Comparative study of the treatment of prostatic adenoma: laser photocoagulation versus endoscopic resection

OBJECTIVE: Resection of the prostate using a Nd YAG laser is designed to destroy benign prostatic hyperplasia responsible for bladder neck obstruction. This technique is currently under investigation. PATIENTS AND TECHNIQUE: A total of 56 patients, with a minimal follow-up of 6 months and presenting indications for endoscopic resection of the prostate were treated by TULIP [22] or VLAP [34] laser coagulation. The objective and subjective results were compared to a group of patients [30] treated by endoscopic resection during the same period. Results are expressed as the percentage of patient responding to treatment in terms of objective (peak flow rate > 15 ml/s with improvement > 30% or between 12 and 15 ml, but improvement > 50%) and subjective parameters (IPSS < 7 and improvement > 30% or between 7 and 10, but improvement < 50%). RESULTS: With a minimal follow-up of 6 months, the objective response rates were 55.5% (TULIP), 84.6% (VLAP) and 83.2% (TURP), while the subjective response rates were 55.5% (TULIP), 92.3% (VLAP) and 83.3% (TURP). The hospital stay was significantly shorter in the laser group (2.1 VLAP and 3.3 TULIP; 4.93 TURP). In the TULIP group, 3 patients were incontinent and 4 developed chronic prostatitis. At 6 months, 4 patients in the VLAP group and 6 patients in the TULIP group had to undergo a complementary TURP. CONCLUSION: These results indicate that laser photocoagulation is effective in the treatment of benign prostatic hyperplasia. The VLAP technique appears to be better adapted to this indication. The benefit of VLAP will be more clearly demonstrated by the randomized study currently underway, provided the length of hospital stay, postoperative complications and cost-effectiveness ratio are taken into account. In contrast, the TULIP system is associated with numerous complications which appear to be unacceptable.     

Direct electrooxidation of methanol on highly dispersed platinum-based catalyst electrodes: temperature effect

The direct electrooxidation of methanol in acid medium was studied on electrodes made of a perfluorinated membrane with small amounts of metal catalysts incorporated by chemical reduction. Platinum is a good electrocatalyst for this reaction, but needs to be modified by other metals in order to obtain oxidation potentials much more compatible with a working anode in a direct methanol fuel cell. Ruthenium and tin appear to give encouraging results, leading to a negative shift of more than 250 mV as compared to the potential obtained with pure platinum. Other parameters were investigated in this work, such as the working temperature, and the manner of introduction of the methanol into the cell. By gaseous supply, it was possible to carry out measurements at higher temperatures than with methanol in solution, and consequently to greatly improve the performance of the catalytic electrode.     

Operations standards for global ATM networks: network element view

The International Telecommunication Union (ITU) has completed work on a series of standards on asynchronous transfer mode (ATM) equipment functional operations and network element management. The objective of these standards is to enable flexible design and interoperability of network elements for use in a global ATM network, independent of any specific implementation. This article discusses these standards with respect to their development and application in planning ATM networks. Specifically, it addresses the following: the modeling approach taken in the development of the ITU standards, key operational features specified in the ATM network element functional model, and the capabilities of the ATM network element management interface. Examples of ATM equipment are provided to illustrate how the functional models specified in the ITU standards may be used by network planners and equipment manufacturers to specify and develop ATM equipment tailored to specific needs, while ensuring network interoperability. The article concludes with some points on the future enhancement of these and related ATM equipment operations standards     

Nephrotic syndrome. What is new since the 1988 study?

Hormone-refractory prostate cancer (HRPC) patients often have nonmeasurable disease. In such patients, predictive biomarkers other than tumor response may be required to compare therapeutic effects. We examined the predictive value for survival of various clinical and laboratory parameters, including prostate-specific antigen (PSA), in HRPC patients treated with suramin. Data from 103 HRPC patients were analyzed using various survival analyses, the likelihood ratio approach, and logistic regression analyses. When pretreatment factors, percentage decrease in PSA at 4 weeks from start of treatment (deltaPSA), and updated survival data were fit by a multivariate Cox proportional hazards model, acid phosphatase, lactate dehydrogenase, and deltaPSA were significant, with risk ratios close to 1. There was a decrease in likelihood ratio with increasing APSA. A logistic regression model was developed to predict the probability of <1 year of survival from the start of treatment. Hemoglobin and deltaPSA were found to be significant variables. However, in view of the complexities involving the relationship between PSA expression and prostate cancer growth and possible selective effect of treatment on PSA, further prospective testing is necessary. Therefore, deltaPSA cannot necessarily be used as a biomarker for survival response in individual patients during the evaluation of the therapeutic response of HRPC to new antineoplastic drugs.     

Electrooxidation of methanol at platinum–ruthenium catalysts prepared from colloidal precursors: Atomic composition and temperature effects

The electrocatalytic oxidation of methanol was investigated on PtRu electrodes of different atomic compositions at several temperatures (from 25 to 110 °C). Very active catalyst nanoparticles supported on active carbon (Vulcan XC 72) were obtained using the colloidal synthesis developed by Bönnemann et al. [11], allowing easy variation of the atomic composition. These electrocatalysts were characterized by TEM, EDX and XRD; results indicate that they consist of platinum nanoparticles decorated by ruthenium. Methanol oxidation was studied as a function of composition, temperature and methanol concentration. Two effects were investigated: the effect of the working temperature and the effect of the atomic composition. It appeared that for lower methanol electrooxidation overvoltages, the best catalysts are ruthenium-rich, whereas at higher overvoltages the best one is the Pt + Ru (80:20)/C composition, irrespective of the working temperature, either in half-cell or in a single DMFC.     

Enhancement of the electrooxidation of ethanol on a Pt–PEM electrode modified by tin. Part I: Half cell study

The direct platinisation of a solid polymer electrolyte (Nafion^® membrane) was realized by chemical reduction of a platinum salt. The Pt–PEM electrodes thus obtained were modified by tin to improve the electrocatalytic activity towards the electrooxidation of ethanol. The Pt–PEM and Pt–Sn–PEM electrodes were characterized by TEM, EDX and XRD analysis, cyclic voltammetry, and their polarisation curves for the electrooxidation of ethanol were determined under quasisteady state conditions.     

An efficient and generic extension to ITK to process arbitrary shaped regions of interest

The paper describes a software method to extend ITK (Insight ToolKit, supported by the National Library of Medicine), leading to ITK++. This method, which is based on the extension of the iterator design pattern, allows the processing of regions of interest with arbitrary shapes, without modifying the existing ITK code. We experimentally evaluate this work by considering the practical case of the liver vessel segmentation from CT-scan images, where it is pertinent to constrain processings to the liver area. Experimental results clearly prove the interest of this work: for instance, the anisotropic filtering of this area is performed in only 16 s with our proposed solution, while it takes 52 s using the native ITK framework. A major advantage of this method is that only add-ons are performed: this facilitates the further evaluation of ITK++ while preserving the native ITK framework.     

Electrochemical and spontaneous deposition of ruthenium at platinum electrodes for methanol oxidation: an electrochemical quartz crystal microbalance study

PtRu electrodes with Ru surface concentration ranging from 20 to 50% were prepared by electrolysis of Ru(NO)(NO₃)₃ at a constant potential and/or by spontaneous Ru deposition performed at open circuit potential from a RuCl₃ solution. The amount of either spontaneously or electrochemically deposited ruthenium on the platinum electrode was determined by means of an electrochemical quartz crystal microbalance (EQCM). The effect of the Ru surface concentration on the rate of methanol electrooxidation was also investigated and correlated to the EQCM measurements.