Management of vesicoureteral reflux

Four cases of vesicoureteral reflux are discussed by prominent pediatric urologists. The condition can range from minimal reflux into the distal ureter to massive reflux causing tortuosity of the ureter and hydronephrosis. Treatment options range from medical management to tapering of the ureter with reimplantation. The cross-trigonal technique is popular among pediatric urologists, and the Politano-Leadbetter technique is a very successful technique that has stood the test of time. The extravesical approach to ureteral reimplantation reduces morbidity, shortens hospital stays, reduces medical costs, and maintains the high success rates of the intravesical techniques. Subureteric injection of bulking agents to correct the reflux holds promise as an alternative to open surgery, but presents the challenge of identifying the ideal bulking agent.     

Gastroesophageal reflux disease pathogenesis

Pathophysiological mechanisms of gastroesophageal reflux disease are described, including vagal stimulation of motor activity of upper stomach and oaesophagal divisions. Serotonin role is indicated (own research results including), as its place at this mechanisms of NO, cholecistokinin, prostaglandins, epidermal growth factor and other biologically active substances. There are highlighted some aspects of interleukins, adgesive molecules and other components of immune system activity in state of gastroesophageal reflux disease.     

A mechanism for internal reflux in foam fractionation

Multiple equilibrium stages can be engendered in foam fractionation, a process used for the enrichment of streams of proteins, by returning some of the foamate stream to the top of the column as external reflux liquor. However, it was recognised, 40 years ago that reflux could be autogenously created through the coalescence of bubbles in fractionation columns. By invoking the hydrodynamic theory of rising foam, we suggest a mechanism for the creation of internal reflux in foam fractionation. This method can give internal reflux rate as a function of bubble size. However, since the bubble size profile in a rising foam cannot be estimated, we cannot yet estimate how internal reflux varies with position in the column.