Sample records for diagnostic techniques urological

  1. Changes in urological surgical techniques

    Oktay Üçer


    Full Text Available Recently, laparoscopic and afterwards robotic techniques have constituted most of urologic surgery procedures. Open surgery may give place to robotic surgery due to possible widespread use of robots in the future. Studies, that compare these two techniques are usually designed about radical prostatectomy, since it is the most common operation performed by using these techniques. In literature,robotic surgery seems more advantageous than other techniques but the most important disadvantage of this technique is cost-effective problems. In present review,history of open, laparoscopic and robotic surgery, and comparison of advantages, disadvantages and cost of these techniques have been discussed with literature.

  2. Urological conditions in pregnancy: a diagnostic and therapeutic challenge.

    Shrotri, K N; Morrison, I D; Shrotri, N C


    Urological conditions in pregnancy represent a major diagnostic and therapeutic challenge. The potential adverse effects of anaesthesia, radiation and drugs on the fetus often complicate traditional diagnostic and treatment measures. As frontline clinicians, obstetricians need an awareness of symptoms, associated obstetric complications and an appreciation of available current diagnostic and therapeutic modalities and their associated risks. This article describes common urinary problems encountered in pregnancy: infection, hydronephrosis and urolithiasis specifically. The aim of this paper is to review the safety, efficacy and role of different imaging studies available for the diagnosis of urolithiasis in pregnancy. Conservative management as first line treatment and a variety of interventional urological procedures with postoperative management are also discussed. Such a background may facilitate a rational management protocol for urological problems in a pregnant woman.

  3. [Transparency regime: semiotics of radiographical images in urological diagnostics].

    Martin, M; Fangerau, H


    Shortly after Röntgen discovered x-rays urology became one of the main test fields for the application of this new technology. Initial scepticism among physicians, who were inclined to cling to traditional manual methods of diagnosing, was replaced by enthusiasm for radiographic technologies and the new method soon became the standard in, for example the diagnosis of concrements. Patients favoring radiographic procedures over the use of probes and a convincing documentation of stones in radiograms were factors that impacted the relatively rapid integration of radiology into urology. The radiographic representation of soft tissues and body cavities was more difficult and the development of contrast agents in particular posed a serious problem. Several patients died during this research. A new diagnostic dimension was revealed when radiography and cystography were combined to form the method of retrograde pyelography. However, the problem of how urologists could learn how to read the new images remained. In order to allow trainee physicians to practice interpreting radiograms atlases were produced which offered explanatory texts and drawings for radiographic images of the kidneys, the bladder etc. Thus, urologists developed a self-contained semiotics which facilitated the appropriation of a unique urological radiographical gaze.

  4. Near-infrared fluorescence with indocyanine green for diagnostics in urology: initial experience.

    Morozov, Andrey O; Alyaev, Yuri G; Rapoport, Leonid M; Tsarichenko, Dmitrii G; Bezrukov, Eugene A; Butnaru, Denis V; Sirota, Eugene S


    Fluorescence imaging with indocyanine green is used in urology for the detection of sentinel lymph nodes and identification of prostate margins in radical prostatectomy for delineation of resection zone and selective clamping of vessels in partial nephrectomy; for identification and evaluation of length of ureteral strictures; for assessment of perfusion and viability of anastomoses during reconstructive stage of cystectomy. Safety of this technique is proven, while its diagnostic value and usefulness is still controversial. This pilot study of using the SPY Elite Fluorescence Imaging System for diagnostics was performed in the I.M. Sechenov First Moscow State Medical University. Ten patients were enrolled: four patients underwent retropubic RP and lymph node dissection, five patients underwent partial nephrectomy, and one patient underwent ureteroplasty. Fluorophore was injected transrectally with TRUS guidance during RP in order to assess the lymph nodes. During partial nephrectomy, the compound was injected intravenously to differentiate the tumor from parenchyma by its blood supply. During ureteroplasty, the indocyanine green solution was injected into the renal pelvis to dye the ureter and locate the stricture. Sensitivity of this technique for visualization of sentinel lymph nodes was 100%, and specificity was 73.3%. In patients who underwent partial nephrectomy, all lesions were malignant and hypofluorescent when compared with healthy parenchyma. SPY allowed us to determine the location and extension of the stricture during ureteroplasty. No hypersensitivity reactions or complications were observed during injection of the compound.

  5. Nanotechnology in Urology

    Jayasimha, Sudhindra


    Introduction: Nanotechnology has revolutionized our approach to medical diagnostics as well as therapeutics and has spanned an entirely new branch of research. This review addresses the potential applications of Nanotechnology in Urology. This article is based on the Dr. Sitharaman Best Essay award of the Urological Society of India for 2016. Methods: A PubMed search was performed for all relevant articles using the terms, “nanotechnology, nanoparticles, nanoshells, nanoscaffolds, and nanofibers.” Results: The developments in diagnostics include novel techniques of imaging of genitourinary malignancies, prostate-specific antigen measurement, early detection of mutations that are diagnostic for polycystic kidney disease. The potential applications of nanotechnology are in the targeted therapy of genitourinary malignancies, erectile dysfunction, overactive bladder, bladder reconstruction, construction of artificial kidneys and biodegradable stents as well as in robotic surgery. Conclusions: Nanotechnology is a rapidly emerging branch of research in urology with diverse and clinically significant applications in diagnostics as well as therapeutics. PMID:28197024

  6. [Hernia surgery in urology. Part 2: parastomal, trocar and incisional hernias - fundamentals of clinical diagnostics and treatment].

    Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U


    Hernias are a common occurrence with a correspondingly huge clinical and economic impact on the healthcare system. Parastomal and trocar hernias are rare in routine urological work. The therapy of parastomal hernias remains problematic but basically the surgeon is able to use conventional techniques with suture repair or procedures with mesh implantation. The conventional parastomal hernia repair with mesh can be classified into sublay, onlay and intraperitoneal techniques. Furthermore, a relocation of the stoma is possible. Trocar hernias represent a rare but hazardous complication. Due to the increase in keyhole surgery there is also the danger of a rise in their occurrence. Incisional hernias occur frequently in patients who have undergone laparotomy and for repair different surgical techniques and types of meshes are available. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostic and therapy of parastomal, trocar and incisional hernias.

  7. Evolution of urological imaging.

    Bueschen, Anton J; Lockhart, Mark E


    The evolution of urological imaging has had a major impact on the diagnosis and treatment of urological diseases since the discovery of the X-ray by Roentgen in 1895. Early developments included plain films of the abdomen, retrograde urographic techniques, development of contrast media, excretory urography, renal mass puncture, renal angiography, cystography and nuclear medicine procedures. These procedures led to the maturation of the specialties of diagnostic radiology and urology, and the development of the subspecialties of pediatric urology and urological radiology during the first seven decades of the 20th century. Subsequently, many imaging advances have occurred leading to changes in diagnosis and management of urological patients. Ultrasound and cross-sectional imaging technologies (computed tomography and magnetic resonance imaging) are increasingly applied in urological evaluation, treatment and surveillance. Current developments include dual energy computed tomography, positron emission tomography computed tomography, renal donor and renal transplant imaging, prostate magnetic resonance imaging, and microbubble contrast enhanced ultrasound. Imaging advances will continue. It is the responsibility of all physicians to assess the advantages of new developments while weighing those advantages against the additional radiation exposure and the costs associated with new procedures.

  8. Optical coherence tomography diagnostics for onco–urology. Review of clinical perspectives

    Sergiy Kharchenko


    Full Text Available Introduction. Optical coherence tomography (OCT is being investigated widely for use in urologic pathology. The current imaging of urogenital cancers cannot be perfect, thus, routine methods demands new updates or inventions of alternative radiological scope. OCT presents so–called “live” optical biopsy. The authors aim to review this modality for uro–oncological purposes.Matherial and methods. A series of 37 publications between 1989 and 2012 was selected and cited from GoogleScholar and PubMED/MEDLINE. The urogenital tract (bladder, ureter, scrotum organs and prostate was imaged by OCT.Results. The overall OCT sensitivity, specificity, accuracy, negative and positive predictive values ranged a lot on example of the urinary bladder’s tumors screening. The data were 75–100%, 65–97.9%, 92%, 75%, 100%, respectively. Notwithstanding, a diagnostic importance of OCT may be comparable with urine cytology, cystoscopy, computerized tomography and magnetic resonance imaging.Conclusions. OCT demonstrated its imaging potential, while till the present OCT plays role of an additional imaging. Future progress of OCT involvement in experimental and clinical once–urological diagnostics is needed under high evidence control.

  9. Imaging Techniques for Microwave Diagnostics

    Donne, T. [FOM-Institute for Plasma Physics Rijnhuizen, Trilateral Euregio Cluster, PO Box 1207, 3430 BE Nieuwegein (Netherlands); Luhmann Jr, N.C. [University of California, Davis, CA 95616 (United States); Park, H.K. [POSTECH, Pohang, Gyeongbuk 790-784 (Korea, Republic of); Tobias, B.


    Advances in microwave technology have made it possible to develop a new generation of microwave imaging diagnostics for measuring the parameters of magnetic fusion devices. The most prominent of these diagnostics is electron cyclotron emission imaging (ECE-I). After the first generation of ECE-I diagnostics utilized at the TEXT-U, RTP and TEXTOR tokamaks and the LHD stellarator, new systems have recently come into operation on ASDEX-UG and DIII-D, soon to be followed by a system on KSTAR. The DIII-D and KSTAR systems feature dual imaging arrays that observe different parts of the plasma. The ECE-I diagnostic yields two-dimensional movies of the electron temperature in the plasma and has given already new insights into the physics of sawtooth oscillations, tearing modes and edge localized modes. Microwave Imaging Reflectometry (MIR) is used on LHD to measure electron density fluctuations. A pilot MIR system has been tested at TEXTOR and, based on the promising results, a new system is now under design for KSTAR. The system at TEXTOR was used to measure the plasma rotation velocity. The system at KSTAR and also the one on LHD will be/are used for measuring the profile of the electron density fluctuations in the plasma. Other microwave imaging diagnostics are phase imaging interferometry, and imaging microwave scattering. The emphasis in this paper will be largely focused on ECE-I. First an overview of the advances in microwave technology are discussed, followed by a description of a typical ECE-I system along with some typical experimental results. Also the utilization of imaging techniques in other types of microwave diagnostics will be briefly reviewed. This document is composed of the slides of the presentation. (authors)

  10. [Hernia surgery in urology: part 1: inguinal, femoral and umbilical hernias - fundamentals of clinical diagnostics and treatment].

    Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U


    Hernias are a common occurrence with correspondingly huge clinical and economic impacts on the healthcare system. The most common forms of hernia which need to be diagnosed and treated in routine urological work are inguinal and umbilical hernias. With the objective of reconstructing and stabilizing the inguinal canal there are the possibilities of open and minimally invasive surgery and both methods can be performed with suture or mesh repair. Indications for surgery of umbilical hernias are infrequent although this is possible with little effort under local anesthesia. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostics and therapy of inguinal, femoral and umbilical hernias.

  11. Advanced urology nursing practice.

    Crowe, Helen


    Urology nursing has developed as a specialty over the past few decades in response to several factors, workload demands being a prime reason. Nurses are taking on additional roles and activities including procedures such as cystoscopy and prostate biopsy, and running nurse-led clinics for a variety of urological conditions. Audits of advanced urological nursing practice have shown this care to be of a high standard and investigative procedures performed by these nurses match the diagnostic quality of existing services. Professional urological nursing organizations support the professional needs of these nurses, but the provision of education and training for advanced practice activities remains an unaddressed need. A range of confusing advanced urology nursing titles exists, and uncertainty regarding the roles and scope of practice for these nurses remains a concern. Acceptance and support from medical colleagues is required for the success of advanced urological nursing practice, but opinions on these roles remain divided.

  12. Nanotechnology in Disease Diagnostic Techniques.

    Savaliya, Reema; Shah, Darshini; Singh, Ragini; Kumar, Ashutosh; Shankar, Rishi; Dhawan, Alok; Singh, Sanjay


    Currently the major research highlights of bioengineering and medical technology are directed towards development of improved diagnostic techniques to screen complex diseases. Screening requirements are for the identification of the cause of illnesses, monitoring the improvement or progression of the state of diseases such as cancer, cardiovascular or neurodegenerative diseases. Nanotechnology enables the manipulation of materials at nanoscale and has shown potential to enhance sensitivity, selectivity and lower the cost of a diagnosis. The causative biomolecules (DNA, proteins) can be detected by red-shifted absorbance of gold nanoparticles or alteration in the conductance of a nanowire or nanotubes, and deflection of a micro or nano-cantilever. Several types of nanomaterials such as metals, metal-oxides and quantum dots have shown ample advantages over traditional diagnosis, intracellular labeling and visualization of target cells/tissues. Nanotechnology has also opened several avenues which could be further developed to enable enhanced visualization of tissues, cells, DNA and proteins over a point-of-care device. Protein or gene chips created using nanomaterials could be further be integrated into a convenient nano-fluidic device for better disease diagnosis.

  13. Integrated diagnostic technique for nuclear power plants

    Gofuku, Akio [Graduate School of Natural Science and Technology, Okayama University, Okayama (Japan)


    It is very important to detect and identify small anomalies and component failures for the safe operation of complex and large-scale artifacts such as nuclear power plants. Each diagnostic technique has its own advantages and limitations. These facts inspire us not only to enhance the capability of diagnostic techniques but also to integrate the results of diagnostic subsystems in order to obtain more accurate diagnostic results. The article describes the outline of four diagnostic techniques developed for the condition monitoring of the fast breeder reactor 'Monju'. The techniques are (1) estimation technique of important state variables based on a physical model of the component, (2) a state identification technique by non-linear discrimination function applying SVM (Support Vector Machine), (3) a diagnostic technique applying WT (Wavelet Transformation) to detect changes in the characteristics of measurement signals, and (4) a state identification technique effectively using past cases. In addition, a hybrid diagnostic system in which a final diagnostic result is given by integrating the results from subsystems is introduced, where two sets of values called confidence values and trust values are used. A technique to determine the trust value is investigated under the condition that the confidence value is determined by each subsystem.

  14. Advances in laparoscopic urologic surgery techniques [version 1; referees: 3 approved

    Haidar M. Abdul-Muhsin


    Full Text Available The last two decades witnessed the inception and exponential implementation of key technological advancements in laparoscopic urology. While some of these technologies thrived and became part of daily practice, others are still hindered by major challenges. This review was conducted through a comprehensive literature search in order to highlight some of the most promising technologies in laparoscopic visualization, augmented reality, and insufflation. Additionally, this review will provide an update regarding the current status of single-site and natural orifice surgery in urology.

  15. Survey of Diagnostic Techniques for Dynamic Components


    sensitive to torque fluctuations (19). • NP4 deteriorates as the severity of the damage increases on multiple gear teeth (25). • Crest factor indicates...diagnostic techniques that have been developed for dynamic components such as bearings and gears . There has been a tremendous amount of research... Gears 13  3.1  Diagnostic or Signal Enhancement Techniques ............................................................14  3.2  Time Synchronous Average

  16. [Use of levofloxacin in the antibiotic prophylaxis for diagnostic procedures in urology].

    Trinchieri, Alberto; Mangiarotti, Barbara; Lizzano, Renata


    Chemoprophylaxis is the use of antimicrobial agents before contamination in the hope of preventing infections. The need for prophylaxis depends on the type of procedure and the risk for each individual patient. The risk for infection from urethral catheterization in a hospital setting is 5% for men and 10-20% for women, after routine cystoscopy is 4.7%, after transurethral resection of the bladder (TURB) is 39%, after transurethral resection of the prostate (TURP) is 6-43%, after transrectal biopsy of the prostate is 6.2-87%, and after shock wave lithotripsy is 5.7%. On this basis prophylactic treatment is recommended in all patients for transrectal prostate biopsy and transurethral surgery and in patients with increased risk of infection for diagnostic endoscopy of the urinary tract and SWL. Risk factors such as age, immunosuppression, metabolic dysfunction (e.g., diabetes), reduced general condition, prolonged operative time and bleeding, should be considered. Broad-spectrum cephalosporin, penicillins and fluoroquinolones are most often used. The choice of the drug also depends on its pharmacokinetic properties that should secure effective tissue levels during the procedure. Levofloxacin meets these criteria and reduces the incidence of infection after transrectal prostate biopsy and endoscopy of the urinary tract.

  17. Alternative diagnostic technique for carpal tunnel syndrome

    Hayakawa, Katsuhiko; Nakane, Takashi [Aiko Orthopaedic Hospital, Nagoya (Japan); Kobayashi, Shigeru; Shibata, Kunio [Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine


    Compressive and entrapment neuropathies are common clinical syndromes characterized by neurologic deficits due to mechanical or dynamic compression of peripheral nerves. However, the definitive diagnosis based on clinical symptoms alone is difficult in many cases, and the electrophysiological diagnostic method is solely used as a supplementary diagnostic method at present. As a new diagnostic method for entrapment neuropathy, the present study investigated the usefulness of gadolinium-enhanced MRI in carpal tunnel syndrome. On enhanced MRI of idiopathic carpal tunnel syndrome, contrast-enhancement in the median nerve was found in 30 of 34 hands (88.2%). Enhanced MRI allows to visualize intraneural edema in the nerve easily on the naked eye. Therefore, this technique supplied useful information for making definitive diagnosis and is promising as a non-invasive diagnostic method for entrapment neuropathy. (author)

  18. Novel diagnostic techniques for celiac disease.

    Kurppa, Kalle; Taavela, Juha; Saavalainen, Päivi; Kaukinen, Katri; Lindfors, Katri


    The diagnosis of celiac disease has long been based on the demonstration of gluten-induced small-bowel mucosal damage. However, due to the constantly increasing disease prevalence and limitations in the histology-based criteria there is a pressure towards more serology-based diagnostics. The serological tools are being improved and new non-invasive methods are being developed, but the constantly refined endoscopic and histologic techniques may still prove helpful. Moreover, growing understanding of the disease pathogenesis has led researchers to suggest completely novel approaches to celiac disease diagnostics regardless of disease activity. In this review, we will elucidate the most recent development and possible future innovations in the diagnostic techniques for celiac disease.

  19. Comparative diagnostic techniques for cryptosporidium infection.

    Omoruyi, Beauty E; Nwodo, Uchechukwu U; Udem, Chukwuneke S; Okonkwo, Francis O


    Diarrhoea caused by Cryptosporidium is usually mild in immune competent individuals but severe in the young and those with underlying disease leading to compromised immunity. The conventional diagnosis of Cryptosporidium requires observation of the infective oocysts however, their tiny size yields indistinct results, thus limiting the effectiveness of the conventional diagnostic technique, modified Ziehl-Neelsen (ZN) differential staining. Consequent to the abovementioned limitation, ZN staining, sandwich antigen detection enzyme linked immunosorbent assay (sad-ELISA) and a direct polymerase chain reaction (PCR) assay techniques were evaluated for diagnostic efficacy. Stool samples were collected from 180 consenting adult patients attending outpatient and inpatient clinics at Victoria Hospital, Alice, Eastern Cape Province of South Africa. Subjects were stratified as; 35 HIV-positive and diarrhoeagenic, 125 HIV-negative diarrhoeagenic and 20 apparently healthy controls. Cryptosporidium incidence following diagnostic techniques were 13 (37.1%; ZN staining), 26 (74.3%; sad-ELISA) and 23 (65.7%; PCR), respectively, among HIV-positive diarrhoeagenic patients and 34 (27.2%; ZN staining), 96 (76.8%; sad-ELISA) and 89 (71.2%; PCR) among HIV-negative diarrhoeagenic patients. Sensitivity, specificity and predictive values of the diagnostic techniques' efficiency were: sensitivity: 46.2% (HIV-positive) and 32.3% (HIV-negative) against the ZN technique and 96.9% against sad-ELISA and PCR, respectively, for both HIV-positive and -negative patients; specificity was 88.9% (HIV-positive) and 96.6% (HIV-negative) against the ZN technique. Lastly, the predictive values were 92.3% (HIV-positive) and 96.9% (HIV-negative), respectively, following ZN staining. The sad-ELISA technique proved more suitable for the determination of the presence of Cryptosporidium oocysts. The high incidence of Cryptosporidium in HIV-positive subjects as compared to the HIV-negative population accentuates

  20. Comparative Diagnostic Techniques for Cryptosporidium Infection

    Beauty E. Omoruyi


    Full Text Available Diarrhoea caused by Cryptosporidium is usually mild in immune competent individuals but severe in the young and those with underlying disease leading to compromised immunity. The conventional diagnosis of Cryptosporidium requires observation of the infective oocysts however, their tiny size yields indistinct results, thus limiting the effectiveness of the conventional diagnostic technique, modified Ziehl-Neelsen (ZN differential staining. Consequent to the abovementioned limitation, ZN staining, sandwich antigen detection enzyme linked immunosorbent assay (sad-ELISA and a direct polymerase chain reaction (PCR assay techniques were evaluated for diagnostic efficacy. Stool samples were collected from 180 consenting adult patients attending outpatient and inpatient clinics at Victoria Hospital, Alice, Eastern Cape Province of South Africa. Subjects were stratified as; 35 HIV-positive and diarrhoeagenic, 125 HIV-negative diarrhoeagenic and 20 apparently healthy controls. Cryptosporidium incidence following diagnostic techniques were 13 (37.1%; ZN staining, 26 (74.3%; sad-ELISA and 23 (65.7%; PCR, respectively, among HIV-positive diarrhoeagenic patients and 34 (27.2%; ZN staining, 96 (76.8%; sad-ELISA and 89 (71.2%; PCR among HIV-negative diarrhoeagenic patients. Sensitivity, specificity and predictive values of the diagnostic techniques’ efficiency were: sensitivity: 46.2% (HIV-positive and 32.3% (HIV-negative against the ZN technique and 96.9% against sad-ELISA and PCR, respectively, for both HIV-positive and -negative patients; specificity was 88.9% (HIV-positive and 96.6% (HIV-negative against the ZN technique. Lastly, the predictive values were 92.3% (HIV-positive and 96.9% (HIV-negative, respectively, following ZN staining. The sad-ELISA technique proved more suitable for the determination of the presence of Cryptosporidium oocysts. The high incidence of Cryptosporidium in HIV-positive subjects as compared to the HIV-negative population

  1. Diagnostics of nonlocal plasmas: advanced techniques

    Mustafaev, Alexander; Grabovskiy, Artiom; Strakhova, Anastasiya; Soukhomlinov, Vladimir


    This talk generalizes our recent results, obtained in different directions of plasma diagnostics. First-method of flat single-sided probe, based on expansion of the electron velocity distribution function (EVDF) in series of Legendre polynomials. It will be demonstrated, that flat probe, oriented under different angles with respect to the discharge axis, allow to determine full EVDF in nonlocal plasmas. It is also shown, that cylindrical probe is unable to determine full EVDF. We propose the solution of this problem by combined using the kinetic Boltzmann equation and experimental probe data. Second-magnetic diagnostics. This method is implemented in knudsen diode with surface ionization of atoms (KDSI) and based on measurements of the magnetic characteristics of the KDSI in presence of transverse magnetic field. Using magnetic diagnostics we can investigate the wide range of plasma processes: from scattering cross-sections of electrons to plasma-surface interactions. Third-noncontact diagnostics method for direct measurements of EVDF in remote plasma objects by combination of the flat single-sided probe technique and magnetic polarization Hanley method.

  2. Dental diagnostics using optical coherence techniques

    Nathel, H. [Lawrence Livermore National Lab., CA (United States); Colston, B. [Univ. of California, San Francisco, CA (United States); Armitage, G. [Univ. of California, Davis, CA (United States)] [and others


    Optical radiation can be used for diagnostic purposes in oral medicine. However, due to the turbid, amorphous, and inhomogeneous nature of dental tissue conventional techniques used to transilluminate materials are not well suited to dental tissues. Optical coherence techniques either in the time- of frequency-domain offer the capabilities of discriminating scattered from unscattered light, thus allowing for imaging through turbid tissue. Currently, using optical time-domain reflectometry we are able to discriminate specular from diffuse reflections occurring at tissue boundaries. We have determined the specular reflectivity of enamel and dentin to be approximately 6.6 x 10{sup -5} and 1.3 x 10{sup -6}, respectively. Implications to periodontal imaging will be discussed.

  3. Appearance of urology at the beginining of xxth century -from the general surgeon up to the highly trained specialist

    Ignjatović Ivan M.


    Full Text Available Evolvement of urology as a separate scientific discipline depends on several factors. Endoscopic diagnostics, radiological diagnostics, and operative techniques in general surgery, had provided an ability to perform more complex and longer operations. Urology had evolved from the great schools of surgery in Germany and France, and their the most important surgeons, who were intersted in urological surgery. The first endoscope was introduced in 1806, and received today’s form in 1879. Application of "X" rays in medicine started in 1895, and it was later applied as a cystography, retrograde pyelography as well as intravenous urography. The most important thing for the operative technique evolution were application of anhestesia, asepsis and new hemostatic devices. During the one century long development, urology had passed the way from completely unknown field, up to the discipline with the best diagnostic preciseness.

  4. Dusts in ITER: diagnostics and removal techniques

    Rosanvallon, S.; Grisolia, C.; Worms, J.; Hong, S.H. [Association Euratom-CEA Cadarache (DRFC/SIPP), 13 - Saint-Paul-lez-Durance (France). Dept. de Recherches sur la Fusion Controlee; Delaporte, P. [Universite de la Mediterranee, LP3, UMR 6182 CNRS, 13 - Marseille (France); Onofrie, J.F. [University of Provence, IUSTI-CNRS, 13 - Marseille (France); Counsell, G. [Association Euratom/UKAEA, Culham Science Centre, Abingdon (United Kingdom); Winter, J. [lnstitute of Experimental Physics 2, Bochum (Germany)


    Full text of publication follows: Dusts will be present in ITER and will represent an issue in terms of safety. As a matter of facts, dusts will be created by interaction of the plasma with the in-vessel materials and will be thus made of carbon, beryllium and tungsten. They will be activated, tritiated and chemically toxic. Safety limits have been set in order to reduce these dust hazards. The first set of limits is based on a limitation of the radiological impact on environment in case of dust spreading. Tungsten has been used as representative of ITER dust because it is the most radiologically hazardous of the plasma facing materials. Thus the mobilizable dust inside the vacuum vessel has to be limited to few hundreds of kilograms of carbon, beryllium and tungsten. The objective of the second set of limits is to ensure that the dust chemical reactivity is adequately controlled. Indeed this reactivity is greatly enhanced on the hot surfaces of the divertor in case of steam ingress, oxidation of the metals, beryllium in particular, leading to hydrogen production and possible explosion. The dusts on the hot surfaces of the divertor should not exceed few kilograms of carbon, beryllium and tungsten. Some calculations have shown that the dusts limits inside the vacuum vessel could be reached in about 500 plasma pulses, and in any case before the assumed replacement of the divertor for planned maintenance. Thus techniques for dust diagnostics and removal need to be developed for ITER to ensure that the set of safety limits are fulfilled. To minimize the impact on the machine operation time, these techniques have to be elaborated considering the ITER vacuum vessel constraints if entering the machine (magnetic field, radiation, vacuum and temperature) or to be non invasive. This paper will present a strategy that could be developed at different periods of the machine operation (during/between pulses and during short or long maintenance periods) in order to monitor the

  5. Advances in Pediatric Urologic Laparoscopy

    M. C. Smaldone


    Full Text Available The spectrum of laparoscopic surgery in children has undergone a dramatic evolution. Initially used as a diagnostic modality for many pediatric urologists, complex as well as reconstructive procedures are now being performed laparoscopically. Laparoscopic orchiopexy and nephrectomy are well established and are being performed at many centers. Laparoscopic partial nephrectomy, adrenalectomy, and dismembered pyeloplasty series have reported shortened hospital stays and operative times that are comparable to that of open techniques or are decreasing with experience. The initial experiences with laparoscopic ureteral reimplantation and laparoscopic-assisted bladder reconstructive surgery have been described, reporting encouraging results with regards to feasibility, hospital stay, and cosmetic outcome. This report will provide a directed review of the literature to establish the current indications for laparoscopy in pediatric urologic surgery.

  6. History of urology in Iwów (Lemberg, Lviv). the impact of political changes on progress in urology and medicine.

    Zajaczkowski, Tadeusz


    Innovations in diagnostic techniques due to the introduction of endoscopy, and the development in X-ray technology were fundamental in lessening dependence on surgery, and for urology to be recognised as a new discipline. Afterwards, endoscopic surgery came to the fore. Urology in Lemberg, The aim of the study is to present the development of urology in Lemberg as an independent speciality, and its separation from surgery. Well-known Lemberg surgeons who were interested in surgery of the genitourinary system are discussed. The beginning of urology and its development within the framework of surgical departments, and as an independent facility in the interwar period is described. The fate of the Polish department of urology during the interwar period and the World War II is also presented. The development of Ukrainian urology after the World War II is also described. Extensive research was undertaken to collect the literature and documents in Polish and German archives and libraries in order to prepare this study. The author also presents the leading Ukrainian urologists who contributed from the post war period to the last 22 years of free Ukraine (from December 1991), and discusses the development of modern urology in Lviv today.

  7. Current status of nanotechnology in urology

    Suresh K. Goyal


    Full Text Available Nanotechnology has been investigated for its applications in medicine. The objective of this review was to summarize the current applications of nanotechnology in Urology. A systematic search of literature was performed and relevant articles were analyzed with specific reference to applications in Urology. Nanotechnology has applications in diagnostic urology like in uroimaging using nanoparticles and nanosensors. It has therapeutic applications in infections, malignancies, genetic disease using targeted drug delivery, gene transfers, nano device-based manipulations etc. Nanotechnology has many applications in Urology. More efforts are required to make these applications practically feasible and affordable. [Int J Res Med Sci 2016; 4(8.000: 3114-3120

  8. Antenna Diagnostics using Near Field Techniques

    Paquay, M.H.A.


    The radiation characteristics of an antenna are fully determined by its aperture distribution. Measured Near Field data gives an impression but this is not good enough to detect small anomalies. For good antenna diagnostics, the field at the aperture plane is required. The Near Field Measurement Tec

  9. Development of novel fuel ion ratio diagnostic techniques

    Korsholm, S. B.; Stejner, M.; Bindslev, H.; Furtula, V.; Leipold, F.; Meo, F.; Michelsen, P. K.; Moseev, D.; Nielsen, S. K.; Salewski, M. [Association EURATOM-Risoe DTU, 4000 Roskilde (Denmark); Conroy, S.; Ericsson, G. [Association EURATOM-VR, Uppsala University, 75120 Uppsala (Sweden); Gorini, G.; Tardocchi, M. [Association EURATOM-ENEA CNR, 20125 Milano (Italy); Hellermann, M. von; Lischtschenko, O.; Delabie, E. [Association EURATOM-FOM, 3430 BE Nieuwegein (Netherlands); Jaspers, R. J. E. [Department of Applied Physics, Fusion Group, Eindhoven University of Technology, 5612 AZ Eindhoven (Netherlands)


    To overcome the challenge of measuring the fuel ion ratio in the core ({rho}<0.3) of ITER, a coordinated effort aiming at developing diagnostic techniques has been initiated. The investigated techniques are novel uses or further development of existing methods such as charge exchange recombination spectrometry, neutron spectrometry, and collective Thomson scattering. An overview of the work on the three diagnostic techniques is presented.

  10. [Urological emergencies].

    Danuser, H; Ackermann, D K; Studer, U E


    Every general practitioner has to deal with urologic emergencies. The most frequent illnesses are urinary retention, acute scrotum, priapism, macrohematuria, nephritic colic, obstructive pyelonephritis and pyonephrosis. Whereas urinary retention, as well as acute ureteric stone colic must generally be treated by the practitioner, the urologist must often be consulted in case of an acute scrotum or for priapism. Testicular torsion is one situation, where surgical treatment needs to be performed within 6 hours. Of utmost importance is his timely assistance with the obstructive pyelonephritis and pyonephrosis. These are initially often not recognized, especially because the first ultrasound examination of the intrarenal pyelone may not show a dilatation of the collecting system despite obstruction. If the adequate treatment with drainage and antibiotics is applied too late, this can result in serious and potentially lethal consequences.

  11. [Economic profitability: current aspects of X-ray contrast diagnosis in urology].

    Ukolov, V A; Perepanova, T S; Grigor'ev, A A


    A diversity of X-ray contrast diagnostic techniques used in urology provides a way of using different groups of X-ray contrast materials (XCMs) in accordance of the set tasks. Many years' experience in handling water-soluble triiodinated XCMs while examining the kidneys and urinary tract provides evidence for their diagnostic effectiveness and safety. The new Triombrast (OAO "Farmac", Kiev) synthesized on the basis of the Spanish substance (Justesa Imagen SA) has successfully undergone clinical trials and meets the high requirements made by the specialized urological facilities is economically profitable. The paper has been prepared, by using the reports on the results of preclinical studies of the agent and the experience of its use in the clinic of the Research Institute of Urology and City Clinical Hospital No. 47, Moscow.

  12. Comparative analyses of plasma probe diagnostics techniques

    Godyak, V. A. [Electrical Engineering and Computer Science Department, University of Michigan, Ann Arbor, Michigan 48109, USA and RF Plasma Consulting, Brookline, Massachusetts 02446 (United States); Alexandrovich, B. M. [Plasma Sensors, Brookline, Massachusetts 02446 (United States)


    The subject of this paper is a comparative analysis of the plasma parameters inferred from the classical Langmuir probe procedure, from different theories of the ion current to the probe, and from measured electron energy distribution function (EEDF) obtained by double differentiation of the probe characteristic. We concluded that the plasma parameters inferred from the classical Langmuir procedure can be subjected to significant inaccuracy due to the non-Maxwellian EEDF, uncertainty of locating the plasma potential, and the arbitrariness of the ion current approximation. The plasma densities derived from the ion part of the probe characteristics diverge by as much as an order of magnitude from the density calculated according to Langmuir procedure or calculated as corresponding integral of the measured EEDF. The electron temperature extracted from the ion part is always subjected to uncertainty. Such inaccuracy is attributed to modification of the EEDF for fast electrons due to inelastic electron collisions, and to deficiencies in the existing ion current theories; i.e., unrealistic assumptions about Maxwellian EEDFs, underestimation of the ion collisions and the ion ambipolar drift, and discounting deformation of the one-dimensional structure of the region perturbed by the probe. We concluded that EEDF measurement is the single reliable probe diagnostics for the basic research and industrial applications of highly non-equilibrium gas discharge plasmas. Examples of EEDF measurements point up importance of examining the probe current derivatives in real time and reiterate significance of the equipment technical characteristics, such as high energy resolution and wide dynamic range.

  13. Stem cells in urology.

    Aboushwareb, Tamer; Atala, Anthony


    The shortage of donors for organ transplantation has stimulated research on stem cells as a potential resource for cell-based therapy in all human tissues. Stem cells have been used for regenerative medicine applications in many organ systems, including the genitourinary system. The potential applications for stem cell therapy have, however, been restricted by the ethical issues associated with embryonic stem cell research. Instead, scientists have explored other cell sources, including progenitor and stem cells derived from adult tissues and stem cells derived from the amniotic fluid and placenta. In addition, novel techniques for generating stem cells in the laboratory are being developed. These techniques include somatic cell nuclear transfer, in which the nucleus of an adult somatic cell is placed into an oocyte, and reprogramming of adult cells to induce stem-cell-like behavior. Such techniques are now being used in tissue engineering applications, and some of the most successful experiments have been in the field of urology. Techniques to regenerate bladder tissue have reached the clinic, and exciting progress is being made in other areas, such as regeneration of the kidney and urethra. Cell therapy as a treatment for incontinence and infertility might soon become a reality. Physicians should be optimistic that regenerative medicine and tissue engineering will one day provide mainstream treatment options for urologic disorders.

  14. Intraoperative radioguidance with a portable gamma camera: a novel technique for laparoscopic sentinel node localisation in urological malignancies

    Vermeeren, L.; Valdes Olmos, R.A.; Vogel, W.V.; Sivro, F.; Hoefnagel, C.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Meinhardt, W.; Bex, A.; Poel, H.G. van der; Horenblas, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands)


    Our aim was to assess the feasibility of intraoperative radioguidance with a portable gamma camera during laparoscopic sentinel node (SN) procedures in urological malignancies. We evaluated the use of the intraoperative portable gamma camera in 20 patients: 16 patients with prostate carcinoma (PCC), 2 patients with renal cell carcinoma (RC) and 2 patients with testicular cancer (TC). Intra/peritumoural injection of {sup 99m}Tc-nanocolloid ({sup 99m}Tc) was followed by planar lymphoscintigraphy, SPECT/CT and marking of SN levels. Before laparoscopy a {sup 125}I seed was fixed on the laparoscopic gamma probe as a pointer of SN seeking. The portable gamma camera was set to display the {sup 99m}Tc signal for SN localisation and the {sup 125}I signal for SN seeking. Matching of these signals on screen indicated exact SN localisation, and consequently this SN was removed. The mean injected dose was 218 MBq in PCC, 228 MBq in RC and 88 MBq in TC. Pelvic SN were visualised in all PCC patients, with uncommonly located SN in seven patients. SN metastases were found in seven patients (one in a uncommonly located SN). Both RC patients and TC patients had para-aortic SN, which were all tumour free. A total of 59 SN were removed. The portable gamma camera enabled real-time SN display/identification in 18 patients (90%). The use of a portable gamma camera in combination with a laparoscopic gamma probe incorporates intraoperative real-time imaging with improved SN identification in urological malignancies. This procedure might also be useful for SN identification of other deep draining malignancies. (orig.)

  15. The future of urology.

    Abrams, Paul; Brausi, Maurizio; Buntrock, Stefan; Ebert, Thomas; Hashim, Hashim; Tiselius, Hans-Göran; Wyndaele, Jean-Jacques


    The Future of Urology has been written in times of economic downturn, with the inevitable effects on health sector spending. Nevertheless, this document aims to define a path whereby the EAU can play a pivotal role in ensuring the highest standard of care throughout Europe, and by setting standards, throughout the rest of the world. The future of urology will be dependent on improved education and training leading to high quality urological care, and to developing a service that is patient focused. The patient focus is becoming increasingly important in urology. This means providing full information about disease processes and urological procedures to patients and allowing them to judge the quality of the urological service that they may choose. Education must start in medical school and as 5% of community medical practice is urology then every medical student must receive urological training. This also applies to nurses and the other professions allied to medicine (PAMS). The EAU should provide a urological curriculum for training of medical students, nurses and PAMS, as well as the more conventional curriculum for postgraduate training and continued medical education for urological specialists. An integrated EAU Knowledge and Learning Centre would provide an invaluable resource to patients and to those who deliver urologic care alike. With high quality training must come a vigorous assessment of knowledge and competence. In the future, the competence of all those delivering urological care will need to be assessed. For urologists in training and specialist urologists this will include not only an assessment of knowledge but an assessment of surgical competence. Improving quality will be supported by the continued subspecialisation of urology, ensuring that all urologists have a surgical portfolio which ensures their competency in the procedures they deliver. This will inevitably result in a concentration of urological services and indeed to the development of

  16. Forgotten urological stent.

    Bhuiyan, Z H; Bhuiyan, N I; Khan, S A; Tawhid, M H; Islam, M F


    "Forgotten" Ureteral stent DJ stent related complication is not uncommon even in the era of modern urology in the developed world. In this context we have undertaken a retro-prospective study in relation to its various causes, complications, management and prevention of forgotten stents in a single teaching institute. The study period was from January'04 to December'09. The sample size was 60. The effect of "forgotten stent" in our study reflects mild UTI to various complications including severe renal failure. We had approached all of our cases judiciously using various modalities of minimal access endourological techniques either alone or in combinations with successful outcome. The study concluded that it is vary easy to prevent "forgotten stent" and so its complications. However if we confront such unwanted complications that could be managed successfully with the use of endourological techniques. We did not use other techniques like laparoscopy and open surgery in this study.

  17. Muon Diagnostics : A New Technique of Heliosphere Investigations

    Petrukhin, A. A.


    A new technique of remote monitoring of dynamic processes in the heliosphere (muon diagnostics) has been presented. The approach is based on the analysis of spatial-angular and temporal variations of muon flux detected at the ground level simultaneously from all directions of the upper hemisphere. F

  18. Muon Diagnostics : A New Technique of Heliosphere Investigations

    Petrukhin, A. A.


    A new technique of remote monitoring of dynamic processes in the heliosphere (muon diagnostics) has been presented. The approach is based on the analysis of spatial-angular and temporal variations of muon flux detected at the ground level simultaneously from all directions of the upper hemisphere. F

  19. News on pediatric urology

    Giuseppe Masnata


    Full Text Available Pediatric urology is a pediatric speciality dedicated to the diagnosis and treatment of congenital and acquired genitourinary tract diseases. It is a speciality that is rapidly changing, thanks to the technological development that has been emerging in recent years. There have been important diagnostic and therapeutic news.Congenital anomalies of the kidneys and urinary tract (CAKUT include various entities of structural malformations that result from defects in their morphogenesis. Clinical research and genetic studies on the origins of CAKUT are quickly evolving, with significant growth of high-quality research.Management goals of CAKUT include prevention of febrile urinary tract infections (UTIs in newborns and toddles and renal injury, while minimizing the morbidity of treatment and follow-up. Treatment options include observation with or without continuous antibiotic prophylaxis (CAP and surgical correction. Now, randomized controlled studies show that children with normal urinary tracts or low-grade vesicoureteral reflux (VUR do not benefit from prophylaxis.All children with known mechanical or functional obstructions of the urinary tract are considered to have UTI. Functional obstruction often results from lower urinary tract dysfunction (LUTD of either neurogenic or non-neurogenic origin and dilating VUR.The role of bladder and bowel dysfunction (BBD in children with UTI and the long-term risk of renal scarring have shed new light on treatment strategies. Often it is BBD, rather than reflux, that causes UTI in children older than 2 years.Pediatric urology has evolved in recent years, with a greater focus on bladder and renal function, minimally invasive treatment, evidence-based interventions, and guideline adherence. Other topics in pediatric urology include urinary incontinence in children with special needs and the use of robot-assisted laparoscopic surgery (RALS in children, with advantages over conventional laparoscopic surgery

  20. Pediatric urologic emergencies and urgencies.

    Leslie, Jeffrey A; Cain, Mark P


    The more common urologic problems seen in infancy and childhood that require urgent or emergent pediatric urologic referral are discussed, including a brief description of the usual presenting signs or symptoms, differential diagnoses, proper diagnostic work-up recommended before or at the time of referral, and the usual therapeutic course of management after evaluation by the urologist. These conditions include the acutely swollen scrotum, scrotal masses, penile swelling and erythema, exstrophy, hematuria, urinary retention, abdominal masses, and various genital abnormalities including interlabial masses, hypospadias with any degree of cryptorchidism, and ambiguous genitalia. This article is designed to provide the primary care practitioner with a focused review and a useful resource for managing children who have genitourinary abnormalities in the hospital or clinic setting.

  1. Diagnostic Emergency Ultrasound: Assessment Techniques In The Pediatric Patient.

    Guttman, Joshua; Nelson, Bret P


    Emergency ultrasound is performed at the point of care to answer focused clinical questions in a rapid manner. Over the last 20 years, the use of this technique has grown rapidly, and it has become a core requirement in many emergency medicine residencies and in some pediatric emergency medicine fellowships. The use of emergency ultrasound in the pediatric setting is increasing due to the lack of ionizing radiation with these studies, as compared to computed tomography. Utilizing diagnostic ultrasound in the emergency department can allow clinicians to arrive at a diagnosis at the bedside rather than sending the patient out of the department for another study. This issue focuses on common indications for diagnostic ultrasound, as found in the pediatric literature or extrapolated from adult literature where pediatric evidence is scarce. Limitations, current trends, controversies, and future directions of diagnostic ultrasound in the emergency department are also discussed.

  2. Management of pelvic fractures with concomitant urologic injuries.

    Taffet, R


    Controversy exists regarding the management of pelvic fractures with concomitant injuries to the lower urologic tract. This can be seen in both the urologic and orthopedic literature as it pertains to the ideal form of treatment for either problem and the timing of surgical intervention, if it is needed. This article reviews the anatomy, mechanism of injury, diagnostic approach, and treatment.

  3. Career development resource: urology.

    Gormley, E Ann


    Urology has always been seen as being on the cutting edge of technology and this has been especially prevalent in the past 10 to 15 years with a move to robotic surgery, increased use of laser technology, and stem cell research leading to organ regeneration. Urology has a number of subspecialties including pediatrics, urologic oncology, renal transplantation, male infertility and andrology, calculi, female urology, neurourology, and trauma and reconstruction. Urologists have a wide array of practice options ranging from performing major oncologic procedures with extensive reconstruction to having an office-based practice and performing endoscopic cases with everything else in between. Subspecialization is becoming increasingly more organized and regulated.

  4. Reconstructive Urology

    Fikret Fatih Önol


    Full Text Available In the treatment of urethral stricture, Buccal Mucosa Graft (BMG and reconstruction is applied with different patch techniques. Recently often prefered, this approach is, in bulber urethra strictures of BMG’s; by “ventral onley”, in pendulous urethra because of thinner spingiosis body, which provides support and nutrition of graft; by means of “dorsal inley” being anastomosis. In the research that Cordon et al. did, they compared conventional BMJ “onley” urethroplast and “pseudo-spongioplasty” which base on periurethral vascular tissues to be nourished by closing onto graft. In repairment of front urethras that spongiosis supportive tissue is insufficient, this method is defined as peripheral dartos [çevre dartos?] and buck’s fascia being mobilized and being combined on BMG patch. Between the years 2007 and 2012, assessment of 56 patients with conventional “ventral onley” BMG urethroplast and 46 patients with “pseudo-spongioplasty” were reported to have similar success rates (80% to 84% in 3.5 year follow-up on average. While 74% of the patients that were applied pseudo-spongioplasty had disease present at distal urethra (pendulous, bulbopendulous, 82% of the patients which were applied conventional onley urethroplast had stricture at proximal (bulber urethra yet. Also lenght of the stricture at the pseudo-spongioplasty group was longer in a statistically significant way (5.8 cm to 4.7 cm on average, p=0.028. This study which Cordon et al. did, shows that conditions in which conventional sponjiyoplasti is not possible, periurethral vascular tissues are adequate to nourish BMG. Even it is an important technique in terms of bringing a new point of view to today’s practice, data especially about complications that may show up after pseudo-spongioplasty usage on long distal strictures (e.g. appearance of urethral diverticulum is not reported. Along with this we think that, providing an oppurtinity to patch directly

  5. 78 FR 63997 - Kidney, Urologic, and Hematologic Diseases Interagency Coordinating Committee; Urology...


    ... Coordinating Committee; Urology Subcommittee Workshop SUMMARY: The Urology Subcommittee of the Kidney, Urologic...--Urology Subcommittee, National Institute of Diabetes and Digestive and Kidney Diseases, 6707 Democracy..., workshop held by the KUHICC Urology Subcommittee, also called the ``Urology Interagency...

  6. New diagnostic technique for Zeeman-compensated atomic beam slowing: technique and results

    Molenaar, P.A.; Straten, P. van der; Heideman, H.G.M.; Metcalf, H.


    We have developed a new diagnostic tool for the study of Zeeman-compensated slowing of an alkali atomic beam. Our time-of-flight technique measures the longitudinal veloc- ity distribution of the slowed atoms with a resolution below the Doppler limit of 30 cm/s. Furthermore, it can map the position

  7. [Plagiarism techniques in practice journal Johannes Franc (1649–1725) and copying practice illustrated by urology texts].

    Breuer, R; Winckelmann, H J


    In the seventeenth century it was customary in medicine to copy texts from other authors without citing the source. This practice is illustrated by the diary of Johannes Franc (1649–1725), a physician in the city of Ulm, who handwrote a practice journal in Latin and German Gothic script entering text passages plagiarized as follows: he reproduced them almost word for word in order to pass them off as his own experiences, used them as a model for his prescriptions and as a template for his case histories, and integrated them into his work to support his argumentation. In addition, he summarized texts from various sources, refined them by omitting portions, and incorporated his own experiences for embellishment. These plagiarism techniques and the purpose they served are analyzed and compared to some passages taken from the original texts.

  8. Diagnostic techniques for measuring suprathermal electron dynamics in plasmas (invited).

    Coda, S


    Plasmas, both in the laboratory and in space, are often not in thermodynamic equilibrium, and the plasma electron distribution function is accordingly non-Maxwellian. Suprathermal electron tails can be generated by external drives, such as rf waves and electric fields, or internal ones, such as instabilities and magnetic reconnection. The variety and importance of the phenomena in which suprathermal electrons play a significant role explains an enduring interest in diagnostic techniques to investigate their properties and dynamics. X-ray bremsstrahlung emission has been studied in hot magnetized plasmas for well over two decades, flanked progressively by electron-cyclotron emission in geometries favoring the high-energy end of the distribution function (high-field-side, vertical, oblique emission), by electron-cyclotron absorption, by spectroscopic techniques, and at lower temperatures, by Langmuir probes and electrostatic analyzers. Continuous progress in detector technology and in measurement and analysis techniques, increasingly sophisticated layouts (multichannel and tomographic systems, imaging geometries), and highly controlled suprathermal generation methods (e.g., perturbative rf modulation) have all been brought to bear in recent years on an increasingly detailed, although far from complete, understanding of suprathermal electron dynamics.

