[Diurnal enuresis in childhood is effectively treated with terodiline].

Efficacy and tolerance of the anticholinergic calcium antagonist, terodiline (Mictrol), were investigated in a placebo-controlled double-blind cross-over study of 42 children with diurnal enuresis. At a daily dosage of 25 mg, terodiline was well tolerated and, as compared with placebo, resulted in a statistically significant reduction in the daily frequency of wetting. Thus the findings show terodiline to be effective in the treatment of diurnal enuresis, an added advantage being the low incidence of side effects.

Arteriovenous shunting and regional blood flow in myocutaneous island flaps: an experimental study in pigs.

In eight pigs, total blood flow, regional capillary blood flow distribution, and arteriovenous (AV) shunting were studied during the first 4 postoperative hours after elevation of a myocutaneous rectus abdominis island flap. Capillary blood flow and AV shunting were measured using radioactive microspheres before flap creation and 1 and 4 hours after surgery. Total blood flow, measured continuously as venous outflow, increased in the first postoperative hour (p less than 0.

Long-term treatment of nocturnal enuresis with desmopressin. A follow-up study.

Eight patients with monosymptomatic nocturnal enuresis (age 11-24 years) were investigated prior to and after 24 weeks of desmopressin treatment in order to evaluate the impact on the endogenous vasopressin secretion and urinary output. No effect on plasma vasopressin, diurnal urinary volume, and urinary osmolality were found after this long-term treatment. Overall no changes in either body weight, blood pressure, or hematological variables were demonstrated.

Continuous direct tissue oxygen tension measurement. A new application for an intravascular oxygen sensor.

An oxygen tension measurement equipment, developed for continuous intravascular monitoring was tested as a direct tissue oxygen tension meter. The sterile disposable oxygen probe consists of a Clark type polaro-graphic bipolar electrode placed in a 5 cm long flexible polyethylene catheter (OD 0.55 mm).

Biomechanical wall properties of the porcine rectum: a study using impedance planimetry.

The aim was to investigate biomechanical wall properties of the porcine rectum by way of manometry and impedance planimetry. Distension of a balloon inserted into the rectum with definite pressure steps up to 80 cm H2O was done for simultaneous recording of pressure and the balloon cross-sectional area (Bcsa). Viscoelastic wall properties were derived in terms of compliance.

Impedance planimetry: a new approach to biomechanical intestinal wall properties.

This paper surveys impedance planimetry, a technique based on the measurement of electrical impedance for estimation of active and passive biomechanical wall properties of the intact intestine. The paper mainly concerns methodological aspects of the recording technique and possible sources of error. Furthermore, the historical background concerning developments of the technique and physiological results during the last two decades are described.

The influence of tissue tension on the microcirculation in myocutaneous flaps: an experimental study in dogs.

The effect of increased and decreased uniaxial tissue tension on capillary blood flow, plasma volume, edema formation, and vascular permeability in myocutaneous flaps was studied. A total of 64 equally sized arterialized myocutaneous flaps were outlined on the abdomen of 16 dogs. The four areas on each dog were randomized to either untouched control area, reattachment to normal tension, increased (one and one-half times the original length), or decreased (one-half times the original length).

Regulation of renal pelvic pressure by diuresis and micturition.

The influence of the voiding cycle and diuresis on the hydrodynamic pressures of the renal pelvis in the multicalyceal kidney of miniature pigs has been examined. Identification of the pressure patterns characteristic of the renal pelvis with an undisturbed pelviureteric and ureterovesical junction was emphasized. The frequency and amplitude of contractions in the renal pelvis were measured bilaterally.

Variations in duodenal cross-sectional area during the interdigestive migrating motility complex.

A probe for measurement of intestinal cross-sectional area (CA) was used to elucidate variations of human gut CA during the interdigestive migrating motility complex (MMC). A balloon was inflated by saline at a pressure of 1 kPa, and variations of balloon CA (BCSA) were measured by means of the field-gradient principle. Duodenal phasic activity was measured by perfused side holes proximal to, distal to, and inside the balloon.

Regional cerebral blood flow in pigs estimated by microspheres.

Regional cerebral blood flow in anaesthetized pigs is determined with the microsphere method. Five regions of cortical grey matter and three white subcortical areas in each hemisphere are examined together with anatomically classic structures. The validity of the biopsies was confirmed by freeze drying of the tissue.

The impact of unilateral ureteral obstruction on pelvic and parenchymal transit times in the pig kidney.

