476
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Guenzinger R, Voegele K, Wildhirt S, Wagner I, Schwaiger M, Lange R. Magnetic resonance imaging identifies significant LV mass reduction and improvement of LV enddiastolic volume index within 6 months follow-up in patients undergoing mitral valve repair. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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477
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Voss B, Krane M, Schad H, Heimisch W, Jung C, Lange R, Bauernschmitt R. Effect of „physiological“ pulsatile perfusion on renal blood flow during cardiopulmonary bypass. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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478
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Wildhirt S, von Canal F, Benz M, Grammer J, Voss B, Bauernschmitt R, Tassani P, Lange R. Histopathology and morphometry of radial arteries used as conduits for CABG in patients beyond age 70. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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479
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Hörer J, Karl E, Theodoratou G, Schreiber C, Kostolny M, Wottke M, Cleuziou J, Vogt M, Holper K, Lange R. Risk factors for systemic ventricular failure 27 years after the senning operation - a single-center experience in 335 patients. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-861897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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480
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Guenther T, Eicken A, Nöbauer C, Augustin N, Wottke M, Holper K, Lange R. Treatment strategies in patients with cardiac and mediastinal tumors: a 25 year review. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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481
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Boehm J, Grammer J, Lehnert F, Dietrich W, Wagenpfeil S, Wottke M, Lange R, Bauernschmitt R. Effects of Factor V Leiden mutation on postoperative blood loss under aprotinin: A prospective trial in 1500 cardiac surgical patients. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-861973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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482
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Cleuziou J, Schreiber C, Kostolny M, Wottke M, Hörer J, Eicken A, Holper K, Lange R. Pulmonary atresia with intact ventricular septum. Long-term results after uni- and biventricular repair. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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483
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Bauernschmitt R, Schirmbeck EU, Knoll A, Mayer H, Nagy I, Wessel N, Wildhirt SM, Lange R. Towards robotic heart surgery: Introduction of autonomous procedures into an experimental surgical telemanipulator. Int J Med Robot 2005. [DOI: 10.1581/mrcas.2005.010304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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484
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Kuehn A, Oberhoffer R, Vogt M, Lange R, Hess J. Aortopulmonary window with ventricular septal defect and pulmonary atresia: prenatal diagnosis and successful early surgical correction. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2004; 24:793-796. [PMID: 15586382 DOI: 10.1002/uog.1752] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report a case in which aortopulmonary window (APW) in combination with pulmonary atresia was diagnosed correctly in a neonate by echocardiography. Prenatal echocardiography showed progression of tetralogy of Fallot to pulmonary atresia with retrograde pulmonary perfusion, concealing the concomitant APW in fetal life. Due to intractable heart failure, primary correction was successfully performed at the age of 4 weeks (weight 2280 g).
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485
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Schubert H, Eissfeldt I, Lange R, Trefflich F. Synthese von kristallin-flüssigen Verbindungen. I. n-Alkyl- und n-Alkoxyderivate des 3-Hydroxy-2,5-diphenyl-pyrazins. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/prac.19660330508] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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486
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Lange R, Heschel W, Wirling J. Beeinflussung der Porenstruktur von Adsorbentien durch Abscheidung von Kohlenstoff und die Auswirkungen auf Adsorptionskapazität und -geschwindigkeit. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200403428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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487
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Nebe B, Lüthen F, Lange R, Becker P, Beck U, Rychly J. Topography-induced alterations in adhesion structures affect mineralization in human osteoblasts on titanium. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2004. [DOI: 10.1016/j.msec.2004.08.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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488
