The clinical effect of combining electroacupuncture with long needle sacral nerve stimulation in the treatment of diabetic overactive bladder / 中华物理医学与康复杂志

Objective:To observe the clinical efficacy of combining electroacupuncture with long needle sacral nerve acupuncture in the treatment of diabetic overactive bladder.Methods:A total of 90 patients with diabetic overactive bladder were randomly divided into an observation group and a control group, each of 45. In addition to the basic treatment for diabetes, the observation group received electroacupuncture combined with long needle sacral nerve acupuncture 5 times a week for 4 weeks, while the control group was given 5mg of oral solinax succinate once a day as a course of treatment. One week before the beginning of the experiment and one week before its end, urination diary cards were used to record the average number of times of daytime and nighttime urination daily, as well as any urgent urination and urinary incontinence during the week. Bladder overactivity syndrome score (OABSS), the bladder overactivity quality of life questionnaire (OAB-q), maximum urine flow rate (Qmax) and mean urine flow rate (Qave) were employed to quantify urination status, life quality and the urodynamics of the 2 groups before and after the treatment.Results:After the treatment, significant improvement was observed in the average weekly incidence of daytime and nighttime urination, of urgent urination and of urinary incontinence. The average OABSS, OAB-q, Qmax and Qave scores improved in both groups, but the experimental group showed significantly better improvement than the control group.Conclusion:Electroacupuncture combined with sacral nerve needling can significantly reduce the frequency of urination, relieve the symptoms of urgent urination and incontinence, and improve the rate of urine flow, improving the life quality of patients with diabetic overactive bladder.

Obstructive Acute Kidney Injury with Maintenance of Diuresis: A Case of Ureter Bifidity / Lesión Renal Aguda Obstructiva con Mantenimiento de la Diuresis: Un Caso de BifidezUreteral

Abstract Percutaneous kidney biopsyin transplanted kidneys remains an essential and commonly performed procedure required for diagnostic and prognostic information. Hemorrhage is the main complication of renal graft biopsy. We report a case of a 47-year-old caucasian womanadmitted to perform an ultrasound(US)-guided biopsy of the renal graft. Six hours later, she presented with macroscopic hematuriawhichimproved after urethral catheterization and intravenous hydration. However the hematuria reappeared associated with anemia and worsening of the serum creatinine value. The US study, revealed hydronephrosis with high Doppler derived renal resistive index compatible with clot obstruction.Despite the vesical lavage with drainage of several clots, the patient rapidly progressed to hemorrhagic shock with worsening of renal function. Pelvic computed tomography (CT) revealed calyx and pelvis duplicity and ureter bifidity which merged into a single ureter and inserted into the right anterolateral wall of the bladder. The inferior ureter was enlarged due to an obstructive clot. Most acute obstructive uropathies are associated with significant pain or the abrupt diminution of urine flow. The presence of ureter bifidity in the CT study explained the maintenance of significantdiuresis despite obstruction, located only to the lower ureter but with sufficient functional impact to condition acute kidney injury (AKI).

Resumen La biopsia renal percutánea en riñones trasplantados sigue siendo un procedimiento esencial y común, necesario para obtener información diagnóstica y pronóstica. La hemorragia es la principal complicación de la biopsia de injerto renal. Presentamos un caso de una mujer caucásica de 47 años, quien fue hospitalizada para la realización de una biopsia de injerto renal guiada por ultrasonido (US). Seis horas después, presentó hematuria macroscópica que mejoró después de la cateterización uretral e hidratación intravenosa. Sin embargo, la hematuria reapareció asociada con anemia y empeoramiento del valor sérico de creatinina. El estudio de US reveló, mediante Doppler, una hidronefrosis con alto índice de resistencia renal, compatible con obstrucción por un coágulo. A pesar del lavado vesical con drenaje de varios coágulos, la paciente progresó rápidamente a choque hemorrágico con empeoramiento de la función renal. La tomografía computarizada (TC) pélvica reveló la duplicidad del cáliz y la pelvis y la bifidez ureteral, que se fusionó en un solo uréter y se insertó en la pared anterolateral derecha de la vejiga. El uréter inferior se agrandó debido a un coágulo obstructivo. La mayoría de las uropatías obstructivas agudas están asociadas con dolor significativo o la disminución abrupta del flujo de orina. La presencia de la bifidez del uréter en el estudio de TC explicó el mantenimiento de una diuresis significativa a pesar de la obstrucción, localizada solo en el uréter inferior, pero con suficiente impacto funcional como para provocar insuficiencia renal aguda (IRA).

Application of branchedspongiosum repair in duckett surgery for hypospadias / 中华泌尿外科杂志

Objective@#To explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery.@*Methods@#Retrospective analysis was performed for the clinical data of 140 surgical infants with hypospadias Duckett surgery from January 2016 to April 2018. According to different covering materials on newly formed urethra, the experimental group (68 cases) cut dysplasia, branched spongiosum and lateral Buck′s fascia from tunica albuginea to coronary groove and then sutured over newly formed urethra, and the control group (72 cases) used Dartos fascia or subcutaneous fascia. The operative age, penile curvature, length of urethral defect, operation time, added value of coronary groove before and after operation, maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups, and the therapeutic effect was analyzed.@*Results@#There was no statistically significant difference between two groups in operating time[(135±49)min vs.(135±45)min, P=0.580] and the value added of coronary sulcus[(0.1±0.2)cm vs.(0.1±0.1)cm, P=0.167]. In experimental group, there were 8 cases of urethra percutaneous fistula (11.8%) (coronary groove fistula in 3 cases, 4.4%)and 6 cases of urethral stenosis (8.8%) without urethral dehiscence. In control group, there were 18 cases of urethra percutaneous fistula (25.0%)(coronary groove fistula in 11 cases, 15.3%), 10 cases of urethral stenosis (13.9%), and 2 cases of urethral dehiscence (2.8%). The incidence of postoperative urinary fistula and total complications in experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05), while the incidence of urethral stenosis was not statistically different between two groups (P>0.05). The maximum urine flow rate of experimental group at 6 months after surgery was significantly higher than control group[(9.5±3.8)ml/s vs.(6.8±2.8)ml/s], and the difference was statistically significant (P<0.001).@*Conclusions@#Urethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate.

Application of branchedspongiosum repair in duckett surgery for hypospadias / 中华泌尿外科杂志

Objective To explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery.Methods Retrospective analysis was performed for the clinical data of 140 surgical infants with hypospadias Duckett surgery from January 2016 to April 2018.According to different covering materials on newly formed urethra,the experimental group (68 cases) cut dysplasia,branched spongiosum and lateral Buck's fascia from tunica albuginea to coronary groove and then sutured over newly formed urethra,and the control group (72 cases) used Dartos fascia or subcutaneous fascia.The operative age,penile curvature,length of urethral defect,operation time,added value of coronary groove before and after operation,maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups,and the therapeutic effect was analyzed.Results There was no statistically significant difference between two groups in operating time [(135 ± 49) min vs.(135 ± 45) min,P =0.580] and the value added of coronary sulcus [(0.1 ± 0.2) cm vs.(0.1 ± 0.1) cm,P =0.167].In experimental group,there were 8 cases of urethra percutaneous fistula (11.8％) (coronary groove fistula in 3 cases,4.4％) and 6 cases of urethral stenosis (8.8％) without urethral dehiscence.In control group,there were 18 cases of urethra percutaneous fistula (25.0％) (coronary groove fistula in 11 cases,15.3％),10 cases of urethral stenosis (13.9％),and 2 cases of urethral dehiscence (2.8％).The incidence of postoperative urinary fistula and total complications in experimental group was lower than that in the control group,and the difference was statistically significant (P ＜ 0.05),while the incidence of urethral stenosis was not statistically different between two groups (P ＞ 0.05).The maximum urine flow rate of experimental group at 6 months after surgery was significantly higher than control group [(9.5 ± 3.8) ml/s vs.(6.8 ± 2.8) ml/s],and the difference was statistically significant (P ＜ 0.001).Conclusions Urethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate.

