Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a 74 years old woman who developed bleeding per vaginam following a paroxysm of cough colposcopic inspection revealed a yellowish-brown soft tissue of the mucous membrane of the upper vaginal vault. Microscopical examination showed a typical Malacoplacia of the vagina. Bleeding per vaginam resulted from ruptured vessels of this granulation tissue. This seems to be the 2nd case of a Malacoplacia of the vagina, as far as we are informed.
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PMID:[Malacoplacia of the vagina, a rare cause of vaginal bleeding (author's transl)]. 43 56

A 50-year-old Japanese female with choriocarcinoma showed three unusual features: the primary tumor developed in the vagina ectopically without uterine lesion; the first symptoms of atypical vaginal bleeding and coughing occurred 23 years after the last pregnancy; and the tumor appeared during postmenopause. The possible mechanisms for the ectopic location and latency are discussed.
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PMID:Latent vaginal choriocarcinoma in a postmenopausal woman. 103 57

In order to understand the pathology of incontinence, it is important to investigate urinary symptoms, urological and neurological examinations and urodynamics. There are two kinds of incontinence. One is true incontinence in which urine passes through urethra, and the other is false incontinence due to the ectopic opening of the ureter, for example to the vagina. The former includes stress incontinence, urge incontinence, reflex incontinence, overflow incontinence and total incontinence. Stress incontinence occurs with the sudden increase of abdominal pressure such as cough, running and exertion. The cause of stress incontinence is thought to be weakening of pelvic floor muscles after delivery or aging. In these patients, the bladder base and urethra move downwards and backwards, which make the posterior vesico-urethral angle more than 120 degrees. Treatment of stress incontinence includes pelvic floor exercise, administration of alpha-stimulants which increase the tonus of the internal sphincter and surgery to elevate the urethra. Urge incontinence is observed when detrusor instability occurs. It is also seen in patients with neurological diseases such as multiple cerebral infarction or with benign prostatic hypertrophy (BPH). Treatment of urge incontinence includes administration of anticholinergics to decrease bladder hyperreflexia. Reflex incontinence is seen in patients with spinal cord disorders. It occurs due to reflex contraction of detrusor and the treatment involves administration of anti-cholinergics. Overflow incontinence is seen in patients with voiding difficulties due to BPH. It occurs when residual urine increases and when the intravesical pressure exceeds urethral pressure on body movement. Treatment for this is intended to improve voiding difficulties. Total incontinence occurs when total sphincter function is damaged.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The pathology and treatment of incontinence]. 159 84

Urinary incontinence was observed in 19 patients after bladder neck elevation or vaginal repair operations. Characteristically, patients could not suppress their urge to micturate on getting up in the morning, and they wet before arrival at the toilet. Urodynamically, a high posterior cough transmission ratio was noted. A 1.5 cm longitudinal incision in the vagina, dissected free and resutured horizontally (I-plasty), immediately cured this particular condition, but ultimately failed in 1/3 cases. Most of these failed patients were subsequently cured by further adjustment of vaginal tension under local anaesthesia (Tuck procedure). These findings confirm the emphasis given by the Integral Theory of Female Urinary Incontinence as to maintain adequate elasticity in the zone of critical elasticity (ZCE) of the supralevator vagina. The ZCE acts as an elastic hinge, allowing (i.e. facilitates) the separate and opposite contractile forces of anterior pubococcygeus, and levator plate which are necessary to close off urethra and bladder neck respectively. Inadequate elasticity at the ZCE converts the ZCE's role from facilitation to opposition. The stronger levator muscle contraction counteracts the forward section of the weaker anterior part of pubococcygeus muscle, preventing bladder neck closure.
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PMID:The tethered vagina syndrome, post surgical incontinence and I-plasty operation for cure. 209 76

Six patients, average age 80 years, with no previous operations, presented with urinary incontinence. The predominant symptoms were "being wet all the time" and "sudden uncontrolled urine loss". They had no symptoms of urgency or stress incontinence, and no objective evidence of "detrusor instability" or urine loss on cough stress pad testing. All but one patients were cured by the simultaneous combined Intravaginal Sling and Tuck operation, indicating that the primary cause of the symptoms was an anatomical defect in the vagina and the ligamentous supports in the region of the bladder neck, as stated in the Integral Theory of Urinary Incontinence, this supplement, elderly.
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PMID:Non stress non urge female urinary incontinence--diagnosis and cure: a preliminary report. 209 77

The changes in urethral pressure that occur during a cough, and microtransducer measurements of urethral pressures at rest, suggest that structures extrinsic to the urethra and vesical neck influence sphincteric function. The present study examined the structure of the extrinsic continence mechanism as it relates to these physiologic observations. Serial histologic sections of the pelvic viscera made from eight female cadavers and dissections of 34 cadavers were examined. In the proximal urethra, the anterior vaginal wall is attached to the muscles of the pelvic diaphragm and to the arcus tendineus fasciae pelvis. Contraction of the pelvic diaphragm would pull the vagina against the posterior surface of the urethra, causing an increase in posteriorly measured "pressures." Support of the urethra at rest comes from both its attachment to the arcus tendineus fasciae pelvis and the resting tone of the pelvic diaphragm muscles. Two arches of striated muscle (compressor urethrae and urethrovaginal sphincter) run over the distal urethra in the region of the perineal membrane (ie, urogenital diaphragm). Activity of these muscles could compress the urethra distally, causing the urethral pressure rise that precedes and exceeds the rise in abdominal pressure during a cough and explaining asymmetry of pressure measurements in this area. Recognition of these structural relationships can help us understand urethral pressures during a cough and directional "pressure" variations seen in patients with stress incontinence. They may also contribute to the understanding of surgical failures that occur despite successful urethral suspension.
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PMID:Structural aspects of the extrinsic continence mechanism. 340 47

