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Sample records for bladder neck descent

  1. 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

  2. Paediatric Post-Traumatic Bladder Neck Distraction Injury: Case Series

    PubMed Central

    Sawant, Ajit S.; Kumar, Vikash; Pawar, Prakash; Tamhankar, Ashwin S.

    2017-01-01

    The bladder neck distraction is a rare posterior urethral injury in paediatric age group. It mostly occurs secondary to road traffic accidents. We report three cases of paediatric bladder neck distraction injury. Three paediatric patients aged between 4 to 7 years (mean 5 year), who presented with post traumatic bladder neck distraction injury but no other major injury, they were treated with early urethro-vesical anastomosis. Postoperatively all patients were continent and with good urine flow rates. In paediatric bladder neck distraction injury, immediate urethro-vesical anastomosis gives good results. PMID:28384935

  3. Primary bladder neck obstruction may be determined by postural imbalances.

    PubMed

    Camerota, Tommaso Ciro; Zago, Matteo; Pisu, Stefano; Ciprandi, Daniela; Sforza, Chiarella

    2016-12-01

    Primary bladder neck obstruction (PBNO) is a frequent under-investigated urological condition in which the bladder neck fails to open adequately during voiding. In the majority of cases no known etiological factor can be found. In this study we propose a new hypothesis to explain the origin of the disease in young male patients with no neurological disorders. We suggest a possible role of an unbalanced biomechanics of the pelvis on urethral sphincters activity and on functional bladder capacity. To support the proposed hypothesis, we present pilot gait analysis data of young male patients with primary bladder neck obstruction.

  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. Incontinence, bladder neck mobility, and sphincter ruptures in primiparous women

    PubMed Central

    2010-01-01

    Objective To compare the function of the pelvic floor in primiparae before and during pregnancy with the status post partum concerning symptoms of incontinence, sphincter ruptures, bladder-neck mobility and the influence of the different modes of deliveries. Methods Questionnaire evaluating symptoms of urinary and anal incontinence in nulliparous women before and after delivery and correlating these symptoms with functional changes of the pelvic floor based on a careful gynaecologic examination as well as perineal and endoanal ultrasound. Results 112 women were included in our study and came for the first visit, 99 women returned for follow-up 6 months after childbirth. Stress and flatus incontinence significantly increased from before pregnancy (3 and 12%) to after childbirth (21 and 28%) in women with spontaneous delivery or vacuum extraction. No new symptoms occurred after c-section. There was no significant difference between the bladder neck position before and after delivery. The mobility of the bladder neck was significantly higher after vaginal delivery using a vacuum extraction compared to spontaneous delivery or c-section. The bladder neck in women with post partum urinary stress incontinence was significantly more mobile than in continent controls. The endoanal ultrasound detected seven occult sphincter defects without any correlation to symptoms of anal incontinence. Conclusion Several statistically significant changes of the pelvic floor after delivery were demonstrated. Spontaneous vaginal delivery or vacuum extraction increases the risk for stress or anal incontinence, delivery with vacuum extraction leads to higher bladder neck mobility and stress incontinent women have more mobile bladder necks than continent women. PMID:20696633

  6. Surgical correction of bladder neck contracture following prostate cancer treatment.

    PubMed

    Bugeja, Simon; Andrich, Daniela E; Mundy, Anthony R

    2014-01-01

    The surgical and non-surgical treatment of localised prostate cancer may be complicated by bladder neck contractures, prostatic urethral stenoses and bulbomembranous urethral strictures. In general, such complications following radical prostatectomy are less extensive, easier to treat and associated with a better outcome and more rapid recovery than the same complications following radiotherapy, high-intensity focussed ultrasound and cryotherapy. Treatment options range from minimally invasive endoscopic procedures to more complex and specialised open surgical reconstruction.In this chapter the surgical management of bladder neck contractures following the treatment of prostate cancer is described together with the management of prostatic urethral stenoses and bulbomembranous urethral strictures, given the difficulty in distinguishing them from one another clinically.

  7. Bladder Neck Urothelial Carcinoma: A Urinary Bladder Subsite Carcinoma With Distinct Clinicopathology.

    PubMed

    Xiao, Guang-Qian; Rashid, Hani

    2015-10-01

    To evaluate the clinicopathology of carcinomas originating in the urinary bladder neck, 316 cystectomies for urinary bladder carcinoma performed between January 1, 2008, and December 31, 2013, were analyzed. Clinicopathological parameters were compared between bladder neck carcinomas (BNCs) and non-BNCs. Among the 316 cystectomies were 19 BNCs and 297 non-BNCs. BNCs accounted for 19/316 (6%) of all the cases, with a male-to-female ratio 18:1. Bladder neck location was significantly associated with advanced tumor stage. Ninety percent and 58% BNCs presented at stage ≥T2 and ≥T3, respectively, versus 62% and 38% non-BNCs at ≥T2 and ≥T3, respectively. Significantly higher percentage of lymphovascular invasion and lymph node metastasis were also seen in BNCs (68% and 47%, respectively) than in non-BNCs (29% and 17%, respectively). In conclusion, BNCs present with a significantly higher frequency of muscle invasion and advanced tumor stage, lymphovascular invasion, as well as local and distant metastasis at diagnosis compared with the non-BNCs group. Recognition of these unique clinicopathologic features with early detection and possibly more aggressive management of BNC can potentially have a significant impact on the patient's outcome.

  8. 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

  9. Necessity of routine histopathological evaluation subsequent to bladder neck contracture resection

    PubMed Central

    Kaynar, Mehmet; Kucur, Mustafa; Çelik, Esin; Bugday, M. Serdar; Goktas, Serdar

    2016-01-01

    Introduction Bladder neck contracture is a well-known complication following some urologic surgical procedures. Regardless of the surgical procedure, any specimen resected should be submitted for histopathological evaluation worldwide. However, the charges of histopathological evaluation may bring a heavy burden to the hospital and health care system. Also, waiting the period of the pathological evaluation process can be an anxious time for patients. Hence, we aimed to investigate the necessity of routine histopathological evaluation of bladder neck contracture bladder neck contraction specimens. Material and methods Patients undergoing bladder neck contraction resection, from 2010 to 2015 were identified. Patient demographics, type of surgery and histopathological diagnosis and cost of histopathological analyses of the specimens were recorded and analyzed. Results Findings of the histopathologic evaluations of 340 bladder neck specimens were reviewed. Out of these, 294 had underwent transurethral resection of the prostate, 38 open prostatectomy, and 8 radical prostatectomy. Evidence of malignant disease involving prostate cancer was present in only 2 specimens. Both of the specimens had a known preexisting history of malignant disease. The remaining 338 specimens showed chronic inflammation (n = 176), chronic active inflammation (n = 64), adenomatous hyperplasia (n = 78) or cystitis (n = 20). Conclusions Our results indicate that routine histopathological examination of bladder neck contraction specimens is clinically unnecessary. We recommend that the surgeon should decide the need for histological examination on individual basis, depending on known preoperative risk factors. PMID:28127450

  10. Role of the pelvic floor in bladder neck opening and closure I: muscle forces.

    PubMed

    Petros, P E; Ulmsten, U

    1997-01-01

    The aim of the study was to identify the striated muscle forces hypothesized to assist bladder neck opening and closure in females. Cadaveric dissection was used to identify the levator plate (LP), the anterior portion of pubococcygeus muscle (PCM), the longitudinal muscle of the anus (LMA), and their relation to the bladder, vagina and rectum. X-ray video recordings were made during coughing, straining, squeezing and micturition in a group of 20 incontinent patients and 4 controls, along with surface EMG, urethral pressure and digital palpation studies. During effort, urethral closure appeared to be activated by a forward muscle force corresponding to PCM, and bladder neck closure by backward muscle forces corresponding to LP and LMA. During micturition the PCM force appeared to relax, allowing LP and LMA to pull open the outflow tract. The data appear to support the hypothesis of specific directional muscle forces stretching the vagina to assist bladder neck opening and closure.

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

    PubMed

    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.

  12. 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

  13. Bladder Neck Rupture Following Perineal Bull Horn Injury: A Surgical Challenge

    PubMed Central

    Padilla-Fernandez, B.; Diaz-Alferez, F.J.; Garcia-Garcia, M.A.; Herrero-Polo, M.; Velasquez-Saldarriaga, J.F.; Lorenzo-Gomez, M.F.

    2012-01-01

    Pelvic-abdominal injuries caused by goring are serious lesions which require rapid diagnosis and urgent treatment in the context of a polytraumatized patient. The simultaneous rupture of both the bladder and the prostatic-membranous urethra occurs in 10%–29% of males with pelvic fractures but bladder neck injuries in adults are rarer. Unstable pelvic fractures, bilateral fractures of the ischiopubic branches (also referred to as fractures from falling astride) and the diastasis of the pubic symphysis are those that have the greatest likelihood of injuring both the posterior urethra and the bladder. We present a case of perineal bull horn injury with muscle laceration, bone fractures, scrotal avulsion and rupture of the bladder neck involving the right ureter which required two operations to be repaired. PMID:23066348

  14. 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

  15. 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

  16. Feasibility of electronic nose technology for discriminating between head and neck, bladder, and colon carcinomas.

    PubMed

    van de Goor, R M G E; Leunis, N; van Hooren, M R A; Francisca, E; Masclee, A; Kremer, B; Kross, K W

    2017-02-01

    Electronic nose (e-nose) technology has the potential to detect cancer at an early stage and can differentiate between cancer origins. Our objective was to compare patients who had head and neck squamous cell carcinoma (HNSCC) with patients who had colon or bladder cancer to determine the distinctive diagnostic characteristics of the e-nose. Feasibility study An e-nose device was used to collect samples of exhaled breath from patients who had HNSCC and those who had bladder or colon cancer, after which the samples were analyzed and compared. One hundred patients with HNSCC, 40 patients with bladder cancer, and 28 patients with colon cancer exhaled through an e-nose for 5 min. An artificial neural network was used for the analysis, and double cross-validation to validate the model. In differentiating HNSCC from colon cancer, a diagnostic accuracy of 81 % was found. When comparing HNSCC with bladder cancer, the diagnostic accuracy was 84 %. A diagnostic accuracy of 84 % was found between bladder cancer and colon cancer. The e-nose technique using double cross-validation is able to discriminate between HNSCC and colon cancer and between HNSCC and bladder cancer. Furthermore, the e-nose technique can distinguish colon cancer from bladder cancer.

  17. Using transurethral Ho:YAG-laser resection to treat urethral stricture and bladder neck contracture

    NASA Astrophysics Data System (ADS)

    Bo, Juanjie; Dai, Shengguo; Huang, Xuyuan; Zhu, Jing; Zhang, Huiguo; Shi, Hongmin

    2005-07-01

    Objective: Ho:YAG laser had been used to treat the common diseases of urinary system such as bladder cancer and benign prostatic hyperplasia in our hospital. This study is to assess the efficacy and safety of transurethral Ho:YAG-laser resection to treat the urethral stricture and bladder neck contracture. Methods: From May 1997 to August 2004, 26 cases of urethral stricture and 33 cases of bladder neck contracture were treated by transurethral Ho:YAG-laser resection. These patients were followed up at regular intervals after operation. The uroflow rate of these patients was detected before and one-month after operation. The blood loss and the energy consumption of holmium-laser during the operation as well as the complications and curative effect after operation were observed. Results: The therapeutic effects were considered successful, with less bleeding and no severe complications. The Qmax of one month postoperation increased obviously than that of preoperation. Of the 59 cases, restenosis appeared in 11 cases (19%) with the symptoms of dysuria and weak urinary stream in 3-24 months respectively. Conclusions: The Ho:YAG-laser demonstrated good effect to treat the obstructive diseases of lower urinary tract such as urethral stricture and bladder neck contracture. It was safe, minimal invasive and easy to operate.

  18. [Injury of the urethra, sphincter and bladder neck by a piercing].

    PubMed

    Nissl, A; Straub, M

    2014-08-01

    A 27-year-old woman presented to our clinic with total incontinence. The reason of the incontinence was an injury of the urethra, caused by a genital piercing of the sexual partner. Reconstruction of the urethra and the bladder neck was performed 10 weeks after injury. Upon removal of the catheter 6 weeks after surgery, the patient was fully continent.

  19. [Female urethral obstruction and bladder neck stenosis - fact or myth - how to proceed].

    PubMed

    Gunnemann, A; Liedl, B; Palma, P C R; Yoshimura, Y; Muctar, S

    2015-09-01

    The female urethra is probably the most neglected organ in women. Female urethral stricture and primary bladder neck obstruction are rare clinical entities. Traditional and new surgical techniques have been described for the treatment of female urethral stricture. However, they are based on limited data. There is no consensus on best management. The techniques of urethroplasty all have a higher mean success rate (80-94%) than urethral dilatation (< 50%), albeit with shorter mean follow-up. Urethroplasty performed by experienced surgeons appears to be a feasible option in women who have failed urethral dilatation, although there is a lack of high-level evidence to recommend one technique over another.Primary bladder neck obstruction (PBNO) is a condition in which the bladder neck fails to open adequately during voiding. This leads to increased striated sphincter activity or obstruction of urinary flow without another anatomic cause being present, for example an obstruction caused by genitourinary prolapse in women. Watchful waiting, pharmacotherapy and surgical intervention are possible treatments.

  20. 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

  1. Standardized 4-step technique of bladder neck dissection during robot-assisted radical prostatectomy

    PubMed Central

    Zanaty, Marc; Rajih, Emad; El-Hakim, Assaad; Zorn, Kevin C.

    2016-01-01

    Bladder neck (BN) dissection is considered one of the most challenging steps during robot-assisted radical prostatectomy. Better understanding of the BN anatomy, coupled with a standardized approach may facilitate dissection while minimizing complications. We describe in this article the 4 anatomic spaces during standardized BN dissection, as well other technical maneuvers of managing difficult scenarios including treatment of a large median lobe or patients with previous transurethral resection of the prostate. The first step involves the proper identification of the BN followed by slow horizontal dissection of the first layer (the dorsal venous complex and perivesicle fat). The second step proceeds with reconfirming the location of the BN followed by midline dissection of the second anatomical layer (the anterior bladder muscle and mucosa) using the tip of the monopolar scissor until the catheter is identified. The deflated catheter is then grasped by the assistant to apply upward traction on the prostate from 2 directions along with downward traction on the posterior bladder wall by the tip of the suction instrument. This triangulation allows easier, and safer visual, layer by layer, dissection of the third BN layer (the posterior bladder mucosa and muscle wall). The forth step is next performed by blunt puncture of the fourth layer (the retrotrigonal fascia) aiming to enter into the previously dissected seminal vesical space. Finally, both vas deferens and seminal vesicles are pulled through the open BN and handed to the assistant for upper traction to initiate Denovillier's dissection and prostate pedicle/neurovascular bundle control. PMID:27995220

  2. 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

  3. Bladder neck preservation improves time to continence after radical prostatectomy: a systematic review and meta-analysis

    PubMed Central

    Yang, Chunguang; Wu, Guanqing; Xu, Nan; Wang, Meng; Zeng, Xing; Hu, Zhiquan; Song, Ranran; Yuh, Bertram; Wang, Zhihua; Ye, Zhangqun

    2016-01-01

    Bladder neck preservation (BNP) during radical prostatectomy (RP) may improve postoperative urinary continence, although its overall effectiveness remains controversial. We systematically searched PubMed, Ovid Medline, Embase, CBM and the Cochrane Library to identify studies published before February 2016 that assessed associations between BNP and post-RP urinary continence. Thirteen trials (1130 cases and 1154 controls) assessing BNP versus noBNP (or with bladder neck reconstruction, BNR) were considered suitable for meta-analysis, including two randomized controlled trials (RCT), six prospective and five retrospective studies. Meta-analysis demonstrated that BNP improved early urinary continence rates (6 mo, OR = 1.66; 95% CI, 1.21–2.27; P = 0.001) and long-term urinary continence outcomes (>12 mo, OR = 3.99; 95% CI, 1.94–8.21; P = 0.0002). Patients with BNP also had lower bladder neck stricture frequencies (OR = 0.49; 95% CI, 0.29–0.81; P = 0.006). Anastomotic leak rates, positive surgical margins and biochemical failure rates were comparable between the two groups (P>0.05). There were no differences in baseline characteristics except for a smaller average prostate volume (WMD = −2.24 ml; 95% CI, -4.27 to -0.22; P = 0.03) in BNP patients. Our analyses indicated that BNP during RP improved early recovery and overall long-term (1 year) urinary continence and decreased bladder neck stricture rates without compromising oncologic control. PMID:27634899

  4. Bipolar plasma vaporization in secondary bladder neck sclerosis – initial experience with a new technique

    PubMed Central

    Geavlete, B; Stănescu, F; Niţă, Gh; Jecu, M; Moldoveanu, C; Geavlete, P

    2012-01-01

    Introduction: Secondary bladder neck sclerosis (BNS) represents one of the most common long-term complications after prostate surgical treatment. In this retrospective study, we aimed to evaluate our initial experience concerning the bipolar plasma vaporization (BPV) performed in patients with secondary BNS and to assess the efficiency, safety and short-term postoperative results of this approach. Materials & Methods: Between May 2009 and May 2010, a total of 30 male patients with BNS underwent BPV and were followed for a period of 6 months. BNS was secondary to monopolar transurethral resection of prostate (TURP) in 19 cases, to open surgery for BPH (open prostatectomy) in 8 cases and to radical prostatectomy for prostate cancer in 3 cases. The follow-up protocol included the International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum flow rate (Qmax) and post-voiding residual urinary volume (RV) evaluated at 1, 3 and 6 months after surgery. Results: BPV was successfully performed in all cases. All patients were able to void spontaneously and were continent after catheter removal. The mean operating time was 9 minutes, the mean catheterization period was 18 hours and the mean hospital stay was 24 hours. Preoperatively and at 1, 3 and 6 months after surgery, the mean values for Qmax and RV were 7.2 ml/s and 110 ml, 23.9 ml/s and 20 ml, 23.8 ml/s and 28 ml, and 23.4 ml/s and 26 ml, respectively. Before surgery and at 1, 3 and 6 months, the IPSS and QoL scores were 22.6 and 4.1, 3.4 and 1.2, 3.6 and 1.4, and 3.7 and 1.4, respectively. Conclusions: BPV represents a valuable endoscopic treatment alternative for secondary BNS with good efficacy, reduced morbidity, fast postoperative recovery and satisfactory follow-up parameters. Abbreviations BNS – bladder neck sclerosis, BPV – bipolar plasma vaporization, TURP – transurethral resection of the prostate, IPSS – International Prostate Symptom Score, QoL – quality of life score, Qmax

  5. 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

  6. Management of the devastated posterior urethra and bladder neck: refractory incontinence and stenosis.

    PubMed

    Anderson, Kirk M; Higuchi, Ty T; Flynn, Brian J

    2015-02-01

    Stricture of the proximal urethra following treatment for prostate cancer occurs in an estimated 1-8% of patients. Following prostatectomy, urethral reconstruction is feasible in many patients. However, in those patients with prior radiation therapy (RT), failed reconstruction, refractory incontinence or multiple comorbidities, reconstruction may not be feasible. The purpose of this article is to review the evaluation and management options for patients who are not candidates for reconstruction of the posterior urethra and require urinary diversion. Patient evaluation should result in the decision whether reconstruction is feasible. In our experience, risk factors for failed reconstruction include prior radiation and multiple failed endoscopic treatments. Pre-operative cystoscopy is an essential part of the evaluations to identify tissue necrosis, dystrophic calcification, or tumor in the urethra, prostate and/or bladder. If urethral reconstruction is not feasible it is imperative to discuss options for urine diversion with the patient. Treatment options include simple catheter diversion, urethral ligation, and both bladder preserving and non-preserving diversion. Surgical management should address both the bladder and the bladder outlet. This can be accomplished from a perineal, abdominal or abdomino-perineal approach. The devastated bladder outlet is a challenging problem to treat. Typically, patients undergo multiple procedures in an attempt to restore urethral continuity and continence. For the small subset who fails reconstruction, urinary diversion provides a definitive, "end-stage" treatment resulting in improved quality of life.

  7. Role of neuronal voltage-gated K+ channels in the modulation of the nitrergic neurotransmission of the pig urinary bladder neck

    PubMed Central

    Hernández, M; Barahona, M V; Recio, P; Navarro-Dorado, J; Bustamante, S; Benedito, S; García-Sacristán, A; Prieto, D; Orensanz, L M

    2008-01-01

    Background and purpose: As nitric oxide (NO) plays an essential role in the inhibitory neurotransmission of the bladder neck of several species, the current study investigates the mechanisms underlying the NO-induced relaxations in the pig urinary bladder neck. Experimental approach: Urothelium-denuded bladder neck strips were dissected and mounted in isolated organ baths containing a physiological saline solution at 37 °C and continuously gassed with 5% CO2 and 95% O2, for isometric force recording. The relaxations to transmural nerve stimulation (EFS), or to exogenously applied acidified NaNO2 solution were carried out on strips pre-contracted with phenylephrine, and treated with guanethidine and atropine, to block noradrenergic neurotransmission and muscarinic receptors, respectively. Key results: EFS (0.2–1 Hz) and addition of acidified NaNO2 solution (1 μM–1 mM) evoked frequency- and concentration-dependent relaxations, respectively. These responses were potently reduced by the blockade of guanylate cyclase and were not modified by the K+ channel blockers iberiotoxin, charybdotoxin, apamin or glibenclamide. The voltage-gated K+ (Kv) channels inhibitor 4-aminopyridine, greatly enhanced the nitrergic relaxations evoked by EFS, but did not affect the NaNO2 solution-induced relaxations. Conclusions and implications: NO, whose release is modulated by pre-junctional Kv channels, relaxes the pig urinary bladder neck through a mechanism dependent on the activation of guanylate cyclase, in which post-junctional K+ channels do not seem to be involved. Modulation of Kv channels could be useful in the therapy of the urinary incontinence produced by intrinsic sphincteric deficiency. PMID:18223671

  8. Descent of mesonephric duct to the final position of the vas deferens in human embryo and fetus

    PubMed Central

    Abe, Hiroshi; Hinata, Nobuyuki; Li, Xiang Wu; Murakami, Gen; Rodríguez-Vázquez, José Francisco

    2016-01-01

    Because the ureter arises from the mesonephric or Wolffian duct (WD), the WD opening should migrate inferiorly along the urogenital sinus or future urethra. However, this process of descent has not been evaluated morphometrically in previous studies and we know little about intermediate morphologies for the descent. In the present work, serial sagittal sections of 15 specimens at gestational age 6–12 weeks and serial horizontal sections of 20 specimens at 6–10 weeks were analyzed. Monitoring of horizontal sections showed that, until 9 weeks, a heart-, lozenge- or oval-shape of the initial urogenital sinus remained in the bladder and urethra. Thus, the future bladder and urethra could not be distinguished by the transverse section or plane. The maximum width of the urogenital sinus or bladder at 6–10 weeks was 0.8 mm, although its supero-inferior length reached 5 mm at 10 weeks. During earlier stages, however, the medial shift of the WD was rather evident. Depending on the extent of upward growth of the bladder smooth muscle, the descent of the vas deferens became evident at 10–12 weeks. Development of the urethral rhabdosphincter likely resulted in the differentiation of urogenital sinus into the urethra and bladder before formation of the bladder neck with 3-layered smooth muscles. Development of the prostate followed these morphological changes, later accelerating the further descent of the WD opening. Because of their close topographical relationships, slight anomalies or accidents of the umbilical cord at 10–12 weeks may have a significant effect on normal anatomy. PMID:28127497

  9. Steepest Descent

    SciTech Connect

    Meza, Juan C.

    2010-02-12

    The steepest descent method has a rich history and is one of the simplest and best known methods for minimizing a function. While the method is not commonly used in practice due to its slow convergence rate, understanding the convergence properties of this method can lead to a better understanding of many of the more sophisticated optimization methods. Here, we give a short introduction and discuss some of the advantages and disadvantages of this method. Some recent results on modified versions of the steepest descent method are also discussed.

  10. Bipolar plasma vaporization versus standard transurethral resection in secondary bladder neck sclerosis: a prospective, medium-term, randomized comparison

    PubMed Central

    Geavlete, Bogdan; Moldoveanu, Cristian; Iacoboaie, Catalin

    2013-01-01

    Objectives: This prospective, randomized, medium-term trial aimed to assess the efficiency, safety and postoperative results of bipolar plasma vaporization (BPV) in comparison with monopolar transurethral resection (TUR) in cases of secondary bladder neck sclerosis (BNS). Methods: A total of 70 patients with BNS secondary to transurethral resection of the prostate (TURP; 46 cases), open prostatectomy for benign prostatic hypertrophy (BPH; 18 cases) and radical prostatectomy for prostate cancer (6 cases) were enrolled in the trial. The inclusion criteria consisted of maximum flow rate (Q max) <10 ml/s and International Prostate Symptom Score (IPSS) >19. All patients were evaluated preoperatively and at 1, 3, 6, 12 and 18 months after surgery by IPSS, quality of life score (QoL), Q max and postvoiding residual urinary volume (PVR). Results: The mean operation time (10.3 versus 14.9 minutes), catheterization period (0.75 versus 2.1 days) and hospital stay (1.1 versus 3.2 days) were significantly reduced in the BPV series. During the immediate postoperative follow up, recatheterization for acute urinary retention only occurred in the TUR series (5.7%). The medium-term retreatment requirements due to BNS recurrence were lower in the BPV study arm (2.8% versus 8.5%). At the 1, 3, 6, 12 and 18 months assessments, statistically similar parameters were found concerning the IPSS and QoL symptom scores, Q max and PVR values specific for the two therapeutic alternatives. Conclusions: BPV constitutes a valuable endoscopic treatment approach for secondary BNS. The method emphasized superior efficacy, a satisfactory safety profile and similar medium-term follow-up features when compared with standard TUR. PMID:23554842

  11. Randomized controlled trial comparing the effects of Nd:YAG prostate ablation with or without KTP laser bladder neck incision

    NASA Astrophysics Data System (ADS)

    Langley, Stephen; Gallegos, Christopher; Moisey, Clifford

    1997-05-01

    A randomized, double blind, power determined, prospective study compared patients with benign prostatic hyperplasia undergoing endoscopic laser ablation of prostate, ELAP, -- Group 1 -- to those with KTP bladder neck incision and ELAP -- Group 2. A dual wavelength Laserscope KPT/532TM laser was used with add/stat side-firing fibers. Post-operatively a urethral catheter was inserted, which was removed at 18 hours. Patients unable to void at this stage where then re-catheterized, discharged and readmitted two weeks later for catheter removal. Patients were followed up at three month intervals. Eighty eight patients were studied, pre-operatively there was no statistical difference between Group 1 and Group 2 in mean age, 68.0, 68.4 yrs; prostate size 28, 29 g; post void residual, PVR, 141, 126 ml; max flow rate, Qmax, 9.8, 9.4 ml/s; or AUA score 18.0, 20.4; respectively. Post-operatively 57% of Group 1 patients were able to void on catheter removal at 18 hours compared to 80% from Group 2; p less than 0.05, (chi) 2. After one month, two patients from Group 2 and one from Group 1 failed to void and required further surgery. At six months, data for Group 1 and 2 respectively: PVR equals 78.7, 61.4 ml, Qmax equals 16.2, 18.1 ml/s, AUA score equals 9.6, 6.38, p less than 0.005 for each. Group 2 had a significantly greater improvement in AUA7 score than Group 1.

  12. Effect of Bladder Neck Preservation and Posterior Urethral Reconstruction during Robot-Assisted Laparoscopic Radical Prostatectomy for Urinary Continence

    PubMed Central

    You, Youn Chul; Kim, Tae Hyo

    2012-01-01

    Purpose To report our results on urinary continence after bladder neck preservation (BNP) and posterior urethral reconstruction (PUR) during robot-assisted laparoscopic radical prostatectomy (RALP). Materials and Methods Data from 107 patients who underwent RALP were compared on the basis of whether the patients underwent BNP and PUR, BNP only, or the standard technique (ST). In group A (n=31 patients), ST was performed by using Ven velthoven continuous suturing for urethrovesical anastomosis. In group B (n=28 patients), ST with only PUR was performed. In group C (n=48 patients), both the BNP and PUR techniques were used. "Recovery of continence" was defined as the use of 1 pad (50 ml) or less within 24 hours. Results The three groups were comparable in terms of patient demographics. The mean operative time and the mean blood loss decreased significantly from group A to group C (p=0.021 for mean operative time and p=0.004 for the mean blood loss). Mean catheterization time was 8.9, 7.8, and 7.1 days in each group (p=0.047). Early return of urinary continence at 3 months was observed in group B (89.2%) and group C (90.6%) compared with group A (71%). However, continence at 6 months was comparable in the 3 groups (87.5% in group A, 92.8% in group B, and 92.3% in group C). Rates of positive surgical margins decreased from 30.2% in group A to 20% in group B and 12% in group C. Conclusions BNP and PUR during RALP showed a favorable impact on the early postoperative recovery of continence while not affecting positive surgical margins. PMID:22323971

  13. 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.

  14. A comparison of incidences of bladder neck contracture of 80- versus 180-W GreenLight laser photoselective vaporization of benign prostatic hyperplasia.

    PubMed

    Hu, Bo; Song, Zhenyu; Liu, Hui; Qiao, Liang; Zhao, Yong; Wang, Muwen; Song, Wei; Zhang, Dong; Jin, Xunbo; Zhang, Haiyang

    2016-11-01

    Bladder neck contracture (BNC) after GreenLight laser photoselective vaporization (PVP) of benign prostatic hyperplasia is a common complication. In the present study, data of patients received 80 or 180 W PVP were collected. Perioperative parameters, including applied energy, irradiation time, catheter removal time, and hospital stay, were recorded. Postoperative parameters, including maximum urinary flow rate, International Prostate Symptom Score, post-void residual volume, and incidences of BNC, were recorded at 3 and 12 months after operations. Bladder neck tissues were taken at 3 months after operations for immunohistochemical staining and western blot analysis to examine the expressions of collagen I, matrix metalloproteinase-3 (MMP-3), and transforming growth factor-β (TGF-β). Sample size of patients was calculated with a power of 80 %. Chi-square test and one-way analysis of variance were performed as statistical methods. Three hundred twenty-six patients who received potassium titanyl phosphate (KTP) laser and 256 who received X-ray photoelectron spectroscopy (XPS) laser entered into the study. Perioperative parameters were comparable, except for shorter irradiation time in 180 W group (P = 0.032). Postoperative parameters were also similar, except for higher incidence of BNC in 80 W group at 3 months after operations (P = 0.022). Immunohistochemical staining and western blot analysis showed higher expressions of collagen I, MMP-3, and TGF-β in 80 W group than in 180 W group. In conclusion, 80 W GreenLight laser showed a comparable efficacy with 180-W laser in PVP but showed a higher incidence of BNC in short term, which might be the result of up-regulated fibrotic factors in bladder neck triggered by lasers.

  15. 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

  16. Surgical management of stress urinary incontinence: Burch colposuspension, modified Pereyra and Stamey bladder neck suspension, and collagen injection--Toa Payoh Hospital experience.

    PubMed

    Tay, K P; Lim, P H; Chng, H C

    1995-12-01

    A retrospective analysis was performed on 34 female patients who underwent corrective surgery for stress urinary incontinence over a 4-year period at the Toa Payoh Hospital. These patients were offered surgery only after an adequate trial of medical therapy, pelvic floor exercises and weight reduction. Bladder neck suspension operations were performed via the Burch, Stamey and modified Pereyra techniques. Towards the later part of this study, endoscopic injection of Collagen was performed as a salvage procedure in 2 patients. The Burch colposuspension gave uniformly good results, with all patients being completely dry. Seventy percent and sixty percent complete continence were achieved via the modified Pereyra and Stamey techniques respectively. Three patients required additional surgical procedures. Using these techniques, the overall results showed that 27 patients (79.4%) had complete urinary continence following surgery, while the remaining 7 patients (20.6%) experienced significant improvement of symptoms.

  17. 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.

  18. Alpha1L-adrenoceptor mediation of smooth muscle contraction in rabbit bladder neck: a model for lower urinary tract tissues of man.

    PubMed

    Kava, M S; Blue, D R; Vimont, R L; Clarke, D E; Ford, A P

    1998-04-01

    1. The alpha1-adrenoceptor population mediating contractile responses to noradrenaline (NA) in smooth muscles of the bladder neck from rabbit (RBN) has been characterized by use of quantitative receptor pharmacology. 2. Experiments with several 'key' alpha1-adrenoceptor antagonists of varying subtype selectivities (RS-17053, BMY 7378, indoramin, 5-methylurapidil, prazosin, REC 15/2739, SNAP 5089, terazosin, WB 4101, tamsulosin, (+)-cyclazosin and RS-100329) were conducted. Schild regression analyses yielded affinity (mean pKb) estimates of 7.1, 6.2, 8.6, 8.6, 8.4, 9.3, 7.0, 7.4, 8.9, 10.0, 7.1 and 9.3, respectively, although deviations from unit Schild regression slope question the robustness of data for RS-17053 and SNAP 5089. 3. The nature of antagonism by these agents and the profile of affinity determinations generated together suggest that a single alpha1-adrenoceptor subtype mediates contractile responses of RBN to NA. Additional studies with phenylephrine indicated also an agonist-independence of this profile. Pharmacologically, this profile was reminiscent of that described as 'alpha1L'-adrenoceptor, which has been shown to mediate contractions of several tissues including lower urinary tract (LUT) tissues of man. Furthermore, a similarity was noticed between the 'alpha1L'-adrenoceptor described here in RBN and the rabbit and human cloned alpha1a-adrenoceptor (based on data from both whole cell radioligand binding at 37 degrees C and [3H]-inositol phosphates accumulation assays), characterizations of which have been published elsewhere. 4. In conclusion, the RBN appears to provide a predictive pharmacological assay for the study of NA-induced smooth muscle contraction in LUT tissues of man.

  19. Acute Bladder Necrosis after Pelvic Arterial Embolization for Pelvic Trauma: Lessons Learned from Two Cases of Immediate Postembolization Bladder Necrosis

    PubMed Central

    Osterberg, E. Charles; Elliott, Sean P.; Hittelman, Adam B.

    2016-01-01

    We report two cases of acute bladder injury with bladder neck necrosis identified during the initial operative evaluation and within the early postprocedural period in patients with significant pelvic trauma requiring pelvic vascular embolization. To our knowledge, this is the first report of bladder neck necrosis found during the initial intraoperative surgical evaluation or early postoperative setting. PMID:27656309

  20. Bladder Outlet Obstruction: Causes in Men?

    MedlinePlus

    ... is the most common cause of bladder outlet obstruction in men Scarring of the urinary channel (urethra) or bladder neck, as a result of injury or surgery Use of certain medications, including antihistamines, decongestants ... of bladder outlet obstruction is important to prevent serious problems caused by ...

  1. Transformable descent vehicles

    NASA Astrophysics Data System (ADS)

    Pichkhadze, K. M.; Finchenko, V. S.; Aleksashkin, S. N.; Ostreshko, B. A.

    2016-12-01

    This article presents some types of planetary descent vehicles, the shape of which varies in different flight phases. The advantages of such vehicles over those with unchangeable form (from launch to landing) are discussed. It is shown that the use of transformable descent vehicles widens the scope of possible tasks to solve.

  2. 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.

  3. Bladder Health

    MedlinePlus

    ... organ, much like a balloon, that stores urine. Pelvic floor muscles help hold urine in the bladder. The ... the bathroom more often. The bladder wall and pelvic floor muscles may weaken. Weak bladder wall muscles may ...

  4. 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

  5. Emergency descent device

    NASA Technical Reports Server (NTRS)

    Belew, R. R.

    1974-01-01

    Device includes cable wound on reel; special assembly enclosed in fluid medium controls unwinding speed of cable during descent. Device is compact and reliable. It can be rewound quickly because reel disengages from latches when it is turned in opposite direction.

  6. Bladder stones

    MedlinePlus

    Stones - bladder; Urinary tract stones; Bladder calculi ... Benway BM, Bhayani SB. Lower urinary tract calculi. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 55. Sharma R, ...

  7. Bladder cancer

    MedlinePlus

    ... workers, aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest risk. Chemotherapy: The ... Avoid exposure to chemicals linked to bladder cancer. Alternative Names Transitional cell carcinoma of the bladder; Urothelial ...

  8. Bladder cancer.

    PubMed Central

    Leung, H. Y.; Griffiths, T. R.; Neal, D. E.

    1996-01-01

    Bladder cancer is the fourth most common cancer in England and Wales. The most common presenting symptom is macroscopic haematuria. The management options for superficial and invasive bladder cancer depend on the stage at presentation. Most superficial bladder cancers are managed by transurethral resection and cytoscopic follow-up. The prognosis for patients with invasive bladder cancer is less good. The role of chemical, radiotherapeutic and surgical intervention are discussed. PMID:9015464

  9. Complementary Curves of Descent

    DTIC Science & Technology

    2012-11-16

    provision of law , no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid...curves of descent 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT...NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) US Naval Academy,Physics Department,Annapolis,MD,21402-1363 8. PERFORMING ORGANIZATION

  10. 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

  11. 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

  12. Urethral duplication with unusual cause of bladder outlet obstruction.

    PubMed

    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.

  13. 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.

  14. 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.

  15. Bladder hernia.

    PubMed

    Nicola, Massimiliano; De Luca, Francesco

    2006-06-01

    Bladder hernia is a rare condition, but crural herniation of the bladder into the scrotum is very rare. A case of bladder hernia presenting with urological symptoms is described. A 71-year-old man presented to the urological ward complaining for persistent frequency and nocturia associated with loss offorce and decrease of caliber of the urinary stream and the presence of a large mass of the right scrotum. An IVP (intra venous pyelography) showed a large herniation of the bladder through the right inguinal canal into the scrotum. An inguinal incision was made and a crural hernia was identified. The hernia sac, containing bowel and bladder, was dissectedfreefrom the spermatic cord and the testis and the hernia defect was repaired.

  16. Entry, Descent, Landing Animation (Animation)

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Click on the image for Entry, Descent, Landing animation

    This animation illustrates the path the Stardust return capsule will follow once it enters Earth's atmosphere.

  17. Neurogenic bladder

    MedlinePlus

    ... cause skin to break down and lead to pressure sores Kidney damage if the bladder becomes too full, ... More Tumor Patient Instructions Multiple sclerosis - discharge Preventing pressure ulcers Review Date 5/30/2016 Updated by: Amit ...

  18. Neck dissection

    MedlinePlus

    ... There are three main types of neck dissection surgery: Radical neck dissection: All the tissue on the side of ... Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap ...

  19. Mars Science Laboratory's Descent Stage

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This portion of NASA's Mars Science Laboratory, called the descent stage, does its main work during the final few minutes before touchdown on Mars.

    The descent stage will provide rocket-powered deceleration for a phase of the arrival at Mars after the phases using the heat shield and parachute. When it nears the surface, the descent stage will lower the rover on a bridle the rest of the way to the ground.

    The Mars Science Laboratory spacecraft is being assembled and tested for launch in 2011.

    This image was taken at NASA's Jet Propulsion Laboratory, Pasadena, Calif., which manages the Mars Science Laboratory Mission for NASA's Science Mission Directorate, Washington. JPL is a division of the California Institute of Technology.

  20. Reinforcement Learning Through Gradient Descent

    DTIC Science & Technology

    1999-05-14

    Reinforcement learning is often done using parameterized function approximators to store value functions. Algorithms are typically developed for...practice of existing types of algorithms, the gradient descent approach makes it possible to create entirely new classes of reinforcement learning algorithms

  1. 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.

  2. Overactive Bladder.

    PubMed

    White, Nicola; Iglesia, Cheryl B

    2016-03-01

    Overactive bladder (OAB) is a condition affecting millions of individuals in the United States. Anticholinergics are the mainstay of treatment. Bladder botulinum toxin injections have shown an improvement in symptoms of OAB equivalent to anticholinergic therapy. Percutaneous tibial nerve stimulation can decrease symptoms of urinary frequency and urge incontinence. Sacral neuromodulation for refractory patients has been approved by the Food and Drug Administration for treatment of OAB, urge incontinence, and urinary retention. Few randomized, head-to-head comparisons of the different available alternatives exist; however, patients now have increasing options to manage their symptoms and improve their quality of life.

  3. Neck pain

    MedlinePlus

    ... neck. If neck pain involves compression of your nerves, you may feel numbness, tingling, or weakness in your arm or ... When to Contact a Medical Professional ... fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. This may be ...

  4. Traumatic injury of the bladder and urethra

    MedlinePlus

    ... urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption ... bladder wall. Less than 1 in 10 pelvic fractures lead to bladder injury. Other causes of bladder ...

  5. Numerical analysis of the orthogonal descent method

    SciTech Connect

    Shokov, V.A.; Shchepakin, M.B.

    1994-11-01

    The author of the orthogonal descent method has been testing it since 1977. The results of these tests have only strengthened the need for further analysis and development of orthogonal descent algorithms for various classes of convex programming problems. Systematic testing of orthogonal descent algorithms and comparison of test results with other nondifferentiable optimization methods was conducted at TsEMI RAN in 1991-1992 using the results.

  6. [Disorders of bladder compliance and neurogenic bladder].

    PubMed

    Chartier-Kastler, E; Comperat, E; Ruffion, A

    2007-05-01

    Bladder compliance is defined as the relationship between change in bladder volume and change in detrusor pressure (DV/DP). The pathophysiology of neurogenic disorders of bladder compliance is still poorly understood. Experimental reduction of blood flow in the bladder wall, bilateral hypogastric nerve section in rats, the study of spinalized rat bladders, and reduction of oestrogen impregnation show that these conditions induce loss of the viscoelastic properties of the bladder. With the arrival of new treatments active on afferent and/or efferent pathways or on the central nervous system, it is very important to improve our understanding of the pathophysiology of neurogenic disorders of bladder compliance. The reversibility of these disorders constitutes a major therapeutic challenge and their functional consequences constitute a crucial prognostic element of neurogenic bladder. Disorders of bladder compliance can be assessed clinically from two points of view: 1) The natural history of onset of these disorders in neurogenic bladder. Clinical experience demonstrates certain risk factors for the development of these disorders, such as the voiding mode (intermittent self-catheterization or by a carer versus indwelling catheter), the level of the spinal cord lesion (suprasacral versus sacral, incomplete versus complete, and cauda equina lesions), and the presence of myelomeningocele. 2) Data derived from conservative management of these disorders in patients with neurogenic bladder: urethral dilatation, various types of sphincterotomy, vesical denervation, alpha-blockers, sympatholytics, vanilloids (resiniferatoxin and capsaicin), intra-detrusor botulinum toxin and intrathecal baclofen have been shown to improve disorders of compliance of neurogenic bladder.

  7. Stem Cell Therapy in Bladder Dysfunction: Where Are We? And Where Do We Have to Go?

    PubMed Central

    Lee, Sang-Rae; Song, Yun Seob; Lee, Hong Jun

    2013-01-01

    To date, stem cell therapy for the bladder has been conducted mainly on an experimental basis in the areas of bladder dysfunction. The therapeutic efficacy of stem cells was originally thought to be derived from their ability to differentiate into various cell types. Studies about stem cell therapy for bladder dysfunction have been limited to an experimental basis and have been less focused than bladder regeneration. Bladder dysfunction was listed in MESH as “urinary bladder neck obstruction”, “urinary bladder, overactive”, and “urinary bladder, neurogenic”. Using those keywords, several articles were searched and studied. The bladder dysfunction model includes bladder outlet obstruction, cryoinjured, diabetes, ischemia, and spinal cord injury. Adipose derived stem cells (ADSCs), bone marrow stem cells (BMSCs), and skeletal muscle derived stem cells (SkMSCs) are used for transplantation to treat bladder dysfunction. The main mechanisms of stem cells to reconstitute or restore bladder dysfunction are migration, differentiation, and paracrine effects. The aim of this study is to review the stem cell therapy for bladder dysfunction and to provide the status of stem cell therapy for bladder dysfunction. PMID:24151627

  8. 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…

  9. Neck lump

    MedlinePlus

    ... the neck lump treated. When to Contact a Medical Professional Call your health care provider if you have an abnormal neck swelling or ... to Expect at Your Office Visit The health care provider will take your medical history and do a physical exam. You may ...

  10. 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.

  11. An Investigation into the Nature of Non-Voiding Contractions Resulting from Detrusor Hyperreflexia in Neurogenic Bladders Following Spinal Cord Injury

    DTIC Science & Technology

    2013-10-01

    voiding contractions (NVC) during normal bladder filling. These NVC are responsible for incontinence episodes, bladder and bladder neck damage, as...eliminated, however, voiding occurred by a combination of augmented overflow incontinence (NVC-driven and a vesicosomatic reflex of the hindquarters...spinal micturition reflex, but rather an augmented overflow incontinence with a locomotor component (High amplitude pressure swings in bottom trace

  12. Neck Pain

    MedlinePlus

    ... injuries and conditions that cause pain and restrict motion. Neck pain causes include: Muscle strains. Overuse, such ... body then forms bone spurs that affect joint motion and cause pain. Nerve compression. Herniated disks or ...

  13. 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.

  14. Bladder Cancer Advocacy Network

    MedlinePlus

    ... Sexuality Life after Radical Cystectomy Women and Bladder Cancer Immunotherapy To watch the recordings and download the transcripts, click here! Look for more topics coming this spring! Bladder cancer is the fifth most commonly diagnosed cancer in ...

  15. 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 ...

  16. 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.

  17. Human factors by descent energy management

    NASA Technical Reports Server (NTRS)

    Curry, R. E.

    1979-01-01

    This paper describes some of the results of a human factors study of energy management during descent using standard aircraft displays. Discussions with pilots highlighted the practical constraints involved and the techniques (algorithms) used to accomplish the descent. The advantages and disadvantages of these algorithms are examined with respect to workload and their sensitivity to disturbances. Vertical navigation and flight performance computers are discussed in terms of the information needed for effective pilot monitoring and takeover

  18. [One case of complete reduplication of the bladder (author's transl)].

    PubMed

    Seriat-Gautier, B; Alessandrini, P; Aubrespy, P

    1979-01-01

    We report one case of complete reduplication of lower urinary tract associated with bilateral vesico-urethral reflux, hip dislocation, incomplete sacral agenesis and neck malformation. The two bladders are physiologically functional and we only operated the bilateral reflux by Leadbetter-Politano procedure. A review is presented of the twenty-two published cases, with the classification.

  19. 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

  20. 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.

  1. Fiddler's neck.

    PubMed

    Moreno, J C; Gata, I M; García-Bravo, B; Camacho, F M

    1997-03-01

    The dermatologic pathological condition of musicians is a rare medical problem. We would like to draw attention to what is called "Fiddler's neck," a process that is peculiar to violin, viola, or cello players and that may be caused by two different mechanisms: contact allergic reaction or a mechanical action.

  2. 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

  3. Biomatrices for bladder reconstruction.

    PubMed

    Lin, Hsueh-Kung; Madihally, Sundar V; Palmer, Blake; Frimberger, Dominic; Fung, Kar-Ming; Kropp, Bradley P

    2015-03-01

    There is a demand for tissue engineering of the bladder needed by patients who experience a neurogenic bladder or idiopathic detrusor overactivity. To avoid complications from augmentation cystoplasty, the field of tissue engineering seeks optimal scaffolds for bladder reconstruction. Naturally derived biomaterials as well as synthetic and natural polymers have been explored as bladder substitutes. To improve regenerative properties, these biomaterials have been conjugated with functional molecules, combined with nanotechology, or seeded with exogenous cells. Although most studies reported complete and functional bladder regeneration in small-animal models, results from large-animal models and human clinical trials varied. For functional bladder regeneration, procedures for biomaterial fabrication, incorporation of biologically active agents, introduction of nanotechnology, and application of stem-cell technology need to be standardized. Advanced molecular and medical technologies such as next generation sequencing and magnetic resonance imaging can be introduced for mechanistic understanding and non-invasive monitoring of regeneration processes, respectively.

  4. Mouse bladder wall injection.

    PubMed

    Fu, Chi-Ling; Apelo, Charity A; Torres, Baldemar; Thai, Kim H; Hsieh, Michael H

    2011-07-12

    Mouse bladder wall injection is a useful technique to orthotopically study bladder phenomena, including stem cell, smooth muscle, and cancer biology. Before starting injections, the surgical area must be cleaned with soap and water and antiseptic solution. Surgical equipment must be sterilized before use and between each animal. Each mouse is placed under inhaled isoflurane anesthesia (2-5% for induction, 1-3% for maintenance) and its bladder exposed by making a midline abdominal incision with scissors. If the bladder is full, it is partially decompressed by gentle squeezing between two fingers. The cell suspension of interest is intramurally injected into the wall of the bladder dome using a 29 or 30 gauge needle and 1 cc or smaller syringe. The wound is then closed using wound clips and the mouse allowed to recover on a warming pad. Bladder wall injection is a delicate microsurgical technique that can be mastered with practice.

