Experimental model of bladder instability in rabbits

OBJECTIVE: Propose a new experimental model of bladder instability in rabbits after partial bladder obstruction. MATERIALS and METHODS: Thirty North Folk male rabbits, weighting 1,700 to 2,820 g (mean: 2,162 g) were studied. The animals were distributed in 2 experimental groups, formed by 15 rabbits each: Group 1 - clinical control. In this group there was no surgical intervention; Group 2 - bladder outlet obstruction. In this group, after anesthetizing the animal, urethral cannulation with Foley catheter 10F was performed and then an adjustable plastic bracelet was passed around the bladder neck. It was then adjusted in order to not constrict the urethra. The following parameters were studied in M1 - pre-operative period; M2 - 4 weeks post-operatively moments: 1)- urine culture; 2)- cystometric study; 3)- serum creatinine and BUN. RESULTS: Bladder weight was 2.5 times larger in the group with obstruction than in the control group. Cystometric evaluation showed a significant increase in maximal vesical volume in the final moment at Group G2. However, there was no statistically significant difference among the groups studied. There was no statistically significant difference between maximal detrusor pressure and vesical compliance in the different moments or in the studied groups. There was an absence of uninhibited detrusor contractions in all the animals in group 1, and involuntary contractions were detected in 93% of group 2 animals. There was no significant variation in BUN and serum creatinine either among the groups or in the same group. CONCLUSIONS: We observed in the group with obstruction a bladder weight 2.5 higher than normal bladders. We detected involuntary contractions in 93% of the animals in group 2, establishing this experimental model as appropriate to secondary bladder instability and partial bladder outlet obstruction.

Urodinâmica convencional versus cistometria simplificada para caracterização da incontinência urinária feminina

OBJETIVO: avaliar a concordância dos diferentes parâmetros urodinâmicos comparados à cistometria simplificada, permitindo uma diminuição na relação custo-benefício no diagnóstico da incontinência urinária de esforço (IUE) na mulher. MÉTODOS: foram coletadas e avaliadas retrospectivamente as informações contidas dos prontuários de trinta pacientes acompanhadas, no período de janeiro de 2000 a março de 2001. Todas foram submetidas a exame físico geral e ginecológico. O estudo urodinâmico foi realizado pela técnica convencional, utilizando-se aparelho Dynograph Recorder R-611. A cistometria simplificada foi realizada com auxílio de um equipo em Y de PVC (pressão venosa central), conectado a um sonda de Foley 14 F, que permitia tanto a infusão de soro fisiológico como a captação da pressão intra-vesical. Foram analisados os parâmetros: volume residual, capacidade vesical, complacência, presença de contrações involuntárias do detrusor e perdas urinárias aos esforços. Para determinação da proporção de concordância entre os métodos foram utilizados o teste de concordância de Pearson e o teste de Wilcoxon, para amostras relacionadas. RESULTADOS: a média de idade foi de 50 anos, com extremos variando de 28 a 70 anos. O índice de concordância entre os estudos, na demonstração das perdas urinárias aos esforços, foi de 67%. Para a detecção das contrações involuntárias do detrusor, a proporção de concordância foi de 90%. A média do volume residual encontrado na cistometria simplificada foi de 16,8 ml contra 2 ml da urodinâmica convencional, com diferença significativa (p < 0,01). A média de capacidade vesical máxima no estudo urodinâmico foi de 440,5 ml, enquanto que, na cistometria simplificada, foi de 387 ml (p < 0,05). A complacência vesical foi, em média, significativamente maior na cistometria simplificada (43,0 ml/cmH2O) quando comparada ao estudo urodinâmico (31,5 ml/cmH2O), com p < 0,01. CONCLUSÃO: Avaliações preliminares sugerem que a propedêutica uroginecológica associada à cistometria simplificada é uma opção a ser considerada na avaliação clínica e pré-operatória de pacientes com IUE em substituição à urodinâmica convencional, particularmente onde esta última não se encontra disponível. A cistometria simplificada é um exame acessível que é capaz de detectar contrações involuntárias do detrusor, assim como identificar perdas urinárias com relativa sensibilidade, proporcionando ao examinador noções fidedignas do comportamento vesical.