Ratios of the amplitudes of the pressure increments in the urethra and vagina during coughing have been measured with two types of microtransducer catheters in fixed and loose positions. The data obtained from 14 urge incontinent women clearly indicate an artifactual contribution to the cough-induced urethral pressure increment measured by a semirigid microtransducer catheter attached to a withdrawal apparatus. This contribution due to urethral movement over the microtransducer catheter is negative in the proximal urethra and positive distally and accounts for the S-shaped distribution of transmission ratios along the urethra, as has been described for continent women. Transmission ratios exceeding 100 per cent were found over at least a part of the urethra. This excess proved to be present in all four versions of measurement and consequently cannot be considered as artifactual.
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PMID:Cough-induced microtransducer movements in the urethra affecting pressure measurements. 394 22

A technique for video urethrocystography in women is described and evaluated from the results of examinations on 76 subjects. The patients were examined seated in the lateral position and investigations were carried out at rest, and during straining and coughing, micturition and holding-back maneuvers. Special attention was paid to the overall morphology and the position of the bladder base, the bladder neck and the urethra. Apart from the contour of the symphysis, which in some patients was difficult to identify, the various structures were easily displayed. Also the dynamics of the function of the bladder base, the bladder neck and the urethra were visualized. Almost all patients were able to carry out all parts of the examination including micturition without difficulty. TLD dosimeters in the vagina and uterus showed a low radiation dose to the ovaries.
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PMID:Dynamic urethrocystography in women. 668 61

Your recent lead article on toxic shock and tampons (November 1, p. 1161) prompts me to report a case of pelvic infection and staphylococcal septicemia 8 days after the insertion of a Lippes loop. Pelvic infection is a recognized complication of IUDs; although there have been 2 reports of endocarditis occurring in susceptible patients following the insertion of an IUD, septicemia is rare. A previously healthy 31-year old married woman had a loop inserted at a family planning clinic. 3 days later she developed sweating, vomiting, confusion, and cough and during the following 48 hours became disoriented with hallucinations. She was referred to the hospital with suspected encephalitis and on admission was febrile (38.8 degrees Celsius) and stuporose but responded to simple commands. Blood pressure was 95/60 mmHg but there were no other abnormal signs. Hemoglobin was 12.2 g/dl, white blood count 4.0x109/1 (80% neutrophils), erythrocyte sedimentation rate 70mm in the 1st hour; cerebrospinal fluid normal. Chest x-ray examination revealed patchy consolidation in the upper lobes of both lungs and an electroencephalogram showed bilateral nonspecific abnormality. 3 blood cultures taken on admission yielded penicillin-resistant Staphylococcus aureus. She was treated with high-dose intravenous cloxacillin and 24 hours after starting the antibiotic had improved markedly and the IUD was removed. Culture from the coil and also from a high vaginal swab yielded Staph aureus with a similar antibiogram to that of the organism cultured from the blood. Subsequent recovery was uneventful, although repeat chest x-ray examination showed small abscess cavities in the upper lobes of both lungs. The patient was discharged 4 weeks after admission and serial chest radiographs have confirmed complete resolution of the pneumonia and abscesses. There is little doubt that this patients' septicemia with lung abscess formation and encephalopathy originated in the genital tract. The patient was both toxic and shocked but was different from patients with the recently described toxic shock syndrome in that her blood culture was positive for Staph aureus. The case provides another example of the importance of this organism as a cause of infection associated with the insertion of foreign bodies into or through the vagina.
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PMID:Staphylococcal septicaemia after insertion of an intrauterine contraceptive device. 744 49

The aim of the study was to determine the contribution of intra-abdominal pressure transmission to urinary continence in the female. Five patients with genuine stress incontinence (GSI) were studied. Pressure transmission was measured in equivalent positions inside and outside the urethra and bladder during the Intravaginal Slingplasty procedure, a surgical operation used for treatment of urinary incontinence, and performed under local anaesthesia. A 6 mm diameter channel was created alongside the urethra. Two separate microtransducer catheters appropriately marked for length were inserted, one inside the urethra, and the other inside the described channel. With the vaginal hammock intact, an average of 10 simultaneous pressure measurements were made intraoperatively in response to coughing and straining in equivalent positions inside the urethra, and directly outside. Significantly higher pressure readings were found inside the urethra (P = 0.0025), indicating that an active component within the urethra may have created this pressure rise. After opening out two suburethral vaginal flaps, large quantities of urine were lost on coughing in all patients. Continence was achieved on tightening the suburethral vagina, indicating that an adequately tight vaginal hammock is a critical element in the continence process. The findings of this study question intraabdominal pressure as a mechanism contributing to continence, but support an alternative mechanism, musculovaginal closure of the urethra.
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PMID:Urethral pressure increase on effort originates from within the urethra, and continence from musculovaginal closure. 891 19


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