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Sample records for bladder neck descent

  1. Bladder neck contracture

    PubMed Central

    Simhan, Jay; Ramirez, Daniel; Morey, Allen F.

    2014-01-01

    Bladder neck contracture (BNC) is a well-described complication of the surgical treatment of benign and malignant prostate conditions. Nevertheless, etiologies of BNC development are highly dependent on the primary treatment modality undertaken with BNC also occurring after pelvic radiation. The treatment options for BNC can range from simple, office-based dilation procedures to more invasive, complex abdomino-perineal reconstructive surgery. Although numerous strategies have been described, a patient-specific approach is usually necessary in the management of these complex patients. In this review, we highlight various therapeutic maneuvers described for the management of BNC and further delineate a tailored approach utilized at our institution in these complicated patients. PMID:26816768

  2. Weakness of the Pelvic Floor Muscle and Bladder Neck Is Predicted by a Slight Rise in Abdominal Pressure During Bladder Filling: A Video Urodynamic Study in Children

    PubMed Central

    2016-01-01

    Purpose: To investigate the significance of slowly rising abdominal pressure (SRAP), which is often observed in nonneurogenic children during bladder filling in video urodynamic studies (VUDSs). Methods: The records of patients who underwent VUDS from July 2011 to June 2013 were reviewed. SRAP was defined as a rising curve over 5 cm H2O from the baseline abdominal pressure during the filling phase in VUDS. Bladder descent was defined when the base of the bladder was below the upper line of the pubic symphysis. An open bladder neck was defined as the opening of the bladder neck during the filling phase. Results: Of the 488 patients, 285 were male patients. The mean age at VUDS was 3.7 years (range, 0.2–17.6 years). The VUDS findings were as follows: SRAP, 20.7% (101 of 488); descending bladder, 14.8% (72 of 488); and bladder neck opening, 4.3% (21 of 488). Of the 72 patients with a descending bladder, 84.7% had SRAP. A significant difference in the presence of SRAP was found between the descending bladder and the normal bladder (P<0.001). Of the 101 patients with SRAP, 40 (39.6%) did not have a descending bladder. Of the 40 patients, 14 (35.0%) had a bladder neck opening, which was a high incidence compared with the 4.3% in all subjects (P<0.001). Conclusions: SRAP was associated with a descending bladder or a bladder neck opening, suggesting that SRAP is a compensatory response to urinary incontinence. SRAP may also predict decreased function of the bladder neck or pelvic floor muscle. PMID:27032558

  3. Bladder neck sparing in radical prostatectomy

    PubMed Central

    Smolski, Michal; Esler, Rachel C.; Turo, Rafal; Collins, Gerald N.; Oakley, Neil; Brough, Richard

    2013-01-01

    The role of a bladder neck sparing (BNS) technique in radical prostatectomy (RP) remains controversial. The potential advantages of improved functional recovery must be weighed against oncological outcomes. We performed a literature review to evaluate the current knowledge regarding oncological and functional outcomes of BNS and bladder neck reconstruction (BNr) in RP. A systematic literature review using on-line medical databases was performed. A total of 33 papers were identified evaluating the use of BNS in open, laparoscopic and robotic-assisted RP. The majority were retrospective case series, with only one prospective, randomised, blinded study identified. The majority of papers reported no significant difference in oncological outcomes using a BNS or BNr technique, regardless of the surgical technique employed. Quoted positive surgical margin rates ranged from 6% to 32%. Early urinary continence (UC) rates were ranged from 36% to 100% at 1 month, with long-term UC rate reported at 84-100% at 12 months if the bladder neck (BN) was spared. BNS has been shown to improve early return of UC and long-term UC without compromising oncological outcomes. Anastomotic stricture rate is also lower when using a BNS technique. PMID:24235797

  4. Bladder neck incompetence at posterior urethroplasty

    PubMed Central

    Koraitim, Mamdouh M.

    2015-01-01

    The finding of an incompetent bladder neck (BN) at the time of posterior urethroplasty will necessarily exacerbate the already difficult situation. In such cases the aim of the treatment is not only to restore urethral continuity by end-to-end urethral anastomosis, but also to restore the function of the BN to maintain urinary continence. Fortunately, the incidence of incompetence of the BN at posterior urethroplasty is uncommon, usually ≈4.5%. It seems that pelvic fracture-related BN injuries, in contrast to urethral injuries which result from a shearing force, are due to direct injury by the sharp edge of the fractured and displaced pubic bone. The risk of injuries to the BN is greater in children, in patients with a fracture involving both superior and inferior pubic rami on the same side, and in those managed initially by primary realignment. An incompetent BN is suspected by finding an open rectangular BN on cystography, and a fixedly open BN on suprapubic cystoscopy. An incompetent BN can be treated either subsequent to or concomitant with the urethral repair, according to whether a perineal or a perineo-abdominal urethroplasty is used, respectively. Several options have been reported to treat pelvic fracture-related BN incompetence, including reconstructing the BN, forming a new sphincter by tubularisation of a rectangular flap of the anterior bladder wall, and mechanical occlusion by an artificial sphincter or collagen injection. Reconstruction of the BN by the Young-Dees-Leadbetter∗∗ procedure probably provides the most successful results. PMID:26019982

  5. Metal Fatigue Causing Cystoscope Rupture During Bladder Neck Incision

    PubMed Central

    Fernandez, Alfonso

    2011-01-01

    The modern cystoscope is the result of the advancement in technology in numerous areas and is an invaluable tool that allows the urologist to perform a number of diagnostic and therapeutic procedures. Although various degrees of endoscope failure have been widely reported, instrument breakage that leads to a foreign body has not. While performing a bladder neck stricture incision for a 72-year-old male patient with a previous radical prostatectomy for prostate cancer and a resulting bladder neck stricture, we documented a major 17-French cystoscope malfunction and a resulting foreign body that was retrieved from the bladder using a 22-French scope and alligator forceps. PMID:21985739

  6. Role of autologous bladder-neck slings: a urogynecology perspective.

    PubMed

    Zoorob, Dani; Karram, Mickey

    2012-08-01

    The concept of the autologous pubovaginal sling involves supporting the proximal urethra and bladder neck with a piece of graft material, achieving continence either by providing a direct compressive force on the urethra/bladder outlet or by reestablishing a reinforcing platform or hammock against which the urethra is compressed during transmission of increased abdominal pressure. Pubovaginal slings using a biological sling material (whether autologous, allograft, or xenograft) can be used successfully to manage primary or recurrent stress incontinence. This article addresses the indications for the use of an autologous bladder-neck sling, describes the surgical techniques, and discusses outcomes and technical considerations. PMID:22877713

  7. Contractile responses in bladder body, bladder neck and prostate from rat, guinea pig and cat.

    PubMed

    Cohen, M L; Drey, K

    1989-03-01

    Lower urinary tract smooth muscle displays marked heterogeneity in pharmacologic responsiveness to contractile agents. The present study details differences among species with regard to muscarinic, adrenergic, histaminergic and serotonergic agonists in the bladder body, bladder neck and prostate from guinea pig, rat and cat. Under in vitro conditions, all smooth muscle preparations contracted to potassium chloride. The muscarinic agonist, carbamylcholine, produced maximal contraction, whereas alpha receptor agonists exerted only minimal, if any, effect in bladder body preparations from all three species. In contrast, alpha receptor-mediated responses predominated relative to muscarinic responses in bladder neck preparations from all three species. Prostatic contractility was examined in tissue from guinea pig and rat and contraction occurred to both alpha and muscarinic receptor agonists. Contractile response to norepinephrine in bladder neck and prostate was potentiated by neuronal uptake inhibition but not by beta receptor blockade. Serotonin and histamine exhibited more diverse effects among species and tissues. In general, histamine contracted all three tissues from guinea pig with minimal contraction occurring in tissues from rat or cat. On the other hand, serotonin markedly contracted the cat bladder body and rat prostate, but exerted no effect on tissues from the guinea pig. These data reinforce and detail the heterogeneity of pharmacologic contractile responses in lower urinary tract smooth muscle. Furthermore, the studies document the relative similarity among species in cholinergic and adrenergic responsiveness and the dissimilarity among species in serotonergic and histaminergic responsiveness of lower urinary tract smooth muscle. PMID:2539454

  8. Post-Radical-Prostatectomy Urinary Incontinence: The Management of Concomitant Bladder Neck Contracture

    PubMed Central

    King, Thomas; Almallah, Y. Zaki

    2012-01-01

    Urinary incontinence postradical prostatectomy is a common problem which adversely affects quality of life. Concomitant bladder neck contracture in the setting of postprostatectomy incontinence represents a challenging clinical problem. Postprostatectomy bladder neck contracture is frequently recurrent and makes surgical management of incontinence difficult. The aetiology of bladder neck contracture and what constitutes the optimum management strategy are controversial. Here we review the literature and also present our approach. PMID:22611382

  9. 5-hydroxytryptamine induced relaxation in the pig urinary bladder neck

    PubMed Central

    Recio, Paz; Barahona, María Victoria; Orensanz, Luis M; Bustamante, Salvador; Martínez, Ana Cristina; Benedito, Sara; García-Sacristán, Albino; Prieto, Dolores; Hernández, Medardo

    2009-01-01

    Background and purpose 5-Hydroxytryptamine (5-HT) is one of the inhibitory mediators in the urinary bladder outlet region. Here we investigated mechanisms involved in 5-HT-induced relaxations of the pig bladder neck. Experimental approach Urothelium-denuded strips of pig bladder were mounted in organ baths for isometric force recordings of responses to 5-HT and electrical field stimulation (EFS). Key results After phenylephrine-induced contraction, 5-HT and 5-HT receptor agonists concentration-dependently relaxed the preparations, with the potency order: 5-carboxamidotryptamine (5-CT) > 5-HT = RS67333 > (±)-8-hydroxy-2-dipropylaminotetralinhydrobromide > m-chlorophenylbiguanide > α-methyl-5-HT > ergotamine. 5-HT and 5-CT relaxations were reduced by the 5-HT7 receptor antagonist (2R)-1-[(3-hydroxyphenyl)sulphonyl]-2-[2-(4-methyl-1-piperidinyl)ethyl]pyrrolidine hydrochloride and potentiated by (S)-N-tert-butyl-3-(4-(2-methoxyphenyl)-piperazin-1-yl)-2-phenylpropanamide dihydrochloride (WAY 100135) and cyanopindolol, 5-HT1A and 5-HT1A/1B receptor antagonists respectively. Inhibitors of 5-HT1B/1D, 5-HT2, 5-HT2B/2C, 5-HT3, 5-HT4, 5-HT5A and 5-HT6 receptors failed to modify 5-HT responses. Blockade of monoamine oxidase A/B, noradrenergic neurotransmission, α-adrenoceptors, muscarinic and purinergic receptors, nitric oxide synthase, guanylate cyclase and prostanoid synthesis did not alter relaxations to 5-HT. Inhibitors of Ca2+-activated K+ and ATP-dependent K+ channels failed to modify 5-HT responses but blockade of neuronal voltage-gated Na+-, Ca2+-and voltage-gated K+ (Kv)-channels potentiated these relaxations. Adenylyl cyclase activation and cAMP-dependent protein kinase (PKA) inhibition potentiated and reduced, respectively, 5-HT-induced responses. Under non-adrenergic, non-cholinergic, non-nitrergic conditions, EFS induced neurogenic, frequency-dependent, relaxations which were resistant to WAY 100135 and cyanopindolol. Conclusions and implications 5-HT relaxed

  10. Detrusor function with lesions of the cauda equina, with special emphasis on the bladder neck.

    PubMed

    Light, J K; Beric, A; Petronic, I

    1993-03-01

    A total of 13 patients with proved lesions of the cauda equina underwent neurological evaluation. All patients had video urodynamic testing, while 9 underwent a varying combination of pelvic floor electromyography, lumbosacral evoked potentials to tibial nerve stimulation and the sympathetic skin response from the perineum. All patients had detrusor areflexia with varying degrees of bladder neck incompetence. Reports of clinical and experimental studies are discussed in relation to the pathophysiology of bladder neck function following lesions of the pudendal and preganglionic pelvic nerve to explain why there have been conflicting reports in the literature regarding bladder neck function with lesions of the cauda equina. The adaptive changes observed in the experimental animal, consisting of random regeneration of the cholinergic neuroeffective junctions, adrenergic hyperinnervation and an increased sensitivity of the prejunctional inhibitory muscarinic receptors on the adrenergic nerve, may explain the degree of variability of bladder neck incompetence observed clinically. PMID:8437259

  11. Epigenetic silencing of S100A2 in bladder and head and neck cancers

    PubMed Central

    Lee, Juna; Wysocki, Piotr T.; Topaloglu, Ozlem; Maldonado, Leonel; Brait, Mariana; Begum, Shahnaz; Moon, David; Kim, Myoung Sook; Califano, Joseph A.; Sidransky, David; Hoque, Mohammad O.; Moon, Chulso

    2015-01-01

    S100A2, a member of the S100 protein family, is known to be downregulated in a number of human cancers, leading to its designation as a potential tumor suppressor gene. Here, we investigated the expression and methylation status of S100A2 in head&neck and bladder cancer. Reduced mRNA and protein expression was observed in 8 head&neck and bladder cancer cell lines. To explore the mechanism responsible for the downregulation of S100A2, we treated six cell lines with 5-aza-2′-deoxycytidine. We found S100A2 is silenced in association with aberrant promoter-region methylation and its expression is restored with 5-aza-2′-deoxycytidine treatment. Of 31 primary head&neck cancer cases and 31 bladder cancer cases, promoter methylation was detected in 90% and 80% of cases, respectively. Interestingly, only 1/9 of normal head&neck tissues and 2/6 of normal bladder tissues showed promoter methylation. S100A2 promoter methylation can be detected in urine and is more frequent in bladder cancer patients than in healthy subjects (96% vs 48% respectively). Moreover, increased methylation of S100A2 is linked to the progression of the tumor in bladder cancer (p<0.01). Together, this data shows that methylation-associated inactivation of S100A2 is frequent and may be an important event in the tumorigenesis of head&neck and bladder cancer. PMID:26097874

  12. Bladder neck closure and suprapubic catheter placement as definitive management of neurogenic bladder

    PubMed Central

    Colli, Janet; Lloyd, L. Keith

    2011-01-01

    Objective Surgical management for neurogenic bladder may require abandonment of the native urethra due to intractable urinary incontinence, irreparable urethral erosion, severe scarring from previous transurethral procedures, or urethrocutaneous fistula. In these patients, bladder neck closure (BNC) excludes the native urethra and provides continence while preserving the antireflux mechanism of the native ureters. This procedure is commonly combined with ileovesicostomy or continent catheterizable stoma, with or without augmentation enterocystoplasty. Alternatively, BNC can be paired with suprapubic catheter diversion. This strategy does not require a bowel segment, resulting in shorter operative times and less opportunity for bowel-related morbidity. The study purpose is to examine preoperative characteristics, indications, complications, and long-term maintenance of renal function of BNC patients. Methods A retrospective review of medical records of 35 patients who underwent BNC with suprapubic catheter placement from 1998 to 2007 by a single surgeon (LKL) was completed. Results Neurogenic bladder was attributable to spinal cord injury in 71%, 23% had multiple sclerosis, and 9% had cerebrovascular accident. Indications for BNC included severe urethral erosion in 80%, decubitus ulcer exacerbated by urinary incontinence in 34%, urethrocutaneous fistula in 11%, and other indications in 9%. The overall complication rate was 17%. All but two patients were continent at follow-up. Forty-nine per cent of patients had imaging available for review, none of which showed deterioration of the upper tracts. Conclusions Our results suggest that BNC in conjunction with suprapubic catheter diversion provides an excellent chance at urethral continence with a reasonable complication rate. PMID:21756565

  13. Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review

    PubMed Central

    Tazi, Mohammed Fadl; Riyach, Omar; Ahallal, Youness; Mellas, Soufiane; Khallouk, Abdelhak; El Fassi, Mohammed Jamal; Farih, Moulay Hassan

    2012-01-01

    Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000 mL fluid in the collecting system of the kidney mimicking an ascites in an adult male. PMID:22606637

  14. Emergency primary repair of grade V bladder neck injury complicating pelvic fracture.

    PubMed

    Weledji, Elroy P; Fokam, Pius; Nzade, Djatche; Eyongeta, Divine

    2014-01-01

    We report a case of a grade V bladder injury complicating an open-book pelvic fracture following a road traffic accident. The bladder neck injury was primarily repaired in the emergency setting of a poor-resourced area with successful outcome. The dangers of urinary extravasation are still to be considered of importance and we advocate and encourage immediate/emergency open intervention although it remains controversial to say the least in a lesser resourced healthcare set up. PMID:25076980

  15. Emergency primary repair of grade V bladder neck injury complicating pelvic fracture

    PubMed Central

    2014-01-01

    We report a case of a grade V bladder injury complicating an open-book pelvic fracture following a road traffic accident. The bladder neck injury was primarily repaired in the emergency setting of a poor-resourced area with successful outcome. The dangers of urinary extravasation are still to be considered of importance and we advocate and encourage immediate/emergency open intervention although it remains controversial to say the least in a lesser resourced healthcare set up. PMID:25076980

  16. Management of Urinary Incontinence in Complete Bladder Duplication by Injection of Bulking Agent at Bladder Neck Level into the Proximal Urethra

    PubMed Central

    Khorramirouz, Reza; Ladi Seyedian, Seyedeh Sanam; Keihani, Sorena; Kajbafzadeh, Abdol-Mohammad

    2016-01-01

    Bladder duplication is a rare entity in children. The term encompasses a wide spectrum of anomalies from isolated bladder duplication in coronal or sagittal planes to duplicated bladder exstrophy and associated musculoskeletal and visceral anomalies. Given this wide variability, the treatment of these patients is not standardized. We hereby present a female patient with chief complaint of long-standing urinary incontinence who had complete bladder and urethral duplication and pubic diastasis. The patient was treated with bulking agent injection at the incompetent bladder neck and proximal urethra with resolution of incontinence, obviating the need for extensive surgeries. PMID:26904349

  17. Intralesional Injection of Mitomycin C at Transurethral Incision of Bladder Neck Contracture May Offer Limited Benefit: TURNS Study Group

    PubMed Central

    Redshaw, Jeffrey D.; Broghammer, Joshua A.; Smith, Thomas G.; Voelzke, Bryan B.; Erickson, Bradley A.; McClung, Christopher D.; Elliott, Sean P.; Alsikafi, Nejd F.; Presson, Angela P.; Aberger, Michael E.; Craig, James R.; Brant, William O.; Myers, Jeremy B.

    2015-01-01

    Purpose Injection of mitomycin C may increase the success of transurethral incision of the bladder neck for the treatment of bladder neck contracture. We evaluated the efficacy of mitomycin C injection across multiple institutions. Materials and Methods Data on all patients who underwent transurethral incision of the bladder neck with mitomycin C from 2009 to 2014 were retrospectively reviewed from 6 centers in the TURNS. Patients with at least 3 months of cystoscopic followup were included in the analysis. Results A total of 66 patients underwent transurethral incision of the bladder neck with mitomycin C and 55 meeting the study inclusion criteria were analyzed. Mean ± SD patient age was 64 ± 7.6 years. Dilation or prior transurethral incision of the bladder neck failed in 80% (44 of 55) of patients. Overall 58% (32 of 55) of patients achieved resolution of bladder neck contracture after 1 transurethral incision of the bladder neck with mitomycin C at a median followup of 9.2 months (IQR 11.7). There were 23 patients who had recurrence at a median of 3.7 months (IQR 4.2), 15 who underwent repeat transurethral incision of the bladder neck with mitomycin C and 9 of 15 (60%) who were free of another recurrence at a median of 8.6 months (IQR 8.8), for an overall success rate of 75% (41 of 55). Incision with electrocautery (Collins knife) was predictive of success compared with cold knife incision (63% vs 50%, p=0.03). Four patients experienced serious adverse events related to mitomycin C and 3 needed or are planning cystectomy. Conclusions The efficacy of intralesional injection of mitomycin C at transurethral incision of the bladder neck was lower than previously reported and was associated with a 7% rate of serious adverse events. PMID:25200807

  18. Laparoscopic radical prostatectomy with bladder neck preservation: positive surgical margin and urinary continence status

    PubMed Central

    Jaskulski, Jaroslaw; Jarecki, Piotr; Dudek, Przemysław; Szopiński, Tomasz; Chłosta, Piotr

    2014-01-01

    Introduction Preservation of the bladder neck (BN) has been controversial, as limited excision of the bladder neck may result in incomplete resection of the disease. Moreover, the urinary continence rate may not be improved. Aim To evaluate the effect of bladder neck sparing on urinary continence, and surgical margins status in prostate cancer (PCa) patients treated with laparoscopic radical extraperitoneal prostatectomy. Material and methods A retrospective analysis of 295 consecutive patients who had undergone laparoscopic radical extraperitoneal prostatectomy for clinically localised prostate cancer in a single institution was performed. Positive surgical margin (SM(+)) and urinary continence status at 3, 6, and 12 months were evaluated. Results The distribution of SM(+) for pT2, pT3, and pT4a was 15.3% (27/176), 49.1% (58/118), and 100% (1/1), respectively. Overall, there were 55.61%, 80.61%, and 84.69% of men continent at 3, 6, and 12 months, respectively. However, when limiting the analysis to those who did not receive adjuvant radiotherapy within 12 months following surgery, urinary continence rates were 59.23%, 85.86%, and 90.21% at 3, 6, and 12 months, respectively. Preoperative prostate-specific antigen (PSA) and pathological T stage were identified as significant predictors of positive surgical margins. Conclusions Conclusions: Laparoscopic radical extraperitoneal prostatectomy with bladder neck preservation has been a safe procedure which has resulted in good functional outcome. We observed a relatively high incidence of positive surgical margins which could be attributed to a large number of extracapsular disease cases. PMID:25337159

  19. Botulinum Toxin A Injection in the Bladder Neck: A Promising Treatment for Urinary Retention

    PubMed Central

    Alam, Marianne; Zgheib, Joseph; El Khoury, Fouad

    2016-01-01

    Secondary to failure of optimal medical therapy and the high morbidity that accompanies surgical techniques in high risk patients, the use of de novo treatments including botulinum toxin A is emerging in the treatment of benign prostatic hyperplasia (BPH). However, the treatment of urinary retention secondary to BPH via injecting botulinum toxin into the bladder neck is not well established in the literature. This case report describes the case of a 75-year-old male patient with a chronic history of obstructive lower urinary tract symptoms (LUTS) and multiple comorbidities who was admitted to the hospital for management of recurrent urinary retention. The patient was not a surgical candidate for transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP). Botulinum toxin injection into the bladder neck was performed with very satisfying results. Botulinum toxin injection in the bladder neck presents a promising minimally invasive, tolerated, and cost-effective approach for the treatment of urinary retention in patients with benign prostatic obstruction who are not candidates for surgery or in whom medical treatment has failed. More research is needed to identify the efficacy of this novel approach. PMID:27088032

  20. An appraisal of a technical modification for prevention of bladder neck stenosis in retropubic prostatectomy: An initial report

    PubMed Central

    Ajape, Abdulwahab Akanbi; Kuranga, Sulyman Alege; Babata, AbdulLateef; Kura, Mustapha Mohammed; Bello, Jibril O.

    2016-01-01

    Objective: To report the experience with our technical modification of the trigone-bladder neck complex management in the prevention of bladder neck stenosis (BNS) following open simple retropubic prostatectomy. Materials and Methods: It was a retrospective review of data of patients that underwent open simple retropubic prostatectomy with technical modification of the trigone-bladder neck complex in two Nigerian tertiary hospitals, by a single surgeon, from January 2007 to December 2011. The data analysed included the demographic variables, the modes of presentation, need for blood transfusion, duration of catheterization and the duration of hospital stay. The primary end-point was the development or otherwise of BNS. Results: Eighty-seven patients’ data were available for analysis from a total of 91 patients. The mean age (±standard deviation [SD]) was 65.14 years (±10.55). Preoperative urinary retention was present in 58% of the patients. The maximal flow rate (Qmax) was 12.05 ml/s among the 20 patients that had preoperative uroflowmetry. The transfusion rate was 35%, but almost two-third of them had only one unit of blood transfused. The mean weight (±SD) of the enucleated adenoma was 82.64 g (±36.63). Bladder irrigation was required in 14% of the patients, majority of the patients had urethral catheter removed after 96 h and the mean hospital stay was 6.52 days. No patient developed BNS after a mean follow-up duration of 16.39 months. Conclusion: Bladder neck stenosis can be a distressing complication of prostatectomy. The result of our technical modification of managing the trigone-bladder-neck complex looks promising for prevention or delaying the onset of BNS. A long-term observation and a prospective randomised control trial to ascertain this initial experience is needed. PMID:26834392

  1. The Musculature of the Bladder-neck of the Male in Health and Disease

    PubMed Central

    Macalpine, J. B.

    1934-01-01

    Two muscles, one voluntary the other involuntary, and an inch or more apart, exist at the bladder-neck, both functioning as sphincters. This dual musculature is explained by the emergence of the ejaculatory ducts between them. If both these muscles are open when semen is discharged, secretion may escape into the bladder or to the exterior; also any urine in the bladder would flow out. The internal sphincter is usually tightly contracted during ejaculation. Instances are given in which the internal sphincter is paralysed or injured, e.g. after operation, in prostatic hypertrophy, and in certain nervous diseases. Two instances are reported of direct injury to this localized area, with the result, in all cases, that ejaculation failed. In prostatic hypertrophy the internal sphincter is dilated by the growing adenoma, and at operation it is further stretched and perhaps cut across. Continence then depends on the external sphincter. Two cases are reported in which the external sphincter had previously been paralysed, total incontinence resulting. Recent work on the trigonal muscle; its function in opening the internal sphincter. Influence of this muscle on prostatic enlargement. In central nervous disease the dilatation of the internal sphincter resulting in funnel-neck is very common. Series of cases of nervous disease examined in order to determine the frequency of this sign are reported. Other cases occurring apart from nervous disease are also reported. The part played by the sphincters in ejaculation is discussed and illustrated by reports of further cases of paralysis of the sphincter. It is shown that in the normal way the external sphincter weakens during coitus, and especially during ejaculation, but when the internal sphincter is paralysed no weakening is evident. Penile erection is associated with spasm of the internal sphincter, and spasm of the internal sphincter is produced by irritation, e.g. vesical stone may produce priapism. The varying types of

  2. Unroofed midline prostate cyst misled into a stricture with obliterative bladder neck contracture following a laser prostatectomy.

    PubMed

    Diaz, Richilda Red; Lee, Joo Yong; Choi, Young Deuk; Cho, Kang Su

    2013-03-01

    We report on a case of a 67-year-old man who presented with persistent lower urinary tract symptoms following a potassium titanyl phosphate laser photoselective vaporization of prostate. Upon further diagnostic examinations were performed, he was noted to have an obliterative bladder neck contracture with an incidental, misleading, and rare presence of an unroofed midline anterior prostatic cyst presenting as a stricture. As we were presented with this case, it was imperative to address these complications of bladder neck contracture and incompletely ablated prostatic cyst. This report brings to light underestimated complicating factors in the urinary tract, and the diagnostic and therapeutic interventions we had undertaken to rectify the identified complications and improve patien's quality of life. The patient underwent internal urethrotomy, resection of prostatic cyst wall and transurethral resection of the prostate directed to improve his quality of life and prevent urinary retention. PMID:23610710

  3. Unroofed Midline Prostate Cyst Misled Into a Stricture With Obliterative Bladder Neck Contracture Following a Laser Prostatectomy

    PubMed Central

    Diaz, Richilda Red; Lee, Joo Yong; Choi, Young Deuk

    2013-01-01

    We report on a case of a 67-year-old man who presented with persistent lower urinary tract symptoms following a potassium titanyl phosphate laser photoselective vaporization of prostate. Upon further diagnostic examinations were performed, he was noted to have an obliterative bladder neck contracture with an incidental, misleading, and rare presence of an unroofed midline anterior prostatic cyst presenting as a stricture. As we were presented with this case, it was imperative to address these complications of bladder neck contracture and incompletely ablated prostatic cyst. This report brings to light underestimated complicating factors in the urinary tract, and the diagnostic and therapeutic interventions we had undertaken to rectify the identified complications and improve patien's quality of life. The patient underwent internal urethrotomy, resection of prostatic cyst wall and transurethral resection of the prostate directed to improve his quality of life and prevent urinary retention. PMID:23610710

  4. Transvaginal closure of the bladder neck and placement of a suprapubic catheter for destroyed urethra after long-term indwelling catheterization.

