by Yeung Chung Kwong. / Thesis (M.D.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 279-311). / STATEMENT OF ORIGINALITY --- p.8 / ABSTRACT --- p.9 / INDEX TO TABLES --- p.17 / INDEX TO FIGURES --- p.19 / ACKNOWLEDGEMENTS --- p.22 / Chapter SECTION I --- INTRODUCTION / Chapter CHAPTER 1 --- Traditional Concepts of Vesicoureteric Reflux --- p.25 / Chapter 1.1 --- Historic Review --- p.26 / Chapter 1.2 --- Vesicoureteric Reflux (VUR) as an Anomaly --- p.28 / Chapter 1.2.1 --- The Normal Ureterovesical Junction --- p.28 / Chapter 1.2.2 --- Proposed Pathogenesis of VUR --- p.29 / Chapter 1.2.3 --- Ureteric Bud Theory --- p.31 / Chapter 1.2.4 --- Primary versus Secondary VUR --- p.31 / Chapter 1.3 --- Prevalence and Sex Distribution of VUR --- p.33 / Chapter 1.4 --- Diagnosis and Grading --- p.35 / Chapter 1.4.1 --- Micturating Cystourethrogram in the Diagnosis of VUR --- p.35 / Chapter 1.4.2 --- Radionuclide Cystography --- p.36 / Chapter 1.4.3 --- Grading Systems of VUR --- p.37 / Chapter 1.5 --- Natural History of VUR --- p.38 / Chapter CHAPTER 2 --- Reflux Nephropathy --- p.40 / Chapter 2.1 --- Introduction --- p.41 / Chapter 2.2 --- Pathogenesis of Reflux-associated Scarring --- p.41 / Chapter 2.2.1 --- VUR and Urinary Tract Infection --- p.43 / Chapter 2.2.2 --- "Intrarenal Reflux and ""Big Bang"" Theory" --- p.45 / Chapter 2.2.3 --- VUR with Sterile Urine --- p.47 / Chapter 2.3 --- Effect of VUR on Renal Growth and Function --- p.49 / Chapter CHAPTER 3 --- Management of VUR --- p.52 / Chapter 3.1 --- Introduction --- p.53 / Chapter 3.2 --- Medical Management --- p.54 / Chapter 3.3 --- Antireflux surgery --- p.56 / Chapter 3.3.1 --- Ureteric Reimplantation --- p.57 / Chapter 3.3.2 --- Endoscopic Procedure --- p.58 / Chapter 3.4 --- Medical versus Surgical Treatment: Continuing Dilemma --- p.59 / Chapter CHAPTER 4 --- Antenatal Diagnosis of Fetal Uropathies: Impact on Pathogenesis of VUR --- p.63 / Chapter 4.1 --- Primary VUR Detected Following Antenatal Diagnosis of Fetal Hydronephrosis --- p.64 / Chapter 4.2 --- Impact on Traditional Concepts of VUR and Reflux Nephropathy --- p.67 / Chapter CHAPTER 5 --- Cystometric Concept of VUR --- p.70 / Chapter 5.1 --- Introduction --- p.71 / Chapter 5.2 --- Bladder Dysfunctions Associated with VUR --- p.73 / Chapter 5.3 --- Need for A Cystometric Classification of VUR --- p.75 / Chapter CHAPTER 6 --- "Summary, Hypothesis and Outline of Studies" --- p.77 / Chapter 6.1 --- Continuing Controversies in VUR and Reflux Nephropathy --- p.78 / Chapter 6.2 --- "Hypothesis, Objectives and Outline of Studies" --- p.81 / Chapter SECTION II --- STUDY DESIGN AND RESULTS / Chapter CHAPTER 7 --- Primary VUR in Infants with Prenatally Diagnosed Hydronephrosis: Differences Between the Two Sexes --- p.87 / Chapter CHAPTER 8 --- A Clinicopathological Study on Reflux Nephropathy in Children Submitted to Unilateral Nephrectomy --- p.109 / Chapter CHAPTER 9 --- Urethrograms in Male Refluxing Infants with Prenatally Diagnosed Hydronephrosis: Further Evidence for Transient In-utero Bladder Outlet Obstruction --- p.127 / Chapter CHAPTER 10 --- Urodynamic Studies in Children --- p.144 / Chapter 10.1 --- Conventional Cystometry in Children --- p.145 / Chapter 10.2 --- Difficulties for Conventional Cystometry in Infants with VUR --- p.146 / Chapter CHAPTER 11 --- Natural Filling Cystometry in Infants and Young Children: A New Technique --- p.149 / Chapter CHAPTER 12 --- Some New Insights into Bladder Function in Infancy --- p.168 / Chapter CHAPTER 13 --- Natural Filling Urodynamic Studies in Young Infants with Primary VUR --- p.185 / Chapter CHAPTER 14 --- Primary VUR Detected in Early Infancy: Relationship Between Bladder Functional Status and Outcome of Reflux in the Second Year of Life --- p.207 / Chapter CHAPTER 15 --- Natural Filling Direct Isotope Cystography with Synchronous Urodynamic Study (NFDIC): A New Technique with Significant Prognostic Value for Primary VUR --- p.226 / Chapter CHAPTER 16 --- Quantitation of VUR and Bladder Emptying by Synchronous Isotope Cystograpgy and Urodynamic Recording (QIC) --- p.242 / SECTION III DISCUSSION --- p.266 / REFERENCES --- p.279

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2009. / Härtill 4 uppsatser.

