MRI-detected inflammation around the extensor tendons of metacarpophalangeal (MCP-) joints is prevalent in RA and poses a markedly increased risk of RA development when present in arthralgia... Show moreMRI-detected inflammation around the extensor tendons of metacarpophalangeal (MCP-) joints is prevalent in RA and poses a markedly increased risk of RA development when present in arthralgia patients. Such inflammation is called 'peritendinitis' since anatomy literature reports no presence of a tenosynovial sheath at these tendons. However, the presence or absence of tenosynovium at these extensor tendons has never been studied. Therefore, an anatomical and histological study of extensor tendons at the MCP-joints of three embalmed human hands was performed. Immunohistochemical staining showed the presence of markers for synovial macrophages and fibroblast-like synoviocytes bordering a natural dorsal space next to the extensor tendon, suggesting the presence of a synovial lining. This implies that contrast-enhancement on MRI around extensor tendons at MCP-joints observed in early RA and pre-RA likely represents tenosynovitis and that inflammation of this synovial tissue is an early feature of RA. Show less
With advancement of techniques in endourology, treatments for renal stones have increased possibilities. This thesis analyses existing surgical treatments, pain treatments and renal anatomy.
Overactive bladder syndrome (OAB) is a common lower urinary tract disorder. So far, no therapy is beneficial and applicable for all OAB patients because patients with OAB represent a very... Show moreOveractive bladder syndrome (OAB) is a common lower urinary tract disorder. So far, no therapy is beneficial and applicable for all OAB patients because patients with OAB represent a very heterogeneous group of patients. Research has mainly focused on bladder function. recently the international continence society has called for research to urethral function within OAB. The aim of this thesis is to further elucidate the role of urethral function within OAB to contribute to better targeted therapy in patients with OAB. This thesis consists of seven chapters and contains the results of an anatomical study to the presence of adrenoceptor B3 in the human female urethra, a review of the literature on this subject, the results of a functional urodynamic study to assess the best method to demonstrate urethral pressure variations and the results of clinical urodynamic study to the effect of pharmacotherapy with adrenoceptor B3-agonist in patients with OAB and urethral pressure variations and finally the results of a pilot study to the efficacy of a localized treatment with botuline toxin-A treatment for patients with urethral pressure variations. Show less
