews the current state of the art for hypospadias repair using tubularized, incised plate (TIP). Materials and Methods Personal experience and literature reports were reviewed to summarize use of TIP urethroplasty for distal, proximal, and re-operative hypospadias repairs. Results The TIP can be used to correct all distal and most proximal hypospadias. The major contraindication is ventral curvature that leads to urethral plate transection for straightening, which is only necessary in some proximal cases. Reoperations can also be performed using TIP provided the urethral plate has been maintained and is not grossly scarred. Complication rates are comparable to previously used techniques, while cosmetic appearance after TIP is considered superior to other available procedures. Conclusions Recognition of the urethral plate and its incorporation into the neourethra has revolutionized hypospadias repair. The most commonly used operative procedure today is TIP. PMID:19468397

  15. Posterior atlantoaxial dislocation without associated fracture.

    PubMed

    Sud, S; Chaturvedi, S; Buxi, T B S; Singh, S

    2002-09-01

    We report on a 38-year-old man with post-traumatic posterior displacement of the atlas with respect to the axis without any associated fracture or neurological deficit caused by the displacement. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) revealed posterior displacement of the atlas with the odontoid peg lying anterior and to the right of the anterior arch of the atlas. PMID:12195506

  16. An Unexpected Course after Simultaneous Urethral Repair and Reimplantation of Penile Prosthesis in a Patient with a Urethral Stricture

    PubMed Central

    Shin, Yu Seob; Ko, Oh Seok; Zhang, Li Tao; Zhao, Chen

    2014-01-01

    We experienced the growth of urethral hair along the urethral stricture six years after simultaneous urethral repair and reimplantation of penile prosthesis (RPP) in a patient with a urethral stricture. We detected hair in the urethra with a stricture on the bulbous urethra. Further, we performed hair removal by using a pair of cystoscopic forceps and internal urethrotomy. Then, we performed RPP, and the patient voided well; the prosthesis worked very well and without any complications. One-stage urethroplasty with a pedicle island of the penile skin and RPP in a simultaneous stage may be an option for treating the long-segment urethral stricture in the penile prosthesis patient. However, we should pay attention to the urethral hair growth that can occur after urethral repair performed using a skin graft. PMID:25606569

  17. Dorsolateral onlay urethroplasty for pan anterior urethral stricture by a unilateral urethral mobilisation approach

    PubMed Central

    Chaudhary, Ranjit; Jain, Nidhi; Singh, Kulwant; Bisoniya, Hari Singh; Chaudhary, Rahul; Biswas, Rakesh

    2011-01-01

    The preferred management of urethral strictures involving long segments of anterior urethra is dorsal onlay buccal mucosa augmentation urethroplasty. This requires circumferential mobilisation of the urethra, which might cause ischaemia of the urethra in addition to chordee. The authors managed a pan anterior urethral stricture, applying a dorsolateral free graft by unilateral urethral mobilisation through a perineal approach. This is a recently described surgical technique which preserves the lateral vascular supply on one side thereby minimising ischaemia. Since circumferential mobilisation of urethra is not carried out in this technique, there are no chances of developing a chordee. Entire procedure is carried out by a perineal incision and no incision is made on the penis except for meatotomy. The pendulous urethra is accessed by penile eversion through the perineal wound. Obviating penile incisions minimises chances of wound infection and fistula formation. PMID:22689855

  18. 21 CFR 876.4590 - Interlocking urethral sound.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...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...

  19. 21 CFR 876.4590 - Interlocking urethral sound.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...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...

  20. 21 CFR 876.4590 - Interlocking urethral sound.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  1. 21 CFR 876.4590 - Interlocking urethral sound.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...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...

  2. 21 CFR 876.4590 - Interlocking urethral sound.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...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...

  3. Vascularisation of Urethral Repairs with the Gracilis Muscle Flap

    PubMed Central

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

    2013-01-01

    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

  4. Traumatic rectourethral fistula repair: A potential application of porcine small intestinal submucosa.

    PubMed

    Rajaian, Shanmugasundaram; Rajadoss, Muthukrishna Pandian; Nayak, Sukriya; Kekre, Nitin S

    2013-04-01

    Rectourethral fistula is an uncommon but devastating condition. Traumatic rectourethral fistula is still uncommon and repair of traumatic rectourethral fistula involves a complex procedure. Most of the urologists would prefer to repair the fistula through perineal route especially when urethral reconstruction is also required. The repaired ends of the fistula are separated with various interposition flaps and grafts in order to prevent recurrence. Gracilis interposition muscle flap is commonly used. We describe the first case of traumatic rectourethral fistula repair in a 45-year-old man using interposition of a porcine small intestinal submucosal (Biodesign™ (Surgisis(®)) graft. PMID:23956521

  5. Urethral catheters: can we reduce use?

    Microsoft Academic Search

    Pieter J van den Broek; Jan C Wille; Birgit HB van Benthem; Rom JM Perenboom; M Elske van den Akker-van Marle; Barbara S Niël-Weise

    2011-01-01

    Background  Indwelling urinary catheters are the main cause of healthcare-associated urinary tract infections. It can be expected that\\u000a reduction of the use of urinary catheters will lead to decreased numbers of urinary tract infection.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The efficacy of an intervention programme to improve adherence to recommendations to reduce the use of urethral catheters\\u000a was studied in a before-after comparison in ten Dutch

  6. Isolated posterior capsular rupture following blunt head trauma

    PubMed Central

    Mansour, Ahmad M; Jaroudi, Mahmoud O; Hamam, Rola N; Maalouf, Fadi C

    2014-01-01

    Closed-globe traumatic cataract is not uncommon in males in the pediatric age group. However, there is a relative paucity of literature on isolated posterior lens capsule rupture associated with closed-globe traumatic cataract. We report a case of a 6-year-old boy who presented with white cataract 1 day after blunt trauma to the forehead associated with posterior capsular rupture that was detected by B-scan ultrasonography preoperatively. No stigmata of trauma outside the posterior capsule could be detected by slit-lamp exam, funduscopy, and optical coherence tomography. Phacoemulsification with posterior chamber intraocular lens implant was performed 24 hours after trauma, with the patient achieving 6/6 visual acuity 1 week and 6 months after surgery. Our case is unique, being the youngest (amblyogenic age) to be reported, with prompt surgical intervention, and with no signs of trauma outside the posterior capsule. PMID:25506201

  7. Penile urethral reconstruction: concepts and concerns.

    PubMed

    Barbagli, Guido; Palminteri, Enzo; Bracka, Aivar; Caparrós Sariol, Joan

    2003-06-01

    Reconstruction of the penile urethra is a challenging exercise, and for many surgeons an ungratifying experience. The past three decades have seen us move from predominantly 2-staged surgery, through foreskin grafts, and then single stage flap reconstructions, and now in the 3rd millennium, for some situations 2-stage repair has again become the favoured option. Satisfying short-term solutions have sometimes resulted in poor long-term outcomes when reviewed 10 years later. Clearly there are still problems to be resolved, hence the need for continuing evolution in our surgical management. Lessons have been learned from the treatment of Lichen Sclerosus, from strictures following hypospadias repair, and strictures associated with severe spongiofibrosis. Management of these problems has traditionally been associated with not only a high incidence of restricture and fistula formation, but also with poor cosmetic results, something that men today find increasingly difficult to accept. Several considerations are fundamental to achieving the best functional and aesthetic results. These include the presence or absence of Lichen Sclerosus, the extent of urethral disease and its grade (i.e. mucosal disease or with accompanying spongiofibrosis); furthermore the use of non-genital grafts for urethral reconstruction when the local penile tissues are deficient or unhealthy. In arriving at our present strategy, a collaborative approach that integrates established urological practice with the different perspectives of a plastic surgeon (A.B.) has proved constructive and beneficial. PMID:12918316

  8. Sacral Neuromodulation Effects on Periurethral Sensation and Urethral Sphincter Activity

    PubMed Central

    Gleason, Jonathan L; Kenton, Kimberly; Greer, W. Jerod; Ramm, Olga; Szychowski, Jeff M.; Wilson, Tracey; Richter, Holly E.

    2013-01-01

    Aims To characterize the effect of sacral neuromodulation (SNM) on urethral neuromuscular function. Methods Following IRB approval, women with refractory overactive bladder (OAB) underwent standardized urethral testing prior to and after stage 1 SNM implantation. Periurethral sensation was measured using current perception thresholds (CPT). Striated urethral sphincter activity was quantified using concentric needle electromyography (CNE) and Multi-Motor Unit Action Potential (MUP) analysis software. Nonparametric analyses were used to characterize pre/post changes with intervention. Baseline CPT and CNE findings were compared between SNM responders and non-responders. Results 27 women were enrolled in this pilot study with a mean age of 61±13 years. Twenty of 26 women (76.9%) responded to SNM and went to stage 2 permanent implantation. Four (14.8%) withdrew after stage 1 implantation; 3 of the 4 withdrawals had not had therapeutic responses to SNM. CPT and CNE parameters did not significantly differ from baseline 2 weeks after SNM. Pre-SNM urethral sensation was not significantly different between responders and non-responders. However, responders had larger amplitude, longer duration and more turns and phases at baseline approaching significance, reflecting more successful urethral reinnervation, than non-responders. Conclusions SNM does not alter urethral neuromuscular function two weeks post Stage 1implantation. Women with more successful urethral reinnervation may be more responsive to SNM. PMID:23168535

  9. Adult Urethral Stricture Disease after Childhood Hypospadias Repair

    PubMed Central

    Tang, Shou-Hung; Hammer, Clarisa C.; Doumanian, Leo; Santucci, Richard A.

    2008-01-01

    Background. Adult patients with urethral stricture after childhood hypospadias surgeries are infrequently discussed in the literature. We report our experience in treating such patients. Materials and Methods. A retrospective chart review was performed. From 2002 through 2007, nine consecutive adult patients who had current urethral stricture and had undergone childhood hypospadias surgeries were included. All adult urethral strictures were managed by a single surgeon. Results. Mean patient age was 38.9 years old. The lag time of urethral stricture presentation ranged from 25 to 57 years after primary hypospadias surgery, with an average of 36 years. Stricture length ranged from 1 to 17 cm (mean: 10.3 cm). Open graft-based urethroplasties were performed in 4/9 cases. Salvage perineal urethrostomy was performed in 2/9 cases. Another 3 cases chose to undergo repeat urethrotomy or dilatations—none of these patients was cured by such treatment. Complications included one urethrostomy stenosis and one urinary tract infection. Conclusion. Urethral stricture may occur decades after initial hypospadias surgery. It can be the most severe form of anterior urethral stricture, and may eventually require salvage treatment such as a perineal urethrostomy. Patients undergoing hypospadias surgery should receive lifelong follow-up protocol to detect latent urethral strictures. PMID:19009025

  10. The stone formation in the Memotherm urethral stent implantation area: Is it a rare complication?

    PubMed Central

    Karakose, Ayhan; Atesci, Yusuf Ziya; Aydogdu, Ozgu

    2014-01-01

    Recurrent urethral stricture is one of the biggest problems in urology. Urethral stents as an alternative treatment has been used since 1985. The stone formation in the Memotherm (Angiomed) urethral stent implantation area is a rare complication. We report the case of a 67-year-old man who had a stone in the Memotherm urethral stent implantation area 6 years after his urethral stent surgery. PMID:24678370

  11. Traumatic haemobilia.

    PubMed

    Vallidis, E; Papalexandris, N

    1975-03-01

    A case of traumatic haemobilia which was diagnosed preoperatively, is reported. The site of bleeding was demonstrated by operative angiography through the right hepatic artery. The patient was treated by ligation of the common hepatic artery. Re-bleeding required a second operation and ligation of the right hepatic branch without adverse consequences on the hepatic function. PMID:1122364

  12. Poor Quality of Life in Patients with Urethral Stricture Treated with Intermittent Self-Dilation

    PubMed Central

    Lubahn, Jessica D.; Zhao, Lee C.; Scott, J. Francis; Hudak, Steven J.; Chee, Justin; Terlecki, Ryan; Breyer, Benjamin; Morey, Allen F.

    2014-01-01

    Purpose We assessed patient perceptions of regular intermittent self-dilation in men with urethral stricture. Materials and Methods We constructed and distributed a visual analog questionnaire to evaluate intermittent self-dilation via catheterization by men referred for urethral stricture management at a total of 4 institutions. Items assessed included patient duration, frequency, difficulty and pain associated with intermittent self-dilation as well as interference of intermittent self-dilation with daily activity. The primary outcome was patient perceived quality of life. Multivariate analysis was performed to assess factors that affected this outcome. Results Included in the study were 85 patients with a median age of 68 years, a median of 3.0 years on intermittent self-dilation and a median frequency of 1 dilation per day. On a 1 to 10 scale the median intermittent self-dilation difficulty was 5.0 ± 2.7, the median pain score was 3.0 ± 2.7 and median interference with daily life was 2.0 ± 1.3. Overall quality of life in patients with stricture was poor (median score 7.0 ± 2.6 with poor quality of life defined as 7 or greater). On univariate analysis younger age (p <0.01), interference (p = 0.03), pain (p <0.01) and difficulty performing intermittent self-dilation (p = 0.03) correlated with poor quality of life in a statistically significant manner. On multivariate analysis only difficulty catheterizing (p <0.01) and younger age (p = 0.05) were statistically significant predictors. Patients with stricture involving the posterior urethra had a statistically significant increase in difficulty and decrease in quality of life (each p = 0.04). Conclusions Most patients with urethral stricture who are on intermittent selfdilation rate difficulty and pain as moderate, and inconvenience as low but report poor quality of life. PMID:23820057

  13. The female urethral syndrome: external sphincter spasm as etiology.

    PubMed

    Kaplan, W E; Firlit, C F; Schoenberg, H W

    1980-07-01

    Many women suffer a constellation of urinary and pelvic symptoms commonly referred to as the urethral syndrome. Numerous medical, surgical and psychological treatment modalities have been used to alleviate the symptoms. Urodynamic techniques were used to study a group of women with the urethral syndrome. Based on the findings of external urethral sphincter spasm and/or pelvic floor hyperactivity the institution of diazepam therapy not only has provided clinical relief but also sphincter synergy as demonstrated by post-treaatment urodynamics. PMID:7411719

  14. Penile fracture with bilateral corporeal rupture without urethral involvement

    PubMed Central

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

    2014-01-01

    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

  15. Reconstruction for the distal urethral end incorrectly anastomosed to the proximal false passage in the treatment of urethral stricture

    PubMed Central

    Li, Zhao-Lun; Fu, De-Lai; Chong, Tie; Li, He-Cheng

    2014-01-01

    Patient: Male, 24 Final Diagnosis: Urethral stricture Symptoms: — Medication: — Clinical Procedure: — Specialty: Urology Objective: Unusual or unexpected effect of treatment Background: The most dependable management of anterior urethral stricture is the complete excision of the area of fibrosis, with a primary reanastomosis of the normal ends of the anterior urethra. Case Report: A 24-year-old man had urethral stricture in the penoscrotal junction caused by catheterization approximately 3 years ago. After the resection of the urethral stricture segment and the end-to-end anastomosis were performed, in addition to stricture, urethrocutaneous fistula formation as another complication in the penoscrotal junction was confirmed. The direct vision internal urethrotomy did not improve all the above symptoms. The retrograde urethrogram and voiding cysto-urethrogram showed complete obliteration in the penile urethra, urethrocutaneous fistula, and proximal urethral bifurcation singularity. Intraoperatively, we found that the distal urethral end had been anastomosed to the proximal false passage in the initial surgery and the proximal urethra was located in the dorsal side of the false passage. Then, tubularized preputial flap urethroplasty was performed. The patient was followed up for 10 months. His peak urinary flow was 18.3 milliliter per second. Conclusions: We would remind urologists that urethral end intraoperatively anastomosed to the false passage is a rare, serious, avoidable, and elementary medical error. Urethroplasty is one of the curative choices for treatment of this unexpected condition. PMID:24917901

  16. Posterior atlantoaxial arthrodesis. A simplified method.

    PubMed

    Rodrigues, F A; Hodgson, B F; Craig, J B

    1991-08-01

    A simplified method of posterior atlantoaxial arthrodesis allowing immediate stabilization and mobilization is described. This method of fixation has been used since 1984 in 33 cases, with the indications being nonunion of odontoid peg fractures, atlantoaxial dislocation, and other traumatic conditions about the axis. A solid fusion was noted in all 33 patients by 3 months postsurgery, and the complication rate was minimal. This method of atlantoaxial arthrodesis is simple, allows immediate mobilization, controls rotation and lateral bending, and is inexpensive. PMID:1948372

  17. Full Functional-Length Urethral Sphincter Preservation During Radical Prostatectomy

    Microsoft Academic Search

    Thorsten Schlomm; Hans Heinzer; Thomas Steuber; Georg Salomon; Oliver Engel; Uwe Michl; Alexander Haese; Markus Graefen; Hartwig Huland

    2011-01-01

    BackgroundA key prerequisite for urinary continence after radical prostatectomy (RP) is the functional length of the urethral sphincter and the stabilisation of its anatomic position within the pelvic floor.

  18. Traumatic Brain Injury

    MedlinePLUS

    NINDS Traumatic Brain Injury Information Page Clinical Trials Phase 2 Pediatric Autologous BMMNC for Severe TBI The purpose of this study ... Organizations Additional resources from MedlinePlus What is Traumatic Brain Injury? Traumatic brain injury (TBI), a form of ...

  19. The morbidity of urethral stricture disease among male Medicare beneficiaries

    PubMed Central

    2010-01-01

    Background To date, the morbidity of urethral stricture disease among American men has not been analyzed using national datasets. We sought to analyze the morbidity of urethral stricture disease by measuring the rates of urinary tract infections and urinary incontinence among men with a diagnosis of urethral stricture. Methods We analyzed Medicare claims data for 1992, 1995, 1998, and 2001 to estimate the rate of dual diagnoses of urethral stricture with urinary tract infection and with urinary incontinence occurring in the same year among a 5% sample of beneficiaries. Male Medicare beneficiaries receiving co-incident ICD-9 codes indicating diagnoses of urethral stricture and either urinary tract infection or urinary incontinence within the same year were counted. Results The percentage of male patients with a diagnosis of urethral stricture who also were diagnosed with a urinary tract infection was 42% in 2001, an increase from 35% in 1992. Eleven percent of male Medicare beneficiaries with urethral stricture disease in 2001 were diagnosed with urinary incontinence in the same year. This represents an increase from 8% in 1992. Conclusions Among male Medicare beneficiaries diagnosed with urethral stricture disease in 2001, 42% were also diagnosed with a urinary tract infection, and 11% with incontinence. Although the overall incidence of stricture disease decreased over this time period, these rates of dual diagnoses increased from 1992 to 2001. Our findings shed light into the health burden of stricture disease on American men. In order to decrease the morbidity of stricture disease, early definitive management of strictures is warranted. PMID:20167087

  20. Urethral Sparing Histotripsy of the Prostate in a Canine Model

    PubMed Central

    Schade, George R.; Hall, Timothy L.; Roberts, William W.

    2012-01-01

    Objective To evaluate the feasibility and healing response to urethral sparing prostate histotripsy a canine model of benign prostatic hypertrophy. Methods Histotripsy was performed on 10 canines using a 750 kHz piezoelectric ultrasound transducer targeting the prostatic parenchyma while avoiding the urethra. Periprocedure prostatic urethral integrity was evaluated with serial cystourethroscopy. Evolution of histotripsy treatment effect and subjects’ response to urethral sparing was evaluated with serial ultrasound and laboratory evaluation, respectively. Subjects were euthanized acutely or chronically and findings were confirmed histologically. Results Bilateral treatment was possible in 8/10 subjects while unilateral treatment was performed in 2/10. Failure to spare the urethra was observed in 2/18 treatments; one acutely and one chronically despite normal cystourethroscopy for the first week. Modest prostatic volume reduction was seen in subjects survived to 8 weeks post-histotripsy. Laboratory studies revealed transient perioperative increases in mean white-blood cell count, C-reactive protein, and lactate dehydrogenase. On histology, 80% of successful urethral sparing treatment cavities were completely epithelialized, containing simple fluid with minimal cellular debris at 8 weeks despite no communication with the urethra. Conclusions Urethral sparing histotripsy of the prostate is feasible and well tolerated in a canine model, resulting in modest volume reduction and prompt resorption of homogenized tissue debris. Human studies to evaluate the clinical utility and symptomatic response of urethral sparing are needed. PMID:22840869

  1. Urethral caruncle: Case report of a rare acute urinary retension cause

    PubMed Central

    Çoban, Soner; B?y?k, Ismail

    2014-01-01

    A urethral caruncle is a benign vascular tumour usually originating from the rear lip of the external urethral mea and often observed in postmenopausal women. Urethral caruncle is not included within the list of bladder overdistension causes in women. We present urethral caruncle as a rare cause of acute urinary obstruction in a 41-year-old woman. The case was evaluated with physical examination and the bladder was evacuated with a 12-Fr urethral catheter. A pressure flow study was performed. The caruncle was excised under spinal anesthesia. There were no complications. The urethral catheter was withdrawn on the sixth day and she was discharged with local estrogen. PMID:24839498

  2. Urethroplasty Using Autologous Urethral Tissue-embedded Acellular Porcine Bladder Submucosa Matrix Grafts for the Management of Long-Segment Urethral Stricture in a Rabbit Model.

    PubMed

    Chun, So Young; Kim, Bum Soo; Kwon, Se Yun; Park, Sung Il; Song, Phil Hyun; Yoo, Eun Sang; Kim, Bup Wan; Kwon, Tae Gyun; Kim, Hyun Tae

    2015-03-01

    We conducted this study to evaluate the combined effect of acellular bladder submucosa matrix (BSM) and autologous urethral tissue for the treatment of long segment urethral stricture in a rabbit model. To prepare the BSM, porcine bladder submucosa was processed, decellularized, configured into a sheet-like shape, and sterilized. Twenty rabbits were randomized to normal control, urethral stricture, urethroplasty using BSM only or BSM/autologous urethral tissue (n=5 per group). Retrograde urethrography was performed at 4, 8, and 12 weeks postoperatively, and the grafted specimens were harvested at week 12 to evaluate urethral reconstruction through histopathologic and immunohistochemical analysis. The mean urethral width of the control, stricture, BSM, and BSM/autologous urethral tissue groups at week 12 was 10.3±0.80, 3.8±1.35, 8.8±0.84, and 9.1±1.14 mm, respectively. The histopathologic study revealed that the BSM/autologous urethral tissue graft had a normal area of urethral lumen, compact muscular layers, complete epithelialization, and progressive infiltration by vessels in the regenerated urethra. In contrast, the BSM grafts revealed keratinized epithelium, abundant collagenized fibrous connective tissue, and were devoid of bundles of circular smooth muscle. Nontransected ventral onlay-augmented urethroplasty using an acellular BSM scaffold combined with an autologous urethral tissue graft represents a feasible procedure for urethral reconstruction. PMID:25729254

  3. Bougie urethral dilators: revival or survival?

    PubMed Central

    Al–Adawi, Mohammad Ahmad

    2013-01-01

    Objectives To present our center's experience in managing bladder outlet obstruction (BOO) conditions using bougie dilators. We described the dilation technique methodically for teaching purpose. Patients and method Retrospectively, a total of 196 medical records over the last four years denoting BOO conditions in men, women, and children were retrieved for analysis. Data reviewed for common complications was namely: perforation, recurrence, urinary tract obstruction (UTI) and inability to overcome the obstruction. Results Among the 196 analyzed cases, 24 (12.2%) cases were cured, whereas 172 (87.8%) cases reported complications. Within the complicated cases analyzed, 134 (68.4%) cases had recurrent obstructions, 13 (6.6%) cases had perforations, 6 (3.0%) cases developed UTI, while in 19 (9.7%) cases, we failed to pass the obstruction. Conclusions In our center where urethral dilation technique has revived four years ago, it turned back to be the standard choice in managing BOO cases. We propose the technique to Urology training program directors, all over the world, to teach it as a compulsory skill for junior urologists to master. PMID:24757552

  4. Female urethral diverticulum: cases report and literature

    PubMed Central

    2014-01-01

    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

  5. Sonic hedgehog Signaling from the Urethral Epithelium Controls External Genital Development

    E-print Network

    Cohn, Martin

    Sonic hedgehog Signaling from the Urethral Epithelium Controls External Genital Development Claire tubercle outgrowth, urethral plate epithelium expresses Sonic hedgehog (Shh). In mice with a targeted: external genitalia; urethra; polarizing activity; mouse embryo; Sonic hedgehog; Hox gene; apoptosis

  6. Transurethral holmium laser vaporization to the urethral tumour through a ureteroscope

    PubMed Central

    Li, Aihua; Fang, Wei; Zuo, Xiaoming; Zhang, Feng; Li, Weiwu; Lu, Honghai; Liu, Sikuan; Wang, Hui; Zhang, Binghui

    2014-01-01

    We present 2 cases of urethral cancers: one is recurrent bladder transitional cell carcinoma accompanied by urethral metastatic carcinoma located on the right side of verumontanum, and the other is primary bladder and metastatic urethral adenocarcinoma. The urethral tumour was treated by transurethral holmium laser vaporization to the urethral tumour through a ureteroscope and the bladder tumour was treated with transurethral resection and degeneration of the bladder tumour (TURD-Bt). After the second or third therapy, patients were free of urethral or bladder tumour recurrence; they also did not experience urethral stricture or urinary incontinence during the 24- to 36-month follow-up. Transurethral holmium laser vaporization and TURD-Bt could be performed to treat non-invasive urethral cancer accompanied with bladder cancer and preserve the urethra and bladder. PMID:25553166

  7. Transurethral holmium laser vaporization to the urethral tumour through a ureteroscope.

    PubMed

    Li, Aihua; Fang, Wei; Zuo, Xiaoming; Zhang, Feng; Li, Weiwu; Lu, Honghai; Liu, Sikuan; Wang, Hui; Zhang, Binghui

    2014-11-01

    We present 2 cases of urethral cancers: one is recurrent bladder transitional cell carcinoma accompanied by urethral metastatic carcinoma located on the right side of verumontanum, and the other is primary bladder and metastatic urethral adenocarcinoma. The urethral tumour was treated by transurethral holmium laser vaporization to the urethral tumour through a ureteroscope and the bladder tumour was treated with transurethral resection and degeneration of the bladder tumour (TURD-Bt). After the second or third therapy, patients were free of urethral or bladder tumour recurrence; they also did not experience urethral stricture or urinary incontinence during the 24- to 36-month follow-up. Transurethral holmium laser vaporization and TURD-Bt could be performed to treat non-invasive urethral cancer accompanied with bladder cancer and preserve the urethra and bladder. PMID:25553166

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

    Microsoft Academic Search

    Fang Chen; James J Yoo; Anthony Atala

    1999-01-01

    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

  9. Using Buccal Mucosa for Urethral Reconstruction in Primary and Re-Operative Surgery

    Microsoft Academic Search

    D. Kröpfl; A. Tucak; D. Prlic; A. Verweyen

    1998-01-01

    Objective: Urethral reconstruction using buccal mucosa grafts finds increased broader use in patients with congenital or acquired urethral defects. The authors present their experience of 20 such treated patients. 12 repeatedly operated patients (11 congenital defects, 1 war injury) showed urethral defects of 4.5–20 cm in length. In 8 patients, 6 with hypospadias and 2 with prior straightening of the

  10. Posterior fossa tumor

    MedlinePLUS

    Posterior fossa tumor is a type of brain tumor located in or near the bottom of the ... The posterior fossa is a small space in the skull, found near the brainstem and cerebellum. The cerebellum is ...

  11. Medication Effects on Periurethral Sensation and Urethral Sphincter Activity

    PubMed Central

    Greer, W. Jerod; Gleason, Jonathan L.; Kenton, Kimberly; Szychowski, Jeff M.; Goode, Patricia S; Richter, Holly E

    2014-01-01

    Aim To characterize urethral neuromuscular function before and 2 weeks after medication therapy. Methods Premenopausal women without lower urinary tract symptoms were randomly allocated to one of six medications for 2 weeks (pseudoephedrine ER 120mg, imipramine 25mg, cyclobenzaprine 10mg, tamsulosin 0.4mg, solifenacin 5mg or placebo). At baseline and after medication, participants underwent testing: quantitative concentric needle EMG (CNE) of the urethral sphincter using automated Multi-Motor Unit Action Potential (MUP) software; current perception threshold (CPT) testing to measure periurethral sensation; and standard urodynamic pressure flow studies (PFS). Nonparametric tests were used to compare pre-post differences. Results 56 women had baseline testing; 48 (85.7%) completed follow-up CNE, and 49 (87.5%) completed follow-up CPT and PFS testing. Demographics showed no significant differences among medication groups with respect to age (mean 34.3 ± 10.1), BMI (mean 31.8 ± 7.5), parity (median 1, range 0–7), or race (14% Caucasian, 80% African American). PFS parameters were not significantly different within medication groups. No significant pre-post changes in CNE values were noted; however, trends in amplitudes were in a direction consistent with the expected physiologic effect of the medications. With CPT testing, a trend toward increased urethral sensation at the 5 Hz stimulation level, was observed following treatment with pseudoephedrine (0.15 to 0.09 mA at 5Hz; P=0.03). Conclusion In women without LUTS, pseudoephedrine improved urethral sensation, but not urethral neuromuscular function on CNE or pressure flow studies. Imipramine, cyclobenzaprine, tamsulosin, solifenacin, and placebo did not change urethral sensation or neuromuscular function. PMID:25185603

  12. Development of an artificial urethral valve using SMA actuators

    NASA Astrophysics Data System (ADS)

    Chonan, S.; Jiang, Z. W.; Tani, J.; Orikasa, S.; Tanahashi, Y.; Takagi, T.; Tanaka, M.; Tanikawa, J.

    1997-08-01

    The development of an artificial urethral valve for the treatment of urinary incontinence which occurs frequently in the aged is described. The prototype urethral valve is assembled in hand-drum form with four thin shape memory alloy (SMA) (nickel - titanium alloy) plates of 0.3 mm thickness. The shape memory effect in two directions is used to replace the urinary canal sphincter muscles and to control the canal opening and closing functions. The characteristic of the SMA is to assume the shape of a circular arc at normal temperatures and a flat shape at higher temperatures. Experiments have been conducted using a canine bladder and urinary canal.

  13. [Traumatic recurrence of idiopathic spinal cord herniation].

    PubMed

    Lorente-Muñoz, Asís; Cortés-Franco, Severiano; Moles-Herbera, Jesús; Casado-Pellejero, Juan; Rivero-Celada, David; Alberdi-Viñas, Juan

    2013-01-01

    Idiopathic spinal cord herniation is a rare cause of thoracic myelopathy and its recurrence is even more infrequent. Cord herniation is through an anterior dural defect in thoracic spine with unknown causes. Symptomatic cases must be surgically treated to reduce the hernia and seal the defect to prevent recurrences. We report a patient presenting a Brown-Séquard syndrome secondary to a D5 spinal cord herniation treated successfully and its posterior traumatic recurrence. PMID:23453309

  14. Urethral pseudodiverticulum secondary to penile fracture and complete urethra dissection

    PubMed Central

    Di Pierro, Giovanni B.; Iannotta, Luca; Innocenzi, Michele; Caterina, Gulia; Grande, Pietro; Cristini, Cristiano; Gentile, Vincenzo

    2013-01-01

    A 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck’s fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudodiverticulum was found at anastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion. PMID:23766837

  15. Congenital urethral stenosis in a male miniature piglet

    PubMed Central

    Pouleur-Larrat, Bénédicte; Maccolini, Edouard; Carmel, Eric Norman; Hélie, Pierre

    2014-01-01

    A 2-month-old male miniature pig showed progressive abdominal pain, pollakiuria, and stranguria that progressed to complete urinary obstruction. Postmortem examination revealed idiopathic urethral stenosis at the level of the recess, of probable congenital origin. Urinary tract malformations should be included in the differential diagnosis of miniature piglets with urinary disorders. PMID:24891635

  16. Urethral reconstruction following an unsuccessful one-stage hypospadias repair

    Microsoft Academic Search

    Jack S. Elder; John W. Duckett

    1987-01-01

    At present, essentially all cases of hypospadias may be repaired in a single stage on an outpatient basis or with a single night's stay. Urethrocutaneous fistula, anastomotic stricture, and meatal stenosis are the most common complications. A urethral diverticulum may develop following a transverse preputial island flap if the caliber of the neourethra is too large or secondary to postoperative

  17. Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty

    PubMed Central

    Tinaut-Ranera, Javier; Arrabal-Polo, Miguel Ángel; Merino-Salas, Sergio; Nogueras-Ocaña, Mercedes; López-León, Víctor Manuel; Palao-Yago, Francisco; Arrabal-Martín, Miguel; Lahoz-García, Clara; Alaminos, Miguel; Zuluaga-Gomez, Armando

    2014-01-01

    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

  18. Preputial island flap in extensive urethral stricture repair

    Microsoft Academic Search

    A. I. Mitre; S. Arap; A. M. Lucon

    1992-01-01

    Seven patients with extensive urethral strictures were treated with a preputial island flap applied as a tubularised neourethra or as a patch covering the longitudinally incised urethra. This flap enables the correction of strictures as long as 9 cm. In two subjects, a double preputial island flap was employed, with the outer layer being used to replace the lacking skin.

  19. Understanding Child Traumatic Stress

    MedlinePLUS

    ... us of what happened. Back to Top How Development Influences Posttraumatic Stress Responses Age, developmental maturity, and ... to Top The Impact of Traumatic Stress on Development Traumatic experiences have effects on children's development that ...

  20. Coping with Traumatic Events

    MedlinePLUS Videos and Cool Tools

    ... Health Services Administration (SAMHSA) Resource Page Violence and Mental Illness Fact Sheet Coping with Violence and Traumatic Events ... Blog About Coping with Traumatic Events Understanding Severe Mental Illness January 11, 2011 Tragedy at Fort Hood November ...

  1. Management of recurrent bulbar urethral stricture-a 54 patients study with Allium bulbar urethral stent (BUS)

    PubMed Central

    Culha, Melih; Ozkuvanci, Unsal; Ciftci, Seyfettin; Saribacak, Ali; Ustuner, Murat; Yavuz, Ufuk; Yilmaz, Hasan; Ozkan, Levend

    2014-01-01

    The Allium Bulbar Urethral Stent (BUS) is a fully covered, self-expandable, large caliber metal stent specially designed for the treatment of bulbar urethra strictures. The stent is intended for a long term use for the purpose of opening the occluded urethral passage and to allow spontaneous urination. This study objective was to evaluate the clinical efficacy of temporary placement of the Allium BUS stent. This was a prospective study in 54 men with recurrent benign urethral stricture conducted during 2009 to 2012. All men underwent an internal urethrotomy or dilatation procedure followed by an endoscopic stent placement. Clinical success was achieved in 44 (81.4%) of the 54 patients. No patient reported discomfort at the stent site. 2 stents migrated distally. 1 stent was occluded. All stents were removed in a mean time of 8.8 (range 3-18) months following implantation. This experience with the Allium BUS for treating urethral strictures suggests that it is safe and reliable treatment modality. PMID:25419377

  2. Post-Traumatic Cavernous Fistula Fed by Persistent Trigeminal Artery: Treatment by GDC Embolisation

    PubMed Central

    Deol, P.S.; Mishra, N.K.; Gupta, V.; Gaikwad, S.B.; Garg, A.; Singh, N.

    2001-01-01

    Summary A case of traumatic persistent primitive trigeminal artery (PPTA) cavernous sinus fistula treated with GDC embolisation is reported. Because of the small lumen of PPTA, posteriorly directed course and flow contribution from the posterior circulation, balloon embolisation via the carotid system was not considered appropriate. The fistula was successfully closed by GDC embolisation. PMID:20663331

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

    PubMed

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

    1996-11-01

    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

  4. Ventral free oral mucous membrane graft for bulbar urethral stricture.

    PubMed

    Haque, M E; Rahman, M A; Islam, M F; Siddique, F H; Uddin, M M; Khondoker, M I; Kaiser, I; Siddiqui, O; Karim, M M; Saha, P; Salam, M A

    2012-10-01

    The use of oral mucous membrane graft onlay urethroplasty represents the most widespread method of bulbar urethral stricture repair. We investigated the short term result of oral mucous membrane graft placed on the ventral surface for management of bulbar urethral stricture. Patients with Bulbar urethral stricture of any length, infection free urinary tract and informed consent for oral mucosa harvesting and urethroplasty were selected for study. We enrolled 108 cases of bulbar urethral stricture patients from January 2004 to July 2009. The mean ± SD preoperative maximum flow rate of 5.2 ± 2.6 ml/sec and mean ± SD PVR 87 ± 58.3 ml were treated by substitution urethroplasty with oral mucous membrane by a single surgical team in a private hospital. Causes of stricture were trauma 26(24.1%), infection 58(53.7%), catheter induced 8(7.4%), post TURP 11(10.2%) and unknown 5(4.6%). Oral mucous membrane was harvested from the cheek or from the inner side of lower lip. Defect of the urethra displayed by longitudinal ventral urethrotomy and the graft was sutured over the edges of the incised urethral mucosa over a 14 Fr latex Foley's catheter. Spongiosum tissue was closed over the graft. Pericatheter urethrogram was performed in all cases to check for the anastomotic leakage and the Catheter was removed after 2 weeks of the procedure. After removal of catheter uroflowmetry & ultrasound scan of bladder were performed to estimate the maximum flow rate and post voidal residue. The patient was followed-up every 3 months with uroflowmetry & ultrasonography. The median (range) age of the patients was 32(21-72) years. Mean follow up period was 36 months (range 12-54). Mean ± SD stricture length was 3.7 ± 2.6 cm. The overall success rate was 91.7%. Mean ± SD flow rate was 23 ± 4.2 ml/sec, mean ± SD post void residue was 25 ± 15.5 ml and patient quality of life (QOL) was excellent in almost all patients. Overall complications were seen in 9(8.3%) cases. Of which, restricture occurred in 6 patients; periurethral fistulae seen in 2 cases and per urethral bleeding in 1 patient. No significant complications were observed at the donor site. Oral numbness and mild discomfort complained by 67.6% patients which were managed by reassurance only. In our experience ventral placement of oral mucous membrane graft along with spongioplasty is a very easy procedure with very encouraging short term result. PMID:23134920

  5. Posterior Ischemic Optic Neuropathy

    Microsoft Academic Search

    Y. Isayama; T. Takahashi; M. Inoue; T. Jimura

    1983-01-01

    14 cases of posterior ischemic optic neuropathy (PION) were clinically analyzed, in whom we excluded known etiologies of optic nerve disturbances and confirmed the decreased blood supply to the posterior portion of the optic nerve. On the basis of our clinical findings, we have proposed the following criteria for the diagnosis of idiopathic PION: (1) sudden onset of unilateral visual

  6. Endoscopic endonasal posterior clinoidectomy

    PubMed Central

    Silva, Danilo; Attia, Moshe; Kandasamy, Jothy; Alimi, Marjan; Anand, Vijay K.; Schwartz, Theodore H.

