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Biomedical subjects

T Sundin

Publications and source records attributed to T Sundin.

At least 55 records · Page 3Linked to original sources
PubMed1977

Back-flow from urinary collecting devices into the ileal conduit.

The occurrence of back-flow from urinary collecting devices into the ileal conduit was observed in 9 out of 46 patients. In 6 of them back-flow to the upper urinary tract also occurred. Nipple stomas of at least 2 cm height were found to resist back-flow into the conduit better than any flat stoma.

Adult↗
PubMed1977

Kinetic studies on an intramuscular iron-poly (sorbitol-gluconic acid) complex.

Levels of iron and unsaturated iron binding capacity in serum and the renal excretion of iron were studied in 15 anaemic patients receiving Ferastral. Various dose schedules were used, 100 mg Fe daily for 10 days, 200 mg Fe daily for 5 days, and 500 mg Fe twice at various intervals from 2 to 7 days. A continuous increase of iron in serum was seen after the doses 100 mg and 200 mg daily as well as after 500 mg given at intervals of 2 and 3 days. Longer 500 mg dose intervals resulted in a fluctuation in the iron concentration. Peak levels varied between 740 and 5 260 microgram/100 ml (132 and 942 mumol/1). A transient decrease in the UIBC was seen. Urinary excretion of iron varied between 8.9 and 26.9% of the dose given. No local or general side effects occurred.

Adult↗
PubMed1977

Intravaginal electrical stimulation. Clinical experiments of urethral closure.

The effect on the urethra of intravaginal electrical stimulation (IVS) was registered by means of urethral pressure profiles (UPP). With the object of finding the most appropriate electrical parameters and optimal electrode positions within the vagina, 24 patients with stress incontinence, 22 with urgency and 4 continent women were studied. Electrical stimulation was given via an obturator with seven electrodes, which could be connected in different combinations of pairs. In all the women, stimulation with the electrodes in specific positions effected a more marked rise in the UPPs than with the electrodes in other positions. A change in position of more than 5 to 10 mm caused a decrease in the response. It was determined that a frequency of between 20 to 50 Hz with a pulse duration of 1 to 5 ms was most effective for urethral closure.

Adult↗
PubMed1977

Intravaginal electrical stimulation. Clinical experiments on bladder inhibition.

The effect of intravaginal electrical stimulation (IVS) on the bladder in 17 patients with motor detrusor instability was explored. Isotonic volume registrations and cystometries were used for evaluation of volume increase and inhibition of abortive detrusor contractions. With either one or the other method, bladder inhibition was found in all patients, but with both methods only in 6. During isotonic volume registration, the volume increase showed considerable variations ranging between 4 to 465%, and during cystometry between 11 to 3500%. Bladder inhibition proved to be most effective when using a frequency of 10 Hz.

Adult↗
PubMed1977

Long-term intravaginal electrical stimulation in urge and stress incontinence.

Using a new device for intravaginal electrical stimulation (IVS), 24 women with pure stress incontinence, mixed urge and stress incontinence or urge incontinence due to detrusor instability, were treated. To minimize mechanical discomfort, the electrode carrier was made of flexible material and inflatable. Furthermore, this design facilitated fixed, constant positioning of the electrodes at individually tested sites to produce maximum response at voltage well tolerated by the patient. The stimulation frequency was adjusted to suit the cause of incontinence: 20 to 50 Hz in stress incontinence, 10 Hz detrusor instability. The electrode carrier was well accepted. Seven of the 9 patients with pure stress incontinence became continent during IVS. Three of them have so far remained continent for 2 to 8 months without IVS. The 15 patients with detrusor instability or mixed incontinence were all free from symptoms after IVS for more than 3 months. Two of them have remained cured for more than 3 months after they had stopped IVS.

Adult↗
PubMed1977

The sympathetic innervation and adrenoreceptor function of the human lower urinary tract in the normal state and after parasympathetic denervation.

