The pseudo-obstructed bladder in enuretic children

In a minority of enuretic children with severe day symptoms, and especially when there is urinary infection, there a bladder diverticula and trabeculation and possbily also harmful vesicoureteric reflux which suggest the presence of an infravesical obstruction. However, in 11 children with this syndrome who underwent urodynamic studies, no anatomical or functional obstruction was demonstrable. It is contended that the obstructive signs are the result of uninhibited detrusor contractions being voluntarily resisted by contraction of the external urethral sphincter so that abnormallay high intravesical pressures result. Management involves the use of detrusor-inhibitory drugs. Ureteric reimplantation may be needed for reflux. In the majority of cases symptoms improve with time but the bladder diverticula persist.     

A possible explanation of wet and dry nights in enuretic children

OBJECTIVES: Intracavernosal injection of vasodilating agents has been a mainstay in the treatment of erectile dysfunction. Recently, a transurethral delivery system (MUSE) for alprostadil (prostaglandin E1) was introduced as an alternative form of pharmacotherapy. METHODS: One hundred consecutive patients with erectile dysfunction were treated with MUSE in doses ranging from 125 to 1000 micrograms and their erections were observed in the clinical setting. All patients had previous intracavernosal injections of combination pharmacotherapy (papavarine, Regitine, and/or prostaglandin E1). RESULTS: Of these 100 patients that used MUSE, only 7% had well-sustained, rigid erections while 30% had full erections but with partial rigidity. The remaining 63% of patients did not achieve erections that they thought were adequate for penetration. Penile and/or perineal pain occurred in 24% of patients, 3% had a syncopal episode, and 3% experienced urethral bleeding. One patient had priapism that required drainage. Using intracavernosal injections, 49% had sustained rigid erections, 40% had full erections with partial rigidity, and 11% did not have a response satisfactory for penetration. CONCLUSIONS: These data suggest that intracavernosal injections appear to be more effective than MUSE in achieving a rigid erection in men with erectile dysfunction.     

Neuropsychological function and diurnal variation in depression

Twenty-six patients suffering from DSM-III-R major depressive episode with diurnal variation of mood were examined at approximately 8 AM and 8 PM, using a neuropsychological test battery. We found that tests of executive function, especially the verbal fluency test, were sensitive measures of diurnal variation, but that personality measures were relatively robust in that they were not significantly affected by diurnal variations of mood. The relevance of detecting and assessing diurnal changes of mood with reliable, objective measures of performance is discussed.     

Blood pressure and diurnal variation in sodium, potassium, and water excretion

This study was designed to investigate the prevalence of Cilia-associated respiratory (CAR) bacillus infection in rabbits reared for meat production in Italy and to correlate the presence of CAR bacillus with inflammatory lesions of the respiratory tract. Seventy health, 3-month-old, New Zealand White rabbits, raised in 10 different rabbitries in Northern Italy were randomly selected at slaughter. No gross lesions were found at necropsy in any rabbit. In each animal, the trachea and lungs were sampled, fixed in 10% formalin, embedded in paraffin and stained with the Warthin-Starry method to evaluate the presence of CAR bacillus, and with haematoxylin and eosin to evaluate the presence of inflammatory lesions. CAR bacillus was present in 50 out of 70 rabbits (71.4%) with a prevalence of the infection that varied from 30% to 100% in the seven rabbitries. CAR bacillus was present both in the trachea and bronchi in 23 cases (32.8%), only in the trachea in 24 cases (34.3%) and only in the bronchi in three cases (4.3%). Inflammatory lesions were found in the trachea (22 cases, 31.4%) and the bronchi (58 cases, 82.8). There was a strong, statically significant correlation between the presence of CAR bacillus in the bronchi and bronchial inflammatory lesions (P < 0.0001). This study indicates that CAR bacillus infection is widespread in conventionally reared rabbits in Italy and that a possible correlation exists between the presence of CAR bacillus and bronchial inflammatory lesions.     

Effects of a waking schedule on primary enuretic children treated with full-spectrum home training.

