RESUMO
OBJECTIVE: The aim of the study was to evaluate the use of new-type implants for the treatment of female urinary stress incontinence. The patients with intrinsic sphincter deficiency were also included, the other were after previous surgery for GSI. DESIGN: Original article. SETTING: Departments of Obstetrics and Gynaecology, Faculty Hospital Na Bulovce and General Faculty Hospital, 1. Faculty of Medicine, Charles University, Prague, Institute of Macromolecular Chemistry, Czech Academy of Science, Prague. METHODS: We operated 9 patients, two of them with type III (McGuire) urinary stress incontinence the rest after operations for GSI in general anesthesia. Six to nine hydrogel swelling implants were introduced into the submucosa of proximal urethra under the transrectal ultrasound guidance. We evaluated the effect 6 to 9 months after the operation. RESULTS: Two patient were dry (negative stress-test and pad-weight test), one patient had substantial improvement, 4 had mild improvement and 2 did not notice any change. We found de novo urge symptoms in four patients, two of them were of the motor type. CONCLUSION: The new type of implants reached the success rate of other currently used materials. The improvement of stress incontinence was on the cost of de novo urge symptoms in some patients. The urgency was successfully managed with spasmolytic drugs.
Assuntos
Hidrogel de Polietilenoglicol-Dimetacrilato , Próteses e Implantes , Incontinência Urinária por Estresse/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Projetos PilotoRESUMO
Changes in MR images and 1H spectra of 20 patients with hyperphenylalaninaemia were compared with data of controls. Major changes in T2 MR images were found in the periventricular area (20/19). Some patients showed lesions in MR images of basal ganglia (20/7) and in the cerebellum (20/4). The results of proton MR spectroscopy show no significant difference for NAA/Cr ratios but significant ones between the ratios of NAA/Cho (p = 0.97) and Cho/Cr (p = 0.98) of controls and patients with hyperphenylalaninaemia.
Assuntos
Encefalopatias/diagnóstico , Encéfalo/fisiopatologia , Fenilalanina/análise , Fenilcetonúrias/complicações , Adulto , Ácido Aspártico/análise , Biopterinas/deficiência , Química Encefálica , Encefalopatias/etiologia , Encefalopatias/fisiopatologia , Criança , Colina/análise , Creatina/análise , Doenças Desmielinizantes/complicações , Doenças Desmielinizantes/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Fenilcetonúrias/fisiopatologiaRESUMO
The authors present a case-history pertaining to the early diagnosis of Perthes' disease by magnetic resonance in a patient with a marked clinical symptomatology and a negative classical skiagram. Typical changes on the X-ray picture developed after a three-month interval. Confirmation of the importance of magnetic resonance for early diagnosis of Perthes' disease is consistent with the quoted literature. Key words: early diagnosis, Perthes' disease, magnetic resonance.