The role of urodynamics in the evaluation of voiding dysfunction in men after cerebrovascular accident

PURPOSE: The etiology of voiding dysfunction was determined in men after a cerebrovascular accident who were at risk for obstructive uropathy to evaluate whether the cause of voiding dysfunction could be predicted by the type (obstructive or irritative) or onset of symptoms. MATERIALS AND METHODS: We evaluated 38 men with complaints of voiding dysfunction following a cerebrovascular accident. All patients were of the age when bladder outlet obstruction secondary to benign prostatic hyperplasia would otherwise be prevalent. After a comprehensive history and physical examination, all patients underwent multichannel urodynamic studies at a medium fill rate (20 to 50 ml. per minute). Findings were classified by the Abrams-Griffiths nomogram as obstruction, no obstruction or equivocal. RESULTS: Mean patient age was 70 years (range 54 to 87). Patients were grouped according to the presenting voiding complaints (purely irritative in 42%, purely obstructive in 34% or mixed in 24%). In 34 patients (89%) the onset of symptoms paralleled the occurrence of the cerebrovascular accident. Detrusor hyperreflexia was noted in 82% of the patients. There was no statistically significant difference in the occurrence of detrusor hyperreflexia among the 3 symptom groups (Fisher's exact test). Pressure-flow analysis clearly showed obstruction in 24 patients (63%), no obstruction in 9 (24%) and equivocal results in 5 (13%) according to the nomogram. There was no statistically significant difference in the incidence of obstruction among the 3 symptom groups (Fisher's exact test). CONCLUSIONS: Presenting symptoms did not predict the urodynamic findings of bladder outlet obstruction or detrusor hyperreflexia. The significant incidence of onset of symptoms after stroke suggests that the cerebrovascular accident induced voiding dysfunction in the face of preexisting bladder outlet obstruction may exacerbate the symptoms of the latter condition or vice versa.     

The relationship of IL-6 to hormonal mediators, fuel utilization, and systemic hypermetabolism after surgical trauma

OBJECTIVES: To define the relationship between inflammatory cytokines, hormonal mediators, alteration of energy substrate and hypermetabolism during the early phase after surgical trauma. DESIGN: A prospective case-control study of 13 patients underwent elective surgery for carcinoma between November 1993 and January 1995. MATERIALS AND METHODS: They received parenteral supply of adequate glucose and amino acids through central venous catheter after surgery equally. Inflammatory cytokines such as TNF- alpha, IL-1 and IL-6, stress hormones such as norepinephrine, glucagon and insulin, and fuel utilization and hypermetabolism variables such as resting energy expenditure (REE), CRP, free fatty acid, respiratory quotient, the calculated rates of glucose and fat oxidation using indirect calorimetry were measured serially (the day before operation, the end of surgery, and postoperative day (POD) 1, 2 and 5). MEASUREMENTS AND MAIN RESULTS: TNF- alpha and IL-1 were not detected during the study period. Initial elevation and steady decline of IL-6 concentrations were seen after surgical injury, and this response related significantly to post-operative norepinephrine and glucagon levels throughout the study period, and to insulin levels only at the end of surgery. %REE (REE/BEEHB; basal energy expenditure according to the Harris-Benedict equation) on POD 2 and 5, and all CRP levels after surgery were significantly related to IL-6 levels more than hormone levels. Fuel utilization variables on POD 2 were related to both IL-6 and hormone levels. CONCLUSIONS: Initial elevation of IL-6 concentration might induce stress hormones such as norepinephrine and glucagon, but not insulin after surgical trauma. Moreover not only hormonal mediators but also cytokine such as IL-6 are responsible for the development of the stress response of the alteration of energy substrate and hypermetabolism.     

Instron texture profile of buffalo milk cheddar cheese as influenced by composition and ripening changes

Buffalo milk Cheddar cheese samples of different ages were analysed for compositional attributes (CA), ripening indices (RI) and Instron Textural Profile (ITP). All samples were compositionally alike, except for pH and salt-in-moisture (SM) contents. RI showed significant variations. CA and RI showed highly significant correlations within themselves and with each other, except for moisture with pH, SM with moisture, MNFS, Fat and FDM and Fat with MNFS. The ITPs of cheeses showed significant variations and had highly significant intercorrelations indicating their interdependence. CA (except moisture and MNFS) and RI showed a highly significant correlationship with ITPs. Moisture content showed a highly significant correlationship with all ITPs, except cohesiveness and springiness, where it was significant. MNFS content showed significant correlations only with hardness and brittleness. Stepwise regression analysis revealed that MI was the most predominant factor influencing cheese texture, followed by pH, SM, FDM and TVFA. Knowing Ca and RI, the textural properties of cheeses can be forecast through mathematical equations. Similarly the age of cheese can also be predicted if RI and/or textural properties are known.     

