فهرست مطالب mohammadreza safarinejad
-
بی اختیاری استرسی ادرار، خروج غیرارادی ادرار از پیشابراه بعلت افزایش فشار شکمی در غیاب انقباض مثانه است که منجر به افزایش فشار مثانه ای به بیش از مقدار فشار پیشابراهی می شود. زنان میانسال بیشترین قشر در بیماران مبتلا به این عارضه هستند. علیرغم آمار بالای بیماران مبتلا به این بیماری، اطلاعات بسیار اندکی در مورد مکانیک و نحوه عملکرد آن از لحاظ نظری وجود دارد. هدف پژوهش جاری، ایجاد یک مدل محاسباتی از مثانه و پیشابراه تحت یک فشار خارجی (همانند یک عطسه) است که بتواند به کمک روش های عددی المان محدود و تکنیک های برهمکنش سیال-جامد به بررسی این عارضه بپردازد. در ایجاد این مدل، خواص مکانیکی اعمال شده به دیواره مثانه و پیشابراه و همچنین شرایط مرزی بافت های حمایت کننده از اهمیت بسیار زیادی برخوردار هستند. نوآوری این طرح نسبت به طرح های مشابه، استفاده از روش صریح در حل عددی و توجه بیشتر به ارتباط بالینی در قیاس با نگرش صرف مهندسی به موضوع است. نتایج نشان می دهد که دقت فشار پیش بینی شده در مرکز مثانه برای مدلی که از مدل ماده غیرخطی (هایپرالاستیک) استفاده می کند نسبت به مدل خطی (الاستیک) به طور قابل توجهی بیشتر است. نتایج مدل های محاسباتی حاکی از آن است که می توان با استفاده از روش های عددی و ساده سازی فیزیک سامانه های زیستی همانند دستگاه ادراری تحتانی، نتایج آزمایشگاهی را در محیط مجازی با هدف شناخت سازوکارهای پاتولوژیکی مجددا تولید کرد.کلید واژگان: دینامیک سیالات محاسباتی, دستگاه ادراری, بی اختیاری ادراری استرسی, روش اجزاء محدود, برهمکنش سیال, جامد}Stress urinary incontinence (SUI) is characterized by the involuntary transurethral leakage of urine caused by an increase in abdominal pressure in the lack of an adequate bladderý ýcontraction that raises the vesical pressure to a level that exceeds urethral pressureý. ýAdult women are most commonly affected by SUI which is believed to be caused in part byý ýinjuries to the pelvic floor sustained during childbirthý. ýDespite the large number of women affected by SUIý, ýlittle is known about the mechanisms associated with the maintenance of urinary continence in womený. ýThe work in this ýresearch ýfocuses on studying the behavior of the bladder and the dynamics of the urine during an increase in abdominal pressure like a coughý. ýThe computational model is developed by using the Finite Elements Method (FEM) and Fluid-structure interaction (FSI) techniques. ýThe results show a good accordance between the clinical data and predicted values of the computational models. ýSimulated pressure is more accurate in the model in which non-linear material properties are utilized. The results of the computational methods indicate that by using numerical techniques and simplification of the physics of biological systems, clinical results can be reached in virtual environments in order to understand pathological mechanisms.Keywords: Computational Fluid Dynamics?, ?Fluid Structure Interaction?, ?Finite Element Method?, ?Urinary System?, ?Stress Urinary Incontinence}
-
IntroductionInferior vena cava tumor thrombectomy in renal cell carcinoma patients is a challenging procedure, frequently requiring the vascular bypass technique for high-level thrombi with additional complications. Adopting a technique such as intrapericardial control in selected cases will circumvent these problems. Here, we present the results of our intrapericardial control technique during supradiaphragmatic inferior vena caval tumor thrombectomy.Case PresentationThe records of six patients with supradiaphragmatic tumor thrombi, who underwent radical nephrectomy and thrombectomy at our center with intrapericardial control between the years 2008 and 2015, were retrospectively reviewed. The patients characteristics, intra- and postoperative data, histology, and follow-up records were gathered and compared. There were no immediate or 30-day postoperative deaths. The mean age of the patients was 61.3 years (range 46 - 75). The total mean duration of surgery was 315 minutes and the mean amount of transfused red blood cells was 4.33 units during surgery and 0.8 units in the postoperative period. The average hospitalization duration was 8 days (range 5 - 17). Tumor stage was T3 in four patients and T4 in two, due to ipsilateral adrenal involvement. The mean duration of follow-up was 33.5 months. Only one of the patients developed recurrences, first in the tumor bed and then at the site of the skin incision; these were excised with no apparent complications.ConclusionsRadical nephrectomy and tumor thrombectomy by intrapericardial control without cardiopulmonary bypass and hypothermic circulatory arrest is a safe and effective procedure that can avoid serious intra- and postoperative complications while providing acceptable cancer-control and mortality results.Keywords: Carcinoma, Renal Cell, Surgery, Vena Cava, Inferior, Surgery, Venous Thrombosis, Cardiopulmonary Bypass, Kidney Neoplasm, Nephrectomy, Methods}
