All-Solid-State Tunable Ultraviolet Subnanosecond Laser with Direct Pumping by the Fifth Harmonic of a Nd:YAG laser.

We report what we believe is the first all-solid-state tunable ultraviolet laser pumped by the fifth harmonic of a Q-switched Nd:YAG laser. Our laser based on a Ce(3+):LiLuF(4) active medium stably generates a single, satellite-free, 0.88-ns pulse under 5-ns, 10-Hz repetition rate pumping conditions. A novel tilted-incident-angle side-pumping scheme resulted in a simple laser-cavity design.

Morphological and functional factors predicting bladder deterioration after spinal cord injury.

PURPOSE: We investigated factors predictive of morphological and functional deterioration of the bladder in patients with spinal cord injury. MATERIALS AND METHODS: Urological evaluation, including excretory urography and urodynamic studies, was performed once a year in 66 patients. Bladder compliance was used as an index of bladder function. RESULTS: Mean age of the patients with worsening bladder form and function was significantly greater than that of those with no change. In patients with worsening bladder function intermittent catheterization was performed less frequently and mean catheterization volume was greater compared to those with improvement and no change. Catheterization was less frequent and at long intervals in patients with a high urethral closure pressure. CONCLUSIONS: High storage pressure due to a high urethral closure pressure is believed to cause deterioration of bladder form and function.

[Clam ileocystoplasty for neurogenic bladder due to spina bifida].

A 24-year-old female with neurogenic bladder due to spina bifida consulted our department for further evaluation and treatment of a left renal stone. She innately voided urine by Crede's method. At the age of 15 years, intermittent self-catheterization was started because left severe hydronephrosis was found. At the age of 19 years, cystostomy was performed because of low compliance bladder and an aggravation of hydronephrosis in spite of intermittent catheterization. Thereafter, she was referred to our department for further evaluation and treatment of a left renal stone since the stone was increasing in size. First, left percutaneous nephrolithotomy was performed successfully. Secondly, clam ileocystoplasty using the ileum was carried out, followed by 1) increase of the bladder capacity, 2) improvement of the bladder compliance, 3) adequate intermittent self-catheterization, and 4) disappearance of urinous odor resulting from removal of the cystostomy catheter. Thus, the clinical effects were thought to be significant.

[Clinical evaluation for voiding dysfunction in patients with cerebral-palsy].

Urological assessments were done on 132 patients with cerebral palsy, ranging from 5 to 59 years in age (mean 23.2). Concerning urological symptoms, urinary incontinence, decreased urinary stream and urinary tract infection were at 31.8, 14.4 and 16.7%, respectively. Patients with functionally impaired ambulation had a high incidence of urinary incontinence and decreased urinary stream. Decreased urinary stream was more prominent in an elderly patient group, and urinary incontinence was observed almost at the same rate in all age-classified groups. Urodynamic studies were performed in 30 patients with cerebral palsy who were referred to with urological symptoms. The patients were classified into two groups according to the presence or absence of spinal cord lesions. In a group of 15 patients with spinal cord lesions, electromyography of the external sphincter demonstrated detrusor-sphincter dyssynergia (DSD) in 9, of whom 6 complained of decreased urinary stream; while in the group without spinal cord lesions there was no DSD. These findings suggest that the cause of decreased urinary stream in cerebral palsied patients could be explained by DSD secondary to spinal cord lesions.

[The acetabular roof formation of the operative treatment in CDH (author's transl)]. / Pfannendachbildender Effekt verschiedener operativer Eingriffe in der Behandlung der sogenannten kongenitalen Hüftgelenksluxation

The acetabular roof construction is discussed in the open reductions, pelvic osteotomy and derotational osteotomy. Open reduction under 18 manth old, if without secondary change of the femoral head, gets sufficient acetabular covering. Pelvic osteotomy as the reconstructive manoeuver around 3 years old can also get a good acetabular condition.