Improvement in embryo recovery using double uterine flushing

The objective of the present study was to evaluate the effects of double uterine flushing on the recovery of embryos/ova in cattle. Two hundred and ten embryo recovery procedures were conducted using a double uterine flushing method, and the results were compared with 432 conventional single-flushing procedures. Cyclic Limousin (n = 403) and Guzera (n = 239) donor cows received an intravaginal progesterone releasing device and 2 mg of estradiol benzoate on Day 0. Between Days 5 and 9, donors received decreasing doses of FSH, which ranged from 200 to 300 IU (Bos indicus) and 300 to 500 IU (Bos taut-us). on the afternoon of Day 7, donors received an injection of 500 mu g cloprostenol and progesterone implants were removed 12 It later (morning of Day 8). Artificial insemination was performed between 14 and 26 h after first detection of behavioral estrus. Cows were randomly assigned to have embryos recovered by a double-flushing method (n = 210) or the conventional single-flushing procedure (n = 432). For the double-flushing procedure, after first flushing the whole uterus with 1 L of Dubelco's Phosphate Buffered Saline (DPBS), a Foley catheter was positioned in the uterine body to permit refilling of the uterus with fresh DPBS (80-150 mL). The catheter was closed with the plunger of a disposable 5 mL syringe, and the donors were allowed to rest in a holding area for 30 min. Thereafter, a second flush was performed to recover the solution remaining in the uterus. Animals from the control group were subjected to a single uterine flush. From 2 10 double-flushing procedures, 1409 viable embryos were recovered. In comparison, from 432 cows receiving the single-flushing procedure, 1993 embryos were recovered. Double flushing increased (P < 0.05) the number of embryos recovered per procedure compared to single flushing (6.7 +/- 0.4 versus 4.6 +/- 0.2, respectively; mean +/- S.E.M.). When double flushing was performed, average recovered embryos/ova increased (P < 0.05) from 8.3 +/- 0.4 to 12.7 +/- 0.7 in Limousin and from 7.9 to 11.5 in Guzera. Also, utilization of double flushing increased (P < 0.05) the number of viable embryos from 4.7 +/- 0.3 to 6.9 +/- 0.5 in Limousin and from 4.5 +/- 0.4 to 6.4 +/- 0.7 in Guzera. Mean total embryos/ova was similar (P > 0.05) between the control group and after the first uterine flushing in the double-flushing group; therefore, both flushings were conducted efficiently. In conclusion, double uterine flushing increased embryo recovery in cattle. (C) 2004 Elsevier B.V. All rights reserved.

Uso de dilatador temporário em papilas mamárias de vacas, submetidas a lesões experimentais

Trinta e duas papilas mamárias de vacas da raça Holandesa, em período seco, foram submetidas a telotomia lateral que produziu defeito linear na mucosa da parte papilar do seio lactífero (PPSL). Houve excisão de um retângulo de mucosa de tamanho padronizado que provocou um defeito retangular na mucosa do PPSL, oposto à telotomia. Todas as telotomias foram suturadas e, aleatoriamente, em 16 delas foram introduzidas sondas de Foley de 2,7mm de diâmetro, formando o grupo de papilas com dilatador. A distensão dos balonetes das sondas de Foley provocou a dilatação da PPSL o que forçou a manutenção das sondas, por sete dias, na papila mamária. As 16 papilas restantes formaram o grupo de papilas sem dilatador. Foram realizadas videoteloscopias antes (dia 0) e após as telotomias (dia 8, após a retirada das sondas de Foley e dia 15). As avaliações morfológica e histológica do processo de cicatrização dos defeitos lineares e retangulares evidenciaram que o uso de dilatador na PPSL auxiliou na orientação cicatricial, mantendo a patência do seio lactífero em um maior número de papilas, quando os dois grupos foram comparados. A dilatação da PPSL interferiu na cicatrização das telotomias, e provocou maior número de alterações no epitélio de revestimento do seio lactífero.

