Biomedical subjects

Jian Guo Wen

Publications and source records attributed to Jian Guo Wen.

8 recordsLinked to original sources

PubMed2006

Is it possible to use urodynamic variables to predict upper urinary tract dilatation in children with neurogenic bladder-sphincter dysfunction?

OBJECTIVE: To investigate the possibility of using urodynamic variables to predict upper urinary tract dilatation (UUTD) in children with neurogenic bladder-sphincter dysfunction (NBSD). PATIENTS AND METHODS: The study included 200 children with NBSD, of whom 103 had UUTD and 97 did not; they were examined using routine urological, neurological and urodynamic methods. The group with UUTD was divided into three subgroups (group 1-3, from mild to severe hydronephrosis). A urodynamic risk score (URS) was calculated, including a detrusor leak-point pressure (DLPP) of >40 cmH2O, a bladder compliance (BC) of <9 mL/cmH2O and evidence of acontractile detrusor (ACD). RESULTS: The postvoid residual urine volume (PVR), DLPP, incidences of ACD and DLPP of >40 cmH2O were greater and the BC significantly less in groups 1-3 than in the control group. Moreover, the BC decreased, while the PVR, DLPP and the incidence of DLPP of >40 cmH2O were significantly higher in group 3 than in group 2. The relative safe cystometric capacity of groups 2 and 3 were lower, respectively, than that of the control and group 1, and the relative unsafe cystometric capacity (RUCC) and relative risk rate of cystometric capacity (RRRCC) were significantly greater with the severity of UUTD. The maximum detrusor pressure on voiding or at maximum flow rate, and the Abrams-Griffiths number for voluntary contractile bladders, of the UUTD group were significantly higher than those of the control group. There was a positive correlation between URS and UUTD. CONCLUSIONS: The selective use of urodynamic variables might be valuable for predicting the risk of UUTD in children with NBSD. Decreased BC, and increased DLPP and ACD are the main urodynamic risk factors, and they reciprocally increase the occurrence and grades of UUTD. The grades of UUTD are compatible with increases in RUCC, RRRCC and URS.

Adolescent↗

PubMed2006

Development of nocturnal urinary control in Chinese children younger than 8 years old.

OBJECTIVES: To estimate the development of nocturnal urinary control (NUC) with age in Chinese children younger than 8 years of age using cross-sectional and retrospective surveys. METHODS: We used a cross-sectional survey of 4754 children (1 to 8 years old), a retrospective investigation of 2745 children younger than 9 years old, and an anonymous questionnaire of 8222 children 9 to 18 years old . The children without NUC were subdivided into infant (1 to 3 years old), preschool age (4 to 6 years old), and primary school (7 to 8 years old) groups. RESULTS: The response rate to the cross-sectional and retrospective surveys was 90% and 89%, respectively. In the cross-sectional survey, the prevalence of children attaining NUC was 52% for those younger than 2 years of age, 76% for those aged 2 to 3 years, and 93% at age 8. Girls were more likely than boys to acquire NUC earlier. In the retrospective survey, the prevalence of children attaining NUC before age 2 was 17% and was 72% for those aged 2 to 3 years, and 98% by age 8. The proportion of nonmonosymptomatic bedwettings in children without NUC was 14%. Arousal difficulty and a positive family history were found in 67% and 11% of children with nocturnal wetting, respectively. The severity of bedwetting and arousal difficulty was significantly greater in infants than in preschool and school-age children. CONCLUSIONS: The results from the cross-sectional and retrospective surveys showed that the most important period of attaining NUC is 2 to 3 years of age. Nearly 90% of children attained NUC by the age of 5.

Adolescent↗

PubMed2006

Chronic prostatitis during puberty.

OBJECTIVE: To investigate the features of chronic prostatitis (CP) during puberty and the effects of biofeedback on young males with this disease. PATIENTS AND METHODS: In all, 40 patients were divided into two groups; group 1 included 25 pubertal patients with CP (mean age 16.5 years, sd 1.1) and group 2 was a control group including 15 patients (mean age 16.2 years, sd 1.2) with a normal lower urinary tract. National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores (three parts) were assessed individually in both groups. Expressed prostatic secretions and urine samples after prostate massage from group 1 were cultured to determine whether patients were infected with bacteria, and group 1 was categorized into various NIH types. Each patients in the two groups underwent urodynamics and group 1 were treated with biofeedback. RESULTS: In group 1, there were one, three and 21 patients with type II, IIIA and IIIB prostatitis. The incidence of staccato voiding and detrusor-sphincter dyssynergia (DSD), and the maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), maximum detrusor pressure (Pdetmax) and maximum urethral closure pressure (MUCP) between the groups were significantly different (P < 0.05). The total NIH-CPSI scores and all the subdomains between the groups before biofeedback were significantly different (P < 0.001). In group 1 the difference in NIH-CPSI scores and Qmax before and after biofeedback was significant (P < 0.05). CONCLUSIONS: The main type of CP during puberty is IIIB; the dominating symptom is a voiding disorder. The impact on life and psychological effects are substantial. Pubertal boys with CP have pelvic floor dysfunction and several abnormal urodynamic values, i.e. staccato voiding, DSD, decreasing Qmax, and increasing Pdetmax and MUCP. The effect of biofeedback strategies for treating pubertal CP is satisfactory.