Adrenergic innervation of the human urinary bladder was studied in vitro in specimens excised during operation from six neurologically normal bladders and from five parasympathetically denervated (lower motor neuron lesion) bladders. Using a specific histochemical fluorescence technique, it was found that the adrenergic nerve terminals of the detrusor of the patients with lower motor neuron lesions were thicker, had a stronger fluorescence intensity, and were in most cases also more densely distributed than those of any of the six neurologically normal bladders examined. By recording the changes in the isometric tension of detrusor strips after different pharmacologic treatments, the existence of alpha-adrenergic receptors could be demonstrated in the parasympathetically denervated detrusor but not in the normal detrusor. The influence of alpha-adrenolytic treatment (phenoxybenzamine) was studied in vivo in seven patients with lower motor neuron lesions. In the cystometrograms, the bladders were more hypotonic and the "autonomous waves" appeared at a higher level of filling or were totally extinguished after this pharmacologic treatment. With an isotonic volume registration method, a bladder volume increase was recorded after alpha-adrenergic blockade. Using sphincterometry or urethral pressure profile studies, a decrease in the urethral resistance was observed after alpha-adrenolytic treatment.

Adult↗
PubMed1976

The adrenergic innervation and adrenergic receptor activity of the feline urinary bladder and urethra in the normal state and after hypogastric and/or parasympathetic denervation.

After long-term parasymphatetic denervation, detrusor muscle hypertrophy was found regardless of whether the hypogastric nerves had been sectioned simultaneously or not. After hypogastric denervation only, there was no difference in gross appearance from normal bladders. Adrenergic innervation was studied by means of a histochemical fluorescence technique. After hypogastric denervation, there was usually a slight increase in the detrusor innervation, and a clear decrease in the trigone and urethral adrenergic innervation. After parasympathetic denervation, the detrusor showed an increase in adrenergic innervation, while the innervation of the trigone and the urethra was unchanged. After simultaneous parasympathetic and hypogastric denervation, the adrenergic innervation of the detrusor was similar to that of the bladders subjected to parasympathetic denervation only. The adrenergic innervation of the trigone and urethra was similar to that found after hypogastric denervation only. Adrenergic receptor functions were studied by a method in which changes in the isometric tension of muscle strips were recorded following different pharmacological treatments. In the normal state, noradrenalin and phenylephrine caused contraction and isoprenaline relaxation of the trigone-urethra. In the detrusor, noradrenalin caused relaxation of strips contracted by carbacholine. Relaxed detrusor muscle strips were usually not contracted by noradenalin. In 2 out of 8 normal cats, however, a contraction was observed after very large doses of noradrenalin. After hypogastric denervation, the adrenoreceptor functions were consistent with those of the normal state. After parasympathetic denervation, the trigone-urethral receptor functions were unchanged compared with the normal receptor functions. In the detrusor, isoprenaline caused relaxation and noradrenalin and phenylephrine contraction. After simultaneous parasympathetic and hypogastric denervation, the results were consistent with those obtained after parasympathetic denervation only. Thus, the present study showed an increased adrenergic detrusor innervation and alpha-receptor activity after parasympathetic denervation regardless of whether the hypogastric nerves had been sectioned simultaneously or not. Although alpha-receptors might exist in the normal detrusor, beta-receptors dominate strongly. After parasympathetic denervation, there seems to be a change in the relation between alpha- and beta-receptors in favour of alpha-receptors.

Animals↗
PubMed1975

Anterior urethropexy according to Lapides in stress urinary incontinence. A follow-up study.

Thirty-five women with a mean age of 53 years were investigated for an average of 3 1/2 years after anterior urethropexy according to Lapides (1961). The material was divided into two groups: 23 patients with a history of pure stress urinary incontinence and 12 patients with a mixed stress and urgency incontinence. In the former group, the cure rate was nearly 100%; one patient had a remaining nonembarrassing slight stress incontinence, which could not be classified as pathologic. Another patient had a recurrence 2 years postoperatively at which time she fractured her pelvis in an accident. In the latter group, only 4 patients were cured while another 3 patients improved considerably. The operative procedure did not cause residual urine, since the urethra cannot be compressed as in other retropubic operations. The risk of recurrence is minimized, since continence is not dependent upon non-relaxation of other structures, but upon scar-fixation between the urethra and the periosteum of the pubic bone.