-
Urology Journal, Volume:12 Issue: 6, Non-Dec 2015, PP 2434 -2435PurposePeyronie's disease (PD) is a condition of middle aged men and frequently accompanied by erectile dysfunction (ED) which was attributed to penile deformity, vascular pathology and psychological components. The implantation of semi-rigid penile prosthesis allows for these patients to undergo a simple procedure aimed at correction both penile deformity and ED. The aim of this study was to investigate surgical and clinical outcomes and patient satisfaction rate at long term follow-up after semi-rigid penile prosthesis implantation (PPI) in men with PD and ED.Materials And MethodsA total of 66 patients with mean age of 49.2 (range, 30-76) years old underwent semi-rigid PPI between 1995 and 2006. Genesis (Coloplast®) was used for implantation in a standard manner by penoscrotal approach without using any graft and remodeling technique. In all patients, dilatation of corpora was performed without any difficulty and straightening of the penis was achieved. A retrospective review of clinical database and prospective telephone survey were conducted in all patients.ResultsThe mean follow-up time was 9.7 years (range, 6 to 17). There wasnt any clinical infection and complication during follow-up period. Fifty-nine patients were sexually active at the time of the interview. None of the patients reported residual curvature. The overall patient satisfaction was 91.5% (54 patients). Primary reasons for dissatisfaction were decreased penile length and prosthesis problems.ConclusionBased on our results semi-rigid PPI is effective and easy procedure for treatment of men with PD and ED without any complication and with high patient satisfaction rate in long-term follow up period.
-
Telemedicine and e-Health: Definitions, Technologies, Applications, and its Role in Battlefield
-
PurposeMyocardial infarction is among the most common diagnoses in patients admitted to hospitals in western countries, and its rapid diagnosis is of utmost importance. This study was conducted to determine the most sensitive double-marker cardiac isoenzyme of creatinine kinase, troponin I, and myoglobin for diagnosing acute myocardial infarction.Materials And MethodsThis was an observational-analytic research on a diagnostic test conducted on 256 patients who had referred to the emergency department with chest pain from 4 to 24 hours before their referral. They were sorted equally into two groups of 4-14 hours and 15-24 hours from onset of pain, each group including 128 patients.ResultsIn the first time period, the combination of troponin and myoglobin had the highest sensitivity (sensitivity = 97.3%, specificity = 98.1%), whereas the combination of double-marker and troponin proved the most sensitive (sensitivity = 100%, specificity = 96.3%).ConclusionThe double-marker combination of troponin and myoglobin is more appropriate for the first time period (i.e. during the first 24 hours from the onset of chest pain),while it would be more helpful to use the combination of troponin during the second period of time.Keywords: myocardial infarction, isoenzyme of creatinine kinase, troponin, myoglobin, diagnosis}
-
Urology Journal, Volume:9 Issue: 3, Summer 2012, PP 600 -605PurposeTo assess whether bowel preparation prior to kidney-ureter-bladder (KUB) radiography and intravenous urography (IVU) are of value in improving visualization of the urinary system.Materials And MethodsA total of 186 patients participated in this study. Thirty-nine patients with chronic constipation based on Rome III criteria and 147 patients with normal bowel habits were included. All the patients were randomly divided into two groups. Patients in group 1 received castor oil before imaging and had to eat or drink nothing after midnight. Patients in group 2 were allowed to eat and drink before the examination and received no bowel preparation. Kidney-ureter-bladder radiographies were obtained in all the patients and IVUs were indicated in 77 patients. To assess the image quality, radiographic images were divided into 5 anatomical regions and each region was scored from 0 to 3 based on obscurity of the images by the bowel gas or fecal residue.ResultsMean total score for visualization of the urinary system on plain and contrast images did not differ significantly between the two groups (P =. 253). However, patients with chronic constipation who received bowel preparation revealed a significantly better visualization score on plain images (P =. 001).ConclusionBowel preparation prior to KUB and IVU does not improve the quality of the images in patients with normal bowel habits. However, a significantly better visualization of KUB was noted among patients with chronic constipation who had received bowel preparation.
