[Unconventional treatment procedures of the bladder in paraplegia and myelomeningocele]. / Behandlungsverfahren der Blase bei Querschnittlähmung und Myelomeningozele.

The established treatment of neurogenic lower urinary tract dysfunction (NLUTD) in patients with spinal cord injury (SCI) or meningomyelocele (MMC) is mainly conservative and is aimed at the lower urinary tract. For example, oral antimuscarinic medication is the standard treatment of neurogenic detrusor overactivity. Recently, however, treatment aiming directly or indirectly at the innervation of the urinary tract has gained increasing attention. Current evidence does not justify the use of nerve rerouting but the existing preliminary data are more promising for MMC patients than for those with SCI. Sacral neuromodulation is already a therapeutic option for incomplete SCI patients. Initial data from a pilot study indicate that in patients with complete SCI implementation in the spinal shock phase may prevent the development of NLUTD. Licensing of onabotulinum toxin A (Botox®) facilitated its clinical use for treating NLUTD but it is limited to the indication of neurogenic detrusor overactivity incontinence with a dosage of 200 IU. The mentioned unconventional treatments, although discussed controversially, are promising future treatment options for NLUTD.

Hypnosis for cataract surgery in an American Society of Anesthesiologists physical status IV patient.

A 73-year-old morbidly obese female patient (weight 125 kg, height 156 cm) was scheduled for cataract surgery of her right eye. Due to a number of severe co-morbidities general anaesthesia was contraindicated. However the patient was very anxious and requested sedation if the procedure was to be undertaken under local anaesthesia. She responded very positively to the proposal of utilising perioperative hypnosis. Hypnotic induction was achieved with the heavy eyelid technique, putting the patient into trance within 30 seconds. Continuous relaxing suggestions as described by the patient herself the day before surgery were used to maintain the trance state. She later reported that she was not aware of being in the operating room, but experienced profound relaxation during the procedure. Perioperative hypnosis proved to be a satisfactory option for sedation in this high-risk patient and should be actively considered for similar easily suggestible patients who are undergoing minor surgery.

[The value of intravesical electrostimulation in the treatment of acute prolonged bladder overdistension]. / Der Stellenwert der intravesikalen Elektrostimulation in der Therapie der akuten prolongierten Blasenüberdehnung.

BACKGROUND: The effectiveness of intravesical electrostimulation (IVES) in the treatment of acute prolonged bladder overdistension (PBO) was investigated. METHODS: Sixteen patients (female 11, male 5, ø 54 years) after PBO (bladder filling volume: 1317+/-320 ml) were evaluated: 11 after surgery and 5 after polytrauma, psychosomatic disorder or LV4 fracture. After exclusion of a neurogenic aetiology and a urodynamic examination, IVES was performed besides IC or suprapubic catheter. RESULTS: Group 1: six patients with a weak detrusor (p(detr. max.)<30 cmH(2)O); group 2: ten patients had detrusor acontractility. After 25 IVES sessions, group 1 showed a significant increase of p(detr. max.) (p=0.01) as well as a decrease in PVR (31% to 3% of bladder capacity, p=0.02). Group 2 had no significant increase of p(detr. max). CONCLUSIONS: Two-thirds of patients with a weak detrusor after PBO will regain balanced voiding after IVES due to detrusor reinforcement. With an acontractile detrusor only bladder sensation improves.

Optimisation of the microwave-assisted extraction of pigments from paprika (Capsicum annuum L.) powders.

The efficiency of microwave-assisted extraction (MAE) for the extraction of colour pigments from paprika (Capsicum annuum) powders was evaluated using 30 extracting solvent mixtures. The separation efficacy and selectivity of MAE was carried out using a spectral mapping technique and the relationship between the efficacy and selectivity of extraction and the physicochemical parameters of solvent mixtures was calculated by stepwise regression analysis. The calculation results were verified experimentally by the separation of pigment fractions by high-performance liquid chromatography. It was established that both the efficacy and selectivity of MAE depend significantly on the dielectric constant of the extraction solvent mixture.

Cortical evoked potentials of the vesicourethral junction--a predictor for the outcome of intravesical electrostimulation in patients with sensory and motor detrusor dysfunction.