  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. [Radiotherapy of bladder cancer].

    PubMed

    Riou, O; Chauvet, B; Lagrange, J-L; Martin, P; Llacer Moscardo, C; Charissoux, M; Lauche, O; Aillères, N; Fenoglietto, P; Azria, D

    2016-09-01

    Surgery (radical cystectomy) is the standard treatment of muscle-invasive bladder cancer. Radiochemotherapy has risen as an alternative treatment option to surgery as part as organ-sparing combined modality treatment or for patients unfit for surgery. Radiochemotherapy achieves 5-year bladder intact survival of 40 to 65% and 5-year overall survival of 40 to 50% with excellent quality of life. This article introduces the French recommendations for radiotherapy of bladder cancer: indications, exams, technique, dosimetry, delivery and image guidance.

  7. Non-communicating multiseptate gall bladder and choledochal cyst: a case report and review of publications.

    PubMed Central

    Tan, C E; Howard, E R; Driver, M; Murray-Lyon, I M

    1993-01-01

    A 14 year old girl with multiseptate gall bladder and cystic dilatation of the biliary tree is presented. This is the 20th published case report of patients with multiseptate gall bladder and only the second to be associated with a choledochal cyst. The cystic spaces of the gall bladder did not communicate with the neck of the gall bladder or the rest of the biliary tree, and this unusual feature has not been previously described. A multiseptate gall bladder with a normal biliary tree commonly causes symptoms suggestive of cholecystitis, although gall stones are seldom present. Diagnosis is confirmed by an oral cholecystogram or ultrasound scan that may show the fine intraluminal septae, and these features should be looked for in patients with biliary symptoms without biliary calculi. Cholecystectomy is curative for the isolated gall bladder anomaly but hepaticojejunostomy may be necessary for an associated choledochal cyst. Images Figure 1 Figure 2 PMID:8314522

  8. 'Fiddler's neck'.

    PubMed

    Peachey, R D; Matthews, C N

    1978-06-01

    'Fiddler's neck' is a condition affecting violin and viola players. Although well known to musicians it is not well recognized by dermatologists. Clinically the lesions usually consist of a localized area of lichenification of the left side of the neck--just below the angle of the jaw. Pigmentation, erythema and inflammatory papules or pustules are frequently present, while severe inflammatory induration, cyst formation and scarring occur in more severely affected subjects. The aetiology of the skin changes is probably due to a combination of factors; friction giving rise to lichenification, while local pressure, shearing stress and occlusion may play a part in producing the acne-like changes and cyst formation. In addition, poor hygiene may predispose to local sepsis.

  9. 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…

  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. 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.

  12. 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…

  13. 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.

  14. Addressing ketamine bladder syndrome.

    PubMed

    Logan, Karen

    The rise in ketamine misuse means more health professionals will need to diagnose, refer and treat ketamine bladder syndrome. Prevention and raising awareness of the problem among multidisciplinary teams will help limit damage to the bladder as well as making treatment and management more effective.

  15. 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

  16. 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.

  17. Analysis of Online Composite Mirror Descent Algorithm.

    PubMed

    Lei, Yunwen; Zhou, Ding-Xuan

    2017-03-01

    We study the convergence of the online composite mirror descent algorithm, which involves a mirror map to reflect the geometry of the data and a convex objective function consisting of a loss and a regularizer possibly inducing sparsity. Our error analysis provides convergence rates in terms of properties of the strongly convex differentiable mirror map and the objective function. For a class of objective functions with Hölder continuous gradients, the convergence rates of the excess (regularized) risk under polynomially decaying step sizes have the order [Formula: see text] after [Formula: see text] iterates. Our results improve the existing error analysis for the online composite mirror descent algorithm by avoiding averaging and removing boundedness assumptions, and they sharpen the existing convergence rates of the last iterate for online gradient descent without any boundedness assumptions. Our methodology mainly depends on a novel error decomposition in terms of an excess Bregman distance, refined analysis of self-bounding properties of the objective function, and the resulting one-step progress bounds.

  18. Ultrasound: Bladder (For Parents)

    MedlinePlus

    ... Tract Infections and Related Conditions Urinary Tract Infections Bedwetting Kidneys and Urinary Tract Urine Tests X-Ray ... Bladder) Urinary Tract Infections (UTIs) Your Urinary System Bedwetting Urinary Tract Infections Kidneys and Urinary Tract Bedwetting ( ...

  19. What Is Bladder Cancer?

    MedlinePlus

    ... bladder, which is called the urothelium or transitional epithelium . As the cancer grows into or through the ... in the inner layer of cells (the transitional epithelium) but have not grown into the deeper layers. ...

  20. 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 ...

  1. 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

  2. Intravesical therapy for overactive bladder.

    PubMed

    Evans, Robert J

    2005-11-01

    Overactive bladder and urgency incontinence are common conditions generally treated with oral anticholinergic therapy. Despite the development of new antimuscarinic agents, many patients do not tolerate or fail to respond to oral therapy. Intravesical instillation therapy can provide an alternative method of managing bladder overactivity. Intravesical instillation of anticholinergics such as oxybutynin and atropine can achieve cholinergic blockade without producing systemic side effects. Botulinum A toxin injected directly into the detrusor has been shown in preliminary studies to increase bladder capacity and decrease uncontrolled bladder contractility for up to 6 months. Intravesical local anesthetics such as lidocaine and bupivacaine block the conduction of unmyelinated C fibers and when administered into the bladder, lead to an increase in functional bladder capacity. Intravesical capsaicin and resiniferatoxin also affect afferent innervation by blocking C-fiber afferents, leading to decreased bladder contractility and increased bladder capacity. Intravesical instillation therapy can provide an alternative treatment for the management of overactive bladder.

  3. Kinetic analysis of stair descent: Part 1. Forwards step-over-step descent.

    PubMed

    Cluff, Tyler; Robertson, D Gordon E

    2011-03-01

    This study examined lower extremity biomechanics during the initiation of stair descent from an upright, static posture. Seventeen healthy subjects (aged 23±2.4 years) descended a five-step, steel-reinforced, wooden laboratory staircase (34° decline). Ten trials of stair descent were separated into two blocks of five trials. Beginning from an upright posture, subjects descended the staircase at their preferred velocity (0.53±0.082 m/s) and continued the length of the laboratory walkway (∼4 m). Joint mechanics were contrasted between gait cycles. Relative to the initiation cycle at the top of the staircase, the dissipative knee extensor (K3) and hip flexor (H2) moments and powers were independent of progression velocity and approximated steady-state (i.e., constant) values after the first cycle of the trail limb (Step 5 to Step 3). In contrast, a salient relationship was observed between progression velocity and ankle joint mechanics at initial-contact. The plantiflexor moment, power and work at initial-contact (A1) increased with centre of mass velocity. Our results demonstrate that while the knee extensor moment is the primary dissipater of mechanical energy in stair descent, the ankle plantiflexors are the primary dissipaters associated with increased progression velocity. In addition, the results show that steady-state stair descent may not be attained during the first gait cycle of the trail limb. These data shed light on locomotive strategies used in stair descent and can be applied in biomechanical models of human stair gait. Researchers and practitioners should take into consideration the influence of gait cycle and progression velocity when evaluating lower extremity function in stair descent.

  4. Patterns of intraneural ganglion cyst descent.

    PubMed

    Spinner, Robert J; Carmichael, Stephen W; Wang, Huan; Parisi, Thomas J; Skinner, John A; Amrami, Kimberly K

    2008-04-01

    On the basis of the principles of the unifying articular theory, predictable patterns of proximal ascent have been described for fibular (peroneal) and tibial intraneural ganglion cysts in the knee region. The mechanism underlying distal descent into the terminal branches of the fibular and tibial nerves has not been previously elucidated. The purpose of this study was to demonstrate if and when cyst descent distal to the articular branch-joint connection occurs in intraneural ganglion cysts to understand directionality of intraneural cyst propagation. In Part I, the clinical records and MRIs of 20 consecutive patients treated at our institution for intraneural ganglion cysts (18 fibular and two tibial) arising from the superior tibiofibular joint were retrospectively analyzed. These patients underwent cyst decompression and disconnection of the articular branch. Five of these patients developed symptomatic cyst recurrence after cyst decompression without articular branch disconnection which was done elsewhere prior to our intervention. In Part II, five additional patients with intraneural ganglion cysts (three fibular and two tibial) treated at other institutions without disconnection of the articular branch were compared. These patients in Parts I and II demonstrated ascent of intraneural cyst to differing degrees (12 had evidence of sciatic nerve cross-over). In addition, all of these patients demonstrated previously unrecognized MRI evidence of intraneural cyst extending distally below the level of the articular branch to the joint of origin: cyst within the proximal most portions of the deep fibular and superficial fibular branches in fibular intraneural ganglion cysts and descending tibial branches in tibial intraneural ganglion cysts. The patients in Part I had complete resolution of their cysts at follow-up MRI examination 1 year postoperatively. The patients in Part II had intraneural recurrences postoperatively within the articular branch, the parent

  5. Bladder Control and Nerve Disease

    MedlinePlus

    ... the sphincter muscles relax to allow urine to pass through the urethra as the bladder contracts to ... contract at the same time, so urine cannot pass easily. Drug therapy for an uncoordinated bladder and ...

  6. Giant Intradiverticular Bladder Tumor

    PubMed Central

    Noh, Mohamad Syafeeq Faeez Md; Aziz, Ahmad Fuad Abdul; Ghani, Khairul Asri Mohd; Siang, Christopher Lee Kheng; Yunus, Rosna; Yusof, Mubarak Mohd

    2017-01-01

    Patient: Male, 74 Final Diagnosis: Giant intradiverticular bladder tumor with metastasis Symptoms: Hematuria Medication:— Clinical Procedure: — Specialty: Urology Objective: Rare disease Background: Intradiverticular bladder tumors are rare. This renders diagnosis of an intradiverticular bladder tumor difficult. Imaging plays a vital role in achieving the diagnosis, and subsequently staging of the disease. Case Report: A 74-year-old male presented to our center with a few months history of constitutional symptoms. Upon further history, he reported hematuria two months prior to presentation, which stopped temporarily, only to recur a few days prior to coming to the hospital. The patient admitted to having lower urinary tract symptoms. However, there was no dysuria, no sandy urine, and no fever. Palpation of his abdomen revealed a vague mass at the suprapubic region, which was non tender. In view of his history and the clinical examination findings, an ultrasound of the abdomen and computed tomography (CT) was arranged. These investigations revealed a giant tumor that seemed to be arising from a bladder diverticulum, with a mass effect and hydronephrosis. He later underwent operative intervention. Conclusions: Intradiverticular bladder tumors may present a challenge to the treating physician in an atypical presentation; thus requiring a high index of suspicion and knowledge of tumor pathophysiology. As illustrated in our case, CT with its wide availability and multiplanar imaging capabilities offers a useful means for diagnosis, disease staging, operative planning, and follow-up. PMID:28246375

  7. 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.

  8. African Descent and Glaucoma Evaluation Study (ADAGES)

    PubMed Central

    Girkin, Christopher A.; Sample, Pamela A.; Liebmann, Jeffrey M.; Jain, Sonia; Bowd, Christopher; Becerra, Lida M.; Medeiros, Felipe A.; Racette, Lyne; Dirkes, Keri A.; Weinreb, Robert N.; Zangwill, Linda M.

    2010-01-01

    Objective To define differences in optic disc, retinal nerve fiber layer, and macular structure between healthy participants of African (AD) and European descent (ED) using quantitative imaging techniques in the African Descent and Glaucoma Evaluation Study (ADAGES). Methods Reliable images were obtained using stereoscopic photography, confocal scanning laser ophthalmoscopy (Heidelberg retina tomography [HRT]), and optical coherence tomography (OCT) for 648 healthy subjects in ADAGES. Findings were compared and adjusted for age, optic disc area, and reference plane height where appropriate. Results The AD participants had significantly greater optic disc area on HRT (2.06 mm2; P<.001) and OCT (2.47 mm2; P<.001) and a deeper HRT cup depth than the ED group (P<.001). Retinal nerve fiber layer thickness was greater in the AD group except within the temporal region, where it was significantly thinner. Central macular thickness and volume were less in the AD group. Conclusions Most of the variations in optic nerve morphologic characteristics between the AD and ED groups are due to differences in disc area. However, differences remain in HRT cup depth, OCT macular thickness and volume, and OCT retinal nerve fiber layer thickness independent of these variables. These differences should be considered in the determination of disease status. PMID:20457974

  9. Adenocarcinoma of the urinary bladder.

    PubMed

    Dadhania, Vipulkumar; Czerniak, Bogdan; Guo, Charles C

    2015-01-01

    Adenocarcinoma is an uncommon malignancy in the urinary bladder which may arise primarily in the bladder as well as secondarily from a number of other organs. Our aim is to provide updated information on primary and secondary bladder adenocarcinomas, with focus on pathologic features, differential diagnosis, and clinical relevance. Primary bladder adenocarcinoma exhibits several different growth patterns, including enteric, mucinous, signet-ring cell, not otherwise specified, and mixed patterns. Urachal adenocarcinoma demonstrates similar histologic features but it can be distinguished from bladder adenocarcinoma on careful pathologic examination. Secondary bladder adenocarcinomas may arise from the colorectum, prostate, endometrium, cervix and other sites. Immunohistochemical study is valuable in identifying the origin of secondary adenocarcinomas. Noninvasive neoplastic glandular lesions, adenocarcinoma in situ and villous adenoma, are frequently associated with bladder adenocarcinoma. It is also important to differentiate bladder adenocarcinoma from a number of nonneoplastic lesions in the bladder. Primary bladder adenocarcinoma has a poor prognosis largely because it is usually diagnosed at an advanced stage. Urachal adenocarcinoma shares similar histologic features with bladder adenocarcinoma, but it has a more favorable prognosis than bladder adenocarcinoma, partly due to the relative young age of patients with urachal adenocarcinoma.

  10. Adenocarcinoma of the urinary bladder

    PubMed Central

    Dadhania, Vipulkumar; Czerniak, Bogdan; Guo, Charles C

    2015-01-01

    Adenocarcinoma is an uncommon malignancy in the urinary bladder which may arise primarily in the bladder as well as secondarily from a number of other organs. Our aim is to provide updated information on primary and secondary bladder adenocarcinomas, with focus on pathologic features, differential diagnosis, and clinical relevance. Primary bladder adenocarcinoma exhibits several different growth patterns, including enteric, mucinous, signet-ring cell, not otherwise specified, and mixed patterns. Urachal adenocarcinoma demonstrates similar histologic features but it can be distinguished from bladder adenocarcinoma on careful pathologic examination. Secondary bladder adenocarcinomas may arise from the colorectum, prostate, endometrium, cervix and other sites. Immunohistochemical study is valuable in identifying the origin of secondary adenocarcinomas. Noninvasive neoplastic glandular lesions, adenocarcinoma in situ and villous adenoma, are frequently associated with bladder adenocarcinoma. It is also important to differentiate bladder adenocarcinoma from a number of nonneoplastic lesions in the bladder. Primary bladder adenocarcinoma has a poor prognosis largely because it is usually diagnosed at an advanced stage. Urachal adenocarcinoma shares similar histologic features with bladder adenocarcinoma, but it has a more favorable prognosis than bladder adenocarcinoma, partly due to the relative young age of patients with urachal adenocarcinoma. PMID:26309895

  11. 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

  12. Head, Neck, and Oral Cancer

    MedlinePlus

    ... find out more. Head, Neck and Oral Pathology Head, Neck and Oral Pathology Close to 49,750 Americans ... find out more. Head, Neck and Oral Pathology Head, Neck and Oral Pathology Close to 49,750 Americans ...

  13. 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

  14. 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.

  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 ... swallowing A change or hoarseness in the voice Head and neck cancers are twice as common in men. Using ...

  16. 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.

  17. Probability of identity by descent in metapopulations.

    PubMed Central

    Kaj, I; Lascoux, M

    1999-01-01

    Equilibrium probabilities of identity by descent (IBD), for pairs of genes within individuals, for genes between individuals within subpopulations, and for genes between subpopulations are calculated in metapopulation models with fixed or varying colony sizes. A continuous-time analog to the Moran model was used in either case. For fixed-colony size both propagule and migrant pool models were considered. The varying population size model is based on a birth-death-immigration (BDI) process, to which migration between colonies is added. Wright's F statistics are calculated and compared to previous results. Adding between-island migration to the BDI model can have an important effect on the equilibrium probabilities of IBD and on Wright's index. PMID:10388835

  18. 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.

  19. Error Analysis of Stochastic Gradient Descent Ranking.

    PubMed

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

    2012-12-31

    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.

  20. 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.

  1. 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.

  2. Planetary entry, descent, and landing technologies

    NASA Astrophysics Data System (ADS)

    Pichkhadze, K.; Vorontsov, V.; Polyakov, A.; Ivankov, A.; Taalas, P.; Pellinen, R.; Harri, A.-M.; Linkin, V.

    2003-04-01

    Martian meteorological lander (MML) is intended for landing on the Martian surface in order to monitor the atmosphere at landing point for one Martian year. MMLs shall become the basic elements of a global network of meteorological mini-landers, observing the dynamics of changes of the atmospheric parameters on the Red Planet. The MML main scientific tasks are as follows: (1) Study of vertical structure of the Martian atmosphere throughout the MML descent; (2) On-surface meteorological observations for one Martian year. One of the essential factors influencing the lander's design is its entry, descent, and landing (EDL) sequence. During Phase A of the MML development, five different options for the lander's design were carefully analyzed. All of these options ensure the accomplishment of the above-mentioned scientific tasks with high effectiveness. CONCEPT A (conventional approach): Two lander options (with a parachute system + airbag and an inflatable airbrake + airbag) were analyzed. They are similar in terms of fulfilling braking phases and completely analogous in landing by means of airbags. CONCEPT B (innovative approach): Three lander options were analyzed. The distinguishing feature is the presence of inflatable braking units (IBU) in their configurations. SELECTED OPTION (innovative approach): Incorporating a unique design approach and modern technologies, the selected option of the lander represents a combination of the options analyzed in the framework of Concept B study. Currently, the selected lander option undergoes systems testing (Phase D1). Several MMLs can be delivered to Mars in frameworks of various missions as primary or piggybacking payload: (1) USA-led "Mars Scout" (2007); (2) France-led "NetLander" (2007/2009); (3) Russia-led "Mars-Deimos-Phobos sample return" (2007); (4) Independent mission (currently under preliminary study); etc.

  3. Bladder outlet obstruction

    MedlinePlus

    ... narrowing of the urethra Tests to determine how fast urine flows out of the body ( uroflowmetry ) Tests to see how much the urine flow is blocked and how well the bladder contracts (urodynamic testing) Ultrasound to locate the blockage of urine and find ...

  4. Urinary bladder xanthomatous cystitis

    PubMed Central

    Shah, Shrenik J.; Ajitsaria, Vineet; Singh, Vineet

    2017-01-01

    Xanthoma cystitis of urinary bladder is a rare entity and may present as an intravesical mass. A 38-year-old female presented with abdominal pain and imaging was done which was suggestive of a malignant mass with surrounding tissue infiltration. Partial cystectomy was performed, and histological examination of the mass showed xanthomatous cystitis. PMID:28197037

  5. 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

  6. 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.

  7. Murine bladder wall biomechanics following partial bladder obstruction.

    PubMed

    Chen, Joseph; Drzewiecki, Beth A; Merryman, W David; Pope, John C

    2013-10-18

    Evaluation of bladder wall mechanical behavior is important in understanding the functional changes that occur in response to pathologic processes such as partial bladder outlet obstruction (pBOO). In the murine model, the traditional approach of cystometry to describe bladder compliance can prove difficult secondary to small bladder capacity and surgical exposure of the bladder. Here, we explore an alternative technique to characterize murine mechanical properties by applying biaxial mechanical stretch to murine bladders that had undergone pBOO. 5-6 week old female C57/Bl6 mice were ovariectomized and subjected to pBOO via an open surgical urethral ligation and sacrificed after 4 weeks (n=12). Age matched controls (n=6) were also analyzed. Bladders were separated based on phenotype of fibrotic (n=6) or distended (n=6) at the time of harvest. Biaxial testing was performed in modified Kreb's solution at 37°C. Tissue was preconditioned to 10 cycles and mechanical response was evaluated by comparing axial strain at 50kPa. The normal murine bladders exhibited anisotropy and were stiffer in the longitudinal direction. All mice showed a loss of anisotropy after 4 weeks of pBOO. The two phenotypes observed after pBOO, fibrotic and distended, exhibited less and more extensibility, respectively. These proof-of-principle data demonstrate that pBOO creates quantifiable changes in the mechanics of the murine bladder that can be effectively quantified with biaxial testing.

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

    PubMed

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

    2016-09-01

    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.

  9. Metastatic tumors to the urinary bladder: clinicopathologic study of 11 cases.

    PubMed

    Xiao, Guang-Qian; Chow, Jonathan; Unger, Pamela D

    2012-08-01

    Secondary neoplasms of the urinary bladder are uncommon, with metastatic tumors being an even rarer event. The authors studied the clinicopathology of 11 cases of metastatic tumors to bladder, which were collected from their archives between 1995 and 2010. The most common metastases in this series were breast. Some unusual metastases, including several not being previously reported, were also presented, namely, ileal carcinoid tumor, ileal gastrointestinal stromal tumor, ovarian squamous carcinoma, pancreatic gastrinoma, and renal collecting duct carcinoma. Vast majority of these patients (10/11, 91%) were female. Ninety percent of the patients presented with hematuria and/or obstructive urinary symptom as well as bladder lesions in the area of trigone, posterior wall, and/or bladder neck. Seven of the 11 patients had a known history of other metastases besides the bladder. Most of the patients (4/7, 57%) died within 1 year after diagnosis of bladder metastasis. Metastasis must be distinguished from a primary bladder neoplasm. Morphology and clinical correlation supplemented with immunohistochemical study is critical for the correct diagnosis.

  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. Descent guidance and mission planning for space shuttle

    NASA Technical Reports Server (NTRS)

    Joosten, B. K.

    1985-01-01

    The Space Shuttle descent mission planning, mission design, deorbit targeting, and entry guidance have necessarily become interrelated because of the nature of the Orbiter's design and mission requirements. The desired descent trajectory has been formulated in a drag acceleration/relative velocity state space since nearly all of the vehicle's highly constraining flight limitations can be uniquely represented in this plane. Constraints and flight requirements that affect the descent are described. The guidance logic which allows the Orbiter to follow the designed trajectory, the impacts of contingency aborts and flightcrew interaction are discussed. The mission planning and guidance techniques remain essentially unchanged through the Shuttle flight test program and subsequent operational flights.

  12. 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.

  13. 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

  14. Innovation in Bladder Cancer Immunotherapy.

    PubMed

    Grossman, H Barton; Lamm, Donald L; Kamat, Ashish M; Keefe, Stephen; Taylor, John A; Ingersoll, Molly A

    2016-10-01

    Bladder cancer is understudied despite its high prevalence and its remarkable response to immunotherapy. Indeed, funding for studies to explore mechanisms of tumor immunity and novel new therapeutics is disproportionately lower for bladder cancer in comparison with malignancies of the breast, prostate, or lung. However, the recent successes of checkpoint blockade therapy suggest that new therapeutic strategies are on the horizon for bladder cancer. Here, we give a perspective into the evolution of bladder cancer therapy, focusing on strategies to treat high-risk nonmuscle invasive disease, followed by a discussion of recent advances in the treatment of muscle invasive bladder cancer and their potential applicability to lower stage disease. Finally, we explore immunotherapeutic strategies, which have been demonstrated to be successful in the treatment of other malignancies, for their potential to treat and cure patients with nonmuscle and muscle invasive bladder cancer.

  15. 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.

  16. Effects of electroacupuncture combined with bladder training on the bladder function of patients with neurogenic bladder after spinal cord injury

    PubMed Central

    Xia, Li-Ping; Fan, Fan; Tang, Ai-Ling; Ye, Wen-Qin

    2014-01-01

    Neurogenic bladder is a common complication of spinal cord injury and results in urinary bladder dysfunction through lost control of micturition, or urination. Although several treatment options exist, the efficacies of many of these treatments are unknown. In particular, electroacupuncture and bladder training have had some success as individual treatments. The aim of this study was to explore effects of electroacupuncture combined with bladder training on bladder function of patients with neurogenic bladder after spinal cord injury (SCI) above the sacral segment. Forty-two patients with neurogenic bladder after SCI were evenly divided into two groups (n=21) and given only bladder function training (control group) or electroacupuncture combined with bladder function training (treatment group). Urodynamic changes, IPSS score, and therapeutic efficacy were compared between groups pre- and post-treatment. After either treatment, patients had higher bladder volume and bladder compliance, but lower residual urine volume, bladder pressure, rectal pressure, and detrusor pressure, compared to pre-treatment (P<0.05). Compared to controls, treatment group patients had significantly increased bladder volume and bladder compliance, but significantly decreased residual urine volume, bladder pressure, rectal pressure, and detrusor pressure (P<0.05). Treatment group patients had lower IPSS scores post-treatment (P<0.05) and better therapeutic efficacy (P<0.05) than control group patients. Altogether, our results suggest that electroacupuncture combined with bladder function training can clinically improve bladder function of patients with neurogenic bladder after SCI above the sacral segment. PMID:24995093

  17. 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.

  18. [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.

  19. 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.

  20. 25 CFR 11.711 - Descent and distribution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... ORDER CODE Probate Proceedings § 11.711 Descent and distribution. (a) The court shall distribute the estate according to the terms of the will of the decedent which has been admitted to probate. (b) If...

  1. 25 CFR 11.711 - Descent and distribution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... ORDER CODE Probate Proceedings § 11.711 Descent and distribution. (a) The court shall distribute the estate according to the terms of the will of the decedent which has been admitted to probate. (b) If...

  2. 25 CFR 11.711 - Descent and distribution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ORDER CODE Probate Proceedings § 11.711 Descent and distribution. (a) The court shall distribute the estate according to the terms of the will of the decedent which has been admitted to probate. (b) If...

  3. 25 CFR 11.711 - Descent and distribution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... ORDER CODE Probate Proceedings § 11.711 Descent and distribution. (a) The court shall distribute the estate according to the terms of the will of the decedent which has been admitted to probate. (b) If...

  4. 25 CFR 11.711 - Descent and distribution.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... ORDER CODE Probate Proceedings § 11.711 Descent and distribution. (a) The court shall distribute the estate according to the terms of the will of the decedent which has been admitted to probate. (b) If...

  5. 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.

  6. Descent Stage of Mars Science Laboratory During Assembly

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This image from early October 2008 shows personnel working on the descent stage of NASA's Mars Science Laboratory inside the Spacecraft Assembly Facility at NASA's Jet Propulsion Laboratory, Pasadena, Calif.

    The descent stage will provide rocket-powered deceleration for a phase of the arrival at Mars after the phases using the heat shield and parachute. When it nears the surface, the descent stage will lower the rover on a bridle the rest of the way to the ground. The larger three of the orange spheres in the descent stage are fuel tanks. The smaller two are tanks for pressurant gas used for pushing the fuel to the rocket engines.

    JPL, a division of the California Institute of Technology, manages the Mars Science Laboratory Project for the NASA Science Mission Directorate, Washington.

  7. Instantaneous, predictable balloon system descent from high altitude

    NASA Astrophysics Data System (ADS)

    Hazlewood, K.

    The 13 inch diameter helium valve has long been the only method for initiating and controlling balloon system descent. As greater altitudes have become standard, the 13 inch valves have become less and less effective. It takes as long as a half hour or more to effect a noticeable descent, even with two or three valves, at altitudes in excess of 120,000 ft. The project that prompted this study called for a descent rate of >1000 ft/min from 131,000 ft to 60,000 ft. The method by which this was accomplished is presented along with recommendations for future work to provide closer control of rapid descents such as this. The National Center for Atmospheric Research is sponsored by the National Science Foundation. Any opinions, findings, and conclusions or recommendations expressed in this publication are those of the author and do not necessarily reflect the views of the National Science Foundation

  8. Genome-wide association study identifies multiple loci associated with bladder cancer risk

    PubMed Central

    Figueroa, Jonine D.; Ye, Yuanqing; Siddiq, Afshan; Garcia-Closas, Montserrat; Chatterjee, Nilanjan; Prokunina-Olsson, Ludmila; Cortessis, Victoria K.; Kooperberg, Charles; Cussenot, Olivier; Benhamou, Simone; Prescott, Jennifer; Porru, Stefano; Dinney, Colin P.; Malats, Núria; Baris, Dalsu; Purdue, Mark; Jacobs, Eric J.; Albanes, Demetrius; Wang, Zhaoming; Deng, Xiang; Chung, Charles C.; Tang, Wei; Bas Bueno-de-Mesquita, H.; Trichopoulos, Dimitrios; Ljungberg, Börje; Clavel-Chapelon, Françoise; Weiderpass, Elisabete; Krogh, Vittorio; Dorronsoro, Miren; Travis, Ruth; Tjønneland, Anne; Brenan, Paul; Chang-Claude, Jenny; Riboli, Elio; Conti, David; Gago-Dominguez, Manuela; Stern, Mariana C.; Pike, Malcolm C.; Van Den Berg, David; Yuan, Jian-Min; Hohensee, Chancellor; Rodabough, Rebecca; Cancel-Tassin, Geraldine; Roupret, Morgan; Comperat, Eva; Chen, Constance; De Vivo, Immaculata; Giovannucci, Edward; Hunter, David J.; Kraft, Peter; Lindstrom, Sara; Carta, Angela; Pavanello, Sofia; Arici, Cecilia; Mastrangelo, Giuseppe; Kamat, Ashish M.; Lerner, Seth P.; Barton Grossman, H.; Lin, Jie; Gu, Jian; Pu, Xia; Hutchinson, Amy; Burdette, Laurie; Wheeler, William; Kogevinas, Manolis; Tardón, Adonina; Serra, Consol; Carrato, Alfredo; García-Closas, Reina; Lloreta, Josep; Schwenn, Molly; Karagas, Margaret R.; Johnson, Alison; Schned, Alan; Armenti, Karla R.; Hosain, G.M.; Andriole, Gerald; Grubb, Robert; Black, Amanda; Ryan Diver, W.; Gapstur, Susan M.; Weinstein, Stephanie J.; Virtamo, Jarmo; Haiman, Chris A.; Landi, Maria T.; Caporaso, Neil; Fraumeni, Joseph F.; Vineis, Paolo; Wu, Xifeng; Silverman, Debra T.; Chanock, Stephen; Rothman, Nathaniel

    2014-01-01

    Candidate gene and genome-wide association studies (GWAS) have identified 11 independent susceptibility loci associated with bladder cancer risk. To discover additional risk variants, we conducted a new GWAS of 2422 bladder cancer cases and 5751 controls, followed by a meta-analysis with two independently published bladder cancer GWAS, resulting in a combined analysis of 6911 cases and 11 814 controls of European descent. TaqMan genotyping of 13 promising single nucleotide polymorphisms with P < 1 × 10−5 was pursued in a follow-up set of 801 cases and 1307 controls. Two new loci achieved genome-wide statistical significance: rs10936599 on 3q26.2 (P = 4.53 × 10−9) and rs907611 on 11p15.5 (P = 4.11 × 10−8). Two notable loci were also identified that approached genome-wide statistical significance: rs6104690 on 20p12.2 (P = 7.13 × 10−7) and rs4510656 on 6p22.3 (P = 6.98 × 10−7); these require further studies for confirmation. In conclusion, our study has identified new susceptibility alleles for bladder cancer risk that require fine-mapping and laboratory investigation, which could further understanding into the biological underpinnings of bladder carcinogenesis. PMID:24163127

  9. 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.'

  10. Genetics Home Reference: bladder cancer

    MedlinePlus

    ... SA, James ND, Jankowski JA, Wallace DM. Molecular pathways in bladder cancer: part 1. BJU Int. 2005 Mar;95(4): ... SA, James ND, Jankowski JA, Wallace DM. Molecular pathways in bladder cancer: part 2. BJU Int. 2005 Mar;95(4): ...

  11. Head and Neck Cancer Treatment

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What ... there any new developments in treating my disease? Head and neck cancer overview The way a particular head and ...

  12. Head and Neck Cancer

    MedlinePlus

    ... a person’s risk of head and neck cancer. Marijuana use. Research suggests that people who have used marijuana may be at higher risk for head and ... head and neck cancer include: Avoiding alcohol Discussing marijuana as a risk factor with your doctor and ...

  13. Neck x-ray

    MedlinePlus

    ... look at cervical vertebrae. These are the 7 bones of the spine in the neck. ... A neck x-ray can detect: Bone joint that is out of position (dislocation) Breathing in a foreign object Broken bone (fracture) Disk problems (disks ...

  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. 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

  16. Proliposomal Intravesical Paclitaxel for Treatment of Low-Grade, Stage Ta, Non Muscle Invasive Bladder Cancer

    ClinicalTrials.gov

    2017-03-16

    Bladder Cancer Cell Transitional; Non-Muscle Invasive Bladder Cancer; Bladder Cancer; Urinary Bladder; Transitional Cell Carcinoma of the Bladder; Urinary Bladder Neoplasms; Urologic Neoplasms; Urogenital Neoplasms; Urinary Bladder Diseases; Urologic Diseases

  17. 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

  18. AB111. Genetic variations rs11892031 and rs401681 are associated with bladder cancer risk in a Chinese population

    PubMed Central

    Zhang, Yu; Hu, Hailong; Tian, Dawei; Wu, Changli

    2016-01-01

    Objective Genome-wide association studies (GWAS) have identified a number of genetic variants associated with risk of bladder cancer in populations of European descent. Methods we assessed association of two of these variants, rs11892031 (2q37.1 region) and rs401681 (5p15.33 region) in a Chinese case-control study, which included 367 bladder cancer cases and 420 controls. Results We found that the AC genotype of rs11892031 was associated with remarkably decreased risk of bladder cancer [adjusted odds ratio (OR), 0.27; 95% confidence interval (CI), 0.09–0.81; P=0.019), compared with the AA genotype of rs11892031; and that CT/CC genotypes of rs401681 were associated with significantly increased risk of bladder cancer (adjusted OR, 1.79; 95% CI, 1.10–2.91; P=0.02), compared with the TT genotype of rs401681. We further conducted stratification analysis to examine the correlation between single nucleotide polymorphism (SNP) rs11892031/rs401681 and tumor grade/stage. Results showed that heterogeneity in ORs of tumor categories was not significant for either rs11892031 or rs401681 (P>0.05), indicating that the two SNPs seemingly do not associate with tumor grade and stage of bladder cancer in our study population. Conclusions The present study suggests that the SNPs rs11892031 and rs401681 are associated with bladder cancer risk in a Chinese population.

  19. One - staged reconstruction of bladder exstrophy in male patients: long - term follow-up outcomes

    PubMed Central

    Giron, Amilcar Martins; Mello, Marcos Figueiredo; Carvalho, Paulo Afonso; Moscardi, Paulo Renato Marcelo; Lopes, Roberto Iglesias; Srougi, Miguel

    2017-01-01

    ABSTRACT Introduction The surgical correction of bladder exstrophy remains challenging. In our institution, the repair has evolved from a staged repair to one-stage reconstruction. The one-stage reconstruction includes; bladder closure, Cantwell-Ransley neourethroplasty and abdominoplasty using groin flaps, without the need of pelvic ostheotomies. Repair of urinary continence (UC) and vesicoureteral reflux (VUR) is done after development of the infant. Objective To present our experience of our modified one-stage reconstruction of bladder exstrophy in male patients. Materials and Methods Medical records of male patients submitted to one-stage reconstruction of bladder exstrophy were analyzed retrospectively. Fifteen exstrophy bladder patients with mean age 4.2±7 years were treated at our institution between 1999-2013. Results 2 5 Conclusions One-stage reconstruction minimizes the number of surgical procedures required to achieve UC and potentiates bladder-neck function. The advantages of using groin flaps over current techniques for complete repair are the small risk for penile tissue loss and the avoidance of ostheotomies. PMID:28124539

  20. 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

  1. Fiddler's neck: A review.

    PubMed

    Myint, Calvin W; Rutt, Amy L; Sataloff, Robert T

    2017-02-01

    Fiddler's neck is a common dermatologic condition associated with instrument use in violin and viola players. It typically manifests as a submandibular and/or supraclavicular lesion. It is a benign condition, but it may be mistaken for lymphedema or a salivary gland malignancy. Otolaryngologists who treat patients with fiddler's neck should be aware of appropriate management protocols and the need to avoid surgical excision. We obtained informed consent from 3 violinists to present their cases as specific examples of fiddler's neck. In addition, we present a literature review based on our PubMed search for articles about this instrument-induced dermatitis. The literature suggests that submandibular fiddler's neck is caused by mechanical pressure and shear stress on the skin and that it can present as erythema, scarring, edema, and lichenification. Supraclavicular fiddler's neck, on the other hand, is caused by allergic contact dermatitis, and it can present as an eczematous, scaly, and/or vesicular lesion. In most cases, a good history (especially of string instrument use), physical examination, and a patch test are sufficient to diagnose this condition. Management of fiddler's neck includes a topical steroid, proper instrument handling, neck padding, changing the instrument's materials, and/or reducing the amount of playing time. Surgical excision is usually not advisable.

  2. 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.

  3. Bladder diverticulitis: a case report.

    PubMed

    Silberman, Michael; Jeanmonod, Rebecca

    2011-01-01

    Bladder diverticulum, an outpouching of the mucosa through the muscular wall of the bladder, is a multifactorial disease process that can be either acquired or congenital. Although small diverticuli are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation. We describe the case of an elderly gentleman who presented to the emergency department with abdominal pain and was ultimately diagnosed with bladder diverticulitis, a disease not previously described in the literature.

  4. Histology of the kidney and urinary bladder of Siphonops annulatus (Amphibia-Gymnophiona).

    PubMed

    Carvalho, E T; Junqueira, L C

    1999-03-01

    The histology of the kidney and urinary bladder of Siphonops annulatus was studied by light microscopy in semithin sections of tissue embedded in hydrophilic resin. The kidney's nephron comprises the renal corpuscle, neck segment, proximal tubule, intermediate segment, distal tubule and collecting tubule. Nephrostomes are present. This structure, the neck segment, and intermediate tubules present long cilia, and probably play important roles in the propulsion of the peritoneal fluid and glomerular filtrate. The proximal tubule cells possess loosely packed microvilli and contain abundant polymorphic granules and vesicles that assume the aspect of lysosomes in different stages of intracellular digestion. The distal tubules are characterized by large, vertically disposed mitochondria assuming the aspect of ions transporting cells. The urinary bladder is lined with a transitional epithelium, whose aspect varies according to the quantity of urine.

  5. 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).

  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. Teardrop bladder: additional considerations

    SciTech Connect

    Wechsler, R.J.; Brennan, R.E.

    1982-07-01

    Nine cases of teardrop bladder (TDB) seen at excretory urography are presented. In some of these patients, the iliopsoas muscles were at the upper limit of normal in size, and additional evaluation of the perivesical structures with computed tomography (CT) was necessary. CT demonstrated only hypertrophied muscles with or without perivesical fat. The psoas muscles and pelvic width were measured in 8 patients and compared with the measurements of a control group of males without TDB. Patients with TDB had large iliopsoas muscles and narrow pelves compared with the control group. The psoas muscle width/pelvic width ratio was significantly greater (p < 0.0005) in patients with TDB than in the control group, with values of 1.04 + 0.05 and 0.82 + 0.09, respectively. It is concluded that TDB is not an uncommon normal variant in black males. Both iliopsoas muscle hypertrophy and a narrow pelvis are factors that predispose a patient to TDB.

  8. The gubernaculum during testicular descent in the human fetus.

    PubMed Central

    Heyns, C F

    1987-01-01

    This study of 178 male human fetuses and infants demonstrates that descent of the testis through the inguinal canal is a rapid process, with 75% of testes descending between 24 and 28 weeks of gestation. The gubernaculum is a cylindrical, gelatinous structure attached cranially to the testis and epididymis. While the testis is in the abdomen, the caudal tip of the gubernaculum is firmly attached to the region of the inguinal canal. In a few fetuses prior to descent the globular tip of the gubernaculum can be seen bulging through the external inguinal ring, covered by superficial fascia, with no macroscopically discernible extensions to the scrotum or any other area. Once the testis has passed through the inguinal canal, the bulbous lower tip of the gubernaculum is no longer firmly attached to any structure, nor does it extend to the bottom of the scrotum. Histologically the gubernaculum consists of undifferentiated mesenchymatous tissue. Prior to descent of the testis, there is an increase in the length of the intra-abdominal gubernaculum. The wet mass of the gubernaculum relative to the fetal mass increases rapidly prior to descent, while the relative wet mass of the testis remains constant during this period. There is also an increase in the wet/dry mass ratio of the gubernaculum, denoting an increase in its water content prior to descent. This indicates that a combination of growth processes is responsible for testicular descent, with the increase in the size of the gubernaculum playing the most important role in passage of the testis through the inguinal canal. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 PMID:2892824

  9. Increased residual urine in patients with bladder neuropathy secondary to suprasacral spinal cord lesions.

    PubMed

    Mayo, M E; Kiviat, M D

    1980-05-01

    Multichannel urodynamic studies were done on 30 patients with incomplete bladder emptying secondary to suprasacral spinal cord lesions. In 11 patients fluoroscopy was done simultaneously. A single most important factor accounting for the increased residual urine was present in 21 cases: inadequate detrusor contraction in 10, sphincter dyssynergia in 6 and bladder neck obstruction in 5. A combination of 2 of these factors was present in 3 patients. Although the initial residual urine volume was high in 6 patients voiding during the urodynamic study was efficient and no residual urine was demonstrated at that time. Urethral pressure profiles were variable, depending on whether a spastic external sphincter contraction was present during the procedure. It is concluded that bladder pressure and sphincter electromyographic measurement during voiding, combined with fluoroscopy, are ideal methods to identify the factors responsible for incomplete emptying in problem cases. The urethral pressure profile is of limited value in the initial assessment of these patients.

  10. Prevention, Identification, and Successful Transvaginal Repair of Bladder Injuries During Laparoscopic-Assisted Vaginal Hysterectomy

    PubMed

    Thanos; Thanos; Weinberg

    1996-08-01

    A retrospective review of laparoscopic-assisted vaginal hysterectomies performed at a medium-size community hospital revealed eight bladder injuries from December 1991 through December 1995. The preoperative indications varied widely, as did the operating physicians. All of the injuries occurred in the vaginal dissection portion of the procedures and all were identified and repaired during the initial surgery. The first six cases involved vaginal repair with interposition of a fat pad when possible between the bladder suture line and the vaginal cuff. The last two included laparoscopic-directed placement of omentum between these two layers. All of the patients did well and had no further complications. Since these injuries tend to occur at the bladder neck, identification of the ureteral orifices is critical to a successful repair.

  11. Inflammatory Myofibroblastic Bladder Tumor in a Patient with Wolf-Hirschhorn Syndrome

    PubMed Central

    Marte, Antonio; Indolfi, Paolo; Ficociello, Carmine; 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

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. Powered-descent trajectory optimization scheme for Mars landing

    NASA Astrophysics Data System (ADS)

    Liu, Rongjie; Li, Shihua; Chen, Xisong; Guo, Lei

    2013-12-01

    This paper presents a trajectory optimization scheme for powered-descent phase of Mars landing with considerations of disturbance. Firstly, θ-D method is applied to design a suboptimal control law with descent model in the absence of disturbance. Secondly, disturbance is estimated by disturbance observer, and the disturbance estimation is as feedforward compensation. Then, semi-global stability analysis of the composite controller consisting of the nonlinear suboptimal controller and the disturbance feedforward compensation is proposed. Finally, to verify the effectiveness of proposed control scheme, an application including relevant simulations on a Mars landing mission is demonstrated.

  17. 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.

  18. [Evolution of urinary bladder substitution].

    PubMed

    Kock, N G

    1992-11-01

    The historical background to the currently used methods for continent bladder substitution is shortly outlined. The significance for the patient's quality of life of various methods for bladder reconstruction or urinary diversion is briefly discussed. The importance of reservoir configuration for achieving a high compliant urinary receptacle is pointed out. Factors affecting reabsorption of urinary constituents are stressed and the significance of an antireflux mechanism is discussed. Currently the majority of patients undergoing cystectomy for cancer or for other reasons can be offered bladder substitutes providing continence and easy emptying; that is, complete control over voiding. This can be achieved by orthotopic bladder reconstruction or by diverting the urine to the augmented and valved rectum or to the skin via a continent intestinal reservoir.

  19. 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.

  20. 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

  1. 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.

  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. Neck dissection - discharge

    MedlinePlus

    ... If pain in your neck and throat is making it hard to eat: Take your pain medicine 30 minutes before meals. Choose soft foods, such as ripe bananas, hot cereal, and moist chopped meat and vegetables. Limit ...

  4. 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).

  5. Paraganglioma of the urinary bladder.

    PubMed

    Adraktas, Dionesia; Caserta, Melanie; Tchelepi, Hisham

    2014-09-01

    Extra-adrenal paragangliomas of the urinary bladder are rare. Typically, patients present with symptoms related to catecholamine hypersecretion or mass effect, but these tumors can also be encountered incidentally on imaging studies obtained for a different purpose. It is important to recognize the key imaging features of this entity so that it may be suggested as a possible differential diagnosis in the setting of a newly identified bladder mass.

  6. Neurogenic bladder in Hunter's syndrome.

    PubMed Central

    Koyama, K; Moda, Y; Sone, A; Tanaka, H; Hino, Y

    1994-01-01

    We encountered a rare patient with Hunter's syndrome who exhibited urinary retention as a result of a neurogenic bladder, uninhibited detrusor contractions, and detrusor-sphincter dyssynergia. Neurological findings were consistent with cervical myelopathy and cervical MR imaging showed very narrow segments at the cord level C2-4. We speculate that this Hunter's syndrome patient has cervical myelopathy and that this neurological dysfunction causes the neurogenic bladder. PMID:8014981

  7. Bladder cancer epidemiology and genetic susceptibility

    PubMed Central

    Chu, Haiyan; Wang, Meilin; Zhang, Zhengdong

    2013-01-01

    Bladder cancer is the most common malignancy of the urinary system. The incidence of bladder cancer of men is higher than that of women (approximately 4:1). Here, we summarize the bladder cancer-related risk factors, including environmental and genetic factors. In recent years, although the mortality rate induced by bladder cancer has been stable or decreased gradually, the public health effect may be pronounced. The well-established risk factors for bladder cancer are cigarette smoking and occupational exposure. Genetic factors also play important roles in the susceptibility to bladder cancer. A recent study demonstrated that hereditary non-polyposis colorectal cancer is associated with increased risk of bladder cancer. Since 2008, genome-wide association study (GWAS) has been used to identify the susceptibility loci for bladder cancer. Further gene-gene or gene-environment interaction studies need to be conducted to provide more information for the etiology of bladder cancer. PMID:23720672

  8. Whole-body angular momentum during stair ascent and descent.

    PubMed

    Silverman, Anne K; Neptune, Richard R; Sinitski, Emily H; Wilken, Jason M

    2014-04-01

    The generation of whole-body angular momentum is essential in many locomotor tasks and must be regulated in order to maintain dynamic balance. However, angular momentum has not been investigated during stair walking, which is an activity that presents a biomechanical challenge for balance-impaired populations. We investigated three-dimensional whole-body angular momentum during stair ascent and descent and compared it to level walking. Three-dimensional body-segment kinematic and ground reaction force (GRF) data were collected from 30 healthy subjects. Angular momentum was calculated using a 13-segment whole-body model. GRFs, external moment arms and net joint moments were used to interpret the angular momentum results. The range of frontal plane angular momentum was greater for stair ascent relative to level walking. In the transverse and sagittal planes, the range of angular momentum was smaller in stair ascent and descent relative to level walking. Significant differences were also found in the ground reaction forces, external moment arms and net joint moments. The sagittal plane angular momentum results suggest that individuals alter angular momentum to effectively counteract potential trips during stair ascent, and reduce the range of angular momentum to avoid falling forward during stair descent. Further, significant differences in joint moments suggest potential neuromuscular mechanisms that account for the differences in angular momentum between walking conditions. These results provide a baseline for comparison to impaired populations that have difficulty maintaining dynamic balance, particularly during stair ascent and descent.

  9. 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.…

  10. Self-Hatred in Americans of African Descent.

    ERIC Educational Resources Information Center

    Vontress, Clemmont E.

