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Biomedical subjects

R Bosch

Publications and source records attributed to R Bosch.

At least 19 recordsLinked to original sources
PubMed2005

[Pudendal nerve stimulation therapy of the overactive bladder -- an alternative to sacral neuromodulation?].

PURPOSE: Sacral neuromodulation is known to be an alternative therapeutic option for patients with anticholinergic resistant overactive bladder (OAB). For the same indication, a microstimulation system called BION is available since last year. The BION-stimulator, which only measures 2.8 x 0.3 cm, is designed for pudendal nerve stimulation. Its implantation technique as well as the first clinical results are presented and discussed. MATERIALS AND METHODS: During an outpatient percutaneous screening test (PST), a pudendal nerve stimulation is performed with a needle electrode in local anesthesia. A 50 % increase in the urodynamic parameters (bladder capacity, first desire to void, compliance, etc.) is an indication for a chronic implantation of the BION stimulator, which also can be placed in local anesthesia. RESULTS: Two patients have been treated with a BION-stimulator in our clinic so far. Patient I suffered from an OAB with frequent urinary incontinence and patient II had a sensory OAB with high voiding frequency. After the BION(R)-implantation, patient I showed a reduction in incontinence episodes by 31.5 % a day and patient II had lowered voiding frequencies from 12.6 to 7 a day. The postoperative urodynamic investigations confirmed these clinical results. CONCLUSIONS: The BION-system and chronic pudendal nerve stimulation seem to be alternatives to sacral neuromodulation, however, patient selection is difficult as subchronic stimulation for a longer period of time is not possible so far.

Aged↗
PubMed2004

Epidemiology/risk factors of sexual dysfunction.

INTRODUCTION: Accurate estimates of prevalence/incidence are important in understanding the true burden of male and female sexual dysfunction and in identifying risk factors for prevention efforts. AIM: To provide recommendations/guidelines concerning state-of-the-art knowledge for the epidemiology/risk factors of sexual dysfunctions in men and women. METHODS: An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Epidemiology/Risk Factors Committee, there were seven experts from four countries. MAIN OUTCOME MEASURE: Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. RESULTS: Standard definitions of male and female sexual dysfunctions are needed. The incidence rate for erectile dysfunction is 25-30 cases per thousand person years and increases with age. There are no parallel data for women's sexual dysfunctions. The prevalence of sexual dysfunction increases as men and women age; about 40-45% of adult women and 20-30% of adult men have at least one manifest sexual dysfunction. Common risk factor categories associated with sexual dysfunction exist for men and women including: individual general health status, diabetes mellitus, cardiovascular disease, other genitourinary disease, psychiatric/psychological disorders, other chronic diseases, and socio-demographic conditions. Endothelial dysfunction is a condition present in many cases of erectile dysfunction and there are common etiological pathways for other vascular disease states. Increasing physical activity lowers incidence of ED in males who initiate follow-up in their middle ages. CONCLUSIONS: There is a need for more epidemiologic research in male and female sexual dysfunction.

Adult↗
PubMed2003

Experience with an ICD incorporating biventricular pacing.

Biventricular pacing for cardiac resynchronization is a promising therapy for symptomatic improvement in selected patients with underlying severe congestive heart failure. ICD treatment has been shown to prolong life in patients with life threatening ventricular tachyarrhythmias, but it does not improve quality of life. This review discusses current experience with ICD's incorporating biventricular pacing.

Arrhythmias, Cardiac↗
PubMed2001

[Dermatography. An effective method for pacemaker marking after spinal cord injuries and implantation of a Brindley stimulator for neurogenic bladder].

In our department, two spinal cord lesion patients suffering from neurogenic bladder dysfunction were selected for the implantation of a Brindley stimulator, as they could not be managed by conservative treatment. Accurate positioning of the external transmitter block over the subcutaneous receiver block, which is essential for the Brindley stimulator to function correctly, posed problems for the relatives who had to apply the external transmitter. In order to facilitate positioning, dermatography was used to mark the exact spot where the external transmitter should be placed. A 3-year follow-up showed that this marking solved the problem completely and that recurrent urinary tract infections stopped.