    PubMed

    Zimmern, P E; Hadley, H R; Leach, G E; Raz, S

    1985-09-01

    We report on 6 women with continuous urinary incontinence as a late complication of an indwelling urethral catheter for neurogenic bladder. Pressure necrosis by the balloon resulted in progressive destruction of the entire urethra, with subsequent incontinence despite the catheter. Surgical attempts at bladder neck closure to correct the incontinence generally have been unsuccessful. Instead of supravesical urinary diversion, we performed transvaginal closure of the bladder neck and percutaneous placement of a permanent suprapubic tube cystostomy. All 6 patients remained dry after closure and none has shown upper urinary tract deterioration at followup for as long as 5 years. PMID:4040980

  5. Bipolar Transurethral Incision of Bladder Neck Stenoses with Mitomycin C Injection

    PubMed Central

    Lyon, Timothy D.; Ayyash, Omar M.; Ferroni, Matthew C.; Rycyna, Kevin J.; Chen, Mang L.

    2015-01-01

    Introduction. To determine the efficacy of bipolar transurethral incision with mitomycin C (MMC) injection for the treatment of refractory bladder neck stenosis (BNS). Materials and Methods. Patients who underwent bipolar transurethral incision of BNS (TUIBNS) with MMC injection at our institution from 2013 to 2014 were retrospectively reviewed. A total of 2 mg of 40% mitomycin C solution was injected in four quadrants of the treated BNS. Treatment failure was defined as the need for subsequent intervention. Results. Thirteen patients underwent 17 bipolar TUIBNS with MMC injection. Twelve (92%) patients had failed a mean of 2.2 ± 1.1 prior endoscopic procedures. Median follow-up was 16.5 months (IQR: 14–18.4 months). Initial success was 62%; five (38%) patients had a recurrence with a median time to recurrence of 7.3 months. Four patients underwent a repeat procedure, 2 (50%) of which failed. Overall success was achieved in 77% (10/13) of patients after a mean of 1.3 ± 0.5 procedures. BNS recurrence was not significantly associated with history of pelvic radiation (33% versus 43%, p = 0.9). There were no serious adverse events. Conclusions. Bipolar TUIBNS with MMC injection was comparable in efficacy to previously reported techniques and did not result in any serious adverse events. PMID:26635876

  6. Incidence of bladder neck contracture after robot-assisted laparoscopic and open radical prostatectomy

    PubMed Central

    Breyer, Benjamin N.; Davis, Cole B.; Cowan, Janet E.; Kane, Christopher J.; Carroll, Peter R.

    2013-01-01

    OBJECTIVE To evaluate the incidence and risk factors for bladder neck contracture (BNC) in men treated with robot-assisted laparoscopic radical prostatectomy (RALP) and open radical prostatectomy (ORP), as BNC is a well-described complication of ORP and may be partially attributable to technique. PATIENTS AND METHODS The University of California San Francisco Urologic Oncology Database was queried for patients undergoing RALP or ORP from 2002 to 2008. Patient demographics, prostate cancer-specific information, surgical data, and follow-up were collected. For each surgical approach, multivariate Cox proportional hazards regression was performed to evaluate associations of demographics and clinical characteristics with BNC. Time to BNC after RP was evaluated using life table and Kaplan–Meier methods. RESULTS From 2002 to 2008, 988 patients underwent RP as primary treatment and had at least 12 months of follow-up. Of these men, 695 underwent ORP and 293 underwent RALP. The mean (SD) age was 59.3 (6.80) years and 91% of men were Caucasian. D’Amico risk groups at diagnosis were low (38%), intermediate (38%), and high (24%). The BNC incidence was 2.2% (22 cases) overall, 1.4% (four) for RALP, and 2.6% (18) for ORP (P = 0.12). Patients with BNC were diagnosed a median (range) of 4.7 (1–15) months after surgery. At 18 months after surgery, the BNC-free rate was 97% for ORP and 99% for RALP (log-rank P = 0.13). The most common presenting complaint was slow stream, followed by urinary retention. In Cox proportional hazards regression analysis, earlier year of surgery, older age at diagnosis and higher PSA level at diagnosis were significantly associated with BNC among ORP patients. In the RALP group, none of the covariates were associated with BNC. CONCLUSIONS The overall incidence of BNC was low in both RALP and ORP groups. Technical factors such as enhanced magnification and a running bladder anastomosis may explain the lower BNC incidence in the RALP group. PMID

  7. Combined abdominal and vaginal approach for bladder neck closure and permanent suprapubic tube: urinary diversion in the neurologically impaired woman.

    PubMed

    Levy, J B; Jacobs, J A; Wein, A J

    1994-12-01

    Chronic indwelling Foley catheter placement in the neurologically impaired patient can lead to pressure necrosis of the urethra with incontinence. We report on 2 series of patients who underwent bladder neck closure and insertion of a suprapubic catheter for this problem. Our initial group includes 4 patients who underwent 5 transvaginal procedures, of which 2 (40%) were successful. Subsequently, we modified our approach, and used a combined abdominal and transvaginal repair, which was successful in 10 consecutive patients with a followup of 6 to 40 months (mean 15.6). PMID:7966679

  8. Pelvic Floor Muscle Training in Women With Stress Urinary Incontinence Causes Hypertrophy of the Urethral Sphincters and Reduces Bladder Neck Mobility During Coughing

    PubMed Central

    McLean, Linda; Varette, Kevin; Gentilcore-Saulnier, Evelyne; Harvey, Marie-Andree; Baker, Kevin; Sauerbrei, Eric

    2016-01-01

    Aims The purpose of this study was to determine the effect of a 12-week pelvic floor muscle (PFM) training program on urethral morphology and mobility in women with stress urinary incontinence (SUI). Methods Forty women with SUI were randomly assigned to one of two groups: the treatment group received 12 weekly physiotherapy sessions during which they learned how to properly contract their pelvic floor muscles (PFMs) and a home exercise program was prescribed, reviewed, and progressed; the control group received no treatment. Before and after the 12-week study period, ultrasound imaging was used to evaluate bladder neck position and mobility during coughing and Valsalva maneuver in supine and in standing, as well as urethral morphology. Secondary outcome measures included a 3-day bladder diary, 30-min pad test, the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6). Results The women in the treatment group demonstrated reduced bladder neck mobility during coughing and increased cross-sectional area of their urethra after as compared to before the training. These changes were not evident in the control group. No differences in the resting position of the bladder neck or in bladder neck excursion during Valsalva maneuver were noted in either group. Concomitantly the women in the treatment group demonstrated significant improvements in the 3-day bladder diary and IIQ-7 after the PFM training and improved significantly more than the control group. Conclusion Physiotherapist-supervised PFM training reduces bladder neck motion during coughing, and results in hypertrophy of the urethral sphincter in women who present with SUI. PMID:23861324

  9. The Musculature of the Bladder-neck of the Male in Health and Disease: (Section of Urology).

    PubMed

    Macalpine, J B

    1934-11-01

    Two muscles, one voluntary the other involuntary, and an inch or more apart, exist at the bladder-neck, both functioning as sphincters. This dual musculature is explained by the emergence of the ejaculatory ducts between them. If both these muscles are open when semen is discharged, secretion may escape into the bladder or to the exterior; also any urine in the bladder would flow out. The internal sphincter is usually tightly contracted during ejaculation. Instances are given in which the internal sphincter is paralysed or injured, e.g. after operation, in prostatic hypertrophy, and in certain nervous diseases. Two instances are reported of direct injury to this localized area, with the result, in all cases, that ejaculation failed. In prostatic hypertrophy the internal sphincter is dilated by the growing adenoma, and at operation it is further stretched and perhaps cut across. Continence then depends on the external sphincter. Two cases are reported in which the external sphincter had previously been paralysed, total incontinence resulting.Recent work on the trigonal muscle; its function in opening the internal sphincter. Influence of this muscle on prostatic enlargement.In central nervous disease the dilatation of the internal sphincter resulting in funnel-neck is very common. Series of cases of nervous disease examined in order to determine the frequency of this sign are reported. Other cases occurring apart from nervous disease are also reported.The part played by the sphincters in ejaculation is discussed and illustrated by reports of further cases of paralysis of the sphincter. It is shown that in the normal way the external sphincter weakens during coitus, and especially during ejaculation, but when the internal sphincter is paralysed no weakening is evident. Penile erection is associated with spasm of the internal sphincter, and spasm of the internal sphincter is produced by irritation, e.g. vesical stone may produce priapism.The varying types of adenoma

  10. Treatment of Urethral/Bladder Neck Stricture After High-Intensity Focused Ultrasound for Prostate Cancer With Holmium: Yttrium-Aluminium-Garnet Laser

    PubMed Central

    Cho, Won Jin; Kim, Tae Heon; Lee, Hyo Serk; Chung, Jin Woo; Lee, Ha Na

    2013-01-01

    Purpose To evaluate the efficacy and safety of the Holmium: yttrium-aluminium-garnet (YAG) laser for the treatment of urethral/bladder neck strictures after high-intensity focused ultrasound for prostate cancer. Methods Between February 2007 and July 2010, Holmium: YAG laser urethrotomies were performed in eleven patients for bladder neck strictures or prostatic urethral strictures. The laser was used with a 550-µm fiber at 2 J and frequency 30 to 50 Hz. The medical records were retrospectively reviewed for medical history, perioperative and postoperative data, uroflowmetry, International Prostate Symptoms Score/quality of life, and stricture recurrence. Results At a median follow-up of 12.0 months (range, 4 to 35 months), the mean postoperative maximal flow rate and residual volume were improved significantly (P<0.05). The mean postoperative total, voiding and quality of life of international prostate symptom score were improved significantly (P<0.05). Of the 11 patients, 7 patients required one treatment, 4 patients two treatment, and 1 patients three treatment. 2 patients who had a documented urinary incontinence prior to the laser treatment subsequently required artificial urinary sphincter implantation and reported satisfaction without developing any recurrent strictures or artificial urinary sphincter erosion. All patients exhibited well-healed strictures and could void without difficulty. Conclusions Holmium: YAG laser therapy represents a safe, effective and minimally invasive treatment for urethral/bladder neck strictures occurring secondary to high-intensity focused ultrasound for prostate cancer. PMID:23610708

  11. Descent vehicles

    NASA Technical Reports Server (NTRS)

    Popov, Y. I.

    1985-01-01

    The creation of descent vehicles marked a new stage in the development of cosmonautics, involving the beginning of manned space flight and substantial progress in space research on the distant bodies of the Solar System. This booklet describes these vehicles and their structures, systems, and purposes. It is intended for the general public interested in modern problems of space technology.

  12. Cigarette Smoking Prior to First Cancer and Risk of Second Smoking-Associated Cancers Among Survivors of Bladder, Kidney, Head and Neck, and Stage I Lung Cancers

    PubMed Central

    Shiels, Meredith S.; Gibson, Todd; Sampson, Joshua; Albanes, Demetrius; Andreotti, Gabriella; Beane Freeman, Laura; Berrington de Gonzalez, Amy; Caporaso, Neil; Curtis, Rochelle E.; Elena, Joanne; Freedman, Neal D.; Robien, Kim; Black, Amanda; Morton, Lindsay M.

    2014-01-01

    Purpose Data on smoking and second cancer risk among cancer survivors are limited. We assessed associations between smoking before first cancer diagnosis and risk of second primary smoking-associated cancers among survivors of lung (stage I), bladder, kidney, and head/neck cancers. Methods Data were pooled from 2,552 patients with stage I lung cancer, 6,386 with bladder cancer, 3,179 with kidney cancer, and 2,967 with head/neck cancer from five cohort studies. We assessed the association between prediagnostic smoking and second smoking-associated cancer risk with proportional hazards regression, and compared these estimates to those for first smoking-associated cancers in all cohort participants. Results Compared with never smoking, current smoking of ≥ 20 cigarettes per day was associated with increased second smoking-associated cancer risk among survivors of stage I lung (hazard ratio [HR] = 3.26; 95% CI, 0.92 to 11.6), bladder (HR = 3.67; 95% CI, 2.25 to 5.99), head/neck (HR = 4.45; 95% CI, 2.56 to 7.73), and kidney cancers (HR = 5.33; 95% CI, 2.55 to 11.1). These estimates were similar to those for first smoking-associated cancer among all cohort participants (HR = 5.41; 95% CI, 5.23 to 5.61). The 5-year cumulative incidence of second smoking-associated cancers ranged from 3% to 8% in this group of cancer survivors. Conclusion Understanding risk factors for second cancers among cancer survivors is crucial. Our data indicate that cigarette smoking before first cancer diagnosis increases second cancer risk among cancer survivors, and elevated cancer risk in these survivors is likely due to increased smoking prevalence. The high 5-year cumulative risks of smoking-associated cancers among current smoking survivors of stage I lung, bladder, kidney, and head/neck cancers highlight the importance of smoking cessation in patients with cancer. PMID:25385740

  13. Selective Transurethral Resection of the Prostate Combined with Transurethral Incision of the Bladder Neck for Bladder Outlet Obstruction in Patients with Small Volume Benign Prostate Hyperplasia (BPH): A Prospective Randomized Study

    PubMed Central

    Li, Xin; Pan, Jin-hong; Liu, Qi-gui; He, Peng; Song, Si-ji; Jiang, Tao; Zhou, Zhan-song

    2013-01-01

    Purpose Transurethral resection of the prostate (TURP) has a high failure rate in patients with small volume benign prostate hyperplasia (BPH) with bladder outlet obstruction (BOO). We describe and report the results of an alternative surgical method, selective transurethral resection of the prostate (STURP) in combination with transurethral incision of the bladder neck (TUIBN). Methods Patients were randomized to receive TURP or STRUP+TUIBN in combination with TUIBN. Maximum urinary flow rate (Qmax), voided volume, and post voiding residual volume (PVR) were assessed at baseline and at 1, 3, and 6 months after surgery. Efficacy of treatment was assessed by lower urinary tract symptoms and IPSS. Results Sixty three patients received STRUP+TUIBN and 61 received TURP. Surgical time, amount of prostate tissue resected, and blood loss was the same in both groups (all, p>0.05). The mean duration of follow-up was 9.02 and 8.53 months in patients receiving TURP and STRUP+TUIBN, respectively. At 6 months postoperatively, IPSS was 4.26±1.22 and 4.18±1.47 in patients receiving TURP and STRUP+TUIBN, respectively (p>0.05), and the Qmax in patients receiving STRUP+TUIBN was markedly higher than in those receiving TURP (28.28±6.46 mL/s vs. 21.59±7.14 mL/s; p<0.05). Bladder neck contracture and urinary tract infections were observed in 3 and 5 patients receiving TURP, respectively, and none in STURP. Conclusions STRUP+TUIBN may offer a more effective and safer alternative to TURP for small volume BPH patients. PMID:23691002

  14. Dose to the Bladder Neck Is the Most Important Predictor for Acute and Late Toxicity After Low-Dose-Rate Prostate Brachytherapy: Implications for Establishing New Dose Constraints for Treatment Planning

    SciTech Connect

    Hathout, Lara; Folkert, Michael R.; Kollmeier, Marisa A.; Yamada, Yoshiya; Cohen, Gil'ad N.; Zelefsky, Michael J.

    2014-10-01

    Purpose: To identify an anatomic structure predictive for acute (AUT) and late (LUT) urinary toxicity in patients with prostate cancer treated with low-dose-rate brachytherapy (LDR) with or without external beam radiation therapy (EBRT). Methods and Materials: From July 2002 to January 2013, 927 patients with prostate cancer (median age, 66 years) underwent LDR brachytherapy with Iodine 125 (n=753) or Palladium 103 (n=174) as definitive treatment (n=478) and as a boost (n=449) followed by supplemental EBRT (median dose, 50.4 Gy). Structures contoured on the computed tomographic (CT) scan on day 0 after implantation included prostate, urethra, bladder, and the bladder neck, defined as 5 mm around the urethra between the catheter balloon and the prostatic urethra. AUT and LUT were assessed with the Common Terminology Criteria for Adverse Events, version4. Clinical and dosimetric factors associated with AUT and LUT were analyzed with Cox regression and receiver operating characteristic analysis to calculate area under the receiver operator curve (ROC) (AUC). Results: Grade ≥2 AUT and grade ≥2 LUT occurred in 520 patients (56%) and 154 patients (20%), respectively. No grade 4 toxicities were observed. Bladder neck D2cc retained a significant association with AUT (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.03-1.04; P<.0001) and LUT (HR, 1.01; 95% CI, 1.00-1.03; P=.014) on multivariable analysis. In a comparison of bladder neck with the standard dosimetric variables by use of ROC analysis (prostate V100 >90%, D90 >100%, V150 >60%, urethra D20 >130%), bladder neck D2cc >50% was shown to have the strongest prognostic power for AUT (AUC, 0.697; P<.0001) and LUT (AUC, 0.620; P<.001). Conclusions: Bladder neck D2cc >50% was the strongest predictor for grade ≥2 AUT and LUT in patients treated with LDR brachytherapy. These data support inclusion of bladder neck constraints into brachytherapy planning to decrease urinary toxicity.

  15. Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate

    PubMed Central

    Tao, Huang; Jiang, Yu Yong; Jun, Qi; Ding, Xu; Jian, Duan Liu; Jie, Ding; Ping, Zhu Yu

    2016-01-01

    ABSTRACT Purpose: To determine risk factors of postoperative urethral stricture (US) and vesical neck contracture (BNC) after transurethral resection of prostate (TURP) from perioperative parameters. Materials and Methods: 373 patients underwent TURP in a Chinese center for lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO), with their perioperative and follow-up clinical data being collected. Univariate analyses were used to determine variables which had correlation with the incidence of US and BNC before logistic regression being applied to find out independent risk factors. Results: The median follow-up was 29.3 months with the incidence of US and BNC being 7.8% and 5.4% respectively. Resection speed, reduction in hemoglobin (ΔHb) and hematocrit (ΔHCT) levels, incidence of urethral mucosa rupture, re-catheterization and continuous infection had significant correlation with US, while PSA level, storage score, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), resection time and resected gland weight had significant correlation with BNC. Lower resection speed (OR=0.48), urethral mucosa rupture (OR=2.44) and continuous infection (OR=1.49) as well as higher storage score (OR=2.51) and lower TPV (OR=0.15) were found to be the independent risk factors of US and BNC respectively. Conclusions: Lower resection speed, intraoperative urethral mucosa rupture and postoperative continuous infection were associated with a higher risk of US while severer storage phase symptom and smaller prostate size were associated with a higher risk of BNC after TURP. PMID:27256185

  16. Bladder stones

    MedlinePlus

    ... such as: Bladder diverticulum Enlarged prostate Neurogenic bladder Urinary tract infection Almost all bladder stones occur in men. Bladder ... stream Pain, discomfort in the penis Signs of urinary tract infection (such as fever, pain when urinating, and need ...

  17. Ascent/Descent Software

    NASA Technical Reports Server (NTRS)

    Brown, Charles; Andrew, Robert; Roe, Scott; Frye, Ronald; Harvey, Michael; Vu, Tuan; Balachandran, Krishnaiyer; Bly, Ben

    2012-01-01

    The Ascent/Descent Software Suite has been used to support a variety of NASA Shuttle Program mission planning and analysis activities, such as range safety, on the Integrated Planning System (IPS) platform. The Ascent/Descent Software Suite, containing Ascent Flight Design (ASC)/Descent Flight Design (DESC) Configuration items (Cis), lifecycle documents, and data files used for shuttle ascent and entry modeling analysis and mission design, resides on IPS/Linux workstations. A list of tools in Navigation (NAV)/Prop Software Suite represents tool versions established during or after the IPS Equipment Rehost-3 project.

  18. Bladder cancer

    MedlinePlus

    Transitional cell carcinoma of the bladder; Urothelial cancer ... In the United States, bladder cancer usually starts from the cells lining the bladder. These cells are called transitional cells. These tumors are classified by the way ...

  19. Bladder Diseases

    MedlinePlus

    ... frequent, urgent urination Bladder cancer Doctors diagnose bladder diseases using different tests. These include urine tests, x- ... National Institute of Diabetes and Digestive and Kidney Diseases

  20. Bladder stones

    MedlinePlus

    Stones - bladder; Urinary tract stones; Bladder calculi ... Benway BM, Bhayani SM. Lower urinary tract calculi. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 89. Sharma R, Dill CE, Gelman DY. Urinary ...

  1. Bladder Health

    MedlinePlus

    ... life (the person’s level of health, comfort, and happiness). In fact, people with bladder problems may have a lower quality of life than people with diabetes, heart disease, or high blood pressure. Bladder problems ...

  2. Neurogenic Bladder

    PubMed Central

    Dorsher, Peter T.; McIntosh, Peter M.

    2012-01-01

    Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented. PMID:22400020

  3. Bladder Monitor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Diagnostic Ultrasound Corporation's Bladder Scan Monitor continuously records and monitors bladder fullness and alerts the wearer or caretaker when voiding is required. The sensor is held against the lower abdomen by a belt and connected to the monitor by a cable. The sensor obtains bladder volume data from sound waves reflecting off the bladder wall. The device was developed by Langley Research Center, the Ames Research Center and the NASA Technology Applications Team. It utilizes Langley's advanced ultrasound technology. It is licensed to the ARC for medical applications, and sublicensed to Diagnostics Ultrasound. Central monitoring systems are planned for the future.

  4. Urethral duplication with unusual cause of bladder outlet obstruction

    PubMed Central

    Venkatramani, Vivek; George, Arun Jacob Philip; Chandrasingh, J.; Panda, Arabind; Devasia, Antony

    2016-01-01

    A 12-year-old boy presented with poor flow and recurrent urinary tract infections following hypospadias repair at the age of 3 years. The evaluation revealed urethral duplication with a hypoplastic dorsal urethra and patent ventral urethra. He also had duplication of the bladder neck, and on voiding cystourethrogram the ventral bladder neck appeared hypoplastic and compressed by the dorsal bladder neck during voiding. The possibility of functional obstruction of the ventral urethra by the occluded dorsal urethra was suspected, and he underwent a successful urethro-urethrostomy. PMID:27127361

  5. Terminal Descent Sensor Simulation

    NASA Technical Reports Server (NTRS)

    Chen, Curtis W.

    2009-01-01

    Sulcata software simulates the operation of the Mars Science Laboratory (MSL) radar terminal descent sensor (TDS). The program models TDS radar antennas, RF hardware, and digital processing, as well as the physics of scattering from a coherent ground surface. This application is specific to this sensor and is flexible enough to handle end-to-end design validation. Sulcata is a high-fidelity simulation and is used for performance evaluation, anomaly resolution, and design validation. Within the trajectory frame, almost all internal vectors are represented in whatever coordinate system is used to represent platform position. The trajectory frame must be planet-fixed. The platform body frame is specified relative to arbitrary reference points relative to the platform (spacecraft or test vehicle). Its rotation is a function of time from the trajectory coordinate system specified via dynamics input (file for open loop, callback for closed loop). Orientation of the frame relative to the body is arbitrary, but constant over time. The TDS frame must have a constant rotation and translation from the platform body frame specified at run time. The DEM frame has an arbitrary, but time-constant, rotation and translation with respect to the simulation frame specified at run time. It has the same orientation as sigma0 frame, but is possibly translated. Surface sigma0 has the same arbitrary rotation and translation as DEM frame.

  6. Neurogenic bladder

    MedlinePlus

    ... on the cause. They often include symptoms of urinary incontinence . Symptoms of overactive bladder: Having to urinate too ... If you are having urinary incontinence, organizations are available for further information and support.

  7. Complete transurethral bladder eversion 3 months after hemipelvectomy.

    PubMed

    Lowe, Gregory; Mandalapu, Subbarao; Gilleran, Jason

    2010-02-01

    A 46-year-old white female underwent a left hemipelvectomy for chondrosarcoma. She presented with total incontinence and a bulging vaginal mass. Exam confirmed complete transurethral bladder eversion that was addressed with transvaginal multilayer bladder neck closure and suprapubic tube placement. Eventually she underwent abdominal hysterectomy, mesh sacral colpopexy, and catheterizable stoma creation. Patient is continent of urine 3 months postoperatively. We present the first reported case of bladder eversion after hemipelvectomy and propose possible pathophysiologic mechanisms. PMID:19629370

  8. Bladder exstrophy repair

    MedlinePlus

    Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy ... in boys and is often linked to other birth defects. Surgery is necessary to: Allow the child to ...

  9. Neck pain

    MedlinePlus

    ... Alternative Names Pain - neck; Neck stiffness; Cervicalgia; Whiplash Images Neck pain Whiplash Location of whiplash pain References ... pubmed/19272509 . Read More Diskectomy Foraminotomy Laminectomy Spinal fusion Patient Instructions Spine surgery - discharge Update Date 3/ ...

  10. Overactive bladder

    PubMed Central

    Wallace, Karen M.; Drake, Marcus J.

    2015-01-01

    Overactive bladder syndrome is highly prevalent, and increasingly so with aging. It is characterized by the presence of urinary urgency, and can be associated with incontinence, increased voiding frequency, and nocturia. Assessment needs to exclude serious medical disorders that might present with similar symptoms, and a bladder diary is an invaluable part of understanding the presentation. Initial management is conservative, comprising education, bladder training, and advice on fluid intake. Drug therapy options include antimuscarinic medications and beta-3 adrenergic receptor agonists. Persistent overactive bladder syndrome, despite initial therapy, requires a review of the patient’s understanding of conservative management and compliance, and adjustment of medications. For refractory cases, specialist review and urodynamic testing should be considered; this may identify detrusor overactivity or increased filling sensation, and needs to exclude additional factors, such as stress incontinence and voiding dysfunction. Botulinum neurotoxin-A bladder injections can be used in severe overactivity, provided the patient is able and willing to do intermittent self-catheterisation, which is necessary in about 5% of treated patients. Sacral nerve stimulation and tibial nerve stimulation are other approaches. Major reconstructive surgery, such as augmentation cystoplasty, is rarely undertaken in modern practice but remains a possibility in extreme cases. PMID:26918151

  11. Simulation Test Of Descent Advisor

    NASA Technical Reports Server (NTRS)

    Davis, Thomas J.; Green, Steven M.

    1991-01-01

    Report describes piloted-simulation test of Descent Advisor (DA), subsystem of larger automation system being developed to assist human air-traffic controllers and pilots. Focuses on results of piloted simulation, in which airline crews executed controller-issued descent advisories along standard curved-path arrival routes. Crews able to achieve arrival-time precision of plus or minus 20 seconds at metering fix. Analysis of errors generated in turns resulted in further enhancements of algorithm to increase accuracies of its predicted trajectories. Evaluations by pilots indicate general support for DA concept and provide specific recommendations for improvement.

  12. Management options for sphincteric deficiency in adults with neurogenic bladder

    PubMed Central

    Mayer, Erik N.; Lenherr, Sara

    2016-01-01

    Neurogenic bladder is a very broad disease definition that encompasses varied disease and injury states affecting the bladder. The majority of patients with neurogenic bladder dysfunction do not have concomitant intrinsic sphincteric deficiency (ISD), but when this occurs the challenges of management of urinary incontinence from neurogenic bladder are compounded. There are no guidelines for surgical correction of ISD in adults and most of the literature on treatment of the problem comes from treatment of children with congenital diseases, such as myelomeningocele. Our goal, in this review, is to present some of the common surgical options for ISD [including artificial urinary sphincters, bladder slings, bladder neck reconstruction (BNR) and urethral bulking agents] and the evidence underlying these treatments in adults with neurogenic bladder. PMID:26904420

  13. Bipolar plasma vaporization versus monopolar TUR and “cold-knife" TUI in secondary bladder neck sclerosis – An evidence based, retrospective critical comparison in a single center clinical setting

    PubMed Central

    Moldoveanu, C; Geavlete, B; Jecu, M; Stanescu, F; Adou, L; Bulai, C; Ene, C; Geavlete, P

    2014-01-01

    Introduction: A long term, retrospective study was performed aiming to outline a critical comparison concerning the efficacy, safety and durability of the bipolar plasma vaporization (BPV), standard monopolar transurethral resection (TUR) and “cold-knife" “star" transurethral incision (TUI) in secondary bladder neck sclerosis (BNS) cases. Materials & Methods: Of the 126 patients included in the trial based on maximum flow rate (Qmax) below 10 mL/s and International Prostate Symptom Score (IPSS) over 19, classical resection was performed in 46 cases, “cold-knife" TUI in 37 cases and bipolar vaporization in 43 patients. The evaluation protocol comprised IPSS, QoL (quality of life) score, Qmax and PVR (post-voiding residual urinary volume) assessment performed at 1, 3, 6, 12, 18 and 24 months after the initial intervention. Results: Significant intraoperative complications (capsular perforation – 8.7%; bleeding – 4.3%) occurred secondary to monopolar resection. “Star" TUI was the fastest technique, followed by plasma-button vaporization (7.2 and 11.4 versus 16.5 minutes). BPV and TUI patients benefitted from the shortest catheterization periods (0.75 and 1 versus 2.0 days) and hospital stays (1.0 and 1.25 versus 2.0 days). Immediate postoperative adverse events consisted of hematuria (6.5% of the TUR cases) and acute urinary retention (8.1% of the TUI group). Significantly higher long term BNS recurrence rates requiring re-treatment were established in the TUI (18.7%) and TUR (12.8%) series by comparison to BPV (5.4%). Among patients that completed the follow-up protocol, equivalent IPSS, QoL, Qmax and PVR features were determined in the 3 study arms. Conclusions: The plasma vaporization approach was confirmed as a successful match to conventional TUR and “cold-knife" TUI in terms of surgical safety profile, postoperative recovery, therapeutic durability and urodynamic and symptom score parameters. PMID:24653766

  14. EXOMARS Descent Module GNC Performance

    NASA Astrophysics Data System (ADS)

    Portigliotti, S.; Capuano, M.; Montagna, M.; Martella, P.; Venditto, P.