In 10 female pigs a partial unilateral ureteral obstruction was investigated for 3 weeks. The pigs were monitored with 131I-iodo-hippuran scintigraphies before obstruction and once a week during the course of obstruction. Parenchymal and pelvic mean transit times were calculated by deconvolution analysis.

[Oddi's sphincter dysfunction].

Dysfunction of the sphincter of Oddi (SOD) is an uncommon condition which must be considered in cases of persistent pain in the upper abdomen following uncomplicated cholecystectomy, when disease in other organs, such as gastric ulcer, esophagitis and pancreatitis has been eliminated. The pathogenesis is not fully elucidated, but it is assumed that the cholecystectomy in some cases induces an increased tendency to spasm in the sphincter of Oddi (SO), and, perhaps in connection with an increased sensitivity to pressure elevations in the biliary tree, results in attacks of pain. Whether fibrosis (stenosis) of the SO due to instrumentation or passage of stones is part of the etiology is obscure.

Bladder filling in mice: an experimental in vivo model to evaluate the reservoir function of the urinary bladder in a long term study.

We report a simple, reproducible, and low-invasive in vivo method for repeated examination of bladder well properties in mice. Over a period of 21 days transurethral bladder fillings were performed every second day on the same animal. Analysis of the bladder volume at an intravesical pressure of 10 and 20 mm.

Sleep cystometries in children with nocturnal enuresis.

A combined analysis was done of sleep and bladder filling during sleep. Cystometry did not specifically affect sleep, since most of the cystometry studies in cases of enuresis did not lead to sleep stage changes on electroencephalography. Bladder instability was not accompanied by lighter sleep.

Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis.

The diurnal variation of plasma vasopressin (AVP), urinary excretion rate, urinary osmolality, and serum osmolality was studied twice in 15 patients with enuresis and in 11 age, weight, and sex matched nonenuretic normal subjects. A diurnal rhythm of AVP with constant levels during the day (8 AM-10 PM) and a highly significant increase during the night (10 PM-8 AM) was found in normal subjects. In contrast, enuretics showed a significantly less pronounced nocturnal increase in AVP with significantly lower nocturnal levels than normal subjects.

Consistency in manual scoring analysis of gastrointestinal pressure recordings.

The aim of the present study was to evaluate the consistency in visual scoring and whether this could be the basis for computer analysis using pattern recognition techniques. We studied the consistency of visual scoring of pressure tracings from the upper gastrointestinal tract with regard to pressure wave identification. The aim was to make such an identification the golden standard for computerized analysis of pressure waves.

Spontaneous anorectal pressure activity. Evidence of internal anal sphincter contractions in response to rectal pressure waves.

To characterize spontaneous anorectal pressure activity and a possible relation between the activity in the rectum and the anal canal, 11 healthy female volunteers were investigated. Resting activities were obtained during 1-h recordings with a multi-channel perfused catheter measuring the pressure 1, 2, 3, 7, and 8 cm from the anal verge. In five subjects sequences of rhythmic rectal pressure waves with amplitudes exceeding the maximal anal resting pressure coincided with a similar internal anal sphincter activity, preventing rectal pressure from exceeding the anal pressure at any point.

Pyeloureteral dynamics. Pelvic pressure and kidney function in partial long-term ureteric obstruction.

In 10 pigs with reno-scintigraphically proven normal upper urinary tracts, a standardized partial obstruction of the left ureter was created at the lower kidney pole level. Three weeks later kidney function was scintigraphically reassessed and the pressure flow relationship in the flow range 0-20 ml/min outlined. The partially obstructed pelvic baseline pressure varied from 9.

Short- and long-term reproducibility of cystometry.

We investigated 8 male patients, age 28-51 years, mean 35, with symptoms of bladder neck dysfunction by means of repeated water-cystometry. We made four cystometries with different patient positions and filling rates followed by a further two cystometries after an interval of 8 days. We found no difference in bladder volumes at first sensation and maximal capacity between the different investigations, irrespective of patient position and filling rate.

Nocturnal studies in enuretics. A polygraphic study of sleep-EEG and bladder activity.

In patients with monosymptomatic enuresis we investigated bladder activity together with electroencephalography during sleep on two consecutive nights. Thirty-one patients were investigated. Enuretic episodes were found to be normal micturitions not related to any specific sleep stage.

Computer analysis of manometric recordings. A study of overnight rectal activity in normal children.

To read and analyze manometric tracings from selected biological systems, a computer program was produced using low cost personal computer hardware. The program contains facilities for automatic scoring of contractions, intercontractile intervals (modality) and frequency analysis. This report concerns analysis of two overnight rectal motility recordings in 11 normal teenagers.