-
Urology Journal, Volume:9 Issue: 3, Summer 2012, PP 541 -548PurposeTo determine the role of glutathione S-transferases (GSTs; GSTM1, GSTT1, and GSTP1) gene polymorphisms in susceptibility to male factor infertility.Materials And MethodsWe report a pooled analysis of 11 studies on the association of GSTM1, GSTT1, and GSTP1 polymorphisms and male factor infertility, including 1323 cases and 1054 controls.ResultsAn overall significant association was determined between the GSTM1 null genotype [odds ratio (OR), 2.74; 95% confidence interval (CI), 1.72 to 3.84; P =. 003], GSTT1 null genotype (OR, 1.54; 95% CI, 1.43 to 3.47; P =. 02), and male factor infertility. The GSTP1 Ile/Val genotype had overall protective effect against development of infertility (OR, 0.48; 95% CI, 0.27 to 0.77), while there was significant heterogeneity between studies. In sensitivity analysis, two studies were excluded; the association and direction between GSTM1 and GSTT1 null genotypes and GSTP1 Ile/Val genotype and male infertility remained unchanged. There was no significant interaction between smoking status and studied genotypes on male infertility risk (P =. 26).ConclusionThese results demonstrated that amongst populations studied to date, GSTM1 and GSTT1 null genotypes are associated with strong and modest increase in the risk of male infertility, respectively. On the contrary, GSTP1 Ile/Val genotype has protective effect.
-
Urology Journal, Volume:9 Issue: 2, Spring 2012, PP 498 -504PurposeTo compare sexual function between two groups of women who had normal vaginal delivery (NVD) and planned cesarean section (PCS).Materials And MethodsIn this cross-sectional study, two groups of healthy women, with antenatally normal singleton pregnancies at term, who underwent NVD (n = 114) or PCS without labor (n = 99), have been retrospectively studied. Sexual function of participants was assessed using physician-administered Female Sexual Function Index (FSFI) questionnaire before pregnancy and 6 and 24 months after delivery. Primary outcome measures were questions 3 to 6 and 14 to 16 from FSFI questionnaire. Secondary outcome measures included the remaining items.ResultsThere were no significant differences regarding six domains of sexual function, including desire (P =. 55), arousal (P =. 39), lubrication (P =. 45), orgasm (P =. 36), pain (P =. 74), and satisfaction (P =. 39) between the two groups. Eighty percent of women who had undergone vaginal delivery complained from hypotonic pelvic floor muscles.ConclusionWe believe that PCS is not preferred to NVD in regard to preserving normal sexual functioning.
-
Effects of Varicocele Repair on Spontaneous First Trimester Miscarriage: A Randomized Clinical TrialUrology Journal, Volume:9 Issue: 2, Spring 2012, PP 505 -513PurposeTo evaluate the effects of varicocelectomy on semen parameters, pregnancy rates, and live birth in couples with first term recurrent miscarriage.Materials And MethodsOne hundred and thirty-six women with recurrent miscarriage were recruited into this study. All of the husbands had normal semen parameters according to World Health Organization criteria and clinical varicocele. In order to evaluate the causes of recurrent pregnancy loss, we looked for chromosomal abnormalities and endocrine, chronic inflammatory, and infectious diseases. Both groups were well matched according to male/female age, varicocele grade, and smoking history. These couples were assigned randomly into two groups: group one (n = 68), in which male partners underwent varicocele repair, and group two (n = 68), which underwent expectant therapy. All of the couples were followed up monthly up to 12 months. All of the women who conceived were followed up until delivery. In each 3-month follow-up visits, two semen analyses were performed.ResultsMean sperm concentration, sperm progressive motility, and sperm with normal morphology improved significantly after elapsing 6 months from varicocelectomy by 75.0%, 15.9%, and 14.3%, respectively, versus the expectant group (P <. 01). The overall pregnancy rate was 44.1% and 19.1% within a 12-month period in groups 1 and 2, respectively (P =. 003). Of women who conceived in groups 1 and 2, 13.3% and 69.2% developed miscarriage (P =. 001). Sperm density/mL (r = 0.072; P =. 001), time elapsed from varicocelectomy (r = 0.068; P =. 001), and female age (r = -0.062; P =. 002) were three most significantly related independent factors to pregnancy rate by multiple regression analysis.ConclusionVaricocelectomy improves semen quality, increases pregnancy rate, and decreases miscarriage rate significantly. Further controlled studies to confirm our results seem warranted.
نمایش عناوین بیشتر...
بدانید!
- در این صفحه نام مورد نظر در اسامی نویسندگان مقالات جستجو میشود. ممکن است نتایج شامل مطالب نویسندگان هم نام و حتی در رشتههای مختلف باشد.
- همه مقالات ترجمه فارسی یا انگلیسی ندارند پس ممکن است مقالاتی باشند که نام نویسنده مورد نظر شما به صورت معادل فارسی یا انگلیسی آن درج شده باشد. در صفحه جستجوی پیشرفته میتوانید همزمان نام فارسی و انگلیسی نویسنده را درج نمایید.
- در صورتی که میخواهید جستجو را با شرایط متفاوت تکرار کنید به صفحه جستجوی پیشرفته مطالب نشریات مراجعه کنید.