    2007-08-01

    The ExoMars mission is the first ESA led robotic mission of the Aurora Programme and combines technology development with investigations of major scientific interest. Italy is by far the major contributor to the mission through the strong support of the Italian Space Agency (ASI). ExoMars will search for traces of past and present life, characterize the Mars geochemistry and water distribution, improve the knowledge of the Mars environment and geophysics, and identify possible surface hazards to future human exploration missions. ExoMars will also validate the technology for safe Entry, Descent and Landing (EDL) of a large size Descent Module (DM) carrying a Rover with medium range surface mobility and the access to subsurface. The ExoMars project is presently undergoing its Phase B1 with Thales Alenia Space-Italia as Industrial Prime Contractor. Additionally, as Descent Module responsible, a dedicated simulation tool is under development in Thales Alenia Space-Italia, Turin site, for the end-to-end design and validation / verification of the DM Entry Descent and Landing.

  15. Consert during the Philae Descent

    NASA Astrophysics Data System (ADS)

    Herique, Alain; Berquin, Yann; Blazquez, Alejandro; Antoine Foulon, Marc; Hahnel, Ronny; Hegler, Sebastian; Jurado, Eric; Kofman, Wlodek; Plettemeier, Dirk; Rogez, Yves; Statz, Christoph; Zine, Sonia

    2014-05-01

    The CONSERT experiment on board Rosetta and Philae is to perform the tomography of the 67P/CG comet nucleus measuring radio waves transmission from the Rosetta S/C to the Philae Lander and using the 67P nucleus rotation to cover different geometries. CONSERT will operate during the Philae descent. This geometry strongly differs from the "nominal" bistatic tomography where the orbiter is on the opposite side of the nucleus by regard to the lander. During the descent, CONSERT will measure direct wave propagating from orbiter to lander and waves reflected / scattered by the 67P surface and subsurface. This signal will provide information of the greatest interest for both scientific investigations of 67P and technical operations of Philae. The landing site position is known a priori with a large ellipse of dispersion due to uncertainties on the Rosetta velocity and Rosetta/Philae separation strength. This dispersion is increased by the difference between nominal and emergency separation strength. An accurate estimation of the landing position as soon as possible after landing is of the greatest interest to optimize Philae operation during FSS. So propagation delay of the direct and reflected waves measured by CONSERT will help to reconstruct the descent geometry in order to more precisely estimate the landing position. The reflected signal is determined by the surface properties: its dielectric permittivity, its roughness and layering. The signal power inversion will allow to map surface properties especially in the vicinity of the landing site. This paper details the measurement configuration. It presents the data retrieval based on Monte-Carlo simulation using Metropolis-Hastings algorithm and expected performances for both science and operations.

  16. Spirit's Descent to Mars-1706

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image, taken by the descent image motion estimation system camera located on the bottom of the Mars Exploration Rover Spirit's lander, shows a view of Gusev Crater as the lander descends to Mars. The picture is taken at an altitude of 1706 meters. Numerous small impact craters can be seen on the surface of the planet. These images help the onboard software to minimize the lander's horizontal velocity before its bridle is cut, and it falls freely to the surface of Mars.

  17. Spirit's Descent to Mars-1433

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image, taken by the descent image motion estimation system camera located on the bottom of the Mars Exploration Rover Spirit's lander, shows a view of Gusev Crater as the lander descends to Mars. The picture is taken at an altitude of 1433 meters. Numerous small impact craters can be seen on the surface of the planet. These images help the onboard software to minimize the lander's horizontal velocity before its bridal is cut, and it falls freely to the surface of Mars.

  18. Spirit's Descent to Mars-1983

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image, taken by the descent image motion estimation system camera located on the bottom of the Mars Exploration Rover Spirit's lander, shows a view of Gusev Crater as the lander descends to Mars. The picture is taken at an altitude of 1983 meters. Numerous small impact craters can be seen on the surface of the planet. These images help the onboard software to minimize the lander's horizontal velocity before its bridal is cut, and it falls freely to the surface of Mars.

  19. A new steepest descent method

    NASA Astrophysics Data System (ADS)

    Abidin, Zubai'ah Zainal; Mamat, Mustafa; Rivaie, Mohd; Mohd, Ismail

    2014-06-01

    The classical steepest descent (SD) method is known as one of the earliest and the best method to minimize a function. Even though the convergence rate is quite slow, but its simplicity has made it one of the easiest methods to be used and applied especially in the form of computer codes. In this paper, a new modification of SD method is proposed using a new search direction (dk) in the form of two parameters. Numerical results shows that this new SD has far superior convergence rate and more efficient than the classical SD method.

  20. Ant colony optimization and stochastic gradient descent.

    PubMed

    Meuleau, Nicolas; Dorigo, Marco

    2002-01-01

    In this article, we study the relationship between the two techniques known as ant colony optimization (ACO) and stochastic gradient descent. More precisely, we show that some empirical ACO algorithms approximate stochastic gradient descent in the space of pheromones, and we propose an implementation of stochastic gradient descent that belongs to the family of ACO algorithms. We then use this insight to explore the mutual contributions of the two techniques. PMID:12171633

  1. Bladder outlet reconstruction: fate of the silicone sheath.

    PubMed

    Kropp, B P; Rink, R C; Adams, M C; Keating, M A; Mitchell, M E

    1993-08-01

    The placement of a 1.5 cm. wide silicone sheath around a newly constructed urethra/bladder neck to ensure maintenance of repair length and to facilitate future placement of a sphincter cuff was reported by our institution in 1985. We present our long-term followup and new recommendations for use of the silicone sheath. A total of 15 silicone sheaths was placed between March 1981 and July 1984. Of the sheaths 14 were placed at the time of urinary reconstruction around the Young-Dees-Leadbetter bladder neck repair and 1 was placed after erosion of an artificial urinary sphincter cuff. Of the 15 sheaths 10 have eroded into the urethra and 4 sheaths remain in situ. Another sheath was replaced 2 years after its original insertion with an artificial urinary sphincter cuff. Mean time to erosion was 48.2 months, with a range of 2 to 108 months. Long-term followup of 10 patients revealed that 4 ultimately required ligation of the bladder neck and construction of continent stoma after erosion, 1 is dry after placement of a bulbar artificial urinary sphincter, 2 remain dry after removal of the eroded sheath alone, 2 required bladder neck revision to achieve continence after erosion and the most recent patient remains diverted with a suprapubic tube. All 4 patients with sheaths still remaining are dry without evidence of erosion (mean duration 116 months). These long-term results using a silicone wrap around a newly constructed bladder neck reveal an unacceptably high rate of erosion. Therefore, we no longer recommend or support the use of the silicone sheath in the manner we have described for bladder neck reconstruction. PMID:8326628

  2. Correlation as Probability of Common Descent.

    ERIC Educational Resources Information Center

    Falk, Ruma; Well, Arnold D.

    1996-01-01

    One interpretation of the Pearson product-moment correlation ("r"), correlation as the probability of originating from common descent, important to the genetic measurement of inbreeding, is examined. The conditions under which "r" can be interpreted as the probability of "identity by descent" are specified, and the possibility of generalizing this…

  3. Space Shuttle Orbiter descent navigation

    NASA Technical Reports Server (NTRS)

    Montez, M. N.; Madden, M. F.

    1982-01-01

    The entry operational sequence (OPS 3) begins approximately 2 hours prior to the deorbit maneuver and continues through atmospheric entry, terminal area energy management (TAEM), approach and landing, and rollout. During this flight phase, the navigation state vector is estimated by the Space Shuttle Orbiter onboard navigation system. This estimate is computed using a six-element sequential Kalman filter, which blends inertial measurement unit (IMU) delta-velocity data with external navaid data. The external navaids available to the filter are tactical air navigation (TACAN), barometric altimeter, and microwave scan beam landing system (MSBLS). Attention is given to the functional design of the Orbiter navigation system, the descent navigation sensors and measurement processing, predicted Kalman gains, correlation coefficients, and current flights navigation performance.

  4. Predictability of Top of Descent Location for Operational Idle-Thrust Descents

    NASA Technical Reports Server (NTRS)

    Stell, Laurel L.

    2010-01-01

    To enable arriving aircraft to fly optimized descents computed by the flight management system (FMS) in congested airspace, ground automation must accurately predict descent trajectories. To support development of the trajectory predictor and its uncertainty models, commercial flights executed idle-thrust descents at a specified descent speed, and the recorded data included the specified descent speed profile, aircraft weight, and the winds entered into the FMS as well as the radar data. The FMS computed the intended descent path assuming idle thrust after top of descent (TOD), and the controllers and pilots then endeavored to allow the FMS to fly the descent to the meter fix with minimal human intervention. The horizontal flight path, cruise and meter fix altitudes, and actual TOD location were extracted from the radar data. Using approximately 70 descents each in Boeing 757 and Airbus 319/320 aircraft, multiple regression estimated TOD location as a linear function of the available predictive factors. The cruise and meter fix altitudes, descent speed, and wind clearly improve goodness of fit. The aircraft weight improves fit for the Airbus descents but not for the B757. Except for a few statistical outliers, the residuals have absolute value less than 5 nmi. Thus, these predictive factors adequately explain the TOD location, which indicates the data do not include excessive noise.

  5. MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position

    PubMed Central

    Renzi, Adolfo; Monaco, Luigi; Serra, Nicola; Feragalli, Beatrice; Iacomino, Aniello; Brunese, Luca; Cappabianca, Salvatore

    2016-01-01

    Introduction. Functional disorders of the pelvic floor represent have a significant impact on the quality of life. The advent of open-configuration systems allowed for the evaluation of defecation with MR imaging in sitting position. The purpose of the present study is to compare the results of static and dynamic pelvic MR performed in supine position versus sitting position, using a new MR prototype machine, in the diagnosis of pelvic floor descent. Materials and Methods. Thirty-one patients with pelvic floor disorders were enrolled, and underwent MR Defecography in supine position with 1.5 T closed magnet (MAGNETOM Symphony, Siemens, Germany) and in sitting position with a 0.25-Tesla open magnet system (G-Scan ESAOTE, Italy). Results. In rest and squeezing phases, positions of bladder, vagina, and ARJ were significantly different when the patient was imaged in supine versus sitting position. In the defecation phase, a significant difference for the bladder and vagina position was detected between the two exams whereas a significant difference for the ARJ was not found. A statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position. Conclusion. Our results show that MR Defecography in sitting position may represent a useful tool to correctly diagnose and grade the pelvic organ descent. PMID:26880893

  6. Bladder Preservation for Muscle Invasive Bladder Cancer

    PubMed Central

    Mirza, Arafat; Choudhury, Ananya

    2016-01-01

    The standard treatment for muscle invasive bladder cancer (MIBC) has been considered to be radical cystectomy (RC) with pelvic lymphadenectomy. However morbidity and impact on quality of life is significant. Radiotherapy has been used in MIBC patients who choose bladder preservation or who are unfit for RC with comparable outcomes. Evidence from some prospective and large retrospective series supports the use of radiotherapy as an attractive alternative option. In this paper we review the evidence and practice of bladder preservation strategies with radiotherapy for muscle invasive bladder cancer. PMID:27376137

  7. Bladder function - neurological control

    MedlinePlus Videos and Cool Tools

    ... with urine, sensory nerves send impulses to the brain indicating that the bladder is full. The sensory ... cord to relay this information. In turn, the brain sends impulses back to the bladder instructing the ...

  8. Bladder Cancer Advocacy Network

    MedlinePlus

    ... future bladder cancer research through the Patient Survey Network. Read More... Don’t Miss the 2016 BCAN ... Click here for more details Bladder Cancer Advocacy Network 4915 St. Elmo Avenue, Suite 202 Bethesda, Maryland ...

  9. Descent Advisor Preliminary Field Test

    NASA Technical Reports Server (NTRS)

    Green, Steven M.; Vivona, Robert A.; Sanford, Beverly

    1995-01-01

    A field test of the Descent Advisor (DA) automation tool was conducted at the Denver Air Route Traffic Control Center in September 1994. DA is being developed to assist Center controllers in the efficient management and control of arrival traffic. DA generates advisories, based on trajectory predictions, to achieve accurate meter-fix arrival times in a fuel efficient manner while assisting the controller with the prediction and resolution of potential conflicts. The test objectives were: (1) to evaluate the accuracy of DA trajectory predictions for conventional and flight-management system equipped jet transports, (2) to identify significant sources of trajectory prediction error, and (3) to investigate procedural and training issues (both air and ground) associated with DA operations. Various commercial aircraft (97 flights total) and a Boeing 737-100 research aircraft participated in the test. Preliminary results from the primary test set of 24 commercial flights indicate a mean DA arrival time prediction error of 2.4 seconds late with a standard deviation of 13.1 seconds. This paper describes the field test and presents preliminary results for the commercial flights.

  10. Descent advisor preliminary field test

    NASA Technical Reports Server (NTRS)

    Green, Steven M.; Vivona, Robert A.; Sanford, Beverly

    1995-01-01

    A field test of the Descent Advisor (DA) automation tool was conducted at the Denver Air Route Traffic Control Center in September 1994. DA is being developed to assist Center controllers in the efficient management and control of arrival traffic. DA generates advisories, based on trajectory predictions, to achieve accurate meter-fix arrival times in a fuel efficient manner while assisting the controller with the prediction and resolution of potential conflicts. The test objectives were to evaluate the accuracy of DA trajectory predictions for conventional- and flight-management-system-equipped jet transports, to identify significant sources of trajectory prediction error, and to investigate procedural and training issues (both air and ground) associated with DA operations. Various commercial aircraft (97 flights total) and a Boeing 737-100 research aircraft participated in the test. Preliminary results from the primary test set of 24 commercial flights indicate a mean DA arrival time prediction error of 2.4 sec late with a standard deviation of 13.1 sec. This paper describes the field test and presents preliminary results for the commercial flights.

  11. Feature Clustering for Accelerating Parallel Coordinate Descent

    SciTech Connect

    Scherrer, Chad; Tewari, Ambuj; Halappanavar, Mahantesh; Haglin, David J.

    2012-12-06

    We demonstrate an approach for accelerating calculation of the regularization path for L1 sparse logistic regression problems. We show the benefit of feature clustering as a preconditioning step for parallel block-greedy coordinate descent algorithms.

  12. [Fiddler's neck].

    PubMed

    Knierim, C; Goertz, W; Reifenberger, J; Homey, B; Meller, S

    2013-10-01

    The fiddler's neck is an uncommon variant of acne mechanica in violinists and violists. It is a single firm red-brown dermal nodule usually on the left side of neck. This special form of acne mechanica represents a therapeutic challenge since the triggering mechanical factors persist, unless they can be corrected by changes in positioning or modifications of the chin pad. A 72-year-old woman who had played the violin since childhood presented with a red-brown nodule on her neck for 18 months. Cushioning provided no relief. Excision of the affected area with primary closure represented one therapeutic option. Further supportive measures include improved posture to reduce the pressure between skin and instrument and interposing a neck cloth. PMID:23989244

  13. Neck pain

    MedlinePlus

    ... falls can cause severe neck injuries, such as vertebral fractures, whiplash, blood vessel injury, and even paralysis. Other ... fibromyalgia Cervical arthritis or spondylosis Ruptured disk ... spine from osteoporosis Spinal stenosis (narrowing of the spinal ...

  14. Artist's rendering of Descent to Lunar Surface

    NASA Technical Reports Server (NTRS)

    1969-01-01

    Descent to Lunar Surface: The Commander and Lunar Module Pilot transfer to the IM, separate it from the Command and Service Module, and fire the IM descent engine to land on the Moon. After checking out the spacecraft and eating and resting, the Commander climbs down the ladder and places his left foot on the Moon while his right foot is inside the Lunar Module landing pad.

  15. Descent relations in cubic superstring field theory

    NASA Astrophysics Data System (ADS)

    Aref'eva, I. Y.; Gorbachev, R.; Medvedev, P. B.; Rychkov, D. V.

    2008-01-01

    The descent relations between string field theory (SFT) vertices are characteristic relations of the operator formulation of SFT and they provide self-consistency of this theory. The descent relations langleV2|V1rangle and langleV3|V1rangle in the NS fermionic string field theory in the κ and discrete bases are established. Different regularizations and schemes of calculations are considered and relations between them are discussed.

  16. Apollo experience report: Descent propulsion system

    NASA Technical Reports Server (NTRS)

    Hammock, W. R., Jr.; Currie, E. C.; Fisher, A. E.

    1973-01-01

    The propulsion system for the descent stage of the lunar module was designed to provide thrust to transfer the fully loaded lunar module with two crewmen from the lunar parking orbit to the lunar surface. A history of the development of this system is presented. Development was accomplished primarily by ground testing of individual components and by testing the integrated system. Unique features of the descent propulsion system were the deep throttling capability and the use of a lightweight cryogenic helium pressurization system.

  17. Neoadjuvant Intravesical Vaccine Therapy in Treating Patients With Bladder Carcinoma Who Are Undergoing Cystectomy

    ClinicalTrials.gov

    2014-12-22

    Bladder Adenocarcinoma; Bladder Squamous Cell Carcinoma; Bladder Urothelial Carcinoma; Recurrent Bladder Carcinoma; Stage I Bladder Cancer; Stage II Bladder Cancer; Stage III Bladder Cancer; Stage IV Bladder Cancer

  18. Reference energy-altitude descent guidance: Simulator evaluation. [aircraft descent and fuel conservation

    NASA Technical Reports Server (NTRS)

    Abbot, K. H.; Knox, C. E.

    1985-01-01

    Descent guidance was developed to provide a pilot with information to ake a fuel-conservative descent and cross a designated geographical waypoint at a preselected altitude and airspeed. The guidance was designed to reduce fuel usage during the descent and reduce the mental work load associated with planning a fuel-conservative descent. A piloted simulation was conducted to evaluate the operational use of this guidance concept. The results of the simulation tests show that the use of the guidance reduced fuel consumption and mental work load during the descent. Use of the guidance also decreased the airspeed error, but had no effect on the altitude error when the designated waypoint was crossed. Physical work load increased with the use of the guidance, but remained well within acceptable levels. The pilots found the guidance easy to use as presented and reported that it would be useful in an operational environment.

  19. Descent of the larynx in chimpanzee infants.

    PubMed

    Nishimura, Takeshi; Mikami, Akichika; Suzuki, Juri; Matsuzawa, Tetsuro

    2003-06-10

    The human larynx descends during infancy and the early juvenile periods, and this greatly contributes to the morphological foundations of speech development. This developmental phenomenon is believed to be unique to humans. This concept has formed a basis for paleoanthropological studies on the origin and evolution of human speech. We used magnetic resonance imaging to study the development of three living chimpanzees and found that their larynges also descend during infancy, as in human infants. This descent was completed primarily through the rapid descent of the laryngeal skeleton relative to the hyoid, but it was not accompanied by the descent of the hyoid itself. The descent is possibly associated with developmental changes of the swallowing mechanism. Moreover, it contributes physically to an increased independence between the processes of phonation and articulation for vocalization. Thus, the descent of the larynx and the morphological foundations for speech production must have evolved in part during hominoid evolution, and not in a single shift during hominid evolution. PMID:12775758

  20. Drugs Approved for Bladder Cancer

    MedlinePlus

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Bladder Cancer This page lists cancer ... in bladder cancer that are not listed here. Drugs Approved for Bladder Cancer Atezolizumab Cisplatin Doxorubicin Hydrochloride ...

  1. Assessment of GPS radiosonde descent data

    NASA Astrophysics Data System (ADS)

    Venkat Ratnam, M.; Pravallika, N.; Babu, S. Ravindra; Basha, G.; Pramitha, M.; Krishna Murthy, B. V.

    2014-04-01

    Radiosondes are widely used to obtain basic meteorological parameters such as pressure (P), temperature (T), relative humidity (RH) and horizontal winds during the balloon ascent up to the altitude of balloon burst, usually ~ 32-35 km. Data from the radiosondes released from Gadanki (13.5° N, 79.2° E), a tropical station in India, have been collected during the ascent and during the descent as well without attaching any parachute or its equivalent since the year 2008. In the present study an attempt has been made to characterize the radiosonde descent data with the main objective of exploring its usefulness and reliability for scientific purposes. We compared the data obtained during ascent and descent phases of the same sounding. The mean differences in T, RH and horizontal winds between ascent and descent data are found to be small and are sometimes even within the uncertainty of the measurements and/or expected diurnal variation itself. The very good consistency observed between the ascent and the descent data shows that one more profile of the meteorological parameters can be constructed within 3 h of time of balloon launch practically at no additional cost. Further checks are done by utilizing the 3-hourly radiosonde observations collected during the Tropical Tropopause Dynamics campaigns conducted at Gadanki. In the process of checking the consistency between the radiosonde ascent and descent data, several new findings are arrived at and are reported in this study. In general, it has taken more than half an hour for the balloon to reach the ground from the burst altitude. It is also observed that the fall velocity is close to 10 m s-1 near the surface. Finally, it is suggested to record the observations also when the balloon is descending as this information is useful for scientific purposes.

  2. Assessment of GPS radiosonde descent data

    NASA Astrophysics Data System (ADS)

    Venkat Ratnam, M.; Pravallika, N.; babu, S. Ravindra; Basha, G.; Pramitha, M.; Krishna Murthy, B. V.

    2013-12-01

    Radiosondes are widely used to obtain basic meteorological parameters such as pressure (P), temperature (T), relative humidity (RH), and horizontal winds during the balloon ascent up to the altitude of balloon burst, usually ∼32-35 km. Data from the radiosondes released from Gadanki (13.5° N, 79.2° E), a tropical station in India, has been collected during the ascent and during the descent as well without attaching any parachute or its equivalent since the year 2008. In the present study an attempt has been made to characterize the radiosonde descent data with the main objective of exploring its usefulness and reliability for scientific purposes. We compared the data obtained during ascent and descent phases of the same sounding. The mean differences in T, RH and horizontal winds between ascent and descent data are found to be small and are sometimes even within the uncertainty of the measurements and/or expected diurnal variation itself. The very good consistency observed between the ascent and the descent data shows that one more profile of the meteorological parameters can be constructed within 3 h of time of balloon launch practically at no additional cost. Further checks are done by utilizing the 3 hourly radiosonde observations collected during the Tropical Tropopause Dynamics campaign conducted at Gadanki. In the process of checking the consistency between the radiosonde ascent and descent data, several new findings are arrived at and are reported in this study. In general, it has taken more than half-an-hour for the balloon to reach the ground from the burst altitude. It is also observed that the fall velocity is close to 10 m s-1 near the surface. Finally, it is suggested to record also the observations when the balloon is descending as this information is also useful for scientific purposes.

  3. Neck Pain

    MedlinePlus

    ... get better. No 7. Did you have a whiplash-type injury in the past, or do you have pain and/or stiffness every day in your neck, hands, knees, hips or other joints? Yes Your pain may be from DEGENERATIVE CERVICAL ARTHRITIS, a disorder that affects the bones and ...

  4. Diabatic Descent In The Stratospheric Polar Vortex

    NASA Astrophysics Data System (ADS)

    Rosenfield, J.; Schoeberl, M.

    Polar regions experience diabatic cooling during the fall and winter months, resulting in a downward mass flux. An accurate measure of this fall and winter diabatic descent, as well as an understanding of the transport of air into and out of the winter polar vor- tices, is required for estimates of polar ozone depletion. We have calculated diabatic cooling rates using a radiative transfer code and U.K. Met Office (UKMO) tempera- tures for the years 1992-2000. These cooling rates, together with UKMO horizontal winds, have been used to compute three-dimensional forward and backward diabatic trajectories for the seven month fall to spring period in both the NH and the SH. The forward calculations estimate the maximum amount of descent that can occur. How- ever, they are not necessarily a good indicator of the origin of the springtime vortex air because more equatorward air from lower altitudes can be entrained within the vortex during its formation. The back trajectories, starting in the springtime lower middle stratosphere, show a complex final distribution of parcels. One population originates in the fall in the upper stratosphere and mesosphere and experiences considerable de- scent, while the remaining parcels originate at lower altitudes in the midlatitudes and are mixed into the polar regions during vortex formation. The amount of descent ex- perienced by the first population shows little variability from year to year, while the computed descent and mixing of the remaining parcels show considerable interannual variability due to the varying polar meteorology. Because of this complex parcel dis- tribution it is not meaningful to speak of a net amount of descent experienced over the entire winter period. We have also compared diabatic trajectories with kinematic tra- jectories, in which the vertical motion is given by the UKMO analysed omega fields. These show that the kinematic trajectory descent is much less than the diabatic tra- jectory descent and exhibits

  5. Entry, Descent, and Landing With Propulsive Deceleration

    NASA Technical Reports Server (NTRS)

    Palaszewski, Bryan

    2012-01-01

    The future exploration of the Solar System will require innovations in transportation and the use of entry, descent, and landing (EDL) systems at many planetary landing sites. The cost of space missions has always been prohibitive, and using the natural planetary and planet s moons atmospheres for entry, descent, and landing can reduce the cost, mass, and complexity of these missions. This paper will describe some of the EDL ideas for planetary entry and survey the overall technologies for EDL that may be attractive for future Solar System missions.

  6. Neck pain

    PubMed Central

    2008-01-01

    Introduction Non-specific neck pain has a postural or mechanical basis and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but may become chronic in about 10% of people. Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident, although this varies between countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for people with non-specific neck pain without severe neurological deficit? What are the effects of treatments for acute whiplash injury? What are the effects of treatments for chronic whiplash injury? What are the effects of treatments for neck pain with radiculopathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 91 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of the evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, biofeedback, drug treatments (analgesics, antidepressants, epidural steroid injections, muscle relaxants, non-steroidal anti-inflammatory drugs [NSAIDs]), early mobilisation, early return to normal activity, exercise, heat or cold, manipulation (alone or plus exercise), mobilisation, multimodal treatment, patient education, percutaneous radiofrequency neurotomy

  7. Bladder exstrophy repair

    MedlinePlus

    ... this case, the newborn is sent home on antibiotics. The bladder, which is outside the abdomen, must be kept moist. It can take months for the bladder to grow to the right size. The infant will be followed closely by a medical team ...

  8. Daily Bladder Diary

    MedlinePlus

    ... page you would like to print out: View page 1 of the Bladder Diary View page 2 of the Bladder Diary This content is ... Information Center Phone: 1-800-860-8747 | TTY: 1-866-569-1162 | Email: healthinfo@niddk.nih.gov | Hours: 8:30 a.m. to 5 p.m. Eastern time, M-F

  9. Ka-Band Radar Terminal Descent Sensor

    NASA Technical Reports Server (NTRS)

    Pollard, Brian; Berkun, Andrew; Tope, Michael; Andricos, Constantine; Okonek, Joseph; Lou, Yunling

    2007-01-01

    The terminal descent sensor (TDS) is a radar altimeter/velocimeter that improves the accuracy of velocity sensing by more than an order of magnitude when compared to existing sensors. The TDS is designed for the safe planetary landing of payloads, and may be used in helicopters and fixed-wing aircraft requiring high-accuracy velocity sensing

  10. Descent Assisted Split Habitat Lunar Lander Concept

    NASA Technical Reports Server (NTRS)

    Mazanek, Daniel D.; Goodliff, Kandyce; Cornelius, David M.

