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Unknown  |  1992-06-06  |  346.7 KB

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hex view
+--------+-------------------------+-------------------------+--------+--------+
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|000006c0| 7b 4a 75 6e 65 20 31 39 | 38 38 7d 0d 0a 24 59 42 |{June 19|88}..$YB|
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|00000780| 20 28 63 29 20 59 65 61 | 72 62 6f 6f 6b 20 4d 65 | (c) Yea|rbook Me|
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|00001380| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001390| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|000013b0| 63 61 6c 20 4c 6f 6f 6b | 20 61 74 20 55 72 6f 64 |cal Look| at Urod|
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|000013d0| 0d 0a 50 61 79 6e 65 20 | 53 52 2c 20 54 69 6d 6f |..Payne |SR, Timo|
|000013e0| 6e 65 79 20 41 47 2c 20 | 4d 63 4b 65 6e 6e 69 6e |ney AG, |McKennin|
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|00001410| 4d 61 73 6b 65 6c 6c 20 | 52 4d 0d 0a 28 53 74 20 |Maskell |RM..(St |
|00001420| 4d 61 72 79 27 73 20 48 | 6f 73 70 2c 20 50 6f 72 |Mary's H|osp, Por|
|00001430| 74 73 6d 6f 75 74 68 2c | 20 45 6e 67 6c 61 6e 64 |tsmouth,| England|
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|00001450| 2d 31 31 32 36 2c 20 4e | 6f 76 20 31 32 2c 20 31 |-1126, N|ov 12, 1|
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|00001470| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001480| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001490| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000014a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000014b0| 2d 2d 2d 0d 0a 0d 0a 41 | 62 73 74 72 61 63 74 0d |---....A|bstract.|
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|000036f0| 2e 52 2e 20 4d 69 73 68 | 65 6c 6c 2c 20 4a 72 2e |.R. Mish|ell, Jr.|
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|00005100| 2e 20 4d 69 73 68 65 6c | 6c 2c 20 4a 72 2e 2c 20 |. Mishel|l, Jr., |
|00005110| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|00005120| 68 74 20 28 63 29 20 59 | 65 61 72 62 6f 6f 6b 20 |ht (c) Y|earbook |
|00005130| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
|00005140| 72 73 2c 20 49 6e 63 2e | 2c 20 31 39 39 30 0d 0a |rs, Inc.|, 1990..|
|00005150| 0d 0a 31 39 39 30 20 59 | 65 61 72 20 42 6f 6f 6b |..1990 Y|ear Book|
|00005160| 20 6f 66 20 4f 62 73 74 | 65 74 72 69 63 73 20 61 | of Obst|etrics a|
|00005170| 6e 64 20 47 79 6e 65 63 | 6f 6c 6f 67 79 20 28 52 |nd Gynec|ology (R|
|00005180| 29 0d 0a 0d 0a 43 68 61 | 70 74 65 72 20 31 32 2d |)....Cha|pter 12-|
|00005190| 2d 47 79 6e 65 63 6f 6c | 6f 67 69 63 20 55 72 6f |-Gynecol|ogic Uro|
|000051a0| 6c 6f 67 79 0d 0a 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |logy....|--------|
|000051b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000051f0| 2d 2d 2d 2d 2d 2d 0d 0a | 4d 61 6e 61 67 65 6d 65 |------..|Manageme|
|00005200| 6e 74 20 6f 66 20 52 65 | 66 72 61 63 74 6f 72 79 |nt of Re|fractory|
|00005210| 20 44 65 74 72 75 73 6f | 72 20 49 6e 73 74 61 62 | Detruso|r Instab|
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|00005230| 73 69 63 61 6c 20 50 68 | 65 6e 6f 6c 20 49 6e 6a |sical Ph|enol Inj|
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|00005250| 6e 2d 53 74 72 61 6e 67 | 65 20 41 2c 20 4d 69 6c |n-Strang|e A, Mil|
|00005260| 6c 61 72 64 20 52 4a 0d | 0a 28 50 72 69 6e 63 65 |lard RJ.|.(Prince|
|00005270| 20 48 65 6e 72 79 20 48 | 6f 73 70 2c 20 53 79 64 | Henry H|osp, Syd|
|00005280| 6e 65 79 29 0d 0a 42 72 | 20 4a 20 55 72 6f 6c 20 |ney)..Br| J Urol |
|00005290| 36 32 3a 33 32 33 2d 33 | 32 35 2c 20 4f 63 74 6f |62:323-3|25, Octo|
|000052a0| 62 65 72 20 31 39 38 38 | 0d 0a 2d 2d 2d 2d 2d 2d |ber 1988|..------|
|000052b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000052c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000052d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000052e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000052f0| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|00005300| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 53 6f 6d |ract....| Som|
|00005310| 65 20 70 61 74 69 65 6e | 74 73 20 77 69 74 68 20 |e patien|ts with |
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|00005340| 70 6f 6e 64 20 74 6f 20 | 62 6c 61 64 64 65 72 0d |pond to |bladder.|