Adult↗
PubMed1975

Late effects of transurethral resection of bladder tumours at the ureteric orifice.

Nineteen patients, transurethrally resected for low-grade malignant tumours of the urinary bladder at or near the ureteric orifice, were investigated with respect to the presence of distal ureteric stenosis and/or vesico-ureteric reflux. The follow-up studies were performed from 6 to 28 (mean 12) months after the resection and included intravenous pyelography, voiding cystography, cytoscopy with catheterization of the ureteric orifice on the operated side, quantitative urinary culture, and serum creatinine determination. The intravenous pyelographies showed that the ureters on the operated side were significantly wider than those on the control side. This widening was recorded regardless of whether vesico-ureteric reflux was present or not. Vesico-ureteric refluxwas found on the operated side in 9 patients. No reflux was found on the control side in any patient. Preoperatively, no difference in ureteric width was observed between the tumour side and the control side. No severe stenosis was found at the follow-up investigation-in all cases at least a 5 French catheter could be inserted. Postoperatively, the urinary cultures were positive in 4 patients, 3 of whom had a vesico-ureteric reflux. A slight increase in the serum creatinine was noticed in one patient. The absence of ureteric stenosis in this series might be caused by the fact that the resection was performed with a minimum of coagulation.

Female↗
PubMed1975

Cystometry and simultaneous electomyography from the striated uretheral and anal sphincters and from levator ani.

For more than one decade, we have used the cystometry-electromyography (EMG) investigation as a clinical method in patients with known or suspected neurologic disorders in whom a defect in bladder emptying, in spite of an active detrusor contraction, is found at cystometry. The electomyographic activity during bladder filling and micturition has also been studied in healthy subjects. Among other things, a voluntary control of the external urethral sphincter relaxation--independent of the degree of bladder filling--was found in most of these healthy volunteers. The cystometry-EMG investigation is easy to perform and gives reliable information as to whether a detrusor-sphincter dyssynergia exists. This information is indispensable for the choice of therapy in neurogenic cases with infravesical obstruction. In patients with upper motor neuron lesions a detrusor-sphincter dyssynergia was found when performing the ice water test. In some cases, the sphincteric contraction was so strong that the ice water was prevented from being expelled by a forceful detrusor contraction. Such false negative ice water tests can be avoided by recording the intravesical pressure when performing the test.

Anal Canal↗
PubMed1975

Neurourologic evaluation after resection of the sacrum.

Five patients with bilateral, and four patients with unilateral, well defined sacral nerve lesions after sacral resection for tumor were examined with a clinical evaluation, cystometry, and cystoscopy including a test of vesical and urethal sensibility with different stimuli. In patients with bilateral division of the sacral nerves below the S 2 level, no active detrusor contractions were registered, indicating that the second sacral segment alone cannot subserve the micturition reflex. In patients with unilateral division of sacral nerves 1 to 5 or 2 to 5, a normal micturition reflex was registered. There was a complete loss of bladder mucosal pain when sacral nerves 3 to 5 had been cut bilaterally, while the sensibility was normal when sacral nerves 4 to 5 had been cut bilaterally. In patients with unilateral division of all sacral nerves below L 5 or S 1, mucosal pain tested by means of electrcoagulation of the bladder and pin-pricking of the urethra could not be felt on the denervated side. Stretching of the detrusor wall with a ureteral catheter, however, could be felt on the denervated side, indicating that this sensation was not mediated in sacral nerves but probably in the hypogastric nerves. Thermesthesia of the mucosa was demonstrated on the intact side of the bladder but not on the denervated side when the patients with unilateral sacral nerve lesions were tested with jet streams of cold or hot saline against the bladder wall.

Adult↗