    2008-01-01

    The Descent Assisted Split Habitat (DASH) lunar lander concept utilizes a disposable braking stage for descent and a minimally sized pressurized volume for crew transport to and from the lunar surface. The lander can also be configured to perform autonomous cargo missions. Although a braking-stage approach represents a significantly different operational concept compared with a traditional two-stage lander, the DASH lander offers many important benefits. These benefits include improved crew egress/ingress and large-cargo unloading; excellent surface visibility during landing; elimination of the need for deep-throttling descent engines; potentially reduced plume-surface interactions and lower vertical touchdown velocity; and reduced lander gross mass through efficient mass staging and volume segmentation. This paper documents the conceptual study on various aspects of the design, including development of sortie and outpost lander configurations and a mission concept of operations; the initial descent trajectory design; the initial spacecraft sizing estimates and subsystem design; and the identification of technology needs

  11. The hormonal control of testicular descent.

    PubMed

    Levy, J B; Husmann, D A

    1995-01-01

    Descent of the testes is a complex event mediated by hormonal and mechanical factors. At present we hypothesize that testicular descent occurs as the result of the secretion of descendin from a normal testicle. Descendin secretion results in selective growth of the gubernacular cells. Gubernacular outgrowth results in masculinization of the inguinal canal. At the beginning of testicular descent, the patent processus migrates into the inguinal canal, transmitting intraabdominal pressure to the gubernaculum. The gubernaculum in turn applies traction to the testicle to introduce the testicle into the inguinal canal. Descent of the testes into and through the inguinal canal is an interplay between intraabdominal pressure transmitted by a patent processus vaginalis and androgen-induced gubernacular regression. Specifically, we hypothesize that androgens under control of an intact fetal hypothalamic-pituitary axis alter the viscoelastic properties of the gubernaculum. Reductions in the turgidity of the gubernaculum allow intraabdominal pressure to push the testicle into the scrotum. Functional abnormalities in any of the above factors will result in cryptorchidism. PMID:8867594

  12. Coping with Discrimination among Mexican Descent Adolescents

    ERIC Educational Resources Information Center

    Edwards, Lisa M.; Romero, Andrea J.

    2008-01-01

    The current research is designed to explore the relationship among discrimination stress, coping strategies, and self-esteem among Mexican descent youth (N = 73, age 11-15 years). Results suggest that primary control engagement and disengagement coping strategies are positively associated with discrimination stress. Furthermore, self-esteem is…

  13. America's Descent into Madness

    ERIC Educational Resources Information Center

    Giroux, Henry A.

    2014-01-01

    This article describes America's descent into madness under the regime of neoliberalism that has emerged in the United States since the late 1970s. In part, this is due to the emergence of a public pedagogy produced by the corporate-owned media that now saturates Americans with a market-driven value system that undermines those formative…

  14. Research study: STS-1 Orbiter Descent

    NASA Technical Reports Server (NTRS)

    Hickey, J. S.

    1981-01-01

    The conversion of STS-1 orbiter descent data from AVE-SESAME contact programs to the REEDA system and the reduction of raw radiosonde data is summarized. A first difference program, contact data program, plot data program, and 30 second data program were developed. Six radiosonde soundings were taken. An example of the outputs of each of the programs is presented.

  15. Method of descent for integrable lattices

    NASA Astrophysics Data System (ADS)

    Bogoyavlensky, Oleg

    2009-05-01

    A method of descent for constructing integrable Hamiltonian systems is introduced. The derived periodic and nonperiodic lattices possess Lax representations with spectral parameter and have plenty of first integrals. Examples of Liouville-integrable four-dimensional Hamiltonian Lotka-Volterra systems are presented.

  16. Optimum Strategies for Selecting Descent Flight-Path Angles

    NASA Technical Reports Server (NTRS)

    Wu, Minghong G. (Inventor); Green, Steven M. (Inventor)

    2016-01-01

    An information processing system and method for adaptively selecting an aircraft descent flight path for an aircraft, are provided. The system receives flight adaptation parameters, including aircraft flight descent time period, aircraft flight descent airspace region, and aircraft flight descent flyability constraints. The system queries a plurality of flight data sources and retrieves flight information including any of winds and temperatures aloft data, airspace/navigation constraints, airspace traffic demand, and airspace arrival delay model. The system calculates a set of candidate descent profiles, each defined by at least one of a flight path angle and a descent rate, and each including an aggregated total fuel consumption value for the aircraft following a calculated trajectory, and a flyability constraints metric for the calculated trajectory. The system selects a best candidate descent profile having the least fuel consumption value while the fly ability constraints metric remains within aircraft flight descent flyability constraints.

  17. A Descent Rate Control Approach to Developing an Autonomous Descent Vehicle

    NASA Astrophysics Data System (ADS)

    Fields, Travis D.

    Circular parachutes have been used for aerial payload/personnel deliveries for over 100 years. In the past two decades, significant work has been done to improve the landing accuracies of cargo deliveries for humanitarian and military applications. This dissertation discusses the approach developed in which a circular parachute is used in conjunction with an electro-mechanical reefing system to manipulate the landing location. Rather than attempt to steer the autonomous descent vehicle directly, control of the landing location is accomplished by modifying the amount of time spent in a particular wind layer. Descent rate control is performed by reversibly reefing the parachute canopy. The first stage of the research investigated the use of a single actuation during descent (with periodic updates), in conjunction with a curvilinear target. Simulation results using real-world wind data are presented, illustrating the utility of the methodology developed. Additionally, hardware development and flight-testing of the single actuation autonomous descent vehicle are presented. The next phase of the research focuses on expanding the single actuation descent rate control methodology to incorporate a multi-actuation path-planning system. By modifying the parachute size throughout the descent, the controllability of the system greatly increases. The trajectory planning methodology developed provides a robust approach to accurately manipulate the landing location of the vehicle. The primary benefits of this system are the inherent robustness to release location errors and the ability to overcome vehicle uncertainties (mass, parachute size, etc.). A separate application of the path-planning methodology is also presented. An in-flight path-prediction system was developed for use in high-altitude ballooning by utilizing the path-planning methodology developed for descent vehicles. The developed onboard system improves landing location predictions in-flight using collected flight

  18. Origins of Bladder Cancer.

    PubMed

    Czerniak, Bogdan; Dinney, Colin; McConkey, David

    2016-05-23

    Bladder cancer, one of the most frequently occurring human cancers, develops via two tracks referred to as papillary and nonpapillary that correspond to clinically different forms of the disease. Most bladder cancers are chemically induced, with tobacco smoking being the leading risk factor. Recent advances in bladder cancer research have enhanced our understanding of the origin of this disease from urothelial progenitor cells via field effects along papillary/luminal and nonpapillary/basal pathways. Evident from the outset of the disease, the diversity of the luminal and basal pathways, together with cell lineage tracing studies, postulates the origin of molecularly distinct subtypes from different uroprogenitor cells. The molecular mechanisms initiating field effects involve a new class of genes referred to as forerunner (FR) genes that generally map around major tumor suppressors such as RB1. These genes are silenced, predominantly by hypermethylation and less frequently by mutations, and drive the expansion of intraurothelial preneoplastic cells. Different FR genes are involved in various molecular subtypes of bladder cancer and they sensitize the uroprogenitor cells to the development of luminal and basal bladder cancers in animal models. In human bladder cancer, luminal and basal forms have dissimilar clinical behavior and response to conventional and targeted chemotherapeutic manipulations. These new research developments hold the promise of expanding our armamentarium of diagnostic and treatment options for patients with bladder cancer and improving our ability to select patients most likely to respond to a specific therapy. PMID:26907529

  19. Bladder operated robotic joint

    NASA Technical Reports Server (NTRS)

    Robertson, Glen A. (Inventor)

    1993-01-01

    This invention is a robotic joint which is operated by inflatable bladders and which can be used in applications where it is desired to move or hold an object. A support block supports an elongated plate to which is pivotally attached a finger. A tension strip passes over a lever attached to the finger and is attached at its ends to the support block on opposite sides of the plate. Bladders positioned between the plate and the tension strip on opposite sides of the plate can be inflated by pumps to pivot the finger, with one of the bladders being inflated while the other is being deflated.

  20. Neck Injuries and Disorders

    MedlinePlus

    ... another common cause of neck pain. Whiplash, a soft tissue injury to the neck, is also called neck sprain or strain. Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing ...

  1. Rhinoplasty in the patient of African descent.

    PubMed

    Harris, Monte O

    2010-02-01

    We are in the midst of truly changing times, as patients of African descent actively embrace facial cosmetic surgery. Gaining surgical consistency in patients of African descent has proven to be elusive and unpredictable for many rhinoplasty surgeons. Surgical success relies on the surgeon's ability precisely to identify anatomic variables and reconcile these anatomic realities with the patient's expectations for aesthetic improvement and ethnic identity. An appreciation for underlying heritage provides a link culturally to connect with prospective patients and serves as a tool for establishing realistic aesthetic goals. This article highlights the significance of exploring ancestry in the rhinoplasty consultation; identifies key anatomic variables in the nasal tip, dorsum, and alar base; and reviews surgical logic that has facilitated the achievement of consistent, balanced aesthetic outcomes. PMID:20206100

  2. Giant bladder diverticulum.

    PubMed

    Tortorelli, Antonio Pio; Rosa, Fausto; Papa, Valerio; Alfieri, Sergio; Doglietto, Giovanni Battista

    2011-03-01

    We present the case of a 73-year-old man affected by progressive and painful abdominal distension and paresthesia/hypoesthesia at the left leg. US and CT-scan revealed the presence in the left retroperitoneum of a large cystic mass without parietal thickening or enhancement after contrast injection. This mass disappeared after positioning a vesical Foley's catheter and a retrograde cystography confirmed the suspected diagnosis of a large bladder diverticulum due to a severe prostatic hypertrophy; the patient underwent an open diverticulectomy and endoscopic prostatic resection. Bladder diverticula can occasionally appear as complex pelvic masses not obviously connected to the bladder, eventually leading to diagnostic confusion; while small size diverticulum resolves with relief of bladder outlet obstruction, open or laparoscopic diverticulectomy is needed in large size diverticulum if symptomatic, even considering the possible tumor harboring. PMID:21229344

  3. Ultrasound: Bladder (For Parents)

    MedlinePlus

    ... bladder area and images are recorded on a computer. The black-and-white images show the internal ... the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging ...

  4. Cystocele (Fallen Bladder)

    MedlinePlus

    ... interprets the images. A woman does not need anesthesia. A health care provider can also use a ... completely emptying her bladder. A woman receives local anesthesia. A health care provider may use a voiding ...

  5. Urinary Incontinence: Bladder Training

    MedlinePlus

    ... following ways: Lengthen the amount of time between bathroom trips. Increase the amount of urine your bladder ... Kegel exercises may also help control urges. Scheduled bathroom trips: Some people control their incontinence by going ...

  6. Daily Bladder Diary

    MedlinePlus

    ... bladder diary. If you have Adobe's® Acrobat® Reader Software , you might prefer looking at the Print PDF Version (80 KB) of the diary as the print quality will be much enhanced. Please select which page ...

  7. Mars Exploration Entry, Descent and Landing Challenges

    NASA Technical Reports Server (NTRS)

    Braun, Robert D.; Manning, Robert M.

    2006-01-01

    The United States has successfully landed five robotic systems on the surface of Mars. These systems all had landed mass below 0.6 metric tons (t), had landed footprints on the order of hundreds of km and landed at sites below -1.4 km MOLA elevation due the need to perform entry, descent and landing operations in an environment with sufficient atmospheric density. At present, robotic exploration systems engineers are struggling with the challenges of increasing landed mass capability to 0.8 t while improving landed accuracy to tens of km and landing at a site as high as +2 km MOLA elevation for the Mars Science Laboratory project. Meanwhile, current plans for human exploration of Mars call for the landing of 40-80 t surface elements at scientifically interesting locations within close proximity (tens of m) of pre-positioned robotic assets. This paper summarizes past successful entry, descent and landing systems and approaches being developed by the robotic Mars exploration program to increased landed performance (mass, accuracy and surface elevation). In addition, the entry, descent and landing sequence for a human exploration system will be reviewed, highlighting the technology and systems advances required.

  8. Simulating Descent and Landing of a Spacecraft

    NASA Technical Reports Server (NTRS)

    Balaram, J.; Jain, Abhinandan; Martin, Bryan; Lim, Christopher; Henriquez, David; McMahon, Elihu; Sohl, Garrett; Banerjee, Pranab; Steele, Robert; Bentley, Timothy

    2005-01-01

    The Dynamics Simulator for Entry, Descent, and Surface landing (DSENDS) software performs high-fidelity simulation of the Entry, Descent, and Landing (EDL) of a spacecraft into the atmosphere and onto the surface of a planet or a smaller body. DSENDS is an extension of the DShell and DARTS programs, which afford capabilities for mathematical modeling of the dynamics of a spacecraft as a whole and of its instruments, actuators, and other subsystems. DSENDS enables the modeling (including real-time simulation) of flight-train elements and all spacecraft responses during various phases of EDL. DSENDS provides high-fidelity models of the aerodynamics of entry bodies and parachutes plus supporting models of atmospheres. Terrain and real-time responses of terrain-imaging radar and lidar instruments can also be modeled. The program includes modules for simulation of guidance, navigation, hypersonic steering, and powered descent. Automated state-machine-driven model switching is used to represent spacecraft separations and reconfigurations. Models for computing landing contact and impact forces are expected to be added. DSENDS can be used as a stand-alone program or incorporated into a larger program that simulates operations in real time.

  9. Neuromodulation in neurogenic bladder

    PubMed Central

    Sanford, Melissa T.

    2016-01-01

    While neuromodulation is a well-established treatment option for patients with non-neurogenic overactive bladder and urinary retention, its applicability to the neurogenic bladder population has only recently been examined more in depth. In this article we will discuss the outcomes, contraindications, and special considerations of sacral and percutaneous tibial nerve stimulation (PTNS) in patients with neurogenic lower urinary tract dysfunction. PMID:26904417

  10. Squamous Dysplasia of the Urinary Bladder: A Consecutive Cystectomy Series.

    PubMed

    Warrick, Joshua I; Kaag, Matthew; Raman, Jay D; Chan, Wilson; Tran, Truc; Kunchala, Sudhir; DeGraff, David; Chen, Guoli

    2016-06-01

    Squamous dysplasia of the urinary bladder is uncommon and may represent a precursor to invasive squamous cell carcinoma. Though significant focus has been devoted to squamous differentiation in invasive bladder cancer, relatively little attention has been given to squamous dysplasia. We methodically reviewed microscopic slides from a consecutive cystectomy series at our institution (n = 303; 2001-2014), with special attention given to squamous dysplasia and squamous differentiation within association invasive carcinoma. Of these 303 cases, 3% (9 cases) had squamous dysplasia. The majority (89%; 8/9) had a similar morphological appearance to squamous dysplasia of the head and neck (ie, cytological atypia, architectural disturbances, and abnormal keratinization). Invasive carcinoma was present in 230 of the cystectomy cases. Of these 230 cases with invasive carcinoma, 4% (8 cases) also had squamous dysplasia. The invasive carcinoma had evidence of squamous differentiation in all cases with concurrent squamous dysplasia. Concurrent flat urothelial carcinoma in situ was present in 3 of the 8 cases with both invasive carcinoma and squamous dysplasia. Squamous dysplasia was not associated with clinical outcomes data, including death from bladder cancer and bladder cancer recurrence. The data from this study indicate that squamous dysplasia is uncommon in the cystectomy setting, frequently has the morphology of head and neck dysplasia, and is often associated with invasive carcinoma with squamous differentiation. PMID:26860905

  11. Traumatic injury of the bladder and urethra

    MedlinePlus

    Injury - bladder and urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption ... Types of bladder injuries include: Blunt trauma (such as a blow to the body) Penetrating wounds (such as bullet or stab wounds) The ...

  12. System for Estimating Horizontal Velocity During Descent

    NASA Technical Reports Server (NTRS)

    Johnson, Andrew; Cheng, Yang; Wilson, Reg; Goguen, Jay; Martin, Alejandro San; Leger, Chris; Matthies, Larry

    2007-01-01

    The descent image motion estimation system (DIMES) is a system of hardware and software, designed for original use in estimating the horizontal velocity of a spacecraft descending toward a landing on Mars. The estimated horizontal velocity is used in generating rocket-firing commands to reduce the horizontal velocity as part of an overall control scheme to minimize the landing impact. DIMES can also be used for estimating the horizontal velocity of a remotely controlled or autonomous aircraft for purposes of navigation and control.

  13. APOLLO 11: Lunar Module Separates for descent

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Separation of the Lunar module for descent to the Lunar surface From the film documentary 'APOLLO 11:'The eagle Has Landed'', part of a documentary series on the APOLLO missions made in the early '70's and narrated by Burgess Meredith. APOLLO 11: First manned lunar landing and return to Earth with Neil A. Armstrong, Michael Collins, and Edwin E. Aldrin. Landed in the Sea of Tranquilityon July 20, 1969; deployed TV camera and EASEP experiments, performed lunar surface EVA, returned lunar soil samples. Mission Duration 195 hrs 18 min 35sec

  14. Nerve Disease and Bladder Control

    MedlinePlus

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... KB) Alternate Language URL Nerve Disease and Bladder Control Page Content On this page: What bladder control ...

  15. Arteriovenous malformations of the bladder.

    PubMed

    Grunberger, I; DeAsis, A; Torno, R; Godec, C J

    1989-01-01

    We report a rare case of a localized arteriovenous malformation of the bladder mimicking a bladder tumor and presenting with gross hematuria. The mass was successfully resected transurethrally. PMID:2908934

  16. General Information about Bladder Cancer

    MedlinePlus

    ... Research Bladder Cancer Treatment (PDQ®)–Patient Version General Information About Bladder Cancer Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  17. Superficial bladder cancer.

    PubMed

    Hall, R R

    1994-04-01

    Bladder cancer is almost certainly a product of the industrial revolution and the cigarette smoking that has accompanied it. Exposure to a chemical bladder carcinogen such as beta naphthylamine, benzidine, or 4-diphenylaniline can be proved in only a small proportion of patients and only a handful obtain industrial diseases benefit after developing "Prescribed Industrial Disease C23." None the less, the continued use of known carcinogenic substances in British industry for many years after their identification, the wide range of industries with a known or suspected increased risk of bladder cancer, and our ignorance of the carcinogenic potential of many materials used in current manufacturing should be a cause for continuing concern. PMID:8173377

  18. Regression Analysis of Top of Descent Location for Idle-thrust Descents

    NASA Technical Reports Server (NTRS)

    Stell, Laurel; Bronsvoort, Jesper; McDonald, Greg

    2013-01-01

    In this paper, multiple regression analysis is used to model the top of descent (TOD) location of user-preferred descent trajectories computed by the flight management system (FMS) on over 1000 commercial flights into Melbourne, Australia. The independent variables cruise altitude, final altitude, cruise Mach, descent speed, wind, and engine type were also recorded or computed post-operations. Both first-order and second-order models are considered, where cross-validation, hypothesis testing, and additional analysis are used to compare models. This identifies the models that should give the smallest errors if used to predict TOD location for new data in the future. A model that is linear in TOD altitude, final altitude, descent speed, and wind gives an estimated standard deviation of 3.9 nmi for TOD location given the trajec- tory parameters, which means about 80% of predictions would have error less than 5 nmi in absolute value. This accuracy is better than demonstrated by other ground automation predictions using kinetic models. Furthermore, this approach would enable online learning of the model. Additional data or further knowl- edge of algorithms is necessary to conclude definitively that no second-order terms are appropriate. Possible applications of the linear model are described, including enabling arriving aircraft to fly optimized descents computed by the FMS even in congested airspace. In particular, a model for TOD location that is linear in the independent variables would enable decision support tool human-machine interfaces for which a kinetic approach would be computationally too slow.

  19. Bladder afferent hyperexcitability in bladder pain syndrome/interstitial cystitis

    PubMed Central

    Yoshimura, Naoki; Oguchi, Tomohiko; Yokoyama, Hitoshi; Funahashi, Yasuhito; Yoshikawa, Satoru; Sugino, Yoshio; Kawamorita, Naoki; Kashyap, Mahendra P; Chancellor, Michael B; Tyagi, Pradeep; Ogawa, Teruyuki

    2014-01-01

    Bladder pain syndrome/interstitial cystitis is a disease with lower urinary tract symptoms, such as bladder pain and urinary frequency, which results in seriously impaired quality of life of patients. The extreme pain and urinary frequency are often difficult to treat. Although the etiology of bladder pain syndrome/interstitial cystitis is still not known, there is increasing evidence showing that afferent hyperexcitability as a result of neurogenic bladder inflammation and urothelial dysfunction is important to the pathophysiological basis of symptom development. Further investigation of the pathophysiology will lead to the effective treatment of patients with bladder pain syndrome/interstitial cystitis. PMID:24807488

  20. Stair ascent and descent at different inclinations.

    PubMed

    Riener, Robert; Rabuffetti, Marco; Frigo, Carlo

    2002-02-01

    The aim of this study was to investigate the biomechanics and motor co-ordination in humans during stair climbing at different inclinations. Ten normal subjects ascended and descended a five-step staircase at three different inclinations (24 degrees, 30 degrees, 42 degrees ). Three steps were instrumented with force sensors and provided 6 dof ground reactions. Kinematics was analysed by a camera-based optoelectronic system. An inverse dynamics approach was applied to compute joint moments and powers. The different kinematic and kinetic patterns of stair ascent and descent were analysed and compared to level walking patterns. Temporal gait cycle parameters and ground reactions were not significantly affected by staircase inclination. Joint angles and moments showed a relatively low but significant dependency on the inclination. A large influence was observed in joint powers. This can be related to the varying amount of potential energy that has to be produced (during ascent) or absorbed (during descent) by the muscles. The kinematics and kinetics of staircase walking differ considerably from level walking. Interestingly, no definite signs could be found indicating that there is an adaptation or shift in the motor patterns when moving from level to stair walking. This can be clearly seen in the foot placement: compared to level walking, the forefoot strikes the ground first--independent from climbing direction and inclination. This and further findings suggest that there is a certain inclination angle or angular range where subjects do switch between a level walking and a stair walking gait pattern. PMID:11809579

  1. Expression of Aggrus/podoplanin in bladder cancer and its role in pulmonary metastasis

    PubMed Central

    Takagi, Satoshi; Oh-hara, Tomoko; Sato, Shigeo; Gong, Bo; Takami, Miho; Fujita, Naoya

    2014-01-01

    Platelet aggregation-inducing factor Aggrus, also known as podoplanin, is associated with tumor malignancy by promoting hematogenous metastasis. Aggrus overexpression has been reported in some tumor tissues including lung, esophagus, head and neck and brain. We here found the frequent upregulation of aggrus mRNA in urinary bladder cancers using cancer tissue panels from various organs. Immunohistochemical analysis confirmed Aggrus protein expression in urinary bladder cancers and suggested a positive correlation between Aggrus expression and metastatic tendency in bladder cancers. Endogenous expression of Aggrus protein on the cell surface was found in the mouse bladder cancer MBT-2 cell line and human bladder cancer SCaBER cell lines. Knockdown of Aggrus expression in MBT-2 cells decreased their ability to induce platelet aggregation and form pulmonary metastasis in syngeneic mouse models. Knockdown of Aggrus expression in the human bladder cancer SCaBER cells also attenuated their ability to induce platelet aggregation and form pulmonary metastasis in mice. Moreover, pulmonary metastasis of SCaBER cells was prevented by prior administration of our generated anti-Aggrus neutralizing monoclonal antibodies by attenuating their retention in lung. These results indicate that Aggrus plays an important role in bladder cancer metastasis. Thus, anti-Aggrus neutralizing antibodies would be useful for the prevention of hematogenous metastasis of Aggrus-positive bladder cancer. PMID:24222607

  2. Long-term complications following bladder augmentations in patients with spina bifida: bladder calculi, perforation of the augmented bladder and upper tract deterioration

    PubMed Central

    2016-01-01

    Background We desire to review our experience with bladder augmentation in spina bifida patients followed in a transitional and adult urologic practice. This paper will specifically focus on three major complications: bladder calculi, the most frequent complication found following bladder augmentation, perforation of the augmentation, its most lethal complication and finally we will address loss of renal function as a direct result of our surgical reconstructive procedures. Methods We reviewed a prospective data base maintained on patients with spina bifida followed in our transitional and adult urology clinic from 1986 to date. Specific attention was given to patients who had developed bladder calculi, sustained a spontaneous perforation of the augmented bladder or had developed new onset of renal scarring or renal insufficiency (≥ stage 3 renal failure) during prolonged follow-up. Results The development of renal stones (P<0.05) and symptomatic urinary tract infections (P<0.0001) were found to be significantly reduced by the use of high volume (≥240 mL) daily bladder wash outs. Individuals who still developed bladder calculi recalcitrant to high volume wash outs were not benefited by the correction of underlying metabolic abnormalities or mucolytic agents. Spontaneous bladder perforations in the adult patient population with spina bifida were found to be directly correlated to substance abuse and noncompliance with intermittent catheterization, P<0.005. Deterioration of the upper tracts as defined by the new onset of renal scars occurred in 40% (32/80) of the patients managed by a ileocystoplasty and simultaneous bladder neck outlet procedure during a median follow-up interval 14 years (range, 8–45 years). Development of ≥ stage 3 chronic renal failure occurred within 38% (12/32) of the patients with scarring i.e., 15% (12/80) of the total patient population. Prior to the development of the renal scarring, 69% (22/32) of the patients had been noncompliant

  3. Postmenopausal overactive bladder

    PubMed Central

    2014-01-01

    Bladder storage symptoms have a severe impact on many areas as regards the quality of life including health-related, social, psychological and working functions. Pharmacotherapy of lower urinary tract stores (LUTS) has been developed to optimize neural control of the lower urinary tract in pathologic states. The bladder can be overactive or underactive. Overactive bladder (OAB) is highly prevalent and is associated with considerable morbidity, especially in aging population. Therefore, an effective treatment of OAB must result in a meaningful reduction in urinary symptoms. Pharmacotherapy for the OAB must be individualized based on the degree of bother, medication side-effect profile, concomitant comorbidities and current medication regimen. Antimuscarinic agents will continue to represent the current gold standard for the first-line pharmacological management of OAB. Alternatively to antimuscarinic therapy, β3-adrenergic receptor agonists, due to their efficacy and favorable adverse event profile, are a novel and attractive option of pharmacological treatment of overactive bladder symptoms. A combination of selective antimuscarinic and β3-adrenergic receptor agonists, agents with the different mechanism of action, gives a new treatment option for the patient with OAB according to its harms profile. A number of putative novel therapeutic agents is under clinical evaluations that may ultimately provide alternative or combination treatment options for OAB in the nearest future. PMID:26327873

  4. Hair Breakage in Patients of African Descent: Role of Dermoscopy

    PubMed Central

    Quaresma, Maria Victória; Martinez Velasco, María Abril; Tosti, Antonella

    2015-01-01

    Dermoscopy represents a useful technique for the diagnosis and follow-up of hair and scalp disorders. To date, little has been published regarding dermoscopy findings of hair disorders in patients of African descent. This article illustrates how dermoscopy allows fast diagnosis of hair breakage due to intrinsic factors and chemical damage in African descent patients. PMID:27170942

  5. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Performance: Uncontrolled descent. 31.19 Section 31.19 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a) The following must be...

  6. Mars Science Laboratory Entry, Descent and Landing System Overview

    NASA Technical Reports Server (NTRS)

    Steltzner, Adam D.; San Martin, A. Miguel; Rivellini, Tomasso P.; Chen, Allen

    2013-01-01

    The Mars Science Laboratory project recently places the Curiosity rove on the surface of Mars. With the success of the landing system, the performance envelope of entry, descent and landing capabilities has been extended over the previous state of the art. This paper will present an overview to the MSL entry, descent and landing system design and preliminary flight performance results.

  7. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Performance: Uncontrolled descent. 31.19 Section 31.19 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a) The following must be...

  8. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Performance: Uncontrolled descent. 31.19 Section 31.19 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a) The following must be...

  9. Bladder outlet obstruction triggers neural plasticity in sensory pathways and contributes to impaired sensitivity in erectile dysfunction.

    PubMed

    Malykhina, Anna P; Lei, Qi; Chang, Shaohua; Pan, Xiao-Qing; Villamor, Antonio N; Smith, Ariana L; Seftel, Allen D

    2013-05-15

    Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common problems in aging males worldwide. The objective of this work was to evaluate the effects of bladder neck nerve damage induced by partial bladder outlet obstruction (PBOO) on sensory innervation of the corpus cavernosum (CC) and CC smooth muscle (CCSM) using a rat model of PBOO induced by a partial ligation of the bladder neck. Retrograde labeling technique was used to label dorsal root ganglion (DRG) neurons that innervate the urinary bladder and CC. Contractility and relaxation of the CCSM was studied in vitro, and expression of nitric oxide synthase (NOS) was evaluated by Western blotting. Concentration of the sensory neuropeptides substance P (SP) and calcitonin gene-related peptide was measured by ELISA. Partial obstruction of the bladder neck caused a significant hypertrophy of the urinary bladders (2.5-fold increase at 2 wk). Analysis of L6-S2 DRG sections determined that sensory ganglia received input from both the urinary bladder and CC with 5-7% of all neurons double labeled from both organs. The contractile responses of CC muscle strips to KCl and phenylephrine were decreased after PBOO, followed by a reduced relaxation response to nitroprusside. A significant decrease in neuronal NOS expression, but not in endothelial NOS or protein kinase G (PKG-1), was detected in the CCSM of the obstructed animals. Additionally, PBOO caused some impairment to sensory nerves as evidenced by a fivefold downregulation of SP in the CC (P ≤ 0.001). Our results provide evidence that PBOO leads to the impairment of bladder neck afferent innervation followed by a decrease in CCSM relaxation, downregulation of nNOS expression, and reduced content of sensory neuropeptides in the CC smooth muscle. These results suggest that nerve damage in PBOO may contribute to LUTS-ED comorbidity and trigger secondary changes in the contraction/relaxation mechanisms of CCSM. PMID:23535456

  10. A Gradient Descent Approximation for Graph Cuts

    NASA Astrophysics Data System (ADS)

    Yildiz, Alparslan; Akgul, Yusuf Sinan

    Graph cuts have become very popular in many areas of computer vision including segmentation, energy minimization, and 3D reconstruction. Their ability to find optimal results efficiently and the convenience of usage are some of the factors of this popularity. However, there are a few issues with graph cuts, such as inherent sequential nature of popular algorithms and the memory bloat in large scale problems. In this paper, we introduce a novel method for the approximation of the graph cut optimization by posing the problem as a gradient descent formulation. The advantages of our method is the ability to work efficiently on large problems and the possibility of convenient implementation on parallel architectures such as inexpensive Graphics Processing Units (GPUs). We have implemented the proposed method on the Nvidia 8800GTS GPU. The classical segmentation experiments on static images and video data showed the effectiveness of our method.