    2012-01-01

    Background: Posterior clinoidectomy is a useful procedure for maximizing exposure to the interpeduncular cistern via transcranial approaches for basilar tip aneurysms and select intracranial tumors. The value of posterior clinoidectomy during endonasal endoscopic transclival surgery is not well described. Methods: We performed endoscopic endonasal transsphenoidal extradural bilateral posterior clinoidectomy and dorsum sella removal on five silicon-injected cadaveric heads. The dorsum sella was split in the midline and removed from medial to lateral until the posterior clinoids were encountered. The posterior clinoid was dissected from the medial wall of the cavernous sinus and mobilized medially in order to detach it from the ligaments and carefully fractured it from the bony attachment to the petrous apex and carotid canal. Following this, the clival and dorsum sella dura was opened to expose the interpeduncular cistern and its contents. Results: The technical feasibility of endoscopic endonasal extradural posterior clinoidectomy was reproduced in all five cadaveric specimens. This technique was performed without damaging the vital structures, including preservation of the pituitary gland. After performing bilateral posterior clinoidectomy, the retrosellar dura was opened, allowing good visualization of the contents of the prepontine and interpeduncular cistern. Conclusion: We describe the technique of endoscopic endonasal extradural posterior clinoidectomy. We believe this approach is best suited for retrosellar pathology located in the interpeduncular cistern and is a useful adjunct to the transclival approach to increase the field of view and maximize the extent of resection. PMID:22754729

  7. The Treatment of Traumatic Posterior Sternoclavicular Joint Injuries

    Microsoft Academic Search

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

    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

  8. Urethral and neobladder cytologic survey in patients with total cystectomy.

    PubMed

    Raica, M; Ioiart, I

    1992-01-01

    Fourteen patients with total cystectomy and sigmoidian ureterostomy, 10 with cutaneous ureterostomy and 6 with substitution bladder were studied from the cytologic point of view; from all patients samples of voided urine, urethral and neobladder washing were taken and smears stained with blue polychrom-tanin Dr?gan; the smears which belong to the last group were cytochemically investigated, too. From morphohistochemical point of view biopsies taken from cases with recurrences and one case with substitution bladder which died in the 10th day after surgery were studied. The cytologic study revealed two recurrences: one urethral and one at the pelvis level at 18 and respectively 4 months from total cystectomy, both being transitional cell carcinoma. Cytologic and histochemical aspects of the intestinal wall used as neobladder are described, revealing epithelial modifications and chronic inflammatory infiltrate with marked decrease of mucous synthesis. The importance of urinary cytology in oncologic survey of these patients is discussed. PMID:1295605

  9. Recurrent urethral fibroepithelial polyps in a golden retriever.

    PubMed

    Grant, David C; Troy, Gregory C

    2014-01-01

    A 2 yr old castrated male golden retriever was referred multiple times over a period of 7.5 yr for stranguria, pollakiuria, urinary incontinence and urinary outflow obstructions due to urethral polyps. Diagnostic imaging modalities used to identify polyps included abdominal ultrasound, excretory urography, double-contrast retrograde urethrocystograms, and urethrocystoscopy, which revealed multiple filling defects within the proximal and prostatic urethra. Multiple cystotomies and endourologic procedures were performed to remove the multiple fibroepithelial polyps within the proximal and prostatic urethra. Urinary incontinence resulted from treatments, but did respond to phenylpropanolamine. Medical treatment consisted of a nonsteroidal anti-inflammatory drug, which appeared to decrease the recurrence of the polyps over time. Urethral polyps are an uncommon cause of urinary outflow obstruction and do not usually recur after removal. This case illustrates an uncommon clinical presentation and the difficulties encountered in treatment over an expanded time frame. PMID:25028431

  10. Late urethral erosion of transobturator suburethral mesh (Obtape ® ): a minimally invasive management under local anaesthesia

    Microsoft Academic Search

    Tiago Moura Mendonça; David Martinho; José Palma dos Reis

    2011-01-01

    The placement of transobturator sub-urethral synthetic tapes, although with a high success rate of achieving continence, carries\\u000a the risk of tape erosion to adjacent structures. While vaginal erosion occurs more frequently, urethral erosion has also been\\u000a reported, usually in the immediate or early postoperative period. We present two different cases of urethral erosion with\\u000a the Obtape® sling, the first one

  11. Nitinol urethral stents: long-term results in dogs

    Microsoft Academic Search

    D. Latal; J. Mraz; P. Zerhau; M. Susani; M. Marberger

    1994-01-01

    No information has been available to date on the long-term behavior of nitinol (nickel-titanium alloy) urethral stents. In the present study, prostheses of this type were implanted in 18 German shepherd dogs in order to evaluate the reaction of the mucosa, muscles and periurethral tissue. Follow-up examinations performed after 1 week, and 1, 3, 6, 12 and 18 months included

  12. Urethral Erosion and Perineal Cellulitis after Midurethral Sling Procedure

    PubMed Central

    Kim, Jong Min; Bae, Jang Ho; Song, Phil Hyun; Shin, Esther

    2011-01-01

    Midurethral tension-free sling procedure has become one of the most popular techniques for the treatment of stress urinary incontinence. As the time elapsed, however, complications associated with a synthetic tape have been reported to occur. Recently, we experienced a rare case of urethral erosion with perineal cellulitis at anterior wall of vagina after midurethral sling procedure. So our experience was presented with a review of literature. PMID:21811701

  13. Somatomotor and sensory urethral control of micturition in female rats.

    PubMed

    Cruz, Yolanda; Pastelín, César; Balog, Brian M; Zaszczurynski, Paul J; Damaser, Margot S

    2014-12-01

    In rats, axons of external urethral sphincter (EUS) motoneurons travel through the anastomotic branch of the pudendal nerve (ABPD) and anastomotic branch of the lumbosacral trunk (ABLT) and converge in the motor branch of the sacral plexus (MBSP). The aim of the present study was to determine in female rats the contribution of these somatomotor pathways and urethral sensory innervation from the dorsal nerve of the clitoris on urinary continence and voiding. EUS electromyographic (EMG) activity during cystometry, leak point pressure (LPP), and voiding efficiency (VE) were assessed in anesthetized virgin Sprague-Dawley female rats before and after transection of the above nerve branches. Transection of the MBSP eliminated EUS EMG, decreased LPP by 50%, and significantly reduced bladder contraction duration, peak pressure, intercontraction interval, and VE. Transection of the ABPD or ABLT decreased EUS EMG discharge and LPP by 25% but did not affect VE. Transection of the dorsal nerve of the clitoris did not affect LPP but reduced contraction duration, peak pressure, intercontraction interval, and VE. We conclude that somatomotor control of micturition is provided by the MBSP with axons travelling through the ABPD and ABLT. Partial somatomotor urethral denervation induces mild urinary incontinence, whereas partial afferent denervation induces voiding dysfunction. ABPD and ABLT pathways could represent a safeguard ensuring innervation to the EUS in case of upper nerve damage. Detailed knowledge of neuroanatomy and functional innervation of the urethra will enable more accurate animal models of neural development, disease, and dysfunction in the future. PMID:25339694

  14. Diagnosis and therapy of the female urethral diverticula.

    PubMed

    Fortunato, P; Schettini, M; Gallucci, M

    2001-01-01

    The various diagnostic and therapeutic modalities currently in use for urethral diverticula are reviewed. Various radiographic techniques have been reported, but only voiding cystourethrography (VCUG) and positive-pressure urethrography (PPU) are currently utilized. Urethroscopy is another suitable technique for diagnosis. Various sonographic techniques have been proposed, but their sensitivity is improved only by the transvaginal approach and magnetic resonance imaging (MRI). Various treatment methods have been proposed. The standard operative approach is surgical, through the vagina. The techniques currently in use to treat urethral diverticula are the Spence procedure, the typical urethral diverticulectomy, and the Tancer partial ablation technique. A full history, and physical examination is the first step in screening. When the diagnosis is suspected ultrasound and radiological imaging is necessary. Sonography is the first non-invasive examination to be performed. In negative cases it is imperative to perform a PPU or MRI. Symptomatic and very large diverticula must be treated in the easiest way possible. The best treatment, except for complicated and infected diverticula, is excision. PMID:11294533

  15. Acute urinary retention in women due to urethral calculi: A rare case

    PubMed Central

    Turo, Rafal; Smolski, Michal; Kujawa, Magda; Brown, Stephen C.W.; Brough, Richard; Collins, Gerald N.

    2014-01-01

    We present a case of a 51-year-old woman with acute urinary retention caused by a urethral calculus. Urethral calculi in women are extremely rare and are usually formed in association with underlying genitourinary pathology. In this case, however, no pathology was detected via thorough urological evaluation. We discuss the pathogenesis, clinical presentation and treatment of urethral calculi. To our knowledge, this is the second reported case of a primary urethral calculus in a female with an anatomically normal urinary tract and the first in a middle-aged Caucasian female. PMID:24554984

  16. [Traumatic lung hernia].

    PubMed

    Marsico, Giovanni Antonio; Boasquevisque, Carlos Henrique Ribeiro; Loureiro, Gustavo Lucas; Marques, Rodrigo Felipe; Clemente, Antonio Miraldi

    2011-01-01

    Traumatic lung herniation is an unusual clinical problem. We present a case of a large left post-traumatic lung hernia on the left, anterior, second intercostal space following blunt chest trauma. An important factor in the etiology of these lesions is the relative lack of muscular support of the anterior part of the chest. This report describes the diagnosis and management of a post-traumatic lung hernia. PMID:21537748

  17. STABILITY AND INFINITESIMAL ROBUSTNESS OF POSTERIOR DISTRIBUTIONS AND POSTERIOR QUANTITIES

    E-print Network

    Basu, Sanjib

    STABILITY AND INFINITESIMAL ROBUSTNESS OF POSTERIOR DISTRIBUTIONS AND POSTERIOR QUANTITIES revision February, 1998 Abstract Infinitesimal sensitivities of the posterior distribution P (\\DeltajX ) and posterior quantities ae(P ) w.r.t. the choice of the prior P are considered. In a very general setting

  18. Traumatic Childhood and Marriage

    Microsoft Academic Search

    Linda Skogrand; Daniel Woodbury; John Defrain; Nikki Defrain; Jean E. Jones

    2005-01-01

    This exploratory, qualitative study of 84 adults who have survived and transcended a traumatic childhood describes the role their spouses played in the process of rising above their difficult childhood experiences. The participants talked about what they were looking for in a spouse, negative marriage experiences, and the positive role spousal support played in transcending the traumatic childhood. The study

  19. Facilitating post traumatic growth

    Microsoft Academic Search

    de Sales Turner; Helen Cox

    2004-01-01

    BACKGROUND: Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal

  20. Traumatic Brain Injury

    NSDL National Science Digital Library

    Dr. Leslie Nader (MSMR)

    2000-02-01

    Very concise description of what constitutes a traumatic brain injury and the cost to society in hospitalizations, injuries and deaths resulting from traumatic brain injury. It also looks very concisely at new understandings of the nature of TBIs and the research being done to find better treatments.

  1. Experimental traumatic brain injury

    PubMed Central

    2010-01-01

    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 pathology of traumatic brain injury towards the development of novel treatments. Among the rodent models of traumatic brain injury the most commonly used are the weight-drop, the fluid percussion, and the cortical contusion injury models. As the entire spectrum of events that might occur in traumatic brain injury cannot be covered by one single rodent model, the design and choice of a specific model represents a major challenge for neuroscientists. This review summarizes and evaluates the strengths and weaknesses of the currently available rodent models for traumatic brain injury. PMID:20707892

  2. Posterior Predictive Inference Sudipto Banerjee

    E-print Network

    Carlin, Bradley P.

    Posterior Predictive Inference Sudipto Banerjee sudiptob@biostat.umn.edu University of Minnesota Posterior Predictive Inference ­ p. 1/ #12;Posterior Predictive Checks Assume modelling data as y = (y1(T(yrep, ) > T(y, ) | y) = 1 M M t=1 1[T(yt rep, t) > T(y, t)]. Posterior Predictive Inference ­ p. 2/ #12;Model

  3. Traumatic lumbosacral lateral dislocation without fracture

    Microsoft Academic Search

    Federico De Iure; Stefania Paderni; Alessandro Gasbarrini; Stefano Bandiera; Stefano Boriani

    2008-01-01

    Study design  A unique case of lumbosacral lateral dislocation without fracture is reported.\\u000a \\u000a \\u000a \\u000a Objective  To report on the diagnosis and treatment of a traumatic L5-S1 lateral dislocation in a polytrauma 34-year-old male with L5\\u000a nerve root paralysis.\\u000a \\u000a \\u000a \\u000a Method  Interbody fusion following decompression, posterior reduction and interbody grafting combined with posterior plating was performed.\\u000a \\u000a \\u000a \\u000a Results  At an early stage the patient was able to return

  4. Spondylolisthesis and posterior instability.

    PubMed

    Niggemann, P; Simons, P; Kuchta, J; Beyer, H K; Frey, H; Grosskurth, D

    2009-04-01

    We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI. PMID:19253068

  5. Post-traumatic stress disorder

    Microsoft Academic Search

    Jonathan I. Bisson

    2007-01-01

    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,

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

    PubMed Central

    2014-01-01

    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

  7. Acute traumatic hallux valgus.

    PubMed

    Lui, T H

    2013-01-01

    Post-traumatic hallux valgus is an uncommon condition with sporadic reports. The deformity usually develops in a gradual manner following direct injury to the first ray; including injury to the first metatarsophalangeal joint, the first metatarsal bone or the first metatarsal-cuneiform joint. A case of acute traumatic hallux valgus following metatarsal neck fractures of the lesser rays is reported. We believe that understanding the importance of the transverse 'tie-bar' system in the pathogenesis of post-traumatic hallux valgus deformity avoids unnecessary surgery to the great toe. PMID:23688849

  8. Posterior sagittal proctectomy.

    PubMed Central

    Stringer, M. D.; Crabbe, D. C.

    1998-01-01

    Rectal excision for non-malignant conditions using a posterior sagittal approach is described in three patients. The technique allows excellent exposure of the rectum, meticulous haemostasis, minimal risk of pelvic nerve injury and accurate reconstruction of the pelvic floor without the need for drainage. Images Figure 2 PMID:9623381

  9. Posterior distribution Andrew Gelman

    E-print Network

    Gelman, Andrew

    Posterior distribution Andrew Gelman Volume 3, pp 1627­1628 in Encyclopedia of Environmetrics (ISBN of the vector of uncertain quantities w1, . . . , wJ, as illustrated in the following matrix: l w1 w2 Ð Ð Ð wJ 1

  10. Posterior Cranial Fossa Meningiomas*

    PubMed Central

    Javalkar, Vijayakumar; Banerjee, Anirban Deep; Nanda, Anil

    2012-01-01

    This study evaluated the outcomes, complications, and recurrence rates of posterior cranial fossa meningiomas. We retrospectively reviewed our surgical experience with 64 posterior cranial fossa meningiomas. Mean age was 56 years with a female preponderance (67.2%). Headache was the most common symptom. Retrosigmoid approach was the commonest surgical procedure (23.4%). The incidence of cranial nerve related complications was 28%. Postoperatively facial nerve weakness was observed in 11%. The incidence of cerebrospinal fluid leak was 4.6%. Gross total resection was achieved in 37 patients (58%). Sixteen patients (25%) with residual tumors underwent Gamma knife radiosurgery. Recurrence or tumor progression was observed in 12 patients (18.7%). Operative mortality was 3.1%. At their last follow-up, 93% of the cases achieved Glasgow Outcome Scale scores 4 or 5. Total excision is the ideal goal which can be achieved with meningiomas located in certain location, such as lateral convexity, but for other posterior fossa meningiomas the close proximity of critical structures is a major obstacle in achieving this goal. In practicality, a balance between good functional outcome and extent of resection is important for posterior cranial fossa meningiomas in proximity to critical structures. PMID:23372989

  11. Urethral Dysfunction in Female Mice with Estrogen Receptor ? Deficiency

    PubMed Central

    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

    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

  12. Immediate open anterior reduction and antero-posterior fixation\\/fusion for bilateral cervical locked facets

    Microsoft Academic Search

    2005-01-01

    Summary Background. Bilateral cervical locked facets is a severe traumatic lesion, most frequently resulting in tetraplegia. The common treatment strategy has been an attempt of awake, closed reduction, adding general anesthesia, muscle relaxation and manual traction in difficult cases. In cases of failed closed reduction, open reduction has most commonly been performed by a posterior approach. Patients in the current

  13. Traumatic events and children

    MedlinePLUS

    ... traumatic events are: Natural disasters, such as a tornado, hurricane, fire, or flood Rape Witness shooting or ... near you or hold your hand. Accept and work with your child on regressed behaviors. Monitor information ...

  14. Traumatic Brain Injury

    MedlinePLUS

    ... Adults CDC Pediatric MTBI Workgroup Online Training Press, Social Media, and New Media Guide to Writing about Traumatic Brain Injury in News and Social Media Heads Up to Concussion Injury Center Topics Saving ...

  15. Traumatic Brain Injury

    MedlinePLUS

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  16. Suprapubic Cystostomy for the Management of Urethral Injuries During Penile Prosthesis Implantation

    PubMed Central

    Anele, Uzoma A; Le, Brian V; Burnett, Arthur L

    2014-01-01

    Introduction Urethral injury is an uncommon surgical complication of penile prosthesis (PP) surgery. Conventional dogma requires abortion of the procedure if the adjacent corporal body is involved or delayed implantation to avert device infection associated with urinary extravasation. Besides the setback of the aborted surgery, this management approach also presents the possible difficulty of encountering corporal fibrosis at the time of reoperation. Aim We report an approach using primary urethral repair and temporary suprapubic cystostomy for the management of incidental urethral injuries in a cohort of patients allowing for successful completion of unaborted PP implantation. Materials and Methods We performed a retrospective analysis of all patients receiving PPs from 1990 to 2014 in which incidental urethral injuries were repaired and PP implantation was completed with suprapubic cystostomy (suprapubic tube [SPT] insertion). After allowing for urethral healing and urinary diversion via SPT for 4–8 weeks, the PP was activated. Main Outcome Measures Successful management was determined by the absence of perioperative complications within 6 months of implantation. Results We identified four cases, all receiving inflatable PPs, managed with temporary suprapubic cystostomy. These patients sustained urethral injuries during corporal dissection (one patient), corporal dilation (one patient), and penile straightening (two patients). All patients were managed safely and successfully. Conclusion Primary urethral repair followed by temporary suprapubic cystostomy offers a surgical approach to complete PP implantation successfully in patients who sustain urethral injury complications, particularly for complex PP surgeries. Anele UA, Le BV, and Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation. PMID:25548649

  17. Thalamic integrity underlies executive dysfunction in traumatic brain injury

    PubMed Central

    Little, D. M.; Kraus, M. F.; Joseph, J.; Geary, E. K.; Susmaras, T.; Zhou, X. J.; Pliskin, N.; Gorelick, P. B.

    2010-01-01

    Objective: To quantify the effects of traumatic brain injury on integrity of thalamocortical projection fibers and to evaluate whether damage to these fibers accounts for impairments in executive function in chronic traumatic brain injury. Methods: High-resolution (voxel size: 0.78 mm × 0.78 mm × 3 mm3) diffusion tensor MRI of the thalamus was conducted on 24 patients with a history of single, closed-head traumatic brain injury (TBI) (12 each of mild TBI and moderate to severe TBI) and 12 age- and education-matched controls. Detailed neuropsychological testing with an emphasis on executive function was also conducted. Fractional anisotropy was extracted from 12 regions of interest in cortical and corpus callosum structures and 7 subcortical regions of interest (anterior, ventral anterior, ventral lateral, dorsomedial, ventral posterior lateral, ventral posterior medial, and pulvinar thalamic nuclei). Results: Relative to controls, patients with a history of brain injury showed reductions in fractional anisotropy in both the anterior and posterior corona radiata, forceps major, the body of the corpus callosum, and fibers identified from seed voxels in the anterior and ventral anterior thalamic nuclei. Fractional anisotropy from cortico-cortico and corpus callosum regions of interest did not account for significant variance in neuropsychological function. However, fractional anisotropy from the thalamic seed voxels did account for variance in executive function, attention, and memory. Conclusions: The data provide preliminary evidence that traumatic brain injury and resulting diffuse axonal injury results in damage to the thalamic projection fibers and is of clinical relevance to cognition. GLOSSARY ACR = anterior corona radiata; AN = anterior thalamic nucleus; bCC = body of the corpus callosum; CST = cortical-spinal tract; DAI = diffuse axonal injury; DM = dorsomedial nucleus; DTI = diffusion tensor imaging; FA = fractional anisotropy; fMaj = forceps major; fMin = forceps minor; FOV = field of view; FSE = fast spin echo; gCC = genu of the corpus callosum; IC = internal capsule; IFOF = inferior frontal occipital fasciculus; LOC = loss of consciousness; miTBI = mild TBI; msTBI = moderate to severe TBI; NEX = number of excitations; PCR = posterior corona radiata; PTA = posttraumatic amnesia; PU = pulvinar; ROI = region of interest; sCC = splenium of the corpus callosum; SLF = superior longitudinal fasciculus; SS = sagittal stratum; TBI = traumatic brain injury; TE = echo time; TR = repetition time; VA = ventral anterior thalamic nucleus; VL = ventral lateral thalamic nucleus; VPL = ventral posterior lateral nucleus; VPM = ventral posterior medial nucleus. PMID:20089945

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

    PubMed Central

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

    2014-01-01

    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. PMID:25405054

  19. Anterior urethral reconstruction using the circular fasciocutaneous flap technique: long-term follow-up

    Microsoft Academic Search

    Christian Schwentner; Joerg Seibold; Daniela Colleselli; Saladin H. Alloussi; Georgios Gakis; David Schilling; Karl-Dietrich Sievert; Arnulf Stenzl; Christian Radmayr

    2011-01-01

    Purpose  The circular fasciocutaneous skin flap technique (FCF) yields excellent short-term results for complex anterior urethral reconstruction.\\u000a We performed an observational retrospective and descriptive study to report our long-term experience.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 36 adults with anterior urethral strictures (AUS) exceeding 3 cm underwent single-stage urethroplasty using the\\u000a FCF. Exclusion criteria were: lichen sclerosus, absence of the urethral plate and hypospadias. All

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

    NASA Astrophysics Data System (ADS)

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

    2007-02-01

    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.

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

    SciTech Connect

    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

    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.

  2. Traumatic Alterations in Consciousness: Traumatic Brain Injury

    PubMed Central

    Blyth, Brian J.; Bazarian, Jeffrey J.

    2010-01-01

    Mild traumatic brain injury (mTBI) refers to the clinical condition of transient alteration of consciousness as a result of traumatic injury to the brain. The priority of emergency care is to identify and facilitate the treatment of rare but potentially life threatening intra-cranial injuries associated with mTBI through the judicious application of appropriate imaging studies and neurosurgical consultation. Although post-mTBI symptoms quickly and completely resolve in the vast majority of cases, a significant number of patients will complain of lasting problems that may cause significant disability. Simple and early interventions such as patient education and appropriate referral can reduce the likelihood of chronic symptoms. Although definitive evidence is lacking, mTBI is likely to be related to significant long-term sequelae such as Alzheimer's disease and other neurodegenerative processes. PMID:20709244

  3. Persistent occiput posterior.

    PubMed

    Barth, William H

    2015-03-01

    Persistent occiput posterior (OP) is associated with increased rates of maternal and newborn morbidity. Its diagnosis by physical examination is challenging but is improved with bedside ultrasonography. Occiput posterior discovered in the active phase or early second stage of labor usually resolves spontaneously. When it does not, prophylactic manual rotation may decrease persistent OP and its associated complications. When delivery is indicated for arrest of descent in the setting of persistent OP, a pragmatic approach is suggested. Suspected fetal macrosomia, a biparietal diameter above the pelvic inlet or a maternal pelvis with android features should prompt cesarean delivery. Nonrotational operative vaginal delivery is appropriate when the maternal pelvis has a narrow anterior segment but ample room posteriorly, like with anthropoid features. When all other conditions are met and the fetal head arrests in an OP position in a patient with gynecoid pelvic features and ample room anteriorly, options include cesarean delivery, nonrotational operative vaginal delivery, and rotational procedures, either manual or with the use of rotational forceps. Recent literature suggests that maternal and fetal outcomes with rotational forceps are better than those reported in older series. Although not without significant challenges, a role remains for teaching and practicing selected rotational forceps operations in contemporary obstetrics. PMID:25730235

  4. Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

    PubMed Central

    Batdorf, Niles J.; Lettieri, Salvatore C.

    2013-01-01

    Summary: Proximal, posterior thigh wounds from oncologic or traumatic defects can be difficult wounds to reconstruct if local flap options have been sacrificed during the trauma or oncologic resection. Free flap options to cover these defects are also difficult because of the lack of convenient recipient vessels in the region. The authors present 2 cases (oncologic and traumatic) wherein a myocutaneous anterolateral thigh (ALT) flap was harvested and tunneled from the anterior muscle compartment to the posterior muscle compartment of the thigh through a medially based transmuscular tunnel, decreasing the required pedicle distance to the wound. This technique of transmuscular tunneling of the ALT flap expands the indications and utility of the ALT flap to cover posterior thigh wounds. PMID:25289275

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

    PubMed Central

    Ross, Curtis

    2013-01-01

    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

  6. TRAUMATIC BRAIN INJURY (TBI) DATABASE

    EPA Science Inventory

    The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Instit...

  7. Traumatic Brain Injury and Dystonia

    MedlinePLUS

    Traumatic brain injury (TBI) occurs when a sudden trauma damages to the brain. TBI can occur when the head suddenly ... between dystonia and TBI is urgently needed. Traumatic Brain Injury & Dystonia Diagnosis & Treatment • TBI may involve physical, cognitive, ...

  8. Facilitating post traumatic growth

    PubMed Central

    Turner, de Sales; Cox, Helen

    2004-01-01

    Background Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal care. All participants were injured through involvement in a motor vehicle accident, with the exception of one, who was injured through falling off the roof of a house. Methods In this qualitative study, we used an audio-taped in-depth interview with each participant as the means of data collection. Interviews were transcribed verbatim and analysed thematically to determine the participants' unique perspectives on the experience of recovery from traumatic injury. In reporting the findings, all participants' were given a pseudonym to assure their anonymity. Results Most participants indicated that their involvement in a traumatic occurrence was a springboard for growth that enabled them to develop new perspectives on life and living. Conclusion There are a number of contributions that health providers may make to the recovery of individuals who have been traumatically injured to assist them to develop new views of vulnerability and strength, make changes in relationships, and facilitate philosophical, physical and spiritual growth. PMID:15248894

  9. Palliative Surgery for Rare Cases of Anterior Urethral Metastasis in Prostate Cancer

    PubMed Central

    Gómez Gómez, Enrique; Carrasco Aznar, Jose Carlos; Moreno Rodríguez, Maria del Mar; Valero Rosa, José; Requena Tapia, Maria José

    2014-01-01

    Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature. PMID:25161796

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

    Microsoft Academic Search

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

    2009-01-01

    The purpose of this study was to evaluate the effect of colpocleisis and concomitant mid-urethral sling on voiding function.\\u000a This is an IRB-approved, retrospective case series of women who underwent a colpocleisis with concomitant synthetic mid-urethral\\u000a sling for treatment of stress urinary incontinence (SUI) between January 2005 and September 2007. Thirty-eight women with\\u000a pelvic organ prolapse and SUI symptoms were

  11. Physiological effects of human muscle-derived stem cell implantation on urethral smooth muscle function

    Microsoft Academic Search

    Akira Furuta; Ron J. Jankowski; Ryan Pruchnic; Shin Egawa; Naoki Yoshimura; Michael B. Chancellor

    2008-01-01

    The physiological effects of human muscle-derived stem cell (MDSC) implantation on urethral smooth muscle function were investigated\\u000a in pudendal nerve-transected nude rats with human MDSC (TM) or saline (TS) injection into the proximal urethra compared with\\u000a sham-operated, saline-injected nude rats (SS). Leak point pressure (LPP) before and after hexamethonium application, which\\u000a can block autonomic efferent nerves, and proximal urethral contractile

  12. The role of urethral dilation in managing pediatric neurogenic bladder dysfunction

    Microsoft Academic Search

    Julian Wan

    2009-01-01

    Urethral dilation is an effective method of treating children with neurogenic bladders who have poor bladder compliance, high\\u000a leak point pressure, and are unresponsive to standard therapy with anticholinergic medications and clean intermittent catheterization.\\u000a Urethral dilation can be successfully applied to boys and girls and has few side effects. There are no demonstrated long-term\\u000a effects on continence. However, the use

  13. Congenital anterior urethral diverticulum: antenatal diagnosis with subsequent neonatal endoscopic management.

    PubMed

    Adam, Ahmed; Myint, Michael; Kennedy, Sean E; Dally, Elizabeth; Challis, Daniel

    2015-04-01

    Congenital anterior urethral diverticulum is a rare cause of urethral obstruction in boys. We report on the antenatal diagnosis of this rare phenomenon, making this the sixth prenatally diagnosed case in the English literature (to the best of our knowledge). Our initial prenatal assessment, postnatal endoscopic management, along with the eventual clinical course is outlined. The embryologic theories, differential diagnosis, literature review, imaging, and treatment modalities of this entity are discussed. PMID:25704997

  14. Current controversies in anterior urethral stricture repair: free-graft versus pedicled skin-flap reconstruction

    Microsoft Academic Search

    Hunter Wessells; Jack W. McAninch

    1998-01-01

    Reconstruction of long anterior urethral strictures that cannot be excised and reanastomosed remains controversial. We critically\\u000a reviewed the literature on free-graft and pedicled skin-flap urethroplasty to determine the optimal method of repair. Overall,\\u000a free grafts were successful in 84.3% of cases and flaps, in 85.9%. Buccal mucosa grafts are the most successful method for\\u000a reconstruction of bulbar urethral strictures. For

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

    PubMed Central

    Badiee, Zohreh; Sadeghnia, Alireza; Zarean, Noushin

    2014-01-01

    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. PMID:25317295

  16. Tissue Engineering for Human Urethral Reconstruction: Systematic Review of Recent Literature

    PubMed Central

    de Kemp, Vincent; de Graaf, Petra; Fledderus, Joost O.; Ruud Bosch, J. L. H.; de Kort, Laetitia M. O.

    2015-01-01

    Background Techniques to treat urethral stricture and hypospadias are restricted, as substitution of the unhealthy urethra with tissue from other origins (skin, bladder or buccal mucosa) has some limitations. Therefore, alternative sources of tissue for use in urethral reconstructions are considered, such as ex vivo engineered constructs. Purpose To review recent literature on tissue engineering for human urethral reconstruction. Methods A search was made in the PubMed and Embase databases restricted to the last 25 years and the English language. Results A total of 45 articles were selected describing the use of tissue engineering in urethral reconstruction. The results are discussed in four groups: autologous cell cultures, matrices/scaffolds, cell-seeded scaffolds, and clinical results of urethral reconstructions using these materials. Different progenitor cells were used, isolated from either urine or adipose tissue, but slightly better results were obtained with in vitro expansion of urothelial cells from bladder washings, tissue biopsies from the bladder (urothelium) or the oral cavity (buccal mucosa). Compared with a synthetic scaffold, a biological scaffold has the advantage of bioactive extracellular matrix proteins on its surface. When applied clinically, a non-seeded matrix only seems suited for use as an onlay graft. When a tubularized substitution is the aim, a cell-seeded construct seems more beneficial. Conclusions Considerable experience is available with tissue engineering of urethral tissue in vitro, produced with cells of different origin. Clinical and in vivo experiments show promising results. PMID:25689740

  17. Management of the stricture of fossa navicularis and pendulous urethral strictures

    PubMed Central

    Singh, Shrawan K.; Agrawal, Santosh K.; Mavuduru, Ravimohan S.

    2011-01-01

    Objective: Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods: The literature in English language was searched from the National Library of Medicine database, using the appropriate key words for the period 1985-2010. Out of 475 articles, 115 were selected for the review based on their relevance to the topic. Results: Etiology of stricture is shifting from infective to inflammatory and iatrogenic causes. Stricture of fossa navicularis is most often caused by lichen sclerosus et atrophicus and instrumentation. Direct visual internal urethrotomy is limited to selected cases in the management of pendulous urethral stricture. With experience and identification of various prognostic factors, conservative management by dilatation and internal urethrotomy is being replaced by various reconstructive procedures, using skin flaps and grafts with high success rates. Single-stage urethroplasty is preferred over the 2-stage procedure as the latter disfigures the penis and poses sexual problems temporarily. Conclusions: Flaps or grafts are useful for single-stage reconstruction of fossa navicularis and pendulous urethral strictures. The buccal and lingual mucosa serves as a preferred resource material for providing the inner lining of the urethra. Off-the-shelf materials, such as acellular collagen matrix, are promising. PMID:22022062

  18. Severe Traumatic Injury

    PubMed Central

    Minei, Joseph P.; Schmicker, Robert H.; Kerby, Jeffrey D.; Stiell, Ian G.; Schreiber, Martin A.; Bulger, Eileen; Tisherman, Samuel; Hoyt, David B.; Nichol, Graham

    2014-01-01

    Objectives The public health implications of regional variation in incidence and outcome of severe traumatic injury remain to be analyzed. The objective of this study was to determine whether the incidence and outcome associated with severe traumatic injury differs across geographic regions of North America. Methods A prospective, observational study was conducted of the Resuscitation Outcomes Consortium of all patients in 9 North American sites (6 US and 3 Canadian) sustaining severe traumatic injury from April 1, 2006 to March 31, 2007 followed to hospital discharge. Eligible patients were assessed by organized emergency medical services, and had field-based physiologic criteria including systolic blood pressure ?90 mm Hg, Glasgow Coma Scale score ?12, respiratory rate <10 or >29 per minute, advanced airway procedure, or traumatic death in the field. Census data were used to determine rates adjusted for age and sex. The main outcome measures were incidence rate, mortality rate, case fatality rate, and survival to discharge for patients sustaining severe traumatic injury assessed by EMS. Results The total catchment population of 20.5 million yielded 7080 cases of severe traumatic injury. Median age was 36 years and 67% were male. The median incidence of EMS-assessed severe traumatic injury per 100,000 population across sites was 37.4 (interquartile range [IQR] = 24.6 – 69.6); survival ranged from 39.8% to 80.8%, with a median of 64.5% (IQR = 55.5–78.4). About 942 cases were pronounced dead at the scene and 5857 patients were transported to hospital; 4477 (63.2%) were discharged alive. The median incidence of severe trauma due to a blunt mechanism, transported to hospital, was 25.8 (IQR = 13.1–44.3); survival ranged from 52.6% to 87.3%, with a median of 78.0% (IQR = 68.4–83.5). The median incidence of severe penetrating trauma, transported to hospital, was 2.6 (IQR = 1.5–10.4); survival ranged from 37.5% to 84.7%, with a median of 67.5% (IQR = 54.1–75.9). All P values for differences across sites for incidence and survival were <0.001. Conclusions In this study involving 9 geographic regions in North America, there were significant and important regional differences in severe traumatic injury, incidence, and outcome. These differences were sustained for patients with either isolated blunt or penetrating injury mechanisms. PMID:20531005

  19. Traumatic Lumbosacral Spondyloptosis: A Case Report and Review of the Literature

    PubMed Central

    Akesen, Burak; Mutlu, Müren; Kara, Kür?at; Ayd?nl?, Ufuk

    2013-01-01

    Study Design?Case report and review of the literature. Objective?To report a case of traumatic L5–S1 spondyloptosis and review the literature. Method?A 28-year-old man presented with severe low back pain, numbness at the soles of feet, and bowel and bladder dysfunction. Two days before admission, a tree trunk fell on his back while he was seated. A two-stage posterior-anterior procedure was performed. At the first stage, posterior decompression, reduction, and fusion with instrumentation were performed. At the second stage, which was performed 6 days after the first stage, the patient underwent anterior lumbar interbody fusion. The patient received physical therapy 1?week after the second stage. Results?The patient's numbness improved immediately after the first posterior surgery. His fecal and urinary incontinence improved 6 months after discharge. He has been pain-free for a year and has returned to work. Conclusion?A PubMed search was performed using the following keywords: lumbosacral spondyloptosis, lumbosacral dislocation, and L5–S1 traumatic dislocation. The search returned only nine reported cases of traumatic spondyloptosis. Traumatic spondyloptosis at the lumbosacral junction is a rare ailment that should be suspected in cases of high, direct, and posterior impact on the low lumbar area, and surgical treatment should be the standard choice of care. PMID:24494183

  20. Detailed urethral dosimetry in the evaluation of prostate brachytherapy-related urinary morbidity

    SciTech Connect

    Allen, Zachariah A. [Schiffler Cancer Center, Wheeling, WV (United States); Merrick, Gregory S. [Schiffler Cancer Center, Wheeling, WV (United States) and Wheeling Jesuit University, Wheeling, WV (United States)]. E-mail: gmerrick@wheelinghospital.com; Butler, Wayne M. [Schiffler Cancer Center, Wheeling, WV (United States); Wheeling Jesuit University, Wheeling, WV (United States); Wallner, Kent E. [Puget Sound Healthcare Corporation, Group Health Cooperative, and University of Washington, Seattle, WA (United States); Kurko, Brian [Schiffler Cancer Center, Wheeling, WV (United States); Anderson, Richard L. [Schiffler Cancer Center, Wheeling, WV (United States); Murray, Brian C. [Schiffler Cancer Center, Wheeling, WV (United States); Galbreath, Robert W. [Schiffler Cancer Center, Wheeling, WV (United States); Wheeling Jesuit University, Wheeling, WV (United States); Ohio University Eastern, St. Clairsville, OH (United States)

    2005-07-15

    Purpose: To evaluate the relationship between urinary morbidity after prostate brachytherapy and urethral doses calculated at the base, midprostate, apex, and urogenital diaphragm. Methods and Materials: From February 1998 through July 2002, 186 consecutive patients without a prior history of a transurethral resection underwent monotherapeutic brachytherapy (no supplemental external beam radiation therapy or androgen deprivation therapy) with urethral-sparing techniques (average urethral dose 100%-140% minimum peripheral dose) for clinical T1c-T2b (2002 AJCC) prostate cancer. The median follow-up was 45.5 months. Urinary morbidity was defined by time to International Prostate Symptom Score (IPSS) resolution, maximum increase in IPSS, catheter dependency, and the need for postimplant surgical intervention. An alpha blocker was initiated approximately 2 weeks before implantation and continued at least until the IPSS returned to baseline. Evaluated parameters included overall urethral dose (average and maximum), doses to the base, midprostate, apex, and urogenital diaphragm, patient age, clinical T stage, preimplant IPSS, ultrasound volume, isotope, and D90 and V100/150/200. Results: Of the 186 patients, 176 (94.6%) had the urinary catheter permanently removed on the day of implantation with only 1 patient requiring a urinary catheter >5 days. No patient had a urethral stricture and only 2 patients (1.1%) required a postbrachytherapy transurethral resection of the prostate (TURP). For the entire cohort, IPSS on average peaked 2 weeks after implantation with a mean and median time to IPSS resolution of 14 and 3 weeks, respectively. For the entire cohort, only isotope predicted for IPSS resolution, while neither overall average prostatic urethra nor segmental urethral dose predicted for IPSS resolution. The maximum postimplant IPSS increase was best predicted by preimplant IPSS and the maximum apical urethral dose. Conclusions: With the routine use of prophylactic alpha blockers and strict adherence to urethral-sparing techniques, detailed urethral dosimetry did not substantially improve the ability to predict urinary morbidity. Neither the average dose to the prostatic urethra nor urethral doses stratified into base, midprostate, apex, or urogenital diaphragm segments predicted for IPSS normalization. Radiation doses of 100%-140% minimum peripheral dose are well tolerated by all segments of the prostatic urethra with resultant tumorcidal doses to foci of periurethral cancer.