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Bauer T, Güttel R, Schubert M, Lange R, Lehner P, Turek T. Zur Modellierung und Simulation von Monolith-Reaktoren für Dreiphasen-Reaktionen. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200490262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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489
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Schubert M, Bauer T, Lange R. Flüssigkeits-Hold up in Trickle-Bed Reaktoren bei stationärer und instationärer Betriebsweise. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200490147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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490
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Bauer T, Roy S, Schubert M, Al-Dahhan M, Lange R. Untersuchungen zur Gas/Flüssig-Verteilung in Monolithreaktoren mittels Computertomographie. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200490144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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491
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Lange R, Weiller C, Liepert J. Chronic Dose effects of Reboxetine on Motor Skill Acquisition and Cortical Excitability. KLIN NEUROPHYSIOL 2004. [DOI: 10.1055/s-2004-832069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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492
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Diener HC, Eikermann A, Gessner U, Göbel H, Haag G, Lange R, May A, Müller-Schwefe G, Voelker M. Efficacy of 1,000 mg Effervescent Acetylsalicylic Acid and Sumatriptan in Treating Associated Migraine Symptoms. Eur Neurol 2004; 52:50-6. [PMID: 15240983 DOI: 10.1159/000079544] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2003] [Accepted: 04/06/2004] [Indexed: 11/19/2022]
Abstract
Recently a new effervescent acetylsalicylic acid (ASA) tablet with high buffering capacity has been developed. In this double-blind, 3-arm, multicenter, parallel-group study, 433 patients were treated either with 1,000 mg effervescent ASA or 50 mg encapsulated sumatriptan or placebo. The primary endpoint was the percentage of patients with complete remission of the 3 accompanying symptoms nausea, photophobia and phonophobia within 2 h after intake of the study drug. 43.8% of patients treated with ASA, 43.7% of patients treated with sumatriptan and 30.9% of patients treated with placebo showed complete remission of all 3 accompanying symptoms (p < 0.05 for ASA and sumatriptan vs. placebo). Both active treatments were superior to placebo regarding the individual symptoms photophobia and phonophobia, but not for nausea. The percentage of patients with reduction in headache severity from moderate or severe to mild or no pain (secondary objective) was 49.3% for ASA, 48.8% for sumatriptan and 32.9% for placebo. All active treatments were superior to placebo (p < 0.05). 25.3, 24.4 and 14.5% of patients treated with ASA, sumatriptan or placebo were pain free at 2 h. Drug-related adverse events were reported in 3.9, 4.7 and 6.7% of patients treated with placebo, ASA or sumatriptan. The study showed that administration of effervescent ASA leads to remission of the migraine symptoms nausea, photophobia and phonophobia, reduces migraine headache and is comparable to sumatriptan.
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493
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Vogt M, Mühlbauer F, Braun SL, Lang T, Busch R, Lange R, Frösner G, Hess J. Prevalence and Risk Factors of Hepatitis C Infection after Cardiac Surgery in Childhood before and after Blood Donor Screening. Infection 2004; 32:134-7. [PMID: 15188071 DOI: 10.1007/s15010-004-2209-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2002] [Accepted: 12/01/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since 1974, the risk of acquiring non-A non-B hepatitis by blood transfusion is well known. In 1999, children having had polytransfusions (group 1) after cardiac surgery prior to the establishment of routine blood donor screening could be identified as a risk group for hepatitis C (HCV) infection. PATIENTS AND METHODS In 1991, Germany began screening blood donors for hepatitis C. To describe the risk after the implementation of blood donor screening, we studied 211 children (group 2) having had open heart surgery after 1991 and compared prevalence for anti-HCV antibodies and known risk factors to group 1. RESULTS None of the 211 patients with cardiac surgery after 1991 had detectable anti-HCV antibodies, compared to 67 of the 458 patients (14.6%) of group 1 (p < 0.001). The mean number of operations in both groups was virtually the same (mean 1.7 +/- 0.9 in group 1, mean 1.6 +/- 0.9 in group 2, p = 0.075), whereas the total number of blood products per patient differed significantly (group 1 mean 8 +/- 17.6, group 2 mean 3.5 +/- 2.8; p < 0.001). Multivariate analysis of risk factors demonstrates affiliation to group 1, transfusion of fresh blood, warm whole blood, heparinized blood (p < 0.001) and plasma (p = 0.004) as significant. CONCLUSION After the implementation of blood donor screening, the risk for HCV infection after cardiac surgery in childhood dropped significantly from 14.6% to < 0.5%. These data show the necessity of HCV screening for patients at risk (operations before 1991) and do not favor a general screening for all patients.
