Biomedical subjects

J Miklos

Publications and source records attributed to J Miklos.

8 recordsLinked to original sources

PubMed2002

Repeat tension-free transvaginal tape (TVT) sling for the treatment of recurrent stress urinary incontinence.

The pubovaginal sling is one of the preferred procedures for the treatment of female stress urinary incontinence because of its improved long-term cure rates. Recently a modified technique of the pubovaginal sling, known as the tension-free transvaginal tape (TVT), has gained popularity. We present the first reported cases of repeat TVT pubovaginal sling for the treatment of patients with recurrent stress urinary incontinence. Both patients had repeat TVT slings performed between 6 and 9 months following the initial procedure without revision or removal of the previous TVT sling. Both patients reported surgical cure without significant intraoperative or postoperative complications. It appears that reapplication of the TVT polypropolene sling may be a viable option in the event of initial TVT sling failure.

Aged↗

PubMed2001

Prospective randomized controlled trial of extended-release oxybutynin chloride and tolterodine tartrate in the treatment of overactive bladder: results of the OBJECT Study.

OBJECTIVE: To compare the efficacy and tolerability of extended-release oxybutynin chloride and tolterodine tartrate at 12 weeks in participants with overactive bladder. SUBJECTS AND METHODS: The OBJECT (Overactive Bladder: Judging Effective Control and Treatment) study was a prospective, randomized, double-blind, parallel-group study conducted between March and October 2000 at 37 US study sites. Participants who had between 7 and 50 episodes of urge incontinence per week and 10 or more voids in 24 hours received extended-release oxybutynin, 10 mg/d, or tolterodine, 2 mg twice daily. The outcome measures were the number of episodes of urge incontinence, total incontinence, and micturition frequency at 12 weeks adjusted for baseline. RESULTS: A total of 315 women and 63 men were randomized and treated, and 332 participants (276 women, 56 men) completed the study. At the end of the study, extended-release oxybutynin was significantly more effective than tolterodine in each of the main outcome measures: weekly urge incontinence (P=.03), total incontinence (P=.02), and micturition frequency episodes (P=.02) adjusted for baseline. Both drugs improved symptoms of overactive bladder significantly from baseline to the end of the study as assessed by the 3 main outcome measures (P<.001). Dry mouth, the most common adverse event, was reported by 28.1% and 33.2% of participants taking extended-release oxybutynin and tolterodine, respectively (P=.32). Rates of central nervous system and other adverse events were low and similar in both groups. CONCLUSIONS: Extended-release oxybutynin was more effective than tolterodine as measured by end-of-study urge incontinence, total incontinence, and micturition frequency episodes. Both groups had similar rates of dry mouth and other adverse events.

Aged↗

PubMed2000

Suprapubic bladder drainage after extraperitoneal cystotomy.

OBJECTIVE: To observe the effects of cessation of continuous bladder drainage after short-term catheterization in women who had extraperitoneal cystotomies. METHODS: The study population included 84 women, 78 of whom had retropubic urethropexies and six of whom had retropubic paravaginal repairs. Intentional cystotomy was done intraoperatively to assure ureteral patency, bladder integrity, and no inadvertent suture penetration into the bladder. All cystotomies were closed in two layers with 3-0 chromic suture. Suprapubic catheters were placed intraoperatively in all cases. In all women except four with gross hematuria, continuous bladder drainage was stopped and voiding trials were started within 24 hours after surgery. Suprapubic catheters were removed when women spontaneously voided 80% of total bladder volume. RESULTS: Suprapubic catheters were discontinued on average 4.1 days after surgery (range 2.7-14.1 days). Average bladder volume at initial clamping of the suprapubic catheter was 382 mL (range 224-510 mL). At this volume the integrity of the cystotomy should have been challenged appropriately. The women were observed for a minimum of 3 months with no immediate or long-term complications. CONCLUSION: Extraperitoneal cystotomy in a nondependent portion of the bladder does not require continuous bladder drainage for more than 24 hours. This information should allow pelvic surgeons to be more liberal with intraoperative cystotomies if bladder integrity or ureteral patency needs to be confirmed.

Cystostomy↗

PubMed1992

Effects of orchidectomy on gonadotropin and inhibin subunit messenger ribonucleic acids in the pituitary of the rhesus monkey (Macaca mulatta).

Our research programs required the preparation of hypophysectomized and orchidectomized rhesus monkeys. This afforded us the possibility to characterize and compare levels of the gonadotropin and inhibin subunit mRNAs in pituitaries from intact and castrate monkeys. Eighteen adult male monkeys, four of which had been bilaterally orchidectomized 5-9 months previously, were used in this study. Plasma concentrations of LH and FSH were, respectively, 188.5 +/- 5.3 and 246.8 +/- 25.2 ng/ml in the castrate monkeys and 25.8 +/- 4.5 and 4.1 +/- 1.1 ng/ml (mean +/- SEM) in the intact animals. Total pituitary RNA was hybridized to cDNA probes for cynomolgus monkey gonadotropin subunits (FSH beta, LH beta, and the common alpha-subunit) and for human inhibin subunits (alpha, beta B, and beta A) by Northern blot analysis, and mRNA levels were normalized by subsequent hybridization to cyclophilin. Each of the gonadotropin subunit probes hybridized to a single RNA species with the approximate sizes of 1.6 kilobases (kb; FSH beta), 0.7 kb (LH beta), and 0.8 kb (alpha). Levels of LH beta and alpha-subunit mRNAs in pituitaries from castrate monkeys were about 5- and 2-fold higher, respectively, than those in pituitaries from intact monkeys. FSH beta mRNA, on the other hand, was elevated about 27-fold in castrate monkeys [mean +/- SEM, 3176 +/- 408 cpm bound (n = 4 castrate) and 116 +/- 30 cpm bound (n = 8 intact]). Inhibin beta B-subunit mRNA was present in the monkey pituitary as a doublet of about 5 kb, and it was approximately twice as abundant in intact pituitaries as in castrate pituitaries. Hybridizations involving inhibin beta A cDNA revealed a faint band in the region expected for monkey beta A mRNA (6.5 kb) in three of six RNA samples from intact monkeys and a 0.3- to 0.4-kb mRNA species. mRNA encoding the inhibin alpha-subunit was undetectable by Northern blot hybridization. These results indicate that the postpubertal testis imposes an inhibition on the expression of the genes encoding FSH beta, LH beta, and glycoprotein hormone alpha-subunit and that this suppression of the FSH beta gene in the monkey is much greater than that in the rat. In addition, the monkey pituitary may be a source of activin, which may act locally to modulate FSH gene expression and secretion.