    In spite of attempts to destigmatize themselves with the "black is beautiful" rhetoric, efforts by Americans of African descent to disavow their imputed inferiority have not been successful. The black is reacted to as a handicapped person by the white American. Whites look with disdain on black-white sexual relationships, black language, and…

  11. 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.

  12. APOLLO 16 TECHNICIAN ATTACHES PLAQUE TO LUNAR MODULE'S DESCENT STAGE

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Working inside the Apollo 16 Saturn V space vehicle at the launch pad, technician Ken Crow attaches a stainless steel plaque bearing the names of Apollo 16 astronauts John W. Young, Thomas K. Mattingly II and Charles M. Duke, Jr., to the Lunar Module's descent stage, which will remain on the Moon's surface.

  13. 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,…

  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. 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.

  16. 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.

  17. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a... from any single tear in the balloon envelope between tear stoppers: (1) The maximum vertical velocity..., with the balloon descending at the maximum vertical velocity determined in paragraph (a)(1) of...

  18. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a... from any single tear in the balloon envelope between tear stoppers: (1) The maximum vertical velocity..., with the balloon descending at the maximum vertical velocity determined in paragraph (a)(1) of...

  19. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a... from any single tear in the balloon envelope between tear stoppers: (1) The maximum vertical velocity..., with the balloon descending at the maximum vertical velocity determined in paragraph (a)(1) of...

  20. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a... from any single tear in the balloon envelope between tear stoppers: (1) The maximum vertical velocity..., with the balloon descending at the maximum vertical velocity determined in paragraph (a)(1) of...

  1. 14 CFR 31.19 - Performance: Uncontrolled descent.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Flight Requirements § 31.19 Performance: Uncontrolled descent. (a... from any single tear in the balloon envelope between tear stoppers: (1) The maximum vertical velocity..., with the balloon descending at the maximum vertical velocity determined in paragraph (a)(1) of...

  2. 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…

  3. 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

  4. 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

  5. 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.

  6. A healthy bladder: a consensus statement.

    PubMed

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

    2011-10-01

    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

  7. 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.

  8. Overactive bladder in children

    PubMed Central

    Ramsay, Sophie; Bolduc, Stéphane

    2017-01-01

    Overactive bladder (OAB) is a highly prevalent disorder in the pediatric population. This condition is especially troublesome for pediatric patients and their families when associated with incontinence, since it negatively affects self-esteem and impairs children’s development. From the patient’s perspective, urgency and urge incontinence can have a significant impact, negatively affecting their quality of life. For a therapy to have true benefit, changes must not only be statistically significant, but must also be perceived as meaningful by the patient. A stepwise approach is favoured to treat this pathology, starting with behavioural therapy, followed by medical management, and eventually more invasive procedures. Antimuscarinic agents are the mainstay of medical treatment for OAB. Oxybutynin is the most commonly used antimuscarinic in the pediatric population. However, some patients have a suboptimal response to antimuscarinics and many experience bothersome side effects, which have been documented with all antimuscarinics to a significantly higher degree than placebo. Although there have been reports about the use of tolterodine, fesoterodine, trospium, propiverine, and solifenacin in children, to date, only oxybutynin has been officially approved for pediatric use by medical authorities in North America. This review will address alternative treatment options for pediatric patients presenting with OAB, from conservative measures to more invasive therapies. PMID:28265325

  9. Recovery After Stroke: Bladder and Bowel Function

    MedlinePlus

    Recovery After Stroke: Bladder & Bowel Function Problems with bladder and bowel function are common but distressing for ... embarrassed by – these issues.  Get information on stroke recovery from National Stroke Association.  Visit www. stroke. org ...

  10. Genetic and Epigenetic Alterations in Bladder Cancer

    PubMed Central

    2016-01-01

    Bladder cancer is one of the most common cancers worldwide, with a high rate of recurrence and poor outcomes as a result of relapse. Bladder cancer patients require lifelong invasive monitoring and treatment, making bladder cancer one of the most expensive malignancies. Lines of evidence increasingly point to distinct genetic and epigenetic alteration patterns in bladder cancer, even between the different stages and grades of disease. In addition, genetic and epigenetic alterations have been demonstrated to play important roles during bladder tumorigenesis. This review will focus on bladder cancer-associated genomic and epigenomic alterations, which are common in bladder cancer and provide potential diagnostic markers and therapeutic targets for bladder cancer treatment. PMID:27915480

  11. Treatment of bladder cancer. Oncology overview

    SciTech Connect

    Not Available

    1982-10-01

    Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories throughout the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Surgical treatment of common bladder cancers; Radiation therapy of common bladder cancers; Chemotherapy of common bladder cancers; Immunotherapy of common bladder cancers; Multimodal treatment of common bladder cancers; Other treatment modalities of common bladder cancers; Treatment of less common bladder cancers; Reviews of treatment of bladder cancers.

  12. Molecular pathology and biomarkers of bladder cancer.

    PubMed

    Czerniak, Bogdan

    2010-01-01

    Bladder cancer originates in the epithelial lining of the bladder's mucosa and develops in association with several habitual, industrial, and environmental risk factors via papillary and non-papillary pathways. In this chapter we review novel concepts concerning the molecular mechanisms of early field change in bladder neoplasia stemming from whole-organ genomic mapping studies. These mechanisms are discussed in the context of molecular pathogenesis of bladder cancer and in relation to treatment and biomarker-based detection strategies.

  13. p16 expression is not associated with human papillomavirus in urinary bladder squamous cell carcinoma.

    PubMed

    Alexander, Riley E; Hu, Yingchuan; Kum, Jennifer B; Montironi, Rodolfo; Lopez-Beltran, Antonio; Maclennan, Gregory T; Idrees, Muhammad T; Emerson, Robert E; Ulbright, Thomas M; Grignon, David G; Eble, John N; Cheng, Liang

    2012-11-01

    Squamous cell carcinoma of the urinary bladder is unusual and of unknown etiology. There is a well-established association between human papillomavirus (HPV) infection and the development of cervical and head/neck squamous cell carcinomas. However, the role of HPV in the pathogenesis of squamous cell carcinoma of the urinary bladder is uncertain. The purposes of this study were to investigate the possible role of HPV in the development of squamous cell carcinoma of the urinary bladder and to determine if p16 expression could serve as a surrogate marker for HPV in this malignancy. In all, 42 cases of squamous cell carcinoma of the urinary bladder and 27 cases of urothelial carcinoma with squamous differentiation were investigated. HPV infection was analyzed by both in situ hybridization at the DNA level and immunohistochemistry at the protein level. p16 protein expression was analyzed by immunohistochemistry. HPV DNA and protein were not detected in 42 cases of squamous cell carcinoma (0%, 0/42) or 27 cases of urothelial carcinoma with squamous differentiation (0%, 0/15). p16 expression was detected in 13 cases (31%, 13/42) of squamous cell carcinoma and 9 cases (33%, 9/27) of urothelial carcinoma with squamous differentiation. There was no correlation between p16 expression and the presence of HPV infection in squamous cell carcinoma of the bladder or urothelial carcinoma with squamous differentiation. Our data suggest that HPV does not play a role in the development of squamous cell carcinoma of the urinary bladder or urothelial carcinoma with squamous differentiation. p16 expression should not be used as a surrogate marker for evidence of HVP infection in either squamous cell carcinoma of the urinary bladder or urothelial carcinoma with squamous differentiation as neither HVP DNA nor protein is detectable in these neoplasms.

  14. α1-, α2- and β-adrenoceptors in the urinary bladder, urethra and prostate

    PubMed Central

    Michel, Martin C; Vrydag, Wim

    2006-01-01

    We have systematically reviewed the presence, functional responses and regulation of α1-, α2- and β-adrenoceptors in the bladder, urethra and prostate, with special emphasis on human tissues and receptor subtypes. α1-Adrenoceptors are only poorly expressed and play a limited functional role in the detrusor. α1-Adrenoceptors, particularly their α1A-subtype, show a more pronounced expression and promote contraction of the bladder neck, urethra and prostate to enhance bladder outlet resistance, particularly in elderly men with enlarged prostates. α1-Adrenoceptor agonists are important in the treatment of symptoms of benign prostatic hyperplasia, but their beneficial effects may involve receptors within and outside the prostate. α2-Adrenoceptors, mainly their α2A-subtype, are expressed in bladder, urethra and prostate. They mediate pre-junctional inhibition of neurotransmitter release and also a weak contractile effect in the urethra of some species, but not humans. Their overall post-junctional function in the lower urinary tract remains largely unclear. β-Adrenoceptors mediate relaxation of smooth muscle in the bladder, urethra and prostate. The available tools have limited the unequivocal identification of receptor subtypes at the protein and functional levels, but it appears that the β3- and β2-subtypes are important in the human bladder and urethra, respectively. β3-Adrenoceptor agonists are promising drug candidates for the treatment of the overactive bladder. We propose that the overall function of adrenoceptors in the lower urinary tract is to promote urinary continence. Further elucidation of the functional roles of their subtypes will help a better understanding of voiding dysfunction and its treatment. PMID:16465187

  15. Head and Neck Cancer: Symptoms and Signs

    MedlinePlus

    ... and Neck Cancer: Symptoms and Signs Request Permissions Head and Neck Cancer: Symptoms and Signs Approved by the Cancer. ... f t k e P Types of Cancer Head and Neck Cancer Guide Cancer.Net Guide Head and Neck ...

  16. 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.

  17. Bladder trauma: multidetector computed tomography cystography.

    PubMed

    Ishak, Charbel; Kanth, Nalini

    2011-08-01

    Multidetector computed tomography (MDCT) cystography is rapidly becoming the most recommended study for evaluation of the bladder for suspected trauma. This article reviews the bladder trauma with emphasis on the application of MDCT cystography to traumatic bladder injuries using a pictorial essay based on images collected in our level I trauma center.

  18. 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

  19. CT angiography - head and neck

    MedlinePlus

    ... medlineplus.gov/ency/article/007677.htm CT angiography - head and neck To use the sharing features on this page, ... create pictures of the blood vessels in the head and neck. How the Test is Performed You will be ...

  20. [Occupational hazards and bladder cancer].

    PubMed

    Nizamova, R S

    1991-01-01

    Occupational exposure to health hazards was studied in 258 industrial workers who had developed cancer of the bladder against 454 matched controls. All the test subjects and controls were residents of the Tambov Province centers of chemical industry. Statistical significance (relative risk-4.7) was established for exposure to aromatic amines. For those contacting with aniline dyes the relative risk (RR) made up 2.4. The risk to develop bladder cancer in powder shops (RR-3.2) was attributed to the hazards of dyes and diphenylamine. In leather-shoe and textile industry the exposure to dyes was not safe (RR-6.1), neither was it to chemicals, oil products, pesticides, overheating (RR-3.2, 1.6, 3.2 and 2.9, respectively). It is stated that in line with a significant risk to develop bladder cancer at exposure to aromatic amines there exist a number of occupational factors contributing to this risk.

  1. Circulating Biomarkers in Bladder Cancer

    PubMed Central

    Nandagopal, Lakshminarayanan; Sonpavde, Guru

    2016-01-01

    Bladder cancer is a molecularly heterogeneous disease characterized by multiple unmet needs in the realm of diagnosis, clinical staging, monitoring and therapy. There is an urgent need to develop precision medicine for advanced urothelial carcinoma. Given the difficulty of serial analyses of metastatic tumor tissue to identify resistance and new therapeutic targets, development of non-invasive monitoring using circulating molecular biomarkers is critically important. Although the development of circulating biomarkers for the management of bladder cancer is in its infancy and may currently suffer from lower sensitivity of detection, they have inherent advantages owing to non-invasiveness. Additionally, circulating molecular alterations may capture tumor heterogeneity without the sampling bias of tissue biopsy. This review describes the accumulating data to support further development of circulating biomarkers including circulating tumor cells, cell-free circulating tumor (ct)-DNA, RNA, micro-RNA and proteomics to improve the management of bladder cancer. PMID:28035318

  2. Urinary markers for bladder cancer

    PubMed Central

    Smith, Zachary L.

    2013-01-01

    Bladder cancer has the fifth highest incidence of all malignancies in the United States, with a propensity to recur, requiring lifelong surveillance after diagnosis. Urinary markers of disease have been of extreme interest in this field in an effort to simplify surveillance schedules and improve early detection of tumors. Many markers have been described, but most remain investigational. However, some markers have undergone clinical trials and are approved for clinical use. In this review, urinary markers and their application for screening and surveillance of bladder cancer are discussed. PMID:23864929

  3. [Rare cases of bladder stones].

    PubMed

    Sampalmieri, Gregorio; Moretti, Antonello; Sampalmieri, Matteo

    2014-01-01

    We present here two special cases of urolithiasis. The first one shows a giant bladder lithiasis resulting in severe renal insufficiency in a 63-year-old patient, who had previously had nicturia (2-3 times), occasional episodes of urinary frequency and burning micturition, in the absence of renal colic, hematuria or interrupted urination. The second case referes to an 85-year-old man suffering from prostatic enlargement and bladder stones, hospitalized to undergo intervention of trans-vesical prostatic adenomectomy, during which two star-shaped stones were found without obvious symptoms.

  4. 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.

  5. 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

  6. 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.

  7. A conjugate gradient method with descent direction for unconstrained optimization

    NASA Astrophysics Data System (ADS)

    Yuan, Gonglin; Lu, Xiwen; Wei, Zengxin

    2009-11-01

    A modified conjugate gradient method is presented for solving unconstrained optimization problems, which possesses the following properties: (i) The sufficient descent property is satisfied without any line search; (ii) The search direction will be in a trust region automatically; (iii) The Zoutendijk condition holds for the Wolfe-Powell line search technique; (iv) This method inherits an important property of the well-known Polak-Ribière-Polyak (PRP) method: the tendency to turn towards the steepest descent direction if a small step is generated away from the solution, preventing a sequence of tiny steps from happening. The global convergence and the linearly convergent rate of the given method are established. Numerical results show that this method is interesting.

  8. 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.

  9. Peak knee flexion angles during stair descent in TKA patients.

    PubMed

    Bjerke, Joakim; Öhberg, Fredrik; Nilsson, Kjell G; Foss, Olav A; Stensdotter, Ann K

    2014-04-01

    Reduced peak knee flexion during stair descent (PKSD) is demonstrated in subjects with total knee arthroplasty (TKA), but the underlying factors are not well studied. 3D gait patterns during stair descent, peak passive knee flexion (PPKF), quadriceps strength, pain, proprioception, demographics, and anthropometrics were assessed in 23 unilateral TKA-subjects ~19 months post-operatively, and in 23 controls. PKSD, PPKF and quadriceps strength were reduced in the TKA-side, but also in the contralateral side. A multiple regression analysis identified PPKF as the only predictor (57%) to explain the relationship with PKSD. PPKF was, however sufficient for normal PKSD. Deficits in quadriceps strength in TKA-group suggest that strength is also contributing to smaller PKSD. Increased hip adduction at PKSD may indicate both compensatory strategy and reduced hip strength.

  10. 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.

  11. 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.

  12. Social stress induces changes in urinary bladder function, bladder NGF content, and generalized bladder inflammation in mice.

    PubMed

    Mingin, Gerald C; Peterson, Abbey; Erickson, Cuixia Shi; Nelson, Mark T; Vizzard, Margaret A

    2014-10-01

    Social stress may play a role in urinary bladder dysfunction in humans, but the underlying mechanisms are unknown. In the present study, we explored changes in bladder function caused by social stress using mouse models of stress and increasing stress. In the stress paradigm, individual submissive FVB mice were exposed to C57BL/6 aggressor mice directly/indirectly for 1 h/day for 2 or 4 wk. Increased stress was induced by continuous, direct/indirect exposure of FVB mice to aggressor mice for 2 wk. Stressed FVB mice exhibited nonvoiding bladder contractions and a decrease in both micturition interval (increased voiding frequency) and bladder capacity compared with control animals. ELISAs demonstrated a significant increase in histamine protein expression with no change in nerve growth factor protein expression in the urinary bladder compared with controls. Unlike stressed mice, mice exposed to an increased stress paradigm exhibited increased bladder capacities and intermicturition intervals (decreased voiding frequency). Both histamine and nerve growth factor protein expression were significantly increased with increased stress compared with control bladders. The change in bladder function from increased voiding frequency to decreased voiding frequency with increased stress intensity suggests that changes in social stress-induced urinary bladder dysfunction are context and duration dependent. In addition, changes in the bladder inflammatory milieu with social stress may be important contributors to changes in urinary bladder function.

  13. Aerodynamics of the EXPERT Reentry Capsule Along the Descent Trajectory

    NASA Astrophysics Data System (ADS)

    Vashchenkov, P.; Kashkovsky, A.; Ivanov, M.

    2009-01-01

    Results of numerical simulations of high-altitude aero thermodynamics of the EXPERT reentry capsule along its descent trajectory are presented. Aerodynamic characteristics for different angles of attack and rolling of the capsule at altitude of 150 down to 20 km are studied. An engineering local bridging method is used in computations. The uncertainty of the engineering method in the transitional regime is determined by comparisons with results obtained by DSMC simulations.

  14. 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.

  15. Inflammatory Bowel Disease in Children of Middle Eastern Descent

    PubMed Central

    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

  16. Free-falls and parachute descents in the standard atmosphere

    NASA Technical Reports Server (NTRS)

    Webster, A P

    1947-01-01

    A detailed table of the standard equilibrium velocity and standard equilibrium time is presented for bodies falling in the standard atmosphere. This table gives the velocity at various altitudes and the time of fall from sea level to -4000 feet and from 80,000 feet to sea level. In addition to this standard table, there are given short tables and charts of an open-parachute descent and free-falls; the terminal velocity at sea level, and the variation of the weight-to-drag ratio (2w/cds)1/2 for various weight jumpers from 90 to 30 feet in open-parachute descent; and estimations of drag coefficients of silk and nylon parachutes. The table of standard equilibrium velocities and standard equilibrium times may be used directly for open-parachute descents, given the weight of the jumper, the diameter of the parachute, and the drag coefficient. For free-falls starting from horizontal flight, approximately 14 seconds must be added to the equilibrium time given in the table to obtain the total time to sea level. (author)

  17. Entry, Descent, and Landing Performance of the Mars Phoenix Lander

    NASA Technical Reports Server (NTRS)

    Desai, Prasun N.; Prince, Jill L.; Wueen, Eric M.; Cruz, Juan R.; Grover, Myron R.

    2008-01-01

    On May 25, 2008, the Mars Phoenix Lander successfully landed on the northern arctic plains of Mars. An overview of a preliminary reconstruction analysis performed on each entry, descent, and landing phase to assess the performance of Phoenix as it descended is presented and a comparison to pre-entry predictions is provided. The landing occurred 21 km further downrange than the predicted landing location. Analysis of the flight data revealed that the primary cause of Phoenix s downrange landing was a higher trim total angle of attack during the hypersonic phase of the entry, which resulted in Phoenix flying a slightly lifting trajectory. The cause of this higher trim attitude is not known at this time. Parachute deployment was 6.4 s later than prediction. This later deployment time was within the variations expected and is consistent with a lifting trajectory. The parachute deployment and inflation process occurred as expected with no anomalies identified. The subsequent parachute descent and powered terminal landing also behaved as expected. A preliminary reconstruction of the landing day atmospheric density profile was found to be lower than the best apriori prediction, ranging from a few percent less to a maximum of 8%. A comparison of the flight reconstructed trajectory parameters shows that the actual Phoenix entry, descent, and landing was close to pre-entry predictions. This reconstruction investigation is currently ongoing and the results to date are in the process of being refined.

  18. Airborne Management of Traffic Conflicts in Descent With Arrival Constraints

    NASA Technical Reports Server (NTRS)

    Doble, Nathan A.; Barhydt, Richard; Krishnamurthy, Karthik

    2005-01-01

    NASA is studying far-term air traffic management concepts that may increase operational efficiency through a redistribution of decisionmaking authority among airborne and ground-based elements of the air transportation system. One component of this research, En Route Free Maneuvering, allows trained pilots of equipped autonomous aircraft to assume responsibility for traffic separation. Ground-based air traffic controllers would continue to separate traffic unequipped for autonomous operations and would issue flow management constraints to all aircraft. To evaluate En Route Free Maneuvering operations, a human-in-the-loop experiment was jointly conducted by the NASA Ames and Langley Research Centers. In this experiment, test subject pilots used desktop flight simulators to resolve conflicts in cruise and descent, and to adhere to air traffic flow constraints issued by test subject controllers. Simulators at NASA Langley were equipped with a prototype Autonomous Operations Planner (AOP) flight deck toolset to assist pilots with conflict management and constraint compliance tasks. Results from the experiment are presented, focusing specifically on operations during the initial descent into the terminal area. Airborne conflict resolution performance in descent, conformance to traffic flow management constraints, and the effects of conflicting traffic on constraint conformance are all presented. Subjective data from subject pilots are also presented, showing perceived levels of workload, safety, and acceptability of autonomous arrival operations. Finally, potential AOP functionality enhancements are discussed along with suggestions to improve arrival procedures.

  19. Lunar Surface Access Module Descent Engine Turbopump Technology: Detailed Design

    NASA Technical Reports Server (NTRS)

    Alarez, Erika; Thornton, Randall J.; Forbes, John C.

    2008-01-01

    The need for a high specific impulse LOX/LH2 pump-fed lunar lander engine has been established by NASA for the new lunar exploration architecture. Studies indicate that a 4-engine cluster in the thrust range of 9,000-lbf each is a candidate configuration for the main propulsion of the manned lunar lander vehicle. The lander descent engine will be required to perform minor mid-course corrections, a Lunar Orbit Insertion (LOI) burn, a de-orbit burn, and the powered descent onto the lunar surface. In order to achieve the wide range of thrust required, the engines must be capable of throttling approximately 10:1. Working under internal research and development funding, NASA Marshall Space Flight Center (MSFC) has been conducting the development of a 9,000-lbf LOX/LH2 lunar lander descent engine testbed. This paper highlights the detailed design and analysis efforts to develop the lander engine Fuel Turbopump (FTP) whose operating speeds range from 30,000-rpm to 100,000-rpm. The capability of the FTP to operate across this wide range of speeds imposes several structural and dynamic challenges, and the small size of the FTP creates scaling and manufacturing challenges that are also addressed in this paper.

  20. Lunar Surface Access Module Descent Engine Turbopump Technology: Detailed Design

    NASA Technical Reports Server (NTRS)

    Alvarez, Erika; Forbes, John C.; Thornton, Randall J.

    2010-01-01

    The need for a high specific impulse LOX/LH2 pump-fed lunar lander engine has been established by NASA for the new lunar exploration architecture. Studies indicate that a 4-engine cluster in the thrust range of 9,000-lbf each is a candidate configuration for the main propulsion of the manned lunar lander vehicle. The lander descent engine will be required to perform multiple burns including the powered descent onto the lunar surface. In order to achieve the wide range of thrust required, the engines must be capable of throttling approximately 10:1. Working under internal research and development funding, NASA Marshall Space Flight Center (MSFC) has been conducting the development of a 9,000-lbf LOX/LH2 lunar lander descent engine technology testbed. This paper highlights the detailed design and analysis efforts to develop the lander engine Fuel Turbopump (FTP) whose operating speeds range from 30,000-rpm to 100,000-rpm. The capability of the FTP to operate across this wide range of speeds imposes several structural and dynamic challenges, and the small size of the FTP creates scaling and manufacturing challenges that are also addressed in this paper.

  1. Titan Explorer Entry, Descent and Landing Trajectory Design

    NASA Technical Reports Server (NTRS)

    Fisher, Jody L.; Lindberg, Robert E.; Lockwood, Mary Kae

    2006-01-01

    The Titan Explorer mission concept includes an orbiter, entry probe and inflatable airship designed to take remote and in-situ measurements of Titan's atmosphere. A modified entry, descent and landing trajectory at Titan that incorporates mid-air airship inflation (under a parachute) and separation is developed and examined for Titan Explorer. The feasibility of mid-air inflation and deployment of an airship under a parachute is determined by implementing and validating an airship buoyancy and inflation model in the trajectory simulation program, Program to Optimize Simulated Trajectories II (POST2). A nominal POST2 trajectory simulation case study is generated which examines different descent scenarios by varying airship inflation duration, orientation, and separation. The buoyancy model incorporation into POST2 is new to the software and may be used in future trajectory simulations. Each case from the nominal POST2 trajectory case study simulates a successful separation between the parachute and airship systems with sufficient velocity change as to alter their paths to avoid collision throughout their descent. The airship and heatshield also separate acceptably with a minimum distance of separation from the parachute system of 1.5 km. This analysis shows the feasibility of airship inflation on a parachute for different orientations, airship separation at various inflation times, and preparation for level-flight at Titan.

  2. Penetrating neck traumas

    PubMed Central

    Kaczmarski, Jacek; Brzeziński, Daniel; Cieślik-Wolski, Bartosz; Kozak, Józef

    2014-01-01

    Aim of the study Aim of the study is to present our own experiences in the treatment of people suffering from penetrating neck traumas. Material and methods In the years 1996-2012, 10 patients with penetrating neck traumas were treated, including 3 women and 7 men. The patients’ age ranged from 16 to 55 (the average age being 40.7 years). In 9 cases the wound was caused by cutting or stabbing, while in one case it was inflicted by a gunshot. In 8 patients it was a single cut wound, while one patient suffered from 34 stab wounds to the neck, chest and stomach. Two cut wounds resulted from a suicide attempt. The remaining injuries were the result of a crime. Results All patients underwent immediate surgery, which involved revision of the neck wounds in 8 cases, one longitudinal sternotomy and one left-sided thoracotomy. The indications for surgery included increased subcutaneous emphysema in 5 patients, bleeding from the wound in 3 patients, and mediastinal hematoma in 2 patients. The damage assessed intraoperatively included tracheal damage in 6 patients, damage to carotid vessels in 3 patients, larynx in 2 patients, thoracic vessels in 2 patients, oesophagus in 1 patient and thyroid gland in 1 patient. In 9 patients, the treatment yielded positive results. The patient with a gunshot wound died during the surgery due to massive bleeding from the aorta. Conclusions In patients with penetrating neck wounds, early and rapid diagnostics allows one to determine the indications for surgery and prevent serious fatal complications. PMID:26336390

  3. Treatment of Neck Pain

    PubMed Central

    Hurwitz, Eric L.; Cheng, Ivan; Carroll, Linda J.; Nordin, Margareta; Guzman, Jaime; Peloso, Paul; Holm, Lena W.; Côthé, Pierre; Hogg-Johnson, Sheilah; van der Velde, Gabrielle; Cassidy, J. David; Haldeman, Scott

    2008-01-01

    Study Design Best evidence synthesis. Objective To identify, critically appraise, and synthesize literature from 1980 through 2006 on surgical interventions for neck pain alone or with radicular pain in the absence of serious pathologic disease. Summary of Background Data There have been no comprehensive systematic literature or evidence-based reviews published on this topic. Methods We systematically searched Medline for literature published from 1980 to 2006 on percutaneous and open surgical interventions for neck pain. Publications on the topic were also solicited from experts in the field. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our Best Evidence Synthesis. Results Of the 31,878 articles screened, 1203 studies were relevant to the Neck Pain Task Force mandate and of these, 31 regarding treatment by surgery or injections were accepted as scientifically admissible. Radiofrequency neurotomy, cervical facet injections, cervical fusion and cervical arthroplasty for neck pain without radiculopathy are not supported by current evidence. We found there is support for short-term symptomatic improvement of radicular symptoms with epidural corticosteroids. It is not clear from the evidence that long-term out comes are improved with the surgical treatment of cervical radiculopathy compared to non operative measures. However, relatively rapid and substantial symptomatic relief after surgical treatment seems to be reliably achieved. It is not evident that one open surgical technique is clearly superior to others for radiculopathy. Cervical foramenal or epidural injections are associated with relatively frequent minor adverse events (5%–20%); however, serious adverse events are very uncommon (<1%). After open surgical procedures on the cervical spine, potentially serious acute complications are seen in approximately 4% of patients. Conclusion Surgical treatment and limited

  4. 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.

  5. 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.

  6. Stem Cells in Functional Bladder Engineering

    PubMed Central

    Smolar, Jakub; Salemi, Souzan; Horst, Maya; Sulser, Tullio; Eberli, Daniel

    2016-01-01

    Conditions impairing bladder function in children and adults, such as myelomeningocele, posterior urethral valves, bladder exstrophy or spinal cord injury, often need urinary diversion or augmentation cystoplasty as when untreated they may cause severe bladder dysfunction and kidney failure. Currently, the gold standard therapy of end-stage bladder disease refractory to conservative management is enterocystoplasty, a surgical enlargement of the bladder with intestinal tissue. Despite providing functional improvement, enterocystoplasty is associated with significant long-term complications, such as recurrent urinary tract infections, metabolic abnormalities, stone formation, and malignancies. Therefore, there is a strong clinical need for alternative therapies for these reconstructive procedures, of which stem cell-based tissue engineering (TE) is considered to be the most promising future strategy. This review is focused on the recent progress in bladder stem cell research and therapy and the challenges that remain for the development of a functional bladder wall. PMID:27781020

  7. 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

  8. African descents are more sensitive than European descents to the antitumor compounds α-hederin and kalopanaxsaponin I.

    PubMed

    Feller, Geva; Kugel, Aleksandra; Moonshine, Dana; Chalifa-Caspi, Vered; Scholz, Martin; Prüfer, Dirk; Rabinski, Tatiana; Müller, Kai J; Ofir, Rivka

    2010-11-01

    α-Hederin, a natural triterpene saponin and its derivative kalopanaxsaponin I (ksI) exhibit cytotoxicity against various cancer cell lines and IN VIVO tumors. We studied the genetic variants contributing to the activity of these two anticancer compounds. Cell lines derived from 30 trios of European descent (Centre d'Etude du Polymorphisme Human, CEPH; CEU) and 30 trios of African descent (Yoruban, YRI) were used. Cytotoxicity was determined as inhibition of cell growth at increasing concentrations of α-hederin or ksI for 24 h. In comparison to the European, the Yoruban populations revealed a higher sensitivity to α-hederin and to ksI that can be attributed to several unique SNPs. These SNPs are located near 111 and 130 genes in the European and the Yoruban populations, respectively, raising the possibility that some of these genes contribute to the differential sensitivity to these compounds.

  9. 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.

  10. Ultrasonic lithotripsy of bladder stones.

    PubMed

    Cetin, S; Ozgür, S; Yazicioğlu, A; Unsal, K; Ilker, Y

    1988-01-01

    In the second half of 1985, 15 patients with 25 bladder stones were treated with Lutzeyer's Ultrasonic Lithotriptor. Of the patients 13 underwent additional operations, mostly transurethral resection of the prostate. The average duration of lithotripsy was 30.5 minutes. Some difficulties were experienced especially when drilling hard stones and as a complication late urethral bleeding occurred in one patient.

  11. Mars Science Laboratory: Entry, Descent, and Landing System Performance

    NASA Technical Reports Server (NTRS)

    Way, David W.; Powell, Richard W.; Chen, Allen; Steltzner, Adam D.; San Martin, Alejandro M.; Burkhart, Paul D.; mendeck, Gavin F.

    2006-01-01

    In 2010, the Mars Science Laboratory (MSL) mission will pioneer the next generation of robotic Entry, Descent, and Landing (EDL) systems, by delivering the largest and most capable rover to date to the surface of Mars. To do so, MSL will fly a guided lifting entry at a lift-to-drag ratio in excess of that ever flown at Mars, deploy the largest parachute ever at Mars, and perform a novel Sky Crane maneuver. Through improved altitude capability, increased latitude coverage, and more accurate payload delivery, MSL is allowing the science community to consider the exploration of previously inaccessible regions of the planet. The MSL EDL system is a new EDL architecture based on Viking heritage technologies and designed to meet the challenges of landing increasing massive payloads on Mars. In accordance with level-1 requirements, the MSL EDL system is being designed to land an 850 kg rover to altitudes as high as 1 km above the Mars Orbiter Laser Altimeter defined areoid within 10 km of the desired landing site. Accordingly, MSL will enter the largest entry mass, fly the largest 70 degree sphere-cone aeroshell, generate the largest hypersonic lift-to-drag ratio, and deploy the largest Disk-Gap-Band supersonic parachute of any previous mission to Mars. Major EDL events include a hypersonic guided entry, supersonic parachute deploy and inflation, subsonic heatshield jettison, terminal descent sensor acquisition, powered descent initiation, sky crane terminal descent, rover touchdown detection, and descent stage flyaway. Key performance metrics, derived from level-1 requirements and tracked by the EDL design team to indicate performance capability and timeline margins, include altitude and range at parachute deploy, time on radar, and propellant use. The MSL EDL system, which will continue to develop over the next three years, will enable a notable extension in the advancement of Mars surface science by delivering more science capability than ever before to the surface of

  12. Mars Science Laboratory: Entry, Descent, and Landing System Performance

    NASA Technical Reports Server (NTRS)

    Way, David W.; Powell, Richard W.; Chen, Allen; SanMartin, A. Miguel; Burkhart, P. Daniel; Mendeck, Gavin F.

    2007-01-01

    In 2010, the Mars Science Laboratory (MSL) mission will pioneer the next generation of robotic Entry, Descent, and Landing (EDL) systems, by delivering the largest and most capable rover to date to the surface of Mars. To do so, MSL will fly a guided lifting entry at a lift-to-drag ratio in excess of that ever flown at Mars, deploy the largest parachute ever at Mars, and perform a novel Sky Crane maneuver. Through improved altitude capability, increased latitude coverage, and more accurate payload delivery, MSL is allowing the science community to consider the exploration of previously inaccessible regions of the planet. The MSL EDL system is a new EDL architecture based on Viking heritage technologies and designed to meet the challenges of landing increasing massive payloads on Mars. In accordance with level-1 requirements, the MSL EDL system is being designed to land an 850 kg rover to altitudes as high as 1 km above the Mars Orbiter Laser Altimeter defined areoid within 10 km of the desired landing site. Accordingly, MSL will enter the largest entry mass, fly the largest 70 degree sphere-cone aeroshell, generate the largest hypersonic lift-to-drag ratio, and deploy the largest Disk-Gap-Band supersonic parachute of any previous mission to Mars. Major EDL events include a hypersonic guided entry, supersonic parachute deploy and inflation, subsonic heatshield jettison, terminal descent sensor acquisition, powered descent initiation, sky crane terminal descent, rover touchdown detection, and descent stage flyaway. Key performance metrics, derived from level-1 requirements and tracked by the EDL design team to indicate performance capability and timeline margins, include altitude and range at parachute deploy, time on radar, and propellant use. The MSL EDL system, which will continue to develop over the next three years, will enable a notable extension in the advancement of Mars surface science by delivering more science capability than ever before to the surface of

  13. A multi-stage genome-wide association study of bladder cancer identifies multiple susceptibility loci

    PubMed Central

    Rothman, Nathaniel; Garcia-Closas, Montserrat; Chatterjee, Nilanjan; Malats, Nuria; Wu, Xifeng; Figueroa, Jonine; Real, Francisco X; Van Den Berg, David; Matullo, Giuseppe; Baris, Dalsu; Thun, Michael; Kiemeney, Lambertus A; Vineis, Paolo; De Vivo, Immaculata; Albanes, Demetrius; Purdue, Mark P; Rafnar, Thorunn; Hildebrandt, Michelle A T; Kiltie, Anne E; Cussenot, Olivier; Golka, Klaus; Kumar, Rajiv; Taylor, Jack A; Mayordomo, Jose I; Jacobs, Kevin B; Kogevinas, Manolis; Hutchinson, Amy; Wang, Zhaoming; Fu, Yi-Ping; Prokunina-Olsson, Ludmila; Burdette, Laurie; Yeager, Meredith; Wheeler, William; Tardón, Adonina; Serra, Consol; Carrato, Alfredo; García-Closas, Reina; Lloreta, Josep; Johnson, Alison; Schwenn, Molly; Karagas, Margaret R; Schned, Alan; Andriole, Gerald; Grubb, Robert; Black, Amanda; Jacobs, Eric J; Diver, W Ryan; Gapstur, Susan M; Weinstein, Stephanie J; Virtamo, Jarmo; Cortessis, Victoria K; Gago-Dominguez, Manuela; Pike, Malcolm C; Stern, Mariana C; Yuan, Jian-Min; Hunter, David; McGrath, Monica; Dinney, Colin P; Czerniak, Bogdan; Chen, Meng; Yang, Hushan; Vermeulen, Sita H; Aben, Katja K; Witjes, J Alfred; Makkinje, Remco R; Sulem, Patrick; Besenbacher, Soren; Stefansson, Kari; Riboli, Elio; Brennan, Paul; Panico, Salvatore; Navarro, Carmen; Allen, Naomi E; Bueno-de-Mesquita, H Bas; Trichopoulos, Dimitrios; Caporaso, Neil; Landi, Maria Teresa; Canzian, Federico; Ljungberg, Borje; Tjonneland, Anne; Clavel-Chapelon, Francoise; Bishop, David T; Teo, Mark T W; Knowles, Margaret A; Guarrera, Simonetta; Polidoro, Silvia; Ricceri, Fulvio; Sacerdote, Carlotta; Allione, Alessandra; Cancel-Tassin, Geraldine; Selinski, Silvia; Hengstler, Jan G; Dietrich, Holger; Fletcher, Tony; Rudnai, Peter; Gurzau, Eugen; Koppova, Kvetoslava; Bolick, Sophia C E; Godfrey, Ashley; Xu, Zongli; Sanz-Velez, José I; García-Prats, María D; Sanchez, Manuel; Valdivia, Gabriel; Porru, Stefano; Benhamou, Simone; Hoover, Robert N; Fraumeni, Joseph F; Silverman, Debra T; Chanock, Stephen J

    2010-01-01

    We conducted a multi-stage, genome-wide association study (GWAS) of bladder cancer with a primary scan of 589,299 single nucleotide polymorphisms (SNPs) in 3,532 cases and 5,120 controls of European descent (5 studies) followed by a replication strategy, which included 8,381 cases and 48,275 controls (16 studies). In a combined analysis, we identified three new regions associated with bladder cancer on chromosomes 22q13.1, 19q12 and 2q37.1; rs1014971, (P=8×10−12) maps to a non-genic region of chromosome 22q13.1; rs8102137 (P=2×10−11) on 19q12 maps to CCNE1; and rs11892031 (P=1×10−7) maps to the UGT1A cluster on 2q37.1. We confirmed four previous GWAS associations on chromosomes 3q28, 4p16.3, 8q24.21 and 8q24.3, validated previous candidate associations for the GSTM1 deletion (P=4×10−11) and a tag SNP for NAT2 acetylation status (P=4×10−11), as well as demonstrated smoking interactions with both regions. Our findings on common variants associated with bladder cancer risk should provide new insights into mechanisms of carcinogenesis. PMID:20972438

  14. Neck abscess: 79 cases

    PubMed Central

    Bulgurcu, Suphi; Arslan, Ilker Burak; Demirhan, Erhan; Kozcu, Sureyya Hikmet; Cukurova, Ibrahim

    2015-01-01

    OBJECTIVE: Neck abscess is a disease that might cause mortality and severe morbidity, if it is not treated urgently. In our study, patients with diagnosis of neck abscess in our clinic were analyzed retrospectively and presented in the light of the literature. METHODS: In our clinic, age distribution, source of infection, systemic disease, imaging methods that were used in diagnosis, preferred anaesthesia during drainage, abscess sites, culture results of abscess material, complications during treatment procedure, any antibiotherapy before admission and duration of hospitalization of 79 cases with neck abscess who were treated in the hospital between January 2008 and January 2015 were assessed. RESULTS: Cases in our study were aged between 1–79 (mean 28.3) years and 43 of them were female and 36 were male patients. Systemic diseases were determined in 19 of the cases. The most common systemic disease was diabetes mellitus. Abscesses were localized mostly at peritonsillar region and 13 of the cases were operated when abscess were in multipl localizations. In 74 of the cases, drainage was performed under local anaesthesia and in 5 cases under general anaesthesia. Four of these 5 cases, abscesses were localized within retropharyngeal region and 1 of them had multiple abscesses at various regions. Staphylococcus aereus was the most detected microorganism based on culture results. Three adult cases were followed up in the intensive care unit because of development of mediastinitis. One of these 3 cases exited because of sepsis. Hospitalization periods of 79 cases ranged between 2–21 days (mean 7.64 days). Hospitalization period of 19 cases with systemic diseases were 9.47 days (p<0.05) and statistically which were statistically significantly longer when compared with those without any systemic disease. CONCLUSION: Neck abscess must be diagnosed early and treated with surgical drainage and parenteral therapy because it might cause severe complications. PMID:28058371

  15. Adrenergic signaling elements in the bladder wall of the adult rat.

    PubMed

    Persyn, Sara; Eastham, Jane; De Wachter, Stefan; Gillespie, James

    2016-12-01

    A growing body of work is describing the absence of a significant sympathetic innervation of the detrusor implying little sympathetic regulation of bladder contractility. However, low doses of adrenergic agonists are capable of relaxing the bladder smooth muscle. If these effects underpin a physiological response then the cellular nature and operation of this system are currently unknown. The present immunohistochemistry study was done to explore the existence of alternative adrenergic signaling elements in the rat bladder wall. Using antibodies to tyrosine hydroxylase (TH) and vesicular mono-amine transporter (vmat), few adrenergic nerves were found in the detrusor although TH immunoreactive (IR) nerves were apparent in the bladder neck. TH-IR and vmat-IR nerves were however abundant surrounding blood vessels. A population of vmat-IR cells was found within the network of interstitial cells that surround the detrusor muscle bundles. These vmat-IR cells were not or only weakly TH-IR. This suggests that these interstitial cells have the capacity to store and release catecholamines that may involve noradrenaline. Cells expressing the β1-adrenoceptor (β1AR-IR) were also detected within the interstitial cell network. Double staining with antibodies to β1AR and vmat suggests that the majority of vmat-IR interstitial cells show β1AR-IR indicative of an autocrine signaling system. In conclusion, a population of interstitial cells has the machinery to store, release and respond to catecholamines. Thus, there might exist a non-neuronal β-adrenergic system operating in the bladder wall possibly linked to one component of motor activity, micro-contractions, a system that may be involved in mechanisms underpinning bladder sensation.

  16. Early history of neck dissection.

    PubMed

    Rinaldo, Alessandra; Ferlito, Alfio; Silver, Carl E

    2008-12-01

    With the exception of distant metastases, the presence of lymph node metastasis in the neck is accepted as the single most important adverse independent prognostic factor and an indicator of survival in squamous carcinoma of the head and neck. Neck dissection in its various forms is the standard surgical treatment for clinical, subclinical and subpathologic metastatic cancer to the neck. The pertinent literature from the beginning of the nineteenth century to the middle of the twentieth century was reviewed. The four giants of late nineteenth century surgery: von Langenbeck, Billroth, von Volkmann and Kocher developed and reported the early cases of different types of neck dissection. Butlin, in England, conceived and developed the concept of elective neck dissection. In 1888, the Polish surgeon Jawdyńsky reported and described in detail the first successful extended en bloc neck dissection. Crile, in 1905 and 1906, reported the first significant series of radical en bloc neck dissections, bringing this procedure to the attention of the medical world as an effective operation with reproducible technique and results. The greatest impetus to the status of this surgical procedure came from Martin and colleagues, who published a monumental report in 1951 of 1,450 cases that established the place and technique of radical neck dissection in the modern treatment of head and neck cancer. Neck dissection, for treatment of cervical lymph node metastases in head and neck cancer, was conceived and attempted in the nineteenth century, with some limited success reported by the end of that era. An effective operation was described and reported in the early twentieth century and evolved by the mid century into a fundamental tool in the management of patients with head and neck cancer.

  17. Powered Descent Guidance with General Thrust-Pointing Constraints

    NASA Technical Reports Server (NTRS)

    Carson, John M., III; Acikmese, Behcet; Blackmore, Lars

    2013-01-01

    The Powered Descent Guidance (PDG) algorithm and software for generating Mars pinpoint or precision landing guidance profiles has been enhanced to incorporate thrust-pointing constraints. Pointing constraints would typically be needed for onboard sensor and navigation systems that have specific field-of-view requirements to generate valid ground proximity and terrain-relative state measurements. The original PDG algorithm was designed to enforce both control and state constraints, including maximum and minimum thrust bounds, avoidance of the ground or descent within a glide slope cone, and maximum speed limits. The thrust-bound and thrust-pointing constraints within PDG are non-convex, which in general requires nonlinear optimization methods to generate solutions. The short duration of Mars powered descent requires guaranteed PDG convergence to a solution within a finite time; however, nonlinear optimization methods have no guarantees of convergence to the global optimal or convergence within finite computation time. A lossless convexification developed for the original PDG algorithm relaxed the non-convex thrust bound constraints. This relaxation was theoretically proven to provide valid and optimal solutions for the original, non-convex problem within a convex framework. As with the thrust bound constraint, a relaxation of the thrust-pointing constraint also provides a lossless convexification that ensures the enhanced relaxed PDG algorithm remains convex and retains validity for the original nonconvex problem. The enhanced PDG algorithm provides guidance profiles for pinpoint and precision landing that minimize fuel usage, minimize landing error to the target, and ensure satisfaction of all position and control constraints, including thrust bounds and now thrust-pointing constraints.

  18. Measuring foot placement and clearance during stair descent.

    PubMed

    Muhaidat, Jennifer; Kerr, Andrew; Rafferty, Danny; Skelton, Dawn A; Evans, Jonathan J

    2011-03-01

    Falls during stair descent are a serious problem and can lead to accidental death. Inappropriate foot placement on, and clearance over, steps have been identified as causes for falls on stairs. This study investigated a new method for measuring placement and clearance during stair descent in 10 healthy young subjects. The effect of foot length was accounted for during the measurement of foot placement by calculating the percentage length of the foot overhanging the step. Foot clearance was measured as the resultant of the minimum vertical and horizontal distances from the heel of the foot to the edge of the step. Clearance was divided into landing and passing clearance depending on the planned placement of the foot in relation to the step edge being cleared. Each subject performed seven trials of stairs descent. Mean (SD) and CV (SD) were 16% (6), 0.28 (0.15) for placement; 45.88 (10.05), 0.21 (0.07) for landing clearance; 107.25 (5.59), 0.25 (0.08) for passing clearance. There was no statistically significant effect of trial on placement and clearance (p>0.05). There was a significant effect of step number on landing and passing clearance (p=0.01, p<0.001 respectively). Landing and passing clearances were greater for the third step compared to the second step. Passing clearance was also significantly greater than landing clearance (p<0.001). The repeatable methods and findings from this study might be useful in providing a technical background and normal values for the design of future gait studies on stairs.

  19. Entry, Descent, and Landing for Human Mars Missions

    NASA Technical Reports Server (NTRS)

    Munk, Michelle M.; DwyerCianciolo, Alicia M.

    2012-01-01

    One of the most challenging aspects of a human mission to Mars is landing safely on the Martian surface. Mars has such low atmospheric density that decelerating large masses (tens of metric tons) requires methods that have not yet been demonstrated, and are not yet planned in future Mars missions. To identify the most promising options for Mars entry, descent, and landing, and to plan development of the needed technologies, NASA's Human Architecture Team (HAT) has refined candidate methods for emplacing needed elements of the human Mars exploration architecture (such as ascent vehicles and habitats) on the Mars surface. This paper explains the detailed, optimized simulations that have been developed to define the mass needed at Mars arrival to accomplish the entry, descent, and landing functions. Based on previous work, technology options for hypersonic deceleration include rigid, mid-L/D (lift-to-drag ratio) aeroshells, and inflatable aerodynamic decelerators (IADs). The hypersonic IADs, or HIADs, are about 20% less massive than the rigid vehicles, but both have their technology development challenges. For the supersonic regime, supersonic retropropulsion (SRP) is an attractive option, since a propulsive stage must be carried for terminal descent and can be ignited at higher speeds. The use of SRP eliminates the need for an additional deceleration system, but SRP is at a low Technology Readiness Level (TRL) in that the interacting plumes are not well-characterized, and their effect on vehicle stability has not been studied, to date. These architecture-level assessments have been used to define the key performance parameters and a technology development strategy for achieving the challenging mission of landing large payloads on Mars.

  20. OFT ascent/descent ancillary data requirements document

    NASA Technical Reports Server (NTRS)

    Bond, A. C., Jr.; Abramson, B.

    1978-01-01

    Requirements are presented for the ascent/descent (A/D) navigation and attitude-dependent ancillary data products to be generated for the space shuttle orbiter in support of orbital flight test requirements, MPAD guidance and navigation performance assessment, and the mission evaluation team. It was intended that this document serve as the sole requirements control instrument between MPB/MPAD and the A/D ancillary data users. The requirements are primarily functional in nature, but some detail level requirements are also included.