  11. Distributed Control by Lagrangian Steepest Descent

    NASA Technical Reports Server (NTRS)

    Wolpert, David H.; Bieniawski, Stefan

    2004-01-01

    Often adaptive, distributed control can be viewed as an iterated game between independent players. The coupling between the players mixed strategies, arising as the system evolves from one instant to the next, is determined by the system designer. Information theory tells us that the most likely joint strategy of the players, given a value of the expectation of the overall control objective function, is the minimizer of a function o the joint strategy. So the goal of the system designer is to speed evolution of the joint strategy to that Lagrangian mhimbhgpoint,lowerthe expectated value of the control objective function, and repeat Here we elaborate the theory of algorithms that do this using local descent procedures, and that thereby achieve efficient, adaptive, distributed control.

  12. Error analysis of stochastic gradient descent ranking.

    PubMed

    Chen, Hong; Tang, Yi; Li, Luoqing; Yuan, Yuan; Li, Xuelong; Tang, Yuanyan

    2013-06-01

    Ranking is always an important task in machine learning and information retrieval, e.g., collaborative filtering, recommender systems, drug discovery, etc. A kernel-based stochastic gradient descent algorithm with the least squares loss is proposed for ranking in this paper. The implementation of this algorithm is simple, and an expression of the solution is derived via a sampling operator and an integral operator. An explicit convergence rate for leaning a ranking function is given in terms of the suitable choices of the step size and the regularization parameter. The analysis technique used here is capacity independent and is novel in error analysis of ranking learning. Experimental results on real-world data have shown the effectiveness of the proposed algorithm in ranking tasks, which verifies the theoretical analysis in ranking error. PMID:24083315

  13. Head, Neck, and Oral Cancer

    MedlinePlus

    ... Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans will be diagnosed ... Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans will be diagnosed ...

  14. Bridle Device in Mars Science Laboratory Descent Stage

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This view of a portion of the descent stage of NASA's Mars Science Laboratory shows two of the stage's three spherical fuel tanks flanking the bridle device assembly. The photograph was taken in early October 2008 from the center of the descent stage looking outward. The top of the descent stage is toward the top of the image.

    The bridle device assembly is about two-thirds of a meter, or 2 feet, from top to bottom, and has two main parts. The cylinder on the top is the descent brake. The conical-shaped mechanism below that is the bridle assembly, including a spool of nylon and Vectran cords that will be attached to the rover.

    When pyrotechnic bolts fire to sever the rigid connection between the rover and the descent stage, gravity will pull the tethered rover away from the descent stage. The bridle or tether, attached to three points on the rover, will unspool from the bridle assembly, beginning from the larger-diameter portion. The rotation rate of the assembly, hence the descent rate of the rover, will be governed by the descent brake. Inside the housing of that brake are gear boxes and banks of mechanical resistors engineered to prevent the bridle from spooling out too quickly or too slowly. The length of the bridle will allow the rover to be lowered about 7.5 meters (25 feet) while still tethered to the descent stage.

    The Starsys division of SpaceDev Inc., Poway, Calif., provided the descent brake. NASA's Jet Propulsion Laboratory, Pasadena, Calif., built the bridle assembly. Vectran is a product of Kuraray Co. Ltd., Tokyo. JPL, a division of the California Institute of Technology, manages the Mars Science Laboratory Project for the NASA Science Mission Directorate, Washington.

  15. Head and Neck Cancer

    MedlinePlus

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the ... increases your risk. In fact, 85 percent of head and neck cancers are linked to tobacco use, including smoking ...

  16. Neck Injuries and Disorders

    MedlinePlus

    ... the neck, is also called neck sprain or strain. Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar. You rarely need surgery.

  17. Neck dissection - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000659.htm Neck dissection - discharge To use the sharing features on this page, please enable JavaScript. Neck dissection is surgery to remove the lymph nodes in ...

  18. Head and Neck Cancer

    MedlinePlus

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the ... swallowing A change or hoarseness in the voice Head and neck cancers are twice as common in men. Using ...

  19. Bladder leiomyoma presenting as dyspareunia

    PubMed Central

    Xin, Jun; Lai, Hai-ping; Lin, Shao-kun; Zhang, Qing-quan; Shao, Chu-xiao; Jin, Lie; Lei, Wen-hui

    2016-01-01

    Abstract Introduction: Leiomyoma of the bladder is a rare tumor arising from the submucosa. Most patients with bladder leiomyoma may present with urinary frequency or obstructive urinary symptoms. However, there are a few cases of bladder leiomyoma coexisting with uterine leiomyoma presenting as dyspareunia. We herein report an unusual case of coexisting bladder leiomyoma and uterine leiomyoma presenting as dyspareunia. Case presentation: A 44-year-old Asian female presented to urologist and complained that she had experienced dyspareunia over the preceding several months. A pelvic ultrasonography revealed a mass lesion located in the trigone of urinary bladder. The mass lesion was confirmed on contrast-enhanced computed tomography (CT). The CT scan also revealed a lobulated and enlarged uterus consistent with uterine leiomyoma. Then, the biopsies were then taken with a transurethral resection (TUR) loop and these biopsies showed a benign proliferation of smooth muscle in a connective tissue stroma suggestive of bladder leiomyoma. An open local excision of bladder leiomyoma and hysteromyomectomy were performed successfully. Histological examination confirmed bladder leiomyoma coexisting with uterine leiomyoma. Conclusion: This case highlights a rare presentation of bladder leiomyoma, dyspareunia, as the chief symptom in a patient who had coexisting uterine leiomyoma. Bladder leiomyomas coexisting with uterine leiomyomas are rare and can present with a wide spectrum of complaints including without symptoms, irritative symptoms, obstructive symptoms, or even dyspareunia. PMID:27428187

  20. Female Bladder Outlet Obstruction.

    PubMed

    Hoffman, Daniel S; Nitti, Victor W

    2016-04-01

    The non-specific symptoms the patients express upon the presentation of female bladder outlet obstruction make it a challenge to diagnose. There are subtle differences between the obstructed patient and those whose bladders are underactive and/or fail to mount a detrusor contraction. These disparities can be extracted through a thorough history and examination. At times, the clinician may utilize nomograms, non-invasive uroflow, and urodynamics with the addition of fluoroscopy to establish the diagnosis of obstruction. Management of the obstruction depends on the nature of the condition, whether functional or anatomical. The increase in the number of sling procedures performed to treat stress urinary incontinence has resulted in a rise in the number of iatrogenic obstructions. The temporal relationship between surgery and obstruction is the key to identifying the problem. PMID:26902625

  1. Overactive bladder in males

    PubMed Central

    Dmochowski, Roger R.; Gomelsky, Alex

    2009-01-01

    The prevalence of overactive bladder (OAB) symptoms is considerable in both men and women and the impact on quality of life (QOL) is equally substantial. Ironically, despite nearly equal prevalence, OAB symptoms in men are infrequently treated, and often with medical therapies aimed at bladder outlet obstruction (BOO). In this review, we examine the pathophysiology of OAB and its evaluation in the context of benign prostatic hypertrophy and concomitant BOO. We then consider the efficacy and safety of individual therapeutic options for lower urinary tract symptoms in men, focusing on the mainstays of medical therapy: α-adrenergic blockers, 5-α reductase inhibitors, and antimuscarinic agents. Finally, we aim to comment on new therapeutic strategies and targets that may one day be available for the treatment of male OAB. PMID:21789068

  2. Endoscopic Management of Bladder Diverticula.

    PubMed

    Pham, Khanh N; Jeldres, Claudio; Hefty, Thomas; Corman, John M

    2016-01-01

    A 50-year-old man with benign prostatic hyperplasia and urinary retention had a very large diverticulum on the posterior wall of the bladder. The patient was managed with transurethral resection of the prostate and endoscopic fulguration of the bladder diverticulum mucosa using the Orandi technique. There was near-complete resolution of the bladder diverticulum following endoscopic management, obviating the need for bladder diverticulectomy. The patient now empties his bladder, with a postvoid residual < 50 mL and the absence of urinary tract infection after 6-month follow-up. We report the successful treatment of a large bladder diverticulum with endoscopic fulguration to near-complete resolution. This minimally invasive technique is a useful alternative in patients unfit for a more extensive surgical approach. PMID:27601971

  3. Endoscopic Management of Bladder Diverticula

    PubMed Central

    Pham, Khanh N.; Jeldres, Claudio; Hefty, Thomas; Corman, John M.

    2016-01-01

    A 50-year-old man with benign prostatic hyperplasia and urinary retention had a very large diverticulum on the posterior wall of the bladder. The patient was managed with transurethral resection of the prostate and endoscopic fulguration of the bladder diverticulum mucosa using the Orandi technique. There was near-complete resolution of the bladder diverticulum following endoscopic management, obviating the need for bladder diverticulectomy. The patient now empties his bladder, with a postvoid residual < 50 mL and the absence of urinary tract infection after 6-month follow-up. We report the successful treatment of a large bladder diverticulum with endoscopic fulguration to near-complete resolution. This minimally invasive technique is a useful alternative in patients unfit for a more extensive surgical approach. PMID:27601971

  4. Pharmacogenomics in bladder cancer

    PubMed Central

    Dancik, Garrett M.; Theodorescu, Dan

    2014-01-01

    Bladder cancer is a common cancer worldwide. For patients presenting with muscle-invasive disease, the five year survival rate is approximately 50%. Cisplatinum-based combination chemotherapy is recommended in the neoadjuvant setting prior to cystectomy and is also the first line in the metastatic setting. However, the survival benefit of such therapy is modest. The identification of pharmacogenomic biomarkers would enable the rational and personalized treatment of patients by selecting those patients that would benefit most from such therapies sparing others the unnecessary toxicity. Conventional therapies would be recommended for an expected responder while a non-responder would be considered for alternative therapies selected on the basis of the individual’s molecular profile. Although few effective bladder cancer therapies have been introduced in the past 30 years, several targeted therapies against the molecular drivers of bladder cancer appear promising. This review summarizes pharmacogenomic biomarkers that require further investigation and/or prospective evaluation, publicly available tools for drug discovery and biomarker identification from in vitro data, and targeted agents that have been evaluated in preclinical models. PMID:24360659

  5. Bladder and vaginal transitional cell carcinoma: A case report

    PubMed Central

    Aoun, Fouad; Kourie, Hampig Raphael; El Rassy, Elie; van Velthoven, Roland

    2016-01-01

    The involvement of the female genital tract in transitional cell carcinoma (TCC) has not been fully elucidated in women, although involvement is usually associated with a poor prognosis. The vagina, in particular, is considered to be the most commonly affected gynecological organ, with an incidence of 4% of total TCC cases. The pathogenesis of vaginal TCC is challenging to determine, although it is essential for the adequate management of the tumor and to determine the appropriate treatment. The present study reports a case of bladder TCC and metachronous vaginal TCC. The patient had a history of high risk non muscle invasive bladder cancer treated by BCG and presented with a recurrent carcinoma in situ. A novel cycle of BCG was initiated but the patient had a persistent disease and a palpable mass on bimanual examination. Radical anterior pelvectomy and bilateral pelvic and inguinal lymph node dissection was performed revealing the presence of TCC of the bladder neck and the invasion into the anterior vaginal wall. The differences between local vaginal invasion and the metastatic spread from a primary bladder TCC, the occurrence of a second primary vaginal tumor and the direct implantation of TCC via urine that contains transitional cancer cells were reviewed and analyzed. Finally, a management plan was determined. PMID:27602160

  6. Contemporary Management of Bladder Cancer

    PubMed Central

    Bell, David; Fradet, Yves

    1991-01-01

    Bladder cancer is currently the fifth most common cancer in Western society, and its incidence appears to be increasing. Important advances have recently occurred in both diagnostic and therapeutic approaches to bladder neoplasms. Presentation is not unique, and physician awareness is important to identify patients who are at risk for bladder neoplasia and consequently require further investigation. A diagnostic approach and contemporary management are discussed. ImagesFigure 1Figure 4 PMID:21229043

  7. Intraurethral Stimulation for Reflex Bladder Activation Depends on Stimulation Pattern and Location

    PubMed Central

    Bruns, Tim M.; Bhadra, Narendra; Gustafson, Kenneth J.

    2012-01-01

    Aims Reflex bladder excitation has been demonstrated by stimulation of the pudendal nerve and several of its distal branches. However, excitation parameters have not been consistent and the relationship to anatomical locations within the urethra has not been fully investigated. An improved understanding of the lower urinary tract neurophysiology will improve human studies and neuroprosthetic device development. Methods Intraurethral stimulation was performed in nine cats at near isovolumetric bladder volumes before and/or after spinalization. Bladder excitability profiles were obtained for lower (2 Hz) and higher (33 Hz) frequency stimuli along the urethra between the bladder neck and external meatus. Results Higher frequency stimuli were excitable at all urethral locations prior to spinalization but only excitable in the middle and distal urethra after spinalization. Lower frequency stimuli were excitable at proximal and middle locations before spinalization but not excitable at any location after spinalization. In most evaluations, bursting pulse stimulation patterns evoked greater bladder pressures than the dominant continuous frequency (2 or 33 Hz). Conclusions These data indicate the potential presence of two distinct pathways for reflex bladder activation within the urethra: a supra-T10 circuit initiated in the proximal and mid urethra that responds to lower and higher frequency stimuli, and a sacral circuit initiated in the mid and distal urethra that responds to higher frequency stimuli. This work suggests potential anatomical targets and stimulus patterns for clinical evaluations of peripheral nerve-based neuroprostheses for bladder control. PMID:19260091

  8. [Deep neck infections].

    PubMed

    Nowak, Katarzyna; Szyfter, Witold

    2006-01-01

    Deep neck infection is relatively rare but potentially life threatening complication of common oropharyngeal infections. This retrospective study was aimed at analyzing the occurrence of complications, diagnostic methods and proper management of deep neck infection. A review was conducted in 32 cases who were diagnosed as having deep neck infection from 1995 to 2005. The causes of deep neck infections were tonsillitis (16 cases), tooth diseases (6 cases), paratonsillar abscess (4 cases), parotitis (1 case), pussy lymphonodes after tonsillectomy (2 cases), pussy congenital neck cyst (1 case), chronic otitis media (1 case), parotitis (1 case), foreign body of the esophagus (1 case). All the puss bacterial cultivation were positive. All the patients were treated by different ways of chirurgical drainage and use of large dosage of antibiotics. Deep neck infection should be suspected in patients with long lasting fever and painful swelling of the neck and treatment should begin quick as possible. PMID:17152800

  9. Surface erosion caused on Mars from Viking descent engine plume

    USGS Publications Warehouse

    Hutton, R.E.; Moore, H.J.; Scott, R.F.; Shorthill, R.W.; Spitzer, C.R.

    1980-01-01

    During the Martian landings the descent engine plumes on Viking Lander 1 (VL-1) and Viking Lander 2 (VL-2) eroded the Martian surface materials. This had been anticipated and investigated both analytically and experimentally during the design phase of the Viking spacecraft. This paper presents data on erosion obtained during the tests of the Viking descent engine and the evidence for erosion by the descent engines of VL-1 and VL-2 on Mars. From these and other results, it is concluded that there are four distinct surface materials on Mars: (1) drift material, (2) crusty to cloddy material, (3) blocky material, and (4) rock. ?? 1980 D. Reidel Publishing Co.

  10. Surface erosion caused on Mars from Viking descent engine plume

    NASA Technical Reports Server (NTRS)

    Hutton, R. E.; Moore, H. J.; Scott, R. F.; Shorthill, R. W.; Spitzer, C. R.

    1980-01-01

    During the Martian landings the descent engine plumes on Viking Lander 1 (VL-1) and Viking Lander 2 (VL-2) eroded the Martian surface materials. This had been anticipated and investigated both analytically and experimentally during the design phase of the Viking spacecraft. This paper presents data on erosion obtained during the tests of the Viking descent engine and the evidence for erosion by the descent engines of VL-1 and VL-2 on Mars. From these and other results, it is concluded that there are four distinct surface materials on Mars: (1) drift materials, (2) crusty to cloddy material, (3) blocky material, and (4) rock.

  11. [Diet in bladder cancer ethiopathogenesis].

    PubMed

    Radosavljević, V; Ilić, M; Janković, S; Djokić, M

    2005-01-01

    The aim of this paper is to show influence of different foods on bladder cancer appearance, as well as possible consequent ways of prevention. Consuption of food rich in animal fat and cholesterol, fried foods, especially several times used cookin oil for frying, processed meat with additives (nitrates, nitrites, azo-colourrs) can influence bladder cancer occurrence. Regularly, continous consumption of fermented milk products, which contains come types of milky--acids bacterias, is considered as protective factor in developing bladder cancer. Reports that fruit and vegetable are protective food items are pretty consistent. Data about mineral intake and bladder cancer are obscure. PMID:16812999

  12. Bladder Cancer and Genetic Mutations.

    PubMed

    Zhang, Xiaoying; Zhang, Yangde

    2015-09-01

    The most common type of urinary bladder cancer is called as transitional cell carcinoma. The major risk factors for bladder cancer are environmental, tobacco smoking, exposure to toxic industrial chemicals and gases, bladder inflammation due to microbial and parasitic infections, as well as some adverse side-effects of medications. The genetic mutations in some chromosomal genes, such as FGFR3, RB1, HRAS, TP53, TSC1, and others, occur which form tumors in the urinary bladder. These genes play an important role in the regulation of cell division which prevents cells from dividing too quickly. The changes in the genes of human chromosome 9 are usually responsible for tumor in bladder cancer, but the genetic mutation of chromosome 22 can also result in bladder cancer. The identification of p53 gene mutation has been studied at NIH, Washington, DC, USA, in urine samples of bladder cancer patients. The invasive bladder cancers were determined for the presence of gene mutations on p53 suppressor gene. The 18 different bladder tumors were evaluated, and 11 (61 %) had genetic mutations of p53 gene. The bladder cancer studies have suggested that 70 % of bladder cancers involve a specific mutation in a particular gene, namely telomerase reverse transcriptase (TERT) gene. The TERT gene is involved in DNA protection, cellular aging processes, and cancer. The Urothelial carcinomas of the bladder have been described in Atlas of genetics and cytogenetics in oncology and hematology. HRAS is a proto-oncogene and has potential to cause cancer in several organs including the bladder. The TSC1 c. 1907 1908 del (E636fs) mutation in bladder cancer suggests that the location of the mutation is Exon 15 with frequency of TSC1 mutation of 11.7 %. The recent findings of BAP1 mutations have shown that it contributes to BRCA pathway alterations in bladder cancer. The discoveries of more gene mutations and new biomarkers and polymerase chain reaction bioassays for gene mutations in bladder

  13. Bladder outlet obstruction treated with transurethral ultrasonic aspiration

    NASA Astrophysics Data System (ADS)

    Malloy, Terrence R.

    1991-07-01

    Fifty-nine males with bladder outlet obstruction were treated with transurethral ultrasonic aspiration of the prostate. Utilizing a 26.5 French urethral sheath, surgery was accomplished with a 10 French, 0-700 micron vibration level ultrasonic tip with an excursion rate of 39 kHz. Complete removal of the adenoma was accomplished, followed by transurethral electrocautery biopsies of both lateral lobes to compare pathologic specimens. One-year follow-up revealed satisfactory voiding patterns in 57 of 59 men (96%). Two men developed bladder neck contractures. Pathologic comparisons showed 100% correlation between aspirated and TUR specimens (56 BPH, 3 adeno-carcinoma). Forty-sevel men were active sexually preoperatively (6 with inflatable penile prostheses). Post ultrasonic aspiration, 46 men had erectile function similar to preoperative levels with one patient suffering erectile dysfunction. Forty men (85%) had antegrade ejaculation while 7 (15%) experienced retrograde or retarded ejaculation. No patients were incontinent.

  14. Orion Entry, Descent, and Landing Simulation

    NASA Technical Reports Server (NTRS)

    Hoelscher, Brian R.

    2007-01-01

    The Orion Entry, Descent, and Landing simulation was created over the past two years to serve as the primary Crew Exploration Vehicle guidance, navigation, and control (GN&C) design and analysis tool at the National Aeronautics and Space Administration (NASA). The Advanced NASA Technology Architecture for Exploration Studies (ANTARES) simulation is a six degree-of-freedom tool with a unique design architecture which has a high level of flexibility. This paper describes the decision history and motivations that guided the creation of this simulation tool. The capabilities of the models within ANTARES are presented in detail. Special attention is given to features of the highly flexible GN&C architecture and the details of the implemented GN&C algorithms. ANTARES provides a foundation simulation for the Orion Project that has already been successfully used for requirements analysis, system definition analysis, and preliminary GN&C design analysis. ANTARES will find useful application in engineering analysis, mission operations, crew training, avionics-in-the-loop testing, etc. This paper focuses on the entry simulation aspect of ANTARES, which is part of a bigger simulation package supporting the entire mission profile of the Orion vehicle. The unique aspects of entry GN&C design are covered, including how the simulation is being used for Monte Carlo dispersion analysis and for support of linear stability analysis. Sample simulation output from ANTARES is presented in an appendix.

  15. Auroral precipitation and descent of thermospheric NO

    NASA Astrophysics Data System (ADS)

    Kühl, Sven; Espy, Patrick; Hibbins, Robert; Paxton, Larry; Funke, Bernd

    2016-07-01

    Energetic particle precipitation in Auroras (E <20 keV) produces nitric oxide (NO) in the upper meso- and lower thermosphere region (UMLT). The subsequent descent of the NO produced in the UMLT to the lower meso- and upper stratosphere is referred to as the energetic particle precipitation indirect effect (EPP IE). The downwelling of NO produced in Auroras alters the chemistry of the mesosphere and upper stratosphere (e.g. by the NOx cycle) and possibly has important effects also on its dynamics. By observations of auroral precipitation from SSUSI(DMSP) and measurements of NO from MIPAS(ENVISAT) and SMR(ODIN) we investigate the quantitative relation of the electron fluxes and characteristic energies of auroral precipitation to the NO produced in the lower thermosphere and the subsequent downwelling of NO. Using additional ground-based (e.g. Meteor Radar, Microwave Radiometer) and satellite observations (SOFIE) we attempt to quantify the EPP IE and its impact on atmospheric chemistry and dynamics.

  16. Emerging technology in head and neck ultrasonography.

    PubMed

    Holtel, Michael R

    2010-12-01

    Increased use of ultrasonography of the head and neck by clinicians has resulted from more compact, higher resolution ultrasound machines that can be more readily used in the office setting. Palm-sized machines are already used for vascular access and bladder assessment. As the resolution of these machines becomes adequate for head and neck assessment, ultrasonography is likely to become a routine adjunct to the office physical examination. Further techniques to reduce artifact beyond spatial compounding, second harmonics, and broadband inversion techniques are likely to be developed to improve ultrasound images. Manual palpation using the ultrasound transducer or "sound palpation," using sound to recreate vibration provides information on tissue "stiffness," which has been successfully used to distinguish between benign and malignant lesions in the head and neck (particularly thyroid nodules). Microbubble contrast-enhanced ultrasound provides improved resolution of ultrasound images. Three- and four-dimensional ultrasonography provides for more accurate diagnosis. The ability of microbubbles with ligands affixed to their outer surface to target specific tissue makes them excellent delivery vehicles. DNA plasmids, chemotherapy agents, and therapeutic drugs can be released at a specific anatomic site. The motion of microbubbles stimulated by ultrasound can be used to increase drug penetration through tissues and has been shown to be effective in breaking up clots in stroke patients (without increased risk). High-intensity focused ultrasound can be used to create coagulation necrosis without significant damage to adjacent tissue. It has been effectively used in neurosurgery and urology, but its effectiveness in the head and neck is still being determined. A prototype for surgical navigation with ultrasound has been developed for the head and neck, which allows real-time imaging of anatomic surgical changes. PMID:21044741

  17. Men of African Descent and Carcinoma of the Prostate Consortium

    Cancer.gov

    The Men of African Descent and Carcinoma of the Prostate Consortium collaborates on epidemiologic studies to address the high burden of prostate cancer and to understand the causes of etiology and outcomes among men of African ancestry.

  18. Design and Development of the MSL Descent Stage Propulsion System

    NASA Technical Reports Server (NTRS)

    Weiss, Jeffrey M.; Guernsey, Carl S.

    2013-01-01

    On August 5, 2012, The Mars Science Laboratory mission successfully landed the largest interplanetary rover ever built, Curiosity, on the surface of Mars. The Entry, Descent, and Landing (EDL) phase of this mission was by far the most complex landing ever attempted on a planetary body. The Descent Stage Propulsion System played an integral and critical role during Curiosity's EDL. The Descent Stage Propulsion System was a one of a kind hydrazine propulsion system designed specifically for the EDL phase of the MSL mission. It was designed, built, and tested at the Jet Propulsion Laboratory (JPL). The purpose of this paper is to present an overview of the design and development of the MSL Descent Stage Propulsion System. Driving requirements, system design, component selection, operational sequence of the system at Mars, new developments, and key challenges will be discussed.

  19. Automation for Accommodating Fuel-Efficient Descents in Constrained Airspace

    NASA Technical Reports Server (NTRS)

    Coopenbarger, Richard A.

    2010-01-01

    Continuous descents at low engine power are desired to reduce fuel consumption, emissions and noise during arrival operations. The challenge is to allow airplanes to fly these types of efficient descents without interruption during busy traffic conditions. During busy conditions today, airplanes are commonly forced to fly inefficient, step-down descents as airtraffic controllers work to ensure separation and maximize throughput. NASA in collaboration with government and industry partners is developing new automation to help controllers accommodate continuous descents in the presence of complex traffic and airspace constraints. This automation relies on accurate trajectory predictions to compute strategic maneuver advisories. The talk will describe the concept behind this new automation and provide an overview of the simulations and flight testing used to develop and refine its underlying technology.

  20. Ascent/descent ancillary data production user's guide

    NASA Technical Reports Server (NTRS)

    Brans, H. R.; Seacord, A. W., II; Ulmer, J. W.

    1986-01-01

    The Ascent/Descent Ancillary Data Product, also called the A/D BET because it contains a Best Estimate of the Trajectory (BET), is a collection of trajectory, attitude, and atmospheric related parameters computed for the ascent and descent phases of each Shuttle Mission. These computations are executed shortly after the event in a post-flight environment. A collection of several routines including some stand-alone routines constitute what is called the Ascent/Descent Ancillary Data Production Program. A User's Guide for that program is given. It is intended to provide the reader with all the information necessary to generate an Ascent or a Descent Ancillary Data Product. It includes descriptions of the input data and output data for each routine, and contains explicit instructions on how to run each routine. A description of the final output product is given.

  1. Design principles of descent vehicles with an inflatable braking device

    NASA Astrophysics Data System (ADS)

    Alexashkin, S. N.; Pichkhadze, K. M.; Finchenko, V. S.

    2013-12-01

    A new type of descent vehicle (DVs) is described: a descent vehicle with an inflatable braking device (IBD DV). IBD development issues, as well as materials needed for the design, manufacturing, and testing of an IBD and its thermal protection, are discussed. A list is given of Russian integrated test facilities intended for testing IBD DVs. Progress is described in the development of IBD DVs in Russia and abroad.

  2. Air-Traffic Controllers Evaluate The Descent Advisor

    NASA Technical Reports Server (NTRS)

    Tobias, Leonard; Volckers, Uwe; Erzberger, Heinz

    1992-01-01

    Report describes study of Descent Advisor algorithm: software automation aid intended to assist air-traffic controllers in spacing traffic and meeting specified times or arrival. Based partly on mathematical models of weather conditions and performances of aircraft, it generates suggested clearances, including top-of-descent points and speed-profile data to attain objectives. Study focused on operational characteristics with specific attention to how it can be used for prediction, spacing, and metering.