Leung Yee Fong. / "August 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 262-287). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Thesis (Ph.D.)--University of Adelaide, Dept. of Paediatrics, 1999. / Bibliography: leaves 231-266.

Thesis (doctoral)--Ludwig-Maximilians-Universität zu München, 1979.

No description available.

<p>Urinary tract infections (UTIs) are the second most common type of infection identified in the clinical setting and disproportionately afflict women. UTIs most frequently manifest in the form of infection of the lower urinary tract, involving the bladder. Uropathogens, particularly uropathogenic E. coli, progressively colonize the urethra and ascend to the bladder, where they initiate cystitis. In some cases, infection further ascends through the ureters and reaches the kidneys, where it causes pyelonephritis. Infection of both the upper and lower urinary tract can have serious ramifications for the host, and this is in large part due not to infection itself but to host-directed responses to bacterial insults. </p><p> In this thesis, I will describe and discuss two distinct aspects of UTIs. In the first study, in vivo work in a mouse model of urinary tract infection revealed a novel role for mast cells, which are tissue-resident granulated innate immune cells, in directing the detachment and death of epithelial cells during cystitis, facilitating the clearance of bacteria from the bladder. An ex vivo porcine bladder infection model suggested a specific role for mast cell granules and the proteases contained therein, which was corroborated with in vitro experiments utlizing isolated mast cell granules and human epithelial cells to demonstrate granule-induced exfoliation and cell death. From this work, it is clear that mast cells play a highly targeted role in modulating urothelial integrity during bladder infection by mediating host-directed epithelial loss.</p><p> In the second study described in this dissertation, the synergistic roles of both pyelonephritis and vesico-ureteric reflux (VUR), a congenital urinary tract defect that results in the improper backflow of urine from the bladder to the kidney, in the development of reflux nephropathy, a fibrotic host response characterized by renal scar formation, were elucidated in a series of in vivo experiments. Specifically, the C3H mouse, which is naturally susceptible to VUR, was utilized to characterize the dynamics of kidney infection and the onset of reflux nephropathy. Renal scarring was dependent on the presence of sustained kidney infection and the accompanying inflammatory response due to VUR, while neither transient infection nor reflux alone were sufficient to provoke nephropathy. Thus, the development of reflux nephropathy is dependent upon the confluence of both infection and VUR. </p><p> This body of work reveals the double-edged sword of the host inflammatory response to urinary tract infection. In the bladder, mast cell activation and degranulation leads to granule-induced epithelial exfoliation and consequently a reduction in the bacterial burden in the bladder. However, the sustained inflammatory response that accompanies pyelonephritis in vesico-ureteric reflux-affected individuals results in significant damage to the kidney without any accompanying reduction in infection. These findings highlight the dueling roles of the host inflammatory response to infection in the upper and lower urinary tract and strongly suggest that differential clinical approaches to cystitis and pyelonephritis are necessary to promote an effective mast cell in the bladder in the former and facilitate the clearance of renal infection while mitigating tissue damage in the latter.</p> / Dissertation

Bibliography: leaves 231-266. / 271 leaves : col. ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Indicates that injections under the ureteric orifice can cure VUR and that the tissue response to the plastics becomes quiescent. Research into embolisation from solid implants from intravenous tubing and the possibility of antibody formation to implanted plastics is also included. A model for fetal VUR has been developed to clarify focus of the uncertainity about reflux disease. / Thesis (Ph.D.)--University of Adelaide, Dept. of Paediatrics, 1999

Bibliography: leaves 231-266. / 271 leaves : col. ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Indicates that injections under the ureteric orifice can cure VUR and that the tissue response to the plastics becomes quiescent. Research into embolisation from solid implants from intravenous tubing and the possibility of antibody formation to implanted plastics is also included. A model for fetal VUR has been developed to clarify focus of the uncertainity about reflux disease. / Thesis (Ph.D.)--University of Adelaide, Dept. of Paediatrics, 1999

Masters of Science - Msc (Physiotherapy) / Post-operative physiotherapy plays a vital role in the management of patients with incontinence in order to optimise the outcome of obstetric fistula surgery. Women who suffer residual urinary incontinence continue to experience shame, social isolation and institutional rejection. Incontinence continues to impair them leading to lower levels of role participation and restriction in most activities. Gynocare Fistula Center, Eldoret, receives a number of referrals for women with obstetric fistula requiring surgical and physiotherapy care. Many studies have focused on the determinants of surgical outcomes and social reintegration but none have focused on woman's perceptions and experiences with postoperative physiotherapy. While continence is not always achieved immediately after surgery, this study was designed to explore women's perceptions and experience of postoperative physiotherapy management at an obstetric fistula center in Eldoret,Kenya. Participants were then asked about their experiences and related perceptions and perceived challenges regarding the physiotherapy service following discharge from the Center. An explorative qualitative method was used to explore the women's perceptions and experiences of the post-operative physiotherapy management, as well as their perceived challenges regarding access to physiotherapy post discharge.