Quantificação do interferon-tau durante o reconhecimento materno da gestação em fêmeas bovinas Bos taurus indicus

During the critical period of the maternal recognition, which occurs between days 15 and 19 of pregnancy, the conceptus must competently synthesize molecules capable of blocking the synthesis of prostaglandin F2α (PGF2α) and luteolysis. In cattle, the major macromolecule involved in suck blockage is the protein interferontau (IFN-τ). During the critical period, failures in the recognition of pregnancy determine embryonic mortality on up to 40% of inseminated cows. Data about IFN-τ in Bos taurus indicus are still scarce. Objective of this study was to quantitatively evaluate the presence of IFN-τ during the critical period for maternal recognition of pregnancy in uterine flushings obtained in vivo by Foley catheter (Days 14, 16 and 18 post estrus) or post-mortem (Day 18 post estrus). Multiparous, cyclic or pregnant zebu cows (Bos taurus indicus) on days 14, 16 and 18 post estrus were used for in vivo or post mortem uterine flushing collection. In both cases, a Ringer solution was used to wash the uterus of cows. Uterine flushings were concentrated by ultrafiltration and lyophilized. Proteins were separated by one-dimensional electrophoresis (SDS-PAGE) in a 15% polyacrilamide gel. Interferontau quantification in uterine flushings was performed by western blotting and densitometry. Non-specific protein bands were observed in both in vivo and post mortem uterine flushings. Interferon-tau was detected only in uterine flushings obtained from pregnant cows post-mortem (P<0.05). Optical density of protein bands was not affected by the day of the critical period, state (cyclic or pregnant) or interaction day x state. There was no effect of the conceptus weight or progesterone concentration on the day of uterine flushing collection in the optical density of the IFN-τ protein band. It was concluded that the detection and quantification of IFN-τ in the uterine environment of zebu cows, in these experimental?conditions, is only possible in uterine flushings obtained post-mortem.

Formação de biofilme cristalino de Proteus mirabilis em cateter urológico

The indwelling urethral catheter has an important role for patients with urinary retention, bladder obstruction, neurological damage and other diseases. Urine contains minerals which precipitate in alkaline pH, crystallize and block the urological catheter. The crystallization of the ionic components of urine occurs in the presence of urease, an enzyme produced by Proteus mirabilis. This bacterium adheres to inanimate surfaces and forms biofilms. The aim of this study was to investigate the formation of crystalline biofilm on the luminal surface of siliconized latex catheters by means of scanning electron microscope, after channeling artificial urine infected with Proteus mirabilis. The experiment was performed in vitro using a dynamic flow system. The artificial urine compounds were salts of calcium, magnesium, phosphates, urea and egg albumin, and it was infected with Proteus mirabilis ATCC 25933. The urine flow was stopped after crystallization of the ionic components. Crystallization was observed after alkalinization of urine. Scanning electron microscopy showed the presence of crystals and morphologies typical of bacilli embedded in an amorphous mass on the internal lumen of the catheter. The present study showed that catheter encrustation may limit the use of long-term indwelling catheter. © SBEB - Sociedade Brasileira de Engenharia Biomédica.

Efeitos da termoterapia induzida pela água na próstata: estudo experimental em cães

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação de biofilme de proteus mirabilis em modelo experimental de fluxo dinâmico

Pós-graduação em Biociências e Biotecnologia Aplicadas à Farmácia - FCFAR

Improving IRT parameter estimates with small sample sizes: Evaluating the efficacy of a new data augmentation technique

The 3PL model is a flexible and widely used tool in assessment. However, it suffers from limitations due to its need for large sample sizes. This study introduces and evaluates the efficacy of a new sample size augmentation technique called Duplicate, Erase, and Replace (DupER) Augmentation through a simulation study. Data are augmented using several variations of DupER Augmentation (based on different imputation methodologies, deletion rates, and duplication rates), analyzed in BILOG-MG 3, and results are compared to those obtained from analyzing the raw data. Additional manipulated variables include test length and sample size. Estimates are compared using seven different evaluative criteria. Results are mixed and inconclusive. DupER augmented data tend to result in larger root mean squared errors (RMSEs) and lower correlations between estimates and parameters for both item and ability parameters. However, some DupER variations produce estimates that are much less biased than those obtained from the raw data alone. For one DupER variation, it was found that DupER produced better results for low-ability simulees and worse results for those with high abilities. Findings, limitations, and recommendations for future studies are discussed. Specific recommendations for future studies include the application of Duper Augmentation (1) to empirical data, (2) with additional IRT models, and (3) the analysis of the efficacy of the procedure for different item and ability parameter distributions.