  9. Resonant laser techniques for combustion and flow diagnostics

    Fritzon, Rolf


    This thesis presents results from two areas of research. Firstly, the resonant coherent laser techniques polarization spectroscopy (PS), degenerate four-wave mixing (DFWM) and stimulated emission (SE) have been developed in the general field of combustion diagnostics. Secondly, laser induced fluorescence (LIF) has been developed and applied for the visualization of mixture fractions in turbulent non reacting flows. PS was developed for instantaneous two-dimensional imaging of minor species in flames, the technique being demonstrated on OH and NO. Various aspects of imaging and of detection in general were investigated. Two-photon induced PS was demonstrated for the detection of NH{sub 3}, CO and N{sub 2} molecules. LIF was monitored simultaneously to allow a quantitative comparison between the techniques. Furthermore, PS and DFWM were developed for instantaneous two-dimensional OH temperature imaging. Through a novel experimental approach based on the use of a dual-wavelength dye laser and a diffraction grating the temperature imaging measurements were performed using only one laser and one CCD camera. A comparison between the two techniques was made. SE was through a crossed-beam arrangement developed for spatially resolved detection of flame species. Two-dimensional LIF was developed and applied for measuring mixture fractions in the shear layer between two co-flowing turbulent gaseous jets. The technique was further applied in a study of the mixing of a turbulent water jet impinging orthogonally onto a flat surface. Average concentration fields in the center-plane of the jet was compared with results from large eddy simulations and with data from the literature 221 refs, 48 figs, 5 tabs

  10. New diagnostic technique for Zeeman-compensated atomic beam slowing: technique and results

    Molenaar, P.A.; Van Der Straten, P.; Heideman, H.G.M.; Metcalf, H


    We have developed a new diagnostic tool for the study of Zeeman-compensated slowing of an alkali atomic beam. Our time-of-flight technique measures the longitudinal veloc- ity distribution of the slowed atoms with a resolution below the Doppler limit of 30 cm/s. Furthermore, it can map the position and velocity distribution of atoms in either ground hyperfine level inside the solenoid without any devices inside the solenoid. The technique reveals the optical pumping ef- fects, and shows in de...

  11. Diagnostic Techniques to Elucidate the Aerodynamic Performance of Acoustic Liners

    June, Jason; Bertolucci, Brandon; Ukeiley, Lawrence; Cattafesta, Louis N., III; Sheplak, Mark


    In support of Topic A.2.8 of NASA NRA NNH10ZEA001N, the University of Florida (UF) has investigated the use of flow field optical diagnostic and micromachined sensor-based techniques for assessing the wall shear stress on an acoustic liner. Stereoscopic particle image velocimetry (sPIV) was used to study the velocity field over a liner in the Grazing Flow Impedance Duct (GFID). The results indicate that the use of a control volume based method to determine the wall shear stress is prone to significant error. The skin friction over the liner as measured using velocity curve fitting techniques was shown to be locally reduced behind an orifice, relative to the hard wall case in a streamwise plane centered on the orifice. The capacitive wall shear stress sensor exhibited a linear response for a range of shear stresses over a hard wall. PIV over the liner is consistent with lifting of the near wall turbulent structure as it passes over an orifice, followed by a region of low wall shear stress.

  12. Prevention of urological cancer

    M S Ansari


    Full Text Available Objectives: Many urological cancers like prostate and bladder have protracted course and maybe ideal for chemoprevention strategies. This article reviews the biol-ogy, epidemiology and possible preventive strategies for the various urological cancers. Methods: The author reviewed the relevant articles published in the last 20 years and studied the biology of the various urological cancers. An attempt is made to identify the various dietary, nutritional and occupation-related factors implicated in the onset and progression of various urological cancers. The various interventions and clinical trial results are described to prove the relevance of these factors. Results: Epidemiological reports provide the strongest evidence of protective role for dietary agents in cancer of prostate, bladder and kidney. Cancers of prostate and blad-der are uniquely suitable for chemopreventive strategies. For prostate cancer strong evidence exists for a preven-tive effect of reduced fat intake, vitamin E, selenium, lycopene and soya proteins. Vitamin A administration shows a strong inverse relation to bladder cancer. Better prevention is seen with combination of high doses of vita-mins A, C, E and B6. High-energy intake is related to the higher incidence of renal cell carcinoma (RCC. While vitamins D and E supplementation has resulted in lower incidence of RCC. Conclusions: Numerous studies implicate dietary and nutritional factors in the onset and progression of various urological cancers. Hence, it is possible that bioactive compounds (anti-oxidants like vits. A, D, C, and E, min-erals like selenium and carotenoids like lycopene along with reduction of animal fat in diet can be a part of pre-ventive strategies for various urological cancers.

  13. The reliability of specific sacro-occipital technique diagnostic tests.

    Leboeuf, C


    Four interexaminer and one intraexaminer agreement studies were performed on specific diagnostic tests commonly employed within sacro-occipital technique (SOT). Ten of the tests were evaluated in more than one interexaminer study. Of these, only one test (bilateral supine leg raise with cervical compaction) had at least fair reliability more than once. Six of these 10 tests obtained poor agreement in more than one study. One examiner out of two had a number of excellent and fair intraexaminer values, whereas the other examiner generally had poor results. There may have been some treatment effect as a comparison of the combined intraexaminer diagnosis for two observers after no treatment and after treatment showed that the repeatability diminished from Kappa of 0.36 in untreated cases (which were expected to have high agreement of before and after treatment findings) to a Kappa of 0.27 for those subjects having received treatment (which were expected to have low agreement of before and after treatment findings). It appears unlikely that SOT tests can be reproduced to a sufficiently high degree to constitute useful clinical procedures.

  14. Development of advanced strain diagnostic techniques for reactor environments.

    Fleming, Darryn D.; Holschuh, Thomas Vernon,; Miller, Timothy J.; Hall, Aaron Christopher; Urrea, David Anthony,; Parma, Edward J.,


    The following research is operated as a Laboratory Directed Research and Development (LDRD) initiative at Sandia National Laboratories. The long-term goals of the program include sophisticated diagnostics of advanced fuels testing for nuclear reactors for the Department of Energy (DOE) Gen IV program, with the future capability to provide real-time measurement of strain in fuel rod cladding during operation in situ at any research or power reactor in the United States. By quantifying the stress and strain in fuel rods, it is possible to significantly improve fuel rod design, and consequently, to improve the performance and lifetime of the cladding. During the past year of this program, two sets of experiments were performed: small-scale tests to ensure reliability of the gages, and reactor pulse experiments involving the most viable samples in the Annulated Core Research Reactor (ACRR), located onsite at Sandia. Strain measurement techniques that can provide useful data in the extreme environment of a nuclear reactor core are needed to characterize nuclear fuel rods. This report documents the progression of solutions to this issue that were explored for feasibility in FY12 at Sandia National Laboratories, Albuquerque, NM.

  15. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Babić Uroš


    Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

  16. Pheochromocytoma in Urologic Practice

    Waingankar, Nikhil; Bratslavsky, Gennady; Jimenez, Camilo; Russo, Paul; Kutikov, Alexander


    Context Pheochromocytoma is regularly encountered in urological practice and requires a thoughtful and careful clinical approach. Objective To review clinical aspects of management of pheochromocytoma in urologic practice. Evidence Acquisition A systematic review of English-language literature was performed through year 2015 using the Medline database. Manuscripts were selected with consensus of the coauthors and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Evidence Synthesis Findings and recommendations of the evaluated manuscripts are discussed with an emphasis on the description of presentation, diagnosis, evaluation, and perioperative care. Conclusion In addition to surgical expertise, appropriate management of pheochromocytoma in urologic practice requires nuanced understanding of pathophysiology, genetics, and endocrinological principles. When skillfully managed, the vast majority of patients with pheochromocytoma should expect an excellent prognosis. Patient Summary In this article we review the clinical approach to patients with pheochromocytoma, a tumor that stems from the innermost part of the adrenal gland and that often secretes excessive amounts of powerful hormones such as noradrenaline and adrenaline. Significant expertise is required to appropriately manage patients with these tumors. Take Home Message In addition to surgical expertise, appropriate management of pheochromocytoma in urologic practice requires nuanced understanding of pathophysiology, genetics, and endocrinological principles. When skillfully managed, vast majority of patients with pheochromocytoma should expect an excellent prognosis. PMID:28078330

  17. FDG in Urologic Malignancies

    Høilund-Carlsen, Poul Flemming; Poulsen, Mads Hvid; Petersen, Henrik;


    F-fluoro-deoxy-glucose (FDG). PET imaging has been applied more often in prostate cancer. FDG-PET/CT is claimed to have a high frequency of false-negative results in urologic cancers; however, this finding may instead reflect correctly the state of disease being due to slow-growing cancers...

  18. Comparision of different diagnostic techniques against Fasciolosis in Buffaloes



    Full Text Available The present study was conducted to compare different diagnostic tests viz., Direct Smear (DS, Agar gel precipitation (AGP, Sedimentation (Sd, and Zinc Sulfate (ZnSO4 flotation for fasciolosis in dairy buffaloes as well as the economic losses due to fasciolosis. A total of 200 faecal samples were examined and DS, AGP, Sd, and ZnSO4 flotation techniques showed an overall prevalence of 2, 8, 5 and 4%, respectively. The highest agreement was observed between Sd and ZnSO4 (0.88, 95%CI; 0.74-1.02 followed by AGP and Sd (0.75, 95%CI; 0.62-0.88, ZnSO4 and DS (0.65,95%CI; 0.52-0.78, AGP and ZnSO4 (0.648, 95%CI; 0.51-0.77, DS and Sd (0.55, 95%CI; 0.43-0.68, and DSM and AGP (0.38, 95%CI; 0.27-0.48. By taking DS as a gold standard, all tests showed 100 percent sensitivity results and same trend was observed in case of negative predictive values (NPV. Highest specificity was shown by ZnSO4, followed by Sd and AGP. Similar trends were observed in the positive predictive values (PPV. Then, by taking AGP as gold standard, all tests showed 100 percent specificity and positive predictive values (PPV while, Sd showed highest sensitivity followed by ZnSO4 and AGP and similar trend was observed regarding NPV of tests. To this end, most effective test is AGP followed by Sd, ZnSO4 and DS method. Moreover, AGP is the most suitable method for diagnosing the fasciolosis in early stages. Total economic losses due to fasciolosis during three months (Oct. – Dec. 2004 were found very high i.e Rs. 1016400. [Vet. World 2009; 2(4.000: 129-132

  19. Urologic Issues During Pregnancy

    Jeffrey P. Weiss


    Full Text Available Pregnancy induces a variety of physiologic changes in the urinary tract. When such changes become accentuated the physiologic becomes the pathologic and symptoms arise, at times of significance enough to threaten the well being of mother and/or fetus. This article intends to describe the basis for urinary physiology and its pathologic counterparts during pregnancy. Such a background may then facilitate a rational management protocol for various urologic problems in the gravid state.

  20. The laser in urology

    Hofstetter, Alfons G.


    Laser is an acronym for a physical principle and means: Light Amplification by stimulated Emission of Radiation. This principle offers a lot of tissue/light effects caused by the parameters: power density/time and the special qualities of the laser light. Nowadays for diagnosis and therapy following lasers are used in urology: Krypton- and Dye-lasers as well as the Neodymium-YAG- (nd:YAG-), Holmium-YAG (Ho:YAG-), Diode-, Argon- and the CO2-lasers.

  1. EAU standardised medical terminology for urologic imaging: a taxonomic approach.

    Loch, Tillmann; Carey, Brendan; Walz, Jochen; Fulgham, Pat Fox


    The terminology and abbreviations used in urologic imaging have generally been adopted on an ad hoc basis by different speciality groups; however, there is a need for shared nomenclature to facilitate clinical communication and collaborative research. This work reviews the current nomenclature for urologic imaging used in clinical practice and proposes a taxonomy and terminology for urologic imaging studies. A list of terms used in urologic imaging were compiled from guidelines published by the European Association of Urology and the American Urological Association and from the American College of Radiology Appropriateness Criteria. Terms searched were grouped into broad categories based on technology, and imaging terms were further stratified based on the anatomic extent, contrast or phases, technique or modifiers, and combinations or fusions. Terms that had a high degree of utilisation were classified as accepted. We propose a new taxonomy to define a more useful and acceptable nomenclature model acceptable to all health professionals involved in urology. The major advantage of a taxonomic approach to the classification of urologic imaging studies is that it provides a flexible framework for classifying the modifications of current imaging modalities and allows the incorporation of new imaging modalities. The adoption of this hierarchical classification model ranging from the most general to the most detailed descriptions should facilitate hierarchical searches of the medical literature using both general and specific terms. This work is limited in its scope, as it is not currently all-inclusive. This will hopefully be addressed by future modification as others embrace the concept and work towards uniformity in nomenclature. This paper provides a noncomprehensive list of the most widely used terms across different specialties. This list can be used as the basis for further discussion, development, and enhancement. In this paper we describe a classification system

  2. Wound healing in urology.

    Ninan, Neethu; Thomas, Sabu; Grohens, Yves


    Wound healing is a dynamic and complex phenomenon of replacing devitalized tissues in the body. Urethral healing takes place in four phases namely inflammation, proliferation, maturation and remodelling, similar to dermal healing. However, the duration of each phase of wound healing in urology is extended for a longer period when compared to that of dermatology. An ideal wound dressing material removes exudate, creates a moist environment, offers protection from foreign substances and promotes tissue regeneration. A single wound dressing material shall not be sufficient to treat all kinds of wounds as each wound is distinct. This review includes the recent attempts to explore the hidden potential of growth factors, stem cells, siRNA, miRNA and drugs for promoting wound healing in urology. The review also discusses the different technologies used in hospitals to treat wounds in urology, which make use of innovative biomaterials synthesised in regenerative medicines like hydrogels, hydrocolloids, foams, films etc., incorporated with growth factors, drug molecules or nanoparticles. These include surgical zippers, laser tissue welding, negative pressure wound therapy, and hyperbaric oxygen treatment.

  3. Met in Urological Cancers

    Miyata, Yasuyoshi, E-mail:; Asai, Akihiro; Mitsunari, Kensuke; Matsuo, Tomohiro; Ohba, Kojiro; Mochizuki, Yasushi; Sakai, Hideki [Department of Urology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501 (Japan)


    Met is a tyrosine kinase receptor that is considered to be a proto-oncogene. The hepatocyte growth factor (HGF)-Met signaling system plays an important role in tumor growth, invasion, and metastasis in many types of malignancies. Furthermore, Met expression has been reported to be a useful predictive biomarker for disease progression and patient survival in these malignancies. Many studies have focused on the clinical significance and prognostic role of Met in urological cancers, including prostate cancer (PCa), renal cell carcinoma (RCC), and urothelial cancer. Several preclinical studies and clinical trials are in progress. In this review, the current understanding of the pathological role of Met in cancer cell lines, its clinical significance in cancer tissues, and its predictive value in patients with urological cancers are summarized. In particular, Met-related malignant behavior in castration-resistant PCa and the different pathological roles Met plays in papillary RCC and other histological types of RCC are the subjects of focus. In addition, the pathological significance of phosphorylated Met in these cancers is shown. In recent years, Met has been recognized as a potential therapeutic target in various types of cancer; therapeutic strategies used by Met-targeted agents in urological cancers are summarized in this review.

  4. Developpement de techniques de diagnostic non intrusif par tomographie optique

    Dubot, Fabien

    Que ce soit dans les domaines des procedes industriels ou de l'imagerie medicale, on a assiste ces deux dernieres decennies a un developpement croissant des techniques optiques de diagnostic. L'engouement pour ces methodes repose principalement sur le fait qu'elles sont totalement non invasives, qu'elle utilisent des sources de rayonnement non nocives pour l'homme et l'environnement et qu'elles sont relativement peu couteuses et faciles a mettre en oeuvre comparees aux autres techniques d'imagerie. Une de ces techniques est la Tomographie Optique Diffuse (TOD). Cette methode d'imagerie tridimensionnelle consiste a caracteriser les proprietes radiatives d'un Milieu Semi-Transparent (MST) a partir de mesures optiques dans le proche infrarouge obtenues a l'aide d'un ensemble de sources et detecteurs situes sur la frontiere du domaine sonde. Elle repose notamment sur un modele direct de propagation de la lumiere dans le MST, fournissant les predictions, et un algorithme de minimisation d'une fonction de cout integrant les predictions et les mesures, permettant la reconstruction des parametres d'interet. Dans ce travail, le modele direct est l'approximation diffuse de l'equation de transfert radiatif dans le regime frequentiel tandis que les parametres d'interet sont les distributions spatiales des coefficients d'absorption et de diffusion reduit. Cette these est consacree au developpement d'une methode inverse robuste pour la resolution du probleme de TOD dans le domaine frequentiel. Pour repondre a cet objectif, ce travail est structure en trois parties qui constituent les principaux axes de la these. Premierement, une comparaison des algorithmes de Gauss-Newton amorti et de Broyden- Fletcher-Goldfarb-Shanno (BFGS) est proposee dans le cas bidimensionnel. Deux methodes de regularisation sont combinees pour chacun des deux algorithmes, a savoir la reduction de la dimension de l'espace de controle basee sur le maillage et la regularisation par penalisation de Tikhonov

  5. The diagnostic contribution of CT volumetric rendering techniques in routine practice

    Perandini Simone; Faccioli N; Zaccarella A; Re T; Mucelli R


    Computed tomography (CT) volumetric rendering techniques such as maximum intensity projection (MIP), minimum intensity projection (MinIP), shaded surface display (SSD), volume rendering (VR), and virtual endoscopy (VE) provide added diagnostic capabilities. The diagnostic value of such reconstruction techniques is well documented in literature. These techniques permit the exploration of fine anatomical detail that would be difficult to evaluate using axial reconstructions alone. Although thes...

  6. Tunable diode laser spectroscopy as a technique for combustion diagnostics

    Bolshov, M. A.; Kuritsyn, Yu. A.; Romanovskii, Yu. V.


    Tunable diode laser absorption spectroscopy (TDLAS) has become a proven method of rapid gas diagnostics. In the present review an overview of the state of the art of TDL-based sensors and their applications for measurements of temperature, pressure, and species concentrations of gas components in harsh environments is given. In particular, the contemporary tunable diode laser systems, various methods of absorption detection (direct absorption measurements, wavelength modulation based phase sensitive detection), and relevant algorithms for data processing that improve accuracy and accelerate the diagnostics cycle are discussed in detail. The paper demonstrates how the recent developments of these methods and algorithms made it possible to extend the functionality of TDLAS in the tomographic imaging of combustion processes. Some prominent examples of applications of TDL-based sensors in a wide range of practical combustion aggregates, including scramjet engines and facilities, internal combustion engines, pulse detonation combustors, and coal gasifiers, are given in the final part of the review.

  7. Tunable diode laser spectroscopy as a technique for combustion diagnostics

    Bolshov, M.A., E-mail:; Kuritsyn, Yu.A.; Romanovskii, Yu.V.


    Tunable diode laser absorption spectroscopy (TDLAS) has become a proven method of rapid gas diagnostics. In the present review an overview of the state of the art of TDL-based sensors and their applications for measurements of temperature, pressure, and species concentrations of gas components in harsh environments is given. In particular, the contemporary tunable diode laser systems, various methods of absorption detection (direct absorption measurements, wavelength modulation based phase sensitive detection), and relevant algorithms for data processing that improve accuracy and accelerate the diagnostics cycle are discussed in detail. The paper demonstrates how the recent developments of these methods and algorithms made it possible to extend the functionality of TDLAS in the tomographic imaging of combustion processes. Some prominent examples of applications of TDL-based sensors in a wide range of practical combustion aggregates, including scramjet engines and facilities, internal combustion engines, pulse detonation combustors, and coal gasifiers, are given in the final part of the review. - Highlights: • Overview of modern TDL-based sensors for combustion • TDL systems, methods of absorption detection and algorithms of data processing • Prominent examples of TDLAS diagnostics of the combustion facilities • Extension of the TDLAS on the tomographic imaging of combustion processes.

  8. Diabetes and Sexual and Urologic Problems

    ... Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes & Sexual & Urologic Problems Troublesome bladder symptoms and changes in ... of these sexual and urologic problems. Diabetes and Sexual Problems Both men and women with diabetes can ...

  9. Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis

    Héctor Julian Canaval-Zuleta

    Full Text Available Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

  10. Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis.

    Canaval Zuleta, Héctor Julián; Company Campins, María M; Dolz Abadía, Carlos


    Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

  11. Application of Molecular Diagnostic Techniques for Viral Testing

    Cobo, Fernando


    Nucleic acid amplification techniques are commonly used currently to diagnose viral diseases and manage patients with this kind of illnesses. These techniques have had a rapid but unconventional route of development during the last 30 years, with the discovery and introduction of several assays in clinical diagnosis. The increase in the number of commercially available methods has facilitated the use of this technology in the majority of laboratories worldwide. This technology has reduced the...

  12. Predictive models in urology.

    Cestari, Andrea


    Predictive modeling is emerging as an important knowledge-based technology in healthcare. The interest in the use of predictive modeling reflects advances on different fronts such as the availability of health information from increasingly complex databases and electronic health records, a better understanding of causal or statistical predictors of health, disease processes and multifactorial models of ill-health and developments in nonlinear computer models using artificial intelligence or neural networks. These new computer-based forms of modeling are increasingly able to establish technical credibility in clinical contexts. The current state of knowledge is still quite young in understanding the likely future direction of how this so-called 'machine intelligence' will evolve and therefore how current relatively sophisticated predictive models will evolve in response to improvements in technology, which is advancing along a wide front. Predictive models in urology are gaining progressive popularity not only for academic and scientific purposes but also into the clinical practice with the introduction of several nomograms dealing with the main fields of onco-urology.

  13. Laboratory diagnosis of Toxoplasma gondii infection with direct and indirect diagnostic techniques

    Salvatore Pignanelli


    Full Text Available Background: Toxoplasma gondii infection, common parasitic zoonoses, is an important cause of spontaneous abortion, mental retardation, encephalitis, ocular disease and death worldwide. Today the major diagnostic techniques for the toxoplasmosis are serological assays, but its have many limitations. Aim : The goal in this study is to improve the diagnostic accuracy of T. gondii infection, using direct (Real Time PCR and indirect (IgM, IgA, IgG and IgG avidity diagnostic techniques. Materials and Methods: In the period between 2007 and 2008, 96 non consecutive different clinical samples (38 blood, 40 amniotic fluids, 8 cerebrospinal fluids, 10 vitreous humors and 96 sera have been studied simultaneously through molecular biology and serological techniques. Results: Direct and indirect diagnostic techniques used in this study for laboratory diagnosis of T. gondii infection were always concordant. Conclusions : The high correlation between direct and indirect diagnostic techniques exhibit that serologic techniques are accurate diagnostic assays as screening test in laboratory diagnosis of toxoplasmosis.

  14. Electro-optic techniques in electron beam diagnostics

    van Tilborg, Jeroen; Toth, Csaba; Matlis, Nicholas; Plateau, Guillaume; Leemans, Wim


    Electron accelerators such as laser wakefield accelerators, linear accelerators driving free electron lasers, or femto-sliced synchrotrons, are capable of producing femtosecond-long electron bunches. Single-shot characterization of the temporal charge profile is crucial for operation, optimization, and application of such accelerators. A variety of electro-optic sampling (EOS) techniques exists for the temporal analysis. In EOS, the field profile from the electron bunch (or the field profile from its coherent radiation) will be transferred onto a laser pulse co-propagating through an electro-optic crystal. This paper will address the most common EOS schemes and will list their advantages and limitations. Strong points that all techniques share are the ultra-short time resolution (tens of femtoseconds) and the single-shot capabilities. Besides introducing the theory behind EOS, data from various research groups is presented for each technique.

  15. Image-guided urological interventions: What the urologists must know

    Chandan J Das


    Full Text Available Advances in imaging technology, especially in the last two decades, have led to a paradigm shift in the field of image-guided interventions in urology. While the traditional biopsy and drainage techniques are firmly established, image-based stone management and endovascular management of hematuria have evolved further. Ablative techniques for renal and prostate cancer and prostate artery embolization for benign prostatic hypertrophy have evolved into viable alternative treatments. Many urologic diseases that were earlier treated surgically are now effectively managed using minimally invasive image-guided techniques, often on a day care basis using only local anesthesia or conscious sedation. This article presents an overview of the technique and status of various image-guided urological procedures, including recent emerging techniques.

  16. Measurement Techniques for Electrothermal-Chemical Gun Diagnostics


    conductors of a circuit ( Askeland 1985). This technique has been successfully applied to other experimental work including the pressure measurements made in...Fe2O4 ( Askeland 1985). Ferrites are implemented by wrapping the power cords and coaxial data lines of all electronics equipment tightly for several... Askeland , D. R. The Sciece and Engineering of Materials. Prindle, Weber, and Schmidt, 1985. Burden. H. S., and D. D. Shear. "Transient Noise in Electronic

  17. Development of fault diagnostic technique using reactor noise analysis

    Park, Jin Ho; Kim, J. S.; Oh, I. S.; Ryu, J. S.; Joo, Y. S.; Choi, S.; Yoon, D. B


    The ultimate goal of this project is to establish the analysis technique to diagnose the integrity of reactor internals using reactor noise. The reactor noise analyses techniques for the PWR and CANDU NPP(Nuclear Power Plants) were established by which the dynamic characteristics of reactor internals and SPND instrumentations could be identified, and the noise database corresponding to each plant(both Korean and foreign one) was constructed and compared. Also the change of dynamic characteristics of the Ulchin 1 and 2 reactor internals were simulated under presumed fault conditions. Additionally portable reactor noise analysis system was developed so that real time noise analysis could directly be able to be performed at plant site. The reactor noise analyses techniques developed and the database obtained from the fault simulation, can be used to establish a knowledge based expert system to diagnose the NPP's abnormal conditions. And the portable reactor noise analysis system may be utilized as a substitute for plant IVMS(Internal Vibration Monitoring System). (author)

  18. Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology

    Troccaz, Jocelyne; Berkelman, Peter; Cinquin, Philippe; Daanen, Vincent; Leroy, Antoine; Marchal, Maud; Payan, Yohan; Promayon, Emmanuel; Voros, Sandrine; Bart, Stéphane; Bolla, Michel; Chartier-Kastler, Emmanuel; Descotes, Jean-Luc; Dusserre, Andrée; Giraud, Jean-Yves; Long, Jean-Alexandre; Moalic, Ronan; Mozer, Pierre


    Until recently, Computer-Aided Medical Interventions (CAMI) and Medical Robotics have focused on rigid and non deformable anatomical structures. Nowadays, special attention is paid to soft tissues, raising complex issues due to their mobility and deformation. Mini-invasive digestive surgery was probably one of the first fields where soft tissues were handled through the development of simulators, tracking of anatomical structures and specific assistance robots. However, other clinical domains, for instance urology, are concerned. Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU, radiofrequency, or cryoablation), increasingly early detection of cancer, and use of interventional and diagnostic imaging modalities, recently opened new challenges to the urologist and scientists involved in CAMI. This resulted in the last five years in a very significant increase of research and developments of computer-aided urology systems. In this paper, we propose a description of the main problems rel...

  19. Analysis of diagnostic calorimeter data by the transfer function technique

    Delogu, R. S.; Poggi, C.; Pimazzoni, A.; Rossi, G.; Serianni, G.


    This paper describes the analysis procedure applied to the thermal measurements on the rear side of a carbon fibre composite calorimeter with the purpose of reconstructing the energy flux due to an ion beam colliding on the front side. The method is based on the transfer function technique and allows a fast analysis by means of the fast Fourier transform algorithm. Its efficacy has been tested both on simulated and measured temperature profiles: in all cases, the energy flux features are well reproduced and beamlets are well resolved. Limits and restrictions of the method are also discussed, providing strategies to handle issues related to signal noise and digital processing.

  20. Analysis of diagnostic calorimeter data by the transfer function technique

    Delogu, R. S., E-mail:; Pimazzoni, A.; Serianni, G. [Consorzio RFX, Corso Stati Uniti, 35127 Padova (Italy); Poggi, C.; Rossi, G. [Università degli Studi di Padova, Via 8 Febbraio 1848, 35122 Padova (Italy)


    This paper describes the analysis procedure applied to the thermal measurements on the rear side of a carbon fibre composite calorimeter with the purpose of reconstructing the energy flux due to an ion beam colliding on the front side. The method is based on the transfer function technique and allows a fast analysis by means of the fast Fourier transform algorithm. Its efficacy has been tested both on simulated and measured temperature profiles: in all cases, the energy flux features are well reproduced and beamlets are well resolved. Limits and restrictions of the method are also discussed, providing strategies to handle issues related to signal noise and digital processing.

  1. Minimal Invasive Urologic Surgery and Postoperative Ileus

    Fouad Aoun


    Full Text Available Postoperative ileus (POI is the most common cause of prolonged length of hospital stays (LOS and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress in the future. In the field of gastrointestinal surgery, several studies had reported lower incidence rates for POI following minimal invasive surgery compared to conventional open procedures. In contrast, little is known about the effect of minimal invasive approach on the recovery of bowel motility after urologic surgery. We performed an overview of the potential benefit of minimal invasive approach on POI for urologic procedures. The mechanisms and risk factors responsible for the onset of POI are discussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radical cystectomy but it is rarely of clinical significance for other minimal invasive interventions. Laparoscopy or robotic assisted laparoscopic techniques when studied individually may reduce to their own the duration and prevent the onset of POI in a subset of procedures. The potential influence of age and urinary diversion type on postoperative ileus is contradictory in the literature. There is some evidence suggesting that BMI, blood loss, urinary extravasation, existence of a major complication, bowel resection, operative time and transperitoneal approach are independent risk factors for POI. Treatment of POI remains elusive. One of the most important and effective management strategies for patients undergoing radical cystectomy has been the development and use of enhanced recovery programs. An optimal rational strategy to shorten the duration of POI should incorporate minimal invasive approach when appropriate into multimodal fast track programs designed to reduce POI and shorten LOS.

  2. Sexual abuse evaluation in urological practice

    Beck, Jacobus Johannes Hendrikus


    The primary aim of this study is to investigate the prevalence of sexual abuse in a urological outpatient clinic. Can differences been made in urological population, i.e. general urological clinic, a university urological clinic and a tertiary university pelvic floor clinic? Do urologists inquire

  3. A High-Resolution Antenna Diagnostics Technique for Spherical Nesr-Field Measurements

    Cappellin, Cecilia; Breinbjerg, Olav; Frandsen, Aksel


    A new diagnostics technique for spherical near-field antenna measurements, that can provide a high spatial resolution of the reconstructed aperture field, is presented. This technique is realized by transforming the spherical wave expansion (SWE) of the radiated field into the corresponding plane...

  4. Comparison of different antenna diagnostics techniques with limited far field data input

    Pivnenko, Sergey; Cappellin, Cecilia


    In this paper, three different antenna diagnostics techniques are compared for the case when the input far-field data represent only few complete cuts or a two-dimensional grid with a limited angular sector. The techniques are applied to several different antennas: a high-gain offset reflector...... and extreme near fields....

  5. The influence on finite measurement accuracy on the SWE-to-PWE antenna diagnostics technique

    Cappellin, Cecilia; Breinbjerg, Olav; Frandsen, Aksel


    A new antenna diagnostics technique based on the transformation of the spherical wave expansion (SWE) into the plane wave expansion (PWE) is proposed. The new technique allows the recovery of the plane wave spectrum in the visible region, and in principle also in part of the invisible region, from...


    Kuzminova, J A; Plyasunova, S A; Jogov, V V; Smetanina, N S


    The laboratory diagnostic of inherent spherocytosis is based on detection of spherocytes in peripheral blood, decreasing of index of sphericity, decreasing of osmotic resistance of erythrocytes. The new test of diagnostic of hereditary spherocytosis build on molecular defect was developed on the basis of binding extracellular fragments of protein of band 3 with eosin-5-maleimide (EMA-test). The study was carried out to implement comparative analysis of sensitivity and specificity of techniques applied to diagnose inherent spherocytosis. The sampling of 94 patients with various forms of anemias was analyzed All patients were applied complex clinical laboratory examination including analysis of osmotic resistance of erythrocytes, erythrocytometry and EMA-test as specific techniques of diagnostic of inherent spherocytosis. In 51 out of 94 patients (54%) decreasing of values of EMA-test was detected and in 47 patients diagnosis of inherent spherocytosis was confirmed. The standard values of EMA-test were established in 43 patients (46%) and 12 patients out of them with established diagnosis of inherent spherocytosis. Therefore, sensitivity of EMA-test made up to 79% and specificity - 80%. The most sensitive techniques of diagnostic remain osmotic resistance of erythrocytes (91%) and index of sphericity (up to 96%). But the highest specificity in this respect has EMA-test (80%). Nowadays, none of implemented techniques of diagnostic of inherent spherocytosis can be applied as a universal one. The implementation of complex examination is needed for proper diagnostic of disease.

  7. Application of the SWE-to-PWE antenna diagnostics technique to an offset reflector antenna

    Cappellin, Cecilia; Frandsen, A; Breinbjerg, Olav


    A new antenna diagnostics technique has been developed for the DTU-ESA Spherical Near-Field Antenna Test Facility at the Technical University of Denmark. The technique is based on the transformation of the Spherical Wave Expansion (SWE) of the radiated field, obtained from a spherical near...... will be detected in the antenna far-field pattern, and the accuracy and ability of the diagnostics technique to subsequently identify them will be investigated. Real measurement data will be employed for each test case....... measurement accuracy, have been reported previously, we validate here the new antenna diagnostics technique through an experimental investigation of a commercially available offset reflector antenna, where a tilt of the feed and surface distortions are intentionally introduced. The effects of these errors...

  8. Coherent Rayleigh-Brillouin scattering as a flow diagnostic technique

    Graul, J. S.; Lilly, T. C. [Department of Mechanical and Aerospace Engineering, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918 (United States)


    Broadband coherent Rayleigh-Brillouin scattering (CRBS) was used to measure translational gas temperatures for nitrogen at the ambient pressure of 0.8 atm using a purpose-built Fabry-Perot etalon spectrometer. Temperatures derived from the CRBS spectral analysis were compared with experimentally-measured temperatures, and were found to be, on average, within 2% of the experimentally-measured value. Axial flow velocities from a double jet at a pressure ratio of 0.38 were also measured by looking at the Doppler shift of the CRBS line shape. With recent developments in chirped laser technology and the capacity of CRBS to simultaneously provide thermodynamic and bulk flow information, the CRBS line shape acquisition and analysis technique presented here may allow for future time-resolved, characterization of aerospace flows.

  9. Cardiovascular procedures/diagnostic techniques and therapeutic procedures

    Tilkian, A.G.; Daily, E.K.


    This book covers the technical and therapeutic aspects of cardiovascular procedures in immense detail. There are large and appropriate diagrams and tables. The topics of the chapters are tools for catheterization, venous access, arterial access, hemodynamic monitoring, cardiac catheterization and coronary arteriography, ergonovine provocation testing for coronary artery spasm, pulmonary angiography, endomyocredial biopsy, electrophysiologic studies, pericardiocentesis and drainage, intraaortic balloon pumping, direct current cardioversion and defibrilaltion, pacemaker implantation of the automatic implantable cardioverter/defibrillator, coronary angioplasty, thrombolytic therapy, transluminal catheter extraction and resolution of intracardiac catheter knots, cardiopulmonary resuscitation, contrast media toxicity and allergic reactions, radiation hazards, and medicolegal concerns. An appendix and index follow these chapters. In general, each chapter covers historical aspects, indications, complications, techniques, and preoperative and postoperative care.

  10. A Hybrid Neural Network-Genetic Algorithm Technique for Aircraft Engine Performance Diagnostics

    Kobayashi, Takahisa; Simon, Donald L.


    In this paper, a model-based diagnostic method, which utilizes Neural Networks and Genetic Algorithms, is investigated. Neural networks are applied to estimate the engine internal health, and Genetic Algorithms are applied for sensor bias detection and estimation. This hybrid approach takes advantage of the nonlinear estimation capability provided by neural networks while improving the robustness to measurement uncertainty through the application of Genetic Algorithms. The hybrid diagnostic technique also has the ability to rank multiple potential solutions for a given set of anomalous sensor measurements in order to reduce false alarms and missed detections. The performance of the hybrid diagnostic technique is evaluated through some case studies derived from a turbofan engine simulation. The results show this approach is promising for reliable diagnostics of aircraft engines.

  11. Review of Physicochemical-Based Diagnostic Techniques for Assessing Insulation Condition in Aged Transformers

    Janvier Sylvestre N’cho


    Full Text Available A power transformer outage has a dramatic financial consequence not only for electric power systems utilities but also for interconnected customers. The service reliability of this important asset largely depends upon the condition of the oil-paper insulation. Therefore, by keeping the qualities of oil-paper insulation system in pristine condition, the maintenance planners can reduce the decline rate of internal faults. Accurate diagnostic methods for analyzing the condition of transformers are therefore essential. Currently, there are various electrical and physicochemical diagnostic techniques available for insulation condition monitoring of power transformers. This paper is aimed at the description, analysis and interpretation of modern physicochemical diagnostics techniques for assessing insulation condition in aged transformers. Since fields and laboratory experiences have shown that transformer oil contains about 70% of diagnostic information, the physicochemical analyses of oil samples can therefore be extremely useful in monitoring the condition of power transformers.

  12. Cost Analysis on Imaging Diagnostic Techniques in Cerebral and Abdominal Neonatal Pathology



    Background: Improvement of health care quality and cost control are the main aims of the health care reform in Romania. Objective: The aims of the research are to analyse the trend of costs for imaging techniques used as diagnostic tools for cerebral and abdominal neonatal pathology and to study the relationship between cost and diagnostic benefits. Design: This is a retrospective observational study design without a control group, conducted in the Radio-Imaging Department, Cluj District Univ...

  13. Development of detection techniques and diagnostics for airborne carbon nanoparticles.

    Michelsen, Hope A.; Witze, Peter O.; Settersten, Thomas B.


    We have recorded time-resolved LII signals from a laminar ethylene diffusion flame over a wide range of laser fluences at 532 nm. We have performed these experiments using an injection-seeded NdYAG laser with a pulse duration of 7 ns. The beam was spatially filtered and imaged into the flame to provide a homogeneous spatial profile. These data were used to aid in the development of a model, which will be used to test the validity of the LII technique under varying environmental conditions. The new model describes the heating of soot particles during the laser pulse and the subsequent cooling of the particles by radiative emission, sublimation, and conduction. The model additionally includes particle heating by oxidation, accounts for the likelihood of particle annealing, and incorporates a mechanism for nonthermal photodesorption, which is required for good agreement with our experimental results. In order to investigate the fast photodesorption mechanism in more detail, we have recorded LII temporal profiles using a regeneratively amplified Nd:YAG laser with a pulse duration of 70 ps to heat the particles and a streak camera with a temporal resolution of {approx}65 ps to collect the signal. Preliminary results confirm earlier indications of a fast mechanism leading to signal decay rates of much less than a nanosecond. Parameters to which the model is sensitive include the initial soot temperature, the temperature of the ambient gas, and the partial pressure of oxygen. In order to narrow the model uncertainties, we have developed a source of soot that allows us to determine and control these parameters. Soot produced by a burner is extracted, diluted, and cooled in a flow tube, which is equipped with a Scanning Mobility Particle Sizer (SMPS) for characterization of the aggregates.

  14. Urologic robots and future directions

    Mozer, Pierre; Troccaz, Jocelyne; Stoianovici, Dan


    International audience; PURPOSE OF REVIEW: Robot-assisted laparoscopic surgery in urology has gained immense popularity with the daVinci system, but a lot of research teams are working on new robots. The purpose of this study is to review current urologic robots and present future development directions. RECENT FINDINGS: Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots. SUMMARY: The final goal of robot...

  15. Pediatric robotic urologic surgery-2014

    James T Kearns


    Full Text Available We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide.

  16. Application of artificial intelligence to the management of urological cancer.

    Abbod, Maysam F; Catto, James W F; Linkens, Derek A; Hamdy, Freddie C


    Artificial intelligence techniques, such as artificial neural networks, Bayesian belief networks and neuro-fuzzy modeling systems, are complex mathematical models based on the human neuronal structure and thinking. Such tools are capable of generating data driven models of biological systems without making assumptions based on statistical distributions. A large amount of study has been reported of the use of artificial intelligence in urology. We reviewed the basic concepts behind artificial intelligence techniques and explored the applications of this new dynamic technology in various aspects of urological cancer management. A detailed and systematic review of the literature was performed using the MEDLINE and Inspec databases to discover reports using artificial intelligence in urological cancer. The characteristics of machine learning and their implementation were described and reports of artificial intelligence use in urological cancer were reviewed. While most researchers in this field were found to focus on artificial neural networks to improve the diagnosis, staging and prognostic prediction of urological cancers, some groups are exploring other techniques, such as expert systems and neuro-fuzzy modeling systems. Compared to traditional regression statistics artificial intelligence methods appear to be accurate and more explorative for analyzing large data cohorts. Furthermore, they allow individualized prediction of disease behavior. Each artificial intelligence method has characteristics that make it suitable for different tasks. The lack of transparency of artificial neural networks hinders global scientific community acceptance of this method but this can be overcome by neuro-fuzzy modeling systems.

  17. Robotic Urological Surgery%机器人泌尿外科手术

    吴志辉; 莱锦洪


    @@ 1 Introduction In past few decades, better understandings of anatomy and advance in techniques and technology have revolutionized urological surgery. Laparoscopic surgery has now become one of the basic instruments of urologists. Laparoscopic radical nephrectomy is currently the standard of care in most urological centers.

  18. An accurate automated technique for quasi-optics measurement of the microwave diagnostics for fusion plasma

    Hu, Jianqiang; Liu, Ahdi; Zhou, Chu; Zhang, Xiaohui; Wang, Mingyuan; Zhang, Jin; Feng, Xi; Li, Hong; Xie, Jinlin; Liu, Wandong; Yu, Changxuan


    A new integrated technique for fast and accurate measurement of the quasi-optics, especially for the microwave/millimeter wave diagnostic systems of fusion plasma, has been developed. Using the LabVIEW-based comprehensive scanning system, we can realize not only automatic but also fast and accurate measurement, which will help to eliminate the effects of temperature drift and standing wave/multi-reflection. With the Matlab-based asymmetric two-dimensional Gaussian fitting method, all the desired parameters of the microwave beam can be obtained. This technique can be used in the design and testing of microwave diagnostic systems such as reflectometers and the electron cyclotron emission imaging diagnostic systems of the Experimental Advanced Superconducting Tokamak.

  19. [Doping and urologic tumors].

    Pinto, F; Sacco, E; Volpe, A; Gardi, M; Totaro, A; Calarco, A; Racioppi, M; Gulino, G; D'Addessi, A; Bassi, P F


    Several substances such as growth hormone (GH), erythropoietin (Epo), and anabolic steroids (AS) are improperly utilized to increase the performance of athletes. Evaluating the potential cancer risk associated with doping agents is difficult since these drugs are often used at very high doses and in combination with other licit or illicit drugs. The GH, via its mediator, the insulin-like growth factor 1 (IGF-1), is involved in the development and progression of cancer. Animal studies suggested that high levels of GH/IGF-1 increase progression of androgen-independent prostate cancer. Clinical data regarding prostate cancer are mostly based on epidemiological studies or indirect data such as IGF-1 high levels in patients with prostate cancer. Even if experimental studies showed a correlation between Epo and cancer, no clinical data are currently available on cancer development related to Epo as a doping agent. Androgens are involved in prostate carcinogenesis modulating genes that regulate cell proliferation, apoptosis and angiogenesis. Most information on AS is anecdotal (case reports on prostate, kidney and testicular cancers). Prospective epidemiologic studies failed to support the hypothesis that circulating androgens are positively associated with prostate cancer risk. Currently, clinical and epidemiological studies supporting association between doping and urological neoplasias are not available. Nowadays, exposure to doping agents starts more prematurely with a consequent longer exposition period; drugs are often used at very high doses and in combination with other licit or illicit drugs. Due to all these elements it is impossible to predict all the side effects, including cancer; more detailed studies are therefore necessary.

  20. Anesthesia Technique In A Patient With Langerhans Cell Histiocytosis For Diagnostic Biopsy

    Abdi S


    Full Text Available Histiocytosis under general anesthesia. In these patients, depend on organs involvement and dysfunction, anesthesia technique and specific drugs should be selected.of langerhans cells consist of a range of clinical manifestations, including bone eosimophilic granuloma, Hand-Schuller-Chiristian syndrome and Letterer-Siwe disease. Definitive diagnosis is based on biopsy of involved tissues. This report describes anesthesia technique in a 2 years old girl for diagnostic biopsy

  1. A novel technique for detecting antibiotic-resistant typhoid from rapid diagnostic tests.


    Fluoroquinolone-resistant typhoid is increasing. An antigen-detecting rapid diagnostic test (RDT) can rapidly diagnose typhoid from blood cultures. A simple, inexpensive molecular technique performed with DNA from positive RDTs accurately identified gyrA mutations consistent with phenotypic susceptibility testing results. Field diagnosis combined with centralized molecular resistance testing could improve typhoid management and surveillance in low-resource settings.

  2. The Sandtray Technique for Swedish Children 1945-1960: Diagnostics, Psychotherapy and Processes of Individualisation

    Nelson, Karin Zetterqvist


    The present article examines the development of a diagnostic and therapeutic technique named The Sandtray at the Erica Foundation, a privately-run child counselling service in Stockholm. Originally it was called The World, developed by the British paediatrician and child psychiatrist Margaret Lowenfeld. In the 1930s it was imported to Sweden,…

  3. Advanced Laser-Based Techniques for Gas-Phase Diagnostics in Combustion and Aerospace Engineering.

    Ehn, Andreas; Zhu, Jiajian; Li, Xuesong; Kiefer, Johannes


    Gaining information of species, temperature, and velocity distributions in turbulent combustion and high-speed reactive flows is challenging, particularly for conducting measurements without influencing the experimental object itself. The use of optical and spectroscopic techniques, and in particular laser-based diagnostics, has shown outstanding abilities for performing non-intrusive in situ diagnostics. The development of instrumentation, such as robust lasers with high pulse energy, ultra-short pulse duration, and high repetition rate along with digitized cameras exhibiting high sensitivity, large dynamic range, and frame rates on the order of MHz, has opened up for temporally and spatially resolved volumetric measurements of extreme dynamics and complexities. The aim of this article is to present selected important laser-based techniques for gas-phase diagnostics focusing on their applications in combustion and aerospace engineering. Applicable laser-based techniques for investigations of turbulent flows and combustion such as planar laser-induced fluorescence, Raman and Rayleigh scattering, coherent anti-Stokes Raman scattering, laser-induced grating scattering, particle image velocimetry, laser Doppler anemometry, and tomographic imaging are reviewed and described with some background physics. In addition, demands on instrumentation are further discussed to give insight in the possibilities that are offered by laser flow diagnostics.


    Kuladeepa Ananda Vaidya


    Full Text Available The technical capability to perform a correct and timely diagnosis of malaria infection in an ill patient is of critical importance since symptoms of complicated malaria may suddenly develop, leading to death of the patient. Even though peripheral blood smear examination is considered as the gold standard technique, tests like Quantitative Buffy Coat (QBC test and Rapid diagnostic tests (RDTs are widely used and more sensitive in detecting malaria parasite. Here we are briefly highlighting the importance of QBC and other useful diagnostic methods for diagnosing malaria. [National J of Med Res 2012; 2(3.000: 386-388

  5. Calibration techniques for fast-ion D{sub {alpha}} diagnostics

    Heidbrink, W. W.; Bortolon, A.; Muscatello, C. M.; Ruskov, E. [University of California, Irvine, California 92697 (United States); Grierson, B. A.; Podesta, M. [Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States)


    Fast-ion D{sub {alpha}} measurements are an application of visible charge-exchange recombination (CER) spectroscopy that provide information about the energetic ion population. Like other CER diagnostics, the standard intensity calibration is obtained with an integrating sphere during a vacuum vessel opening. An alternative approach is to create plasmas where the fast-ion population is known, then calculate the expected signals with a synthetic diagnostic code. The two methods sometimes agree well but are discrepant in other cases. Different background subtraction techniques and simultaneous measurements of visible bremsstrahlung and of beam emission provide useful checks on the calibrations and calculations.

