Transcutaneous electrical nerve stimulation and temporary S3 neuromodulation in idiopathic detrusor instability

PURPOSE: We studied the effects of electrical stimulation on idiopathic detrusor instability. MATERIALS AND METHODS: Between January 1993 and December 1994, 30 men and 41 women (mean age plus or minus standard deviation 48 +/- 16 years) underwent transcutaneous electrical nerve stimulation (TENS) of the S2-S3 dermatomes, and 13 men and 22 women (mean age 48 +/- 12 years) underwent S3 neuromodulation. Subjective assessment was performed using a diary and symptom score of 0 to 14. Objective outcome was analyzed with urodynamic studies. RESULTS: Mean duration of TENS was 3 +/- 1 weeks (range 2 to 4). Although there were no major complications 31% of the patients reported local skin irritation. The overall urinary symptom scores improved from 10 +/- 2 (range 5 to 14) before the study to 7 +/- 3 (range 1 to 14) during stimulation. Urodynamic analysis revealed significant (p < 0.05) improvements in total bladder capacity and voided volume, and decreases in the number and frequency of unstable contractions. Mean duration of S3 neuromodulation was 6 +/- 1 days (range 4 to 8 days). Four procedures failed due to electrode displacement in 3 cases and procedure intolerance in 1. Hemorrhage from the puncture site occurred in 1 patient. Overall urinary symptom scores were 10 +/- 3 (range 5 to 14) before the study and 5 +/- 2 (range 2 to 10) during stimulation. Although symptomatic relief was more pronounced with S3 neuromodulation, no statistically significant differences were found regarding urinary symptoms compared to TENS. CONCLUSIONS: In patients with severe detrusor instability refractory to conservative treatments the use of TENS and S3 neuromodulation produced significant changes in urodynamic parameters and presenting symptoms. Our results appear to justify evaluation with neuromodulatory techniques before definitive surgical intervention in these patients.     

Electrocatalysis of methanol,ethanol and formic acid using a Ru/Pt metallic bilayer

This work describes the methanol, ethanol and formic acid oxidation using a metallic bilayer electrodeposited on a platinum substrate. Firstly, one monolayer of ruthenium was deposited on the substrate and over it a 1.1 layer of metallic platinum. In the blank solution it was observed that the electrochemical behavior of both the Pt/Ru/Pt and bulk Pt were very similar, except in the oxygen evolution potential region. Using X-ray photoelectronic spectroscopy (XPS) it was not possible to identify the presence of Ru atoms on the bilayer surface. The electroactive area and the RMS roughness factor measured with atomic force microscopy (AFM) for both materials are the same. A CO monolayer oxidation procedure confirmed that the systems have the same real surface area and also showed a shift in the negative direction for 54 mV on the CO peak potential for the bilayer. For the voltammetric organic molecules oxidation, an enhancement in the current densities of 350, 390 and 420% was observed for ethanol, methanol and formic acid, respectively, for the bilayer system compared to the bulk Pt electrodes. Also, a decrease of 110 mV in the beginning of the ethanol oxidation process was observed over the bilayer system compared to bulk Pt.     

Refined theory for the analysis of laminated orthotropic structures

A new higher-order theory for the analysis of laminated orthotropic plates and shells subject to both mechanical and thermal loads is developed. Using the variational approach the system of governing differential equations and corresponding boundary conditions are derived. Two refined models of the stress and strain state are considered, their application and accuracy are discussed. The analytical solution is obtained for plates and shells with the Navier boundary conditions on the side surfaces. The results of calculations are given and compared with an exact three-dimensional solution available in the literature. The influence of the laminated structure upon the exactness of results and the characteristics of stress–strain state is studied and discussed.     

Housing Affordability in Singapore: Can We Move from Public to Private Housing?

With 84 per cent of the Singapore resident population housed in public housing, the ultimate dream for many is to move into private housing, which is generally considered to offer better quality and more exclusive living. This article is concerned with the enabling factors of affordability in housing mobility. It examines the Singapore public housing homeowners' affordability of private housing, suggesting a measure of that affordability. The survey findings indicate that only a small percentage of public homeowners can afford to move to median-priced private apartments. The number is even smaller for the relatively more expensive landed housing with own garden. On a theoretical level, the study demonstrates that the use of multiple methods to measure housing affordability is beneficial as more affordability determinants are included in the measurement.     

Diagnostic testing for Prader-Willi and Angelman syndromes: response

Between 1992 and 1997, every year, approximately 30,000 examinations of the liver and bile ducts were done. Addition of colour Doppler imaging improves safety of procedures and allowed to perform ultrasound guided biopsy in 73 patients. On the basis of our experience we state that colour Doppler sonography guided percutaneous fine needle biopsy of the liver is useful, sufficient and safety diagnostic method of abscesses, cysts and malignant tumours of the liver.     

Management guidelines for progressive chronic renal failure. New Zealand Nephrologists Consensus Group

Consensus guidelines are provided for the conservative management of adult patients with chronic and progressive renal failure, together with a brief review of the evidence relating to various treatable complications. Blood pressure control, diet, hyperlipidaemia, calcium and phosphate metabolism, anaemia and acidosis are considered.     

Gray-box identification of dynamic models for the bleaching operation in a pulp mill

The development and application of gray-box identification techniques for modelling the bleaching operation in a Bleached Chemi-Thermo Mechanical Pulp (BCTMP) mill are explained. The process is characterized as a delay dominant recycle process with significant input nonlinearities. The identification was carried out using routine operating data in which the outputs were measured irregularly. The effects of these characteristics and consequent modifications of the system identification techniques are discussed. The resulting models are being used for online prediction and model-based controller design at the mill with satisfactory performance.     

Three‐dimensional flow dynamics around deflectors

Many river rehabilitation projects to enhance the aquatic habitat focus on the creation of pool and riffle habitat by the implementation of flow deflectors, with various degrees of successes and failures. A more comprehensive understanding of the complex three‐dimensional flow dynamics that induces scour around instream structures is required for a more effective design. The objective of this study is to examine the three‐dimensional mean and turbulent flow characteristics around paired flow deflectors for various types of deflector design in a laboratory flume. Three deflector angles (45°, 90° and 135°) and two deflector heights (with flow under and over the deflector height) were tested over a smooth (plexiglas) bed and a sand bed. Three‐dimensional velocity measurements were taken with an acoustic Doppler velocimeter at several planform positions at two heights above the bed. Results show that the 90° deflectors create the most important disturbance in the mean flow field, in turbulence intensity and bed shear stress. There is, however, a marked difference in the spatial distribution of the mean and turbulent parameters over a mobile bed and over a smooth, fixed bed. This stresses the importance of understanding the feedback between bed topography and flow dynamics and limits the applicability of conclusions drawn from plane bed experiments to natural rivers. Copyright © 2005 John Wiley & Sons, Ltd.     

Exact polarised rib waveguide analysis

An exact Fourier operator transform method (F-OPT) is presented for finding the polarised mode propagation constants of a rib waveguide with any number of supporting layers and an arbitrary cladding. The implementation is of the order of one hundred times faster than the finite difference method for the same accuracy of the normalised propagation constant