ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719427

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

ABSTRACTA rabbit experimental model was used to ascertain how epinephrine influences uptake of epidurally-administered [3H]-D-mannitol and [14C]-carboxyl-inulin into regions of brain and spinal cord. [3H]-D-mannitol and [14C]-carboxyl-inulin, 20 (iCi each, were distributed in normal saline (control) and normal saline with 0.03μM (1:200,000 diluted) epinephrine. These tracers were administered as bolus and slow epidural infusion for 90 min. Epinephrine decreased the uptake of [3H]-D-mannitol and [14C]-carboxyl-inulin into the serum collected at 15, 30, 45, 60, 75 and 90 min intervals during the administration of tracers. Epinephrine did not alter the uptake of [3H]-D-mannitol and [14C]-carboxyl-inulin into the regions of the brain (cerebrum, cerebellum, brain stem including midbrain and pons) and upper regions of the spinal cord (mid-cervical and mid-thoracic) compared to controls. The uptake of [3H]-D-mannitol and [14C]-carboxyl-inulin into the mid-lumbar region is significantly increased compared to the control. The differential uptake of [3H]-D-mannitol and [14C]-carboxyl-inulin into 1 cm thick sections of lumbo-sacral cord was significantly increased by epinephrine at the site of the epidural catheter placement, while sections of the cord distal on either end (thoracic and sacral ends) did not show significant differences compared to the control. The efficacy of epinephrine in increasing spinal cord uptake of hydrophilic [3H]-D-mannitol and [14C]-carboxyl-inulin may be attributed to its vasoconstrictive properties and its ability to increase vascular endothelial cell permeability across the blood-spinal cord barrier.

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719428

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

ABSTRACTThe causes of poor semen quality following spinal cord injury (SCI) are unknown. One possible mechanism is decreased testicular blood flow. Chronic testicular ischemia in non-SCI animals has been shown to have significant adverse impact on spermatogenesis. This study was designed to evaluate testicular blood flow following SCI in the Sprague Dawley rat. Testicular blood flows were determined in 11 rats with SCI at thoracic level nine (T9) and six sham control rats three days prior and three days and 14 days after SCI. Testicular blood flow velocity was measured with a Doppler flow probe. Blood flows were compared between groups using T-tests. There were no significant changes in blood flow in the sham operated rats three or 14 days after surgery. However, three days after SCI, blood flow had decreased in the SCI rats to 78±5 percent of the pre-SCI flow (t =-4.65 with 10 df, p<0.001). At 14 days after SCI, blood flow was still decreased to 77+8 percent, (t =-3.40 with 3 df, p<0.05). This study established that following SCI, testicular blood flow decreases in the Sprague Dawley rat.(J Spinal Cord/Wed; 19:183–185)

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719429

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

ABSTRACTThis study is a prospective multicenter cooperative survey of the evaluation and treatment of erectile dysfunction in men with spinal cord injury (SCI). Uniform database questionnaires were completed prospectively by patients seeking therapy for erectile dysfunction. Eighty-five SCI men aged 17–68 years (mean age=26±17) were enrolled. Mean duration of traumatic SCI was 3±3.2 years (Range=0.3–18 years). The level of injury was cervical in 20 patients, thoracic in 31, lumbar in 29 and sacral in five. Patients were fully evaluated and then counseled as to their therapeutic options. Twenty-eight chose to use a vacuum erection device (VED), 26 preferred pharmacological penile injection and five used both intracorporeal therapy and VED. The remainder were managed with marriage and sexual counseling in 10 patients, three underwent penile prosthesis placement and two used topical pharmacotherapy. Four patients used other forms of treatment and in nine no therapy was recommended. Of the patients that used pharmacologic injection only, 74 percent used papaverine as a single agent, 20 percent used papaverine with phentolamine, five percent used prostaglandin E (PGE1) alone and one percent used a mixture. Patients using injection therapy report sexual intercourse a mean of 3±3.4 times per month as compared with 5±3.2 times per month in those using VED. Five intracorporeal injection patients developed priapism while two patients using the VED developed subcutaneous bleeding and one developed penile ischemia. We conclude that although a spectrum of erectile dysfunction treatment is present among SCI centers, VED and pharmacological penile injection are by far the two most popular methods of treatment and papaverine is the most common drug. The incidence of complications is small in the model centers.(J Spinal CordWed; 19:186–189)

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719430

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

ABSTRACTCapsaicin is known to be neurotoxic for C-fiber afferents. We investigated the intravesical application of capsaicin in the treatment of detrusor hyperreflexia (DH) in seven patients (ages 23–52) with neurologic impairment. The patients were evaluated with both ice-water cystometry and formal video-urodynamic studies. Four biweekly courses of intravesical capsaicin treatment were administered using increasing concentrations (100μM, 500μM, 1 mM and 2 mM). Treatment effect was monitored using a bladder diary and urodynamic evaluation one month after capsaicin treatment. Prior to treatment, six of the seven patients demonstrated a positive ice-water test and DH. Two patients were not able to complete the study due to discomfort attributed to capsaicin. Five of the seven patients completed the four courses of increasingly concentrated capsaicin. Three patients noted symptomatic improvement while two did not. The mean urodynamic bladder capacity significantly increased from 124±39 ml pre-capsaicin to 231±62 ml one month post-cap-saicin in the three patients with symptomatic improvement (p<0.05). Urodynamic testing revealed that one of the six patients with a positive ice-water test lost that response after intravesical capsaicin. Intravesical capsaicin is a novel and promising treatment for detrusor hyperreflexia in neurologically impaired patients.(J Spinal Cord Med\19:190–193)

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719431

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

ABSTRACTIntermittent catheterization (ICP) is a well-proven effective means of urologie management for spinal cord diseased (SCD) persons who meet the following criteria: adequate low pressure bladder capacity (350–400cc minimum), adequate hand function, unobstructed urethra and compliant, understanding, continent, cooperative patients. Time-directed (Q4H-Q6H), ICP-obtained volumes on twenty-one patients revealed a majority of early, unnecessary as well as some late over-distended bladder catheterizations. The PCI 5000 or“Bladder Manager”, a miniaturized ultrasonic bladder volume measuring device developed by Diagnostic Ultrasound of Seattle, was evaluated. It allowed the patients to perform volume-directed ICP which results in less frequent catheterizations and prevents bladder overdistension.(J Spinal Cord Med-,19:194–196)

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719432

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

abstractLower urinary tract reconstruction has been performed on the spinal injured population at our institution since 1988. Careful pre-operative evaluation including a detailed history, physical examination and radiographic and/or urodynamic studies are usually obtained to determine which type of procedure would be most beneficial for each individual patient. Typically, patients receive either a cutaneous (i.e., Kock or Indiana) diversion or undergo a form of bladder augmentation (usually ileocystoplasty). Pre-operative findings and the patient’s history are carefully considered prior to choosing the appropriate procedure. Occasionally, a particular finding influences the decision. We describe a patient who received a hemi-Kock ileocystoplasty with a continent abdominal stoma who, in retrospect, would have benefitted from a supravesical diversion.(J Spinal Cord Med\19:197–200)

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719433

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

abstractWe present the first report of neurogenic lower urinary tract dysfunction associated with neurosarcoidosis. Urodynamic findings of detrusor hyperreflexia with detrusor-sphincter dyssynergia correlate with this patient’s magnetic resonance imaging (MRI) examination which found intramedullary involvement at the mid-thoracic level.(J Spinal Cord Meet,19:201–203)

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719434

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

ISSN:1079-0268    

DOI:10.1080/10790268.1996.11719435

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor