These drugs have no significant role to decrease detrusor contractility or increase bladder capacity, because α - adrenergic antagonists have minimal contractile effects on human detrusor smooth muscle from normal individuals. However, the peripheral contribution of these receptors of the bladder get changed in neurological diseases or injury and in bladder outlet obstruction. Parasympathetic decentralization has been reported to lead to a marked increase in adrenergic innervations of the bladder, with a resultant conversion of the usual beta (relaxant) response of the bladder in response to sympathetic stimulation to an alpha (contractile) effect. ICI committee judged the pharmacologic and physiologic evidence and they did not recommend it for OAB.
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This was a cross-sectional study done in SBB college of physiotherapy, VS hospital Ahmedabad. 46 pre-menopausal women between 20 to 45 years of the age was included in the study. Female willing to participate with Regular menstrual cycle without any complain that would suggest premature menopause were included in the study. Premenopausal women having diabetes mellitus, chronic lung disease, history of recurrent UTI, any neurological condition, surgery for urinary incontinence, major pelvic surgery were excluded for the study. OUTCOME MEASURE- (1)Body mass index (BMI), (2) International Classification of Incontinence Questionnaire- Over active bladder symptom (ICIQ-OAB).Subject were informed about nature of the study and were given information relevant to the intended purpose. Verbally consent and demographic details were taken at the time of the study. Demographic details about name, age, gender, height, weight, education, profession were taken. Height and weight of all the participant was measured for calculating the BMI.Printed version of questionnaire was used in the language they easily understood. All the participant completed the over active bladder questionnaire and return the questionnaire at same time with, no questions were left unanswered. It took approximately 10-15 min to complete the questionnaire. STSTISTICAL ANALYSIS
Pelvic floor disorder was assessed based on women’s reporting of symptoms. Each pelvic floor disorder (Stress urinary incontinences (SUI), over active bladder (OAB), pelvic organ prolapse (POP), and anal incontinence (AI)) was dichotomized as present or absent based on responses to each symptom domain. Over active bladder was assessed by asking, “Do you rush to urinate so that you will not have leakage of urine?”, “Do you experience fre- quent urination?”, “Have you experienced urine leakage related to a feeling of urgency?” Stress urinary incontin- ence was assessed by asking, “Do you experience urine leakage related to activity, coughing, or sneezing?” and “Do you experience small amounts of urine leakage (drops)?” Pelvic organ prolapse was assessed by asking, “Do you have a sensation that there is a bulge in your va- gina or that something is falling out from your vagina?” Anal incontinence was assessed by asking, “Do you lose gas from your rectum that is beyond your control?”, “Do you lose stool beyond your control if your stool is loose or liquid?”, “Do you lose well-formed stool beyond your con- trol?” Positive responses to at least one of the questions from each of the pelvic floor disorder categories defined the presence of the problem. Women who had at least one pelvic floor disorder were categorized as “have PFD” and women who did not report at least one pelvic floor dis- order were categorized as “do not have PFD” [12, 24, 25].
Self-care and self-medication have attracted considerable international health- care policy interest because they effectively reduce the burden on health services. A large number of people make use of non-prescription over-the-counter (OTC) medicines for themselves or their children, and many health professionals in primary care settings recommend them to their patients as a first-line treatment for a range of non-serious conditions . Pharmacists play an increasingly im- portant role in patient care, in particular in the recommendation of non-pre- scription remedies. This is being shown to be beneficial to patients . Phar- macists are becoming more patient oriented and are bringing many positive changes in lives of patients. There is mounting evidence that patient counseling and product recommendation by the pharmacist enhance patient satisfaction  and improve patient outcomes .
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hypoxic areas (57.81% and 41.8% at 4 h and 24 h post-injection, respectively). The results could be attributed to the high tumor accumulation of the NPs, which allowed for sustained oxygen generation in the bladder cancer tissues. Such enhanced oxygenation in bladder cancer tissue could favor the increased PDT efficacy in vivo to overcome the hypoxia-associated photodynamic resistance.
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Our study has some limitations. First, our data were obtained from the experience at a single institution and the number of patient is relatively small. Second, we evaluated the position of the bladder neck in a restricted condition, in that cystography was performed in the su- pine position without straining or standing. With in- creased abdominal pressure, the bladder neck presumably will present in a lower position. Third, we did not evaluate various other parameters which may correlate with incontinence. Pre- and/or post-operative membranous urethral length, preoperative LUTS, pre- operative incontinence, and the surgeon’s extent of ex- perience were not evaluated in our series, because of a lack of adequate data. However, regardless of these limi- tations, the location of the bladder neck visualized by a cystogram may become a helpful predictor of post-prostatectomy incontinence.
sarcoplasmic reticulum, which causes release of activator Ca 2+ . 16,17 DAG along with Ca 2+ activates PKC which phosphorylates specific target proteins. In most smooth muscles, PKC has contraction-promoting effects such as phosphorylation of Ca 2+ channels that regulate cross- bridge cycling. Activator Ca 2+ binds to calmodulin, leading to activation of myosin light chain kinase. This kinase phosphorylates the light chain of myosin and in conjunction with actin, cross-bridge cycling occurs which start initiating shortening of the smooth muscle cell. 18,11 This Ca 2+ can enter the cytoplasm through the cell membrane via Ca 2+ channels or released from the sarcoplasmic reticulum (SR). The release of Ca 2+ from the SR is an important step in activation of the detrusor muscle. The Ca 2+ activation of the contractile proteins is considered to occur via a phosphorylation pathway where Ca 2+ binds to calmodulin to form Ca 2+ - calmodulin complex. This complex activates the MLCK which catalyzes the phosphorylation of the myosin regulatory light chains. The Ca 2+ induced activation of MLCK and the MLCP activity are the main pathways for contraction and relaxation. Ca 2+ concentration and myosin light-chain phosphorylation is variable in the muscle. The phosphorylated myosin interacts with the actin filaments to form cross- bridges. The cross- bridges between actin and myosin continue if the intracellular calcium is maintained but if there is some declination of Ca 2+ , the enzyme myosin phosphatase is activated. 11 As a result, appropriate contraction occurs in urinary bladder muscles.
independent of water flow. Phloretin, when present at 10 -4 M concentration in the medium bathing the luminal surface of the toad bladder, strongly inhibits the movement of urea, acetamide, and propionamide across the toad bladder, both in the absence and presence of vasopressin. The vasopressin-stimulated movement of formaldehyde and thiourea is also reduced. Osmotic water flow, on the other hand, is not affected; nor is the movement of ethanol and ethylene glycol, or the net transport of sodium. On the basis of these studies we would conclude that the movement of many, if not all, solutes across the cell membrane is independent of water flow, and that a vasopressin-sensitive carrier may be involved in the transport of certain solutes across the cell membrane.
These results also show that baseline depression can lead to increased feelings of helplessness at six months, which in turn leads to greater pain at one-year. It is possible that a depressed mood may cast a negative light on one’s perceived ability to cope with pain over time or it may reflect feelings of helplessness. There is evidence that depression level (high or low) moderates the effect of patient coping in the relationship between catastrophizing and pain. 28 Thus, clinicians may consider appropriate antidepressant intervention alongside a referral to a psychosocial de-catastrophizing program to optimise pain management outcomes.
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Bladder irrigation was carried out twice each week by senior urological nurses according to the following standardized protocol: 1) explain the reason and the procedure to the patient; 2) insert a two-way or three-way catheter (16F - 22F) with using of aseptic technique; 3) Place blue sheet under the catheter and drainage bag connection, unsterile jug on bottom of trolley; 4) Clean catheter and drainage bag connection with chlorhexidine wipes, disconnect and wrap the drainage bag end in a chlorhexidine swab and if possible give to the patient to hold; 5) Use a Catheter tip 50 ml syringe and Sterile normal saline to irrigate the catheter by flushing in and drawing back to evacuate any clot or debris; 6) the intake volume should not exceed the patient’s bladder safety volume according to urodynamics in order to protect the upper urinary tract; 7) empty each returned syringe di- rectly into the unsterile jug on the bottom of the trolley; 8) bladder irrigation procedure was performed twice a week.