|00005350| 0a 74 72 61 69 6e 69 6e | 67 20 6f 72 20 61 6e 74 |.trainin|g or ant|
|00005360| 69 63 68 6f 6c 69 6e 65 | 72 67 69 63 20 6d 65 64 |icholine|rgic med|
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|00005440| 72 20 6f 74 68 65 72 20 | 6d 65 61 73 75 72 65 73 |r other |measures|
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|00005490| 78 69 63 20 62 6c 61 64 | 64 65 72 20 66 75 6e 63 |xic blad|der func|
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|000054b0| 20 69 6e 6a 65 63 74 69 | 6f 6e 73 20 6f 66 20 36 | injecti|ons of 6|
|000054c0| 25 20 61 71 75 65 6f 75 | 73 20 70 68 65 6e 6f 6c |% aqueou|s phenol|
|000054d0| 2c 20 31 30 0d 0a 6d 6c | 2c 20 77 65 72 65 20 6d |, 10..ml|, were m|
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|000054f0| 6c 20 61 6e 65 73 74 68 | 65 73 69 61 2e 20 20 54 |l anesth|esia. T|
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|00005540| 64 20 62 6c 61 64 64 65 | 72 20 6e 65 63 6b 20 6f |d bladde|r neck o|
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|00005560| 64 20 61 64 76 61 6e 63 | 65 64 20 6a 75 73 74 0d |d advanc|ed just.|
|00005570| 0a 6c 61 74 65 72 61 6c | 20 74 6f 20 74 68 65 20 |.lateral| to the |
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|00005590| 65 72 20 66 6f 72 20 32 | 2d 33 20 63 6d 2e 0d 0a |er for 2|-3 cm...|
|000055a0| 20 20 20 20 20 54 68 65 | 20 6f 76 65 72 61 6c 6c | The| overall|
|000055b0| 20 73 75 63 63 65 73 73 | 20 72 61 74 65 20 77 61 | success| rate wa|
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|000055d0| 6f 76 65 6d 65 6e 74 20 | 6f 63 63 75 72 72 65 64 |ovement |occurred|
|000055e0| 20 77 69 74 68 69 6e 20 | 32 34 0d 0a 68 6f 75 72 | within |24..hour|
|000055f0| 73 20 6f 66 20 74 68 65 | 20 70 68 65 6e 6f 6c 20 |s of the| phenol |
|00005600| 69 6e 6a 65 63 74 69 6f | 6e 2e 20 20 42 6f 74 68 |injectio|n. Both|
|00005610| 20 64 69 75 72 6e 61 6c | 20 66 72 65 71 75 65 6e | diurnal| frequen|
|00005620| 63 79 20 61 6e 64 20 6e | 6f 63 74 75 72 69 61 20 |cy and n|octuria |
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|000056a0| 20 70 68 65 6e 6f 6c 20 | 69 6e 6a 65 63 74 69 6f | phenol |injectio|
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|00005740| 64 20 61 20 73 6c 6f 75 | 67 68 20 61 74 20 74 68 |d a slou|gh at th|
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|00005760| 20 69 6e 20 32 20 70 61 | 74 69 65 6e 74 73 20 77 | in 2 pa|tients w|
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|00005780| 6e 64 65 72 77 65 6e 74 | 20 70 65 6c 76 69 63 20 |nderwent| pelvic |
|00005790| 72 61 64 69 6f 74 68 65 | 72 61 70 79 2e 0d 0a 20 |radiothe|rapy... |
|000057a0| 20 20 20 20 54 72 61 6e | 73 76 65 73 69 63 61 6c | Tran|svesical|
|000057b0| 20 70 68 65 6e 6f 6c 20 | 69 6e 6a 65 63 74 69 6f | phenol |injectio|
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|00005870| 0a 0d 0a 50 6f 73 74 2d | 43 6f 6d 6d 65 6e 74 0d |...Post-|Comment.|
|00005880| 0a 0d 0a 20 20 20 20 20 | 54 68 65 20 69 6e 69 74 |... |The init|
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|00005d30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00005d50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00005d70| 6c 6f 6e 20 49 6e 6a 65 | 63 74 69 6f 6e 20 69 6e |lon Inje|ction in|
|00005d80| 20 46 65 6d 61 6c 65 20 | 53 74 72 65 73 73 20 49 | Female |Stress I|
|00005d90| 6e 63 6f 6e 74 69 6e 65 | 6e 63 65 3a 20 20 45 66 |ncontine|nce: Ef|
|00005da0| 66 65 63 74 20 6f 6e 20 | 55 72 65 74 68 72 61 6c |fect on |Urethral|
|00005db0| 20 50 72 65 73 73 75 72 | 65 0d 0a 50 72 6f 66 69 | Pressur|e..Profi|
|00005dc0| 6c 65 20 61 6e 64 20 46 | 6c 6f 77 20 52 61 74 65 |le and F|low Rate|
|00005dd0| 0d 0a 0d 0a 56 65 73 65 | 79 20 53 47 2c 20 52 69 |....Vese|y SG, Ri|
|00005de0| 76 65 74 74 20 41 2c 20 | 4f 27 42 6f 79 6c 65 20 |vett A, |O'Boyle |
|00005df0| 50 4a 0d 0a 28 4d 75 73 | 67 72 6f 76 65 20 50 61 |PJ..(Mus|grove Pa|
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|00005e30| 4a 75 6c 79 20 31 39 38 | 38 0d 0a 2d 2d 2d 2d 2d |July 198|8..-----|
|00005e40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005e80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 0d 0a 0d 0a 41 62 73 |--------|-....Abs|
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+--------+-------------------------+-------------------------+--------+--------+
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