The incidence of reflux increases with greater degrees of sonographic dilatation but a normal ultrasound does not exclude reflux and, therefore, voiding cystourethrogram is recommended in all children with prenatally detected hydronephrosis. Since urinary tract infections are uncommon with prevention, antibiotics should be continued until reflux resolves and/or hydronephrosis significantly improves.
In the last century, the pathophysiology of stress urinary incontinence (SUI) has been investigated and several surgical techniques have been utilized for cure. The most recent evolution in the study of SUI is the minimally invasive tension-free vaginal tape (TVT) procedure, which can be done under local anesthesia and intravenous sedation and is individualized for each patient. The procedure recreates the "hammock" of the anterior vaginal wall and endopelvic fascia with a mesh tape of polypropylene. The cure rates of the initial studies are equal to or better than other anti-incontinence procedures, and the permanent supportive mesh is very well tolerated. The TVT creates a backboard on which the urethra compresses itself when it rotates posteriorly during cough or stress. The procedure accomplishes subjective and objective cure without elevating the bladder neck or altering urethral mobility.
Naturally-occurring dissolved organic matter (DOM) is a major component of ocean color signatures, especially in coastal transition zones. Accurate characterization of DOM optical properties is crucial for accurate measurement of chlorophyll from remotely-sensed color data and for modelling spectral light penetration in the ocean. Correlation between optical properties and concentration of DOM could potentially be exploited to evaluate dissolved versus particulate carbon fluxes on a global scale.Determination of DOM optical properties is made difficult by low absorption coefficients and by generally featureless absorption spectra. In coastal areas, changes in the huinic acid: fuMc acid ratio of geibstoff from riverine to marine environments cause significant changes in the spectral slope parameter but are difficult to predict a priori and impossible to measure without extracting gelbstoff from seawater. Fluorescence is orders of magnitude more sensitive than absorption and can be used to distinguish between gelbstoff from terrestrial and marine sources without preconcentration of water samples.Our recent results from a wide variety of natural waters show that DOM optical properties are a function of physical, chemical, and biological processes. Detailed fluorescence spectroscopy shows changes in the optical properties of geibstoff related to the onset of marine productivity in coastal transition zones which are indicative of changes in chemical composition of DOM. The magnitude of observed changes in optical properties caused by production of new marine geibstoff and its subsequent transformation not only effects spectral absorption and reflectance in seawater but also can provide important geochemical information on carbon cycling in the ocean. In this paper, we will discuss our efforts to use fluorescence to aid interpretation of variability in geibstoff spectral slopes for development of next generation chlorophyll algorithms and for development of an optical tracer of geochemical processes involving dissolved organic carbon (DOC).
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