The biological behavior of cancer cells in tumor tissues is generally affected by the extracellular matrix (ECM) and the recognition, adhesion, and interaction between cells. In this perspective, the ECM modulates the behavior and features of solid tumors. 37,38 Here, the collagen and osteopontin compo- nents of the ECM can modify the microenvironment in solid tumors to regulate drug-resistance, proliferation, and metas- tasis of tumor cells. As a membrane protein, the ADAMs can function as a key regulator of adhesion and interaction between cells in their ECM. Here, ADAM15 promotes the extracellular shedding of E-cadherin, which is involved in cell activation and proliferation. With such an effect, the down-regulation of ADAM15 could kill bladder cancer cells. Thus, the results of the present work also provide a theoretical basis for future targeted treatment of bladder cancer. Moreover, ADAMs also have other functions. For instance, Zhang et al and Dosch et al suggested that ADAM17 and ADAM10 mediate the cleaving and activation of the NOTCH (Notch Signaling pathway) protein and enhance the EMT and resistance of tumor cells. 39,40 A such, targeting these ADAMs could be an approach for antitumor Table 4 The Inhibitory Rates of miR-3174 on Five Patient-
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One of the main therapeutic approaches is so-called "gly- cosaminoglycan (GAG) replacement therapy." This is partly based upon earlier observation that the so-called "GAG Layer" is lost or damaged in the interstitial cystitis bladder [6,7]. The "GAG Layer" is a complex set of prote- oglycans and glycoproteins on the bladder surface has been isolated and characterized from cow and human bladder [8-11]. Whether or not glycosaminoglycans actu- ally restore impermeability of the bladder in interstitial cystitis is controversial [12-15]. Nonetheless, many patients respond to intravesical instillations of pentosan polysulphate (Elmiron) , hyaluronate (Cystistat) , chondroitin sulphate (Uracyst) or heparin . In this paper, we use three different models of bladder damage to determine whether GAG instilled intravesically actually binds preferentially to damaged bladder. We pre- pared a fluorescent-labeled chondroitin sulphate mole- cule by covalently attaching Texas Red to the reducing terminus of the GAG chain and then observing bladder sections by fluorescence to determine where the labelled GAG was found.
The PLpro monomer is consists of 4 domains including the extended ubiquitin-like domain (UBL), the thumb domain, the palm domain and the fingers domain (12). The active site is located at the interface of the thumb and palm sub-domains and contains a classic catalytic triad, composed of Cys856–His1017–Asp1031, adjacent to the flexible BL2 loop containing Trp851 (according to the homology modeled structure residue numbering). The enzyme has four substrate recognition subsites (S1-S4) (26). Figure 4b represents the active site, the residues and the related subsites. S1 and S2-subsites are mostly buried. S1-subsite includes residues Gly1016, Trp851, Cys856, and Tyr857. Residues Leu907, Asp909, Gly1016, and Tyr1018 are involved in shaping the conserved S2-subsite (residues colored in orange). S3- subsite is partially solvent-exposed and include Gly2016. Like S1 and S2, S4 is also buried and is structured by Asp1047, Pro993, Tyr1009, Tyr1013, Tyr1018, and Thr1046 (residues colored in purple) (28). S2 and S4-subsites are the binding sites for SARS-CoV PLpro competitive inhibitors (28, 29).
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duced copolymer has broad bimodal molecular weight distributions (Table 1, Figure 2, M w /M n = 14) and char- acterized by optimal particle size for slurry polymer- ization process (̴ 250 microns), narrow particle size distribution (SPAN = 0.68) and high bulk density (390 g/L). Data on activity of the VMC and characteristics of polymer samples produced over VMC during the ethylene-1-butene polymerization with different po- lymerization times are shown in Table 1 (runs 5 and 6) and Figure 3. The kinetic curves of ethylene-1-butene copolymerization in the presence of hydrogen (Figure 3) resemble the kinetic curves of ethylene-1-hexene copolymerization (Figure 1): the maximum rate of the
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Urodynamic studies were conducted on this patient in both 2008 and 2010. In these studies, a 12 Fr trilumen catheter was transurethrally inserted into the bladder to measure vesicular pressure, while abdominal pressure was measured by intrarectal balloon catheter. Detrusor pres- sure was obtained by subtracting abdominal pressure from bladder pressure. In 2008, the studies revealed OAB with
18. Underwood M, Bartlett J, Reeves J, Gardiner DS, Scott R, Cooke T. C-erbB-2 gene amplification: a molecular marker in recurrent bladder tumors? Cancer Res 1995; 55: 2422–30. 19. Vollmer RT, Humphrey PA, Swanson PE, Wick MR, Hudson ML. Invasion of the bladder by transitional cell carcinoma: its relation to histologic grade and expression of p53, MIB-1, c-erb B-2, epidermal growth factor receptor, and bcl-2. Cancer 1998; 82: 715–23.