  3. Immunotherapy for bladder cancer

    PubMed Central

    Fuge, Oliver; Vasdev, Nikhil; Allchorne, Paula; Green, James SA

    2015-01-01

    It is nearly 40 years since Bacillus Calmette–Guérin (BCG) was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment. As a better understanding of its mechanism of action and the clinical response to it have evolved, some of the questions around optimal dosing and treatment protocols have been answered. However, its potential for toxicity and failure to produce the desired clinical effect in a significant cohort of patients presents an ongoing challenge to clinicians and researchers alike. This review summarizes the evidence behind the established mechanism of action of BCG in bladder cancer, highlighting the extensive array of immune molecules that have been implicated in its action. The clinical aspects of BCG are discussed, including its role in reducing recurrence and progression, the optimal treatment regime, toxicity and, in light of new evidence, whether or not there is a superior BCG strain. The problems of toxicity and non-responders to BCG have led to development of new techniques aimed at addressing these pitfalls. The progress made in the laboratory has led to the identification of novel targets for the development of new immunotherapies. This includes the potential augmentation of BCG with various immune factors through to techniques avoiding the use of BCG altogether; for example, using interferon-activated mononuclear cells, BCG cell wall, or BCG cell wall skeleton. The potential role of gene, virus, or photodynamic therapy as an alternative to BCG is also reviewed. Recent interest in the immune check point system has led to the development of monoclonal antibodies against proteins involved in this pathway. Early findings suggest benefit in metastatic disease, although the role in superficial bladder cancer remains unclear. PMID:26000263

  4. Immunotherapy for bladder cancer.

    PubMed

    Fuge, Oliver; Vasdev, Nikhil; Allchorne, Paula; Green, James Sa

    2015-01-01

    It is nearly 40 years since Bacillus Calmette-Guérin (BCG) was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment. As a better understanding of its mechanism of action and the clinical response to it have evolved, some of the questions around optimal dosing and treatment protocols have been answered. However, its potential for toxicity and failure to produce the desired clinical effect in a significant cohort of patients presents an ongoing challenge to clinicians and researchers alike. This review summarizes the evidence behind the established mechanism of action of BCG in bladder cancer, highlighting the extensive array of immune molecules that have been implicated in its action. The clinical aspects of BCG are discussed, including its role in reducing recurrence and progression, the optimal treatment regime, toxicity and, in light of new evidence, whether or not there is a superior BCG strain. The problems of toxicity and non-responders to BCG have led to development of new techniques aimed at addressing these pitfalls. The progress made in the laboratory has led to the identification of novel targets for the development of new immunotherapies. This includes the potential augmentation of BCG with various immune factors through to techniques avoiding the use of BCG altogether; for example, using interferon-activated mononuclear cells, BCG cell wall, or BCG cell wall skeleton. The potential role of gene, virus, or photodynamic therapy as an alternative to BCG is also reviewed. Recent interest in the immune check point system has led to the development of monoclonal antibodies against proteins involved in this pathway. Early findings suggest benefit in metastatic disease, although the role in superficial bladder cancer remains unclear. PMID:26000263

  5. Descent from the Summit of 'Husband Hill'

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Click on the image for Descent from the Summit of 'Husband Hill' (QTVR)

    In late November 2005 while descending 'Husband Hill,' NASA's Mars Exploration Rover Spirit took the most detailed panorama so far of the 'Inner Basin,' the rover's next target destination. Spirit acquired the 405 individual images that make up this 360-degree view of the surrounding terrain using five different filters on the panoramic camera. The rover took the images on Martian days, or sols, 672 to 677 (Nov. 23 to 28, 2005 -- the Thanksgiving holiday weekend).

    This image is an approximately true-color rendering using camera's 750-, 530-, and 430-nanometer filters. Seams between individual frames have been eliminated from the sky portion of the mosaic to better simulate the vista a person standing on Mars would see.

    'Home Plate,' a bright, semi-circular feature scientists hope to investigate, is harder to discern in this image than in earlier views taken from higher up the hill. Spirit acquired this more oblique view, known as the 'Seminole panorama,' from about halfway down the south flank of Husband Hill, 50 meters (164 feet) or so below the summit. Near the center of the panorama, on the horizon, are 'McCool Hill' and 'Ramon Hill,' named, like Husband Hill, in honor of the fallen astronauts of the space shuttle Columbia. Husband Hill is visible behind the rover, on the right and left sides of the panorama. An arc of rover tracks made while avoiding obstacles and getting into position to examine rock outcrops can be traced over a long distance by zooming in to explore the panorama in greater detail.

    Spirit is now significantly farther downhill toward the center of this panorama, en route to Home Plate and other enigmatic soils and outcrop rocks in the quest to uncover the history of Gusev Crater and the 'Columbia Hills.'

  6. A descent of the aurora over Lapland

    NASA Astrophysics Data System (ADS)

    Whiter, Daniel; Partamies, Noora

    2014-05-01

    A very large statistical study (≃ 4 × 105 measurements) into the peak emission height of the aurora has shown that the aurora over Lapland descended significantly between 1996 and 2007. The study was performed using images from a network of ground-based all-sky cameras which form part of the MIRACLE (Magnetometers-Ionospheric Radar-All-sky Cameras Large Experiment) network, and are located at various observation stations across northern Finland and Sweden. The height of the aurora was first measured about a century ago. Since then, it has generally been assumed that the peak emission height of any particular auroral emission is constant for similar geomagnetic conditions. The present work was motivated by the need to improve estimates of the height of the aurora used to calculate other ionospheric and auroral properties, such as optical flow velocities and auroral arc widths. In recent years MIRACLE has produced approximately 105 images of the aurora per station per year. In order to analyse such a large number of images, a novel fast and automatic method was developed for finding the peak emission height of an auroral structure from a pair of all-sky camera images with overlapping fields of view. This method has been applied to all auroral images recorded by the MIRACLE intensified CCD cameras in operation between 1996 and 2007. Such a large data set allows the study of variations in the height of the aurora with time (yearly, monthly, hourly) and with solar and geomagnetic indices such as F10.7 and Kp. Results from the statistical study show that the peak emission height of green (557.7 nm, O1S - O1D transition) aurora over Lapland descended by about 10 km between 1996 and 2007. This descent occurred independently of the solar cycle, and is thought to be due to a cooling and contraction of the mesosphere and lower thermosphere.

  7. Forgotten triangles of neck

    PubMed Central

    Singh, Manpreet; Vashistha, Arpit; Chaudhary, Manoj; Kaur, Gagandeep

    2016-01-01

    The purpose of this manuscript is to add some more information in the present scientific literature on these nearly forgotten triangles of surgical importance. The neck is an area that lends itself to anatomical geometry, such as triangles. Many triangles of the neck have been described, and some are well-known, yet, some have been nearly forgotten, i.e., Lesser's triangle, Farabeuf triangle, Pirogoff's triangle, and Beclard's triangle. From the anatomic and surgical point of view, the neck is an amazingly interesting place. It is like a connection where crucial functional units meet and pass. Added surgical landmarks are always helpful to the surgeon while dealing with the neck. Described triangles of neck in this article are always reliable and constant landmarks for head and neck surgeons

  8. American Head and Neck Society

    MedlinePlus

    American Head & Neck Society Head and Neck Cancer Research & Education American Head & Neck Society | AHNS Head and Neck Cancer Research & Education About AHNS ... and Announcements Copyright ©2016 · American Head and Neck Society · Privacy and Return Policy Managed by BSC Management, ...

  9. Neck skin rejuvenation.

    PubMed

    Duplechain, J Kevin

    2014-05-01

    The author of this article uses the pulsed ablative CO2 laser for resurfacing of the neck and face, based on the gold standard status of the CO2 laser and a novel post-treatment plan that greatly reduces adverse effects traditionally associated with fully ablative resurfacing. The croton oil peel is an inexpensive and effective modality for rejuvenating neck skin. The use of either technique as an adjunct to neck lift surgery, with or without facelift surgery, permits surgeons to fulfill the expectations of patients who want the skin of their face and neck to be homogeneous and more attractive. PMID:24745383

  10. Genome-Wide Association Study of Bladder Cancer in a Chinese Cohort Reveals a New Susceptibility Locus at 5q12.3.

    PubMed

    Wang, Meilin; Li, Zhiqiang; Chu, Haiyan; Lv, Qiang; Ye, Dingwei; Ding, Qiang; Xu, Chuanliang; Guo, Jianming; Du, Mulong; Chen, Jianhua; Song, Zhijian; Yin, Changjun; Qin, Chao; Gu, Chengyuan; Zhu, Yao; Xia, Guowei; Liu, Fang; Zhang, Zhengsheng; Yuan, Lin; Fu, Guangbo; Hu, Zhibin; Tong, Na; Shen, Jiawei; Liu, Ke; Sun, Jielin; Sun, Yinghao; Li, Jue; Li, Xingwang; Shen, Hongbing; Xu, Jianfeng; Shi, Yongyong; Zhang, Zhengdong

    2016-06-01

    Genome-wide association studies (GWAS) of bladder cancer have identified a number of susceptibility loci in European populations but have yet to uncover the genetic determinants underlying bladder cancer incidence among other ethnicities. Therefore, we performed the first GWAS in a Chinese cohort comprising 3,406 cases of bladder cancer and 4,645 controls. We identified a new susceptibility locus for bladder cancer at 5q12.3, located in the intron of CWC27 (rs2042329), that was significantly associated with disease risk (OR = 1.40; P = 4.61 × 10(-11)). However, rs2042329 was not associated with bladder cancer risk in patients of European descent. The rs2042329 risk allele was also related to significantly increased expression levels of CWC27 mRNA and protein in bladder cancer tissues from Chinese patients. Additional functional analyses suggested that CWC27 played an oncogenic role in bladder cancer by inducing cell proliferation and suppressing apoptosis. In conclusion, the identification of a risk-associated locus at 5q12.3 provides new insights into the inherited susceptibility to bladder cancer in Chinese populations and may help to identify high-risk individuals. Cancer Res; 76(11); 3277-84. ©2016 AACR. PMID:27206850

  11. Chemoprevention of bladder cancer.

    PubMed

    Kamat, Ashish M; Lamm, Donald L

    2002-02-01

    The data presented herein, although highly supportive for a protective role of various nutrients against bladder cancer, are far from definitive. Many authorities question the validity of current recommendations for nutritional chemoprevention against bladder cancer. The reason for the wide variations reported in epidemiologic studies lies in the nature of observational studies. Dietary studies are limited in their conclusions because the protection afforded by the consumption of a particular nutrient may be multifactorial, with different components of the food exerting potential chemopreventive effects. Furthermore, measuring levels of nutrients in the food intake of populations is confounded by factors that might affect these levels and also the incidence of cancer. For example, vitamin A can come from animal or vegetarian sources. Because animal fat has been identified as a potential carcinogen in man, depending on the source of the vitamin, varying levels of protection might be deduced. In addition, chemoprevention studies using dietary supplements are expected to have mild effects, and large studies would be required to confirm statistical significance. Even with agents such as intravesical chemotherapy, only half the studies achieve statistical significance [29]. Prospective randomized trials with a large sample size, longer follow-up, and an extended duration of treatment are needed to clarify the association between micronutrients and cancer protection. With these caveats in mind, several recommendations can be made. Simple measures, such as drinking more fluids (especially water), can have a profound impact on the incidence of bladder cancer. Vitamins are being extensively studied in chemopreventive trials for different cancers. There is strong evidence for a chemoprotective effect of vitamin A in bladder cancer. The authors recommend 32,000 IU/day of vitamin A initially, with lower doses (24,000 IU) for persons less than 50 kg. Because liver toxicity is a

  12. Ureteral bladder augmentation.

    PubMed

    Churchill, B M; Aliabadi, H; Landau, E H; McLorie, G A; Steckler, R E; McKenna, P H; Khoury, A E

    1993-08-01

    Virtually all segments of the gastrointestinal tract have been used successfully in augmentation cystoplasty. The complications inherent in enterocystoplasty are well described. Megaureters subtending effete kidneys (poorly or nonfunctioning) provide a novel and excellent source of augmentation material with urothelium and muscular backing, free of the electrolyte and acid base disturbances, and mucus production that plague enterocystoplasty. Augmentation cystoplasty using detubularized, reconfigured, otherwise disposable megaureter, with or without ipsilateral total or partial nephrectomy, was performed in 16 patients (mean age 8.8 years, range 1 to 25) with inadequate and dysfunctional bladders. Postoperative followup varied between 8 and 38 months (mean 22). The overall renal function and radiographic appearance of the remaining upper tracts have remained stable or improved in all patients. Of the 16 patients 15 require intermittent catheterization and 1 voids spontaneously. Ten patients are continent day and night, 5 have improved continence (4 damp at night and 1 stress incontinence) and 1 has failed to gain continence despite good capacity and compliance. Complete postoperative urodynamic evaluations in 12 of 13 patients show good capacity, low pressure bladders with no instability. Complications occurred in 5 patients, including transient urine extravasation in 2, contralateral ureterovesical obstruction in 2 and Mitrofanoff stomal stenosis in 1. Augmentation ureterocystoplasty combines the benefits common to all enterocystoplasties without adding any of the untoward complications or risks associated with nonurothelial augmentations. PMID:8326632

  13. Design of automation tools for management of descent traffic

    NASA Technical Reports Server (NTRS)

    Erzberger, Heinz; Nedell, William

    1988-01-01

    The design of an automated air traffic control system based on a hierarchy of advisory tools for controllers is described. Compatibility of the tools with the human controller, a key objective of the design, is achieved by a judicious selection of tasks to be automated and careful attention to the design of the controller system interface. The design comprises three interconnected subsystems referred to as the Traffic Management Advisor, the Descent Advisor, and the Final Approach Spacing Tool. Each of these subsystems provides a collection of tools for specific controller positions and tasks. This paper focuses primarily on the Descent Advisor which provides automation tools for managing descent traffic. The algorithms, automation modes, and graphical interfaces incorporated in the design are described. Information generated by the Descent Advisor tools is integrated into a plan view traffic display consisting of a high-resolution color monitor. Estimated arrival times of aircraft are presented graphically on a time line, which is also used interactively in combination with a mouse input device to select and schedule arrival times. Other graphical markers indicate the location of the fuel-optimum top-of-descent point and the predicted separation distances of aircraft at a designated time-control point. Computer generated advisories provide speed and descent clearances which the controller can issue to aircraft to help them arrive at the feeder gate at the scheduled times or with specified separation distances. Two types of horizontal guidance modes, selectable by the controller, provide markers for managing the horizontal flightpaths of aircraft under various conditions. The entire system consisting of descent advisor algorithm, a library of aircraft performance models, national airspace system data bases, and interactive display software has been implemented on a workstation made by Sun Microsystems, Inc. It is planned to use this configuration in operational

  14. Mars Descent Imager (MARDI) on the Mars Polar Lander

    USGS Publications Warehouse

    Malin, M.C.; Caplinger, M.A.; Carr, M.H.; Squyres, S.; Thomas, P.; Veverka, J.

    2001-01-01

    The Mars Descent Imager, or MARDI, experiment on the Mars Polar Lander (MPL) consists of a camera characterized by small physical size and mass (???6 ?? 6 ?? 12 cm, including baffle; <500 gm), low power requirements (<2.5 W, including power supply losses), and high science performance (1000 x 1000 pixel, low noise). The intent of the investigation is to acquire nested images over a range of resolutions, from 8 m/pixel to better than 1 cm/pixel, during the roughly 2 min it takes the MPL to descend from 8 km to the surface under parachute and rocket-powered deceleration. Observational goals will include studies of (1) surface morphology (e.g., nature and distribution of landforms indicating past and present environmental processes); (2) local and regional geography (e.g., context for other lander instruments: precise location, detailed local relief); and (3) relationships to features seen in orbiter data. To accomplish these goals, MARDI will collect three types of images. Four small images (256 x 256 pixels) will be acquired on 0.5 s centers beginning 0.3 s before MPL's heatshield is jettisoned. Sixteen full-frame images (1024 X 1024, circularly edited) will be acquired on 5.3 s centers thereafter. Just after backshell jettison but prior to the start of powered descent, a "best final nonpowered descent image" will be acquired. Five seconds after the start of powered descent, the camera will begin acquiring images on 4 s centers. Storage for as many as ten 800 x 800 pixel images is available during terminal descent. A number of spacecraft factors are likely to impact the quality of MARDI images, including substantial motion blur resulting from large rates of attitude variation during parachute descent and substantial rocket-engine-induced vibration during powered descent. In addition, the mounting location of the camera places the exhaust plume of the hydrazine engines prominently in the field of view. Copyright 2001 by the American Geophysical Union.

  15. Bladder Injury During Cesarean Delivery

    PubMed Central

    Tarney, Christopher M.

    2013-01-01

    Cesarean section is the most common surgery performed in the United States with over 30% of deliveries occurring via this route. This number is likely to increase given decreasing rates of vaginal birth after cesarean section (VBAC) and primary cesarean delivery on maternal request, which carries the inherent risk for intraoperative complications. Urologic injury is the most common injury at the time of either obstetric or gynecologic surgery, with the bladder being the most frequent organ damaged. Risk factors for bladder injury during cesarean section include previous cesarean delivery, adhesions, emergent cesarean delivery, and cesarean section performed at the time of the second stage of labor. Fortunately, most bladder injuries are recognized at the time of surgery, which is important, as quick recognition and repair are associated with a significant reduction in patient mortality. Although cesarean delivery is a cornerstone of obstetrics, there is a paucity of data in the literature either supporting or refuting specific techniques that are performed today. There is evidence to support double-layer closure of the hysterotomy, the routine use of adhesive barriers, and performing a Pfannenstiel skin incision versus a vertical midline subumbilical incision to decrease the risk for bladder injury during cesarean section. There is also no evidence that supports the creation of a bladder flap, although routinely performed during cesarean section, as a method to reduce the risk of bladder injury. Finally, more research is needed to determine if indwelling catheterization, exteriorization of the uterus, and methods to extend hysterotomy incision lead to bladder injury. PMID:24876830

  16. Intermittent catheterization failure and an approach to bladder rehabilitation in spinal cord injury patients.

    PubMed

    Perkash, I

    1978-01-01

    Forty-six patients with spinal injury with dysfunctional neurogenic bladder were analyzed. Fourteen patients on prolonged intermittent catheterization from 12 weeks to more than 1 year did not develop a balanced bladder, 14 patients had indwelling catheters after intermittent catheterization failed elsewhere and 18 patients on external condom drainage presented with difficult voiding and repeated infections. There were 16 quadriplegics (1 incomplete), 21 paraplegics, and 9 incomplete cauda equina lesions. Urologic and urodynamic evaluation revealed detrusor-sphincter dyssynergia in 15 patients, vesicoureteral reflux in 10, and areflexic bladders in 11. Five patients over the age of 55 years showed slight enlargement of the prostrate. Some degree of bladder neck fibrosis was suspected in 26. More than one urologic pathology was encountered in the same patient. Transurethral sphincterotomy was carried out in 38 patients and only one transurethral resection of the prostrate (TURP) in an incomplete quadriplegic patient. In seven patients with no obvious urodynamic abnormality, a balanced bladder was achieved with intermittent catheterization; however, one of these patients needed a transurethral sphincterotomy on subsequent admission. A balanced bladder was achieved in all patients except the one with incomplete quadriplegia. Significant improvement in vesicoureteral reflux and relief from autonomic dysreflexic symptoms were recorded in all patients. PMID:619856

  17. A rare urinary bladder tumour

    PubMed Central

    Haddad-Lacle, Judella Edwina Maria; Haddad, Charles Joseph; Villas, Bruce

    2014-01-01

    This case report describes a 54-year-old man who presented to his primary care physician with low back pain. During his workup, an incidental finding of a bladder mass was diagnosed. He underwent transurethral resection of the bladder tumour and the resulting pathology was consistent with extra nodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). Presentation of MALT lymphoma in the urinary bladder is rare. This malignancy is more commonly found in the stomach. The prognosis for this rare tumour is excellent. Our patient showed no sign of recurrence with transurethral excision and radiation alone. PMID:24835803

  18. Underactive Bladder in Older Adults.

    PubMed

    Chuang, Yao-Chi; Plata, Mauricio; Lamb, Laura E; Chancellor, Michael B

    2015-11-01

    Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies. PMID:26476113

  19. Increased bladder permeability in interstitial cystitis/painful bladder syndrome

    PubMed Central

    Greenwood-Van Meerveld, Beverley; Wisniewski, Amy B.; VanGordon, Samuel; Lin, HsuehKung; Kropp, Bradley P.; Towner, Rheal A.

    2015-01-01

    The definition of interstitial cystitis (IC) has evolved over the years from being a well-defined entity characterized by diagnostic lesion (Hunner’s ulcer) in the urothelium to a clinical diagnosis by exclusion [painful bladder syndrome (PBS)]. Although the etiology is unknown, a central theme has been an association with increased permeability of the bladder. This article reviews the evidence for increased permeability being important to the symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) and in treating the disorder. Recent work showing cross-communication among visceral organs is also reviewed to provide a basis for understanding IC/PBS as a systemic disorder of a complex, interconnected system consisting of the bladder, bowel and other organs, nerves, cytokine-responding cells and the nervous system. PMID:26751576

  20. Ct2 Bladder Cancer.

    PubMed

    Soloway, Mark S

    2016-09-01

    The patient is an 80-year-old man who presented with gross hematuria. His past medical history indicates he was a cigarette smoker with 50 pack/years. He was successfully treated for carcinoma of the lung 7 years ago. He received chemotherapy, radiation, and surgery. He has mild COPD but has a good performance status. His laboratory studies do not indicate any abnormalities in terms of renal function. He does not have any significant cardiac disease. He has a medium build. He had prostate cancer and underwent a successful radical prostatectomy 10 years ago. His PSA is undetectable. He has some urinary incontinence and wears two pads/day. He underwent the appropriate investigations for gross hematuria. A CT scan of the abdomen and pelvis was normal with the exception of a 4-cm posterior mass in the bladder. There was no hydronephrosis and no enlarged lymph nodes. He underwent a transurethral resection of a solitary bladder tumor performed by another urologist. The tumor was described as large and sessile. It was located on the posterior wall and was approximately 4 cm. The bimanual examination did not reveal a mass. The pathology report stated that the tumor was a high-grade urothelial carcinoma with invasion into the muscularis propria. There was no lymphovascular invasion. I performed a reTURBT, and at that procedure, I did not identify any obvious tumor but the prior resection site was evident. I resected the prior tumor site quite extensively both in depth and width. The pathology revealed only focal carcinoma in situ. There was ample muscle in the specimen and there was some fat as well. As stated, they were free of any cancer. The patient is receptive to any treatment approach. PMID:27457483

  1. Augmentation cystoplasty in neurogenic bladder.

    PubMed

    Çetinel, Bülent; Kocjancic, Ervin; Demirdağ, Çetin

    2016-09-01

    The aim of this review is to update the indications, contraindications, technique, complications, and the tissue engineering approaches of augmentation cystoplasty (AC) in patients with neurogenic bladder. PubMed/MEDLINE was searched for the keywords "augmentation cystoplasty," "neurogenic bladder," and "bladder augmentation." Additional relevant literature was determined by examining the reference lists of articles identified through the search. The update review of of the indications, contraindications, technique, outcome, complications, and tissue engineering approaches of AC in patients with neurogenic bladder is presented. Although some important progress has been made in tissue engineering AC, conventional AC still has an important role in the surgical treatment of refractory neurogenic lower urinary tract dysfunction. PMID:27617312

  2. Augmentation cystoplasty in neurogenic bladder

    PubMed Central

    Kocjancic, Ervin; Demirdağ, Çetin

    2016-01-01

    The aim of this review is to update the indications, contraindications, technique, complications, and the tissue engineering approaches of augmentation cystoplasty (AC) in patients with neurogenic bladder. PubMed/MEDLINE was searched for the keywords "augmentation cystoplasty," "neurogenic bladder," and "bladder augmentation." Additional relevant literature was determined by examining the reference lists of articles identified through the search. The update review of of the indications, contraindications, technique, outcome, complications, and tissue engineering approaches of AC in patients with neurogenic bladder is presented. Although some important progress has been made in tissue engineering AC, conventional AC still has an important role in the surgical treatment of refractory neurogenic lower urinary tract dysfunction. PMID:27617312

  3. Drugs Approved for Bladder Cancer

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for bladder cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  4. Genetics Home Reference: bladder cancer

    MedlinePlus

    ... chemicals. Studies suggest that chronic bladder inflammation, a parasitic infection called schistosomiasis, and some medications used to treat ... Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Patient Support and Advocacy Resources (2 links) American Cancer ...

  5. Sequential transurethral enucleation of the prostate and laparoscopic bladder diverticulectomy.

    PubMed

    Yu, Yang; Guan, Sheng; Shen, Chen; Yang, Bo

    2016-08-01

    Transurethral endoscopic technique and standard laparoscopic technique are surgical options for the management of benign prostatic hyperplasia (BPH) associated with urinary bladder diverticuli (UBD). In this article, we report laparoscopic diverticulectomy (LD) and transurethral plasmakinetic enucleation of the prostate (TUEP) in the same patient sequentially. To the best of our knowledge, this is the first case report of LD combined with TUEP. An 82-year-old patient with benign prostatic hyperplasia and two secondary large bladder diverticuli underwent sequential TUEP and LD. After completion of the TUEP procedure, the detached adenoma was pushed into the bladder as a whole. Then laparoscopic transperitoneal extravesical diverticulectomy assisted by cystoscopic transillumination was performed immediately, and the enucleated prostate was removed via the neck of the diverticulum. The enucleation time and diverticulectomy time was 18 minutes and 108 minutes, respectively. The catheter was removed on the tenth postoperative day. Transurethral endoscopic surgery combined with LD is a good choice in treating BPH and UBD in one session. But the combined procedure is time-consuming, especially for fragmentation of the prostate. TUEP can greatly reduce the operative time of the combined procedure. PMID:27249185

  6. Crew Procedures for Continuous Descent Arrivals Using Conventional Guidance

    NASA Technical Reports Server (NTRS)

    Oseguera-Lohr, Rosa M.; Williams, David H.; Lewis, Elliot T,

    2007-01-01

    This paper presents results from a simulation study which investigated the use of Continuous Descent Arrival (CDA) procedures for conducting a descent through a busy terminal area, using conventional transport-category automation. This research was part of the Low Noise Flight Procedures (LNFP) element within the Quiet Aircraft Technology (QAT) Project, that addressed development of flight guidance, and supporting pilot and Air Traffic Control (ATC) procedures for low noise operations. The procedures and chart were designed to be easy to understand, and to make it easy for the crew to make changes via the Flight Management Computer Control-Display Unit (FMC-CDU) to accommodate changes from ATC. The test runs were intended to represent situations typical of what exists in many of today's terminal areas, including interruptions to the descent in the form of clearances issued by ATC.

  7. MSL Entry, Descent and Landing Performance and Environments

    NASA Technical Reports Server (NTRS)

    Lockwood, Mary Kae; Dwyer-Cianciola, Alicia; Dyakonov, Artem; Edquist, Karl; Powell, Dick; Striepe, Scott; Way, David; Graves, Claude; Carman, Gil; Sostaric, Ron

    2005-01-01

    A viewgraph presentation on the MARS Science Laboratory (MSL) Entry, Descent and Landing (EDL) performance and environments is shown. The topics include: 1) High Altitude and Precision Landing; 2) Guided, Lifting, Ballistic Trade; 3) Supersonic Chute Deploy Altitude; 4) Guided, Lifting, Ballistic Landing Footprint Video; 5) Transition Indicator at Peak Heating Point on Trajectory; 6) Aeroheating at Peak Heating Point on Trajectory Nominal, No Uncertainty Included; 7) Comparison to Previous Missions; 8) Pork Chop Plots - EDL Performance for Mission Design; 9) Max Heat Rate Est (CBE+Uncert) W/cm2; 10) Nominal Super Chute Deploy Alt Above MOLA (km); 11) Monte Carlo; 12) MSL Option M2 Entry, Descent and Landing; 13) Entry Performance; 14) Entry Aeroheating and Entry g's; 15) Terminal Descent; and 16) How An Ideal Chute Deployment Altitude Varies with Time of Year and Latitude (JSC Chart).

  8. [Melanosis of the urinary bladder].