Examined the effects of adding a waking schedule to full-spectrum home training (FSHT) for primary enuresis. 20 children (aged 5–23 yrs) received FSHT, and 17 children (aged 5–14 yrs) received FSHT plus a waking schedule. The addition of a waking schedule to FSHT failed to shorten the length of time it took Ss to attain a success criterion. Across both treatment groups, 75.6% of Ss achieved a dry bed, and only 21% experienced a relapse by 1-yr follow-up. Although results support the efficacy of FSHT, the previously reported (R. J. Bollard and T. Nettlebeck; see record 1981-24041-001) beneficial effects of a waking schedule were not replicated. The use of a waking schedule may be beneficial only for that subgroup of enuretic children with a sleep-arousal problem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is diurnal variation of mood associated with parasympathetic activity?

70 patients older than 50 years (mean age: 60.2 years) underwent a CD-spondylodesis from 1987 to 1991 for degenerative changes of the lumbar spine, and were followed for 2 years. 88.2% improved, but only 47.1% showed a good-to-excellent result. Patients with fair and poor outcomes had had significantly more operations on the lumbar spine (p < 0.001), had a greater extent of preoperative lumbar kyphosis (p < 0.05), motor weakness (p < 0.05), had less vertebral slips (p < 0.01), had less posterior distraction postoperatively (p < 0.001), and had a greater extent of postoperative motor weakness compared to patients with good-to-excellent outcomes. Age, sex, duration of back/leg pain, taking of analgetic drugs, preoperative pain status, profession, range of walking, time of operation, number of fused segments, blood loss, blood transfusion, postoperative profile of the spine did not show any significant influence upon clinical results. Already at 6-months-follow-up there was significant difference of the clinical outcome (p < 0.001), making improvement of a then fair or poor result unlikely.     

The effect of diurnal variation on the regional differences in sweating and skin blood flow during exercise

The aim of the present study was to examine changes in the control of heat-dissipation responses to exercise associated with the diurnal variation in core temperature from the viewpoint of the regional response patterns. We studied seven men during exercise on a cycle ergometer at 100 W for 40 min at 25 degrees C at 0630 (morning) 1630 (evening) hours on 2 separate days. Oesophageal temperature (T(oes)), local skin temperature, local sweating rate (msw) on the forehead, back, forearm and thigh, and skin blood flow by laser Doppler flowmeter (LDF) on the back and forearm were measured continuously. The T(oes) at rest was significantly higher in the evening than in the morning, the difference averaging approximately 0.4 degrees C (P < 0.05). The T(oes) thresholds for each site in msw and that for back in LDF were significantly different between the two times of day (P < 0.05). The change in T(oes) thresholds for sweating and vasodilatation for morning and evening were similar to T(oes) at rest. Although msw on the forehead was significantly higher in the morning than in the evening, msw on the back was significantly higher in the evening than in the morning (P < 0.05). Total local sweating rate (msw,tot) for each site during exercise was significantly higher on the forehead than on the forearm in the morning, and on the back than on the forearm in the evening, respectively (P < 0.05). The results would suggest that the diurnal variation of heat-dissipation responses to exercise is influenced not only by a central controlling mechanism but also by changes in the regional differences.     

Daily variation of CNS gene expression in nocturnal vs. diurnal rodents and in the developing rat brain