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494
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Torrent J, Marchal S, Tortora P, Lange R, Balny C. High pressure, an alternative approach to understand protein misfolding diseases. Cell Mol Biol (Noisy-le-grand) 2004; 50:377-85. [PMID: 15529748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Protein folding is essential for the flow of genetic information to biological activity. A failure in this process can result in disease, by causing cell damage and sometimes death. The misfolding of proteins often induces their aggregation, initiating the fibril formation seen in a range of human and animal diseases. Because misfolding and aggregation are of fundamental importance in vivo, there is currently great interest in understanding their mechanisms. To gain insight into the folding and unfolding processes of proteins, for nearly a century, an original biophysical approach has been successfully used: the application of high hydrostatic pressure combined with various spectroscopic and kinetic techniques. Because high pressure provides new insight into protein structure and folding which cannot be obtained by other techniques, the conformations of pressure-induced unfolding intermediates and species involved in the initial states of aggregation of proteins associated with specific diseases are currently being investigated. Our contention is that by exploring folding kinetics, misfolding pathways and stability under pressure, it will be possible to understand the mechanisms of amyloidogenesis, with the ultimate goal to design therapeutic strategies to prevent progression of the disease.
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495
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Fritzsch J, Richter M, Edelmann C, Lange R, Tannapfel A. [35-year old male with fever and round mass of the liver]. Internist (Berl) 2004; 45:713-6. [PMID: 15133612 DOI: 10.1007/s00108-004-1195-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A 35 year old male suffered from fever till 39 degrees C and malaise since 6 months; infectious or neoplastic causes have been ruled out. Ultrasonography revealed a hypoechoic lesion of 75 mm diameter in the liver. The histologic examination of the needle biopsy showed an inflammatory process, and the final diagnosis was inflammatory pseudotumor. EBV specific LMP-1 protein was detected within the tumor immunohistochemically. A liver segment resection was performed, and the patient has been well and without fever since then for 18 months. Inflammatory pseudotumor is a rare but important differential diagnosis in cases of hypoechoic liver lesions associated by fever, if there is no abscess or malignancy. The diagnosis must be confirmed histologically, because imaging techniques cannot reliably classify the lesion.
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496
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Ahmed SN, Anthony AE, Beier EW, Bellerive A, Biller SD, Boger J, Boulay MG, Bowler MG, Bowles TJ, Brice SJ, Bullard TV, Chan YD, Chen M, Chen X, Cleveland BT, Cox GA, Dai X, Dalnoki-Veress F, Doe PJ, Dosanjh RS, Doucas G, Dragowsky MR, Duba CA, Duncan FA, Dunford M, Dunmore JA, Earle ED, Elliott SR, Evans HC, Ewan GT, Farine J, Fergani H, Fleurot F, Formaggio JA, Fowler MM, Frame K, Fulsom BG, Gagnon N, Graham K, Grant DR, Hahn RL, Hall JC, Hallin AL, Hallman ED, Hamer AS, Handler WB, Hargrove CK, Harvey PJ, Hazama R, Heeger KM, Heintzelman WJ, Heise J, Helmer RL, Hemingway RJ, Hime A, Howe MA, Jagam P, Jelley NA, Klein JR, Kos MS, Krumins AV, Kutter T, Kyba CCM, Labranche H, Lange R, Law J, Lawson IT, Lesko KT, Leslie JR, Levine I, Luoma S, MacLellan R, Majerus S, Mak HB, Maneira J, Marino AD, McCauley N, McDonald AB, McGee S, McGregor G, Mifflin C, Miknaitis KKS, Miller GG, Moffat BA, Nally CW, Nickel BG, Noble AJ, Norman EB, Oblath NS, Okada CE, Ollerhead RW, Orrell JL, Oser SM, Ouellet C, Peeters SJM, Poon AWP, Robertson BC, Robertson RGH, Rollin E, Rosendahl SSE, Rusu VL, Schwendener MH, Simard O, Simpson JJ, Sims CJ, Sinclair D, Skensved P, Smith MWE, Starinsky N, Stokstad RG, Stonehill LC, Tafirout R, Takeuchi Y, Tesić G, Thomson M, Thorman M, Van Berg R, Van de Water RG, Virtue CJ, Wall BL, Waller D, Waltham CE, Tseung HWC, Wark DL, West N, Wilhelmy JB, Wilkerson JF, Wilson JR, Wouters JM, Yeh M, Zuber K. Measurement of the total active 8B solar neutrino flux at the Sudbury Neutrino Observatory with enhanced neutral current sensitivity. PHYSICAL REVIEW LETTERS 2004; 92:181301. [PMID: 15169480 DOI: 10.1103/physrevlett.92.181301] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2003] [Indexed: 05/24/2023]
Abstract
The Sudbury Neutrino Observatory has precisely determined the total active (nu(x)) 8B solar neutrino flux without assumptions about the energy dependence of the nu(e) survival probability. The measurements were made with dissolved NaCl in heavy water to enhance the sensitivity and signature for neutral-current interactions. The flux is found to be 5.21 +/- 0.27(stat)+/-0.38(syst) x 10(6) cm(-2) s(-1), in agreement with previous measurements and standard solar models. A global analysis of these and other solar and reactor neutrino results yields Deltam(2)=7.1(+1.2)(-0.6) x 10(-5) eV(2) and theta=32.5(+2.4)(-2.3) degrees. Maximal mixing is rejected at the equivalent of 5.4 standard deviations.
