Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One-hundred and fifty-two male patients suffering from non-gonococcal urethritis were treated with an oral dosage of 300 mg roxithromycin daily for seven days. Chlamydia trachomatis was isolated from the urethra in 53 patients (35%), and Ureaplasma urealyticum in 42 patients (28%). After treatment, 49 (92%) of the 53 patients with positive Chlamydia trachomatis cultures and 34 (81%) of the 42 patients with positive Ureaplasma urealyticum cultures had negative cultures at follow-up. A clinical cure was observed in 137 patients (90%). Ten patients (7%) showed side effects consisting of nausea, sensation of distended abdomen, headache and fatigue. Seventy-eight male patients suffering from nongonococcal urethritis were treated with an oral dosage of 2 X 150mg roxithromycin daily for seven days. Chlamydia trachomatis was isolated from the urethra in 22 patients (28%), and Ureaplasma urealyticum in 30 patients (38%). After treatment, all of the 22 patients with formerly positive Chlamydia trachomatis cultures and 23 (77%) of the 30 patients with formerly positive Ureaplasma urealyticum cultures were negative at follow-up. A clinical cure was observed in 70 patients (90%). Three patients (4%) showed side-effects consisting of nausea and headache. It is concluded that roxithromycin is a good alternative to tetracycline and erythromycin in the treatment of non-gonococcal urethritis in males.
 ...
PMID:Evaluation of roxithromycin in the treatment of non-gonococcal urethritis in males. 380 73

Phenoxybenzamine (Dibenzyline) has been extremely effective in treating patients with detrusor dyssynergia. Its minimal side effects include: mouth dryness, nasal congestion, drowsiness and fatigue, nausea and vomiting, palpitations, ejaculatory failure, and retrograde ejaculation. Nineteen men treated with phenoxybenzamine for detrusor dyssynergia reported ejaculatory failure during treatment; normal ejaculation returned after treatment was discontinued. Postmasturbation urine and semen samples were analyzed for sperm and fructose. The results of the study suggest that ejaculatory failure was due to the lack of seminal emission into the posterior urethra, rather than retrograde ejaculation. Some implications of this study are also discussed.
 ...
PMID:Effect of phenoxybenzamine (dibenzyline) on sexual function in man. 611 73

The striated musculature of the dog urethra was studied histochemically. Two main groups of muscle fibers could be identified: 1 with slow twitch oxidative fibers, which are fatigue resistant (type 1), and 1 with fast twitch fibers (type 2). The fast twitch fibers were subdivided into glycolytic (fatiguable) and oxidative glycolytic (fatigue resistant) fibers: the latter constitute 20 per cent of all fast twitch fibers. Type 1 constitutes of 35 per cent of the whole musculature and its proportion tends to decrease toward the distal end of the external urethral sphincter. From these observations we infer that type 1 fibers are likely responsible for continence at rest and that type 2 fibers are recruited in stress conditions, for example, during coughing or sneezing. Additional studies are needed to confirm this conjecture. The clinical implications of these studies for the control of incontinence, urinary retention and dyssynergic urethral sphincter are presented.
 ...
PMID:Histochemical study of urethral striated musculature in the dog. 621 91

Chronic electrostimulation of the sacral roots induces an increase in urethral resistance due to activation of muscles of the striated urethral sphincter. Histochemical study of the urethral striated musculature (nonstimulated) revealed 3 main varieties of fibers: 1) Slow twitch fibers (35 per cent of the whole muscle); 2) Fast twitch fatiguable fibers (52 per cent); and 3) An intermediate type, fast twitch fatigue resistant (13 per cent). Ten dogs with chronically implanted electrodes at the 2nd sacral root were subjected to a program of prolonged stimulation under anesthesia. After prolonged electrostimulation, we detected hypertrophy of the striated muscle fibers of the urethra, anal sphincter and stimulated side of the tail. The stimulated muscle fibers showed a higher overall oxidative activity than the controls. This occurred both in intact and spinalized animals. We thus expect the urethral striated musculature to be more resistant to fatigue because of the increased oxidative activity. Stimulated fibers also had increased glycolytic activity as shown by the enhanced intermyofibrillar deposition, especially in the fast twitch fibers. The increased glycolytic activity may also increase fatigue resistance by producing energy during periods of low oxygen supply at the peak of muscular contraction. As a consequence of increase in oxidative and glycolytic capacities and muscular hypertrophy, we expect that the striated musculature of the urethra will be not only more resistant to fatigue but also capable of generating higher tension. Both are important in achieving continence via electrostimulation of sacral nerve roots. Approximately 3 months after conclusion of the stimulation program these changes had gradually reverted to the normal prestimulation level.
 ...
PMID:Effect of chronic electrostimulation of the sacral roots on the striated urethral sphincter. 715 9