Artificial Organs↗
PubMed2001

Inflammatory myofibroblastic tumour of larynx.

Inflammatory myofibroblastic tumour (IMT) is a benign pseudoneoplastic proliferation, mainly developing in the lung and extremely rare in the larynx. A patient with a two-month history of dysphonia and a polypoid left true vocal fold tumour is presented. Histological and clinical knowledge of this lesion is important to exclude a misdiagnosis (e.g. malignant epithelial or mesenchymal tumours) and an inappropriate treatment.

Aged↗
PubMed2000

Complete nucleotide sequence and evolutionary significance of a chromosomally encoded naphthalene-degradation lower pathway from Pseudomonas stutzeri AN10.

Pseudomonas stutzeri strain AN10 is a naphthalene-degrading strain whose dissimilatory genes are chromosomally encoded. We sequenced the entire naphthalene-degradation lower pathway of P. stutzeri AN10, this being, together with the upper-pathway reported previously (Bosch R. et al., 1999a. Gene 236, 149-157) the first complete DNA sequence for an entire naphthalene-catabolic pathway. Eleven open reading frames were identified. The nahGTHINLOMKJ genes encode enzymes for the metabolism of salicylate to pyruvate and acetyl-CoA, and nahR encodes the NahR regulatory protein. Our findings suggest that catabolic modules were recruited through transposition events and recombination among tnpA-like genes, and subsequent rearrangements and deletions of non-essential DNA fragments allowed the formation of the actual catabolic pathway. Our results also suggest that the genes encoding the xylene/toluene-degradation enzymes of P. putida mt-2 (pWW0) have coexisted with the nah genes of the P. stutzeri AN10 ancestral genome. This could allow the selection, via recombination events among homologous genes, for a combination of genes enabling the metabolism of a given aromatic compound in the ancestral host strain. Such events accelerate the evolution of modern catabolic pathways and provide new genetic material to the environment, ultimately resulting in improved, natural, bioremediation potential.

Amino Acid Sequence↗
PubMed2000

Factors causing differences in voiding parameters between conventional and ambulatory urodynamics.

Voiding parameter values measured with ambulatory urodynamic monitoring (AM) are generally found to be different from those measured with conventional cystometry (CMG). The reason for this is unclear, but might be related to differences in the voided volume. To verify this hypothesis, we compared voidings from female patients at an initial bladder volume that was close to the modal volume (that is, the volume most often voided by the patient as derived from frequency/volume charts) with voidings at maximum cystometric capacity during a routine video urodynamic examination. A first group of 35 patients voided at the modal volume before they did at capacity. The order was reversed in a second group of 12 patients. The dependence of the voiding parameters on the voided volume and the order of the measurements were examined. It was found that the maximum flow rate depended significantly on the voided volume, but the associated detrusor pressure did not. Urethral resistance and bladder contraction strength were not volume dependent either. It was concluded that the differences between AM and CMG cannot be explained from possible differences in the voided volume.

Female↗
PubMed2000

[Spondylolysis in the developmental stage: diagnostic contribution of MRI].

