The incorporation of [14C]leucine and [14C]threonine into kidney cortex proteins was studied during 6 days’ hypothermic perfusion of dog kidneys at 8–10 °C and during in vitro incubation of dog kidney cortex slices at 37 °C. Leucine carbon was incorporated into proteins at a higher rate than threonine carbon both during in vitro incubation of kidney cortex slices and during hypothermic kidney perfusion. The incorporation of leucine and threonine during hypothermic perfusion was linear for 6 days but 50–100 times lower than the incorporation of leucine and threonine in kidney cortex slices at 37 °C. During hypothermic perfusion there was a decrease in specific activity of leucine and threonine in the perfusate corresponding to a degradation of proteins which was greater than protein synthesis as calculated from the incorporation of label into proteins. Leucine carbon was recovered in CO2 during hypothermic perfusion and in vitro incubation of kidney cortex slices at 37 °C. The incorporation of threonine carbon into CO2 was about 10% of the corresponding value for leucine both during hypothermic kidney perfusion and during in vitro incubation of kidney cortex slices at 37 °C. It is concluded that there is a turnover of kidney proteins during hypothermic perfusion with a perfusate containing amino acids.
Summary. The object of this study was to evaluate the function of the pelvic floor and urethral sphincters in women with genuine stress incontinence before and after treatment. A total of 20 patients were randomized to 6 months' pelvic floor training or electrical stimulation. They were assessed by comprehensive analysis of pressure recordings in the urethra, vagina and anus. There were few significant correlations between subjective effect, pad tests and urodynamic results. Urethral, vaginal and anal profilometry is of limited value for assessment of training effects.Pelvic floor training has been used in female genuine stress incontinence since its first advocacy by Kegel [12]. The laboratory methods used for objective evaluation of the effect of pelvic floor contraction seem inadequate. The Kegel perineometer has the important disadvantage of recording changes in abdominal pressure as well as the force exerted by the pelvic floor, implying the lack of a possibility of reading the "genuine" pelvic floor pressure during different exercises. Assessment of the contraction by electromyograph (EMG) recordings obtained from the pelvic floor muscles is not valid for a long-term study since variation in the positioning of the recording electrode would make comparisons difficult. By measuring resting and squeeze pressures in all three channels affected by the pelvic floor muscles, i.e. the urethra (including cough profiles), vagina and anal canal, we attempted to obtain a measure of the state of the pelvic floor and urethral sphincters in women with genuine stress incontinence before and after conservative treatment by means of pelvic floor training and intravaginal electrical stimulation.
Patients and methodsA total of 20 patients with genuine stress urinary incontinence who had not been surgically treated and were consecutively referred for therapy were offered conservative treatment as an alternative to surgery. Their ages were 34 -64 years (mean, 47.2 years). After they had given oral and written informed consent, they were randomized to pelvic floor training or electrical stimulation by means of the Contelle device [8]. The period of treatment was 6 months. Patients who were not cured after undergoing 6 months of one of these modes of treatment were offeted the other one. The training program was conducted by an experienced physiotherapist and was in essence based on the following:1. Relaxing and co-ordinating exercises to identify the proper muscles (submaximal contractions in short sequences). 2. Exercises to strengthen the muscles, whereby the patient was instructed to contract them maximally in short sequences. These exercises were also performed against resistance. 3. Training carried out in specific provocative situations such as jumping or coughing. Details of the training program have been presented elsewhere [9].The state of the pelvic floor was assessed by digital vaginal examination. The effect of treatment was assessed by a short provocative pad test [9]. Electrical stimulation was delivered by the new ...
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