  1. Shuttle program: OFT ascent/descent ancillary data requirements document

    NASA Technical Reports Server (NTRS)

    Bond, A. C., Jr.; Knoedler, J.

    1980-01-01

    Requirements are presented for the ascent/descent (A/D) navigation and attitude-dependent ancillary data products to be generated for the space shuttle orbiter in support of the orbital flight test (OFT) flight test requirements, MPAD guidance and navigation performance assessment, and the mission evaluation team. The A/D ancillary data support for OFT mission evaluation activities is confined to providing postflight position, velocity, attitude, and associated navigation and attitude derived parameters for the Orbiter over particular flight phases and time intervals.

  2. Revalidation of the Huygens Descent Control Sub-System

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The Huygens probe, part of the Cassini mission to Saturn, is designed to investigate the atmosphere of Titan, Saturn's largest moon. The passage of the probe through the atmosphere is controlled by the Descent Control Sub-System (DCSS), which consists of three parachutes and associated mechanisms. The Cassini / Huygens mission was launched in October 1997 and was designed during the early 1990's. During the time since the design and launch, analysis capabilities have improved significantly, knowledge of the Titan environment has improved and the baseline mission has been modified. Consequently, a study was performed to revalidate the DCSS design against the current predictions.

  3. A model to predict bladder shapes from changes in bladder and rectal filling.

    PubMed

    Lotz, Heidi T; Remeijer, Peter; van Herk, Marcel; Lebesque, Joos V; de Bois, Josien A; Zijp, Lambert J; Moonen, Luc M

    2004-06-01

    The purpose of this study is to develop a model that quantifies in three dimensions changes in bladder shape due to changes in bladder and/or rectal volume. The new technique enables us to predict changes in bladder shape over a short period of time, based on known urinary inflow. Shortly prior to the treatment, the patient will be scanned using a cone beam CT scanner (x-ray volume imager) that is integrated with the linear accelerator. After (automated) delineation of the bladder, the model will be used to predict the short-term shape changes of the bladder for the time interval between image acquisition and dose delivery. The model was developed using multiple daily CT scans of the pelvic area of 19 patients. For each patient, the rigid bony structure in follow-up scans was matched to that of the planning CT scan, and the outer bladder and rectal wall were delineated. Each bladder wall was subdivided in 2500 domains. A fixed reference point inside the bladder was used to calculate for each bladder structure a "Mercator-like" 2D scalar map (similar to a height map of the globe), containing the distances from this reference point to each domain on the bladder wall. Subsequently, for all bladder shapes of a patient and for all domains on the wall individually, the distance to the reference point was fitted by a linear function of both bladder and rectal volume. The model uses an existing bladder structure to create a new structure via expansion (or contraction), until the expressed volume is reached. To evaluate the predictive power of the model, the jack-knife method was used. The errors in the fitting procedure depended on the part of the bladder and range from 0 to 0.5 cm (0.2 cm on average). It was found that a volume increase of 150 cc can lead to a displacement up to about 2.5 cm of the cranial part of the bladder. With the model, the uncertainty in the position of the bladder wall can be reduced down to a maximum value of about 0.5 cm in case the bladder

  4. STS-1 operational flight profile. Volume 5: Descent, cycle 3. Appendix C: Monte Carlo dispersion analysis

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The results of three nonlinear the Monte Carlo dispersion analyses for the Space Transportation System 1 Flight (STS-1) Orbiter Descent Operational Flight Profile, Cycle 3 are presented. Fifty randomly selected simulation for the end of mission (EOM) descent, the abort once around (AOA) descent targeted line are steep target line, and the AOA descent targeted to the shallow target line are analyzed. These analyses compare the flight environment with system and operational constraints on the flight environment and in some cases use simplified system models as an aid in assessing the STS-1 descent flight profile. In addition, descent flight envelops are provided as a data base for use by system specialists to determine the flight readiness for STS-1. The results of these dispersion analyses supersede results of the dispersion analysis previously documented.

  5. Ruptured urinary bladder attributable to urethral compression by a haematoma after vertebral fracture in a bull

    PubMed Central

    2014-01-01

    Background In male cattle, rupture of the urinary bladder is usually associated with urethral obstruction by uroliths. Less common causes include urethral compression or stricture. This case report describes the findings in a young Limousion breeding bull with rupture of the urinary bladder because of urethral compression by a haematoma after coccygeal fracture. Case presentation The bull had been introduced into a 40-head Red-Holstein herd one week before being injured. One week after introduction to the herd, the bull had an acute onset of anorexia and he was referred to the clinic. There was marked abdominal distension, reduced skin turgor and enophthalmus. The serum concentration of urea and creatinine was increased. Ultrasonographic examination revealed severe ascites and abdominocentesis yielded clear yellow fluid with high urea and creatinine concentrations, which supported a diagnosis of uroperitoneum. The bull was euthanatized because of a poor prognosis. Postmortem examination revealed a comminuted fracture of the first two coccygeal vertebrae associated with a massive haematoma that obstructed entire pelvic cavity. The haematoma compressed the urethra thereby preventing outflow of urine, which resulted in a 5-cm tear ventrally at the neck of the bladder. It was assumed that the newly-introduced bull had sustained the vertebral fractures when he was mounted by a cow. Conclusions The present case study serves to expand the differential diagnosis of urinary bladder rupture. Therefore, in addition to obstructive urolithiasis, compression and stricture of the urethra might be considered in male cattle with uroperitoneum. PMID:24666697

  6. [Surgical treatment for gall bladder cancer with a confluence stone-a case report].

    PubMed

    Ota, Hideo; Ohtsuru, Minoru; Komai, Takanori; Katayama, Tomohiro; Machida, Tomohiko; Ishii, Takaaki; Hiraoka, Kunihiko; Sinozaki, Kouji; Kawasaki, Yasuhito; Ikeda, Yukio; Senba, Hidemine; Yasuda, Seiji

    2012-11-01

    The patient was a 71-year-old man. In September 2011, he experienced abdominal pain with high fever. Abdominal computed tomography (CT) diagnosed acute cholecystitis with a confluence stone (corlette classification type II). He underwent total cholecystectomy and placement of a T-tube in the main bile duct through the gall bladder duct. However, pathological investigations revealed gall bladder cancer in the neck and body part of the gall bladder, leading to a diagnosis of gall bladder adenocarcinoma(Gbn, Flat type, tub2, INF β,pSS, pHinf0, pBinf1, pPV0, pA0, pT3) with a confluence stone. We suspected that the tumor was present in the common bile duct. Therefore, in October 2011, he underwent choledochectomy, resection of the liver bed, lymph node dissection, and choledocho-jejunostomy. Pathological findings revealed that the tumor was present in the common bile duct. He died 8 months after the last surgery because of recurrence of peritoneal metastasis.

  7. Ultrasound and Biomarker Tests in Predicting Cancer Aggressiveness in Tissue Samples of Patients With Bladder Cancer

    ClinicalTrials.gov

    2016-06-09

    Bladder Papillary Urothelial Carcinoma; Stage 0a Bladder Urothelial Carcinoma; Stage 0is Bladder Urothelial Carcinoma; Stage I Bladder Cancer With Carcinoma In Situ; Stage I Bladder Urothelial Carcinoma; Stage II Bladder Urothelial Carcinoma; Stage III Bladder Urothelial Carcinoma; Stage IV Bladder Urothelial Carcinoma

  8. Emulating a Fish Swim Bladder

    NASA Astrophysics Data System (ADS)

    Vesenka, James; Meredith, Dawn; Bolker, Jessica; Schubert, Christopher; Kraut, Gertrud

    2009-10-01

    The University of New Hampshire and the University of New England are developing biologically relevant physics laboratories for their predominantly health science audiences. Buoyancy plays an important role in a variety of biological processes. We describe an inexpensive laboratory activity based on the Cartesian Diver that allows students to quantitatively emulate the swim bladder of a fish. Inflation of the ``bladder'' is externally controlled through an external gas syringe or squeezing on the plastic water containment vessel (a 2L soda bottle). The students can accurately determine the volume of a ``fish'' at the point of neutral buoyancy by visual measurement of the trapped air pocket. A simple electronic gas pressure sensor allows the hydrostatic pressure on the fish to be analyzed simultaneously.

  9. Research Findings on Overactive Bladder

    PubMed Central

    Patra, Phani B.; Patra, Sayani

    2015-01-01

    Several physiopathologic conditions lead to the manifestation of overactive bladder (OAB). These conditions include ageing, diabetes mellitus, bladder outlet obstruction, spinal cord injury, stroke and brain injury, Parkinson's disease, multiple sclerosis, interstitial cystitis, stress and depression. This review has discussed research findings in human and animal studies conducted on the above conditions. Several structural and functional changes under these conditions have not only been observed in the lower urinary tract, but also in the brain and spinal cord. Significant changes were observed in the following areas: neurotransmitters, prostaglandins, nerve growth factor, Rho-kinase, interstitial cells of Cajal, and ion and transient receptor potential channels. Interestingly, alterations in these areas showed great variation in each of the conditions of the OAB, suggesting that the pathophysiology of the OAB might be different in each condition of the disease. It is anticipated that this review will be helpful for further research on new and specific drug development against OAB. PMID:26195957

  10. Role of angiogenesis in urothelial bladder carcinoma

    PubMed Central

    Górnicka, Barbara

    2016-01-01

    Introduction Bladder cancer is the most common urinary tract malignancy in western countries. In recent years, extensive research has suggested that angiogenesis plays an important role in bladder cancer biology, contributing to tumor growth and progression. Material and methods In this review, we discuss general mechanisms of angiogenesis and highlight the influence of pro- and anti-angiogenic factors, and cancer stem cells on bladder cancer biology, their relation to disease progression, and potential use in novel targeted therapies. Results Expression of a number of proangiogenic factors, including HIF-1, VEGF, bFGF, IL-8 and MMPs, as well as anti-angiogenic factor TSP-1, was found to be altered in bladder tumors. Involvement of cancer stem cells in bladder cancer development was also proposed. Conclusions High expression of most pro-angiogenic factors correlated with disease progression and shorter patient survival, but discrepancies between studies urge us to continue evaluating the significance of angiogenesis in bladder cancer. PMID:27729991

  11. Bladder tear during revision total hip arthroplasty.

    PubMed

    Grauer, Jonathan N; Halim, Andrea; Keggi, Kristaps J

    2014-08-01

    Total hip arthroplasty (THA) and revision total hip arthroplasty are among the most commonly performed orthopedic procedures. There are many reported complications of THA, but intrapelvic complications are a rare subset. Bladder injuries have infrequently been described in association with this common procedure. We present an unusual case of a bladder tear occurring intraoperatively during a revision THA. It is suspected that the patient's history of multiple prior hip procedures caused adhesions of the bladder to the pelvic floor and predisposed the bladder to injury during acetabular revision. Previous reports of bladder injury relating to THA have described thermal necrosis, component migration, and occasional direct perforation. There are no prior case reports describing bladder tears related to adhesions occurring intraoperatively during revision THA. This case report highlights the importance of surgeon awareness of an unusual complication. In this case, intraoperative and postoperative recognition of a hematuria diagnosis led to the appropriate treatment, and this patient had an acceptable outcome.

  12. Developmental biomechanics of neck musculature.

    PubMed

    Lavallee, Amy V; Ching, Randal P; Nuckley, David J

    2013-02-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6-23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects' ability to maintain 70% of peak force over 30s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (p<0.0001) increase with age. The MVC force, averaged across all directions and normalized to the adult values, exhibits the following maturation curve: %MVC Force=-0.0879(age)(2)+6.018(age)+8.120. Neck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions.

  13. Developmental biomechanics of neck musculature

    PubMed Central

    Lavallee, Amy V.; Ching, Randal P.; Nuckley, David J.

    2012-01-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6–23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects’ ability to maintain 70% of peak force over 30 s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (p<0.0001) increase with age. The MVC force, averaged across all directions and normalized to the adult values, exhibits the following maturation curve: %MVC Force= −0.0879(age)2+6.018(age)+8.120. Neck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions. PMID:23127787

  14. An evaluation of descent strategies for TNAV-equipped aircraft in an advanced metering environment

    NASA Technical Reports Server (NTRS)

    Izumi, K. H.; Schwab, R. W.; Groce, J. L.; Coote, M. A.

    1986-01-01

    Investigated were the effects on system throughput and fleet fuel usage of arrival aircraft utilizing three 4D RNAV descent strategies (cost optimal, clean-idle Mach/CAS and constant descent angle Mach/CAS), both individually and in combination, in an advanced air traffic control metering environment. Results are presented for all mixtures of arrival traffic consisting of three Boeing commercial jet types and for all combinations of the three descent strategies for a typical en route metering airport arrival distribution.

  15. [The latest news on bladder cancer].

    PubMed

    Retz, M; Lehmann, J; Nawroth, R; Gschwend, J E

    2007-07-01

    A review of the current literature provides new scientific insights into the diagnosis, prognosis and novel molecular targets for bladder cancer. The new WHO classification refines our staging system and influences treatment options. International clinical databases provide new tools for calculating the individual risk for bladder cancer recurrence and progression. Systematic gene cluster analysis defines multimarker panels that can serve as robust predictors of outcome. Discoveries of new signaling pathways in bladder cancer are leading to novel molecular targets for innovative therapies.

  16. [Diagnosis of tuberculosis of bladder].

    PubMed

    Kul'chavenia, E V; Kholtobin, D P

    2014-01-01

    A comparative analysis of cystoscopic and pathologic patterns in 190 patients hospitalized for differential diagnosis or treatment of genitourinary tuberculosis in 2008-2011 was performed. All patients underwent polyfocal biopsy followed by pathologic examination of biopsy specimens. Furthermore, a comparison of results ofpathomorphological studies of tissue obtained by biopsy and after cystectomy was conducted. Cystoscopy in all patients with tuberculosis of the bladder (TB) revealed the reduced bladder capacity in contrast to patients with other urological diseases. Deformation of orifices, trabecularity and contact bleeding were observed in 66.7 to 94.4% of cases in patients with TB, which were significantly more common than in other diseases. Polymorphism of pathological pattern and the lack of specific changes in the majority of patients with TB were noted; multinucleated Pirogov-Langhans cells were found only in 11.8% of cases, and only in biopsies, whereas in the tissues obtained after cystectomy in same patients, lymphocytic infiltration and fibrosis were observed. The algorithm of diagnosis of tuberculosis of the bladder is suggested.

  17. Design of a randomised acupuncture trial on functional neck/shoulder stiffness with two placebo controls

    PubMed Central

    2014-01-01

    Background Functional neck/shoulder stiffness is one of the most well-known indications for acupuncture treatment in Japan. There is little evidence for the effectiveness of acupuncture treatment for functional neck/shoulder stiffness. Research using two different placebos may allow an efficient method to tease apart the components of real acupuncture from various kinds of ‘non-specific’ effects such as ritual with touch or ritual alone. Herein, we describe a protocol of an ongoing, single-centre, randomised, placebo-controlled trial which aims to assess whether, in functional neck/shoulder stiffness, acupuncture treatment with skin piercing has a specific effect over two types of placebo: skin-touching plus ritual or ritual alone. Methods Six acupuncturists and 400 patients with functional neck/shoulder stiffness are randomly assigned to four treatment groups: genuine acupuncture penetrating the skin, skin-touch placebo or no-touch placebo needles in a double-blind manner (practitioner-patient blinding) or no-treatment control group. Each acupuncturist applies a needle to each of four acupoints (Bladder10, Small Intestine14, Gallbladder21 and Bladder42) in the neck/shoulder to 50 patients. Before, immediately after and 24 hours after the treatment, patients are asked about the intensity of their neck/shoulder stiffness. After the treatment, practitioners and patients are asked to guess whether the treatment is “penetrating”, “skin-touch” or “no-touch” or to record “cannot identify the treatment”. Discussion In addition to intention-to-treat analysis, we will conduct subgroup analysis based on practitioners’ or patients’ guesses to discuss the efficacy and effectiveness of treatments with skin piercing and various placebo controls. The results of practitioner and patient blinding will be discussed. We believe this study will further distinguish the role of different components of acupuncture. Trial registration Current Controlled Trial

  18. Atezolizumab in Treating Patients With Recurrent BCG-Unresponsive Non-muscle Invasive Bladder Cancer

    ClinicalTrials.gov

    2017-03-30

    Recurrent Bladder Urothelial Carcinoma; Stage 0a Bladder Urothelial Carcinoma; Stage 0is Bladder Urothelial Carcinoma; Stage I Bladder Cancer With Carcinoma In Situ; Stage I Bladder Urothelial Carcinoma

  19. Ruptured urinary bladder in a heifer.

    PubMed

    Roussel, A J; Ward, D S

    1985-06-15

    A yearling Holstein heifer was admitted with abdominal pain and bilateral, ventral abdominal distention. Bladder rupture was diagnosed by abdominocentesis and endoscopy. Correction of metabolic derangements was accomplished by volume diuresis, with maintenance of a urethral catheter before surgical repair of the bladder. The cause of the bladder rupture was believed to be related to adhesions resulting from previous surgery for urachal abscessation. Bladder rupture, which usually occurs in bulls or steers secondary to urolithiasis or in cows after dystocia, also should be considered in prepartum heifers with dehydration, abdominal pain, and abdominal distention.

  20. Mars Exploration Rover Terminal Descent Mission Modeling and Simulation

    NASA Technical Reports Server (NTRS)

    Raiszadeh, Behzad; Queen, Eric M.

    2004-01-01

    Because of NASA's added reliance on simulation for successful interplanetary missions, the MER mission has developed a detailed EDL trajectory modeling and simulation. This paper summarizes how the MER EDL sequence of events are modeled, verification of the methods used, and the inputs. This simulation is built upon a multibody parachute trajectory simulation tool that has been developed in POST I1 that accurately simulates the trajectory of multiple vehicles in flight with interacting forces. In this model the parachute and the suspended bodies are treated as 6 Degree-of-Freedom (6 DOF) bodies. The terminal descent phase of the mission consists of several Entry, Descent, Landing (EDL) events, such as parachute deployment, heatshield separation, deployment of the lander from the backshell, deployment of the airbags, RAD firings, TIRS firings, etc. For an accurate, reliable simulation these events need to be modeled seamlessly and robustly so that the simulations will remain numerically stable during Monte-Carlo simulations. This paper also summarizes how the events have been modeled, the numerical issues, and modeling challenges.

  1. Mars Science Laboratory Entry Descent and Landing Simulation Using DSENDS

    NASA Technical Reports Server (NTRS)

    Burkhart, P. Daniel; Casoliva, Jordi; Balaram, Bob

    2013-01-01

    The most recent planetary science mission to Mars is Mars Science Laboratory (MSL) with the Curiosity rover, launched November 26, 2011 and landed at Gale Crater on August 6, 2012. This spacecraft was the first use at Mars of a complete closed-loop Guidance Navigation and Control (GN&C) system, including guided entry with a lifting body that greatly reduces dispersions during the Entry, Descent and Landing (EDL) phase to achieve a 25 km x 20 km landing error relative to the selected Gale Crater landing target. In order to confirm meeting the above landing criteria, high-fidelity simulation of the EDL phase is required. The tool used for 6DOF EDL trajectory verification analysis is Dynamics Simulator for Entry, Descent and Surface landing (DSENDS), which is a high-fidelity simulation tool from JPLs Dynamics and Real-Time Simulation Laboratory for the development, test and operations of aero-flight vehicles. DSENDS inherent capability is augmented for MSL with project-specific models of atmosphere, aerodynamics, sensors and thrusters along with GN&C flight software to enable high-fidelity trajectory simulation. This paper will present the model integration and independent verification experience of the JPL EDL trajectory analysis team.

  2. Mars Science Laboratory Entry Descent and Landing Simulation Using DSENDS

    NASA Technical Reports Server (NTRS)

    Burkhart, P. Daniel; Casoliva, Jordi; Balaram, Bob

    2013-01-01

    The most recent planetary science mission to Mars was Mars Science Laboratory (MSL) with the Curiosity rover, launched November 26, 2011 and landed at Gale Crater on August 6, 2012. This spacecraft was the first use at Mars of a complete closed-loop Guidance Navigation and Control (GN&C) system, including guided entry with a lifting body that greatly reduces dispersions during the Entry, Descent and Landing (EDL) phase to achieve a 25 km X 20 km landing error relative to the selected Gale Crater landing target. In order to confirm meeting the above landing criteria, high-fidelity simulation of the EDL phase is required. The tool used for 6DOF EDL trajectory verification analysis is Dynamics Simulator for Entry, Descent and Surface landing (DSENDS), which is a high-fidelity simulation tool from JPLs Dynamics and Real-Time Simulation Laboratory for the development, test and operations of aero-flight vehicles. DSENDS inherent capability is augmented for MSL with project-specific models of atmosphere, aerodynamics, sensors and thrusters along with GN&C flight software to enable high-fidelity trajectory simulation. This paper will present the model integration and independent verification experience of the JPL EDL trajectory analysis team.

  3. Efficient Love wave modelling via Sobolev gradient steepest descent

    NASA Astrophysics Data System (ADS)

    Browning, Matt; Ferguson, John; McMechan, George

    2016-05-01

    A new method for finding solutions to ordinary differential equation boundary value problems is introduced, in which Sobolev gradient steepest descent is used to determine eigenfunctions and eigenvalues simultaneously in an iterative scheme. The technique is then applied to the 1-D Love wave problem. The algorithm has several advantages when computing dispersion curves. It avoids the problem of mode skipping, and can handle arbitrary Earth structure profiles in depth. For a given frequency range, computation times scale approximately as the square root of the number of frequencies, and the computation of dispersion curves can be implemented in a fully parallel manner over the modes involved. The steepest descent solutions are within a fraction of a per cent of the analytic solutions for the first 25 modes for a two-layer model. Since all corresponding eigenfunctions are computed along with the dispersion curves, the impact on group and phase velocity of the displacement behaviour with depth is thoroughly examined. The dispersion curves are used to compute synthetic Love wave seismograms that include many higher order modes. An example includes addition of attenuation to a model with a low-velocity zone, with values as low as Q = 20. Finally, a confirming comparison is made with a layer matrix method on the upper 700 km of a whole Earth model.

  4. Arachnid aloft: directed aerial descent in neotropical canopy spiders

    PubMed Central

    Yanoviak, Stephen P.; Munk, Yonatan; Dudley, Robert

    2015-01-01

    The behaviour of directed aerial descent has been described for numerous taxa of wingless hexapods as they fall from the tropical rainforest canopy, but is not known in other terrestrial arthropods. Here, we describe similar controlled aerial behaviours for large arboreal spiders in the genus Selenops (Selenopidae). We dropped 59 such spiders from either canopy platforms or tree crowns in Panama and Peru; the majority (93%) directed their aerial trajectories towards and then landed upon nearby tree trunks. Following initial dorsoventral righting when necessary, falling spiders oriented themselves and then translated head-first towards targets; directional changes were correlated with bilaterally asymmetric motions of the anterolaterally extended forelegs. Aerial performance (i.e. the glide index) decreased with increasing body mass and wing loading, but not with projected surface area of the spider. Along with the occurrence of directed aerial descent in ants, jumping bristletails, and other wingless hexapods, this discovery of targeted gliding in selenopid spiders further indicates strong selective pressures against uncontrolled falls into the understory for arboreal taxa. PMID:26289654

  5. Viking Mars hydrazine terminal descent engine thermal design considerations

    NASA Technical Reports Server (NTRS)

    Cunningham, C. R.; Morrisey, D. C.

    1977-01-01

    A description is given of some of the more significant thermal design considerations employed in the development and qualification of the monopropellant hydrazine terminal descent engines on the Viking Mars lander spacecraft. The terminal descent engine operates in a blowdown and throttling mode, which results in an operating thrust range of 638 to 90 lbf. Martian entry thermal design boundary conditions are described, along with resulting radiative and conductive engine thermal isolation hardware. Test results are presented, showing engine thermal design performance as compared with specified requirements. General engine materials of construction are described, along with Hastelloy B shell structural characteristics, which were extended to 2000 F by test and are compared with limited existing MIL-HDBK-5 data. Subscale test results are presented, showing the maximum catalyst bed cylinder design temperature of 1970 F. Test results also are presented, showing local reactor internal convective heat-transfer coefficients. Such data are unique, since the engine employs a completely radial flow catalyst bed design. This design approach is the first of its kind in the monopropellant hydrazine gas generator field to be flight qualified.

  6. Mars 2020 Entry, Descent and Landing Instrumentation 2 (MEDLI2)

    NASA Technical Reports Server (NTRS)

    Hwang, Helen H.; Bose, Deepak; White, Todd R.; Wright, Henry S.; Schoenenberger, Mark; Kuhl, Christopher A.; Trombetta, Dominic; Santos, Jose A.; Oishi, Tomomi; Karlgaard, Christopher D.; Mahzari, Milad; Pennington, Steven P.

    2016-01-01

    The Mars Entry Descent and Landing Instrumentation 2 (MEDLI2) sensor suite will measure aerodynamic, aerothermodynamic, and TPS performance during the atmospheric entry, descent, and landing phases of the Mars 2020 mission. The key objectives are to reduce design margin and prediction uncertainties for the aerothermal environments and aerodynamic database. For MEDLI2, the sensors are installed on both the heatshield and backshell, and include 7 pressure transducers, 17 thermal plugs, and 3 heat flux sensors (including a radiometer). These sensors will expand the set of measurements collected by the highly successful MEDLI suite, collecting supersonic pressure measurements on the forebody, a pressure measurement on the aftbody, direct heat flux measurements on the aftbody, a radiative heating measurement on the aftbody, and multiple near-surface thermal measurements on the thermal protection system (TPS) materials on both the forebody and aftbody. To meet the science objectives, supersonic pressure transducers and heat flux sensors are currently being developed and their qualification and calibration plans are presented. Finally, the reconstruction targets for data accuracy are presented, along with the planned methodologies for achieving the targets.

  7. Controller evaluations of the descent advisor automation aid

    NASA Technical Reports Server (NTRS)

    Tobias, Leonard; Volckers, Uwe; Erzberger, Heinz

    1989-01-01

    An automation aid to assist air traffic controllers in efficiently spacing traffic and meeting arrival times at a fix has been developed at NASA Ames Research Center. The automation aid, referred to as the descent advisor (DA), is based on accurate models of aircraft performance and weather conditions. The DA generates suggested clearances, including both top-of-descent point and speed profile data, for one or more aircraft in order to achieve specific time or distance separation objectives. The DA algorithm is interfaced with a mouse-based, menu-driven controller display that allows the air traffic controller to interactively use its accurate predictive capability to resolve conflicts and issue advisories to arrival aircraft. This paper focuses on operational issues concerning the utilization of the DA, specifically, how the DA can be used for prediction, intrail spacing, and metering. In order to evaluate the DA, a real time simulation was conducted using both current and retired controller subjects. Controllers operated in teams of two, as they do in the present environment; issues of training and team interaction will be discussed. Evaluations by controllers indicated considerable enthusiasm for the DA aid, and provided specific recommendations for using the tool effectively.

  8. Prevention of falls during stairway descent in older adults.

    PubMed

    Kim, B J

    2009-05-01

    A prospective design was applied to examine how older adults would adapt stairway intervention stimuli to gait patterns during stairway descent to prevent falls. Ambient lighting and an auditory signal were used as stairway intervention stimuli. The gait pattern changes with and without stimuli were compared. No significant change of angular displacement was found between normal condition and intervention conditions under daylight and nightlight. The lighting intervention tended to increase the knee's angular velocity for both daylight and nightlight conditions, but not the ankle's angular velocity. However, adding the auditory signal to the lighting intervention under nightlight condition increased the ankle's angular velocity. Under the daylight condition, every intervention was significantly helpful to make people step on the floor more confidently compared to the condition without interventions. However, the intervention of lighting had an opposite effect on the confidence of stepping under the nightlight condition. The intervention of lighting may contribute to increase of confidence during stair descent while compromising the declined stride length in older adults and the potential "rush" factor for falls on stairs.

  9. Steepest descent moment method for three-dimensional magnetohydrodynamic equilibria

    SciTech Connect

    Hirshman, S.P.; Whitson, J.C.

    1983-11-01

    An energy principle is used to obtain the solution of the magnetohydrodynamic (MHD) equilibrium equation J Vector x B Vector - del p = 0 for nested magnetic flux surfaces that are expressed in the inverse coordinate representation x Vector = x Vector(rho, theta, zeta). Here, theta and zeta are poloidal and toroidal flux coordinate angles, respectively, and p = p(rho) labels a magnetic surface. Ordinary differential equations in rho are obtained for the Fourier amplitudes (moments) in the doubly periodic spectral decomposition of x Vector. A steepest descent iteration is developed for efficiently solving these nonlinear, coupled moment equations. The existence of a positive-definite energy functional guarantees the monotonic convergence of this iteration toward an equilibrium solution (in the absence of magnetic island formation). A renormalization parameter lambda is introduced to ensure the rapid convergence of the Fourier series for x Vector, while simultaneously satisfying the MHD requirement that magnetic field lines are straight in flux coordinates. A descent iteration is also developed for determining the self-consistent value for lambda.

  10. Interventional radiology neck procedures.

    PubMed

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation.

  11. Palpable mass of the neck in the course of Takayasu arteritis.

    PubMed

    Andrzejewska, Karolina; Starba, Aleksandra; Misterska-Skóra, Maria; Wiland, Piotr; Guziński, Maciej

    2017-01-01

    Takayasu arteritis is a rare, idiopathic inflammatory disease of the aorta and its major branches, usually affecting young women of Asian descent. In the course of the disease stenosis, occlusions as well as dilatations and aneurysms of vessels occur. Because of many possible localizations of pathological changes, the symptoms have a wide range, but the most common are a weak pulse or its absence on the brachial artery and a difference in systolic pressure above 10 mm Hg between the upper extremities. Here we present a case report of a young woman with Takayasu arteritis, who presented a palpable mass in the back of her neck, significantly diminished after treatment with glucocorticoids.

  12. Effect of Assistive Device for Neck Retraction (ANR) on Neck Muscles during Neck Retraction Exercise.

    PubMed

    Kim, Dong-Hyun; Kwon, Hun; Yoo, Won-Gyu

    2013-05-01

    [Purpose] The purpose of present study was to develop an exercise device for assisting neck retraction exercise and to investigate its effectiveness. [Subjects] Fifteen male subjects were recruited. [Methods] The subjects performed the neck retraction exercises with and without assistive device for neck retraction (ANR). EMG activities of the lower cervical erector spinae (LCE), and sternocleidomatoid (SCM) muscles were recorded. [Results] The ANR condition significantly increased LCE activation compared to the control condition. The ANR condition significantly decreased SCM activation compared to the control condition. [Conclusion] We suggest that the ANR condition will help the efficacy of the neck retraction exercise.

  13. The Effects of Acupuncture on Bladder Interstitial Cells of Cajal Excitability in Rats with Overactive Bladder

    PubMed Central

    Feng, Qi-fan; Hou, Yuen-hao; Hou, Wen-guang; Lin, Zhi-xian; Tang, Kang-min; Chen, Yue-lai

    2013-01-01

    It is well known that acupuncture treatment has an effect on patients with an overactive bladder, but the mechanism of its action remains to be clarified. This study was aimed to investigate the effects of acupuncture on bladder overactivity, and the excitability of interstitial cells of Cajal of the bladder in a rat model of partial bladder outlet obstruction. Electroacupuncture (continuous wave, 30 Hz, 1 mA) was applied to stimulate the Ciliao point (BL32) and the Huiyang point (BL35) of rats for 20 min, 3 days. Results showed that acupuncture suppressed detrusor unstable contraction frequency and decreased detrusor maximum pressure in the bladder filling period. Compared with the normal control rats, HCN2 mRNA and protein expression within the bladder were upregulated and were reversed by electroacupuncture in overactive bladder rats as determined by RT-PCR, western blotting and immunohistochemistry. Moreover, in-vitro cell-cultured OAB rats bladder interstitial cells of Cajal intracellular Ca2+ concentration were higher than normal control rats, which were lowered after acupuncture treatment. These findings suggest that acupuncture stimulation can suppress bladder overactivity, and regulate the excitability of bladder interstitial cells of Cajal in treatment of overactive bladder myogenic mechanism. PMID:24194780

  14. Evaluation of vertical profiles to design continuous descent approach procedure

    NASA Astrophysics Data System (ADS)

    Pradeep, Priyank

    The current research focuses on predictability, variability and operational feasibility aspect of Continuous Descent Approach (CDA), which is among the key concepts of the Next Generation Air Transportation System (NextGen). The idle-thrust CDA is a fuel economical, noise and emission abatement procedure, but requires increased separation to accommodate for variability and uncertainties in vertical and speed profiles of arriving aircraft. Although a considerable amount of researches have been devoted to the estimation of potential benefits of the CDA, only few have attempted to explain the predictability, variability and operational feasibility aspect of CDA. The analytical equations derived using flight dynamics and Base of Aircraft and Data (BADA) Total Energy Model (TEM) in this research gives insight into dependency of vertical profile of CDA on various factors like wind speed and gradient, weight, aircraft type and configuration, thrust settings, atmospheric factors (deviation from ISA (DISA), pressure and density of the air) and descent speed profile. Application of the derived equations to idle-thrust CDA gives an insight into sensitivity of its vertical profile to multiple factors. This suggests fixed geometric flight path angle (FPA) CDA has higher degree of predictability and lesser variability at the cost of non-idle and low thrust engine settings. However, with optimized design this impact can be overall minimized. The CDA simulations were performed using Future ATM Concept Evaluation Tool (FACET) based on radar-track and aircraft type data (BADA) of the real air-traffic to some of the busiest airports in the USA (ATL, SFO and New York Metroplex (JFK, EWR and LGA)). The statistical analysis of the vertical profiles of CDA shows 1) mean geometric FPAs derived from various simulated vertical profiles are consistently shallower than 3° glideslope angle and 2) high level of variability in vertical profiles of idle-thrust CDA even in absence of

  15. Bladder aspergillosis detected by urine cytology.

    PubMed

    Martínez-Girón, Rafael; Martínez-Torre, Santiago; Mosquera-Martínez, Joaquín

    2015-05-01

    Bladder aspergillosis is an unusual infection. We report the case of a 79-year-old man with clinical records of transitional cell carcinoma diagnosed 5 years ago. The presence of a fruiting body and septate hyphae in urine cytological smears were the key for a final diagnosis of fungal bladder infection caused by Aspergillus niger.

  16. Photodynamic management of bladder cancer

    NASA Astrophysics Data System (ADS)

    Johansson, A.; Stepp, H.; Beyer, W.; Pongratz, T.; Sroka, R.; Bader, M.; Kriegmair, M.; Zaak, D.; Waidelich, R.; Karl, A.; Hofstetter, A.; Stief, C.; Baumgartner, R.

    2009-06-01

    Bladder cancer (BC) is among the most expensive oncological diseases. Any improvement in diagnosis or therapy carries a high potential for reducing costs. Fluorescence cystoscopy relies on a selective formation of Protoporphyrin IX (PpIX) or more general photoactive porphyrins (PAP) in malignant urothelium upon instillation of 5-aminolevulinic acid (5-ALA) or its hexyl-derivative h-ALA. Fluorescence cystoscopy equipment has been developed with the aim to compensate for the undesired distortion caused by the tissue optical properties by displaying the red fluorescence simultaneously with the backscattered blue light. Many clinical studies proved a high sensitivity in detecting flat carcinoma in situ and small papillary malignant tumours. As a result, recurrence rates were significantly decreased in most studies. The limitation lies in a low specificity, caused by false positive findings at inflamed bladder wall. Optical coherence tomography (OCT) is currently being investigated as a promising tool to overcome this limitation. H-ALA-PDT (8 or 16 mM h-ALA in 50 ml instillation for 1-2 h, white light source, catheter applicator) has recently been investigated in a phase I study. 17 patients were applied 100 J/cm2 (3 patients received incrementing doses of 25 - 50 - 100 J/cm2) during approx. 1 hour irradiation time in 3 sessions, 6 weeks apart. PDT was performed without any technical complications. Complete photobleaching of the PpIX-fluorescence, as intended, could be achieved in 43 of 45 PDT-sessions receiving 100 J/cm2. The most prominent side effects were postoperative urgency and bladder pain, all symptoms being more severe after 16 mM h-ALA. Preliminary evaluation shows complete response assessed at 3 months after the third PDT-session (i.e. 6 months after first treatment) in 9 of 12 patients. 2 of these patients were free of recurrence until final follow-up at 84 weeks.

  17. Calcium transport in turtle bladder

    SciTech Connect

    Sabatini, S.; Kurtzman, N.A. )

    1987-12-01

    Unidirectional {sup 45}Ca fluxes were measured in the turtle bladder under open-circuit and short-circuit conditions. In the open-circuited state net calcium flux (J{sup net}{sub Ca}) was secretory (serosa to mucosa). Ouabain reversed J{sup net}{sub Ca} to an absorptive flux. Amiloride reduced both fluxes such that J{sup net}{sub Ca} was not significantly different from zero. Removal of mucosal sodium caused net calcium absorption; removal of serosal sodium caused calcium secretion. When bladders were short circuited, J{sup net}{sub Ca} decreased to approximately one-third of control value but remained secretory. When ouabain was added under short-circuit conditions, J{sup net}{sub Ca} was similar in magnitude and direction to ouabain under open-circuited conditions (i.e., absorptive). Tissue {sup 45}Ca content was {approx equal}30-fold lower when the isotope was placed in the mucosal bath, suggesting that the apical membrane is the resistance barrier to calcium transport. The results obtained in this study are best explained by postulating a Ca{sup 2+}-ATPase on the serosa of the turtle bladder epithelium and a sodium-calcium antiporter on the mucosa. In this model, the energy for calcium movement would be supplied, in large part, by the Na{sup +}-K{sup +}-ATPase. By increasing cell sodium, ouabain would decrease the activity of the mucosal sodium-calcium exchanger (or reverse it), uncovering active calcium transport across the serosa.

  18. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model

    NASA Astrophysics Data System (ADS)

    Chai, Xiangfei; van Herk, Marcel; Betgen, Anja; Hulshof, Maarten; Bel, Arjan

    2012-06-01

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  19. Automatic bladder segmentation on CBCT for multiple plan ART of bladder cancer using a patient-specific bladder model.

    PubMed

    Chai, Xiangfei; van Herk, Marcel; Betgen, Anja; Hulshof, Maarten; Bel, Arjan

    2012-06-21

    In multiple plan adaptive radiotherapy (ART) strategies of bladder cancer, a library of plans corresponding to different bladder volumes is created based on images acquired in early treatment sessions. Subsequently, the plan for the smallest PTV safely covering the bladder on cone-beam CT (CBCT) is selected as the plan of the day. The aim of this study is to develop an automatic bladder segmentation approach suitable for CBCT scans and test its ability to select the appropriate plan from the library of plans for such an ART procedure. Twenty-three bladder cancer patients with a planning CT and on average 11.6 CBCT scans were included in our study. For each patient, all CBCT scans were matched to the planning CT on bony anatomy. Bladder contours were manually delineated for each planning CT (for model building) and CBCT (for model building and validation). The automatic segmentation method consisted of two steps. A patient-specific bladder deformation model was built from the training data set of each patient (the planning CT and the first five CBCT scans). Then, the model was applied to automatically segment bladders in the validation data of the same patient (the remaining CBCT scans). Principal component analysis (PCA) was applied to the training data to model patient-specific bladder deformation patterns. The number of PCA modes for each patient was chosen such that the bladder shapes in the training set could be represented by such number of PCA modes with less than 0.1 cm mean residual error. The automatic segmentation started from the bladder shape of a reference CBCT, which was adjusted by changing the weight of each PCA mode. As a result, the segmentation contour was deformed consistently with the training set to fit the bladder in the validation image. A cost function was defined by the absolute difference between the directional gradient field of reference CBCT sampled on the corresponding bladder contour and the directional gradient field of validation

  20. Bladder cancer documentation of causes: multilingual questionnaire, 'bladder cancer doc'.

    PubMed

    Golka, Klaus; Abreu-Villaca, Yael; Anbari Attar, Rowshanak; Angeli-Greaves, Miriam; Aslam, Muhammad; Basaran, Nursen; Belik, Rouslana; Butryee, Chaniphun; Dalpiaz, Orietta; Dzhusupov, Keneshbek; Ecke, Thorsten H; Galambos, Henrieta; Galambos, Henrieta; Gerilovica, Helena; Gerullis, Holger; Gonzalez, Patricia Casares; Goossens, Maria E; Gorgishvili-Hermes, Lela; Heyns, Chris F; Hodzic, Jasmin; Ikoma, Fumihiko; Jichlinski, Patrice; Kang, Boo-Hyon; Kiesswetter, Ernst; Krishnamurthi, Kannan; Lehmann, Marie-Louise; Martinova, Irina; Mittal, Rama Devi; Ravichandran, Beerappa; Romics, Imre; Roy, Bidyut; Rungkat-Zakaria, Fransiska; Rydzynski, Konrad; Scutaru, Cristian; Shen, Jianhua; Soufi, Maria; Toguzbaeva, Karlygash; Vu Duc, Trinh; Widera, Agata; Wishahi, Mohamed; Hengstler, Jan G

    2012-06-01

    There is a considerable discrepancy between the number of identified occupational-related bladder cancer cases and the estimated numbers particularly in emerging nations or less developed countries where suitable approaches are less or even not known. Thus, within a project of the World Health Organisation Collaborating Centres in Occupational Health, a questionnaire of the Dortmund group, applied in different studies, was translated into more than 30 languages (Afrikaans, Arabic, Bengali, Chinese, Czech, Dutch, English, Finnish, French, Georgian, German, Greek, Hindi, Hungarian, Indonesian, Italian, Japanese, Kannada, Kazakh, Kirghiz, Korean, Latvian, Malay, Persian (Farsi), Polish, Portuguese, Portuguese/Brazilian, Romanian, Russian, Serbo-Croatian, Slovak, Spanish, Spanish/Mexican, Tamil, Telugu, Thai, Turkish, Urdu, Vietnamese). The bipartite questionnaire asks for relevant medical information in the physician's part and for the occupational history since leaving school in the patient's part. Furthermore, this questionnaire is asking for intensity and frequency of certain occupational and non-occupational risk factors. The literature regarding occupations like painter, hairdresser or miner and exposures like carcinogenic aromatic amines, azo dyes, or combustion products is highlighted. The questionnaire is available on www.ifado.de/BladderCancerDoc.

  1. The Role of la Familia for Women of Mexican Descent Who Are Leaders in Higher Education

    ERIC Educational Resources Information Center

    Elizondo, Sandra Gray

    2012-01-01

    The purpose of this qualitative case study was to describe the role of "la familia" for women of Mexican descent as it relates to their development as leaders and their leadership in academia. Purposeful sampling was utilized to reach the goal of 18 participants who were female academic leaders of Mexican descent teaching full time in…

  2. Introduction to the special issue on lesbians of African descent: contemporary perspectives.

    PubMed

    Wilson, Bianca D M; Johnson, Verlena L

    2011-01-01

    This article serves as an introduction to the special issue entitled, "Lesbians of African Descent: Contemporary Perspectives." We briefly discuss our framing of this collection as a contemporary contribution to the canon of Black lesbian writing and art, and identify themes that appear to transcend both earlier and current works of lesbians of African descent.

  3. Ethnic Identity and Acculturative Stress as Mediators of Depression in Students of Asian Descent

    ERIC Educational Resources Information Center

    Lantrip, Crystal; Mazzetti, Francesco; Grasso, Joseph; Gill, Sara; Miller, Janna; Haner, Morgynn; Rude, Stephanie; Awad, Germine

    2015-01-01

    This study underscored the importance of addressing the well-being of college students of Asian descent, because these students had higher rates of depression and lower positive feelings about their ethnic group compared with students of European descent, as measured by the Affirmation subscale of the Ethnic Identity Scale. Affirmation mediated…

  4. Mars Exploration Rover Mission: Entry, Descent, and Landing System Validation

    NASA Technical Reports Server (NTRS)

    Mitcheltree, Robert A.; Lee, Wayne; Steltzner, Adam; SanMartin, Alejanhdro

    2004-01-01

    System validation for a Mars entry, descent, and landing system is not simply a demonstration that the electrical system functions in the associated environments. The function of this system is its interaction with the atmospheric and surface environment. Thus, in addition to traditional test-bed, hardware-in-the-loop, testing, a validation program that confirms the environmental interaction is required. Unfortunately, it is not possible to conduct a meaningful end-to-end test of a Mars landing system on Earth. The validation plan must be constructed from an interconnected combination of simulation, analysis and test. For the Mars Exploration Rover mission, this combination of activities and the logic of how they combined to the system's validation was explicitly stated, reviewed, and tracked as part of the development plan.

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

    NASA Astrophysics Data System (ADS)

    Heilimo, Jyri; Aleksashkin, Sergey; Martynov, Maxim; Schmidt, Walter; Harri, Ari-Matti; Vsevolod Koryanov, D.; Kazakovtcev, Victor; Haukka, Harri; Arruego, Ignacio; Finchenko, Valery; Ostresko, Boris; Ponomarenko, Andrei; Martin, Susanna; Siili, Tero

    Abstract A new generation of inflatable Entry, Descent and Landing System (EDLS) or Mars has been developed. It is used in both the initial atmospheric entry and atmospheric descent before the semi-hard impact of the penetrator into Martian surface. The EDLS applicability to Earth’s atmosphere is studied by the EU/RITD [1] project. Project focuses to the analysis and tests of the transonic behaviour of this compact and light weight payload entry system at the Earth re-entry 1. EDLS for Earth The dynamical stability of the craft is analysed, concentrating on the most critical part of the atmospheric re-entry, the transonic phase. In Martian atmosphere the MetNet vehicle stability during the transonic phase is understood. However, in the more dense Earth’s atmosphere, the transonic phase is shorter and turbulence more violent. Therefore, the EDLS has to be sufficiently dynamically stable to overcome the forces tending to deflect the craft from its nominal trajectory and attitude. The preliminary design of the inflatable EDLS for Earth will be commenced once the scaling of the re-entry system and the dynamical stability analysis have been performed. The RITD-project concentrates on mission and applications achievable with the current MetNet-type (i.e. “Mini-1” category) of lander, and on requirements posed by other type Earth re-entry concepts. 2. Entry Angle Determination for Mini-1 - lander For successful Earth landing, the suitable re-entry angle and velocity with specific descent vehicle (DV) mass and heat flux parameters need to be determined. These key parameters in determining the Earth re-entry for DV are: - qmax (kW/m2): maximal specific heat flux, - Q (MJ/m2): specific integral heat flux to DV front shield, - m (kg): descent vehicle (DV) mass, - V (m/s): re-entry velocity and - theta(deg.): flight-path angle at Earth re-entry For Earth re-entry, the calculation results in the optimal value of entry velocity for MetNet (“Mini-1” category) -type

  6. The descent of words: evolutionary thinking 1780-1880.

    PubMed

    van Wyhe, John

    2005-09-01

    Histories of evolutionary thought are dominated by organic evolution. The colossus in our midst that is evolutionary biology casts its shadow over history, making it appear that what is so widespread and important today was always the primary subject of evolutionary speculation. Thus many histories assume that the core meaning of evolution is the change of organic life and that other forms of evolutionary thinking, such as linguistic, social or cultural evolution, are only analogies or offshoots of the main biological evolutionary trunk. Ironically this is an ahistorical understanding. Long before the work of Charles Darwin, scholars were independently developing evolutionary concepts such as descent with modification and divergence from a common stock in order to understand cultural change.

