• Title/Summary/Keyword: Bladder dysfunction

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Effect of different contraction methods on pelvic floor muscle contraction in middle-aged women

  • Kim, Ji-Seon;Choi, Jong-Duk;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
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    • v.4 no.2
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    • pp.103-107
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    • 2015
  • Objective: Pelvic floor muscles (PFMs) form the base of the abdomino-pelvic cavity and also the PFMs function is important for urinary continence. PFMs training (PFMT) is considered to be the first method for PFM dysfunction. This study demonstrated correct PFMs contraction among commonly used different contraction methods for PFMT. Design: Cross-sectional study. Methods: In this study, nineteen middle-aged (40-70 years) women participated. To evaluate PFM function, ultrasonography was used to measure the distance of the bladder base movement. The distance of the PFM movements were calculated at rest and during the other contractions. The following four different contraction methods were performed randomly: (1) PFM contraction, (2) abdominal drawing-in maneuver (ADIM), (3) anal contraction, and (4) hip adductor muscle contraction. The participants held the contraction for 3 seconds for a total of 3 times with a 30 seconds rest period between each trial. The mean of three measurements in each position were obtained and compared with that in the resting position. Results: The bladder base movement values were significantly greater when comparing PFM with ADIM and hip adductor contractions (p<0.05). The bladder base movement values were significantly greater when comparing ADIM and anal contractions with hip adductor contractions (p<0.05). Conclusions: The results of this study suggest that performing PFM contractions is the best method among the common methods for PFMT. Performing PFM contractions was more effective than the other contraction methods.

The Relaxing Effect of ${\alpha}$-Defensin 1 on the Adrenergic Responses of Rat Bladder

  • Lee, Shin-Young;Kim, Don-Kyu;Kim, Kyung-Do;Myung, Soon-Chul;Lee, Moo-Yeol
    • The Korean Journal of Physiology and Pharmacology
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    • v.15 no.3
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    • pp.143-147
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    • 2011
  • Defensins, cysteine-rich cationic polypeptides released from neutrophils, are known to have powerful antimicrobial properties. In this study, we sacrificed 30 rats to investigate the effects of ${\alpha}$-defensin 1 on detrusor muscle contractions in isolated rat bladder. From the experiments we found relaxing effects of ${\alpha}$-defensin 1 on the contractions induced by phenylephrine (PE) but not by bethanechol (BCh) in the detrusor smooth muscles. To determine the mechanisms of the effects of ${\alpha}$-defensin 1, the changes of effects on PE-induced contraction by ${\alpha}$-defensin 1 pretreatment were observed after pretreatment of Rho kinase inhibitor (Y-27632), protein kinase C (PKC) inhibitor (Calphostin C), potent activator of PKC (PDBu; phorbol 12,13-dibutyrate), and NF-${\kappa}B$ inhibitors (PDTC; pyrrolidinedithiocarbamate and sulfasalazine). The contractile responses of PE ($10^{-9}{\sim}10^{-4}$ M) were significantly decreased in some concentrations of ${\alpha}$-defensin 1 ($5{\times}10^{-9}$ and $5{\times}10^{-8}$ M). When strips were pretreated with NF-kB inhibitors (PDTC and sulfasalazine; $10^{-7}{\sim}10^{-6}$ M), the relaxing responses by ${\alpha}$-defensin 1 pretreatment were disappeared. The present study demonstrated that ${\alpha}$-defensin 1 has relaxing effects on the contractions of rat detrusor muscles, through NF-${\kappa}B$ pathway. Further studies in vivo are required to clarify whether ${\alpha}$-defensin 1 might be clinically related with bladder dysfunction by inflammation process.

Sophora flavescens Extracts Have Therapeutic Effects on Overactive Bladder Syndrome by Potentiation of Large-Conductance Calcium-Activated Potassium Channel

  • Jo, Heeji;Lee, Hyun Jun;Jang, Sung Joo;Moh, Sang Hyun;Cheong, Jae Hoon;Park, Chul-Seung
    • Natural Product Sciences
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    • v.27 no.3
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    • pp.193-200
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    • 2021
  • Sophora flavescens Ait. (Fabaceae) is a medicinal plant widely founded in Northeast Asia, and its dried root (Kushen) has been used as a traditional Chinese herbal medicine. The therapeutic effects of Kushen in micturition disorder was not investigated comprehensively yet. In the present study, we examined and compared the efficacy of three batches of Kushen extract using different ethanol content through an in vitro cell-based assay. Among them, we chose the batch with the highest efficacy and augmented the volume of extract for industrial purpose. The bulk extract was examined in its efficacy in the in vitro cell-based assay, and the therapeutic effects through an in vivo behavioral assay of OAB rats. The main components of the extracts were analyzed by liquid chromatography. Cytotoxicity of the extracts was investigated by MTT assay. The overall efficacy of the extract was as much as, or more than, kurarinone, a potent BKCa channel activator. Thus, the extract was a potent relaxant of urinary smooth muscle by upregulating the activity of BKCa channel. The Kushen extract could be explored as an alternative medicine against overactive bladder patients indicating severe dysfunction of BKCa channel.

