Diabetic cystopathy: A review.

Herein we review and discuss epidemiological, clinical, and experimental studies on diabetic cystopathy, a common chronic complication of diabetes mellitus with a variety of lower urinary tract symptoms, providing directions for future research. A search of published epidemiological, clinical, or preclinical trial literature was performed using the key words "diabetes", "diabetic cystopathy", "diabetic bladder dysfunction", "diabetic lower urinary tract dysfunction", "diabetic detrusor instability". The classic symptoms of diabetic cystopathy are decreased bladder sensation, increased bladder capacity, and impaired bladder emptying with resultant increased post-void residual volume. However, recent clinical evidence indicates a presence of storage symptoms, such as overactive bladder symptoms. The pathophysiology of diabetic cystopathy is multifactorial, including disturbances of the detrusor, neuron, urothelium, and urethra. Hyperglycemia, oxidative stress, and polyuria play important roles in inducing voiding dysfunction in diabetic individuals. Treatment choice depends on clinical symptoms and urodynamic abnormalities. Urodynamic evaluation is the cornerstone of diagnosis and determines management strategies. Diabetes mellitus could cause a variety of lower urinary tract symptoms, leading to diabetic cystopathy with broadly varied estimates of the prevalence rates. The exact prevalence and pathogenesis of diabetic cystopathy remains to be further investigated and studied in multicenter, large-scaled, or randomized basic and clinical trials, and a validated and standardized workup needs to be made, improving diabetic cystopathy management in clinical practice. Further studies involving only female diabetics are recommended.

Acupuncture for overactive bladder in female adult: a randomized controlled trial.

PURPOSE: To assess the effectiveness of acupuncture in treating female adult with overactive bladder. MATERIALS AND METHODS: After we excluded other causes for storage symptoms, a total of 240 consecutive female patients with overactive bladder were enrolled and completed all aspects of this prospective randomized controlled trial, of which 118 cases were randomly assigned to receive a weekly acupuncture treatment (intervention group), while the other 122 cases were given a pharmacological treatment of oral tolterodine tartrate 2 mg twice daily (control group) for 4 weeks. Data on urgency, incontinence, micturition frequency, nocturia episodes and voided volume were collected and statistically analyzed before and after 4 weekly acupuncture treatments or 4 weeks' pharmacological treatment using a 3-day micturition diary. RESULTS: The two groups of female patients with overactive bladder were given treatment with weekly acupuncture (n = 118), oral tolterodine tartrate (n = 122) for 4 weeks respectively. At weeks 4, subjects in both intervention and control groups had significant decreases in number of urinary urgency episodes, incontinence episodes, daytime frequency, nocturia episodes and increase in volume voided per micturition without a significant difference in the changes of overactive bladder symptoms between the groups. There were no serious adverse events during the study. CONCLUSIONS: This randomized controlled trial demonstrates that acupuncture is safe with significant improvements in patient assessment of overactive bladder symptoms and may be considered a clinically alternative treatment for overactive bladder in female adult.

Molecular detection of trisomy 21 by bicolor competitive fluorescent PCR.

OBJECTIVE: To develop a reliable and specific method for rapid prenatal diagnosis of Trisomy 21 (Down syndrome). METHODS: We established a dual color competitive fluorescent Polymerase Chain Reaction (PCR) to measure the gene dosage of Down syndrome critical region (DSCR), a single copy sequence in chromosome 21. Another unique single copy sequence located on chromosome 2 (USC2) but not glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was chose as reference gene. RESULTS: The DSCR3/USC2 ratio of peripheral blood in trisomy 21 syndrome patients to normal subjects was 1.41∼1.74 to 0.93∼1.15, respectively (p < 0.01). Dual color competitive fluorescent PCR technique effectively differentiates the normal subjects from the Down syndrome patients. Next, according to the dual color competitive fluorescence quantitative PCR, among the 46 pregnant women, 3 cases were Down syndrome and 43 cases were normal, and these were confirmed by cytogenetic karyotype analysis. CONCLUSION: This indicated that the new technique may be a reliable and specific method for the rapid prenatal diagnosis of Trisomy 21.

Primary erythromelalgia with leukonychia combined with ulcerations and infection by Monilia guilliermondii.

An 8-year-old girl presented with recurrent redness, warming, and pain of the lower extremities for more than 4 years, with exacerbation and accompanying swelling for the past 1 year and ulcers for 1 month. The episodes were triggered by exertion and heat. Her family history revealed that her mother had experienced similar symptoms. Physical examination showed proximal white nails and the distal border in normal color. There was some ulceration in the dorsum of the feet with thick, yellowish secretions, covered by some crusted lesions. Laboratory culture result showed that there were many Monilia guilliermondii in the ulcer specimen. Finally, she was diagnosed with juvenile onset of primary erythromelalgia and was given symptomatic treatment for neuropathic pain and pedal ulcers.