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497
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Ahmed SN, Anthony AE, Beier EW, Bellerive A, Biller SD, Boger J, Boulay MG, Bowler MG, Bowles TJ, Brice SJ, Bullard TV, Chan YD, Chen M, Chen X, Cleveland BT, Cox GA, Dai X, Dalnoki-Veress F, Doe PJ, Dosanjh RS, Doucas G, Dragowsky MR, Duba CA, Duncan FA, Dunford M, Dunmore JA, Earle ED, Elliott SR, Evans HC, Ewan GT, Farine J, Fergani H, Fleurot F, Formaggio JA, Fowler MM, Frame K, Frati W, Fulsom BG, Gagnon N, Graham K, Grant DR, Hahn RL, Hall JC, Hallin AL, Hallman ED, Hamer AS, Handler WB, Hargrove CK, Harvey PJ, Hazama R, Heeger KM, Heintzelman WJ, Heise J, Helmer RL, Hemingway RJ, Hime A, Howe MA, Jagam P, Jelley NA, Klein JR, Kos MS, Krumins AV, Kutter T, Kyba CCM, Labranche H, Lange R, Law J, Lawson IT, Lesko KT, Leslie JR, Levine I, Luoma S, MacLellan R, Majerus S, Mak HB, Maneira J, Marino AD, McCauley N, McDonald AB, McGee S, McGregor G, Mifflin C, Miknaitis KKS, Miller GG, Moffat BA, Nally CW, Neubauer MS, Nickel BG, Noble AJ, Norman EB, Oblath NS, Okada CE, Ollerhead RW, Orrell JL, Oser SM, Ouellet C, Peeters SJM, Poon AWP, Robertson BC, Robertson RGH, Rollin E, Rosendahl SSE, Rusu VL, Schwendener MH, Simard O, Simpson JJ, Sims CJ, Sinclair D, Skensved P, Smith MWE, Starinsky N, Stokstad RG, Stonehill LC, Tafirout R, Takeuchi Y, Tesić G, Thomson M, Thorman M, Van Berg R, Van de Water RG, Virtue CJ, Wall BL, Waller D, Waltham CE, Tseung HWC, Wark DL, West N, Wilhelmy JB, Wilkerson JF, Wilson JR, Wittich P, Wouters JM, Yeh M, Zuber K. Constraints on nucleon decay via invisible modes from the Sudbury Neutrino Observatory. PHYSICAL REVIEW LETTERS 2004; 92:102004. [PMID: 15089201 DOI: 10.1103/physrevlett.92.102004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2003] [Indexed: 05/24/2023]
Abstract
Data from the Sudbury Neutrino Observatory have been used to constrain the lifetime for nucleon decay to "invisible" modes, such as n-->3nu. The analysis was based on a search for gamma rays from the deexcitation of the residual nucleus that would result from the disappearance of either a proton or neutron from 16O. A limit of tau(inv)>2 x 10(29) yr is obtained at 90% confidence for either neutron- or proton-decay modes. This is about an order of magnitude more stringent than previous constraints on invisible proton-decay modes and 400 times more stringent than similar neutron modes.
