The Experts below are selected from a list of 726 Experts worldwide ranked by ideXlab platform
Gloria Bachmann - One of the best experts on this subject based on the ideXlab platform.
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assessing the thickness of the vaginal wall and vaginal mucosa in pre menopausal versus post menopausal women by transabdominal ultrasound a feasibility study
Maturitas, 2017Co-Authors: Adrian Balica, Daniella Waldspielman, Katherine Schertz, Susan Egan, Gloria BachmannAbstract:Abstract Objective As life expectancy increases, the number of women reporting adverse genito-urinary symptoms (genitourinary syndrome of menopause; GSM) from menopause, including vaginal dryness and sexual pain, also will increase. Current objective measurements of vaginal atrophy such as maturation index require vaginal swabs and are invasive; at present, no minimally invasive measurements exist. The purpose of this study was to assess whether total vaginal wall thickness (TVT) and total vaginal mucosa thickness (TMT) as measured by transabdominal ultrasound could qualify as additional objective markers of vaginal wall thinning which could be related to menopausal status. Design Women presenting for pelvic ultrasound had a transabdominal ultrasound scan performed to measure TVT and TMT at the level of the Bladder Trigone. In addition, a transvaginal endometrial lining thickness was measured. Results The ultrasound measurement data from 76 participants showed that there was a significant difference in the mean value for TVT and endometrial lining between pre- and post-menopausal women. The same difference in mean was not observed for TMT. Conclusion TVT may be a reliable measure of vaginal thinning, which worsens with estrogen decline. These preliminary data also suggest that TMT does not have the same correlation as the TVT measurement. A larger sample is needed to further assess the usefulness and sensitivity of these measures and whether there is clinical and/or research usefulness in obtaining vaginal wall measurements by transabdominal ultrasound.
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Transabdominal sonography to measure the total vaginal and mucosal thicknesses.
Journal of clinical ultrasound : JCU, 2017Co-Authors: Adrian Balica, Katherine Schertz, Susan Egan, Daniella Wald-spielman, Gloria BachmannAbstract:Transabdominal and transvaginal sonography are used to measure Bladder wall and detrusor thickness. Only transvaginal sonography has been used to measure the vaginal wall thickness. We describe the use of transabdominal sonography to measure the total vaginal wall thickness and total vaginal mucosal thickness at the Bladder Trigone. The mean Bladder wall thickness and SD from published data were within the 95% confidence interval of our data. Total vaginal and mucosal thicknesses are reliable measurements, which require specific evaluation in a postmenopausal population. They could be used to quantify vaginal atrophy and could correlate to symptoms of atrophy and response to treatment. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:461-464, 2017.
Cathy Mendelsohn - One of the best experts on this subject based on the ideXlab platform.
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Vesicoureteral Obstruction and Vesicoureteral Reflux: Different Congenital Defects With a Common Cause
Kidney Development Disease Repair and Regeneration, 2016Co-Authors: Julia B. Finkelstein, Cathy MendelsohnAbstract:Removal of toxic substances from the blood depends on patent connections among the kidneys, ureters, and Bladder that are established when the ureter moves from the original insertion site in the nephric duct to the Bladder Trigone, the final insertion site. A number of studies provide new insights into the normal process of ureter maturation that, when abnormal, results in vesicoureteral obstruction, vesicoureteral reflux, and hydronephrosis, pathologies that affect 1–2% of the human population and are a major cause of renal disease in children. According to the Ureteric Bud Theory of Mackie and Stephens, proper positioning of the distal ureter depends on differentiation of the common nephric duct, the caudal-most nephric duct segment, into the Trigone, a muscular structure at the Bladder neck that marks the junction between the ureteral and sex duct insertion sites. The availability of mouse models has enabled us to reexamine this hypothesis in the context of normal and abnormal development. We find that nephric duct insertion, an event that occurs before ureteric bud formation, is critical for proper positioning of the distal ureter in the Bladder. Our studies indicate that, unlike what has been thought, the common nephric duct does not differentiate into the Bladder Trigone but instead undergoes a continuous process of apoptosis as it is adsorbed into the urogenital sinus. These cellular rearrangements bring the distal ureter close to the urogenital sinus, separate the ureter from the common nephric duct, and promote insertion of the distal ureter into the urogenital sinus. Once inserted, growth of the urogenital sinus, in particular the Bladder neck, moves the distal ureter farther from the nephric duct. Failure at any of these steps can result in ectopically positioned distal ureters, leading to vesicoureteral reflux or obstruction, depending on the final position of the ureter orifice relative to the Trigone.