PURPOSE: To assess the value of MR imaging in demonstrating ongoing spondylolysis in adolescents. METHODS: MRI was performed in 9 juvenile patients (3 female, 6 male aged 8-16 years; mean 12.5 y) with pain during hyperextension. In 6 patients a CT scan and in 5 a plain film was available. RESULTS: In all patients bone marrow edema was found in the pars interarticularis and the pedicle, which was bilateral in 4 patients. In 7/9 cases the L5 vertebra was affected, in 2/9 cases spondylolysis was found in L4. In 3 cases the edema reached the middle third of the vertebral body and a tumor was suspected. In all CT scans a bilateral incomplete or complete cleft in the pars inter-articularis was found. In 4/6 CT-scans a sclerosis was seen in the area of the bone marrow edema. Only in 1/5 plain films was there a suspicion for a spondylolysis, four examinations were completely normal. CONCLUSIONS: To eliminate underlying causal conditions of spondylolysis and to install specific therapy, early diagnosis is mandatory. MR imaging should be the first and only imaging modality in young patients with low back pain during and after exercise and pain with hyperextension. Bone scans and CT scans should be avoided due to irradiation, plain films usually do not reveal pathological findings in developing sponylolysis.

Adolescent↗
PubMed1999

Genetic characterization and evolutionary implications of a chromosomally encoded naphthalene-degradation upper pathway from Pseudomonas stutzeri AN10.

Pseudomonas stutzeri strain AN10 is a naphthalene-degrading strain whose dissimilatory genes are chromosomally encoded. We sequenced a total of 11514bp including the entire naphthalene-degradation upper pathway (nah) of P. stutzeri AN10. Nine open reading frames, nahAaAbAcAdBFCED, encoding the enzymes for the degradation of naphthalene to salicylate, were identified. The nah genes of P. stutzeri AN10 have been compared with genes encoding isofunctional proteins from other Pseudomonas naphthalene-degradation upper pathways. The implications of the sequence homologies to the evolution of aromatic catabolic pathways are discussed. Our findings indicate that this entire catabolic module of P. stutzeri AN10 was recruited from other microorganisms and a short period of time has elapsed after its incorporation within the P. stutzeri AN10 genome. Comparisons also suggest the coexistence of two entire nah upper pathways in a host strain, and further recombination between them. These events could accelerate the evolution of modern catabolic pathways.

Amino Acid Sequence↗
PubMed1999

The responsiveness of the ICSmale questionnaire to outcome: evidence from the ICS-'BPH' study.

OBJECTIVE: To evaluate the responsiveness of the ICSmale questionnaire to the outcome of treatments for lower urinary tract symptoms (LUTS). PATIENTS AND METHODS: Consecutive men aged >45 years attending 23 urology centres in 12 countries, with symptoms suggestive of bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH), were recruited to Phase I of the International Continence Society (ICS)-'BPH' study. In Phase II of the ICS-'BPH' study, 355 men in 15 centres in nine countries were followed up, having proceeded to treatment according to clinical practice. All men completed the ICS-'BPH' study questionnaire at baseline and follow-up, including the ICSmale which concerns LUTS and related problems. RESULTS: Patients included in Phase II were similar to those in Phase I according to age and levels of baseline symptoms. Patients received a range of treatments: 32% TURP, 29% drug therapies, 20% watchful waiting, 9% minimally invasive therapies and 10% 'others' (including open prostatectomy). For patients who underwent TURP, most LUTS, including voiding and filling symptoms, were highly statistically significantly better at follow-up than at baseline (P<0.0001). For drug, minimally invasive and 'other' treatments, fewer LUTS were highly statistically significantly better. For those undergoing watchful waiting, no symptoms were significantly different between baseline and follow-up. CONCLUSION: The ICSmale questionnaire, in addition to being psychometrically valid and reliable, is responsive to change in outcome.

Age Factors↗
PubMed1999

NahW, a novel, inducible salicylate hydroxylase involved in mineralization of naphthalene by Pseudomonas stutzeri AN10.