Adolescent↗

PubMed2005

An epidemiological study of primary nocturnal enuresis in Chinese children and adolescents.

AIMS: Assessment of the prevalence of primary nocturnal enuresis (PNE) and its risk factors in Chinese children and adolescents in the central areas of mainland China. METHODS: A cross-sectional study of PNE was performed by distributing 11799 self-administered questionnaires to parents of 5-18-year-old students in 32 schools of Henan province China. The questionnaire asked about sociodemographic data, PNE data, physical or psychological disorders, and family stressors. The PNE children were divided into a pediatric group (age 5-12) and an adolescent group (age 13-18). RESULTS: The response rate was 88% (10383/11799) in which 10088 (85.5%) were qualified to enter the final statistical analysis. The overall prevalence of PNE was 4.07% (95%CI 3.68-4.46) and that of marked PNE was 1.46% (95%CI 1.23-1.69). PNE was significantly more in boys than in girls. The prevalence decreased with age without gender bias. Of all enuretic children, 21.17% had daytime urinary symptoms and 22.87% had a positive family history. Only 6.08% of PNE had sought professional help. The episodic severity of PNE, associated daytime symptoms, positive family history, and seeking for professional help in adolescent group were significantly higher than those of pediatric group. Age, inhabitation (living in rural or urban areas), arousal dysfunction, associated daytime symptoms and family history were found to be significant predictors of marked PNE. Among PNE cases with a positive family history, there was no significant difference in the familial distribution between boys and girls. CONCLUSIONS: The prevalence of age-related PNE from Chinese school children is lower than those reported from western countries and other Asian countries. Age, inhabitation (rural or urban), arousal dysfunction, associated daytime symptom and family history are significant as predictors of marked PNE. The misconceptions among Chinese parents require health education intervention.

Adolescent↗

PubMed2004

Early release of neonatal ureteral obstruction preserves renal function.

The incidence of congenital hydronephrosis is approximately 1% and is often associated with renal insufficiency. It is unknown whether early release is essential to prevent deterioration of renal function. Rats were subjected to partial unilateral ureteral obstruction (PUUO) on postnatal day 2. The obstruction was left in place or released after 1 or 4 wk. Renal blood flow (RBF) and kidney size were measured sequentially over 24 wk using MRI. In rats in which the obstruction was left in place, RBF of the obstructed kidney was progressively reduced to 0.92 +/- 0.17 vs. 1.79 +/- 0.12 ml.min(-1).100 g body wt(-1) (P < 0.05) after 24 wk. Similarly, glomerular filtration rate of the obstructed kidney was severely reduced at 24 wk: 172 +/- 36 vs. 306 +/- 42 microl.min(-1).100 g body wt(-1) (P < 0.05). These changes were preceded by development of severe hydronephrosis and obstructive nephropathy with a reduction in total protein content: 45 +/- 3 vs. 58 +/- 4 mg/kidney. Moreover, nonreleased PUUO caused a marked natriuresis (0.32 +/- 0.07 vs. 0.11 +/- 0.02 micromol.min(-1).100 g body wt(-1), P < 0.05) and impaired solute free water reabsorption (0.47 +/- 0.16 vs. 2.71 +/- 0.67 microl.min(-1).100 g body wt(-1), P < 0.05), consistent with a significant downregulation of Na-K-ATPase to 62 +/- 7%, aquaporin-1 to 53 +/- 3%, and aquaporin-3 to 53 +/- 7% of sham levels. Release after 1 wk completely prevented development of hydronephrosis, reduction in RBF and glomerular filtration rate, and downregulation of renal transport proteins, whereas release after 4 wk had no effect. These results suggest that early release of neonatal obstruction provides dramatically better protection of renal function than release of obstruction after the maturation process is completed.

Aging↗

PubMed2003

The effect of unilateral ureteral obstruction on renal function in pigs measured by diffusion-weighted MRI.