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Using mouse models to understand normal and abnormal urogenital tract development.
Organogenesis, 2009Co-Authors: Cathy MendelsohnAbstract:Removal of toxic substances from the blood depends on patent connections between the kidneys, ureters and Bladder that are established when the ureter is transposed from its original insertion site in the Wolffian duct, to the Bladder Trigone, its final insertion site. According to the Ureteric Bud Theory of Mackie and Stephens, this repositioning of the ureter orifice occurs as the Trigone forms from the common nephric duct, the caudal-most Wolffian duct segment. The availability of mouse models has enabled us to re-examine this hypothesis in the context of normal and abnormal development. We find than in contrast to what has been previously thought, the common nephric duct does not differentiate into the Bladder Trigone but instead undergoes apoptosis, a crucial step in ureter transposition. Interestingly, apoptosis only occurs in close proximity with the sinus ridge, a raised epithelial structure located at the dorsal aspect of the urogenital sinus, suggesting that signals from this site may be importa...
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The development of the Bladder Trigone, the center of the anti-reflux mechanism.
Development (Cambridge England), 2007Co-Authors: Renata Viana, Ekatherina Batourina, Hongying Huang, Gregory R. Dressler, Akio Kobayashi, Richard R. Behringer, Ellen Shapiro, Terry W. Hensle, Sarah M. Lambert, Cathy MendelsohnAbstract:The urinary tract is an outflow system that conducts urine from the kidneys to the Bladder via the ureters that propel urine to the Bladder via peristalsis. Once in the Bladder, the ureteral valve, a mechanism that is not well understood, prevents backflow of urine to the kidney that can cause severe damage and induce end-stage renal disease. The upper and lower urinary tract compartments form independently, connecting at mid-gestation when the ureters move from their primary insertion site in the Wolffian ducts to the Trigone, a muscular structure comprising the Bladder floor just above the urethra. Precise connections between the ureters and the Trigone are crucial for proper function of the ureteral valve mechanism; however, the developmental events underlying these connections and Trigone formation are not well understood. According to established models, the Trigone develops independently of the Bladder, from the ureters, Wolffian ducts or a combination of both; however, these models have not been tested experimentally. Using the Cre-lox recombination system in lineage studies in mice, we find, unexpectedly, that the Trigone is formed mostly from Bladder smooth muscle with a more minor contribution from the ureter, and that Trigone formation depends at least in part on intercalation of ureteral and Bladder muscle. These studies suggest that urinary tract development occurs differently than previously thought, providing new insights into the mechanisms underlying normal and abnormal development.
Adrian Balica - One of the best experts on this subject based on the ideXlab platform.
