• Title/Summary/Keyword: Bladder Pressure

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Peritoneopericardial diaphragmatic hernia in adult dog (성견에서 관찰된 심막-복막 허니아 증례)

  • Jeong, Jae-Ho;Cho, Kyoung-Oh;Park, In-Chul;Cho, Ho-Seong;Kim, Hyun-Jin;Park, Nam-Yong
    • Korean Journal of Veterinary Pathology
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    • v.7 no.1
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    • pp.59-62
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    • 2003
  • A two-year-old pointer dog showed a liver failure for long duration. By radiographic examination, barium or gas filled intestine was detected in the pericardium. Although liver function was bad, surgery was tried to repair hernia due to the poor prognosis. Intestine, omentum, and liver with gall bladder were dislocated in the pericadial sac by peritoneopericardial diaphragmatic hernia (PPDH). Intestine was easily removed from pericardial sac but omentum and liver were not because of strong adhesion to the pericardial sac. Postmortem examination was performed because the patient was died after surgery. Grossly, herniated liver whose right medial lobe was strongly adhered to the pericardial sac was severely congested with fibrin adhesion on the surface. Hypoplastic abnormally up-located heart had a fissure in the outside of lower right venticulum bordered apex and depressed large vessels including vena cava and aortic arch into the base of heart. It was suggested that formation of a fissure and depression of vessels might be due to the pressure of herniated organs. In the veterinary literature as far as we knew, PPDH associated with liver failure due to adhesion of liver to the pericardial sac has not been reported.

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Predictors of Acute Postoperative Urinary Retention after Transvaginal Uterosacral Suspension Surgery

  • Son, Eun-Joo;Joo, Eunwook;Hwang, Woo Yeon;Kang, Mi Hyun;Choi, Hyun Jin;Yoo, Eun-Hee
    • Journal of Menopausal Medicine
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    • v.24 no.3
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    • pp.163-168
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    • 2018
  • Objectives: To investigate the rate of postoperative urinary retention (POUR) and identify the risk factors for this complication in women who underwent transvaginal uterosacral suspension surgery. Methods: A retrospective chart review was conducted for 75 women who underwent transvaginal uterosacral suspension surgery with vaginal hysterectomy, repair of cystocele, and levator myorrhaphy with/without transobturator anti-incontinence surgery. POUR was defined as a need for continuous intermittent catheterization on the third day subsequent to removal of the urethral indwelling catheter. Results: Acute POUR was reported in 18 women (24.0%). Thirty-six of the 75 patients (48.0%) had undergone anti-incontinence surgery. Crude analysis revealed significant association between the following variables and the risk of POUR: hypertension, the lower average flow rate in the pressure-flow study (PFS), greater post-void residual (PVR) urine volume in PFS, and PVR >30% of the total bladder capacity (TBC) in PFS. In the logistic regression analysis, PVR >30% of the TBC in PFS was identified as the only significant predictor of POUR (odds ratio, 15.4; 95% confidence interval, 2.5-90.9; P = 0.003). Conclusions: The PVR >30% of the TBC in PFS was identified as the only predictive factor of acute POUR in women who underwent transvaginal uterosacral suspension surgery.

Efficacy and Safety of OnabotulinumtoxinA in Patients With Neurogenic Detrusor Overactivity Caused by Spinal Cord Injury: A Systematic Review and Meta-Analysis

  • Li, Guang-Ping;Wang, Xiao-Yan;Zhang, Yong
    • International Neurourology Journal
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    • v.22 no.4
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    • pp.275-286
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    • 2018
  • Purpose: OnabotulinumtoxinA (BoNT-A) is a promising therapy for treating neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). This systematic review and meta-analysis aimed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI. Methods: The PubMed, Embase, and Cochrane databases were searched for all relevant articles published from 2001 to 2016 that referred to NDO, SCI, and BoNT-A or botulinum toxin A. All data were recorded in an Excel spreadsheet by 2 individual reviewers. Review Manager version 5.3 was used to carry out the meta-analysis. Results: This analysis included 17 studies involving 1,455 patients. Compared with placebo and baseline, BoNT-A was effective in increasing maximum cystometric capacity, volume at first involuntary detrusor contraction, cystometric bladder capacity (all P<0.00001), compliance (P=0.001), and the number of patients with complete dryness (P=0.0003), and decreasing detrusor pressure, the number of patients with no involuntary detrusor contractions, the maximum flow rate, the incidence of detrusor overactivity (all P<0.00001), and the number of urinary incontinence episodes (P=0.001). There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa. There were no life-threatening adverse events. Conclusions: BoNT-A is effective and safe in treating NDO after SCI. There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa. However, more high-quality randomized controlled trials are still needed.