  1. Corneal topography of posterior keratoconus.

    PubMed

    Mannis, M J; Lightman, J; Plotnik, R D

    1992-07-01

    Posterior keratoconus is an unusual abnormality of the cornea generally classified as one of the anterior chamber cleavage anomalies. It is characterized clinically by the presence of a circumscribed or generalized corneal thinning with posterior depression of the cornea and is considered distinct from keratoconus. Although patients with posterior keratoconus may have visual complaints clearly related to their abnormal corneas, the surface topography of these corneas has not been studied in detail. Keratometry and photokeratoscopy provide an incomplete picture of the surface geometry of posterior keratoconus. We utilized computer assisted topographic analysis to study the cornea of a patient with posterior keratoconus. The Topographic Modeling System demonstrated that the patient's cornea showed a central steepened "cone" coincident with the area of circumscribed posterior keratoconus as well as paracentral flattening. This report documents the topographic abnormality in this rare disorder. PMID:1424657

  2. Traumatic sacral spondylolisthesis

    Microsoft Academic Search

    Thomas Dwyer; Michael O'Brien; Christopher Dewald; Daniel Gelb; Laura Flawn; Thomas Lowe

    2002-01-01

    Purpose of study: Increased fracture rates among osteoporotic patients in proximity to instrumentation and prosthetic joint replacements is well documented in the literature. The authors have recently described burst fractures of the caudal end-instrumented lumbar vertebrae in adult patients treated with an instrumented fusion for scoliosis. The purpose of this study was to describe traumatic sacral spondylolisthesis (TSS), which is

  3. Traumatic Brain Injury

    Microsoft Academic Search

    Janet M. Leathem; Muriel Christianson

    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, &

  4. Altering traumatic memory

    Microsoft Academic Search

    Veronika Nourkova; Daniel Bernstein; Elizabeth Loftus

    2004-01-01

    Can you experimentally contaminate memory for truly traumatic events? We investigated this question in a study in which 80 Russian participants reported on their memories for one of two terrorist bombings. Half the participants recalled the 1999 attacks on Moscow apartment buildings while the others recalled the 2001 attacks on the World Trade Center in New York. Participants recalled the

  5. Novel posterior fixation keratoprosthesis

    NASA Astrophysics Data System (ADS)

    Lacombe, Emmanuel

    1992-08-01

    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.

  6. Endoscopic Assessment and Prediction of Prostate Urethral Disintegration After Histotripsy Treatment in a Canine Model*

    PubMed Central

    Schade, George R.; Styn, Nicholas R.; Hall, Timothy L.

    2012-01-01

    Abstract Background and Purpose Histotripsy is a nonthermal focused ultrasound technology that uses acoustic cavitation to homogenize tissue. Previous research has demonstrated that the prostatic urethra is more resistant to histotripsy effects than prostate parenchyma, a finding that may complicate the creation of transurethral resection of the prostate-like treatment cavities. The purpose of this study was to characterize the endoscopic appearance of the prostatic urethra during and after histotripsy treatment and to identify features that are predictive of urethral disintegration. Materials and Methods Thirty-five histotripsy treatments were delivered in a transverse plane traversing the prostatic urethra in 17 canine subjects (1–3/prostate ?1?cm apart). Real-time endoscopy was performed in the first four subjects to characterize development of acute urethral treatment effect (UTE). Serial postprocedure endoscopy was performed in all subjects to assess subsequent evolution of UTE. Results Endoscopy during histotripsy was feasible with observation of intraurethral cavitation, allowing characterization of the real-time progression of UTE from normal to frank urethral disintegration. While acute urethral fragmentation occurred in 3/35 (8.6%) treatments, frank urethral disintegration developed in 24/35 (68.5%) within 14 days of treatment. Treating until the appearance of hemostatic pale gray shaggy urothelium was the best predictor of achieving urethral fragmentation within 14 days of treatment with positive and negative predictive values of 0.91 and 0.89, respectively. Conclusion Endoscopic assessment of the urethra may be a useful adjunct to prostatic histotripsy to help guide therapy to ensure urethral disintegration, allowing drainage of the homogenized adenoma and effective tissue debulking. PMID:22050511

  7. Use of Martius flap in the complex female urethral surgery

    PubMed Central

    Tupikina, Nataliya; Pushkar, Dmitry

    2014-01-01

    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

  8. Gonococcal urethral stricture and watering-can perineum.

    PubMed Central

    Osoba, A O; Alausa, O

    1976-01-01

    A total of sixteen patients with urethral stricture and/or perineal urinary fistulae (water-can perineum) complicating gonorrhoea were seen at the Special Treatment Clinic, University College Hospital, Ibadan, Nigeria. The patients were aged between 25 and 80 years, and the latent period between the time of original attack of gonococcal infection and the development of complications varied from 4 to 50 years. The rate of divorce or marital separation is high among these patients with late sequelae of gonorrhoea. The factors responsible for the present higher incidence of early and late complications of gonorrhoea among patients in Nigeria and other tropical countries compared with their counterparts in Europe and North American include: (a) Lack of medical facilities in most rural areas; (b) Inadequate treatment of veneral diseases, including the urban areas where self-medication is practised on a large scale by the general population; (c) Illiteracy and ignorance of venereal diseases. The cases of watering-can perineum reported here, and the subsequent chronic pyelonephritis and hypertension, reinforce the plea for early and energetic treatment of acute gonorrhoea in Africa as well as large-scale control measures by the health authorities. Images PMID:1009418

  9. Urethral Pain Among Prostate Cancer Survivors 1 to 14 Years After Radiation Therapy

    SciTech Connect

    Pettersson, Niclas, E-mail: niclas.pettersson@vgregion.se [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden)] [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden); Olsson, Caroline [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden)] [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Alsadius, David; Wilderaeng, Ulrica [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden)] [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden); Johansson, Karl-Axel [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden)] [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden); Steineck, Gunnar [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden)] [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden)

    2013-01-01

    Purpose: To investigate how treatment-related and non-treatment-related factors impact urethral pain among long-term prostate cancer survivors. Methods and Materials: Men treated for prostate cancer with radiation therapy at the Sahlgrenska University Hospital in Goeteborg, Sweden from 1993 to 2006 were approached with a study-specific postal questionnaire addressing symptoms after treatment, including urethral burning pain during urination (n=985). The men had received primary or salvage external-beam radiation therapy (EBRT) or EBRT in combination with brachytherapy (BT). Prescribed doses were commonly 70 Gy in 2.0-Gy fractions for primary and salvage EBRT and 50 Gy plus 2 Multiplication-Sign 10.0 Gy for EBRT + BT. Prostatic urethral doses were assessed from treatment records. We also recruited 350 non-pelvic-irradiated, population-based controls matched for age and residency to provide symptom background rates. Results: Of the treated men, 16% (137 of 863) reported urethral pain, compared with 11% (27 of 242) of the controls. The median time to follow-up was 5.2 years (range, 1.1-14.3 years). Prostatic urethral doses were similar to prescription doses for EBRT and 100% to 115% for BT. Fractionation-corrected dose and time to follow-up affected the occurrence of the symptom. For a follow-up {>=}3 years, 19% of men (52 of 268) within the 70-Gy EBRT + BT group reported pain, compared with 10% of men (23 of 222) treated with 70 Gy primary EBRT (prevalence ratio 1.9; 95% confidence interval 1.2-3.0). Of the men treated with salvage EBRT, 10% (20 of 197) reported urethral pain. Conclusions: Survivors treated with EBRT + BT had a higher risk for urethral pain compared with those treated with EBRT. The symptom prevalence decreased with longer time to follow-up. We found a relationship between fractionation-corrected urethral dose and pain. Among long-term prostate cancer survivors, the occurrence of pain was not increased above the background rate for prostatic urethral doses up to 70 Gy{sub 3}.

  10. Bacterial Vaginosis–Associated Bacteria in Men: Association of Leptotrichia/Sneathia spp. With Nongonococcal Urethritis

    PubMed Central

    Manhart, Lisa E.; Khosropour, Christine M.; Liu, Congzhu; Gillespie, Catherine W.; Depner, Kevin; Fiedler, Tina; Marrazzo, Jeanne M.; Fredricks, David N.

    2014-01-01

    Background Approximately 45% of nongonococcal urethritis cases have no identified etiology. Novel bacteria recently associated with bacterial vaginosis (BV) in women may be involved. We evaluated the association of idiopathic nongonococcal urethritis and 5 newly described BV-associated bacteria (BVAB). Methods Heterosexual men 16 years or older attending a sexually transmitted disease clinic in Seattle, Washington, from May 2007 to July 2011 and negative for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, and Ureaplasma urealyticum–biovar2 were eligible. Cases had urethral discharge or 5 or more polymorphonuclear leukocytes per high-power field in urethral exudates. Controls had no urethral discharge and less than 5 polymorphonuclear leukocytes per high-power field. Urine was tested for Atopobium spp., BVAB-2, BVAB-3, Megasphaera spp., and Leptotrichia/Sneathia spp. using quantitative taxon-directed polymerase chain reaction. Results Cases (n = 157) and controls (n = 102) were of similar age, education, and income, and most were white. Leptotrichia/Sneathia spp. was significantly associated with urethritis (24/157 [15.3%] vs. 6/102 [5.9%], P = 0.03). BVAB-2 was more common in cases than in controls (7/157 [4.5%] vs. 1/102 [1.0%], P = 0.15), and BVAB-3 (n = 2) and Megasphaera spp. (n = 1) were only detected in men with urethritis, but these bacteria were found only in men who also had Leptotrichia/Sneathia spp. Atopobium spp. was not associated with urethritis. The quantity of bacteria did not differ between cases and controls. Among treated cases, doxycycline was more effective than azithromycin for clinical cure of men with Leptotrichia/Sneathia spp. (9/10 vs. 7/12, P = 0.16) and BVAB-2 (3/3 vs. 0/3, P = 0.10). Conclusions Leptotrichia/Sneathia spp. may be urethral pathogens or contribute to a pathogenic microbiota that can also include BVAB-2, BVAB-3, and Megasphaera spp. Doxycycline may be more effective than azithromycin against these newly identified bacteria. PMID:24220356

  11. Posterior cortical atrophy: Unique features

    Microsoft Academic Search

    T. Tom; J. L. Cummings; J. Pollak

    1998-01-01

    Posterior cortical atrophy (PCA) is a visual-cognitive syndrome caused by Creutzfeldt-Jakob disease (CJD), Alzheimer's disease (AD), or subcortical gliosis. We report a case of posterior cortical atrophy unique in (1) comprehensive documentation of clinical, radiologic, electroencephalograph, metabolic and histopathologic findings, (2) repeated clinical and laboratory assessment, and (3) establishment of unique occipital subcortical gliosis in a patient with AD. Clinical

  12. When Horror and Loss Intersect: Traumatic Experiences and Traumatic Bereavement

    Microsoft Academic Search

    Kent Drescher; David W. Foy

    2010-01-01

    Members of the clergy serve on the front lines as caregivers for individuals whose lives have been forever changed by life-threatening\\u000a traumatic events, and by the sudden traumatic deaths of loved ones. This article is intended to provide useful information\\u000a to clergy about the nature of traumatic experiences, predictable human reactions to them, and ways that clergy can be helpful

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

    PubMed Central

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

    2013-01-01

    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

  14. Leukocyte esterase urine strips for the screening of men with urethritis--use in developing countries.

    PubMed Central

    Tyndall, M W; Nasio, J; Maitha, G; Ndinya-Achola, J O; Plummer, F A; Sellors, J W; Luinstra, K E; Jang, D; Mahony, J B; Chernesky, M A

    1994-01-01

    BACKGROUND AND OBJECTIVES--The leukocyte esterase (LE) strip is a useful tool for the screening of men with urethritis. In developing countries, where laboratory facilities are limited, and sexually transmitted diseases endemic, simple and inexpensive diagnostic tests which perform well, would be of great value. METHODS--Men presenting with urethritis to a referral clinic for sexually transmitted diseases in Nairobi, Kenya participated in this cohort analytical study. First-void urine was collected for LE dipstick testing as part of the diagnostic work-up. The results of the dipstick measurement were compared with the laboratory detection of Chlamydia trachomatis and Neisseria gonorrhoeae. RESULTS--Of 200 men with symptoms of urethritis, 33 (17%) had a pathogen detected from the urethra or the urine. Chlamydia was detected in urine by PCR in 22 (11%), and gonorrhoea was cultured from the urethra in 11 (6%). Esterase activity (trace or greater) had a sensitivity of 76%, a specificity of 80%, a positive predictive value of 42% and a negative predictive value of 94% for the presence of chlamydia or gonorrhoea. CONCLUSIONS--The use of the LE dipstick for the screening of men with symptomatic urethritis can improve diagnostic accuracy and reduce the amount of empiric antimicrobial therapy. The low detection rate of chlamydia in these men with a clinical diagnosis of nongonococcal urethritis needs further study. PMID:8300096

  15. Spontaneous photo-relaxation of urethral smooth muscle from sheep, pig and rat and its relationship with nitrergic neurotransmission

    PubMed Central

    Triguero, D; Costa, G; Labadía, A; Jiménez, E; García-Pascual, A

    2000-01-01

    In the present work we have characterized the relaxant response induced by light stimulation (LS) in the lower urinary tract from sheep, pig and rat, establishing its relationship with nitrergic neurotransmission. Urethral, but not detrusor, preparations showed pronounced photo-relaxation (PR) which declined progressively following repetitive LS. Sheep urethral PR was again restored either spontaneously or (to a greater extent) by exogenous nitric oxide (NO) addition and by electrical field stimulation (EFS) of intrinsic nitrergic nerves. Greater NO generation was detected from sheep urethral than from detrusor homogenates following illumination. Sheep urethral PR was inhibited by oxyhaemoglobin, but not by methaemoglobin, carboxy-PTIO, extracellular superoxide anion generators or superoxide dismutase. Guanylyl cyclase but not adenylyl cyclase activation mediates urethral relaxation to LS. Urethral PR was more resistant to inhibition by L-thiocitrulline than EFS-induced responses, although this agent prevented PR restoration by high-frequency EFS. Urethral PR was TTX insensitive and partially modified in high-K+ solutions. Cold storage for 24 h greatly impaired urethral PR, although it was restored by high-frequency EFS. Repetitive exposure to LS, EFS or exogenous NO induced changes in the shape of the EFS-induced nitrergic relaxation, possibly by pre-synaptic mechanisms. In conclusion, we suggest the presence of an endogenous, photo-labile, nitro-compound store in the urethra, which seems to be replenished by neural nitric oxide synthase activity, indicating a close functional relationship with the nitrergic neurotransmitter. PMID:10713968

  16. Modified posterior musculofascial plate reconstruction decreases the posterior vesicourethral angle and improves urinary continence recovery in patients undergoing laparoscopic radical prostatectomy.

    PubMed

    Ito, Keiichi; Kenji, Seguchi; Yoshii, Hidehiko; Hamada, Shinsuke; Asakuma, Junichi; Tasaki, Shinsuke; Kuroda, Kenji; Sato, Akinori; Horiguchi, Akio; Asano, Tomohiko

    2013-11-01

    The aim of this study was to evaluate the efficacy of our modified posterior musculofascial plate reconstruction (PMPR) procedure in laparoscopic radical prostatectomy (LRP). Prior to 2010, four operative procedures were used to expedite continence recovery: preserving the fascia covering the levator ani muscle, preserving the bladder neck, securing a functional urethral length by using a lateral-view dissection technique and suspending the vesicourethral anastomosis from the puboprostatic ligaments. Since February, 2010, a running suture between Denonvilliers' fascia (DF) and the median fibrous raphe (MFR, the fibrous tissue that lies immediately underneath the urethra) has also been used. In vesicourethral anastomosis, a double-armed running suture was performed. At the beginning of the anastomosis, the first stitches (at 1 and 11 o'clock positions on the bladder neck) were placed 1-2 cm dorsocephalad to the bladder neck (first through the seromuscular layer and then through the full thickness of the bladder neck). At the 5 and 7 o'clock positions of the urethra, the stitches were placed through the urethral mucosa as well as the the reconstructed musculofascial plate. The bladder shape was evaluated by postoperative cystography and the clinical results were compared between patients undergoing LRP without PMPR (group A) and those undergoing LRP with PMPR (group B). The cystograms demonstrated that the PMPR significantly shortened the vertical length of the bladder and significantly decreased the posterior vesicourethral angle. At 1, 3 and 6 months after LRP, the number of daily used pads was significantly lower in group B compared to that in group A and the time to achieve a pad-free status was significantly shorter in group B. Our modified PMPR procedure significantly improved the recovery of urinary continence following LRP and this improvement may be due in part to changes of the bladder shape. PMID:24649279

  17. Traumatic extrathoracic lung herniation

    Microsoft Academic Search

    Pierre-Mathieu Bonnet; François Pons; Louis Brinquin; René Jancovici

    2002-01-01

    Traumatic extrathoracic lung herniation is an exceptional complication of blunt chest trauma. We report the case of a 46-year-old man who was involved in a motorcycle accident and who suffered a left clavicle fracture-dislocation associated with multiple rib fractures and massive herniation of the left upper lobe through an upper anterior chest wall defect. Immediate surgical repair through an atypical

  18. Traumatic extrathoracic lung herniation.

    PubMed

    Lang-Lazdunski, Loïc; Bonnet, Pierre-Mathieu; Pons, François; Brinquin, Louis; Jancovici, René

    2002-09-01

    Traumatic extrathoracic lung herniation is an exceptional complication of blunt chest trauma. We report the case of a 46-year-old man who was involved in a motorcycle accident and who suffered a left clavicle fracture-dislocation associated with multiple rib fractures and massive herniation of the left upper lobe through an upper anterior chest wall defect. Immediate surgical repair through an atypical transcostal vertical thoracotomy resulted in full recovery of pulmonary function at 1 year. PMID:12238872

  19. Traumatic Atlantooccipital Dislocation

    Microsoft Academic Search

    Heiko Koller; Ulrich Holz; Allan Assuncao; Michael Oberst; Dietmar Ulbricht

    2006-01-01

    Traumatic atlantooccipital dislocation (AOD) is a severe injury which functionally separates the head from the spine. Neurological\\u000a compromise or death is the common sequela. We report on a survivor after AOD, who came back to sportive activities after operative\\u000a stabilization C0–2. Actually, due to the lack of large single institution series, there are no clearly recommended guidelines\\u000a concerning diagnostics and

  20. Traumatic Brain Injury

    Microsoft Academic Search

    Ramnik Singh; Michael W. O’Dell

    Patients with traumatic brain injury (TBI) pose an enormous clinical, emotional, and intellectual challenge to rehabilitation\\u000a professionals. For public policymakers, the cost of care for approximately 6 million survivors of TBI is measured in the billions\\u000a of dollars. In addition to the motor, sensory, and language deficits commonly seen in nontraumatic etiologies, the patient\\u000a with TBI often experiences cognitive and\\/or

  1. Mild Traumatic Brain Injury

    Microsoft Academic Search

    Grant L. Iverson; Rael T. Lange

    \\u000a Mild traumatic brain injuries (MTBI) are heterogeneous. This injury falls on a broad spectrum, from very mild neurometabolic\\u000a changes in the brain with rapid recovery to permanent problems due to structural brain damage. It is incorrect to assume that\\u000a MTBIs cannot cause permanent brain damage and it is incorrect to assume that MTBIs typically cause permanent brain damage. This is

  2. Traumatic Brain Injury

    Microsoft Academic Search

    Terri Morris

    \\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

  3. Understanding vicarious traumatization.

    PubMed

    Blair, D T; Ramones, V A

    1996-11-01

    1. Close and prolonged work with victims of trauma and abuse can have serious psychological consequences for professionals. 2. The consequences to professionals can include development of anxiety, depression, intrusive thoughts, alienation, dissociative episodes, feeling of helplessness, paranoia, hypervigilance, and disrupted personal relationships. 3. The concepts of cognitive processing models and investigation into memory dynamics can offer understanding of vicarious traumatization, and may help define preventive measures and treatment options for this condition. PMID:8923347

  4. Traumatic cerebral aneurysms

    PubMed Central

    Benoit, Brien G.; Wortzman, George

    1973-01-01

    Six cases of traumatic cerebral aneurysm are presented, four situated at the base of the brain, and two on peripheral branches. Serial radiography was obtained in five patients, and in each the aneurysms had changed: spontaneous thrombosis, enlargement and change in shape, or rupture with destruction occurred. If surgical treatment of the aneurysm is delayed after the diagnosis has been made by angiogram, repeated angiography is recommended. Images PMID:4691685

  5. [Effects of traumatic stress].

    PubMed

    Herbst, Gesa; Jaeger, Ulrich; Leichsenring, Falk; Streeck-Fischer, Annette

    2009-01-01

    The diagnosis PTSD does not adequately describe the impact of exposure to childhood trauma of the developing child. The objective of the study was to examine the prevalence of different interpersonal trauma types and to describe the long-term effects of maltreatment and neglect in a clinical sample of 34 adolescents. The majority (62%) of the sample was exposed to two different types of trauma during childhood. Emotional abuse and emotional neglect have been the most common trauma types (59%; 53%). 71% of the traumatized adolescents did not meet the criteria for PTSD. The most common diagnosis in the sample was Borderline Personality Disorder. All average scores at SCL-90-Symptom-Scale were clinical significant. Half of the sample reported suicide attempts and self destructive behavior. One third reported substance abuse and aggressive behavior against others respectively. None of the traumatized adolescents had a positive Self-concept. Altogether the results show that abused children and adolescents have a range of psychological sequelae that are not captured in the PTSD diagnostic criteria. Therefore the results support the necessity for a new and more precise diagnosis for chronically traumatized children and adolescents. PMID:19961125

  6. Post-traumatic headaches.

    PubMed

    Riechers, Ronald G; Walker, Mark F; Ruff, Robert L

    2015-01-01

    Chronic pain, especially headache, is an exceedingly common complication of traumatic brain injury (TBI). In fact, paradoxically, the milder the TBI, the more likely one is to develop headaches. The environment of injury and the associated comorbidities can have a significant impact on the frequency and severity of headaches and commonly serve to direct management of the headaches. Trauma likely contributes to the development of headaches via alterations in neuronal signaling, inflammation, and musculoskeletal changes. The clinical picture of the patient with post-traumatic headaches is often that of a mixed headache disorder with features of tension-type headaches as well as migrainous headaches. Treatment of these headaches is thus often guided by the predominant characteristics of the headaches and can include pharmacologic and nonpharmacologic strategies. Pharmacologic therapies include both abortive and prophylactic agents with prophylaxis targeting comorbidities, primarily impaired sleep. Nonpharmacologic interventions for post-traumatic headaches include thermal and physical modalities as well as cognitive behavioral approaches. As with many postconcussive symptoms, headaches can lessen with time but in up to 25% of patients, chronic headaches are long-term residua. PMID:25701908

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

    PubMed Central

    Reddy, K. Rajeshwar

    2013-01-01

    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

  8. Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi

    PubMed Central

    Ikegami, Akiko; Kondo, Takeshi; Tsukamoto, Tomoko; Ohira, Yoshiyuki; Ikusaka, Masatomi

    2015-01-01

    We report a rare case of iliac vein compression syndrome caused by urethral calculus. A 71-year-old man had a history of urethral stenosis. He complained of bilateral leg edema and dysuria for 1 week. Physical examination revealed bilateral distention of the superficial epigastric veins, so obstruction of both common iliac veins or the inferior vena cava was suspected. Plain abdominal computed tomography showed a calculus in the pendulous urethra, distention of the bladder (as well as the right renal pelvis and ureter), and compression of the bilateral common iliac veins by the distended bladder. Iliac vein compression syndrome was diagnosed. Bilateral iliac vein compression due to bladder distention (secondary to neurogenic bladder, benign prostatic hyperplasia, or urethral calculus as in this case) is an infrequent cause of acute bilateral leg edema. Detecting distention of the superficial epigastric veins provides a clue for diagnosis of this syndrome. PMID:25802794

  9. Radiation therapy: posterior segment complications.

    PubMed

    Seregard, Stefan; Pelayes, David E; Singh, Arun D

    2013-01-01

    Therapeutic radiation to the posterior segment of the eye is a common option for posterior segment tumors. Such tumors are often malignant, but sometimes, benign neoplasms are treated with ionizing radiation. Also, non-neoplastic intraocular lesions like wet age-related macular degeneration may be treated with radiotherapy. Orbital disease, both neoplastic lesions like optic nerve sheath meningioma and non-neoplastic entities like Graves' ophthalmopathy may be treated with radiotherapy and this may include radiation of the optic nerve and posterior segment of the eye. Occasionally, radiotherapy of extraocular malignant disease, involving, e.g. the paranasal sinuses, may cause significant radiation damage to the eye. Complications after radiation to the posterior segment of the eye are largely related to the radiation dose to the posterior segment. The amount of irradiated volume of normal tissue and fractionation are also important for the development of radiation complications to the posterior segment. Radiation retinopathy is the most common complication of the posterior segment, but radiation optic neuropathy also occurs frequently. Radiation scleral necrosis is less frequent probably due to the radioresistance of the scleral collagen. These complications have the potential to cause blindness (radiation retinopathy and optic neuropathy) or enucleation of the eye (scleral necrosis). Although numerous treatments have been advocated, management of radiation-induced damage remains controversial. Efficacy for any treatment still needs to be proven and, if possible, the best option by far is to minimize radiation changes to normal tissue. PMID:23989132

  10. Photodynamic therapy of urethral condylomata acuminata using topically 5-aminolevulinic acid

    NASA Astrophysics Data System (ADS)

    Wang, Xiuli; Wang, Hongwei; Wang, Haishan; Xu, Shizheng; Liao, Kanghuang; Hillemanns, Peter

    2005-07-01

    Background Electrocoagulation and laser evaporation for urethral condylomata acuminata have high recurrence rates and can be associated with urethral malformations. Objective To investigate the effect of photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) on urethral condylomata acuminata and to examine the histological changes in lesions of condylomata acuminata after ALA-PDT. Methods One hundred and sixty-four urethral condylomata patients were given topical ALA followed by intraurethral PDT through a cylindrical fiber. Among the cases, 16 penile and vulval condylomatous lesions in 11 patients were treated with topical ALA-PDT at same time. After the treatment, biopsy specimens were collected from the 16 penile and vulval lesions. The histological changes were then evaluated by light microscope and electron microscope. Results The complete response rate for urethral condylomata by topical ALA-PDT was 95.12% and the recurrence rate was 5.13% after 6 to 24 months follow-up. Keratinocytes in middle and upper layers of the epidermis with marked vacuolation and some necrocytosis were detected one and three hours after PDT. Necrosis in all layers of the epidermis was noted five hours after PDT by microscopy. In electron microscopy of kerationcytes, distinct ultrastructural abnormalities of mitochondrion, endoplasmic reticulum and membrane damage were observed. Apoptotic bodies were detected three hours after PDT and a large number of the keratinocytes exhibited necrosis five hours after PDT by electron microscope. Conclusions Results suggests that topical ALA-PDT is a simple, effective, relatively safe, less recurrent and comparatively well tolerated treatment for urethral condylomata acuminata. The mechanisms might be that ALA-PDT could trigger apoptotic process and necrosis in the HPV infected keratinocytes. Key words:

  11. Isolated urethral tuberculosis in a middle-aged man: a case report

    PubMed Central

    2013-01-01

    Introduction Urogenital tuberculosis is a frequent disease in endemic countries. It is characterized by clinical polymorphism. The isolated urethral form is exceptional, even in countries with endemic tuberculosis. We present a rare case of urogenital tuberculosis in a man revealed by urethral narrowing and multiple urethro-scrotal fistulas. Case presentation The patient, a Moroccan man, was 40 years old. He visited our hospital for a urology consultation and presented with dysuria, purulent discharge and a meatic penoscrotal fistula. A retrograde and voiding urethrocystography was performed and revealed an extended narrowing of the whole anterior urethra associated with multiple fistulous portions toward the scrotum and perineum. At this stage, we reached a diagnosis of nonspecific sclero-inflammatory urethral stricture with complicating fistulas. We decided to perform a urethroplasty enlargement to clear the narrowing urethral sinus tracts. The evolution was marked by delayed wound healing associated with the persistence of fistulas extending into the corpus cavernosum with purulent discharge. It was at this point in the treatment that we suspected tuberculosis. Multiple biopsies were then performed on the periurethral tissue and fistula tracts. The histological examination confirmed urethral tuberculosis and showed the presence of giant cell epithelial lesions with caseous necrosis characteristic of tuberculosis. The treatment for tuberculosis was immediately established and the evolution was marked by a localized, rapid and significant improvement. A second-stage urethroplasty was scheduled for two months after the start of his antituberculous treatment. Conclusions Urogenital tuberculosis is common, but isolated urethral involvement is very rare even in countries with endemic tuberculosis. We urge practitioners, and especially urologists, to consider the disease in their investigation whenever given clinical signs are declared. PMID:23566379

  12. Posterior sampling with improved efficiency

    SciTech Connect

    Hanson, K.M.; Cunningham, G.S.

    1998-12-01

    The Markov Chain Monte Carlo (MCMC) technique provides a means to generate a random sequence of model realizations that sample the posterior probability distribution of a Bayesian analysis. That sequence may be used to make inferences about the model uncertainties that derive from measurement uncertainties. This paper presents an approach to improving the efficiency of the Metropolis approach to MCMC by incorporating an approximation to the covariance matrix of the posterior distribution. The covariance matrix is approximated using the update formula from the BFGS quasi-Newton optimization algorithm. Examples are given for uncorrelated and correlated multidimensional Gaussian posterior distributions.

  13. [A case of prostatic urethral calculus associated with perineal abscess and urethrocutaneous fistula].

    PubMed

    Toyoshima, Yuta; Hosokawa, Yukinari; Hashimura, Masaya; Takada, Satoshi; Hayashi, Yoshiki; Fujimoto, Kiyohide; Hirao, Yoshihiko

    2012-01-01

    A 37-year-old male who had sustained a lumbar vertebral fracture presented with the chief complaint of high fever and urine leakage from the perineal region. Computed tomography and urethroscopy showed a huge prostatic urethral calculus. He had a urethrocutaneous fistula in the perineal region. Transvesical prostate-urethrolithotomy, debridement of perineal abscess and cystostomy were performed. After operation, he had total incontinence during clamping of the cystostomy. Four months later, ileal-conduit formation and simple cystectomy were performed to improve urinary management. The pathogenesis of prostatic urethral calculus and the management of neurogenic bladder patients with spinal cord injury are reviewed. PMID:22343742

  14. Y-type urethral duplication presented with perineal fistula in a boy

    PubMed Central

    Dayanc, Murat; Irkilata, Hasan Cem; Kibar, Yusuf; Bozkurt, Yasar; Basal, Seref; Xhafa, Ajet

    2010-01-01

    Urethral duplication is a rare congenital anomaly of the lower urinary system and has varied presentation. According to the Effmann classification, type IIA2-Y urethral duplication is charcterized by the duplicated urethra originating from the bladder neck and opening into either the rectum or the perineum. The accessory urethra is normal and functional and the normally positioned dorsal urethra is hypoplastic and stenotic in unusual form of Y-type duplication. We present a new case with unusual form of Y-type duplication and discuss its treatment. PMID:21139990

  15. Posterior Tibial Tendon Dysfunction (PTTD)

    MedlinePLUS

    ... ACFAS | Información en Español Advanced Search Home » Foot & Ankle Conditions » Posterior Tibial Tendon Dysfunction (PTTD) Text Size ... the arch, and an inward rolling of the ankle. As the condition progresses, the symptoms will change. ...

  16. Posterior skull surgery in craniosynostosis

    Microsoft Academic Search

    S. Sgouros; J. H. Goldin; A. D. Hockley; M. J. C. Wake

    1996-01-01

    In 1984, two young infants with unusual “clover-leaf” patterns of skull deformity were treated by posterior skull-releasing surgery that dramatically improved their overall skull shape, to the extent that further operative intervention was not required. This focused our attention on the posterior skull and its role in craniosynostosis. In cases of multi-suture craniosynostosis and craniofacial syndromes severely raised intracranial pressure

  17. Traumatic Brain Injury and Aggression.

    ERIC Educational Resources Information Center

    Miller, Laurence

    1994-01-01

    Persons who have suffered traumatic injury to the brain may subsequently display aggressive behavior. Three main syndromes of aggression following traumatic brain injury are described: (1) episodic dyscontrol; (2) frontal lobe disinhibition; and (3) exacerbation of premorbid antisociality. The neuropsychological substrates of these syndromes are…

  18. Interviewing Abused and Traumatized Children

    Microsoft Academic Search

    John B. Mordock

    2001-01-01

    Interviewing young traumatized children, particularly those traumatized by physical and sexual abuse, is difficult, not only because of children's recall deficiencies, but more often because standard interviewing formats can be ineffective with economically disadvantaged and culturally different children. Economically disadvantaged children's exposure to different family interaction patterns and control-dominated childrearing styles can affect their ability to respond to both verbal

  19. Mild traumatic brain injury.

    PubMed

    Hyatt, Kyong S

    2014-11-01

    Mild traumatic brain injury (mTBI) can have a profoundly negative effect on the injured person's quality of life, producing cognitive, physical, and psychological symptoms; impeding postinjury family reintegration; creating psychological distress among family members; and often having deleterious effects on spousal and parental relationships. This article reviews the most commonly reported signs and symptoms of mTBI, explores the condition's effects on both patient and family, and provides direction for developing nursing interventions that promote patient and family adjustment. PMID:25319524

  20. Traumatic war. Stress & schizophrenia.

    PubMed

    Yaktin, U S; Labban, S

    1992-06-01

    1. An examination of the effects of the Lebanese war on the citizens found that traumatic war events can be regarded as of primary importance for risk factors triggering the onset of schizophrenia. 2. The overall findings indicate an increase in the rate of admission for men diagnosed with schizophrenia throughout the 12 years of the war. The most significant increases occurred either following intensive fighting episodes or months later due to the additive effect of stress. 3. How soon individuals are affected by environmentally induced war stress may be related to their level of vulnerability to the disorder. PMID:1613685

  1. The regeneration process of the striated urethral sphincter involves activation of intrinsic satellite cells

    Microsoft Academic Search

    René Yiou; Jean-Pascal Lefaucheur; Anthony Atala

    2003-01-01

    The regeneration of adult skeletal muscle is mediated by satellite cells. Classically, these are considered to be somitically derived cells that colonize the limbs during early embryogenesis. The striated urethral sphincter presents specific developmental characteristics that distinguish it from skeletal muscles, such as the non-somitic origin of its precursor cells and the late formation of its myofibers. This prompted us

  2. Conditioning Stimulus Can In£uence an External Urethral Sphincter Contraction Evoked by a Magnetic Stimulation

    Microsoft Academic Search

    Bjoern Wefer; Peter A. Knapp; Andreas Bannowsky; Klaus-Peter Juenemann; Brigitte Schurch

    Aims: To study the e¡ect of a conditioning stimulus on an external urethral sphincter (EUS) contraction evoked by a magnetic stimulation at di¡erent time intervals. Methods: Seven healthy male volunteers underwent EUS pressure measurement. At baseline, magnetic stimulation of the lumbosacral spinal cord above the motor threshold was performed and evoked EUS pressure responses were recorded. The lumbosacral magnetic stimulation

  3. An endothelialized urothelial cell-seeded tubular graft for urethral replacement

    PubMed Central

    Imbeault, Annie; Bernard, Geneviève; Rousseau, Alexandre; Morissette, Amélie; Chabaud, Stéphane; Bouhout, Sara; Bolduc, Stéphane

    2013-01-01

    Introduction Many efforts are used to improve surgical techniques and graft materials for urethral reconstruction. We developed an endothelialized tubular structure for urethral reconstruction. Methods: Two tubular models were created in vitro. Human fibroblasts were cultured for 4 weeks to form fibroblast sheets. Then, endothelial cells (ECs) were seeded on the fibroblast sheets and wrapped around a tubular support to form a cylinder for the endothelialized tubular urethral model (ET). No ECs were added in the standard tubular model (T). After 21 days of maturation, urothelial cells were seeded into the lumen of both models. Constructs were placed under perfusion in a bioreactor for 1 week. At several times, histology and immunohistochemistry were performed on grafted nude mice to evaluate the impact of ECs on vascularization. Results: Both models produced an extracellular matrix, without exogenous material, and developed a pseudostratified urothelium. Seven days after the graft, mouse red blood cells were present only in the outer layers in T model, but in the full thickness of ET model. After 14 days, erythrocytes were present in both models, but in a greater proportion in ET model. At day 28, both models were well-vascularized, with capillary-like structures in the whole thickness of the tubes. Conclusion: Incorporating endothelial cells was associated with an earlier vascularization of the grafts, which could decrease the necrosis of the transplanted tissue. As those models can be elaborated with the patient’s cells, this tubular urethral graft would be unique in its autologous property. PMID:23401738

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

    PubMed Central

    Singh, Sunita; Rawat, Jiledar

    2013-01-01

    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

  5. Impact on sexual function after reconstructive surgery for anterior urethral stricture disease

    PubMed Central

    Singh, Uday P; Maheshwari, Ruchir; Kumar, Vikas; Srivastava, Aneesh; Kapoor, Rakesh

    2010-01-01

    Objective: To evaluate the effect of urethral reconstructive surgery on sexual drive, erectile function and ejaculation. Materials and Methods: The study group consisted of 150 men with a median (range) age of 40 (18–73) years who underwent 168 urethral reconstructive procedures for anterior urethral stricture disease between October 2003 and May 2009. We evaluated sexual functioning using the O’Leary Brief Male Sexual Function Inventory before and after surgery. Results: The median follow-up was 33 months (range 4–72). There were no significant changes in sexual drive and erectile function scores postoperatively for men in the 20-29, 30-39, 40-49, 50-59 and 60-69 years age groups. Overall, there was a significant improvement in ejaculatory function scores after surgery. This improvement was most robust in men in the 20-29, 30-39 and 40-49 years age group. Conclusion: Overall, anterior urethral reconstruction appears no more likely to cause postoperative sexual dysfunction. Different types of urethroplasties, surgical complexity with long stricture excision and the use of buccal graft, preputial flap/tube did not influence outcome. PMID:20877594

  6. Bilateral Corporal Fracture With Urethral Rupture Following Intercourse-Case Report With Review Of Literature

    Microsoft Academic Search

    SINGH IQBAL; MITTAL G; CHAKRABORTHY S

    A 32-year-old man presented with complaints of pain and sudden detumescence of penis during intercourse. On examination his penis was flaccid but swollen and deviated to the left side with severe tenderness on the right side of shaft. On exploration a diagnosis of bilateral fracture penis with penile urethral rupture was confirmed. Repair of both the corpora and primary anastomotic

  7. Urethro-urethral fistula: A rare cause of post-TURP incontinence.

    PubMed

    Moorthy, H Krishna; Pillai, Biju S

    2014-11-01

    Prostatic abscess rarely follows acute prostatitis and can sometimes lead to a fistula by breaking into the prostatic urethra, peri-rectal tissues, the perineum, or the rectum. We report a case of a prostatic abscess tracking into the bulbar urethra after a transurethral resection of the prostate. This created a fistula, mimicking a urethral duplication and leading to urinary incontinence. PMID:25553167

  8. Complete Genome Sequence of the Urethral Catheter Isolate Myroides sp. A21

    PubMed Central

    Burghartz, Melanie; Bunk, Boyke; Spröer, Cathrin; Voget, Sonja; Daniel, Rolf; Overmann, Jörg

    2015-01-01

    Myroides sp. A21, isolated from a urethral catheterized patient without symptoms of a urinary tract infection in Germany, proved to be extensively drug resistant. Here, we report the 4.16-Mb complete genome sequence of strain A21, carrying unusual pathogenicity islands and explaining the features of multidrug resistance. PMID:25745004

  9. Posterior atlantoaxial dislocation without fracture and neurologic deficit: a case report and the review of literature

    PubMed Central

    Jiang, Lei-Sheng; Shen, Lei; Wang, Wei; Wu, Hao

    2009-01-01

    Traumatic posterior atlantoaxial dislocation without related fracture of the odontoid process is very rare, and only ten cases have been previously reported. The objective of this paper was to describe a case of traumatic posterior atlantoaxial dislocation without related fracture of the odontoid process, and its management with atlantoaxial transarticular screw fixation and bony fusion through an anterior retropharyngeal approach, and to review the relevant literature. The patient’s medical and radiographic history is reviewed as well as the relevant medical literature. Posterior atlantoaxial dislocation was confirmed in a 48-year-old male struck by an automobile through conventional radiography, computed tomography and magnetic resonance imaging. No related fracture of the odontoid process or neurological deficit was found in this patient. Transarticular screw fixation of the atlantoaxial articulation through anterior retropharyngeal approach was performed after several unsuccessful attempts of closed reduction. At the latest follow-up, the lateral cervical spine radiography in flexion and extension demonstrated no instability of the atlantoaxial complex 21 months after the operation. In conclusion, patients with posterior atlantoaxial dislocation without fracture may survive with few or no-long term neurological deficit. Routine CT and MRI of the cervical spine should be carried out in patients with head or neck trauma to prevent missing of this rare clinical entity. Transarticular screw fixation of the atlantoaxial articulation through anterior retropharyngeal approach is safe and useful in case the management of dislocation is unsuccessful under closed reduction. PMID:19714372

  10. The Microbial Communities in Male First Catch Urine Are Highly Similar to Those in Paired Urethral Swab Specimens

    PubMed Central

    Toh, Evelyn; Diao, Lixia; Gao, Xiang; Fortenberry, J. Dennis; Van Der Pol, Barbara

    2011-01-01

    Urine is the CDC-recommended specimen for STI testing. It was unknown if the bacterial communities (microbiomes) in urine reflected those in the distal male urethra. We compared microbiomes of 32 paired urine and urethral swab specimens obtained from adult men attending an STD clinic, by 16S rRNA PCR and deep pyrosequencing. Microbiomes of urine and swabs were remarkably similar, regardless of STI status of the subjects. Thus, urine can be used to characterize urethral microbiomes when swabs are undesirable, such as in population-based studies of the urethral microbiome or where multiple sampling of participants is required. PMID:21603636

  11. Surgical Outcome of Urethroplasty Using Penile Circular Fasciocutaneous Flap for Anterior Urethral Stricture

    PubMed Central

    Kim, Kyoung Rok; Suh, Jun-Gyo; Paick, Jae-Seung

    2014-01-01

    Purpose Penile circular fasciocutaneous flap urethroplasty is a useful technique for a long anterior urethral stricture due to the flap's hairless nature and ample length. We investigated the surgical outcomes of urethroplasty for a complex anterior urethral stricture, performed using a penile circular fasciocutaneous flap. Materials and Methods Between 2008 and 2013, we performed a retrospective review of 29 patients who underwent urethroplasty using a penile circular fasciocutaneous flap and had at least 6 months of follow-up. A total of 20 cases utilized only a fasciocutaneous flap, while 9 cases combined a fasciocutaneous flap with other surgery. Success was defined as no requirement of additional urethral instrumentation. Results The overall success rate was 68.9% (20 out of 29 cases) at a median follow-up of 19 months. Furthermore, fasciocutaneous flap urethroplasty rendered the actual stricture-free rate of 79.3%. The location of recurrence was mostly at the junction of the flap. Among 9 surgical failures, 5 cases were treated successfully by using an additional surgical procedure. Fistula repair was needed in 1 case 4 months later. Further, periodic urethral dilation was performed in the remaining 3 cases. The failure rate was significantly higher in patients with suprapubic cystostomy than in patients without suprapubic cystostomy. The most common complication was post-micturition dribbling. Conclusions Penile circular fasciocutaneous flap urethroplasty is a useful method for the reconstruction of a long anterior urethral stricture. A sufficient healthy margin should be acquired for better surgical results due to the fact that most recurrence occurs at the junction of the flap. PMID:25237658

  12. The dose-dependence biological effect of laser fluence on rabbit fibroblasts derived from urethral scar.

    PubMed

    Yang, Yong; Yu, Bo; Sun, Dongchong; Wu, Yuanyi; Xiao, Yi

    2015-04-01

    Two-micrometer laser vaporization resection has been used in clinic for years, but some patients received the treatment are still faced with excessive and abnormal wound repair which leads to the recurrent of urethral stricture eventually. Fibroblasts play a key role in the processes of "narrow-expansion/operation-restenosis" recurring problems. Here, we investigated the effect of laser fluence biomodulation on urethral scar fibroblasts as well as the underlying mechanism. Urethral scar fibroblasts were isolated and cultured, and laser irradiation (2 ?m) was applied at different laser fluence or doses (0, 0.125, 0.5, 2, 8, 32 J/cm(2)) with a single exposure in 1 day. The effect of 2-?m laser irradiation on cell proliferation, viability, and expression of scar formation related genes were investigated. Two-micrometer laser irradiation with intermediate dose (8 J/cm(2)) promoted scar fibroblasts proliferation and reactive oxygen species (ROS) production, while higher doses of 32 J/cm(2) are suppressive as it decreased the survival rate, viability, and proliferation of fibroblasts. In addition, qRT-PCR and Western blotting results both proven that collagen type I, collagen IV, MMP9, and CTGF display significant increase, yet the TGF-?1 expression was severely reduced at intermediate dose (8 J/cm(2)) group when compared with the others groups. Our findings suggest the scar formation-related genes are sensitive to intermediate laser irradiation dose, the most in scar fibroblasts. We revealed the bioeffect and molecular mechanism of 2-?m laser irradiation on rabbit urethral scar fibroblasts. Our study provides new insights into the mechanisms which involved in the excessive and abnormal wound repair of 2-?m laser vaporization resection. These results could potentially contribute to further study on biological effects and application of 2-?m laser irradiation in urethral stricture therapy. PMID:25388915

  13. Reconstruction of Long Anterior Urethral Strictures by Dorsally Quilted Penile Skin Flap

    PubMed Central

    Abuzeid, Abdel Moneim M.; Abdel Kader, M. S.