To identify risk factors associated with an increased risk for ipsilateral breast tumor recurrence following breast-conserving surgery, a cohort of 759 women with T1-T2 tumors were studied. The majority of the patients (88%) had received postoperative radiation therapy to the breast. Median follow-up time was 10 (range: 6-17) years. There was a 1-1.5% yearly increase in ipsilateral breast tumor recurrences. For women < 50 ys the cumulative recurrence rate at 10 years was 18% and for women > or = 50 ys, 9%. Node positive women had a cumulative breast recurrence rate of 25% versus 10% for node negative women. Ten years postoperatively, irradiated patients had a cumulative recurrence rate of 11% versus 26% when no irradiation was given. The beneficial effect of radiotherapy was substantial during the first four postoperative years. The relative risk for an ipsilateral breast tumor recurrence during this period was 4.5 times higher than for non-irradiated patients. However, the protective effect of radiotherapy decreased with time. After ten years the relative risk of ipsilateral breast tumor recurrence was the same among irradiated and non-irradiated patients although the number of events during this period was low. Univariate analysis showed that seven factors were significantly associated with an increased risk of ipsilateral breast tumor recurrence, namely age < 50 ys, increasing tumor size, uncertain microscopic margins, axillary lymph node metastases, no postoperative tamoxifen treatment, premenopausal status, and no postoperative radiotherapy. Three factors remained independently significant after multivariate analysis: age < 50 ys, no postoperative radiation therapy, and positive lymph nodes. In conclusion, radiotherapy reduced the breast recurrence rate, but the effect decreased with time. Node-negative women > or = 50 were a low risk-group for ipsilateral breast tumor recurrence, with a cumulative risk at 10 years of 9% without radiation therapy and 5% with breast irradiation.     

Studies on the mechanism of diurnal variation of proliferative indices in the small bowel mucosa of the rat

In the rat small bowel mucosa significant variation was found in both the labelling and the mitotic indices with time of day. The zenith and the nadir of labelling and mitotic activity coincided at 15.00 and 02.00 hours respectively. Small changes were found in the "cut-off" position, but this variation in proliferative compartment size was insufficient to account for the comparatively wider fluctuations in proliferative indices. Measurements of the rate of entry into mitosis, using metaphase arrest with vincristine at three widely separated times during the day, showed no significant change. Changes in the growth fraction or in the birth rate as measured cannot account for diurnal variation in the proliferative activity of the small bowel mucosa. We propose a hypothesis which involves diurnal fluctuations in the transit times through G1 and through G2.     

Lack of diurnal variation in vision, refraction, or keratometry after excimer laser photorefractive keratectomy

PURPOSE: To examine whether diurnal variation in visual acuity, spherical equivalent, keratometry, or intraocular pressure occurs in patients who have undergone photorefractive keratectomy. METHODS: Twenty-nine post-photorefractive keratectomy patients underwent morning and evening measurements of visual acuity, spherical equivalent, keratometry, and intraocular pressure at intervals between 5 and 13 months after photorefractive keratectomy. RESULTS: There was no statistically significant post-photorefractive keratectomy diurnal variation in visual acuity, spherical equivalent, or keratometry in the group studied. Diurnal variation in post-photorefractive keratectomy intraocular pressure was not significantly different between patients' treated and untreated eyes. CONCLUSION: Photorefractive keratectomy does not appear to result in diurnal variation in visual acuity, spherical equivalent, or keratometry post-operatively, nor does it seem to effect normal diurnal variation in intraocular pressure.     

Localization of melatonin in the digestive tract of the rat. Effect of maturation, diurnal variation, melatonin treatment and pinealectomy

Using highly specific antibodies, melatonin was identified in the gastrointestinal tract of the rat as early as several hours of postnatal life. Its amount progressively increased and reached the adult levels around day 21. Exogenously administered melatonin concentrates in all parts of the gastrointestinal tract with most pronounced accumulation in the colon and the rectum. Diurnal variations were not clearly demonstrated in any part of the alimentary canal. Pinealectomy had no visible effect on the levels of melatonin in the tissues investigated. A hypothesis of ontogenic as well as phylogenic development of production of N-acetylated indolealkylamines in the pineal and the extrapineal tissues and their physiological role is presented.     

Ethnic variation in the prevalence of obesity in North American children and youth

The estimated prevalence of obesity in North American children and youth (6 to 17 years) in the 1960s through the 1980s is reported. Use of the triceps skinfold and BMI independently and in combination as indicators of obesity provides different estimates of prevalence due to ethnicity. With the triceps skinfold as the indicator, there is an increase in the prevalence of obesity and a reduction in variation between Black and White children and youth from the 1960s to 1980; however, with the BMI as the indicator, there is no change in the prevalence of obesity and negligible ethnic difference in these national data sets. On the other hand, the prevalence of obesity has increased over time in Mexican American and American Indian children and youth. Data for American children and youth of Asiatic ancestry are limited.     