The evaluation of cortical evoked potentials after stimulation of the vesicourethral junction shows accurate and reproducible results and offers an elegant technique for evaluation of the viscerosensory pathways in patients with lower urinary tract dysfunction. The results must be considered in context with the results of simultaneously investigated pudendal somatosensory evoked potentials and the clinical symptomatology. They are of great help (1) in differentiating between intraspinal and extraspinal lesions of the afferent pathways of the detrusor if the etiology is unknown, (2) in differentiating between neurogenic and myogenic damage to the urinary bladder, and (3) in selecting patients not suitable for intravesical electrotherapy for bladder rehabilitation.

New combination for the therapy of canine otitis externa. II. Efficacy in vitro and in vivo.

A new, effective drug combination was developed for the therapy of canine otitis externa (OE) by taking into consideration the microorganisms most frequently isolated from dogs affected with OE, their combination, their drug sensitivity and the type and incidence of ear canal inflammation. The antimycotic active ingredient of the combination is ketoconazole, its antibacterial component is gentamicin sulphate, while its antiphlogistic constituent is mazipredone hydrochloride. Based upon the results of in vitro pharmacodynamic tests, the antifungal activity of the combination is superior to that of ketoconazole used alone at the same concentration. A total of 210 dogs affected with OE were treated with the combination: 94.2 per cent of them became clinically symptomless and microbiologically negative in an average of 8.5 days. No adverse reactions were observed in connection with the use of the drug combination. The therapeutic results can be attributed to the high antifungal efficacy of the combination demonstrated in vitro and to the favourable properties of the solvent mixture.

New combination for the therapy of canine otitis externa. I. Microbiology of otitis externa.

In order to compound a new drug combination against canine otitis externa (OE), 515 dogs affected with OE were subjected to physical examination and microbiological analysis of their ear exudates. OE was erythematous-ceruminous in 83 per cent and suppurative in 17 per cent of the patient material. Erythematous-ceruminous inflammations were characterised by severe pruritus and accumulation of brownish, greasy cerumen in the auditory canal. The yeast Malassezia pachydermatis was isolated from the ears of 76 per cent of the dogs, often in combination with Staphylococcus intermedius bacteria. M pachydermatis showed the most sensitivity, in decreasing order of efficacy, to ketoconazole, econazole, clotrimazole, miconazole and nystatin. S intermedius isolates were most sensitive to amoxycillin-clavulanic acid, enrofloxacin, cephalexin and gentamicin. The microorganism most frequently isolated from dogs with suppurative OE was Pseudomonas aeruginosa; in some cases Proteus, Streptococcus and Pasteurella were also isolated. The P aeruginosa isolates showed the highest sensitivity to gentamicin, polymyxin B and tobramycin.

[Intravesical electrostimulation for treatment of bladder dysfunction. Initial experiences after gynecological operations]. / Intravesikale Elektrostimulation zur Behandlung von Blasenfunktionsstörungen. Erste Erfahrungen nach gynäkologischen Operationen.

OBJECTIVE: We investigated the role of intravesical electrical stimulation in the treatment of voiding dysfunctions following major gynecologic surgery. METHODS: 19 female patients with sensory and/or motor voiding dysfunction following gynecologic operations underwent intravesical electrostimulation after failure of traditional treatments. Before and after therapy, urodynamic examinations were performed. The follow-up was 6-24 months. RESULTS: All cases of sensory bladder dysfunction were cured. Volumes of residual urine significantly decreased (mean 274 vs. 53 ml: p = 0.0003) and maximum detrusor pressure increased (mean 6 vs. 27 cm H20; p = 0.0007). An early start of therapy (within 6 weeks after surgery) resulted in a better outcome. CONCLUSIONS: Intravesical electrical stimulation was effective in the treatment of sensory and motor voiding dysfunctions following major gynecologic surgery.

Identification of two alfalfa early nodulin genes with homology to members of the pea Enod12 gene family.

In a search for plant genes expressed during early symbiotic interactions between Medicago sativa and Rhizobium meliloti, we have isolated and characterized two alfalfa genes which have strong sequence similarity to members of the Enod12 gene family of Pisum sativum. The M. sativa genes, MsEnod12A and B, encode putative protein products of 8066 Da and 12849 Da, respectively, each with a signal sequence at the N-terminus followed by a repetitive proline-rich region. Based on their expression during the initial period of nodule development, MsEnod12A and B are alfalfa early nodulin genes.