    PubMed

    Wöllner, J; Janzen, J; Pannek, J

    2016-01-01

    Melanosis of the bladder is rare. Only 10 cases have been described in the literature. We present the case of an 80-year-old woman with neurogenic lower urinary tract dysfunction due to spinal paralysis. During the diagnostic work-up which included cystoscopy, black spots in the bladder wall were observed. Histopathological evaluation revealed a benign suburothelial melanosis. Thus, with cystoscopic suspicion of a malignancy (melanoma), a biopsy is mandatory and regular cystoscopic follow-up is recommended. PMID:26358438

  9. Cloacal anomaly with bladder tumor

    PubMed Central

    Seth, Amlesh; Ram, Ishwar

    2013-01-01

    A rare case of squamous cell carcinoma of bladder occurring in a 36-year-old female with persistent cloacal anomaly who presented with frequency, urgency, dysuria, and recurrent urinary tract infection is reported. Contrast Enhanced Computed Tomography with three dimensional reconstruction showed presence of bladder tumor and persistent cloaca. She underwent pelvic exenteration and wet colostomy. Histopathologic findings revealed locally advanced moderately differentiated squamous cell carcinoma. PMID:23956519

  10. Inflammatory myofibroblastic bladder tumor in a patient with wolf-hirschhorn syndrome.

    PubMed

    Marte, Antonio; Indolfi, Paolo; Ficociello, Carmine; Russo, Daniela; Oreste, Matilde; Bottigliero, Gaetano; Gualdiero, Giovanna; Barone, Ciro; Vigliar, Elena; Indolfi, Cristiana; Casale, Fiorina

    2013-01-01

    Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm described in several tissues and organs including genitourinary system, lung, head, and neck. The etiology of IMT is contentious, and whether it is a postinflammatory process or a true neoplasm remains controversial. To our knowledge, we report the first reported case of IMT of urinary bladder in a pediatric patient with Wolf-Hirschhorn (WHS). We also review the literature about patients with associated neoplasia. PMID:24024066

  11. Leiomyoma of the bladder in a patient with von Recklinghausen’s neurofibromatosis

    PubMed Central

    Däuth, T L; Conradie, M; Chetty, R

    2003-01-01

    Leiomyomas are an uncommon manifestation of neurofibromatosis type 1 (NF-1) and occur most often in the gastrointestinal tract. Here, they have a proclivity for the proximal small bowel and tend to be multiple. Urinary tract involvement by NF-1 is usually in the form of neurofibromas, and leiomyomas are exceptionally rare. This report describes a case of solitary leiomyoma occurring in a 49 year old woman with NF-1. The patient had symptoms related to a lower urinary tract infection and on examination was found to have a distended bladder. Imaging of the bladder showed a mass involving the posterior wall, neck, and trigone causing bilateral hydronephrosis. The mass was excised with part of the bladder. Microscopic examination revealed typical features of a leiomyoma and there was strong immunoreactivity for desmin and smooth muscle actin. Leiomyoma must be considered in the differential diagnosis of spindle cell neoplasms in patients with NF-1. PMID:12944559

  12. Rosetta Mission's "7 Hours of Terror" and Philae's Descent

    NASA Astrophysics Data System (ADS)

    Blanco, Philip

    2015-09-01

    In November 2014 the Rosetta mission to Comet 67P/Churyumov-Gerasimenko made the headlines when its Philae lander completed a successful unpowered descent onto the surface of the comet nucleus after "7 hours of terror" for the mission scientists. 67P's irregular shape and rotation made this task even more challenging. Philae fell almost radially towards 67P, as shown in an animation produced by the European Space Agency (ESA) prior to the event. Below, we investigate whether it is possible to model the spacecraft's descent time and impact speed using concepts taught in an introductory physics course.

  13. Gradient descent learning algorithm overview: a general dynamical systems perspective.

    PubMed

    Baldi, P

    1995-01-01

    Gives a unified treatment of gradient descent learning algorithms for neural networks using a general framework of dynamical systems. This general approach organizes and simplifies all the known algorithms and results which have been originally derived for different problems (fixed point/trajectory learning), for different models (discrete/continuous), for different architectures (forward/recurrent), and using different techniques (backpropagation, variational calculus, adjoint methods, etc.). The general approach can also be applied to derive new algorithms. The author then briefly examines some of the complexity issues and limitations intrinsic to gradient descent learning. Throughout the paper, the author focuses on the problem of trajectory learning. PMID:18263297

  14. Mars Smart Lander Simulations for Entry, Descent, and Landing

    NASA Technical Reports Server (NTRS)

    Striepe, S. A.; Way, D. W.; Balaram, J.

    2002-01-01

    Two primary simulations have been developed and are being updated for the Mars Smart Lander Entry, Descent, and Landing (EDL). The high fidelity engineering end-to-end EDL simulation that is based on NASA Langley's Program to Optimize Simulated Trajectories (POST) and the end-to-end real-time, hardware-in-the-loop simulation testbed, which is based on NASA JPL's (Jet Propulsion Laboratory) Dynamics Simulator for Entry, Descent and Surface landing (DSENDS). This paper presents the status of these Mars Smart Lander EDL end-to-end simulations at this time. Various models, capabilities, as well as validation and verification for these simulations are discussed.

  15. Flight Data Entry, Descent, and Landing (EDL) Repository

    NASA Technical Reports Server (NTRS)

    Martinez, Elmain M.; Winterhalter, Daniel

    2012-01-01

    Dr. Daniel Winterhalter, NASA Engineering and Safety Center Chief Engineer at the Jet Propulsion Laboratory, requested the NASA Engineering and Safety Center sponsor a 3-year effort to collect entry, descent, and landing material and to establish a NASA-wide archive to serve the material. The principle focus of this task was to identify entry, descent, and landing repository material that was at risk of being permanently lost due to damage, decay, and undocumented storage. To provide NASA-wide access to this material, a web-based digital archive was created. This document contains the outcome of the effort.

  16. Space shuttle descent design: From development to operations

    NASA Technical Reports Server (NTRS)

    Crull, T. J.; Hite, R. E., III

    1985-01-01

    The descent guidance system, the descent trajectories design, and generating of the associated flight products are discussed. The programs which allow the successful transitions from development to STS operations, resulting in reduced manpower requirements and compressed schedules for flight design cycles are addressed. The topics include: (1) continually upgraded tools for the job, i.e., consolidating tools via electronic data transfers, tailoring general purpose software for needs, easy access to tools through an interactive approach, and appropriate flexibility to allow design changes and provide growth capability; (2) stabilizing the flight profile designs (I-loads) in an uncertain environment; and (3) standardizing external interfaces within performance and subsystems constraints of the Orbiter.

  17. Entry, Descent and Landing Systems Analysis Study: Phase 1 Report

    NASA Technical Reports Server (NTRS)

    DwyerCianciolo, Alicia M.; Davis, Jody L.; Komar, David R.; Munk, Michelle M.; Samareh, Jamshid A.; Powell, Richard W.; Shidner, Jeremy D.; Stanley, Douglas O.; Wilhite, Alan W.; Kinney, David J.; McGuire, M. Kathleen; Arnold, James O.; Howard, Austin R.; Sostaric, Ronald R.; Studak, Joseph W.; Zumwalt, Carlie H.; Llama, Eduardo G.; Casoliva, Jordi; Ivanov, Mark C.; Clark, Ian; Sengupta, Anita

    2010-01-01

    NASA senior management commissioned the Entry, Descent and Landing Systems Analysis (EDL-SA) Study in 2008 to identify and roadmap the Entry, Descent and Landing (EDL) technology investments that the agency needed to make in order to successfully land large payloads at Mars for both robotic and human-scale missions. This paper summarizes the motivation, approach and top-level results from Year 1 of the study, which focused on landing 10-50 mt on Mars, but also included a trade study of the best advanced parachute design for increasing the landed payloads within the EDL architecture of the Mars Science Laboratory (MSL) mission

  18. Melanoma - neck (image)

    MedlinePlus

    This melanoma on the neck is variously colored with a very darkly pigmented area found centrally. It has irregular ... be larger than 0.5 cm. Prognosis in melanoma is best defined by its depth on resection.

  19. Head and Neck Cancer

    MedlinePlus

    ... head and neck cancer. Poor oral and dental hygiene . Poor care of the mouth and teeth has ... sore throat Foul mouth odor not explained by hygiene Hoarseness or change in voice Nasal obstruction or ...

  20. Talar neck fractures.

    PubMed

    Berlet, G C; Lee, T H; Massa, E G

    2001-01-01

    Clinical management of talar neck fractures is complex and fraught with complications. As Gaius Julius Caesar stated: "The die is cast"; often the outcome of a talar neck fracture is determined at the time of injury. The authors believe, however, that better results can be achieved by following some simple guidelines. The authors advocate prompt and precise anatomic surgical reduction, preferring the medial approach with secondary anterolateral approach. Preservation of blood supply can be achieved by a thorough understanding of vascular pathways and efforts to stay within appropriate surgical intervals. The authors advocate bone grafting of medial neck comminution (if present) to prevent varus malalignment and rigid internal fixation to allow for joint mobilization postoperatively. These guidelines may seem simple, but when dealing with the complexity of talar neck fractures, the foot and ankle surgeon needs to focus and rely on easily grasped concepts to reduce poor outcomes. PMID:11465133

  1. Neck-Tongue Syndrome.

    PubMed

    Hu, Nancy; Dougherty, Carrie

    2016-04-01

    Neck-tongue syndrome (NTS) is a headache disorder often initiated by rapid axial rotation of the neck resulting in unilateral neck and/or occipital pain and transient ipsilateral tongue sensory disturbance. In this review, we examine reported cases of NTS since its initial description in 1980 to highlight the significance of this condition in the differential diagnosis of headache in patients presenting with neck pain and altered tongue sensation. The anatomical basis of NTS centers on the C1-C2 facet joint, C2 ventral ramus, and inferior oblique muscle in the atlanto-axial space. NTS may be categorized as complicated (secondary to another disease process) or uncomplicated (hereditary, related to trauma, or idiopathic). Diagnosis is based on clinical suspicion after a thorough history and physical without a pathognomonic radiologic finding. It is typically treated conservatively with medications, local injections, immobilization with cervical collars, or physical therapy; rarely is surgical intervention pursued. PMID:26984539

  2. Torticollis (wry neck) (image)

    MedlinePlus

    Torticollis is a form of dystonia (prolonged muscle contractions) in which the neck muscles, particularly the sternocleidomastoid muscle, contract involuntarily causing the head to turn. Torticollis may occur without known cause (idiopathic), ...

  3. TCGA head Neck

    Cancer.gov

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

  4. J incision in neck dissections.

    PubMed

    Acar, A; Dursun, G; Aydin, O; Akbaş, Y

    1998-01-01

    Metastasis in the neck lymph system of primary tumours of the head and neck is frequently seen. In order to prevent this metastasis, neck dissection is carried out by various types of skin incisions. In this study, types of skin incision used in neck dissections were defined, and the advantages, disadvantages and results of J incisions, which have been performed on 320 radical neck dissection patients in our clinic between 1985-1996, were compared with those of other incision types. PMID:9538447

  5. Clinical pitfalls in diagnosis of nonmuscle-invasive bladder cancer.

    PubMed

    Serretta, Vincenzo; Scalici Gesolfo, Cristina

    2015-10-01

    Current global economic crisis imposes healthcare system to reduce unnecessary investigations and increase early detection of tumors, to decrease the costs of an advanced disease. Several diagnostic pitfalls may occur dealing with bladder cancer (BC), particularly in nonmuscle-invasive (NMIBC) one. Hematuria, the commonest sign in NMIBC, is often underestimated. Urinary cytology is highly specific for high-grade tumors, but has a low sensitivity for low-grade BC, is operator dependent, and not always obtainable in clinical practice. Numerous urinary tests are available to ameliorate the accuracy of cytology, but none of them is routinly used in urological practice. Ultrasound could hardly detect a small bladder tumor, especially if located in the bladder neck or in the anterior wall. Computed tomography (CT) is widely adopted as an alternative to conventional urography, but its usefulness in patients with hematuria is still debated. MRI has a higher accuracy than CT for staging BC and evaluate the bladder-wall invasion. A negative cystoscopy cannot exclude Tis and should be accompanied by urinary cytology in patients with suspected Tis or high-risk NMIBC; however, new techniques such as narrow band imaging (NBI) and photodynamic (PDD) increase the detection rate of BC and flat lesions. Nearly half of all diagnostic resections present omission of muscle in the specimen or its mention in the pathology report, which is associated with an increased mortality. An adequate muscle sampling during endoscopic resection is mandatory, particularly in patients with high-grade disease. Recognition of pitfalls in diagnosis and management of BC represents the first step for a correct approach. PMID:26481718

  6. Botulinum toxin: An emerging therapy in female bladder outlet obstruction

    PubMed Central

    Pradhan, Aditya A.

    2009-01-01

    Introduction: We evaluated the utility of botulinum toxin in functional female bladder outlet obstruction. Materials and Methods: A total of 7 consecutive female patients with bladder outlet obstruction were included. Patients with neurogenic bladder were excluded. All were previously treated with periodic dilations. Diagnosis was based on symptomatology, cystometry, and micturating cystograms. A total of 2 patients had been in chronic retention with residual volumes more than 400 ml. All were managed with an injection of botulinum toxin, 100 units in 2 ml of saline injected with a flexible cystoscopic needle. The site of the injection was deep submucosally, 0.5 ml in each quadrant at the level of the most prominent narrowing seen endoscopically. All the procedures were done as day care procedures under local anaesthesia. After the procedure, no catheter was placed. Patients were followed up for changes in IPSS scores and post void residual urine measurements. In all cases, multiple injections were used. Results: The follow-up period ranged from 48–52 weeks. The IPSS reduced by an average of 12 points. Post void residual urine reduced by 62%. Improvements commenced 4.85 days (average) after the procedure and lasted for an average of 16.8 weeks (range: 10.8–28 weeks). Discussion: There is a gradual improvement in symptoms over time and the maximal effect occurred at 10–14 days. The duration of improvement was approximately 16.8 weeks. All patients were satisfied by the degree of improvement felt. Conclusions: Botulinum toxin proved successful in improving the voiding characteristics. It possibly acts at the zone of hypertonicity at the bladder neck or midurethra. The only disadvantage is the high cost of the drug. PMID:19881122

  7. Triple cancer: chronic lymphocytic leukemia with bladder and prostate carcinoma.

    PubMed

    Gajendra, Smeeta; Sharma, Rashi; Sahoo, Manas Kumar

    2015-08-01

    B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a common lymphoproliferative disorder with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin. The decreased immunity and B-cell dysfunction in CLL probably accounts for this emergence of second malignancies. We report a case of synchronous bladder transitional cell carcinoma (TCC) and prostatic carcinoma with CLL. A 74-year-old male who underwent transurethral resection of the prostate (TURP) for benign prostatic hyperplasia 2 years before, presented with recurrent urinary tract infection. Peripheral blood smear revealed leukocytosis with absolute lymphocytosis (absolute lymphocyte count: 37870 cells/mm³). Flow cytometric immunophenotyping revealed 75% abnormal lymphoid cells which were positive for CD 19, CD5, CD23, CD22, CD200, CD20 (moderate) with lambda light chain restriction and negative for CD3, CD10, FMC7, CD38, CD138, IgM, CD103, CD123. F Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed increased metabolic activity of the left lateral wall of the urinary bladder extending to the left UV junction, adjacent part of trigone and bladder neck region along with multiple heterogeneous enhancing areas with increased FDG avidity within the prostate. Transurethral resection of the bladder tumour by cystoscopy was performed. Histopathology showed high grade, muscle invasive urothelial carcinoma. Due to presence of uptake in the prostate, transurethral resection of the prostate was done and histopathology revealed adenocarcinoma of prostate (prostate specific antigen- positive), Gleason grade III+III and Gleason score 6. A high index of suspicion is required to detect synchronous and metachronous malignancies. Ancillary studies such as immunohistochemistry, flow cytometry and PET/CT are often essential for detection and an accurate diagnosis. PMID:26277675

  8. Overactive bladder in children.

    PubMed

    Franco, Israel

    2016-09-01

    Overactive bladder (OAB) is a ubiquitous syndrome that is defined by urinary urgency with, or without urinary incontinence. OAB is observed in all parts of the world, with a prevalence of 5-12% in children (5-10 years of age) and a prevalence of 0.5% in older adolescents (16-18 years of age). Published data indicate that around a third of children with OAB are likely to become adults with similar complaints. Studies in children and in adults with OAB indicate that these individuals are more likely to also have anxiety, depression and attention deficit problems, and that appropriate treatment of these comorbidities can often improve the patient's OAB symptoms. Furthermore, data from twin studies and familial surveys seem to indicate a genetic component of OAB. Pharmacological treatments of OAB in children have improved in the past 5 years, moving beyond anticholinergic agents and including the off-label use of α-blockers, β3-agonists and intravesical botulinum toxin. Use of several different electrical stimulation techniques is also effective, both as first-line treatments, and for patients with treatment-refractory symptoms. Overall the outlook of children with OAB seems to be improving, with a greater understanding of the pathophysiology of this syndrome. Treatment modalities that target the source of the underlying problem, especially in children, are likely to provide the best patient outcomes. PMID:27530266

  9. Bladder Cancer in the Elderly

    PubMed Central

    Shariat, Shahrokh F.; Milowsky, Matthew; Droller, Michael J.

    2014-01-01

    Introduction Age is now widely accepted as the greatest single risk factor for developing bladder cancer, and bladder cancer is considered as primarily a disease of the elderly. Because of the close link between age and incidence of bladder cancer, it can be expected that this disease will become an enormous challenge with the growth of an aging population in the years ahead. Methods Using MEDLINE, a search of the literature between January 1966 and July 2007 was performed to describe normative physiologic changes associated with aging, elucidate genetic and epigenetic alterations that associate aging with bladder cancer and its phenotypes; and to characterize how aging influences efficacies, risks, side effects and potential complications of the treatments needed for the various stages of bladder cancer.. Results We discuss influence of aging on host physiology, genetic and epigenetic changes, environmental influences, and host factors in the development and treatment of bladder cancer. Treatments with intravesical Bacille Calmette Guerin, radical cystectomy, and perioperative chemotherapy are less well tolerated and have poorer response in elderly patients compared to their younger counterparts. Elderly patients face both clinical and broader institutional barriers to appropriate treatment and may receive less aggressive treatment and sub-therapeutic dosing. However, when appropriately selected, elderly patients tolerate and respond well to cancer treatments. Conclusions The decision to undergo treatment for cancer is a tradeoff between loss of function and/or independence and extension of life which is complicated by a host of concomitant issues such as co-morbid medical conditions, functional declines and “frailty”, family dynamics, and social and psychological issues. Chronological age should not preclude definitive surgical therapy. It is imperative that healthcare practitioners and researchers from disparate disciplines collectively focus efforts towards

  10. A Comparison of Inexact Newton and Coordinate Descent Meshoptimization Technqiues

    SciTech Connect

    Diachin, L F; Knupp, P; Munson, T; Shontz, S

    2004-07-08

    We compare inexact Newton and coordinate descent methods for optimizing the quality of a mesh by repositioning the vertices, where quality is measured by the harmonic mean of the mean-ratio metric. The effects of problem size, element size heterogeneity, and various vertex displacement schemes on the performance of these algorithms are assessed for a series of tetrahedral meshes.

  11. Abuse against Women with Disabilities of Mexican Descent: Cultural Considerations

    ERIC Educational Resources Information Center

    Graf, Noreen M.; Reed, Bruce J.; Sanchez, Rubi

    2008-01-01

    Although considerable attention has been focused on violence against women with disabilities, environmental and cultural factors that contribute to this violence have received limited attention. This paper examines violence against women of Mexican descent with disabilities. Recommendations are offered to researchers, educators, and service…

  12. A Portfolio of Outstanding Americans of Mexican Descent.

    ERIC Educational Resources Information Center

    Lelevier, Benjamin, Jr.

    A cross section of Mexican American achievement is presented in a portfolio of 37 portraits of outstanding Americans of Mexican descent. Drawn in black and white on heavy paper stock by Mr. David L. Rodriguez, the sketches are suitable for display purposes. With the likenesses are biographical sketches in both English and Spanish which were…

  13. LANDER program manual: A lunar ascent and descent simulation

    NASA Technical Reports Server (NTRS)

    1988-01-01

    LANDER is a computer program used to predict the trajectory and flight performance of a spacecraft ascending or descending between a low lunar orbit of 15 to 500 nautical miles (nm) and the lunar surface. It is a three degree-of-freedom simulation which is used to analyze the translational motion of the vehicle during descent. Attitude dynamics and rotational motion are not considered. The program can be used to simulate either an ascent from the Moon or a descent to the Moon. For an ascent, the spacecraft is initialized at the lunar surface and accelerates vertically away from the ground at full thrust. When the local velocity becomes 30 ft/s, the vehicle turns downrange with a pitch-over maneuver and proceeds to fly a gravity turn until Main Engine Cutoff (MECO). The spacecraft then coasts until it reaches the requested holding orbit where it performs an orbital insertion burn. During a descent simulation, the lander begins in the holding orbit and performs a deorbit burn. It then coasts to pericynthion, where it reignites its engines and begins a gravity turn descent. When the local horizontal velocity becomes zero, the lander pitches up to a vertical orientation and begins to hover in search of a landing site. The lander hovers for a period of time specified by the user, and then lands.

  14. "Rosetta" Mission's "7 Hours of Terror" and "Philae's" Descent

    ERIC Educational Resources Information Center

    Blanco, Philip

    2015-01-01

    In November 2014 the "Rosetta" mission to Comet 67P/Churyumov-Gerasimenko made the headlines when its "Philae" lander completed a successful unpowered descent onto the surface of the comet nucleus after "7 hours of terror" for the mission scientists. 67P's irregular shape and rotation made this task even more…

  15. Stress within a Bicultural Context for Adolescents of Mexican Descent.

    ERIC Educational Resources Information Center

    Romero, Andrea J.; Roberts, Robert E.

    2003-01-01

    Folkman and Lazarus's theory of stress and coping was used to develop a measure assessing the perceived stress within a bicultural context. Middle school students of Mexican descent (N=881) reported their perceived stress from intergenerational acculturation gaps, within-group discrimination, out-group discrimination, and monolingual stress.…

  16. Simulation Results for Airborne Precision Spacing along Continuous Descent Arrivals

    NASA Technical Reports Server (NTRS)

    Barmore, Bryan E.; Abbott, Terence S.; Capron, William R.; Baxley, Brian T.

    2008-01-01

    This paper describes the results of a fast-time simulation experiment and a high-fidelity simulator validation with merging streams of aircraft flying Continuous Descent Arrivals through generic airspace to a runway at Dallas-Ft Worth. Aircraft made small speed adjustments based on an airborne-based spacing algorithm, so as to arrive at the threshold exactly at the assigned time interval behind their Traffic-To-Follow. The 40 aircraft were initialized at different altitudes and speeds on one of four different routes, and then merged at different points and altitudes while flying Continuous Descent Arrivals. This merging and spacing using flight deck equipment and procedures to augment or implement Air Traffic Management directives is called Flight Deck-based Merging and Spacing, an important subset of a larger Airborne Precision Spacing functionality. This research indicates that Flight Deck-based Merging and Spacing initiated while at cruise altitude and well prior to the Terminal Radar Approach Control entry can significantly contribute to the delivery of aircraft at a specified interval to the runway threshold with a high degree of accuracy and at a reduced pilot workload. Furthermore, previously documented work has shown that using a Continuous Descent Arrival instead of a traditional step-down descent can save fuel, reduce noise, and reduce emissions. Research into Flight Deck-based Merging and Spacing is a cooperative effort between government and industry partners.

  17. The Challenge of Mars EDL (Entry, Descent, and Landing)

    NASA Technical Reports Server (NTRS)

    Sostaric, Ronald

    2010-01-01

    This slide presentation reviews the some of the challenges of Martian atmospheric entry, descent and landing (EDL) on the surface of Mars. It reviews some of the technological difficulties, and some solutions that are being developed for future unmanned missions with larger payloads than previous landers, and ultimately human spacecraft landing.

  18. 14 CFR 23.69 - Enroute climb/descent.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Enroute climb/descent. 23.69 Section 23.69 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Flight Performance § 23.69...

  19. Women of African Descent: Persistence in Completing Doctorates

    ERIC Educational Resources Information Center

    Iddrisu, Vannetta Bailey

    2010-01-01

    This study examines the educational persistence of women of African descent (WOAD) in pursuit of a doctorate degree at universities in the southeastern United States. WOAD are women of African ancestry born outside the African continent. These women are heirs to an inner dogged determination and spirit to survive despite all odds (Pulliam, 2003,…

  20. A healthy bladder: a consensus statement

    PubMed Central

    Lukacz, E S; Sampselle, C; Gray, M; MacDiarmid, S; Rosenberg, M; Ellsworth, P; Palmer, M H

    2011-01-01

    A panel of experts in urology, urogynecology, nursing, and behavioral therapy convened in 2010 to discuss the importance of a healthy bladder on overall health. They determined that a consensus statement was necessary to raise awareness among the general public, healthcare providers, payors, and policymakers, with the goals of minimizing the impact of poor bladder health and stimulating primary prevention of bladder conditions. In this statement, ‘healthy’ bladder function is described, as well as internal and external factors that influence bladder health. It is suggested that primary prevention strategies should be aimed at providing education regarding normal lower urinary tract structures and functioning to the public, including patients and healthcare providers. This education may promote the achievement of optimal bladder health by increasing healthy bladder habits and behaviors, awareness of risk factors, healthcare seeking, and clinician engagement and reducing stigma and other barriers to treatment. Promoting optimal bladder health may reduce the personal, societal and economic impact of bladder conditions, including anxiety and depression and costs associated with conditions or diseases and their treatment. While adopting healthy bladder habits and behaviors and behaviors may improve or maintain bladder health, it is important to recognize that certain symptoms may indicate the presence of conditions that require medical attention; many bladder conditions are treatable with a range of options for most bladder conditions. Lastly, the authors propose clinical directives based on persuasive and convergent research to improve and maintain bladder health. The authors hope that this statement will lead to promotion and achievement of optimal bladder health, which may improve overall health and help minimize the effects of bladder conditions on the public, healthcare professionals, educators, employers, and payors. The advisors are in consensus regarding the

  1. The Huygens Descent Trajectory Working Group and the Reconstruction of the Huygens Probe Entry and Descent Trajectory at Titan

    NASA Astrophysics Data System (ADS)

    Atkinson, David H.; Kazeminejad, Bobby; Lebreton*, Jean-Pierre

    2015-04-01

    Cassini/Huygens, a flagship mission to explore the rings, atmosphere, magnetic field, and moons that make up the Saturn system, is a joint endeavor of NASA, the European Space Agency, and Agenzia Spaziale Italiana. Comprising two spacecraft - a Saturn orbiter built by NASA and a Titan entry/descent probe built by the European Space Agency - Cassini/Huygens was launched in October 1997 and arrived at Saturn in 2004. The Huygens probe parachuted to the surface of Titan in January 2005. During the descent, six science instruments provided measurements of Titan's atmosphere, clouds, and winds, and photographed Titan's surface. It was recognized early in the Huygens program that to correctly interpret and correlate results from the probe science experiments and to provide a reference set of data for ground truth calibration of the Cassini orbiter remote sensing observations, an accurate reconstruction of the probe entry and descent trajectory and surface landing location would be necessary. The Huygens Descent Trajectory Working Group (DTWG) was chartered in 1996 as a subgroup of the Huygens Science Working Team. With membership comprising representatives from all the probe engineering and instrument teams as well as representatives of industry and the Cassini and Huygens Project Scientists, the DTWG presented an organizational framework within which instrument data was shared, the entry and descent trajectory reconstruction implemented, and the trajectory reconstruction efficiently disseminated. The primary goal of the Descent Trajectory Working Group was to develop retrieval methodologies for the probe descent trajectory reconstruction from the entry interface altitude of 1270 km to the surface using navigation data, and engineering and science data acquired by the instruments on the Huygens Probe, and to provide a reconstruction of the Huygens probe trajectory from entry to the surface of Titan that is maximally consistent with all available engineering and science

  2. Measurement of CPAS Main Parachute Rate of Descent

    NASA Technical Reports Server (NTRS)

    Ray, Eric S.