Animals↗

PubMed1991

[Polyostotic fibrous dysplasia (Jaffe-Lichtenstein)].

The study describes two cases of polyostotic fibrous dysplasia of the pelvis tending to progress along the lower extremities. The disease is of unknown origin and develops in the period of puberty. Has chronic qualities with remissions which could last for several years. The disease leads to deformities but spontaneous fractures are also possible. It is diagnosed by means of thorough radiologic examinations and histologically. Therapeutical treatment consists of symptomatic therapy and physiatric procedures, while cases of marked deformities and spontaneous fractures require surgical treatment.

Adult↗

PubMed1990

Rapid stimulatory effect of activin-A on messenger RNA encoding the follicle-stimulating hormone beta-subunit in rat pituitary cell cultures.

Activin, a dimer of the beta-subunits of inhibin, stimulates FSH secretion by cultured rat pituitary cells. Both the cell content of FSH and total FSH (secreted plus intracellular) are increased by activin, suggesting an effect on FSH biosynthesis. To test this idea directly, we examined the effect of purified human activin-A of recombinant DNA origin (rhactivin-A) on steady state levels of mRNAs for the gonadotropin subunits in pituitary cell cultures prepared from adult male rats. A preliminary study of the time course of rhactivin-A action indicated that the first significant effect on FSH secretion was observed at 6 h, with maximal stimulation occurring at 24-72 h. A small (20-30%), but significant, increase in LH secretion was also observed by 24 h. For RNA analysis, pituitary cell-cultures were treated for 2-72 h with a maximally effective concentration (50 ng/ml) of rhactivin-A. FSH secretion in rhactivin-A-treated cultures was elevated by 2- to 2.5-fold. Intracellular FSH increased gradually from 24-72 h. Recombinant human activin-A stimulated FSH beta mRNA levels at all times examined; FSH beta mRNA levels in activin-treated cultures were already twice those in control cultures at 2 h, and the magnitude of this effect remained constant up to 72 h. Recombinant human activin-A brought about small increases in secretion and cell content of LH and free glycoprotein alpha-subunit and in LH beta and alpha mRNAs at various times. Thus, the increases in gonadotropin release and cell content stimulated by rhactivin-A can be accounted for by increases in the gonadotropin subunit mRNAs.(ABSTRACT TRUNCATED AT 250 WORDS)

Activins↗

PubMed1988

Two methods for examining angular response of personnel dosimeters.

The American National Standard ANSI N13.11-1983 is used to test the accuracy (bias plus precision) of dosimetry processors as part of the dosimetry accreditation program of the National Voluntary Laboratory Accreditation Program (NVLAP). Section 3.8 of the ANSI N13.11-1983 standard requires that a study of the angular response of a dosimeter be carried out once, although no pass/fail criterion is given for angular response. The NVLAP accreditation program excluded Section 3.8, and thus no angular response data have been generated in an organized fashion. The objective of this project is to examine the feasibility of two alternative methods to test the angular response of personnel dosimeters. The first alternative involves static irradiations with the dosimeters at fixed angles to a radiation source. The second alternative involves dynamic irradiations with the dosimeters mounted on a rotating phantom. A Panasonic UD-802 personnel dosimetry system** was used to generate data to examine both alternatives. The results lead to two major conclusions. Firstly, Section 3.8 of the ANSI N13.11-1983 standard should be amended to require a pass/fail test for angular response. Secondly, a comparison between angular response data generated with a fixed or a rotating phantom shows that the rotating phantom is the more cost-effective method.

Algorithms↗

PubMed1985

Production of element correction factors for thermoluminescent dosimeters.

Approximately 80 processors of personal dosimetry in the United States use thermoluminescent dosimeters (TLDs). Recent demands that dosimetry processors be able to measure radiation doses to within +/- 50% of the correct value have focused attention on the reproducibility of the TL elements within each TLD. The phosphors for these TLDs are manufactured by three companies. A dosimetry processor faces three options concerning the quality of the TL elements purchased; trust the supplier's quality control program, screen new TL elements and discard those that are extremely bad, or use element correction factors (ECFs). The first option results in dosimetry processors failing the +/- 50% accuracy requirement due to excessive variability among the TL elements. The second option still permits large precision errors that come close to the +/- 50% accuracy requirement. This paper advocates the third option and presents a 10-step procedure to produce ECFs. The procedure ensures that the ECFs represent only variations among the TL elements and not variations caused by stability problems with the TLD reader. Following is an example of ECF production for 3000 TLDs.

Quality Control↗