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

    NASA Astrophysics Data System (ADS)

    Heilimo, Jyri; Harri, Ari-Matti; Aleksashkin, Sergey; Koryanov, Vsevolod; Arruego, Ignacio; Schmidt, Walter; Haukka, Harri; Finchenko, Valery; Martynov, Maxim; Ostresko, Boris; Ponomarenko, Andrey; Kazakovtsev, Viktor; Martin, Susanna; Siili, Tero

    2014-05-01

    A new generation of inflatable Entry, Descent and Landing System (EDLS) for Mars has been developed. It is used in both the initial atmospheric entry and atmospheric descent before the semi-hard impact of the penetrator into Martian surface. The EDLS applicability to Earth's atmosphere is studied by the EU/RITD [1] project. Project focuses to the analysis and tests of the transonic behaviour of this compact and light weight payload entry system at the Earth re-entry. 1. EDLS for Earth The dynamical stability of the craft is analysed, concentrating on the most critical part of the atmospheric re-entry, the transonic phase. In Martian atmosphere the MetNet vehicle stability during the transonic phase is understood. However, in the more dense Earth's atmosphere, the transonic phase is shorter and turbulence more violent. Therefore, the EDLS has to be sufficiently dynamically stable to overcome the forces tending to deflect the craft from its nominal trajectory and attitude. The preliminary design of the inflatable EDLS for Earth will be commenced once the scaling of the re-entry system and the dynamical stability analysis have been performed. The RITD-project concentrates on mission and applications achievable with the current MetNet-type (i.e. 'Mini-1' category) of lander, and on requirements posed by other type Earth re-entry concepts. 2. Entry Angle Determination for Mini-1 - lander For successful Earth landing, the suitable re-entry angle and velocity with specific descent vehicle (DV) mass and heat flux parameters need to be determined. These key parameters in determining the Earth re-entry for DV are: qmax (kW/m2): maximal specific heat flux, Q (MJ/m2): specific integral heat flux to DV front shield, m (kg): descent vehicle (DV) mass, V (m/s): re-entry velocity and Θ (deg.): flight-path angle at Earth re-entry For Earth re-entry, the calculation results in the optimal value of entry velocity for MetNet ('Mini-1' category) -type lander, with mass of 22kg, being

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

    NASA Technical Reports Server (NTRS)

    Prakash, Ravi; Burkhart, P. Dan; Chen, Allen; Comeaux, Keith A.; Guernsey, Carl S.; Devin, M. Kipp; Mendeck, Gavin F.; Powell, Richard W.; Rivellini, Tommaso P.; San Martin, A. Miguel; Sell, Steven W.; Steltzner, Adam D.; Way, David W.

    2008-01-01

    In 2010, the Mars Science Laboratory (MSL) mission will pioneer the next generation of robotic Entry, Descent, and Landing (EDL) systems by delivering the largest and most capable rover to date to the surface of Mars. In addition to landing more mass than prior missions to Mars, MSL will offer access to regions of Mars that have been previously unreachable. The MSL EDL sequence is a result of a more stringent requirement set than any of its predecessors. Notable among these requirements is landing a 900 kg rover in a landing ellipse much smaller than that of any previous Mars lander. In meeting these requirements, MSL is extending the limits of the EDL technologies qualified by the Mars Viking, Mars Pathfinder, and Mars Exploration Rover missions.

  9. The stabilization interval system of a tethered descent underwater vehicle

    NASA Astrophysics Data System (ADS)

    Gayvoronskiy, S. A.; Ezangina, T.; Khozhaev, I.; Efimov, S. V.

    2016-04-01

    To damp the vertical oscillations of a descent submersible caused by dusting the control system utilizing a shock-absorbing hoist located on the submersible was developed. A robust proportional-plus-integral action controller was included in the control loop to ensure acceptable dynamic properties of the system by interval variations of the module mass, the rope length, the equivalent value of stiffness of a spring linkage and the equivalent value of damping factor of the spring linkage. A parametric synthesis of the controller was carried out on the basis of the robust expansion of the coefficient method of the quality rating estimation. The system operability was confirmed by the results of the digital simulation parameters

  10. Human Mars Entry, Descent, and Landing Architecture Study Overview

    NASA Technical Reports Server (NTRS)

    Cianciolo, Alicia D.; Polsgrove, Tara T.

    2016-01-01

    The Entry, Descent, and Landing (EDL) Architecture Study is a multi-NASA center activity to analyze candidate EDL systems as they apply to human Mars landing in the context of the Evolvable Mars Campaign. The study, led by the Space Technology Mission Directorate (STMD), is performed in conjunction with the NASA's Science Mission Directorate and the Human Architecture Team, sponsored by NASA's Human Exploration and Operations Mission Directorate. The primary objective is to prioritize future STMD EDL technology investments by (1) generating Phase A-level designs for selected concepts to deliver 20 t human class payloads, (2) developing a parameterized mass model for each concept capable of examining payloads between 5 and 40 t, and (3) evaluating integrated system performance using trajectory simulations. This paper summarizes the initial study results.

  11. CryoScout: A Descent Through the Mars Polar Cap

    NASA Technical Reports Server (NTRS)

    Hecht, M. H.; Saunders, R. S.

    2003-01-01

    CryoScout was proposed as a subsurface investigation of the stratigraphic climate record embedded in Mars North Polar cap. After landing on a gentle landscape in the midst of the mild summer season, CryoScout was to use the continuous polar sunlight to power the descent of a cryobot, a thermal probe, into the ice at a rate of about 1 m per day. CryoScout would probe deep enough into this time capsule to see the effects of planetary obliquity variations and discrete events such as dust storms or volcanic eruptions. By penetrating tens of meters of ice, the mission would explore at least one of the dominant "MOC layers" observed in exposed layered terrain.

  12. A guidance law for hypersonic descent to a point

    NASA Astrophysics Data System (ADS)

    Eisler, G. R.; Hull, David G.

    1992-08-01

    A neighboring extremal control problem is formulated for a hypersonic glider to execute a maximum-terminal-velocity descent to a stationary target. The resulting two-part, feedback control scheme initially solves a nonlinear algebraic problem to generate a nominal trajectory to the target altitude. Secondly, a neighboring optimal path computation about the nominal provides the lift and side-force perturbations necessary to achieve the target downrange and crossrange. On-line feedback simulations of the proposed scheme and a form of proportional navigation are compared with an off-line parameter optimization method. The neighboring optimal terminal velocity compares very well with the parameter optimization solution and is far superior to proportional navigation.

  13. An approximate, maximum-terminal-velocity descent to a point

    NASA Astrophysics Data System (ADS)

    Eisler, G. Richard; Hull, David G.

    A neighboring extremal control problem is formulated for a hypersonic glider to execute a maximum-terminal-velocity descent to a stationary target in a vertical plane. The resulting two-part, feedback control scheme initially solves a nonlinear algebraic problem to generate a nominal trajectory to the target altitude. Secondly, quadrature about the nominal provides the lift perturbation necessary to achieve the target downrange. On-line feedback simulations are run for the proposed scheme and a form of proportional navigation and compared with an off-line parameter optimization method. The neighboring extremal terminal velocity compares very well with the parameter optimization solution and is far superior to proportional navigation. However, the update rate is degraded, though the proposed method can be executed in real time.

  14. Gametogenesis processes and multilocus gene identity by descent.

    PubMed Central

    Guo, S. W.

    1996-01-01

    With few exceptions, the determination of unconditional probability of genes shared identical by descent (IBD) by relatives can be very difficult, especially if the relationship is complex or if multiple loci are involved. It is particularly difficult if one needs the IBD probability in a explicit form, expressed in terms of interlocus recombination fractions. In this paper, I will further extend the concept of gametogenesis process introduced elsewhere and indicate that it completely determines the gene IBD events of interest in pedigrees. I will demonstrate that the gametogenesis process not only serves as a convenient conceptual framework in considering IBD events in pedigrees but also provides a simple yet powerful tool to solve a wide range of seemingly difficult problems. In particular, I consider the problem of multilocus IBD probability for relative pairs, k siblings, and a group of pedigree members. In addition, I consider the problem of multilocus autozygosity probability and the problem of gene preservation in close relatives. PMID:8571968

  15. Transitions and transversions in evolutionary descent - An approach to understanding

    NASA Technical Reports Server (NTRS)

    Holmquist, R.

    1983-01-01

    A quantitative theoretical groundwork is presented for determining the proportions of the possible types of base substitutions observed between 12 genes sharing a common ancestor and isolated from extant species. Three methods (direct count, regression, and informational entropy maximization) are described by which conditional base substitution probabilities that determine evolutionary descent can be estimated from experimental data. These methods are utilized to study the ratio of transversions to transitions during gene divergence. The limiting ratio is directly calculated from a knowledge of the 12 conditional probabilities for each type of base substitution and from a knowledge of the equilibrium base composition of the DNAs compared. An expression is developed for this calculation. It is concluded that multiple substitutions per se do not lead to a decrease in transition differences with increasing evolutionary divergence.

  16. Overview of the Phoenix Entry, Descent and Landing System Architecture

    NASA Technical Reports Server (NTRS)

    Grover, Myron R., III; Cichy, Benjamin D.; Desai, Prasun N.

    2008-01-01

    NASA s Phoenix Mars Lander began its journey to Mars from Cape Canaveral, Florida in August 2007, but its journey to the launch pad began many years earlier in 1997 as NASA s Mars Surveyor Program 2001 Lander. In the intervening years, the entry, descent and landing (EDL) system architecture went through a series of changes, resulting in the system flown to the surface of Mars on May 25th, 2008. Some changes, such as entry velocity and landing site elevation, were the result of differences in mission design. Other changes, including the removal of hypersonic guidance, the reformulation of the parachute deployment algorithm, and the addition of the backshell avoidance maneuver, were driven by constant efforts to augment system robustness. An overview of the Phoenix EDL system architecture is presented along with rationales driving these architectural changes.

  17. Pathophysiology of bladder dysfunction in Parkinson's disease.

    PubMed

    Sakakibara, Ryuji; Tateno, Fuyuki; Kishi, Masahiko; Tsuyuzaki, Yohei; Uchiyama, Tomoyuki; Yamamoto, Tatsuya

    2012-06-01

    Bladder dysfunction (urinary urgency/frequency) is a common non-motor disorder in Parkinson's disease (PD). In contrast to motor disorders, bladder dysfunction is sometimes non-responsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine basal ganglia-frontal circuit, which normally suppresses the micturition reflex. The pathophysiology of the bladder dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. These treatments might be beneficial in maximizing the patients' quality of life.

  18. Spectroscopic Imaging of Bladder Cancer

    SciTech Connect

    Demos, S G; Gandour-Edwards, R; Ramsamooj, R; deVere White, R

    2003-01-01

    The feasibility of developing bladder cancer detection methods using intrinsic tissue optical properties is the focus of this investigation. In vitro experiments have been performed using polarized elastic light scattering in combination with tissue autofluorescence in the NIR spectral region under laser excitation in the green and red spectral regions. The experimental results obtained from a set of tissue specimens from 25 patients reveal the presence of optical fingerprint characteristics suitable for cancer detection with high contrast and accuracy. These photonic methods are compatible with existing endoscopic imaging modalities which make them suitable for in-vivo application.

  19. Y Chromosome Lineages in Men of West African Descent

    PubMed Central

    Keita, Shomarka O. Y.; Kittles, Rick A.

    2012-01-01

    The early African experience in the Americas is marked by the transatlantic slave trade from ∼1619 to 1850 and the rise of the plantation system. The origins of enslaved Africans were largely dependent on European preferences as well as the availability of potential laborers within Africa. Rice production was a key industry of many colonial South Carolina low country plantations. Accordingly, rice plantations owners within South Carolina often requested enslaved Africans from the so-called “Grain Coast” of western Africa (Senegal to Sierra Leone). Studies on the African origins of the enslaved within other regions of the Americas have been limited. To address the issue of origins of people of African descent within the Americas and understand more about the genetic heterogeneity present within Africa and the African Diaspora, we typed Y chromosome specific markers in 1,319 men consisting of 508 west and central Africans (from 12 populations), 188 Caribbeans (from 2 islands), 532 African Americans (AAs from Washington, DC and Columbia, SC), and 91 European Americans. Principal component and admixture analyses provide support for significant Grain Coast ancestry among African American men in South Carolina. AA men from DC and the Caribbean showed a closer affinity to populations from the Bight of Biafra. Furthermore, 30–40% of the paternal lineages in African descent populations in the Americas are of European ancestry. Diverse west African ancestries and sex-biased gene flow from EAs has contributed greatly to the genetic heterogeneity of African populations throughout the Americas and has significant implications for gene mapping efforts in these populations. PMID:22295064

  20. Assessment on EXPERT Descent and Landing System Aerodynamics

    NASA Astrophysics Data System (ADS)

    Wong, H.; Muylaert, J.; Northey, D.; Riley, D.

    2009-01-01

    EXPERT is a re-entry vehicle designed for validation of aero-thermodynamic models, numerical schemes in Computational Fluid Dynamics codes and test facilities for measuring flight data under an Earth re-entry environment. This paper addresses the design for the descent and landing sequence for EXPERT. It includes the descent sequence, the choice of drogue and main parachutes, and the parachute deployment condition, which can be supersonic or subsonic. The analysis is based mainly on an engineering tool, PASDA, together with some hand calculations for parachute sizing and design. The tool consists of a detailed 6-DoF simulation performed with the aerodynamics database of the vehicle, an empirical wakes model and the International Standard Atmosphere database. The aerodynamics database for the vehicle is generated by DNW experimental data and CFD codes within the framework of an ESA contract to CIRA. The analysis will be presented in terms of altitude, velocity, accelerations, angle-of- attack, pitch angle and angle of rigging line. Discussion on the advantages and disadvantages of each parachute deployment condition is included in addition to some comparison with the available data based on a Monte-Carlo method from a Russian company, FSUE NIIPS. Sensitivity on wind speed to the performance of EXPERT is shown to be strong. Supersonic deployment of drogue shows a better performance in stability at the expense of a larger G-load than those from the subsonic deployment of drogue. Further optimization on the parachute design is necessary in order to fulfill all the EXPERT specifications.

  1. Neoadjuvant chemotherapy for bladder cancer.

    PubMed

    Black, Peter C; Brown, Gordon A; Grossman, H Barton; Dinney, Colin P

    2006-11-01

    The 30-45% failure rate after radical cystoprostatectomy mandates that we explore and optimize multimodal therapy to achieve better disease control in these patients. Cisplatin-based multi-agent combination chemotherapy has been used with success in metastatic disease and has therefore also been introduced in patients with high-risk but non-metastatic bladder cancer. There is now convincing evidence that chemotherapy given pre-operatively can improve survival in these patients. In this review we establish the need for peri-operative chemotherapy in bladder cancer patients and summarize the evidence for the efficacy of neoadjuvant chemotherapy. The advantages and disadvantages of neoadjuvant versus adjuvant chemotherapy are discussed, and the main shortcomings of both--treatment-related toxicity and the inability to prospectively identify likely responders--are presented. Finally, a risk-adapted approach to neoadjuvant chemotherapy is presented, whereby the highest risk patients are offered treatment while those unlikely to benefit are spared the treatment-related toxicity.

  2. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study

    PubMed Central

    Ariens, G; Bongers, P; Douwes, M; Miedema, M; Hoogendoorn, W; van der Wal, G; Bouter, L; van Mechelen, W

    2001-01-01

    OBJECTIVE—To study the relation between neck pain and work related neck flexion, neck rotation, and sitting.
METHODS—A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured exposure data (video recordings) of neck flexion, neck rotation, and sitting posture. Neck pain was assessed by a questionnaire. Adjustments were made for various physical factors that were related or not related to work, psychosocial factors, and individual characteristics.
RESULTS—A significant positive relation was found between the percentage of the working time in a sitting position and neck pain, implying an increased risk of neck pain for workers who were sitting for more than 95% of the working time (crude relative risk (RR) 2.01, 95% confidence interval (95% CI) 1.04 to 3.88; adjusted RR 2.34, 95% CI 1.05 to 5.21). A trend for a positive relation between neck flexion and neck pain was found, suggesting an increased risk of neck pain for people working with the neck at a minimum of 20° of flexion for more than 70% of the working time (crude RR 2.01, 95% CI 0.98 to 4.11; adjusted RR 1.63, 95% CI 0.70 to 3.82). No clear relation was found between neck rotation and neck pain.
CONCLUSION—Sitting at work for more than 95% of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain. No clear relation was found between neck rotation and neck pain.


Keywords: neck pain; physical risk factors; longitudinal cohort study PMID:11171934

  3. Neurogenic bladder in spinal cord injury patients

    PubMed Central

    Taweel, Waleed Al; Seyam, Raouf

    2015-01-01

    Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury. PMID:26090342

  4. Influence of behavior modification on overactive bladder.

    PubMed

    Burgio, Kathryn L

    2002-11-01

    Behavioral interventions have been used for decades to treat urge incontinence and other symptoms of overactive bladder. Perhaps the earliest form of treatment was the bladder drill, an intensive intervention designed to increase the interval between voids to establish a normal frequency of urination and normalization of bladder function. Bladder training is a modification of bladder drill that is conducted more gradually on an outpatient basis and has resulted in significant reduction of incontinence in older, community-dwelling women. Multicomponent behavioral training is another form of behavioral treatment that includes pelvic floor muscle training and exercise. This intervention focuses less on voiding habits and more on altering the physiologic responses of the bladder and pelvic floor muscles. Using biofeedback or other teaching methods, patients learn strategies to inhibit bladder contraction using pelvic floor muscle contraction and other urge suppression strategies. Although behavioral and drug therapies are known to be highly effective for reducing urge incontinence, few patients are cured with either treatment alone. Thus, future research should explore ways to enhance the effectiveness of these conservative therapies. Although the mechanisms by which behavioral treatments work have not been established, there is some evidence that behavioral and drug interventions may operate by different mechanisms, suggesting that they may have additive effects and that combining them may result in better outcomes. Future research needs to examine the mechanisms by which these therapies reduce incontinence and whether combining behavioral and drug treatment will result in better outcomes than either therapy alone.

  5. Computational and theoretical investigation of Mars's atmospheric impact on the descent module "Exomars-2018" under aerodynamic deceleration

    NASA Astrophysics Data System (ADS)

    Golomazov, M. M.; Ivankov, A. A.

    2016-12-01

    Methods for calculating the aerodynamic impact of the Martian atmosphere on the descent module "Exomars-2018" intended for solving the problem of heat protection of the descent module during aerodynamic deceleration are presented. The results of the investigation are also given. The flow field and radiative and convective heat exchange are calculated along the trajectory of the descent module until parachute system activation.

  6. Experimental constraints on the Skaergaard liquid line of descent

    NASA Astrophysics Data System (ADS)

    Thy, P.; Lesher, C. E.; Nielsen, T. F. D.; Brooks, C. K.

    2006-11-01

    New experimental information permits a forward approach to modeling the liquid line of descent of the Skaergaard intrusion. A series of melting experiments on chilled margins of evolved tholeiitic and ferrobasaltic dikes associated with the intrusion is, in combination with existing data, used to develop quantitative crystallization models that allow liquid and solid compositions to be predicted for initial magma compositions and crystallization conditions open or closed with respect to oxygen. The new experimental results comprise 6 experiments with melts coexisting with plagioclase and olivine, 29 experiments in addition containing augite, 14 experiments in addition containing ilmenite and/or magnetite, and 6 experiments in addition containing pigeonite and sometimes lacking olivine. All melting experiments were done at atmospheric pressure and with a furnace gas mostly controlled to the fayalite-magnetite-quartz oxygen buffer (FMQ). Using these experimental results, the melt evolution can be constrained for the layered series of the Skaergaard intrusion. Fractionation of a LZa troctolitic assemblage drives the residual liquid toward increasing iron with slight increase in silica. The appearance of augite as an abundant mineral phase in the LZb and the fractionation of a gabbroic assemblage adjust the liquid trend to one of slightly decreasing silica with continued strong increase in iron. Silica decline is principally dependent on the crystallization of augite and restricted to LZb. The appearance of Fe-Ti oxide minerals and the fractionation of Fe-Ti oxide gabbroic assemblages in LZc deflect the evolution trends of iron and silica. The modeling based on the experimental results suggests marked LZc-MZ silica enrichment concurrently with increasing iron content until upper MZ and thereafter relatively constant or slightly decreasing iron. The iron concentration level at which the deflection in iron and silica contents occurs is dependent on several factors of

  7. Head and Neck Cancer Treatment

    MedlinePlus

    ... the cancer and the stage (extent) of the disease. In general, patients with early-stage head and neck cancers (particularly those limited to the site of origin) are treated with one modality—either radiation therapy ...

  8. Tumour-associated eosinophilia in the bladder.

    PubMed Central

    Lowe, D; Fletcher, C D; Gower, R L

    1984-01-01

    Tumour eosinophilia is an uncommon but striking phenomenon which has been found in many tumours, mostly of large cell type or squamous differentiation. The incidence, appearance and importance of tumour eosinophilia in the bladder are described. Eosinophilia is commoner in deeply invasive tumours and in tumours showing squamous metaplasia. Transitional cell carcinomas with eosinophilia have a better prognosis than those without, but this improvement is not seen in squamous cell carcinomas of the bladder. When eosinophilia is found on superficial biopsies of a bladder tumour, the possibility of muscle invasion should be considered. PMID:6725595

  9. [Placenta percreta with bladder invasion. Case report].

    PubMed

    Torres Gómez, Luis Guillermo; Torres Farías, Emigdio; Rodríguez Sandoval, Rosa María

    2007-09-01

    We report a case of a 30-year-old woman, who had two previous caesarean sections, attended for the first time at 18 weeks of gestation. Pelvic ultrasonography and color Doppler imaging showed a placenta percreta invading the urinary bladder. A caesarean section was carried out at 27th week of gestation for preterm premature rupture of membranes. Placental tissue was firmly attached to the anterior surface of the bladder. A cesarean hysterectomy was performed with bilateral anterior internal iliac artery ligation before hysterectomy was finished. The bladder was repaired, leaving a suprapubic catheter.

  10. Neurogenic and non-neurogenic bladder dysfunction.

    PubMed

    Nijman, R J

    2001-11-01

    Children with a neurological defect have a clear cause for their bladder dysfunction; however, in neurologically normal children the cause of their incontinence is usually unclear. When no anatomical abnormalities seem to be present a functional problem is generally the cause. This type of incontinence is referred to as 'functional incontinence'. The different forms of bladder and sphincter dysfunction will be discussed and treatment modalities described. As the treatment modalities in children with neuropathic bladders focus on medical and especially surgical options, special attention is paid to new developments in surgical treatment. For those with functional incontinence treatment options are more variable and the new developments are described.

  11. Imaging of pediatric neck masses.

    PubMed

    Friedman, Elliott R; John, Susan D

    2011-07-01

    Palpable neck masses are a common indication for pediatric imaging. Such lesions may be caused by infectious, inflammatory, tumoral, traumatic, lymphovascular, immunologic, or congenital etiologies. Radiological assessment of neck masses in young children should be tailored based on patient presentation and physical examination, as well as clinical suspicion. The goal of imaging should be to help arrive at a diagnosis or limited differential in an efficient manner while minimizing radiation exposure.

  12. Bladder filling variation during radiation treatment of prostate cancer: Can the use of a bladder ultrasound scanner and biofeedback optimize bladder filling?

    SciTech Connect

    Stam, Marcel R. . E-mail: m.stam@rther.umcn.nl; Lin, Emile N.J. Th. van; Vight, Lisette P. van der; Kaanders, Johannes; Visser, Andries G.

    2006-06-01

    Purpose: To investigate the use of a bladder ultrasound scanner in achieving a better reproducible bladder filling during irradiation of pelvic tumors, specifically prostate cancer. Methods and Materials: First, the accuracy of the bladder ultrasound scanner relative to computed tomography was validated in a group of 26 patients. Next, daily bladder volume variation was evaluated in a group of 18 patients. Another 16 patients participated in a biofeedback protocol, aiming at a more constant bladder volume. The last objective was to study correlations between prostate motion and bladder filling, by using electronic portal imaging device data on implanted gold markers. Results: A strong correlation between bladder scanner volume and computed tomography volume (r = 0.95) was found. Daily bladder volume variation was very high (1 Sd = 47.2%). Bladder filling and daily variation did not significantly differ between the control and the feedback group (47.2% and 40.1%, respectively). Furthermore, no linear correlations between bladder volume variation and prostate motion were found. Conclusions: This study shows large variations in daily bladder volume. The use of a biofeedback protocol yields little reduction in bladder volume variation. Even so, the bladder scanner is an easy to use and accurate tool to register these variations.

  13. Differentiating bladder carcinoma from bladder wall using 3D textural features: an initial study

    NASA Astrophysics Data System (ADS)

    Xu, Xiaopan; Zhang, Xi; Liu, Yang; Tian, Qiang; Zhang, Guopeng; Lu, Hongbing

    2016-03-01

    Differentiating bladder tumors from wall tissues is of critical importance for the detection of invasion depth and cancer staging. The textural features embedded in bladder images have demonstrated their potentials in carcinomas detection and classification. The purpose of this study was to investigate the feasibility of differentiating bladder carcinoma from bladder wall using three-dimensional (3D) textural features extracted from MR bladder images. The widely used 2D Tamura features were firstly wholly extended to 3D, and then different types of 3D textural features including 3D features derived from gray level co-occurrence matrices (GLCM) and grey level-gradient co-occurrence matrix (GLGCM), as well as 3D Tamura features, were extracted from 23 volumes of interest (VOIs) of bladder tumors and 23 VOIs of patients' bladder wall. Statistical results show that 30 out of 47 features are significantly different between cancer tissues and wall tissues. Using these features with significant differences between these two types of tissues, classification performance with a supported vector machine (SVM) classifier demonstrates that the combination of three types of selected 3D features outperform that of using only one type of features. All the observations demonstrate that significant textural differences exist between carcinomatous tissues and bladder wall, and 3D textural analysis may be an effective way for noninvasive staging of bladder cancer.

  14. Descent strategy comparisons for TNAV-equipped aircraft under airplane-preferred operating conditions

    NASA Technical Reports Server (NTRS)

    Izumi, K. H.

    1989-01-01

    Three 4-D descent strategies were evaluated which were employed by TNAV-equipped aircraft in an advanced metering air traffic control environment. The Flow Management Evaluation Model (FMEM) was used to assess performance using three criteria when traffic enters the simulation under preferred cruise operating conditions (altitude and speed): throughput, fuel usage, and conflict probability. In comparison to an evaluation previously performed under NASA contract, the current analysis indicates that the optimal descent strategy is preferred over the clean-idle and constant descent angle (CFPA) strategies when all three criteria are considered.

  15. Rapid Generation of Optimal Asteroid Powered Descent Trajectories Via Convex Optimization

    NASA Technical Reports Server (NTRS)

    Pinson, Robin; Lu, Ping

    2015-01-01

    This paper investigates a convex optimization based method that can rapidly generate the fuel optimal asteroid powered descent trajectory. The ultimate goal is to autonomously design the optimal powered descent trajectory on-board the spacecraft immediately prior to the descent burn. Compared to a planetary powered landing problem, the major difficulty is the complex gravity field near the surface of an asteroid that cannot be approximated by a constant gravity field. This paper uses relaxation techniques and a successive solution process that seeks the solution to the original nonlinear, nonconvex problem through the solutions to a sequence of convex optimal control problems.

  16. Study of Some Planetary Atmospheres Features by Probe Entry and Descent Simulations

    NASA Technical Reports Server (NTRS)

    Gil, P. J. S.; Rosa, P. M. B.

    2005-01-01

    Characterization of planetary atmospheres is analyzed by its effects in the entry and descent trajectories of probes. Emphasis is on the most important variables that characterize atmospheres e.g. density profile with altitude. Probe trajectories are numerically determined with ENTRAP, a developing multi-purpose computational tool for entry and descent trajectory simulations capable of taking into account many features and perturbations. Real data from Mars Pathfinder mission is used. The goal is to be able to determine more accurately the atmosphere structure by observing real trajectories and what changes are to expect in probe descent trajectories if atmospheres have different properties than the ones assumed initially.

  17. The Danish Bladder Cancer Database

    PubMed Central

    Hansen, Erik; Larsson, Heidi; Nørgaard, Mette; Thind, Peter; Jensen, Jørgen Bjerggaard

    2016-01-01

    Aim of database The aim of the Danish Bladder Cancer Database (DaBlaCa-data) is to monitor the treatment of all patients diagnosed with invasive bladder cancer (BC) in Denmark. Study population All patients diagnosed with BC in Denmark from 2012 onward were included in the study. Results presented in this paper are predominantly from the 2013 population. Main variables In 2013, 970 patients were diagnosed with BC in Denmark and were included in a preliminary report from the database. A total of 458 (47%) patients were diagnosed with non-muscle-invasive BC (non-MIBC) and 512 (53%) were diagnosed with muscle-invasive BC (MIBC). A total of 300 (31%) patients underwent cystectomy. Among the 135 patients diagnosed with MIBC, who were 75 years of age or younger, 67 (50%) received neoadjuvent chemotherapy prior to cystectomy. In 2013, a total of 147 patients were treated with curative-intended radiation therapy. Descriptive data One-year mortality was 28% (95% confidence interval [CI]: 15–21). One-year cancer-specific mortality was 25% (95% CI: 22–27%). One-year mortality after cystectomy was 14% (95% CI: 10–18). Ninety-day mortality after cystectomy was 3% (95% CI: 1–5) in 2013. One-year mortality following curative-intended radiation therapy was 32% (95% CI: 24–39) and 1-year cancer-specific mortality was 23% (95% CI: 16–31) in 2013. Conclusion This preliminary DaBlaCa-data report showed that the treatment of MIBC in Denmark overall meet high international academic standards. The database is able to identify Danish BC patients and monitor treatment and mortality. In the future, DaBlaCa-data will be a valuable data source and expansive observational studies on BC will be available. PMID:27822081

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

    NASA Technical Reports Server (NTRS)

    Steltzner, Adam D.; Burkhart, P. Dan; Chen, Allen; Comeaux, Keith A.; Guernsey, Carl S.; Kipp, Devin M.; Lorenzoni, Leila V.; Mendeck, Gavin F.; Powell, Richard W.; Rivellini, Tommaso P.; San Martin, A. Miguel; Sell, Steven W.; Prakash, Ravi; Way, David W.

    2010-01-01

    In 2012, the Mars Science Laboratory (MSL) mission will pioneer the next generation of robotic Entry, Descent, and Landing (EDL) systems by delivering the largest and most capable rover to date to the surface of Mars. In addition to landing more mass than prior missions to Mars, MSL will offer access to regions of Mars that have been previously unreachable. The MSL EDL sequence is a result of a more stringent requirement set than any of its predecessors. Notable among these requirements is landing a 900 kg rover in a landing ellipse much smaller than that of any previous Mars lander. In meeting these requirements, MSL is extending the limits of the EDL technologies qualified by the Mars Viking, Mars Pathfinder, and Mars Exploration Rover missions. Thus, there are many design challenges that must be solved for the mission to be successful. Several pieces of the EDL design are technological firsts, such as guided entry and precision landing on another planet, as well as the entire Sky Crane maneuver. This paper discusses the MSL EDL architecture and discusses some of the challenges faced in delivering an unprecedented rover payload to the surface of Mars.

  19. Human Mars Entry, Descent and Landing Architectures Study Overview

    NASA Technical Reports Server (NTRS)

    Polsgrove, Tara T.; Dwyer Cianciolo, Alicia

    2016-01-01

    Landing humans on Mars will require entry, descent and landing (EDL) capability beyond the current state of the art. Nearly twenty times more delivered payload and an order of magnitude improvement in precision landing capability will be necessary. Several EDL technologies capable of meeting the human class payload delivery requirements are being considered. The EDL technologies considered include low lift-to-drag vehicles like Hypersonic Inflatable Aerodynamic Decelerators (HIAD), Adaptable Deployable Entry and Placement Technology (ADEPT), and mid range lift-to-drag vehicles like rigid aeroshell configurations. To better assess EDL technology options and sensitivities to future human mission design variations, a series of design studies has been conducted. The design studies incorporate EDL technologies with conceptual payload arrangements defined by the Evolvable Mars Campaign to evaluate the integrated system with higher fidelity than have been performed to date. This paper describes the results of the design studies for a lander design using the HIAD, ADEPT and rigid shell entry technologies and includes system and subsystem design details including mass and power estimates. This paper will review the point design for three entry configurations capable of delivering a 20 t human class payload to the surface of Mars.

  20. ExoMars Entry, Descent, and Landing Science

    NASA Astrophysics Data System (ADS)

    Karatekin, Özgür; Forget, Francois; Withers, Paul; Colombatti, Giacomo; Aboudan, Alessio; Lewis, Stephen; Ferri, Francesca; Van Hove, Bart; Gerbal, Nicolas

    2016-07-01

    Schiaparelli, the Entry Demonstrator Module (EDM) of the ESA ExoMars Program will to land on Mars on 19th October 2016. The ExoMars Atmospheric Mars Entry and Landing Investigations and Analysis (AMELIA) team seeks to exploit the Entry Descent and Landing (EDL) engineering measurements of Schiaparelli for scientific investigations of Mars' atmosphere and surface. ExoMars offers a rare opportunity to perform an in situ investigation of the martian environment over a wide altitude range. There has been only 7 successfully landing on the surface of Mars, from the Viking probes in the 1970's to the Mars Science Laboratory (MSL) in 2012. ExoMars EDM is equipped with an instrumented heat shield like MSL. These novel flight sensors complement conventional accelerometer and gyroscope instrumentation, and provide additional information to reconstruct atmospheric conditions with. This abstract outlines general atmospheric reconstruction methodology using complementary set of sensors and in particular the use of surface pressure and radio data. In addition, we discuss the lessons learned from previous EDL and the plans for ExoMars AMELIA data analysis.

  1. Experimental Study of Rotor Vortex Wakes in Descent

    NASA Astrophysics Data System (ADS)

    Stack, James; Carradonna, Frank; Savas, Omer

    2002-11-01

    An experimental study is performed on a three-bladed rotor model in a water towing tank. The blade pitch and rotational velocity, the rotor plane angle of attack, and the carriage speed are all varied in order to simulate a wide range of rotorcraft operating states. Circulation Reynolds numbers are of order 105 and blade Reynolds numbers are of order 104. Flow visualization is done using air bubbles or dye injected from the blade tips to mark the vortex core, showing the development of an instability on the helical vortices in the wake. PIV data provide quantitative measures of the flow field as the wake develops. Strain gages are also used to record transient load measurements, allowing a correlation to be made between the rotor performance and the development of the vortex wake. The data so far indicate that as the instability develops, the adjacent vortices merge and form thick vortex rings, especially during descent. The vorticity spreads and is periodically shed from the wake, resulting in significant fluctuations in the rotor loading.

  2. HLA Type Inference via Haplotypes Identical by Descent

    NASA Astrophysics Data System (ADS)

    Setty, Manu N.; Gusev, Alexander; Pe'Er, Itsik

    The Human Leukocyte Antigen (HLA) genes play a major role in adaptive immune response and are used to differentiate self antigens from non self ones. HLA genes are hyper variable with nearly every locus harboring over a dozen alleles. This variation plays an important role in susceptibility to multiple autoimmune diseases and needs to be matched on for organ transplantation. Unfortunately, HLA typing by serological methods is time consuming and expensive compared to high throughput Single Nucleotide Polymorphism (SNP) data. We present a new computational method to infer per-locus HLA types using shared segments Identical By Descent (IBD), inferred from SNP genotype data. IBD information is modeled as graph where shared haplotypes are explored among clusters of individuals with known and unknown HLA types to identify the latter. We analyze performance of the method in a previously typed subset of the HapMap population, achieving accuracy of 96% in HLA-A, 94% in HLA-B, 95% in HLA-C, 77% in HLA-DR1, 93% in HLA-DQA1 and 90% in HLA-DQB1 genes. We compare our method to a tag SNP based approach and demonstrate higher sensitivity and specificity. Our method demonstrates the power of using shared haplotype segments for large-scale imputation at the HLA locus.

  3. Physics-based Entry, Descent and Landing Risk Model

    NASA Technical Reports Server (NTRS)

    Gee, Ken; Huynh, Loc C.; Manning, Ted

    2014-01-01

    A physics-based risk model was developed to assess the risk associated with thermal protection system failures during the entry, descent and landing phase of a manned spacecraft mission. In the model, entry trajectories were computed using a three-degree-of-freedom trajectory tool, the aerothermodynamic heating environment was computed using an engineering-level computational tool and the thermal response of the TPS material was modeled using a one-dimensional thermal response tool. The model was capable of modeling the effect of micrometeoroid and orbital debris impact damage on the TPS thermal response. A Monte Carlo analysis was used to determine the effects of uncertainties in the vehicle state at Entry Interface, aerothermodynamic heating and material properties on the performance of the TPS design. The failure criterion was set as a temperature limit at the bondline between the TPS and the underlying structure. Both direct computation and response surface approaches were used to compute the risk. The model was applied to a generic manned space capsule design. The effect of material property uncertainty and MMOD damage on risk of failure were analyzed. A comparison of the direct computation and response surface approach was undertaken.

  4. Eigenanalysis of SNP data with an identity by descent interpretation.

    PubMed

    Zheng, Xiuwen; Weir, Bruce S

    2016-02-01

    Principal component analysis (PCA) is widely used in genome-wide association studies (GWAS), and the principal component axes often represent perpendicular gradients in geographic space. The explanation of PCA results is of major interest for geneticists to understand fundamental demographic parameters. Here, we provide an interpretation of PCA based on relatedness measures, which are described by the probability that sets of genes are identical-by-descent (IBD). An approximately linear transformation between ancestral proportions (AP) of individuals with multiple ancestries and their projections onto the principal components is found. In addition, a new method of eigenanalysis "EIGMIX" is proposed to estimate individual ancestries. EIGMIX is a method of moments with computational efficiency suitable for millions of SNP data, and it is not subject to the assumption of linkage equilibrium. With the assumptions of multiple ancestries and their surrogate ancestral samples, EIGMIX is able to infer ancestral proportions (APs) of individuals. The methods were applied to the SNP data from the HapMap Phase 3 project and the Human Genome Diversity Panel. The APs of individuals inferred by EIGMIX are consistent with the findings of the program ADMIXTURE. In conclusion, EIGMIX can be used to detect population structure and estimate genome-wide ancestral proportions with a relatively high accuracy.

  5. Engineering description of the ascent/descent bet product

    NASA Technical Reports Server (NTRS)

    Seacord, A. W., II

    1986-01-01

    The Ascent/Descent output product is produced in the OPIP routine from three files which constitute its input. One of these, OPIP.IN, contains mission specific parameters. Meteorological data, such as atmospheric wind velocities, temperatures, and density, are obtained from the second file, the Corrected Meteorological Data File (METDATA). The third file is the TRJATTDATA file which contains the time-tagged state vectors that combine trajectory information from the Best Estimate of Trajectory (BET) filter, LBRET5, and Best Estimate of Attitude (BEA) derived from IMU telemetry. Each term in the two output data files (BETDATA and the Navigation Block, or NAVBLK) are defined. The description of the BETDATA file includes an outline of the algorithm used to calculate each term. To facilitate describing the algorithms, a nomenclature is defined. The description of the nomenclature includes a definition of the coordinate systems used. The NAVBLK file contains navigation input parameters. Each term in NAVBLK is defined and its source is listed. The production of NAVBLK requires only two computational algorithms. These two algorithms, which compute the terms DELTA and RSUBO, are described. Finally, the distribution of data in the NAVBLK records is listed.

  6. Orion Entry, Descent, and Landing Performance and Mission Design

    NASA Technical Reports Server (NTRS)

    Broome, Joel M.; Johnson, Wyatt

    2007-01-01

    The Orion Vehicle is the next spacecraft to take humans into space and will include missions to ISS as well as missions to the Moon. As part of that challenge, the vehicle will have to accommodate multiple mission design concepts, since return from Low Earth Orbit and return from the Moon can be quite different. Commonality between the different missions as it relates to vehicle systems, guidance capability, and operations concepts is the goal. Several unique mission design concepts include the specification of multiple land-based landing sites for a vehicle with closed-loop direct and skip entry guidance, followed by a parachute descent and landing attenuation system. This includes the ability of the vehicle to accurately target and land at a designated landing site, including site location aspects, landing site size, and landing opportunities assessments. Analyses associated with these mission design and flight performance challenges and constraints will be discussed as well as potential operational concepts to provide feasibility and/or mission commonality.

  7. Preliminary Study of a Model Rotor in Descent

    NASA Technical Reports Server (NTRS)

    McAlister, K. W.; Tung, C.; Sharpe, D. L.; Huang, S.; Hendley, E. M.

    2000-01-01

    Within a program designed to develop experimental techniques for measuring the trajectory and structure of vortices trailing from the tips of rotor blades, the present preliminary study focuses on a method for quantifying the trajectory of the trailing vortex during descent flight conditions. This study also presents rotor loads and blade surface pressures for a range of tip-path plane angles and Mach numbers. Blade pressures near the leading edge and along the outer radius are compared with data obtained on the same model rotor, but in open jet facilities. A triangulation procedure based on two directable laser-light sheets, each containing an embedded reference, proved effective in defining the spatial coordinates of the trailing vortex. When interrogating a cross section of the flow that contains several trailing vortices, the greatest clarity was found to result when the flow is uniformly seeded. Surface pressure responses during blade-vortex interactions appeared equally sensitive near the leading edge and along the outer portion of the blade, but diminished rapidly as the distance along the blade chord increased. The pressure response was virtually independent of whether the tip-path plane angle was obtained through shaft tilt or cyclic pitch. Although the shape and frequency of the pressure perturbations on the advancing blade during blade-vortex interaction are similar to those obtained in open-jet facilities, the angle of the tip-path plane may need to be lower than the range covered in this study.

  8. STS-40 descent BET products: Development and results

    NASA Technical Reports Server (NTRS)

    Oakes, Kevin F.; Wood, James S.; Findlay, John T.

    1991-01-01

    Descent Best Estimate Trajectory (BET) Data were generated for the final Orbiter Experiments Flight, STS-40. This report discusses the actual development of these post-flight products: the inertial BET, the Extended BET, and the Aerodynamic BET. Summary results are also included. The inertial BET was determined based on processing Tracking and Data Relay Satellite (TDRSS) coherent Doppler data in conjunction with observations from eleven C-band stations, to include data from the Kwajalein Atoll and the usual California coastal radars, as well as data from five cinetheodolite cameras in the vicinity of the runways at EAFB. The anchor epoch utilized for the trajectory reconstruction was 53,904 Greenwich Mean Time (GMT) seconds which corresponds to an altitude at epoch of approximately 708 kft. Atmospheric data to enable development of an Extended BET for this mission were upsurped from the JSC operational post-flight BET. These data were evaluated based on Space Shuttle-derived considerations as well as model comparisons. The Aerodynamic BET includes configuration information, final mass properties, and both flight-determined and predicted aerodynamic performance estimates. The predicted data were based on the final pre-operational databook, updated to include flight determined incrementals based on an earlier ensemble of flights. Aerodynamic performance comparisons are presented and correlated versus statistical results based on twenty-two previous missions.

  9. Development of a Mars Airplane Entry, Descent, and Flight Trajectory

    NASA Technical Reports Server (NTRS)

    Murray, James E.; Tartabini, Paul V.

    2001-01-01

    An entry, descent, and flight (EDF) trajectory profile for a Mars airplane mission is defined as consisting of the following elements: ballistic entry of an aeroshell; supersonic deployment of a decelerator parachute; subsonic release of a heat shield; release, unfolding, and orientation of an airplane to flight attitude; and execution of a pull up maneuver to achieve trimmed, horizontal flight. Using the Program to Optimize Simulated Trajectories (POST) a trajectory optimization problem was formulated. Model data representative of a specific Mars airplane configuration, current models of the Mars surface topography and atmosphere, and current estimates of the interplanetary trajectory, were incorporated into the analysis. The goal is to develop an EDF trajectory to maximize the surface-relative altitude of the airplane at the end of a pull up maneuver, while subject to the mission design constraints. The trajectory performance was evaluated for three potential mission sites and was found to be site-sensitive. The trajectory performance, examined for sensitivity to a number of design and constraint variables, was found to be most sensitive to airplane mass, aerodynamic performance characteristics, and the pull up Mach constraint. Based on the results of this sensitivity study, an airplane-drag optimized trajectory was developed that showed a significant performance improvement.

  10. Estimating Controller Intervention Probabilities for Optimized Profile Descent Arrivals

    NASA Technical Reports Server (NTRS)

    Meyn, Larry A.; Erzberger, Heinz; Huynh, Phu V.

    2011-01-01

    Simulations of arrival traffic at Dallas/Fort-Worth and Denver airports were conducted to evaluate incorporating scheduling and separation constraints into advisories that define continuous descent approaches. The goal was to reduce the number of controller interventions required to ensure flights maintain minimum separation distances of 5 nmi horizontally and 1000 ft vertically. It was shown that simply incorporating arrival meter fix crossing-time constraints into the advisory generation could eliminate over half of the all predicted separation violations and more than 80% of the predicted violations between two arrival flights. Predicted separation violations between arrivals and non-arrivals were 32% of all predicted separation violations at Denver and 41% at Dallas/Fort-Worth. A probabilistic analysis of meter fix crossing-time errors is included which shows that some controller interventions will still be required even when the predicted crossing-times of the advisories are set to add a 1 or 2 nmi buffer above the minimum in-trail separation of 5 nmi. The 2 nmi buffer was shown to increase average flight delays by up to 30 sec when compared to the 1 nmi buffer, but it only resulted in a maximum decrease in average arrival throughput of one flight per hour.

  11. Foot clearance during stair descent: effects of age and illumination.

    PubMed

    Hamel, Kathryn A; Okita, Noriaki; Higginson, Jill S; Cavanagh, Peter R

    2005-02-01

    It is likely that many stair accidents result from a trip during stair negotiation, yet few studies have examined the exact nature of balance loss during falls on stairs. The purpose of this study was to investigate potential age-related differences in the minimum clearance of the foot during stair descent, and to explore whether the minimum foot clearance was affected by the available ambient lighting. Twelve young adults (24+/-3.3 years) and 10 older adults (73.7+/-1.9 years) participated in the study. The older adults had significantly greater within subject coefficients of variation compared to the young adults, and had a significantly larger number of minimum foot clearances which fell below 5 mm. While the young subjects increased their minimum clearance by 3.6 mm on average in response to a decrease in ambient lighting, the older adults maintained the same clearance over all stairs except one. These results suggest that the variability of minimum foot clearance, and lack of precautionary increases in foot clearance under reduced lighting may contribute to falls on stairs by the elderly.

  12. Cortical network functional connectivity in the descent to sleep.

    PubMed

    Larson-Prior, Linda J; Zempel, John M; Nolan, Tracy S; Prior, Fred W; Snyder, Abraham Z; Raichle, Marcus E

    2009-03-17

    Descent into sleep is accompanied by disengagement of the conscious brain from the external world. It follows that this process should be associated with reduced neural activity in regions of the brain known to mediate interaction with the environment. We examined blood oxygen dependent (BOLD) signal functional connectivity using conventional seed-based analyses in 3 primary sensory and 3 association networks as normal young adults transitioned from wakefulness to light sleep while lying immobile in the bore of a magnetic resonance imaging scanner. Functional connectivity was maintained in each network throughout all examined states of arousal. Indeed, correlations within the dorsal attention network modestly but significantly increased during light sleep compared to wakefulness. Moreover, our data suggest that neuronally mediated BOLD signal variance generally increases in light sleep. These results do not support the view that ongoing BOLD fluctuations primarily reflect unconstrained cognition. Rather, accumulating evidence supports the hypothesis that spontaneous BOLD fluctuations reflect processes that maintain the integrity of functional systems in the brain.

  13. Description of the computations and pilot procedures for planning fuel-conservative descents with a small programmable calculator

    NASA Technical Reports Server (NTRS)

    Vicroy, D. D.; Knox, C. E.

    1983-01-01

    A simplified flight management descent algorithm was developed and programmed on a small programmable calculator. It was designed to aid the pilot in planning and executing a fuel conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The algorithm may also be used for planning fuel conservative descents when time is not a consideration. The descent path was calculated for a constant Mach/airspeed schedule from linear approximations of airplane performance with considerations given for gross weight, wind, and nonstandard temperature effects. The flight management descent algorithm and the vertical performance modeling required for the DC-10 airplane is described.

  14. Description of the computations and pilot procedures for planning fuel-conservative descents with a small programmable calculator

    SciTech Connect

    Vicroy, D.D.; Knox, C.E.

    1983-05-01

    A simplified flight management descent algorithm was developed and programmed on a small programmable calculator. It was designed to aid the pilot in planning and executing a fuel conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The algorithm may also be used for planning fuel conservative descents when time is not a consideration. The descent path was calculated for a constant Mach/airspeed schedule from linear approximations of airplane performance with considerations given for gross weight, wind, and nonstandard temperature effects. The flight management descent algorithm and the vertical performance modeling required for the DC-10 airplane is described.