A novel approach for the treatment of pelvic abscess: transrectal endoscopic drainage facilitated by transanal endoscopic microsurgery access

Postoperative pelvic abscesses in patients submitted to colorectal surgery are challenging. The surgical approach may be too risky, and image-guided drainage often is difficult due to the complex anatomy of the pelvis. This article describes novel access for drainage of a pelvic collection using a minimally invasive natural orifice approach. A 37 year-old man presented with sepsis due to a pelvic abscess during the second postoperative week after a Hartmann procedure due to perforated rectal cancer. Percutaneous drainage was determined by computed tomography to be unsuccessful, and another operation was considered to be hazardous. Because the pelvic fluid was very close to the rectal stump, transrectal drainage was planned. The rectal stump was opened using transanal endoscopic microsurgery (TEM) instruments. The endoscope was advanced through the TEM working channel and the rectal stump opening, accessing the abdominal cavity and pelvic collection. The pelvic collection was endoscopically drained and the local cavity washed with saline through the scope channel. A Foley catheter was placed in the rectal stump. The patient's recovery after the procedure was successful, without the need for further intervention. Transrectal endoscopic drainage may be an option for selected cases of pelvic fluid collection in patients submitted to Hartmann's procedure. The technique allows not only fluid drainage but also visualization of the local cavity, cleavage of multiloculated abscesses, and saline irrigation if necessary. The use of TEM instrumentation allows safe access to the peritoneal cavity.

Using Mitrofanoff's principle and Monti's technique as a surgical option for bladder augmentation with a continent stoma: a case report

Abstract Introduction Hydronephrosis, reflux and renal failure are serious complications that occur in patients with neurogenic bladder associated with myelomeningocele. When the bladder compliance is lost, it is imperative to carry out surgery aimed at reducing bladder storage pressure. An ileocystoplasty, and for patients not suitable for intermittent catheterization, using the Mitrofanoff principle to form a continent stoma and the subsequent closure of the bladder neck, can be used. We report here, for the first time to the best of our knowledge, an association between two previously described techniques (the Mitrofanoff principle and the technique of Monti), that can solve the problem of a short appendix in obese patients. Case presentation A 33-year-old male Caucasian patient with myelomeningocele and neurogenic bladder developed low bladder compliance (4.0 mL/cm H2O) while still maintaining normal renal function. A bladder augmentation (ileocystoplasty) with continent derivation principle (Mitrofanoff) was performed. During surgery, we found that the patient's appendix was too short and was insufficient to reach the skin. We decided to make an association between the Mitrofanoff conduit and the ileal technique of Monti, through which we performed an anastomosis of the distal stump of the appendix to the bladder (with an antireflux valve). Later, the proximal stump of the appendix was anastomosed to an ileal segment of 2.0 cm that was open longitudinally and reconfigured transversally (Monti technique), modeled by a 12-Fr urethral catheter, and finally, the distal stump was sutured at the patient's navel. After the procedure, a suprapubic cystostomy (22 Fr) and a Foley catheter (10 Fr) through the continent conduit were left in place. The patient had recovered well and was discharged on the tenth day after surgery. He remained with the Foley catheter (through the conduit) for 21 days and cystostomy for 30 days. Six months after surgery he was continent with good bladder compliance without reflux and fully adapted to catheterization through the navel. Conclusion The unpublished association between the Mitrofanoff and Monti techniques is feasible and a very useful alternative in urologic cases of derivation continent in which the ileocecal appendix is too short to reach the skin (i.e., in obese patients).

