[Urodynamic study of lower urinary tract. VIII. Theoretical considerations of urethral resistance and bladder work in view of micturition energy (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Kondo.
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Two cases of redundant nerve roots syndrome are presented. Both cases displayed coiled and elongated nerve roots of cauda equina, associated with proliferated fibrous tissue on the ligamentum flavum or with spondylosis and disc protrusion compressing the caudal dural sac. The pathogenesis of the syndrome of redundant nerve roots is briefly discussed.
A counterimmunoelectrophoresis technique for detection of serum myoglobin (Mb) was improved using non-ionic polymer dextran. Precipitin lines were graded according to their strength, which was ascertained by radioimmunoassay data. By this method, serum Mb in concentrations of 500 ng./ml. before stain and of 200 ng./ml. after stain were detected. Electrophoretic time was 60 minutes. Among 32 cases of acute myocardial infarction (AMI) whose blood samples were collected within 24 hours after disease onset, precipitin lines were detected in 25 cases (78%) before stain and 31 cases (97%) after stain. Considering the early peak concentration time (approximately 10 hours) of serum Mb after AMI onset, diagnosis becomes more rapid and exact with this method, especially in severe cases.
Multiple neurinomas in the cauda equina were found in a 56-year-old patient, who had been suffered from left-sided sciatica for about one and half years. The origins were suspected in right L3 nerve root and left L4 nerve root. Multiple tumours in the cauda equina are not common; therefore, the authors discuss in this paper how rare the case is and about the difficulties of the differential diagnosis between herniated disk and tumour in the cauda equina.
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Several micturition parameters in healthy volunteers have been studied with digital computer analysis. The accuracy of the uroflowmeter has also been tested. Total voiding time, average flow rate, maximum flow rate, volume and time at maximum flow rate are all the function of volume voided. The first half of urinary volume is rapidly evacuated in the first one third of the total voiding time, and the rest in the remaining two thirds of the voiding period. When the constant stream hits at the center of the disk, the response of the flowmeter is fairly good. Once the urinary stream is accelerated and/or hits at the edge of the disk, the response is not reliable.
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Effects of single exposure to toluene on Sidman avoidance response in rats were studied. The animals, in which the behavioral base line had been established, were exposed 0, 1,000 and 3,000 ppm of toluene vapor for 4 hours and the effects on the behavioral pattern were investigated using Sidman avoidance test for one hour after the termination of toluene exposure. 1) Exposure to 0 or 1,000 ppm of toluene did not produce marked change on the operant behavior. After the exposure to 3,000 ppm, the animals produced increased responses with shortening of the inter-response-time (IRT) and no changes in shock counts from the beginning to the 50 min. zone of the Sidman avoidance test when compared with those before exposure. The behavioral change indicated here appears to be caused by a temporary breakdown of the established timing of lever pressing. 2) The effect of toluene on the operant behavior was strongest immediately after the termination of the exposure and the behavior recovered in about an hour. This result suggested that toluene is rapidly transfered to and removed from the brain.
Within the past 6 months we paid special attention to the superior facet syndrome on examining the patients with lumbar pain at the outpatient clinic. Out of 264 patients who complained of lumbago or sciatica, this syndrome was suspected in three patients and verified in all of them by operation. Neurologically it was difficult to differentiate this syndrome from disc protrusion or other related conditions. On the other hand, plain roentgenographic examinations were valuable: horizontal portion of the superior facet was larger and thicker than normal so that the a-p view of the lumbar spine showed a large bulbous processes joining in the frontal plane, and a narrowing of the interlaminal spaces was seen in some case. A differential diagnosis between this syndrome and the major type of lumbar canal stenosis can be made by means of dynamic myelography. Although the myelography with watersoluble contrast medium reveals nerve roots better than Myodil myelography, identification of the nerve roots at the lateral recesses is not necessarily easy, and the final diagnosis has to be made at operation.
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A sensitive and specific radioimmunoassay has been developed for the measurement of serum Mb. immunization of rabbit with human Mb yielded anti-Mb antibody which was purified by affinity chromatography. Human hemoglobin, CK, and the component of serum per se did not appear to cross-react with the antibody. Mb was radiolabeled by the chloramine T method. The radioimmunoassay method could detect as little as 0.3 ng of Mb and was not affected by hemolysis. Information is also given on precision, recovery, and specimen preservation. Mb levels could be detected in all of 120 normal adults, and the values ranged between 1 and 28 ng/ml (mean, 13.1 +/- 6.1). No sex difference was observed. Levels were markedly elevated in all the patients with progressive muscular dystrophy, especially in the Duchenne type at the level of 40 to 1700 ng/ml. It was also noticed that about 70% of female gene carriers of Duchenne type had a slightly increased Mb level. An elevated serum Mb was also noted in polymyositis. In every case of acute myocardial infarction, serum Mb levels were increased, peak values ranging from 175 to 4400 ng/ml and averaging 1162 +/- 287.9. Mb levels were elevated faster and peaked earlier (within 6 to 12 hr after the attack) than serum CK activity and returned to nearly normal range within 3 to 4 days. The increase in serum Mb was also noticed in shock and surgery. These data indicate that radioimmunoassay of Mb is a useful test for judging the myolytic state of myogenic myopathies and for early detection of myocardial infarction.
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