  15. Cystometric analysis of the transplanted bladder

    PubMed Central

    Rocha, Jeová Nina

    2017-01-01

    ABSTRACT Objective Cystometric evaluation of the bladder after autotransplant and isogeneic transplant in female rats. Material and Methods Two groups were constituted: (A) bladder autotransplant with two subgroups: R1 – (control) and R2 – (bladder transplant); (B) isogeneic bladder transplant with three subgroups; T1 – (control); T2–T3, two subgroups observed for 30 and 60 days after transplant, respectively. All animals underwent cystometric evaluation. Afterwards, the bladders were removed for histological study. Results The transplanted bladders did not show significant changes in filling/storage and emptying/micturition functions after 30 and 60 days of evolution. Upon macroscopical evaluation, there was good revascularization and the tissue was well preserved. Cystometry results: Did not show significant differences in the micturition pressure in subgroups T2-T3, but did between subgroups R1−R2, T1−T2, and T1−T3. Significant differences were verified in the micturition interval between T1−T3, T2−T3, but not between R1−R2, T1−T2. There was significant difference in the micturition duration between T1−T3 but not between R1−R2, T1−T2 and T2−T3. No fistula was noted on the suture site nor leakage of urine in the abdominal cavity or signs of necrosis or retraction were observed. Conclusions Transplant of the bladder was shown to be a viable procedure. The results indicate that there was structural and functional regeneration of transplanted bladders, and these results indicate that it is possible that vascular endothelium growth and neurogenesis factors are involved and activated in the process of the preservation or survival of the transplanted organ. PMID:28124533

  16. [Management of neuropathic bladder in multiple sclerosis].

    PubMed

    Pappalardo, A; Patti, F; Reggio, A

    2004-05-01

    It is estimated that almost 70% of patients affected by multiple sclerosis (MS) suffer from urinary symptoms, with devastant impact on Quality of Life (QoL). The major aims of management should be to ameliorate the patients quality of life and to prevent the frequent complications of bladder dysfunction such as infention and renal damage. Therapy can usually eliminate or reduce the symptoms of neuropathic bladder. In the following pages is discussed the complex management of urinary symptoms in MS patients.

  17. [Intravesical treatment of overactive bladder syndrome].

    PubMed

    Haferkamp, A; Hohenfellner, M

    2006-10-01

    Overactive bladder and urgency incontinence are common conditions generally treated with oral anticholinergic medication. Despite the development of new antimuscarinic substances, many patients are refractory to or cannot tolerate the oral therapy due to severe side effects. Intravesical instillation therapy can provide an alternative method to manage detrusor overactivity. Intravesical instillation of anticholinergics such as oxybutynin and trospium chloride can achieve cholinergic blockade without producing systemic side effects. Botulinum toxin type A injections into the detrusor have been shown to increase bladder capacity and to decrease detrusor overactivity for 6 or more months. Intravesical local anesthetics such as lidocaine and bupivacaine block the conduction of unmyelinated C fibers which results in an increase of functional bladder capacity. Intravesical capsaicin and resiniferatoxin also affect the afferent C fiber innervation of the bladder, leading to a decrease in detrusor overactivity and also an increased bladder capacity. The use of intravesical anticholinergics and of local anesthetic medications, both known for their short-term efficacy, is limited due to the necessity of daily intermittent catheterization. In conclusion, intravesical therapies can provide an alternative treatment for the management of overactive bladder.

  18. MACV/Radio integrated navigation for Mars powered descent via robust desensitized central difference Kalman filter

    NASA Astrophysics Data System (ADS)

    Lou, Taishan; Liu, Jie; Jin, Pan; Wang, Yan

    2017-01-01

    An innovative integrated navigation scheme based on MCAV/Radio measurement information during Mars powered descent phase, and a robust desensitized central difference Kalman filter (DCDKF) for systems with uncertain parameters or biases are proposed to improve the navigation descent accuracy. Based on the altitude and velocity information of the Miniature Coherent Altimeter and Velocimeter (MCAV), the radio-range information is added into the integrated navigation system to correct the horizontal position error of the vehicle during the Mars powered descent phase. Based the central difference transform, the sensitivity propagation of the state estimate errors in the DCDKF is described, and a designed desensitized cost function is minimized to obtain the gain matrix of the DCDKF. The performances of the innovative navigation scheme and the proposed DCDKF are all demonstrated by two Monte Carlo simulations with the Inertial Measurement Unit biases during the Mars power descent phase.

  19. Antarctic Polar Descent and Planetary Wave Activity Observed in ISAMS CO from April to July 1992

    NASA Technical Reports Server (NTRS)

    Allen, D. R.; Stanford, J. L.; Nakamura, N.; Lopez-Valverde, M. A.; Lopez-Puertas, M.; Taylor, F. W.; Remedios, J. J.

    2000-01-01

    Antarctic polar descent and planetary wave activity in the upper stratosphere and lower mesosphere are observed in ISAMS CO data from April to July 1992. CO-derived mean April-to-May upper stratosphere descent rates of 15 K/day (0.25 km/day) at 60 S and 20 K/day (0.33 km/day) at 80 S are compared with descent rates from diabatic trajectory analyses. At 60 S there is excellent agreement, while at 80 S the trajectory-derived descent is significantly larger in early April. Zonal wavenumber 1 enhancement of CO is observed on 9 and 28 May, coincident with enhanced wave 1 in UKMO geopotential height. The 9 May event extends from 40 to 70 km and shows westward phase tilt with height, while the 28 May event extends from 40 to 50 km and shows virtually no phase tilt with height.

  20. A conflict analysis of 4D descent strategies in a metered, multiple-arrival route environment

    NASA Technical Reports Server (NTRS)

    Izumi, K. H.; Harris, C. S.

    1990-01-01

    A conflict analysis was performed on multiple arrival traffic at a typical metered airport. The Flow Management Evaluation Model (FMEM) was used to simulate arrival operations using Denver Stapleton's arrival route structure. Sensitivities of conflict performance to three different 4-D descent strategies (clear-idle Mach/Constant AirSpeed (CAS), constant descent angle Mach/CAS and energy optimal) were examined for three traffic mixes represented by those found at Denver Stapleton, John F. Kennedy and typical en route metering (ERM) airports. The Monte Carlo technique was used to generate simulation entry point times. Analysis results indicate that the clean-idle descent strategy offers the best compromise in overall performance. Performance measures primarily include susceptibility to conflict and conflict severity. Fuel usage performance is extrapolated from previous descent strategy studies.

  1. The Cassini/Huygens Doppler Wind Experiment: Results from the Titan Descent

    NASA Astrophysics Data System (ADS)

    Bird, M. K.; Dutta-Roy, R.; Allison, M. D.; Asmar, S. W.; Atkinson, D. H.; Edenhofer, P.; Plettemeier, D.; Tyler, G. L.

    2005-03-01

    The Huygens Doppler Wind Experiment (DWE) determined the height profile of the zonal winds during the Titan descent, commencing with parachute deployment at an altitude of ca. 150 km down to impact on the surface.

  2. User's manual for a fuel-conservative descent planning algorithm implemented on a small programmable calculator

    SciTech Connect

    Vicroy, D.D.

    1984-01-01

    A simplified flight management descent algorithm was developed and programmed on a small programmable calculator. It was designed to aid the pilot in planning and executing a fuel conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The algorithm may also be used for planning fuel conservative descents when time is not a consideration. The descent path was calculated for a constant Mach/airspeed schedule from linear approximations of airplane performance with considerations given for gross weight, wind, and nonstandard temperature effects. An explanation and examples of how the algorithm is used, as well as a detailed flow chart and listing of the algorithm are contained.

  3. Analysis of Flight Management System Predictions of Idle-Thrust Descents

    NASA Technical Reports Server (NTRS)

    Stell, Laurel

    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 predictor and its uncertainty models, descents from cruise to the meter fix were executed using vertical navigation in a B737-700 simulator and a B777-200 simulator, both with commercial FMSs. For both aircraft types, the FMS computed the intended descent path for a specified speed profile assuming idle thrust after top of descent (TOD), and then it controlled the avionics without human intervention. The test matrix varied aircraft weight, descent speed, and wind conditions. The first analysis in this paper determined the effect of the test matrix parameters on the FMS computation of TOD location, and it compared the results to those for the current ground predictor in the Efficient Descent Advisor (EDA). The second analysis was similar but considered the time to fly a specified distance to the meter fix. The effects of the test matrix variables together with the accuracy requirements for the predictor will determine the allowable error for the predictor inputs. For the B737, the EDA prediction of meter fix crossing time agreed well with the FMS; but its prediction of TOD location probably was not sufficiently accurate to enable idle-thrust descents in congested airspace, even though the FMS and EDA gave similar shapes for TOD location as a function of the test matrix variables. For the B777, the FMS and EDA gave different shapes for the TOD location function, and the EDA prediction of the TOD location is not accurate enough to fully enable the concept. Furthermore, the differences between the FMS and EDA predictions of meter fix crossing time for the B777 indicated that at least one of them was not sufficiently accurate.

  4. An analytical study of nonlinear oscillations during uncontrolled descent in the atmosphere

    NASA Astrophysics Data System (ADS)

    Privarnikov, O. A.

    Reference is made to an earlier study (Privarnikov, 1980) in which expressions have been obtained for the analysis of plane nonlinear oscillations during uncontrolled ballistic descent in the atmosphere. Here, a more accurate solution to the ballistic descent problem is obtained which allows for the nonlinearity of the aerodynamic coefficients and for the effect of oscillations on the motion of the center of mass. The accuracy of the solution is estimated for different degrees of nonlinearity of the aerodynamic coefficients.

  5. Green's-function solutions to dynamical-simulated annealing and steepest-descents equations of motion

    SciTech Connect

    Benedek, R.; Min, B.I.; Garner, J.

    1987-08-01

    Solutions to the dynamical-simulated-annealing and the steepest-descents equations of motion for electron states are presented. The relations proposed by Payne et al. and by Williams and Soler can be obtained from the first-born approximation by applying additional decoupling approximations. A numerical example is presented to contrast the behavior of the Green's function and finite-difference solutions to the steepest-descents dynamics. 14 refs., 2 figs.

  6. Mars Science Laboratory Entry, Descent and Landing System Development Challenges and Preliminary Flight Performance

    NASA Technical Reports Server (NTRS)

    Steltzner, Adam D.; San Martin, A. Miguel; Rivellini, Tommaso P.

    2013-01-01

    The Mars Science Laboratory project recently landed the Curiosity rover 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 of the MSL entry, descent, and landing system, a discussion of a subset of its development challenges, and include a discussion of preliminary results of the flight reconstruction effort.

  7. Phase-only Beam Broadening in Large Transmit Arrays Using Complex-Weight Gradient Descent

    DTIC Science & Technology

    2014-04-15

    used gradient descent modified with a classic SVD technique to create point and sector nulls as desired. Here Day’s approach is extended to allow for...amplitude variation. He used gradient descent modified with a classic SVD technique to create point and sector nulls as desired. Here Day’s approach is...steering offset is still present in the plot to better display the weights.) A singular-value decomposition ( SVD ) approach is used to avoid restricting the

  8. Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor

    PubMed Central

    Vincent, D. Paul

    2017-01-01

    Vesical explosion during transurethral resection of the prostate (TURP) is a very rare occurrence. Very few cases have been reported in the literature. The literature was reviewed pertaining to the etiology of bladder explosion during transurethral resection. The underlying mechanism for intravesical explosion is the generation and trapping of explosive gasses under the dome of the bladder which eventually detonates when it comes into contact with the cautery electrode during TURP. Various techniques have been suggested to prevent this dreaded complication. A 75-year-old male with chronic retention of urine underwent TURP. There was Grade 2 trilobar enlargement of the prostate. There were multiple diverticula with one large diverticulum in the dome of the bladder. During hemostasis, there was a loud pop sound and the bladder exploded. Lower midline laparotomy was performed and the intraperitoneal bladder rupture was repaired. He had an uneventful postoperative recovery, and he is asymptomatic at 6 months of follow-up. Even though all the precautions were taken to avoid this complication, bladder rupture was encountered. The presence of multiple diverticula is being suggested as an additional risk factor for this complication as the bladder is thinned out and also possibly due to trapping of air bubble within the diverticulum. In such cases where there are multiple bladder diverticula, the employment of a suprapubic trocar for continuous drainage of the air bubble, could well be a practical consideration. PMID:28216933

  9. Manifold regularized discriminative nonnegative matrix factorization with fast gradient descent.

    PubMed

    Guan, Naiyang; Tao, Dacheng; Luo, Zhigang; Yuan, Bo

    2011-07-01

    Nonnegative matrix factorization (NMF) has become a popular data-representation method and has been widely used in image processing and pattern-recognition problems. This is because the learned bases can be interpreted as a natural parts-based representation of data and this interpretation is consistent with the psychological intuition of combining parts to form a whole. For practical classification tasks, however, NMF ignores both the local geometry of data and the discriminative information of different classes. In addition, existing research results show that the learned basis is unnecessarily parts-based because there is neither explicit nor implicit constraint to ensure the representation parts-based. In this paper, we introduce the manifold regularization and the margin maximization to NMF and obtain the manifold regularized discriminative NMF (MD-NMF) to overcome the aforementioned problems. The multiplicative update rule (MUR) can be applied to optimizing MD-NMF, but it converges slowly. In this paper, we propose a fast gradient descent (FGD) to optimize MD-NMF. FGD contains a Newton method that searches the optimal step length, and thus, FGD converges much faster than MUR. In addition, FGD includes MUR as a special case and can be applied to optimizing NMF and its variants. For a problem with 165 samples in R(1600), FGD converges in 28 s, while MUR requires 282 s. We also apply FGD in a variant of MD-NMF and experimental results confirm its efficiency. Experimental results on several face image datasets suggest the effectiveness of MD-NMF.

  10. Application of inflatable aeroshell structures for Entry Descent and Landing

    NASA Astrophysics Data System (ADS)

    Jurewicz, David; Lichodziejewski, Leo; Tutt, Ben; Gilles, Brian; Brown, Glen

    Future space missions will require improvements in the Entry, Descent, and Landing (EDL) phases of the mission architecture. The focus of this paper is to discuss recent advances in analysis, fabrication techniques, ground testing, and flight testing of a stacked torus Hypersonic Inflatable Aerodynamic Decelerator (HIAD) and its application to the future of EDL. The primary structure of a stacked torus HIAD consists of nested inflatable tori of increasing major diameter bonded and strapped to form a rigid structure after inflation. The underlying structure of the decelerator is covered with a flexible Thermal Protection System (TPS) capable of high heat flux. The inflatable aeroshell and TPS are packed around a centerbody within the launch fairing and deployed prior to atmospheric reentry. Recent fabrication of multiple HIADs between 3 and 6 meters has led to significant advances in process control and validation of the scalability of the technology. Progress has been made in generating and validating LS-DYNA FEA models to replicate flight loading in addition to analytical models of substructures. Coupon and component testing has improved the validation of modeling techniques and assumptions at the subsystem level. A ground testing campaign at the National Full-Scale Aerodynamics Center (NFAC) wind tunnel at NASA Ames Research center generated substantial aerodynamic and loading data to validate full system modeling with comparable dynamic pressures to a hypersonic reentry. The Inflatable Reentry Vehicle - 3 (IRVE-3) sounding rocket flight test was conducted with NASA Langley Research Center in July 2012. The IRVE-3 mission verified the structural and thermal performance of the stacked torus configuration. Further development of the stacked torus configuration is currently being conducted to increase the thermal capability, deceleration loads, and understanding of the interactions and effects of constituent components. The results of this research have expanded the

  11. Experiments on liquid immiscibility along tholeiitic liquid lines of descent

    NASA Astrophysics Data System (ADS)

    Charlier, Bernard; Grove, Timothy L.

    2012-07-01

    Crystallization experiments have been conducted on compositions along tholeiitic liquid lines of descent to define the compositional space for the development of silicate liquid immiscibility. Starting materials have 46-56 wt% SiO2, 11.7-17.7 wt% FeOtot, and Mg-number between 0.29 and 0.36. These melts fall on the basaltic trends relevant for Mull, Iceland, Snake River Plain lavas and for the Sept Iles layered intrusion, where large-scale liquid immiscibility has been recognized. At one atmosphere under anhydrous conditions, immiscibility develops below 1,000-1,020°C in all of these compositionally diverse lavas. Extreme iron enrichment is not necessary; immiscibility also develops during iron depletion and silica enrichment. Variations in melt composition control the development of silicate liquid immiscibility along the tholeiitic trend. Elevation of Na2O + K2O + P2O5 + TiO2 promotes the development of two immiscible liquids. Increasing melt CaO and Al2O3 stabilizes a single-liquid field. New data and published phase equilibria show that anhydrous, low-pressure fractional crystallization is the most favorable condition for unmixing during differentiation. Pressure inhibits immiscibility because it expands the stability field of high-Ca clinopyroxene, which reduces the proportion of plagioclase in the crystallizing assemblage, thus enhancing early iron depletion. Magma mixing between primitive basalt and Fe-Ti-P-rich ferrobasalts can serve to elevate phosphorous and alkali contents and thereby promote unmixing. Water might decrease the temperature and size of the two-liquid field, potentially shifting the binodal (solvus) below the liquidus, leading the system to evolve as a single-melt phase.

  12. Efficient clustering of identity-by-descent between multiple individuals

    PubMed Central

    Qian, Yu; Browning, Brian L.; Browning, Sharon R.

    2014-01-01

    Motivation: Most existing identity-by-descent (IBD) detection methods only consider haplotype pairs; less attention has been paid to considering multiple haplotypes simultaneously, even though IBD is an equivalence relation on haplotypes that partitions a set of haplotypes into IBD clusters. Multiple-haplotype IBD clusters may have advantages over pairwise IBD in some applications, such as IBD mapping. Existing methods for detecting multiple-haplotype IBD clusters are often computationally expensive and unable to handle large samples with thousands of haplotypes. Results: We present a clustering method, efficient multiple-IBD, which uses pairwise IBD segments to infer multiple-haplotype IBD clusters. It expands clusters from seed haplotypes by adding qualified neighbors and extends clusters across sliding windows in the genome. Our method is an order of magnitude faster than existing methods and has comparable performance with respect to the quality of clusters it uncovers. We further investigate the potential application of multiple-haplotype IBD clusters in association studies by testing for association between multiple-haplotype IBD clusters and low-density lipoprotein cholesterol in the Northern Finland Birth Cohort. Using our multiple-haplotype IBD cluster approach, we found an association with a genomic interval covering the PCSK9 gene in these data that is missed by standard single-marker association tests. Previously published studies confirm association of PCSK9 with low-density lipoprotein. Availability and implementation: Source code is available under the GNU Public License http://cs.au.dk/~qianyuxx/EMI/. Contact: qianyuxx@gmail.com Supplementary information: Supplementary data are available at Bioinformatics online. PMID:24363374

  13. Mars 2020 Entry, Descent and Landing Instrumentation (MEDLI2)

    NASA Technical Reports Server (NTRS)

    Bose, Deepak; Wright, Henry; White, Todd; Schoenenberger, Mark; Santos, Jose; Karlgaard, Chris; Kuhl, Chris; Oishi, TOmo; Trombetta, Dominic

    2016-01-01

    This paper will introduce Mars Entry Descent and Landing Instrumentation (MEDLI2) on NASA's Mars2020 mission. Mars2020 is a flagship NASA mission with science and technology objectives to help answer questions about possibility of life on Mars as well as to demonstrate technologies for future human expedition. Mars2020 is scheduled for launch in 2020. MEDLI2 is a suite of instruments embedded in the heatshield and backshell thermal protection systems of Mars2020 entry vehicle. The objectives of MEDLI2 are to gather critical aerodynamics, aerothermodynamics and TPS performance data during EDL phase of the mission. MEDLI2 builds up the success of MEDLI flight instrumentation on Mars Science Laboratory mission in 2012. MEDLI instrumentation suite measured surface pressure and TPS temperature on the heatshield during MSL entry into Mars. MEDLI data has since been used for unprecedented reconstruction of aerodynamic drag, vehicle attitude, in-situ atmospheric density, aerothermal heating, transition to turbulence, in-depth TPS performance and TPS ablation. [1,2] In addition to validating predictive models, MEDLI data has highlighted extra margin available in the MSL forebody TPS, which can potentially be used to reduce vehicle parasitic mass. MEDLI2 expands the scope of instrumentation by focusing on quantities of interest not addressed in MEDLI suite. The type the sensors are expanded and their layout on the TPS modified to meet these new objectives. The paper will provide key motivation and governing requirements that drive the choice and the implementation of the new sensor suite. The implementation considerations of sensor selection, qualification, and demonstration of minimal risk to the host mission will be described. The additional challenges associated with mechanical accommodation, electrical impact, data storage and retrieval for MEDLI2 system, which extends sensors to backshell will also be described.

  14. Optimal sliding guidance algorithm for Mars powered descent phase

    NASA Astrophysics Data System (ADS)

    Wibben, Daniel R.; Furfaro, Roberto

    2016-02-01

    Landing on large planetary bodies (e.g. Mars) with pinpoint accuracy presents a set of new challenges that must be addressed. One such challenge is the development of new guidance algorithms that exhibit a higher degree of robustness and flexibility. In this paper, the Zero-Effort-Miss/Zero-Effort-Velocity (ZEM/ZEV) optimal sliding guidance (OSG) scheme is applied to the Mars powered descent phase. This guidance algorithm has been specifically designed to combine techniques from both optimal and sliding control theories to generate an acceleration command based purely on the current estimated spacecraft state and desired final target state. Consequently, OSG yields closed-loop trajectories that do not need a reference trajectory. The guidance algorithm has its roots in the generalized ZEM/ZEV feedback guidance and its mathematical equations are naturally derived by defining a non-linear sliding surface as a function of the terms Zero-Effort-Miss and Zero-Effort-Velocity. With the addition of the sliding mode and using Lyapunov theory for non-autonomous systems, one can formally prove that the developed OSG law is globally finite-time stable to unknown but bounded perturbations. Here, the focus is on comparing the generalized ZEM/ZEV feedback guidance with the OSG law to explicitly demonstrate the benefits of the sliding mode augmentation. Results show that the sliding guidance provides a more robust solution in off-nominal scenarios while providing similar fuel consumption when compared to the non-sliding guidance command. Further, a Monte Carlo analysis is performed to examine the performance of the OSG law under perturbed conditions.

  15. Mars Exploration Rover Entry, Descent, and Landing: A Thermal Perspective

    NASA Technical Reports Server (NTRS)

    Tsuyuki, Glenn T.; Sunada, Eric T.; Novak, Keith S.; Kinsella, Gary M.; Phillip, Charles J.

    2005-01-01

    Perhaps the most challenging mission phase for the Mars Exploration Rovers was the Entry, Descent, and Landing (EDL). During this phase, the entry vehicle attached to its cruise stage was transformed into a stowed tetrahedral Lander that was surrounded by inflated airbags through a series of complex events. There was only one opportunity to successfully execute an automated command sequence without any possible ground intervention. The success of EDL was reliant upon the system thermal design: 1) to thermally condition EDL hardware from cruise storage temperatures to operating temperature ranges; 2) to maintain the Rover electronics within operating temperature ranges without the benefit of the cruise single phase cooling loop, which had been evacuated in preparation for EDL; and 3) to maintain the cruise stage propulsion components for the critical turn to entry attitude. Since the EDL architecture was inherited from Mars Pathfinder (MPF), the initial EDL thermal design would be inherited from MPF. However, hardware and implementation differences from MPF ultimately changed the MPF inheritance approach for the EDL thermal design. With the lack of full inheritance, the verification and validation of the EDL thermal design took on increased significance. This paper will summarize the verification and validation approach for the EDL thermal design along with applicable system level thermal testing results as well as appropriate thermal analyses. In addition, the lessons learned during the system-level testing will be discussed. Finally, the in-flight EDL experiences of both MER-A and -B missions (Spirit and Opportunity, respectively) will be presented, demonstrated how lessons learned from Spirit were applied to Opportunity.

  16. Atmospheric Environments for Entry, Descent and Landing (EDL)

    NASA Technical Reports Server (NTRS)

    Justus, Carl G.; Braun, Robert D.

    2007-01-01

    Scientific measurements of atmospheric properties have been made by a wide variety of planetary flyby missions, orbiters, and landers. Although landers can make in-situ observations of near-surface atmospheric conditions (and can collect atmospheric data during their entry phase), the vast majority of data on planetary atmospheres has been collected by remote sensing techniques from flyby and orbiter spacecraft (and to some extent by Earth-based remote sensing). Many of these remote sensing observations (made over a variety of spectral ranges), consist of vertical profiles of atmospheric temperature as a function of atmospheric pressure level. While these measurements are of great interest to atmospheric scientists and modelers of planetary atmospheres, the primary interest for engineers designing entry descent and landing (EDL) systems is information about atmospheric density as a function of geometric altitude. Fortunately, as described in in this paper, it is possible to use a combination of the gas-law relation and the hydrostatic balance relation to convert temperature-versus-pressure, scientific observations into density-versus-altitude data for use in engineering applications. The following section provides a brief introduction to atmospheric thermodynamics, as well as constituents, and winds for EDL. It also gives methodology for using atmospheric information to do "back-of-the-envelope" calculations of various EDL aeroheating parameters, including peak deceleration rate ("g-load"), peak convective heat rate. and total heat load on EDL spacecraft thermal protection systems. Brief information is also provided about atmospheric variations and perturbations for EDL guidance and control issues, and atmospheric issues for EDL parachute systems. Subsequent sections give details of the atmospheric environments for five destinations for possible EDL missions: Venus. Earth. Mars, Saturn, and Titan. Specific atmospheric information is provided for these destinations

  17. Is gall bladder cancer a bad cancer per se?

    PubMed

    Kapoor, Vinay K

    2015-07-27

    Gall bladder cancer (GBC) has one of the poorest outcomes of all cancers. Early GBC is difficult to diagnose on even computed tomography. GB has no submucosa and the cancer infiltrates directly into the muscularis propria. GB wall is thin and important adjacent organs viz. liver, duodenum and pancreas get easily infiltrated. Tumor in the GB neck often needs extended right hepatectomy. Infiltration of duodenum/pancreas may necessitate pancreato-duodenectomy or even hepato-pancreato-duodenectomy. Mortality of surgical procedures, when performed for GBC, is higher than when performed for other cancers. Survival in GBC, even after R0 resection, is poor. There is no proven role of neo-adjuvant or adjuvant therapy for loco-regionally advanced GBC. There is no role of palliative surgery in metastatic GBC. Early GBC is diagnosed incidentally after cholecystectomy for stones and requires reoperation for completion extended cholecystectomy but unfortunately, most surgeons are not aware of this. GBC has a peculiar epidemiology and is uncommon in the West and has, therefore, not received much attention. Preventive cholecystectomy for asymptomatic stones is not recommended and there is no serum marker for screening. With all factors pitched against it, it does appear that GBC is a bad cancer per se!

  18. Is gall bladder cancer a bad cancer per se?

    PubMed Central

    Kapoor, Vinay K

    2015-01-01

    Gall bladder cancer (GBC) has one of the poorest outcomes of all cancers. Early GBC is difficult to diagnose on even computed tomography. GB has no submucosa and the cancer infiltrates directly into the muscularis propria. GB wall is thin and important adjacent organs viz. liver, duodenum and pancreas get easily infiltrated. Tumor in the GB neck often needs extended right hepatectomy. Infiltration of duodenum/pancreas may necessitate pancreato-duodenectomy or even hepato-pancreato-duodenectomy. Mortality of surgical procedures, when performed for GBC, is higher than when performed for other cancers. Survival in GBC, even after R0 resection, is poor. There is no proven role of neo-adjuvant or adjuvant therapy for loco-regionally advanced GBC. There is no role of palliative surgery in metastatic GBC. Early GBC is diagnosed incidentally after cholecystectomy for stones and requires reoperation for completion extended cholecystectomy but unfortunately, most surgeons are not aware of this. GBC has a peculiar epidemiology and is uncommon in the West and has, therefore, not received much attention. Preventive cholecystectomy for asymptomatic stones is not recommended and there is no serum marker for screening. With all factors pitched against it, it does appear that GBC is a bad cancer per se! PMID:26225192

  19. The Descent Rates of the Shear Zones of the Equatorial QBO.

    NASA Astrophysics Data System (ADS)

    Kinnersley, Jonathan S.; Pawson, Steven

    1996-07-01

    The influence of vertical advection on the descent rate of the zero-wind line in both phases of the equatorial quasi-biennial oscillation (QBO) is investigated with the help of the `THIN AIR' stratosphere two-and-a-half-dimensional model. The model QBO is forced by two symmetric easterly and westerly waves, and yet the model reproduces qualitatively the observed asymmetry in the descent rates of the two shear zones due to the enhanced heating during easterly descent combined with the equatorial heating induced by the extratropical planetary waves. Observations show that the maximum easterly accelerations occur predominantly from May until July, which is when the modeled equatorial planetary-wave-induced heating rates are weakest. Hence, model results are consistent with the theory that vertical advection induced by extratropical planetary waves slows significantly the descent of the easterly shear zone. The model also shows the observed increase in vertical wind shear during stalling of the easterly descent (which increases the impact of vertical advection). In the model, the effect of cross-equatorial advection of momentum by the mean flow is negligible compared to the vertical advection. Changes in the propagation of planetary waves depending on the sign of the equatorial zonal wind have a small effect on the modeled equatorial heating rates and therefore do not play a large part in producing the modeled asymmetry in descent rates.

  20. The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction

    PubMed Central

    Andersson, Karl-Erik; Boedtkjer, Donna B.; Forman, Axel

    2016-01-01

    The vascular supply to the human bladder is derived mainly from the superior and inferior vesical arteries, the latter being directly connected to the internal iliac artery. Aging is associated with an impairment of blood vessel function and changes may occur in the vasculature at the molecular, cellular and functional level. Pelvic arterial insufficiency may play an important role in the development of bladder dysfunctions such as detrusor overactivity (DO) and the overactive bladder syndrome. Chronic ischemia-related bladder dysfunction may progress to bladder underactivity and it would be desirable to treat not only lower urinary tract symptoms (LUTS) induced by chronic ischemia, but also the progression of the morphological bladder changes. Studies in experimental models in rabbits and rats have shown that pelvic arterial insufficiency may result in significant bladder ischemia with reduced bladder wall oxygen tension. In turn, this will lead to oxidative stress associated with upregulation of oxidative stress-sensitive genes, increased muscarinic receptor activity, ultrastructural damage, and neurodegeneration. The phosphodiesterase type 5 (PDE5) inhibitor tadalafil, the α1-adrenoceptor (AR) blocker silodosin, the β3-AR agonist mirabegron, and the free radical scavenger melatonin, exerted a protecting effect on urodynamic parameters, and on functional and morphological changes of the bladder demonstrable in vitro. Since the agents tested are used clinically for relieving LUTS, the results from the animal models seem to have translational value, and may be of relevance for designing clinical studies to demonstrate if the drugs may prevent progression of ischemia-related functional and morphological bladder changes. PMID:28042309

  1. Transcriptional and translational plasticity in rodent urinary bladder TRP channels with urinary bladder inflammation, bladder dysfunction, or postnatal maturation.

    PubMed

    Merrill, Liana; Girard, Beatrice M; May, Victor; Vizzard, Margaret A

    2012-11-01

    These studies examined the transcriptional and translational plasticity of three transient receptor potential (TRP) channels (TRPA1, TRPV1, TRPV4) with established neuronal and non-neuronal expression and functional roles in the lower urinary tract. Mechanosensor and nociceptor roles in either physiological or pathological lower urinary tract states have been suggested for TRPA1, TRPV1, and TRPV4. We have previously demonstrated the neurochemical, organizational, and functional plasticity in micturition reflex pathways following induction of urinary bladder inflammation using the antineoplastic agent, cyclophosphamide. More recently, we have characterized similar plasticity in micturition reflex pathways in a transgenic mouse model with chronic urothelial overexpression (OE) of nerve growth factor (NGF) and in a transgenic mouse model with deletion of vasoactive intestinal polypeptide (VIP). In addition, the micturition reflex undergoes postnatal maturation that may also reflect plasticity in urinary bladder TRP channel expression. Thus, we examined plasticity in urinary bladder TRP channel expression in diverse contexts using a combination of quantitative, real-time PCR and western blotting approaches. We demonstrate transcriptional and translational plasticity of urinary bladder TRPA1, TRPV1, and TRVP4 expression. Although the functional significance of urinary bladder TRP channel plasticity awaits further investigation, these studies demonstrate context- (inflammation, postnatal development, NGF-OE, VIP deletion) and tissue-dependent (urothelium + suburothelium, detrusor) plasticity.

  2. Relationship between Schistosomiasis and Bladder Cancer

    PubMed Central

    Mostafa, M. H.; Sheweita, S. A.; O’Connor, P. J.

    1999-01-01

    Carcinoma of the urinary bladder is the most common malignancy in the Middle East and parts of Africa where schistosomiasis is a widespread problem. Much evidence supports the association between schistosomiasis and bladder cancer: this includes the geographical correlation between the two conditions, the distinctive patterns of gender and age at diagnosis, the clinicopathological identity of schistosome-associated bladder cancer, and extensive evidence in experimentally infected animals. Multiple factors have been suggested as causative agents in schistosome-associated bladder carcinogenesis. Of these, N-nitroso compounds appear to be of particular importance since they were found at high levels in the urine of patients with schistosomiasis-associated bladder cancer. Various strains of bacteria that can mediate nitrosation reactions leading to the formation of N-nitrosamines have been identified in the urine of subjects with schistosomiasis at higher intensities of infection than in normal subjects. In experimental schistosomiasis, the activities of carcinogen-metabolizing enzymes are increased soon after infection but are reduced again during the later chronic stages of the disease. Not only could this prolong the period of exposure to activated N-nitrosamines, but also inflammatory cells, sitmulated as a result of the infection, may induce the endogenous synthesis of N-nitrosamines as well as generating oxygen radicals. Higher than normal levels of host cell DNA damage are therefore anticipated, and they have indeed been observed in the case of alkylation damage, together with an inefficiency in the capacity of relevant enzymes to repair this damaged DNA. In experimental schistosomiasis, it was also found that endogenous levels of host cell DNA damage were related to the intensity of infection. All of these factors could contribute to an increased risk of bladder cancer in patients with schistosomiasis, and in particular, the gene changes observed may have

  3. Lightweight bladder lined pressure vessels

    DOEpatents

    Mitlitsky, F.; Myers, B.; Magnotta, F.

    1998-08-25

    A lightweight, low permeability liner is described for graphite epoxy composite compressed gas storage vessels. The liner is composed of polymers that may or may not be coated with a thin layer of a low permeability material, such as silver, gold, or aluminum, deposited on a thin polymeric layer or substrate which is formed into a closed bladder using tori spherical or near tori spherical end caps, with or without bosses therein, about which a high strength to weight material, such as graphite epoxy composite shell, is formed to withstand the storage pressure forces. The polymeric substrate may be laminated on one or both sides with additional layers of polymeric film. The liner may be formed to a desired configuration using a dissolvable mandrel or by inflation techniques and the edges of the film sealed by heat sealing. The liner may be utilized in most any type of gas storage system, and is particularly applicable for hydrogen, gas mixtures, and oxygen used for vehicles, fuel cells or regenerative fuel cell applications, high altitude solar powered aircraft, hybrid energy storage/propulsion systems, and lunar/Mars space applications, and other applications requiring high cycle life. 19 figs.

  4. Lightweight bladder lined pressure vessels

    DOEpatents

    Mitlitsky, Fred; Myers, Blake; Magnotta, Frank

    1998-01-01

    A lightweight, low permeability liner for graphite epoxy composite compressed gas storage vessels. The liner is composed of polymers that may or may not be coated with a thin layer of a low permeability material, such as silver, gold, or aluminum, deposited on a thin polymeric layer or substrate which is formed into a closed bladder using torispherical or near torispherical end caps, with or without bosses therein, about which a high strength to weight material, such as graphite epoxy composite shell, is formed to withstand the storage pressure forces. The polymeric substrate may be laminated on one or both sides with additional layers of polymeric film. The liner may be formed to a desired configuration using a dissolvable mandrel or by inflation techniques and the edges of the film seamed by heat sealing. The liner may be utilized in most any type of gas storage system, and is particularly applicable for hydrogen, gas mixtures, and oxygen used for vehicles, fuel cells or regenerative fuel cell applications, high altitude solar powered aircraft, hybrid energy storage/propulsion systems, and lunar/Mars space applications, and other applications requiring high cycle life.

  5. Initial conformation of kinesin's neck linker

    NASA Astrophysics Data System (ADS)

    Geng, Yi-Zhao; Ji, Qing; Liu, Shu-Xia; Yan, Shi-Wei

    2014-10-01

    How ATP binding initiates the docking process of kinesin's neck linker is a key question in understanding kinesin mechanisms. By exploiting a molecular dynamics method, we investigate the initial conformation of kinesin's neck linker in its docking process. We find that, in the initial conformation, the neck linker has interactions with β0 and forms a ‘cover-neck bundle’ structure with β0. From this initial structure, the formation of extra turns and the docking of the cover-neck bundle structure can be achieved. The motor head provides a forward force on the initial cover-neck bundle structure through ATP-induced rotation. This force, together with the hydrophobic interaction of ILE327 with the hydrophobic pocket on the motor head, drives the formation of the extra turn and initiates the neck linker docking process. Based on these findings, a pathway from ATP binding-induced motor head rotation to neck linker docking is proposed.

  6. Neck dissection: current concepts and future directions.

    PubMed

    Rigual, Nestor R; Wiseman, Sam M

    2004-01-01

    For individuals diagnosed with head and neck cancer, neck dissection may be performed for therapy or disease staging. The classification of neck dissection and the definition of precise anatomic landmarks have allowed for this operation, and its many variations, to become standardized world-wide. SLNBX shows promise in its ability to accurately stage NO head and neck cancer and may allow patients with no micro metastatic disease to avoid neck dissection. Before this technique becomes adopted into routine clinical practice, however, it must first be prospectively scrutinized in large patient populations. Regardless of the future role of SLNBX in the management of head and neck cancer, currently it is only through a complete understanding of the clinical, theoretic, and technical aspects of neck dis-section that surgeons may benefit individual patients and the head and neck cancer patient population as a whole.

  7. Bladder Control Problems in Women: Lifestyle Strategies for Relief

    MedlinePlus

    ... Some foods and beverages can irritate your bladder. Caffeine and alcohol both increase urine production. This can lead to increased frequency and urgency of urination. Caffeine can also cause bladder spasms. Certain acidic fruits — ...

  8. Noninvasive Electromagnetic Detection of Bladder Cancer

    PubMed Central

    Cormio, Luigi; Vedruccio, Clarbruno; Leucci, Giorgio; Massenio, Paolo; Di Fino, Giuseppe; Cavaliere, Vincenzo; Carrieri, Giuseppe

    2014-01-01

    Objectives. Normal and neoplastic human tissues have different electromagnetic properties. This study aimed to determine the diagnostic accuracy of noninvasive electromagnetic detection of bladder cancer (BC) by the tissue-resonance interaction method (TRIM-prob). Patients and Methods. Consecutive patients were referred for cystoscopy because of (i) microscopic or gross hematuria and/or irritative voiding symptoms and (ii) bladder ultrasounds and urinary cytology findings negative or just suspicious of malignancy. Patients were first submitted to TRIM-prob bladder scanning by a single investigator and then to cystoscopy by another investigator blind to TRIM-prob data. Results. In 125 evaluated patients cystoscopy was positive for BC in 47 and negative in the remaining 78; conversely, TRIM-prob bladder scanning was positive for BC in 53 and negative in 72. In particular, TRIM-prob scanning yielded 7 false positives and only one false negative; therefore, its overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 97.9%, 89.9%, 86.8%, 98.6%, and 93.6%, respectively. Conclusions. TRIM-prob bladder scanning was a simple and quite accurate method for non-invasive electromagnetic detection of BC. If the elevated positive and negative predictive values will be replicated in further well-designed studies, it could be used to screen asymptomatic patients at high risk of BC. PMID:24563795

  9. Overactive bladder - 18 years - Part I.

    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

    Overactive bladder syndrome is one of the lower urinary tract dysfunctions with the highest number of scientific publications over the past two decades. This shows the growing interest in better understanding this syndrome, which gathers symptoms of urinary urgency and increased daytime and nighttime voiding frequency, with or without urinary incontinence and results in a negative impact on the quality of life of approximately one out of six individuals - including both genders and almost all age groups. The possibility of establishing the diagnosis just from clinical data made patients' access to specialized care easier. Physiotherapy resources have been incorporated into the urological daily practice. A number of more selective antimuscarinic drugs with consequent lower adverse event rates were released. Recently, a new class of oral drugs, beta-adrenergic agonists has become part of the armamentarium for Overactive Bladder. Botulinum toxin injections in the bladder and sacral neuromodulation are routine modalities of treatment for refractory cases. During the 1st Latin-American Consultation on Overactive Bladder, a comprehensive review of the literature related to the evolution of the concept, epidemiology, diagnosis, and management was conducted. This text corresponds to the first part of the review Overactive Bladder 18-years.

  10. Glucocorticoid therapy and risk of bladder cancer

    PubMed Central

    Dietrich, K; Schned, A; Fortuny, J; Heaney, J; Marsit, C; Kelsey, K T; Karagas, M R

    2009-01-01

    Background: Use of immunosuppressive drugs post organ transplantation, and prolonged use of glucorticoids for other conditions have been associated with subsequent risk of certain malignancies, that is, skin cancers and lymphoma. There is evidence that the incidence of bladder cancer is also elevated among organ transplant recipients, however, it is unknown whether other groups of patients, that is, those taking oral glucocorticoids, likewise are at an increased risk. Methods: In a population-based case–control study in New Hampshire, USA, we compared the use of glucocorticoids in 786 bladder cancer cases and in 1083 controls. We used unconditional logistic regression analysis to compute adjusted odds ratios (ORs) associated with oral glucocorticoid use. Results: In our analysis, the risk of bladder cancer was related to a history of prolonged oral glucocorticoid use (OR=1.85, 95% CI=1.24–2.76, adjusted for age, gender and smoking). Associations with oral glucocorticoid use were stronger for invasive tumours (OR=2.12, 95% CI=1.17–3.85) and tumours with high (3+) p53 staining intensity (OR=2.35, 95% CI=1.26–4.36). Conclusion: Our results raise the possibility of an increased risk of bladder cancer from systemic use of glucocorticoids, and a potential role of immune surveillance in bladder cancer aetiology. PMID:19773763

  11. Aerodynamics of Reentry Vehicle Clipper at Descent Phase

    NASA Astrophysics Data System (ADS)

    Semenov, Yu. P.; Reshetin, A. G.; Dyadkin, A. A.; Petrov, N. K.; Simakova, T. V.; Tokarev, V. A.

    2005-02-01

    From Gagarin spacecraft to reusable orbiter Buran, RSC Energia has traveled a long way in the search for the most optimal and, which is no less important, the most reliable spacecraft for manned space flight. During the forty years of space exploration, in cooperation with a broad base of subcontractors, a number of problems have been solved which assure a safe long stay in space. Vostok and Voskhod spacecraft were replaced with Soyuz supporting a crew of three. During missions to a space station, it provides crew rescue capability in case of a space station emergency at all times (the spacecraft life is 200 days).The latest modification of Soyuz spacecraft -Soyuz TMA -in contrast to its predecessors, allows to become a space flight participant to a person of virtually any anthropometric parameters with a mass of 50 to 95 kg capable of withstanding up to 6 g load during descent. At present, Soyuz TMA spacecraft are the state-of-the-art, reliable and only means of the ISS crew delivery, in-flight support and return. Introduced on the basis of many years of experience in operation of manned spacecraft were not only the principles of deep redundancy of on-board systems and equipment, but, to assure the main task of the spacecraft -the crew return to Earth -the principles of functional redundancy. That is, vital operations can be performed by different systems based on different physical principles. The emergency escape system that was developed is the only one in the world that provides crew rescue in case of LV failure at any phase in its flight. Several generations of space stations that have been developed have broadened, virtually beyond all limits, capabilities of man in space. The docking system developed at RSC Energia allowed not only to dock spacecraft in space, but also to construct in orbit various complex space systems. These include large space stations, and may include in the future the in-orbit construction of systems for the exploration of the Moon and

  12. Trial of Postoperative Radiation, Cisplatin, and Panitumumab in Locally Advanced Head and Neck Cancer

    ClinicalTrials.gov

    2016-06-28

    Cancer of Head; Cancer of Head and Neck; Cancer of Neck; Cancer of the Head; Cancer of the Head and Neck; Cancer of the Neck; Head and Neck Cancer; Head Cancer; Head Neoplasms; Head, Neck Neoplasms; Neck Cancer; Neck Neoplasms; Neoplasms, Head; Neoplasms, Head and Neck; Neoplasms, Neck; Neoplasms, Upper Aerodigestive Tract; UADT Neoplasms; Upper Aerodigestive Tract Neoplasms

  13. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES SID-IIsD Side Impact Crash Test Dummy, Small Adult Female § 572.193 Neck assembly. (a) The neck assembly consists of parts shown in drawing 180-2000. For purposes of this test, the neck assembly is mounted within the...

  14. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES SID-IIsD Side Impact Crash Test Dummy, Small Adult Female § 572.193 Neck assembly. (a) The neck assembly consists of parts shown in drawing 180-2000. For purposes of this test, the neck assembly is mounted within the...

  15. X-Ray Exam: Neck (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Neck KidsHealth > For Parents > X-Ray Exam: Neck Print A A A What's in ... español Radiografía: cuello What It Is A neck X-ray is a safe and painless test that uses ...

  16. Shake rattle and roll: the bony labyrinth and aerial descent in squamates.

    PubMed

    Boistel, Renaud; Herrel, Anthony; Lebrun, Renaud; Daghfous, Gheylen; Tafforeau, Paul; Losos, Jonathan B; Vanhooydonck, Bieke

    2011-12-01

    Controlled aerial descent has evolved many times independently in vertebrates. Squamates (lizards and snakes) are unusual in that respect due to the large number of independent origins of the evolution of this behavior. Although some squamates such as flying geckos of the genus Ptychozoon and the flying dragons of the genus Draco show obvious adaptations including skin flaps or enlarged ribs allowing them to increase their surface area and slow down their descent, many others appear unspecialized. Yet, specializations can be expected at the level of the sensory and neural systems allowing animals to maintain stability during controlled aerial descent. The vestibular system is a likely candidate given that it is an acceleration detector and is well-suited to detect changes in pitch, roll and yaw. Here we use conventional and synchrotron μCT scans to quantify the morphology of the vestibular system in squamates able to perform controlled aerial descent compared to species characterized by a terrestrial or climbing life style. Our results show the presence of a strong phylogenetic signal in the data with the vestibular system in species from the same family being morphologically similar. However, both our shape analysis and an analysis of the dimensions of the vestibular system showed clear differences among animals with different life-styles. Species able to perform a controlled aerial descent differed in the position and shape of the inner ear, especially of the posterior ampulla. Given the limited stability of squamates against roll and the fact that the posterior ampulla is tuned to changes in roll this suggests an adaptive evolution of the vestibular system in squamates using controlled aerial descent. Future studies testing for similar differences in other groups of vertebrates known to use controlled aerial descent are needed to test the generality of this observation.

  17. Delayed Diagnosis of Iatrogenic Bladder Perforation in a Neonate

    PubMed Central

    Perez, Jose A.; Rich, Mark A.; Swana, Hubert S.

    2016-01-01

    Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates. PMID:27747129

  18. Bladder cancer: smoking, beverages and artificial sweeteners

    PubMed Central

    Morgan, Robert W.; Jain, Meera G.

    1974-01-01

    A matched patient-control study of bladder cancer examined the relationship of the disease to occupation, smoking and intake of tea, coffee, cola, alcohol and artificial sweeteners. There was no association of disease with occupation for these patients. Heavy smoking gave relative risks of 6.37 and 4.36 for men and women respectively; there was evidence of a dose-response relationship. Tea and coffee intake did not increase the risk of disease nor did prolonged use of artificial sweeteners. Alcohol and cola intake increased the relative risk of bladder cancer among male smokers. There is some suggestion that smoking interacts with both alcohol and cola intake in the production of bladder cancer. PMID:4429932

  19. Unusual presentation of metastatic gall bladder cancer.

    PubMed

    Shukla, Piyush; Roy, Soumyajit; Tiwari, Vivek; Mohanti, Bidhu K

    2014-01-01

    To report the first case of rare isolated breast metastasis from carcinoma gall bladder. Single patient case report. A 35-year-old pre-menopausal female presented with 2 * 2 cm right upper outer quadrant breast lump. Post-mastectomy, histology confirmed it to be metastatic adenocarcinoma positive for both Cytokeratin (CK) 7 and CK20. Past history as told by the patient revealed that 2 years back, cholecystectomy was performed for gall stones, of which no histology reports were present; she had a port site scar recurrence which showed it to be adenocarcinoma. Adjuvant chemotherapy and radiotherapy was advised which the patient did not complete. This is probably the first case reported of isolated breast metastasis from gall bladder carcinoma, diagnosed retrospectively. It also highlights the importance of adjuvant treatment in gall bladder malignancy.