Rates of change in peak expiratory flow and in diurnal variation in peak flow in patients recovering from acute severe asthma

Reexpression of the insulin-like growth factor type II (IGF-II) gene has recently been described in hepatocellular carcinoma (HCC). In this study, we used a nonisotopic in situ hybridization method to analyze the expression of IGF-II mRNA in a series of 28 HCCs arising on cirrhotic and noncirrhotic livers. An immunohistochemical method was used to detect IGF-II peptide. Hepatitis B virus (HBV) status and the histological differentiation degree were also evaluated. Increased expression of IGF-II mRNA was found in 4 of 28 HCCs, and 7 of 17 cirrhotic patients showed IGF-II mRNA in the cirrhotic nodules surrounding the HCC. A slightly higher rate of positivity for IGF-II mRNA was found in the HBV-negative patients than in HBV-positive ones. Positive immunostaining for the IGF-II peptide in the HCC and/or in surrounding cirrhotic nodules was found in 10 of 28 cases. The normal hepatocytes of the noncirrhotic patients were always negative for IGF-II peptide and mRNA. The similarities between our results and those from experimental models in woodchucks seem to support the concept that heterogeneous phenotypic groups could exist in human HCCs.     

Surgical procedure for modifying the duodenum in cattle to measure bile flow and the diurnal variation in biliary manganese, iron, copper and zinc excretion

A surgical procedure is described for modifying the duodenum of cattle so that bile can be sampled and its rate of flow measured for long periods. In 12 steers, aged three months to three years and weighing between 50 and 650 kg, bile flow ranged from 2 to 12 ml per minute, the rate of flow increasing with bodyweight. The rate of flow expressed as ml per minute per 100 kg bodyweight decreased as bodyweight increased, the regression equation being in (ml per minute per 10 kg) = 1.65-0.0022 x where x = bodyweight (kg), r = 0.871. The mean concentrations of copper, iron, manganese and zinc in bile were 8.2, 6.2, 17.1 and 3.3 mumol per litre respectively. The concentration of iron was the least variable between the steers. The average total cholate concentration was 100 mmol per litre and total solids ranged from 5.4 to 7.2 per cent. Diurnal patterns in bile flow and trace element excretion were measured in four adult steers during a period of 38.5 hours. Although the rate of excretion of iron, zinc and copper and bile flow varied throughout the period, changes could not be associated with feeding or time of day. The concentration of manganese in bile and its excretion rate varied in a reproducible manner which may be related to feeding activity. The mean output of the four trace elements in bile from the four steers during 24 hours was, copper 37.7 mumol, iron 68.0 mumol, manganese 80.3 mumol and zinc 59.6 mumol.     

Is there a diurnal variation in the susceptibility of mouse skin to the tumorigenic action of methylcholanthrene? A study of tumour yield with special reference to the variation between cages

Skin tumour development was studied in groups of mice painted once with 125 mug of 3-methylcholanthrene (MCA) either at 12:00 or at 24:00 MET. Eight animals were kept in each box. The animals were observed weekly for 20 months and all tumours were registered. There was no difference between the two groups of mice as regards tumour induction time or number of papilloma-bearing mice. In the groups of mice treated at 24:00 the number of skin tumours to develop was 9 per cent higher than in groups of mice treated at 12:00. This difference in papilloma yields is not statistically significant. Among female mice painted at 24:00 carcinoma-bearing animals were significantly more numerous (50 per cent) than among those painted at 12:00, whereas there was no difference between the groups of male mice. Considering the groups collectively (males + females), the intergroup difference (17 per cent) in advantage of painting at 24:00 was barely significant (0.5 less than p less than 0.10). There was no difference between the groups as regards the total number of carcinomas to occur. When the tumour yields in individual boxes were found to vary greatly. The slight increase in tumour yield after night painting correlates with the circadian variation in proliferative activity of the epidermidis. Previous reports in the literature have shown similar differences. Further investigations and better methods seem necessary before a definite conclusion can be drawn concerning a possible diurnal variation in the susceptibility of mouse skin to chemical carcinogenesis. It is also emphasized that it is necessary to exercise great caution when the results of classical epidermal chemical carcinogenesis experiments are to be interpreted. It seems necessary to observe animals for at least 15 months before any conclusion can be drawn.     