  6. Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

    Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E


    Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

  7. MR cholangiopancreatography: technique, potential indications, and diagnostic features of benign, postoperative, and malignant conditions

    Becker, C.D. [Department of Radiology, Division of Diagnostic and Interventional Radiology, University Hospital of Geneva, CH-1211 Geneva (Switzerland); Grossholz, M. [Department of Radiology, Division of Diagnostic and Interventional Radiology, University Hospital of Geneva, CH-1211 Geneva (Switzerland); Mentha, G. [Department of Surgery, University Hospital of Geneva, CH-1211 Geneva (Switzerland); Peyer, R. de [Division of Gastroenterology, University Hospital of Geneva, CH-1211 Geneva (Switzerland); Terrier, F. [Department of Radiology, Division of Diagnostic and Interventional Radiology, University Hospital of Geneva, CH-1211 Geneva (Switzerland)


    The objective of this article is to review technical aspects, discuss potential clinical indications for MR cholangiopancreatography (MRCP) and demonstrate the spectrum of diagnostic findings in benign, postoperative, and malignant conditions. We describe our current imaging protocol in comparison with other available techniques. Using a non-breath-hold, heavily T2-weighted fast-spin-echo (FSE) sequence with or without respiratory gating we obtained coronal and axial source images and maximum intensity projections (MIPs) in 102 patients with suspected abnormalities of the biliary or pancreatic ducts. Based on this series we demonstrate the diagnostic appearance of a variety of benign, postoperative, and malignant conditions of the biliary and pancreatic ducts and discuss potential clinical indications for MRCP. The non-breath-hold FSE technique enables a consistent image quality even in patients who cannot cooperate well. Respiratory gating increased the rate of diagnostic examinations from 79 to 95 %. Acquisition of coronal and axial source images enables detection of bile duct stones as small as 2 mm, although calculi that are impacted and not surrounded by hyperintense bile may sometimes be difficult to detect. The MIP reconstructions help to determine the level of obstruction in malignant jaundice, delineate anatomical variants and malformations, and to diagnose inflammatory conditions, e. g., sclerosing cholangitis, the Mirizzi syndrome and inflammatory changes in the main pancreatic duct. The MRCP technique also correctly demonstrates the morphology of bilio-enteric or bilio-biliary anastomoses. Because MRCP provides sufficient diagnostic information in a wide range of benign and malignant biliary and pancreatic disorders, it could obviate diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in many clinical settings. The ERCP technique may be increasingly reserved for patients in whom nonsurgical interventional procedures are anticipated. (orig

  8. Comparison of diagnostic performances among bronchoscopic sampling techniques in the diagnosis of peripheral pulmonary lesions.

    Boonsarngsuk, Viboon; Kanoksil, Wasana; Laungdamerongchai, Sarangrat


    There are many sampling techniques dedicated to radial endobronchial ultrasound (R-EBUS) guided flexible bronchoscopy (FB). However, data regarding the diagnostic performances among bronchoscopic sampling techniques is limited. This study was conducted to compare the diagnostic yields among bronchoscopic sampling techniques in the diagnosis of peripheral pulmonary lesions (PPLs). A prospective study was conducted on 112 patients who were diagnosed with PPLs and underwent R-EBUS-guided FB between Oct 2012 and Sep 2014. Sampling techniques-including transbronchial biopsy (TBB), brushing cell block, brushing smear, rinsed fluid of brushing, and bronchoalveolar lavage (BAL)-were evaluated for the diagnosis. The mean diameter of the PPLs was 23.5±9.5 mm. The final diagnoses included 76 malignancies and 36 benign lesions. The overall diagnostic yield of R-EBUS-guided bronchoscopy was 80.4%; TBB gave the highest yield among the 112 specimens: 70.5%, 34.8%, 62.5%, 50.0% and 42.0% for TBB, brushing cell block, brushing smear, rinsed brushing fluid, and BAL fluid (BALF), respectively (Ptechniques should be performed together.

  9. In-vitro and in-vivo diagnostic techniques for prostate cancer: a review.

    McClure, Patrick; Elnakib, Ahmed; Abou El-Ghar, Mohamed; Khalifa, Fahmi; Soliman, Ahmed; El-Diasty, Tarek; Suri, Jasjit S; Elmaghraby, Adel; El-Baz, Ayman


    This paper overviews one of the most important, interesting, and challenging problems in oncology, early diagnosis of prostate cancer. Developing effective diagnostic techniques for prostate cancer is of great clinical importance and can improve the effectiveness of treatment and increase the patient's chance of survival. The main focus of this study is to overview the different in-vitro and in-vivo technologies for diagnosing prostate cancer. This review discusses the current clinically used in-vitro cancer diagnostic tools, such as biomarker tests and needle biopsies and including their applications, advantages, and limitations. Moreover, the current in-vitro research tools that focus on the role of nanotechnology in prostate cancer diagnosis have been detailed. In addition to the in-vitro techniques, the current study discusses in detail developed in-vivo non-invasive state-of-the-art Computer-Aided Diagnosis (CAD) systems for prostate cancer based on analyzing Transrectal Ultrasound (TRUS) and different types of magnetic resonance imaging (MRI), e.g., T2-MRI, Diffusion Weighted Imaging (DWI), Dynamic Contrast Enhanced (DCE)-MRI, and multi-parametric MRI, focusing on their implementation, experimental procedures, and reported outcomes. Furthermore, the paper addresses the limitations of the current prostate cancer diagnostic techniques, outlines the challenges that these techniques face, and introduces the recent trends to solve these challenges, which include biomarkers used in in-vitro lab-on-a-chip nanotechnology-based methods.

  10. Electrical-Based Diagnostic Techniques for Assessing Insulation Condition in Aged Transformers

    Issouf Fofana


    Full Text Available The condition of the internal cellulosic paper and oil insulation are of concern for the performance of power transformers. Over the years, a number of methods have been developed to diagnose and monitor the degradation/aging of the transformer internal insulation system. Some of this degradation/aging can be assessed from electrical responses. Currently there are a variety of electrical-based diagnostic techniques available for insulation condition monitoring of power transformers. In most cases, the electrical signals being monitored are due to mechanical or electric changes caused by physical changes in resistivity, inductance or capacitance, moisture, contamination or aging by-products in the insulation. This paper presents a description of commonly used and modern electrical-based diagnostic techniques along with their interpretation schemes.

  11. Molecular isothermal techniques for combating infectious diseases: towards low-cost point-of-care diagnostics.

    de Paz, Hector David; Brotons, Pedro; Muñoz-Almagro, Carmen


    Nucleic acid amplification techniques such as PCR have facilitated rapid and accurate diagnosis in central laboratories over the past years. PCR-based amplifications require high-precision instruments to perform thermal cycling reactions. Such equipment is bulky, expensive and complex to operate. Progressive advances in isothermal amplification chemistries, microfluidics and detectors miniaturisation are paving the way for the introduction and use of compact 'sample in-results out' diagnostic devices. However, this paradigm shift towards decentralised testing poses diverse technological, economic and organizational challenges both in industrialized and developing countries. This review describes the landscape of molecular isothermal diagnostic techniques for infectious diseases, their characteristics, current state of development, and available products, with a focus on new directions towards point-of-care applications.

  12. Tumor banks: the cornerstone of basic research in urology

    Sabrina T. Reis


    Full Text Available PURPOSE: Tumor banks have the primary responsibility for collecting, cataloging, storing and disseminating samples of tissues, cells and fluids, which are used by researchers to identify diagnostic molecular markers, prognostic indicators and therapeutic targets. The objective of this review was to describe a simple, reliable and reproducible protocol for obtaining and storing samples of urological tumors. MATERIALS AND METHODS: Urogenital tumor tissues were collected by the surgeons from the Urology Division of University of Sao Paulo Medical School. The obtained surgical specimens were immediately placed in liquid nitrogen, dry ice or in a tube containing RNAlater ®, and then stored by cryopreservation (-80°C. A mirror fragment was fixed in 10% formalin processed routinely and embedded in Paraplast®. RESULTS: We developed a protocol for the collection, cataloging, storage, conservation and use of tumor samples. During a period of one year the Urological Tumor Bank of the Urology Division stored 274 samples of prostate, bladder, kidney, penis and testicle tumors of different histological types, 74 urine and 271 serum samples. CONCLUSIONS: Having biological materials characterized and available along with the clinical patient information provides an integrated portrait of the patients and their diseases facilitating advances in molecular biology. It also promotes the development of translational research improving methods of diagnosis and cancer treatment.

  13. Nanotechnology applications in urology: a review.

    Maddox, Michael; Liu, James; Mandava, Sree Harsha; Callaghan, Cameron; John, Vijay; Lee, Benjamin R


    The objectives of this review are to discuss the current literature and summarise some of the promising areas with which nanotechnology may improve urological care. A Medline literature search was performed to elucidate all relevant studies of nanotechnology with specific attention to its application in urology. Urological applications of nanotechnology include its use in medical imaging, gene therapy, drug delivery, and photothermal ablation of tumours. In vitro and animal studies have shown initial encouraging results. Further study of nanotechnology for urological applications is warranted to bridge the gap between preclinical studies and translation into clinical practice, but nanomedicine has shown significant potential to improve urological patient care.




    Full Text Available Breast cancer is the most common cancer in women in both developed and undeveloped countries, and the second most frequent cause of cancer deaths after lung cancer. Although there have been many chemotherapeutic agents like 5-fluorouracil, taxol, tamoxifen, doxorubicin, cisplatin, and camptothecin and hormones are used to treat breast cancer. This review focuses on the causes of breast cancer, latest diagnostic techniques and various molecules under clinical trials for the treatment of breast cancer.

  15. Plasma diagnostic techniques in thermal-barrier tandem-mirror fusion experiments

    Silver, E.H.; Clauser, J.F.; Carter, M.R.; Failor, B.H.; Foote, J.H.; Hornady, R.S.; James, R.A.; Lasnier, C.J.; Perkins, D.E.


    We review two classes of plasma diagnostic techniques used in thermal-barrier tandem-mirror fusion experiments. The emphasis of the first class is to study mirror-trapped electrons at the thermal-barrier location. The focus of the second class is to measure the spatial and temporal behavior of the plasma space potential at various axial locations. The design and operation of the instruments in these two categories are discussed and data that are representative of their performance is presented.

  16. Diagnostic techniques for measurement of aerodynamic noise in free field and reverberant environment of wind tunnels

    El-Sum, H. M. A.; Mawardi, O. K.


    Techniques for studying aerodynamic noise generating mechanisms without disturbing the flow in a free field, and in the reverberation environment of the ARC wind tunnel were investigated along with the design and testing of an acoustic antenna with an electronic steering control. The acoustic characteristics of turbojet as a noise source, detection of direct sound from a source in a reverberant background, optical diagnostic methods, and the design characteristics of a high directivity acoustic antenna. Recommendations for further studies are included.

  17. Diagnostic Values of Laser Fluorescence Device with Other Techniques in Occlusal Caries Detection

    A. Chehresaz


    Full Text Available Objective: The aim of the present study was to compare the performance of laser fluorescence (LF method with other conventional diagnostic techniques in detection of smallocclusal caries in permanent teeth.Materials and Methods: Prior to this in vitro diagnostic study, a pilot study assessed intra-examiner reliability and reproducibility. The occlusal surfaces of 90 extracted human premolars were examined with four diagnostic methods: probing, visual inspection, bitewing(BW radiographs, and LF. The teeth were then sectioned for the purpose of histological examination. The data were analyzed using SPSS 15 software, and sensitivity,specificity and other diagnostic criteria of the techniques were calculated.Results: The intra-examiner reproducibility for probing and also radiographic techniques was 100%. The corresponded figure for LF (88% was more than visual inspection (82%.The highest level of validity of the examiner turned out to be in probing technique(76.9%. Sensitivity of visual inspection, probing, and LF methods was 54.5% and that of BW radiography was 27.5%. Specificity and efficiency of LF method were 84.8% and 81.1%, respectively. Probing and visual inspection showed the highest specificity (97.5% and 94.9, respectively and efficiency (92.2% and 90%, respectively among the methods.Conclusion: Specificity and efficiency of LF method were lower compared to those of other methods. Among all the investigated methods, the most efficient methods in the diagnosis of small occlusal caries in permanent teeth were probing and visual inspection,respectively.

  18. Magnetic Diagnostics of the Solar Corona: Synthesizing Optical and Radio Techniques

    Casini, R.; White, S. M.; Judge, P. G.


    In this contribution we review the current state-of-the-art of coronal magnetometry, in both optical and radio domains. We address the achievable objectives and the challenges of present measurement techniques and interpretation tools. In particular, we focus on the role that these observations can play for constraining and validating numerical models of the global coronal magnetic field. With regard to optical techniques, we mainly focus on the use of M1 diagnostics, further developing the theory of the formation of their polarization signatures in the magnetized corona.

  19. Optical diagnostics of vascular reactions triggered by weak allergens using laser speckle-contrast imaging technique

    Kuznetsov, Yu L; Kalchenko, V V [Department of Veterinary Resources, Weizmann Institute of Science, Rehovot, 76100 (Israel); Astaf' eva, N G [V.I.Razumovsky Saratov State Medical University, Saratov (Russian Federation); Meglinski, I V [N.G. Chernyshevsky Saratov State University, Saratov (Russian Federation)


    The capability of using the laser speckle contrast imaging technique with a long exposure time for visualisation of primary acute skin vascular reactions caused by a topical application of a weak contact allergen is considered. The method is shown to provide efficient and accurate detection of irritant-induced primary acute vascular reactions of skin. The presented technique possesses a high potential in everyday diagnostic practice, preclinical studies, as well as in the prognosis of skin reactions to the interaction with potentially allergenic materials. (laser biophotonics)

  20. Optical diagnostics of vascular reactions triggered by weak allergens using laser speckle-contrast imaging technique

    Kuznetsov, Yu L.; Kalchenko, V. V.; Astaf'eva, N. G.; Meglinski, I. V.


    The capability of using the laser speckle contrast imaging technique with a long exposure time for visualisation of primary acute skin vascular reactions caused by a topical application of a weak contact allergen is considered. The method is shown to provide efficient and accurate detection of irritant-induced primary acute vascular reactions of skin. The presented technique possesses a high potential in everyday diagnostic practice, preclinical studies, as well as in the prognosis of skin reactions to the interaction with potentially allergenic materials.

  1. Cost Analysis on Imaging Diagnostic Techniques in Cerebral and Abdominal Neonatal Pathology

    Carolina BOTAR-JID


    Full Text Available Background: Improvement of health care quality and cost control are the main aims of the health care reform in Romania. Objective: The aims of the research are to analyse the trend of costs for imaging techniques used as diagnostic tools for cerebral and abdominal neonatal pathology and to study the relationship between cost and diagnostic benefits. Design: This is a retrospective observational study design without a control group, conducted in the Radio-Imaging Department, Cluj District University Hospital, Romania, from October 2000 to February 2006. Patients: The study population was represented by neonates investigated in the Radio-Imaging Department, Cluj District University Hospital. Intervention: Five imaging diagnostic techniques used in the diagnosis of cerebral and abdominal neonatal pathology were investigated. Measurements: The costs of the investigated techniques were calculated. The concordance between clinical and imaging diagnostic was recorded. Results: Magnetic resonance proved to be the most expensive investigation. The rate between the raising of costs on investigation type on year was constant. The average cost of imaging investigations for patients with identified pathological aspects (€ 42.72 was not statistically significant (p > 0.05 compared with the average cost for patients with no pathologic imaging aspects (€ 37.62. The concordance between the clinical suspicion and the radio-imaging diagnosis was of 52.35%. Conclusions: The raise of radio-imaging investigation costs had a decreasing tendency over the years studied, decrease explained by the stabilization of the Romanian monetary market. The results on concordance analysis lead to the necessity of training of both clinicians and radiologists.

  2. PREFACE: IX International Conference on Modern Techniques of Plasma Diagnostics and their Application

    Savjolov, A. S.; Dodulad, E. I.


    The IX Conference on ''Modern Techniques of Plasma Diagnosis and their Application'' was held on 5 - 7 November, 2014 at National Research Nuclear University MEPhI (NRNU MEPhI). The goal of the conference was an exchange of information on both high-temperature and low-temperature plasma diagnostics as well as deliberation and analysis of various diagnostic techniques and their applicability in science, industry, ecology, medicine and other fields. The Conference also provided young scientists from scientific centres and universities engaged in plasma diagnostics with an opportunity to attend the lectures given by the leading specialists in this field as well as present their own results and findings. The first workshop titled ''Modern problems of plasma diagnostics and their application for control of chemicals and the environment'' took place at Moscow Engineering and Physics Institute (MEPhI) in June 1998 with the support of the Section on Diagnostics of the Council of Russian Academic of Science on Plasma Physics and since then these forums have been held at MEPhI every two years. In 2008 the workshop was assigned a conference status. More than 150 specialists on plasma diagnostics and students took part in the last conference. They represented leading Russian scientific centres (such as Troitsk Institute of Innovative and Thermonuclear Research, National Research Centre ''Kurchatov Institute'', Russian Federal Nuclear Centre - All-Russian Scientific Research Institute of Experimental Physics and others) and universities from Belarus, Ukraine, Germany, USA, Belgium and Sweden. About 30 reports were made by young researchers, students and post-graduate students. All presentations during the conference were broadcasted online over the internet with viewers in Moscow, Prague, St. Petersburgh and other cities. The Conference was held within the framework of the Centre of Plasma, Laser Research and Technology supported by MEPhI Academic Excellence Project (Russian

  3. Evaluation of ovine abortion associated with Toxoplasma gondii in Spain by different diagnostic techniques.

    Pereira-Bueno, J; Quintanilla-Gozalo, A; Pérez-Pérez, V; Alvarez-García, G; Collantes-Fernández, E; Ortega-Mora, L M


    A total of 173 aborted ovine foetuses and seven aborted caprine foetuses, submitted from different points of north and central Spain, were analysed to determine the role of T. gondii in abortion and to compare the utility of the most widely used techniques in diagnosis of the congenital infection (histopathology, serology--IFAT and ELISA--and a nested-PCR). Parasite infection was diagnosed in 40 (23.1%; n = 173) ovine foetuses by at least one of the diagnostic techniques used. A higher percentage of foetuses were diagnosed using serological techniques (IFAT and ELISA) (28.3%; n = 106) than by histologic examination (8.7%; n = 173) or PCR (6.9%; n = 173). No significant association between infection and the foetal age categories was found (P > 0.05). In this study, 106 aborted foetuses were analysed by all of the three diagnostic techniques. When we compared serological results, perfect agreement between ELISA and IFAT was obtained. On the contrary, slight to fair agreements were observed when histology results were compared with those obtained by serology and PCR techniques. All the positive foetuses were aborted in the mid (60%) or last (40%) term of pregnancy, but no significant differences were found between ages of the infected and non-infected foetuses (P > 0.05). This report indicates that toxoplasmosis may be a common cause of small ruminant abortion and neonatal death in Spain and points out the necessity of using different and complementary techniques to increase the probability of detecting Toxoplasma infection in an aborted foetus.

  4. Evidence-based medical research on diagnostic criteria and screening technique of vascular mild cognitive impairment

    Xia-wei LIU


    Full Text Available Background Vascular mild cognitive impairment (VaMCI is the prodromal syndrome of vascular dementia (VaD and key target for drug treatment. There is controversy over the diagnostic criteria and screening tools of VaMCI, which affects its clinical diagnosis. This paper aims to explore the clinical features, diagnostic criteria and screening technique of VaMCI.  Methods Taking "vascular mild cognitive impairment OR vascular cognitive impairment no dementia" as retrieval terms, search in PubMed database from January 1997 to March 2015 and screen relevant literatures concerning VaMCI. According to Guidance for the Preparation of Neurological Management Guidelines revised by European Federation of Neurological Societies (EFNS in 2004, evidence grading was performed on literatures. Results A total of 32 literatures in English were selected according to inclusion and exclusion criteria, including 3 guidelines and consensus and 29 clinical studies. Seven literatures (2 on Level Ⅰ, 5 on Level Ⅱ studied on neuropsychological features in VaMCI patients and found reduced processing speed and executive function impairment were main features. Two literatures reported the diagnostic criteria of VaMCI, including VaMCI criteria published by American Heart Association (AHA/American Stroke Association (ASA in 2011 and "Diagnostic Criteria for Vascular Cognitive Disorders" published by International Society for Vascular Behavioral and Cognitive Disorders (VASCOG in 2014. Fifteen literatures (4 on LevelⅠ, 11 on Level Ⅱ described the diagnostic criteria of VaMCI used in clinical research, from which 6 operational diagnostic items were extracted. Fourteen literatures (4 on Level Ⅰ, 10 on Level Ⅱ described neuropsychological assessment tools for VaMCI screening, and found the 5-minute protocol recommended by National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN was being good consistency with other neuropsychological

  5. Pelvic actinomycosis: urologic perspective

    Venkata K. Marella


    Full Text Available PURPOSE: Actinomycosis is a chronic granulomatous infection caused by the gram-positive anaerobic bacteria, Actinomyces israelli. This paper reviews the etiology and clinical presentation associated with Actinomycosis that often presents as a pelvic mass that mimics a pelvic malignancy. MATERIALS AND METHODS: A combination of patients treated by the authors in the recent past and a literature review of patients with pelvic Actinomycosis were assessed for diographic, clinical and predisposing co-factors. An analysis is made of age distribution, gender, diagnostic methods and treatment concepts. RESULTS: Thirty-three patients were included in the study that included 2 current patients and 31 obtained from literature review. There were 27 fiales (age range 16 - 69 years, mean 38 years and 6 males (16 - 55 years, mean 36 years. Presenting signs and symptoms were lower abdominal mass in 28 (85%; lower abdominal pain in 21 (63%; vaginal discharge or hiaturia in 7 (22%. Two patients developed fistulae (entero-vesico 1; vesico-cutaneous 1. Nineteen (70% of the 27 fiale patients had intra-uterine contraceptive devices (IUD. Four patients (12.5% (3 males and 1 fiale had urachus or urachal rinants. Cystoscopy in 12 patients noted an extrinsic mass effect, bullous edia and in one patient vegetative proliferation proven to be a chronic inflammatory change. Exploratory laparotomy was performed in 32 of the 33 patients who had excision of mass and involved organs. Diagnosis was established by histologic examination of rioved tissue. Penicillin (6 weeks therapy was utilized to control infections. CONCLUSION: Pelvic actinomycosis mimics pelvic malignancy and may be associated with the long-term use of intra-uterine contraceptive devices, and persistent urachal rinants. Rioval of infected mass and antibiotic therapy will eradicate the inflammatory process.

  6. Nuclear medicine in urological cancers: what is new?

    Nanni, Cristina; Zanoni, Lucia; Fanti, Stefano


    The diffusion of PET/computed tomography has opened up a new role for nuclear imaging in urological oncology. Prostate cancer is evaluated with choline ((11)C or (18)F) PET due to a lack of sensitivity of (18)F-fluorodeoxyglucose (FDG). However, many new tracers, such as (18)F-fluorocyclobutane-1-carboxylic acid and (68)Ga-prostate-specific membrane antigen, are under investigation, offering promising results in the particular setting of radically treated patients with biochemical relapse. The performance of (18)F-FDG depends on the histological type; indeed, renal cell cancer may present variable metabolic uptake. In this field, mainly antibodies labeled with positron emitters are under clinical evaluation. Finally, (18)F-FDG PET/computed tomography has been proven to show good accuracy in detecting metastatic testicular and bladder cancers, despite not having valid results in detecting local disease. The urological cancer diagnostic process is currently under continuous development.

  7. Iterative reconstruction technique with reduced volume CT dose index: diagnostic accuracy in pediatric acute appendicitis

    Didier, Ryne A. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Vajtai, Petra L. [Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States); Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Hopkins, Katharine L. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States)


    Iterative reconstruction technique has been proposed as a means of reducing patient radiation dose in pediatric CT. Yet, the effect of such reductions on diagnostic accuracy has not been thoroughly evaluated. This study compares accuracy of diagnosing pediatric acute appendicitis using contrast-enhanced abdominopelvic CT scans performed with traditional pediatric weight-based protocols and filtered back projection reconstruction vs. a filtered back projection/iterative reconstruction technique blend with reduced volume CT dose index (CTDI{sub vol}). Results of pediatric contrast-enhanced abdominopelvic CT scans done for pain and/or suspected appendicitis were reviewed in two groups: A, 192 scans performed with the hospital's established weight-based CT protocols and filtered back projection reconstruction; B, 194 scans performed with iterative reconstruction technique and reduced CTDI{sub vol}. Reduced CTDI{sub vol} was achieved primarily by reductions in effective tube current-time product (mAs{sub eff}) and tube peak kilovoltage (kVp). CT interpretation was correlated with clinical follow-up and/or surgical pathology. CTDI{sub vol}, size-specific dose estimates (SSDE) and performance characteristics of the two CT techniques were then compared. Between groups A and B, mean CTDI{sub vol} was reduced by 45%, and mean SSDE was reduced by 46%. Sensitivity, specificity and diagnostic accuracy were 96%, 97% and 96% in group A vs. 100%, 99% and 99% in group B. Accuracy in diagnosing pediatric acute appendicitis was maintained in contrast-enhanced abdominopelvic CT scans that incorporated iterative reconstruction technique, despite reductions in mean CTDI{sub vol} and SSDE by nearly half as compared to the hospital's traditional weight-based protocols. (orig.)

  8. Mycoplasma pneumoniae: Current knowledge on nucleic acid amplification techniques and serological diagnostics

    Katherine eLoens


    Full Text Available Mycoplasma pneumoniae (M. pneumoniae belongs to the class Mollicutes and has been recognized as a common cause of respiratory tract infections (RTIs, including community-acquired pneumonia (CAP, that occur worldwide and in all age groups. In addition, M. pneumoniae can simultaneously or sequentially lead to damage in the nervous system and has been associated with a wide variety of other acute and chronic diseases. During the past 10 years, the proportion of LRTI in children and adults, associated with M. pneumoniae infection has ranged from 0% to more than 50%. This variation is due to the age and the geographic location of the population examined but also due to the diagnostic methods used. The true role of M. pneumoniae in RTIs remains a challenge given the many limitations and lack of standardization of the applied diagnostic tool in most cases, with resultant wide variations in data from different studies.Correct and rapid diagnosis and/or management of M. pneumoniae infections is, however, critical to initiate appropriate antibiotic treatment and is nowadays usually done by PCR and/or serology. Several recent reviews have summarized current methods for the detection and identification of M. pneumoniae. This review will therefore provide a look at the general principles, advantages, diagnostic value, and limitations of the most currently used detection techniques for the etiological diagnosis of a M. pneumoniae infection as they evolve from research to daily practice.

  9. Application of RNB for high sensitive wear diagnostics in medicine technique and industry

    Fehsenfeld, P. E-mail:; Eifrig, C.; Kubat, R


    The RTM--Radionuclide Technique in Mechanical engineering--is now extended to the solution of world wide problems in medicine technique (prosthetics), and in development of modern materials (synthetic materials, ceramics, hard coatings, etc.) and their industrial application. RNB--Radioactive Nuclear Beams of {sup 7}Be or {sup 22}Na--may enable the required extreme thin radioactive surface labeling (several micrometers) of synthetic materials for wear measurements without producing radiation damages of influence to the wear properties of the material. The function principle and special properties of the RTM on-line wear diagnostics and its components, the measurement methods, the radioactive surface labeling, and the measurement instruments are explained. The quality features of a {sup 7}Be and {sup 22}Na-beam for RTM application are specified.

  10. Diagnostic procedures in tularaemia with special focus on molecular and immunological techniques.

    Splettstoesser, W D; Tomaso, H; Al Dahouk, S; Neubauer, H; Schuff-Werner, P


    Tularaemia is a severe bacterial zoonosis caused by the highly infectious agent Francisella tularensis. It is endemic in countries of the northern hemisphere ranging from North America to Europe, Asia and Japan. Very recently, Francisella-like strains causing disease in humans were described from tropical northern Australia. In the last decade, efforts have been made to develop sensitive and specific immunological and molecular techniques for the laboratory diagnosis of tularaemia and also for the definite identification of members of the species F. tularensis and its four subspecies. Screening for the keyword 'Francisella' a Medline search over the last decade was performed and articles describing diagnostic methods for tularaemia and its causative agent were selected. Besides classical microbiological techniques (cultivation, biochemical profiling, susceptibility testing) several new immunological and molecular approaches to identify F. tularensis have been introduced employing highly specific antibodies and various polymerase chain reaction (PCR)-based methods. Whereas direct antigen detection by enzyme-linked immunosorbent assay (ELISA) or immunofluorescence might allow early presumptive diagnosis of tularaemia, these methods--like all PCR techniques--still await further evaluation. Therefore, diagnosis of tularaemia still relies mainly on the demonstration of specific antibodies in the host. ELISA and immunoblot methods started to replace the standard tube or micro-agglutination assays. However, the diagnostic value of antibody detection in the very early clinical phase of tularaemia is limited. Francisella tularensis is regarded as a 'highest priority' biological agent (category 'A' according to the CDC, Atlanta, GA, USA), thus rapid and reliable diagnosis of tularaemia is required not only for a timely onset of therapy, the handling of outbreak investigations but also for the surveillance of endemic foci. Only very recently, evaluated test kits for

  11. Mining for diagnostic information in body surface potential maps: A comparison of feature selection techniques

    McCullagh Paul J


    Full Text Available Abstract Background In body surface potential mapping, increased spatial sampling is used to allow more accurate detection of a cardiac abnormality. Although diagnostically superior to more conventional electrocardiographic techniques, the perceived complexity of the Body Surface Potential Map (BSPM acquisition process has prohibited its acceptance in clinical practice. For this reason there is an interest in striking a compromise between the minimum number of electrocardiographic recording sites required to sample the maximum electrocardiographic information. Methods In the current study, several techniques widely used in the domains of data mining and knowledge discovery have been employed to mine for diagnostic information in 192 lead BSPMs. In particular, the Single Variable Classifier (SVC based filter and Sequential Forward Selection (SFS based wrapper approaches to feature selection have been implemented and evaluated. Using a set of recordings from 116 subjects, the diagnostic ability of subsets of 3, 6, 9, 12, 24 and 32 electrocardiographic recording sites have been evaluated based on their ability to correctly asses the presence or absence of Myocardial Infarction (MI. Results It was observed that the wrapper approach, using sequential forward selection and a 5 nearest neighbour classifier, was capable of choosing a set of 24 recording sites that could correctly classify 82.8% of BSPMs. Although the filter method performed slightly less favourably, the performance was comparable with a classification accuracy of 79.3%. In addition, experiments were conducted to show how (a features chosen using the wrapper approach were specific to the classifier used in the selection model, and (b lead subsets chosen were not necessarily unique. Conclusion It was concluded that both the filter and wrapper approaches adopted were suitable for guiding the choice of recording sites useful for determining the presence of MI. It should be noted however

  12. [Application of molecular diagnostic techniques in precision medicine of personalized treatment for colorectal cancer].

    Fu, Ji; Lin, Guole


    Precision medicine is to customize the treatment options for individual patient based on the personal genome information. Colorectal cancer (CRC) is one of the most common cancer worldwide. Molecular heterogeneity of CRC, which includes the MSI phenotype, hypermutation phenotype, and their relationship with clinical preferences, is believed to be one of the main factors responsible for the considerable variability in treatment response. The development of powerful next-generation sequencing (NGS) technologies allows us to further understand the biological behavior of colorectal cancer, and to analyze the prognosis and chemotherapeutic drug reactions by molecular diagnostic techniques, which can guide the clinical treatment. This paper will introduce the new findings in this field. Meanwhile we integrate the new progress of key pathways including EGFR, RAS, PI3K/AKT and VEGF, and the experience in selective patients through associated molecular diagnostic screening who gain better efficacy after target therapy. The technique for detecting circulating tumor DNA (ctDNA) is introduced here as well, which can identify patients with high risk for recurrence, and demonstrate the risk of chemotherapy resistance. Mechanism of tumor drug resistance may be revealed by dynamic observation of gene alteration during treatment.

  13. A study on the fault diagnostic techniques for reactor internal structures using neutron noise analysis

    Kim, Tae Ryong; Jeong, Seong Ho; Park, Jin Ho; Park, Jin Suk [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)


    The unfavorable phenomena, such as flow induced vibration and aging process in reactor internals, cause degradation of structural integrity and may result in loosing some mechanical binding components which might impact other equipments and components or cause flow blockage. Since these malfunctions and potential failures change reactor noise signal, it is necessary to analyze reactor noise signal for early fault diagnosis in the point of few of safety and plant economics. The objectives of this study are to establish fault diagnostic and TS(thermal shield), and to develop a data acquisition and signal processing software system. In the first year of this study, an analysis technique for the reactor internal vibration using the reactor noise was proposed. With the technique proposed and the reactor noise signals (ex-core neutron and acceleration), the dynamic characteristics of Ulchin-1 reactor internals were obtained, and compared with those of Tricastin-1 which is the prototype of Ulchin-1. In the second year, a PC-based expert system for reactor internals fault diagnosis is developed, which included data acquisition, signal processing, feature extraction function, and represented diagnostic knowledge by the IF-THEN rule. To know the effect of the faults, the reactor internals of Ulchin-1 is modeled using FEM and simulated with an artificial defect given in the hold-down spring. Trend in the dynamic characteristics of reactor internals is also observed during one fuel cycle to know the effect of boron concentration. 100 figs, 7 tabs, 18 refs. (Author).

  14. Institutional Review Board approval and innovation in urology: current practice and safety issues.

    Sundaram, Varun; Vemana, Goutham; Bhayani, Sam B


    To retrospectively review recent publications describing novel procedures/techniques, and describe the Institutional Review Board (IRB)/ethics approval process and potential ethical dilemmas in their reporting. We searched PubMed for papers about innovative or novel procedures/techniques between 2011 and August 2012. A query of titles/abstracts in the Journal of Urology, Journal of Endourology, European Urology, BJU International, and Urology identified relevant papers. These results were reviewed for human studies that described an innovative technique, procedure, approach, initial series, and/or used new technology. In all, 91 papers met criteria for inclusion; 25 from the Journal of Endourology, 14 from the Journal of Urology, nine from European Urology, 15 from the BJU International and 28 from Urology. IRB/ethics approval was given for an experimental procedure or database in 24% and 22%, respectively. IRB/ethics approval was not mentioned in 52.7% of studies. Published IRB/ethics approvals for innovative techniques are heterogeneous including database, retrospective, and prospective approvals. Given the concept that innovations are likely not in the legal or ethical standard of care, strong consideration should be given to obtaining IRB/ethics approval before the actual procedure, instead of approval to merely report database outcomes. © 2013 The Authors. BJU International © 2013 BJU International.

  15. Development of a 2D temperature measurement technique for combustion diagnostics using 2-line atomic fluorescence

    Engstroem, Johan


    The present thesis is concerned with the development and application of a novel planar laser-induced fluorescence (PLIF) technique for temperature measurements in a variety of combusting flows. Accurate measurement of temperature is an essential task in combustion diagnostics, since temperature is one of the most fundamental quantities for the characterization of combustion processes. The technique is based on two-line atomic fluorescence (TLAF) from small quantities of atomic indium (In) seeded into the fuel. It has been developed from small-scale experiments in laboratory flames to the point where practical combustion systems can be studied. The technique is conceptually simple and reveals temperature information in the post-flame regions. The viability of the technique has been tested in three extreme measurement situations: in spark ignition engine combustion, in ultra-lean combustion situations such as lean burning aero-engine concepts and, finally, in fuel-rich combustion. TLAF was successfully applied in an optical Sl engine using isooctane as fuel. The wide temperature sensitivity, 700 - 3000 K, of the technique using indium atoms allowed measurements over the entire combustion cycle in the engine to be performed. In applications in lean combustion a potential problem caused by the strong oxidation processes of indium atoms was encountered. This limits measurement times due to deposits of absorbing indium oxide on measurement windows. The seeding requirement is a disadvantage of the technique and can be a limitation in some applications. The results from experiments performed in sooting flames are very promising for thermometry measurements in such environments. Absorption by hydrocarbons and other native species was found to be negligible. Since low laser energies and low seeding concentrations could be used, the technique did not, unlike most other incoherent optical thermometry techniques, suffer interferences from LII of soot particles or LIF from PAH

  16. Perceived Role of Social Media in Urologic Knowledge Acquisition Among Young Urologists: A European Survey.

    Rivas, Juan Gomez; Socarras, Moises Rodriguez; Patruno, Giulio; Uvin, Pieter; Esperto, Francesco; Dinis, Paulo Jorge; Roupret, Morgan; Borgmann, Hendrik


    Social media (SoMe) are increasingly being integrated into personal and professional life, with urology being a leading medical specialty in SoMe adoption. We aimed to assess the perceived role of SoMe in urologic knowledge acquisition among young urologists across Europe. Members of the European Society of Residents in Urology designed a 20-item online survey via The survey was designed in accordance with Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines and was distributed via e-mail and social media in 23 European countries to urology residents and young urologists. Statistical Package for the Social Sciences (SPSS) software was used for descriptive statistics and statistical analysis. For comparative analysis the Mann-Whitney U test was used. A total of 316 young urologists with a mean age of 31.2±3.9 yr responded to the survey. Of the respondents, 99% use SoMe in a personal and/or professional way. YouTube and LinkedIn are the most frequently used platforms for professional use. SoMe were ranked in third place as an information source for urologic news/updates, lying behind journals and websites but ahead of congresses and books. Video content from YouTube or other sources was ranked as a preferred tool to see/understand surgical techniques ahead of websites and reference books. 61% follow urologic associations, 47% follow urologic events, 44% follow urologic journals, and 39% follow urologic experts on SoMe. The perceived influence of SoMe on urology knowledge was rated as moderate to high by 63% and as low to none by 37% of young urologists. Of the respondents, 44% apply guidelines on the appropriate use of SoMe in urology. SoMe play a significant role in knowledge acquisition by young urologists in Europe. Physicians, organizations, and institutions should strive to spread and provide valuable educational content through SoMe. Social media can be valuable for education in urology because it is useful to keep

  17. Urine sampling techniques in symptomatic primary-care patients: a diagnostic accuracy review.

    Holm, Anne; Aabenhus, Rune


    Choice of urine sampling technique in urinary tract infection may impact diagnostic accuracy and thus lead to possible over- or undertreatment. Currently no evidencebased consensus exists regarding correct sampling technique of urine from women with symptoms of urinary tract infection in primary care. The aim of this study was to determine the accuracy of urine culture from different sampling-techniques in symptomatic non-pregnant women in primary care. A systematic review was conducted by searching Medline and Embase for clinical studies conducted in primary care using a randomized or paired design to compare the result of urine culture obtained with two or more collection techniques in adult, female, non-pregnant patients with symptoms of urinary tract infection. We evaluated quality of the studies and compared accuracy based on dichotomized outcomes. We included seven studies investigating urine sampling technique in 1062 symptomatic patients in primary care. Mid-stream-clean-catch had a positive predictive value of 0.79 to 0.95 and a negative predictive value close to 1 compared to sterile techniques. Two randomized controlled trials found no difference in infection rate between mid-stream-clean-catch, mid-stream-urine and random samples. At present, no evidence suggests that sampling technique affects the accuracy of the microbiological diagnosis in non-pregnant women with symptoms of urinary tract infection in primary care. However, the evidence presented is in-direct and the difference between mid-stream-clean-catch, mid-stream-urine and random samples remains to be investigated in a paired design to verify the present findings.

  18. [Traditional Chinese medicine in urology].

    Hüsch, T; Tsaur, I; Reiter, M; Mager, R; Haferkamp, A


    Traditional Chinese medicine (TCM) is an ancient holistic medicine based on the doctrine of Tao and Qi. Tao represents an alteration from which the polarity of Yin and Yang arises and Qi is the vitality which circulates through the body. Therapeutic concepts of TCM include acupuncture, herbal therapy, nutrition and Tuina, a form of manual therapy. TCM is now gaining increased acceptance in the Western society as a complementary therapy. Acupuncture and herbal therapy are the main forms of implementation of TCM in urology.

  19. Hollow waveguide for urology treatment

    Jelínková, H.; Němec, M.; Koranda, P.; Pokorný, J.; Kőhler, O.; Drlík, P.; Miyagi, M.; Iwai, K.; Matsuura, Y.


    The aim of our work was the application of the special sealed hollow waveguide system for the urology treatment - In our experimental study we have compared the effects of Ho:YAG (wavelength 2100 nm) and Er:YAG (wavelength 2940 nm) laser radiation both on human urinary stones (or compressed plaster samples which serve as a model) fragmentation and soft ureter tissue incision in vitro. Cyclic Olefin Polymer - coated silver (COP/Ag) hollow glass waveguides with inner and outer diameters 700 and 850 μm, respectively, were used for the experiment. To prevent any liquid to diminish and stop the transmission, the waveguide termination was utilized.

  20. Robot-assisted laparoscopic urological surgery in children.

    Sávio, Luís F; Nguyen, Hiep T


    Robot-assisted laparoscopic surgery (RALS) has been proven to be safe and effective for various urological procedures in children, including pyeloplasty, orchiopexy, nephrectomy, and bladder augmentation. The robot system enables delicate and precise movements, which are ideal for the types of reconstructive surgeries that children with urological issues often require, overcoming many of the impediments associated with the conventional laparoscopic approach. RALS helps the relative novice to perform fine surgical techniques and is thought to reduce the learning curve associated with some surgical techniques, such as intracorporeal suturing, owing to the improved freedom of movement of the surgical instruments, the ergonomic positioning of the surgeon, and the 3D vision provided by the robotic system. Given the favourable safety profile and associated benefits of the robot system, including reductions in mean postoperative hospital stay compared with conventional procedures, RALS is becoming more widely adopted by paediatric urologists.

  1. Indications and results of the unilateral /sup 123/I-hippurate-clearance in an ambulant urological-nephrological patients collective

    Mariss, P.; Haubold, E.


    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg /sup 123/I-hippurate using a large field scintillation camera, external scintillation probe over the right shoulder and a computer system. The indications were patients with hypertension, chronic pyelonephritis, unilateral nephrocirrhosis, exclusion or approval of renal failure, furthermore diverse malformations of the urovesical system, nephrolithiasis and follow-up after urological operations. The unilateral renal clearance by /sup 123/I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods.

  2. Current laparoscopy training in urology: a comparison of fellowships governed by the Society of Urologic Oncology and the Endourological Society.

    Yap, Stanley A; Ellison, Lars M; Low, Roger K


    Laparoscopic surgery is now an integral technique in the practice of urology, particularly in the management of certain urologic malignancies. Advanced laparoscopy training in urology is primarily reserved for those pursuing fellowship training and is offered both by traditional endourology fellowships and increasingly in urologic oncology fellowships. The purpose of our study was to evaluate and compare current laparoscopy training at the fellowship level. A 17-item questionnaire was developed with support from both the Endourological Society (EUS) and Society of Urologic Oncology (SUO). Surveys were sent to program directors of fellowships recognized by the EUS and SUO. Directors were surveyed on the laparoscopic case volume, degree of oncology training, and career choice of their graduates. Data were analyzed with Wilcoxon rank-sum and Student t tests. Our survey had an overall response rate of 60%. Fellows performed more than 100 laparoscopies during their training period in 57% of EUS and 25% of SUO fellowship programs. Similar trends are demonstrated when analyzing robotic procedures, with 73% of EUS fellows performing more than 50 procedures compared with 43% of SUO fellows. The majority (59%) of EUS programs provide oncologic training. Between 44% and 100% of graduates from EUS and SUO fellowships obtain academic positions. The majority of SUO directors (63%) believe that fellowship training in laparoscopy should be provided in fellowships governed solely by the SUO, while 41% of EUS directors believe this training should be governed solely by the EUS. Endourology fellowships currently provide a greater exposure to laparoscopy and robotics than SUO fellowships. The percentage of fellows seeking academic positions is similar for EUS and SUO fellowship programs and has remained stable for several years. Directors of fellowship programs that offer advanced laparoscopic training have divergent views as to which administrative body should govern its future.


    Mozer, Pierre; Troccaz, Jocelyne; Stoianovici, Dan


    Purpose of review Robot-assisted laparoscopic surgery in urology has gained immense popularity with the Da Vinci system but a lot of research teams are working on new robots. The purpose of this paper is to review current urologic robots and present future developments directions. Recent findings Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots. Summary The final goal of robots is to allow safer and more homogeneous outcomes with less variability of surgeon performance, as well as new tools to perform tasks based on medical transcutaneous imaging, in a less invasive way, at lower costs. It is expected that improvements for remote system could be augmented reality, haptic feed back, size reduction and development of new tools for NOTES surgery. The paradigm of image-guided robots is close to a clinical availability and the most advanced robots are presented with end-user technical assessments. It is also notable that the potential of robots lies much further ahead than the accomplishments of the daVinci system. The integration of imaging with robotics holds a substantial promise, because this can accomplish tasks otherwise impossible. Image guided robots have the potential to offer a paradigm shift. PMID:19057227

  4. Urologic robots and future directions

    Mozer, Pierre; Stoianovici, Dan; 10.1097/MOU.0b013e32831cc1ba


    PURPOSE OF REVIEW: Robot-assisted laparoscopic surgery in urology has gained immense popularity with the daVinci system, but a lot of research teams are working on new robots. The purpose of this study is to review current urologic robots and present future development directions. RECENT FINDINGS: Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots. SUMMARY: The final goal of robots is to allow safer and more homogeneous outcomes with less variability of surgeon performance, as well as new tools to perform tasks on the basis of medical transcutaneous imaging, in a less invasive way, at lower costs. It is expected that improvements for a remote system could be augmented in reality, with haptic feedback, size reduction, and development of new tools for natural orifice translumenal endoscopic surgery. The paradigm of image-guided robots is close to clinical availability and the most advanced robots are presented with end-use...

  5. URobotics--Urology Robotics at Johns Hopkins.

    Stoianovici, D


    URobotics (Urology Robotics) is a program of the Urology Department at the Johns Hopkins Medical Institutions dedicated to the development of new technology for urologic surgery ( urobotics). The program is unique in that it is the only academic engineering program exclusively applied to urology. The program combines efforts and expertise from the medical and engineering fields through a close partnership of clinical and technical personnel. Since its creation in 1996, the URobotics lab has created several devices, instruments, and robotic systems, several of which have been successfully used in the operating room. This article reviews the technology developed in our laboratory and its surgical applications, and highlights our future directions.

  6. [The latex agglutination with video digital registration: the enhancement of diagnostic significance of conventional technique].

    Starovoĭtova, T A; Steriopolo, N A; Zaĭko, V V; Vengerov, Iu Iu


    The rapid semiquantitative latex-tests, because of their analytic characteristics and convenient application, became widespread in the practice of laboratory diagnostics. Though, in spite of high sensitivity and specificity, their diagnostic effectiveness is lower that it could be mainly because of the impossibility to document the results of latex agglutinative re4actions and to manage the objective quality control. The application of systems of video digital registration permits to enhance the clinical significance of these analyses. By means of scanner systems (control and program complex "Expert Lab") the image of analytic objects is received with the results of latex agglutination reaction. The application of program techniques (the programs "Expert Lab - Agglutination" and "Expert Lab - Agglutination - Micros") in data processing permits to get the precise qualitative characteristics of active reactions, to ensure the automatic interpretation of results and gives an opportunity to proceed with the internal laboratory quality control. The saving of analytic object image in computer memory after termination of reaction favors the formation of data base, the implementation of retrospective evaluation of obtained results, additional consultations in dubious cases, including on-line. The application of complex "Expert Lab" permitted to develop the miniaturizes matrix systems permitting to decrease the withdrawal of latex reagents, to increase the productivity of analytical stage of operation preserving all analytical characteristics of method.

  7. A novel non-invasive diagnostic sampling technique for cutaneous leishmaniasis.

    Taslimi, Yasaman; Sadeghipour, Pardis; Habibzadeh, Sima; Mashayekhi, Vahid; Mortazavi, Hossien; Müller, Ingrid; Lane, Majella E; Kropf, Pascale; Rafati, Sima


    Accurate diagnosis of cutaneous leishmaniasis (CL) is important for chemotherapy and epidemiological studies. Common approaches for Leishmania detection involve the invasive collection of specimens for direct identification of amastigotes by microscopy and the culturing of promastigotes from infected tissues. Although these techniques are highly specific, they require highly skilled health workers and have the inherent risks of all invasive procedures, such as pain and risk of bacterial and fungal super-infection. Therefore, it is essential to reduce discomfort, potential infection and scarring caused by invasive diagnostic approaches especially for children. In this report, we present a novel non-invasive method, that is painless, rapid and user-friendly, using sequential tape strips for sampling and isolation of DNA from the surface of active and healed skin lesions of CL patients. A total of 119 patients suspected of suffering from cutaneous leishmaniasis with different clinical manifestations were recruited and samples were collected both from their lesions and from uninfected areas. In addition, 15 fungal-infected lesions and 54 areas of healthy skin were examined. The duration of sampling is short (less than one minute) and species identification by PCR is highly specific and sensitive. The sequential tape stripping sampling method is a sensitive, non-invasive and cost-effective alternative to traditional diagnostic assays and it is suitable for field studies as well as for use in health care centers.

  8. Non-invasive diagnostic techniques in the diagnosis of squamous cell carcinoma.

    Warszawik-Hendzel, Olga; Olszewska, Małgorzata; Maj, Małgorzata; Rakowska, Adriana; Czuwara, Joanna; Rudnicka, Lidia


    Squamous cell carcinoma is the second most common cutaneous malignancy after basal cell carcinoma. Although the gold standard of diagnosis for squamous cell carcinoma is biopsy followed by histopathology evaluation, optical non-invasive diagnostic tools have obtained increased attention. Dermoscopy has become one of the basic diagnostic methods in clinical practice. The most common dermoscopic features of squamous cell carcinoma include clustered vascular pattern, glomerular vessels and hyperkeratosis. Under reflectance confocal microscopy, squamous cell carcinoma shows an atypical honeycomb or disarranged pattern of the spinous-granular layer of the epidermis, round nucleated bright cells in the epidermis and round vessels in the dermis. High frequency ultrasound and optical coherence tomography may be helpful in predominantly in pre-surgical evaluation of tumor size. Emerging non-invasive or minimal invasive techniques with possible application in the diagnosis of squamous cell carcinoma of the skin, lip, oral mucosa, vulva or other tissues include high-definition optical coherence tomography, in vivo multiphoton tomography, direct oral microscopy, electrical impedance spectroscopy, fluorescence spectroscopy, Raman spectroscopy, elastic scattering spectroscopy, differential path-length spectroscopy, nuclear magnetic resonance spectroscopy, and angle-resolved low coherence interferometry.