    2011-01-01

    The Crew Exploration Vehicle Parachute Assembly System (CPAS) is being designed to land the Orion Crew Module (CM) at a safe rate of descent at splashdown. Flight test performance must be measured to a high degree of accuracy to ensure this requirement is met with the most efficient design possible. Although the design includes three CPAS Main parachutes, the requirement is that the system must not exceed 33 ft/s under two Main parachutes, should one of the Main parachutes fail. Therefore, several tests were conducted with clusters of two Mains. All of the steady-state rate of descent data are normalized to standard sea level conditions and checked against the limit. As the Orion design gains weight, the system is approaching this limit to within measurement precision. Parachute "breathing," cluster interactions, and atmospheric anomalies can cause the rate of descent to vary widely and lead to challenges in characterizing parachute terminal performance. An early test had contradictory rate of descent results from optical trajectory and Differential Global Positioning Systems (DGPS). A thorough analysis of the data sources and error propagation was conducted to determine the uncertainty in the trajectory. It was discovered that the Time Space Position Information (TSPI) from the optical tracking provided accurate position data. However, the velocity from TPSI must be computed via numerical differentiation, which is prone to large error. DGPS obtains position through pseudo-range calculations from multiple satellites and velocity through Doppler shift of the carrier frequency. Because the velocity from DGPS is a direct measurement, it is more accurate than TSPI velocity. To remedy the situation, a commercial off-the-shelf product that combines GPS and an Inertial Measurement Unit (IMU) was purchased to significantly improve rate of descent measurements. This had the added benefit of solving GPS dropouts during aircraft extraction. Statistical probability

  3. RITD - Adapting Mars Entry, Descent and Landing System for Earth

    NASA Astrophysics Data System (ADS)

    Heilimo, Jyri; Harri, Ari-Matti; Aleksashkin, Sergei; Koryanov, Valeri; Arruego, Ignacio; Schmidt, Walter; Haukka, Harri; Finchenko, Valeri; Martynov, Maxim; Ponomarenko, Andrey; Kazakovtsev, Victor; Martin, Susana

    2015-04-01

    We have developed an atmospheric re-entry and descent system concept based on inflatable hypersonic decelerator techniques that were originally developed for Mars. The ultimate goal of this EU-funded RITD-project (Re-entry: Inflatable Technology Development) was to assess the benefits of this technology when deploying small payloads from low Earth orbits to the surface of the Earth with modest costs. The principal goal was to assess and develop a preliminary EDLS design for the entire relevant range of aerodynamic regimes expected to be encountered in Earth's atmosphere during entry, descent and landing. Low Earth Orbit (LEO) and even Lunar applications envisaged include the use of the EDLS approach in returning payloads of 4-8 kg down to the surface. Our development and assessments show clearly that this kind of inflatable technology originally developed for the Martian atmosphere, is feasible for use by Earth entry and descent applications. The preliminary results are highly promising indicating that the current Mars probe design could be used as it is for the Earth. According tp our analyses, the higher atmospheric pressure at an altitude of 12 km and less requires an additional pressurizing device for the in atable system increasing the entry mass by approximately 2 kg. These analyses involved the calculation of 120 different atmospheric entry and descent trajectories. The analysis of the existing technologies and current trends have indicated that the kind of inflatable technology pursued by RITD has high potential to enhance the European space technology expertise. This kind of technology is clearly feasible for utilization by Earth entry and descent applications.

  4. Caudal clonidine-bupivicaine block with bladder hydrodistension: a novel combined treatment for the painful bladder.

    PubMed

    Tempest, Heidi; Stoneham, Mark; Frampton, Claire; Noble, Jeremy

    2011-01-01

    The authors describe a new combination procedure consisting of bladder hydrodistension with clonidine-bupivicaine caudal block for the symptomatic relief of bladder pain. They report this new technique whereby patients who had tried multiple forms of therapy with little response, including bladder hydrodistension under general anaesthesia for their chronic pelvic bladder pain, responded to this novel combination therapy. PMID:22696635

  5. Extraperitoneally Ruptured, Everted, and Prolapsed Bladder: A Very Rare Complication of Pelvic Injury

    PubMed Central

    Ojewola, Rufus Wale; Tijani, Kehinde Habeeb; Badmus, Olakunle Olaleke; Oliyide, Abisola Ekundayo; Osegbe, Chukwudi Emmanuel

    2015-01-01

    Traumatic rupture of the bladder with eversion and protrusion via the perineum is a rare complication of pelvic injury. We present a 36-year-old lady who sustained severe pelvic injury with a bleeding right-sided deep perineal laceration. She had closed reduction of pelvic fracture with pelvic banding and primary closure of perineal laceration at a private hospital. She subsequently had dehiscence of repaired perineal laceration with protrusion of fleshy mass from vulva and leakage of urine per perineum five weeks later. Examination revealed a fleshy mucosa-like mass protruding anteriorly with a bridge of tissue between it and right anterolateral vaginal wall. Upward pressure on this mass revealed the bladder neck and ureteric orifices. She had perineal and pelvic exploration with findings of prolapsed, completely everted bladder wall through a transverse anterior bladder wall rent via the perineum, and an unstable B1 pelvic disruption. She had repair of the ruptured, everted, and prolapsed bladder, double-plate and screw fixation of disrupted pelvis and repair of the pelvic/perineal defect. She commenced physiotherapy and ambulation a week after surgery. Patient now walks normally and is continent of urine. We conclude that the intrinsic urethral continent mechanism plays a significant role in maintaining continence in females. PMID:26417472

  6. Extraperitoneally Ruptured, Everted, and Prolapsed Bladder: A Very Rare Complication of Pelvic Injury.

    PubMed

    Ojewola, Rufus Wale; Tijani, Kehinde Habeeb; Badmus, Olakunle Olaleke; Oliyide, Abisola Ekundayo; Osegbe, Chukwudi Emmanuel

    2015-01-01

    Traumatic rupture of the bladder with eversion and protrusion via the perineum is a rare complication of pelvic injury. We present a 36-year-old lady who sustained severe pelvic injury with a bleeding right-sided deep perineal laceration. She had closed reduction of pelvic fracture with pelvic banding and primary closure of perineal laceration at a private hospital. She subsequently had dehiscence of repaired perineal laceration with protrusion of fleshy mass from vulva and leakage of urine per perineum five weeks later. Examination revealed a fleshy mucosa-like mass protruding anteriorly with a bridge of tissue between it and right anterolateral vaginal wall. Upward pressure on this mass revealed the bladder neck and ureteric orifices. She had perineal and pelvic exploration with findings of prolapsed, completely everted bladder wall through a transverse anterior bladder wall rent via the perineum, and an unstable B1 pelvic disruption. She had repair of the ruptured, everted, and prolapsed bladder, double-plate and screw fixation of disrupted pelvis and repair of the pelvic/perineal defect. She commenced physiotherapy and ambulation a week after surgery. Patient now walks normally and is continent of urine. We conclude that the intrinsic urethral continent mechanism plays a significant role in maintaining continence in females. PMID:26417472

  7. Bladder cancer immunotherapy.

    PubMed

    Lamm, D L; Thor, D E; Stogdill, V D; Radwin, H M

    1982-11-01

    A randomized controlled prospective evaluation of intravesical and percutaneous bacillus Calmette-Guerin immunotherapy was done in 57 patients with transitional cell carcinoma of the bladder. In addition, 9 patients at high risk for tumor recurrence were treated with bacillus Calmette-Guerin produced a self-limited cystitis and 1 complication (hydronephrosis) of immunotherapy was observed. Of the 57 randomized patients 54 were followed for 3 to 30 months. Tumor recurrence was documented in 13 of 26 controls (50 per cent) and only 6 of 28 patients (21 per cent) treated with bacillus Calmette-Guerin (p equals 0.027, chi-square). The interval free of disease was prolonged significantly with bacillus Calmette-Guerin treatment (p equals 0.014, generalized Wilcoxon test). Importantly, a simple purified protein derivative skin test distinguished those patients who responded to bacillus Calmette-Guerin immunotherapy from those who did not. Only 1 of 17 treated patients (6 per cent) whose purified protein derivative test converted from negative to positive had tumor recurrence compared to 5 recurrences (38 per cent) among the 13 patients whose test remained negative or had been positive before treatment (p equals 0.022, chi-square). Bacillus Calmette-Guerin was given to 10 patients with stage B transitional cell carcinoma who were not candidates for cystectomy and 7 are free of disease. Of 5 patients with carcinoma in situ 3 remain free of tumor after bacillus Calmette-Guerin treatment and 5 of 6 who had multiple recurrences after intravesical chemotherapy responded favorably to bacillus Calmette-Guerin immunotherapy. PMID:6757467

  8. Implantable Bladder Sensors: A Methodological Review

    PubMed Central

    Dakurah, Mathias Naangmenkpeong; Koo, Chiwan; Choi, Wonseok; Joung, Yeun-Ho

    2015-01-01

    The loss of urinary bladder control/sensation, also known as urinary incontinence (UI), is a common clinical problem in autistic children, diabetics, and the elderly. UI not only causes discomfort for patients but may also lead to kidney failure, infections, and even death. The increase of bladder urine volume/pressure above normal ranges without sensation of UI patients necessitates the need for bladder sensors. Currently, a catheter-based sensor is introduced directly through the urethra into the bladder to measure pressure variations. Unfortunately, this method is inaccurate because measurement is affected by disturbances in catheter lines as well as delays in response time owing to the inertia of urine inside the bladder. Moreover, this technique can cause infection during prolonged use; hence, it is only suitable for short-term measurement. Development of discrete wireless implantable sensors to measure bladder volume/pressure would allow for long-term monitoring within the bladder, while maintaining the patient’s quality of life. With the recent advances in microfabrication, the size of implantable bladder sensors has been significantly reduced. However, microfabricated sensors face hostility from the bladder environment and require surgical intervention for implantation inside the bladder. Here, we explore the various types of implantable bladder sensors and current efforts to solve issues like hermeticity, biocompatibility, drift, telemetry, power, and compatibility issues with popular imaging tools such as computed tomography and magnetic resonance imaging. We also discuss some possible improvements/emerging trends in the design of an implantable bladder sensor. PMID:26620894

  9. Implantable Bladder Sensors: A Methodological Review.

    PubMed

    Dakurah, Mathias Naangmenkpeong; Koo, Chiwan; Choi, Wonseok; Joung, Yeun-Ho

    2015-09-01

    The loss of urinary bladder control/sensation, also known as urinary incontinence (UI), is a common clinical problem in autistic children, diabetics, and the elderly. UI not only causes discomfort for patients but may also lead to kidney failure, infections, and even death. The increase of bladder urine volume/pressure above normal ranges without sensation of UI patients necessitates the need for bladder sensors. Currently, a catheter-based sensor is introduced directly through the urethra into the bladder to measure pressure variations. Unfortunately, this method is inaccurate because measurement is affected by disturbances in catheter lines as well as delays in response time owing to the inertia of urine inside the bladder. Moreover, this technique can cause infection during prolonged use; hence, it is only suitable for short-term measurement. Development of discrete wireless implantable sensors to measure bladder volume/pressure would allow for long-term monitoring within the bladder, while maintaining the patient's quality of life. With the recent advances in microfabrication, the size of implantable bladder sensors has been significantly reduced. However, microfabricated sensors face hostility from the bladder environment and require surgical intervention for implantation inside the bladder. Here, we explore the various types of implantable bladder sensors and current efforts to solve issues like hermeticity, biocompatibility, drift, telemetry, power, and compatibility issues with popular imaging tools such as computed tomography and magnetic resonance imaging. We also discuss some possible improvements/emerging trends in the design of an implantable bladder sensor. PMID:26620894

  10. Transurethral Electrovaporization of Bladder Diverticulum: An Alternative to Open or Laparoscopic Bladder Diverticulectomy

    PubMed Central

    Chandhoke, Ryan A.

    2015-01-01

    Abstract We used transurethral electrovaporization of the diverticular mucosa as the primary treatment for an acquired bladder diverticulum in a female patient. The bladder diverticulum was secondary to bladder outlet obstruction from a previous pubovaginal sling. In comparison to either open or laparoscopic bladder diverticulectomy, transurethral electrovaporization of the bladder diverticulum was effective in significantly reducing the diverticular size while being less invasive, requiring a short operative time, and a quick patient recovery.

  11. Analysis of various descent trajectories for a hypersonic-cruise, cold-wall research airplane

    NASA Technical Reports Server (NTRS)

    Lawing, P. L.

    1975-01-01

    The probable descent operating conditions for a hypersonic air-breathing research airplane were examined. Descents selected were cruise angle of attack, high dynamic pressure, high lift coefficient, turns, and descents with drag brakes. The descents were parametrically exercised and compared from the standpoint of cold-wall (367 K) aircraft heat load. The descent parameters compared were total heat load, peak heating rate, time to landing, time to end of heat pulse, and range. Trends in total heat load as a function of cruise Mach number, cruise dynamic pressure, angle-of-attack limitation, pull-up g-load, heading angle, and drag-brake size are presented.

  12. Helicopter optimal descent and landing after power loss

    NASA Technical Reports Server (NTRS)

    Johnson, W.

    1977-01-01

    An optimal control solution is obtained for the descent and landing of a helicopter after the loss of power in level flight. The model considers the helicopter vertical velocity, horizontal velocity, and rotor speed; and it includes representations of ground effect, rotor inflow time lag, pilot reaction time, rotor stall, and the induced velocity curve in the vortex ring state. The control (rotor thrust magnitude and direction) required to minimize the vertical and horizontal velocity at contact with the ground is obtained using nonlinear optimal control theory. It is found that the optimal descent after power loss in hover is a purely vertical flight path. Good correlation, even quantitatively, is found between the calculations and (non-optimal) flight test results.

  13. Efficient Sensor Placement Optimization Using Gradient Descent and Probabilistic Coverage

    PubMed Central

    Akbarzadeh, Vahab; Lévesque, Julien-Charles; Gagné, Christian; Parizeau, Marc

    2014-01-01

    We are proposing an adaptation of the gradient descent method to optimize the position and orientation of sensors for the sensor placement problem. The novelty of the proposed method lies in the combination of gradient descent optimization with a realistic model, which considers both the topography of the environment and a set of sensors with directional probabilistic sensing. The performance of this approach is compared with two other black box optimization methods over area coverage and processing time. Results show that our proposed method produces competitive results on smaller maps and superior results on larger maps, while requiring much less computation than the other optimization methods to which it has been compared. PMID:25196164

  14. Apollo LM guidance computer software for the final lunar descent.

    NASA Technical Reports Server (NTRS)

    Eyles, D.

    1973-01-01

    In all manned lunar landings to date, the lunar module Commander has taken partial manual control of the spacecraft during the final stage of the descent, below roughly 500 ft altitude. This report describes programs developed at the Charles Stark Draper Laboratory, MIT, for use in the LM's guidance computer during the final descent. At this time computational demands on the on-board computer are at a maximum, and particularly close interaction with the crew is necessary. The emphasis is on the design of the computer software rather than on justification of the particular guidance algorithms employed. After the computer and the mission have been introduced, the current configuration of the final landing programs and an advanced version developed experimentally by the author are described.

  15. A Symmetric Time-Varying Cluster Rate of Descent Model

    NASA Technical Reports Server (NTRS)

    Ray, Eric S.

    2015-01-01

    A model of the time-varying rate of descent of the Orion vehicle was developed based on the observed correlation between canopy projected area and drag coefficient. This initial version of the model assumes cluster symmetry and only varies the vertical component of velocity. The cluster fly-out angle is modeled as a series of sine waves based on flight test data. The projected area of each canopy is synchronized with the primary fly-out angle mode. The sudden loss of projected area during canopy collisions is modeled at minimum fly-out angles, leading to brief increases in rate of descent. The cluster geometry is converted to drag coefficient using empirically derived constants. A more complete model is under development, which computes the aerodynamic response of each canopy to its local incidence angle.

  16. Optimum climb and descent trajectories for airline missions

    NASA Technical Reports Server (NTRS)

    Erzberger, H.

    1981-01-01

    The characteristics of optimum fixed-range trajectories whose structure is constrained to climb, steady cruise, and descent segments are derived by application of optimal control theory. The performance function consists of the sum of fuel and time costs, referred to as direct operating cost (DOC). The state variable is range to go and the independent variable is energy. In this formulation a cruise segment always occurs at the optimum cruise energy for sufficiently large range. At short ranges (400 n. mi. and less), a cruise segment may also occur below the optimum cruise energy. The existence of such a cruise segment depends primarily on the fuel flow vs thrust characteristics and on thrust constraints. If thrust is a free control variable along with airspeed, it is shown that such cruise segments will not generally occur. If thrust is constrained to some maximum value in climb and to some minimum in descent, such cruise segments generally will occur.

  17. RITD - Adapting Mars Entry, Descent and Landing System for Earth

    NASA Astrophysics Data System (ADS)

    Haukka, H.; Heilimo, J.; Harri, A.-M.; Aleksashkin, S.; Koryanov, V.; Arruego, I.; Schmidt, W.; Finchenko, V.; Martynov, M.; Ponomarenko, A.; Kazakovtsev, V.; Martin, S.

    2015-10-01

    We have developed an atmospheric re-entry and descent system concept based on inflatable hypersonic decelerator techniques that were originally developed for Mars. The ultimate goal of this EU-funded RITD-project (Re-entry: Inflatable Technology Development) was to assess the benefits of this technology when deploying small payloads from low Earth orbits to the surface of the Earth with modest costs. The principal goal was to assess and develop a preliminary EDLS design for the entire relevant range of aerodynamic regimes expected to be encountered in Earth's atmosphere during entry, descent and landing. Low Earth Orbit (LEO) and even Lunar applications envisaged include the use of the EDLS approach in returning payloads of 4-8 kg down to the surface.

  18. Flight Management System Execution of Idle-Thrust Descents in Operations

    NASA Technical Reports Server (NTRS)

    Stell, Laurel L.

    2011-01-01

    To enable arriving aircraft to fly optimized descents computed by the flight management system (FMS) in congested airspace, ground automation must accurately predict descent trajectories. To support development of the trajectory predictor and its error models, commercial flights executed idle-thrust descents, and the recorded data includes the target speed profile and FMS intent trajectories. The FMS computes the intended descent path assuming idle thrust after top of descent (TOD), and any intervention by the controllers that alters the FMS execution of the descent is recorded so that such flights are discarded from the analysis. The horizontal flight path, cruise and meter fix altitudes, and actual TOD location are extracted from the radar data. Using more than 60 descents in Boeing 777 aircraft, the actual speeds are compared to the intended descent speed profile. In addition, three aspects of the accuracy of the FMS intent trajectory are analyzed: the meter fix crossing time, the TOD location, and the altitude at the meter fix. The actual TOD location is within 5 nmi of the intent location for over 95% of the descents. Roughly 90% of the time, the airspeed is within 0.01 of the target Mach number and within 10 KCAS of the target descent CAS, but the meter fix crossing time is only within 50 sec of the time computed by the FMS. Overall, the aircraft seem to be executing the descents as intended by the designers of the onboard automation.

  19. A new steepest descent method with global convergence properties

    NASA Astrophysics Data System (ADS)

    Abidin, Zubai'ah Zainal; Mamat, Mustafa; Rivaie, Mohd.

    2016-06-01

    One of the earliest and the best method to minimize a function is the classical steepest descent (SD) method. In this paper, a new modification of SD method is suggested using a new search direction, d k. The numerical results are presented based on number of iterations and CPU time. It shows that the new d k are efficient when compared to the classical SD.

  20. Overactive bladder - 18 years - Part II.

    PubMed

    Truzzi, Jose Carlos; Gomes, Cristiano Mendes; Bezerra, Carlos A; Plata, Ivan Mauricio; Campos, Jose; Garrido, Gustavo Luis; Almeida, Fernando G; Averbeck, Marcio Augusto; Fornari, Alexandre; Salazar, Anibal; Dell'Oro, Arturo; Cintra, Caio; Sacomani, Carlos Alberto Ricetto; Tapia, Juan Pablo; Brambila, Eduardo; Longo, Emilio Miguel; Rocha, Flavio Trigo; Coutinho, Francisco; Favre, Gabriel; Garcia, Jose Antonio; Castano, Juan; Reyes, Miguel; Leyton, Rodrigo Eugenio; Ferreira, Ruiter Silva; Duran, Sergio; Lopez, Vanda; Reges, Ricardo

    2016-01-01

    Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics - pillars of the overactive bladder pharmacotherapy - started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning - as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder - 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder. PMID:27176185

  1. Bladder health across the life course.

    PubMed

    Ellsworth, P; Marschall-Kehrel, D; King, S; Lukacz, E

    2013-05-01

    Influences on bladder health begin during infancy and continue throughout the lifespan. Bladder anatomy and physiology change as individuals age, and the risk and propensity for bladder conditions, including lower urinary tract symptoms, throughout life are related to factors specific to age, sex, and life events. Bladder habits and dysfunctions at one stage of life may affect bladder health in subsequent stages. However, bladder problems are neither a normal part of aging nor inevitable at any stage of life. Many of the factors that negatively impact bladder health at all ages may be modifiable, and healthy bladder habits may prevent or reverse bladder dysfunctions that can occur naturally or in response to life events. There are opportunities to further define and promote healthy bladder habits through focused research and heightened public awareness of the importance of bladder health, which may lead to improvements in overall health and quality of life. It is our hope that this paper will inform and encourage public health initiatives and research programs aimed at this goal. PMID:23574100

  2. Immunotherapeutic strategies for bladder cancer

    PubMed Central

    Chevalier, Mathieu F; Nardelli-Haefliger, Denise; Domingos-Pereira, Sonia; Jichlinski, Patrice; Derré, Laurent

    2014-01-01

    Bladder cancer is a common urologic malignancy with rising incidence in the elderly population. In most cases, bladder cancer is non-muscle-invasive at diagnosis and shows dramatically high recurrence rates, although current treatments often reduce the risk of disease progression. Immunotherapy using intravesical instillation of Bacillus Calmette-Guérin (BCG) remains the most effective therapy for patients with high risk tumors. However, BCG-therapy has important limitations including substantial adverse events and frequent treatment failure. Thus, it appears crucial to either improve or replace current therapy using new immunotherapeutic strategies. Here, we discuss the clinical trials that assessed therapeutic vaccination of bladder cancer patients using tumor associated antigens and we also argue for novel approaches arising from murine models. Vaccination routes to induce appropriate T-cell homing in the tumor site as well as the use of local immunostimulation to enhance recruitment of vaccine-induced T cells are discussed to highlight what we believe is a promising therapeutic vaccination strategy for patients with non-muscle-invasive bladder cancer. PMID:24384699

  3. Cancer of the Urinary Bladder

    MedlinePlus

    ... at a Glance Show More At a Glance Estimated New Cases in 2016 76,960 % of All New Cancer Cases 4.6% Estimated Deaths in 2016 16,390 % of All Cancer ... of This Cancer : In 2013, there were an estimated 587,426 people living with bladder cancer in ...

  4. [Specific types of bladder cancer].

    PubMed

    Bertz, S; Hartmann, A; Knüchel-Clarke, R; Gaisa, N T

    2016-02-01

    Bladder cancer shows rare variants and special subtypes with diverse prognostic importance and therefore may necessitate different therapeutic approaches. For pathologists it is important to histologically diagnose and specify such variants. Nested variants of urothelial carcinoma with inconspicuous, well-formed tumor cell nests present with an aggressive course. The plasmacytoid variant, which morphologically resembles plasma cells is associated with a shorter survival time and a high frequency of peritoneal metastasis. Micropapillary urothelial carcinoma with small papillary tumor cell islands within artificial tissue retraction spaces and frequent lymphovascular invasion also has a poor prognosis. Other important rare differential variants listed in the World Health Organization (WHO) classification are microcystic, lymphoepithelioma-like, sarcomatoid, giant cell and undifferentiated urothelial carcinomas. Additionally, there are three special types of bladder cancer: squamous cell carcinoma, adenocarcinoma and small cell neuroendocrine carcinoma of the bladder. These tumors are characterized by pure squamous cell or glandular differentiation and are sometimes less responsive to adjuvant (chemo)therapy. Small cell carcinoma of the bladder mimics the neuroendocrine features of its pulmonary counterpart, shows an aggressive course but is sensitive to (neo-)adjuvant chemotherapy. The morphology and histology of the most important variants and special types are discussed in this review. PMID:26782034

  5. Nephrogenic adenoma of the bladder.

    PubMed

    Vorreuther, R; Nayal, W; Hake, R; Engelmann, U

    1994-01-01

    A nephrogenic adenoma of the bladder in a 4-year-old girl with a past history of urologic surgery for vesicorenal reflux is described. The multifocal tumor was treated by transurethral resection. Relapse occurred 15 months later and was again treated by transurethral resection. Pathological aspects, clinical features and therapeutic considerations of this proliferative lesion are reviewed and discussed. PMID:7855943

  6. Immunotherapeutic strategies for bladder cancer.

    PubMed

    Chevalier, Mathieu F; Nardelli-Haefliger, Denise; Domingos-Pereira, Sonia; Jichlinski, Patrice; Derré, Laurent

    2014-01-01

    Bladder cancer is a common urologic malignancy with rising incidence in the elderly population. In most cases, bladder cancer is non-muscle-invasive at diagnosis and shows dramatically high recurrence rates, although current treatments often reduce the risk of disease progression. Immunotherapy using intravesical instillation of Bacillus Calmette-Guérin (BCG) remains the most effective therapy for patients with high risk tumors. However, BCG-therapy has important limitations including substantial adverse events and frequent treatment failure. Thus, it appears crucial to either improve or replace current therapy using new immunotherapeutic strategies. Here, we discuss the clinical trials that assessed therapeutic vaccination of bladder cancer patients using tumor associated antigens and we also argue for novel approaches arising from murine models. Vaccination routes to induce appropriate T-cell homing in the tumor site as well as the use of local immunostimulation to enhance recruitment of vaccine-induced T cells are discussed to highlight what we believe is a promising therapeutic vaccination strategy for patients with non-muscle-invasive bladder cancer. PMID:24384699

  7. Bladder Cancer Risk Prediction Models

    Cancer.gov

    Developing statistical models that estimate the probability of developing bladder cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  8. Pathobiology and Chemoprevention of Bladder Cancer

    PubMed Central

    Tanaka, Takuji; Miyazawa, Katsuhito; Tsukamoto, Tetsuya; Kuno, Toshiya; Suzuki, Koji

    2011-01-01

    Our understanding of the pathogenesis of bladder cancer has improved considerably over the past decade. Translating these novel pathobiological discoveries into therapies, prevention, or strategies to manage patients who are suspected to have or who have been diagnosed with bladder cancer is the ultimate goal. In particular, the chemoprevention of bladder cancer development is important, since urothelial cancer frequently recurs, even if the primary cancer is completely removed. The numerous alterations of both oncogenes and tumor suppressor genes that have been implicated in bladder carcinogenesis represent novel targets for therapy and prevention. In addition, knowledge about these genetic alterations will help provide a better understanding of the biological significance of preneoplastic lesions of bladder cancer. Animal models for investigating bladder cancer development and prevention can also be developed based on these alterations. This paper summarizes the results of recent preclinical and clinical chemoprevention studies and discusses screening for bladder cancer. PMID:21941546

  9. Inflammatory bowel disease in children of middle eastern descent.

    PubMed

    Naidoo, Christina Mai Ying; Leach, Steven T; Day, Andrew S; Lemberg, Daniel A

    2014-01-01

    Increasing rates of inflammatory bowel disease (IBD) are now seen in populations where it was once uncommon. The pattern of IBD in children of Middle Eastern descent in Australia has never been reported. This study aimed to investigate the burden of IBD in children of Middle Eastern descent at the Sydney Children's Hospital, Randwick (SCHR). The SCHR IBD database was used to identify patients of self-reported Middle Eastern ethnicity diagnosed between 1987 and 2011. Demographic, diagnosis, and management data was collected for all Middle Eastern children and an age and gender matched non-Middle Eastern IBD control group. Twenty-four patients of Middle Eastern descent were identified. Middle Eastern Crohn's disease patients had higher disease activity at diagnosis, higher use of thiopurines, and less restricted colonic disease than controls. Although there were limitations with this dataset, we estimated a higher prevalence of IBD in Middle Eastern children and they had a different disease phenotype and behavior compared to the control group, with less disease restricted to the colon and likely a more active disease course. PMID:24987422

  10. Random versus Deterministic Descent in RNA Energy Landscape Analysis

    PubMed Central

    Day, Luke; Abdelhadi Ep Souki, Ouala; Albrecht, Andreas A.; Steinhöfel, Kathleen

    2016-01-01

    Identifying sets of metastable conformations is a major research topic in RNA energy landscape analysis, and recently several methods have been proposed for finding local minima in landscapes spawned by RNA secondary structures. An important and time-critical component of such methods is steepest, or gradient, descent in attraction basins of local minima. We analyse the speed-up achievable by randomised descent in attraction basins in the context of large sample sets where the size has an order of magnitude in the region of ~106. While the gain for each individual sample might be marginal, the overall run-time improvement can be significant. Moreover, for the two nongradient methods we analysed for partial energy landscapes induced by ten different RNA sequences, we obtained that the number of observed local minima is on average larger by 7.3% and 3.5%, respectively. The run-time improvement is approximately 16.6% and 6.8% on average over the ten partial energy landscapes. For the large sample size we selected for descent procedures, the coverage of local minima is very high up to energy values of the region where the samples were randomly selected from the partial energy landscapes; that is, the difference to the total set of local minima is mainly due to the upper area of the energy landscapes. PMID:27110241