Research on displacement model of urine flow rate meter calibration device based on regression analysis / 医疗卫生装备

Objective To determine the relationship between the theory and actual displacement of the urine flow rate meter calibration device gear pump, and to construct a model between actual and theory displacement, in order to obtain actual displacement via theory displacement. Methods The weight of the standard water flow in each flow rate was measured by B2000S digital scales,and the scatter plot between the theory displacement and actual displacement was drawn to find the best fitted curve;then the MATLAB Curve Fitting Tool was used to obtain the best quasi relational equation. Results The error between the fitted displacement and the actual displacement of the gear bump was 1.494% in maximum and-0.010% in minimum, far less than 5% of the requirements for urinary flow meter measurement. Conclusion Based on regression analysis, the relationship between the theoretical displacement and actual displacement of the flow rate meter calibration device is established,the fitting error is small,and the method is simple and easy to achieve.

Clinical Observation of Heat-sensitive Moxibustion for Bladder Dysfunction After Poisonous Snakebite / 上海针灸杂志

Objective To discuss the safety and effectiveness of heat-sensitive moxibustion for bladder dysfunction after poisonous snakebite. Method Twenty-six patients with bladder dysfunction due to poisonous snakebite were intervened by heat-sensitive moxibustion, and the changes of residual urine volume and uroflowmetry parameters were analyzed by using type-B ultrasonic scanning and uroflowmetry. Result According to the ultrasonic scanning and uroflowmetry, the residual urine volume was significantly changed after treatment in the 26 subjects (P<0.05), and the maximum urine flow rate (Qmax) was also significantly different from that before treatment (P<0.05). Conclusion Heat-sensitive moxibustion can improve the residual urine volume and Qmax in bladder dysfunction after poisonous snakebite, and it’s a safe and reliable method.

Evaluation of Automated Flow Cytometric Analyzer Sysmex UF-100 for Cell Counting of Cerebrospinal Fluid / 임상검사와정도관리

BACKGROUND: The counting of erythrocyte and leukocyte in cerebrospinal fluid (CSF) is still performed microscopically, using a chamber in most laboratories. However, it is imprecise, has wide inter-observer variability, and is labor-intensive and time-consuming. This study was aimed to examine the possibility of using Sysmex UF-100 flow cytometry (Toa Medical Electronics, Japan) as a means of counting cells in CSF samples. METHODS: From May to September 2006, we obtained 115 routinely collected CSF samples from 90 patients. We compared the performance of the automated method of the UF-100 with the manual counting method using Neubauer chamber. RESULTS: Accuracy statistics for erythrocyte and leukocyte showed a high correlation between the UF-100 and the manual counting method, with correlation coefficients of r2=0.95 and 0.89, respectively. Linearity results demonstrated that the UF-100 method provides accurate results throughout the reportable ranges of erythrocyte and leukocytes. A high degree of inter-assay precision for the UF-100 method was seen. Five cases with high lymphocytes percentage showed falsely low value of leukocyte counts. CONCLUSIONS: The flow cytometric analysis of CSF with the UF-100 offered a rapid and reliable erythrocyte and leukocyte count. UF-100 is expected to be useful for screening method in CSF cell counting. But the manual counting method is still needed for the samples with high leukocyte count or contaminated with peripheral bloods.