Two genes, nahG and nahW, encoding two independent salicylate 1-hydroxylases have been identified in the naphthalene-degrading strain Pseudomonas stutzeri AN10. While nahG resides in the same transcriptional unit as the meta-cleavage pathway genes, forming the naphthalene degradation lower pathway, nahW is situated outside but in close proximity to this transcriptional unit. The nahG and nahW genes of P. stutzeri AN10 are induced and expressed upon incubation with salicylate, and the enzymes that are encoded, NahG and NahW, are involved in naphthalene and salicylate metabolism. Both genes, nahG and nahW, have been cloned in Escherichia coli JM109. The overexpression of these genes yields peptides with apparent molecular masses of 46 kDa (NahG) and 43 kDa (NahW), respectively. Both enzymes exhibit broad substrate specificities and metabolize salicylate, methylsalicylates, and chlorosalicylates. However, the relative rates by which the substituted analogs are transformed differ considerably.

Amino Acid Sequence↗
PubMed1998

The N-terminal portion of parathyroid hormone-related protein mediates the inhibition of apical Na+/H+ exchange in opossum kidney cells.

Parathyroid hormone (PTH) and PTH-related protein (PTHrP) can activate a common receptor in several different cell types. Both PTH and N-terminal PTHrP peptides have been shown to acutely inhibit the apical Na+/H+ exchanger in the renal proximal tubule. In this study, the ability of various PTHrP fragments to inhibit apical Na+/H+ exchange was investigated. In addition, the signal transduction events associated with PTHrP inhibition of apical Na+/H+ exchange in polarized OK-P cells were characterized. Both PTHrP-(1-34)NH2 and recombinant full-length PTHrP-(1-141) inhibited apical Na+/H+ exchange activity by approximately 50%. These changes occurred in close temporal association with significant (threefold) increases in cellular cAMP accumulation. PTHrP-(1-34)NH2 had no effect on intracellular Ca2+, inositol phosphate production, or protein kinase C activity. PTHrP peptides, including PTHrP-(38-64)NH2, PTHrP-(67-86)NH2, PTHrP-(102-107)NH2, and PTHrP-(107-139)NH2, which lack the PTH-like N terminus, had no effect on the antiporter activity or cAMP accumulation. The results demonstrate that the N-terminal portion of the PTHrP molecule is responsible for inhibition of the apical Na+/H+ antiporter in OK-P cells.

Animals↗
PubMed1997

Identification of gene products from the Azotobacter vinelandii nifBfdxNnifOQ operon.

The Azotobacter vinelandii nifBfdxNnifOQ operon is required for synthesis of the nitrogenase iron-molybdenum cofactor. To further characterize the roles of its gene products, specific antibodies against NifB and NifO were generated, and the NifB, NifO and NifQ gene products were visualized and identified in nitrogen-fixing A. vinelandii cell extracts by a combination of two-dimensional gel electrophoresis of radiolabelled extracts and immunological detection methods. The three proteins showed apparent pI and M(r) values similar to those expected from sequence data, except for NifO, which showed an apparent M(r) of ca. 23 kDa (vs. 16 kDa expected).

Azotobacter vinelandii↗
PubMed1996

The influence of extracellular Ca2+ on the time course of isovolumetric pressure development in the guinea-pig urinary bladder.

Isovolumetric contractions were induced electrically in five guinea-pig bladders in a 1.8 mM Ca2+ buffer solution at two different volumes. The rate of pressure development was studied by analysis of phase-plots, which are plots of the rate of change of intravesical pressure as a function of pressure. At relatively large volumes the rate of pressure development showed a biphasic nature, suggesting that two different processes were involved in different phases of contraction. Extracellular Ca2+ was manipulated to identify these processes. Removal of extracellular Ca2+ led to an 85% reduction of the maximum isovolumetric pressure in subsequent stimulations, but pressure developed faster. The biphasic nature of pressure development at large volumes tended to disappear. It was concluded that at large bladder volumes pressure development in this type of smooth muscle is determined by the release of intracellularly stored Ca2+ in the early phase of contraction. In the final phase the rate of pressure development is limited by the extracellular Ca2+ influx. At small bladder volumes the Ca2+ influx takes place at a higher rate, so that the contribution of intracellular Ca2+ release to pressure development could not be identified at these volumes.

Animals↗