Development of Dynamic Kidney Phantom System and its Evaluation of Usability of Application in Nuclear Medicine (핵의학 동적 신장팬텀시스템 개발 적용의 유용성 평가)

  • Park, Hoon-Hee;Lee, Juyoung;Kim, Sang-Wook;Lyu, Kwang Yeul;Jin, Gye Hwan
    • Journal of radiological science and technology
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    • v.36 no.1
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    • pp.49-55
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    • 2013
  • Currently, commercially available phantom can reproduce and evaluate only a static situation, the study is incomplete research on phantom and system which is can confirmed functional situation in the kidney by time through dynamic phantom and blood flow velocity, various difference according to the amount of radioactive. Therefore, through this study, it has produced the dynamic kidney phantom to reproduce images through the dynamic flow of the kidney, it desires to evaluate the usefulness of nuclear medicine imaging. The production of the kidney phantom was fabricated based on the normal adult kidney, in order to reproduce the dynamic situation based on the fabricated kidney phantom, in this study, it was applied the volume pump that can adjust the speed of blood flow, so it can be integrated continuously radioactive isotopes in the kidney by using $^{99m}Tc$-pertechnate. Used the radioactive isotope was supplied through the two pump. It was confirmed the changes according to the infusion rate, radioactive isotopes and the different injection speeds on the left and right, analysis of the acquired images was done by drawn five times ROI in order to check the reproducibility of each on the front and rear of the kidney and bladder. Depending on the speed of injection, radioisotope was a lot of integrated and emissions up when adjusting the pressure of the pump as 30 stroke, it was the least integrated and emissions up when adjusting as 40 stroke. The integration of the left & right kidney was not reached in the amount of the highest when adjusting as 10 stroke. In the changes according to the amount of the radioactive isotope, 0.6 mCi(22.2 MBq), 0.8 mCi (29.6 MBq)was showed up similar tendency but, in the result of the different injection 0.8 mCi, it was showed up counts close to double of 0.6 mCi. In the result of the differently injection speed of the left & right kidney, as a result of different conditions that injection speed was 20 stroke through left kidney phantom, the injection speed was 30 stroke through right kidney phantom, it was enough difference in the resulting image can be easily distinguished with the naked eye. Through this study, the results showed that the dynamic kidney phantom system is able to similarly reproduce renogram in the actual clinical practice. Especially, the depicted over time for the flow to be excreted through the kidney into the bladder was adequately reproduce, it is expected to be utilized as basic data to check the quality of the dynamic images. In addition, it is considered to help in the field of functional imaging and quality control.

Dietary Sodium Effects on Responses of Atrial Natriuretic Peptide, Aldosterone and Renin Release to Acute Volume Expansion in SHR (장기간 고염 섭취한 SHR 고혈압 쥐에서, 급성 혈장량 증가에 대한 Atrial Natriuretic Peptide, Aldosterone 및 Renin 분비 반응의 비교)

  • Kim, Ae-Ra;Lee, Won-Jung;Choo, Young-Eun;Kim, Suhn-Hee;Cho, Kyung-Woo
    • The Korean Journal of Physiology
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    • v.23 no.2
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    • pp.253-261
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    • 1989
  • Responses of atrial natriuretic peptide (ANP), aldosterone and renin release to acute volume expansion were compared in normotensive Wistar and spontaneously hypertensive rat (SHR) fed low or high-sodium diet (2 or 25 mmol Na/100 g diet). Experimental diets were fed for 6 weeks from 7-week-old and the growth rate was similar in all groups. In the morning of the experiment, catheters were inserted under ether anesthesia in femoral artery for pressure recording and blood collection, femoral vein for saline infusion, and bladder for urine collection. Then, the rats were placed in restraining cages. When the rats were recovered from anesthesia and the arterial pressure became stabilized, control urine and blood samples were collected. Then, 0.9% saline was infused for 30 min for volume expansion (3% BW). Arterial pressure was significantly higher in the high-sodium SHR but there was no difference between the two groups of Wistar rats. Control plasma levels of Na, K, ANP, renin activity, and hematocrit were not different among the 4 groups. However, plasma aldosterone level was significantly higher in the low-sodium groups. Wistar low-sodium rats showed approximately two times higher plasma aldosterone level than the SHR counterpart. Volume expansion produced a marked increase in plasma ANP level, especially in the high-sodium groups. The low-sodium groups of both strains showed approximately two-fold increase in plasma ANP level. Following a volume expansion plasma aldosterone level and renin activity decreased in all groups. There was a significant logarithmic positive correlation between plasma renin activity and aldosterone concentration. The low-sodium rats produced a greater increase in aldosterone release by small increase in plasma renin than did the high-sodium rats. The low- and high-sodium rats produced a similar degree of diuresis and natriuresis after volume expansion. However, SHR produced a greater natriuresis than did the Wistar rats. The above results indicate that regulatory mechanisms of ANP, aldosterone and renin release are different between the normotensive and hypertensive rats, and between the low- and high-sodium groups.

