Bladder neck competency at rest in women with incontinence

PURPOSE: We determine the presence of an open bladder neck during video urodynamic studies and relate that finding to the presence of stress urinary incontinence. MATERIALS AND METHODS: Patients presenting with urinary incontinence, voiding dysfunction or pelvic floor prolapse underwent video urodynamics. With the patient upright and after 200 ml. contrast material had been instilled into the bladder the bladder neck was viewed to determine if it was open or closed. At that point the abdominal leak point pressure was measured. RESULTS: Of 102 women, average age 56.5 years (range 31 to 82), 13% had an open bladder neck and demonstrable stress incontinence on video urodynamics with an average abdominal leak point pressure of 45 cm. water (range 26 to 90). Of those with stress incontinence on urodynamics 23% had an open bladder neck. No continent patient had an open bladder neck. CONCLUSIONS: The presence of an open bladder neck with the bladder filled to 200 ml. correlates strongly with the presence of stress incontinence.     

Electromagnetic modes in conical transmission lines withapplication to the linearly tapered slot antenna

A transmission line analysis of the bow-tie antenna and the linearly tapered slot antenna (LTSA) is presented. These structures belong to the class of conical transmission lines defined here in terms of conical coordinates. A complete set of solutions of the Helmholtz equation is obtained exhibiting TE and TM modes. Modal fields are expressed by Lame (1837) and Bessel-Schelkunoff functions. TE and TM eigenmode analysis is particularized to the bow-tie structure. Bow-tie antenna and LTSA are shown to be dual conical transmission lines by the image method and Babinet's principle. The modes of LTSA are calculated on the basis of the results obtained for the bow-tie structure. The radiation pattern of the LTSA is computed as the integral of a closed-form expression of the dyadic Green's function weighted by the modal electric field distribution over the slot aperture. The obtained dominant mode radiation patterns are validated by measurements from the literature. The radiation patterns of the first two-order modes are calculated and compared     

Hallucinations, sleep fragmentation, and altered dream phenomena in Parkinson''s disease

Middle ear effusion has been considered the most common cause of vestibular disturbance in children. However, there have been only a few studies on vestibular disturbance in children with otitis media with effusion. We studied the vestibular systems of 30 children with otitis media with effusion aged 8 to 13 years and compared the results with 15 age- and sex-matched controls. A questionnaire relating to vestibular disturbance was given to patients and their parents. Spontaneous nystagmus and positional nystagmus were recorded by electronystagmography as diagnostic tests of the vestibular system. Romberg's and past-pointing tests were performed on children with otitis media with effusion and controls. After vestibular tests were completed, myringotomy was performed, and a ventilation tube was inserted. The questionnaire and the vestibular tests were repeated after the operation and during the first month after surgery. Our study showed that there was a history of vestibular disturbance in 33% of children with otitis media with effusion. Electronystagmography and Romberg's test findings demonstrated that 33% of the children had vestibular dysfunction (p < 0.05). After myringotomy with ventilation tube insertion, vestibular test results returned to normal, and symptoms related to vestibular disturbance improved. These findings confirm the assumption that middle ear effusion may affect the vestibular system, which can be resolved after myringotomy with ventilation tube insertion.     

Upper tibial hyperextension fractures in infants: another occult toddler''s fracture

Our study describes a newly designed stapedotomy prosthesis which consists of two components: (1) a platinum ribbon, and (2) a Teflon shaft. The first innovation is a flattened 'tab' on the posterior aspect of the platinum ribbon. The second innovation concerns the dual diameter cylinder-like shaft. Our prosthesis was implanted into 25 individuals, who underwent stapedotomy for stapes fixation, and the results are shown and discussed. Our innovations offer a proper and safe insertion of the prosthesis into the oval window associated with excellent manipulation and handling. At the same time, maximum visualization of the surgical field is achieved, while the stepped-down design of the shaft prevents the prosthesis protruding into the vestibule.     

Vasoactive intestinal peptide stimulation of human trabecular meshwork cell growth

PURPOSE: To demonstrate that vasoactive intestinal peptide (VIP), a 28-amino acid neuropeptide, is a growth factor of human trabecular meshwork (TM) cells in culture and in a corneoscleral explant organ culture treated with laser trabeculoplasty (LTP). METHODS: Proliferating human TM cells in cell cultures were incubated with VIP for 20 hours, followed by total cell number determination, using a Coulter counter. The percentage of proliferating TM cells was assessed, using an antibody against the proliferating cell nuclear antigen (PCNA). To test the growth effect of VIP on TM cells in situ, corneoscleral explants in organ cultures were first treated with argon LTP to initiate TM-cell proliferation and then were exposed to VIP for 48 hours. The mitotic TM cells were demonstrated immunocytochemically, using anti-PCNA in paraffin sections of the explants; and the total number of TM cells was determined after paraffin sections were counterstained by hematoxylin. RESULTS: Vasoactive intestinal peptide dose-dependently stimulated the proliferation of TM cells in cell culture. Treatment with 5 x 10(-10) M VIP resulted in a maximal increase of 40% in cell number. The effect of VIP was blocked by a VIP antagonist. The number of PCNA-stained TM cells and the total cell number in the TM in LTP-treated corneoscleral explants were increased by VIP. CONCLUSIONS: Exogenously applied VIP stimulated the proliferation of human TM cells in subconfluent cultures and in LTP-treated corneoscleral explants. In that LTP has been shown to increase the number of TM cells in situ, the growth stimulatory effect of VIP may help enhance this therapy.