Psychophysische Skalierung visueller Merkmalssalienz

Die Messung der Stärke von Empfindungen hat in der Psychologie eine lange Tradition, die bis in die Zeit der Entstehung der Psychologie als eine eigenständige Wissenschaft gegen Ende des 19. Jahrhunderts zurückreicht. Gustav Theodor Fechner verband die Beobachtung Webers der Konstanz des Koeffizienten des eben merklichen Unterschieds zu der Vergleichsintensität (sog. "Weber-Quotient") mit der Annahme einer sensorischen Schwelle, und entwickelte daraus erstmals eine Skala für die Stärke von Empfindungen. Die Fechner-Skala verwendet die Anzahl sukzessiver Schwellenschritte als natürliche, psychologische Einheit. Die Stärke einer Empfindung für eine gegebene Reizintensität wird ausgedrückt als die Anzahl von Schwellenschritten, die man gehen muss, um von keiner Empfindung bis zur in Frage stehenden Empfindung zu gelangen. Die Funktion, die den Zusammenhang von Reizintensität und der Anzahl nötiger Schwellenschritte beschreibt, ist stets logarithmisch und über sukzessive Schwellenmessungen für Reize aus den verschiedensten Sinnesmodalitäten bestimmbar. Derart sich ergebende Skalierungen heißen "indirekt", weil die in Frage stehende Reizintensität selbst nicht von der Urteilsperson bewertet wird. Intensitäten sind vom Urteiler nur mit anderen Intensitäten in Bezug auf ein "stärker" oder "schwächer", also ordinal, zu vergleichen. Indirekte Skalierungsmethoden eignen sich insbesondere, wenn der Reizeindruck flüchtig und von der absoluten Stärke her schwer durch den Urteiler zu quantifizieren ist. Ein typisches Beispiel hierfür ist die Auffälligkeit (Salienz) von visuellen Objekten, die in zufällig wechselnde Hintergründe eingebettet sind und dem Betrachter nur als ein rasches raumzeitliches Aufblitzen präsentiert werden. Die Stärke des Unterschieds in Merkmalen wie Helligkeit, Farbe, Orientierung, Schattierung, Form, Krümmung, oder Bewegung bestimmt das Ausmaß der Salienz von Objekten. Obschon eine Fülle von Arbeiten existiert zu der Frage, welche Merkmale und deren Kombinationen ohne Wissen des Ortes ihrer Präsentation automatisch starke Salienz ("Pop-Out") erzeugen, existieren bislang keine systematischen Versuche, die Salienz von Merkmalen für einen weiten Bereich von Merkmalsunterschieden zu erfassen und vergleichbar zu machen. Indirekte Skalierungen liegen vor für die Merkmale Kontrast (Legge und Foley, 1980) und Orientierung (Motoyoshi und Nishida, 2001). Ein Vergleich der Salienz über mehrere Merkmale und der Nachweis, dass die Salienz eine eigene, von der Merkmalsdimension unabhängige sensorische Qualität ist, steht aber bislang aus. In der vorliegenden Arbeit wird gezeigt, dass der Unterschied von Objekten zur einbettenden Umgebung hinsichtlich visueller Merkmale zu Salienz führt und diese Salienz unabhängig von dem sie erzeugenden Merkmal der Stärke nach skalierbar ist. Es wird ferner gezeigt, dass die Einheiten der für zwei Merkmale erhobenen indirekten Skalierungsfunktionen in einem absoluten Sinne gleich sind, solange sichergestellt ist, dass (i) keine alternativen Hinweisreize existieren und nur der reine Merkmalsunterschied von Objekt und Umgebung bewertet wird und (ii) das sensorische Rauschen in den aktivierten Merkmalskanälen für beide Merkmale gleich ist. Für diesen Aufweis wurden exemplarisch die Merkmale Orientierung und Ortsfrequenz ausgewählt und die Salienz ihrer Merkmalskontraste über Naka-Rushton-Funktionen, gewonnen aus den zugrundeliegenden Salienz-Inkrementschwellenmessungen, indirekt skaliert. Für das Merkmal Ortsfrequenz liegt hiermit erstmals eine indirekte Skalierung vor. Hierfür musste eine spezielle Messtechnik entwickelt werden, die die Bewertung reiner Ortsfrequenzunterschiede, frei von konfundierenden absoluten Ausprägungen der Ortsfrequenzen, sicherstellt. Die Methode ist in Kapitel 7 dargestellt. Experimente, die die konfundierende Wirkung absoluter Merkmalsausprägungen auf die Salienzmessung demonstrieren, sind in Kapitel 6 dargestellt. In Kapitel 8 findet sich ein empirischer Abgleich der Ergebnisse von Inkrement- und Dekrementschwellenmessungen, eine Messtechnik, die zur Erfassung von Unterschiedsschwellen im Extrembereich der Orientierungsunterschiede von 90° nötig ist. Kapitel 9 enthält den empirischen Aufweis der Transitivität der Gleichheitsrelation für Salienzmessungen von Orientierung und Ortsfrequenz durch Abgleich mit einem dritten Merkmal und erbringt damit den Beleg der merkmalsunabhängigen Erfassung von Auffälligkeit über die indirekte Skalierungsmethodik. Ferner wird dort die Wirksamkeit der Grundsalienz von Mustern, gegeben über externes Rauschen in den Merkmalen (sog. "Merkmalsjitter") für die Verschiebung des Nullpunktes der Skalierungsfunktion aufgezeigt. Im letzten Experiment (Kapitel 10) wird dann die Skalierung von Orientierung und Ortsfrequenz bei gleicher Grundsalienz der Muster verglichen und gezeigt, dass beide Skalen in einem absoluten Sinne gleiche Einheiten aufweisen (also gleiche Skalenzahlen gleiche sensorische Auffälligkeiten anzeigen, obwohl sie von verschiedenen Merkmalen stammen), wenn der Effekt des sensorischen Rauschens, der im Merkmal Orientierung nicht über die verschiedenen Schwellenschritte konstant ist, kompensiert wird. Die Inkonstanz des Effektes des sensorischen Rauschens im Merkmal Orientierung wird über die Veränderung der Steigung der psychometrischen Präferenzfunktion für die Vergleichsurteile der Orientierungssalienz für eine fest vorgegebene Ortsfrequenzsalienz greifbar, und der Effekt der Steigungsveränderung kompensiert exakt die Nichtlinearität in der für beide Merkmale erhobenen Salienz-Matchingfunktion. Im letzten Kapitel wird ein Ausblick auf eine mögliche Modellierung der Salienzfunktionen über klassische Multikanal-Feedforwardmodelle gegeben. In den ersten fünf Kapiteln sind einführend die Gebiete der indirekten Skalierung, der Merkmalssalienz und der Texturtrennung im menschlichen visuellen System dargestellt.