    2012-01-01

    Objective. To present the results of reconstruction of long (>5?cm), penile, bulbar, and bulbopenile urethral strictures by penile skin flap as dorsal onlay in one-stage procedure. Patients and Methods. Between January, 1998 and December, 2004, 18 patients (aged from 28-65 years) presented with long urethral strictures, 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 onlay 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). Followup of all patients after reconstruction included urine flow rate at weekly intervals, RUG at 6–12 weeks, and urethrocystoscopy at 12 and 18 months. Results. The urethral patency was achieved in 77% of patients. The complications were fistula in one patient (5.5%), restricture occurred in 3 patients (16.6%) that required visual internal urethrotomy and two patients (11%) showed curvature on erection that dose not interfere with sexual intercourse. Diverticulum (penile urethra) was seen in one 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 followup period. Conclusion. Free penile skin flaps offer good results (functional and cosmetic) in long penile and/or bulbar urethral strictures. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15?cm long. PMID:22567421

  14. Posterior crossbite - treatment and stability

    PubMed Central

    de ALMEIDA, Renato Rodrigues; de ALMEIDA, Marcio Rodrigues; OLTRAMARI-NAVARRO, Paula Vanessa Pedron; CONTI, Ana Cláudia de Castro Ferreira; NAVARRO, Ricardo de Lima; MARQUES, Henry Victor Alves

    2012-01-01

    Posterior crossbite is defined as an inadequate transversal relationship of maxillary and mandibular teeth. Even when eliminating the etiologic factors, this malocclusion does not have a spontaneous correction, and should be treated with maxillary expansion as early as possible. This treatment aims at providing a better tooth/skeletal relationship, thereby improving masticatory function, and establishing a symmetrical condyle/fossa relationship. Should posterior crossbite not be treated early, it may result in skeletal changes, demanding a more complex approach. Additionally, an overcorrection expansion protocol should be applied in order to improve the treatment stability. Although the literature has reported a high rate of relapse after maxillary expansion, the goal of this study was to demonstrate excellent stability of the posterior crossbite correction 21 years post treatment. PMID:22666850

  15. Mild traumatic brain injury.

    PubMed

    Katz, Douglas I; Cohen, Sara I; Alexander, Michael P

    2015-01-01

    Mild traumatic brain injury (TBI) is common but accurate diagnosis and defining criteria for mild TBI and its clinical consequences have been problematic. Mild TBI causes transient neurophysiologic brain dysfunction, sometimes with structural axonal and neuronal damage. Biomarkers, such as newer imaging technologies and protein markers, are promising indicators of brain injury but are not ready for clinical use. Diagnosis relies on clinical criteria regarding depth and duration of impaired consciousness and amnesia. These criteria are particularly difficult to confirm at the least severe end of the mild TBI continuum, especially when relying on subjective, retrospective accounts. The postconcussive syndrome is a controversial concept because of varying criteria, inconsistent symptom clusters and the evidence that similar symptom profiles occur with other disorders, and even in a proportion of healthy individuals. The clinical consequences of mild TBI can be conceptualized as two multidimensional disorders: (1) a constellation of acute symptoms that might be termed early phase post-traumatic disorder (e.g., headache, dizziness, imbalance, fatigue, sleep disruption, impaired cognition), that typically resolve in days to weeks and are largely related to brain trauma and concomitant injuries; (2) a later set of symptoms, a late phase post-traumatic disorder, evolving out of the early phase in a minority of patients, with a more prolonged (months to years), sometimes worsening set of somatic, emotional, and cognitive symptoms. The later phase disorder is highly influenced by a variety of psychosocial factors and has little specificity for brain injury, although a history of multiple concussions seems to increase the risk of more severe and longer duration symptoms. Effective early phase management may prevent or limit the later phase disorder and should include education about symptoms and expectations for recovery, as well as recommendations for activity modifications. Later phase treatment should be informed by thoughtful differential diagnosis and the multiplicity of premorbid and comorbid conditions that may influence symptoms. Treatment should incorporate a hierarchical, sequential approach to symptom management, prioritizing problems with significant functional impact and effective, available interventions (e.g., headache, depression, anxiety, insomnia, vertigo). PMID:25702214

  16. Primary myelolipoma in posterior mediastinum

    PubMed Central

    Xiong, Yan; Wang, Yong

    2014-01-01

    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

  17. Traumatic asphyxia in weightlifters.

    PubMed

    Jumbelic, Mary I

    2007-05-01

    The cases presented here are an unrecognized source of accidental asphyxia--compression of the neck by barbells. Two cases of traumatic asphyxia due to this preventable hazard occurred in a 5-year period in central New York. There have been at least 11 similar deaths reported to the United States Consumer Product Safety Commission (CPSC) and cataloged in the National Electronic Injury Surveillance System between 1999 and 2002. A petition filed in 2003 with the CPSC-proposed mandatory labeling of bench presses to make consumers aware of this hazard, but was denied. This report looks at the deaths that have occurred due to this unrecognized safety threat and provides pertinent advice to make bench-pressing a safer activity. PMID:17456099

  18. Ventral inlay buccal mucosal graft urethroplasty: A novel surgical technique for the management of urethral stricture disease

    PubMed Central

    Terlecki, Ryan Patrick

    2015-01-01

    To describe the novel technique of ventral inlay substitution urethroplasty for the management of male anterior urethral stricture disease. A 58-year-old gentleman with multifocal bulbar stricture disease measuring 7 cm in length was treated using a ventral inlay substitution urethroplasty. A dorsal urethrotomy was created, and the ventral urethral plated was incised. The edges of the urethral plate were mobilized without violation of the ventral corpus spongiosum. A buccal mucosa graft was harvested and affixed as a ventral inlay to augment the caliber of the urethra. The dorsal urethrotomy was closed over a foley catheter. No intraoperative or postoperative complications occurred. Postoperative imaging demonstrated a widely patent urethra. After three years of follow-up, the patient continues to do well with no voiding complaints and low postvoid residuals. Ventral inlay substitution urethroplasty appears to be a safe and feasible technique for the management of bulbar urethral strictures. PMID:25685305

  19. Ventral inlay buccal mucosal graft urethroplasty: A novel surgical technique for the management of urethral stricture disease.

    PubMed

    Kovell, Robert Caleb; Terlecki, Ryan Patrick

    2015-02-01

    To describe the novel technique of ventral inlay substitution urethroplasty for the management of male anterior urethral stricture disease. A 58-year-old gentleman with multifocal bulbar stricture disease measuring 7 cm in length was treated using a ventral inlay substitution urethroplasty. A dorsal urethrotomy was created, and the ventral urethral plated was incised. The edges of the urethral plate were mobilized without violation of the ventral corpus spongiosum. A buccal mucosa graft was harvested and affixed as a ventral inlay to augment the caliber of the urethra. The dorsal urethrotomy was closed over a foley catheter. No intraoperative or postoperative complications occurred. Postoperative imaging demonstrated a widely patent urethra. After three years of follow-up, the patient continues to do well with no voiding complaints and low postvoid residuals. Ventral inlay substitution urethroplasty appears to be a safe and feasible technique for the management of bulbar urethral strictures. PMID:25685305

  20. Traumatic Fracture of Thin Pedicles Secondary to Extradural Meningeal Cyst

    PubMed Central

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

    2011-01-01

    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

  1. FKBP5 genotype and structural integrity of the posterior cingulum.

    PubMed

    Fani, Negar; King, Tricia Z; Reiser, Emily; Binder, Elisabeth B; Jovanovic, Tanja; Bradley, Bekh; Ressler, Kerry J

    2014-04-01

    Alterations in the microarchitecture of the posterior cingulum (PC), a white matter tract proximal to the hippocampus that facilitates communication between the entorhinal and cingulate cortices, have been observed in individuals with psychiatric disorders, such as depression and post-traumatic stress disorder (PTSD). PC decrements may be a heritable source of vulnerability for the development of affective disorders; however, genetic substrates for these white matter abnormalities have not been identified. The FKBP5 gene product modulates glucocorticoid receptor function and has been previously associated with differential hippocampal structure, function, and affect disorder risk. Thus, FKBP5 is an attractive genetic target for investigations of PC integrity. We examined associations between PC integrity, measured through diffusion tensor imaging (DTI) and fractional anisotropy (FA; an index of white matter integrity), and polymorphisms in the FKBP5 SNP rs1360780 in a sample of 82 traumatized female civilians. Findings indicated that, compared with individuals without this allele, individuals who carried two 'risk' alleles for this FKBP5 SNP (T allele; previously associated with mood and anxiety disorder risk) demonstrated significantly lower FA in the left PC, even after statistically controlling for variance associated with age, trauma exposure, and PTSD symptoms. These data suggest that specific allelic variants for an FKBP5 polymorphism are associated with decrements in the left PC microarchitecture. These white matter abnormalities may be a heritable biological marker that indicates increased vulnerability for the development of psychiatric disorders, such as PTSD. PMID:24253961

  2. Children's Understanding of Posterior Probability

    ERIC Educational Resources Information Center

    Girotto, Vittorio; Gonzalez, Michael

    2008-01-01

    Do young children have a basic intuition of posterior probability? Do they update their decisions and judgments in the light of new evidence? We hypothesized that they can do so extensionally, by considering and counting the various ways in which an event may or may not occur. The results reported in this paper showed that from the age of five,…

  3. Unilateral posterior crossbite and mastication

    Microsoft Academic Search

    Benito Rilo; José Luis da Silva; María Jesús Mora; Carmen Cadarso-Suárez; Urbano Santana

    2007-01-01

    ObjectiveThis study was designed to characterize masticatory-cycle morphology, and distance of the contact glide in the closing masticatory stroke, in adult subjects with uncorrected unilateral posterior crossbite (UPXB), comparing the results obtained with those obtained in a parallel group of normal subjects.

  4. Cell-Seeded Tubularized Scaffolds for Reconstruction of Long Urethral Defects: A Preclinical Study

    PubMed Central

    Orabi, Hazem; AbouShwareb, Tamer; Zhang, Yuanyuan; Yoo, James J.; Atala, Anthony

    2012-01-01

    Background The treatment options for patients requiring repair of a long segment of the urethra are limited by the availability of autologous tissues. We previously reported that acellular collagen-based tubularized constructs seeded with cells are able to repair small urethral defects in a rabbit model. Objective We explored the feasibility of engineering clinically relevant long urethras for surgical reconstruction in a canine preclinical model. Design, setting, and participants Autologous bladder epithelial and smooth muscle cells from 15 male dogs were grown and seeded onto preconfigured collagen-based tubular matrices (6 cm in length). The perineal urethral segment was removed in 21 male dogs. Urethroplasties were performed with tubularized collagen scaffolds seeded with cells in 15 animals. Tubularized constructs without cells were implanted in six animals. Serial urethrography and three-dimensional computed tomography (CT) scans were performed pre- and postoperatively at 1, 3, 6, and 12 mo. The animals were euthanized at their predetermined time points (three animals at 1 mo, and four at 3, 6, and 12 mo) for analyses. Outcome measurements and statistical analysis Statistical analysis of CT imaging and histology was not needed. Results and limitations CT urethrograms showed wide-caliber urethras without strictures in animals implanted with cell-seeded matrices. The urethral segments replaced with acellular scaffolds collapsed. Gross examination of the urethral implants seeded with cells showed normal-appearing tissue without evidence of fibrosis. Histologically, an epithelial cell layer surrounded by muscle fiber bundles was observed on the cell-seeded constructs, and cellular organization increased over time. The epithelial and smooth muscle phenotypes were confirmed using antibodies to pancytokeratins AE1/AE3 and smooth muscle–specific desmin. Formation of an epithelial cell layer occurred in the unseeded constructs, but few muscle fibers formed. Conclusions Cell-seeded tubularized collagen scaffolds can be used to repair long urethral defects, whereas scaffolds without cells lead to poor tissue development and strictures. This study demonstrates that long tissue-engineered tubularized urethral segments may be used for urethroplasty in patients. PMID:22877501

  5. Comparison of Antimicrobial Susceptibilities of Pharyngeal, Rectal, and Urethral Neisseria gonorrhoeae Isolates among Men Who Have Sex with Men.

    PubMed

    Kidd, Sarah; Zaidi, Akbar; Asbel, Lenore; Baldwin, Tamara; Gratzer, Beau; Guerry, Sarah; Kerani, Roxanne P; Pathela, Preeti; Pettus, Kevin; Soge, Olusegun O; Stirland, Ali; Weinstock, Hillard S

    2015-05-01

    U.S. surveillance for Neisseria gonorrhoeae antimicrobial susceptibilities is based exclusively on male urethral isolates. These data inform gonorrhea treatment guidelines, including recommendations for the treatment of extragenital infections, but data on the susceptibilities of extragenital isolates are limited. We compared the antimicrobial susceptibilities of pharyngeal, rectal, and urethral gonococcal isolates collected from men who have sex with men (MSM), at five sentinel sites throughout the United States. MICs were determined by the agar dilution method. Generalized linear models were used to compare (i) the proportions of isolates with elevated MICs and (ii) geometric mean MICs according to anatomic site, adjusted for city. In December 2011 to September 2013, totals of 205 pharyngeal, 261 rectal, and 976 urethral isolates were obtained. The proportions of isolates with elevated ceftriaxone MICs (?0.125 ?g/ml) did not differ according to anatomic site (0.5% of pharyngeal isolates, 1.5% of rectal isolates, and 1.7% of urethral isolates, with a city-adjusted odds ratio [aOR] of 0.4 [95% confidence interval {CI}, 0.0 to 3.9] for pharyngeal versus urethral isolates and an aOR of 0.9 [95% CI, 0.2 to 4.2] for rectal versus urethral isolates). The city-adjusted geometric mean ceftriaxone MICs of pharyngeal (0.0153 ?g/ml) and rectal (0.0157 ?g/ml) isolates did not differ from that of urethral isolates (0.0150 ?g/ml) (ratios of geometric mean MICs of 1.02 [95% CI, 0.90 to 1.17] and 1.05 [95% CI, 0.93 to 1.19], respectively). Similar results were observed for other antimicrobials, including cefixime and azithromycin. These findings suggest that, at the population level, gonococcal antimicrobial susceptibility surveillance based on urethral isolates from MSM adequately reflects the susceptibilities of N. gonorrhoeae strains circulating among MSM. PMID:25691638

  6. Transurethral Implantation of Macroplastique® for the Treatment of Female Stress Urinary Incontinence Secondary to Urethral Sphincter Deficiency

    Microsoft Academic Search

    S. C. Radley; C. R. Chapple; I. C. Mitsogiannis; K. S. Glass

    2001-01-01

    Objective: To assess the results of transurethral implantation of Macroplastique® in women with stress incontinence secondary to urethral sphincter deficiency using subjective and objective outcome measures.Methods: A total of 60 women with genuine stress incontinence secondary to intrinsic urethral sphincter deficiency were treated with transurethral implantation of Macroplastique. The patients had undergone a mean of 1.9 (range 0–7) previous episodes

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

    PubMed

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

    2012-01-01

    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

  8. Preoperative MUCP and VLPP Did Not Predict Long-Term (4Year) Outcome after Transobturator Mid-Urethral Sling

    Microsoft Academic Search

    Elisabetta Costantini; Massimo Lazzeri; Antonella Giannantoni; Vittorio Bini; Michele del Zingaro; Massimo Porena

    2009-01-01

    Objective: Maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (VLPP) have been considered objective parameters for studying the urethral integrity and predicting outcome after surgery for stress urinary incontinence (SUI). We test the hypothesis that preoperative MUCP and\\/or VLPP may predict long-term outcome after out-in transobturator tape (TOT) surgery for female SUI. Methods: 65 patients affected by stress

  9. Direct caroticocavernous fistula and traumatic dissection of the ipsilateral internal carotid artery: endovascular treatment

    Microsoft Academic Search

    G. Wilms; P. Demaerel; L. Lagae; I. Casteels; I. Mombaerts

    2000-01-01

    After severe craniocerebral trauma a 14-year-old boy developed progressive exophthalmos with venous congestion and chemosis,\\u000a due to a direct caroticocavernous fistula. Angiography revealed traumatic occlusion of the ipsilateral internal carotid artery\\u000a and absence of the inferior petrosal sinus. After failure of an approach via the anterior and posterior communicating arteries,\\u000a the cavernous sinus was successfully catheterised through the occluded internal

  10. The adult penile urethra is a novel entry site for HIV-1 that preferentially targets resident urethral macrophages.

    PubMed

    Ganor, Y; Zhou, Z; Bodo, J; Tudor, D; Leibowitch, J; Mathez, D; Schmitt, A; Vacher-Lavenu, M-C; Revol, M; Bomsel, M

    2013-07-01

    The penile urethra is routinely targeted by sexually transmitted bacterial and viral pathogens, and also represents a probable site for HIV type-1 (HIV-1) entry. Yet, the mechanisms of urethral HIV-1 transmission are unknown. To describe the initial steps of penile HIV-1 entry, we obtained whole penile tissues from individuals undergoing elective gender reassignment and developed ex vivo polarized explants of different penile epithelia, as well as in vitro immunocompetent reconstructed urethra. In penile explants, 1?h exposure to cell-associated HIV-1 results in higher HIV-1 entry into the urethra, whereas the fossa navicularis and glans are relatively resistant to HIV-1. CCR5+/CD4+ urethral macrophages are the initial cells infected by HIV-1, which exit the epithelial compartment following inoculation with cell-associated HIV-1 that induces decreased CCL2/MCP-1 production. Urethral T cells are mostly CD8+ or naive CD4+, and not infected by HIV-1 on its early entry. In urethral reconstructions, efficient translocation of cell-associated HIV-1 depends on viral tropism (R5>X4) and can be decreased by gp41-specific IgAs. Cell-free HIV-1 is inefficient at urethral penetration. Our results identify the male urethra as a novel entry site for HIV-1 that targets resident urethral macrophages. These results might explain the incomplete prophylactic efficacy of male circumcision in reducing HIV-1 transmission. PMID:23187317

  11. A case report of urethral prolapse in a 38 year old female with 46XY karyotype.

    PubMed

    Watson, Helena; Stasiowska, Ewa

    2014-06-01

    A 38-year old female presented with the acute onset of a vulval mass associated with pain and vaginal bleeding. She is female phenotype but has 46XY karyotype and Complete Androgen Insensitivity Syndrome (CAIS). At 15 years old she had a laparotomy and bilateral orchidectomy. Following admission, an examination under anaesthesia and cystoscopy was performed. A diagnosis of strangulated complete urethral prolapse was made. The lesion was excised with diathermy and the meatal skin was reanastomosed to the urethra. At follow-up, the urethra was well healed. The patient now attends Menopause Clinic for oestrogen-replacement therapy. We hope this case raises awareness of the possibility of urethral prolapse in younger women who are oestrogen deficient. It provides further incentive for compliance with hormone replacement therapy for patients with CAIS following gonadectomy, or other women with premature menopause. PMID:25017598

  12. [Post-traumatic decompression of the optic nerve. Ophthalmologic and x-ray computed tomographic evaluation. Results in a series of 23 cases].

    PubMed

    Soudant, J; Lamas, G; Girard, B; Fougeront, B; Guenon, P

    1990-01-01

    Post traumatic optic nerve compression gives a Clinic picture of physiological section. CT Scan is consistent with optic canal lesion when considering direct signs (bony fragments compressing the nerve) or indirect (fractures and hematoma of posterior orbital wall, of posterior ethmoid, and sphenoid). 23 patients had a surgical decompression through transethmoidosphenoidal approach. A lesion of optic canal was found in 22 out of 23 cases. Improvement of vision was noted in 12 cases. PMID:2221722

  13. Effects of prolonged vaginal distention and beta-aminopropionitrile on urinary continence and urethral structure

    PubMed Central

    Wang, Guifang; Lin, Guiting; Zhang, Haiyang; Qiu, Xuefeng; Ning, Hongxiu; Banie, Lia; Fandel, Thomas; Albersen, Maarten; Lue, Tom F.; Lin, Ching-Shwun

    2011-01-01

    Purpose To investigate the effects of prolonged vaginal distension and beta-aminopropionitrile (BAPN) on urinary patterns and urethral structure in female virgin rats. Materials and Methods Female virgin rats were randomly divided into 3 groups of 7 rats each. The control group received no intervention; the VD group was treated with prolonged vaginal distension (VD) via balloon inflation; the VD+BAPN group was treated with VD plus i.p. injection of 150 mg/kg of BAPN every 3 days. Three weeks later all rats were subjected to conscious cystometric analysis and then sacrificed for histological analysis of the urethra. Results Conscious cystometry identified 0, 3, and 5 rats in the control, VD, and VD+BAPN groups, respectively, as having abnormal voiding pattern. Urethral collagen content was significantly lower in the VD and VD+BAPN rats when compared to control rats. Urethral elastic fibers were disorganized and shorter in the VD and VD+BAPN rats, and were fragmented, lacking the inter-muscle connections in the VD+BAPN rats. Urethral striated muscle fibers were shorter and more widely spaced in VD and VD+BAPN rats than in control rats. Additionally, those in the VD+BAPN group exhibited an abnormal wavy shape suggestive of lacking architectural support. Conclusions Prolonged vaginal distension caused urodynamic changes and histological abnormalities in the urethra including reduced collagen content, fragmented elastic fibers, as well as sparsely arranged and shortened striated muscle fibers. BAPN appears to interfere with the restoration of collagen and elastic fibers. PMID:21982017

  14. Life-threatening urethral bleeding induced by a pseudoaneurysm of the obturator artery.

    PubMed

    Huang, Tsung-Yi; Huang, Chun-Nung; Lee, Yung-Chin

    2013-12-01

    We report the case of a 56-year-old man who in a motor vehicle collision developed a pelvic fracture and complete urethra rupture. Sudden onset of intermittent severe urethral bleeding occurred and it led to life-threatening blood pressure drop and dyspnea. An angiography of internal iliac artery showed a pseudoaneurysm involving the right obturator artery. Super-selective embolization of the feeding vessel was performed with cessation of the blood flow immediately. PMID:24295270

  15. Hitting below the belt (Bladder): Botulinum treatment of urethral and prostate disorders

    Microsoft Academic Search

    H. Henry Lai; Christopher P. Smith

    2007-01-01

    Botulinum toxin type A (BTX-A) has been used to treat urethral and prostatic diseases (off-label uses). Injection of BTX-A\\u000a into the external sphincter of patients with detrusor external sphincter dyssynergia has been shown to successfully lower\\u000a postvoid residual volumes and detrusor pressures. Average efficacy is 3 to 4 months, but long-term effects on detrusor leak\\u000a point pressures or renal function

  16. Surgical Management of Stress Incontinence in Patients with Low Urethral Pressure

    Microsoft Academic Search

    David A. Richardson; Alfida Ramahi; Eva Chalas

    1991-01-01

    Thirty-four women with genuine stress incontinence and low urethral closure pressure were studied pre-and postoperatively. A modified Burch retropubic urethropexy was performed in 29 patients with a cure rate of 78 %, improvement in 7%, and failure in 15%. The modified Stamey procedure was performed in 5 patients with significant pelvic floor relaxation with a cure rate of 40% and

  17. The promise of stem cell therapy to restore urethral sphincter function

    Microsoft Academic Search

    Akira Furuta; Ron J. Jankowski; Ryan Pruchnic; Naoki Yoshimura; Michael B. Chancellor

    2007-01-01

    The promise of stem cell therapy for the treatment of stress urinary incontinence is that transplanted stem cells may undergo\\u000a self-renewal and potential multipotent differentiation, leading to urethral sphincter regeneration. Cell-based therapies are\\u000a most often associated with the use of autologous multipotent stem cells, such as bone marrow cells. However, harvesting bone\\u000a marrow stromal stem cells is difficult, painful, and

  18. Adenovirus urethritis and concurrent conjunctivitis: a case series and review of the literature.

    PubMed

    Liddle, Olivia Louise; Samuel, Mannampallil Itty; Sudhanva, Malur; Ellis, Joanna; Taylor, Chris

    2015-03-01

    We present eight cases and review the literature of concurrent urethritis and conjunctivitis where adenovirus was identified as the causative pathogen. The focus of this review concerns the identification of specific sexual practices, symptoms, signs and any serotypes that seem more commonly associated with such adenovirus infections. We discuss the seasonality of adenovirus infection and provide practical advice for clinicians to give to the patient. PMID:25433050

  19. Treatment of Traumatic Carotid-Cavernous Fistula

    PubMed Central

    Wu, Z.; Zhang, Y.; Wang, C.; YANG, X.; Li, Y.

    2000-01-01

    Summary From 1986 to the end of 1998, 482 cases of traumatic carotid-cavernous fistula (TCCF) were treated by means of intravascular embolisation technique. The experience is overviewed in this article. Many kinds of detachable balloon catheters (including Chinese made detachable balloon catheters), coils and cyano aery late were used as embolic materials. Transcervical, transfemoral, anterior communicating artery, posterior communicating artery approach, or transvenous approach were selected according to conditions. A combination of different approaches or materials was used for complex TCCF. We found that the special sign, named “bileakage sign”, indicated multileakage of TCCF and was not mentioned before. All 482 cases of TCCF were embolised successfully, of which 405 cases maintained the patency of internal carotid artery (ICA). No death related to the treatment occurred in our group and the symptoms or signs in 462 cases were relieved after embolisation. Emergency embolisation was needed in some conditions such as serious epistaxis, delayed or repeatedly subdural haematoma and rapid visual impairment. Endovascular treatment of TCCF is a safe and efficient method. The time of operation, approach, and materials for embolisation must be carefully selected in order to obtain the best result. PMID:20667206

  20. An NTCP Analysis of Urethral Complications from Low Doserate Mono- and Bi-Radionuclide Brachytherapy

    PubMed Central

    Nuttens, V. E.; Nahum, A. E.; Lucas, S.

    2011-01-01

    Urethral NTCP has been determined for three prostates implanted with seeds based on 125I (145?Gy), 103Pd (125?Gy), 131Cs (115?Gy), 103Pd-125I (145?Gy), or 103Pd-131Cs (115?Gy or 130?Gy). First, DU20, meaning that 20% of the urhral volume receive a dose of at least DU20, is converted into an I-125 LDR equivalent DU20 in order to use the urethral NTCP model. Second, the propagation of uncertainties through the steps in the NTCP calculation was assessed in order to identify the parameters responsible for large data uncertainties. Two sets of radiobiological parameters were studied. The NTCP results all fall in the 19%–23% range and are associated with large uncertainties, making the comparison difficult. Depending on the dataset chosen, the ranking of NTCP values among the six seed implants studied changes. Moreover, the large uncertainties on the fitting parameters of the urethral NTCP model result in large uncertainty on the NTCP value. In conclusion, the use of NTCP model for permanent brachytherapy is feasible but it is essential that the uncertainties on the parameters in the model be reduced. PMID:22096647

  1. Detection and quantification of Mycoplasma genitalium in male patients with urethritis.

    PubMed

    Dupin, Nicolas; Bijaoui, Gérard; Schwarzinger, Michaël; Ernault, Pauline; Gerhardt, Philippe; Jdid, Randa; Hilab, Salim; Pantoja, Christina; Buffet, Marc; Escande, Jean-Paul; Costa, Jean-Marc

    2003-08-15

    Detection and quantification of Mycoplasma genitalium were evaluated in 83 patients with urethritis (group 1), 60 patients with urethral symptoms but no urethritis (group 2), and 50 asymptomatic men (group 3). Quantification of M. genitalium was carried out using real-time polymerase chain reaction (PCR) analysis of first-pass urine samples. The rate of detection of M. genitalium was significantly higher in group 1 than in groups 2 and 3 (P<.0001). The mean observed concentration of M. genitalium was 1.2x10(4) equivalent genomes/mL of urine (range, 50 to 8x10(4) equivalent genomes/mL). Analysis of M. genitalium load in serial urine samples collected before and after the administration of antibacterial treatment showed an association between clinical and microbiological responses, with a shift to negative PCR results in symptom-free patients. Our results illustrate the usefulness of monitoring the M. genitalium load in evaluating the susceptibility of M. genitalium to antibacterial treatment. PMID:12905147

  2. Human balanced translocation and mouse gene inactivation implicate Basonuclin 2 in distal urethral development

    PubMed Central

    Bhoj, Elizabeth J; Ramos, Purita; Baker, Linda A; Cost, Nicholas; Nordenskjöld, Agneta; Elder, Frederick F; Bleyl, Steven B; Bowles, Neil E; Arrington, Cammon B; Delhomme, Brigitte; Vanhoutteghem, Amandine; Djian, Philippe; Zinn, Andrew R

    2011-01-01

    We studied a man with distal hypospadias, partial anomalous pulmonary venous return, mild limb-length inequality and a balanced translocation involving chromosomes 9 and 13. To gain insight into the etiology of his birth defects, we mapped the translocation breakpoints by high-resolution comparative genomic hybridization (CGH), using chromosome 9- and 13-specific tiling arrays to analyze genetic material from a spontaneously aborted fetus with unbalanced segregation of the translocation. The chromosome 13 breakpoint was ?400?kb away from the nearest gene, but the chromosome 9 breakpoint fell within an intron of Basonuclin 2 (BNC2), a gene that encodes an evolutionarily conserved nuclear zinc-finger protein. The BNC2/Bnc2 gene is abundantly expressed in developing mouse and human periurethral tissues. In all, 6 of 48 unrelated subjects with distal hypospadias had nine novel nonsynonymous substitutions in BNC2, five of which were computationally predicted to be deleterious. In comparison, two of 23 controls with normal penile urethra morphology, each had a novel nonsynonymous substitution in BNC2, one of which was predicted to be deleterious. Bnc2?/? mice of both sexes displayed a high frequency of distal urethral defects; heterozygotes showed similar defects with reduced penetrance. The association of BNC2 disruption with distal urethral defects and the gene's expression pattern indicate that it functions in urethral development. PMID:21368915

  3. Penile fracture and associated urethral injury: Experience at a tertiary care hospital

    PubMed Central

    Amit, Attam; Arun, Kerketta; Bharat, Behera; Navin, Ram; Sameer, Trivedi; Shankar, Dwivedi Udai

    2013-01-01

    Introduction: Penile fracture may be associated with urethral trauma in 1% to 38% of cases. We present our experience in treating 8 such cases. Methods: Data were collected retrospectively from hospital records and from out-patient department follow-up visits. Results: The mean age of the patients was 30.4 years; trauma during coitus was the most common cause of the penile fracture. One patient presented after 7 days. Two patients had normal examination of their penis despite typical history. All fractures were repaired on an emergency basis via subcoronal incision. In 2 patients with normal findings, the urethra had to be mobilized to locate the site of the injury. In 1 patient, the site of the urethral trauma was 1 cm away from the site of the corporal injury, which was localized by injecting sterile methylene blue per urethra. Postoperatively, all patients voided with good flow and had erections with adequate rigidity. Conclusion: A high level of suspicion for urethral injury during surgical exploration is warranted, especially in the presence of suggestive history and examination. PMID:23589751

  4. Sexually dimorphic expression of Mafb regulates masculinization of the embryonic urethral formation

    PubMed Central

    Suzuki, Kentaro; Numata, Tomokazu; Suzuki, Hiroko; Raga, Dennis Diana; Ipulan, Lerrie Ann; Yokoyama, Chikako; Matsushita, Shoko; Hamada, Michito; Nakagata, Naomi; Nishinakamura, Ryuichi; Kume, Shoen; Takahashi, Satoru; Yamada, Gen

    2014-01-01

    Masculinization of external genitalia is an essential process in the formation of the male reproductive system. Prominent characteristics of this masculinization are the organ size and the sexual differentiation of the urethra. Although androgen is a pivotal inducer of the masculinization, the regulatory mechanism under the control of androgen is still unknown. Here, we address this longstanding question about how androgen induces masculinization of the embryonic external genitalia through the identification of the v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog B (Mafb) gene. Mafb is expressed prominently in the mesenchyme of male genital tubercle (GT), the anlage of external genitalia. MAFB expression is rarely detected in the mesenchyme of female GTs. However, exposure to exogenous androgen induces its mesenchymal expression in female GTs. Furthermore, MAFB expression is prominently down-regulated in male GTs of androgen receptor (Ar) KO mice, indicating that AR signaling is necessary for its expression. It is revealed that Mafb KO male GTs exhibit defective embryonic urethral formation, giving insight into the common human congenital anomaly hypospadias. However, the size of Mafb KO male GTs is similar with that of wild-type males. Moreover, androgen treatment fails to induce urethral masculinization of the GTs in Mafb KO mice. The current results provide evidence that Mafb is an androgen-inducible, sexually dimorphic regulator of embryonic urethral masculinization. PMID:25362053

  5. Posterior cruciate ligament (PCL) injury - aftercare

    MedlinePLUS

    ... of tissue that connects bone to bone. The posterior cruciate ligament (PCL) is located inside your knee ... Curtis C, Bienkowski P, Micheli LJ. Posterior cruciate ligament ... of Physical Medicine and Rehabilitation. 2nd ed. St. Louis, ...

  6. Chronic traumatic encephalopathy.

    PubMed

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

    2013-01-01

    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

  7. Postpartum Post-Traumatic Stress Disorder

    MedlinePLUS

    ... 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, this illness ...