  20. The underactive bladder: detection and diagnosis.

    PubMed

    Osman, Nadir; Mangera, Altaf; Hillary, Christopher; Inman, Richard; Chapple, Christopher

    2016-01-01

    The inability to generate a voiding contraction sufficient to allow efficient bladder emptying within a reasonable time frame is a common problem seen in urological practice. Typically, the symptoms that arise are voiding symptoms, such as weak and slow urinary flow. These symptoms can cause considerable bother to patients and impact upon quality of life. The urodynamic finding of inadequate detrusor contraction has been termed detrusor underactivity (DUA). Although a definition is available for this entity, there are no widely accepted diagnostic criteria. Drawing parallels to detrusor overactivity and the overactive bladder, the symptoms arising from DUA have been referred to as the "underactive bladder" (UAB), while attempts to crystallize the definition of UAB are now ongoing. In this article, we review the contemporary literature pertaining to the epidemiology and etiopathogenesis of DUA as well as discuss the definitional aspects that are currently under consideration.

  1. Bladder carcinoma: MDCT cystography and virtual cystoscopy.

    PubMed

    Panebianco, Valeria; Sciarra, Alessandro; Di Martino, Michele; Bernardo, Silvia; Vergari, Valeria; Gentilucci, Alessandro; Catalano, Carlo; Passariello, Roberto

    2010-06-01

    Bladder carcinoma is the most common tumor among the low urinary tract, accounting for 90% of cancer cases. Conventional cystoscopy represents the gold standard for diagnosis and local management of bladder carcinoma. As the prevalence of transitional cell carcinoma is four-fold greater in men than in women, the endoscopic procedure presents objective difficulties related to the length and bending of male urethra. The most important problems are represented by intense discomfort for the patient and bleeding; furthermore, the high cost, invasivity, and local complications such as infections and mechanical lesions are well-known drawbacks. Additionally, conventional cystoscopy does not provide information about extravescical extensions of the tumor. CT cystography, combined with virtual cystoscopy, is mandatory for TNM staging of the tumor and also is useful when conventional cystoscopy is inconclusive or cannot be performed. We presents the CT cystography findings with virtual endoscopy correlation and bladder carcinoma appearance.

  2. A flowgraph model for bladder carcinoma

    PubMed Central

    2014-01-01

    Background Superficial bladder cancer has been the subject of numerous studies for many years, but the evolution of the disease still remains not well understood. After the tumor has been surgically removed, it may reappear at a similar level of malignancy or progress to a higher level. The process may be reasonably modeled by means of a Markov process. However, in order to more completely model the evolution of the disease, this approach is insufficient. The semi-Markov framework allows a more realistic approach, but calculations become frequently intractable. In this context, flowgraph models provide an efficient approach to successfully manage the evolution of superficial bladder carcinoma. Our aim is to test this methodology in this particular case. Results We have built a successful model for a simple but representative case. Conclusion The flowgraph approach is suitable for modeling of superficial bladder cancer. PMID:25080066

  3. Laparoscopic gastrocystoplasty for tuberculous contracted bladder

    PubMed Central

    Ramalingam, Manickam; Senthil, Kallappan; Balashanmugam, T. S.

    2017-01-01

    The stomach is the preferred augmentation option for a contracted bladder in a patient with renal failure. A 49-year-old female presented with right solitary functioning kidney with tuberculous lower ureteric stricture and contracted bladder. Her creatinine was 2.8 mg%. By laparoscopic approach, right gastroepiploic artery based gastric flap was isolated using staplers and used for augmentation and ureteric replacement. At 6-month follow-up, her creatinine was 1.9 mg%, and bladder capacity was 250 ml. She had mild hematuria, which settled with proton pump inhibitors. Laparoscopic gastrocystoplasty is feasible and effective augmentation option in those with renal failure, giving the benefits of minimally invasive approach. PMID:28197034

  4. Neural reconstruction methods of restoring bladder function

    PubMed Central

    Gomez-Amaya, Sandra M.; Barbe, Mary F.; de Groat, William C.; Brown, Justin M.; Tuite, Gerald F.; Corcos, Jacques; Fecho, Susan B.; Braverman, Alan S.; Ruggieri, Michael R.

    2015-01-01

    During the past century, diverse studies have focused on the development of surgical strategies to restore function of a decentralized bladder after spinal cord or spinal root injury via repair of the original roots or by transferring new axonal sources. The techniques included end-to-end sacral root repairs, transfer of roots from other spinal segments to sacral roots, transfer of intercostal nerves to sacral roots, transfer of various somatic nerves to the pelvic or pudendal nerve, direct reinnervation of the detrusor muscle, or creation of an artificial reflex pathway between the skin and the bladder via the central nervous system. All of these surgical techniques have demonstrated specific strengths and limitations. The findings made to date already indicate appropriate patient populations for each procedure, but a comprehensive assessment of the effectiveness of each technique to restore urinary function after bladder decentralization is required to guide future research and potential clinical application. PMID:25666987

  5. Androgen Receptor Signaling in Bladder Cancer

    PubMed Central

    Li, Peng; Chen, Jinbo; Miyamoto, Hiroshi

    2017-01-01

    Emerging preclinical findings have indicated that steroid hormone receptor signaling plays an important role in bladder cancer outgrowth. In particular, androgen-mediated androgen receptor signals have been shown to correlate with the promotion of tumor development and progression, which may clearly explain some sex-specific differences in bladder cancer. This review summarizes and discusses the available data, suggesting the involvement of androgens and/or the androgen receptor pathways in urothelial carcinogenesis as well as tumor growth. While the precise mechanisms of the functions of the androgen receptor in urothelial cells remain far from being fully understood, current evidence may offer chemopreventive or therapeutic options, using androgen deprivation therapy, in patients with bladder cancer. PMID:28241422

  6. Bladder exstrophy from childhood into adult life.

    PubMed Central

    Ben-Chaim, J; Docimo, S G; Jeffs, R D; Gearhart, J P

    1996-01-01

    Exstrophy of the bladder is rare and the incidence of bladder exstrophy is calculated to be from 1 per 30,000 to 50,000 live births with male to female ratio ranging from 1.5-5 to 1(1-4). It was found that persistence or overgrowth of the cloacal membrane on the lower anterior abdominal area, prevents normal mesenchymal ingrowth. This causes divergence of the lower abdominal muscular structures and forces the genital ridges to fuse caudal to the cloacal membrane. The stage of ingrowth of the urorectal septum at the time of rupture determines whether one will produce an exstrophic urinary tract alone (classic bladder exstrophy or epispadias) or cloacal exstrophy with the hindgut interposed between the hemibladders. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 PMID:8709084

  7. Planning fuel-conservative descents in an airline environmental using a small programmable calculator: algorithm development and flight test results

    SciTech Connect

    Knox, C.E.; Vicroy, D.D.; Simmon, D.A.

    1985-05-01

    A simple, airborne, flight-management descent algorithm was developed and programmed into a small programmable calculator. The algorithm may be operated in either a time mode or speed mode. The time mode was designed to aid the pilot in planning and executing a fuel-conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The speed model was designed for planning fuel-conservative descents when time is not a consideration. The descent path for both modes was calculated for a constant with considerations given for the descent Mach/airspeed schedule, gross weight, wind, wind gradient, and nonstandard temperature effects. Flight tests, using the algorithm on the programmable calculator, showed that the open-loop guidance could be useful to airline flight crews for planning and executing fuel-conservative descents.

  8. Planning fuel-conservative descents in an airline environmental using a small programmable calculator: Algorithm development and flight test results

    NASA Technical Reports Server (NTRS)

    Knox, C. E.; Vicroy, D. D.; Simmon, D. A.

    1985-01-01

    A simple, airborne, flight-management descent algorithm was developed and programmed into a small programmable calculator. The algorithm may be operated in either a time mode or speed mode. The time mode was designed to aid the pilot in planning and executing a fuel-conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The speed model was designed for planning fuel-conservative descents when time is not a consideration. The descent path for both modes was calculated for a constant with considerations given for the descent Mach/airspeed schedule, gross weight, wind, wind gradient, and nonstandard temperature effects. Flight tests, using the algorithm on the programmable calculator, showed that the open-loop guidance could be useful to airline flight crews for planning and executing fuel-conservative descents.

  9. Neck control after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancers

    PubMed Central

    2012-01-01

    Background The purpose of this study was to evaluate neck control outcomes after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancer. Methods We retrospectively reviewed medical records of fifty patients with node-positive head and neck cancer who received definitive radiochemotherapy. Twelve patients subsequently underwent neck dissection for suspicious recurrent or persistent disease. A median dose of 70 Gy (range 60-70.6) was delivered to involved nodes. Response evaluation was performed at a median of 5 weeks after completion of radiotherapy. Results Neck failure was observed in 11 patients and the 3-year regional control (RC) rate was 77.1%. Neck dissection was performed in 10 of the 11 patients; seven of these cases were successfully salvaged, and the ultimate rate of neck control was 92%. The remaining two patients who received neck dissection had negative pathologic results. On univariate analysis, initial nodal size > 2 cm, a less-than-complete response at the primary site, post-radiotherapy nodal size > 1.5 cm, and post-radiotherapy nodal necrosis were associated with RC. On multivariate analysis, less-than-complete primary site response and post-radiotherapy nodal necrosis were identified as independent prognostic factors for RC. Conclusions The neck failure rate after definitive radiochemotherapy without planned neck dissection was 22%. Two-thirds of these were successfully salvaged with neck dissection and the ultimate neck control rate was 92%. Our results suggest that planned neck dissection might not be necessary in patients with complete response of primary site, no evidence of residual lesion > 1.5 cm, or no necrotic lymph nodes at the 1-2 months follow-up evaluation after radiotherapy. PMID:22313843

  10. Tracer-Based Determination of Vortex Descent in the 1999-2000 Arctic Winter

    NASA Technical Reports Server (NTRS)

    Greenblatt, Jeffery B.; Jost, Hans-Juerg; Loewenstein, Max; Podolske, James R.; Hurst, Dale F.; Elkins, James W.; Schauffler, Sue M.; Atlas, Elliot L.; Herman, Robert L.; Webster, Christopher R.

    2001-01-01

    A detailed analysis of available in situ and remotely sensed N2O and CH4 data measured in the 1999-2000 winter Arctic vortex has been performed in order to quantify the temporal evolution of vortex descent. Differences in potential temperature (theta) among balloon and aircraft vertical profiles (an average of 19-23 K on a given N2O or CH4 isopleth) indicated significant vortex inhomogeneity in late fall as compared with late winter profiles. A composite fall vortex profile was constructed for November 26, 1999, whose error bars encompassed the observed variability. High-latitude, extravortex profiles measured in different years and seasons revealed substantial variability in N2O and CH4 on theta surfaces, but all were clearly distinguishable from the first vortex profiles measured in late fall 1999. From these extravortex-vortex differences, we inferred descent prior to November 26: 397+/-15 K (1sigma) at 30 ppbv N2O and 640 ppbv CH4, and 28+/-13 K above 200 ppbv N2O and 1280 ppbv CH4. Changes in theta were determined on five N2O and CH4 isopleths from November 26 through March 12, and descent rates were calculated on each N2O isopleth for several time intervals. The maximum descent rates were seen between November 26 and January 27: 0.82+/-0.20 K/day averaged over 50-250 ppbv N2O. By late winter (February 26-March 12), the average rate had decreased to 0.10+/-0.25 K/day. Descent rates also decreased with increasing N2O; the winter average (November 26-March 5) descent rate varied from 0.75+/-0.10 K/day at 50 ppbv to 0.40+/-0.11 K/day at 250 ppbv. Comparison of these results with observations and models of descent in prior years showed very good overall agreement. Two models of the 1999-2000 vortex descent, SLIMCAT and REPROBUS, despite theta offsets with respect to observed profiles of up to 20 K on most tracer isopleths, produced descent rates that agreed very favorably with the inferred rates from observation.

  11. Tracer-based Determination of Vortex Descent in the 1999/2000 Arctic Winter

    NASA Technical Reports Server (NTRS)

    Greenblatt, Jeffrey B.; Jost, Hans-Juerg; Loewenstein, Max; Podolske, James R.; Hurst, Dale F.; Elkins, James W.; Schauffler, Sue M.; Atlas, Elliot L.; Herman, Robert L.; Webster, Chrisotopher R.

    2002-01-01

    A detailed analysis of available in situ and remotely sensed N2O and CH4 data measured in the 1999/2000 winter Arctic vortex has been performed in order to quantify the temporal evolution of vortex descent. Differences in potential temperature (theta) among balloon and aircraft vertical profiles (an average of 19-23 K on a given N2O or CH4 isopleth) indicated significant vortex inhomogeneity in late fall as compared with late winter profiles. A composite fall vortex profile was constructed for 26 November 1999, whose error bars encompassed the observed variability. High-latitude extravortex profiles measured in different years and seasons revealed substantial variability in N2O and CH4 on theta surfaces, but all were clearly distinguishable from the first vortex profiles measured in late fall 1999. From these extravortex-vortex differences we inferred descent prior to 26 November: as much as 397 plus or minus 15 K (lsigma) at 30 ppbv N2O and 640 ppbv CH4, and falling to 28 plus or minus 13 K above 200 ppbv N2O and 1280 ppbv CH4. Changes in theta were determined on five N2O and CH4 isopleths from 26 November through 12 March, and descent rates were calculated on each N2O isopleth for several time intervals. The maximum descent rates were seen between 26 November and 27 January: 0.82 plus or minus 0.20 K/day averaged over 50- 250 ppbv N2O. By late winter (26 February to 12 March), the average rate had decreased to 0.10 plus or minus 0.25 K/day. Descent rates also decreased with increasing N2O; the winter average (26 November to 5 March) descent rate varied from 0.75 plus or minus 0.10 K/day at 50 ppbv to 0.40 plus or minus 0.11 K/day at 250 ppbv. Comparison of these results with observations and models of descent in prior years showed very good overall agreement. Two models of the 1999/2000 vortex descent, SLIMCAT and REPROBUS, despite theta offsets with respect to observed profiles of up to 20 K on most tracer isopleths, produced descent rates that agreed very

  12. Darifenacin in the treatment of overactive bladder.

    PubMed

    Parsons, M; Robinson, D; Cardozo, L

    2005-07-01

    Antimuscarinic drug therapy has been shown to be effective in the management of patients with symptoms of the overactive bladder syndrome (OAB), but the bothersome antimuscarinic adverse effects of dry mouth, constipation, somnolence and blurred vision often affect compliance with medication. The development of bladder selective M3 specific antagonists offers the possibility of increasing efficacy whilst minimising adverse effects. The M3 specific antagonist solifenacin has recently been marketed, and darifenacin will soon be available. The purpose of this article is to review the pharmacology and clinical trial data available for darifenacin, in addition to examining its role in the treatment of the OBS.

  13. Flat carcinoma in Situ of bladder.

    PubMed

    Riddle, P R; Chisholm, G D; Trott, P A; Pugh, R C

    1975-01-01

    36 patients with flat carcinoma in situ of the bladder have been reviewed. Those with widespread disease usually presented with dysuria or obstructive outflow tract symptoms and radical surgery appeared to give better results than radiotherapy. However, when the lesion was confined to small areas of the bladder mucosa, haematuria or pain were the main presenting symptoms and a conservative approach seemed justified. It is suggested that the term flat carcinoma in situ be used for this lesion whose behavior differs significantly from that of the commoner papillary or invasive tumours. The pathological appearances are to be reported elsewhere in full.

  14. Perioperative management of classic bladder exstrophy

    PubMed Central

    Massanyi, Eric Z; Gearhart, John P; Kost-Byerly, Sabine

    2013-01-01

    The exstrophy-epispadias complex is a rare congenital malformation of the genitourinary system, abdominal wall muscles, and pelvic structures. Modern surgical repairs focus on reconstruction of the bladder and its adjacent structures, with the goal of achieving urinary continence, a satisfactory cosmetic result, and a high quality of life. Complex surgery in neonates and young children, as well as a prolonged postoperative course require close collaboration between surgeons, anesthesiologists, intensivists, pediatricians, and an experienced nursing staff. This article will review the spectrum of bladder exstrophy anomalies, the surgical repair, and the perioperative interdisciplinary management. PMID:24400236

  15. Small cell carcinoma of the bladder

    PubMed Central

    Calado, Bruno Nagel; Maron, Paulo Eduardo Goulart; Vedovato, Bruno César; Barrese, Tomas Zecchini; Fernandes, Roni de Carvalho; Perez, Marjo Deninson Cardenuto

    2015-01-01

    Small cell carcinoma of the urinary bladder is an extremely aggressive and rare tumor. Even though small cell carcinoma most commonly arises from the lungs there are several reports of small cell carcinoma in extrapulmonary sites. Due to its low frequency there is no well-established management for this disease. We report the case of a 61 year-old man with small cell carcinoma of the bladder who underwent radical cystectomy following neoadjuvant chemotherapy. We also reviewed the literature for the optimal treatment strategy. PMID:25517085

  16. Diagnostic Clues to Frontal Fibrosing Alopecia in Patients of African Descent

    PubMed Central

    Reid, Sophia D.; Obayan, Olubusayo; Mcclellan, Liza; Sperling, Leonard

    2016-01-01

    Importance: Frontal fibrosing alopecia has previously been reported as rare among patients of African descent. The authors present 18 cases of frontal fibrosing alopecia affecting African American patients and review all published cases of frontal fibrosing alopecia involving patients of African descent. Observations: Since 2010, there have been 66 published cases of frontal fibrosing alopecia among patients of African descent; 59 women, five men, and two cases of unknown gender. Frontal fibrosing alopecia is not uncommon among patients of African descent. In this study, the authors find that female African American patients may have fewer symptoms and unique clinical presentations. Conclusion and relevance: Frontal fibrosing alopecia is an entity that can be seen in patients with many different ethnic backgrounds, often with varying presentations. The diagnosis of frontal fibrosing alopecia must be considered in any patient of African descent who presents with frontotemporal alopecia. In the authors’ patient population, there was a younger age of presentation. The presence of perifollicular hyperpigmentation along the hairline and concomitant facial hyperpigmentation may aid in making the diagnosis and distinguishing this entity from traction alopecia. PMID:27721910

  17. Kinematics of stair descent in young and older adults and the impact of exercise training.

    PubMed

    Mian, Omar S; Thom, Jeanette M; Narici, Marco V; Baltzopoulos, Vasilios

    2007-01-01

    Stair descent is a challenging task in old age. This study firstly investigated lower extremity kinematics during stair descent in young (YOU) and healthy, community dwelling older adults (OLD). Secondly, the impact of an exercise training intervention on age-related differences in stair descent was assessed. At baseline, a motion analysis system was used to determine spatio-temporal gait variables and lower extremity kinematics as YOU (n=23, age=27+/-3 years) and OLD (n=34, age=73+/-4 years) descended a three step staircase. The older adults were then divided into training (TRA) and control (CON) groups. For 12 months, TRA performed resistance, aerobic, balance, and flexibility exercises under supervision in a class environment (twice per week) and unsupervised at home (once per week). CON carried on with normal daily activities. Following the intervention, baseline measurements were repeated in TRA and CON. At baseline, total descent, stride cycle, and single support times were longer in OLD than in YOU. In addition, sagittal plane knee motion was lower in OLD whilst frontal and transverse plane pelvis and hip motion were higher in OLD. Exercise training did not reduce the age-related differences observed. In conclusion healthy older adults perform stair descent at a slower speed and with greater motion outside the plane of progression than young adults. We found no evidence that these differences are reduced by generic exercise training, at least in non-frail older adults.

  18. TRW - Lunar Descent Engine. Chapter 6, Appendix H

    NASA Technical Reports Server (NTRS)

    Elverum, Gerard W.

    2009-01-01

    it came to Apollo 13, we went back into the record, and said, "Hey, we have pushed this system around up there on Apollo 5, and we have also restarted this tandem configuration." The requirements on Apollo 13 were to put it back into play. The spacecraft was out of free return to the earth at the time of the accident. It would not have come back. NASA said, "Okay, we ll use the descent engine to put the spacecraft in a free trajectory; it will go around the moon and be on free trajectory back to Earth." Then, as it came around the far side of the moon, the guys found out that they had an oxygen problem. As you remember, things were getting pretty bad in there. They said, "We ve got to get it back as fast as we can. Is it okay if we re-fire the engine? Now, we re in a free trajectory, so we want to put as much delta-v (or change in velocity) in as we can. Can we re-fire right now?" We said, "Yes, the data says it has been this period of time." We could re-fire the engine, run the rest of the duty cycle up as far as we needed while preserving enough fluids to make the final correction as the spacecraft got near Earth, and restart the engine. It was pretty fortuitous that we could give them those answers.

  19. Effects of morphine in the isolated mouse urinary bladder.

    PubMed

    Acevedo, C G; Tamayo, L; Contreras, E

    1986-01-01

    Acute morphine increased the responses to acetylcholine of the isolated mouse urinary bladder. A chronic morphine treatment did not change the responses of the urinary bladder to acetylcholine or ATP. The acute administration of morphine did not modify the contractile response to ATP in the urinary bladders from untreated or chronically morphine treated mice. Methadone and ketocyclazocine decreased the responses to the electrical stimulation of the urinary bladder. These depressant effects were not modified by naloxone. The results suggest the nonexistence of opiate receptors in the mouse urinary bladder and the lack of direct effects of morphine on the neuroeffector junction.

  20. Double gall-bladder--two pathologies: a case report.

    PubMed

    Pitiakoudis, M; Papanas, N; Polychronidis, A; Maltezos, E; Prassopoulos, P; Simopoulos, C

    2008-01-01

    True gall-bladder duplication is a rare biliary anomaly, which is usually discovered as an incidental finding. There are reports of double gall-bladders missed during the first operation. We present the case of a double gall-bladder which, albeit suspected during the operation, was confirmed post-operatively. The patient underwent successful laparoscopic cholecystectomy and the examination of the resected gall-bladder revealed two chambers, only one containing stones. Predisposing factors for the development of gall-stones in one gall-bladder only, as well as surgical options, are briefly discussed.

  1. New discoveries in the molecular landscape of bladder cancer

    PubMed Central

    Li, Roger; Choi, Woonyoung; Ferguson 3rd, J.E.; Metcalfe, Michael J.; Kamat, Ashish M.

    2016-01-01

    We are currently on the cusp of exponential growth in the understanding of the molecular landscape of bladder cancer. Emerging data regarding the mutational burden and targetable genomic and protein alterations in bladder cancer have allowed us to tap into treatments directed toward specific molecular characteristics of bladder cancer. In parallel, these developments will enable us to better select patients for existing treatments of bladder cancer in a step toward personalized therapy. The present article reviews select discoveries that have advanced our understanding of bladder cancer and gives a glimpse of the exciting opportunities on the not-so-distant horizon. PMID:28105319

  2. HpD Photobiology And Photodynamic Therapy Of Bladder Carcinoma

    NASA Astrophysics Data System (ADS)

    Lin, Chi-Wei

    1988-02-01

    Bladder carcinoma is considered one of the most favorable targets for the application of photodynamic therapy (PDT) due to the accessibility of the bladder for light delivery. Examination of the bladder and surgical procedures are routinely performed by the insertion of an optical instrument called cystoscope through the urethra. Thus, the treatment of bladder cancer by PDT can be conducted through the cystoscope with minimal invasion. However, to achieve optimal results from this treatment, one must consider both the structure of the bladder and the nature of the carcinoma.

  3. Immunotherapy With MK-3475 in Surgically Resectable Head and Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2017-02-08

    Cancer of Head and Neck; Head and Neck Cancer; Neoplasms, Head and Neck; Carcinoma, Squamous Cell of Head and Neck; Squamous Cell Carcinoma of the Head and Neck; Squamous Cell Carcinoma, Head and Neck

  4. Descent and Landing Triggers for the Orion Multi-Purpose Crew Vehicle Exploration Flight Test-1

    NASA Technical Reports Server (NTRS)

    Bihari, Brian D.; Semrau, Jeffrey D.; Duke, Charity J.

    2013-01-01

    The Orion Multi-Purpose Crew Vehicle (MPCV) will perform a flight test known as Exploration Flight Test-1 (EFT-1) currently scheduled for 2014. One of the primary functions of this test is to exercise all of the important Guidance, Navigation, Control (GN&C), and Propulsion systems, along with the flight software for future flights. The Descent and Landing segment of the flight is governed by the requirements levied on the GN&C system by the Landing and Recovery System (LRS). The LRS is a complex system of parachutes and flight control modes that ensure that the Orion MPCV safely lands at its designated target in the Pacific Ocean. The Descent and Landing segment begins with the jettisoning of the Forward Bay Cover and concludes with sensing touchdown. This paper discusses the requirements, design, testing, analysis and performance of the current EFT-1 Descent and Landing Triggers flight software.

  5. Experimental liquid line of descent and liquid immiscibility for basalt 70017. [lunar rocks

    NASA Technical Reports Server (NTRS)

    Rutherford, M. J.; Hess, P. C.; Daniel, G. H.

    1974-01-01

    The paper describes one possible liquid line of descent produced for a high-titanium mare basalt composition through an arbitrarily chosen series of partial equilibrium and fractional crystallization experiments on basalt 70017. The liquid line of descent leading to immiscibility at 994 C is characterized by enrichment of FeO, K2O, SiO2, and MnO and depletion of MgO and TiO2 in the residual liquids. The composition of the residual liquid at the onset of immiscibility is ferrobasaltic, and the initial appearance of immiscible liquids in the form of silica-rich spherules is in the vicinity of plagioclase-liquid contacts. The integrated bulk composition of the areas of finely exsolved liquids indicates that the trend of the liquid line of descent is at a small angle to the tie lines joining the two liquids.

  6. Advances in POST2 End-to-End Descent and Landing Simulation for the ALHAT Project

    NASA Technical Reports Server (NTRS)

    Davis, Jody L.; Striepe, Scott A.; Maddock, Robert W.; Hines, Glenn D.; Paschall, Stephen, II; Cohanim, Babak E.; Fill, Thomas; Johnson, Michael C.; Bishop, Robert H.; DeMars, Kyle J.; Sostaric, Ronald r.; Johnson, Andrew E.

    2008-01-01

    Program to Optimize Simulated Trajectories II (POST2) is used as a basis for an end-to-end descent and landing trajectory simulation that is essential in determining design and integration capability and system performance of the lunar descent and landing system and environment models for the Autonomous Landing and Hazard Avoidance Technology (ALHAT) project. The POST2 simulation provides a six degree-of-freedom capability necessary to test, design and operate a descent and landing system for successful lunar landing. This paper presents advances in the development and model-implementation of the POST2 simulation, as well as preliminary system performance analysis, used for the testing and evaluation of ALHAT project system models.

  7. Preliminary assessment of the Mars Science Laboratory entry, descent, and landing simulation

    NASA Astrophysics Data System (ADS)

    Way, David W.

    On August 5, 2012, the Mars Science Laboratory rover, Curiosity, successfully landed inside Gale Crater. This landing was the seventh successful landing and fourth rover to be delivered to Mars. Weighing nearly one metric ton, Curiosity is the largest and most complex rover ever sent to investigate another planet. Safely landing such a large payload required an innovative Entry, Descent, and Landing system, which included the first guided entry at Mars, the largest supersonic parachute ever flown at Mars, and the novel Sky Crane landing system. A complete, end-to-end, six degree-of-freedom, multi-body computer simulation of the Mars Science Laboratory Entry, Descent, and Landing sequence was developed at the NASA Langley Research Center. In-flight data gathered during the successful landing is compared to pre-flight statistical distributions, predicted by the simulation. These comparisons provide insight into both the accuracy of the simulation and the overall performance of the Entry, Descent, and Landing system.

  8. Differential Diagnosis and Treatment of Impaired Bladder Emptying

    PubMed Central

    Yoshimura, Naoki; Chancellor, Michael B

    2004-01-01

    Although much attention is paid to urinary incontinence, the condition of incomplete bladder emptying is becoming more common with the aging of the US population and the widespread use of anticholinergic drugs to treat overactive bladder. This disorder can often be silent until end-stage presentation of overflow incontinence. In this article, we review the pathophysiologic conditions of the bladder and urethra that can cause impaired bladder emptying and discuss how to evaluate and screen the patient with a bladder that does not empty. In addition, we provide an overview of treatment options available for impaired bladder emptying and consider the research that is under way to find the best therapies for the failing bladder. PMID:16985851

  9. Migrated Mesh Plug Masquerading as a Bladder Tumor

    PubMed Central

    Dajani, Daoud; Aron, Monish

    2017-01-01

    Abstract Background: The purpose of this case presentation is to demonstrate how erosion of mesh into the bladder can initially present with the same symptoms as bladder malignancy. Case Presentation: A 62-year-old Hispanic male presented with 2 years of hematuria along with imaging concerning for a bladder tumor. The patient underwent cystoscopy with biopsy of a lesion at the anterior bladder. It was ultimately determined that a mesh plug from a prior hernia repair had migrated into the bladder. The mesh plug was excised using the Da Vinci Si robot, which allowed for efficient mobilization of the bladder and other anatomic structures, as well as rapid recovery. Conclusion: Our case demonstrates the need to consider mesh erosion as a cause of hematuria and, furthermore, shows how the robotic approach can help facilitate excision of migrated mesh into the bladder. PMID:28164159

  10. Impact of behaviour and lifestyle on bladder health.

    PubMed

    Burgio, K L; Newman, D K; Rosenberg, M T; Sampselle, C

    2013-06-01

    Bladder conditions, including UTI, UI, and bladder cancer, are highly prevalent and affect a wide range of populations. There are a variety of modifiable behavioral and lifestyle factors that influence bladder health. Some factors, such as smoking and obesity, increase the risk or severity of bladder conditions, whereas other factors, such as pelvic floor muscle exercise, are protective. Although clinical practice may be assumed to be the most appropriate ground for education on behavioral and lifestyle factors that influence bladder health, it is also crucial to extend these messages into the general population through public health interventions to reach those who have not yet developed bladder conditions and to maximize the prevention impact of these behaviors. Appropriate changes in these factors have the potential for an enormous impact on bladder health if implemented on a population-based level.

  11. A Task-Analytic Approach to the Determination of Training Requirements for the Precision Descent

    NASA Technical Reports Server (NTRS)

    Smith, Nancy; Rosekind, Mark (Technical Monitor)

    1996-01-01

    A task-analytic approach was used to evaluate the results from an experiment comparing two training methods for the "Precision Descent," a cockpit procedure designed to complement a new, computer-based air traffic control advisory system by allowing air traffic controllers to assign precise descent trajectories to aircraft. A task model was developed for the procedure using a methodology that represents four different categories of task-related knowledge: (1) ability to determine current flight goals; (2) ability to assess the current flight situation relative to those goals; (3) operational knowledge about flight-related tasks; and (4) knowledge about task selection. This model showed what knowledge experienced pilots already possessed, and how that knowledge was supplemented by training material provided in the two training conditions. All flight crews were given a "Precision Descent Chart" that explained the procedure's clearances and compliance requirements. This information enabled pilots to establish appropriate flight goals for the descent, and to monitor their compliance with those goals. In addition to this chart, half of the crews received a "Precision Descent Bulletin" containing technique recommendations for performing procedure-related tasks. The Bulletin's recommendations supported pilots in task selection and helped clarify the procedure's compliance requirements. Eight type-rated flight crews flew eight Precision Descents in a Boeing 747-400 simulator, with four crews in each of the two training conditions. Both conditions (Chart and Chart-with-Bulletin) relied exclusively on the use of those documents to introduce the procedure. No performance feedback was provided during the experiment. Preliminary result show better procedure compliance and higher acceptability ratings from flight crews in the Chart-with-Bulletin condition. These crews performed flight-related tasks less efficiently, however, using the simpler but less efficient methods suggested

  12. Evolutionary analyses of non-genealogical bonds produced by introgressive descent.

    PubMed

    Bapteste, Eric; Lopez, Philippe; Bouchard, Frédéric; Baquero, Fernando; McInerney, James O; Burian, Richard M

    2012-11-06

    All evolutionary biologists are familiar with evolutionary units that evolve by vertical descent in a tree-like fashion in single lineages. However, many other kinds of processes contribute to evolutionary diversity. In vertical descent, the genetic material of a particular evolutionary unit is propagated by replication inside its own lineage. In what we call introgressive descent, the genetic material of a particular evolutionary unit propagates into different host structures and is replicated within these host structures. Thus, introgressive descent generates a variety of evolutionary units and leaves recognizable patterns in resemblance networks. We characterize six kinds of evolutionary units, of which five involve mosaic lineages generated by introgressive descent. To facilitate detection of these units in resemblance networks, we introduce terminology based on two notions, P3s (subgraphs of three nodes: A, B, and C) and mosaic P3s, and suggest an apparatus for systematic detection of introgressive descent. Mosaic P3s correspond to a distinct type of evolutionary bond that is orthogonal to the bonds of kinship and genealogy usually examined by evolutionary biologists. We argue that recognition of these evolutionary bonds stimulates radical rethinking of key questions in evolutionary biology (e.g., the relations among evolutionary players in very early phases of evolutionary history, the origin and emergence of novelties, and the production of new lineages). This line of research will expand the study of biological complexity beyond the usual genealogical bonds, revealing additional sources of biodiversity. It provides an important step to a more realistic pluralist treatment of evolutionary complexity.

  13. How frequent are overactive bladder symptoms in women with urodynamic verification of an overactive bladder?

    PubMed Central

    Yeniel, Ahmet Özgür; Ergenoğlu, Mete Ahmet; Meseri, Reci; Aşkar, Niyazi; İtil, İsmail Mete

    2012-01-01

    Objective To determine the relationship between overactive bladder symptoms and urodynamic verification of overactive bladder. Material and Methods Between June 2011 and November 2011, 159 patients underwent urodynamics (UDS) at our urogynecology unit in the Ege University Hospital. Of these, 95 patients who complained of urgency, did not have any overt neurological diseases, bladder outlet obstruction and did not take any medication affecting the lower urinary tract function were evaluated. SPSS (ver. 15.0) was used to evaluate the data and the chi-square test and t test for independent samples were used for analysis. Results The mean age was found to be 54.5±12. Frequency was the most frequent symptom in women with overactive bladder (OAB) (82.1%), nocturia (57.8%) and (57.8%) urgency urinary incontinence followed in frequency. Detrusor over activity incidence was found to be 38.9%. There was no significant relationship between the presence of detrusor over activity (DOA) and OAB symptoms. Leak at urodynamics was found in 46.3% and there is no significant association with detrusor overactivity. Total bladder capacity was found to be significantly lower in women who had DOA (p=0.000). Conclusion It appears that overactive bladder symptoms do not predict detrusor over activity. Urodynamic investigation is not mandatory in the initial management of women with only OAB symptoms. PMID:24592016

  14. Pseudosarcomatous and sarcomatous proliferations of the bladder.

    PubMed

    Spiess, Philippe E; Tuziak, Tomasz; Tibbs, Rita F; Bassett, Roland; Tamboli, Pheroze; Brown, Gordon A; Grossman, Herbert Barton; Ayala, Alberto G; Czerniak, Bogdan

    2007-05-01

    Pseudosarcomatous fibromyxoid tumor (PFT), postoperative spindle cell nodule (PSN), sarcoma, and sarcomatoid carcinoma of the bladder are frequently difficult to distinguish histopathologically with significant differences in disease-related outcomes. A retrospective review of our pathology registry over the last 25 years identified 7 PFT, 10 PSN, 18 primary bladder sarcomas, and 17 sarcomatoid carcinomas. Most patients with PFT, PSN, sarcoma, and sarcomatoid carcinoma were diagnosed between the ages of 50 to 60 years with PFT and PSN most commonly detected in women. A previous history of urological instrumentation and bladder cancer was present in all patients with PSN but none of the patients with PFT. Pseudosarcomatous fibromyxoid tumors were characterized by a tissue culture-like proliferation of myofibroblastic cells with focal atypia and overall cytoarchitectural features mimicking nodular fasciitis. Sarcomas and sarcomatoid carcinomas exhibited cellular atypia, mitotic activity with atypical mitosis, and the presence of necrosis. Transurethral resection was sufficient to control all PFT and PSN with no evidence of distant metastatic spread. In contrast, local recurrences and distant metastases frequently occurred in patients with primary sarcoma and sarcomatoid carcinoma despite aggressive surgical management, which was often combined with neoadjuvant chemotherapy (50% and 65% disease-specific mortality, respectively). Pseudosarcomatous fibromyxoid tumor and PSN have unique clinical and pathologic features that allow their distinction from primary bladder sarcoma and sarcomatoid carcinoma.

  15. Gall stones and carcinoma gall bladder.

    PubMed

    Gupta, S C; Misra, V; Singh, P A; Roy, A; Misra, S P; Gupta, A K

    2000-04-01

    One hundred and fifty surgically resected gall bladder specimens were included in the study to evaluate the relationship between the prevalence of gall stones and histochemical alteration in sequential changes of metaplasia, dysplasia and neoplasia in gall bladder epithelium. Multiple sections were processed and stained with haematoxylin and eosin, Periodic acid Schiff's stain, Alcian blue (pH 2.5)/Periodic acid, Orcein/Alcian blue (pH 2.5) and Alcian Blue/Periodic acid/Potassium borohydride saponifications stains. Details of gall stones present were also noted. Prevalence of gall stones in gall bladders with metaplastic, dysplastic and neoplastic mucosal changes was significantly higher (P < 0.001) than those gall bladders which had no epithelial changes. Increase in sialomucin with a corresponding decrease in sulphomucin was observed from metaplasia to malignancy. Neutral mucin increased in metaplastic cells but was significantly reduced in neoplastic cells. Loss of O-acylation in sialmucin was also present in neoplastic cells. The histochemical changes suggest that chronic injury due to cholelithiasis induces appearance of neutral mucin positive metaplastic cells, which may further dedifferentiate to sialomucin containing dysplastic or neoplastic cells if the stimulation persists.

  16. Intravesical Treatments of Bladder Cancer: Review

    PubMed Central

    Shen, Zancong; Shen, Tong; Wientjes, M. Guillaume; O’Donnell, Michael A.

    2008-01-01

    For bladder cancer, intravesical chemo/immunotherapy is widely used as adjuvant therapies after surgical transurethal resection, while systemic therapy is typically reserved for higher stage, muscle-invading, or metastatic diseases. The goal of intravesical therapy is to eradicate existing or residual tumors through direct cytoablation or immunostimulation. The unique properties of the urinary bladder render it a fertile ground for evaluating additional novel experimental approaches to regional therapy, including iontophoresis/electrophoresis, local hyperthermia, co-administration of permeation enhancers, bioadhesive carriers, magnetic-targeted particles and gene therapy. Furthermore, due to its unique anatomical properties, the drug concentration-time profiles in various layers of bladder tissues during and after intravesical therapy can be described by mathematical models comprised of drug disposition and transport kinetic parameters. The drug delivery data, in turn, can be combined with the effective drug exposure to infer treatment efficacy and thereby assists the selection of optimal regimens. To our knowledge, intravesical therapy of bladder cancer represents the first example where computational pharmacological approach was used to design, and successfully predicted the outcome of, a randomized phase III trial (using mitomycin C). This review summarizes the pharmacological principles and the current status of intravesical therapy, and the application of computation to optimize the drug delivery to target sites and the treatment efficacy. PMID:18369709

  17. Bladder leiomyoma: Presentation, evaluation and treatment

    PubMed Central

    Khater, Nazih; Sakr, Ghazi

    2012-01-01

    Background Bladder leiomyomas are benign mesenchymal neoplasms and very rare urinary tumours that represent <0.5% of all bladder tumours, with only 250 cases reported worldwide to date. The importance of recognising their characteristic features, leading to their correct treatment, is fundamental. Therefore, we reviewed reports of leiomyomas of the urinary bladder, their causes, clinical presentations, imaging methods and surgical management, updated to 2012. Methods We retrospectively reviewed articles published in the USA, Europe and Asia, from 1953 to date, using PubMed, Medscape, Medline and the several major journals. We report areas of controversies and well-established guidelines. Results We reviewed 36 articles that confirmed, with a high level of evidence-based medicine, that the male to female ratio is equal, the cause of bladder leiomyomas remains unknown, and their most common presentation is obstructive uropathy; endovesical tumours are the most common. Their radiological diagnosis can be made by ultrasonography, computed tomography or magnetic resonance imaging. Complete surgical resection is a very effective treatment, associated with almost no recurrence. Conclusion In symptomatic patients a complete surgical resection can give a very good outcome, with almost no recurrence. PMID:26579246

  18. Embryogenesis of bladder exstrophy: A new hypothesis

    PubMed Central

    Kulkarni, Bharati; Chaudhari, Navin

    2008-01-01

    Aims and Objective: To postulate a hypothesis to explain the embryogenesis of exstrophy bladder based on our clinical observations. Materials and Methods: In 27 cases of exstrophy, we measured the distance between the lowermost inguinal skin crease to the root of the penis (clitoris) (B) and the distance between the penis (clitoris) and the scrotum (labia majora) (C). These were compared with age, height and XP distance (distance between xiphisternum and symphysis pubis) matched control group of normal children. The distance between the lowermost inguinal skin crease and the penis (clitoris) (A) was measured in control group. Results: The observation was A = B + C. This implies that in exstrophy bladder, the position of the penis (clitoris) has moved cephalad from the lower border of A to the junction of B and C. Conclusion: Based on the observations, we postulate that abnormal origin of genital tubercle may be the cause of exstrophy bladder. The abnormal origin of primordia of the genital tubercle in more cephalad direction than normal causes wedge effect, which will interfere with the medial migration of the mesoderm as well as the midline approximation of mesodermal structures in the lower abdominal wall, thereby resulting in the exstrophy of bladder. PMID:20011468

  19. Bladder calculus presenting as excessive masturbation.

    PubMed

    De Alwis, A C D; Senaratne, A M R D; De Silva, S M P D; Rodrigo, V S D

    2006-09-01

    Masturbation in childhood is a normal behaviour which most commonly begins at 2 months of age, and peaks at 4 years and in adolescence. However excessive masturbation causes anxiety in parents. We describe a boy with a bladder calculus presenting as excessive masturbation.

  20. Arsenic and bladder cancer: observations and suggestions.

    PubMed

    Radosavljević, Vladan; Jakovljević, Branko

    2008-10-01

    Arsenic from drinking water is a well-known risk factor for bladder cancer. The purpose of this paper is to systematize some important yet often overlooked facts considering the relationship between arsenic exposure and the occurrence of bladder cancer. Since the exposure to inorganic arsenic from food, inhaled air, and skin absorption as well as arsenic methylation ability are not fully investigated, our assumption is that the exposure of arsenic only from drinking water is underestimated and its role as a risk factor is highly overestimated. This paper proposes some qualitative and quantitative parameters of arsenic as a risk factor for bladder cancer. The recommended qualitative parameters of arsenic intake are first, pathways of exposure, and second, toxicity and metabolism. The suggested quantitative parameters of arsenic intake include amounts of arsenic absorbed in the body, duration of arsenic exposure, and duration of arsenic presence in the urinary bladder. This approach can be implemented in a systematic classification and explanation of various risk factors and their mutual interactions for other types of cancer or diseases in general.

  1. Somatic mutation of PTEN in bladder carcinoma

    PubMed Central

    Aveyard, J S; Skilleter, A; Habuchi, T; Knowles, M A

    1999-01-01

    The tumour suppressor gene PTEN/MMAC1, which is mutated or homozygously deleted in glioma, breast and prostate cancer, is mapped to a region of 10q which shows loss of heterozygosity (LOH) in bladder cancer. We screened 123 bladder tumours for LOH in the region of PTEN. In 53 informative muscle invasive tumours (≥ pT2), allele loss was detected in 13 (24.5%) and allelic imbalance in four tumours (overall frequency 32%). LOH was found in four of 60 (6.6%) informative, non-invasive tumours (pTa/pT1). We screened 63 muscle invasive tumours for PTEN mutations by single-strand conformation polymorphism (SSCP) analysis and for homozygous deletion by duplex quantitative polymerase chain reaction (PCR). Two homozygous deletions were identified but no mutations. Of 15 bladder tumour cell lines analysed, three showed homozygous deletion of all or part of the PTEN gene, but none had mutations detectable by SSCP analysis. Our results indicate that PTEN is involved in the development of some bladder tumours. The low frequency of mutation of the retained allele in tumours with 10q23 LOH suggests that there may be another predominant mechanism of inactivation of the second allele, for example small intragenic deletions, that hemizygosity may be sufficient for phenotypic effect, or that there is another target gene at 10q23. © 1999 Cancer Research Campaign PMID:10360673

  2. Application of bladder acellular matrix in urinary bladder regeneration: the state of the art and future directions.

    PubMed

    Pokrywczynska, Marta; Gubanska, Iga; Drewa, Gerard; Drewa, Tomasz

    2015-01-01

    Construction of the urinary bladder de novo using tissue engineering technologies is the "holy grail" of reconstructive urology. The search for the ideal biomaterial for urinary bladder reconstruction has been ongoing for decades. One of the most promising biomaterials for this purpose seems to be bladder acellular matrix (BAM). In this review we determine the most important factors, which may affect biological and physical properties of BAM and its regeneration potential in tissue engineered urinary bladder. We also point out the directions in modification of BAM, which include incorporation of exogenous growth factors into the BAM structure. Finally, we discuss the results of the urinary bladder regeneration with cell seeded BAM.

  3. Apollo 12 mission report: Descent, propulsion system final flight evaluation (supplement 5)

    NASA Technical Reports Server (NTRS)

    Seto, R. K. M.; Barrows, R. L.

    1972-01-01

    The results are presented of the postflight analysis of the Descent propulsion system (DPS) performance during the Apollo 12 Mission. The primary objective of the analysis was to determine the steady-state performance of the DPS during the descent phase of the manned lunar landing. This is a supplement ot the Apollo 12 Mission Report. In addition to further analysis of the DPS, this report brings together information from other reports and memorandums analyzing specific anomalies and performance in order to present a comprehensive description of the DPS operation during the Apollo 12 Mission.

  4. Minimum-Cost Aircraft Descent Trajectories with a Constrained Altitude Profile

    NASA Technical Reports Server (NTRS)

    Wu, Minghong G.; Sadovsky, Alexander V.

    2015-01-01

    An analytical formula for solving the speed profile that accrues minimum cost during an aircraft descent with a constrained altitude profile is derived. The optimal speed profile first reaches a certain speed, called the minimum-cost speed, as quickly as possible using an appropriate extreme value of thrust. The speed profile then stays on the minimum-cost speed as long as possible, before switching to an extreme value of thrust for the rest of the descent. The formula is applied to an actual arrival route and its sensitivity to winds and airlines' business objectives is analyzed.

  5. Optimal turning climb-out and descent of commercial jet aircraft

    NASA Technical Reports Server (NTRS)

    Neuman, F.; Kreindler, E.

    1982-01-01

    Optimal turning climb-out and descent flight-paths from and to runway headings are derived to provide the missing elements of a complete flight-path optimization for minimum fuel consumption. The paths are derived by generating a field of extremals, using the necessary conditions of optimal control. Results show that the speed profiles for straight and turning flight are essentially identical, except for the final horizontal accelerating or decelerating turn. The optimal turns, which require no abrupt maneuvers, could easily be integrated with present climb-cruise-descent fuel-optimization algorithms.

  6. Initial Field Evaluation of Pilot Procedures for Flying CTAS Descent Clearances

    NASA Technical Reports Server (NTRS)

    Palmer, Everett; Goka, Tsuyoshi; Cashion, Patricia; Feary, Michael; Graham, Holly; Smith, Nancy; Shafto, Michael (Technical Monitor)

    1994-01-01

    The Center TRACON Automation System (CTAS) is a new support system that is designed to assist air traffic controllers in the management of arrival traffic. CTAS will provide controllers with more information about current air traffic, enabling them to provide clearances for efficient, conflict-free descents that help achieve an orderly stream of aircraft at the final approach fix. CTAS is a computer-based system that functions as a "ground-based FMS" that can predict flight trajectories and arrival times for all incoming aircraft. CTAS uses an aircraft's cruise airspeed; current air traffic, winds and temperature; performance characteristics of the aircraft type; and individual airline preferences to create a flight profile from cruise altitude to the final approach fix. Controllers can use this flight profile to provide a descent clearance that will allow an aircraft to fly an efficient descent and merge more smoothly with other arriving aircraft. A field test of the CTAS Descent Advisor software was conducted at the Denver Center for aircraft arriving at the Stapleton International Airport from September 12-29. CTAS Descent clearances were given to a NASA flight test aircraft and to 77 airline flights that arrived during low traffic periods. For the airline portion of the field test, cockpit procedures and pilot briefing packages for both FMS equipped and unequipped aircraft were developed in cooperation with an airline. The procedures developed for the FMS equipped aircraft were to fly a VNAV descent at a controller specified speed to cross a metering fix at a specified altitude and speed. For nonFMS aircraft, the clearance also specified a CTAS calculated top-of-descent point. Some CTAS related flight deck issues included how much time was available to the pilots' for compliance, the amount of information that needed to be interpreted in the clearance and possible repercussions of misunderstandings. Data collected during the study ranged from subjective data

  7. Entry, Descent and Landing Systems Analysis: Exploration Class Simulation Overview and Results

    NASA Technical Reports Server (NTRS)

    DwyerCianciolo, Alicia M.; Davis, Jody L.; Shidner, Jeremy D.; Powell, Richard W.