Partial outlet obstruction has been shown to result in contractile and metabolic dysfunctions. Specifically, there is a greater reduction in the response to field stimulation (FS) in comparison with the responses to bethanechol and KCl, a greater reduction in the tonic response to stimulation in comparison with the phasic response, and a reduction in oxidative metabolism of glucose accompanied by an increase in the glycolytic metabolism of glucose. The specific aim of the current study was to correlate the effects of partial outlet obstruction on the contractile responses of isolated strips of bladder smooth muscle to repetitive stimulation in the presence and absence of glucose. Adult male Sprague-Dawley rats were subjected to partial outlet obstruction by the surgical placement of silk ligatures around the urethra. After 2 weeks, each rate was anesthetized, the bladder was excised, and isolated strip studies were performed. These studies demonstrated that the maximal phasic response to FS was significantly decreased in the obstructed strips as compared with controls, with no difference being noted for responses to bethanechol or KCl; the tonic responses to all forms of stimulation were significantly decreased after obstruction, with the tonic response to FS being decreased to a greater degree than were the tonic responses to bethanechol and KCl; and in the absence of glucose, the tonic responses of control strips to all forms of stimulation were reduced to a greater degree than were the phasic responses. These studies demonstrate that the tonic response to FS is extremely sensitive to fatigue induced by repetitive stimulation.
 ...
PMID:Effects of partial outlet obstruction on bladder-strip sensitivity to glucose deprivation: an in vitro study in the rat. 873 9

A canine model of urinary neosphincter using electrically stimulated autologous striated muscle is described. The superior belly of canine sartorius was activated by a pacemaker with an intermittent low frequency stimulation (0.5-1 pulse per sec) during 7 weeks. Then, the muscle graft was passed around the urethra and sutured back on to itself to form a neosphincter. The surgical procedure was easy to perform and with no complication. Urethral pressure profile was performed initially (T0), and when the muscle was in peri-urethral position, before (T1) and during electrical stimulation (T2). The continence parameter readings (maximal urethral closure pressure MUP, functional length FL, continence zone CZ, and continence area CA) increased from T0 to T1, and from T1 to T2. We noted: 1) 28%, 38%, 52%, and 86% increases for the MUP, FL, CZ, and CA respectively from T0 to T1, 2) 10%, 41%, 30%, and 43% increases for MUP, FL, CZ, and CA respectively from T1 to T2. Chronic low frequency stimulation could transform a skeletal fast-twitch type 2 muscle into a slow-twitch fatigue-resistant type 1 muscle. In this study, morphological changes of the stimulated muscle were noted, whereas phenotype was unchanged. This dynamic autologous neosphincter may be a new alternative to the artificial urinary sphincter prosthesis with fewer complications. Further studies are ongoing to evaluate the efficacy of such a neosphincter as continent system for bladder substitution after pelvic exenteration for pelvic cancers.
 ...
PMID:Construction of a urinary sphincter by means of an electrically stimulated striated muscle: experimental procedure and urodynamic results on canine model. 880 16