The objective of this study was to examine the effect of unilateral ureteral obstruction on the apparent diffusion coefficient (ADC) in pig kidney. Changes in ADC is suggested to reflect changes in the ratio of extracellular to intracellular volume. Thirteen pigs were allocated into three groups: 1) pigs subjected to acute unilateral ureteral obstruction (AUO) (n = 3), 2) pigs subjected to chronic partial unilateral obstruction (CPUO) (n = 3), and 3) control pigs (n = 7). The extra- to intracellular volume ratio was indirectly measured in both the ipsilateral obstructed kidney and contralateral non-obstructed kidney by the ADC of the renal tissue using diffusion-weighted echo-planar magnetic resonance imaging. ADC was 2.07 +/- 0.27 x 10(-3) mm2/s in the cortex and 2.10 +/- 0.24 x 10(-3) mm2/s in the medulla of normal control kidneys. In the obstructed kidney from the AUO group the ADC of the medulla was significantly reduced 24 hours after occlusion of the ureter (1.65 +/- 0.05 x 10(-3) mm2/s vs 2.10 +/- 0.24 x 10(-3) mm2/s; p < 0.05). Similarly ADC decreased slightly in the cortex of the ipsilateral kidney. In contrast, ADC of the ipsilateral kidney of CPUO pigs was increased both in the renal medulla (3.13 +/- 0.21 x 10(-3) mm2/s vs. 2.10 +/- 0.24 x 10(-3) mm2/s; p < 0.05) and cortex (3.09 +/- 0.14 x 10(-3) mm2/s vs. 2.07 x 10(-3) mm2/s, p < 0.05). In conclusion, the results of the present study suggest that diffusion weighted imaging (ADC) may be a useful parameter to incorporate when identifying whether a ureteric obstruction is acute or chronic.

Animals↗

PubMed2002

Long-term effects of partial unilateral ureteral obstruction on renal hemodynamics and morphology in newborn rats: a magnetic resonance imaging study.

We assessed the longitudinal changes in renal vein blood flow (RVBF) and kidney volume in response to neonatally induced partial unilateral ureteral obstruction (PUUO) in rats with a magnetic resonance imaging (MRI) technique. During anesthesia, either the upper third or two thirds of the left ureter was embedded into the psoas muscle in newborn rats, creating either a mild (n=20) or a severe (n=9) partial obstruction. Control groups consisted of sham-operated (n=12) and non-operated (n=15) rats. During the following 24 weeks, RVBF and kidney volume were measured sequentially every 2-6 weeks with MRI, beginning 9 days after the operation. Both mild and severe obstruction caused a time-dependent decrease in RVBF. At week 24, the mean RVBF had decreased to 79% of the controls in the mildly obstructed kidneys (mean+/-SE: 1.45+/-0.14 vs 1.84+/-0.08 ml/min/100 g body weight, P<0.05) and to 57% of controls in the severely obstructed kidneys (1.05+/-0.10 vs 1.84+/-0.08 ml/min/100 g body weight, P<0.05). The renal pelvis volume increased and the renal parenchymal volume decreased significantly in the severely obstructed kidneys compared to the mildly obstructed kidneys. A good correlation was found between kidney volume measured in vivo using MRI and that measured in vitro (r>0.8, P<0.05), and between RVBF and renal parenchymal volume (r=0.758, P<0.01). In conclusion, the degree of reduction in RVBF depends on the severity and the duration of the PUUO. MRI can safely and reliably be used to monitor the longitudinal changes in RVBF and kidney volume in rats from early life.

Animals↗

PubMed2002

Partial unilateral ureteral obstruction in rats.

This review comprises an overview of the current knowledge on experimental partial unilateral ureteral obstruction (PUUO) and a summary of our latest original experimental PUUO studies in rats. Neonatal PUUO is the type of obstruction that is most often encountered in pediatric clinical practice. However, the pathogenesis of PUUO is still incompletely understood. Most of our knowledge on PUUO has been derived from experimental studies in a variety of animal models. Although progress has been made, the natural history of congenital hydronephrosis is still incompletely described. The effects on kidney functions of long-term urinary tract obstruction, especially PUUO, have been less intensively studied. Recently, we created models with mild and severe PUUO in young rats by embedding the upper one fourth or the upper two thirds of the left ureter into the psoas muscle, respectively. Thereafter, the technique was used to create mild and severe PUUO in newborn rats and magnetic resonance imaging studies showed that both mild and severe obstruction caused a time-dependent decrease in renal blood flow. Compensatory increase in total kidney volume and renal vein blood flow in contralateral non-obstructed kidneys was not detectable when functional deterioration in the partially obstructed kidneys was present. Finally, we investigated the dynamic changes in renal relative signal intensity (RSI) of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) using magnetic resonance imaging in rats with partial, complete unilateral ureteral obstruction and sham-operated controls. The results showed that changes in Gd-DTPA RSI are compatible with the known physiological and anatomical changes in kidneys in response to ureteral obstruction and useful for distinguishing an obstructed from a non-obstructed collecting system and also for differentiating a partially obstructed from a completely obstructed collecting system.

Adult↗