  8. Nanotherapy for posterior eye diseases.

    PubMed

    Kaur, Indu Pal; Kakkar, Shilpa

    2014-11-10

    It is assumed that more than 50% of the most enfeebling ocular diseases have their origin in the posterior segment. Furthermore, most of these diseases lead to partial or complete blindness, if left untreated. After cancer, blindness is the second most dreaded disease world over. However, treatment of posterior eye diseases is more challenging than the anterior segment ailments due to a series of anatomical barriers and physiological constraints confronted for delivery to this segment. In this regard, nanostructured drug delivery systems are proposed to defy ocular barriers, target retina, and act as permeation enhancers in addition to providing a controlled release. Since an important step towards developing effective treatment strategies is to understand the course or a route a drug molecule needs to follow to reach the target site, the first part of the present review discusses various pathways available for effective delivery to and clearance from the posterior eye. Promise held by nanocarrier systems, viz. liposomes, nanoparticles, and nanoemulsion, for effective delivery and selective targeting is also discussed with illustrative examples, tables, and flowcharts. However, the applicability of these nanocarrier systems as self-administration ocular drops is still an unrealized dream which is in itself a huge technological challenge. PMID:24862316

  9. Isolated unilateral oculomotor nerve neuropraxia following a trivial fall in a patient with calcified posterior petroclinoid ligament

    PubMed Central

    Patwardhan, Maneesha Anil

    2015-01-01

    Isolated traumatic oculomotor nerve palsy caused by a trivial fall is extremely rare. We report a case of this condition. A 49-year-old woman had distal radius fracture and ptosis on the same side after having a trivial domestic fall. She did not show any clinical or radiological signs of head injury. Computerized tomography revealed a calcified posterior petroclinoid ligament which has direct anatomical and pathological relation with the oculomotor nerve.

  10. Post-traumatic stress disorder.

    PubMed

    Bisson, Jonathan I

    2007-09-01

    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

  11. Isolated posterior cruciate ligament injuries in athletes

    Microsoft Academic Search

    P. J. Fowler; S. S. Messieh

    1987-01-01

    The literature is divided as to the necessity of an intact posterior cruciate ligament for functional stability. Pre sented here is a prospective study of isolated posterior cruciate injuries seen in the acute stage in 13 patients, 6 males and 7 females. The diagnosis of posterior cruciate ligament tear was made clinically and con firmed by arthroscopy. The average age

  12. Posterior Integration in Dynamic Models Peter Mueller

    E-print Network

    West, Mike

    Posterior Integration in Dynamic Models Peter Mueller Institute of Statistics & Decision Sciences of posterior distributions corresponding to the subsequent stages of the dynamic model. In the absence of these posterior distri­ butions. This paper reviews some previously suggested Monte Carlo based algorithms

  13. Posterior Implementation vs Ex-Post Implementation

    E-print Network

    Franz, Sven Oliver

    Posterior Implementation vs Ex-Post Implementation by Philippe Jehiel, Moritz Meyer-ter-Vehn, Benny Moldovanu and William R. Zame1 This version: 1.9.2006 In this short note we discuss how posterior, posterior implemen- tation is de...ned with respect to the information released by the mechanism

  14. Visualizing highdimensional posterior distributions in Bayesian modeling

    E-print Network

    Kaski, Samuel

    Visualizing high­dimensional posterior distributions in Bayesian modeling Jarkko Venna and Samuel on the posterior distribution of the model parameters. The closed­form solution is seldom known and samples of the posterior have to be computed with Markov Chain Monte Carlo (MCMC) methods. The problem is that for large

  15. UNIFORM STABILITY OF POSTERIORS Sanjib Basu

    E-print Network

    Basu, Sanjib

    UNIFORM STABILITY OF POSTERIORS by Sanjib Basu Northern Illinois University DeKalb, IL 60115, USA E­mail: basu@niu.edu Abstract Infinitesimal sensitivities of the posterior distribution P (\\DeltajX ) and posterior quantities ae(P ) w.r.t. the choice of the prior P are considered. In a very general setting

  16. Posterior Probabilistic Clustering using NMF CSE Department

    E-print Network

    Li, Tao

    Posterior Probabilistic Clustering using NMF Chris Ding CSE Department University of Texas of Computer Science Florida International University wpeng002@cs.fiu.edu ABSTRACT We introduce the posterior probabilistic clustering (PPC), which provides a rigorous posterior probability interpretation for Non- negative

  17. Consistency of Posterior Distributions for Neural Networks

    E-print Network

    Consistency of Posterior Distributions for Neural Networks Herbert Lee \\Lambda May 21, 1998 Abstract In this paper we show that the posterior distribution for feedforward neural networks is asymp problem, then uses bounds on the bracketing entropy to show that the posterior is consistent over

  18. Introduction In normal eyes, the posterior corneal

    E-print Network

    Yoon, Geunyoung

    Introduction In normal eyes, the posterior corneal aberration has a relatively small impact. However, in keratoconic eyes, contribution of the posterior corneal aberration to the total ocular aberration can also be compensated by the posterior corneal aberration. The goal of this study

  19. CONCENTRATION OF POSTERIOR DISTRIBUTIONS WITH MISSPECIFIED MODELS

    E-print Network

    Boyer, Edmond

    CONCENTRATION OF POSTERIOR DISTRIBUTIONS WITH MISSPECIFIED MODELS Christophe ABRAHAMa and Benoît investigate the asymptotic properties of posterior distributions when the model is misspecified, i the asymptotic of the posterior distribution when the model is correctly specified i.e. q is equal to h for some

  20. Preventing Traumatic Brain Injury in Older Adults

    MedlinePLUS

    Preventing Traumatic Brain Injury in Older Adults U.S. Department of Health and Human Services Centers for Disease Control and Prevention Most of ... ways to prevent it. What is a traumatic brain injury or TBI? Traumatic brain injury or TBI is ...

  1. Traumatic catheterisation: a near miss.

    PubMed

    Chen, Han-Kuang; Mackowski, Alicia

    2015-01-01

    A 68-year-old man presented with acute urinary retention. An indwelling catheter was inserted by a junior doctor, which immediately caused perineal pain to the patient. When asked about the catheterisation technique, the junior doctor admitted that he did not insert the catheter to the hilt prior to inflating the balloon. The patient was investigated with a pelvic CT scan and a senior doctor in the emergency department interpreted that the catheter was inserted extravesically with possible haemorrhage. However, subsequent cystoscopy revealed no urethral trauma but a small bladder and a diverticulum. It became clear that the suspected haemorrhage was actually the bladder with markedly thickened wall. What was thought to be the bladder turned out to be the diverticulum. Both pathologies were attributable to chronic bladder outlet obstruction from the occlusive prostate. The patient was discharged with a catheter in situ and planned for transurethral resection of prostate in a week's time. PMID:25878234

  2. USING MORE INFORMATIVE POSTERIOR PROBABILITIES FOR SPEECH RECOGNITION

    E-print Network

    USING MORE INFORMATIVE POSTERIOR PROBABILITIES FOR SPEECH RECOGNITION Hamed Ketabdar, Jithendra speech recognition systems by estimating more informative posteriors taking into account acoustic context knowledge). These posteriors are esti- mated based on HMM state posterior probability definition (typically

  3. Early Intervention with Traumatized Children

    Microsoft Academic Search

    Raul R. Silva; Marylene Cloitre; Lori Davis; Jill Levitt; Sandy Gomez; Irene Ngai; Elissa Brown

    2003-01-01

    With the events of September 11th, childhood trauma has come to the forefront of national attention. One of the common psychiatric outcomes of trauma is Posttraumatic Stress Disorder (PTSD). Despite the fact that certain vulnerabilities may contribute to the development of PTSD in traumatized youth, the existence of an identifiable stressor provides a unique opportunity for early intervention. Cognitive Behavioral

  4. Body's Response to Traumatic Injury

    MedlinePLUS

    ... iframes. Share Print E-mail Related Links Inside Life Science Article: Life After Traumatic Injury: How the Body Responds Up to top This page last reviewed on September 19, 2012 Social Media Links Bookmark & ... National Institute of General Medical Sciences 45 Center Drive MSC 6200 Bethesda, MD 20892- ...

  5. NATIONAL TRAUMATIC OCCUPATIONAL FATALITIES (NTOF)

    EPA Science Inventory

    The National Traumatic Occupational Fatalities (NTOF) surveillance system is a death certificate-based census of occupational injury deaths. Death certificates are obtained from the 50 States, New York City, and the District of Columbia for decedent's ages 16 years or older with ...

  6. Mechanisms of traumatic brain injury.

    PubMed

    Bauer, Derek; Tung, Monica L; Tsao, Jack W

    2015-02-01

    The authors describe the mechanisms of traumatic brain injury (TBI), examining in depth the characteristics of closed head, penetrating, and blast-related TBI. Events on a structural as well as cellular level are reviewed. Blast-related brain injury, in particular, affects military service members preferentially, but is also relevant in cases of industrial accidents as well as terrorist events. PMID:25816125

  7. Post-Traumatic Stress Disorder

    E-print Network

    Bandettini, Peter A.

    Post-Traumatic Stress Disorder (PTSD) National Institute of Mental Health U.S. Department of Healt, or PTSD? 1 Who gets PTSD? 1 What are the symptoms of PTSD? 1 Do children react differently than adults? 3 How is PTSD detected? 3 Why do some people get PTSD and other people do not? 4 How is PTSD

  8. Traumatic Brain Injury Inpatient Rehabilitation

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  9. Evaluation after Traumatic Brain Injury

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  10. Traumatic haemobilia: value of ultrasonography.

    PubMed Central

    Archer, D. J.

    1976-01-01

    A case of post-traumatic haemobilia treated by right hepatic artery ligation is described. The role of 'B'-mode grey-scale ultrasonography in the investigation of hepatic trauma is discussed. Images Fig. 1 Fig. 2 Fig. 3 PMID:984693

  11. Chlamydia trachomatis ompA genotypes in male patients with urethritis in Greece – Conservation of the serovar distribution and evidence for mixed infections with Chlamydophila abortus

    Microsoft Academic Search

    Panagiotis Psarrakos; Eleni Papadogeorgakis; Konrad Sachse; Evangelia Vretou

    2011-01-01

    PCR amplification and nucleotide sequencing of the ompA gene of Chlamydia trachomatis were used to determine the prevalence and distribution of genotypes in 51 urine and urethral specimens from Greek male patients with urethritis, that were positive by the COBAS Amplicor test. A single C. trachomatis serovar was identified in 43 of the 51 amplified samples. Serovars F and E were

  12. Clinical evaluation of a single daily dose of phenylpropanolamine in the treatment of urethral sphincter mechanism incompetence in the bitch

    PubMed Central

    Claeys, Stéphanie; Rustichelli, Frederico; Noël, Stéphanie; Hamaide, Annick

    2011-01-01

    The objective of this retrospective study was to determine the efficacy of a single daily oral dose of phenylpropanolamine (PPA) in the treatment of urethral sphincter mechanism incompetence (USMI) in bitches. Nine bitches diagnosed with USMI were treated with a single daily dose [1.5 mg/kg body weight (BW)] of PPA for at least 1 month. Urethral pressure profiles (UPP) were performed in 7 dogs before treatment and repeated in 4 of them after treatment. Treatment with PPA resulted in long-term continence in 8/9 bitches. One dog did not respond to PPA and was treated surgically later. Recheck UPPs showed a significant increase in maximal urethral closure pressure in the 4 bitches after treatment with PPA compared to before treatment. In conclusion, long-term continence can be achieved in bitches affected with USMI after administration of a single daily dose of PPA (1.5 mg/kg BW). PMID:22043069

  13. Nanoparticle albumin-bound-Paclitaxel in the treatment of metastatic urethral adenocarcinoma: the significance of molecular profiling and targeted therapy.

    PubMed

    Abaza, Yasmin M; Alemany, Carlos

    2014-01-01

    Primary urethral cancer is rare and accounts for only 0.003% of all malignancies arising from the female genitourinary tract. Due to the rarity of this disease, no consensus exists regarding the optimal therapeutic approach. Nanoparticle albumin-bound-paclitaxel has been shown to be effective in the treatment of a number of malignancies including metastatic breast, pancreatic, and bladder cancer. We present a 67-year-old woman with advanced metastatic urethral adenocarcinoma resistant to two lines of chemotherapy (ifosfamide/paclitaxel/cisplatin and irinotecan/5-fluorouracil/leucovorin) that showed a dramatic response to nanoparticle albumin-bound-paclitaxel. This is the first case report to document the use and efficacy of nanoparticle albumin-bound-paclitaxel in the treatment of unresectable metastatic urethral cancer. PMID:25202467

  14. Nanoparticle Albumin-Bound-Paclitaxel in the Treatment of Metastatic Urethral Adenocarcinoma: The Significance of Molecular Profiling and Targeted Therapy

    PubMed Central

    Abaza, Yasmin M.; Alemany, Carlos

    2014-01-01

    Primary urethral cancer is rare and accounts for only 0.003% of all malignancies arising from the female genitourinary tract. Due to the rarity of this disease, no consensus exists regarding the optimal therapeutic approach. Nanoparticle albumin-bound-paclitaxel has been shown to be effective in the treatment of a number of malignancies including metastatic breast, pancreatic, and bladder cancer. We present a 67-year-old woman with advanced metastatic urethral adenocarcinoma resistant to two lines of chemotherapy (ifosfamide/paclitaxel/cisplatin and irinotecan/5-fluorouracil/leucovorin) that showed a dramatic response to nanoparticle albumin-bound-paclitaxel. This is the first case report to document the use and efficacy of nanoparticle albumin-bound-paclitaxel in the treatment of unresectable metastatic urethral cancer. PMID:25202467

  15. Effect of dilution rate on feline urethral sperm motility, viability, and DNA integrity.

    PubMed

    Prochowska, Sylwia; Ni?a?ski, Wojciech; Ochota, Ma?gorzata; Partyka, Agnieszka

    2014-12-01

    This study was designed to investigate if the characteristics of feline urethral sperm can be affected by high dilution in an artificial medium. The semen collected by urethral catheterization from eight male cats was evaluated for sperm concentration and motility and subsequently diluted with a TRIS-based extender to the concentration of spermatozoa 10 × 10(6)/mL, 5 × 10(6)/mL, and 1 × 10(6)/mL. Immediately after the extension samples were assessed for motility, cell viability using SYBR-14 and propidium iodide, acrosome integrity using lectin from Arachis hypogaea Alexa Fluor 488 Conjugate, and propidium iodide and chromatin status by acridine orange. Compared with 10 × 10(6)/mL dilution rate, spermatozoa diluted to 1 × 10(6) sperm/mL had a significantly lower proportion of motile (31.1% ± 19.8 and 0.7% ± 1.6, respectively, P < 0.05) and viable spermatozoa (88.3% ± 3.1 and 69.1% ± 12.8, respectively, P < 0.01). There was no dilution-related difference in the acrosome integrity (76.7% ± 11.9 vs. 75.9% ± 10.6) and chromatin status (defragmentation index, 3.3% ± 0.97 vs. 3.4% ± 1.7). These results indicate that feline urethral semen is susceptible to high dilution rate, and some sperm characteristics can be artifactually changed by semen dilution. It also suggests the potential role of seminal plasma in maintaining sperm motility and viability in high dilution rates. PMID:25262548

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

    PubMed Central

    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

    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

  17. Clinical Outcomes After Posterior Open Elbow Arthrolysis for Posttraumatic Elbow Stiffness

    PubMed Central

    Birjandi Nejad, Ali; Ebrahimzadeh, Mohammad Hosein; Moradi, Ali

    2014-01-01

    Background: Loss of motion is a well-known complication after elbow trauma and in severe cases, arthrolysis of elbow is the procedure of choice. The posterior approach might have some advantages especially in post-traumatic patients who have undergone the same surgical approach in the past. Objectives: The aim of this study was to evaluate the short-term outcomes of elbow arthrolysis through posterior approach. Moreover, we assessed the effect of operation on the patients’ quality of life. Patients and Methods: During a retrospective-cohort study, the medical records of 14 patients (12 men, two women) whose range of movement had been limited post-traumatically and had undergone elbow arthrolysis with posterior approach were reviewed. Before intervention, the patients had a flexion less than 100 degrees or an extension lag of 30 degrees or more. For evaluation of the final outcomes, they were invited to participate in our study and the final range of motion, visual analogue score (VAS), disability of arm, shoulder and hand (DASH), Mayo elbow score (MES) and short form health survey (SF-36) scores were measured in the patients. Results: Mean age of the participants was 28.7 years. The interval from initial injury and arthrolysis was 16 months and the patients were followed for 14 months. The mean range of motion in patients before surgery was 35.8 degrees, which was increased to a mean of 108.9 after the surgery, indicating a 73.1 degrees improvement. The means of VAS, DASH, Mayo elbow and SF-36 scores in the patients were 1.6, 34, 68 and 43, respectively. A significant inverse correlation was found between the preoperative range of motion and final range of motion. Conclusions: According to our results, elbow arthrolysis through posterior approach could be an effective technique with low complications. Since the final range of motion improved significantly, it might be a valuable method in promoting the patients’ quality of life. PMID:25599069

  18. Longitudinal changes of structural connectivity in traumatic axonal injury

    E-print Network

    Abdi, Hervé

    during the first 6 months after traumatic brain injury and to evaluate the utility of diffusion tensor changes occurring between the acute and chronic stages of traumatic brain injury and for predicting of interest; TAI traumatic axonal injury; TBI traumatic brain injury; UF uncinate fasciculus. Traumatic axonal

  19. Squamous cell carcinoma of suprapubic cystostomy tract in a male with locally advanced primary urethral malignancy.

    PubMed

    Boaz, Ranil Johann; John, Nirmal Thampi; Kekre, Nitin

    2015-01-01

    A 65-year-old man with stricture urethra underwent drainage of periurethral abscess and suprapubic cystostomy (SPC) placement. He presented to us 3 months later with a fungating ulcer at the site of perineal incision, the biopsy of which revealed squamous cell carcinoma (SCC). He underwent a total penile amputation, wide local excision scrotum, radical urethrocystoprostatectomy, ileal conduit with the en-bloc excision of the SPC tract. Histopathological examination of the suprapubic tract also revealed SCC. This is the first documented case of SCC of a suprapubic tract in the presence of primary urethral SCC. PMID:25624581

  20. Is it better to avoid urethral catheterization at hysterectomy and caesarean section?

    PubMed

    Barnes, J S

    1998-08-01

    This study involved 329 patients who had either a Caesarean section or a hysterectomy. A comparison has been made between 70 patients who were never catheterized and 251 who had a urethral catheter perioperatively. The absence of recognized urinary tract infections in those without a catheter was significant when compared with the 21 urinary infections identified in the catheterized group (p<0.05). The absence of urinary tract infections in the uncatheterized group clearly demonstrates the benefit of avoiding catheterization when possible. PMID:9761161

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

    PubMed

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

    2014-10-01

    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

  2. Squamous cell carcinoma of suprapubic cystostomy tract in a male with locally advanced primary urethral malignancy

    PubMed Central

    Boaz, Ranil Johann; John, Nirmal Thampi; Kekre, Nitin

    2015-01-01

    A 65-year-old man with stricture urethra underwent drainage of periurethral abscess and suprapubic cystostomy (SPC) placement. He presented to us 3 months later with a fungating ulcer at the site of perineal incision, the biopsy of which revealed squamous cell carcinoma (SCC). He underwent a total penile amputation, wide local excision scrotum, radical urethrocystoprostatectomy, ileal conduit with the en-bloc excision of the SPC tract. Histopathological examination of the suprapubic tract also revealed SCC. This is the first documented case of SCC of a suprapubic tract in the presence of primary urethral SCC. PMID:25624581

  3. Penile prolapse and urethral obstruction secondary to lymphosarcoma of the penis in a dog.

    PubMed

    Michels, G M; Knapp, D W; David, M; Lantz, G C; Munjar, T A; Blevins, W E; DeNicola, D B

    2001-01-01

    A 5-year-old Chihuahua presented for clinical signs of dysuria and penile prolapse. Radiographic studies identified a urethral obstruction distal to the junction of the proximal and middle third of the os penis that appeared to be secondary to swelling of the penis. Penile resection combined with a scrotal urethrostomy was performed. Histopathological examinations of tissue samples of the body of the penis revealed lymphosarcoma. Lymphosarcoma of the penis is a rare finding in all species. It can occur as a primary tumor of the penis in dogs. Penile lymphosarcoma should be considered in the differential diagnosis of dogs affected with penile prolapse and dysuria. PMID:11563447

  4. The Evolution of Surgical Treatment for Female Stress Urinary Incontinence: Era of Mid-Urethral Slings

    PubMed Central

    Lee, Young-Suk; Lee, Ha Na

    2010-01-01

    Based on the integral theory, tension-free placement of a mid-urethral sling (MUS) for female stress urinary incontinence (SUI) has gained substantial popularity owing to the ease of the procedure and its effectiveness. Published series with long-term follow-up show continence rates after the MUS procedure ranging from 70% to 80%. Complication rates after MUS procedures are usually low. This review aimed to describe the historical change and the current use of the MUS. We discuss the efficacy and complications of various MUS procedures and the current strategies for managing failed slings. PMID:20428423

  5. Posterior subcapsular cataract in Degos disease

    Microsoft Academic Search

    Robert Egan; Simmons Lessell

    2000-01-01

    PURPOSE: To report an association of posterior subcapsular cataract with Degos disease.METHOD: Case report of a 42-year-old man.RESULTS: A posterior subcapsular cataract developed in the patient’s left eye at age 43 years, 1 year before his death. The diagnosis of Degos disease was confirmed pathologically by skin biopsy and at necropsy.CONCLUSION: Posterior subcapsular cataract may be associated with Degos disease

  6. Epidemiology of traumatic hip dislocation in patients treated in Ceará, Brazil

    PubMed Central

    Lima, Luciana Cascão; do Nascimento, Robson Alves; de Almeida, Victor Monte Tenório; Façanha, Fernando Antônio Mendes

    2014-01-01

    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

  7. Minimally Invasive Posterior Hamstring Harvest

    PubMed Central

    Wilson, Trent J.; Lubowitz, James H.

    2013-01-01

    Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2- to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions are dissected. Then, an open tendon stripper is used to release the tendon or tendons proximally; a closed, sharp tendon stripper is used to release the tendon or tendons from the pes. Layered, absorbable skin closure is performed, and the skin is covered with a skin sealant, bolster dressing, and plastic adhesive bandage for 2 weeks. PMID:24266003

  8. Posterior Lamellar Keratoplasty in Perspective

    Microsoft Academic Search

    F Arnalich-Montiel; JKG Dart

    \\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

  9. Endovascular treatment of posterior circulation aneurysms.

    PubMed

    Eller, Jorge L; Dumont, Travis M; Mokin, Maxim; Sorkin, Grant C; Levy, Elad I; Snyder, Kenneth V; Nelson Hopkins, L; Siddiqui, Adnan H

    2014-04-01

    Endovascular techniques are well suited for the treatment of posterior circulation aneurysms. This review describes the endovascular management of these aneurysms and discusses relevant technical advances. PMID:24617934

  10. Bony wall damage in the region of the middle and posterior cranial fossa observed during otosurgery

    PubMed Central

    Wiatr, Maciej; Sk?adzie?, Jacek; Tomik, Jerzy; Str?k, Pawe?; Przeklasa-Muszy?ska, Anna

    2012-01-01

    Summary Background Bony wall damages in the region of the middle and posterior cranial fossa are usually observed in cases of chronic otitis media. These defects can also be congenital, post-traumatic, iatrogenic or due to tumors. They can potentially lead to the development of intracranial complications. Material/Methods We analyzed patients who were diagnosed as having bony wall damage in the region of the middle and/or posterior cranial fossa. We also discuss methods of reconstruction during otosurgery. The analysis involves patients who underwent middle ear operations in the Department of Otolaryngology at the Jagiellonian University of Krakow between 2004 and 2008; 495 otosurgeries were performed during this period of time. Results In 70% of patients the reason for otosurgery was chronic otitis media. In 20%, bone defects occurred simultaneously with otosclerosis. Less than 10% underwent otosurgery for other reasons. Bony wall damage in the region of the middle and posterior cranial fossa were diagnosed in 46 patients who underwent surgery. In patients with bony wall damage, otogenic intracranial complications were described in 14 cases. Conclusions The performed reconstruction methods for bony wall damage, which used the fascia, strengthened with the pedicle muscle flap for larger defects and with either bone lamella or cartilage in specific cases, proved successful. Nearly 80% of bony wall damages in the region of the middle and posterior cranial fossa remain asymptomatic and are discovered incidentally during middle ear surgery. The above observations emphasize the significant role of pre-operative imaging diagnostics. PMID:22648242

  11. The Incidence of Infection after Posterior Cervical Spine Surgery: A 10 Year Review

    PubMed Central

    Barnes, Matt; Liew, Sue

    2012-01-01

    Background?The incidence of infection after posterior cervical spine surgery ranges from 0 to 18%. Higher rates have been reported after posterior procedures compared with anterior procedures, but these studies have been for small series. We report on our rate of surgical site infection (SSI) after posterior cervical spine surgery and the risk factors that influence these infections. Methods?We retrospectively reviewed the records of 90 consecutive patients who underwent posterior cervical spine procedures at a major spinal referral center between 1998 and 2007. The main indications for surgery were trauma and degenerative conditions. Tumors and primary infections were excluded. Medical records of these patients were examined for evidence of SSI as diagnosed by Centers for Disease Control and Prevention criteria. Results?Using stringent criteria for diagnosing SSI, we found 15 infected patients (16.67%). The postoperative use of a Philadelphia hard collar was found to be a significant risk factor for SSI with a relative risk of 15.30 (95% confidence interval 2.10 to 111.52). Almost half of infected patients (47%) required reoperation for wound debridement, with four requiring skin flap closure. All 15 patients had successful outcomes with complete resolution of their infection. Conclusions?This study confirms a high incidence of SSI after posterior cervical surgery. The most significant risk factors for SSI were found to be a traumatic etiology and postoperative use of a collar. We believe it is important to develop strategies to minimize the risk of infection after posterior cervical surgery, which include questioning the postoperative use of collars. PMID:24353939

  12. 45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... false Eligibility criteria: Traumatic brain injury. 1308.16 Section 1308.16...1308.16 Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose brain injuries are...

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

    PubMed Central

    Hinata, Nobuyuki; Murakami, Gen

    2014-01-01

    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

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

    PubMed Central

    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

    2014-01-01

    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

  15. Vulvar pseudoverrucous papules and nodules secondary to a urethral--vaginal fistula.

    PubMed

    Garrido-Ruiz, María Concepción; Rosales, Belen; Luis Rodríguez-Peralto, José

    2011-06-01

    Irritant contact dermatitis is a common cause of genital eruptions representing at least one-fifth of presenting anogenital symptoms. A spectrum of inflammatory reactions have been identified, some of them with features severely mimicking more serious dermatoses, which may lead unnecessary workup and treatments. We report a case of a 10-year-old girl who presented at birth with cloacal atresia involving the rectum and the urethra. A diverting colostomy and a urethral-vaginal fistula were created to correct the deformity. Physical examination reveals numerous shiny, white-gray, pseudoverrucous papules and nodules coalescing into plaques over the vulva and its surrounding skin. Histological examination showed psoriasiform epidermal hyperplasia with a marked reactive acanthosis and altered cornification with parakeratosis, hypogranulosis, and pale keratinocytes in the upper reaches of the epidermis. The lesions regress when the irritating factor was removed. This case represents a peculiar form of presentation of perianal pseudoverrucous papules and nodules, usually secondary to urinary incontinence or encopresis (inability to control the elimination of stool) after surgery for Hirschsprung disease. Because similar findings have not been previously observed in patients with urethral-vaginal fistula, we attempt to extend the spectrum of presentations for a better knowledge of this condition. PMID:21285858

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

    PubMed

    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

    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

  17. Tubularized penile-flap urethroplasty using a fasciocutaneous random pedicled flap for recurrent anterior urethral stricture.

    PubMed

    Lee, Yong Jig; Lee, Byung Kwon

    2012-05-01

    This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia), and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique. PMID:22783537

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

    PubMed Central

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

    1988-01-01

    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 oophorectomies, one had shrunken ovaries and ovarian failure, and one had previously undergone oophorectomy and the other ovary could not be seen; in one neither ovary could be seen, and three had ovaries of normal appearance, although two of these women were taking the contraceptive pill. Thirteen of the group had endocrine symptoms and signs characteristic of the polycystic ovary syndrome. Videocystometrography in 17 of the women who were examined by ultrasonography showed low flow rates and high residual volumes of urine after micturition in 12 women who could void, the other five having chronic urinary retention. A speculative hypothesis for the observed association of impaired voiding, abnormal electromyographic activity of the urinary sphincter, and polycystic ovaries is advanced, based on the relative progesterone deficiency that characterises the polycystic ovary syndrome. Progesterone stabilises membranes, and its depletion might permit ephaptic transmission of impulses between muscle fibres in the muscle of the urethral sphincter, giving rise to the abnormal electromyographic activity. This may impair relaxation of the sphincter, resulting in low flow rates of urine, incomplete emptying of the bladder, and, finally, urinary retention. PMID:3147005

  19. Tubularized Penile-Flap Urethroplasty Using a Fasciocutaneous Random Pedicled Flap for Recurrent Anterior Urethral Stricture

    PubMed Central

    Lee, Byung Kwon

    2012-01-01

    This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia), and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique. PMID:22783537

  20. Initial experience with lingual mucosal graft urethroplasty for anterior urethral strictures

    PubMed Central

    Srivastava, Anand; Dutta, A.; Jain, D.K.

    2012-01-01

    Background To present the feasibility of lingual mucosal graft urethroplasty in anterior urethral strictures and appraisal of donor site morbidity. Methods From November 2007 to December 2010, 14 patients underwent dorsal onlay lingual mucosal graft urethroplasty for anterior urethral strictures. Lingual mucosal graft was harvested from the lateral and undersurface of the tongue. Check micturating cystourethrograms were done 2 weeks after catheter removal and uroflowmetry after 3 months. Success was defined as normal uroflowmetry rates at 3 months in the absence of any postoperative instrumentation. Tongue was assessed for any residual pain, taste disturbances or restricted movement at 3 months. Results Four patients had submucosal fibrosis of the oral cavity and their buccal mucosa was unfit for grafting. Mean (range) stricture length was 5 (3–16) cm and the operation time 170 (140–210) min. Graft width averaged 1.6 cm. Average length of harvested graft was 6.5 cm. Mean duration of follow-up was 12.8 months. Two patients developed stricture at the proximal anastomotic site. There were no donor site complications. Conclusions Lingual mucosal graft harvesting is simple, gives graft lengths comparable to buccal mucosa and is associated with negligible donor site morbidity. PMID:24532928

  1. The urethral rhabdosphincter, levator ani muscle, and perineal membrane: a review.

    PubMed

    Hinata, Nobuyuki; Murakami, Gen

    2014-01-01

    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

  2. A rare complication: misdirection of an indwelling urethral catheter into the ureter.

    PubMed

    Ishikawa, Tsutomu; Araki, Motoo; Hirata, Takeshi; Watanabe, Masami; Ebara, Shin; Watanabe, Toyohiko; Nasu, Yasutomo; Kumon, Hiromi

    2014-01-01

    We report 3 patients with the rare complication of an indwelling urethral catheter misdirected into the ureter. This is the largest series to date. Patients were referred to us for a variety of reasons following exchange of their chronic indwelling urinary catheters. CT in all cases demonstrated the urinary catheters residing in the left ureter. The ages of the patients were 37, 67 and 81 years old. All patients suffered from neurogenic bladder. Two patients were female, one was male, and 2 of the 3 had a sensory disorder inhibiting their pain response. The catheters were replaced with open-end Foley catheters. Extensive follow-up CT scans were obtained in one case, demonstrating improvement of hydronephrosis and no evidence of ureteral stenosis. Cystoscopy in this patient demonstrated normally positioned and functioning ureteral orifices. Although the placement of an indwelling urethral catheter is a comparatively safe procedure, one must keep in mind that this complication can occur, particularly in female patients with neurogenic bladder. CT without contrast is a noninvasive, definitive diagnostic tool. PMID:24553489

  3. A Giant Dumbbell Shaped Vesico-Prostatic Urethral Calculus: A Case Report and Review of Literature

    PubMed Central

    Prabhuswamy, Vinod Kumar; Tiwari, Rahul; Krishnamoorthy, Ramakrishnan

    2013-01-01

    Calculi in the urethra are an uncommon entity. Giant calculi in prostatic urethra are extremely rare. The decision about treatment strategy of calculi depends upon the size, shape, and position of the calculus and the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most of the previous reported cases, giant calculi were extracted via the transvesical approach and external urethrotomy. A 38-year-old male patient presented with complaints of lower urinary tract symptoms. Further investigations showed a giant urethral calculus secondary to stricture of bulbo-membranous part of the urethra. Surgical removal of calculus was done via transvesical approach. Two calculi were found and extracted. One was a huge dumbbell calculus and the other was a smaller round calculus. This case was reported because of the rare size and the dumbbell nature of the stone. Giant urethral calculi are better managed by open surgery. PMID:23762742

  4. Traumatic neuroma: a late complication of otoplasty.

    PubMed

    Lwin, Christine T-T; Birch, Jeremy; Giele, Henk

    2007-01-01

    We report on the development of traumatic ear lobe neuromas as a late complication of bilateral otoplasty performed 16 years previously. To our knowledge, this is the first and only described case of traumatic neuromas arising as a late complication of otoplasty in the English literature. Traumatic neuroma should be considered in the differential diagnosis of any nodular lesions that develop within the external ear in patients who have had otoplasty or any other form of external ear surgery or trauma. PMID:17362823

  5. Pediatric post-traumatic headache

    Microsoft Academic Search

    Maria-Carmen B. Wilson; Stanley J. Krolczyk

    2006-01-01

    Post-traumatic headache after craniocerebral trauma is not an uncommon occurrence in children and adolescents. It can occur\\u000a after mild, moderate, or severe injury. The headache may have features of tension-type headache, migraine, or probable migraine\\u000a and is rarely seen in isolation. It is often part of a syndrome encompassing a variety of somatic and psychobehavioral symptoms.\\u000a In time, the headache

  6. Coagulopathy in traumatic brain injury

    Microsoft Academic Search

    Sherman C. Stein; Douglas H. Smith

    2004-01-01

    Abnormalities in blood coagulation, although quite common after traumatic brain injury (TBI), are of unknown significance.\\u000a The authors review the clinical and pathophysiological features of this phenomenon and emphasize its origin in disseminated\\u000a intravascular coagulation. This connection provides a possible explanation for much of the cerebral ischema that accompanies\\u000a TBI, namely intravascular microthrombosis. The authors’ own research findings support this

  7. Depression following traumatic brain injury

    Microsoft Academic Search

    Mitchell Rosenthal; Bruce K. Christensen; Thomas P. Ross

    1998-01-01

    Objective: Review the existing literature on the incidence, neurobiological and psychosocial correlates, and methods of assessment and treatment of depression following traumatic brain injury (TBI).Data Sources: Computerized database searches of the English-language literature from Index Medicus, Psychological Abstracts, Excerpta Medica, and Cumulative Index of Nursing and Allied Health Literature.Study Selection: Given the relatively small number of publications specifically related to

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

    E-print Network

    Delp, Scott

    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

  9. Traumatic injuries in revue dancers.

    PubMed

    Wanke, Eileen M; Arendt, Michael; Mill, Helmgard; Koch, Franziska; Wanke, Alice; Groneberg, David A

    2014-03-01

    Revue productions are a combination of dancing and singing, musical and spoken sequences, and acrobatics, performed with or without a story line, and characterized by a versatility of dance styles and a high number of performances (over 250 in a 10-month season). The aim of this quantitative single cohort study is to evaluate work-related traumatic injuries in this dance genre. Data were obtained from work accident reports of the German Social Accident Insurance Institution for the public sector in Berlin (UKB) involving 440 revue dancers (183 males and 257 females). Analysis was conducted with Excel 2007 and PASW Statistics 18. One out of three female dancers and one out of two male dancers sustained an acute injury in the course of a theatrical season (0.22 injuries per 1,000 hours). The incidence rate was 0.44 for males and 0.31 for females, with the lower extremity as the most commonly injured body region, followed by the spine. Of all occupational accidents, 75.1% happened on stage, with 69% during performances. The dance partner and dance floor were the most common exogenous factors resulting in a traumatic injury. Of all traumatic injuries, 81.7% occurred in the first 3 hours after starting work. Gender specific differences could be observed. Due to the limited availability of comparable studies of other forms of professional dance, in this study revue dance is largely considered as an independent genre. PMID:24568800

  10. Nonoperatively treated isolated posterior cruciate ligament injuries

    Microsoft Academic Search

    Paul M. Keller; K. Donald Shelbourne; John R. McCarroll; Arthur C. Rettig

    1993-01-01

    To evaluate the theory that isolated posterior cruciate ligament injuries do well when treated nonoperatively, we reviewed 40 patients (mean age, 33 years at fol lowup ; average interval from injury, 6 years) who com pleted a modified Noyes knee questionnaire and were reevaluated by physical examination, radiographs, and isokinetic testing. Thirty of the injuries to the posterior cruciate ligament

  11. Visualizing the emergence of posterior cortical atrophy

    Microsoft Academic Search

    Jonathan Kennedy; Manja Lehmann; Magdalena J. Sokolska; Hilary Archer; Elizabeth K. Warrington; Nick C. Fox; Sebastian J. Crutch

    2012-01-01

    Posterior cortical atrophy (PCA) is a neurodegenerative condition characterized by a progressive loss of visual processing skills and other posterior functions. Diagnosis is often delayed in PCA as symptoms can be difficult for the patient to articulate and for the clinician to detect. Diagnosis is particularly challenging in the earliest stages of the disease since visual symptoms are often mistaken

  12. Visualizing the emergence of posterior cortical atrophy

    Microsoft Academic Search

    Jonathan Kennedy; Manja Lehmann; Magdalena J. Sokolska; Hilary Archer; Elizabeth K. Warrington; Nick C. Fox; Sebastian J. Crutch

    2011-01-01

    Posterior cortical atrophy (PCA) is a neurodegenerative condition characterized by a progressive loss of visual processing skills and other posterior functions. Diagnosis is often delayed in PCA as symptoms can be difficult for the patient to articulate and for the clinician to detect. Diagnosis is particularly challenging in the earliest stages of the disease since visual symptoms are often mistaken

  13. Cerebral Palsy Spasticity. Selective Posterior Rhizotomy

    Microsoft Academic Search

    Warwick J. Peacock; Leila J. Arens; Barbara Berman

    1987-01-01

    We have performed selective posterior rhizotomies on 60 children with cerebral palsy. The procedure involves lumbar laminectomy with stimulation of the rootlets (fascicles) of the second lumbar to the first sacral posterior roots bilaterally; those rootlets associated with an abnormal motor response, as evidenced by sustained or diffused muscular contraction, are divided leaving intact rootlets associated with a brief localized

  14. Postoperative radiographic and clinical assessment of the treatment of posterior tibial plafond fractures using a posterior lateral incisional approach.

    PubMed

    Ruokun, Huang; Ming, Xie; Zhihong, Xiao; Zhenhua, Fang; Jingjing, Zhao; Kai, Xiao; Jing, Li

    2014-01-01

    The purpose of the present study was to evaluate the postoperative radiographic and functional outcomes of reduction and fixation of a posterior plafond fracture using a posterolateral approach. We included 38 patients with a tibial plafond fracture. Fixation was most commonly performed using screws, T plates, or meta plates. The average follow-up period was 38 (range 25 to 72) months. The clinical outcomes of these patients were evaluated using the American Orthopaedic Foot Ankle Society score. The radiographs of the included patients were evaluated twice within 2 months by 3 experienced orthopedic trauma surgeons, who performed the retrospective radiographic review. Articular step off measures included the radiographic appearance of the reduction using picture archiving and communication system measurement tools. All 32 patients showed radiologic evidence of bony union at the follow-up visit; 6 patients were lost to follow-up. The American Orthopaedic Foot Ankle Society average score was 92 points; 21 patients (93.7%) had excellent scores (90 to 100 points), 9 patients (28.1%) had good scores (80 to 89 points), and 2 patients (6.2%) had fair scores (<80 points). Excellent to good outcomes were noted in 93.7% of the patients. One patient developed a superficial infection. Another patient experienced a sural cutaneous nerve injury. The radiographic articular step off was measured as 1 mm or less in 29 patients (90.6%) and 1 to 2 mm in 3 patients (9.4%). One patient (3.1%) developed symptomatic post-traumatic arthritis. The posterolateral approach allowed for good exposure and buttress fixation of the posterior plafond fractures with few local complications. The anatomic repositioning and stable fixation resulted in good functional and subjective outcomes. PMID:25154653

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

    PubMed

    Avery, Daniel M; Carolan, Gregory F

    2013-09-01

    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

  16. Traumatic basal subarachnoid hemorrhage suspected to have been caused by contrecoup cerebellar contusions: a case report.