  9. The diagnostic rules of peripheral lung cancer preliminary study based on data mining technique

    Yongqian Qiang; Youmin Guo; Xue Li; Qiuping Wang; Hao Chen; Duwu Cui


    Objective: To discuss the clinical and imaging diagnostic rules of peripheral lung cancer by data mining technique, and to explore new ideas in the diagnosis of peripheral lung cancer, and to obtain early-stage technology and knowledge support of computer-aided detecting (CAD). Methods: 58 cases of peripheral lung cancer confirmed by clinical pathology were collected. The data were imported into the database after the standardization of the clinical and CT findings attributes were identified. The data was studied comparatively based on Association Rules (AR) of the knowledge discovery process and the Rough Set (RS) reduction algorithm and Genetic Algorithm(GA) of the generic data analysis tool (ROSETTA), respectively. Results: The genetic classification algorithm of ROSETTA generates 5 000 or so diagnosis rules. The RS reduction algorithm of Johnson's Algorithm generates 51 diagnosis rules and the AR algorithm generates 123 diagnosis rules. Three data mining methods basically consider gender, age,cough, location, lobulation sign, shape, ground-glass density attributes as the main basis for the diagnosis of peripheral lung cancer. Conclusion: These diagnosis rules for peripheral lung cancer with three data mining technology is same as clinical diagnostic rules, and these rules also can be used to build the knowledge base of expert system. This study demonstrated the potential values of data mining technology in clinical imaging diagnosis and differential diagnosis.

  10. Advanced microscopic and histochemical techniques: diagnostic tools in the molecular era of myology

    G Meola


    Full Text Available Over the past two centuries, myology (i.e. the basic and clinical science of muscle and muscle disease has passed through 3 stages of development: the classical period, the modern stage and the molecular era. The classical period spans the last part of nineteenth century and the earlier part of the twentieth century. During this time, several major muscle disease were clinically and pathologically characterized, including Duchenne muscular dystrophy (DMD, myotonic dystrophy (DM and facioscapulohumeral dystrophy (FSHD. The modern stage in the second half of the twentieth century is characterized by the adaptation of histo and cytochemical techniques to the study of muscle biopsies. These tools improved the diagnostic accuracy and made possible the identification of new changes and structures (Engel and Cunningham, 1963; Scarlato, 1975.

  11. [Techniques and strategy of pathological sampling in the diagnostic and therapeutic management of lung cancer].

    Remmelink, M; Sokolow, Y; Leduc, D


    Histopathology is key to the diagnosis and staging of lung cancer. This analysis requires tissue sampling from primary and/or metastatic lesions. The choice of sampling technique is intended to optimize diagnostic yield while avoiding unnecessarily invasive procedures. Recent developments in targeted therapy require increasingly precise histological and molecular characterization of the tumor. Therefore, pathologists must be economical with tissue samples to ensure that they have the opportunity to perform all the analyses required. More than ever, good communication between clinician, endoscopist or surgeon, and pathologist is essential. This is necessary to ensure that all participants in the process of lung cancer diagnosis collaborate to ensure that the appropriate number and type of biopsies are performed with the appropriate tissue sampling treatment. This will allow performance of all the necessary analyses leading to a more precise characterization of the tumor, and thus the optimal treatment for patients with lung cancer. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  12. Piriformis syndrome: implications of anatomical variations, diagnostic techniques, and treatment options.

    Cassidy, Lindsey; Walters, Andrew; Bubb, Kathleen; Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios


    Details of piriformis syndrome, including the proper diagnosis and most effective form of treatment, continue to be controversial. While the cause, diagnosis, and treatment of piriformis syndrome remain elusive, many studies have been conducted to investigate newly developed diagnostic techniques as well as various treatment options for piriformis-induced sciatica. Despite the quantity of literature, few studies have demonstrated statistically significant results that support one form of treatment over another. Thus, despite the evidence supporting the newer treatment methodologies for piriformis syndrome, research should continue. It is important not only to evaluate treatment outcomes based on associated pain relief, but also to investigate the functional and anatomical return that patients experience from these studied treatments in order to fully explore the most effective form of therapy for piriformis syndrome.

  13. New Diagnostic, Launch and Model Control Techniques in the NASA Ames HFFAF Ballistic Range

    Bogdanoff, David W.


    This report presents new diagnostic, launch and model control techniques used in the NASA Ames HFFAF ballistic range. High speed movies were used to view the sabot separation process and the passage of the model through the model splap paper. Cavities in the rear of the sabot, to catch the muzzle blast of the gun, were used to control sabot finger separation angles and distances. Inserts were installed in the powder chamber to greatly reduce the ullage volume (empty space) in the chamber. This resulted in much more complete and repeatable combustion of the powder and hence, in much more repeatable muzzle velocities. Sheets of paper or cardstock, impacting one half of the model, were used to control the amplitudes of the model pitch oscillations.

  14. Computer Aided Diagnostic Support System for Skin Cancer: A Review of Techniques and Algorithms

    Masood, Ammara; Al-Jumaily, Adel Ali


    Image-based computer aided diagnosis systems have significant potential for screening and early detection of malignant melanoma. We review the state of the art in these systems and examine current practices, problems, and prospects of image acquisition, pre-processing, segmentation, feature extraction and selection, and classification of dermoscopic images. This paper reports statistics and results from the most important implementations reported to date. We compared the performance of several classifiers specifically developed for skin lesion diagnosis and discussed the corresponding findings. Whenever available, indication of various conditions that affect the technique's performance is reported. We suggest a framework for comparative assessment of skin cancer diagnostic models and review the results based on these models. The deficiencies in some of the existing studies are highlighted and suggestions for future research are provided. PMID:24575126

  15. Reducing beam shaper alignment complexity: diagnostic techniques for alignment and tuning

    Lizotte, Todd E.


    Safe and efficient optical alignment is a critical requirement for industrial laser systems used in a high volume manufacturing environment. Of specific interest is the development of techniques to align beam shaping optics within a beam line; having the ability to instantly verify by a qualitative means that each element is in its proper position as the beam shaper module is being aligned. There is a need to reduce these types of alignment techniques down to a level where even a newbie to optical alignment will be able to complete the task. Couple this alignment need with the fact that most laser system manufacturers ship their products worldwide and the introduction of a new set of variables including cultural and language barriers, makes this a top priority for manufacturers. Tools and methodologies for alignment of complex optical systems need to be able to cross these barriers to ensure the highest degree of up time and reduce the cost of maintenance on the production floor. Customers worldwide, who purchase production laser equipment, understand that the majority of costs to a manufacturing facility is spent on system maintenance and is typically the largest single controllable expenditure in a production plant. This desire to reduce costs is driving the trend these days towards predictive and proactive, not reactive maintenance of laser based optical beam delivery systems [10]. With proper diagnostic tools, laser system developers can develop proactive approaches to reduce system down time, safe guard operational performance and reduce premature or catastrophic optics failures. Obviously analytical data will provide quantifiable performance standards which are more precise than qualitative standards, but each have a role in determining overall optical system performance [10]. This paper will discuss the use of film and fluorescent mirror devices as diagnostic tools for beam shaper module alignment off line or in-situ. The paper will also provide an overview

  16. Ex vivo applications of multiphoton microscopy in urology

    Jain, Manu; Mukherjee, Sushmita


    Background: Routine urological surgery frequently requires rapid on-site histopathological tissue evaluation either during biopsy or intra-operative procedure. However, resected tissue needs to undergo processing, which is not only time consuming but may also create artifacts hindering real-time tissue assessment. Likewise, pathologist often relies on several ancillary methods, in addition to H&E to arrive at a definitive diagnosis. Although, helpful these techniques are tedious and time consuming and often show overlapping results. Therefore, there is a need for an imaging tool that can rapidly assess tissue in real-time at cellular level. Multiphoton microscopy (MPM) is one such technique that can generate histology-quality images from fresh and fixed tissue solely based on their intrinsic autofluorescence emission, without the need for tissue processing or staining. Design: Fresh tissue sections (neoplastic and non-neoplastic) from biopsy and surgical specimens of bladder and kidney were obtained. Unstained deparaffinized slides from biopsy of medical kidney disease and oncocytic renal neoplasms were also obtained. MPM images were acquired using with an Olympus FluoView FV1000MPE system. After imaging, fresh tissues were submitted for routine histopathology. Results: Based on the architectural and cellular details of the tissue, MPM could characterize normal components of bladder and kidney. Neoplastic tissue could be differentiated from non-neoplastic tissue and could be further classified as per histopathological convention. Some of the tumors had unique MPM signatures not otherwise seen on H&E sections. Various subtypes of glomerular lesions were identified as well as renal oncocytic neoplasms were differentiated on unstained deparaffinized slides. Conclusions: We envision MPM to become an integral part of regular diagnostic workflow for rapid assessment of tissue. MPM can be used to evaluate the adequacy of biopsies and triage tissues for ancillary studies

  17. Interventional urology: endourology in small animal veterinary medicine.

    Berent, Allyson C


    The use of novel image-guided techniques in veterinary medicine has become more widespread, especially in urologic diseases. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of minimally invasive alternatives using interventional radiology and interventional endoscopy techniques has become incredibly appealing to owners and clinicians. This article provides a brief overview of some of the most common procedures done in endourology in veterinary medicine to date, providing as much evidence-based medicine as possible when comparing with traditional surgical alternatives.

  18. Sportsmen’s Groin—Diagnostic Approach and Treatment With the Minimal Repair Technique

    Muschaweck, Ulrike; Berger, Luise Masami


    Context: Sportsmen’s groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms. Methods: The authors developed an innovative open suture repair—the Minimal Repair technique—to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures. Results: The following advantages of the Minimal Repair technique were found: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median). Conclusion: The Minimal Repair technique is an effective and safe way to treat sportsmen’s groin. PMID:23015941

  19. [Results of an investigation by questionnaire into interest in neuro-urology of urology residents].

    Caremel, R; Bernhard, J-C; Bigot, P; Koutlidis, N; Xylinas, E; Faïs, P-O; Rouache, L; Genevois, S; Mazzola, C; Bessede, T; Gosseine, P-N; Celhay, O; Faivre D'Arcier, B; Benchikh, A; Pignot, G; Guillotreau, J


    To evaluate the interest borne towards neuro-urology within the community of the urology residents. Between January and May 2009, all urology residents received an anonymous questionnaire by e-mail estimating their interest for neuro-urology. The analyzed data were: epidemiologic data; participation in theoretical learning and training courses practices; interest and investment in the speciality; opinion on the current formation. The qualitative variables were compared by the chi-2 test. P values neuro-urology staff, and 80 % were in a service which dealt with suffering patients of neurological bladder. The percentage of urologist residents interested by neuro-urology was 69,2 %, and 61,5 % of them wished to practice this activity in their future exercise. This wish was significantly higher for those resulting from the ENC (pneuro-urology (pneuro-urology were considered as being insufficient for respectively 73,9 % and 64,2 % of the urologist residents. In contrast, the average note allotted to the neuro-urology module of the ECU was of 7,47 out of 10. Neuro-urology seems to be particularly attractive for the urologist residents, and many wished to integrate it in their future exercise. The motivation was more important for those who wished to carry out a career in hospital. Even if the quality of the teaching was very noted, their modalities were considered to be insufficient by most of them. Copyright 2010. Published by Elsevier Masson SAS.

  20. Infrared Thermography-based Biophotonics: Integrated Diagnostic Technique for Systemic Reaction Monitoring

    Vainer, Boris G.; Morozov, Vitaly V.

    A peculiar branch of biophotonics is a measurement, visualisation and quantitative analysis of infrared (IR) radiation emitted from living object surfaces. Focal plane array (FPA)-based IR cameras make it possible to realize in medicine the so called interventional infrared thermal diagnostics. An integrated technique aimed at the advancement of this new approach in biomedical science and practice is described in the paper. The assembled system includes a high-performance short-wave (2.45-3.05 μm) or long-wave (8-14 μm) IR camera, two laser Doppler flowmeters (LDF) and additional equipment and complementary facilities implementing the monitoring of human cardiovascular status. All these means operate synchronously. It is first ascertained the relationship between infrared thermography (IRT) and LDF data in humans in regard to their systemic cardiovascular reactivity. Blood supply real-time dynamics in a narcotized patient is first visualized and quantitatively represented during surgery in order to observe how the general hyperoxia influences thermoregulatory mechanisms; an abrupt increase in temperature of the upper limb is observed using IRT. It is outlined that the IRT-based integrated technique may act as a take-off runway leading to elaboration of informative new methods directly applicable to medicine and biomedical sciences.

  1. Probability-Based Diagnostic Imaging Technique Using Error Functions for Active Structural Health Monitoring

    Rahim Gorgin,


    Full Text Available This study presents a novel probability-based diagnostic imaging (PDI technique using error functions for active structural health monitoring (SHM. To achieve this, first the changes between baseline and current signals of each sensing path are measured, and by taking the root mean square of such changes, the energy of the scattered signal at different times can be calculated. Then, for different pairs of signal acquisition paths, an error function based on the energy of the scattered signals is introduced. Finally, the resultant error function is fused to the final estimation of the probability of damage presence in the monitoring area. As for applications, developed methods were employed to various damage identification cases, including cracks located in regions among an active sensor network with different configurations (pulse-echo and pitch-catch, and holes located in regions outside active network sensors with pitch-catch configuration. The results identified using experimental Lamb wave signals at different central frequencies corroborated that the developed PDI technique using error functions is capable of monitoring structural damage, regardless of its shape, size and location. The developed method doesn’t need direct interpretation of overlaid and dispersed lamb wave components for damage identification and can monitor damage located anywhere in the structure. These bright advantages, qualify the above presented PDI method for online structural health monitoring.

  2. Extending battery life: A low-cost practical diagnostic technique for lithium-ion batteries

    Merla, Yu; Wu, Billy; Yufit, Vladimir; Brandon, Nigel P.; Martinez-Botas, Ricardo F.; Offer, Gregory J.


    Modern applications of lithium-ion batteries such as smartphones, hybrid & electric vehicles and grid scale electricity storage demand long lifetime and high performance which typically makes them the limiting factor in a system. Understanding the state-of-health during operation is important in order to optimise for long term durability and performance. However, this requires accurate in-operando diagnostic techniques that are cost effective and practical. We present a novel diagnosis method based upon differential thermal voltammetry demonstrated on a battery pack made from commercial lithium-ion cells where one cell was deliberately aged prior to experiment. The cells were in parallel whilst being thermally managed with forced air convection. We show for the first time, a diagnosis method capable of quantitatively determining the state-of-health of four cells simultaneously by only using temperature and voltage readings for both charge and discharge. Measurements are achieved using low-cost thermocouples and a single voltage measurement at a frequency of 1 Hz, demonstrating the feasibility of implementing this approach on real world battery management systems. The technique could be particularly useful under charge when constant current or constant power is common, this therefore should be of significant interest to all lithium-ion battery users.

  3. Imaging mammary diagnostics. Diagnostic techniques, archetypical findings, differential diagnostcs and interventions.. 2. rev. and enl. ed.; Bildgebende Mammadiagnostik. Untersuchungstechnik, Befundmuster, Differenzialdiagnose und Interventionen. Kartonierte Sonderausgabe

    Heywang-Koebrunner, S. [Martin-Luther-Univ., Halle-Wittenberg (Germany). Klinik fuer Diagnostische Radiologie; Schreer, I. (eds.) [Mamma-Zentrum des UK Kiel (Germany). Klinik fuer Geburtshilfe und Gynaekologie


    The book includes the following chapters: I. Methodology: anamnesis and interview; clinical evidence, mammography, sonography, magnetic resonance tomography, new imaging techniques (scintigraphy, PET), transcutaneous biopsy, pre-operative marking; II. phenotypes: normal mammary glands, mastopathics, cysts, benign tumors, inflammatory diseases, in-situ carcinomas, invasive carcinomas, lymphomas, other semi-malign and malign tumors, post-traumatic, post-surgical and post-therapeutic changes, skin changes, male mamma, screening, continuative diagnostics of screening evidence and problem solving for symptomatic patients.

  4. Urological manifestations of Duchenne muscular dystrophy.

    Askeland, Eric J; Arlen, Angela M; Erickson, Bradley A; Mathews, Katherine D; Cooper, Christopher S


    Duchenne muscular dystrophy is a dystrophinopathy affecting males that is associated with multiple organ system complications. To our knowledge urological complications of Duchenne muscular dystrophy have been described only anecdotally to date. We reviewed the medical charts of 135 patients with Duchenne or Duchenne-Becker muscular dystrophy for demographics and disease progression, urological diagnoses, intervention and followup. Of 135 patients 67 (50%) had at least 1 documented urological diagnosis and 38 (28%) had multiple manifestations. Lower urinary tract symptoms were the most common urological diagnosis (32% of patients). Survival analysis revealed a median age at onset of lower urinary tract symptoms of 23 years (95% CI 17.7-23.9). Intervention was required in 12 patients (9%), most commonly due to nephrolithiasis. Urological morbidity increased with Duchenne muscular dystrophy progression when stratified by clinical progression. Lower urinary tract symptoms were more common in nonambulatory patients (40.7% vs 19%, p = 0.007), those with a diagnosis of scoliosis (44% vs 19.7%, p = 0.003) and/or scoliosis spine surgery (60% vs 22%, p <0.001), and those on invasive respiratory support (53% vs 29%, p = 0.046). Likewise, nephrolithiasis was more common in nonambulatory patients (10% vs 0%, p = 0.017), those with scoliosis (12% vs 0%, p = 0.004) and/or scoliosis spine surgery (20% vs 1%, p <0.001), and those on invasive respiratory support (29% vs 3%, p <0.001). Only 28% of patients with a urological manifestation were referred to urology. As these patients transition into adolescence and adulthood, the increased prevalence of urological manifestations warrants increased awareness and referral to urologists. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. 21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology fiberoptic retractor. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4530 Gastroenterology-urology fiberoptic retractor. (a) Identification. A gastroenterology-urology fiberoptic...

  6. 21 CFR 876.4370 - Gastroenterology-urology evacuator.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to...

  7. Epidemiology of intestinal parasitosis in Italy between 2005 and 2008: diagnostic techniques and methodologies

    Daniele Crotti


    Full Text Available Aim of the study was to keep a real and actual photo relating to 2005-2008 regarding to diagnostic techniques and methodologies for intestinal parasites; so it would be possible to know specific epidemiology and suggest more rational and efficacious guide-lines. All members of AMCLI were involved in the proposal of a retrospective study regarding bowel parasites, helminths and protozoa.To engaged laboratories we asked how O&P was performed, if a specifical research for E. vermicularis and S. stercoralis was performed, if for the identification of D. fragilis, Entamoeba histolytica/dispar and Cryptosporidum spp were performed recommended specific permanent stains. 23 laboratories gave assent; but for an inferior number was possible to use the data for analysis and evaluation. Relating O&P only some laboratories performed permanent stains: Giemsa for D. fragilis, antigen and/or Trichrome stain for E. histolytica/dispar, antigen and/or acid fast stain for Cryptosporidium spp.Not all laboratories research specifically S. stercoralis. So the epidemiology is differentiated and related more to adequate or not adequate techniques than cohorts of examined populations. The overall positivity for parasites ranged from 0% to18.7%,for protozoa (pathogens or not were from 0% to 14.7%; for nematodes from 0% to 3.7%; for cestodes from 0% to 1.0%; for trematodes from 0% to 1.0%.Among helminths, E. vermicularis, followed by S. stercoralis, also in O&P, is the most frequent.The specific research of S. stercoralis gave a positivity from 0% to 33.3%; the cellophane tape test was positive for E. vermicularis from 0% fo 21.9% of cases.Among pathogen protozoa, D. fragilis, when permanent stain were applied, prevailed from 0% to 16.6%; G. duodenalis from 0.8% to 4.3%; E. histolytica/dispar, using a permanent stain or research of antigen, was identified from 0% to 20.6%. Coccidia were very rare, with Cryptosporidium spp observed from 0% to 5.2%. These are our conclusions

  8. Current practices of diagnostic techniques requiring the use of ophthalmic drugs among KwaZulu- Natal optometrists*

    K. P. Mashige


    Full Text Available In anendeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as gonioscopy that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55% of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53% were certified in di-agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%, 78 D/90 D lens fundus examination (60%, binocular indirect ophthalmoscopy (84% and gonioscopy (78%. Also, among these certified respondents (62 optometrists, a significant proportion (60% disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61% agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%, agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117, 86% agreed that they were confident about the accuracy of their referrals and less than half (45% disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than

  9. Urologic applications of multiplanar and three-dimensional computed tomography.

    Olson, M C; Posniak, H V


    The introduction of helical computed tomography (CT) has resulted in improved quality of multiplanar reformations and three-dimensional reconstructions in the chest and abdomen and has made CT angiography a clinical reality. These imaging techniques are useful for evaluating the urinary tract, adding a new dimension to its display, resulting in improved diagnosis of renal and perirenal disease. This article reviews the indications and techniques utilized for multiplanar and three-dimensional CT for urology. The advantages and limitations are discussed, and normal and pathologic findings in the urinary tract illustrated.

  10. Diagnostic value of the lfuoroscopic triggering 3D LAVA technique for primary liver cancer

    Xiao-Yong Shen; Chun-Hua Chai; Wen-Bo Xiao; Qi-Dong Wang


    BACKGROUND: Primary liver cancer (PLC) is one of the common malignant tumors. Liver acquisition with acceleration volume acquisition (LAVA), which allows simultaneous dynamic enhancement of the hepatic parenchyma and vascu-lature imaging, is of great help in the diagnosis of PLC. This study aimed to evaluate application of the lfuoroscopic triggering 3D LAVA technique in the imaging of PLC and liver vasculature. METHODS: The clinical data and imaging ifndings of 38 adults with PLC (22 men and 16 women;average age 52 years), pathologically conifrmed by surgical resection or biopsy, were collected and analyzed. All magnetic resonance images were obtained with a 1.5-T system (General Electrics Medical Systems) with an eight-element body array coil and application of the lfuoroscopic triggering 3D LAVA technique. Overall image quality was assessed on a 5-point scale by two experienced radiologists. All the nodules and blood vessel were recorded and compared. The diagnostic accuracy and feasibility of LAVA were evaluated. RESULTS: Thirty-eight patients gave high quality images of 72 nodules in the liver for diagnosis. The accuracy of LAVA was 97.2% (70/72), and the coincidence rate between the extent of tumor judged by dynamic enhancement and pathological examination was 87.5%(63/72). Displayed by the maximum intensity projection reconstruction, nearly all cases gave satisfactory images of branchesⅢandⅣof the hepatic artery. Furthermore, small early-stage enhancing hepatic lesions and the parallel portal vein were also well displayed. CONCLUSIONS: Sequence of LAVA provides good multi-phase dynamic enhancement scanning of hepatic lesions. Combined with conventional scanning technology, LAVA effectively and safely displays focal hepatic lesions and the relationship between tumor and normal tissues, especially blood vessels.

  11. Kinetic and Diagnostic Studies of Molecular Plasmas Using Laser Absorption Techniques

    Welzel, S [INP-Greifswald, 17489 Greifswald, Felix-Hausdorff-Str. 2 (Germany); Rousseau, A [Laboratoire de Physique et Technologie des Plasmas, Ecole Polytechnique, CNRS, 91128 Palaiseau (France); Davies, P B [Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW (United Kingdom); Roepcke, J [INP-Greifswald, 17489 Greifswald, Felix-Hausdorff-Str. 2 (Germany)


    Within the last decade mid infrared absorption spectroscopy between 3 and 20 {mu}m, known as Infrared Laser Absorption Spectroscopy (IRLAS) and based on tuneable semiconductor lasers, namely lead salt diode lasers, often called tuneable diode lasers (TDL), and quantum cascade lasers (QCL) has progressed considerably as a powerful diagnostic technique for in situ studies of the fundamental physics and chemistry of molecular plasmas. The increasing interest in processing plasmas containing hydrocarbons, fluorocarbons, organo-silicon and boron compounds has lead to further applications of IRLAS because most of these compounds and their decomposition products are infrared active. IRLAS provides a means of determining the absolute concentrations of the ground states of stable and transient molecular species, which is of particular importance for the investigation of reaction kinetics. Information about gas temperature and population densities can also be derived from IRLAS measurements. A variety of free radicals and molecular ions have been detected, especially using TDLs. Since plasmas with molecular feed gases are used in many applications such as thin film deposition, semiconductor processing, surface activation and cleaning, and materials and waste treatment, this has stimulated the adaptation of infrared spectroscopic techniques to industrial requirements. The recent development of QCLs offers an attractive new option for the monitoring and control of industrial plasma processes as well as for highly time-resolved studies on the kinetics of plasma processes. The aim of the present article is threefold: (i) to review recent achievements in our understanding of molecular phenomena in plasmas (ii) to report on selected studies of the spectroscopic properties and kinetic behaviour of radicals, and (iii) to describe the current status of advanced instrumentation for TDLAS in the mid infrared.

  12. Mini-FLOTAC, an innovative direct diagnostic technique for intestinal parasitic infections: experience from the field.

    Beatrice Divina Barda

    Full Text Available BACKGROUND: Soil-transmitted helminths and intestinal protozoa infection are widespread in developing countries, yet an accurate diagnosis is rarely performed. The aim of this study was to evaluate the recently developed mini-FLOTAC method and to compare with currently more widely used techniques for the diagnosis of intestinal parasitic infections in different settings. METHODOLOGY/PRINCIPAL FINDINGS: The study was carried out in Dharamsala, Himachal Pradesh, India, and in Bukumbi, Tanzania. A total of 180 pupils from two primary schools had their stool analyzed (n = 80 in Dharamsala and n = 100 in Bukumbi for intestinal parasitic infections with three diagnostic methods: direct fecal smear, formol-ether concentration method (FECM and mini-FLOTAC. Overall, 72% of the pupils were positive for any intestinal parasitic infection, 24% carried dual infections and 11% three infections or more. The most frequently encountered intestinal parasites were Entamoeba coli, Entamoeba histolytica/dispar, Giardia intestinalis, hookworm, (and Schistosoma mansoni, in Tanzania. Statistically significant differences were found in the detection of parasitic infections among the three methods: mini-FLOTAC was the most sensitive method for helminth infections (90% mini-FLOTAC, 60% FECM, and 30% direct fecal smear, whereas FECM was most sensitive for intestinal protozoa infections (88% FECM, 70% direct fecal smear, and 68% mini-FLOTAC. CONCLUSION/SIGNIFICANCE: We present the first experiences with the mini-FLOTAC for the diagnosis of intestinal helminths and protozoa. Our results suggest that it is a valid, sensitive and potentially low-cost alternative technique that could be used in resource-limited settings--particularly for helminth diagnosis.

  13. A Training Module for Laparoscopic Urology


    Objectives: A fellowship training model in laparoscopic urological surgery has been established for interested urologists to help them proceed from the pelvic trainer/ animal laboratory environment to safe clinical practice. The objective of the model is to provide trainees with clinical experience under direct mentor supervision before embarking on independent laparoscopic urological surgery at their own base hospitals. Methods: The fellowship model incorporates 9 fluid phases: Phase 1 to co...

  14. The development of malaria diagnostic techniques: a review of the approaches with focus on dielectrophoretic and magnetophoretic methods.

    Kasetsirikul, Surasak; Buranapong, Jirayut; Srituravanich, Werayut; Kaewthamasorn, Morakot; Pimpin, Alongkorn


    The large number of deaths caused by malaria each year has increased interest in the development of effective malaria diagnoses. At the early-stage of infection, patients show non-specific symptoms or are asymptomatic, which makes it difficult for clinical diagnosis, especially in non-endemic areas. Alternative diagnostic methods that are timely and effective are required to identify infections, particularly in field settings. This article reviews conventional malaria diagnostic methods together with recently developed techniques for both malaria detection and infected erythrocyte separation. Although many alternative techniques have recently been proposed and studied, dielectrophoretic and magnetophoretic approaches are among the promising new techniques due to their high specificity for malaria parasite-infected red blood cells. The two approaches are discussed in detail, including their principles, types, applications and limitations. In addition, other recently developed techniques, such as cell deformability and morphology, are also overviewed in this article.

  15. Diagnostic technique of pine wood nematode disease based on THz spectrum

    Liu, Yunfei; Tan, Jiajin; Jiang, Liang; Shi, Shengcai; Jin, Biaobing; Ma, Jinlong


    Pine wood nematode disease, namely pine wilt disease, is caused by the invasion of Bursaphelenchus xylophilus (Bx) into pines. Once susceptible pines are infected by the nematode, the disease develops rapidly, the infected pines cease to exude oleoresin and die quickly. Hence it is called pine cancer. Given the fact that there are still no good methods in diagnosing the disease, here we propose to study the spectroscopic characteristics of pine wood nematode and diseased pine wood in the THz regime in order to look for a rapid spectroscopic discrimination method for the disease. Firstly, we measure the transmittances of a Bx sample, a B. mucronatus (Bm) sample, a healthy Pinus massoniana wood sample and a diseased P. massoniana wood sample by a superconducting heterodyne mixer at 500 GHz. And their characteristics are compared. Secondly, we measure the transmission characteristics of a Bx sample and a Bm sample by terahertz time domain spectroscopy (THz-TDS). The measured time domain spectrums and corresponding frequency domain spectrums are compared to distinguish them from their absorption characteristics. Thirdly, we measure the transmission characteristics of a healthy P. massoniana wood sample and a diseased P. massoniana wood sample by THz TDS and compare their difference in THz absorption spectrum and diffraction dispersive spectrum to confirm the effect of Bx on P. massoniana by the absorption coefficient and refractive index. Some discussions are given for future development of the diagnostic technique of pine wood nematode disease based on THz spectrum.

  16. Characterisation of the properties of a negative hydrogen ion beam by several beam diagnostic techniques

    Maurizio, R.; Fantz, U.; Bonomo, F.; Serianni, G.


    The beam properties of the BATMAN negative ion source, which is the prototype of one module of the source for the ITER neutral beam injection system, are characterised by means of three diagnostic techniques: beam emission spectroscopy (BES), the experimental calorimeter mini-STRIKE and a copper calorimeter. The main beam parameters—beam divergence, homogeneity and top-bottom asymmetries—are studied in different operational scenarios: with different magnetic filter field setups, source settings and with different gases (hydrogen or deuterium). Among all dependences, the influence of the magnetic field configuration on the beam and the evolution of the beam features during some conditioning days are investigated in detail. Data show that the stronger the filter field in the beam region, the higher the beam top-bottom asymmetry—likely a v× B effect. During the conditioning of the source, such vertical beam asymmetry increases as well, suggesting an inhomogeneous H -production at the first grid of the extraction system.

  17. Spiral CT during pharmacoangiography with angiotensin II in patients with pancreatic disease. Technique and diagnostic efficacy

    Kuroda, C.; Mihara, N.; Hosomi, N.; Inoue, E.; Fujita, M. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Diagnostic Radiology; Ohigashi, H.; Ishikawa, O. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Surgery; Nakaizumi, A. [Osaka Medical Center for Cancer and Cardiovascular Deseases (Japan). Dept. of Internal Medicine; Ishiguro, S. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Pathology


    Purpose: To compare the diagnostic efficacy of pancreatic pharmacoangiographic CT using angiotensin II with conventional angiographic CT. Material and Methods: Eighteen patients with space-occupying pancreatic disease were examined in this study. Pharmacoangiographic CT was performed with a 1-3-{mu}/6-ml solution of angiotensin II injected through a catheter into the celiac artery during spiral CT. Results: In 17 of the 18 (94%) patients, the area of pancreatic parenchymal enhancement was the same or larger at pharmacoangiographic CT than at conventional angiographic CT. The attenuation value of the pancreatic parenchyma was significantly increased at pharmacoangiographic CT (p=0.0010). Although the attenuation value of tumors was also increased on images obtained after the injection of angiotensin II, the tumor-to-pancreas contrast was significantly greater at pharmacoangiographic CT (p=0.0479). The mean differences in attenuation between tumor and pancreas at angiographic CT with and without angiotensin II were respectively 182 HU and 115 HU. Conclusion: Pharmacoangiographic CT with angiotensin II proved superior to conventional angiographic CT in the diagnosis of pancreatic disease. We therefore recommend it as a supplementary technique at the angiographic examination of patients with suspected pancreatic tumor. (orig.).

  18. Fungal disease detection in plants: Traditional assays, novel diagnostic techniques and biosensors.

    Ray, Monalisa; Ray, Asit; Dash, Swagatika; Mishra, Abtar; Achary, K Gopinath; Nayak, Sanghamitra; Singh, Shikha


    Fungal diseases in commercially important plants results in a significant reduction in both quality and yield, often leading to the loss of an entire plant. In order to minimize the losses, it is essential to detect and identify the pathogens at an early stage. Early detection and accurate identification of pathogens can control the spread of infection. The present article provides a comprehensive overview of conventional methods, current trends and advances in fungal pathogen detection with an emphasis on biosensors. Traditional techniques are the "gold standard" in fungal detection which relies on symptoms, culture-based, morphological observation and biochemical identifications. In recent times, with the advancement of biotechnology, molecular and immunological approaches have revolutionized fungal disease detection. But the drawback lies in the fact that these methods require specific and expensive equipments. Thus, there is an urgent need for rapid, reliable, sensitive, cost effective and easy to use diagnostic methods for fungal pathogen detection. Biosensors would become a promising and attractive alternative, but they still have to be subjected to some modifications, improvements and proper validation for on-field use. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Robotics in urology: past, present, and future.

    Thiel, David D; Winfield, Howard N


    The modern-day urologist is continually armed with new instruments and technology aimed at decreasing the overall invasiveness of urologic procedures. Robotic technology is aimed at improving clinical outcomes by correcting human technical inadequacies such as hand tremors and imprecise suturing. The first reported use of robotics to assist with surgery was in 1985, and the first use of robotics in urology was published in 1989. The currently utilized master-slave system (da Vinci Robotic Platform), Intuitive Surgical, Sunnyvale, CA) has popularized robotic surgery for use in numerous urologic conditions including prostate cancer, bladder cancer, renal cancer, uretero-pelvic junction obstruction, and pelvic prolapse. New developments in robotic technology may revolutionize many other aspects of urology including percutaneous renal access and rounding on patients after surgery. This review provides a brief overview of the history of robotics in urology, a description of the da Vinci surgical system and its current utilization as well as limitations, and a review of evolving robotic technology in the field of urology.

  20. The impact of robotic surgery in urology.

    Giedelman, C A; Abdul-Muhsin, H; Schatloff, O; Palmer, K; Lee, L; Sanchez-Salas, R; Cathelineau, X; Dávila, H; Cavelier, L; Rueda, M; Patel, V


    More than a decade ago, robotic surgery was introduced into urology. Since then, the urological community started to look at surgery from a different angle. The present, the future hopes, and the way we looked at our past experience have all changed. Between 2000 and 2011, the published literature was reviewed using the National Library of Medicine database and the following key words: robotic surgery, robot-assisted, and radical prostatectomy. Special emphasis was given to the impact of the robotic surgery in urology. We analyzed the most representative series (finished learning curve) in each one of the robotic approaches regarding perioperative morbidity and oncological outcomes. This article looks into the impact of robotics in urology, starting from its background applications before urology, the way it was introduced into urology, its first steps, current status, and future expectations. By narrating this journey, we tried to highlight important modifications that helped robotic surgery make its way to its position today. We looked as well into the dramatic changes that robotic surgery introduced to the field of surgical training and its consequence on its learning curve. Basic surgical principles still apply in Robotics: experience counts, and prolonged practice provides knowledge and skills. In this way, the potential advantages delivered by technology will be better exploited, and this will be reflected in better outcomes for patients. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  1. Current practices of diagnostic techniques requir- ing the use of ophthalmic drugs among KwaZulu- Natal optometrists*

    K. P. Mashige


    Full Text Available In anendeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as goniosco-py that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55% of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53% were certified in di-agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%, 78 D/90 D lens fundus examination (60%, binocular indirect ophthalmoscopy (84% and gonioscopy (78%. Also, among these certified respondents (62 optometrists, a significant proportion (60% disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61% agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%, agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117, 86% agreed that they were confident about the accuracy of their referrals and less than half (45% disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than

  2. Summary of European Association of Urology (EAU) Guidelines on Neuro-Urology.

    Groen, Jan; Pannek, Jürgen; Castro Diaz, David; Del Popolo, Giulio; Gross, Tobias; Hamid, Rizwan; Karsenty, Gilles; Kessler, Thomas M; Schneider, Marc; 't Hoen, Lisette; Blok, Bertil


    Most patients with neuro-urological disorders require life-long medical care. The European Association of Urology (EAU) regularly updates guidelines for the diagnosis and treatment of these patients. To provide a summary of the 2015 updated EAU Guidelines on Neuro-Urology. Structured literature searches in several databases were carried out to update the 2014 guidelines. Levels of evidence and grades of recommendation were assigned where possible. Neurological disorders often cause urinary tract, sexual, and bowel dysfunction. Most neuro-urological patients need life-long care for optimal life expectancy and quality of life. Timely diagnosis and treatment are essential to prevent upper and lower urinary tract deterioration. Clinical assessment should be comprehensive and usually includes a urodynamic investigation. The neuro-urological management must be tailored to the needs of the individual patient and may require a multidisciplinary approach. Sexuality and fertility issues should not be ignored. Numerous conservative and noninvasive possibilities of management are available and should be considered before a surgical approach is chosen. Neuro-urological patients require life-long follow-up and particular attention has to be paid to this aspect of management. The current EAU Guidelines on Neuro-Urology provide an up-to-date overview of the available evidence for adequate diagnosis, treatment, and follow-up of neuro-urological patients. Patients with a neurological disorder often suffer from urinary tract, sexual, and bowel dysfunction and life-long care is usually necessary. The update of the EAU Guidelines on Neuro-Urology, summarized in this paper, enables caregivers to provide optimal support to neuro-urological patients. Conservative, noninvasive, or minimally invasive approaches are often possible. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  3. EAU guidelines on robotic and single-site surgery in urology.

    Merseburger, Axel S; Herrmann, Thomas R W; Shariat, Shahrokh F; Kyriazis, Iason; Nagele, Udo; Traxer, Olivier; Liatsikos, Evangelos N


    This is a short version of the European Association of Urology (EAU) guidelines on robotic and single-site surgery in urology, as created in 2013 by the EAU Guidelines Office Panel on Urological Technologies. To evaluate current evidence regarding robotic and single-site surgery in urology and to provide clinical recommendations. A comprehensive online systematic search of the literature according to Cochrane recommendations was performed in July 2012, identifying data from 1990 to 2012 regarding robotic and single-site surgery in urology. There is a lack of high-quality data on both robotic and single-site surgery for most upper and lower urinary tract operations. Mature evidence including midterm follow-up data exists only for robot-assisted radical prostatectomy. In the absence of high-quality data, the guidelines panel's recommendations were based mostly on the review of low-level evidence and expert opinions. Robot-assisted urologic surgery is an emerging and safe technology for most urologic operations. Further documentation including long-term oncologic and functional outcomes is deemed necessary before definite conclusions can be drawn regarding the superiority or not of robotic assistance compared with the conventional laparoscopic and open approaches. Laparoendoscopic single-site surgery is a novel laparoscopic technique providing a potentially superior cosmetic outcome over conventional laparoscopy. Nevertheless, further advantages offered by this technology are still under discussion and not yet proven. Due to the technically demanding character of the single-site approach, only experienced laparoscopic surgeons should attempt this technique in clinical settings. This work represents the shortened version of the 2013 European Association of Urology guidelines on robotic and single-site surgery. The authors systematically evaluated published evidence in these fields and concluded that robotic assisted surgery is possible and safe for most urologic

  4. Occupational exposure and urological cancer.

    Golka, Klaus; Wiese, Andreas; Assennato, Giorgio; Bolt, Hermann M


    Occupational exposure is definitely a major cause of cancer. In the field of urology, the urinary bladder is the most important target. A classical cause of bladder cancer is exposure to carcinogenic aromatic amines, especially benzidine and beta-naphthylamine. Such exposures were related to work places in the chemical industry, implying production and processing of classical aromatic amines, and in the rubber industry. Occupational bladder cancer has also been observed in dyers, painters and hairdressers. Even some occupations with much lower exposures to carcinogenic aromatic amines, like coke oven workers or workers in the rubber industry after the ban on beta-naphthylamine, are at risk. In these occupations, exposure to complex mixtures of substances containing combustion products (e.g. polycyclic aromatic hydrocarbons) or nitrosamines is common. Renal cell cancer has been observed as an occupational disease in cases of very high exposure to trichloroethylene having led to narcotic or prenarcotic symptoms. Occupationally related cancers of the prostate or the testes appear currently not relevant.

  5. Machine-learning techniques for building a diagnostic model for very mild dementia.

    Chen, Rong; Herskovits, Edward H


    Many researchers have sought to construct diagnostic models to differentiate individuals with very mild dementia (VMD) from healthy elderly people, based on structural magnetic-resonance (MR) images. These models have, for the most part, been based on discriminant analysis or logistic regression, with few reports of alternative approaches. To determine the relative strengths of different approaches to analyzing structural MR data to distinguish people with VMD from normal elderly control subjects, we evaluated seven different classification approaches, each of which we used to generate a diagnostic model from a training data set acquired from 83 subjects (33 VMD and 50 control). We then evaluated each diagnostic model using an independent data set acquired from 30 subjects (13 VMD and 17 controls). We found that there were significant performance differences across these seven diagnostic models. Relative to the diagnostic models generated by discriminant analysis and logistic regression, the diagnostic models generated by other high-performance diagnostic-model-generation algorithms manifested increased generalizability when diagnostic models were generated from all atlas structures. Copyright 2010 Elsevier Inc. All rights reserved.

  6. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)


    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  7. A Review of Transplantation Practice of the Urologic Organs: Is It Only Achievable for the Kidney?

    Donati-Bourne, Jack; Roberts, Harry W; Rajjoub, Yaseen; Coleman, Robert A


    Transplantation is a viable treatment option for failure of most major organs. Within urology, transplantation of the kidney and ureter are well documented; however, evidence supporting transplantation of other urologic organs is limited. Failure of these organs carries significant morbidity, and transplantation may have a role in management. This article reviews the knowledge, research, and literature surrounding transplantation of each of the urologic organs. Transplantation of the penis, testicle, urethra, vas deferens, and bladder is discussed. Transplantation attempts have been made individually with each of these organs. Penile transplantation has only been performed once in a human. Testicular transplantation research was intertwined with unethical lucrative pursuits. Interest in urethra, bladder, and vas deferens transplantation has decreased as a result of successful surgical reconstructive techniques. Despite years of effort, transplantations of the penis, testicle, urethra, vas deferens, and bladder are not established in current practice. Recent research has shifted toward techniques of reconstruction, tissue engineering, and regenerative medicine.

  8. Contrast induced nephropathy in urology

    Viji Samuel Thomson


    Full Text Available Intravenous contrast agents have a distinct role in urological imaging: to study precise anatomical delineation, vascularity, and to assess the function of the renal unit. Contrast induced nephropathy (CIN is a known adverse effect of intravenous contrast administration. The literature on incidence, pathophysiology, clinical features, and current preventive strategies available for CIN relevant to urologists was reviewed. A search of the PubMed database was done using the keywords nephropathy and media, prevention and control or prevention Contrast media (explode, all adverse effects, and kidney diseases (explode. An online search of the EMBASE database for the time ranging from 1977 to February 2009 was performed using the keywords ionic contrast medium, adverse drug reaction, major or controlled clinical study, human, nephrotoxicity, and kidney disease. Current publications and data most relevant to urologists were examined. CIN was the third most common cause of hospital-acquired renal failure. The incidence is less common with intravenous contrast administration as compared with intra-arterial administration. The pathogenesis of contrast mediated nephropathy is due to a combination of toxic injury to renal tubules and medullary ischemic injury mediated by reactive oxygen species. CIN most commonly manifests as a nonoliguric and asymptomatic transient decline in renal function. Patients who developed CIN were found to have increased mortality, longer hospital stay, and complicated clinical course. An overview of risk factors and risk prediction score for prognostication of CIN are elaborated. Preventive strategies including choice of contrast agents, maximum tolerated dose, role of hydration, hydration regime, etc. are discussed. The role of N- acetyl cysteine, Theophylline, Fenoldapam, Endothelin receptor antagonists, iloprost, atrial natriuretic peptide, and newer therapies such as targeted renal therapy (TRT are discussed. A working

  9. Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques

    National Aeronautics and Space Administration — Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and...

  10. Kinematic Measures during a Clinical Diagnostic Technique for Human Neck Disorder: Inter- and Intraexaminer Comparisons

    Joseph Vorro


    Full Text Available Diagnoses of human musculoskeletal dysfunction of the cervical spine are indicated by palpable clues of a patient’s structural compliance/noncompliance as this body segment responds to diagnostic motion demands applied by a clinician. This process includes assessments of motion range, motion performance, and changes in tissue responses. However, biomechanical quantification of these diagnostic actions and their reproducible components is lacking. As a result, this study sought to use objective kinematic measures to capture aspects of the diagnostic process to compare inter- and intraexaminer motion behaviors when performing a specific clinical diagnostic protocol. Pain-free volunteers and a group determined to be symptomatic based on a psychometric pain score were examined by two clinicians while three-dimensional kinematic data were collected. Intraexaminer diagnostic motion ranges of cervical lateral flexion and secondary rotations were consistent for each examiner and for each subject group. However, interexaminer comparisons for motion range, secondary rotations, and average velocities yielded consistently larger measures for one examiner for both subject groups (P<0.05. This research demonstrates that fundamental aspects of the clinical diagnostic process for human neck disorders can be identified and measured using kinematic parameters. Further, these objective data have the potential to be linked to clinical decision making.

  11. Factors influencing scholarly impact: does urology fellowship training affect research output?

    Kasabwala, Khushabu; Morton, Christopher M; Svider, Peter F; Nahass, Thomas A; Eloy, Jean Anderson; Jackson-Rosario, Imani


    Residents seek postresidency fellowship training to increase competency with novel surgical techniques and augment their fund of knowledge. Research productivity is a vital component of advancement in academic urology. Our objectives were to use the h-index (an objective and readily available bibliometric that has been repeatedly shown to correlate with scholarly impact, funding procurement, and academic promotion in urology as well as other specialties) to determine whether any relationship exists between fellowship training and scholarly impact among academic urologists. Additional examination was performed to determine whether any differences in scholarly influence are present among practitioners in the major urologic subspecialties. Overall, 851 faculty members from 101 academic urology departments were organized by academic rank and fellowship completed. Research productivity was calculated using the h-index, calculated from the Scopus database. There was no statistical difference in h-index found between fellowship-trained and nonfellowship-trained academic urologists. The highest h-indices were seen among urologic oncologists (18.1 ± 0.95) and nonfellowship-trained urologists (14.62 ± 0.80). Nearly 70% of department chairs included in this analysis were urologic oncologists or general urologists. No difference in h-index existed between fellowship-trained and nonfellowship-trained urologists, although practitioners in the subspecialty cohorts with the highest research productivity (nonfellowship-trained and urologic oncologists) comprised 70% of department chairpersons. This relationship suggests that a strong research profile is highly valued during selection for academic promotion. Differences existed on further comparison by subspecialty. Fellowship training may represent another potential opportunity to introduce structured research experiences for trainees. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of

  12. [Diagnostic value of HASTE technique and excretory MR urography in urinary system obstructions].