    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 exploration or human-scale missions. The year one exploration class mission activity considered technologies capable of delivering a 40-mt payload. This paper provides an overview of the exploration class mission study, including technologies considered, models developed and initial simulation results from the EDL-SA year one effort.

  8. Overview of the NASA Entry, Descent and Landing Systems Analysis Study

    NASA Technical Reports Server (NTRS)

    Zang, Thomas A.; Dwyer-Cianciolo, Alicia M.; Kinney, David J.; Howard, Austin R.; Chen, George T.; Ivanov, Mark C.; Sostaric, Ronald R.; Westhelle, Carlos H.

    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 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.

  9. Sapanisertib in Treating Patients With Locally Advanced or Metastatic Bladder Cancer With TSC1 and/or TSC2 Mutations

    ClinicalTrials.gov

    2017-03-16

    Metastatic Transitional Cell Carcinoma; Metastatic Urothelial Carcinoma; Recurrent Bladder Carcinoma; Stage III Bladder Urothelial Carcinoma; Stage IV Bladder Urothelial Carcinoma; TSC1 Gene Mutation; TSC2 Gene Mutation

  10. Probiotics, dendritic cells and bladder cancer.

    PubMed

    Feyisetan, Oladapo; Tracey, Christopher; Hellawell, Giles O

    2012-06-01

    What's known on the subject? and What does the study add? The suppressor effect of probiotics on superficial bladder cancer is an observed phenomenon but the specific mechanism is poorly understood. The evidence strongly suggests natural killer (NK) cells are the anti-tumour effector cells involved and NK cell activity correlates with the observed anti-tumour effect in mice. It is also known that dendritic cells (DC) cells are responsible for the recruitment and mobilization of NK cells so therefore it may be inferred that DC cells are most likely to be the interphase point at which probiotics act. In support of this, purification of NK cells was associated with a decrease in NK cells activity. The current use of intravesical bacille Calmette-Guérin in the management of superficial bladder cancer is based on the effect of a localised immune response. In the same way, understanding the mechanism of action of probiotics and the role of DC may potentially offer another avenue via which the immune system may be manipulated to resist bladder cancer. Probiotic foods have been available in the UK since 1996 with the arrival of the fermented milk drink (Yakult) from Japan. The presence of live bacterial ingredients (usually lactobacilli species) may confer health benefits when present in sufficient numbers. The role of probiotics in colo-rectal cancer may be related in part to the suppression of harmful colonic bacteria but other immune mechanisms are involved. Anti-cancer effects outside the colon were suggested by a Japanese report of altered rates of bladder tumour recurrence after ingestion of a particular probiotic. Dendritic cells play a central role to the general regulation of the immune response that may be modified by probiotics. The addition of probiotics to the diet may confer benefit by altering rates of bladder tumour recurrence and also alter the response to immune mechanisms involved with the application of intravesical treatments (bacille Calmette-Guérin).

  11. Genetics of Bladder Malignant Tumors in Childhood

    PubMed Central

    Zangari, Andrea; Zaini, Johan; Gulìa, Caterina

    2016-01-01

    Bladder masses are represented by either benign or malignant entities. Malignant bladder tumors are frequent causes of disease and death in western countries. However, in children they are less common. Additionally, different features are found in childhood, in which non epithelial tumors are more common than epithelial ones. Rhabdomyosarcoma is the most common pediatric bladder tumor, but many other types of lesions may be found, such as malignant rhabdoid tumor (MRT), inflammatory myofibroblastic tumor and neuroblastoma. Other rarer tumors described in literature include urothelial carcinoma and other epithelial neoplasms. Rhabdomyosarcoma is associated to a variety of genetic syndromes and many genes are involved in tumor development. PAX3-FKHR and PAX7-FKHR (P-F) fusion state has important implications in the pathogenesis and biology of RMS, and different genes alterations are involved in the pathogenesis of P-F negative and embryonal RMS, which are the subsets of tumors most frequently affecting the bladder. These genes include p53, MEF2, MYOG, Ptch1, Gli1, Gli3, Myf5, MyoD1, NF1, NRAS, KRAS, HRAS, FGFR4, PIK3CA, CTNNB1, FBXW7, IGF1R, PDGFRA, ERBB2/4, MET, BCOR. Malignant rhabdoid tumor (MRT) usually shows SMARCB1/INI1 alterations. Anaplastic lymphoma kinase (ALK) gene translocations are the most frequently associated alterations in inflammatory myofibroblastic tumor (IMT). Few genes alterations in urothelial neoplasms have been reported in the paediatric population, which are mainly related to deletion of p16/lnk4, overexpression of CK20 and overexpression of p53. Here, we reviewed available literature to identify genes associated to bladder malignancies in children and discussed their possible relationships with these tumors. PMID:27013922

  12. Palpable mass of the neck in the course of Takayasu arteritis

    PubMed Central

    Starba, Aleksandra; Misterska-Skóra, Maria; Wiland, Piotr; Guziński, Maciej

    2017-01-01

    Takayasu arteritis is a rare, idiopathic inflammatory disease of the aorta and its major branches, usually affecting young women of Asian descent. In the course of the disease stenosis, occlusions as well as dilatations and aneurysms of vessels occur. Because of many possible localizations of pathological changes, the symptoms have a wide range, but the most common are a weak pulse or its absence on the brachial artery and a difference in systolic pressure above 10 mm Hg between the upper extremities. Here we present a case report of a young woman with Takayasu arteritis, who presented a palpable mass in the back of her neck, significantly diminished after treatment with glucocorticoids. PMID:28386143

  13. Head and neck position sense.

    PubMed

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

  14. Detection of Subpubic Tumor Causing Bladder Outlet Obstruction by 3D Perineal Ultrasound.

    PubMed

    Albrich, S; Steetskamp, J; Rommens, K; Porta, S; Battista, M; Hoffmann, G; Skala, C

    2015-07-01

    This case report shows that 3D perineal ultrasound can be superior to clinical examination and routine 2D perineal ultrasound in the detection of an unusual subpubic tumor. A 73-year-old female patient was referred to our urogynecological outpatient unit complaining of over-active bladder symptoms and voiding dysfunction for 3 years. Gynecological examination found no signs of pelvic organ prolapse or abnormality in the vaginal cavity. Routine 2D perineal ultrasound showed substantial residual urine (ca. 300 ml on catheter) and limited bladder neck mobility, but no signs of pelvic organ prolapse. Use of standardized 3D perineal ultrasound revealed a 24 × 26 × 32 mm spherical, hypoechoic tumor below the pubic symphysis between the distal urethra and the pubic bones. This structure was mistaken for the pubic symphysis in the midline on 2D ultrasound performed earlier. At surgery, the tumor was completely excised through a vaginal incision between the urethra and the pubic symphysis. After an uneventful postoperative recovery the patient developed de-novo stress urinary incontinence, which was corrected successfully by the insertion of a retropubic tension-free suburethral sling after an interval of 8 weeks. After a further follow-up of 8 weeks the patient reported well-being, urinary continence and no voiding dysfunction; no abnormalities were found on examination. In conclusion, 3D perineal ultrasound is a useful additional tool for the diagnostic workup of bladder outlet obstruction.

  15. Gemcitabine, Paclitaxel, Doxorubicin in Metastatic or Unresectable Bladder Cancer With Decreased Kidney Function

    ClinicalTrials.gov

    2015-06-19

    Distal Urethral Cancer; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Proximal Urethral Cancer; Recurrent Bladder Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage III Bladder Cancer; Stage IV Bladder Cancer; Transitional Cell Carcinoma of the Bladder; Urethral Cancer Associated With Invasive Bladder Cancer

  16. An unusual cause of death: spontaneous urinary bladder perforation.

    PubMed

    Limon, Onder; Unluer, Erden Erol; Unay, Fulya Cakalagaoglu; Oyar, Orhan; Sener, Aslı

    2012-11-01

    Spontaneous urinary bladder perforation is a rare and life-threatening condition similar to traumatic and iatrogenic perforation. The connection with the underlying bladder damage due to previous radiotherapy, inflammation, malignancy, obstruction, or other causes can be found in almost all cases. The symptoms are often nonspecific, and misdiagnosis is common. Here, we present a case of spontaneous urinary bladder perforation due to bladder necrosis in a diabetic woman. She presented to the emergency department with abdominal pain. Exploratory laparotomy was performed by surgeons and revealed necrosis of the anterior and lateral walls of the urinary bladder. Microscopic examination revealed necrotic changes throughout the bladder wall. Ghost-like cellular outlines were compatible with coagulative necrosis. Clusters of bacteria were also present in some necrobiotic tissues. Malignant cells were not present. It appears probable that the infection was due to local interference with the blood supply (arterial, capillary, or venous) combined with the systemic metabolic upset that led to the bladder condition. In our case, we observed partial necrosis of the bladder rather than distortion of the entire blood supply to the bladder as consequences of the microvascular effects of diabetes. Urinary bladder perforation must be considered in the differential diagnosis of patients presenting with free fluid in the abdomen/peritonitis, decreased urine output, and hematuria, and in whom increased levels of urea/creatinine are detected in serum and/ or peritoneal fluid aspirate.

  17. [Neurogenic bladder: pathophysiology of the disorder of compliance].

    PubMed

    Chartier-Kastler, Emmanuel; Ayoub, Nadim; Even-Schneider, Alexia; Richard, François; Soler, Jean-Marc; Denys, Pierre

    2004-09-01

    Bladder compliance is defined by the ratio of the increase of intravesical pressures to the increase of volume (_V/_P). The pathophysiology of disorders of compliance in neurogenic bladder is still poorly elucidated. It can be evaluated in terms of three elements: 1) The natural history of the appearance of these disorders in neurogenic bladders. Clinical experience shows the existence of prognostic factors that determine the development of these disorders, such as the voiding mode adopted (self-catheterization/hetero-catheterization versus indwelling catheter), the level of the spinal cord lesion (suprasacral versus sacral, incomplete versus complete, and cauda equina lesions), and the presence of meningomyelocele. 2). Data derived from conservative management of these disorders in neurogenic bladders: urethral dilatation, various sphincterotomies, bladder disafferentation, alpha-blockers, vanilloids (resiniferatoxin and capsaicin), intra-detrusor botulinum toxin and intrathecal baclofen, have demonstrated a marked improvement of disorders of compliance associated with neurogenic bladder 3). Data derived from experimentations. Morphometric studies on animal or human bladder strips have demonstrated an increased expression of proteolytic enzymes and endogenous tissue inhibitors of metalloproteinases (MMP-1) and type III collagen mRNA in hypocompliant neurogenic bladders. Reduction of bladder wall blood flow, bilateral section of hypogastric nerves in rats, study of the bladders of spinalized rats, and reduction of oestrogenic hormone impregnation, show that these conditions induce loss of the viscoelastic properties of the bladder With the arrival of new treatments, active on afferent and/or efferent pathways or even on the central nervous system, it is very important to further our understanding of the pathophysiology of disorders of compliance in neurogenic bladders. Reversibility of these disorders constitutes a major therapeutic challenge and its functional

  18. Anatomic Variations in Head and Neck Reconstruction

    PubMed Central

    Tan, Bien-Keem; Wong, Chin-Ho; Chen, Hung-Chi

    2010-01-01

    Head and neck reconstruction is a technically challenging procedure. Variations encountered in the recipient vessels and commonly used flaps add to the complexity of surgery. This article reviews the commonly encountered variations in the recipient vessels in the neck with emphasis on alternatives and techniques to circumvent these variations. Flaps commonly used in head and neck reconstruction are also reviewed in detail. Furthermore, safety, potential pitfalls, and technical pearls are highlighted. PMID:22550436

  19. Effects of aircraft and flight parameters on energy-efficient profile descents in time-based metered traffic

    NASA Technical Reports Server (NTRS)

    Dejarnette, F. R.

    1984-01-01

    The influence of several parameters on the time required to fly a nominal profile descent of a B-737 from an entry fix to a metering fix 75 n.mi. away was studied. The ground distance for the constant speed segment was adjusted in each case so that the aircraft would always arrive at the metering fix position at the completion of the five segments of the profile descent. The influence of eight parameters on the same nominal profile descent is outlined, but the method used for the off nominal cases was changed. The time calculated for the constant speed segment in the nominal case is used for all off nominal cases. This method allows the aircraft to arrive at the metering fix before or after the profile descent is complete. It is shown that descent Mach number and wind speed have a large effect on the time error, whereas weight was a much smaller effect.

  20. The proof of sufficient descent condition for a new type of conjugate gradient methods

    NASA Astrophysics Data System (ADS)

    Abashar, Abdelrhaman; Mamat, Mustafa; Rivaie, Mohd; Mohd, Ismail; Omer, Osman

    2014-06-01

    Conjugate gradient methods are effective in solving linear equations and solving non-linear optimization. In this work we compare our new conjugate gradient coefficient βk with classical formula under strong Wolfe line search; our method contains sufficient descent condition. Numerical results have shown that the new βk performs better than classical formula.

  1. Conjugate gradient methods with sufficient descent condition for large-scale unconstrained optimization

    NASA Astrophysics Data System (ADS)

    Ling, Mei Mei; Leong, Wah June

    2014-12-01

    In this paper, we make a modification to the standard conjugate gradient method so that its search direction satisfies the sufficient descent condition. We prove that the modified conjugate gradient method is globally convergent under Armijo line search. Numerical results show that the proposed conjugate gradient method is efficient compared to some of its standard counterparts for large-scale unconstrained optimization.

  2. Use of steepest descent and various approximations for efficient computation of minimum noise aircraft landing trajectories

    NASA Technical Reports Server (NTRS)

    Cook, G.; Witt, R. M.

    1976-01-01

    The following areas related to landing trajectory optimization research were discussed: (1) programming and modifying the steepest descent optimization procedure, (2) successfully iterating toward the optimum for a four-mile trajectory, (3) beginning optimization runs for a twenty-mile trajectory, and (4) adapt wind tunnel data for computer usage. Other related areas were discussed in detail in the two previous annual reports.

  3. Sexual Health Discussions between African-American Mothers and Mothers of Latino Descent and Their Children

    ERIC Educational Resources Information Center

    Murray, Ashley; Ellis, Monica U.; Castellanos, Ted; Gaul, Zaneta; Sutton, Madeline Y.; Sneed, Carl D.

    2014-01-01

    We examined approaches used by African-American mothers and mothers of Latino descent for informal sex-related discussions with their children to inform sexually transmitted infection (STI)/HIV intervention development efforts. We recruited mothers (of children aged 12-15) from youth service agencies and a university in southern California.…

  4. Access to Health Care Among Latinos of Mexican Descent in "Colonias" in Two Texas Counties

    ERIC Educational Resources Information Center

    Ortiz, Larry; Arizmendi, Lydia; Cornelius, Llewellyn J.

    2004-01-01

    Critical to resolving the problem of health disparities among Latinos is examining the needs within ethnic subpopulations. This paper focused on the unique challenges encountered by one ethnic subpopulation -- Latinos of Mexican descent living in colonias. Findings reaffirm the importance of looking within ethnic subpopulations to understand the…

  5. Smart-Divert Powered Descent Guidance to Avoid the Backshell Landing Dispersion Ellipse

    NASA Technical Reports Server (NTRS)

    Carson, John M.; Acikmese, Behcet

    2013-01-01

    A smart-divert capability has been added into the Powered Descent Guidance (PDG) software originally developed for Mars pinpoint and precision landing. The smart-divert algorithm accounts for the landing dispersions of the entry backshell, which separates from the lander vehicle at the end of the parachute descent phase and prior to powered descent. The smart-divert PDG algorithm utilizes the onboard fuel and vehicle thrust vectoring to mitigate landing error in an intelligent way: ensuring that the lander touches down with minimum- fuel usage at the minimum distance from the desired landing location that also avoids impact by the descending backshell. The smart-divert PDG software implements a computationally efficient, convex formulation of the powered-descent guidance problem to provide pinpoint or precision-landing guidance solutions that are fuel-optimal and satisfy physical thrust bound and pointing constraints, as well as position and speed constraints. The initial smart-divert implementation enforced a lateral-divert corridor parallel to the ground velocity vector; this was based on guidance requirements for MSL (Mars Science Laboratory) landings. This initial method was overly conservative since the divert corridor was infinite in the down-range direction despite the backshell landing inside a calculable dispersion ellipse. Basing the divert constraint instead on a local tangent to the backshell dispersion ellipse in the direction of the desired landing site provides a far less conservative constraint. The resulting enhanced smart-divert PDG algorithm avoids impact with the descending backshell and has reduced conservatism.

  6. A Wind Tunnel Study on the Mars Pathfinder (MPF) Lander Descent Pressure Sensor

    NASA Technical Reports Server (NTRS)

    Soriano, J. Francisco; Coquilla, Rachael V.; Wilson, Gregory R.; Seiff, Alvin; Rivell, Tomas

    2001-01-01

    The primary focus of this study was to determine the accuracy of the Mars Pathfinder lander local pressure readings in accordance with the actual ambient atmospheric pressures of Mars during parachute descent. In order to obtain good measurements, the plane of the lander pressure sensor opening should ideally be situated so that it is parallel to the freestream. However, due to two unfavorable conditions, the sensor was positioned in locations where correction factors are required. One of these disadvantages is due to the fact that the parachute attachment point rotated the lander's center of gravity forcing the location of the pressure sensor opening to be off tangent to the freestream. The second and most troublesome factor was that the lander descends with slight oscillations that could vary the amplitude of the sensor readings. In order to accurately map the correction factors required at each sensor position, an experiment simulating the lander descent was conducted in the Martian Surface Wind Tunnel at NASA Ames Research Center. Using a 115 scale model at Earth ambient pressures, the test settings provided the necessary Reynolds number conditions in which the actual lander was possibly subjected to during the descent. In the analysis and results of this experiment, the readings from the lander sensor were converted to the form of pressure coefficients. With a contour map of pressure coefficients at each lander oscillatory position, this report will provide a guideline to determine the correction factors required for the Mars Pathfinder lander descent pressure sensor readings.

  7. High-Resolution Detection of Identity by Descent in Unrelated Individuals

    PubMed Central

    Browning, Sharon R.; Browning, Brian L.

    2010-01-01

    Detection of recent identity by descent (IBD) in population samples is important for population-based linkage mapping and for highly accurate genotype imputation and haplotype-phase inference. We present a method for detection of recent IBD in population samples. Our method accounts for linkage disequilibrium between SNPs to enable full use of high-density SNP data. We find that our method can detect segments of a length of 2 cM with moderate power and negligible false discovery rate in Illumina 550K data in Northwestern Europeans. We compare our method with GERMLINE and PLINK, and we show that our method has a level of resolution that is significantly better than these existing methods, thus extending the usefulness of recent IBD in analysis of high-density SNP data. We survey four genomic regions in a sample of UK individuals of European descent and find that on average, at a given location, our method detects IBD in 2.7 per 10,000 pairs of individuals in Illumina 550K data. We also present methodology and results for detection of homozygosity by descent (HBD) and survey the whole genome in a sample of 1373 UK individuals of European descent. We detect HBD in 4.7 individuals per 10,000 on average at a given location. Our methodology is implemented in the freely available BEAGLE software package. PMID:20303063

  8. A Critical Analysis of Western Perspectives on Families of Arab Descent

    ERIC Educational Resources Information Center

    Beitin, Ben K.; Allen, Katherine R.; Bekheet, Maureen

    2010-01-01

    Western research on families of Arab descent has increased in the current decade, compared to the previous 30 years. In this review of 256 empirical articles, through a critical postcolonial lens, domestic violence and family planning were the two most established areas of study. Generally, samples have come from a small group of countries such as…

  9. Education by Any Means Necessary: Peoples of African Descent and Community-Based Pedagogical Spaces

    ERIC Educational Resources Information Center

    Douglas, Ty-Ron Michael; Peck, Craig

    2013-01-01

    This study examines how and why peoples of African descent access and utilize community-based pedagogical spaces that exist outside schools. Employing a theoretical framework that fuses historical methodology and border-crossing theory, the researchers review existing scholarship and primary documents to present an historical examination of how…

  10. Heritage Learners of Mexican Descent in Higher Education: A Qualitative Study of Past and Present Experiences

    ERIC Educational Resources Information Center

    Gignoux, Alicia

    2009-01-01

    This is a qualitative interpretive study that explores the past and present experiences of heritage learners (HLs) of Mexican descent who were studying or had recently studied advanced Spanish in institutions of higher education. All of the participants had been exposed to Spanish in the home and began their studies in elementary or middle school…

  11. Rotary-Wing Decelerators for Probe Descent Through the Atmosphere of Venus

    NASA Technical Reports Server (NTRS)

    Young, Larry A.; Briggs, Geoffrey; Aiken, Edwin; Pisanich, Greg

    2005-01-01

    An innovative concept is proposed for atmospheric entry probe deceleration, wherein one or more deployed rotors (in autorotation or wind-turbine flow states) on the aft end of the probe effect controlled descent. This concept is particularly oriented toward probes intended to land safely on the surface of Venus. Initial work on design trade studies is discussed.

  12. Showing up, Remaining Engaged, and Partaking as Students: Resilience among Students of Mexican Descent

    ERIC Educational Resources Information Center

    Sosa, Teresa

    2012-01-01

    This paper examines the ways in which 12 high school students of Mexican descent remain resilient amid difficult and stressful realities. Through an examination of students' interview responses, a case is made that students' ability to engage in school and figure out everyday ways to partake as students are signs of resilience. This work suggests…

  13. Chronic disease self-management: views among older adults of Chinese descent.

    PubMed

    Wang, Jing; Matthews, Judith Tabolt

    2010-01-01

    To understand how Chinese culture influences chronic disease self-management, we conducted focus groups with older adults of Chinese descent. Specifically, we explored their perceptions and self-management practices regarding treatment adherence, lifestyle decisions, and patient-provider communication within the context of their culture.

  14. A molecular signature of an arrest of descent in human parturition

    PubMed Central

    MITTAL, Pooja; ROMERO, Roberto; TARCA, Adi L.; DRAGHICI, Sorin; NHAN-CHANG, Chia-Ling; CHAIWORAPONGSA, Tinnakorn; HOTRA, John; GOMEZ, Ricardo; KUSANOVIC, Juan Pedro; LEE, Deug-Chan; KIM, Chong Jai; HASSAN, Sonia S.

    2010-01-01

    Objective This study was undertaken to identify the molecular basis of an arrest of descent. Study Design Human myometrium was obtained from women in term labor (TL; n=29) and arrest of descent (AODes, n=21). Gene expression was characterized using Illumina® HumanHT-12 microarrays. A moderated t-test and false discovery rate adjustment were applied for analysis. Confirmatory qRT-PCR and immunoblot was performed in an independent sample set. Results 400 genes were differentially expressed between women with an AODes compared to those with TL. Gene Ontology analysis indicated enrichment of biological processes and molecular functions related to inflammation and muscle function. Impacted pathways included inflammation and the actin cytoskeleton. Overexpression of HIF1A, IL-6, and PTGS2 in AODES was confirmed. Conclusion We have identified a stereotypic pattern of gene expression in the myometrium of women with an arrest of descent. This represents the first study examining the molecular basis of an arrest of descent using a genome-wide approach. PMID:21284969

  15. Retrieval of the ESA Huygens Probe Entry and Descent Trajectory at Titan

    NASA Astrophysics Data System (ADS)

    Kazeminejad, B.; Atkinson, D. H.; Lebreton, J.-P.; Witasse, O.; Perez, M.; DTWG Team

    2005-08-01

    The Huygens probe was released from the Cassini spacecraft on December 25, 2004 and arrived at Titan for atmospheric entry and surface descent on January 14, 2005. The Huygens entry and descent trajectory reconstruction commenced with the Huygens probe state vector at the entry interface point (defined to be at an altitude of 1270 km above the surface of Titan) as provided by the Cassini Navigation Team at JPL. Integration of the equations of motion using measured accelerations provided the Huygens trajectory beyond the point of initial parachute deployment. From the surface, the Huygens descent trajectory was reconstructed upwards using pressure and temperature measurements from the Atmospheric Structure Instrument, N2/CH4 mole fractions from the Gas Chromatograph and Mass Spectrometer, and the impact time measured by the Surface Science Package penetrometer. Longitudinal drift was provided by the Huygens Doppler Wind Experiment. The entry and descent phases of the trajectory reconstructions were merged by adjustment of the initial state vector. The Huygens trajectory was reconstructed to be maximally consistent with all available science and engineering data.

  16. Mapping of Surface and Shallow Subsurface Signatures in the CONSERT Data during the Descent of Philae

    NASA Astrophysics Data System (ADS)

    Plettemeier, Dirk; Statz, Christoph; Hahnel, Ronny; Hegler, Sebastian; Kofman, Wlodek; Herique, Alain; Rogez, Yves; Pasquero, Pierre; Zine, Sonia; Ciarletti, Valerie

    2016-04-01

    The primary scientific objective of the Comet Nucleus Sounding Experiment by Radiowave Transmission (CONSERT) aboard Rosetta is the characterization of comet 67P/Chuyurmov-Gerasimenko's deep interior dielectric properties. This was done during the first science sequence (FSS) by means of bi-static radio propagation measurements between the the CONSERT instrument aboard lander Philae launched onto the comet's surface and its counterpart aboard the Rosetta orbiter. In addition to the FSS measurements, CONSERT was operated during the separation and descent of Philae onto the 67P/C-G's surface. The received CONSERT signal during the SDL consists of the direct propagation between Rosetta and Philae and indirect reflections of 67P/C-G's surface. Using the peak power measurements in the dominant direct path between Rosetta and Philae during the descent we were able to reconstruct the lander's attitude and estimate the spin rate of the lander along its descent trajectory. The deployment of the lander legs and CONSERT antennas as well as the orbiter change of attitude in order to orient the science towards the assumed lander position are visible in the measured CONSERT data as well. The information gained on Philae's attitude is used in the estimation of 67P/C-G's surface and near subsurface dielectric properties. Information on the surface of 67P/C-G are contained in the data during roughly the last third of the descent of Philae onto the comet's surface. The surface signatures in the measured data are mapped to the location of origin on 67P/C-G's surface. The results from the mapping process show good spatial diversity along the descent track of Philae necessary for the estimation of the dielectric properties of prominent features in the CONSERT SDL data.

  17. Bladder cancer: approaches to prevention and control*

    PubMed Central

    Koroltchouk, V.; Stanley, K.; Stjernswärd, J.; Mott, K.

    1987-01-01

    Bladder cancer is the twelfth most common cancer globally, with approximately 170 000 new cases each year; a third of these cases are in the developing countries. There are two major etiological types. The first is more common in the industrialized countries and is associated with exposure to certain occupational and environmental carcinogens, but most importantly with tobacco smoking. The second type is associated with Schistosoma haematobium infection of the urinary tract and is one of the most frequent tumours in eastern Mediterranean and African countries. Both types of bladder cancer are largely preventable. Comprehensive education and legislative approaches are recommended to reduce tobacco consumption and exposure to industrial carcinogens. Safe and effective drugs are available to treat schistosomiasis within integrated control programmes in endemic areas. PMID:3121200

  18. Occult bladder injury after laparoscopic appendicectomy.

    PubMed

    Lad, Meher; Duncan, Sarah; Patten, Darren K

    2013-11-22

    Minimally invasive procedures have revolutionised surgery by reducing pain and the length of hospital stay for patients. These are not simple procedures and training in laparoscopic surgery is an arduous process. Meticulous preparation prior to surgery is paramount to prevent complications. We report a rare complication involving a 35-year-old patient who underwent a laparoscopic appendicectomy for a perforated appendix. Two days after surgery the patient experienced redness and swelling in the lower abdominal region and oliguria. A delayed computer tomography (CT) scan revealed contrast leakage around the bladder spreading within the peritoneal cavity consistent with an intraperitoneal bladder perforation. She underwent urinary catheterisation for 6 days. A follow-up CT cystogram showed no evidence of leakage into the peritoneal cavity. This case highlights the need for thorough preparation prior to laparoscopic surgery and careful manipulation of instruments during routine procedures to minimise the risk of serious patient complications such as the aforementioned.

  19. Neoadjuvant chemotherapy for invasive bladder cancer.

    PubMed

    Sonpavde, Guru; Sternberg, Cora N

    2012-04-01

    Neoadjuvant cisplatin-based combination chemotherapy is an established standard for resectable muscle-invasive bladder cancer, a disease with a pattern of predominantly distant and early recurrences. Pathologic complete remission appears to be an intermediate surrogate for survival when employing combination chemotherapy. Moreover, baseline host and tumor tissue studies may enable the discovery of biomarkers predictive of activity. The neoadjuvant setting also provides a window of opportunity to evaluate novel biologic agents or rational combinations of biologic agents to obtain a signal of biologic activity. The residual tumor after neoadjuvant therapy may be exploited to study the mechanism of action and resistance. Cisplatin-ineligible patients warrant the evaluation of tolerable neoadjuvant regimens. Given that bladder cancer is characterized by initial localized presentation in the vast majority of cases, the paradigm of neoadjuvant therapy may expedite the development of novel systemic agents.

  20. Persistent neurogenic bladder dysfunction due to infantile botulism.

    PubMed

    Breinbjerg, Anders; Rittig, Søren; Kamperis, Konstantinos

    2014-01-13

    We present a child, 5 months of age, diagnosed with infantile botulism, showing the signs of neurogenic bladder dysfunction. The patient presented with progressive muscle weakness, hypotonia, suckling and swallowing problems and absent peripheral reflexes at clinical examination. Botulinum neurotoxin type A was detected in her serum, confirming the diagnosis. Starting at day 6, the girl presented with a urinary retention initially necessitating free bladder drainage and subsequently intermittent catheterisation. After 6 weeks in intensive care, the patient recovered but the bladder underactivity persisted. Four months following recovery, a urodynamic evaluation was performed, showing a near normal detrusor activity and normal bladder emptying, and the catheterisation was ceased. At 6 months, the girl was diagnosed with a urinary tract infection and bladder emptying problems, which persisted, and clean intermittent catheterisation was started. The final urodynamic evaluation, a year and a half after her initial presentation, revealed a normal detrusor activity and an adequate bladder emptying.

  1. The emerging role of the androgen receptor in bladder cancer.

    PubMed

    Lombard, Alan P; Mudryj, Maria

    2015-10-01

    Men are three to four times more likely to get bladder cancer than women. The gender disparity characterizing bladder cancer diagnoses has been investigated. One hypothesis is that androgen receptor (AR) signaling is involved in the etiology and progression of this disease. Although bladder cancer is not typically described as an endocrine-related malignancy, it has become increasingly clear that AR signaling plays a role in bladder tumors. This review summarizes current findings regarding the role of the AR in bladder cancer. We discuss work demonstrating AR expression in bladder cancer and its role in promoting formation and progression of tumors. Additionally, we discuss the therapeutic potential of targeting the AR in this disease.

  2. Urosepsis complicated by a spontaneous bladder perforation.

    PubMed

    Lutwak, Nancy; Dill, Curt

    2011-11-08

    The authors present a case of a 72-year-old diabetic male s/p pelvic irradiation for prostate carcinoma who arrived in the emergency department with complaints of shaking chills. After admission for urosepsis, he developed severe abdominal pain and examination revealed a diffusely tender abdomen. The patient was diagnosed with spontaneous urinary bladder perforation and underwent surgery. After several weeks of intravenous antibiotics, he was discharged with multiple drains in place and bilateral nephrostomy tubes.

  3. LP/SV Bladder Buoyancy Test Comparison

    DTIC Science & Technology

    2011-07-01

    The buoyant force of the British MK 30 LCX is also unknown; however, this flotation device utilizes a large bladder and may replace the LP/SV. Aim...following inflation using a 45g CO2 canister. Conclusion: In all trials, both flotation devices produced buoyant forces greater that 35 lbs. The British...2. The British use a very similar aircrew flotation device called the MK 30 LCX. It differs from the currently used LP/SV because it utilizes a

  4. Human bladder cancer diagnosis using multiphoton microscopy

    NASA Astrophysics Data System (ADS)

    Mukherjee, Sushmita; Wysock, James S.; Ng, Casey K.; Akhtar, Mohammed; Perner, Sven; Lee, Ming-Ming; Rubin, Mark A.; Maxfield, Frederick R.; Webb, Watt W.; Scherr, Douglas S.

    2009-02-01

    At the time of diagnosis, approximately 75% of bladder cancers are non-muscle invasive. Appropriate diagnosis and surgical resection at this stage improves prognosis dramatically. However, these lesions, being small and/or flat, are often missed by conventional white-light cystoscopes. Furthermore, it is difficult to assess the surgical margin for negativity using conventional cystoscopes. Resultantly, the recurrence rates in patients with early bladder cancer are very high. This is currently addressed by repeat cystoscopies and biopsies, which can last throughout the life of a patient, increasing cost and patient morbidity. Multiphoton endoscopes offer a potential solution, allowing real time, noninvasive biopsies of the human bladder, as well as an up-close assessment of the resection margin. While miniaturization of the Multiphoton microscope into an endoscopic format is currently in progress, we present results here indicating that Multiphoton imaging (using a bench-top Multiphoton microscope) can indeed identify cancers in fresh, unfixed human bladder biopsies. Multiphoton images are acquired in two channels: (1) broadband autofluorescence from cells, and (2) second harmonic generation (SHG), mostly by tissue collagen. These images are then compared with gold standard hematoxylin/eosin (H&E) stained histopathology slides from the same specimen. Based on a "training set" and a very small "blinded set" of samples, we have found excellent correlation between the Multiphoton and histopathological diagnoses. A larger blinded analysis by two independent uropathologists is currently in progress. We expect that the conclusion of this phase will provide us with diagnostic accuracy estimates, as well as the degree of inter-observer heterogeneity.

  5. [Management of bladder cancer in unfit patients].

    PubMed

    Mongiat-Artus, P; Pfister, C; Théodore, C; De Crevoisier, R; Guillotreau, J

    2010-03-01

    Adjuvant therapies in bladder cancer are based on risk of recurrence and associated comorbidities (renal failure). Lymph node involvement is the most important prognostic factor for decision. Two adjuvant chemotherapies exist: MVAC or GC. In unfit patients, association (Gemcitabine and Taxanes) could be proposed. Indication of adjuvant radiotherapy depends on metastatic risk and resection margins. Concomitant chemotherapy and radiotherapy should be proposed to selected patients who refuse or are not candidate for radical cystectomy.

  6. Genetics Home Reference: head and neck squamous cell carcinoma

    MedlinePlus

    ... Health Conditions head and neck squamous cell carcinoma head and neck squamous cell carcinoma Enable Javascript to view the ... body cavities such as the airways and intestines. Head and neck squamous cell carcinoma (HNSCC) develops in the mucous ...

  7. Head and Neck Radiation Treatment and Your Mouth

    MedlinePlus

    ... Head and Neck Radiation Treatment and Your Mouth Head and Neck Radiation Treatment and Your Mouth Main Content Are ... Being Treated With Radiation for Cancer in Your Head or Neck? If so, this booklet can help you. While ...

  8. Ectopic cervical thymus as a rare cause of pediatric neck mass: the role of ultrasound and MRI in the diagnosis. Case report.

    PubMed

    Ozel, Alper; Akdur, Pinar Ozdemır; Celebi, Irfan; Karasu, Rabia; Yilmaz, Banu; Basak, Muzaffer

    2015-06-01

    Ectopic cervical thymus (ECT) is an uncommon cause for cervical mass in the pediatric age group. Ultrasound and magnetic resonance imaging findings of the mass (located along the thymic descent pathway along the thymopharyngeal tract and has identical echostructure and signal intensities to the native thymus in the superior mediastinum) would lead to the diagnosis. The diagnosis is confirmed by fine needle aspiration biopsy or histopathology after resection. The management of ECT is a conservative follow up, except in symptomatic cases with tracheal compression and histologically confirmed neoplasia where surgery is indicated. We present the case of ECT presenting as a left upper neck mass in a 12 year old girl.

  9. Frequent truncating mutations of STAG2 in bladder cancer.

    PubMed

    Solomon, David A; Kim, Jung-Sik; Bondaruk, Jolanta; Shariat, Shahrokh F; Wang, Zeng-Feng; Elkahloun, Abdel G; Ozawa, Tomoko; Gerard, Julia; Zhuang, Dazhong; Zhang, Shizhen; Navai, Neema; Siefker-Radtke, Arlene; Phillips, Joanna J; Robinson, Brian D; Rubin, Mark A; Volkmer, Björn; Hautmann, Richard; Küfer, Rainer; Hogendoorn, Pancras C W; Netto, George; Theodorescu, Dan; James, C David; Czerniak, Bogdan; Miettinen, Markku; Waldman, Todd

    2013-12-01

    Here we report the discovery of truncating mutations of the gene encoding the cohesin subunit STAG2, which regulates sister chromatid cohesion and segregation, in 36% of papillary non-invasive urothelial carcinomas and 16% of invasive urothelial carcinomas of the bladder. Our studies suggest that STAG2 has a role in controlling chromosome number but not the proliferation of bladder cancer cells. These findings identify STAG2 as one of the most commonly mutated genes in bladder cancer.

  10. Frequent truncating mutations of STAG2 in bladder cancer

    PubMed Central

    Solomon, David A.; Kim, Jung-Sik; Bondaruk, Jolanta; Shariat, Shahrokh F.; Wang, Zeng-Feng; Elkahloun, Abdel G.; Ozawa, Tomoko; Gerard, Julia; Zhuang, DaZhong; Zhang, Shizhen; Navai, Neema; Siefker-Radtker, Arleen; Phillips, Joanna J.; Robinson, Brian D.; Rubin, Mark A.; Volkmer, Björn; Hautmann, Richard; Küfer, Rainer; Hogendoorn, Pancras C. W.; Netto, George; Theodorescu, Dan; James, C. David; Czerniak, Bogdan; Miettinen, Markku; Waldman, Todd

    2013-01-01

    Here we report the discovery of truncating mutations of the gene encoding the cohesin subunit STAG2, which regulates sister chromatid cohesion and segregation, in 36% of papillary non-invasive urothelial carcinomas and 16% of invasive urothelial carcinomas of the bladder. Our studies suggest that STAG2 plays a role in controlling chromosome number but not proliferation of bladder cancer cells. These findings identify STAG2 as among the most commonly mutated genes in bladder cancer discovered to date. PMID:24121789

  11. [Tissue engineering in urology, new approaches for urinary bladder reconstruction].

    PubMed

    Murav'ev, A N; Orlova, N V; Blinova, M I; Iudintseva, N M

    2015-01-01

    Tissue engineering as applied to urologic pathology is covered extremely poor in the literature despite recently gaining popularity of regenerative medicine. The review reflects the current problems associated with reconstructive surgery of the urinary bladder, experience of the researchers from the United States in implementing cellular technologies for bladder replacement, the problems and prospects of this direction in case of such a severe pathology, as fibrous transformated bladder.

  12. Four cases of bladder exstrophy in two families.

    PubMed Central

    Messelink, E J; Aronson, D C; Knuist, M; Heij, H A; Vos, A

    1994-01-01

    Bladder exstrophy is a rare congenital anomaly, caused by abnormal development of the cloacal membrane. To our knowledge, 18 familial patients with this malformation have been described. Two sets of familial cases with bladder exstrophy are reported here: two cousins and a mother and son and the published reports of the 18 familial cases among 682 index patients with bladder exstrophy are reviewed. Ultrasonography is advocated as the investigation of choice for early prenatal diagnosis. PMID:8071977

  13. Fluorescence detection of bladder cancer: a review.

    PubMed

    D'Hallewin, Marie-Ange; Bezdetnaya, Lina; Guillemin, François

    2002-11-01

    An effective therapeutic outcome in the treatment of bladder cancer is largely defined by its early detection. In this context, big expectations have been placed on the fluorescence-guided diagnosis of bladder cancer. This paper reviews the applications of endo- and exogenous fluorescence for early diagnosis of in situ carcinoma of the bladder. Despite certain advantages of autofluorescence, exogenous fluorescence, based on the intravesical instillation of fluorophores with the following visible light excitation, has been shown to be more effective in terms of sensitivity and specificity for detecting carcinoma in situ. The equipment consists of a slightly modified light source in order to choose between white (conventional endoscopy) or blue light (fluorescence endoscopy) excitation, and specific lenses, in order to enhance maximally the contrast between normal (blue) autofluorescence and red fluorescence from malignancies. Among exogenous fluorophores, a particular emphasis will be put on the 5-aminolevulinic acid (ALA), its ester derivative (h-ALA) and hypericin. These dyes demonstrated an excellent sensitivity above 90% and specificity ranging from 70% to 90%.

  14. Bladder Cancer Screening in Aluminum Smelter Workers

    PubMed Central

    Taiwo, Oyebode A.; Slade, Martin D.; Cantley, Linda F.; Tessier-Sherman, Baylah; Galusha, Deron; Kirsche, Sharon R.; Donoghue, A. Michael

    2015-01-01

    Objective: To present results of a bladder cancer screening program conducted in 18 aluminum smelters in the United States from January 2000 to December 2010. Methods: Data were collected on a cohort of workers with a history of working in coal tar pitch volatile exposed areas including urine analysis for conventional cytology and ImmunoCyt/uCyt+ assay. Results: ImmunoCyt/uCyt+ and cytology in combination showed a sensitivity of 62.30%, a specificity of 92.60%, a negative predictive value of 99.90%, and a positive predictive value of 2.96%. Fourteen cases of bladder cancer were detected, and the standardized incidence ratio of bladder cancer was 1.18 (95% confidence interval, 0.65 to 1.99). Individuals who tested positive on either test who were later determined to be cancer free had undergone expensive and invasive tests. Conclusions: Evidence to support continued surveillance of this cohort has not been demonstrated. PMID:25525927

  15. Genetics of human congenital urinary bladder disease.

    PubMed

    Woolf, Adrian S; Stuart, Helen M; Newman, William G

    2014-03-01

    Lower urinary tract and/or kidney malformations are collectively the most common cause of end-stage renal disease in children, and they are also likely to account for a major subset of young adults requiring renal replacement therapy. Advances have been made regarding the discovery of the genetic causes of human kidney malformations. Indeed, testing for mutations of key nephrogenesis genes is now feasible for patients seen in nephrology clinics. Unfortunately, less is known about defined genetic bases of human lower urinary tract anomalies. The focus of this review is the genetic bases of congenital structural and functional disorders of the urinary bladder. Three are highlighted. First, prune belly syndrome, where mutations of CHRM3, encoding an acetylcholine receptor, HNF1B, encoding a transcription factor, and ACTA2, encoding a cytoskeletal protein, have been reported. Second, the urofacial syndrome, where mutations of LRIG2 and HPSE2, encoding proteins localised in nerves invading the fetal bladder, have been defined. Finally, we review emerging evidence that bladder exstrophy may have genetic bases, including variants in the TP63 promoter. These genetic discoveries provide a new perspective on a group of otherwise poorly understood diseases.

  16. Chemoimmunotherapy of implanted murine bladder cancer.

    PubMed

    Akaza, H; Crabtree, W N; Matheny, R B; Soloway, M S

    1983-03-01

    The unaltered incidence of recurrence of superficial bladder tumor after discontinuation of intravesical chemotherapy has prompted a search for effective adjuvant therapy. The technique of cauterization and implantation of tumor cells was performed in C3H/He mice to simulate the early stage of bladder cancer to evaluate a regimen of intravesical mitomycin C followed by the systemic immunopotentiator, levamisole. Mice received either normal saline (control), mitomycin C (MMC), levamisole (Leva), or MMC plus Leva. Chemotherapy was given intravesically on days 6 and 13. Immunotherapy was given intraperitoneally on days 7 and 14. All mice were sacrificed on day 21. In the treatment groups, the incidences of bladder tumor varied from 50 to 63 per cent whereas that of the control group was 91 per cent. An increase in spleen weight was observed in the treatment groups of Leva and MMC plus Leva as well as the control group but not observed in the group receiving MMC. Our study suggests that although Leva did not reduce the tumor incidence, an immunostimulator might be of benefit when used in conjunction with MMC.

  17. Diagnostics techniques in nonmuscle invasive bladder cancer

    PubMed Central

    Soubra, Ayman; Risk, Michael C.

    2015-01-01

    Introduction: Nonmuscle invasive bladder cancer (NMIBC) is the most common presentation of bladder cancer and is often treatable with endoscopic resection and intravesical therapies. Cystoscopy and urine cytology are the gold standard in diagnosis and surveillance but are limited by their sensitivity in some situations. We seek to provide an overview of recent additions to the diagnostic armamentarium for urologists treating this disease. Methods: Articles were identified through a literature review of articles obtained through PubMed searches including the terms “bladder cancer” and various diagnostic techniques described in the article. Results: A variety of urinary biomarkers are available to assist the diagnosis and management of patients with NMIBC. Many have improved sensitivity over urine cytology, but less specificity. There are certain situations in which this has proved valuable, but as yet these are not part of the standard guidelines for NMIBC. Fluorescence cystoscopy has level 1 evidence demonstrating increased rates of tumor detection and prolonged recurrence-free survival when utilized for transurethral resection. Other technologies seeking to enhance cystoscopy, such as narrow band imaging, confocal laser endomicroscopy, and optical coherence tomography are still under evaluation. Conclusions: A variety of urine biomarker and adjunctive endoscopic technologies have been developed to assist the management of NMIBC. While some, such as fluorescence cystoscopy, have demonstrated a definite benefit in this disease, others are still finding their place in the diagnosis and treatment of this disease. Future studies should shed light on how these can be incorporated to improve outcomes in NMIBC. PMID:26604438

  18. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

    PubMed Central

    Coskun, H. Hakan; Medina, Jesus E.; Robbins, K. Thomas; Silver, Carl E.; Strojan, Primož; Teymoortash, Afshin; Pellitteri, Phillip K.; Rodrigo, Juan P.; Stoeckli, Sandro J.; Shaha, Ashok R.; Suçrez, Carlos; Hartl, Dana M.; de Bree, Remco; Takes, Robert P.; Hamoir, Marc; Pitman, Karen T.; Rinaldo, Alessandra; Ferlito, Alfio

    2016-01-01

    Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach. PMID:24623715

  19. FOREIGN BODY IN URINARY BLADDER: AN UNUSUAL PRESENTATION.

    PubMed

    Hashmi, Saadat-Hassan; Khan, Ikramullah

    2015-01-01

    Urinary bladder functions for the storage and expulsion of urine. Foreign bodies in male urinary bladder are rare due to lengthy urethra, especially when they are rounded in shape and difficult to be introduced into urinary bladder. This is a case report of a middle age male with thin body habitus and slightly disturbed psychiatric status. He presented with both irritative and obstructive lower urinary tract symptoms (LUTS). He was investigated and found to have an intact bangle in the urinary bladder. The patient was planned for surgery, and the foreign body was removed endoscopically with the help of cystoscope. Later on the patient was referred to a psychiatrist for psychological management.

  20. [Capsaicin and lidocaine usage in functional disorders of urinary bladder].

    PubMed

    Juszczak, Kajetan; Thor, Piotr J

    2011-01-01

    Most of the drugs in the treatment of functional disorders of the urinary bladder has a peripheral effect. Their work consists mainly in reducing detrusor contractility of the bladder, or effects on the afferent innervation. Anticholinergics are the first drugs of choice. An alternative pharmacological treatment is to eliminate the overactivity by acting on the bladder afferent innervation, while not inhibiting its contractility. One option is to modulate the pharmacological activity of sensory mechanisms governing the functioning of the bladder via the vanilloid receptor (TRPV1) and ancyrin (TRPA1). Intravesical treatment with capsaicin or lidocaine only partially reduces bladder sensation. Furthermore, clinical use of lidocaine in the treatment of overactive bladder (OAB) is reduced to intravesical supply before capsaicin instillation to reduce the symptoms associated with initial phase of C-fibres sensitization. This paper presents the current state of knowledge regarding the use of capsaicin and lidocaine in functional disorders of the urinary bladder, as well as discusses the impact of these substances on afferent C-fibres and the activity of the urinary bladder. Based on previous studies intravesical capsaicin and lidocaine therapy is one of the alternative treatment options in selected patients with functional disorders of the urinary bladder (in particular OAB) in addition to standard anticholinergics therapy or the newer generation of therapies using botulinum toxin.