    PubMed

    Sato, Takako; Tsuboi, Kento; Nomura, Masakatsu; Iwata, Misa; Abe, Shuntaro; Tamura, Akiyoshi; Tsuchihashi, Hitoshi; Nishio, Hajime; Suzuki, Koichi

    2014-03-01

    Traumatic cerebellar hemorrhagic contusions are infrequent, and the pathogenic mechanism involves a coup injury that is associated with motor vehicle accidents in most cases. Traumatic basal subarachnoid hemorrhage (TBSAH) is commonly reported after blunt trauma to the neck or unrestricted movement of the head, and the source of the hemorrhage is most frequently identified in the vertebrobasilar arteries. A 55-year-old woman who was addicted to alcohol was found dead in her bed. She had a bruise on the left side of her posterior parietal region, and autopsy revealed massive subarachnoid hemorrhage at the base of the brain; the hematoma was strongly attached to the right lower surface of the cerebellar hemisphere. No ruptured cerebral aneurysms, arteriovenous malformations or vertebrobasilar artery leakage were detected. Hemorrhagic cerebellar contusions were regarded as the source of the TBSAH. This is the first report of TBSAH suspected to have been caused by contrecoup cerebellar contusions. PMID:24411402

  17. Introducing a large animal model to create urethral strictures similar to human stricture disease: A comparative experimental microscopic study

    Microsoft Academic Search

    K.-D. Sievert; C. Selent-Stier; J. Wiedemann; T.-O. Greiner; B. Amend; A. Stenzl; G. Feil; J. Seibold

    PurposeThe aim of this tissue engineering study was to investigate urethral stricture formation for evaluating different treatment modalities in the large animal model and to validate the most current, comparable effect of human stricture development for use in successful human clinical application.

  18. An association between non-gonococcal urethritis and bacterial vaginosis and the implications for patients and their sexual partners

    Microsoft Academic Search

    F E Keane; B J Thomas; L Whitaker; A Renton; D Taylor-Robinson

    1997-01-01

    OBJECTIVES: The aetiology of non-gonococcal urethritis (NGU) in a considerable proportion of men remains unaccounted for. We wished to investigate the possible aetiological role of bacterial vaginosis (BV), the commonest cause of abnormal discharge in women, in this condition. METHODS: We carried out two studies. In the first, case-control, study, we recruited men with and without NGU and examined their

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

    Microsoft Academic Search

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

    1996-01-01

    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

  20. Shoulder arthroplasty in the presence of posterior glenoid bone loss.

    PubMed

    Stephens, Scott P; Paisley, Kevin C; Jeng, Jeffrey; Dutta, Anil K; Wirth, Michael A

    2015-02-01

    ? Chronic osteoarthritis of the glenohumeral joint, traumatic injury, post-reconstruction arthropathy, and developmental conditions such as glenoid dysplasia can result in posterior glenoid bone loss and excessive retroversion of the glenoid. Shoulder replacement in this setting is technically challenging and characterized by higher rates of complications and revisions.? Current options that should be considered for managing glenoid bone loss that results in >15° of retroversion include bone-grafting, augmented glenoid components, and reverse total shoulder replacement.? Asymmetric reaming is commonly used to improve version but should be limited to correction of 10° to 15° of retroversion in order to preserve subchondral bone.? Bone-grafting of glenoid defects has had mixed results and has been associated with graft-related complications, periprosthetic radiolucencies, and glenoid component failure; however, it provides a biologic option for patients with severe bone loss.? Implantation of an augmented polyethylene glenoid component offers the potential to improve version while preserving subchondral bone, but the procedure is technically demanding and without clinical follow-up data at this point.? Reverse total shoulder arthroplasty offers improved fixation and stability compared with an anatomic prosthesis for elderly patients with severe glenoid bone loss but is associated with a high complication rate.? Glenoid dysplasia is defined as a deformity that results in >25° of glenoid retroversion. Advanced imaging needs to be obtained in order to ensure enough glenoid bone stock is present to allow anatomic glenoid component placement. PMID:25653326

  1. Mobile-bearing total knee arthroplasty: a full traumatic rotation of 180°.

    PubMed

    Sudanese, Alessandra; Castiello, Emanuela; Affatato, Saverio

    2013-06-25

    From February 2008 to September 2012 we implanted 204 mobile-bearing knee prostheses in 192 patients. All the prostheses were cemented (both femoral and tibial components), and the patella was not replaced. Only one early complication of the implants (1/204 = 0.004%) occurred after a traumatic event as a full 180° rotation of the mobile-bearing polyethylene insert. A 78-year-old woman presented with swelling and severe pain at her right knee. This traumatic event was the only case among our mobile-bearing insert patients. ?The failed polyethylene inserts were retrieved and studied using a scanning electron microscope (SEM, ZEISS EVO 50 EP, Cambridge, UK) operating at 20 kV. ?Scratching and pitting were found on the UHMWPE insert perpendicular to the machining tracks for the concave surface. SEM micrographs of the insert showed burnishing on the concave surfaces and longitudinal scratches were clearly detectable and well-marked on the analyzed surfaces. ?A traumatic, fully rotating, polyethylene insert is rare and our case is the first report describing a traumatic event with a complete 180 degree rotation mobile-bearing in a total knee prosthesis. ?In the literature few reports discuss clinical outcomes after total knee arthroplasty in patients with Parkinson's disease and they cite mixed results. However, some authors suggest that posterior-stabilized and cruciate-retaining TKA should work well while others prefer cruciate-retaining, condylar constrained kinetics, or hinged devices. Although we did not implant a posterior-stabilized mobile-bearing total knee prosthesis or a constrained prosthesis, we obtained good clinical and radiological results at the 2-year followup. PMID:23653296

  2. Demographic, Behavioral, and Clinical Characteristics of Men With Nongonococcal Urethritis Differ by Etiology: A Case-Comparison Study

    PubMed Central

    Wetmore, Catherine M.; Manhart, Lisa E.; Lowens, M. Sylvan; Golden, Matthew R.; Whittington, William L. H.; Xet-Mull, Ana Maria; Astete, Sabina G.; McFarland, Nicole L.; McDougal, Sarah J.; Totten, Patricia A.

    2014-01-01

    Background Nongonococcal urethritis (NGU) is common, yet up to 50% of cases have no defined etiology. The extent to which risk profiles and clinical presentations of pathogen-associated and idiopathic cases differ is largely unknown. Methods Urethral swabs and urine specimens were collected from 370 NGU treatment trial participants who sought care at a sexually transmitted disease clinic in Seattle, WA from 2007 to 2009 and had a visible urethral discharge and/or microscopic evidence of urethral inflammation assessed by Gram-stain (?5 polymorphonuclear leukocytes per high-powered field [PMNs/HPF]). Neisseria gonorrhoeae, Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV), and Ureaplasma urealyticum (UU) were detected in urine, using nucleic acid amplification tests. Cases negative for all assessed pathogens were considered idiopathic. Bivariate and multivariate analyses identified clinical, sociodemographic, and behavioral factors associated with detection of specific pathogens. Results After excluding 3 participants with gonococcal infection, pathogens were detected in only 50.7% of the 367 eligible cases: CT in 22.3%, MG in 12.5%, TV in 2.5%, and UU in 24.0%, with multiple pathogens detected in 9.5%. In all, 3.5% of cases were negative for CT, MG, and TV but lacked speciated ureaplasma results. The remaining cases (45.8%) were considered idiopathic. Pathogen detection was associated with young age, black race, risky sexual behaviors, cloudy or purulent discharge, and visible discharge plus ?5 PMNs/HPF. In contrast, idiopathic cases were more likely to report prior NGU, were older and less likely to be black, or have an abnormal urethral discharge on examination, compared to all other cases. These cases were not associated with any high risk behaviors. Conclusions NGU is a heterogeneous condition. Pathogen detection was associated with a variety of traditional risk factors and clinical features; whereas, idiopathic cases tended to be diagnosed among lower-risk men. PMID:21285914

  3. Pierre Janet on post-traumatic stress

    Microsoft Academic Search

    Bessei A. van der Kolk; Paul Brown; Onno van der Hart

    1989-01-01

    One hundred years ago, in 1889, Pierre Janet published L'Automatisme Psychologique, his first work to deal with how the mind processes traumatic experiences. Janet claimed that vehement emotions interfere with proper appraisal and appropriate action. Failure to confront the experience fully leads to dissociation of the traumatic memories and their return as fragmentary reliving experiences: feeling states, somatic sensations, visual

  4. Post-traumatic symptoms in abused children

    Microsoft Academic Search

    Jean Goodwin

    1988-01-01

    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

  5. Traumatic Bonding: Clinical Implications in Incest.

    ERIC Educational Resources Information Center

    deYoung, Mary; Lowry, Judith A.

    1992-01-01

    "Traumatic bonding" is defined as "the evolution of emotional dependency between...a child and an adult [in] a relationship characterized by periodic sexual abuse." Maintains that the concept holds promise for explaining confusing dynamics of incest. Demonstrates ways in which traumatic bonding can be applied to cases of incest and discusses…

  6. Traumatic Brain Injury: A Challenge for Educators

    ERIC Educational Resources Information Center

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

    2005-01-01

    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…

  7. Psychosocial research in traumatic stress: An update

    Microsoft Academic Search

    Bonnie L. Green

    1994-01-01

    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

  8. Masculinity and Post-Traumatic Spirituality

    Microsoft Academic Search

    R. Ruard Ganzevoort

    Building on narrative empirical research and counselling with male victims of (sexual) violence, this paper explores post-traumatic spirituality. There is some convincing research to date that shows that traumatization is not always detrimental to spirituality but may even enhance the person's spiritual engagement and growth. Although many more factors are involved, one interesting aspect is the influence of gender in

  9. The Effects of Traumatic and Abusive Relationships

    Microsoft Academic Search

    Tricia L. Orzeck; Ami Rokach; Jacqueline Chin

    2010-01-01

    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

  10. 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 ...

  11. Urethral Trauma

    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 ...

  12. High posterior density ellipsoids of quantum states

    E-print Network

    Christopher Ferrie

    2013-10-07

    Regions of quantum states generalize the classical notion of error bars. High posterior density (HPD) credible regions are the most powerful of region estimators. However, they are intractably hard to construct in general. This paper reports on a numerical approximation to HPD regions for the purpose of testing a much more computationally and conceptually convenient class of regions: posterior covariance ellipsoids (PCEs). The PCEs are defined via the covariance matrix of the posterior probability distribution of states. Here it is shown that PCEs are near optimal for the example of Pauli measurements on multiple qubits. Moreover, the algorithm is capable of producing accurate PCE regions even when there is uncertainty in the model.

  13. Alien hand syndrome in left posterior stroke.

    PubMed

    Bartolo, Michelangelo; Zucchella, C; Pichiecchio, A; Pucci, E; Sandrini, G; Sinforiani, E

    2011-06-01

    Alien hand syndrome is a rare neurological disorder characterized by involuntary and uncontrollable motor behaviour, usually of an arm or hand. The patient perceives the affected limb as alien, and may personify it. The case of a 61-year-old right-handed woman who developed right posterior AHS after ischaemic stroke in the left posterior cerebral artery territory is reported. Neuroimaging studies disclosed no frontal or parietal involvement, while a posterior thalamic lesion was detected. A possible role of the thalamus in the genesis of AHS is discussed. PMID:21327399

  14. Post-traumatic Stress Disorder.

    PubMed

    Javidi, H; Yadollahie, M

    2012-01-01

    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

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

    PubMed

    Jarvis, Hannah C; Cannada, Lisa K

    2012-04-01

    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

  16. POSTERIOR CONSISTENCY IN NONPARAMETRIC REGRESSION PROBLEMS UNDER GAUSSIAN PROCESS PRIORS

    E-print Network

    POSTERIOR CONSISTENCY IN NONPARAMETRIC REGRESSION PROBLEMS UNDER GAUSSIAN PROCESS PRIORS By Taeryon Choi and Mark J. Schervish Carnegie Mellon University Posterior consistency can be thought processes. In this paper, we study posterior consistency in nonparametric regression problems using Gaussian

  17. A Posterior Approach for Microphone Array Based Speech Recognition 

    E-print Network

    Wang, Dong; Himawan, Ivan; Frankel, Joe; King, Simon

    2008-01-01

    posterior-based approach for array-based speech recognition. The main idea is, instead of enhancing speech signals, we try to enhance the posterior probabilities that frames belonging to recognition units, e.g., phones. These enhanced posteriors...

  18. Shining a light on posterior cortical atrophy Sebastian J. Crutcha

    E-print Network

    Dickerson, Brad

    Shining a light on posterior cortical atrophy Sebastian J. Crutcha , Jonathan M. Schotta , Gil D Posterior cortical atrophy (PCA) is a clinicoradiologic syndrome characterized by progressive de- cline; Posterior cortical atrophy; Atypical dementia; Simultanagnosia; Visual disturbances; Differential diagnosis

  19. Urethral adenocarcinoma associated with intestinal-type metaplasia, case report and literature review

    PubMed Central

    Hale, Christopher S; Huang, Hongying; Melamed, Jonathan; Xu, Ruliang; Roberts, Larry; Wieczorek, Rosemary; Pei, Zhiheng; Lee, Peng

    2013-01-01

    The presence of glandular epithelium in urinary tract biopsies poses a diagnostic challenge. Intestinal metaplasia of the urethra may be seen in many congenital, iatrogenic, and reactive conditions, as well as in association with malignant conditions such as urethral adenocarcinoma. We present a case of a 61 year-old woman presenting with microscopic hematuria. Successive biopsies showed glandular epithelium with focal atypia in close association with inflammation, but no overt malignancy. Only on surgical resection was the associated high grade adenocarcinoma revealed. When intestinal-type mucosa is present within a urinary tract biopsy, associated malignancy may be present only focally. Thorough sampling and consideration of the differential diagnosis is imperative. PMID:23923086

  20. On-table urethral catheterisation during laparoscopic appendicectomy: Is it necessary?

    PubMed Central

    Nason, Gregory J.; Burke, Matthew J.; Aslam, Asadullah; Kelly, Michael E.; Walsh, Leon G.; Flood, Hugh D.; Giri, Subhasis K.

    2015-01-01

    Introduction: Laparoscopic appendicectomy (LA) is the most commonly performed surgical emergency procedure. The aim of this study was to highlight a series of iatrogenic bladder injuries during LA and suggest a simple method of prevention. Methods: A retrospective review was carried out of all LA performed in a university teaching hospital over a two year period 2012–2013. Iatrogenic visceral injuries were identified and operative notes examined. Results: During the study period 1124 appendicectomies were performed. Four iatrogenic bladder injuries occurred related to secondary trocar insertion. No patient was catheterised preoperatively. One of the injuries was identified intra-operatively, another in the early postoperative period where as two re-presented acutely unwell post-discharge from hospital. Three were repaired by laparotomy and one laparoscopically. Conclusion: Iatrogenic secondary trocar induced bladder injuries are a rare but preventable and potentially serious complication of LA. Urethral catheterisation during LA is a safe and simple method which can prevent this complication. PMID:25737758

  1. A negative association between condom availability and incidence of urethral discharge in a closed Malawian community.

    PubMed

    Metcalfe, David

    2007-08-01

    Condom promotion in sub-Saharan Africa has been accused by some conservative groups of encouraging promiscuity. This study explored the relationship between condom availability and sexually transmitted infection (STI) incidence in a closed Malawian community. An audit of clinic records charted the changing availability of condoms and the concurrent incidence of patients presenting with STI-associated urethral discharge (UD). When condoms first became available, their distribution steadily increased and the UD incidence declined. During a three-month period of unavailability, this previously uninterrupted decline was reversed and UD incidence increased. Once condoms again became available, UD incidence resumed its decline. This association was found to be statistically significant (Spearman's correlation coefficient, -0.499; P = 0.035). In a small community largely isolated from neighbouring towns, condom distribution appeared to negatively correlate with the number of patients presenting with UD. This may challenge the local belief that condoms have a damaging effect on sexual health in Malawi. PMID:17686220

  2. Correlation of gross urine color with diagnostic findings in male cats with naturally occurring urethral obstruction.

    PubMed

    Brabson, Tamera L; Bloch, Christopher P; Johnson, Justine A

    2014-08-12

    Seventy-five male cats with urethral obstruction were prospectively enrolled to evaluate gross urine color at urinary catheter placement for correlation with diagnostic findings. Cats with darker red urine were more likely to be azotemic (serum creatinine concentration >2.0 mg/dl [177 µmol/l]), and urine color correlated well with serum creatinine and serum potassium concentrations. Darker urine color was negatively correlated with urine specific gravity. Urine color was not associated with the presence or absence of lower urinary tract stones on radiographs or ultrasound. Cats with darker red urine at the time of urinary catheter placement are likely to have more significant metabolic derangements and may require more aggressive supportive care. PMID:25117491

  3. Arthroscopic Repair of Inferior Labrum From Anterior to Posterior Lesions Associated With Multidirectional Instability of the Shoulder

    PubMed Central

    Burt, David M.

    2014-01-01

    Multidirectional instability (MDI) of the shoulder may arise spontaneously; however, recent evidence suggests that traumatic events may play a role in this syndrome. Variable degrees of injury around the circumference of the glenoid have been reported, ranging from Bankart and Kim lesions to 270° of injury and even 360° of injury. Hyperabduction injury may cause inferior subluxation of the shoulder and result in traumatic isolated injury to the inferior labrum from anterior to posterior. This particular lesion spans approximately 180° of the inferior hemisphere and may lead to symptomatic MDI. In contrast to open or arthroscopic plication procedures for atraumatic MDI without labral injury, the goal in these cases is anatomic arthroscopic repair of the inferior labrum tear without the need for capsular plication, volume reduction, or rotator interval closure. PMID:25685683

  4. Echocardiographic examination of the posterior atrioventricular groove.

    PubMed

    Silbiger, Jeffrey J

    2014-02-01

    Abnormalities of the posterior atrioventricular (AV) groove may be mischaracterized or overlooked in the course of routine echocardiographic imaging. Vascular abnormalities in this location include plethora of the coronary sinus and ectasia of the circumflex coronary artery. Excess accumulation of calcium (mitral annular calcification) and of fat (lipomatosis of the posterior AV groove) may also occur in this region. Masses (tumors or thrombus) arising from the floor of the left atrium or extrinsic to it (hiatal hernia, lymph nodes) may occupy the posterior AV groove. Abnormalities of the left ventricle, including aneurysms and pseudoaneurysms may present as masses in the posterior AV groove. This article discusses the echocardiographic features, differential diagnosis, and clinical significance of these abnormalities. PMID:24495083

  5. Efficient search using posterior phone probability estimates. 

    E-print Network

    Renals, Steve; Hochberg, Mike

    1995-01-01

    In this paper we present a novel, efficient search strategy for large vocabulary continuous speech recognition (LVCSR). The search algorithm, based on stack decoding, uses posterior phone probability estimates to substantially increase its...

  6. The Spectrum of Disease in Chronic Traumatic Encephalopathy

    ERIC Educational Resources Information Center

    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

    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…

  7. [Pathogenesis of posterior capsule opacification in pseudophakia].

    PubMed

    ?ukaszewska-Smyk, Agnieszka; Ka?uzny, Józef

    2009-01-01

    The lens epithelial cells of A and E type are involved in pathogenesis of posterior capsule opacification (PCO). They undergo metaplasia into microfibroblasts, then migrate towards posterior capsule where they proliferate and form opacification. These processes are stimulated by cytokines and interleukines. The extracellular matrix which constitutes a scaffold for migration and attachment of epithelial cells plays an important role in PCO formation. Integrines intercede in this process. PMID:20169899

  8. Cognitive rehabilitation in posterior cortical atrophy

    Microsoft Academic Search

    María Roca; Ezequiel Gleichgerrcht; Teresa Torralva; Facundo Manes

    2010-01-01

    Posterior cortical atrophy (PCA) is a rare early-onset dementing syndrome presenting with visuo-perceptual deficits. Clinicopathologically, it is most commonly considered a form of Alzheimer's disease. We present the case of a 64-year-old male patient with posterior cortical atrophy who took part in a cognitive rehabilitation programme that included psychoeducation, compensatory strategies, and cognitive exercises. After the cognitive rehabilitation programme, subtle

  9. Posterior odds ratios for selected regression hypotheses

    Microsoft Academic Search

    A. Zellner; A. Siow

    1980-01-01

    Summary  Bayesian posterior odds ratios for frequently encountered hypotheses about parameters of the normal linear multiple regression\\u000a model are derived and discussed. For the particular prior distributions utilized, it is found that the posterior odds ratios\\u000a can be well approximated by functions that are monotonic in usual sampling theoryF statistics. Some implications of this finding and the relation of our work

  10. The pathogenesis of traumatic coagulopathy.

    PubMed

    Cap, A; Hunt, B J

    2015-01-01

    Over the last 10 years, the management of major haemorrhage in trauma patients has changed radically. This is mainly due to the recognition that many patients who are bleeding when they come in to the emergency department have an established coagulopathy before the haemodilution effects of fluid resuscitation. This has led to the use of new terminology: acute traumatic coagulopathy, acute coagulopathy of trauma shock or trauma-induced coagulopathy. The recognition of acute traumatic coagulopathy is important, because we now understand that its presence is a prognostic indicator, as it is associated with poor clinical outcome. This has driven a change in clinical management, so that the previous approach of maintaining an adequate circulating volume and oxygen carrying capacity before, as a secondary event, dealing with coagulopathy, has changed to haemostatic resuscitation as early as possible. While there is as yet no universally accepted assay or definition, many experts use prolongation of the prothrombin time to indicate that there is, indeed, a coagulopathy. Hypoxia, acidosis and hypothermia and hormonal, immunological and cytokine production, alongside consumption and blood loss, and the dilutional effects of resuscitation may occur to varying extents depending on the type of tissue damaged, the type and extent of injury, predisposing to, or amplifying, activation of coagulation, platelets, fibrinolysis. These are discussed in detail within the article. PMID:25440402

  11. Traumatic optic neuropathy: a review.

    PubMed

    Kumaran, Arjunan Muthu; Sundar, Gangadhara; Chye, Lim Thiam

    2015-03-01

    The aim of this article is to evaluate current literature on investigation and management of traumatic optic neuropathy (TON), propose recommendations for diagnosis and management, and explore novel future treatments. TON, though uncommon, causes substantial visual loss. Without clear guidelines, there is much ambiguity regarding its diagnosis and management. Investigation and treatment (conservative, medical, surgical, and combined) vary widely between centers. Electronic databases PubMed, MEDLINE, PROSPERO, CENTRAL, and EMBASE were searched for content that matched "Traumatic optic neuropathy." Articles with abstracts and full text available, published in the past 10 years, written English and limited to human adults, were selected. All study designs were acceptable except case reports and case series with fewer 10 patients. All abstracts were then evaluated for relevance. References of these studies were evaluated and if also relevant, included. A total of 2,686 articles were retrieved and 43 examined for relevance. Of these, 23 articles were included. TON is a clinical diagnosis. Visual-evoked potential is useful in diagnosis and prognosis. Computed tomography demonstrates canal fractures and concomitant injuries. Magnetic resonance images should be reserved for select and stable patients. Conservative treatment is appropriate in mild TON. Steroids are of questionable benefit and may be harmful. Surgery should be reserved for patients with radiological evidence of compression and individualized. PMID:25709751

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

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

    Microsoft Academic Search

    Heidi M. Zinzow; Joan L. Jackson

    2009-01-01

    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

  14. Epidemiology of traumatic brain injury.

    PubMed

    Faul, Mark; Coronado, Victor

    2015-01-01

    Traumatic brain injury (TBI) is a leading cause of death, and in a recent analysis it was found that nearly one-third of all injury-related deaths in the US have at least one diagnosis of TBI (CDC-Quickstats, 2010). This chapter presents the burden of TBI as regards age group, gender, costs, race, emergency department (ED) visits, hospitalizations, and deaths. Injury trends over a 15 year period are examined. Rehabilitation estimates and disability estimates are also available. Through good epidemiology we can better understand the causes of TBI and design more effective intervention programs to reduce injury. Important sources of evidence for this chapter include mostly studies from the US because of their leading work in the epidemiology of this important injury. PMID:25702206

  15. Pathology of traumatic brain injury.

    PubMed

    Finnie, John W

    2014-12-01

    Although traumatic brain injury (TBI) is frequently encountered in veterinary practice in companion animals, livestock and horses, inflicted head injury is a common method of euthanasia in domestic livestock, and malicious head trauma can lead to forensic investigation, the pathology of TBI has generally received little attention in the veterinary literature. This review highlights the pathology and pathogenesis of cerebral lesions produced by blunt, non-missile and penetrating, missile head injuries as an aid to the more accurate diagnosis of neurotrauma cases. If more cases of TBI in animals that result in fatality or euthanasia are subjected to rigorous neuropathological examination, this will lead to a better understanding of the nature and development of brain lesions in these species, rather than extrapolating data from human studies. PMID:25178417

  16. Anterior versus posterior plating in cervical corpectomy.

    PubMed

    ElSaghir, H; Böhm, H

    2000-01-01

    This is a prospective study comparing anterior and posterior plating in cervical corpectomy. Each group comprised 30 patients who were candidates for corpectomy. In the first group, anterior plating was done using Orosco-type titanium plates. In the second group, lateral mass plating was done. In all cases, titanium cages were used to replace the removed vertebral body or bodies. The mean follow-up was 12.68 months (SD 3.85 months). Pseudarthrosis was not encountered in either group. Posterior plating was better than anterior plating in terms of the stability of the construct and problems related to the hardware. Screw breakage was encountered in seven patients with anterior plating (23.33%). This complication was not seen in the group with posterior plating. The difference between the groups was statistically significant (chi-square = 7.92, p = 0.004). Screw loosening was encountered in 2 patients in the group with anterior plating and in only 1 patient in the group with posterior plating. The difference between the incidence of screw loosening in both groups was not statistically significant (chi-square = 0.35, p = 0.5). Sinking-in of the cage was encountered in 7 cases with anterior plating and in only 3 cases with posterior plating. However, the difference between the groups was not statistically significant (chi-square = 1.92, p = 0.16). PMID:11110134

  17. [Clinical report of posterior leukoencephalopathy syndrome].

    PubMed

    Akhvlediani, R; Mogylevsky, A; Contant, S

    2008-01-01

    The article describes the case history of posterior leukoencephalopathy syndrome - a brain disorder that predominantly affects the cerebral white matter. Edematous lesions involve the posterior parietal and occipital lobes, and may spread to basal ganglia, brain stem and cerebellum. This rapidly evolving neurological condition is clinically characterized by headache, nausea and vomiting, seizures, visual disturbances and altered sensorial functions, and occasionally focal neurological deficit. Posterior leukoencephalopathy syndrome is often associated with an abrupt increase in blood pressure and is usually seen in patients with eclampsia, renal disease and hypertensive encephalopathy. It is also seen in the patients treated with cytotoxic and immunosuppressive drugs such as cyclosporine A, tacrolimus /FK-506, cisplatin, cytarabine, IVIg, erytrophoietin, and interferon alpha. The study demonstrated that lesions of posterior leukoencephalopathy syndrome are best visualized with magnetic resonance [MR] imaging. T2 weighted MR Images, at the height of symptoms, characteristically show diffuse hyper intensity selectively involving the parieto - occipital white matter. Occasionally the lesions also involve the grey matter. Computed tomography can also be used satisfactorily to detect hypodense lesions of posterior leukoencephalopathy. Early recognition of this condition is of paramount importance because prompt control of blood pressure, withdrawal of immunosuppressive agents will cause reversal of the syndrome. Delay in the diagnosis and treatment can result in permanent damage to affected brain tissues. The clinical data and radiological findings depicted in the study add to the investigation of the disorder. PMID:18323587

  18. The Dirichlet process, related priors and posterior asymptotics

    E-print Network

    Ghoshal, Subhashis

    2 The Dirichlet process, related priors and posterior asymptotics Subhashis Ghosal Here we review properties of posterior distributions. Starting with the definition of posterior consistency and examples posterior convergence rates and briefly outline how such rates can be computed in nonparametric examples. We

  19. The Local Sensitivity of Posterior Expectations Paul Gustafson 1

    E-print Network

    The Local Sensitivity of Posterior Expectations Paul Gustafson 1 Carnegie Mellon University We investigate the degree to which posterior expectations are sensitive to prior distributions, using a local of posteriors (or perhaps just a particular posterior quantity), that arises from a specified class of priors

  20. A Fast Posterior Update for Sparse Underdetermined Linear Models

    E-print Network

    Schniter, Philip

    A Fast Posterior Update for Sparse Underdetermined Linear Models Lee C. Potter, Philip Schniter is given for updating posterior probabilities. Emphasis is given to the underdetermined and sparse case, i posterior probability and their exact posterior odds. As a byproduct, this Bayesian model averaged approach

  1. Improving power posterior estimation of statistical evidence , Merrilee Hurn

    E-print Network

    Hurn, Merrilee

    Improving power posterior estimation of statistical evidence Nial Friel , Merrilee Hurn and Jason. This paper focuses on refining the power posterior approach to improve estimation of the evidence. The power posterior method involves transitioning from the prior to the posterior by powering the likelihood

  2. [Post-traumatic nodular scleroderma].

    PubMed

    Bonino, M V; Bianchi, C; Bianchi, O; Garcia Garcia, A

    1983-01-01

    Scleroderma of rare appearance in children appears in minor scale as to the five per cent on the whole incidence of this collagen disease. The children usually present localized scleroderma and at times associated with other pathologies, traumatisms and injections were referred. Two patients aged 5 and 13 years old are presented, both with nodular lesions on anterolateral thigh area, and in the right buttock respectively. The patches of a side bigger than the palm of hand were only touchable and the skin that covered them only showed a slight hyperpigmentation in the edge in one of the cases. The limits were not precise and the nodulose surface was irregular. The evolution was as of two and three years, right after inoculation of antitetanical vaccination and puncture thorn of Yuca leaves. The histological control showed intensive phenomenons of fibrohyalinosis covering almost all the dermis. The studies of the laboratories didn't produce interesting data. The histological and clinical set of symptoms shows differences with the esclerodermic like states as a consequence of excipient of vitamin K, B 12, norhydroxprogesterone and anti-tetanic serum, in which they settle in the cellular subcutaneous tissue and they involution spontaneously. There are also differences with the paniculitis artefacta and with the lincar morphea associated to bifid spine. At last the authors make special mention of the case described by Desmons of progressive linear scleroderma right after the triple vaccination. The nodular or subcutaneous scleroderma is a clinical form in which the histological alteration decays in deep dermis and superficial hypodermis. The cases shown suggest a conection between a previous traumatism and the nodular scleroderma. PMID:6366390

  3. Traumatic injury among females: does gender matter?

    PubMed Central

    2014-01-01

    Background Trauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported. Aim To study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women. Methods We conducted a traditional narrative review using PubMed, MEDLINE and EMBASE, searching for English-language publications for gender-specific trauma between January 1993 and January 2013 using key words “trauma”, “gender”, “female” and “women”. Results Among 1150 retrieved articles, 71 articles were relevant over 20 years. Although it is an important public health problem, traumatic injuries among females remain under-reported. Conclusion There is a need for further research and evaluation of the exact burden of traumatic injuries among females together with the implementation of effective community based preventive programs. PMID:25089153

  4. Post-Traumatic Stress Disorder (PDQ)

    MedlinePLUS

    ... traumatic stress may be triggered when certain smells, sounds, and sights are linked with chemotherapy or other ... an upsetting event. Neutral triggers (such as smells, sounds, and sights) that occurred at the same time ...

  5. TRAUMATIC BRAIN INJURY SURVEILLANCE SYSTEM (TBISS)

    EPA Science Inventory

    The National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC) had developed and maintains a surveillance system to understand the magnitude and characteristics of hospitalized and fatal traumatic brain injuries in the United State...

  6. A preliminary study of neuroSPECT evaluation of patients with post-traumatic smell impairment

    PubMed Central

    Eftekhari, Mohammad; Assadi, Majid; Kazemi, Majid; Saghari, Mohsen; Esfahani, Armaghan Fard; Sichani, Babak Fallahi; Gholamrezanezhad, Ali; Beiki, Davood

    2005-01-01

    Background Most olfactory testings are subjective and since they depend upon the patients' response, they are prone to false positive results. The aim of this study was to use quantitative brain perfusion SPECT in order to detect possible areas of brain activation in response to odorant stimulation in patients with post-traumatic impaired smell in comparison to a group of normal subjects. Methods Fourteen patients with post-traumatic impaired smell and ten healthy controls were entered in this prospective study. All subjects underwent brain SPECT after intravenous injection of 740-MBq 99mTc-ECD and 48 hours later, the same procedure was repeated following olfactory stimulus (vanilla powder). Results In most of seven regions of interest (Orbital Frontal Cortex, Inferior Frontal Pole, Superior Frontal Pole, Posterior Superior Frontal Lobe, Parasagittal Area, Occipital Pole, and Cerebellar area) the post-stimulation quantitative values show increased cortical perfusion being more pronounced in normal volunteers than the anosmic patients (except cerebellar areas and the right occipital pole). Maximal activation was observed in orbitofrontal regions (right+ 25.45% and left +25.47%). Conclusion Brain SPECT is a valuable imaging technique in the assessment of post-traumatic anosmia and could be competitive as an alternative to other imaging techniques, especially when functional MRI is unavailable or unsuitable. However, this procedure may benefit from complementary MRI or CT anatomical imaging. PMID:16313675

  7. Pediatric brainstem hemorrhages after traumatic brain injury.

    PubMed

    Beier, Alexandra D; Dirks, Peter B

    2014-10-01

    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

  8. [Traumatic thrombosis of the inferior vena cava].

    PubMed

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

    2004-07-01

    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

  9. Giant epidermoid cyst of the posterior neck.

    PubMed

    Kim, Cheesun; Park, Myong Chul; Seo, Seung Jo; Yoo, Young Moon; Jang, Yu Jin; Lee, Il Jae

    2011-05-01

    A 49-year-old man was presented for evaluation of a painless mass on his right posterior neck. The mass had gradually enlarged for a 25-year period without inflammation or rupture. On physical examination, a round, nontender, soft-tissue mass, 8 cm in diameter, was noted on the right posterior neck. The neck is a common site of epidermoid cysts, but a mass more than 5 cm in diameter is rare. A contrast-enhanced neck computed tomographic (CT) scan revealed a 7.6 × 6.5 × 5.7 cm unilocular hypodense mass adjacent to the posterior neck muscles.The mass was completely excised under general anesthesia. A histopathologic examination of the excised specimen resulted in a diagnosis of an epidermoid cyst. The patient was discharged from the hospital on the third postoperative day. There were no recurrences in a 2-year follow-up period. PMID:21586972

  10. Successful Endoscopic Therapy of Traumatic Bile Leaks

    PubMed Central

    Spinn, Matthew P.; Patel, Mihir K.; Cotton, Bryan A.; Lukens, Frank J.

    2013-01-01

    Traumatic bile leaks often result in high morbidity and prolonged hospital stay that requires multimodality management. Data on endoscopic management of traumatic bile leaks are scarce. Our study objective was to evaluate the efficacy of the endoscopic management of a traumatic bile leak. We performed a retrospective case review of patients who were referred for endoscopic retrograde cholangiopancreatography (ERCP) after traumatic bile duct injury secondary to blunt (motor vehicle accident) or penetrating (gunshot) trauma for management of bile leaks at our tertiary academic referral center. Fourteen patients underwent ERCP for the management of a traumatic bile leak over a 5-year period. The etiology included blunt trauma from motor vehicle accident in 8 patients, motorcycle accident in 3 patients and penetrating injury from a gunshot wound in 3 patients. Liver injuries were grade III in 1 patient, grade IV in 10 patients, and grade V in 3 patients. All patients were treated by biliary stent placement, and the outcome was successful in 14 of 14 cases (100%). The mean duration of follow-up was 85.6 days (range 54–175 days). There were no ERCP-related complications. In our case review, endoscopic management with endobiliary stent placement was found to be successful and resulted in resolution of the bile leak in all 14 patients. Based on our study results, ERCP should be considered as first-line therapy in the management of traumatic bile leaks. PMID:23525187

  11. Default-Mode Network Disruption in Mild Traumatic Brain Injury

    PubMed Central

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

    2012-01-01

    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

  12. Endoscopic treatment of posteriorly localized talar cysts

    Microsoft Academic Search

    Tahir Ogut; Ali Seker; Fulya Ustunkan

    2011-01-01

    Purpose  This study presents the short-term follow-up results from our case series of patients with posteriorly localized intraosseous\\u000a talar cysts. Patients were treated via hindfoot endoscopy in the prone position.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We evaluated six ankles of five patients treated with hindfoot endoscopy for intraosseous cysts localized to the posterior\\u000a portion of talus. Three patients were men and two were women. The median

  13. Resilience and vulnerability among refugee children of traumatized and non-traumatized parents

    Microsoft Academic Search

    Atia Daud; Britt af Klinteberg; Per-Anders Rydelius

    2008-01-01

    BACKGROUND: The aim of the study was to explore resilience among refugee children whose parents had been traumatized and were suffering from Post-Traumatic Stress Disorder (PTSD). METHODS: The study comprised 80 refugee children (40 boys and 40 girls, age range 6–17 yrs), divided into two groups. The test group consisted of 40 refugee children whose parents had been tortured in

  14. Endovascular Management of the Traumatic Cerebral Aneurysms Associated with Traumatic Carotid Cavernous Fistulas

    Microsoft Academic Search

    Chao-Bao Luo; Michael Mu-Huo Teng; Feng-Chi Chang; Jiing-Feng Lirng; Cheng-Yen Chang

    BACKGROUND AND PURPOSE: Simultaneous traumatic carotid-cavernous fistulas (TCCFs) and traumatic cerebral aneurysms (TCAs) of the internal carotid artery (ICA) are rare. We describe the pitfalls of detecting a TCA before TCCF occlusion and the endovascular management of the TCA and TCCF. METHODS: Over 12 years, 156 patients with TCCFs were treated at our institute. In four men (mean age, 34

  15. Classroom Strategies for Teaching Veterans with Post-Traumatic Stress Disorder and Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Sinski, Jennifer Blevins

    2012-01-01

    Postsecondary institutions currently face the largest influx of veteran students since World War II. As the number of veteran students who may experience learning problems caused by Post-Traumatic Stress Disorder and/or Traumatic Brain Injury continues to rise, the need for instructional strategies that address their needs increases. Educators may…

  16. What do Youth Report as a Traumatic Event? Toward a Developmentally Informed Classification of Traumatic Stressors

    PubMed Central

    Taylor, Leslie K.; Weems, Carl F.