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A New Method For Measuring Acupoint Pigmentation After Cupping Using Cross Polarization (교차편광 촬영술(Cross Polarization Photographic Technique)를 이용한 부항요법의 배수혈 피부 색소 침착 변화 측정 평가)

  • Kim, Soo-Byeong;Jung, Byungjo;Shin, Tae-Min;Lee, Yong-Heum
    • Korean Journal of Acupuncture
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    • v.30 no.4
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    • pp.252-263
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    • 2013
  • Objectives : Skin color deformation by cupping has been widely used as a diagnostic parameter in Traditional Korean Medicine(TKM). Skin color deformation such as ecchymoses and purpura is induced by local vacuum in a suction cup. Since existing studies have relied on a visual diagnostic method, there is a need to use the quantitative measurement method. Methods : We conducted an analysis of cross-polarization photographic images to assess the changes in skin color deformation. The skin color variation was analyzed using $L^*a^*b^*$ space and the skin erythema index(E.I.). The meridian theory in TKM indicates that the condition of primary internal organs is closely related to the skin color deformation at special acupoints. Before conducting these studies, it is necessary to evaluate whether or not skin color deformation is influenced by muscle condition. Hence, we applied cupping at BL13, BL15, BL18, BL20 and BL23 at Bladder Meridian(BL) and measured blood lactate at every acupoint. Results : We confirmed the high system measurement accuracy, and observed the diverse skin color deformations. Moreover, we confirmed that the $L^*$, $a^*$ and E.I. had not changed after 40 minutes(p>0.05). The distribution of blood lactate levels at each part was observed differently. Blood lactate level and skin color deformation at each part was independent of each other. Conclusions : The negative pressure produced by the suction cup induces a reduction in the volumetric fraction of melanosomes and subsequent reduction in epidermal thickness. The relationship between variations of tissue and skin properties and skin color deformation degree must be investigated prior to considering the relationship between internal organ dysfunction and skin color deformation.

Postoperative Radiotherapy in the Rectal Cancers Patterns of Care Study for the Years of $1998\~1999$ (직장암의 방사선치료에 대한 Patterns of Care Study: $1998{\sim}1999$년도 수술 후 방사선치료 환자들의 특성 및 치료내용에 대한 분석결과)

  • Kim, Jong-Hoon;Oh, Do-Hoon;Kang, Ki-Moon;Kim, Woo-Cheol;Kim, Won-Dong;Kim, Jung, Soo;Kim, June-Sang;Kim, Jin-Hee;Kil, Hak-Jae;Suh, Chang-Ok;Sohn, Seung-Chang;Ahn, Yong-Chan;Yang, Dae-Sik
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.22-31
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    • 2005
  • Purpose : To conduct a nationwide survey on the principals in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. Materials and Methods : We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were Inputted to the web based PCS system by each investigators in 19 institutions. Results : Informations on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59 : 41, and the most common location of tumor was lower rectum ($46\%$). Preoperative CEA was checked in $79\%$ of cases and its value was higher than 6 ng/ml in $32\%$. Pathologic stage were I in $1.5\%$, II in $32\%$, III in $53\%$, and IV in $1.6\%$. Low anterior resection was the most common type of surgery and complete resection was peformed in $95\%$ of cases. Distal resection margin was less than 2 cm in $30\%$, and number of lymph node dissected was less than 12 in $31\%$. Chemotherapy was peformed in $91\%$ and most common regimen was 5-FU and leucovorine ($59\%$). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique ($65.0\%$), and there was no AP-PA parallel opposing field used. Patient position was prone in $81.2\%$, and the boost field was used in $61.8\%$. To displace bowel outward, pressure modulating devices or bladder filling was used in $40.1\%$. Radiation dose was prescribed to isocenter in $45.3\%$ and to isodose line in 123 cases ($39.8\%$). Percent delivered dose over $90\%$ was achieved in $92.9\%$. Conclusion : We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to institutions and the variations of radiation dose and field arrangement were within acceptable range.