RESUMEN
Background: Compared to conventional therapies, sacral neuromodulation (SNM) may offer an alternative, non-destructive treatment for SCI patients with bladder dysfunction. Understanding bladder response to SNM treatment for SCI in different phases may yield new insights for innovative use of this promising technique. Materials and Methods: Female Sprague-Dawley rats were used in this study to examine the effects of acute SNM on bladder reflex in complete SCI rats. All rats were anesthetized and set up for continuous saline infusion. Acute SNM treatment was implemented for about 6 hours for each rat. Cystometric parameters, including time between contractions, contraction duration, bladder peak pressure, and number of uninhibited contractions, were analyzed and compared within rats before and after SNM treatment. Results: For the spinally transected rats during early phase (less than two weeks post spinalization), the time between contractions and contraction duration both increased after SNM treatments, yet the increased amplitude was about or less than 20%. For the spinally transected rats with a longer days survival (about two to four weeks post spinalization), the time between contractions and contraction duration substantially increased after SNM treatment and the changes for their average values were more than 90%. For the spinally transected rats with a much longer days survival (more than five weeks post spinalization), the time between contractions and contraction duration increased after SNM treatments, yet the magnitude of changes were less than 30%. Conclusion: The present study suggested that the significant effectiveness of SNM for complete SCI played its role after the spinal shock phase and prior to the development of detrusor overactivity. It indicated that the time point of SNM treatment is necessary to be paid attention.
Asunto(s)
Animales , Femenino , Sacro/fisiopatología , Traumatismos de la Médula Espinal/fisiopatología , Traumatismos de la Médula Espinal/terapia , Estimulación de la Médula Espinal/métodos , Vejiga Urinaria/fisiopatología , Modelos Animales de Enfermedad , Síntomas del Sistema Urinario Inferior/etiología , Síntomas del Sistema Urinario Inferior/prevención & control , Contracción Muscular/fisiología , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Traumatismos de la Médula Espinal/complicaciones , Factores de Tiempo , Resultado del TratamientoRESUMEN
Se presentó un caso raro de ganglioneuroblastoma sacro en un paciente de 32 años de edad, con evolución tórpida. Se presentan datos clínicos, estudios imaginológicos e histológicos. Se realiza revisión del tema
This is a uncommon case of sacral ganglioneuroblastoma in a patient aged 32 with a torpid evolution. Clinical data, imaging and histological studies are showed. A review of this subject is carried out
Asunto(s)
Humanos , Ganglioneuroblastoma/patología , Neoplasias Abdominales , Neuroblastoma/cirugía , Sacro/fisiopatología , Tomografía/métodosRESUMEN
Os autores relatam o caso de um paciente do sexo masculino, 71 anos de idade, com diagnóstico de doença de Paget óssea sacral. Foi realizado estudo com radiografia, cintilografia, tomografia computadorizada e ressonância magnética, e o diagnóstico foi confirmado por análise histopatológica. O paciente evoluiu com boa resposta ao uso de ibandronato 150 mg, mensalmente, com redução significativa dos marcadores bioquímicos da doença.
The authors report a case of a 71-year-old male patient diagnosed with Paget's disease of sacrum. Imaging study was performed with radiography, scintigraphy, computed tomography and magnetic resonance imaging, and the diagnosis was confirmed by biopsy. The patient progressed with a good response to monthly treatment with ibandronate 150 mg, presenting a significant reduction in biochemical markers of disease.