    2009-01-01

    The aim of this study was to explore youth reports of traumatic events by 1) identifying the types of events that children and adolescents report as traumatic in their lives, 2) investigating the association between self reported traumatic events and self and parent reported emotional problems and 3) by examining developmental differences in the types and severity of the events reported as traumatic. Information regarding traumas and symptoms was collected from a sample of youth aged 6–17 using The Child PTSD Checklist. A coding system was developed for classifying the events reported. Findings suggest that youth reported a wide variety of experiences as traumatic that could be reliably coded and classified, and that youth reporting traumatic events and symptoms consistent with PTSD evidence higher levels of emotional, and behavioral problems (via parent and child report) than youth not reporting traumatic events. Youth aged 13–17 tended to report traumas that were rated by independent coders as more severe than youth aged 6–12. While the types of events reported did not differ in PTSD symptoms and other emotional, and behavioral problems there were differences in objective ratings of physical severity and psychological intensity. Implications of the findings are discussed in terms of the creation of developmentally informed classification of traumatic stressors. PMID:20414479

  17. Bursting stimulation of proximal urethral afferents improves bladder pressures and voiding.

    PubMed

    Bruns, Tim M; Bhadra, Narendra; Gustafson, Kenneth J

    2009-12-01

    Reflex bladder excitation has been evoked via pudendal nerve, pudendal nerve branch and intraurethral stimulation; however, afferent-evoked bladder emptying has been less efficient than direct activation of the bladder via sacral root stimulation. A stimulation method that improves activation of the urethra-bladder excitatory reflex with minimal sphincter recruitment may lead to improved bladder emptying. Fine wire electrodes were placed in the wall of the urethra in five cats. Placement of electrodes near the proximal urethra evoked bladder contractions with minimal sphincter activation. On these electrodes, lower frequency burst-patterned stimuli evoked greater bladder voiding efficiencies (71.2 +/- 27.8%) than other stimulus patterns on the same electrodes (50.4 +/- 41.5%, p > 0.05) or any stimulus pattern on electrodes that elicited urethral closure (16.5 +/- 12.7%, p < 0.05). Fine wire electrodes specifically targeted afferent fibers in the urethra, indicating the feasibility of clinical evaluations using the same method. This work may improve the translation of next generation neuroprostheses for bladder control. PMID:19901447

  18. Bursting stimulation of proximal urethral afferents improves bladder pressures and voiding

    NASA Astrophysics Data System (ADS)

    Bruns, Tim M.; Bhadra, Narendra; Gustafson, Kenneth J.

    2009-12-01

    Reflex bladder excitation has been evoked via pudendal nerve, pudendal nerve branch and intraurethral stimulation; however, afferent-evoked bladder emptying has been less efficient than direct activation of the bladder via sacral root stimulation. A stimulation method that improves activation of the urethra-bladder excitatory reflex with minimal sphincter recruitment may lead to improved bladder emptying. Fine wire electrodes were placed in the wall of the urethra in five cats. Placement of electrodes near the proximal urethra evoked bladder contractions with minimal sphincter activation. On these electrodes, lower frequency burst-patterned stimuli evoked greater bladder voiding efficiencies (71.2 ± 27.8%) than other stimulus patterns on the same electrodes (50.4 ± 41.5%, p > 0.05) or any stimulus pattern on electrodes that elicited urethral closure (16.5 ± 12.7%, p < 0.05). Fine wire electrodes specifically targeted afferent fibers in the urethra, indicating the feasibility of clinical evaluations using the same method. This work may improve the translation of next generation neuroprostheses for bladder control.

  19. PCL microparticle-dispersed PLGA solution as a potential injectable urethral bulking agent.

    PubMed

    Oh, Se Heang; Lee, Ji Youl; Ghil, Sung Ho; Lee, Sang Sup; Yuk, Soon Hong; Lee, Jin Ho

    2006-03-01

    The PCL microparticle-dispersed PLGA solutions were prepared as a potential injectable urethral bulking agent. The mixture solutions were prepared by mixing polycarprolactone (PCL) microparticles (diameter, 100 approximately 200mum; fabricated by a temperature-induced phase transition method) and poly(dl-lactic-co-glycolic acid) (PLGA) solution (dissolved in tetraglycol to 10wt%) with different PCL microparticle to PLGA solution ratio. The mixture solution was solidified by the precipitation of PLGA when the solution was contact with water. In contact with water, the PCL microparticles exhibited a well-packed structure entrapped in a solidified porous PLGA matrix, which can effectively prevent the microparticle migration in the body and retain its initial volume even after PLGA matrix degradation. The PCL microparticle-dispersed PLGA solution (particle to solution ratio, 45/55 (w/v)) was easily injected through 18G needle into back of hairless mouse (subcutaneously) and stably located at the apply site. The surrounding tissue including blood vessel were gradually infiltrated into the implant up to 8 weeks without the initial injected volume change and with little inflammatory response. The PCL microparticle-dispersed PLGA solution may be a good candidate as an injectable bulking agent for the treatment of urinary incontinence owing to its good injectability, volume retention potential as well as biocompatibility. PMID:16221494

  20. Therapeutic designing for urethral obstruction by virtual urethra and flow dynamics simulation.

    PubMed

    Ishii, Takuro; Nakamura, Kazuyoshi; Naya, Yukio; Igarashi, Tatsuo

    2014-10-01

    Abstract Introduction: Transurethral surgery is widely accepted as standard therapy for male urethral obstruction. The present study was undertaken to identify and select lesions to be managed by processing endoscopic images of the urethra for assisting less invasive therapy in patients with voiding dysfunction. Material and methods: Cystourethroscopic video files of 25 patients with lower urinary tract symptoms were recorded before and after administration of alpha-1 adrenoceptor antagonists. Each video frame was restored and tagged with information indicating the position in the panoramic image of the urethra. A three-dimensional virtual urethra was created to indicate critical lesions for voiding dysfunction, together with fluid dynamics simulation of urine flow. Results: The urine stream was depicted in the virtual urethras in 19 patients. Before therapy, 17 patients showed vortex formation that was diminished after therapy in nine patients with a significant relationship in improvement of relative energy loss of flow (p=0.025). The narrowing points proximal to the vortex, candidate of lesions, were identified in the panoramic image and linked to the endoscopic image. Discussion: Therapeutic designing for endoscopic management was possible in patients with voiding dysfunction based on computational fluid dynamics, and would be promising as "focal" therapy for aging males. PMID:25273605

  1. INTENTIONAL MAPS IN POSTERIOR PARIETAL CORTEX

    Microsoft Academic Search

    Richard A. Andersen; Christopher A. Buneo

    2002-01-01

    ? Abstract The posterior parietal cortex (PPC), historically believed to be a sensory structure, is now viewed as an area important for sensory-motor integration. Among its functions is the forming of intentions, that is, high-level cognitive plans for movement. There is a map of intentions within the PPC, with different subregions dedicated to the planning of eye movements, reaching movements,

  2. Posterior cruciate ligament tibial inlay reconstruction

    Microsoft Academic Search

    Eugene E. Berg

    1995-01-01

    A patellar bone-tendon-bone tibial inlay reconstruction of the posterior cruciate ligament using a popliteal arthrotomy was designed to minimize graft-tunnel wall abrasion. Arthroscopic techniques are used for femoral graft fixation. In a small series, the procedure decreased the quadriceps active drawer in 70° of flexion by an average of 4 mm and improved patellofemoral symptoms.

  3. Markov Chains for Exploring Posterior Distributions

    Microsoft Academic Search

    Luke Tierney

    1994-01-01

    Several Markov chain methods are available for sampling from a posterior distribution. Two important examples are the Gibbs sampler and the Metropolis algorithm. In addition, several strategies are available for constructing hybrid algorithms. This paper outlines some of the basic methods and strategies and discusses some related theoretical and practical issues. On the theoretical side, results from the theory of

  4. Abnormal visual phenomena in posterior cortical atrophy

    Microsoft Academic Search

    Sebastian J. Crutch; Manja Lehmann; Nikos Gorgoraptis; Diego Kaski; Natalie Ryan; Masud Husain; Elizabeth K. Warrington

    2011-01-01

    Individuals with posterior cortical atrophy (PCA) report a host of unusual and poorly explained visual disturbances. This preliminary report describes a single patient (CRO), and documents and investigates abnormally prolonged colour afterimages (concurrent and prolonged perception of colours complimentary to the colour of an observed stimulus), perceived motion of static stimuli, and better reading of small than large letters. We

  5. Benson's syndrome or Posterior Cortical Atrophy

    Microsoft Academic Search

    Alexis Brice

    2004-01-01

    Key-words Disease name and synonyms Definition \\/ diagnostic criteria Epidemiology Genetic Etiology Abstract Benson's syndrome or Posterior Cortical Atrophy (PCA) is a rare degenerative disorder clinically distinct from Alzheimer's disease (AD). Its frequency is unknown. PCA refers to a clinical syndrome in which higher order visual processing is disrupted owing to a neurodegenerative disorder. The patients present with progressive and

  6. Visual neglect in posterior cortical atrophy

    Microsoft Academic Search

    Katia Andrade; Dalila Samri; Marie Sarazin; Leonardo C de Souza; Laurent Cohen; Michel Thiebaut de Schotten; Bruno Dubois; Paolo Bartolomeo

    2010-01-01

    BACKGROUND: In posterior cortical atrophy (PCA), there is a progressive impairment of high-level visual functions and parietal damage, which might predict the occurrence of visual neglect. However, neglect may pass undetected if not assessed with specific tests, and might therefore be underestimated in PCA. In this prospective study, we aimed at establishing the side, the frequency and the severity of

  7. Imaging correlates of posterior cortical atrophy

    Microsoft Academic Search

    Jennifer L. Whitwell; Clifford R. Jack Jr.; Kejal Kantarci; Stephen D. Weigand; Bradley F. Boeve; David S. Knopman; Daniel A. Drubach; David F. Tang-Wai; Ronald C. Petersen; Keith A. Josephs

    2007-01-01

    The aim of this study was to compare patterns of cerebral atrophy on MRI, and neurochemistry on magnetic resonance spectroscopy (MRS), in patients with posterior cortical atrophy (PCA) and typical Alzheimer's disease (AD). Voxel-based morphometry was used to assess grey matter atrophy in 38 patients with PCA, 38 patients with typical AD, and 38 controls. Clinical data was assessed in

  8. “Apperceptive” Alexia in Posterior Cortical Atrophy

    Microsoft Academic Search

    Mario F. Mendez; Jill S. Shapira; David G. Clark

    2007-01-01

    The most common presenting complaint in posterior cortical atrophy (PCA) is reading difficulty. Although often described as an alexia without agraphia, alexia in PCA may have multiple causes, including a primary visuoperceptual etiology, attentional alexia, and central reading difficulty. This study evaluated 14 patients with early PCA and disturbances in reading ability in comparison to 14 normal controls. All 14

  9. Progressive visual agnosia with posterior cortical atrophy

    Microsoft Academic Search

    Masafumi Mizuno; Giuseppe Sartori; Davide Liccione; Lorella Battelli; Rosario Campo

    1996-01-01

    A patient of posterior cortical atrophy, characterized by early signs of progressive visual agnosia documented by repeated neuropsychological tests, is reported. SPECT and MRI findings showed left unilateral parieto-occipital involvement in the earlier stage. A PET study executed eight months later showed bilateral parieto-occipital hypometabolism, but predominantly in the left hemisphere. This suggests that the degeneration may have developed asymmetrically,

  10. Hearing results after posterior fossa vestibular neurectomy

    Microsoft Academic Search

    SETH I. ROSENBERG; HERBERT SILVERSTEIN; MICHAEL E. HOFFER; ERICA THALER

    1996-01-01

    The effect of posterior fossa vestibular neurectomy on postoperative hearing levels of 172 patients was studied at 1 week, 1 month, 1 year, and 18 to 24 months. According to the 1985 American Academy of Otolaryngology - Head and Neck Surgery guidelines for reporting treatment outcome, 66% of patients had improved or unchanged hearing at 18 to 24 months. One-week

  11. BAER suppression during posterior fossa dural opening

    PubMed Central

    Shields, Christopher B.; Shields, Lisa B. E.; Jiang, Yi Dan; Yao, Tom; Zhang, Yi Ping; Sun, David A.

    2015-01-01

    Background: Intraoperative monitoring with brainstem auditory evoked responses (BAER) provides an early warning signal of potential neurological injury and may avert tissue damage to the auditory pathway or brainstem. Unexplained loss of the BAER signal in the operating room may present a dilemma to the neurosurgeon. Methods: This paper documents two patients who displayed a unique mechanism of suppression of the BAER apparent within minutes following dural opening for resection of a posterior fossa meningioma. Results: In two patients with anterior cerebellopontine angle and clival meningiomas, there was a significant deterioration of the BAER soon after durotomy but prior to cerebellar retraction and tumor removal. Intracranial structures in the posterior fossa lying between the tumor and dural opening were shifted posteriorly after durotomy. Conclusion: We hypothesized that the cochlear nerve and vessels entering the acoustic meatus were compressed or stretched when subjected to tissue shift. This movement caused cochlear nerve dysfunction that resulted in BAER suppression. BAER was partially restored after the tumor was decompressed, dura repaired, and bone replaced. BAER was not suppressed following durotomy for removal of a meningioma lying posterior to the cochlear complex. Insight into the mechanisms of durotomy-induced BAER inhibition would allay the neurosurgeon's anxiety during the operation.

  12. Myopericytoma of the posterior cranial fossa.

    PubMed

    Zhang, Catherine H; Hasegawa, Harutomo; Johns, Paul; Martin, Andrew J

    2014-09-01

    Myopericytoma is a soft tissue tumour believed to be derived from perivascular myoid cells. They are typically found in subcutaneous tissues in the extremities. Intracranial myopericytomas are exceptionally rare. Here we report a man with an asymptomatic posterior fossa myopericytoma with evidence of dural infiltration. PMID:25177778

  13. Correction of Posterior Crossbites: Diagnosis and Treatment

    Microsoft Academic Search

    Robert E. Binder

    2004-01-01

    The correction of posterior crossbites is more complex than it appears. To develop an appropriate treatment plan, it is first necessary to determine if: (1) there is a functional jaw shift on closing; (2) the crossbite is unilateral or bilateral; (3) it is dental, skeletal, or a combination of both; and (4) it is related only to the maxilla or

  14. Subspecialization in the human posterior medial cortex.

    PubMed

    Bzdok, Danilo; Heeger, Adrian; Langner, Robert; Laird, Angela R; Fox, Peter T; Palomero-Gallagher, Nicola; Vogt, Brent A; Zilles, Karl; Eickhoff, Simon B

    2015-02-01

    The posterior medial cortex (PMC) is particularly poorly understood. Its neural activity changes have been related to highly disparate mental processes. We therefore investigated PMC properties with a data-driven exploratory approach. First, we subdivided the PMC by whole-brain coactivation profiles. Second, functional connectivity of the ensuing PMC regions was compared by task-constrained meta-analytic coactivation mapping (MACM) and task-unconstrained resting-state correlations (RSFC). Third, PMC regions were functionally described by forward/reverse functional inference. A precuneal cluster was mostly connected to the intraparietal sulcus, frontal eye fields, and right temporo-parietal junction; associated with attention and motor tasks. A ventral posterior cingulate cortex (PCC) cluster was mostly connected to the ventromedial prefrontal cortex and middle left inferior parietal cortex (IPC); associated with facial appraisal and language tasks. A dorsal PCC cluster was mostly connected to the dorsomedial prefrontal cortex, anterior/posterior IPC, posterior midcingulate cortex, and left dorsolateral prefrontal cortex; associated with delay discounting. A cluster in the retrosplenial cortex was mostly connected to the anterior thalamus and hippocampus. Furthermore, all PMC clusters were congruently coupled with the default mode network according to task-unconstrained but not task-constrained connectivity. We thus identified distinct regions in the PMC and characterized their neural networks and functional implications. PMID:25462801

  15. Post-traumatic stress disorder: a right temporal lobe syndrome?

    NASA Astrophysics Data System (ADS)

    Engdahl, B.; Leuthold, A. C.; Tan, H.-R. M.; Lewis, S. M.; Winskowski, A. M.; Dikel, T. N.; Georgopoulos, A. P.

    2010-12-01

    In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the magnetoencephalography (MEG)-based synchronous neural interactions (SNI) test to differentiate post-traumatic stress disorder (PTSD) subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with PTSD in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of PTSD and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.

  16. Balance function and sensory integration after mild traumatic brain injury.

    PubMed

    Lin, Li-Fong; Liou, Tsan-Hon; Hu, Chaur-Jong; Ma, Hon-Ping; Ou, Ju-Chi; Chiang, Yung-Hsiao; Chiu, Wen-Ta; Tsai, Shin-Han; Chu, Woei-Chyn

    2015-01-01

    Abstract Objective: This study examined the disparities in balance functions and sensory integration in patients with mild traumatic brain injuries (mTBIs) and healthy controls. Participants: One hundred and seven patients with mTBI and 107 age- and sex-matched controls were recruaited for this study. Primary measures: Symptoms of dizziness, balance functions and the ability to perform daily activities were assessed using the dizziness handicap inventory (DHI). This study also performed the postural-stability test and a modified clinical test of sensory integration by using the Biodex Stability System (BBS). Results: DHI scores (functional, emotional, physical and total self-reported scores) were substantially increased in patients following an mTBI compared with the scores of the controls (p?posterior) (p?=?0.045) and the sensory-integration test index (eyes-open-firm-surface index) (p?=?0.006) were substantially lower in patients with mTBI than in the controls. However, indices of two other postural-stability test indices (overall and medial-lateral) and three other sensory-integration tests indices (eyes-closed-firm-surface, eyes-open-foam-surface and eyes-closed-foam-surface) measured for the mTBI group did not differ from those of the control group. Conclusion: Activities of daily living, balance in postural stability and sensory integration were strongly impaired in patients with mTBI. PMID:25265292

  17. Sleep in traumatic brain injury.

    PubMed

    Mazwi, Nicole L; Fusco, Heidi; Zafonte, Ross

    2015-01-01

    Sleep disturbances affect more than half of survivors of traumatic brain injury (TBI) and have the potential to undermine rehabilitation, recovery, and outcomes. Normal sleep architecture has been well-described and the neurophysiology of sleep is becoming better understood in recent years, though this complex process continues to be dissected for better appreciation. There are numerous types of sleep disorder, most of which fall under two categories: dyssomnias and parasomnias. In more challenging scenarios patients may be plagued with more than one dyssomnia and/or parasomnia simultaneously, complicating the diagnostic and therapeutic approach. Objective and subjective methods are used to evaluate sleep disorders and help distinguish them from psychiatric and environmental contributors to poor sleep. There are several pharmacologic and nonpharmacologic treatments options for sleep disturbances after TBI, many of which have been particularly helpful in restoring adequate quantity and quality of sleep for survivors. However, to date no consensus has been established regarding how to treat this entity, and it may be that a multimodal approach is ultimately best. PMID:25701907

  18. Traumatic events and tonic immobility.

    PubMed

    Bados, Arturo; Toribio, Lidia; García-Grau, Eugeni

    2008-11-01

    Tonic immobility is a basic defense strategy which has not been studied in depth in humans. Data suggest that it may be a relatively frequent phenomenon in victims of rape and sexual abuse, but its occurrence has not been systematically explored in other types of trauma. We carried out a retrospective study in a sample of 100 university students to establish whether tonic immobility varies depending on the nature of the worst trauma experienced, defined subjectively by each participant. Immobility was assessed using the Tonic Immobility Scale and traumas were assessed using the modified Traumatic Events Questionnaire. Seventy percent of the sample had experienced trauma of some kind. There were no significant differences in tonic immobility between different types of trauma (e.g., physical abuse, assault or aggression, serious accident), except that the mean tonic immobility score was significantly higher in the group with trauma due to physical/psychological or sexual abuse than in the group with trauma due to receiving news of the mutilation, serious injury, or violent or sudden death of a loved one. We conclude tentatively that tonic immobility may be typical not only of sexual traumas, but of other kinds of directly experienced traumas as well. PMID:18988436

  19. Traumatic brain injury in adults.

    PubMed

    Kolias, Angelos G; Guilfoyle, Mathew R; Helmy, Adel; Allanson, Judith; Hutchinson, Peter J

    2013-08-01

    Traumatic brain injury (TBI) remains a major public health problem. This review aims to present the principles upon which modern TBI management should be based. The early management phase aims to achieve haemodynamic stability, limit secondary insults (eg hypotension, hypoxia), obtain accurate neurological assessment and appropriately select patients for further investigation. Since 2003, the mainstay of risk stratification in the UK emergency departments has been a system of triage based on clinical assessment, which then dictates the need for a CT scan of the head. For patients with acute subdural or extradural haematomas, time from clinical deterioration to operation should be kept to a minimum, as it can affect their outcome. In addition, it is increasingly recognised that patients with severe and moderate TBI should be managed in neuroscience centres, regardless of the need for neurosurgical intervention. The monitoring and treatment of raised intracranial pressure is paramount for maintaining cerebral blood supply and oxygen delivery in patients with severe TBI. Decompressive craniectomy and therapeutic hypothermia are the subject of ongoing international multi-centre randomised trials. TBI is associated with a number of complications, some of which require specialist referral. Patients with post-concussion syndrome can be helped by supportive management in the context of a multi-disciplinary neurotrauma clinic and by patient support groups. Specialist neurorehabilitation after TBI is important for improving outcome. PMID:23487823

  20. Medical interventions for traumatic hyphema

    PubMed Central

    Gharaibeh, Almutez; Savage, Howard I; Scherer, Roberta W; Goldberg, Morton F; Lindsley, Kristina

    2014-01-01

    Background Traumatic hyphema is the entry of blood into the anterior chamber (the space between the cornea and iris) subsequent to a blow or a projectile striking the eye. Hyphema uncommonly causes permanent loss of vision. Associated trauma (e.g. corneal staining, traumatic cataract, angle recession glaucoma, optic atrophy, etc.) may seriously affect vision. Such complications may lead to permanent impairment of vision. Patients with sickle cell trait/disease may be particularly susceptible to increases of elevated intraocular pressure. If rebleeding occurs, the rates and severity of complications increase. Objectives To assess the effectiveness of various medical interventions in the management of traumatic hyphema. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMED-LINE (January 1946 to August 2013), EMBASE (January 1980 to August 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 30 August 2013. Selection criteria Two authors independently assessed the titles and abstracts of all reports identified by the electronic and manual searches. In this review, we included randomized and quasi-randomized trials that compared various medical interventions versus other medical interventions or control groups for the treatment of traumatic hyphema following closed globe trauma. We applied no restrictions regarding age, gender, severity of the closed globe trauma, or level of visual acuity at the time of enrolment. Data collection and analysis Two authors independently extracted the data for the primary and secondary outcomes. We entered and analyzed data using Review Manager 5. We performed meta-analyses using a fixed-effect model and reported dichotomous outcomes as odds ratios and continuous outcomes as mean differences. Main results We included 20 randomized and seven quasi-randomized studies with 2643 participants in this review. Interventions included antifibrinolytic agents (oral and systemic aminocaproic acid, tranexamic acid, and aminomethylbenzoic acid), corticosteroids (systemic and topical), cycloplegics, miotics, aspirin, conjugated estrogens, traditional Chinese medicine, monocular versus bilateral patching, elevation of the head, and bed rest. No intervention had a significant effect on visual acuity whether measured at two weeks or less after the trauma or at longer time periods. The number of days for the primary hyphema to resolve appeared to be longer with the use of aminocaproic acid compared with no use, but was not altered by any other intervention. Systemic aminocaproic acid reduced the rate of recurrent hemorrhage (odds ratio (OR) 0.25, 95% confidence interval (CI) 0.11 to 0.57), but a sensitivity analysis omitting studies not using an intention-to-treat (ITT) analysis reduced the strength of the evidence (OR 0.41, 95% CI 0.16 to 1.09). We obtained similar results for topical aminocaproic acid (OR 0.42, 95% CI 0.16 to 1.10). We found tranexamic acid had a significant effect in reducing the rate of secondary hemorrhage (OR 0.25, 95% CI 0.13 to 0.49), as did aminomethylbenzoic acid as reported in one study (OR 0.07, 95% CI 0.01 to 0.32). The evidence to support an associated reduction in the risk of complications from secondary hemorrhage (i.e. corneal blood staining, peripheral anterior synechiae, elevated intraocular pressure, and development of optic atrophy) by antifibrinolytics was limited by the small number of these events. Use of aminocaproic acid was associated with increased nausea, vomiting, and other adverse events compared with placebo. We found no difference in the number of adverse events with the use of

  1. Neurostimulation for traumatic brain injury.

    PubMed

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

    2014-11-01

    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

  2. Chronic Traumatic Encephalopathy: A Review

    PubMed Central

    Saulle, Michael; Greenwald, Brian D.

    2012-01-01

    Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that is a long-term consequence of single or repetitive closed head injuries for which there is no treatment and no definitive pre-mortem diagnosis. It has been closely tied to athletes who participate in contact sports like boxing, American football, soccer, professional wrestling and hockey. Risk factors include head trauma, presence of ApoE3 or ApoE4 allele, military service, and old age. It is histologically identified by the presence of tau-immunoreactive NFTs and NTs with some cases having a TDP-43 proteinopathy or beta-amyloid plaques. It has an insidious clinical presentation that begins with cognitive and emotional disturbances and can progress to Parkinsonian symptoms. The exact mechanism for CTE has not been precisely defined however, research suggest it is due to an ongoing metabolic and immunologic cascade called immunoexcitiotoxicity. Prevention and education are currently the most compelling way to combat CTE and will be an emphasis of both physicians and athletes. Further research is needed to aid in pre-mortem diagnosis, therapies, and support for individuals and their families living with CTE. PMID:22567320

  3. Traumatic Brain Injury: A Focus on Family and Caregivers

    MedlinePLUS

    Traumatic Brain Injury: A Focus on Family and Caregivers Traumatic Brain Injury (TBI) affects far more than ... navigate the inevitable questions and concerns. As a Caregiver, What Can I Expect? While your initial concern ...

  4. Asymptomatic traumatic diaphragmatic hernia discovered during an aortic valve replacement.

    PubMed

    Fukunaga, Naoto; Seo, Hideya; Hamakawa, Hiroshi; Koyama, Tadaaki

    2014-07-01

    Asymptomatic traumatic diaphragmatic hernia, which presents in an adult, is an extremely rare entity. We discuss the management of a 63-year-old male with an asymptomatic traumatic diaphragmatic hernia discovered during aortic valve replacement. PMID:24750139

  5. What Are Common Traumatic Brain Injury (TBI) Symptoms?

    MedlinePLUS

    ... Institute of Neurological Disorders and Stroke. (2012). Traumatic brain injury information page. Retrieved May 24, 2012, from http:// ... Institute of Neurological Disorders and Stroke. (2012). Traumatic brain injury: Hope through research. Retrieved May 24, 2012, from ...

  6. Posterior Pole Sparing Laser Photocoagulation Combined with Intravitreal Bevacizumab Injection in Posterior Retinopathy of Prematurity

    PubMed Central

    Kim, Rebecca; Kim, Yu Cheol

    2014-01-01

    Purpose. To report the results of the posterior pole sparing laser photocoagulation combined with intravitreal bevacizumab injection (IVB) in retinopathy of prematurity (ROP). Methods. A retrospective chart review of premature babies with ROP, all of whom received laser photocoagulation with IVB. Eleven eyes of 6 infants with advanced zone I ROP underwent laser ablation sparing posterior pole with concurrent IVB. The results were compared with those of full-laser treatment combined with IVB to 8 eyes of 5 infants with advanced ROP without involvement of the posterior pole. Results. The posterior pole sparing laser with IVB was performed with zone I, stage 3+ ROP at the mean postmenstrual age of 36 weeks and 5 days. The plus sign decreased significantly at postoperative day 1, the neovascular proliferation regressed by postoperative week 1, and the normal vascularization started at postoperative day 32 on the average. Two months after treatment, vascularization of the spared avascular area was completed. There was no macular dragging, tractional retinal detachment, foveal destruction by laser scars, or any other adverse event. No significant anatomical differences were identified from those of full-laser ablation combined with IVB. Conclusions. Posterior pole sparing laser with IVB can give favorable results without destruction of posterior pole retina. PMID:25614828

  7. Posterior Vitreous Detachment and Retinal Detachment After Implantation of the Visian Phakic Implantable Collamer Lens

    PubMed Central

    Bamashmus, Mahfouth A.; Al-Salahim, Seddique A.; Tarish, Nabil A.; Saleh, Mahmoud F.; Mahmoud, Hatem A.; Elanwar, Mohamed F.; Awadalla, Mohamed A.

    2013-01-01

    Introduction: To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation. Materials and Methods: This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana’a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively. Results: Preoperatively, 61 (9.9%) eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment (RRD), one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%. Conclusions: Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist. PMID:24339683

  8. Tarsal tunnel syndrome secondary to schwannoma of the posterior tibial nerve.

    PubMed

    Hallahan, Katrina; Vinokur, Jessica; Demski, Sarah; Faulkner-Jones, Beverly; Giurini, John

    2014-01-01

    Schwannoma is a benign tumor that arises from the peripheral nerve sheath. It presents as a discrete, often tender, and palpable nodule associated with neurogenic pain or paresthesia when compressed or traumatized. The growth rate is usually slow, and these lesions seldom exceed 2 cm in diameter. We report the case of a large schwannoma arising from the posterior tibial nerve located in the posterior medial ankle. The core needle biopsy findings were suggestive of a schwannoma, with spindle cells strongly and uniformly immunostaining for S-100 protein. The mass was marginally excised. The surgical specimen consisted of a grossly encapsulated white-yellow mass with irregular contours, measuring 3.7 × 3.5 × 2.7 cm. The cut surface showed areas of pin-point hemorrhage. The patient did not encounter any motor deficits; however, early results showed some subjective numbness. Few reports have been published of schwannomas arising from the tibial nerve. Marginal excision appears to be the recommended therapy for this tumor, without any evidence of recurrence at 9 months of follow-up. PMID:23954095

  9. Determining injuries from posterior and flank stab wounds using computed tomography tractography.

    PubMed

    Bansal, Vishal; Reid, Chris M; Fortlage, Dale; Lee, Jeanne; Kobayashi, Leslie; Doucet, Jay; Coimbra, Raul

    2014-04-01

    Unlike anterior stab wounds (SW), in which local exploration may direct management, posterior SW can be challenging to evaluate. Traditional triple contrast computed tomography (CT) imaging is cumbersome and technician-dependent. The present study examines the role of CT tractography as a strategy to manage select patients with back and flank SW. Hemodynamically stable patients with back and flank SW were studied. After resuscitation, Betadine- or Visipaque®-soaked sterile sponges were inserted into each SW for the estimated depth of the wound. Patients underwent abdominal helical CT scanning, including intravenous contrast, as the sole abdominal imaging study. Images were reviewed by an attending radiologist and trauma surgeon. The tractogram was evaluated to determine SW trajectory and injury to intra- or retroperitoneal organs, vascular structures, the diaphragm, and the urinary tract. Complete patient demographics including operative management and injuries were collected. Forty-one patients underwent CT tractography. In 11 patients, tractography detected violation of the intra- or retroperitoneal cavity leading to operative exploration. Injuries detected included: the spleen (two), colon (one), colonic mesentery (one), kidney (kidney), diaphragm (kidney), pneumothorax (seven), hemothorax (two), iliac artery (one), and traumatic abdominal wall hernia (two). In all patients, none had negative CT findings that failed observation. In this series, CT tractography is a safe and effective imaging strategy to evaluate posterior torso SW. It is unknown whether CT tractography is superior to traditional imaging modalities. Other uses for CT tractography may include determining trajectory from missile wounds and tangential penetrating injuries. PMID:24887674

  10. Brief Information on Childhood Traumatic Grief for School Personnel

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This information sheet summarizes material found in the "In-Depth General Information Guide to Childhood Traumatic Grief" and "In-Depth Information on Childhood Traumatic Grief for School Personnel." Childhood traumatic grief is a condition that some children develop after the death of a close friend or family member. Children who develop…

  11. Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions

    ERIC Educational Resources Information Center

    Edgar-Bailey, Meredith; Kress, Victoria E.

    2010-01-01

    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…

  12. Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions

    Microsoft Academic Search

    Meredith Edgar-Bailey; Victoria E. Kress

    2010-01-01

    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 normal grieving process. The presented

  13. September 8, 1998 Cognitive Communication Disorders After Traumatic

    E-print Network

    Santner, Thomas

    September 8, 1998 1 Cognitive Communication Disorders After Traumatic Brain Injury: Implications and communication deficits often prevent Traumatic Brain Injury (TBI) patients, who are otherwise functioning well on vocational outcomes are also examined. In summary, it is found that the age of a Traumatic Brain Injury

  14. Automated Prediction of Glasgow Outcome Scale for Traumatic Brain Injury

    E-print Network

    Tan, Chew Lim

    Automated Prediction of Glasgow Outcome Scale for Traumatic Brain Injury Bolan Su, Thien Anh Dinh}@nni.com.sg Abstract--Clinical features found in brain CT scan images are widely used in traumatic brain injury (TBI of the system has shown promising results in prediction of GOS of traumatic brain injury cases. Index Terms--Brain

  15. Systems Biology Approaches for Discovering Biomarkers for Traumatic Brain Injury

    E-print Network

    Review Systems Biology Approaches for Discovering Biomarkers for Traumatic Brain Injury Jacob D Jitendra Dave,2 Frank Tortella,2 and Jaques Reifman1 Abstract The rate of traumatic brain injury (TBI words: biomarker; pathway analysis; protein-protein interaction; systems biology; traumatic brain injury

  16. Biomechanics of traumatic brain injury Tamer El Sayed a

    E-print Network

    Ortiz, Michael

    Biomechanics of traumatic brain injury Tamer El Sayed a , Alejandro Mota a , Fernando Fraternali b deformation Plasticity Finite viscoelasticity Diffuse axonal injury Cavitation injury Traumatic brain injury a b s t r a c t A biomechanical model for traumatic brain injury and soft tissue damage is presented

  17. Urban and rural traumatic brain injuries in Colorado

    Microsoft Academic Search

    Barbara Gabella; Richard E. Hoffman; William W. Marine; Lorann Stallones

    1997-01-01

    PURPOSE: The purpose of this study was to compare and contrast the epidemiology of traumatic brain injury among urban and rural residents of Colorado.METHODS: Cases of traumatic brain injury (ICD 800, 801, 803, 804, 850–854) for 1991 and 1992 from the Colorado surveillance system of hospitalized and fatal traumatic brain injuries were used. Urban cases resided in counties designated by

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

    PubMed

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

    2006-06-01

    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

  19. Traumatic tympanic membrane perforations: complications and management.

    PubMed

    Kristensen, S; Juul, A; Gammelgaard, N P; Rasmussen, O R

    1989-07-01

    There is great diversity in the methods of treating traumatic perforations of the tympanic membrane. To elucidate the controversy, we present a long-term follow-up study of 37 patients. On the basis of our present study and available relevant data in the literature, we emphasize that early surgical intervention of a traumatic myringeal perforation is not indicated, as most of these perforations (an average of 88%) do heal spontaneously without complications. However, we stress the importance of performing a meticulous auditory and vestibular examination with close follow-up and repeat audiograms in all patients with acute traumatic myringoruptures to provide enough information for diagnosis of a major perilymph leak that would warrant operation. Myringeal perforations or major conductive hearing losses persisting 3 months after injury warrant tympanotomy and appropriate reconstruction. PMID:2676466

  20. Minor traumatic brain injury in sports.

    PubMed

    Schleimer, Jonathan A

    2002-12-01

    Mild traumatic brain injury (MTBI) is an all-too-frequent occurrence among amateur and professional athletes alike. The increased attention it has received in recent literature may suggest that incidence of this injury has risen. The frequency of MTBI in general may be rising with the increased interest in so-called noncontact sports such as soccer, snowboarding, skateboarding, and motocross. Despite significant improvements made in the quality of protective equipment, head injury remains common in football, soccer, and amateur boxing. The management of athletes who suffer traumatic head injury remains problematic for coaches, trainers, team physicians, primary care physicians, and neurologic specialists. This article addresses guidelines, and diagnostic and treatment protocols to help with the management of athletes with concussion and traumatic head injuries. PMID:12831679

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

    PubMed Central

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

    2014-01-01

    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

  2. Ureaplasma urealyticum Is Associated With Nongonococcal Urethritis Among Men With Fewer Lifetime Sexual Partners: A Case-Control Study

    PubMed Central

    Manhart, Lisa E.; Lowens, M. Sylvan; Golden, Matthew R.; Jensen, Nicole L.; Astete, Sabina G.; Whittington, William L. H.; Totten, Patricia A.

    2011-01-01

    Background.?Ureaplasmas have been inconsistently associated with nongonococcal urethritis (NGU). We evaluated the association of the newly differentiated species Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) with NGU using 2 separate control groups. Methods.?Case patients were men who attended a sexually transmitted disease (STD) clinic in Seattle, Washington, during the period 2007–2009 with NGU (defined as visible urethral discharge and/or ?5 polymorphonuclear neutrophils per high-powered field; n = 329). Control subjects were STD clinic attendees (n = 191) and emergency department (ED) attendees (n = 193) without NGU. Polymerase chain reaction assays detected UU and UP in ureaplasma culture-positive urine. Multivariable logistic regression was used to assess the associations of UU and UP with NGU. Results.?UU was only marginally associated with NGU in aggregate multivariable analyses, irrespective of control group (adjusted odds ratio [aOR]STD-control, 1.6 [95% confidence interval {CI}, 0.9–2.8]; aORED-control, 1.7 [95% CI, 0.97–3.0]). This association was significantly stronger when analyses were restricted to men with fewer lifetime sex partners (<10 vaginal partners: aORSTD-control, 2.9 [95% CI, 1.2–6.7]; aORED-control, 3.2 [95% CI, 1.3–7.6]; <5 vaginal partners: aORSTD-control, 6.2 [95% CI, 1.8–21.0]; aORED-control, 5.2 [95% CI, 1.3–20.2]). UP was not positively associated with NGU overall or among subgroups. Conclusions.?The absence of an association of UU with NGU among men with more lifetime sex partners suggests that adaptive immunity may attenuate the clinical manifestation of UU infection. Similar relationships were not observed with UP, which suggests that it is not a urethral pathogen. PMID:21917901

  3. Urethral sphincter EMG-controlled dorsal penile/clitoral nerve stimulation to treat neurogenic detrusor overactivity

    NASA Astrophysics Data System (ADS)

    Opisso, E.; Borau, A.; Rijkhoff, N. J. M.

    2011-06-01

    The goal of this study was to investigate whether real-time external urethral sphincter (EUS) EMG-controlled dorsal genital nerve (DGN) stimulation can suppress undesired detrusor bladder contractions in patients with both neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD). Detrusor pressure (Pdet) and EUS EMG were recorded in 12 neurogenic patients who underwent two filling cystometries. The first one was without stimulation and was intended to confirm the NDO and DSD and to set the EMG detection threshold. The second one was with real-time EMG-controlled stimulation of DGNs. Two detection methods were analyzed to detect bladder contractions. The first method was a Kurtosis-scaled root mean square (RMS) detector and was used on-line. The second was a simple RMS detector and was used off-line. Of 12 patients included, 10 patients showed both NDO and DSD. In nine of these ten patients relevant EMG concomitant to detrusor activity was detected and stimulation could suppress at least one detrusor contraction. The second filling compared to the first one showed an increase of 84% in bladder capacity (p = 0.002) and a decrease of 106% in Pdet (p = 0.002). Nine false-positive detections occurred during the ten fillings with electrical stimulation. The mean increases of both time and Pdet between stimulation and bladder contraction onsets for method 1 were 1.8 s and 4 cmH2O and for method 2 were 0.9 s and 2 cmH2O, respectively. This study shows that EUS EMG can be used in real time to detect the onset of a bladder contraction. In combination with DGN stimulation has been shown to be feasible to suppress undesired bladder contractions and in turn to increase bladder capacity in subjects with both NDO and DSD.

  4. The Evaluation of Ureteroscopy and Pneumatic Lithotripsy Results in Pregnant Women With Urethral Calculi

    PubMed Central

    Keshvari Shirvan, Maliheh; Darabi Mahboub, Mohammad Reza; Rahimi, Hamid Reza; Seyedi, Ali

    2013-01-01

    Background Urinary stone incidence in pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 cases. Objectives The aim of this study was to investigate the efficacy and safety of ureteroscopic treatment and its results and complications for pregnant women with urinary stones. Patients and Methods From 2003 till 2011, 113 pregnant patients with symptomatic urolithiasis were admitted to the urology emergency clinic at Imam Reza hospital. All patients were initially treated conservatively, resulting in spontaneous passage of the calculi in 69 patients. Forty-four patients with symptomatic urolithiasis were included in the study. Post-operative follow ups, including maternal and fetal health was performed by a gynecologist consult fetal heart rate assessment and urine analysis and culture and renal and urethral ultrasonography. Results The mean age of the patients was 23 years ± 2 (19-34) and the mean gestational age was 24 ± 3 weeks. The overall and pneumatic lithotripsy success rate was 100%. All patients from the interventional group delivered at term with no fetal or maternal complications. There was no morbidity during and after the operation. Conclusions In conditions, medical management of urinary stones and consequent renal colic in pregnant women cannot improve patients’ symptoms, choosing of a surgical method like setting of a DJ catheter or URS and pneumatic lithotripsy can be a safe and effective way for the health of both the mother and fetus. Of course, more research is needed to establish this approach as the standard method in pregnancy urinary stones. PMID:24350085

  5. Are Ureaplasma spp. a Cause of Nongonococcal Urethritis? A Systematic Review and Meta-Analysis

    PubMed Central

    Zhang, Nan; Wang, Rong; Li, Xue; Liu, Xu; Tang, Zhaobing; Liu, Yunde

    2014-01-01

    Background Nongonococcal urethritis (NGU) is the most common male reproductive tract syndrome. Ureaplasmas spp. including U. urealyticum and U. parvum, have been increasingly reported to be implicated in NGU. However, there are still many contradictions about their pathogenic role in NGU. Aims The goals of this study were to evaluate the association of Ureaplasmas spp. with NGU, and to compare the prevalence of Ureaplasmas spp. infection in China relative to the world average. Methods A systematic review and meta-analysis was conducted following standard guidelines for meta-analysis. The quality of included studies was assessed by Newcastle-Ottawa scale. Results A total of seven studies involving 1,507 NGU patients and 1,223 controls were eligible for meta-analysis. There was no significant difference in the Ureaplasma spp. positive rate between the NGU and control groups. However, the U. urealyticum positive rate was significantly higher in NGU patients compared to controls; the U. parvum positive rate was significantly higher in controls compared to NGU patients. Furthermore, within the NGU patient group, the positive rate of U. urealyticum was significantly higher than that of U. parvum, whereas within the control group, the opposite trend was observed. Compared to the world average, a significantly higher positive rate of Ureaplasma spp. was observed in both the NGU and control groups in China. Conclusions Our analysis supports that U. urealyticum, but not U. parvum, is an etiological agent in NGU. More detailed studies of these two species in China and the world could contribute to a better understanding of the epidemiology and pathogenesis, and facilitate the development of better strategies for treatment and prevention of NGU. PMID:25463970

  6. Pseudoexfoliation material on posterior chamber intraocular lenses

    PubMed Central

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

    2014-01-01

    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

  7. Posterior tibial nerve lesions in ankle arthroscopy.

    PubMed

    Cugat, Ramon; Ares, Oscar; Cuscó, Xavier; Garcia, Montserrat; Samitier, Gonzalo; Seijas, Roberto

    2008-05-01

    Ankle arthroscopy provides a minimally invasive approach to the diagnosis and treatment of certain ankle disorders. Neurological complications resulting from ankle arthroscopy have been well documented in orthopaedic and podiatric literature. Owing to the superficial location of the ankle joint and the abundance of overlying periarticular neurovascular structures, complications reported in ankle arthroscopy are greater than those reported for other joints. In particular, all reported neurovascular injuries following ankle arthroscopy have been the direct result of distractor pin or portal placement. The standard posteromedial portal has recognized risks because of the proximity of the posterior neurovascular structures. There can be considerable variability in the course of these portals and their proximity to the neurovascular structures. We found one report of intra-articular damage to the posterior tibial nerve as a result of ankle arthroscopy in the English-language literature and we report this paper as a second case described in the literature. PMID:17618442

  8. Posterior fossa lesions associated with neuropsychiatric symptomatology.

    PubMed

    Pollak, L; Klein, C; Rabey, J M; Schiffer, J

    1996-11-01

    We reviewed 7 cases with posterior fossa structural abnormalities (3 tumors, 2 megacisterna magna and 2 Dandy-Walker syndrome) presenting with neuropsychiatric symptomatology. Derangement in the balance of dopamine, serotonin and noradrenergic networks has been implicated in the pathogenesis of schizophrenia, affective and even personality disorders. Disruption of the cerebellar output to mesial dopaminergic areas, locus coeruleus and raphe nuclei, or deafferentation of the thalamolimbic circuits by a cerebellar lesion may lead to behavioral changes. Seven patients (pts) (comprising 4 men and 3 women with mean age 22 years) were diagnosed as suffering from psychosis (2 pts), major depression (1 pt), personality disorders (2 pts) and somatoform disorders (2 pts) (DSM-IV criteria). Brain CT scan (7 pts) and MRI (4 pts) revealed tumors of the posterior fossa (2 pts), megacisterna magna (2 pts) and Dandy-Walker variant (2 pts). In one patient a IVth ventricle tumor was removed in childhood. PMID:9003973

  9. Effects of unilateral decompressive craniectomy on patients with unilateral acute post-traumatic brain swelling after severe traumatic brain injury

    Microsoft Academic Search

    Wusi Qiu; Chenchen Guo; Hong Shen; Keyong Chen; Liang Wen; Hongjie Huang; Min Ding; Li Sun; Qizhou Jiang; Weiming Wang

    2009-01-01

    INTRODUCTION: Acute post-traumatic brain swelling (BS) is one of the pathological forms that need emergent treatment following traumatic brain injury. There is controversy about the effects of craniotomy on acute post-traumatic BS. The aim of the present clinical study was to assess the efficacy of unilateral decompressive craniectomy (DC) or unilateral routine temporoparietal craniectomy on patients with unilateral acute post-traumatic

  10. Post traumatic stress disorder in anorexia nervosa

    PubMed Central

    Reyes-Rodríguez, Mae Lynn; Von Holle, Ann; Ulman, T. Frances; Thornton, Laura M.; Klump, Kelly L.; Brandt, Harry; Crawford, Steve; Fichter, Manfred M.; Halmi, Katherine A.; Huber, Thomas; Johnson, Craig; Jones, Ian; Kaplan, Allan S.; Mitchell, James E.; Strober, Michael; Treasure, Janet; Woodside, D. Blake; Berrettini, Wade H.; Kaye, Walter H.; Bulik, Cynthia M.

    2011-01-01

    Objective Comorbidity among eating disorders, traumatic events, and post traumatic stress disorder (PTSD) has been reported in several studies. The main objectives of this study were to describe the nature of traumatic events experienced and to explore the relation between PTSD and anorexia nervosa (AN) in a sample of women. Methods Eight hundred twenty-four participants from the National Institutes of Health funded Genetics of Anorexia Nervosa Collaborative Study were assessed for eating disorders, PTSD, and personality characteristics. Results From a final sample of 753 women with AN, 13.7% (n=103) met DSM-IV criteria for PTSD. The sample mean age was 29.5 years (SD=11.1). In pairwise comparisons across AN subtypes, the odds of having a PTSD diagnosis were significantly lower in individuals with restricting AN (RAN) than individuals with purging AN without binge eating (PAN) (OR=0.49, 95% CI=0.30, 0.80). The majority of participants with PTSD reported the first traumatic event before the onset of AN (64.1%, n=66). The most common traumatic events reported by those with a PTSD diagnosis were sexual related traumas during childhood (40.8%) and during adulthood (35.0%). Conclusions AN and PTSD do co-occur and traumatic events tend to occur prior to the onset of AN. Clinically, these results underscore the importance of assessing trauma history and PTSD in individuals with AN and raise the question of whether specific modifications or augmentations to standard treatment for AN should be considered in a subgroup to address PTSD-related psychopathology. PMID:21715295

  11. Regionally Selective Atrophy after Traumatic Axonal Injury

    PubMed Central

    Warner, Matthew A; Youn, Teddy; Davis, Tommy; Chandra, Alvin; de la Plata, Carlos Marquez; Moore, Carol; Harper, Caryn; Madden, Christopher J; Spence, Jeffrey; McColl, Roderick; Devous, Michael; King, Richard; Diaz-Arrastia, Ramon

    2012-01-01

    Objectives To determine the spatial distribution of cortical and subcortical volume loss in patients with diffuse traumatic axonal injury and to assess the relationship between regional atrophy and functional outcome. Design Prospective imaging study. Longitudinal changes in global and regional brain volumes were assessed using high-resolution magnetic resonance imaging (MRI)-based morphometric analysis. Setting Inpatient traumatic brain injury unit Patients or Other Participants Twenty-five patients with diffuse traumatic axonal injury and 22 age- and sex-matched controls. Main Outcome Measure Changes in global and regional brain volumes between initial and follow-up MRI were used to assess the spatial distribution of post-traumatic volume loss. The Glasgow Outcome Scale – Extended was the primary measure of functional outcome. Results Patients underwent substantial global atrophy with mean brain parenchymal volume loss of 4.5% (95% Confidence Interval: 2.7 – 6.3%). Decreases in volume (at a false discovery rate of 0.05) were seen in several brain regions including the amygdala, hippocampus, thalamus, corpus callosum, putamen, precuneus, postcentral gyrus, paracentral lobule, and parietal and frontal cortices, while other regions such as the caudate and inferior temporal cortex were relatively resistant to atrophy. Loss of whole brain parenchymal volume was predictive of long-term disability, as was atrophy of particular brain regions including the inferior parietal cortex, pars orbitalis, pericalcarine cortex, and supramarginal gyrus. Conclusion Traumatic axonal injury leads to substantial post-traumatic atrophy that is regionally selective rather than diffuse, and volume loss in certain regions may have prognostic value for functional recovery. PMID:20625067

  12. Posterior vaginal prolapse and bowel function

    Microsoft Academic Search

    Anne M. Weber; Mark D. Walters; Lester A. Ballard; Delbert L. Booher; Marion R. Piedmonte

    1998-01-01

    Objective: This study’s objectives were to describe symptoms related to bowel dysfunction in women with uterovaginal prolapse and to compare these symptoms according to extent of posterior vaginal prolapse. Study Design: One hundred forty-three women completed a questionnaire assessment of bowel function and underwent standardized physical examination according to the International Continence Society’s system for grading uterovaginal prolapse. Results: The

  13. Posterior cortical atrophy: A brief review

    Microsoft Academic Search

    Howard S. Kirshner; Patrick J. M. Lavin

    2006-01-01

    Posterior cortical atrophy is a striking clinical syndrome in which a dementing illness begins with visual symptoms. Initially,\\u000a the problem may seem to be loss of elementary vision, but over time the patient develops features of visual agnosia, topographical\\u000a difficulty, optic ataxia, simultanagnosia, ocular apraxia (Balint’s syndrome), alexia, acalculia, right-left confusion, and\\u000a agraphia (Gerstmann’s syndrome), and later a more generalized

  14. Posterior approach to ventrally located spinal meningiomas

    PubMed Central

    Voulgaris, Spyridon; Mihos, Evaggelos; Karagiorgiadis, Dimitrios; Zigouris, Andreas; Fotakopoulos, George; Drosos, Dimitrios; Pahaturidis, Dimitrios

    2010-01-01

    For the resection of anteriorly located meningiomas, various approaches have been used. Posterior approach is less invasive and demanding; however, it has been associated with increased risk of spinal cord injury. We evaluated ten consecutive patients that underwent surgery for spinal meningiomas. All patients were preoperative assessed by neurological examination, computed tomography and magnetic resonance imaging. All tumors were ventrally located and removed via a posterior approach. Transcranial motor-evoked potentials (TcMEPs), somatosensory-evoked potential (SSEP) and free running electromyography (EMG) were monitored intraoperative. Postoperative all patients had regular follow-up examinations. There were four males and six females. The mean age was 68.2 years (range 39–82 years). In nine out of ten cases, the tumor was located in the thoracic spine. A case of a lumbar meningioma was recorded. The most common presenting symptom was motor and sensory deficits and unsteady gait, whereas no patient presented with paraplegia. All meningiomas were operated using a microsurgical technique via a posterior approach. During the operation, free running EMG monitoring prompted a surgical alert in case of irritation, whereas TcMEP and SSEP amplitudes remained unchanged. Histopathology revealed the presence of typical (World Health Organisation grade I) meningiomas. The mean Ki-67/MIB-1 index was 2.75% (range 0.5–7). None of our patients sustained a transient or permanent motor deficit. After a mean follow-up period of 26 months (range 56–16 months), no tumor recurrence and no instability were found. Posterior approach for anteriorly located meningiomas is a safe procedure with the use of intraoperative monitoring, less invasive and well-tolerated especially in older patients. Complete tumor excision can be performed with satisfactory results. PMID:20127494

  15. Material Properties of the Posterior Human Sclera?

    PubMed Central

    Grytz, Rafael; Fazio, Massimo A.; Girard, Michael J.A.; Libertiaux, Vincent; Bruno, Luigi; Gardiner, Stuart; Girkin, Christopher A.; Downs, J. Crawford

    2013-01-01

    To characterize the material properties of posterior and peripapillary sclera from human donors, and to investigate the macro- and micro-scale strains as potential control mechanisms governing mechanical homeostasis. Posterior scleral shells from 9 human donors aged 57–90 years were subjected to IOP elevations from 5 to 45 mmHg and the resulting full-field displacements were recorded using laser speckle interferometry. Eye-specific finite element models were generated based on experimentally measured scleral shell surface geometry and thickness. Inverse numerical analyses were performed to identify material parameters for each eye by matching experimental deformation measurements to model predictions using a microstructure-based constitutive formulation that incorporates the crimp response and anisotropic architecture of scleral collagen fibrils. The material property fitting produced models that fit both the overall and local deformation responses of posterior scleral shells very well. The nonlinear stiffening of the sclera with increasing IOP was well reproduced by the uncrimping of scleral collagen fibrils, and a circumferentially-aligned ring of collagen fibrils around the scleral canal was predicted in all eyes. Macroscopic in-plane strains were significantly higher in peripapillary region then in the mid-periphery. In contrast, the meso- and micro-scale strains at the collagen network and collagen fibril level were not significantly different between regions. The elastic response of the posterior human sclera can be characterized by the anisotropic architecture and crimp response of scleral collagen fibrils. The similar collagen fibril strains in the peripapillary and mid-peripheral regions support the notion that the scleral collagen architecture including the circumpapillary ring of collagen fibrils evolved to establish optimal load bearing conditions at the collagen fibril level. PMID:23684352

  16. Posterior Reversible Encephalopathy Syndrome Unmasking Acute Glomerulonephritis

    PubMed Central

    Kumar S., Sathish; M., Kumar; S., Shobhana; Sampath, Sowmya; Kasthuri, R. Kulandai

    2014-01-01

    Posterior reversible encephalopathy syndrome (PRES) is a recently described condition, wherein there is vasogenic oedema, seen on neuroimaging, predominantly over the parieto occipital regions of the cerebrum. Though, as the name implies, the condition is reversible, there may be fatalities and neurological sequelae. We are reporting a 9-year-old female child in whom the typical clinical and neurological findings of PRES were caused by an atypical presentation of acute glomerulonephritis. PMID:24596763

  17. Engineering of pre-vascularized urethral patch with muscle flaps and hypoxia-activated hUCMSCs improves its therapeutic outcome

    PubMed Central

    Sun, Dongchong; Yang, Yong; Wei, Zhitao; Xu, Yong; Zhang, Xu; Hong, Baofa

    2014-01-01

    Tissue engineering has brought new hopes for urethral reconstruction. However, the absence of pre-vascularization and the subsequent degradation of materials often lead to the failure of in vivo application. In this study, with the assistance of hypoxia-activated human umbilical cord mesenchymal stem cells (hUCMSCs), pedicled muscle flaps were used as materials and pre-incubated in ventral penile subcutaneous cavity of rabbit for 3 weeks to prepare a pre-vascularized urethral construct. We found that small vessels and muscle fibres were scattered in the construct after 3 weeks' pre-incubation. The construct presented a fibrous reticular structure, which was similar to that of the corpus spongiosum under microscope examination. The produced constructs were then used as a patch graft for reconstruction of the defective rabbit urethra (experimental group), natural muscular patch was used as control (control group). Twelve weeks after the reconstructive surgery, urethrography and urethroscope inspections showed wide calibres of the reconstructed urethra in the experimental group. Histopathological studies revealed that fibrous connective tissues and abundant muscle fibres constituted the main body of the patch-grafted urethra. In contrast, in the control group, only adipose tissue was found in the stenosis-reconstructed urethra, replacing the originally grafted muscular tissue. To our knowledge, this is the first report that successfully constructed a pre-vascularized urethral construct by using hypoxia-activated hUCMSC and pedicled muscle flaps. More importantly, the pre-vascularized construct showed a good performance in urethral reconstruction when applied in vivo. The study provided a novel strategy for tissue engineering of pre-vascularized urethral construct for the defective urethra, representing a further advancement in urethral reconstruction. PMID:24460735

  18. Posterior right diagonal artery. An angiographic study.

    PubMed

    Margaris, N G; Kostopoulos, K G; Nerantzis, C E; Filippatos, G S; Kardaras, F G; Salahas, A I; Antonellis, J P; Ifandis, G P; Kranidis, A I; Tavernarakis, A G

    1997-08-01

    The purpose of this prospectively performed study was the angiographic visualization of the posterior right diagonal artery (PRDA) and its differentiation from the epicardial branches of the right coronary artery (RCA), that is, the right marginal artery and the posterior descending artery (PDA). The authors prospectively studied the angiographic findings of 607 patients who underwent coronary angiography. The incidence of the angiographically demonstrated PRDA and its distinction from other epicardial branches arising from the distal third of the RCA was the main point of interest. Two types of PDA in those cases where PRDA was present were also demonstrated. Of the patients examined, 535 had dominant right coronary circulation, 59 had left dominant coronary circulation, and 13 had balanced coronary circulation. PRDA was present in 81 patients with right dominant coronary circulation (15.1%), in 2 patients with balanced coronary circulation (15.4%), and in none with left dominant coronary circulation. PRDA was revealed in 48 (40%) of 120 patients with a short PDA and in only 33 (8%) of 415 patients having long PDA. It is imperative to search always for the PRDA, when one is studying coronary arteriographies, bearing in mind that this artery may perfuse the inferior part of the posterior interventricular septum and the adjoining are, depending on the type of PDA. PMID:9269136

  19. Posterior mini-incision hamstring harvest.

    PubMed

    Prodromos, Chadwick C

    2010-03-01

    Many orthopedists looking for alternatives to autograft bone-patellar-tendon-bone grafts are uncertain of their ability to harvest a hamstring graft of adequate length. They may use an allograft instead for this reason despite recent reports of high failure rates. This article presents step-by-step instructions for a posterior mini-incision hamstring harvest that offers a safe and simple method of reliably harvesting sufficient hamstring for 4 or 6 strand repair, while using tiny incisions for excellent cosmesis and minimal pain. Access from the posterior mini-incision allows easy identification and differentiation of the semitendinosus and gracilis (Gr) tendons, as well as precise placement of the anterior mini-incision for tibial tunnel drilling and fixation. Most importantly sectioning of the intertendinous cross-connections is performed under easy direct vision posteriorly, instead of at a distance from the typical anterior incision under retractors. This prevents the tendons from being cut too short by the tendon stripper and is particularly useful in large patients. In addition to the surgical procedure, details on the required equipment are presented. PMID:20160624

  20. Subarachnoid Hemorrhage Following Posterior Spinal Artery Aneurysm

    PubMed Central

    Geibprasert, S.; Krings, T.; Apitzsch, J.; Reinges, M.H.T.; Nolte, K.W.; Hans, F.J.

    2010-01-01

    Summary Isolated posterior spinal artery aneurysms are rare vascular lesions. We describe the case of a 43-year-old man presenting with spinal subarachnoid hemorrhage after a minor trauma who was found to have a dissecting aneurysm of a posterior spinal artery originating from the right T4 level. Endovascular treatment was not contemplated because of the small size of the feeding artery, whereas surgical resection was deemed more appropriate because of the posterolateral perimedullary location that was well appreciated on CT angiography. After surgical resection of the aneurysm the patient had a complete neurological recovery. In comparison to anterior spinal artery aneurysms whose pathogenesis is diverse, posterior spinal aneurysms are most often secondary to a dissection and represent false or spurious aneurysms. Although the definite diagnosis still requires spinal angiography, MRI and CT may better delineate the relationship of the aneurysm to the spinal cord in order to determine the best treatment method. Prompt treatment is recommended as they have high rebleeding and mortality rates. PMID:20642894

  1. Indocyanine green angiography in posterior uveitis.

    PubMed

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

    2013-04-01

    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

  2. Indocyanine green angiography in posterior uveitis

    PubMed Central

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

    2013-01-01

    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

  3. Epilepsy surgery in the posterior cortex.

    PubMed

    Blume, W T; Whiting, S E; Girvin, J P

    1991-06-01

    Fourteen (74%) of 19 patients obtained a significant reduction in seizures after posterior corticectomy; 6 (32%) were seizure-free over a median follow-up of 3.7 years (range, 1 to 14 years). Surgery included limited resections of the occipital lobe in 16 patients, posterior temporal region in 11, and posterior portion of parietal lobe in 7. Surgical failure related to probable multiple areas of epileptogenesis (4 patients), or limited resections (2 patients) to preserve visual fields (2 patients) and to avoid dyslexia (1 patient). Of 14 patients without a complete hemianopia preoperatively, 6 (43%) developed a new or increased visual field deficit, 2 (14%) of which were hemianopia. Four (36%) of 11 occipital lobe resections resulted in a new or increased visual field deficit: quadrantanopia in 3 and hemianopia in 1. Visual phenomena were the most common initial ictal symptoms, occurring in 13 (68%) of the 19 patients. Twelve patients had complex partial seizures: in 2, always without warning; in 7, always following an aura, usually visual; and in 3 patients, with or without warning. Scalp electroencephalography identified the origin of most recorded seizures in 12 (63%) of the 19 patients. A principal interictal spike focus appeared in 15 patients (79%), and always correlated with the epileptogenic lobe as defined by scalp and/or subdural-recorded seizures (14 patients) or by clinical analysis and computed tomography (1 patient). PMID:1892366

  4. What is post-traumatic stress disorder?

    PubMed Central

    Andreasen, Nancy C.

    2011-01-01

    Although post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) are categorized as separate and discrete disorders, the boundary between them is sometimes indistinct. Their separation is based on the assumption that PTSD results primarily from psychological stress, while TBI is the consequence of an identifiable injury to the brain. This distinction is based on an antiquated polarity between mind and brain, and the separation of the two disorders often becomes arbitrary in day-to-day psychiatric practice and research. PMID:22033951

  5. Prognosis for mild traumatic brain injury: results of the who collaborating centre task force on mild traumatic brain injury

    Microsoft Academic Search

    Linda J Carroll; J. David Cassidy; Paul M. Peloso; Jörgen Borg; Hans von Holst; Lena Holm; Chris Paniak; Michel Pépin

    2004-01-01

    We searched the literature on the epidemiology, diagnosis, prognosis, treatment and costs of mild traumatic brain injury. Of 428 studies related to prognosis after mild traumatic brain injury, 120 (28%) were accepted after critical review. These comprise our best-evidence synthesis on prognosis after mild traumatic brain injury. There was consistent and methodologically sound evidence that chil- dren's prognosis after mild

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

    SciTech Connect

    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

    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.

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

    PubMed Central

    Sharp, David J.

    2014-01-01

    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

  8. [Transfer of the posterior tibialis tendon to restore an active dorsiflexion of the foot].

    PubMed

    Mehling, I; Lanz, U; Prommersberger, K-J; Fuhrmann, R A; van Schoonhoven, J

    2012-01-01

    After lesions of the peroneal nerve or damage of the tibialis anterior muscle a lack of active dorsiflexion leads to a drop foot deformity. Ober (1933) described a transfer of the posterior tibialis tendon to the dorsum of the foot to restore active extension of the foot. The aim of this retrospective study was to evaluate the results of this method and to compare our results with those in the literature.Between 1992 and 2004 we performed a posterior tibialis tendon transfer in 16 patients with an average age of 40 years. 10 patients suffered from complete peroneal nerve palsy, which was due to a traumatic lesion (n=8) or iatrogenic damage (n=2). 3 patients had an incomplete peroneal nerve palsy caused by iatrogenic lesion (n=2) and lumbar disc herniation (n=1). 3 patients demonstrated a malfunction of the anterior tibial muscle following a compartment syndrome. 14 patients were available for a clinical follow-up after an average of 64 months. Clinical assessment included the hindfoot, muscular strength, pain, limitation of function and subjective satisfaction. The clinical result was evaluated using the Stanmore score (0-100).8 patients were very satisfied and 2 were satisfied with their results, 4 patients were not satisfied. 11 patients had no pain. The active dorsal ankle extension averaged - 5.7° (10 to - 30°). The Stanmore score revealed an average of 62 points with an excellent result in 2, a good result in 5, a fair result in 2 and a poor result in 5 patients.Transfer of the posterior tibial muscle to restore active dorsiflexion of the foot is a therapeutic option. As it is known from the literature objective results were mostly fair, but there was a high degree of satisfaction among the patients. PMID:22382906

  9. LOCAL SENSITIVITY, FUNCTIONAL DERIVATIVES AND NONLINEAR POSTERIOR QUANTITIES

    E-print Network

    Basu, Sanjib

    LOCAL SENSITIVITY, FUNCTIONAL DERIVATIVES AND NONLINEAR POSTERIOR QUANTITIES by Sanjib Basu 1 University of Arkansas, Fayetteville, AR 72701 February, 1994 Abstract The local sensitivity of a posterior'echet and Gâ??ateaux derivatives (Huber (1981)) are thus used. Differentiability of ratio linear posterior

  10. Computing Posterior Probabilities of Structural Features in Bayesian Networks

    E-print Network

    Tian, Jin

    Computing Posterior Probabilities of Structural Features in Bayesian Networks Jin Tian and Ru He) and Koivisto (2006) pre- sented algorithms that can compute the exact marginal posterior probability of a subnet- work, e.g., a single edge, in O(n2n ) time and the posterior probabilities for all n(n-1) po

  11. Simulating from the posterior density of Bayesian wavelet regression estimates

    E-print Network

    Barber, Stuart

    Simulating from the posterior density of Bayesian wavelet regression estimates STUART BARBER;k, and updated by the observed data y to form a posterior for each coefficient. We then estimate each coefficient by the median of its posterior distribution and the inverse DWT is used upon the resulting estimates to form

  12. Maximum Posterior Probability Estimators of Map Brian M. Steele

    E-print Network

    Steele, Brian

    Maximum Posterior Probability Estimators of Map Accuracy Brian M. Steele Correspondence should approach to map accuracy assessment based on maximum posterior probability estimators is dis- cussed-classification sampling. A calibrated maximum posterior probability estimate of map accuracy is computed by first

  13. PARTIAL LIKELIHOOD FOR ESTIMATION OF MULTI-CLASS POSTERIOR PROBABILITIES

    E-print Network

    Adali, Tulay

    PARTIAL LIKELIHOOD FOR ESTIMATION OF MULTI-CLASS POSTERIOR PROBABILITIES T d a y Adaln, Hongnzei for nonlinear signal processing [l]. In this paper, we present the general formulation for learning posterior such that the network outputs are associated with posterior class probabilities is quite attractive for a number

  14. On Posterior Consistency in Selection Models Jaeyong Lee

    E-print Network

    West, Mike

    On Posterior Consistency in Selection Models Jaeyong Lee National Institute of Statistical Sciences process prior for the weight function is considered and it is proved that the posterior is consistent under the weak topology. Key words and Phrases: Dirichlet process, posterior consistency, selection

  15. Posterior Covariance vs. Analysis Error Covariance in Data Assimilation

    E-print Network

    Boyer, Edmond

    Posterior Covariance vs. Analysis Error Covariance in Data Assimilation F.-X. Le Dimet(1), I (INRIA) Posterior covariance September 27, 2013 1 / 1 hal-00932577,version1-17Jan2014 #12;Overview Introduction Analysis Error Covariance via Hessian Posterior Covariance : A Bayesian approach Effective

  16. A REVIEW OF CONSISTENCY AND CONVERGENCE OF POSTERIOR DISTRIBUTION

    E-print Network

    Ghoshal, Subhashis

    A REVIEW OF CONSISTENCY AND CONVERGENCE OF POSTERIOR DISTRIBUTION By Subhashis Ghosal Indian and conver- gence of posterior distribution, that arise in Bayesian inference with large samples. Both and convergence of posterior distri- bution. This review is aimed for non-specialists. Technical conditions (like

  17. Power-Expected-Posterior Priors for Variable Selection

    E-print Network

    Draper, David

    Power-Expected-Posterior Priors for Variable Selection in Gaussian Linear Models D. Fouskakis , I. Expected-posterior priors are defined via imaginary training samples coming from a common underlying of the main advantages of the expected-posterior priors is that impropriety of baseline priors causes

  18. On Posterior Consistency of Survival Models Yongdai Kim

    E-print Network

    West, Mike

    On Posterior Consistency of Survival Models Yongdai Kim Hankuk University of Foreign Studies, Korea. Jaeyong Lee National Institute of Statistical Science July 2, 1999 1 #12; Posterior consistency 2 Abstract Ghosh and Ramamoorthi (1995) studied the posterior consistency for survival mod­ els and showed

  19. POSTERIOR MOMENTS OF THE CAUCHY DISTRIBUTION DAVID R. WOLF

    E-print Network

    Wolf, David R.

    POSTERIOR MOMENTS OF THE CAUCHY DISTRIBUTION DAVID R. WOLF NASA Ames Research Center MS 269­2 Moffet Field CA 94035­1000 y Abstract. The posterior moments of parameters specifying distributions always exist. In this paper the posterior moments of the posi­ tion parameter of the Cauchy distribution

  20. Bayesian Posterior Comprehension via Message from Monte Carlo

    E-print Network

    Allison, Lloyd

    Bayesian Posterior Comprehension via Message from Monte Carlo Leigh J. Fitzgibbon, David L. Dowe an epitome, or brief summary, of a Bayesian posterior distribution - and then investigate a general solution comprehension, and fast approximation of posterior expectations. We call these the properties of Bayesian

  1. EFFICIENT SEARCH USING POSTERIOR PHONE PROBABILITY ESTIMATES Steve Renals

    E-print Network

    Edinburgh, University of

    EFFICIENT SEARCH USING POSTERIOR PHONE PROBABILITY ESTIMATES Steve Renals Department of Computer). The search algorithm, based on stack decoding, uses posterior phone probabil­ ity estimates to substantially reduced by phone deactivation pruning where phones with a small local posterior probability

  2. Detecting Poor Convergence of Posterior Samplers due to Multimodality

    E-print Network

    West, Mike

    Detecting Poor Convergence of Posterior Samplers due to Multimodality Dawn B. Woodard Department techniques such as Markov chain Monte Carlo (MCMC). The convergence of the sampler to the posterior that this approach may be in- sufficient when the posterior distribution is multimodal­that lack of convergence due

  3. LARGE VOCABULARY DECODING AND CONFIDENCE ESTIMATION USING WORD POSTERIOR PROBABILITIES

    E-print Network

    Hain, Thomas

    LARGE VOCABULARY DECODING AND CONFIDENCE ESTIMATION USING WORD POSTERIOR PROBABILITIES G. Evermann Email: {ge204,pcw}@eng.cam.ac.uk ABSTRACT This paper investigates the estimation of word posterior probabilities based on word lattices and presents applica- tions of these posteriors in a large vocabulary

  4. Posterior Scleritis and Its Association with HLA B27 Haplotype

    Microsoft Academic Search

    Arundhati Anshu; Soon Phaik Chee

    2007-01-01

    Background: Posterior scleritis is most commonly idiopathic but is also found in association with systemic disorders like rheumatoid arthritis. HLA B27 spondyloarthropathy manifests itself mainly in the form of anterior uveitis and anterior scleritis. Posterior scleritis has not been previously reported in patients with HLA B27 haplotype. We document the likely association between posterior scleritis and HLA B27 haplotype in

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

    PubMed

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

    2011-03-01

    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

  6. Post-Traumatic Thoracic Outlet Syndromes

    Microsoft Academic Search

    Laurent Casbas; Xavier Chauffour; Jérôme Cau; Jean-Pierre Bossavy; Dominique Midy; Jean-Claude Baste; André Barret

    2005-01-01

    This retrospective study aims to clarify the mechanisms, frequency, symptoms, treatment, and outcome of post-traumatic thoracic outlet syndromes. A total of 13 patients (7 men and 6 women) with a mean age of 41±16 years were studied. Underlying injuries resulted from sports, road, and household accidents. Bone lesions were pseudarthrosis, hypertrophic callus, and luxations. Congenital anomalies were observed in five

  7. Helping Classrooms Cope with Traumatic Events.

    ERIC Educational Resources Information Center

    Brock, Stephen E.

    1998-01-01

    An updated model for Classroom Crisis Intervention (CCI) including post-CCI activities is presented. CCI may be applied following various types of traumatic incident involvement and for the management of grief reactions. By promoting the idea that trauma responses are normal, CCI helps survivors regain optimism. (EMK)

  8. Surviving and Transcending a Traumatic Childhood

    Microsoft Academic Search

    John Defrain; Jean E. Jones; Linda Skogrand; Nikki Defrain

    2003-01-01

    After studying more than 2,500 pages of written testimony from 90 individuals describing how they believe they have survived and transcended a traumatic childhood, the researchers conclude that human beings are capable of healing from horrendous emotional wounds. However, the journey to health is a long and difficult one, and the early negative experiences appear to be woven into the

  9. Depression following Traumatic Spinal Cord Injury

    Microsoft Academic Search

    Donna M. Dryden; L. Duncan Saunders; Brian H. Rowe; Laura A. May; Niko Yiannakoulias; Lawrence W. Svenson; Donald P. Schopflocher; Donald C. Voaklander

    2005-01-01

    Objectives: To describe the epidemiology of depression following traumatic spinal cord injury (SCI) and identify risk factors associated with depression. Methods: This population-based cohort study followed individuals from date of SCI to 6 years after injury. Administrative data from a Canadian province with a universal publicly funded health care system and centralized databases were used. A Cox proportional hazards model

  10. Traumatic intracranial aneurysms in childhood and adolescence

    Microsoft Academic Search

    E. C. G. Ventureyra; M. J. Higgins

    1994-01-01

    We report four pediatric traumatic intracranial aneurysms occurring before the age of 10 years. Two of these aneurysms were the results of closed head injury. The remaining two were iatrogenic aneurysms which occurred in unusual circumstances. These four children represent 33% of the pediatric intracranial aneurysms seen at the Children's Hospital of Eastern Ontario from 1974 to 1992. Diagnosis of

  11. Traumatic Brain Injury. Quick Turn Around (QTA).

    ERIC Educational Resources Information Center

    Markowitz, Joy; Linehan, Patrice

    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…

  12. Treating Childhood Traumatic Grief: A Pilot Study

    Microsoft Academic Search

    JUDITH A. COHEN; ANTHONY P. MANNARINO; KRAIG KNUDSEN

    2004-01-01

    ObjectiveTo examine the potential efficacy and specific timing of treatment response of individual child and parent trauma-focused cognitive-behavioral therapy for childhood traumatic grief (CTG), a condition in which trauma symptoms impinge on the child's ability to successfully address the normal tasks of grieving.

  13. Traumatic responses among battered women who kill

    Microsoft Academic Search

    Mary Ann Dutton; Laura C. Hohnecker; Paulin M. Halle; Kimberly J. Burghardt

    1994-01-01

    This study compared levels of violence, social support, and post-traumatic stress between battered women charged with a violent crime against an abusive partner and those seeking help from a mental health clinic. Results indicated that forensic battered women were more likely than clinical battered women to report experiencing severe violence, including sexual abuse, in their relationships. Women in the forensic

  14. Functional MRI and Outcome in Traumatic Coma

    PubMed Central

    Giacino, Joseph T.; Wu, Ona

    2013-01-01

    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

  15. Preventing Traumatic Stress: Public Health Approaches

    Microsoft Academic Search

    Susan B. Sorenson

    2002-01-01

    Population-based approaches to the primary prevention of posttraumatic stress disorder (PTSD) focus on the prevention of the stressor itself. Policy decisions also consider ways to allocate resources to best reduce potential damage from traumatic stressors and to ameliorate any resulting harm. A balance between broad risk prevention approaches and narrower treatment and recovery strategies can redistribute the risk of exposure

  16. Adolescent Post-Traumatic Stress Disorder

    ERIC Educational Resources Information Center

    Yule, William

    2003-01-01

    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…

  17. Subacute to chronic mild traumatic brain injury.

    PubMed

    Mott, Timothy F; McConnon, Michael L; Rieger, Brian P

    2012-12-01

    Although a universally accepted definition is lacking, mild traumatic brain injury and concussion are classified by transient loss of consciousness, amnesia, altered mental status, a Glasgow Coma Score of 13 to 15, and focal neurologic deficits following an acute closed head injury. Most patients recover quickly, with a predictable clinical course of recovery within the first one to two weeks following traumatic brain injury. Persistent physical, cognitive, or behavioral postconcussive symptoms may be noted in 5 to 20 percent of persons who have mild traumatic brain injury. Physical symptoms include headaches, dizziness, and nausea, and changes in coordination, balance, appetite, sleep, vision, and hearing. Cognitive and behavioral symptoms include fatigue, anxiety, depression, and irritability, and problems with memory, concentration and decision making. Women, older adults, less educated persons, and those with a previous mental health diagnosis are more likely to have persistent symptoms. The diagnostic workup for subacute to chronic mild traumatic brain injury focuses on the history and physical examination, with continuing observation for the development of red flags such as the progression of physical, cognitive, and behavioral symptoms, seizure, progressive vomiting, and altered mental status. Early patient and family education should include information on diagnosis and prognosis, symptoms, and further injury prevention. Symptom-specific treatment, gradual return to activity, and multidisciplinary coordination of care lead to the best outcomes. Psychiatric and medical comorbidities, psychosocial issues, and legal or compensatory incentives should be explored in patients resistant to treatment. PMID:23198672

  18. Assessing the Consequences of Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Brazil, Kevin

    1992-01-01

    This paper assesses the psychometric features of instruments used in assessing outcomes for survivors of traumatic brain injury, and describes a test development framework based on the principles of construct validity. This approach is seen to avoid common measurement difficulties. Emphasis is on cognitive and social dimensions of recovery.…

  19. Traumatic Brain Injury: Perspectives from Educational Professionals

    ERIC Educational Resources Information Center

    Mohr, J. Darrell; Bullock, Lyndal M.

    2005-01-01

    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…

  20. Neurobehavioral Consequences of Traumatic Brain Injury

    Microsoft Academic Search

    TERESA A. ASHMAN; WAYNE A. GORDON; JOSHUA B. CANTOR; MARY R. HIBBARD

    2006-01-01

    At least 1.4 million people die, or receive hospital or emergency care every year in the United States as a result of traumatic brain injury (TBI). Many more are treated in other settings or receive no treatment at all. Thus TBI is often unidentified, with subsequent cognitive, behavioral, emotional and physical sequelae that are not linked to the injury. Yet,