Surgical Management and Outcome of Tethered Cord Syndrome in School-Aged Children, Adolescents, and Young Adults

  • Kang, Joon-Ki;Yoon, Kang-Jun;Ha, Sang-Su;Lee, II-Woo;Jeun, Sin-Soo;Kang, Seok-Gu
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.468-471
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    • 2009
  • Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

The Effects of Ginseng Saponin on Relaxation of Smooth Muscle in the Lower Urinary Tract and the Corpus Cavernosum (인삼 사포닌이 하부요로와 음경해면체 평활근의 이완작용에 미치는 효과)

  • Jung, Hee-Chang;Oh, Tae-Hee
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.52-61
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    • 2006
  • Background: Korean ginseng (KG) has been used as a general tonic, and for voiding dysfunction for a long time in oriental society. However, scientific basic studies on the use of KG, have been rare, especially for voiding and erectile dysfunction. This study was performed to investigate the effects of KG on voiding and erectile function by examining the effects of total saponin (TS) on the bladder, urethral and penile cavernosal smooth muscle. Materials and methods: To examine the effects of TS, NewZeland white rabbits were used to obtain tissue strips from the smooth muscle of the bladder, proximal urethra and corpus cavernosum. Adult Sprague Dawley rats were used to examine the changes in urodynamic findings and penile erection after administration of TS. Results: In proximal urethral strips, the rate of relaxation of the proximal urethra was increased from $9.0{\pm}2.9$ to $33.7{\pm}4.8%$ in a dose-dependent manner when the concentration of TS was added accumulatively from 0.25 mg/ml to 4.0 mg/ml (p<0.05). However, no significant response was observed in the bladder strips within these concentration ranges. For the corpus cavernosal strips, the rate of relaxation ranged from $5.8{\pm}2.1$ to $36.7{\pm}5.8%$, increasing in a dose-dependent manner when TS was increased from 1.0 mg/ml to 4.0 mg/ml (p<0.05). After administration of 0.1 ml of TS (32 mg/ml) in the rat, the bladder pressure was $37.5{\pm}8.5$ mmHg at $52.1{\pm}7.0$ sec. during isovolumetric bladder contraction, showing no significant differences from $35.7{\pm}7.8mmHg$ and $50.7{\pm}7.2$ sec, respectively, before treatment. However, when 0.1 ml of TS (32 mg/ml) was administered, the relative reduction of urethral pressure was $6.9{\pm}0.5mmHg$ at $62{\pm}7.5$ sec, which was significantly higher compared to $4.6{\pm}1.1mmHg$ at $45{\pm}10$ sec before treatment (p<0.05). For the cavernosal injection study, the change in intracavernosal pressure (${\Delta}ICP$) was examined after administering 0.1 ml of TS. The cumulative additions of TS at concentrations from 0.5 mg/ml to 32 mg/ml increased ${\Delta}ICP$ from $1.3{\pm}0.5$ to $21.3{\pm}7.8mmHg$ in a dose-dependent manner (p<0.05). The duration of tumescence was from $0.3{\pm}0.1$ to $5.2{\pm}0.2$ min, showing dose-dependent increase (p<0.05). Furthermore, the cumulative addition of TS at concentrations from 0.5 mg/ml upto 32 mg/ml did not cause any significant change in systemic blood pressure. Conclusion: These results suggest that ginseng improves voiding functions, which is mainly achieved by TS relaxing the proximal urethra, the most important part of the bladder outlet function. In addition, ginseng safely induced a penile erection hemodynamically by relaxing the corpus cavernosum.

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A Case of Acute Disseminated Encephalomyelitis by Enterovirus 71 (Enterovirus 71에 의한 급성 파종성 뇌척수염 1례)

  • Hwang, Hui Sung;Cho, Sung Hee;Kim, Sun Mi;Jung, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.114-122
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    • 2003
  • Acute transverse myelitis is a focal inflammatory disorder of the spinal cord, resulting in motor, sensory, and autonomic dysfunction which would be the initial manifestation of acute disseminated encephalomyelitis. A 7-year-old boy developed weakness of lower extremities associated with dizziness and urinary dysfunction after upper respiratory infection. He showed gradual decreased mental status with respiratory difficulty. Spinal MRI showed diffuse spinal cord swelling from C3 to C7 levels with high signal intensity lesion on T2-weighted image, which is involved central gray matter of spinal cord from C3 to C7, proximal portion to cervicomedullary junction, and distal portion to the cornus medullaris. After the supplement of high dose intravenous methylprednisolone therapy with ventilator care, he showed gradual improvement. The brain MRI after extubation showed multifocal high signal intensity lesions in bilateral cerebral white matter on axial T2-weighted image. Immunoserologic test(neutral antibody test) for enterovirus 71 was positive. Dysfunction of the bladder lasted for 33 days. We report a case of transverse myelitis which progressed to acute disseminated encephalomyelitis by enterovirus 71 in a 7-year-old boy with related literatures.