    Erdoğmuş, Beşir; Bozkurt, Mahmut; Bakir, Zeki


    To compare the diagnostic value of static-liquid magnetic resonance urography (MRU) in T2-weighted HASTE (half-fourier acquisition single-shot turbo spinecho) sequences and T1-weighted excretory MRU with i.v. diuretic and contrast material injection. The study included 29 patients (15 men, 14 women). Thirty-one urinary obstructions were detected on intravenous urography (IVU) two of which were due to bilateral obstructions. The cases were evaluated by T2 HASTE sequences combined with T1-weighted FLASH 3D sequences after i.v. diuretics and gadolinium DTPA injection. Thirty-one urinary obstructions were detected on IVU. Thirty of which were confirmed by T2-weighted MRU and all were confirmed by excretory MRU. In one nonobstructive case, unilateral grade 1 ureteropelvicaliectasis related to ureteral stone was falsely interpreted by both sequences. There were no statistical differences among IVU, T2-weighted MRU and excretory MRU in detecting the obstruction levels. In 22 cases with ureteral stones, 12 of which were confirmed by T2-weighted MRU and 18 cases were confirmed by excretory MRU. Sensitivity and specificity fo detecting the ureteral stones as a cause of obstruction with T2-weighted MRU were 50%and 89% and with excretory MRU were 77% and 89% respectively. In 9 obstructive cases due to causes other than the stones, 8 of which were detected by T2-weighted MRU and all of which were detected by excretory MRU. Sensitivity and specificity for detecting the causes other than the stones with T2-weighted MRU were 96% and 100% and with excretory MRU were 100% and 100% respectively. MRU is a useful thechnique revealing high-quality images to determine the urinary system obstructions to obtain the causes of obstructions. MRU should be used as an alternative imaging technique in cases which IVU can not be applied. The existence and the causes of obstruction can be detected by HASTE MRU. Excretory MRU can supply additional information in cases with functional kidneys where

  13. Development of a diagnostic technique based on Cherenkov effect for measurements of fast electrons in fusion devices

    Plyusnin, V. V.; Duarte, P.; Fernandes, H.; Silva, C. [Association Euratom/IST, Instituto de Plasmas e Fusao Nuclear, Instituto Superior Tecnico, Universidade Tecnica de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa (Portugal); Jakubowski, L.; Zebrowski, J.; Malinowski, K.; Rabinski, M.; Sadowski, M. J. [National Centre for Nuclear Research (NCBJ), 7 Andrzeja Soltana Str., 05-400 Otwock (Poland)


    A diagnostic technique based on the Cherenkov effect is proposed for detection and characterization of fast (super-thermal and runaway) electrons in fusion devices. The detectors of Cherenkov radiation have been specially designed for measurements in the ISTTOK tokamak. Properties of several materials have been studied to determine the most appropriate one to be used as a radiator of Cherenkov emission in the detector. This technique has enabled the detection of energetic electrons (70 keV and higher) and the determination of their spatial and temporal variations in the ISTTOK discharges. Measurement of hard x-ray emission has also been carried out in experiments for validation of the measuring capabilities of the Cherenkov-type detector and a high correlation was found between the data of both diagnostics. A reasonable agreement was found between experimental data and the results of numerical modeling of the runaway electron generation in ISTTOK.

  14. Robot-assisted surgery: applications in urology

    Mathew C Raynor


    Full Text Available Mathew C Raynor, Raj S PruthiDivision of Urologic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAAbstract: The past decade has seen a dramatic shift in the surgical management of certain urologic conditions with the advent of a robotic surgical platform. In fact, the surgical management of prostate cancer has seen the most dramatic shift, with the majority of cases now being performed robotically. Technical refinements over the years have led to improved outcomes regarding oncologic and functional results. Recently, robotic surgery has also been utilized for the surgical management of bladder cancer, renal cancer, and other benign conditions. As further experience is gained and longer-term outcomes are realized, robotic surgery will likely play an increasing role in the surgical management of many urologic conditions.Keywords: robot-assisted surgery, robotic surgery, cystectomy, prostatectomy, partial nephrectomy

  15. Extracorporeal shock wave therapy (ESWT) in urology

    Fojecki, Grzegorz Lukasz; Thiessen, Stefan; Osther, Palle Jörn Sloth


    PURPOSE: The objective was to evaluate high-level evidence studies of extracorporeal shock wave therapy (ESWT) for urological disorders. METHODS: We included randomized controlled trials reporting outcomes of ESWT in urology. Literature search on trials published in English using EMBASE, Medline...... and PubMed was carried out. The systematic review was performed according to PRISMA guidelines. RESULTS: We identified 10 trials on 3 urological indications. Two of 3 trials on Peyronie's disease (PD) involving 238 patients reported improvement in pain; however, no clinical significant changes in penile......i) responders in 2 of 4 trials and 3 of 4 trials, respectively. Three studies on chronic pelvic pain (CPP) engaging 200 men reported positive changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). There was considerable heterogeneity between trials both with regard...

  16. Resorbable extracellular matrix grafts in urologic reconstruction

    Richard A. Santucci


    Full Text Available PURPOSE: There is an increasingly large body of literature concerning tissue-engineering products that may be used in urology. Some of these are quite complex (such as multilayer patient-specific cell-seeded implants yet the most simple and successful products to date are also the most uncomplicated: resorbable acellular extra-cellular matrices (ECMs harvested from animals. ECMs have been used in a variety of difficult urologic reconstruction problems, and this review is intended to summarize this complex literature for the practicing urologist. METHODS: Medline search of related terms such as "SIS, small intestinal submucosa, ECM, extracellular matrix, acellular matrix and urologic reconstruction". Manuscripts missed in the initial search were taken from the bibliographies of the primary references. RESULTS: Full review of potential clinical uses of resorbable extra-cellular matrices in urologic reconstruction. CONCLUSIONS: Currently, the "state of the art" in tissue engineering solutions for urologic reconstruction means resorbable acellular xenograft matrices. They show promise when used as a pubovaginal sling or extra bolstering layers in ureteral or urethral repairs, although recent problems with inflammation following 8-ply pubovaginal sling use and failures after 1- and 4-ply SIS repair of Peyronie's disease underscore the need for research before wide adoption. Preliminary data is mixed concerning the potential for ECM urethral patch graft, and more data is needed before extended uses such as bladder augmentation and ureteral replacement are contemplated. The distant future of ECMs in urology likely will include cell-seeded grafts with the eventual hope of producing "off the shelf" replacement materials. Until that day arrives, ECMs only fulfill some of the requirements for the reconstructive urologist.

  17. [New microbiological techniques].

    Schubert, S; Wieser, A; Bonkat, G


    Microbiological diagnostic procedures have changed rapidly in recent years. This is especially true in the field of molecular diagnostics. Classical culture-based techniques are still the gold standard in many areas; however, they are already complemented by automated and also molecular techniques to guarantee faster and better quality results. The most commonly used techniques include real-time polymerase chain reaction (RT-PCR) based systems and nucleic acid hybridization. These procedures are used most powerfully from direct patient samples or in assays to detect the presence of nonculturable or fastidious organisms. Further techniques such as DNA sequencing are not yet used routinely for urological samples and can be considered experimental. However, in conjunction with dropping prices and further technical developments, these techniques promise to be used much more in the near future. Regarding bacterial identification from culture, mass spectrometry (MALDI-TOF MS) has become the technique of choice in recent years especially in Europe. It has tremendously shortened the time to result. This is now going to be extended to antibiotic susceptibility testing. This is of paramount importance in view of ever rising antimicrobial resistance rates. Techniques described in this review offer a faster and better microbiological diagnosis. Such continuous improvements are critical especially in times of cost pressure and rising antimicrobial resistance rates. It is in our interest to provide the best possible care for patients and in this regard a good and effective communication between the laboratory and the clinician is of vital importance.

  18. Hybrid Neural-Network: Genetic Algorithm Technique for Aircraft Engine Performance Diagnostics Developed and Demonstrated

    Kobayashi, Takahisa; Simon, Donald L.


    As part of the NASA Aviation Safety Program, a unique model-based diagnostics method that employs neural networks and genetic algorithms for aircraft engine performance diagnostics has been developed and demonstrated at the NASA Glenn Research Center against a nonlinear gas turbine engine model. Neural networks are applied to estimate the internal health condition of the engine, and genetic algorithms are used for sensor fault detection, isolation, and quantification. This hybrid architecture combines the excellent nonlinear estimation capabilities of neural networks with the capability to rank the likelihood of various faults given a specific sensor suite signature. The method requires a significantly smaller data training set than a neural network approach alone does, and it performs the combined engine health monitoring objectives of performance diagnostics and sensor fault detection and isolation in the presence of nominal and degraded engine health conditions.

  19. The Diagnostic Challenge Competition: Probabilistic Techniques for Fault Diagnosis in Electrical Power Systems

    Ricks, Brian W.; Mengshoel, Ole J.


    Reliable systems health management is an important research area of NASA. A health management system that can accurately and quickly diagnose faults in various on-board systems of a vehicle will play a key role in the success of current and future NASA missions. We introduce in this paper the ProDiagnose algorithm, a diagnostic algorithm that uses a probabilistic approach, accomplished with Bayesian Network models compiled to Arithmetic Circuits, to diagnose these systems. We describe the ProDiagnose algorithm, how it works, and the probabilistic models involved. We show by experimentation on two Electrical Power Systems based on the ADAPT testbed, used in the Diagnostic Challenge Competition (DX 09), that ProDiagnose can produce results with over 96% accuracy and less than 1 second mean diagnostic time.

  20. Diagnostic Approach to Ocular Infections Using Various Techniques From Conventional Culture to Next-Generation Sequencing Analysis.

    Eguchi, Hiroshi; Hotta, Fumika; Kuwahara, Tomomi; Imaohji, Haruyuki; Miyazaki, Chika; Hirose, Miou; Kusaka, Shunji; Fukuda, Masahiko; Shimomura, Yoshikazu


    Ocular infection is caused by both endogenous (resident) and exogenous (environmental) microbes. As the ocular surface interacts with both outer environment and its own resident microbiota, clinical ocular samples are predicted to contain a diverse set of microorganisms. Microscopy of sample smears is an important step in the diagnostic process of infectious diseases to interpret the culture results. Traditional culture techniques have several limitations in the detection and/or identification of uncharacterized bacteria of environmental origin. Molecular biological techniques, such as polymerase chain reaction of pathogen-specific virulence genes, 16S rRNA gene clone library analysis, and next-generation sequencing of 16S rDNA amplicons, compensate for diagnostic culture techniques in diagnosing infectious diseases. These techniques are expected to provide novel insights into the ocular microbiota and pathology of ocular infections. In this article, we describe various ocular infections, including contact lens-related keratitis, silicone buckle infection, and dacryocystitis, which were analyzed using molecular biological techniques. The advantages and disadvantages of these highly sensitive and inclusive microbiological detection systems for ocular infections are discussed.

  1. Diagnostics of glass fiber reinforced polymers and comparative analysis of their fabrication techniques with the use of acoustic emission

    Bashkov, O. V.; Bryansky, A. A.; Panin, S. V.; Zaikov, V. I.


    Strength properties of the glass fiber reinforced polymers (GFRP) fabricated by vacuum and vacuum autoclave molding techniques were analyzed. Measurements of porosity of the GFRP parts manufactured by various molding techniques were conducted with the help of optical microscopy. On the basis of experimental data obtained by means of acoustic emission hardware/software setup, the technique for running diagnostics and forecasting the bearing capacity of polymeric composite materials based on the result of three-point bending tests has been developed. The operation principle of the technique is underlined by the evaluation of the power function index change which takes place on the dependence of the total acoustic emission counts versus the loading stress.

  2. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.


    ... generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument, suction... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  3. 21 CFR 876.4890 - Urological table and accessories.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological table and accessories. 876.4890 Section 876.4890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4890 Urological table...

  4. 21 CFR 876.5160 - Urological clamp for males.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological clamp for males. 876.5160 Section 876.5160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5160 Urological clamp for...

  5. Principles for new optical techniques in medical diagnostics for mHealth applications

    Balsam, Joshua Michael

    Medical diagnostics is a critical element of effective medical treatment. However, many modern and emerging diagnostic technologies are not affordable or compatible with the needs and conditions found in low-income and middle-income countries and regions. Resource-poor areas require low-cost, robust, easy-to-use, and portable diagnostics devices compatible with telemedicine (i.e. mHealth) that can be adapted to meet diverse medical needs. Many suitable devices will need to be based on optical technologies, which are used for many types of biological analyses. This dissertation describes the fabrication and detection principles for several low-cost optical technologies for mHealth applications including: (1) a webcam based multi-wavelength fluorescence plate reader, (2) a lens-free optical detector used for the detection of Botulinum A neurotoxin activity, (3) a low cost micro-array reader that allows the performance of typical fluorescence based assays demonstrated for the detection of the toxin staphylococcal enterotoxin (SEB), and (4) a wide-field flow cytometer for high throughput detection of fluorescently labeled rare cells. This dissertation discusses how these technologies can be harnessed using readily available consumer electronics components such as webcams, cell phones, CCD cameras, LEDs, and laser diodes. There are challenges in developing devices with sufficient sensitivity and specificity, and approaches are presented to overcoming these challenges to create optical detectors that can serve as low cost medical diagnostics in resource-poor settings for mHealth.

  6. [Urological problems in pregnancy, birth, and puerperium--a systematic review].

    Nielsen, Rikke Vibeke; Østergaard, Jeanett; Alling-Møller, Lars


    Urological problems in pregnancy represent a diagnostic and therapeutic challenge. Urinary tract symptoms in pregnant women comprise urinary tract infections, urolithiasis, hydronephrosis, urinary retention, urinary frequency and urinary incontinence. The primary purpose of this paper was to link our current understanding of the urinary tract anatomy and physiology to urinary tract symptoms in pregnancy and puerperium and the secondary purpose was to provide a review on diagnosis and management of these.


    E. S. Popova


    Full Text Available In the article due to the need for diagnostics of the production capacity of the organization. Formed methodological framework for evaluating the production potential of the organization. Research capacity will also enable the organization to timely respond to current changes. A classification of types of diagnostics of the production capacity of the organization according to the following criteria: timing, goals, content, purpose results. The article discusses the economic and organizational diagnosis of the production capacity of the organization. Economic diagnosis is based on the calculation of indicators of use of resources of the organization. Organizational diagnosis assesses the security of the organization's activities. Diagnosis productive capacity is the basis for improvement of the organization's activities. Defined diagnostics of the production capacity of the organization. Justified the selection stages of the research production potential. The first stage is the preliminary diagnosis. The second stage provides for the rapid diagnosis of production potential. At the third stage it is advisable to perform problem diagnosis. Problem diagnosis consists of economic and organizational diagnosis. Economic diagnosis assesses the state of the elements of the production potential of the organization. Organizational diagnostics analyses provide productive capacity. The fourth stage is represented by the solution of the problems of utilization of production capacity. Each stage is considered, has its content and specific diagnostic methods of production potential. This method allows determining the state of the elements, the efficiency of utilization of production capacity. The estimation of the production potential is based on the application of utility theory. This assessment provides a definition of the criteria and the scale of usefulness. This will allow you to measure the production potential numerically. In the end, it is revealed

  8. Publication misrepresentation among urology residency applicants.

    Hsi, Ryan S; Hotaling, James M; Moore, Tarah N; Joyner, Byron D


    To assess the extent and types of publication misrepresentation among medical students applying to the urology residency program at the University of Washington. Research experience and publications are the selection criteria used to judge and rank urology residency applicants. Electronic Residency Application Service (ERAS) applications submitted for the incoming class of 2011 for urology residency at the University of Washington were reviewed. All listed publications were verified against PubMed and Google search engines. Misrepresentation was defined as non-authorship of an existing article, authorship claimed of a nonexistent article, or first-authorship listed incorrectly. Of the 198 total applications, 124 (63 %) applicants reported 541 publications, including 112 abstracts and 429 journal articles. 347 (65 %) articles and abstracts were verifiable. Misrepresentation of 12 (3.5 %) published articles was found in 9 applicants (7 %), which included self-promotion to first-authorship (6), followed by non-existent articles (5), and a repeated publication listing (1). On univariate analysis, higher age (p = 0.008), higher number of total publications reported (p misrepresentation. Due to the low incidence, the study was not adequately powered to perform a multivariate analysis. Misrepresentation of publications listed in ERAS among urology applicants remains significant. Residency program directors should require applicants to submit copies of all of their publications, whether in print, in-press, or submitted to be placed as part of their application file.

  9. 3D Printing and Its Urologic Applications

    Soliman, Youssef; Feibus, Allison H; Baum, Neil


    3D printing is the development of 3D objects via an additive process in which successive layers of material are applied under computer control. This article discusses 3D printing, with an emphasis on its historical context and its potential use in the field of urology. PMID:26028997


    Department of Urology, Nelson R. Mandela School of Medicine, University of Natal, Durban,. South Africa .... any colleague in the world with the price of a local phone call. .... unrealistic dream but is a reality which can be achieved via ...

  11. Raman spectroscopy and its urological applications

    Vishwanath S Hanchanale


    Conclusion: Raman spectroscopy is an exciting tool for real-time diagnosis and in vivo evaluation of living tissue. The potential applications of Raman spectroscopy may herald a new future in the management of various malignant, premalignant, and other benign conditions in urology.

  12. 3D Printing and Its Urologic Applications.

    Soliman, Youssef; Feibus, Allison H; Baum, Neil


    3D printing is the development of 3D objects via an additive process in which successive layers of material are applied under computer control. This article discusses 3D printing, with an emphasis on its historical context and its potential use in the field of urology.

  13. A mathematical model of penile vascular dysfunction and its application to a new diagnostic technique.

    Barnea, Ofer; Hayun, Shimon; Gillon, Gabriel


    A noninvasive diagnostic device was developed to assess the vascular origin and severity of penile dysfunction. It was designed and studied using both a mathematical model of penile hemodynamics and preliminary experiments on healthy young volunteers. The device is based on the application of an external pressure (or vacuum) perturbation to the penis following the induction of erection. The rate of volume change while the penis returns to its natural condition is measured using a noninvasive system that includes a volume measurement mechanism that has very low friction, thereby not affecting the measured system. The rate of volume change (net flow) is obtained and analyzed. Simulations using a mathematical model show that the device is capable of differentiating between arterial insufficiency and venous leak and indicate the severity of each. In preliminary measurements on young healthy volunteers, the feasibility of the measurement has been demonstrated. More studies are required to confirm the diagnostic value of the measurements.

  14. Assessment of Diagnostic Value of Single View Dynamic Technique in Diagnosis of Developmental Dysplasia of Hip: A Comparison with Static and Dynamic Ultrasond Techniques.

    Alamdaran, Seyed Ali; Kazemi, Sahar; Parsa, Ali; Moghadam, Mohammad Hallaj; Feyzi, Ali; Mardani, Reza


    Developmental dysplasia of hip (DDH) is a common childhood disorder, and ultrasonography examination is routinely used for screening purposes. In this study, we aimed to evaluate a modified combined static and dynamic ultrasound technique for the detection of DDH and to compare with the results of static and dynamic ultrasound techniques. In this cross-sectional study, during 2013- 2015, 300 high-risk infants were evaluated by ultrasound for DDH. Both hips were examined with three techniques: static, dynamic and single view static and dynamic technique. Statistical analysis was performed using SPSS version 11.5. Patients aged 9 days to 83 weeks. 75% of the patients were 1 to 3 months old. Among 600 hip joints, about 5% were immature in static sonography and almost all of them were unstable in dynamic techniques. 0.3% of morphologically normal hips were unstable in dynamic sonography and 9% of unstable hips had normal morphology. The mean β angle differences in coronal view before and after stress maneuver was 14.43±5.47° in unstable hips. Single view static and dynamic technique revealed that all cases with acetabular dysplasia, instability and dislocation, except two dislocations, were detected by dynamic transverse view. For two cases, Ortolani maneuver showed femoral head reversibility in dislocated hips. Using single view static and dynamic technique was indicative and applicable for detection of more than 99% of cases. Single view static and dynamic technique not only is a fast and easy technique, but also it is of high diagnostic value in assessment of DDH.

  15. Diagnostic Efficacy in Knee MRI Comparing Conventional Technique and Multiplanar Reconstruction with One-Millimeter FSE PDW Images

    Yoon, Y.C.; Kim, S.S.; Chung, H.W.; Choe, B.K.; Ahn, J.H. [Dept. of Radiolog y, Kangwon National Univ. School of Medicine, Kangwon-do (Korea)


    Background: Magnetic resonance (MR) imaging has proved to be an excellent tool in diagnosing injuries of the cruciate ligaments and menisci. However, multiple planes and sometimes optimal oblique or double-oblique scan planes are needed due to the variability in the positioning of important structures, which means there is a lower throughput and longer scanning time. Purpose: To compare the performance of a 1-mm-thickness fast spin-echo (FSE) proton-density-weighted (PDW) MR imaging technique with multiplanar reconstruction (MPR) in diagnosing tears of the menisci and cruciate ligaments with that of conventional MR imaging. Material and Methods: Twenty-five consecutive patients underwent preoperative conventional and 1-mm-thickness FSE PDW MR imaging with subsequent knee arthroscopic surgery. Two musculoskeletal radiologists evaluated the status of the cruciate ligaments and menisci using two sets of MR images (method A: conventional images including seven sequences, taking 26 min; method B: 1-mm-thickness FSE PDW images with MPR, taking 7 min 20 s). The diagnostic efficacies of both methods for tears of the cruciate ligament and menisci were calculated and compared. Results: Arthroscopic surgery revealed 10 anterior cruciate ligament (ACL) tears, one posterior cruciate ligament (PCL) tear, and 26 meniscal tears. The diagnostic values of both methods were 100% for a cruciate ligament tear. The diagnostic values (sensitivity, specificity, accuracy, positive predictive value, and negative predictive value) for meniscal tears were 90%, 100%, 96%, 100%, and 94% for method A, and 95%, 100%, 98%, 100%, and 97% for method B, respectively. There were no significant differences in the diagnostic values between methods A and B. Conclusion: 1-mm-slice-thickness FSE PDW imaging with MPR showed comparable performance in diagnosing tears of the cruciate ligaments and menisci to conventional sequences but the scan time was much shorter. Therefore, this technique (method B) might

  16. Urology in Stettin (Szczecin). The impact of political changes on progress in urology and medicine.

    Zajaczkowski, Tadeusz; Wojewska-Zajaczkowska, Elzbieta


    The history of modern hospitals in Stettin is about 280 years long. The history of urology in Stettin (Szczecin), like in Europe, is closely associated with the construction of the useful cystoscope, discovery of X-rays, and progress in radiology and endoscopy. In Stettin, like in many other cities, patients with urological diseases were treated at departments of surgery or departments of internal medicine. On March 1It, 1919, a specialized urology ward with 27 beds was opened in the Municipal Hospital in Stettin. Dr. Felix Hagen from Berlin was the first head of this ward. The main duty of the urology ward at that time was to conduct differential diagnosis and to offer conservative treatment to patients not needing surgery. Cystoscopy, chromocystoscopy, and radiographs were done in the beginning. Later on, retroperitoneal pneumography, pneumopyelography, and retrograde pyelography were added. Urography in the final period enabled a more precise assessment of the kidney prior to surgery. The preparation of patients with benign prostate hyperplasia for surgery was an important element. Therapeutic activities of the urology ward included transurethral procedures such as lithotripsy of bladder stones and treatment of bladder cancer. Urological surgery was done at the surgery ward. Patients with tuberculosis were usually referred to the Tuberculosis Hospital in Hohenkrug (Zdunowo). In 1935, the urology ward in Stettin was closed and incorporated into the surgery ward. During the World War II, just as during the World War I, the Municipal Hospital in Stettin was transformed into a field hospital. The end of the World War II created a new political situation in Europe. Stettin (Szczecin) and West Pomerania became part of Poland. In 1948, the Polish government established the Pomeranian Medical Academy (PAM) in Stettin. During the first 10 years of its existence all urological operations were performed at surgery wards. In August 1955, a 30-bed urology ward affiliated

  17. [Will the new molecular karyotyping BACs-on-Beads technique replace the traditional cytogenetic prenatal diagnostics? Preliminary reports].

    Piotrowski, Krzysztof; Henkelman, Małgorzata; Zajaczek, Stanisław


    Recently several attempts have been made to introduce molecular karyotyping techniques into prenatal diagnosis. These methods can be used not only for the diagnosis of classical aneuploidies, but first of all they should be employed in the diagnostics of microaberrations, which are not revealed by low resolution methods of classical cytogenetics. The new method BACs-on-Beads is designed for quick detection of broad panel of aneuploidies and microdeletions, by the specified detection of deletions and duplications in the examined fetal DNA acquired from amniocytes. Prenatal diagnostics was performed with the use of BACs-on-Beads and classical amniocyte karyotyping simultaneously in a group of 54 pregnancies. This new method proved to be fully compatible with typical karyotyping in cultures of amniocytes in 98.2%. It was confirmed that the main advantage of this method is the possibility of quick diagnosis, within 48 hours, with much wider spectrum of detected anomalies when compared to classical methods. Contrary to other molecular karyotyping methods, the BACs-on-Beads technique is more economical, less time consuming and less complex equipment is needed than in case of other methods. We suppose that this technique can replace classical karyotyping methods in the near future.

  18. Comparison of advanced optical imaging techniques with current otolaryngology diagnostics for improved middle ear assessment (Conference Presentation)

    Nolan, Ryan M.; Shelton, Ryan L.; Monroy, Guillermo L.; Spillman, Darold R.; Novak, Michael A.; Boppart, Stephen A.


    Otolaryngologists utilize a variety of diagnostic techniques to assess middle ear health. Tympanometry, audiometry, and otoacoustic emissions examine the mobility of the tympanic membrane (eardrum) and ossicles using ear canal pressure and auditory tone delivery and detection. Laser Doppler vibrometry provides non-contact vibrational measurement, and acoustic reflectometry is used to assess middle ear effusion using sonar. These technologies and techniques have advanced the field beyond the use of the standard otoscope, a simple tissue magnifier, yet the need for direct visualization of middle ear disease for superior detection, assessment, and management remains. In this study, we evaluated the use of portable optical coherence tomography (OCT) and pneumatic low-coherence interferometry (LCI) systems with handheld probe delivery to standard tympanometry, audiometry, otoacoustic emissions, laser Doppler vibrometry, and acoustic reflectometry. Comparison of these advanced optical imaging techniques and current diagnostics was conducted with a case study subject with a history of unilateral eardrum trauma. OCT and pneumatic LCI provide novel dynamic spatiotemporal structural data of the middle ear, such as the thickness of the eardrum and quantitative detection of underlying disease pathology, which could allow for more accurate diagnosis and more appropriate management than currently possible.

  19. Using technique vibration diagnostics for assessing the quality of power transmission line supports repairs

    Cherpakov Aleksander


    Full Text Available The considered method for assessing the quality of the repair work to restore the rack supports of transmission lines is based on the method of vibration diagnostics. Power transmission line supports with a symmetrical destruction of the protective layer of concrete in the ground in violation of the construction section were chosen as an object. Finite element modelling package Ansys was used in assessing the quality of repair work. The example of evaluating the quality of repair using the relative adhesion defective area design criteria in the analysis of natural vibration frequencies is given.

  20. Clinical Application of Percutaneous Nephrostomy in Some Urologic Diseases

    Hongbo LUO; Xiuheng LIU; Tianpeng WU; Xiaobin ZHANG


    Percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. Percutaneous nephrostomy for percutaneous nephrolithotomy (PNL) was performed in patients with various renal, perinephric and bladder diseases (n=79). The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4-20 min. 12F-16F single tract was established in nephrohydrop patients and 16F-20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2-12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.

  1. Long-term urological outcomes in cloacal anomalies.

    Caldwell, Brian T; Wilcox, Duncan T


    Cloacal anomalies are the most complex and severe form of congenital anorectal malformations (ARM) and urogenital malformations, and it has been well documented that increased severity of ARM leads to worse outcomes. While short-term data on persistent cloaca are available, a paucity of data on long-term outcomes exists, largely because of a lack of uniform terminology, inclusion with other ARM and evolution of the operative technique. On comprehensive review of the published literature on long-term urological outcomes in patients with cloacal anomalies, we found a significant risk of chronic kidney disease and incontinence, however, with improvements in surgical technique, outcomes have improved. Continence often requires intermittent catheterization and in some cases, bladder augmentation. The complexity of cloacal malformations and associated anomalies make long-term multidisciplinary follow-up imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. [The history of urologic journalism in Spain (II). Chronology of Spanish publications specialized in urologic topics].

    Maganto Pavón, E


    The history of Spanish urological periodicals, like that of the surgical specialties, encompasses several periods as the specialties emerge, are then defined and finally established. It is difficult to determine precisely when the urological specialty began in Spain, since there were surgeons with some dedication to Urology early in the 19th century. Perhaps it began in 1884, when the first service dedicated to the diseases of the urinary tract was created at the Instituto de Terapéutica Operatoria (Institute of Surgical Therapeutics) of the Hospital de la Princesa in Madrid. Although some periodicals with urological descriptions that date back to an earlier period (1800-1850) can be found, it is widely recognized that regular publication of literature and periodicals on the urinary tract started in the mid-19th century, when 'El Especialista' (The Specialist) first appeared in Madrid in 1859. This was the first non monographic specialized periodical where the section 'Genitourinary Disorders' appeared for the first time together with three other specialties. During this second period, journal names were nonspecific or too comprehensive to the point that other medical fields became indiscernible, but they became more explicit as the specialties became more defined. In 1887, the first issue of 'Gaceta de Enfermedades de los Organos Génito-Urinarios' (Gazette of Diseases of the Genitourinary Organs) was published in Madrid. It was the first Spanish journal dedicated exclusively to urological topics. It ushered in a third period, which can be defined as the period of specialized monographic publications, that concluded in 1911 with the founding of the Asociación Española de Urología (Spanish Urological Society). The present article reviews the historical and bibliographical data concerning the six periodicals that were established during these two latter periods.

  3. Diagnostic utility of invasive EEG for epilepsy surgery: Indications, modalities, and techniques.

    Jayakar, Prasanna; Gotman, Jean; Harvey, A Simon; Palmini, André; Tassi, Laura; Schomer, Donald; Dubeau, Francois; Bartolomei, Fabrice; Yu, Alice; Kršek, Pavel; Velis, Demetrios; Kahane, Philippe


    Many patients with medically refractory epilepsy now undergo successful surgery based on noninvasive diagnostic information, but intracranial electroencephalography (IEEG) continues to be used as increasingly complex cases are considered surgical candidates. The indications for IEEG and the modalities employed vary across epilepsy surgical centers; each modality has its advantages and limitations. IEEG can be performed in the same intraoperative setting, that is, intraoperative electrocorticography, or through an independent implantation procedure with chronic extraoperative recordings; the latter are not only resource intensive but also carry risk. A lack of understanding of IEEG limitations predisposes to data misinterpretation that can lead to denying surgery when indicated or, worse yet, incorrect resection with adverse outcomes. Given the lack of class 1 or 2 evidence on IEEG, a consensus-based expert recommendation on the diagnostic utility of IEEG is presented, with emphasis on the application of various modalities in specific substrates or locations, taking into account their relative efficacy, safety, ease, and incremental cost-benefit. These recommendations aim to curtail outlying indications that risk the over- or underutilization of IEEG, while retaining substantial flexibility in keeping with most standard practices at epilepsy centers and addressing some of the needs of resource-poor regions around the world. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  4. Advances in diagnostic techniques of toxoplasmosis%弓形虫病诊断方法研究进展

    冯嘉轩; 赵永坤; 孟繁平; 吴泽民; 刘智; 李娜; 刘全


    Toxoplasmosis is a severe parasitic zoonosis caused byToxoplasma gondii, which poses a threat to human health. In this paper, the diagnostic techniques of toxoplasmosis and detection methods ofT. gondii were reviewed, including non-DNA-based diagnostic methods, serological assays, and molecular methods based on detection of parasite nucleic acid in hope of providing an insight into the development of novel diagnostic technologies and methods of toxoplasmosis.%弓形虫病是由弓形虫感染引起的一种严重的人兽共患寄生虫病,对人类健康造成极大威胁。本文对弓形虫病诊断技术,包括不依赖DNA检测诊断方法、血清学检测以及基于寄生虫核酸的分子生物学方法进行综述,为弓形虫病诊断技术和方法的发展提供新的思路。

  5. Effectiveness of the computer enhanced visual learning method in teaching the society for fetal urology hydronephrosis grading system for urology trainees.

    Marks, Andrew; Maizels, Max; Mickelson, Jennie; Yerkes, Elizabeth; Anthony Herndon, C D; Lane, Jerry; Ben-Ami, Tamar; Maizels, Evelyn; Stoltz, Rachel Stork; Dixon, Scott; Liu, Dennis; Chaviano, Tony; Hagerty, Jennifer; Kaplan, William


    A novel educational tool, Computer Enhanced Visual Learning (CEVL), has been used to improve resident performance of routine orchiopexy. Our objective was to assess the effect of a CEVL teaching module on the diagnostic accuracy of medical trainees in grading neonatal hydronephrosis on ultrasound using the Society for Fetal Urology (SFU) grading system. The authors designed an online-based computerized tutorial to teach the grading of hydronephrosis using multimedia, practice cases and a grading checklist. In a crossover design trial, 29 residents and medical students were asked to grade 16 standard neonatal renal ultrasounds using the SFU grading system before and after viewing the web-based e-learning module. Primary outcome was percent improvement in grading accuracy. The mean percentages of ultrasounds that were graded correctly before and after CEVL intervention were 51% and 72% respectively (mean improvement 21%, 95% CI 3-13%, P < 0.001). Residents graded correctly 56% of ultrasounds before and 74% after CEVL (mean 18%, 7-28%, P = 0.002). Medical students graded correctly 37% before and 69% after CEVL (mean improvement 32%, 95% CI 16-48%, P = 0.002). Exposure to a computer-based learning module based on the CEVL platform improved urology residents' and medical students' correct assignment of SFU hydronephrosis grading to newborn renal ultrasounds. Copyright © 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  6. Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre.

    Schroeder, R P J; Chrzan, R J; Klijn, A J; Kuijper, C F; Dik, P; de Jong, T P V M


    Minimally invasive surgery (MIS) is being utilized more frequently as a surgical technique in general surgery and in paediatric urology. It is associated with a steep learning curve. Currently, the centre does not offer a MIS training programme. It is hypothesized that the number of MIS procedures performed in the low-volume specialty of paediatric urology will offer insufficient training potential for surgeons. To assess the MIS training potential of a highly specialized, tertiary care, paediatric urology training centre that has been accredited by the Joint Committee of Paediatric Urology (JCPU). The clinical activity of the department was retrospectively reviewed by extracting the annual number of admissions, outpatient consultations and operative procedures. The operations were divided into open procedures and MIS. Major ablative procedures (nephrectomy) and reconstructive procedures (pyeloplasty) were analysed with reference to the patients' ages. The centre policy is not to perform major MIS in children who are under 2 years old or who weigh less than 12 kg. Every year, this institution provides approximately 4300 out-patient consultations, 600 admissions, and 1300 procedures under general anaesthesia for children with urological problems. In 2012, 35 patients underwent major intricate MIS: 16 pyeloplasties, eight nephrectomies and 11 operations for incontinence (seven Burch, and four bladder neck procedures). In children ≥2 years of age, 16/21 of the pyeloplasties and 8/12 of the nephrectomies were performed laparoscopically. The remaining MIS procedures included 25 orchidopexies and one intravesical ureteral reimplantation. There is no consensus on how to assess laparoscopic training. It would be valuable to reach a consensus on a standardized laparoscopic training programme in paediatric urology. Often training potential is based on operation numbers only. In paediatric urology no minimum requirement has been specified. The number of procedures quoted

  7. Diagnostic prénatal: quelles sont les techniques actuelles et futures ? (flyer)


    La majorité des bébés qui viennent au monde ne présentent pas d'anomalies particulières. Cependant, il faut savoir qu'environ 1 foetus 170 présente une anomalie chromosomique (défaut de la structure ou du nombre de chromosomes) qui va peser plus ou moins lourdement sur sa vie future et 1 foetus sur 100 présente une maladie génique due à un changement dans un gène. Le diagnostic prénatal a connu et connaît une formidable expansion grâce aux progrès technologiques en génétique et imagerie foetale.

  8. Computer Aided Diagnostic Support System for Skin Cancer: A Review of Techniques and Algorithms

    Ammara Masood


    Full Text Available Image-based computer aided diagnosis systems have significant potential for screening and early detection of malignant melanoma. We review the state of the art in these systems and examine current practices, problems, and prospects of image acquisition, pre-processing, segmentation, feature extraction and selection, and classification of dermoscopic images. This paper reports statistics and results from the most important implementations reported to date. We compared the performance of several classifiers specifically developed for skin lesion diagnosis and discussed the corresponding findings. Whenever available, indication of various conditions that affect the technique’s performance is reported. We suggest a framework for comparative assessment of skin cancer diagnostic models and review the results based on these models. The deficiencies in some of the existing studies are highlighted and suggestions for future research are provided.


    Tsarev, V N; Nikolaeva, E N; Iagodina, E V; Trefilova, Yu A; Ippolitov, E V


    The examination was carried out in the Moscow clinical infectious hospital No 2 concerning 102 patients with verified diagnosis "AIDS-infection" and seropositive according results of detection of anti-HIV-antibodies in blood serum. The study was organized to analyze rate ofcolonization of gums with virulent anaerobic bacteria in HIV-infected (polymerase chain reaction) and antibodies to HIV in gingival fluid (enzyme-linked immunosorbent assay). It is established that in HIV-infected patients, in scrape from gingival sulcus dominate anaerobic bacteria P. gigngivalis and A. ctinomycetemcomitans and in case of periodontitis--P. gingivalis and T. forsythia. The received data permits recommending the test-system "Multident-5" for polymerase chain reaction diagnostic. The reagents kit "Calypte®HIV-1/2"--for enzyme-linked immunosorbent assay gingival fluid. The results of polymerase chain reaction and enzyme-linked immunosorbent assay have no impact of concomitant stomatological (periodontitis, gingivitis) and somatic pathology.

  10. Current status of robotics in urologic laparoscopy.

    Gettman, Matthew T; Blute, Michael L; Peschel, Reinhard; Bartsch, Georg


    Urology has continuously embraced novel technologies like laparoscopy that reduce patient morbidity yet maintain an excellent standard of care. Because of limitations on maneuverability, operative vision, manual dexterity, and tactile sense, laparoscopy can be more difficult to perform than corresponding tasks in open surgery. To potentially increase clinical applicability of laparoscopy, robots that enhance operative performance have recently been introduced for a variety of laparoscopic procedures such as laparoscopic radical prostatectomy, pyeloplasty, and even laparoscopic cystectomy and neobladder construction. While these robots have generated excitement and many robotic applications have been described, the benefit of the advanced technology in expanded series of patients remains largely unknown. In addition, the ability of telerobotics to be used by surgeons inexperienced in conventional laparoscopy is also poorly understood. This review compares current features of available robots, advantages and limitations of robots, the emerging clinical applications, and the future potential of robotics in urology.

  11. Hatha Yoga therapy management of urologic disorders.

    Ripoll, Emmey; Mahowald, Dawn


    Hatha Yoga (often referred to as "yoga") is an ancient type of physical and mental exercise that has been used as a therapeutic modality in traditional Indian medicine for centuries. Yoga as a complementary modality in western medicine is more recent and continues to grow. Chronic urologic disorders are often difficult to diagnose because their presentation mimic other medical conditions and are often a diagnosis of exclusion. Treatment is also frustrating because the more traditional treatments are often unsuccessful in managing chronic disorders. Health care practitioners are often forced to look elsewhere for other modalities to provide pain relief and improve quality of life. Hatha Yoga is one of these modalities which has been extremely useful to many patients in reducing the suffering seen with chronic urologic conditions such as: prostatodynia, chronic orchitis, chronic epididymitis, vulvodynia, interstitial cystitis, etc.

  12. Post-transplant urological and vascular complications

    Safa Javid


    Full Text Available To determine the prevalence of urological and vascular complications in renal trans-plant recipients (RTx at Tabriz Renal Transplant Center, we studied 55 recipients of renal allo-grafts (25 male and 29 female patients with a mean age of 38.3 ± 13.4 years from October 2005 to November 2006. The surgical complications in our study included hematomas: 20.4%, renal artery stenosis: 20.4%, calculi: 7.4%, hydronephrosis or ureteral stricture: 5.6%, urinary leakage: 5.6%, lymphoceles: 1.9%, and renal vein thrombosis: 1.9%. We conclude that the most common urologic complications in our center were ureteric strictures and urine leaks, and the most common vascular complication was renal artery stenosis.

  13. Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions.

    Chakrabarti, Sudipta; Datta, Alok Sobhan; Hira, Michael


    Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

  14. Biomarker, Molecular, and Technologic Advances in Urologic Pathology, Oncology, and Imaging.

    Ellis, Carla L; Harik, Lara R; Cohen, Cynthia; Osunkoya, Adeboye O


    Urologic pathology is evolving rapidly. Emerging trends include the expanded diagnostic utility of biomarkers and molecular testing, as well as adapting to the plethora of technical advances occurring in genitourinary oncology, surgical practice, and imaging. We illustrate those trends by highlighting our approach to the diagnostic workup of a few selected disease entities that pathologists may encounter, including newly recognized subtypes of renal cell carcinoma, pheochromocytoma, and prostate cancer, some of which harbor a distinctive chromosomal translocation, gene loss, or mutation. We illustrate applications of immunohistochemistry for differential diagnosis of needle core renal biopsies, intraductal carcinoma of the prostate, and amyloidosis and cite encouraging results from early studies using targeted gene expression panels to predict recurrence after prostate cancer surgery. At our institution, pathologists are working closely with urologic surgeons and interventional radiologists to explore the use of intraoperative frozen sections for margins and nerve sparing during robotic prostatectomy, to pioneer minimally invasive videoscopic inguinal lymphadenectomy, and to refine image-guided needle core biopsies and cryotherapy of prostate cancer as well as blue-light/fluorescence cystoscopy. This collaborative, multidisciplinary approach enhances clinical management and research, and optimizes the care of patients with urologic disorders.

  15. Urology on the internet - introduction and update

    Inumpudi Anand; Srinivas, M.; A K Hemal


    The Internet, which has truly united the developed and developing nations, is an extensive network of inter-linked computers storing immense bytes of information, which can be accessed by anyone transcending all geographi-cal barriers and this has become the ultimate frontier to access information. The Urology and Andrology informa-tion on Internet is exponentially growing. The urologist need not know the intricacies of the hardware and soft-ware but can start right away navigating through th...

  16. Urologic manifestations of the iliacus hematoma syndrome.

    Colapinto, V; Comisarow, R H


    Anticoagulated patients may have a characteristic syndrome of femoral neuropathy from an iliacus muscle hematoma. They may present with urologic signs and symptoms, including groin, flank and thigh pain, groin tenderness, an iliac fossa mass and hematuria. Urography may reveal an enlarged psoas shadow and hydronephrosis from ureteral obstruction. Prompt diagnosis is essential so that early operative decompression of the femoral nerve can be done. The urologist has an important role in the diagnosis and treatment of this syndrome.

  17. Computer- and robot-assisted urological surgery

    Troccaz, Jocelyne


    The author reviews the computer and robotic tools available to urologists to help in diagnosis and technical procedures. The first part concerns the contribution of robotics and presents several systems at various stages of development (laboratory prototypes, systems under validation or marketed systems). The second part describes image fusion tools and navigation systems currently under development or evaluation. Several studies on computerized simulation of urological procedures are also presented.

  18. Holmium laser for multifunctional use in urology

    Watson, Graham M.; Shroff, Sunil; Thomas, Robert; Kellett, Michael


    The holmium laser pulsed at 350 microsecond cuts tissue and fragments calculi. It has been assessed for minimally invasive urological intervention. It is useful for partly excising and partly coagulating tumors, incising strictures and the obstructed PUJ. It partly drill and partly fragments urinary calculi however hard. Other lasers are more effective at any one particular application, but this laser is a useful compromise as a multifunctional device.

  19. [Fuzzy logic in urology. How to reason in inaccurate terms].

    Vírseda Chamorro, Miguel; Salinas Casado, Jesus; Vázquez Alba, David


    The Occidental thinking is basically binary, based on opposites. The classic logic constitutes a systematization of these thinking. The methods of pure sciences such as physics are based on systematic measurement, analysis and synthesis. Nature is described by deterministic differential equations this way. Medical knowledge does not adjust well to deterministic equations of physics so that probability methods are employed. However, this method is not free of problems, both theoretical and practical, so that it is not often possible even to know with certainty the probabilities of most events. On the other hand, the application of binary logic to medicine in general, and to urology particularly, finds serious difficulties such as the imprecise character of the definition of most diseases and the uncertainty associated with most medical acts. These are responsible for the fact that many medical recommendations are made using a literary language which is inaccurate, inconsistent and incoherent. The blurred logic is a way of reasoning coherently using inaccurate concepts. This logic was proposed by Lofti Zadeh in 1965 and it is based in two principles: the theory of blurred conjuncts and the use of blurred rules. A blurred conjunct is one the elements of which have a degree of belonging between 0 and 1. Each blurred conjunct is associated with an inaccurate property or linguistic variable. Blurred rules use the principles of classic logic adapted to blurred conjuncts taking the degree of belonging of each element to the blurred conjunct of reference as the value of truth. Blurred logic allows to do coherent urologic recommendations (i.e. what patient is the performance of PSA indicated in?, what to do in the face of an elevated PSA?), or to perform diagnosis adapted to the uncertainty of diagnostic tests (e.g. data obtained from pressure flow studies in females).

  20. A Novel Technique for Detecting Antibiotic-Resistant Typhoid from Rapid Diagnostic Tests


    Fluoroquinolone-resistant typhoid is increasing. An antigen-detecting rapid diagnotic test (RDT) can rapidly diagnose typhoid from blood cultures. A simple, inexpensive molecular technique performed with DNA from positive RDTs accurately identified gyrA mutations consistent with phenotypic susceptibility testing results. Field diagnosis combined with centralized molecular resistance testing could improve typhoid management and surveillance in low-resource settings.

  1. Spectroscopic techniques as a diagnostic tool for early detection of osteoporosis

    Singh, Kanika; Lee, Kwang Sung; Lee, Dong Geun; Kim, Yong Ki; Kim, Kyung Chun [Pusan National University, Busan (Korea, Republic of)


    Osteoporosis (OP) a kind of bone disease, is very serious in particular for old persons, and may lead them to immobility and death. Early detection of the diseases is the first consideration for the patients to have more options to live a healthy life. The biomarkers or bonemarkers provide a promising challenge in clinical proteomics for early disease detection. In this paper, optical techniques such as Fourier Transform Infrared Spectroscopy (FTIR) and UV/Visible spectroscopy are employed to find the bone markers and emphasis has been given on noninvasive modalities for early detection of osteoporosis. Blood plasma samples procured from two groups, patients and healthy persons were tested. Both of the optical techniques revealed obvious differences in the spectra: between two groups, for example, increase in intensity for OP persons. New peaks were found at 1646, 1540, 1456 and 1077 cm-1 in FTIR spectra. Except 1588 cm-1, we showed decrease in spectral intensity of OP persons. In UV/Visible spectroscopy results, new peaks appeared in the OP patients spectra at the wavelength of 279 nm and 414 nm. These differences in the spectra of the two types samples, allow rapid and cost-effective discrimination of the potential patients with the optical techniques which were verified by the bone densitometer in the hospitals. The new and novel technique is quick, reliable and effective

  2. Comparative analysis of diagnostic adequacy rate between aspiration and nonaspiration techniques of fine-needle cytology in patients with thyroid cancer and ultrasonographically suspicious cervical lymph nodes.

    Aydin, Cevdet; Dellal, Fatma Dilek; Tam, Abbas Ali; Ogmen, Berna; Kilicarslan, Aydan; Topaloglu, Oya; Ersoy, Reyhan; Cakir, Bekir


    We aimed to compare nonaspiration (NAS) and aspiration (AS) techniques in the evaluation of fine-needle cytology of lymph node (FNC-LN) in terms of diagnostic adequacy of cytologic material. One hundred and twenty-three superficial cervical LNs in 75 patients who underwent NAS and AS-FNC-LN in the same visit were evaluated. Cytological results were categorized as diagnostic and nondiagnostic. The rates of malignancy were 13.8% in AS versus 16.3% in NAS technique, whereas nondiagnostic cytology was detected in 43.1% and 25.2%, respectively (P = .549 and P < .01). The diagnostic adequacy rate in NAS-FNC-LN was significantly higher than AS-FNC-LN. However, NAS technique seems to be more simple and comfortable. We suggest both NAS and AS-FNC-LN in cytologic evaluation of suspicious cervical LNs until the diagnostic accuracy is determined with prospective studies. © 2017 Wiley Periodicals, Inc.

  3. The history of urologic surgery: from reeds to robotics.

    Nahon, Irmina; Waddington, Gordon; Dorey, Grace; Adams, Roger


    Bladder function has interested man since prehistoric times. Evidence of health and well being was often measured from observation of urine. When urologic function was impaired, the extent of the ensuing pain often called for dramatic measures to obtain relief. The practice of urology has advanced substantially since the days when reeds were used to alleviate obstruction of the bladder. This article presents a brief historical overview of urology and the strides made in prostate surgery with modern technology.

  4. [Genitourinary tuberculosis in the urologic works of Professor Rafael Mollá Rodrigo].

    Cánovas Ivorra, Jose Antonio; Tramoyeres Galván, Alfredo; Sánchez Ballester, Francisco; de la Torre Abril, Luis; Ordoño Domínguez, Felipe; Navalón Verdejo, Pedro; Ramada Benlloch, Francisco; López Alcina, Emilio; Pérez Albacete, Mariano; Zaragoza Orts, Julio


    Professor Rafael Molla Rodrigo is considered by some the author who contributed with his scientific work and solid technique to consolidate Urology as a speciality in Valencia. Such importance is also perceived in a national level, as demonstrated by the fact that he belonged to the first board of the Spanish Association of Urology and contributed to its foundation in the two-year period 1910--1911, from his position of head of the department of Surgical Therapy and Operations at the Central University. Genitourinary tuberculosis is one of the most outstanding chapters of his extensive works. We reviewed all his works, selecting all original articles about genitourinary tuberculosis. Original articles have been obtained from the journals Revista de Higiene y Tuberculosis, La Medicina Valenciana, Revista Valenciana de Ciencias Médicas y Policínica, and from his two most important books, Clinical Lessons In Urology and Clinical Lessons in Urology and Genitourinary Surgery. Throughout his work he analyzes features of relevance about this disease, such as diagnosis, about which he emphasizes the clinical and bacteriological difficulties, and treatment, which was only feasible by precocious nephrectomy. He dedicates a great part of his work to the study of this pathology and defends a precocious diagnosis in order to perform the only treatment that had demonstrated efficacy. He also exposes the symptoms and variety of clinical presentations, as well as diagnosis through separate kidney catheterization with the aim to determine unilateral involvement.