PHYSIOLOGICAL PROPERTIES OF KENDO PRACTICES IN TERMS OF URINE AND CREATININE EXCRETION CHANGES / 体力科学

This study was designed to investigate the properties of the three typical kendo practices (kirikaeshi, kakarigeiko, and jigeiko) in terms of changes in urine flow and creatinine excretion after practice events. The subjects were six male university kendo practitioners. They performed four exercises that were three kendo practices and a warming up without a kendo practice as the control, at a separate day respectively. In each exercise, five urine samples were collected continuously as follows: (1) after 30 minutes rest (rest), (2) immediately after warming up (w-up), (3-5) at every 30 minutes after practice event up to 90 minutes (30'--90'-urine) . Two blood sam-ples were collected at the rest period and 5-10 minutes after exercise. The blood lactate concentration after kendo practices rose to 1.09-8.02 times of rest level. The 30'-urine flow tended to decrease than w-up in kirikaeshi, jigeiko and control, but to increase in kakarigeiko. Creatinine concentration of 30'-urine rose significantly in the control, kirikaeshi and jigeiko than w-up, but significantly fell in kakarigeiko. The kakarigeiko brought peculiar changes in 30'-urine. The urinary changes after exercises (30'-urine rest) indicated nonlinear relation with blood lactate change ratios. These results indicate that the kendo practices bring the two-way influences in urinary change, one is diuretic effect accompanied with lactate accumulation in the kakarigeiko, and the other is the antidiuretic effect accompanied with less lactate accumulation in the kirikaeshi and jigeiko.

Comparative study on results between urine flow cytometric DNA analysis and urine cytology in transtional cell carcinoma of bladder / 대한비뇨기과학회지

We compared the roles of urinary cytology and flow cytometric DNA analysis in the evaluation of 26 patients with transitionsl cell carcinoma of bladder from March 1989 to April 1991. When carcinoma was present at the time of specimen collection it was detected by cytology in 65.4 percent and flow cytometric DNA analysis in 73.1 percent. Combination of flow cytemetric DNA analysis and urinary cytology increased the diagnostic yield to 88.5 percent Flow cytometric DNA analysis was slightly more sensitive than urinary cytology for the detection of abnormalities in specimen from low stage. high grade. small size. small number and recurrent cancer but no statistically significant difference was identified. When used in conjunction with urinary cytology. urine flow cytometric DNA analysis was valuable procedure in the diagnosis and follow up of patients with bladder cancer.

Male Flow Rate Nomogram and Clinical Correlation (l) / 대한비뇨기과학회지

The flow rate nomogram was based on 204 flow rate measurements in l65 Korean normal men who ranged in age from 20 to 45 years. Using this nomogram, we tested 10 patients with clinically evident outflow obstruction by flowmetry. In 9 of the maximal flow measurements, the nomogram values were less than minus Z standard deviations. The maximal flow rate value after prostatectomy increased an average 2.41 standard deviations. (p=0.006) The use of flow rate nomogram appears to differentiate reliably normal from obstructed individuals and also is highly useful in the postoperative follow up of urinary outflow obstruction.

The Value of Urethral Pressure Profile and Urine Flow Rate Measurement in the Preoperative assessment for Benign Prostatic Hypertrophy / 대한비뇨기과학회지

Diagnostic urethral Pressure profile and uroflowmetry were performed on 10 cases and 3 cases respectively in benign enlargement of prostates who were admitted to Seoul National University Hospital, during the period from March, 1980 to July, 1980. The results of these studies were summarized as follows; 1. On 10 cases, mean endoscopic prostatic urethral length and mean functional urethral length (prostatic urethral length) in urethral pressure profile were 4.3cm and 4.8cm respectively, mean maximum urethral closing pressure was 70cm H20. These findings revealed that mean maximum urethral closing pressure was lower than normal value, mean functional urethral length was no difference from the normal value. (4.3 to 5.5cm) 2. On 3 cases, the results of uroflowmetry obtained as follows: mean maximum flow rate 11ml/sec, mean flow rate 7.0 ml/sec. 2 cases checked residual urine, 200ml and 70ml. 3. On 2 cases, the cystometric findings showed low value of first voiding sense (70ml and 60ml) and maximum bladder capacity (100ml and 80ml). It indicated the unstable bladder pattern which accompanied occasionally in benign enlargement of prostate. 4. The acceptance and adoption of urethral pressure profile and uroflowmetry in benign enlargement of prostate greatly facilitated understanding of urethral physiology and diagnostic accuracy in addition to rectal examination, excretory urography and endoscopy.