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R&D Trends in Bioelectronic Medicines (전자약 연구개발 동향)

  • Kim, Y.H.;Jung, S.D.;Lee, S.K.;Kim, H.J.;Byun, C.W.;Lee, J.I.;Song, K.B.;Kang, S.W.
    • Electronics and Telecommunications Trends
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    • v.35 no.3
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    • pp.98-110
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    • 2020
  • Precise detection and modulation of electrical signal patterns passing through peripheral nerves connecting organs and brainstems, referred to as electroceuticals or bioelectronic medicines, have emerged as a new type of treatments for neural disorders and chronic diseases. With the rapid advancements in neural interface technologies, electroceuticals are the focus of treatments for these disorders or diseases. In this paper, we introduced electroceuticals as an extension of neuromodulation for the treatment of chronic diseases, such as diabetes, rheumatoid arthritis, obesity, and bladder dysfunction, without side effects that are unavoidably elicited when conventional drugs are taken. Further, this paper reviewed the anatomy of the peripheral nervous system, treatment examples for chronic diseases, technological demands for peripheral nerve interfacing, global R&D programs and market trends for electroceuticals, and prospects on electroceuticals.

The Effect of Lumbar Sympathetic Block in Interstitial Cystitis -A case report- (사이질방광염에서 요부 교감신경차단술의 효과 -증례 보고-)

  • Jung, Jai Yun;Jung, Ji Won;Kim, Young Ik
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.208-209
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    • 2005
  • Interstitial cystitis is an extremely painful and distressing condition, characterized by severe suprapubic pain, which increases with bladder filling and is relieved by voiding. The daily frequency of micturition may approach 100 times, but no incontinence is observed. The symptoms persist throughout the night, which consequently affects sleep. The etiology of this condition is still unknown, but includes infection, autoimmune response, allergic reaction, neurogenic inflammation, epithelial dysfunction and inherited susceptibility. Herein, a case of interstitial cystitis, with severe symptoms, which was successfully treated with lumbar sympathetic block, is reported.

Function Disease Symptom And Organ Coordination of Tri-Energizer Based on the Materiality of Tri-Energizer (삼초유형(三焦有形)으로 살펴본 삼초(三焦)의 기능(機能), 병증(病證) 및 장부배합(臟腑配合))

  • Yoon, Chang-Yeol
    • Journal of Korean Medical classics
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    • v.26 no.2
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    • pp.1-7
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    • 2013
  • Objective & Method : By investigating physiological function of tri-energizer, symptoms, and organ coordination, we obtained following conclusion. Tri-energizer is the membrane structure that surrounds the five visceral organs and six hollow organs, and filled with fluid. Tri-energizer acts as the passage for the flow of qi energy. Result & Conclusion : Therefore, dysfunction of the tri-energizer is caused by abnormal evaporation and metabolism. Upper-energizer regulates cardiopulmonary function, middle-energizer regulates spleen and stomach functions, and lower-energizer regulates liver, kidneys, small and large intestines, and bladder functions. Such a functional specialization is possible by receiving the source of qi through the wall wrapping around the internal organs. Tri-energizer represents the exterior and interior relationship by acting as the membrane structure supporting the five visceral organs and six hollow organs and at the same time, as the pericardium surrounding the heart.

Antibiotics and Probiotics Prophylaxis for Recurrent Urinary Tract Infection in Children

  • Lee, Jung Won
    • Childhood Kidney Diseases
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    • v.20 no.1
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    • pp.1-5
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    • 2016
  • Since many years, continuous low dose antibiotic prophylaxis (CAP) has been used for children at a risk for recurrent urinary tract infection (UTI), especially those with vesicoureteral reflux (VUR). The incidence of recurrent UTI has been shown to be higher in children with VUR with bladder and bowel dysfunction (BBD) than in those with VUR without BBD. Therefore, CAP has been recommended for children with BBD and VUR because of the increased risk of UTI. However, the use of CAP has become highly controversial because of bacterial resistance developed due to antibiotic over-usage. The preventive effects of probiotics have been proved in various adult urogenital infections, and the antimicrobial activities of lactobacilli against uropathogens have been demonstrated in previous in vitro studies. However, a critical assessment of their efficacy in children with UTI is lacking. The importance of the use of urogenital probiotics is that it is a natural approach that replenishes the depleted normal flora to create a better environment to fight off uropathogens. Probiotics have a great potential, particularly today with the increasing threat of antibiotic-resistant microorganisms.