Characterization of Anaplasma phagocytophilum major surface protein 5 and the extent of its cross-reactivity with A. marginale

Major surface protein 5 (Msp5) of Anaplasma marginale is highly conserved in the genus Anaplasma and the antigen used in a commercially available competitive enzyme-linked immunosorbent assay (cELISA) for serologic identification of cattle with anaplasmosis. This study analyzes the degrees of conservation of Msp5 among various isolates of Anaplasma phagocytophilum and the extent of serologic cross-reactivity between recombinant Msp5 (rMsp5) of Anaplasma marginale and A. phagocytophilum. The msp5 genes from various isolates of A. phagocytophilum were sequenced and compared. rMsp5 proteins of A. phagocytophilum and A. marginale were used separately in an indirect ELISA to detect cross-reactivity in serum samples from humans and dogs infected with A. phagocytophilum and cattle infected with A. marginale. Serum samples were also tested with a commercially available competitive ELISA that uses monoclonal antibody ANAF16C1. There were 100% sequence identities in the msp5 genes among all of the A. phagocytophilum isolates from the United States and a horse isolate from Sweden. Sheep isolates from Norway and dog isolates from Sweden were 99% identical to one another but differed in 17 base pairs from the United States isolates and the horse isolate. Serologic cross-reactivity was identified when serum samples from cattle infected with A. marginale were reacted with rMsp5 of A. phagocytophilum and when serum samples from humans and dogs infected with A. phagocytophilum were reacted with rMsp5 of A. marginale in an indirect-ELISA format. Serum samples from dogs or humans infected with A. phagocytophilum did not cross-react with rMsp5 of A. marginale when tested with the commercially available cELISA. These results suggest that rMsp5 of A. phagocytophilum is highly conserved among United States and European isolates and that serologic distinction between A. phagocytophilum and A. marginale infections cannot be accomplished if rMsp5 from either organism is used in an indirect ELISA.