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498
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Bauernschmitt R, Malberg H, Wessel N, Kopp B, Schirmbeck EU, Lange R. Impairment of cardiovascular autonomic control in patients early after cardiac surgery. Eur J Cardiothorac Surg 2004; 25:320-6. [PMID: 15019655 DOI: 10.1016/j.ejcts.2003.12.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2003] [Revised: 12/10/2003] [Accepted: 12/15/2003] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Impairment of the baroreceptor reflex activity reflects an alteration of the autonomous regulation of the cardiovascular system and has proven to predict fatal outcome in patients after acute myocardial infarction. The following study was performed to analyse the baroreceptor sensitivity, heart rate variability and blood pressure variability in patients early after coronary surgery. METHODS Twenty-five male patients undergoing coronary artery bypass were examined in a prospective study; normal values were obtained from healthy volunteers. Arterial pressure signals were recorded from a radial artery catheter for 30 min preoperatively and in short intervals after surgery. Mechanical manipulations and pharmacological interventions were avoided during the sampling periods. Baroreflex function was calculated according to the dual sequence method, heart rate variability and blood pressure variability were calculated including nonlinear methods. RESULTS Initial values of the patients did not differ from healthy volunteers. The strength of baroreflex sensitivity (increase in blood pressure causing a synchronous decrease of heart rate) is low 2 h postoperatively. The number of delayed tachycardic changes of heart rate, which are caused by sympathetic activation, is only moderately reduced as compared to values obtained from healthy volunteers. Heart rate variability is widely unchanged as compared to preoperative values; blood pressure variability showed an increase of low-frequency components, again indicating sympathetic predominance. Nonlinear analyses revealed reduced system complexity at the beginning of the postoperative course. CONCLUSION Obviously, there is a vagal suppression 20 h after surgery, while the sympathetic tonus works in a normal range. This unbalanced interaction of the autonomous systems is similar to findings in patients after myocardial infarction. The predictive value of these markers has to be elucidated in further clinical studies.
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499
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Viereck V, Pauer HU, Bader W, Oppermann M, Hilgers R, Gauruder-Burmester A, Lange R, Emons G, Hackenberg R, Krauss T. Introital ultrasound of the lower genital tract before and after colposuspension: a 4-year objective follow-up. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2004; 23:277-283. [PMID: 15027018 DOI: 10.1002/uog.982] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To assess the topography of the bladder neck by introital ultrasound before and after open colposuspension. METHODS Three hundred and ten women with urodynamically proven stress urinary incontinence were included in this long-term study to investigate the position and function of the bladder neck at rest and during straining. Height (H), distance (D), and urethrovesical angle of the bladder neck (beta) were measured by means of preoperative and postoperative introital ultrasound. Women were followed up; 152 of them (49%) completed 48 months of follow-up. RESULTS At the 6-month follow-up examination, 90.0% of the women were continent (279/310), 3.5% (11/310) showed voiding difficulties, 3.5% (11/310) had urgency, and 1.6% (5/310) had developed de novo urge incontinence. At the 48-month follow-up, 76.8% of the patients were still continent. All postoperative measurements yielded significantly lower values for angle beta at rest and during straining compared with the preoperative results (P < 0.0001). The median linear movement of the bladder neck during straining decreased from 18.0 mm before surgery to 6.4 mm at the 48-month follow-up (P < 0.0001). The median level of ventrocranial elevation of the vesicourethral junction was 14.3 mm immediately after surgery, 9.9 mm after 6 months and 6.6 mm after 48 months. The degree of surgical bladder-neck elevation was associated with postoperative urgency/de novo urge incontinence (P < 0.0001) and voiding difficulty (P < 0.0001). CONCLUSIONS The colposuspension procedure reduces angle beta at rest and during straining, restricts linear movement with straining, and elevates the bladder neck. Perioperative introital ultrasound improves understanding of this surgical procedure and might help to prevent postoperative complications.
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500
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Wittkugel O, Lange R, Fiehler J. Die unilaterale innere Hirnvenenthrombose im MRT. ROFO-FORTSCHR RONTG 2004; 176:259-61. [PMID: 14872383 DOI: 10.1055/s-2004-818813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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