  5. Patient satisfaction in urology: effects of hospital characteristics, demographic data and patients' perceptions of received care.

    Schoenfelder, Tonio; Schaal, Tom; Klewer, Joerg; Kugler, Joachim


    To identify factors that are significantly associated with patient satisfaction in urology and to assess the extent to which satisfaction ratings might be related to hospital and patient characteristics. Data used in this study were obtained from 1040 randomly selected urology patients discharged from nine hospitals who responded to a mailed survey. Bivariate and multivariate techniques were used to reveal relations between patient assessments of received care, hospital and patient characteristics. Bivariate analysis showed a strong association between satisfaction scores and length of stay, provider status, work load of nurses and hospital size, with weaker findings pertaining to type of hospital (teaching versus non-teaching) and patient demographics. The multivariate analysis identified nine vari­ables which are associated with overall satisfaction. Strong factors were treatment outcome, the interper­sonal manner of medical practitioners and nurses, as well as hotel aspects like accommodation and quality of food. Variables reflecting information receiving about the undergoing treatment were not found to have a significant influence on patient satisfaction. This study identified variables that are related to satisfaction in a urological setting and de­livers information about aspects of the hospital stay that are not perceived as relevant by patients. These findings support healthcare professionals with valuable information to meet needs and preferences of pa­tients in urology.

  6. [Minimally invasive surgery in pediatric patients within a general urology department].

    Ríos, Jorge Subirá; Zalabardo, José Manuel Sánchez; Gil, Joaquín Navarro; Conejos, José Ignacio Hijazo; Alonso, Jesús García-Magariño; Calero, David García; López, José Antonio López; Uría, José Gabriel Valdivia


    The advances of minimally invasive surgery in urology over the last years have enabled a progressive and constant implementation of endourology and laparoscopy in pediatric patients. We perform a review of our experience, as a general hospital, with minimally invasive surgery performed in pediatric patients over the last ten years. We retrospectively analyzed the endourological and laparoscopic operations performed between 1997 and 2007 in children up to the age of 16 years, collecting data about patient's age and gender, type of disease, techniques, anesthesia, and perioperative events. seventy-two surgical operations were performed in patients with an age range between 28 days and 16 years, with a mean age of 6.8 years. 56% of the patients were boys and 44% girls. Indications for surgery was vesicoureteral reflux (VUR) in 28 cases (38.8%); lithiasis 17 cases (23.6%) which were distributed in 4 cystolithotripsies, 9 ureterorenoscopy with lithotripsy, one pure percutaneous nephrolithotomy and three mixed; ureterocele 9 cases (12.5%); urethral obstruction 7 cases (9.7%); 3 diagnostic laparoscopies for cryptorchidism (4. 1%), 2 laparoscopic procedures for cystic pathology (2.7%), another 2 laparoscopic renal biopsies (2.7%), and one laparoscopic repair of a ureteropyelic junction syndrome; 1 case of emergency percutaneous nephrostomy in the supine position after open pyeloplasty with subsequent reoperation with percutaneous resection of a granuloma; and 1 case of botulin toxin injection into the detrusor muscle. The consolidation of pediatric endourology in our department, and more recently laparoscopy, has contributed to improve the quality of care in pediatric patients; it has been achieved thanks to our previous know-how in general endourological techniques and the existence of adequate technical and human resources.

  7. Prostate and Urologic Cancer | Division of Cancer Prevention

    [[{"fid":"183","view_mode":"default","fields":{"format":"default","field_file_image_alt_text[und][0][value]":"Prostate and Urologic Cancer Research Group Homepage Logo","field_file_image_title_text[und][0][value]":"Prostate and Urologic Cancer Research Group Homepage Logo","field_folder[und]":"15"},"type":"media","attributes":{"alt":"Prostate and Urologic Cancer Research Group Homepage Logo","title":"Prostate and Urologic Cancer Research Group Homepage Logo","height":"266","width":"400","clas | Conducts and supports research on the prevention and early detection of prostate, bladder, and skin cancers.

  8. Looking forward, looking back-10 years in urology.

    Albersen, Maarten; Cartwright, Rufus; Choyke, Peter; Goldenberg, S Larry; Goldman, Howard; Lawrentschuk, Nathan; Linehan, W Marston; Murphy, Declan; Nagler, Harris; Scardino, Peter; Shortliffe, Linda; Stenzl, Arnulf; Theodorescu, Dan


    When Nature Reviews Urology launched in 2004, the field of urology was vastly different to that which we work in today, and the past 10 years have seen the field change immensely. As a specialty on the forefront of cutting-edge innovation, urologists are often the first to embrace new technologies and ideas. In this Viewpoint, members of the Nature Reviews Urology advisory board were asked what they thought was the most important change, issue or innovation in urology in the past 10 years, and what they expected to be the most important in the next decade. Here are their opinions.

  9. The Current State of Medical Malpractice in Urology.

    Sherer, Benjamin A; Coogan, Christopher L


    Medical malpractice can present an unwelcome professional, emotional, and economic burden to the practicing urologist. To date, there is a paucity of data specific to urologic malpractice in the literature. We performed a comprehensive literature search to identify and evaluate recent studies related to urologic malpractice. We also analyzed 6249 closed urologic claims from the largest available specialty-specific data set gathered by Physician Insurers Association of America from 1985 to 2012. The resulting comprehensive review seeks to raise awareness of current trends in the malpractice environment specific to urologic surgery while also helping urologists identify opportunities for risk management and improved patient care.

  10. Development of a Dermatology Diagnostic Techniques Teaching Session: A Nine-Step Approach.

    Farrell, Robin M; Shell, Linda G


    Creating effective learning experiences for veterinary clinical skills and procedures can be a challenging task. Drawing from both medical and veterinary education literature and personal experiences as practicing veterinarians and educators, the authors share nine key steps that describe the development process of a pre-clinical veterinary clinical skills teaching session. Relevant research and pedagogical principles supporting the effectiveness of the proposed nine-step process were identified and discussed. The aims of this article were to describe the development of a dermatology techniques teaching session and to provide the reader with a structured approach that can be used as a template to design or audit other clinical skills teaching sessions.

  11. Current status of natural orifice trans-endoscopic surgery (NOTES and laparoendoscopic single site surgery (LESS in urologic surgery

    Rafael E. Sanchez-Salas


    Full Text Available Laparoendoscopic single site surgery (LESS and natural orifice transluminal endoscopic surgery (NOTES represent novel approaches in urological surgery. To perform a review of the literature in order describe the current status of LESS and NOTES in Urology. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-02 to 15-05-09. Search terms included single port, single site, NOTES, LESS and single incision. A total of 412 manuscripts were initially identified. Out of these, 64 manuscripts were selected based in their urological content. The manuscript features subheadings for experimental and clinical studies, as NOTES-LESS is a new surgical technique and its future evolution will probably rely in initial verified feasibility. A subheading for reviews presents information regarding common language and consensus for the techniques. The issue of complications published in clinical series and the future needs of NOTES-LESS, are also presented.

  12. Clinical choice of prenatal diagnostic techniques%产前诊断实验技术的临床选择



    产前诊断技术对出生缺陷的控制至关重要。孕妇外周血生化标志检测的产前筛查、羊水脱落细胞、绒毛、脐血细胞的细胞遗传学分析等技术的成熟应用,荧光原位杂交、核酸体外扩增、基因测序、芯片等分子生物学技术的发展,使产前诊断水平得以大幅提高。高通量基因测序无创产前检测技术的应用迎来了产前诊断技术发展的新阶段。面对不断更新、日益增多的检测项目,需要客观地评估各项技术的优势与局限,才能科学地选择与组合各项技术进行产前诊断,充分发挥各技术在产前诊断中的作用。(中华检验医学杂志,2015,38:505-507)%Prenatal diagnosis is vitally important to control birth defects.The mature application of detecting biochemical markers in maternal serum and cytogenetic karyotype analysis of amniotic fluid cells , villi cells and umbilical cord blood cells , as well as the development of fluorescence in situ hybridization , nucleic acid amplification , gene sequencing , chips and other molecular biological techniques , have significantly improved the standards of prenatal diagnosis.The application of high-throughput sequencing , a non-invasive detection technique , ushers the development of prenatal diagnostic techniques into a new stage.In the face of a growing number of and constantly updated test items , it is necessary to assess the advantages and limitations of various prenatal diagnostic techniques , so as to realize scientific selection and combination, and utilize the techniques to their fullest potential.

  13. Comparison of different diagnostic techniques for the detection of cryptosporidiosis in bovines

    H. K. M. Rekha


    Full Text Available Aim: Aim of the present study was to compare different methods, viz., Sheather’s sugar flotation (SSF, Ziehl-Neelsen (ZN, Kinyoun’s acid-fast method (KAF, safranin-methylene blue staining (SMB, and negative staining techniques such as nigrosin staining, light green staining, and malachite green staining for the detection of Cryptosporidium spp. oocysts in bovines. Materials and Methods: A total of 455 fecal samples from bovines were collected from private, government farms and from the clinical cases presented to Department of Medicine, Veterinary College, Bengaluru. They were subjected for SSF, ZN, KAF, SMB and negative staining methods. Results: Out of 455 animal fecal samples screened 5.71% were found positive for Cryptosporidium spp. oocysts. The species were identified as Cryptosporidium parvum in calves and Cryptosporidium andersoni in adults based on the morphological characterization and micrometry of the oocysts. Conclusions: Of all the techniques, fecal flotation with sheather’s was found to be more specific and sensitive method for the detection of Cryptosporidium spp. oocysts. Among the conventional staining methods, the SMB gives better differentiation between oocysts and yeast. Among the three negative staining methods, malachite green was found sensitive over the other methods.

  14. Effects of anatomical position on esophageal transit time: A biomagnetic diagnostic technique

    Teodoro Cordova-Fraga; Modesto Sosa; Cados Wiechers; Jose Maria De la Roca-Chiapas; Alejandro Maldonado Moreles; Jesus BernaI-Alvarado; Raquel Huerta-Franco


    AIM: To study the esophageal transit time (ETT)and compare its mean value among three anatomical inclinations of the body; and to analyze the correlation of ETT to body mass index (BMI).METHODS: A biomagnetic technique was implemented to perform this study: (1) The transit time of a magnetic marker (MM) through the esophagus was measured using two fluxgate sensors placed over the chest of 14 healthy subjects; (2) the ETT was assessed in three anatomical positions (at upright,fowler,and supine positions; 90°,45° and 0°,respectively).RESULTS: ANOVA and Tuckey post-hoc tests demonstrated significant differences between ETT mean of the different positions.The ETT means were 5.2 ±1.1 s,6.1±1.5 s,and 23.6 ± 9.2 s for 90°,45° and 0°,respectively.Pearson correlation results were r = -0.716 and P < 0.001 by subjects' anatomical position,and r =-0.024 and P > 0.05 according the subject's BHI.CONCLUSION: We demonstrated that using this biomagnetic technique,it is possible to measure the ETT and the effects of the anatomical position on the ETT.

  15. Diagnostic Value of Hook Wire Localization Technique for Non-Palpable Breast Lesions

    Demiral, Gokhan; Senol, Metin; Bayraktar, Baris; Ozturk, Hasan; Celik, Yahya; Boluk, Salih


    Background The aim of this study was to investigate the validity of hook wire localization biopsy for non-palpable breast lesions which were detected by ultrasonography (USG) or mammography (MMG). Methods In this retrospective study, USG or MMG-guided hook wire localization technique was performed on 83 patients who had non-palpable breast lesions. Then histopathological examination was performed on surgically removed specimens. All patients’ mammograms or ultrasonograms were categorized using Breast Imaging-Reporting and Data System (BI-RADS) classification. Results Radiologically, 27 (32.53%) patients were classified as BI-RADS 3, 49 (59.04%) BI-RADS 4, one (1.2%) BIRADS 5 and six (7.23%) BI-RADS 0. Histopathological results were benign in 68 (81.9%) and malignant in 15 (18.1%) patients. Twenty-seven patients were classified as BI-RADS 3 and definitive diagnoses for all were benign. Besides, 49 patients were classified as BI-RADS 4 and histopathologically 14 of them were reported as malignant, and 35 as benign. Sensitivity of MMG was 93% and specificity was 55%. For USG, the sensitivity was 100% and the specificity was 73%. Conclusion In early diagnosis of breast cancer, the validity of the imaging-guided hook wire localization biopsy of non-palpable breast lesions has been proved. The cooperation of surgeon, radiologist and pathologist increases the successfull results of hook wire localization technique. PMID:27081425

  16. Diagnostic performance of MRI measurements to assess hindfoot malalignment. An assessment of four measurement techniques

    Buck, Florian M.; Hoffmann, Adrienne; Mamisch-Saupe, Nadja; Hodler, Juerg [University Hospital Balgrist and University of Zurich, Radiology, Zuerich (Switzerland); Farshad, Mazda; Espinosa, Norman [University Hospital Balgrist and University of Zurich, Department of Orthopaedic Surgery, Zuerich (Switzerland); Resnick, Donald [University of California San Diego, Department of Radiology, San Diego, CA (United States)


    To investigate the ability of coronal non-weight-bearing MR images to discriminate between normal and abnormal hindfoot alignment. Three different measurement techniques (calcaneal axis, medial/lateral calcaneal contour) based on weight-bearing hindfoot alignment radiographs were applied in 49 patients (mean, 48 years; range 21-76 years). Three groups of subjects were enrolled: (1) normal hindfoot alignment (0 -10 valgus); (2) abnormal valgus (>10 ); (3) any degree of varus hindfoot alignment. Hindfoot alignment was then measured on coronal MR images using four different measurement techniques (calcaneal axis, medial/lateral calcaneal contour, sustentaculum tangent). ROC analysis was performed to find the MR measurement with the greatest sensitivity and specificity for discrimination between normal and abnormal hindfoot alignment. The most accurate measurement on MR images to detect abnormal hindfoot valgus was the one using the medial calcaneal contour, reaching a sensitivity/specificity of 86 %/75 % using a cutoff value of >11 valgus. The most accurate measurement on MR images to detect abnormal hindfoot varus was the sustentaculum tangent, reaching a sensitivity/specificity of 91 %/71 % using a cutoff value of <12 valgus. It is possible to suspect abnormal hindfoot alignment on coronal non-weight-bearing MR images. (orig.)

  17. Towards non-invasive diagnostic techniques for early detection of acute renal transplant rejection: A review

    Elizabeth Hollis


    Full Text Available The kidney is a very important complicated filtering organ of the body. When the kidney reaches stage 5 chronic kidney disease, end stage renal failure, the preeminent therapy is renal transplantation. Although it is the best form of treatment, lack of kidney donors is still challenging. Therefore, all efforts should be employed to prolong the survival rate of the transplanted kidney. However, graft dysfunction (e.g., acute rejection is one of the serious barriers to long term kidney transplant survival. Currently, graft dysfunction’s gold standard of diagnosis is renal biopsy. Although renal biopsy is helpful, it is not preferred due to its invasive nature, high morbidity rates, and expensiveness. Therefore, noninvasive imaging techniques have become the subject of extensive research and interest, giving a strong promise to replace, or at least to decrease, biopsy usage in diagnosing graft dysfunction. This survey will discuss not only the current diagnosis and treatment of graft dysfunction but also the state-of-the-art imaging techniques in detecting acute renal transplant rejection.

  18. Tandem vaginoscopy with colonoscopy: a diagnostic technique for the assessment of colovaginal fistula.

    Alkhatib, A A; Santoro, G A; Gorgun, E; Abbas, M A


    Colovaginal fistula (CVF) has a negative impact on quality of life. Identifying the fistula track is a critical step in its management. In a subset of patients, localizing the fistula preoperatively can be difficult. The purpose of this report is to describe the technique and results of tandem vaginoscopy with colonoscopy (TVC). A retrospective analysis was conducted of all patients referred to a tertiary centre with symptoms suggestive of CVF but no prior successful localization of a fistula. TVC was performed by one colorectal surgeon in the endoscopy suite under intravenous sedation. Between 2003 and 2013, 18 patients (median age 58 years) underwent TVC. CVF was ruled out in three patients. In the remaining 15 patients, TVC documented the fistula in 13. In eight cases a wire was passed through the fistulous track from the vagina to the colon, in three the track was large enough to be traversed with the endoscope and in two a fistulous opening was noted on the vaginal side but passage of a wire to localize the opening on the colonic side was not possible due to extensive scarring. No TVC-related complications were recorded. The sensitivity, specificity, positive predictive value and negative predictive value for TVC in detecting CVF were 86.7%, 100%, 100% and 60%, respectively. TVC is a useful technique that can localize the fistulous track in most patients with CVF. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  19. Diagnostics and Control of Natural Gas-Fired furnaces via Flame Image Analysis using Machine Vision & Artificial Intelligence Techniques

    Shahla Keyvan


    A new approach for the detection of real-time properties of flames is used in this project to develop improved diagnostics and controls for natural gas fired furnaces. The system utilizes video images along with advanced image analysis and artificial intelligence techniques to provide virtual sensors in a stand-alone expert shell environment. One of the sensors is a flame sensor encompassing a flame detector and a flame analyzer to provide combustion status. The flame detector can identify any burner that has not fired in a multi-burner furnace. Another sensor is a 3-D temperature profiler. One important aspect of combustion control is product quality. The 3-D temperature profiler of this on-line system is intended to provide a tool for a better temperature control in a furnace to improve product quality. In summary, this on-line diagnostic and control system offers great potential for improving furnace thermal efficiency, lowering NOx and carbon monoxide emissions, and improving product quality. The system is applicable in natural gas-fired furnaces in the glass industry and reheating furnaces used in steel and forging industries.

  20. New imaging technique using degree of polarization for the study of polarimetric properties for non-invasive biomedical diagnostic

    Buscemi, Isabella C.; Guyot, Steve; Lemoine, Jacques


    This research proposes a new imaging technique for near real time multispectral acquisition using CCD RGB cameras of the so called "Degree Of Polarization" (DOP) in polarimetry for future clinical investigation. The aim of exploiting the DOP as the contrast element is to demonstrate that the elliptical DOP provides more information characterizing complex medium than the more traditional linear and circular ones. The system considers an incoherent input white light beam and opportunely calibrated nematic crystals (LCVR), so no mechanical tools are necessary. The particular features of the system indicate it to be the perfect candidate for a new imaging system considering in-vivo (as well as ex-vivo) non invasive superficial diagnostic for medical application as dermatologic diagnostics, since no type of sample preparation is necessary, i.e. tissue biopsy, radiation or contrast agent injection. Thus the biomedical application of this method suggests a simple, direct, fast and also easily exploitable future employment, as a desirable mean for clinical investigation but also for digital recognition in biometrics. Further new elements to improve the model of light scattering and matter-light interaction will be acquired, in particular considering a very complete characterization of the system response using latex microspheres suspension to simulate turbid media with different concentration.

  1. Laser diagnodent: a comparative study with other diagnostic techniques; Laser diagnodent: estudo comparativo com outras tecnicas de diagnostico

    Godinho, Reugma Rego


    An evaluation of the Diagnodent equipment (Kavo Company, Germany) for the occlusal caries detection was dane through the comparison with other conventional diagnostic techniques, such as visual inspection, intra-oral micro camera and digital X-ray. The effectiveness of the equipment in the detection of hidden caries and its viability as a diagnosis method for caries in their initial stage was also studied. Fifty eight permanent molars and premolars teeth from patients with age between 6 and 30 years were studied. The obtained results indicated that the conventional methods employed for the caries diagnosis are unable to detect the carious lesion in its initial stage. The Diagnodent equipment has this capability to detect caries presenting a flawless surface, specially the hidden caries, allowing the dentist to decide between a preventive ar a conservative procedure. The main advantage of the Diagnodent is to be an objective method, compared to the visual and radiographic ones, that are dependent on the professional interpretation. The Diagnodent is, therefore, a promising alternative as an objective and standardized diagnosis method for the final diagnostic. (author)

  2. An evaluation of diagnostic techniques utilized in the initial workup of pediatric patients with acute lymphocytic leukemia.

    Kuntz, D J; Leonard, J C; Nitschke, R M; Vanhoutte, J J; Wilson, D A; Basmadjian, G P


    The records of 32 pediatric patients with acute lymphocytic leukemia (ALL) were reviewed to evaluate the role of various diagnostic techniques used to assess the extent of extramedullary disease. Our findings indicate that adequate screening for hepatosplenomegaly is obtained by clinical assessment and for bone and renal involvement by bone scintigraphy including concomitant renal imaging. We recommend that radiographs be restricted to scintigraphically abnormal areas and/or sites of bone pain. Liver-spleen scintigraphy, gallium studies, intravenous pyelography, and ultrasound studies of the abdomen and pelvis should be utilized only to answer specific clinical questions. Evaluation in this manner reduces both radiation exposure and patient expense, while it adequately defines the extent of disease in these organs.

  3. Fuel Cell Manufacturing Diagnostic Techniques: IR Thermography with Reactive Flow through Excitation

    Manak, A. J.; Ulsh, M.; Bender, G.


    While design and material considerations for PEMFCs have a large impact on cost, it is also necessary to consider a transition to high volume production of fuel cell systems, including MEA components, to enable economies of scale and reduce per unit cost. One of the critical manufacturing tasks is developing and deploying techniques to provide in‐process measurement of fuel cell components for quality control. This effort requires a subsidiary task: The study of the effect of manufacturing defects on performance and durability with the objective to establish validated manufacturing tolerances for fuel cell components. This work focuses on the development of a potential quality control method for gas diffusion electrodes (GDEs). The method consists of infrared (IR) thermography combined with reactive flow through (RFT) excitation. Detection of catalyst loading reduction defects in GDE catalyst layers will be presented.

  4. Diagnostic radiography in orthopedics. Focusing techniques; 3. new rev. ed.; Orthopaedische Roentgendiagnostik. Einstelltechnik

    Bernau, A.


    After the introductory chapters dealing inter alia with approaches to defining the imaging tasks in relation to the anatomical regions to be exposed, and the relevant positioning, or aspects of radiological protection, positioning aids, and image optimization, the textbook presents a comprehensive guide to good imaging based on the functional approach commonly used in orthopedics, showing and explaining standard radiographs of the skeleton. The main aspect in this richly illustrated key part of the book is the focusing techniques best suitable for imaging the skull, the spine, the thorax and shoulders, the upper limbs, the pelvic region, and the lower limbs. (MG). 577 figs. [Deutsch] Nach einleitenden Kapiteln, die sich u.a. mit der anatomischen Orientierung, Strahlenschutzaspekten, Lagerungshilfen und Bildoptimierung befassen, wird eine der funktionellen Betrachtungsweise in der Orthopaedie angepasste Normierung der Skelettaufnahmen versucht. Dieser sich mit der Einstelltechnik befassende Hauptteil gliedert sich in die Bereiche Schaedel, Wirbelsaeule, Brustkorb und Schulterguertel, obere Extremitaeten, Beckenguertel sowie untere Extremitaeten. (MG)

  5. MDR-TB screening in a setting with molecular diagnostic techniques: who got tested, who didn't and why?

    Shewade, H D; Govindarajan, S; Sharath, B N; Tripathy, J P; Chinnakali, P; Kumar, A M V; Muthaiah, M; Vivekananda, K; Paulraj, A K; Roy, G


    Contexte : Programme national révisé de Lutte contre la Tuberculose, Pondichéry, Inde, avec une structure de techniques de diagnostic moléculaire.Objectif : Déterminer l'abandon préalable au diagnostic et préalable au traitement et leurs raisons parmi des patients présumés atteints de tuberculose multirésistante (TB-MDR).Méthodes : Dans cette étude utilisant plusieurs méthodes, l'élément quantitatif consistait en une analyse de cohorte rétrospective, grâce à une revue de dossiers, de tous les patients présumés atteints de TB-MDR entre octobre 2012 et septembre 2013. L'élément qualitatif incluait des entretiens approfondis avec des informateurs clés impliqués dans la gestion programmatique des services de TB pharmacorésistante.Résultats : Sur 341 patients présumés TB-MDR éligibles, le taux d'abandon avant le diagnostic et avant le traitement a été de 45,5% (155/341) et 29% (2/7), respectivement. Les patients atteints de TB extra-pulmonaire (RR = 2,3), de coïnfection par le virus de l'immunodéficience humaine et TB (RR = 1,7), inscrits entre octobre et décembre 2012 (RR = 1,3) et identifiés à partir de centres de santé primaires/secondaires (RR = 1,8) avaient moins de chances d'être testés. Les thèmes qui ont émergé lors de l'analyse des données qualitatives ont été « l'absence d'un mécanisme systématique de suivi des patients référés pour culture et test de pharmaco sensibilité », « l'absence de services de coursier pour transporter les crachats », « le manque de connaissances et d'appropriation du personnel de santé en général », « les ruptures de stock de kits de diagnostic » et « la non-adhérence du patient ».Conclusion : En dépit de l'introduction de techniques de diagnostic moléculaire, les problèmes opérationnels de dépistage de la TB-MDR restent préoccupants et requièrent une attention urgente.

  6. Diagnostic imaging of the breast. Examination techniques, appearances, differential diagnosis and interventiones. 3. compl. rev. ed.; Bildgebende Mammadiagnostik. Untersuchungstechnik, Befundmuster, Differenzialdiagnose und Interventionen

    Heywang-Koebrunner, Sylvia H. [Referenzzentrum Mammographie, Muenchen (Germany).; Schreer, Ingrid [Radiologische Allianz, Hamburg (Germany).


    The book on diagnostic imaging of the breast covers the following topics: Part I: Techniques: anamnesis and dialogue, clinical indications, mammography, sonography, nuclear magnetic resonance imaging, new imaging techniques, image clarification and percutaneous breast biopsy, preoperative marking. Part II: Appearance: the normal mamma, benign mamma modifications, cysts, benign tumors, inflammatory diseases, lesions with uncertain biological potential (B3 lesions), in-situ carcinoma, invasive carcinoma. Lymph nodes, other semi-malign and malign tumors, post-traumatic, post-operative and post-therapeutic changes, imaging diagnostics for breast implants, skin changes, the male breast. Part III: Use of imaging breast diagnostics: continuative diagnostics of screening indications and problem solution for the symptomatic patient.

  7. Urological disorders and pregnancy: An overall experience

    Debasmita Mandal


    Full Text Available Aim: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems. Materials and Methods: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. All pregnant women with urological problems were included as subjects. Results: A total of 33 subjects were followed up throughout their antenatal period. Among them majority (72.72% presented with hydro nephrosis followed by hydroureter (60.6%, PUJ obstruction and pyelonephritis each with incidence of 15.15%, then urolithiasis (12.12%, nephrolithiasis (6.06% and renal abscess (12.12%. Interventions required were DJ stenting (72.72%, pyeloplasty (15.15% and others were RURSL, abscess drainage and ATT. The pregnancy outcome was complicated with preterm labor in majority of patients (45.45%, oligohydramnious (18.18%, PIH (9.09% and still birth (6.06%. Twenty four live birth were there. Majority required NICU admissions as predominantly prematurity was an important concern. Majority women with hydronephrosis underwent DJ stenting. Conclusion: Preterm labor is an important obstetric concern. Vaginal delivery is the choicest mode of termination and LSCS can be reserved for obstetric reason. DJ stenting is safe and practical approach for continuation of pregnancy with hydronephrosis. Regular follow up, vigilant antenatal care and multidisciplinary approach from urologist, obstetrician and neonatologist will bring out successful pregnancy outcome.

  8. Urological disorders and pregnancy: An overall experience

    Mandal, Debasmita; Saha, Mriganka Mouli; Pal, Dillip Kumar


    Aim: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems. Materials and Methods: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. All pregnant women with urological problems were included as subjects. Results: A total of 33 subjects were followed up throughout their antenatal period. Among them majority (72.72%) presented with hydro nephrosis followed by hydroureter (60.6%), PUJ obstruction and pyelonephritis each with incidence of 15.15%, then urolithiasis (12.12%), nephrolithiasis (6.06%) and renal abscess (12.12%). Interventions required were DJ stenting (72.72%), pyeloplasty (15.15%) and others were RURSL, abscess drainage and ATT. The pregnancy outcome was complicated with preterm labor in majority of patients (45.45%), oligohydramnious (18.18%), PIH (9.09%) and still birth (6.06%). Twenty four live birth were there. Majority required NICU admissions as predominantly prematurity was an important concern. Majority women with hydronephrosis underwent DJ stenting. Conclusion: Preterm labor is an important obstetric concern. Vaginal delivery is the choicest mode of termination and LSCS can be reserved for obstetric reason. DJ stenting is safe and practical approach for continuation of pregnancy with hydronephrosis. Regular follow up, vigilant antenatal care and multidisciplinary approach from urologist, obstetrician and neonatologist will bring out successful pregnancy outcome. PMID:28216926

  9. [From paediatric urological care to adult urology. Assessment of a transition consultation for adolescents].

    Even, L; Mouttalib, S; Moscovici, J; Soulie, M; Rischmann, P; Game, X; Galinier, P; Bouali, O


    To provide an adequate lifelong urological care in the complex period of adolescence, a transition consultation conducted by a paediatric surgeon and an urologist was developed in our institution. As a real rite of passage, it allows the follow-up and the adapted care of urological conditions, sometimes complex, and permits the transition between childhood and the world of grown-ups. We reported our experience at the Children Hospital of our institution (paediatric surgery and urology departments). During a 6 months period (January-July 2015), forty-five young adults with a mean age of 17.8±3.6 years were seen in transition consultation. Eight patients had neurogenic voiding disorders (4 spina bifida, 1 multiple sclerosis, 1 mitochondrial encephalopathy, 1 metachromic leucodystrophy, 1 paraplegia), 9 patients had idiopathic voiding disorders, 1 patient had a non obstructive malformative uropathy; and 30 patients had surgery during infancy and childhood: hypospadias in 17 young men and malformative uropathy in 13 patients. This consultation occurred within 4.6±4.5 years after the last consultation with paediatric surgeon. For 6 patients, the transition consultation was the first for the urological problem. After this consultation, 8 patients stayed in paediatric surgery and 37 patients were referred to adult urologist. Among those 8 patients: 2 patients had cognitive and psychiatric disorders; 4 patients refused to be transferred to adult unit; 2 patients wanted to come back at transition consultation. Among the 37 patients transferred in adult urological care: 6 patients had urological surgery, and one patient was referred to a sexology consultation. The remaining 30 patients have initiated long-term monitoring. All reconvened patients came back at the follow-up visit (at least 12 months follow-up). A 16-year-old patient (spina bifida with polymalformative syndrome) developed a depressive syndrome at the end of the consultation, in the motive of an awareness of

  10. Cardiovascular dysfunction in obesity and new diagnostic imaging techniques: the role of noninvasive image methods

    Barbosa JA


    Full Text Available José Augusto A Barbosa¹, Alexandre B Rodrigues¹, Cleonice Carvalho C Mota¹, Márcia M Barbosa², Ana C Simões e Silva¹¹Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais (UFMG, Belo Horizonte, Minas Gerais, Brazil; ²Ecocenter, Socor Hospital, Belo Horizonte, Minas Gerais, BrazilAbstract: Obesity is a major public health problem affecting adults and children in both developed and developing countries. This condition often leads to metabolic syndrome, which increases the risk of cardiovascular disease. A large number of studies have been carried out to understand the pathogenesis of cardiovascular dysfunction in obese patients. Endothelial dysfunction plays a key role in the progression of atherosclerosis and the development of coronary artery disease, hypertension and congestive heart failure. Noninvasive methods in the field of cardiovascular imaging, such as measuring intima-media thickness, flow-mediated dilatation, tissue Doppler, and strain, and strain rate, constitute new tools for the early detection of cardiac and vascular dysfunction. These techniques will certainly enable a better evaluation of initial cardiovascular injury and allow the correct, timely management of obese patients. The present review summarizes the main aspects of cardiovascular dysfunction in obesity and discusses the application of recent noninvasive imaging methods for the early detection of cardiovascular alterations.Keywords: cardiovascular risk, endothelium dysfunction, obesity, strain and strain rate, tissue Doppler

  11. Foetal radiography for suspected skeletal dysplasia: technique, normal appearances, diagnostic approach

    Calder, Alistair D. [Great Ormond Street Hospital for Children NHS Foundation Trust, Radiology Department, London (United Kingdom); Offiah, Amaka C. [Sheffield Children' s NHS Foundation Trust, Academic Unit of Child Health, Sheffield (United Kingdom)


    Despite advances in antenatal imaging and genetic techniques, post-delivery post-mortem foetal radiography remains the key investigation in accurate diagnosis of skeletal dysplasia manifesting in the foetus. Foetal radiography is best performed using pathology-specimen radiography equipment and is often carried out in the pathology department without involvement of the radiology unit. However, paediatric radiologists may be asked to interpret post-mortem foetal radiographs when an abnormality is suspected. Many foetal radiographs are carried out before 20 weeks' gestation, and the interpreting radiologist needs to be familiar with the range of normal post-mortem foetal appearances at different gestational ages, as well as the appearances of some of the more commonly presenting skeletal dysplasias, and will benefit from a systematic approach when assessing more challenging cases. In this pictorial essay, we illustrate various normal post-mortem foetal radiographic appearances, give examples of commonly occurring skeletal dysplasias, and describe an approach to establishing more difficult diagnoses. (orig.)

  12. Laser flash photolysis studies of atmospheric free radical chemistry using optical diagnostic techniques

    Wine, Paul H.; Nicovich, J. M.; Hynes, Anthony J.; Stickel, Robert E.; Thorn, R. P.; Chin, Mian; Cronkhite, Jeffrey A.; Shackelford, Christie J.; Zhao, Zhizhong; Daykin, Edward P.


    Some recent studies carried out in our laboratory are described where laser flash photolytic production of reactant free radicals has been combined with reactant and/or product detection using time-resolved optical techniques to investigate the kinetics and mechanisms of important atmospheric chemical reactions. Discussed are (1) a study of the radical-radical reaction O + BrO yields Br + O2 where two photolysis lasers are employed to prepare the reaction mixture and where the reactants O and BrO are monitored simultaneously using atomic resonance fluorescence to detect O and multipass UV absorption to detect BrO; (2) a study of the reaction of atomic chlorine with dimethylsulfide (CH3SCH3) where atomic resonance fluorescence detection of Cl is employed to elucidate the kinetics and tunable diode laser absorption spectroscopy is employed to investigate the HCl product yield; and (3) a study of the aqueous phase chemistry of Cl2(-) radicals where longpath UV absorption spectroscopy is employed to investigate the kinetics of the Cl2(-) + H2O reaction.

  13. Iatrogenic urological triggers of autonomic dysreflexia

    Liu, N; Zhou, M; Biering-Sørensen, F


    Med search using AD/ autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood...... dyssynergia. Without anesthesia, the majority of individuals develop AD during cystoscopy, transurethral litholapaxy and ESWL. The effectiveness of different anesthesia methods relies on blocking the nociceptive signals from the lower urinary tract (LUT) below the level of the neurological lesion. Other...

  14. [German Urological Associations under National Socialism].

    Krischel, M; Moll, F; Fangerau, H


    The Deutsche Gesellschaft für Urologie (German Urological Association), established in 1907, was a German-Austrian medical society in which Jewish physicians held important positions. When the Nazis seized power in 1933, the Austrian Hans Rubritius was president of the society. The non-German presidency and the exclusion of Jewish colleagues from the professional society and medical practice led to a halt of the society's activities. At the same time in the mid 1930s, German urologists founded the Gesellschaft Reichsdeutscher Urologen (Association of Reichs-German Urologists) whose members aligned themselves with Nazi health policies and in turn received professional and personal benefits.

  15. [Management of brain metastases from urological malignancies].

    Gaillard, S; Lebret, T; Scarone, P; Lepeintre, J-F; Méjean, A; Aldea, S


    Brain metastases account for 30 to 40% of all brain tumors in adults. Even if urological carcinomas are not very common, anti-angiogenic drugs have transformed their prognosis, leading physicians to consider their specific treatment. For the majority of cases, surgery is quite simple with low associated morbidity. Depending on the size and the location, surgery or stereotaxic radiotherapy should be discussed. As soon as the metastasis is suspected a neurosurgerical opinion must be sought before beginning any treatment to coordinate the global management.

  16. Cirugía laparoscópica en urología Laparoscopic surgery in urology

    J. I. Pascual


    Full Text Available La cirugía mínimamente invasiva está presente en el momento actual en todos los estándares de calidad de un servicio quirúrgico. La cirugía laparoscópica, base de esta cirugía de mínima invasión, está revolucionando la enseñanza y el manejo de muchas patologías quirúrgicas. En el ámbito urológico, aunque con un retraso de 5 años con respecto a los países de nuestro entorno, la laparoscopia se ha afianzado como una técnica prevalente en muchos procesos del aparato genito-urinario, siendo actualmente la técnica de elección para el tratamiento quirúrgico de la suprarrenal y afianzándose rápidamente en patologías diversas como tumores renales, prostáticos, estadiaje en enfermedades neoplásicas testiculares, patología quirúrgica benigna y en cirugía reconstructiva. El Servicio de Urología del Hospital de Navarra es pionero en el empleo de este tipo de técnicas desde 1995 y desde 1998 en la llamada cirugía laparoscópica avanzada, siendo referente nacional en alguno de los procedimientos como la adrenalectomía laparoscópica. Actualmente están incorporados en el servicio todos los procedimientos laparoscópicos avanzados en urología, con una curva de aprendizaje superada. Todo ello ha permitido mejorar la atención al paciente, consiguiendo una disminución del dolor postoperatorio, estancia hospitalaria y rápida reincorporación a la actividad laboral con unos resultados oncológicos superponibles a los de la cirugía abierta.At the present time minimally invasive surgery is present in all the standards of quality of a surgical service. Laparoscopic surgery, the basis of this minimally invasive surgery, is revolutionising the teaching and handling of many surgical pathologies. In the urological sphere, although with a delay of 5 years with respect to neighbouring countries, laparoscopy has become established as a prevalent technique in many processes of the urinary-genital apparatus. At present it is the chosen

  17. The Positron Emission Tomography. A diagnostic technique; Con la PET diagnosi precoce della malattia

    Salvadori, P. [Consiglio Nazionale delle Ricerche, Istituto di Fisiologia Clinica, Chimica e Radiofarmaceutica, Gruppo PET/Ciclotrone, Pisa (Italy)


    Positron Emission Tomography (PET) is a new imaging modality, which is able to assess non-invasively the biochemical mechanisms, underlying physiological and pathophysiological processes in vivo in humans. The technique relies on the administration of radioactive tracers labeled with short-lived positron emitters, which need to be produced on site via a particle accelerator (cyclotron). Radionuclides are produced upon request and formulated into biologically active organic molecules having precise pharmacokinetics and specificity. The radiotracer can be detected by the PET scanner and represented as tomographic sections (images of body sections) showing its regional distribution and concentration. This makes it possible to address clinical questions concerning occurrence and evolution of many diseases as well as their response to therapy. The ability to image (measure) biological processes and not only anatomy enables PET to explore diseases in the very early stage, including those diseases which are not related to modifications of organ structure (e.g. psychiatric diseases, metabolic disorders, biochemical disfunction). PET plays a major role, in conjunction with the other imaging modalities, to improve diagnosis capabilities and disease mechanism understanding. [Italian] La PET e' correntemente utilizzata come efficace strumento clinico, per l'elevata sensibilita' e specificita', nella valutazione dell'iter diagnostico di pazienti con sospetta cardiopatia ischemica e nel processo di decision making clinico di pazienti con disfunzione ventricolare sinistra e cardiopatia ischemica, in quanto metodica di riferimento per la diagnosi di vitalita' miocardica. In campo oncologico, viene impiegata l'ormai ben documentata capacita' del fluorodesossiglucosio (FDG), un tracciante contenente fluoro-18 ed in grado di permettere la misura del consumo cellulare di glucosio, nel porre in evidenza all'esame PET il tessuto neoplastico

  18. Prevalence of Sexual Abuse among Patients Seeking General Urological Care

    Beck, Jack J. H.; Bekker, Milou D.; van Driel, Mels F.; Roshani, Hossein; Putter, Hein; Pelger, Rob C. M.; Elzevier, Henk W.


    Introduction. Sexual abuse (SA) history can be found in the backgrounds of an important fraction of men (8-10%) and women (12-25%). Until now there are no data about this prevalence within a urological patient population. Aim. To establish the prevalence of SA among men and women visiting a urologic

  19. 21 CFR 876.5130 - Urological catheter and accessories.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Urological catheter and accessories. 876.5130 Section 876.5130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5130...

  20. [The William P. Didusch Center for Urologic History of the American Urological Association: new exciting approaches in presenting urologic history, not only in the USA - a personal guided tour].

    Engel, R M


    The Didusch Center for Urologic History encompasses a rich and varied collection of drawings, photographs, and instruments of historical importance to urology, many displayed in the urological exhibits during the American Urological Association (AUA) conventions. The Center also houses a library devoted to urological and early medical texts and the AUA archives and is the institution of research in all fields of urologic history in the USA. The museum collection features most of Didusch's original drawings, as well as an impressive instrument collection acquired primarily through donations by urologists. The original William P. Didusch Museum (now known as the William P. Didusch Center for Urologic History) was originally housed in the AUA's Baltimore City headquarters building. Upon the association's move to Linthicum, MD in 2003, the museum has evolved into the William P. Didusch Center for Urologic History and taken on new tasks and responsibilities that include the topic of research in urologic history.

  1. [Andres Vesalio, Francisco Díaz, Miguel de Cervantes Saavedra and the birth of urology in the 16th Century].

    Carrillo Esper, Raúl; Carrillo Córdova, Luis Daniel; Carrillo Córdova, Dulce María; Carrillo Córdova, Carlos Alberto; Carrillo Córdova, Jorge Raúl


    In the sixteenth century there were great advances in science, literature, and the arts. During this century, urology as a specialty was conceived, thanks to the contributions of Andreas Vesalius, anatomist and leading physician to the court of Charles V, and Dr. Francisco Diaz, a native of Alcala de Henares, surgeon and clinician. Dr. Diaz had a close relationship with Miguel de Cervantes, who at one point in his life suffered from renal colic. In his masterpiece "Re-Printed Treaty of all diseases of the kidneys, bladder and wattles of the Cock and Urina, divided into three books," of which the first book of urology is the History of Medicine, describes in detail the clinical and therapeutic aspects of urological diseases, known as the "bad stone" and urethral strictures known as "wattles", in addition to describing the different surgical techniques and the development of new instruments for urological procedures, which include the cisorio instrument and the Speculum pudendi. For the above, Dr. Francisco Diaz is considered the father of urology.

  2. Emerging role of robotics in urology

    Kumar Rajeev


    Full Text Available Robotic assistance is one of the latest additions to the field of laparoscopic surgery. The most commonly used robotic device in Urology is the da Vinci ® system of which over 200 devices are installed worldwide including 3 in India. This robot consists of three or four arms, one of which is used to hold and manipulate the laparoscopic camera while the others are used to manipulate specialized laparoscopic instruments with endowrist ® technology that allows 7 degrees of freedom. The robot is currently used primarily for radical prostatectomies where complex dissection and reconstruction can be performed in less than 2 hours with excellent outcomes. There is a progressive increase in the number of surgeries being performed by this device which allows laparoscopy naοve surgeons to offer the benefits of minimally invasive surgery to their patients. The other surgeries where this device has been used to benefit are pyeloplasty, cystectomy with urinary diversion, nephrectomy and ureteric re-implant. The principal drawbacks of the device are the steep cost of machine and disposables. However, the benefits achieved in terms of improved surgical precision, magnified 3 dimensional vision, scaling of movements, remote surgery and as a teaching tools will help the robot establish a definitive place in the urologic armamentarium.

  3. [Contribution to the history of urological pharmacotherapy].

    Mercant, J


    The aim of this work is to present a historical review of urological pharmacotherapy. The containers used to preserve and store medicines are an important source of information in historical research. I studied written sources such as treaties of Medical and Therapeutical Materials, as well as material sources available at the Pharmacy Museum of the Farmacia Monástica de la Real Cartuja de Valldemossa in Mallorca. I examined the old medicine containers and the labelling on ceramic recipients, glass jars and wooden boxes and other medicines found inside them. Different medicines, the most used over the centuries to treat diseases of the urinary system are described, including both simple (of plant, mineral or animal origin) and compound medicines: drumstick tree, agaricus, mechoacan, lupine, fennel, acacia gum, myrtle, Armenian bole, oleum scorpionum, hartshorn plantain, cantharides. I present evidence of knowledge available for each of these remedies in the main bibliographic sources, as well as proof that they were used in Valldemossa. The basis of general and urological pharmacotherapy was concentrated on nature. Medicines of plant origin were the most used. The therapeutic inventory that mankind has accumulated throughout history is the result of a lengthy process of combining practices and knowledge of different cultures and societies. Copyright © 2010 AEU. Published by Elsevier Espana. All rights reserved.

  4. Integrated visualization of problemcentric urologic patient records.

    Bui, Aleex A T; Taira, Ricky K; Churchill, Bernard; Kangarloo, Hooshang


    The collision of computer-based technologies and the medical environment is resulting in an increasingly electronic multimedia patient record, consisting of not only the traditional types of data (e.g., clinic notes and laboratory reports), but also digital images (e.g., computed tomography and magnetic resonance imaging) and other visual representations of patient data (e.g., pulmonary function graphs and urodynamic charts). Given the increasing amount of data made available to physicians, it is not only critical that the totality of a patient's medical record be accessible to a clinician, but that the diverse data be integrated and presented in a manner conducive to patient management: key information should be easily discovered. This paper describes a problemcentric time-based visualization of urologic conditions, whereby a patient's medical history is automatically organized around a medical problem and presented as a graphic chronology. Urology-related data in the patient medical record is organized in accord with an expert constructed knowledge-base, and plotted on a timeline using iconic representations. The user interface permits the physician to quickly view multimedia data and to visualize relationships between events in the patient's history.

  5. Current status of laser applications in urology

    Knipper, Ansgar; Thomas, Stephen; Durek, C.; Jocham, Dieter


    The overall development of laser use in urology is recessing. The reasons are the refinement of methods of radical surgery and the continuing development of alternative technologies involving electric current. Taking the cost factor into account, are lasers still opportune in medicine? The answer is definitely yes. Cost reduction in medical practice without quality loss is only possible with effective methods of minimally invasive surgery. Continuing investigation of cutting, welding, coagulating and ablating instruments is justified. Competition of lasers to other technologies can only be beneficial to the cause. But where are the highlights of laser applications? The unsurpassed utilization of optical properties of lasers lie in the concept of photodynamic therapies and in optical feedback mechanisms for laser applications. The combination of lasers with three dimensional visualization of the treatment area by ultrasound (TULIP-procedure for benign prostatic hyperplasia) is a novel approach in laser application. The further development of these treatment modalities will reveal the true benefit of laser technology in urological applications.

  6. Identifying Students' Mathematical Skills from a Multiple-Choice Diagnostic Test Using an Iterative Technique to Minimise False Positives

    Manning, S.; Dix, A.


    There is anecdotal evidence that a significant number of students studying computing related courses at degree level have difficulty with sub-GCE mathematics. Testing of students' skills is often performed using diagnostic tests and a number of computer-based diagnostic tests exist, which work, essentially, by testing one specific diagnostic skill…

  7. Extracellular MicroRNAs in Urologic Malignancies: Chances and Challenges

    Liang Wang


    Full Text Available Small noncoding RNAs that are 19-23 nucleotides long, known as microRNAs (miRNAs, are involved in almost all biological mechanisms during carcinogenesis. Recent studies show that miRNAs released from live cells are detectable in body fluids and may be taken up by other cells to confer cell-cell communication. These released miRNAs (here referred to as extracellular miRNAs are often protected by RNA-binding proteins or embedded inside circulating microvesicles. Due to their relative stability, extracellular miRNAs are believed to be promising candidates as biomarkers for diagnosis and prognosis of disease, or even as therapeutic agents for targeted treatment. In this review, we first describe biogenesis and characteristics of these miRNAs. We then summarize recent publications involving extracellular miRNA profiling studies in three representative urologic cancers, including: prostate cancer, bladder cancer, and renal cell carcinoma. We focus on the diagnostic, prognostic, and therapeutic potential of these miRNAs in biological fluids, such as serum, plasma, and urine. Finally, we discuss advantages and challenges of these miRNAs in clinical applications.

  8. Magnetic resonance urography and laparoscopy in paediatric urology: a case series.

    Damasio, Maria Beatrice; Costanzo, Sara; Podestà, Emilio; Ghiggeri, Gianmarco; Piaggio, Giorgio; Faranda, Fabio; Degl'Innocenti, Maria Ludovica; Jasonni, Vincenzo; Magnano, Gian Michele; Buffa, Piero; Montobbio, Giovanni; Mattioli, Girolamo


    Paediatric urology often presents challenging scenarios. Magnetic resonance urography (MRU) and laparoscopy are increasingly used. We retrospectively studied children affected by a disease of the upper urinary tract who after MRU were elected for laparoscopic treatment. This pictorial essay draws on our experience; it illustrates some specific MRU findings and highlights the usefulness of MRU for the diagnosis of upper urinary tract pathology in children. It also offers some examples of the potential additional diagnostic information provided by laparoscopy as well as its therapeutic role.

