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PURPOSE: To evaluate the urodynamic changes in patients who have undergone colocystoplasty (CCP), gastrocystoplasty (GCP) and ileocystoplasty (ICP) in a retrospective study. Changes in urinary continence, incidence of pathologic contractions before and after augmentation, alterations of urodynamic parameters were also examined. METHODS: Eighty-four patients were included in the study who underwent bladder augmentation between 1987 and 2017. Group I: 35 patients with CCP. Group II: 18 patients with GCP. Group III: 31 patients with ICP. Cystometry was performed at 3, 6, and every 12 months, then biannually after augmentation. Pre- and postoperative urodynamic changes were analysed statistically. RESULTS: In Group I, two patients and in Group III, one patient remained incontinent after CCP and ICP. Bladder capacity increased significantly, maximal intra-vesical pressure decreased and compliance improved in all groups (p < 0.001). Postoperative studies showed pathologic contractions in the augmented bladder in half of the patients with GCP, in 43% of patients after CCP and 26% of patients with ICP. CONCLUSION: From the urodynamic point of view, ileum is the most adequate option in the long term. Contractions after augmentation might be caused by the remaining peristalsis of the detubularised segment. Further investigations are needed to evaluate pathologic contractions that remained after detubularisation.
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Íleon , Vejiga Urinaria , Urodinámica , Humanos , Estudios Retrospectivos , Femenino , Masculino , Vejiga Urinaria/fisiopatología , Vejiga Urinaria/cirugía , Niño , Íleon/cirugía , Íleon/fisiopatología , Adolescente , Colon/cirugía , Colon/fisiopatología , Preescolar , Estómago/cirugía , Estómago/fisiopatología , Procedimientos Quirúrgicos Urológicos/métodos , LactanteRESUMEN
In this study, we aimed to illustrate the efficiency of correlation analysis of musical and genetic data for certain common ethnic and ethno-musical roots of mankind. The comparison of the results to archaeogenetic data shows that correlations of recent musical and genetic data may reveal past cultural and migration processes resulting in recent connections. The significance tests verified our hypothesis supposing that propagation of oral musical traditions can be related to early human migration processes is well-founded, because the multidimensional point system determined by the inverse rank vectors of correlating Hg-UCT pairs has a very clear structure. We found that associations of Hgs jointly propagating with associations of UCTs (Unified Contour Type) can be identified as significant complex components in both modern and ancient populations, thus, modern populations can be considered as admixtures of these ancient Hg associations. It also seems obvious to conclude that these ancient Hg associations strewed their musical "parent languages" during their migrations, and the correlating UCTs of these musical parent languages may also be basic components of the recent folk music cultures. Thus, we can draw a hypothetical picture of the main characteristics of ancient musical cultures. Modern and prehistoric populations belonging to a common Hg-UCT association are located to very similar geographical areas, consequently, recent folk music cultures are basically determined by prehistoric migrations. Our study could be considered as an initial step in analysis of the correlations of prehistoric and recent musical and genetic characteristics of human evolution history.
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Etnicidad/genética , Etnología , Genética de Población/métodos , Inteligencia Artificial , Cultura , ADN Mitocondrial/genética , Europa (Continente) , Asia Oriental , Migración Humana , Humanos , Música , FilogeniaRESUMEN
We present a new self-learning computational method searching for footprints of early migration processes determining the genetic compositions of recent human populations. The data being analysed are 26- and 18-dimensional mitochondrial and Y-chromosomal haplogroup distributions representing 50 recent and 34 ancient populations in Eurasia and America. The algorithms search for associations of haplogroups jointly propagating in a significant subset of these populations. Joint propagations of Hgs are detected directly by similar ranking lists of populations derived from Hg frequencies of the 50 Hg distributions. The method provides us the most characteristic associations of mitochondrial and Y-chromosomal haplogroups, and the set of populations where these associations propagate jointly. In addition, the typical ranking lists characterizing these Hg associations show the geographical distribution, the probable place of origin and the paths of their protection. Comparison to ancient data verifies that these recent geographical distributions refer to the most important prehistoric migrations supported by archaeological evidences.