The purpose of this study was to investigate the feasibility of dynamic bulbous urinary graciloplasty with respect to graciloplasty histology and urethral pressures. Two adult male goats underwent a pulled-through bulbous urethral graciloplasty with implant of electrodes and a pulse stimulator. Afterwards, a stimulation protocol was applied to have the fatiguable type II fibers replaced by fatigue-resistant type I fibers. Urethral pressure profilometry as well as analysis of histology was performed afterwards and compared with preoperative biopsies and preoperative recorded urethral pressures. Successful conversion from type II into type I muscle fibers was observed; the percentage of type I fibers increased from 29% to 83%. The percentage of connective tissue increased from 8% to 16%. No stricturing of the bulbous urethra was observed. The urethral pressures before stimulation increased from a mean of 107 cm H2O without stimulation, to 187 cm H2O with stimulation for the two goats. After training, the urethral pressure increased from a mean of 85 cm H2O without stimulation, to 118 cm H2O with stimulation. In male goats, successful dynamic urinary graciloplasty at the bulbous urethra is feasible. The achieved muscle fiber conversion guarantees fatigue-resistance, necessary for a continuous sphincteric muscle contraction. The maximal urethral pressures, however, are lower than those without stimulation.
 ...
PMID:Dynamic urinary graciloplasty in male goats: a study on histology and urethral pressures. 904 74

Neurovascularly intact gracilis-muscle transposition to the proximal urethra is an exciting new technique for sphincteric incontinence. The functional urethral closure of gracilis myoplasty assures dryness, permits intermittent self-catheterization when necessary, and avoids the risks of erosion associated with the artificial urinary sphincter. Electrical stimulation of the transposed muscle (dynamic urethral myoplasty) using intramuscular electrodes and a subcutaneously placed pulse generator can alter the molecular physiology of the gracilis muscle from that of predominantly fast-twitch to that of slow-twitch fibers that are fatigue-resistant and more suitable for long-term sphincter function.
 ...
PMID:Gracilis muscle transposition with electrical stimulation for sphincteric incontinence: a new approach. 937 85

In electrically stimulated (dynamic) graciloplasty for urinary incontinence, the gracilis muscle is transposed into the pelvis, and the distal part is used to reconstruct a neosphincter. Clinical outcomes using this technique have been disappointing due to stricture of the urethra caused by ischemia in the distal part of the gracilis and limited gracilis length available for neosphincter construction. Furthermore, the urethra is twisted by the contracting gracilis, rather than circumferentially squeezed. The purpose of the present study was to test the anatomical and functional feasibility of a new surgical approach to reconstruct a urinary sphincter, using the gracilis muscle as a free flap. In 12 human cadavers, the anatomical feasibility for creating a neosphincter by using the gracilis free flap was determined. In all cases, transfer of the gracilis muscle into the pelvis as a free flap (with the nerve intact) was feasible, and ample muscle was available to construct a neosphincter around the bladder neck. Gracilis neosphincter function was studied in seven dogs. The left gracilis muscle was subjected to transfer into the pelvis as an innervated free flap to create a neosphincter around the urethra. The right (control) gracilis muscle was lifted as a single pedicle flap, remained in situ, and was wrapped around a stent to mimic the urethra. Function (expressed as peak pressure generation and fatigue rate) and surface perfusion were determined for all gracilis muscles. In each dog, both sides were compared using the paired Student's t test for statistical analysis, and no significant difference was measured for the two groups. In conclusion, an innervated gracilis free flap can be used to create a neosphincter around the bladder neck. In an acute study in dogs, function and perfusion of the innervated gracilis free flap are not compromised.
 ...
PMID:Electrically stimulated free-flap graciloplasty for urinary sphincter reconstruction: a new surgical procedure. 965 11

The striated muscle forms an outer sleeve around the urethra and occupies about 80% of the wall. In humans more than 60% of the muscle consists of slow, fatigue resistant type I fibres whereas in male greyhounds only about 6% are type I. Most of the remainder (70% of fibres) are type IIa which are classified as fast but can contract for several hours with little decline in amplitude. Stimulation of pudendal but not pelvic nerves produces contraction of the striated muscle and a rapid increase in urethral pressure. Pelvic nerve branches enter the striated muscle sleeve but pass through it to supply the inner layer of smooth muscle. The striated muscles are well suited to maintain contraction necessary for continence.
 ...
PMID:The innervation and properties of the urethral striated muscle. 1140 18


1 2 Next >>