  9. Radionuclide studies in paediatric nephro-urology

    Piepsz, Amy E-mail:


    The main tool of radionuclide techniques applied to paediatric uro-nephrology is the quantitation of function, which is an information not easily obtained by other diagnostic modalities. The radiation burden is low. Drug sedation is only rarely needed, whatever the age of the patient. Accurate determination of glomerular filtration rate can be obtained by means of an intravenous injection of Cr-51 EDTA and one or two blood samples. Tc-99m DMSA scintigraphy is an accurate method for evaluation of regional cortical impairment during acute pyelonephritis and later on, for detection of permanent scarring. Tc-99m MAG3 renography is nowadays a well-standardized method for accurate estimation of the split renal function and of renal drainage with or without furosemide challenge. This technique is particularly indicated in uni- or bilateral uropathies with or without renal and/or ureteral dilatation. Direct and indirect radionuclide cystography are two alternative modalities for X-ray MCUG. Their relative place in the strategy of management of vesicoureteral reflux is discussed.

  10. Comparison of four diagnostic techniques for detection of Trichomonas vaginalis infection in females attending tertiary care hospital of North India

    Razia Khatoon


    Full Text Available Background: Trichomonas vaginalis causes a common sexually transmitted disease trichomoniasis, which may lead to increased risk of transmission of human immunodeficiency virus infection and other pelvic inflammatory diseases. Wet mount examination is the most common test for diagnosis, but it has low sensitivity. Acridine orange staining can be used for diagnosis, but it requires special microscopic facility. Culture is considered as the gold standard, but it takes a long time for diagnosis. OSOM Trichomonas Rapid Test is a recently introduced rapid method based on immunochromatographic assay of trichomonal protein antigens. Hence, the present study was done to compare these four diagnostic techniques for detection of trichomoniasis in females with vaginal discharge. Materials and Methods: Vaginal swabs were taken from 835 female patients and wet mount examination, acridine orange staining, culture in Kupferberg medium, and OSOM Trichomonas Rapid Test, were performed. Results: Out of 835 patients included in our study, 68 (8.1% positive cases of trichomoniasis were detected by culture. OSOM Trichomonas Rapid Test detected 63 (7.5% cases, acridine orange staining detected 53 (6.3% cases, whereas, wet mount examination detected only 45 (5.4% positive cases. OSOM Trichomonas Rapid Test performed well and showed high sensitivity and specificity of 88.2% and 99.6%, respectively. Conclusion: As OSOM Trichomonas Rapid Test is a point of care test and gave better results than both wet mount examination and acridine orange staining; it can be used as a routine test in peripheral areas lacking laboratory facilities.

  11. [The demographic development in Germany : challenge and chances for urology].

    Schneider, A W; Fichtner, J


    Urology is affected by the demographic development in Germany more than any other medical discipline. Despite a relatively stable total population, by the year 2040 there will be an absolute and relevant increase in urological diseases caused only by the demographic development in the population. This is particularly true for the increase in oncological treatment just in the field of the discipline of urology. Even now the current numbers for tumor development in Germany (RKI 2014) in the urological oncology segment of all tumor diseases show an increasing trend with more than 23 %. This significant increase in performance is in contrast to the age development of the specialists in this discipline. In total but especially due to the significantly over-aged specialist medical profession in urology, this leads to a substantial bottleneck of specialists in the discipline of urology. This deficiency of personnel resources in urology is aggravated by the requirements of Generation Y for a well-adjusted work-life balance and the associated feminization of the medical profession. This requires intelligent strategies for.

  12. How to develop a simulation programme in urology.

    Ahmed, Kamran; Amer, Tarik; Challacombe, Ben; Jaye, Peter; Dasgupta, Prokar; Khan, Mohammad Shamim


    What's known on the subject? and What does the study add? Inanimate trainers and simulators have been shown to facilitate the skill acquisition of urologists. However, there are significant challenges to integrating standalone simulation programmes into mainstream urology curricula. This study provides a framework to overcome these challenges and discusses the advantages of centralised urology simulation centres and their potential to serve as key adjuncts in the certification and validation process of urologists. Fixed performance-based outcomes of inanimate trainers and simulators have been praised as useful adjuncts in urology for reducing the learning curve associated with the acquisition of new technical and non-technical skills without compromising patient safety. Simulators are becoming an integral part of the urology training curriculum and their effectiveness is totally dependent on the structure of the programme implemented. The present paper discusses the fundamental concepts of centralized urology centres and their potential to serve as key adjuncts in the certification and validation process of urologists. In summary, proficiency-based curricula with well structured endpoints and objective tools for validating proficiency are critical in developing a simulation programme in urology. We concludes that more educational research into the outcomes of integrated urology curricula followed by trainee/trainer opinion surveys will help address some of these criteria.

  13. The use of smartphone applications by urology trainees.

    Nason, G J; Burke, M J; Aslam, A; Kelly, M E; Akram, C M; Giri, S K; Flood, H D


    Mobile phone technology is continuously advancing- the smartphone allows users instant access to information via the internet. Downloadable applications (apps) are becoming widespread across medical specialities. The aim of this study was to assess the use of smartphone apps among urology trainees in Ireland. An anonymous electronic survey was distributed via Survey Monkey(®) to all urology trainees in Ireland assessing their ownership and use of smartphones and downloadable apps. A search of urology apps was performed using the Apple App Store and the Android Market. 36 (81.8%) of trainees responded with 100% ownership of smartphones. 28 (77%) report downloading apps with 11 (30.6%) reporting paying for them. The mean number of apps downloaded was 4 (Range 1-12). 16 (44.4%) trainees think apps for smartphones are very useful in clinical practice, 14 (42.4%) think they are useful. A total of 126 urology apps were available. 76 (60.3%) were designed for physicians, 46 (36.5%) for patients, 2 (1.6%) for students and 2 (1.6%) for urological nurses. There are an ever increasing number of urology apps available. Urology trainees are using smartphones as an educational and reference tool and find them a useful aide in clinical practice. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. Use of social media in urology: data from the American Urological Association (AUA).

    Loeb, Stacy; Bayne, Christopher E; Frey, Christine; Davies, Benjamin J; Averch, Timothy D; Woo, Henry H; Stork, Brian; Cooperberg, Matthew R; Eggener, Scott E


    To characterise the use of social media among members of the American Urological Association (AUA), as the use of social media in medicine has greatly expanded in recent years. In December 2012 to January 2013, the AUA e-mailed a survey with 34 questions on social media use to 2000 randomly selected urologists and 2047 resident/fellow members. Additional data was collected from Symplur analytics on social media use surrounding the AUA Annual Meeting in May 2013. In all, 382 (9.4%) surveys were completed, indicating 74% of responders had an online social media account. The most commonly used social media platforms were Facebook (93%), followed in descending order by LinkedIn (46%), Twitter (36%) and Google+ (26%). Being aged social media use (83% vs 56%), with greater uptake among residents/fellows compared with attendings (86% vs 66%). Only 28% of respondents used social media partly or entirely for professional purposes. During the 2013 AUA Annual Meeting, there were >5000 tweets from >600 distinct contributors. As of early 2013, among respondents to an e-mail survey, most urologists and urology trainees used some form of social media, and its use in urology conferences has greatly expanded. © 2013 The Authors. BJU International © 2013 BJU International.

  15. Use of Botulinum Toxin in Urologic Diseases.

    Chermansky, Christopher J; Chancellor, Michael B


    OnabotulinumtoxinA (onaBoNTA) is approved by the US Food and Drug Administration for the treatment of urinary incontinence due to neurogenic detrusor overactivity and for the treatment of refractory overactive bladder. As a treatment for benign prostatic hyperplasia, onaBoNTA showed no difference over placebo in recently published studies. In contrast, treating interstitial cystitis/bladder pain syndrome with onaBoNTA has shown efficacy, and the current American Urological Association guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome lists onaBoNTA as fourth-line treatment. This comprehensive review will present all studied applications of onaBoNTA within the lower urinary tract.

  16. Xenogenic extracellular matrices as potential biomaterials for interposition grafting in urological surgery.

    Davis, N F


    PURPOSE: The field of tissue engineering focuses on developing strategies for reconstructing injured, diseased, and congenitally absent tissues and organs. During the last decade urologists have benefited from remodeling and regenerative properties of bioscaffolds derived from xenogenic extracellular matrices. We comprehensively reviewed the current literature on structural and functional characteristics of xenogenic extracellular matrix grafting since it was first described in urological surgery. We also reviewed the clinical limitations, and assessed the potential for safe and effective urological application of extracellular matrix grafting in place of autogenous tissue. MATERIALS AND METHODS: We performed literature searches for English language publications using the PubMed(R) and MEDLINE(R) databases. Keywords included "xenogenic," "extracellular matrix" and "genitourinary tract applications." A total of 112 articles were scrutinized, of which 50 were suitable for review based on clinical relevance and importance of content. RESULTS: Since the mid 1990s xenogenic extracellular matrices have been used to successfully treat a number of pathological conditions that affect the upper and lower genitourinary tract. They are typically prepared from porcine organs such as small intestine and bladder. These organs are harvested and subjected to decellularization and sterilization techniques before surgical implantation. Bioinductive growth factors that are retained during the preparation process induce constructive tissue remodeling as the extracellular matrix is simultaneously degraded and excreted. However, recent documented concerns over durability, decreased mechanical strength and residual porcine DNA after preparation techniques have temporarily hampered the potential of extracellular matrices as a reliable replacement for genitourinary tract structures. CONCLUSIONS: Extracellular matrices are a useful alternative for successfully treating a number of urological

  17. Urological aspects of HIV and AIDS.

    Heyns, Chris F; Smit, Shaun G; van der Merwe, André; Zarrabi, Amir D


    The use of highly active antiretroviral therapy (HAART) in HIV-infected people has led to a dramatic decrease in the incidence of opportunistic infections and virus-related malignancies such as non-Hodgkin lymphoma and Kaposi sarcoma, but not cervical or anal cancer. Advanced-stage cervical cancer is associated with a high incidence of urological complications such as hydronephrosis, renal failure, and vesicovaginal fistula. Adult male circumcison can significantly reduce the risk of male HIV acquisition. Although HAART does not completely eradicate HIV, compliance with medication increases life expectancy. HIV infection or treatment can result in renal failure, which can be managed with dialysis and transplantation (as for HIV-negative patients). Although treatment for erectile dysfunction--including phosphodiesterase 5 inhibitors, intracavernosal injection therapy, and penile prosthesis--can increase the risk of HIV transmission, treatment decisions for men with erectile dysfunction should not be determined by HIV status. The challenges faced when administering chemotherapy to HIV-infected patients with cancer include late presentation, immunodeficiency, drug interactions, and adverse effects associated with compounded medications. Nonetheless, HIV-infected patients should receive the same cancer treatment as HIV-negative patients. The urologist is increasingly likely to encounter HIV-positive patients who present with the same urological problems as the general population, because HAART confers a prolonged life expectancy. Performing surgery in an HIV-infected individual raises safety issues for both the patient (if severely immunocompromised) and the surgeon, but the risk of HIV transmission from patients on fully suppressive HAART is small.

  18. Correlation of acoustic emission with normal zone occurrence in epoxy-impregnated windings: An application of acoustic emission diagnostic technique to pulse superconducting magnets

    Tsukamoto, O.; Iwasa, Y.


    We report results of experiments correlating acoustic emission (AE) data to the presence of normal zones in epoxy-impregnated windings. The results suggest the feasibility of using AE sensors to determine whether or not a superconducting magnet has been driven normal after a rapid discharge. This AE diagnostic technique may be particularly valuable in application to pulse magnets.

  19. Aneurysmal bone cyst: revision of different techniques in imaging diagnostic. Quiste oseo aneurismatico: revision de diferentes tecnicas de diagnostico por la imagen

    Parra Blanco, J.A.; Fernandez Echevarria, M.A.; Pagola Serrano, M.A.; Vara Vara, A.; Gonzalez Tutor, A. (Hospital Universitario ' ' Marques de Valdecilla' ' . Servicio de Radiodiagnostico. Santander (Spain))


    We study simple radiology, conventional tomography, computed tomography and angiography in 8 cases of aneurysmal bone cyst for the purpose of assessing the utility of these diagnostic techniques. Our results, in agreement with those in the literature, indicate that the presence of a generally well-defined lytic, insufflated lesion containing septi should suggest this disorder. (Author)

  20. Field and laboratory comparative evaluation of rapid malaria diagnostic tests versus traditional and molecular techniques in India

    Bharti Praveen K


    Full Text Available Abstract Background Malaria presents a diagnostic challenge in most tropical countries. Microscopy remains the gold standard for diagnosing malaria infections in clinical practice and research. However, microscopy is labour intensive, requires significant skills and time, which causes therapeutic delays. The objective of obtaining result quickly from the examination of blood samples from patients with suspected malaria is now made possible with the introduction of rapid malaria diagnostic tests (RDTs. Several RDTs are available, which are fast, reliable and simple to use and can detect Plasmodium falciparum and non-falciparum infections or both. A study was conducted in tribal areas of central India to measure the overall performance of several RDTs for diagnosis of P. falciparum and non-falciparum infections in comparison with traditional and molecular techniques. Such data will be used to guide procurement decisions of policy makers and programme managers. Methods Five commercially available RDTs were tested simultaneously in field in parallel with peripheral blood smears in outbreak-affected areas. The evaluation is designed to provide comparative data on the performance of each RDT. In addition, molecular method i.e. polymerase chain reaction (PCR was also carried out to compare all three methods. Results A total of 372 patients with a clinical suspicion of malaria from Bajag Primary Health Centre (PHC of district Dindori and Satanwada PHC of district Shivpuri attending the field clinics of Regional Medical Research Centre were included in the study. The analysis revealed that the First Response Malaria Antigen pLDH/HRP2 combo test was 94.7% sensitive (95% CI 89.5-97.7 and 69.9% specific (95% CI 63.6-75.6 for P. falciparum. However, for non-falciparum infections (Plasmodium vivax the test was 84.2% sensitive (95% CI 72.1-92.5 and 96.5% specific (95% CI 93.8-98.2. The Parascreen represented a good alternative. All other RDTs were relatively

  1. The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

    Florian Wagenlehner


    Full Text Available The Global Prevalence of Infections in Urology (GPIU study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI. Investigators registered data through a web-based application ( Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years.

  2. The Global Prevalence of Infections in Urology Study: A Long-Term, Worldwide Surveillance Study on Urological Infections

    Wagenlehner, Florian; Tandogdu, Zafer; Bartoletti, Riccardo; Cai, Tommaso; Cek, Mete; Kulchavenya, Ekaterina; Köves, Béla; Naber, Kurt; Perepanova, Tamara; Tenke, Peter; Wullt, Björn; Bogenhard, Florian; Johansen, Truls Erik Bjerklund


    The Global Prevalence of Infections in Urology (GPIU) study is a worldwide-performed point prevalence study intended to create surveillance data on antibiotic resistance, type of urogenital infections, risk factors and data on antibiotic consumption, specifically in patients at urological departments with healthcare-associated urogenital infections (HAUTI). Investigators registered data through a web-based application ( Data collection includes the practice and characteristics of the hospital and urology ward. On a certain day in November, each year, all urological patients present in the urological department at 8:00 a.m. are screened for HAUTI encompassing their full hospital course from admission to discharge. Apart from the GPIU main study, several side studies are taking place, dealing with transurethral resection of the prostate, prostate biopsy, as well as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions. Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years. PMID:26797640

  3. Spanish adaptation of the recommendations for the appropriate use of social networks in urology of the European Association of Urology.

    Rodríguez-Socarrás, M E; Gómez-Rivas, J; Álvarez-Maestro, M; Tortolero, L; Ribal, M J; Garcia Sanz, M; Roupret, M


    To adapt to Spanish the recommendations for the appropriate use of social media (SoMe) in the urological setting prepared by the European Association of Urology (EAU). The use of SoMe has become fairly popular in the international urological community. Due to the nature of the medical content shared among healthcare professionals through SoMe, however, there is the risk of medical and legal problems. For this reason, various international urological associations such as the American Urological Association, the British Association of Urological Surgeons and EAU have published their recommendations for the appropriate use of social media. Efforts have been made to adapt and summarise the recommendations of the EAU in Spanish and to publish them in Actas Urológicas Españolas (@actasurologicas), the official journal of the Spanish Urological Association (@InfoAEU) and the American Confederation of Urology (@CAU_URO). SoMe include well-known platforms such as Twitter, Facebook and YouTube, which have undoubtedly changed the way in which people communicate and interact. SoMe offer clear advantages for communicating between professionals, working in teams, disseminating knowledge and creating professional profiles and are increasingly used by patients and healthcare practitioners. The introduction of SoMe in the urological community has started a revolution in how scientific articles are shared, how people participate in congresses and how international urological associations communicate with their followers. However, SoMe is generally an open public setting, with potential risks for confidentiality and the doctor-patient relationship due to the nature of the shared information. The present recommendations include tools for creating professional profiles, protecting confidentiality and creating honest and responsible content. SoMe represents a fascinating area for the communication and dissemination of knowledge, with considerable applicability in health care and the

  4. [William P. Didusch. Pioneer of modern scientific illustrations for visualization in urology].

    Görgen, A; Moll, F H; Engel, R; Fangerau, H


    Bill Didusch was one of the most influential illustrators in American urology. His biography is of great importance not only because of his artistic achievements, but also the work he has accomplished in the service of the American Urological Association. He founded a museum of urological artifacts that bears his name. The article reflects Didusch's biography and emphasizes his impact on American urology and urological illustration as an integral part of visualisation in medicine.

  5. Urine cytology in the evaluation of urological malignancy revisited: is it still necessary?

    Falebita, Opeyemi Adegboyega


    OBJECTIVE: We aim to determine if urine cytology was still necessary as a routine part of the evaluation for the presence of urological malignancy and to evaluate its cost effectiveness. METHODS: Urine cytology reports over a 6-year period (2000-2005) were retrieved from our institution\\'s pathology department database. Patients with urine cytology positive for malignant cells were identified. We retrospectively reviewed the charts of these patients for age, sex, flexible cystoscopy and radiological imaging results. The cost of urine cytology was retrieved from the pathology department. RESULTS: There were a total of 2,568 urine cytological examinations. Of these, 25 were positive for malignant cells. There were 19 male (76%) and 6 female (24%) patients with a mean age of 72 years (range: 49-97). In 21 patients with positive cytology, a bladder tumor was identified at flexible cystoscopy and\\/or imaging studies. For a positive cytology yield of 1%, EUR 210,000 was spent. CONCLUSIONS: Routine urine cytology was not cost effective and did not add to the diagnostic yield beyond cystoscopy and diagnostic imaging. It may be omitted in the initial evaluation of urological malignancy.

  6. Applications of three-dimensional printing technology in urological practice.

    Youssef, Ramy F; Spradling, Kyle; Yoon, Renai; Dolan, Benjamin; Chamberlin, Joshua; Okhunov, Zhamshid; Clayman, Ralph; Landman, Jaime


    A rapid expansion in the medical applications of three-dimensional (3D)-printing technology has been seen in recent years. This technology is capable of manufacturing low-cost and customisable surgical devices, 3D models for use in preoperative planning and surgical education, and fabricated biomaterials. While several studies have suggested 3D printers may be a useful and cost-effective tool in urological practice, few studies are available that clearly demonstrate the clinical benefit of 3D-printed materials. Nevertheless, 3D-printing technology continues to advance rapidly and promises to play an increasingly larger role in the field of urology. Herein, we review the current urological applications of 3D printing and discuss the potential impact of 3D-printing technology on the future of urological practice.

  7. Urology Tag Ontology Project: Standardizing Social Media Communication Descriptors.

    Kutikov, Alexander; Woo, Henry H; Catto, James W


    Standardizing social media hashtag descriptors is likely to facilitate communication and promote collaboration in both health care provider and patient communities. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  8. Image guided robotic surgery: Current evidence for effectiveness in urology

    Anum Pervez


    Full Text Available Objectives: Discussion of the evolution of image guided surgery (IGS and its fundamental components and current evidence for effectiveness of IGS in clinical urology. Methods: Literature search for image-guided robotic urology. Results: Current literature in image-guided robotic urology with its use in robot assisted radical prostatectomy and robot assisted partial nephrectomy are shown. Conclusions: Image guided surgery can be a useful aid to improve visualisation of anatomy and subsurface structures during minimally invasive surgery. Soft-tissue deformation makes it difficult to implement IGS in urology but current studies have shown an attempt to address this issue. The feasibility of IGS requires randomised control trials assessing in particular its accuracy and affect on clinical outcome.

  9. A new era of Asian urology: a SWOT analysis.

    Kumar, Rajeev


    Economic prosperity and increasing connectivity have made Asia an emerging centre of growth in health care, including in the field of urology. Large and varied patient populations, the availability of a trained workforce, the use of English as a common communication language, and overall low costs have contributed to this change. Rapid growth of regional urological associations and journals has fuelled the aspirations and abilities of Asian urologists to not only keep abreast of but often lead the change in urological disease management. Asian urology has immense potential to expand in areas in which it currently lags behind, the most important being research. The increasing ability to travel aids in developing networks for collaboration. However, Asian urologists will need to look at sustainable models of engagement and temper the need for short-term results if these opportunities are to reach their maximal potential.

  10. Optimizing urology group partnerships: collaboration strategies and compensation best practices.

    Jacoby, Dana L; Maller, Bruce S; Peltier, Lisa R


    Market forces in health care have created substantial regulatory, legislative, and reimbursement changes that have had a significant impact on urology group practices. To maintain viability, many urology groups have merged into larger integrated entities. Although group operations vary considerably, the majority of groups have struggled with the development of a strong culture, effective decision-making, and consensus-building around shared resources, income, and expense. Creating a sustainable business model requires urology group leaders to allocate appropriate time and resources to address these issues in a proactive manner. This article outlines collaboration strategies for creating an effective culture, governance, and leadership, and provides practical suggestions for optimizing the performance of the urology group practice.

  11. 'Image and treat': an individualized approach to urological tumors

    Bouchelouche, Kirsten; Capala, Jacek


    The current treatment options for advanced urologic cancers demonstrate limited efficacy. To obtain optimal clinical results, there is a need for new, individualized, therapeutic strategies, which have only recently been applied to these malignancies. Nuclear medicine plays an important role in e...... in establishing imaging biomarkers necessary for personalized medicine. This review focuses on the current status of the 'image and treat' approach combining molecular imaging with targeted radionuclide therapy of urological malignancies...

  12. The Global Prevalence of Infections in Urology Study

    Wagenlehner, Florian; Tandogdu, Zafer; Bartoletti, Riccardo;


    as urosepsis. The GPIU study has been annually performed since 2003. Eight-hundred fifty-six urology units from 70 countries have participated so far, including 27,542 patients. A proxy for antibiotic consumption is reflected by the application rates used for antibiotic prophylaxis for urological interventions....... Resistance rates of most uropathogens against antibiotics were high, especially with a note of multidrug resistance. The severity of HAUTI is also increasing, 25% being urosepsis in recent years....

  13. Prenatal Diagnosis Procedures and Techniques to Obtain a Diagnostic Fetal Specimen or Tissue: Maternal and Fetal Risks and Benefits.

    Wilson, R Douglas; Gagnon, Alain; Audibert, François; Campagnolo, Carla; Carroll, June; Brock, Jo-Ann; Chong, Karen; Johnson, Jo-Ann; MacDonald, William; Okun, Nanette; Pastuck, Melanie; Vallee-Pouliot, Karine


    Objectif : Offrir aux fournisseurs de soins de maternité et à leurs patientes des lignes directrices factuelles contemporaines en ce qui concerne les services de counseling traitant des risques et des avantages maternels propres à la tenue des interventions diagnostiques prénatales orientées par échographie (et/ou des techniques permettant l’établissement d’un diagnostic génétique) nécessaires dans les cas où il a été établi pendant la période prénatale que la grossesse serait exposée à des risques, ainsi qu’en ce qui concerne la prise de décisions subséquentes quant à la prise en charge de la grossesse (questions abordant des aspects tels que le niveau du fournisseur de soins obstétricaux, la surveillance prénatale, le lieu où devraient se dérouler les soins et l’accouchement, et la décision de poursuivre ou d’interrompre la grossesse). La présente directive clinique se limite aux services de counseling traitant des risques et des avantages maternels, et aux décisions en matière de prise en charge de la grossesse pour les femmes qui nécessitent (ou qui envisagent) la mise en œuvre d’une intervention ou d’une technique effractive orientée par échographie aux fins de l’établissement d’un diagnostic prénatal. Population de patientes : Femmes enceintes identifiées, à la suite de la mise en œuvre de protocoles établis de dépistage prénatal (taux sériques maternels ± imagerie, résultats d’analyse de l’ADN acellulaire indiquant des risques élevés, résultats anormaux au moment de l’imagerie fœtale diagnostique ou antécédents familiaux de troubles héréditaires), comme étant exposées à un risque accru d’anomalie génétique fœtale. Ces femmes pourraient nécessiter ou demander des services de counseling au sujet des risques et des avantages pour la grossesse de la tenue d’une intervention effractive orientée par échographie visant à déterminer l’étiologie, le diagnostic, et/ou la

  14. Telmisartan inhibits human urological cancer cell growth through early apoptosis



    Angiotensin II receptor blockers (ARBs) are widely used as hypertensive therapeutic agents. In addition, studies have provided evidence that ARBs have the potential to inhibit the growth of several types of cancer cells. It was reported that telmisartan (a type of ARB) has peroxisome proliferator-activated receptor (PPAR)-γ activation activity. We previously reported that the PPAR-γ ligand induces growth arrest in human urological cancer cells through apoptosis. In this study, we evaluated the effects of telmisartan and other ARBs on cell proliferation in renal cell carcinoma (RCC), bladder cancer (BC), prostate cancer (PC) and testicular cancer (TC) cell lines. The inhibitory effects of telmisartan and other ARBs (candesartan, valsartan, irbesartan and losartan) on the growth of the RCC, BC, PC and TC cell lines was investigated using an MTT assay. Flow cytometry and Hoechst staining were used to determine whether the ARBs induced apoptosis. Telmisartan caused marked growth inhibition in the urological cancer cells in a dose- and time-dependent manner. Urological cancer cells treated with 100 μM telmisartan underwent early apoptosis and DNA fragmentation. However, the other ARBs had no effect on cell proliferation in any of the urological cancer cell lines. Telmisartan may mediate potent anti-proliferative effects in urological cancer cells through PPAR-γ. Thus, telmisartan is a potent target for the prevention and treatment of human urological cancer. PMID:22993542

  15. AB39. Cryotherapy in urologic neolplasms

    He, Leye


    Cryosurgery has a long history dating back to the mid-1800s when James Arnott, an English physician, used a salt and ice mixture to treat cervical and breast carcinoma. Modern cryosurgery began in 1961 with the development of automated equipment by Cooper and Lee. Since then, tumors in various organs have been treated with cryoablation, and probes of various shapes and sizes have been designed to improve tumor accessibility and ablation. During the last decade there has been a resurgence of cryotherapy in the field of urology, particularly in the treatment of malignant lesions of the kidney and prostate. As a minimally invasive treatment, the cryotherapy appears to be the most durable. Currently, select kidney and prostatic lesions are treated using cryotherapy and clinical series have provided compelling results, promoting interest in renal and prostatic cryoablation. By the advancement of radiographic technology and surgical instrumentation, much of the interest has been promoted along with the movement toward to provide minimally invasive therapeutic options for patients. The optimal indication for renal cryotherapy is a peripheral, enhancing, well circumscribed lesion less than 4 cm. Along with tumor characteristics, certain patient populations may benefit from kidney cryotherapy. They include elderly patients with comorbidities, particularly hypertension, diabetes, kidney stones, renal insufficiency, cerebrovascular accidents, and congestive heart failure. Other considerations include unique situations such as lesions less than 4 cm in a solitary or transplant kidney, along with certain hereditary conditions such as von Hippel-Lindau disease, tuberous sclerosis, and hereditary papillary renal cell carcinoma. Contraindications to kidney cryoablation include locally advanced and/or metastatic disease and uncontrolled bleeding disorders. Other relative contraindications include lesions contiguous with bowel, great vessels, and/or tumor size of at least 5 cm

  16. Assessment of the usefulness of a diagnostic test: A survey of patient preference for diagnostic techniques in the evaluation of intestinal inflammation

    Pavel Dan


    Full Text Available Abstract Background In order to assess the usefulness of radiolabeled white cell scanning in the diagnosis of intestinal inflammation, subjects were asked to rank several dimensions of preference for white cell scanning in relation to other diagnostic tests. Two groups were surveyed: one known to have inflammatory bowel disease and the second not familiar in most cases with the tests. Subjects were asked to rank preference for each of seven tests: radiolabeled white cell scan, colonoscopy, barium enema, sigmoidoscopy, enteroclysis, stool analysis and laparotomy for the diagnosis of IBD and impressions of discomfort, embarrassment, inconvenience and danger related to each test. Mean rank scores were calculated, test ranks compared within groups and significance determined by the Wilcoxon rank test. Results Significant differences were seen in overall preference for white cell scan over barium enema and colonoscopy (p Conclusion This patient preference combined with the reported accuracy of white cell scanning further establishes the usefulness of this means of IBD diagnosis.

  17. Secondary data sources for health services research in urologic oncology.

    Cole, Alexander P; Friedlander, David F; Trinh, Quoc-Dien


    Though secondary data analyses of large datasets may reduce logistical and financial barriers required to perform significant and innovative work, such research requires specialized skills in data handling and statistical techniques as well as thorough and detailed knowledge of the data sources being used. To provide an overview of several common types of secondary data, focusing on strengths, weaknesses and examples of how these data may be used for health services research. Secondary data comprise a broad and heterogeneous category. This review covers several large categories of such data with examples of their use and discussions about their strengths and weaknesses. Sources include administrative data, claims-based datasets, electronic health records health surveys, patient or disease or both registries, quality improvement initiatives, as well as data from existing trials. Linkages of different types of data may expand the scope of questions answerable using secondary data analysis. Specific strengths and weaknesses of each type of dataset are discussed along with examples from the recent urologic literature. Choice of the appropriate data source should be tailored to the specific research question as well as the research resources and expertise available. Appropriate decisions about which data to use are the foundation for valid, high-impact research using secondary data. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Managed care and its impact on American urology.

    Holtgrewe, H L


    America's health care is undergoing a revolution. A previous private, fee-for-service, delivery system chiefly centered around hospital specialty care is rapidly being replaced by a commercialized system of managed care, controlled by businessmen whose prime motive is profit. Increasing emphasis of these managed care organizations is upon primary physicians who function as gatekeepers. While this new commercialized method of health care has been attended with reductions in the previous omnipresent health care inflation our country has experienced for the past several decades, its impact on quality of care and patient choice of physician remain a great concern. Especially vulnerable in this new system are our nation's academic centers, which, burdened with responsibility for education and research, are at a disadvantage in the competitive cost-based bidding for managed care contracts. Urology work force issues and the number of urologists in our nation remain another concern for urologists as they compete for access to patients in this new highly competitive environment. In a 1995 survey of a cohort of urologists in seven states, the respondents reported 35.8% of gross income came from managed care contracts, 86% reported the need for preservice approval for many diagnostic and therapeutic undertakings, 87% reported an inability to refer complex cases outside the Managed Care Organization (MCO) network, and 23% reported they were required to retain patients for treatment who they would have otherwise referred to a more qualified urologist. The majority of American urologists are reporting dropping gross revenues and increasing overhead in their dealings with managed care contracts. The advent of managed care is being attended with dropping gross revenues, increasing overhead costs and interference with the practice patterns of American urologists.

  19. Urology on the internet - introduction and update

    Inumpudi Anand


    Full Text Available The Internet, which has truly united the developed and developing nations, is an extensive network of inter-linked computers storing immense bytes of information, which can be accessed by anyone transcending all geographi-cal barriers and this has become the ultimate frontier to access information. The Urology and Andrology informa-tion on Internet is exponentially growing. The urologist need not know the intricacies of the hardware and soft-ware but can start right away navigating through this web. We reviewed methods available to take advantage of this network to provide a glimpse to busy urologists to accrue the benefits easily and efficiently rather than to be lost in the information-ocean by surfing individually. By getting connected to Internet, an urologist of any part of the world gains enormous information by interacting with other urologists of the rest of the world. This could be of use to gain knowledge and to offer the best and the most modern treatment to the patient. Internet has revolutionised the scientific publication by virtue of its faster and accurate transmission of manuscripts. We can send manuscripts by this channel and also access journals obviating the lag period inherent in snail mail. The on-line journals have virtually brought the library to the desktop.

  20. Lymphocele – urological complication after renal transplantation

    Wojciech Krajewski


    Full Text Available Renal transplantation is the best renal replacement treatment. It provides longer survival and a better quality of life. The outcome of renal transplantation is influenced by the occurrence of various complications, including urological. One of the most frequently occurring complicationsis lymphocele. Most cases of lymphocele develop during a period of several weeks after the procedure of transplantation. However, there are some literature reports concerning lymphocele diagnosis in the later period, even after several years. Most cases of lymphocele are asymptomatic and are diagnosed accidentally. Nevertheless, a large lymphocele may press the kidney, ureter, urinary bladder or neighbouring blood vessels, causing deterioration of renal function, leg oedema and thrombosis of iliac vessels. Among other complications there are infections. The cause of lymphocele is collection of the lymph drained from damaged lymph vessels surrounding iliac blood vessels and/or lymph vessels of the graft. Important factors predisposing to lymphocele are immunosuppressive treatment, including mTOR inhibitors, mycophenolic acid derivatives and high doses of glucosteroids. Factors favouring occurrence of lymphocele comprise obesity, diabetes, elderly age of recipient, long time of warm ischaemia, acute rejection episodes and delayed graft function. The authors describe presently available treatment methods including aspiration and percutaneous drainage, with or without sclerotisation, drainage using the Tenckhoff catheter and laparoscopic or open fenestration. At present, laparoscopic fenestration is considered to be the most efficient and the safest method. However, there are clinical cases where open surgical treatment is necessary.

  1. Obesity and urologic complications after renal transplantation

    Ashkan Heshmatzadeh Behzadi


    Full Text Available Although obesity has been associated with improved survival on dialysis, its short-and long-term effects on renal transplantation outcomes remain unclear. Herein, we evaluate the short-term and intermediate long-term effects of obesity on first-time renal transplant patients. A retrospective analysis was performed on 180 consecutive renal transplant recipients from living unrelated donors during 2006-2008 in a major transplantation center in Tehran, Iran. Among these, 34 (18% patients were found to be obese (body mass index ≥30 kg/m 2 . Obese patients were more likely to develop post-transplant renal artery stenosis (RAS (17.6% vs. 2.8%, P <0.001, hematoma (47.9% vs. 17.6, P = 0.009, surgical wound complications (64.7% vs. 9.6%, P <0.001 and renal vein thrombosis (2% vs. 0%, P <0.001. However, the incidence of delayed graft function, lymphocele, urologic complications of ureterovesical junction stenosis or urinary leakage, surgical complications of excessive bleeding or renal artery thrombosis and duration of hospitalization were similar between the two groups. The two-year patient and graft survival were also statistically not different. Renal transplantation in obese recipients is associated with a higher incidence of post-transplant RAS, hematoma, surgical wound complications and renal vein thrombosis, but similar two-year patient and graft survival.

  2. The detection of lumpy skin disease virus in samples of experimentally infected cattle using different diagnostic techniques

    E.S.M. Tuppurainen


    Full Text Available Lumpy skin disease (LSD is a disease of cattle, primarily in Africa and Madagascar and rarely in the Middle East. It is caused by a capripoxvirus that belongs to the family Poxviridae. The disease is of economic importance in endemic areas. Effective control of LSD requires accurate and rapid laboratory techniques to confirm a tentative clinical diagnosis. Comparative studies on different diagnostic tests used at different stages of the disease have not been done. The aim of this study was to compare several of these tests. Six seronegative bulls, between 11 and 20 months of age, were infected intravenously and kept in an insect-free facility. The course of the infection was monitored. During a 3-month period blood samples and skin biopsies were collected for virus isolation and polymerase chain reaction (PCR. Skin biopsies were also examined using transmission electron microscopy (TEM. The incubation period in infected animals varied from 4-5 days. The length of the viraemic period did not correlate with the severity of clinical disease. Viraemia was detected from 1-12 days using virus isolation and from 4-11 days using the PCR, which is longer than has previously been reported. Virus was isolated from skin biopsies until Day 39 post infection (p.i. and PCR could demonstrate viral DNA until Day 92 p.i. Transmission electron microscopy of negatively stained skin biopsies detected LSD virus only in one of the four bulls that developed skin lesions until Day 33 p.i. The PCR was a fast and sensitive method to demonstrate viral DNA in blood and skin samples. It could detect viral nucleic acid in skin lesions 53 days longer than virus isolation. Virus isolation from blood and skin samples was sensitive and reliable, but as a single test it may be too time-consuming to use although this depends on how rapidly the diagnosis must be confirmed. In conclusion, this study showed the PCR to be superior in detecting LSD virus from blood and skin samples

  3. [Hygiene in Urological Surgeries - Results of the Health Authority's Visit to all Urological Surgeries in Braunschweig].

    Buhr-Riehm, B; Lenz, T


    Following a patient complaint, the Health Department carried out a hygiene inspection of a urological practice in Braunschweig in February 2013. The topic of the complaint was that a patient assumed having acquired a resistant pathogen in the practice. In the subsequent visit, significant hygiene defects were found, particularly with regard to the processing of medical devices. This led to a decision to commit all urological practices in Braunschweig to hygiene inspections as part of a priority project. In retrospect, the hygiene surveys were justified. Deficiencies included inadequate preparation of medical products, procedures in practice inconsistent with hygiene plans, poor knowledge of hygiene procedures among assistant staff and doctors, lack of expertise of assistant staff and lack of hygiene risk awareness by doctors. Positive experiences were: open communication in a good atmosphere with the Practice managers, willingness to change, good cooperation between the Health Authority and the Labor Inspectorate and Physicians' Association. The claimed deficits were corrected by spring 2014 by the practice operators. The consulting expertise of the health authorities was made use of continuously. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Practical recommendations for performing ultrasound scanning in the urological and andrological fields

    Pasquale Martino


    Full Text Available Aim: US scanning has been defined as the urologist’s stethoscope. These recommendations have been drawn up with the aim of ensuring minimum standards of excellence for ultrasound imaging in urological and andrological practice. A series of essential recommendations are made, to be followed during ultrasound investigations in kidney, prostate, bladder, scrotal and penile diseases. Methods: Members of the Imaging Working Group of the Italian Society of Urology (SIU in collaboration with the Italian Society of Ultrasound in Urology, Andrology and Nephrology (SIEUN identified expert Urologists, Andrologists, Nephrologists and Radiologists. The recommendations are based on review of the literature, previously published recommendations, books and the opinions of the experts. The final document was reviewed by national experts, including members of the Italian Society of Radiology. Results: Recommendations are listed in 5 chapters, focused on: kidney, bladder, prostate and seminal vesicles, scrotum and testis, penis, including penile echo-doppler. In each chapter clear definitions are made of: indications, technological standards of the devices, the method of performance of the investigation. The findings to be reported are described and discussed, and examples of final reports for each organ are included. In the tables, the ultrasound features of the principal male uro-genital diseases are summarized. Diagnostic accuracy and second level investigations are considered. Conclusions: Ultrasound is an integral part of the diagnosis and follow-up of diseases of the urinary system and male genitals in patients of all ages, in both the hospital and outpatient setting. These recommendations are dedicated to enhancing communication and evidence-based medicine in an inter- and multi-disciplinary approach. The ability to perform and interpret ultrasound imaging correctly has become an integral part of clinical practice in uro-andrology, but intra and inter

  5. [The clinic Heilanstalt Weidenplan in Halle (Saale), origin of the German urology. Otto Kneise's founding of the first independent urology department in Germany].

    Zacher, W; Stolze, K-J


    The routine use of cystoscope initiated the development of the modern urology. Otto Kneise (1875-1953) extended the targets of cystoscopy by including examinations of the male bladder and prostate. He achieved the goal that "cystoscopy is part of general work in urology and not a pure gynecological act". He, thus, founded the specialty gynecological urology in the field urology, which prevented it from becoming an independent field. Under the leadership of Otto Kneise, the first independent urology department in Germany was created in the hospital Heilanstalt Weidenplan.

  6. Diagnostic performance of state-of-the-art imaging techniques for morphological assessment of vascular abnormalities in patients with chronic thromboembolic pulmonary hypertension (CTEPH)

    Ley, Sebastian [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Ley-Zaporozhan, Julia [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Johannes Gutenberg University, Department of Diagnostic and Interventional Radiology; Universitaetsmedizin, Mainz (Germany); Pitton, Michael B.; Schneider, Jens; Wirth, Gesine M.; Dueber, Christoph; Kreitner, Karl-Friedrich [Johannes Gutenberg University, Department of Diagnostic and Interventional Radiology; Universitaetsmedizin, Mainz (Germany); Mayer, Eckhard [Kerckhoff-Hospital Bad Nauheim, Department of Thoracic Surgery, Bad Nauheim (Germany)


    To determine the most comprehensive imaging technique for the assessment of pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension (CTEPH). 24 patients with CTEPH were examined by ECG-gated multi-detector CT angiography (MD-CTA), contrast-enhanced MR angiography (ce-MRA) and selective digital subtraction angiography (DSA) within 3 days. Two readers in consensus separately evaluated each imaging technique (48 main, 144 lobar and 449 segmental arteries) for typical changes like complete obstructions, vessel cut-offs, intimal irregularities, incorporated thrombus formations, and bands and webs. A joint interpretation of all three techniques served as a reference standard. Based on image quality, there was no non-diagnostic examination by either imaging technique. DSA did not sufficiently display 1 main, 3 lobar and 4 segmental arteries. The pulmonary trunk was not assessable by DSA. One patient showed thrombotic material at this level only by MD-CTA and MRA. Sensitivity and specificity of MD-CTA regarding CTEPH-related changes at the main/lobar and at the segmental levels were 100%/100% and 100%/99%, of ce-MRA 83.1%/98.6% and 87.7%/98.1%, and of DSA 65.7%/100% and 75.8%/100%, respectively. ECG-gated MD-CTA proved the most adequate technique for assessment of the pulmonary arteries in the diagnostic work-up of CTEPH patients. (orig.)

  7. Optimized design of shields for diagnostic X rays with NCRP 147 technique; Diseno optimizado de blindajes para rayos X diagnostico con tecnica NCRP 147

    Gama T, G. [Calidad XXI SA de CV, Zacatecas 67-007 Col. Roma, 06700 Mexico D.F. (Mexico)]. e-mail:


    A comparison among the design techniques of shielding for X-ray diagnostic rooms with the NCRP 49 (1976) report technique, AAPM 39 (1993) Y the one of the NCRP 147 (2005) technique. The designs correspond to a room of conventional X-rays, one of fluoroscopy, one of tomography Y one of mammography. In all the cases it demonstrates that the NCRP 49 technique overestimate the shieldings. The causes of the overestimation of the NCRP 49 can be attributed to: a) high values of the work charge that don't consider the spectral fluence of the photons that are present in each room, b) to the differences in the values of the kerma in air without attenuation for the dispersed primary radiation Y of leakage among both reports. (Author)

  8. [Postoperative fever in orthopedic and urologic surgery].

    Saavedra, Federico; Myburg, Cristina; Lanfranconi, Marisa B; Urtasun, Martin; De Oca, Luis Montes; Silberman, Andres; Lambierto, Alberto; Gnocchi, Cesar A


    Post-operative fever incidence varies widely. In clean and clean-contaminated surgery the non-infectious fever is more frequent than the infectious fever. We performed a prospective study including 303 patients who underwent orthopedic and urologic elective surgery. The aims of our study were to investigate the incidence of post-operative fever, its etiology, the relationship between time of onset and the etiology, and the usefulness of extensive fever work-up to determine post-operative infection. The incidence of post-operative fever was 14% (42/303) of which 81% (34/42) was noninfectious and 19% (8/42) was infectious. The etiology of the fever in the first 48 hours after surgery was always non-infectious (p fever work-up was performed in patients who presented fever only after the initial 48 hours of surgery with normal physical examination (n = 19) consisting of chest x-ray, blood (2) and urine cultures. The chest x-ray was normal in all the patients, the urine cultures were positive in four cases (21%, IC 95%: 6-45) and the blood cultures in only one case (5%, IC 95%: 0.1-26). Seven patients had post-operative infections without fever as a clinical sign. The most frequently observed etiology of post-operative fever was non-infectious, related to the normal inflammatory host response to surgery. Based on the present results, the extensive fever work-up performed to investigate post-operative infection does not seem to be a useful tool. The diagnosis of post-operative infection was based on clinical follow up and the correct interpretation of the patient's symptoms and signs.

  9. Urologic surgery laparoscopic access: vascular complications

    Branco, Anibal Wood


    ABSTRACT Vascular injury in accidental punctures may occur in large abdominal vessels, it is known that 76% of injuries occur during the development of pneumoperitoneum. The aim of this video is to demonstrate two cases of vascular injury occurring during access in laparoscopic urologic surgery. The first case presents a 60-year old female patient with a 3cm tumor in the superior pole of the right kidney who underwent a laparoscopic partial nephrectomy. After the Verres needle insertion, output of blood was verified. During the evaluation of the cavity, a significant hematoma in the inferior vena cava was noticed. After the dissection, a lesion in the inferior vena cava was identified and controlled with a prolene suture, the estimated bloos loss was 300ml. The second case presents a 42-year old female live donor patient who had her right kidney selected to laparoscopic live donor nephrectomy. After the insertion of the first trocar, during the introduction of the 10mm scope, an active bleeding from the mesentery was noticed. The right colon was dissected and an inferior vena cava perforation was identified; a prolene suture was used to control the bleeding, the estimated blood loss was 200mL, in both cases the patients had no previous abdominal surgery. Urologists must be aware of this uncommon, serious, and potentially lethal complication. Once recognized and in the hands of experienced surgeons, some lesions may be repaired laparoscopically. Whenever in doubt, the best alternative is the immediate conversion to open surgery to minimize morbidity and mortality. PMID:28124541

  10. Implications of Biofilm Formation on Urological Devices

    Cadieux, Peter A.; Wignall, Geoffrey R.; Carriveau, Rupp; Denstedt, John D.


    Despite millions of dollars and several decades of research targeted at their prevention and eradication, biofilm-associated infections remain the major cause of urological device failure. Numerous strategies have been aimed at improving device design, biomaterial composition, surface properties and drug delivery, but have been largely circumvented by microbes and their plethora of attachment, host evasion, antimicrobial resistance, and dissemination strategies. This is not entirely surprising since natural biofilm formation has been going on for millions of years and remains a major part of microorganism survival and evolution. Thus, the fact that biofilms develop on and in the biomaterials and tissues of humans is really an extension of this natural tendency and greatly explains why they are so difficult for us to combat. Firstly, biofilm structure and composition inherently provide a protective environment for microorganisms, shielding them from the shear stress of urine flow, immune cell attack and some antimicrobials. Secondly, many biofilm organisms enter a metabolically dormant state that renders them tolerant to those antibiotics and host factors able to penetrate the biofilm matrix. Lastly, the majority of organisms that cause biofilm-associated urinary tract infections originate from our own oral cavity, skin, gastrointestinal and urogenital tracts and therefore have already adapted to many of our host defenses. Ultimately, while biofilms continue to hold an advantage with respect to recurrent infections and biomaterial usage within the urinary tract, significant progress has been made in understanding these dynamic microbial communities and novel approaches offer promise for their prevention and eradication. These include novel device designs, antimicrobials, anti-adhesive coatings, biodegradable polymers and biofilm-disrupting compounds and therapies.

  11. A pilot study using laser-based technique for non-invasive diagnostics of hypertensive conditions in mice

    Litvinova, Karina S.; Ahmad, Shakil; Wang, Keqing; Rafailov, Ilya E.; Sokolovski, Sergei G.; Zhang, Lin; Rafailov, Edik U.; Ahmed, Asif


    Endothelial dysfunction is directly linked to preeclampsia, a maternal hypertensive condition that is life threating for both the mother and the baby. Epidemiological studies show that women with a history of pre-eclampsia have an elevated risk for cardiovascular disease. Here we report a new non-invasive diagnostic test for preeclampsia in mice that allows us to non-invasively assess the condition of the animals during the experiment and treatment in established models of preeclampsia. A laser-based multifunctional diagnostics system (LAKK-M) was chosen to carry out non-invasive analysis of multiple parameters. The device was used to simultaneously record the microcirculatory blood flow and oxygen saturation, as well as fluorescence levels of endogenous fluorophores. Preliminary experiments were conducted on adenoviral (Ad-)- mediated overexpression of sFlt-1 (Ad-sFlt-1) to mimic preeclampsialike symptoms in mice. The recorded data displayed the ability of the LAKK-M diagnostics device to detect significant differences in perfusion measurements between the control and Ad-sFlt-1 treatment. Preliminary results provide a potential avenue to employ these diagnostics technology to monitor and aid in maintaining control of live animal conditions throughout the experiment and treatment.