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Arqueología/métodos , Instrucción por Computador/métodos , Dermatoglifia , Migración Humana , Algoritmos , Cromosomas Humanos Y , ADN Mitocondrial/análisis , Genética de Población/métodos , Humanos , Aprendizaje , Autoeficacia , Caminata/fisiologíaRESUMEN
The goal of this study is to show two new clustering and visualising techniques developed to find the most typical clusters of 18-dimensional Y chromosomal haplogroup frequency distributions of 90 Western Eurasian populations. The first technique called "self-organizing cloud (SOC)" is a vector-based self-learning method derived from the Self Organising Map and non-metric Multidimensional Scaling algorithms. The second technique is a new probabilistic method called the "maximal relation probability" (MRP) algorithm, based on a probability function having its local maximal values just in the condensation centres of the input data. This function is calculated immediately from the distance matrix of the data and can be interpreted as the probability that a given element of the database has a real genetic relation with at least one of the remaining elements. We tested these two new methods by comparing their results to both each other and the k-medoids algorithm. By means of these new algorithms, we determined 10 clusters of populations based on the similarity of haplogroup composition. The results obtained represented a genetically, geographically and historically well-interpretable picture of 10 genetic clusters of populations mirroring the early spread of populations from the Fertile Crescent to the Caucasus, Central Asia, Arabia and Southeast Europe. The results show that a parallel clustering of populations using SOC and MRP methods can be an efficient tool for studying the demographic history of populations sharing common genetic footprints.
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Cromosomas Humanos Y/genética , Modelos Genéticos , Inteligencia Artificial , Análisis por Conglomerados , Europa (Continente) , Genética de Población , Haplotipos , Migración Humana , Humanos , MasculinoRESUMEN
Molecular and negative ion beams, usually produced in special ion sources, play an increasingly important role in fundamental and applied atomic physics. The ATOMKI-ECRIS is a standard ECR ion source, designed to provide highly charged ion (HCI) plasmas and beams. In the present work, H(-), O(-), OH(-), O(2)(-), C(-), C(60)(-) negative ions and H(2)(+), H(3)(+), OH(+), H(2)O(+), H(3)O(+), O(2)(+) positive molecular ions were generated in this HCI-ECRIS. Without any major modification in the source and without any commonly applied tricks (such as usage of cesium or magnetic filter), negative ion beams of several µA and positive molecular ion beams in the mA range were successfully obtained.
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In this paper a study on the ion transmission ratio of a nanoporous alumina sample is presented. The sample was investigated by scanning transmission ion microscopy (STIM) with different beam sizes. The hexagonally close-packed Al(2)O(3) nanocapillary array, realized as a suspended membrane of 15 microm thickness, had pore diameters of approximately 215 nm and spacing of approximately 450 nm. When the proton beam size was limited to a single domain, a peak transmission ratio of 19% was observed as is expected from the geometry (approximately 19-20%). This result points out an almost perfectly parallel alignment of the capillaries within one domain. However, for larger beam scanning areas (sampling multiple domains) the transmission ratio was reduced to 5%. The STIM analysis over an area larger than the typical domain size revealed an overall capillary angular spread of approximately 2 degrees.
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AIMS: The type of bladder augmentation on pre-existing vesicoureteral reflux (VUR) was assessed. The effects of urodynamic changes on the resolution of VUR following augmentation cystoplasty performed with various gastrointestinal segments were examined. It was queried whether elimination of high-pressure bladder is sufficient to resolve pre-existing reflux. METHODS: A retrospective record review of patients who underwent bladder augmentation between 1987 and 2004. Patients were divided into two groups. Group I included patients who had a simultaneous augmentation and ureteral reimplantation. Group II included patients with reflux in whom only a bladder augmentation was performed. Pre-and post-augmentation urodynamic results were compared in both groups. The outcome of VUR and the role of various gastrointestinal (GI) segments on the resolution of VUR were studied. RESULTS: Sixty-three patients underwent bladder augmentation during the study period. Twenty-six of them had VUR before augmentation. There were 10 patients in Group I and 16 patients in Group II. In Group I, VUR ceased in all patients, while in group II, VUR resolved in 14 patients and persisted in two patients. Small and large bowel segments used for augmentation had no effect on the resolution of VUR but the results of gastrocystoplasties were less favorable. Urodynamically there was no significant difference between the various augmentation cystoplasties. CONCLUSIONS: Bladder augmentation alone without simultaneous antireflux repair is usually sufficient for the resolution of pre-existing reflux. The various GI segments used for augmentation have no effect on urodynamic results and the resolution of VUR.