Growth and characterization of hot-wall epitaxial CdTe on (111) HgCdTe and CdZnTe substrates

Thin CdTe films were deposited by hot-wall epitaxy (HWE) on (111) HgCdTe and CdZnTe substrates at temperatures from about 140 to 335°C. X-ray rocking curves were used to show that crystal quality of the CdTe (111)B films improved as substrate temperature increased from 140 to about 250°C. Rocking curve values for full width at half maximum (FWHM) decreased from 2–4 degrees at 140–150°C to less than 100 arc-s at 250°C, and a FWHM of 59 arc-s was the lowest value observed near 250°C. The FWHM of the HWE CdTe was found to be insensitive to growth rate below about 400Å/min, but increased to four degrees at 1250Å/min. X-ray diffraction confirmed that films grown on the B-face at higher temperatures were epitaxial, but contained a significant volume fraction, 35% to 50%, of rotational in-plane twins. Electron microscopy confirmed a coarse twin density, and photoluminescence spectra showed an absence of excitonic emission in the HWE films. Simultaneous growth on two (111) HgCdTe substrates with different surface polarities between 230°C and 335°C showed that deposition rate on the A-face decreased relative to that on the B-face as temperature increased. Films grown on the B-face exhibited better surface morphologies than those grown on the A-face.     

Aromatic nitrations by mixed acid. Slow liquid-liquid reaction regime

Aromatic nitrations by mixed acid have been selected as a specific case of a heterogeneous liquid-liquid reaction. An extensive experimental programme has been followed using adiabatic and heat-flow calorimetry and pilot reactor experiments, supported by chemical analysis. A series of nitration experiments has been carried out to study the influences of different initial and operating conditions such as temperature, stirring speed and sulphuric acid concentration. In parallel, a mathematical model to predict the overall conversion rate has been developed. In this paper the mathematical modelling and the implementation and experimental validation for benzene, toluene and chlorobenzene mononitration in the kinetic control regime (slow liquid-liquid reaction) are presented and discussed.     

Construction of the plasmid PMEX8-HAK1 and random site-directed mutagenesis of human cytosolic adenylate kinase

The pMEX8-hAK1 vector was devised from the pAK plasmid (Kim J. H. et al., 1989, Protein Engineering 5, 379-386), which could directly express human adenylate kinase proteins without recombination and its single strand DNA could be withdrawn with helper phage for random site-directed mutagenesis. The conserved key residues at Lys21, Lys27, and Thr39 were engineered to obtain mutants for kinetic analysis. Three mutants were obtained as K21P, K27R, and T39S, their specific activities were strikingly reduced compared to those of wild type adenylate kinase. This pMEX8-hAK1 will be a powerful tool for site-directed mutagenesis to detect the substrate-enzyme interaction for human adenylate kinase including various other enzymes.     

Electro-optic sampling system for the testing of high-speedintegrated circuits using a free running solid-state laser

This paper deals with the indirect electro-optic sampling technique for the low-invasive detection of periodical voltage waveforms on lines in high-speed integrated circuits. The system introduced here is based on a passive mode-coupled Ti:Sapphire-Laser as light source for generating optical pulses in the subpicosecond regime. Therefore, we have to synchronize the resulting electric measurement signal and its external trigger onto the pulse repetition rate of this free running solid-state laser. The multi user function of the laser system forces us to transmit the pulses via a single-mode fiber into the measurement setup. For that purpose we developed a special optical arrangement to minimize the widening of the pulses in the time domain. The system's high-temporal resolution of nearly 10 ps in combination with its high-voltage sensitivity of about 800 μV/√(Hz) is demonstrated by measurements of an integrated microwave frequency divider     

The error probability of M-ary PSK block coded modulation schemes

A tight upper bound on the decoding error probability is derived for block-coded modulation structures where an M-ary phase shift keying (M-PSK) signal constellation is employed. This bound, called a tangential sphere bound, is tight for very low (as well as for high) signal-to-noise ratios (SNRs). Berlekamp's tangential union bound, previously derived for binary codes, can be derived for an M-PSK block coded modulation structure as well. However, it is proven that our tangential sphere bound is tighter than Berlekamp's (1980) tangential bound. For particular schemes, it is shown that for low SNRs our bound is considerably tighter than the tangential bound. As one of the examples, a multistage decoder is considered     

Measurements of Stress Intensity Factors of an Interface Crack Under Mixed Mode Loading

The optical method of caustics has been utilised to measure both the stress intensity factor for a crack lying along the interface of an aluminium/epoxy bimaterial specimen, and the mode mixity arising from the difference in the elastic properties across the interface. Measurements were carried out by using a novel modification to the method whereby caustics are produced and measured from both sides of the specimen, so compensating automatically for the distortion induced in the specimen due to misaligned loading fixtures. A flat reflective surface across the interface was obtained by adhering a reflective coating to the specimen. Verification that this coating does not affect measurement accuracy was obtained by comparing stress intensity factors measured from coated and uncoated monolithic aluminium specimens where good agreement was found to exist between both measurements.