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a primary appraisal of the pain that determines whether their pain is perceived as threatening. In a secondary appraisal process, the pain and the situation that the pain occurs in are then evaluated against the individual’s belief that they can manage that pain (i.e., threat) using coping strategies they have likely used in the past. As well, the person exam- ines their belief that this coping will lead to a successful reduction in the pain. In this secondary appraisal of pain, if the coping does not meet the threat level for that pain situation, or over a series of pain situations, then thoughts of helplessness with pain management are likely. In turn, these helplessness thoughts can generate greater anxious thinking when pain is present and thus reinforce greater helplessness unless this negative cycle is intervened upon. 25- 27 The findings from this study reinforce the importance of
With the increasing use of wireless sensor devices over the past decade and an expected exponential increase of usage of such devices over the next decade , the need for better energy-efficient communication schemes has been imminent. Among other things this has led to more research in low-power spread-spectrum (SS) techniques – as an energy-efficient method of communication. SS signals are defined as low power spectral density (PSD) signals that use radio frequency (RF) signal bandwidths that greatly exceed the minimum bandwidth required to transmit their data. The signal’s spectrum is thus spread over a significantly wider RF chan- nel than needed to transmit the information signal , where the ratio between the transmission bandwidth and the bandwidth of the information signal is defined as the processing gain. As SS systems are mostly designed to overlay on top of other radio systems, having a large processing gain can assist in providing robustness against interference. However, receiver signal acquisition can be challenging in SS systems with large processing gains, de-spreading is not activated prior to synchronization and the received signal has to be retrieved at very low signal-to-noise ratio (SNR) levels. This is due to the fact that in SS the PSD is low and more powerful interferers are present. Additionally, in order to make SS robust against multi-path fading, com- plex receiver structures have to be used , –, resulting in longer acquisition times.
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In this study the operative time and hospital stay were significantly shorter in group I than in group II with which was very pleasant for the patients in minim- ize the total cost and early return to their usual life and these results agreed with Ozcan et al. . The difference in the operative blood loss between the two groups was insignificant, so urinary bladder inflation before starting surgery had no effect in minimize the need for blood transfusion in this study or in Ozcan et al.  while this maneuver had minimized incidence of blood transfusion that needed during or immediately postoperative as reported by Matsubara et al. . Furthermore, the later state that the primary aims for the bladder inflation was to minimize the bleeding rather than to prevent the urinary bladder injury as this allowed easy cutting and ligation of the aberrant vessels. As regard to postoperative voiding dysfunction, the patients in both group had a non-significant difference with p > 0.05. Finally remote urinary tract complications as ureteric or urinary fistulae, group I reported one case (2.6%) of postoperative urinary bladder fistula but in the other side group II reported two cases (5.2%) devel- oped remote urinary fistula with mildly statistically significance (p < 0.05).
All experimental data from three independent experiments were presented as mean ± standard deviation (SD). All statistical data were analyzed by SPSS 19.0 software (SPSS Inc.Chicago, IL, USA). The ETS-1 RNA expression differences between bladder cancer tissue and matched normal tissue were analyzed using paired samples t-test. The relationship between ETS-1 level and clinical- pathologic characteristics in 42 patients with bladder cancer were analyzed by Continuous correction chi-square test. The data of CCK-8 assay were analyzed by ANOVA and independent samples t-test was used to analyze other data. A P value of less than 0.05 was considered to be statistically significant.
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