Diurnal variation in intragastric pH in children with and without peptic ulcers

Diurnal variation in intragastric pH in children with peptic ulcers has not been previously reported. Therefore, we monitored intragastric pH during a 24-h period in 82 subjects (10 children with gastric ulcers, 9 children with duodenal ulcers, 58 non-ulcer (comparison group) children, and 5 healthy adults) using a monopolar glass pH electrode. The percent of readings below pH 2, 3, 4, and 5 for each subject was calculated and compared between the comparison group and the two ulcer groups using means and slopes (i.e. changes in percent with age for each group) of percent readings for each pH analysis. In the comparison group children, gastric acidity increased with age and reached adult levels by 14 y. Mean readings for all pH analyses in gastric ulcer children were lower than those in age-adjusted comparison children (p < 0.05). The slopes of the relationships between age and the percent time below any pH for the gastric ulcer group were different from those in the comparison group (p < 0.05) and were negative for all pH analyses. The mean time below pH 2 in children with duodenal ulcers was greater than that in age-adjusted comparison children (p = 0.002). The slope of the relationship between age and the percent time below pH 2 in the duodenal ulcer group was different from that in the comparison group (p < 0.05). Gastric acidity in children with primary gastric ulcers was reduced during childhood, but in children with primary duodenal ulcer, gastric acidity was at or above adult levels.     

Studies on diurnal fluctuation and variation among days in the relative frequencies of the stages of the cycle of seminiferous epithelium in the mouse (author''s transl)]

The clinical records of 7 patients referred to the National Jewish Hospital and Research Center over a 6-year period for evaluation of an abnormal chest x-ray and repeated sputum isolates of rapidly growing mycobacteria (Runyon's Group IV) were reviewed to determine the potential pathogenicity of these organisms. Mycobacterium fortuitum was isolated from 5 patients and Mycobacterium chelonei from 2. Haemoptysis, cough and weight loss were prominent in 6. Three had rheumatoid arthritis. Although two demonstrated cutaneous anergy, lymphocyte responsiveness to PHA was normal. PPD-F was not useful in skin testing or in the in vitro evaluation of lymphocyte function. Histologic examination of the lungs of 2 patients demonstrated caseating granulomata. One patient died of massive pulmonary haemorrhage soon after intiation of therapy. Multi-drug treatment regimens generally resulted in progressive sterilization of the sutum and improvement in the appearance of the chest x-ray. We conclude that some rapidly growing mycobacteria can cause potentially fatal cavitary lung disease and that intensive anti-tuberculosis therapy may successfully alter its course.     

Ascorbate in the corneal epithelium of diurnal and nocturnal species

PURPOSE: To compare the amount of ascorbic acid in the corneal epithelium of various species to unveil possible differences between diurnal and nocturnal mammals. METHODS: Ascorbic acid was determined by high-performance liquid chromatography, using an LC-10 system (Shimadzu, Kyoto, Japan). RESULTS: Diurnal animals show a higher ascorbate concentration in the corneal epithelium than nocturnal animals. Ascorbate concentration is higher in the corneal epithelium than in the matching aqueous humor in diurnal and nocturnal species. The highest ascorbate concentration is found in the corneal epithelium of the reindeer. CONCLUSIONS: Ascorbate level in the corneal epithelium seems to vary in accordance with ambient radiation exposure of the respective species, just as in the aqueous humor. Both phenomena are regarded as environmental adaptations, and the ascorbic acid is suggested as protecting against photokeratitis and as acting as an ultraviolet filter for internal eye structures.