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assessing the thickness of the vaginal wall and vaginal mucosa in pre menopausal versus post menopausal women by transabdominal ultrasound a feasibility study
Maturitas, 2017Co-Authors: Adrian Balica, Daniella Waldspielman, Katherine Schertz, Susan Egan, Gloria BachmannAbstract:Abstract Objective As life expectancy increases, the number of women reporting adverse genito-urinary symptoms (genitourinary syndrome of menopause; GSM) from menopause, including vaginal dryness and sexual pain, also will increase. Current objective measurements of vaginal atrophy such as maturation index require vaginal swabs and are invasive; at present, no minimally invasive measurements exist. The purpose of this study was to assess whether total vaginal wall thickness (TVT) and total vaginal mucosa thickness (TMT) as measured by transabdominal ultrasound could qualify as additional objective markers of vaginal wall thinning which could be related to menopausal status. Design Women presenting for pelvic ultrasound had a transabdominal ultrasound scan performed to measure TVT and TMT at the level of the Bladder Trigone. In addition, a transvaginal endometrial lining thickness was measured. Results The ultrasound measurement data from 76 participants showed that there was a significant difference in the mean value for TVT and endometrial lining between pre- and post-menopausal women. The same difference in mean was not observed for TMT. Conclusion TVT may be a reliable measure of vaginal thinning, which worsens with estrogen decline. These preliminary data also suggest that TMT does not have the same correlation as the TVT measurement. A larger sample is needed to further assess the usefulness and sensitivity of these measures and whether there is clinical and/or research usefulness in obtaining vaginal wall measurements by transabdominal ultrasound.
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Transabdominal sonography to measure the total vaginal and mucosal thicknesses.
Journal of clinical ultrasound : JCU, 2017Co-Authors: Adrian Balica, Katherine Schertz, Susan Egan, Daniella Wald-spielman, Gloria BachmannAbstract:Transabdominal and transvaginal sonography are used to measure Bladder wall and detrusor thickness. Only transvaginal sonography has been used to measure the vaginal wall thickness. We describe the use of transabdominal sonography to measure the total vaginal wall thickness and total vaginal mucosal thickness at the Bladder Trigone. The mean Bladder wall thickness and SD from published data were within the 95% confidence interval of our data. Total vaginal and mucosal thicknesses are reliable measurements, which require specific evaluation in a postmenopausal population. They could be used to quantify vaginal atrophy and could correlate to symptoms of atrophy and response to treatment. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:461-464, 2017.
Anthony A. Caldamone - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic correction of vesicoureteral reflux in children using autologous chondrocytes: preliminary results.
The Journal of urology, 1999Co-Authors: David A. Diamond, Anthony A. CaldamoneAbstract:AbstractPurpose: Previous approaches to the endoscopic correction of vesicoureteral reflux have used foreign bulking substances, raising concern regarding safety and long-term efficacy. We describe the results of a clinical trial using transurethral injection of autologous chondrocytes to correct vesicoureteral reflux in children.Materials and Methods: A total of 29 children (46 ureters) with grades II to IV vesicoureteral reflux were treated at 2 sites. Each child underwent cystoscopy and ear cartilage biopsy at the initial setting. Chondrocytes were grown in culture for 6 weeks. Patients then returned for transurethral injection of chondrocytes into the Bladder Trigone to correct reflux. Ultrasound was performed 1 month and radionuclide cystography was done 3 months postoperatively to confirm reflux resolution. When reflux persisted, repeat treatment with stored chondrocytes was offered.Results: Initial chondrocyte injection corrected reflux in 26 of the 46 ureters (57%), while secondary injection was s...
Robert M. Kay - One of the best experts on this subject based on the ideXlab platform.
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Pediatric urinary tract infection and reflux.
American family physician, 1999Co-Authors: Jonathan H. Ross, Robert M. KayAbstract:Urinary tract infections in children are sometimes associated with vesicoureteral reflux, which can lead to renal scarring if it remains unrecognized. Since the risk of renal scarring is greatest in infants, any child who presents with a urinary tract infection prior to toilet training should be evaluated for the presence of reflux. Children who may be lost to follow-up and those who have recurrent urinary tract infections should also be evaluated. The preferred method for evaluation of urinary reflux is a voiding cystourethrogram. Documented reflux is initially treated with prophylactic antibiotics. Patients who have breakthrough infections on prophylaxis, develop new renal scarring, have high-grade reflux or cannot comply with long-term antibiotic prophylaxis should be considered for surgical correction. The preferred method of surgery is ureteral reimplantation. A newer method involves injection of the Bladder Trigone with collagen.