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Enfermedades de la Vejiga Urinaria/cirugía , Vejiga Urinaria/cirugía , Urodinámica/fisiología , Reflujo Vesicoureteral/cirugía , Adolescente , Extrofia de la Vejiga/cirugía , Niño , Colon/trasplante , Femenino , Estudios de Seguimiento , Humanos , Intestinos/trasplante , Masculino , Meningomielocele/complicaciones , Meningomielocele/cirugía , Presión , Estudios Retrospectivos , Estómago/trasplante , Resultado del Tratamiento , Vejiga Urinaria/fisiopatología , Enfermedades de la Vejiga Urinaria/fisiopatología , Cateterismo Urinario , Procedimientos Quirúrgicos Urológicos , Reflujo Vesicoureteral/fisiopatologíaRESUMEN
UNLABELLED: The aim of this paper was to review the authors' experience with cutaneous vesicostomy (CV) over the last 15 years including indications, results, and complications of CV. MATERIALS AND METHODS: The records of 31 patients treated by CV between 1987 and 2002 were reviewed. There were 20 boys and 11 girls. The two main primary pathologies were neuropathic bladder (19 patients) and posterior urethral valve (PUV) (7 patients). All patients underwent a Blocksom-type operation at a mean age of 23 months (range 14 days-9 years). Pre- and postoperative conventional uromanometry was performed in 18 patients (58%) and bladder function was assessed. RESULTS: In 23 patients (74%) the CV provided a successful diversion with improvement of the upper urinary tract and/or stabilization of the renal function. In 5 patients (16%) with PUV, the improvement was temporary. In 3 patients (10%) the CV did not result in an improvement. Twenty-four patients underwent CV closure after a mean duration of 23 months (range, 1 month-7 years) of diversion. In 2 patients with myelomeningocele (MMC) and severe somato-mental developmental delay, CV was not closed and is being considered as a permanent treatment option. Urodynamic studies in 5 PUV patients showed impaired compliance and high intravesical pressure following a successful valve ablation and closure of CV. In the neuropathic bladder group the bladder function improved following closure of CV and commencement of anticholinergic medication and clean intermittent catheterization (CIC). Our augmentation ratio in the neuropathic bladder group was 22%. Complications of CV included: stenosis in 7 patients (22%), prolapse in 2 (6%), and cellulitis in 2 (6%). The revision rate was 16%. CONCLUSIONS: In young infants CV had a less favourable result in the PUV patients than in cases with high-pressure neuropathic bladder with upper tract dilatation and severe urinary tract infection (UTI), where CV provided decompression and prevented deterioration of the renal function. Cutaneous vesicostomy has stood the test of time in our changing paediatric urological practice and it remains a valuable weapon in the armoury of paediatric urologists in selected patients.
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Uretra/anomalías , Vejiga Urinaria Neurogénica/cirugía , Derivación Urinaria/métodos , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Reoperación , Vejiga Urinaria/cirugía , Derivación Urinaria/efectos adversosRESUMEN
The most common origin of the urinary incontinence are the myelodysplasia and congenital urogenital malformations in childhood. Surgical augmentation of the urinary bladder with or without continent diversion, may be indicated in case of unsatisfactory result of all other conservative treatments. Between 1987-2000 bladder augmentation or substitution was carried out with large bowel or gastric segment in 37 patients. The age at surgery was between 6-21 yrs, (mean 12.3 yrs). The authors discuss the results of the 30 patients in whom follow up was at least 1 yr (12-113 months, mean 43 months). The urinary incontinence could be solved in 24/30 of the children, 6/30 remained in the same condition without worsening any of them. In 11/30 patients complication was not observed at all, but in 19/30 further surgeries were necessary in 30 times, mainly due to stone formation. The authors state that the augmentation cystoplasty is a useful method for the creation of a low pressure urinary reservoire which with or without a continent diversion may solve the urinary incontinence, however the patients need a lifelong follow-up due to the possible long-term risks.
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Vejiga Urinaria/anomalías , Vejiga Urinaria/cirugía , Incontinencia Urinaria/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Adolescente , Adulto , Bacteriuria/microbiología , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Resultado del Tratamiento , Incontinencia Urinaria/etiología , Procedimientos Quirúrgicos Urológicos/efectos adversosRESUMEN
We present a combined rf-guided ion beam and photon emission spectroscopy method, which facilitates state-selective charge-transfer measurements at energies of direct relevance for astrophysics and fusion-plasma diagnostics and modeling. Ion energies have been varied from 1000 eV/amu down to energies as low as 5 eV/amu. Absolute state-selective cross sections have been obtained for He (2+) and N (5+) ions colliding on molecular hydrogen. Orders of magnitude differences are found between theory and the present results. This indicates clearly that such data are valuable as benchmarks for the necessary advancement of theoretical descriptions.
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The authors investigated postoperative capacity, compliance of the urinary bladder and urinary continence in children who underwent bladder augmentation and/or bladder substitution for various forms of urinary incontinence. In 20 children, bladder augmentation and/or bladder substitution procedures were performed because of urinary incontinence, upper urinary tract deterioration and/or failure of conservative treatment (oxybutynin, clean intermittent catheterization--ICC). In 2 patients, reaugmentation was necessary. Urodynamic studies were performed on a regular basis, preoperatively and postoperatively. Based on their experiences, the authors conclude that recognition of changes in bladder capacity and/or compliance and especially the risk of developing upper urinary tract changes is only possible by performing urodynamic studies regularly. Urodynamics is also essential in decision making processes regarding redo surgeries (reaugmentation, transient or permanent urinary diversion).