  12. Readability assessment of online urology patient education materials.

    Colaco, Marc; Svider, Peter F; Agarwal, Nitin; Eloy, Jean Anderson; Jackson, Imani M


    The National Institutes of Health, American Medical Association, and United States Department of Health and Human Services recommend that patient education materials be written at a fourth to sixth grade reading level to facilitate comprehension. We examined and compared the readability and difficulty of online patient education materials from the American Urological Association and academic urology departments in the Northeastern United States. We assessed the online patient education materials for difficulty level with 10 commonly used readability assessment tools, including the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Gunning Frequency of Gobbledygook, New Dale-Chall Test, Coleman-Liau index, New Fog Count, Raygor Readability Estimate, FORCAST test and Fry score. Most patient education materials on the websites of these programs were written at or above the eleventh grade reading level. Urological online patient education materials are written above the recommended reading level. They may need to be simplified to facilitate better patient understanding of urological topics. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. Robotics in urological surgery: evolution, current status and future perspectives.

    Sivaraman, A; Sanchez-Salas, R; Prapotnich, D; Barret, E; Mombet, A; Cathala, N; Rozet, F; Galiano, M; Cathelineau, X


    Robotic surgery is rapidly evolving and has become an essential part of surgical practice in several parts of the world. Robotic technology will expand globally and most of the surgeons around the world will have access to surgical robots in the future. It is essential that we are updated about the outcomes of robot assisted surgeries which will allow everyone to develop an unbiased opinion on the clinical utility of this innovation. In this review we aim to present the evolution, objective evaluation of clinical outcomes and future perspectives of robot assisted urologic surgeries. A systematic literature review of clinical outcomes of robotic urological surgeries was made in the PUBMED. Randomized control trials, cohort studies and review articles were included. Moreover, a detailed search in the web based search engine was made to acquire information on evolution and evolving technologies in robotics. The present evidence suggests that the clinical outcomes of the robot assisted urologic surgeries are comparable to the conventional open surgical and laparoscopic results and are associated with fewer complications. However, long term results are not available for all the common robotic urologic surgeries. There are plenty of novel developments in robotics to be available for clinical use in the future. Robotic urologic surgery will continue to evolve in the future. We should continue to critically analyze whether the advances in technology and the higher cost eventually translates to improved overall surgical performance and outcomes. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Antibiotic prophylaxis for transurethral urological surgeries: Systematic review.

    Alsaywid, Basim S; Smith, Grahame H H


    The use of antibiotic prophylaxis to prevent urinary tract infection and bacteremia (sepsis) following endoscopic urologic procedures is a controversial topic. Evidence in the literature revealed that urological instrumentation is associated with increased incidence of urinary tract infection and bacteremia. The aim of this review is to evaluate the effectiveness of antibiotic prophylaxis in reducing the risk of urinary tract infection in patients who had transurethral urological surgeries. We have selected all RCTs of adult population who underwent all different types of transurethral urological surgery, including cystoscopy, transurethral resection of prostate and transurethral resection of bladder tumor, and received prophylactic antibiotics or placebo/no treatment. At first, more than 3000 references were identified and reviewed; of which 42 studies with a total of 7496 patients were included in the final analysis. All those trials were analyzing antibiotic prophylaxis versus placebo/no treatment, and they were significantly favoring antibiotic use in reducing all outcomes, including bacteriuria (RR 0.36, 95% CI 0.29 to 0.46, P urinary tract infections and its sequels following transurethral urological surgeries in patients with preoperative sterile urine.

  15. Recent trends in the urology workforce in the United States.

    Pruthi, Raj S; Neuwahl, Simon; Nielsen, Matthew E; Fraher, Erin


    The present study examines the current status of urology physician manpower in the United States, in the context of trends in the demographics, geographic distribution, and practice make-up of urologists. Physicians were identified as surgeons and classified into surgical groups using a combination of American Medical Association primary and secondary self-reported specialties and American Board of Medical Specialties certifications. From these groups, urologic surgeons were isolated for analysis. The supply of urologists per capita has declined since 1981 - most dramatically since 1991. With an average age of 52.5 years, urology is one of the oldest surgical specialties. Over 7% of urologists are older than 70 years and 44% are older than 55 years, suggesting an aging urology workforce. The number of female urologists has grown almost a 1000-fold and represents a growing and younger cohort of the workforce. The number of rural urologists and the number of international medical graduates have continued to decline since 1981. Over the past 10 years, an increasing number of urologists are now in group practices (over 60%), and these tended to be younger and in urban settings. In contrast to most other surgical specialties, there has been a decrease in the supply of urologists relative to population growth, which is expected to be exacerbated by an aging and relatively older urology physician workforce, particularly in rural areas, a slight increase in female urologists, and the gravitation of younger urologists toward group practice in urban areas.

  16. A place of androgen deficiency in a clinical portrait of the modern urological patient

    I. A. Tyuzikov


    Full Text Available In article on the basis of literary given both own clinical supervision and researches applied aspects of androgen deficiency in urological practice are considered. True androgen deficiency’ frequency in man’s population remains precisely not established as decrease in testosterone synthesis is connected not only with the age, but also varieties of other factors, including features of geography of area of residing, presence or absence of other hormonal and metabolic disorders, accompanying somatic comorbidity etc. Results of the newest foreign epidemiological researches of androgen deficiency prevalence worldwide, and also results of the first Russian pilot epidemiological research of androgen deficiency at men prevalence in practice of urologists and doctors of adjacent specialities (Yaroslavl Study, 2013 present in the article. Intime pathogenetic communication of androgen deficiency both the most widespread uroandrological and somatic diseases at men is shown. On the basis of own clinical experience optimum algorithms of complex diagnostics of androgen deficiency at urological patients are offered and also the necessity of inclusion of testosterone preparations for pharmacotherapy of the majority of male urinogenital diseases is shown. The review of indications, contra-indications, estimations of risk factors and preparations for androgen replacement therapy is spent. Features of transdermal forms of testosterone preparations (Аndrogel are described and the clinical analysis of their present and perspective application within the limits of modern androgen replacement therapy is carried out.

  17. A place of androgen deficiency in a clinical portrait of the modern urological patient

    I. A. Tyuzikov


    Full Text Available In article on the basis of literary given both own clinical supervision and researches applied aspects of androgen deficiency in urological practice are considered. True androgen deficiency’ frequency in man’s population remains precisely not established as decrease in testosterone synthesis is connected not only with the age, but also varieties of other factors, including features of geography of area of residing, presence or absence of other hormonal and metabolic disorders, accompanying somatic comorbidity etc. Results of the newest foreign epidemiological researches of androgen deficiency prevalence worldwide, and also results of the first Russian pilot epidemiological research of androgen deficiency at men prevalence in practice of urologists and doctors of adjacent specialities (Yaroslavl Study, 2013 present in the article. Intime pathogenetic communication of androgen deficiency both the most widespread uroandrological and somatic diseases at men is shown. On the basis of own clinical experience optimum algorithms of complex diagnostics of androgen deficiency at urological patients are offered and also the necessity of inclusion of testosterone preparations for pharmacotherapy of the majority of male urinogenital diseases is shown. The review of indications, contra-indications, estimations of risk factors and preparations for androgen replacement therapy is spent. Features of transdermal forms of testosterone preparations (Аndrogel are described and the clinical analysis of their present and perspective application within the limits of modern androgen replacement therapy is carried out.

  18. Development of a near-infrared spectroscopy instrument for applications in urology.

    Macnab, Andrew J; Stothers, Lynn


    Near infrared spectroscopy (NIRS) is an established technology using photons of light in the near infrared spectrum to monitor changes in tissue of naturally occurring chromophores, including oxygenated and deoxygenated hemoglobin. Technology and methodology have been validated for measurement of a range of physiologic parameters. NIRS has been applied successfully in urology research; however current instruments are designed principally for brain and muscle study. To describe development of a NIRS instrument specifically designed for monitoring changes in chromophore concentration in the bladder detrusor in real time, to facilitate research to establish the role of this non-invasive technology in the evaluation of patients with voiding dysfunction The portable continuous wave NIRS instrument has a 3 laser diode light source (785, 808 and 830 nanometers), fiber optic cables for light transmission, a self adhesive patient interface patch with an emitter and sensor, and software to detect the difference between the light transmitted and received by the instrument. Software incorporated auto-attenuates the optical signals and converts raw optical data into chromophore concentrations displayed graphically. The prototype was designed, tested, and iteratively developed to achieve optimal suprapubic transcutaneous monitoring of the detrusor in human subjects during bladder filling and emptying. Evaluation with simultaneous invasive urodynamic measurement in men and women indicates good specificity and sensitivity of NIRS chromophore concentration changes by receiver operator curve analysis, and correlation between NIRS data and urodynamic pressures. Urological monitoring with this NIRS instrument is feasible and generates data of potential diagnostic value.

  19. The role of human papilloma virus in urological malignancies.

    Heidegger, Isabel; Borena, Wegene; Pichler, Renate


    Human papillomavirus (HPV) is associated with cancer of the cervix uteri, penis, vulva, vagina, anus and oropharynx. However, the role of HPV infection in urological tumors is not yet clarified. HPV appears not to play a major causative role in renal and testicular carcinogenesis. However, HPV infection should be kept in mind regarding cases of prostate cancer, as well as in a sub-group of patients with bladder cancer with squamous differentiation. Concerning the role of HPV in penile cancer incidence, it is a recognized risk factor proven in a large number of studies. This short review provides an update regarding recent literature on HPV in urological malignancies, thereby, also discussing possible limitations on HPV detection in urological cancer.

  20. The emerging role of social media in urology.

    Leveridge, Michael J


    Social media have become so integrated into modern communications as to be universal in our personal and, increasingly, professional lives. Recent examples of social media uptake in urology, and the emergence of data to quantify it, reveal the expansion of conventional communication routes beyond the in-person forum. In every domain of urologic practice, from patient interaction through research to continuing professional development, the move online has unlocked another layer of conversation, dissemination, and, indeed, caveats. Social media have a democratizing effect, placing patients, trainees, practitioners, and thought leaders in the same arena and on equal footing. If uptake of social media in medicine even remotely parallels its rise to ubiquity in other areas, it will only expand and evolve in the coming years. For these reasons, this article presents an overview of the most recent data on the impact and potential complications of social media usage in the urologic community.

  1. Complications of laparo-endoscopic single-site surgery in urology

    Hagop Sarkissian


    Full Text Available The objective was to give a general overview of common complications and rates reported in the current literature during performance of a variety of urologic procedures using laparo-endoscopic single-site surgery or LESS. A search of published reports using Pubmed and MEDLINE was performed with the following search terms: laparo-endoscopic single-site surgery, LESS or laparo-endoscopic single-site surgery complications within the date range of 2005--2011. Studies that were deemed appropriate and relevant to the current symposium were chosen for review. Overall complication rates were reported as ranging between 10% and 25%. In general, reconstructive procedures had consistently higher rates of complications than their extirpative/ablative counterparts (27% vs. 8%. There remain insufficient data to comment on differences in the rates or types of complications related to variations in the approach (transperitoneal vs. retroperitoneal, site of surgery (upper tract vs. lower tract or specific technique used (instruments, access devices, robotic platforms, etc.. Complication rates associated with LESS in urology appear only slightly higher than with conventional laparoscopy. However, with proper patient selection and careful application of these techniques, proofs of concept and technical feasibility have been shown in several series. There continues to be a need for more standardization of the technique and reporting as well as more collaborative efforts to fully address questions of safety and efficacy of these new procedures.

  2. Coalition for the advancement of prosthetic urology: history, accomplishments, and continuing mission.

    Daubert, Gail


    The Coalition for the Advancement of Prosthetic Urology (CAPU) is the leading policy advocacy group representing the prosthetic urology community and has been very effective in educating federal health care policy-makers.

  3. Late urologic morbidity in 177 consecutive patients after radiotherapy for cervical carcinoma: a longitudinal study

    Lajer, Henrik; Thranow, Ingrid R.; Skovgaard, Lene Theil;


    Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate......Radiotherapy; carcinoma of the uterine cervix; Urologic morbidity; Franco-Italian glossary; Actuarial estimate...

  4. Reliability of diagnostic imaging techniques in suspected acute appendicitis: proposed diagnostic protocol; Indicacion de las tecnicas de diagnostico por la imagen en la sospecha de apendicitis aguda: propuesta de protocolo diagnostico

    Cura del, J. L.; Oleaga, L.; Grande, D.; Vela, A. C.; Ibanez, A. M. [Hospital de Basureto. Bilbao (Spain)


    To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the control group. Moreover, there were fewer complications and a shorter hospital stay in the first group. Among men, however, the rate of negative appendectomy was lower in the control group. The cost of using ultrasound and CT in the management of appendicitis was only slightly higher than that of the control group. Although ultrasound and CT are not necessary in cases in which the probability of appendicitis is low or in men presenting clear clinical evidence, the use of these techniques is indicated in the remaining cases in which appendicitis is suspected. In children, ultrasound is the technique of choice. In all other patients, if negative results are obtained with one of the two techniques, the other should be performed. (Author) 49 refs.

  5. Identification of Underserved Areas for Urologic Cancer Care

    Mossanen, Matthew; Izard, Jason; Wright, Jonathan L.; Harper, Jonathan D.; Porter, Michael P.; Daratha, Kenn B.; Holt, Sarah K.; Gore, John L.


    BACKGROUND The delivery of urologic oncology care is susceptible to regional variation. In the current study, the authors sought to define patterns of care for patients undergoing genitourinary cancer surgery to identify underserved areas for urologic cancer care in Washington State. METHODS The authors accessed the Washington State Comprehensive Hospital Abstract Reporting System from 2003 through 2007. They identified patients undergoing radical prostatectomy, radical cystectomy (RC), partial nephrectomy (PN), radical nephrectomy, and transurethral resection of the prostate (TURP). TURP was included for comparison as a reference procedure indicative of access to urologic care. Hospital service areas (HSAs) are where the majority of local patients are hospitalized; hospital referral regions (HRR) are where most patients receive tertiary care. The authors created multivariate hierarchical logistic regression models to examine patient and HSA characteristics associated with the receipt of urologic oncology care out of the HRR for each procedure RESULTS Greater than one-half of patients went out of their HRR in 7 HSAs (11%) for radical prostatectomy, 3 HSAs (5%) for radical nephrectomy, 10 HSAs (15%) for PN, and 14 HSAs (22%) for RC. No HSAs had high export rates for TURP. Few patient factors were found to be associated with surgical care out of the HRR. High-export HSAs for PN and RC exhibited lower socioeconomic characteristics than low-export HSAs, adjusting for HSA population, race, and HSA procedure rates for PN and RC. CONCLUSIONS Patients living in areas with lower socioeconomic status have a greater need to travel for complex urologic surgery. Consideration of geographic delineation in the delivery of urologic oncology care may aid in regional quality improvement initiatives. PMID:24523042

  6. Future of robotic surgery in urology.

    Rassweiler, Jens J; Autorino, Riccardo; Klein, Jan; Mottrie, Alex; Goezen, Ali Serdar; Stolzenburg, Jens-Uwe; Rha, Koon H; Schurr, Marc; Kaouk, Jihad; Patel, Vipul; Dasgupta, Prokar; Liatsikos, Evangelos


    To provide a comprehensive overview of the current status of the field of robotic systems for urological surgery and discuss future perspectives. A non-systematic literature review was performed using PubMed/Medline search electronic engines. Existing patents for robotic devices were researched using the Google search engine. Findings were also critically analysed taking into account the personal experience of the authors. The relevant patents for the first generation of the da Vinci platform will expire in 2019. New robotic systems are coming onto the stage. These can be classified according to type of console, arrangement of robotic arms, handles and instruments, and other specific features (haptic feedback, eye-tracking). The Telelap ALF-X robot uses an open console with eye-tracking, laparoscopy-like handles with haptic feedback, and arms mounted on separate carts; first clinical trials with this system were reported in 2016. The Medtronic robot provides an open console using three-dimensional high-definition video technology and three arms. The Avatera robot features a closed console with microscope-like oculars, four arms arranged on one cart, and 5-mm instruments with six degrees of freedom. The REVO-I consists of an open console and a four-arm arrangement on one cart; the first experiments with this system were published in 2016. Medicaroid uses a semi-open console and three robot arms attached to the operating table. Clinical trials of the SP 1098-platform using the da Vinci Xi for console-based single-port surgery were reported in 2015. The SPORT robot has been tested in animal experiments for single-port surgery. The SurgiBot represents a bedside solution for single-port surgery providing flexible tube-guided instruments. The Avicenna Roboflex has been developed for robotic flexible ureteroscopy, with promising early clinical results. Several console-based robots for laparoscopic multi- and single-port surgery are expected to come to market within the

  7. Ketamine cystitis: Its urological impact and management

    Yao Chou Tsai


    Full Text Available Ketamine, an n-methyl-d-aspartic acid receptor complex antagonist, has been used as an anesthetic and/or analgesic. However, in the past decade, ketamine has been illegally available as a recreational drug in Asian countries and Taiwan. Due to the characteristic of being short-acting, youngsters widely assume that ketamine is not as harmful as other drugs, such as heroin. Consequently, many young patients used this drug for a longer duration before they presented with severe urinary frequency and urgency symptoms. Subsequently, other cases have been reported in Taiwan, Hong Kong, Singapore, Malaysia, and Europe. Ketamine abuse is increasing, with rates of 0.30% in 2006 to 0.40% in 2007 among those in the 16–59 year age group. In general, affected patients tend to be young with a peak age range of 16–35 years. The incidence of lower urinary tract symptoms in ketamine abuse patients is around 30%. The actual underlying pathomechanism of ketamine cystitis (KC and associated pelvic pain remains unclear. It is speculated that chronic contact and stimulation to the bladder or ureteral mucosa due to metabolites of ketamine will result in submucosal edema, vascular ectasia, fibrosis, detrusor muscle inflammation, and fibrosis. Presentations of KC include remarkable dysuria, urinary frequency/urgency, urge incontinence, and bladder pain. Urine culture usually fails to yield any microbiology in KC with bladder pain alone. The majority of patients can enjoy clinical improvement after cessation of ketamine and urological treatment similar to interstitial cystitis/bladder pain syndrome (IC/BPS. However, patients who are still abusing ketamine and/or who have a longer duration of ketamine abuse might suffer from severe bladder pain, which does not respond to empirical oral or intravesical treatments such as hyaluronic acid. Among these patients, most have a remarkably impaired quality of life and are at risk of developing upper urinary tract damage

  8. Renal and urologic emergencies in the HIV-infected patient.

    Liang, Stephen Y; Overton, E Turner


    Antiretroviral therapy has revolutionized the care of individuals infected with the human immunodeficiency virus (HIV) and has fundamentally altered the scope of the disease. Acute renal failure and chronic kidney disease from medication toxicity and comorbid noninfectious illnesses are just as likely today as end-organ injury from the virus itself. Chronic immunosuppression renders HIV-infected patients vulnerable to any of several unique urological infections not frequently seen in immunocompetent patients. A deeper understanding of renal and urological emergencies in the context of the HIV-infected patient will better prepare the emergency physician to render optimal care to this rapidly expanding and aging patient population.

  9. Genitourinary Prosthetics: A Primer for the Non-urologic Surgeon.

    Lavien, Garjae; Zaid, Uwais; Peterson, Andrew C


    Genitourinary prosthetics are used for correction of functional deficits and to improve the quality of lives of affected patients. General surgeons must evaluate patients scheduled for nonurologic surgery with urologic devices that can impact their perioperative management. Lack of recognition of these prosthetics preoperatively can lead to unnecessary morbidity for the patient and have legal implications for the surgeon. Close consultation with a urologist may avoid common complications associated with these devices and allows for surgical assistance when operative misadventures do occur. This article reviews 3 common urologic prosthetics: testicular prosthesis, artificial urinary sphincter, and penile prosthesis.

  10. Surgical Management of Urologic Trauma and Iatrogenic Injuries.

    Zinman, Leonard N; Vanni, Alex J


    Genitourinary trauma usually occurs in the setting of multisystem trauma, accounting for approximately 10% of all emergency department admissions. Timely evaluation and management of the trauma patient have the potential to minimize urologic morbidity and mortality. New imaging modalities and a growing emphasis on nonoperative expectant management of both upper and lower urinary tract injuries have changed the field of urologic trauma. Concomitant injury to both the upper and the lower urinary tract is rare, but careful evaluation is critical to identify these devastating injuries.

  11. Diagnosis of soil-transmitted helminths in the era of preventive chemotherapy: effect of multiple stool sampling and use of different diagnostic techniques.

    Stefanie Knopp

    Full Text Available BACKGROUND: Soil-transmitted helminth infections are common throughout the tropics and subtropics and they disproportionately affect the poorest of the poor. In view of a growing global commitment to control soil-transmitted helminthiasis, there is a need to elucidate the effect of repeated stool sampling and the use of different diagnostic methods in areas targeted for preventive chemotherapy that are characterized by low-infection intensities. In this study, we focused on schoolchildren on Unguja Island, Zanzibar, an area where anthelminthic drugs have been repeatedly administered over the past decade. METHODOLOGY/PRINCIPAL FINDINGS: Three serial stool samples from each of 342 schoolchildren were examined using the Kato-Katz (K-K, Koga agar plate (KAP, and Baermann (BM techniques. These methods were used individually or in combination for the diagnosis of Ascaris lumbricoides (K-K, Trichuris trichiura (K-K, hookworm (K-K and KAP, and Strongyloides stercoralis (KAP and BM. The examination of multiple stool samples instead of a single one resulted in an increase of the observed prevalence; e.g., an increase of 161% for hookworm using the K-K method. The diagnostic sensitivity of single stool sampling ranged between 20.7% for BM to detect S. stercoralis and 84.2% for K-K to diagnose A. lumbricoides. Highest sensitivities were observed when different diagnostic approaches were combined. The observed prevalences for T. trichiura, hookworm, A. lumbricoides, and S. stercoralis were 47.9%, 22.5%, 16.5%, and 10.8% after examining 3 stool samples. These values are close to the 'true' prevalences predicted by a mathematical model. CONCLUSION/SIGNIFICANCE: Rigorous epidemiologic surveillance of soil-transmitted helminthiasis in the era of preventive chemotherapy is facilitated by multiple stool sampling bolstered by different diagnostic techniques.

  12. Simulators help improve student confidence to acquire skills in urology.

    Rodríguez-Díez, M C; Díez, N; Merino, I; Velis, J M; Tienza, A; Robles-García, J E


    To know the level of confidence of fifth year medical students in order to perform maneuvers in bladder catheterization and rectal examination before and after training with simulators. To be able to assess student satisfaction regarding the use of the simulation as a learning method. The study was conducted in the Simulation Center of the Faculty of Medicine. A total of 173 students who completed a practical workshop on the subject of Urology participated. The students were asked to answer anonymous questionnaires on their level of confidence in performing a bladder catheterization and rectal examination before and after the workshop as well as their satisfaction in using the simulation as a training tool. The workshops were organized using groups of 10 students. A teacher or a resident in that area of expertise supervised each student individually, resolving their doubts and teaching them the proper technique. All the evaluations made on the different abilities were significantly higher after training (P<.001). Significant differences were found in the confidence level between men and women before the training regarding male urethral catheterization maneuvers and recognition of normal or pathological prostate, The confidence level was lower in women (P<.05). These differences disappeared after training. The level of overall satisfaction with the workshop was high, going from 4.47 ± 0.9 to a maximum score of 5. Simulation is a training method that helps improve the confidence of the medical student in performing a bladder catheterization and digital rectal examination. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  13. [Problem-based learning in urology training. The Faculty of Medicine of the Universidad de Castilla-La Mancha model].

    Salinas Sánchez, A S; Hernández Millán, I; Virseda Rodríguez, J A; Segura Martín, M; Lorenzo Romero, J G; Giménez Bachs, J M; Donate Moreno, Ma J; Ruiz Mondéjar, R; Cañamares Pabolaza, L; Polo Ruiz, L; Pastor Guzmán, J M; Martínez Córcoles, B; Martínez Martín, M


    Ongoing changes in the social, economic, technological and scientific realms have generated new needs and led various organizations to suggest that educational institutions should reorient their educational strategies toward developing effective professionals with the skills to meet these needs. These "modern" strategies include problem-based learning, in which the student seeks and selects information, analyzes the data obtained, integrates both prior and newly acquired knowledge, and, finally, offers diagnostic and therapeutic options to resolve the problem posed, as would occur in professional practice. With this approach, prior skills and practical experience form the foundation of learning. Problem-based learning incorporates some aspects of cognitive psychology, a model that mainly centers on the nature of the knowledge structures found in active memory, the processes involved in information storage and retrieval and the various factors that activate these processes. At the Faculty of Medicine of the Universidad de Castilla-La Mancha, urology is part of a core subject (Medical and Surgical Pathology II) taught in the fifth year of coursework together with nephrology. Each course includes approximately 75 students, divided into five groups. The rotation lasts six weeks, with students spending a mean of two hours a day on theory (nephrology and/or urology) and the remaining time on rotations in the various activities: three weeks in nephrology and three weeks in urology. Upon completion of the rotation, the students write a combined theoretical examination with 100 multiple-choice questions (50 on urology) and take a practical skills examination. At the end of the course, another practical test consisting of an objective, structured clinical examination is taken, in which standard patients are used and the professor directly assesses the level of skills acquired with a "real" case.

  14. Feasibility and safety of augmented reality-assisted urological surgery using smartglass.

    Borgmann, H; Rodríguez Socarrás, M; Salem, J; Tsaur, I; Gomez Rivas, J; Barret, E; Tortolero, L


    To assess the feasibility, safety and usefulness of augmented reality-assisted urological surgery using smartglass (SG). Seven urological surgeons (3 board urologists and 4 urology residents) performed augmented reality-assisted urological surgery using SG for 10 different types of operations and a total of 31 urological operations. Feasibility was assessed using technical metadata (number of photographs taken/number of videos recorded/video time recorded) and structured interviews with the urologists on their use of SG. Safety was evaluated by recording complications and grading according to the Clavien-Dindo classification. Usefulness of SG for urological surgery was queried in structured interviews and in a survey. The implementation of SG use during urological surgery was feasible with no intrinsic (technical defect) or extrinsic (inability to control the SG function) obstacles being observed. SG use was safe as no grade 3-5 complications occurred for the series of 31 urological surgeries of different complexities. Technical applications of SG included taking photographs/recording videos for teaching and documentation, hands-free teleconsultation, reviewing patients' medical records and images and searching the internet for health information. Overall usefulness of SG for urological surgery was rated as very high by 43 % and high by 29 % of surgeons. Augmented reality-assisted urological surgery using SG is both feasible and safe and also provides several useful functions for urological surgeons. Further developments and investigations are required in the near future to harvest the great potential of this exciting technology for urological surgery.

  15. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual gastroenterology-urology surgical... Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification. A manual gastroenterology-urology surgical instrument and accessories is a device designed to...

  16. Urological Surveillance and Medical Complications after Spinal Cord Injury in the United States

    Cameron, Anne P.; Lai, Julie; Saigal, Christopher S.; Clemens, J. Quentin; Wijmenga, T. J.


    OBJECTIVE To evaluate the national patterns of urologic follow up after spinal cord injury (SCI) and the occurrence and predictors of urological complications. MATERIALS AND METHODS This retrospective cohort study used a 5% sample of Medicare data 2007-2010. The minimum adequate urologic surveillanc

  17. Myocardial tagging with steady state free precession techniques and semi-automatic postprocessing--impact on diagnostic value

    Johnson, Thorsten R C; Bayrhof, Nicole; Huber, Armin


    ), and 11 patients at 3 T using GRE. Two observers graded image quality and determined the share of the cardiac cycle for which postprocessing could be performed (1, optimal; 2, little interaction; 3, whole cycle assessable; 4, diastole non-assessable; 5, systole incomplete; 6, non-diagnostic). With GRE....... With the SSFP sequence at 1.5 T and GRE at 3 T, an evaluation of the whole cardiac cycle was possible in 71% and 70% of the patients, respectively, and systole was assessable in all patients. Tagging sequences with SSFP readout at 1.5 T make a semi-automatic evaluation of the whole cardiac cycle feasible...

  18. EFDA Task TW6-TPDS-DIADEV deliverable 2: ITER Fast Ion Collective Scattering Development of diagnostic components and techniques

    Michelsen, S.; Bindslev, Henrik; Korsholm, Søren Bang;

    field side and one on the high field side, it is possible to resolve the distribution function of fast ions both for perpendicular and parallel velocities with good spatial and temporal resolution. The present work concerned a continuation of this work, and the following tasks were performed. 1...... experiment was set up in order to test and support the theoretical and numerical results. From the design studies various R&D issues critical to the viability of the CTS diagnostic on ITER were identified; the most urgent ones are addressed in the presented R&D tasks....

  19. EFDA Task TW6-TPDS-DIADEV deliverable 2: ITER fast ion collective scattering development of diagnostic components and techniques

    Michelsen, S.; Bindslev, H.; Korsholm, S.B.; Leipold, F.; Meo, F.; Michelsen, P.K.; Nielsen, A.H.; Tsakadze, E.


    In 2003 the Risoe CTS group finished a feasibility study and a conceptual design of an ITER fast ion collective Thomson scattering system. The purpose of the CTS diagnostic is to measure the distribution function of fast ions in the plasma with particular interest in fusion alphas. The feasibility study demonstrated that the only system, which can fully meet the ITER measurement requirements for confined fusion alphas, is a 60 GHz system. The study showed that by using two powerful microwave sources (gyrotrons) of this frequency both on the low field side, and two antenna systems, one on the low field side and one on the high field side, it is possible to resolve the distribution function of fast ions both for perpendicular andvparallel velocities with good spatial and temporal resolution. The present workvconcerned a continuation of this work, and the following tasks were performed. 1) Optimisation of the design, considering the scattering geometries, variations in plasma profiles, magnetic equilibria etc. 2) Development of numerical codes for determination of the geometry of the antenna system on the high field side, including shapes and positions of mirrors and receiver horns. 3) A model experiment was set up in order to test and support the theoretical and numerical results. From the design studies various R and D issues critical to the viability of the CTS diagnostic on ITER were identified; the most urgent ones are addressed in the presented R and D tasks. (author)

  20. Investigation of ionospheric disturbances and associated diagnostic techniques. Final report, 1 January 1992-31 December 1994

    Duncan, L.M.


    The objectives of this research and development program were to conduct simulation modeling of the generation and propagation of atmospheric acoustic signals associated with surface and subsurface ground disturbances; to construct an experimental measurement system for exploratory research studies of acoustic generated ionospheric disturbances; to model high power radio wave propagation through the ionosphere, including nonlinear wave plasma interaction effects; and to assist in the assessment of diagnostic systems for observation of ionospheric modification experiments using existing and planned high latitude high power RF transmitting facilities. A computer simulation of ionospheric response to ground launched acoustic pulses was constructed and results compared to observational data associated with HF and incoherent scatter radar measurements of ionospheric effects produced by earthquakes and ground level explosions. These results were then utilized to help define the design, construct and test for an HF Doppler radar system. In addition, an assessment was conducted of ionospheric diagnostic instruments proposed for the Air Force/Navy High Frequency Active Auroral Research Program (HAARP).

  1. JAK2 V617F in myeloid disorders: molecular diagnostic techniques and their clinical utility: a paper from the 2005 William Beaumont Hospital Symposium on Molecular Pathology.

    Steensma, David P


    In early 2005, several groups of investigators studying myeloid malignancies described a novel somatic point mutation (V617F) in the conserved autoinhibitory pseudokinase domain of the Janus kinase 2 (JAK2) protein, which plays an important role in normal hematopoietic growth factor signaling. The V617F mutation is present in blood and marrow from a large proportion of patients with classic BCR/ABL-negative chronic myeloproliferative disorders and of a few patients with other clonal hematological diseases such as myelodysplastic syndrome, atypical myeloproliferative disorders, and acute myeloid leukemia. The JAK2 V617F mutation causes constitutive activation of the kinase, with deregulated intracellular signaling that mimics continuous hematopoietic growth factor stimulation. Within 7 months of the first electronic publication describing this new mutation, clinical molecular diagnostic laboratories in the United States and Europe began offering JAK2 mutation testing on a fee-for-service basis. Here, I review the various techniques used by research groups and clinical laboratories to detect the genetic mutation underlying JAK2 V617F, including fluorescent dye chemistry sequencing, allele-specific polymerase chain reaction (PCR), real-time PCR, DNA-melting curve analysis, pyrosequencing, and others. I also discuss diagnostic sensitivity, performance, and other practical concerns relevant to the clinical laboratorian in addition to the potential diagnostic utility of JAK2 mutation tests.

  2. Baseline urologic surgical skills among medical students: Differentiating trainees.

    Gupta, Vishaal; Lantz, Andrea G; Alzharani, Tarek; Foell, Kirsten; Lee, Jason Y


    Urology training programs seek to identify ideal candidates with the potential to become competent urologic surgeons. It is unclear whether innate technical ability has a role in this selection process. We aimed to determine whether there are any innate differences in baseline urologic technical skills among medical students. Second-year medical students from the University of Toronto were recruited for this study and stratified into surgical and non-surgical cohorts based on their reported career aspirations. After a pre-test questionnaire, subjects were tested on several urologic surgical skills: laparoscopy, cystoscopy and robotic surgery. Statistical analysis was performed using chi-squared test, student t-tests and Spearman's correlation where appropriate. A total of 29 students participated in the study and no significant baseline differences were found between cohorts with respect to demographics and prior surgical experience. For laparoscopic skills, the surgical cohort outperformed the non-surgical cohort on several exercises: Lap Beans Missed (4.9 vs. 9.3, p robotic surgery performance metrics: Task Time (50.6 vs. 76.3, p robotics, may differ between early trainees interested in a surgical career compared to those interested in a non-surgical career. Further studies are required to illicit what impact such differences have on future performance and competence.

  3. [Artificial neural networks for decision making in urologic oncology].

    Remzi, M; Djavan, B


    This chapter presents a detailed introduction regarding Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. It includes a description of ANNs methodology and points out the differences between Artifical Intelligence and traditional statistic models in terms of usefulness for patients and clinicians, and its advantages over current statistical analysis.

  4. 'Image and treat': an individualized approach to urological tumors

    Bouchelouche, Kirsten; Capala, Jacek


    The current treatment options for advanced urologic cancers demonstrate limited efficacy. To obtain optimal clinical results, there is a need for new, individualized, therapeutic strategies, which have only recently been applied to these malignancies. Nuclear medicine plays an important role in e...

  5. Quality assessment of economic analyses in pediatric urology.

    Kokorowski, Paul J; Routh, Jonathan C; Nelson, Caleb P


    To describe and evaluate economic analyses or economic evaluations in pediatric urologic literature, including study types such as cost-effectiveness analysis, which are increasingly common in the medical literature. We performed a systematic literature review of the MEDLINE, EMBASE, and Cochrane databases (1990-2011) to identify economic analyses of pediatric urologic topics. Studies were evaluated using published quality metrics. We examined the analysis type, data sources, perspective, methodology, sensitivity analyses, and the reporting of methods, results, limitations, and conclusions. We identified 2945 nonduplicated studies, 60 of which met inclusion criteria. Economic analyses of pediatric urologic topics increased in number during the study period, from 1 study (2%) in 1990 to 7 (12%) in 2010 (P pediatric urologic literature, there is a need for standardization in methods and reporting. Future investigations should attempt to follow standardized reporting guidelines and should pay particular attention to reporting of methods and results, including a comprehensive discussion of limitations. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Acute and chronic urine retention among adults at the urology ...

    E.M.T. Yenli

    a Department of Surgery, Urology Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana b Department of ... urine retention with outcomes were recorded on data sheet. .... Accord- ing to the Ghana Statistical Service (GSS), the population trends .... tive and cost effective treatment options for patients with BPE [41]. Various ...

  7. Challenges facing academic urology training programs: an impending crisis.

    Gonzalez, Chris M; McKenna, Patrick


    To determine the most pressing issues facing academic urology training centers. The supply of urologists per capita in the United States continues to decrease. Stricter resident requirements, restriction of resident duty hours, and a Graduate Medical Education (GME) funding cap on resident education has led to significant challenges for academic centers. A 32-question survey was sent to Society of University Urologists members. Respondents defined themselves as academic faculty tenure track, program director, academic chair, program director and academic chair, clinical faculty nontenure track, and community faculty member. A total of 143 of 446 members(32%) responded. A lack of funding was indicated as an obstacle to adding new residency positions (65% respondents) and recruiting new faculty (60% respondents). Residency positions not funded by GME (40% respondents) required either clinical or hospital dollars to support these slots. Most respondents (51%) indicated resident research rotations are funded with clinical dollars. Surgical skills laboratories are commonly used (85% respondents) and are supported mostly with hospital or clinical dollars. The majority of respondents (84%) indicated they would expand simulation laboratories if they had better funding. Other than urodynamics and ultrasound, urology residency training programs reported little income from ancillary dollars. There is a significant workforce shortage within urology training programs. Clinical revenue and hospital funding seem to be the main financial support engines to supplement the GME funding shortage, proficiency training, and faculty salary support for teaching. The current system of GME funding for urology residency programs is not sustainable. Published by Elsevier Inc.

  8. Laser therapy in the treatment of urological diseases

    Nelius, T.; de Riese, W. T.; Reiher, F.; Filleur, S.; Allhoff, E. P.


    Applications of lasers (light amplification by stimulated emission of radiation) in various disciplines of medicine including Urology are well developed. Urology is among the medical specialties that apply many different types of laser systems to treat a broad spectrum of clinical conditions ranging from genital, bladder and urethral tumors to the treatment of benign prostate hyperplasia (BPH), urethral strictures, and stones. The specific application of various laser systems depends on the characteristics of the laser itself, delivery media for the beams, laser-tissue interaction and the desired effect. These complex conditions require an intensive and continuous exchange of information between non-medical researchers and physicians to verify "what is currently technically possible and what is medically needed". Only this exchange can lead to the development of new laser systems. While lasers have become the treatment of choice in some conditions, they could not, despite excellent clinical results, replace conventional therapy options in others. Nonetheless, the use and the introduction of lasers of different wavelengths forces urologists to keep step with the fast developing laser technology. This paper reviews current indications for clinical laser applications relevant to urology and the advantages and disadvantages of using lasers for the management of various urological lesions.

  9. Future robotic platforms in urologic surgery: recent developments.

    Herrell, S Duke; Webster, Robert; Simaan, Nabil


    To review recent developments at Vanderbilt University of new robotic technologies and platforms designed for minimally invasive urologic surgery and their design rationale and potential roles in advancing current urologic surgical practice. Emerging robotic platforms are being developed to improve performance of a wider variety of urologic interventions beyond the standard minimally invasive robotic urologic surgeries conducted currently with the da Vinci platform. These newer platforms are designed to incorporate significant advantages of robotics to improve the safety and outcomes of transurethral bladder surgery and surveillance, further decrease the invasiveness of interventions by advancing LESS surgery, and to allow for previously impossible needle access and ablation delivery. Three new robotic surgical technologies that have been developed at Vanderbilt University are reviewed, including a robotic transurethral system to enhance bladder surveillance and transurethral bladder tumor, a purpose-specific robotic system for LESS, and a needle-sized robot that can be used as either a steerable needle or small surgeon-controlled micro-laparoscopic manipulator.

  10. The spectrum of urological disease in patients with spina bifida.

    Cahill, R A


    BACKGROUND: [corrected] Urological complications are the major cause of ill health during childhood and adult life of patients with spina bifida but the significance of urinary tract disease on the individual and the healthcare services is underemphasised. AIM: To assess the effects of spina bifida on the individual and the healthcare services. METHODS: A retrospective review was performed to assess the frequency and significance of urological conditions requiring hospital attendance in patients with spina bifida currently attending a specialised multidisciplinary clinic over a period of six months. RESULTS: Urinary sepsis accounted for the majority of admissions (62%), while 38 of 62 patients required 60 surgical procedures. Targeting the primary urological abnormality (the dysfunctional and usually poorly compliant bladder) allows implementation of effective treatments, including regular intermittent bladder catherisation (52%) in order to preserve upper renal tract function. Associated postural abnormalities complicated both conservative and interventional therapies. CONCLUSION: This study highlights the surgical commitment for units caring for patients with spina bifida, the important considerations for the future healthcare services, and the range and severity of urological diseases encountered by these patients.

  11. Future robotic platforms in urologic surgery: Recent Developments

    Herrell, S. Duke; Webster, Robert; Simaan, Nabil


    Purpose of review To review recent developments at Vanderbilt University of new robotic technologies and platforms designed for minimally invasive urologic surgery and their design rationale and potential roles in advancing current urologic surgical practice. Recent findings Emerging robotic platforms are being developed to improve performance of a wider variety of urologic interventions beyond the standard minimally invasive robotic urologic surgeries conducted presently with the da Vinci platform. These newer platforms are designed to incorporate significant advantages of robotics to improve the safety and outcomes of transurethral bladder surgery and surveillance, further decrease the invasiveness of interventions by advancing LESS surgery, and allow for previously impossible needle access and ablation delivery. Summary Three new robotic surgical technologies that have been developed at Vanderbilt University are reviewed, including a robotic transurethral system to enhance bladder surveillance and TURBT, a purpose-specific robotic system for LESS, and a needle sized robot that can be used as either a steerable needle or small surgeon-controlled micro-laparoscopic manipulator. PMID:24253803

  12. Evaluation of urology residents' perception of surgical theater educational environment.

    Binsaleh, Saleh; Babaeer, Abdulrahman; Rabah, Danny; Madbouly, Khaled


    To evaluate surgical theater learning environment perception in urology residents in Saudi Arabia and to investigate association of learning environment perception and stages of residency program, sectors of health care system, and regions of Saudi Arabia. A cross-sectional survey using the surgical theater educational environment measure (STEEM) inventory. The STEEM inventory was used to measure theater learning environment perception of urology residents in Saudi Arabia. Respondents' perception was compared regarding different residency stages, sectors of the health care system, and regions of Saudi Arabia. Internal reliability of the inventory was assessed using the Cronbach α coefficient. Correlation analysis was done using the Spearman ρ coefficient. Of 72 registered residents, 33 (45.8%) completed the questionnaire. The residents perceived their environment less than acceptable (135.9 ± 16.7, 67.95%). No significant differences in perception were found among residents of different program stages, different sectors of health care system, or different regions in Saudi Arabia. Residents from the eastern region perceived the training and teaching domain better (p = 0.025). The inventory showed a high internal consistency with a Cronbach α of 0.862. STEEM survey is an applicable and reliable instrument for assessing the learning environment and training skills of urology residency program in Saudi Arabia. Urology residents in Saudi Arabia perceived the theater learning environment as less than ideal. The perceptions of theater learning environment did not change significantly among different stages of the program, different sectors of health care system, or different training regions of Saudi Arabia assuring the uniformity of urology training all over Saudi Arabia. The training programs should address significant concerns and pay close attention to areas in surgical theater educational environment, which need development and enhancement, mainly planned fashion

  13. Robotic-assisted laparoscopic surgery: recent advances in urology.

    Autorino, Riccardo; Zargar, Homayoun; Kaouk, Jihad H


    The aim of the present review is to summarize recent developments in the field of urologic robotic surgery. A nonsystematic literature review was performed to retrieve publications related to robotic surgery in urology and evidence-based critical analysis was conducted by focusing on the literature of the past 5 years. The use of the da Vinci Surgical System, a robotic surgical system, has been implemented for the entire spectrum of extirpative and reconstructive laparoscopic kidney procedures. The robotic approach can be applied for a range of adrenal indications as well as for ureteral diseases, including benign and malignant conditions affecting the proximal, mid, and distal ureter. Current evidence suggests that robotic prostatectomy is associated with less blood loss compared with the open surgery. Besides prostate cancer, robotics has been used for simple prostatectomy in patients with symptomatic benign prostatic hyperplasia. Recent studies suggest that minimally invasive radical cystectomy provides encouraging oncologic outcomes mirroring those reported for open surgery. In recent years, the evolution of robotic surgery has enabled urologic surgeons to perform urinary diversions intracorporeally. Robotic vasectomy reversal and several other robotic andrological applications are being explored. In summary, robotic-assisted surgery is an emerging and safe technology for most urologic operations. The acceptance of robotic prostatectomy during the past decade has paved the way for urologists to explore the entire spectrum of extirpative and reconstructive urologic procedures. Cost remains a significant issue that could be solved by wider dissemination of the technology. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Oral Vaccination with Heat-Inactivated Mycobacterium bovis Does Not Interfere with the Antemortem Diagnostic Techniques for Tuberculosis in Goats

    Alvaro Roy


    Full Text Available Vaccination against tuberculosis (TB is prohibited in cattle or other species subjected to specific TB eradication campaigns, due to the interference that it may cause with the official diagnostic tests. However, immunization with a heat-inactivated (HI Mycobacterium bovis vaccine via the oral route has been suggested to overcome this issue. In this study, the main goal was to assess the interference of the HI vaccine by different routes of administration using a previous vaccination and re-vaccination (boosting protocol. TB-free kid goats were divided into three groups: oral (n = 16, intramuscular (IM; n = 16, and control (n = 16. Results showed that there was a significant difference in the percentage of animals positive to the single intradermal test (SIT and blood based interferon-gamma release assay (IGRA caused by vaccination when performed in the IM group compared to the oral group (p < 0.001. Nevertheless, no positivity to the SIT or IGRA test was observed in orally vaccinated goats regardless of the different interpretation criteria applied. None of the groups presented positive antibody titers using an in-house ELISA and samples collected 2 months after the boost. These results suggest the potential usefulness of the HI vaccine by the oral route in goats to minimize the interference on diagnostic tests (skin and IGRA tests and reducing the necessity of defined antigens to replace the traditional purified protein derivatives for diagnosis. Finally, the results pave the way to future efficacy studies in goats using different routes of HI vaccination.

  15. 口蹄疫诊断技术的研究进展%Research Progress on Diagnostic Techniques of Foot-and-mouth Disease

    特尼格尔; 黄天鹏


    口蹄疫的准确诊断是有效控制疫情蔓延的重要环节。随着生物学技术的迅速发展,口蹄疫的诊断已经不再局限于传统方法。目前,常用的口蹄疫诊断方法包括血清学检测、分子生物学诊断和病原学诊断,其中以血清学检测的应用最为广泛。阐述了3种诊断方法的原理及优缺点,并展望了口蹄疫诊断技术未来的发展方向。%The accurate diagnosis of foot-and-mouth disease is essential to control the spread of the disease. With the rapid development of biotechnology, the diagnosis of foot-and-mouth disease is no longer restricted to traditional methods. At present, the commonly used methods are including serological detection which has the widest application range, molecular biological diagnosis and etiological diagnosis. In this paper, a review is given on the principle as well as advantages and disadvantages of the 3 above-mentioned diagnostic techniques, and the future development of foot-and-mouth disease diagnostic techniques is prospected.

  16. Update on Urological Management of Spina Bifida from Prenatal Diagnosis to Adulthood.

    Snow-Lisy, Devon C; Yerkes, Elizabeth B; Cheng, Earl Y


    . Surgical intervention is indicated for those at risk for renal deterioration and/or is considered for children who fail to achieve satisfactory continence with medical management. Traditionally surgery concentrates on the bladder and bladder neck, and creation of catheterizable channels. For those with a hostile bladder, enterocystoplasty remains the gold standard for bladder augmentation, although use of bowel for augmentation remains suboptimal due to secondary complications, including increased risk of infections, metabolic abnormalities, neoplastic transformation and risk of life threatening perforation. Recent advances in tissue engineering technology may provide an alternative to traditional augmentation. However, recent results from phase II trials using current techniques to augment the bladder with engineered bladder tissue are disappointing. Catheterizable channels to the bladder and ascending colon further facilitate continence measures and promote independent care. While surgical reconstruction is clearly successful in improving continence, recent outcome studies have questioned the true impact of this type of surgery on quality of life. With improved survival transitional care issues, including health related independence, sexual health needs and development of a support system, are increasingly important. Transitional care remains a significant issue for which few public health measures are being quantitatively evaluated. Despite consensus regarding early urological involvement in the care of patients with spina bifida, controversy remains regarding optimal management. Major reconstructive urological surgeries still have a major role in the management of these cases to protect the upper urinary tract and to achieve continence. However, future studies are needed to better clarify the true impact on quality of life that these interventions have on patients and their families. Transition of urological care to adulthood remains a major avenue for improvement in

  17. 5-aminolevulinic acid in photodynamic diagnosis and therapy of urological malignancies

    Nelius, Thomas; de Riese, Werner T. W.


    Completeness and certainty of tumor detection are very important issues in clinical oncology. Recent technological developments in ultrasound, radiologic and magnetic resonance imaging diagnostics are very promising, but could not improve the detection rate of early stage malignancies. One of the most promising new approaches is the use of 5-aminolevulinic acid, a potent photosensitizer, in photodynamic diagnosis and therapy. 5-aminolevulinic acid is meanwhile a well-established tool in the photodynamic diagnosis of bladder cancer. It has been shown to improve the sensitivity of detection of superficial tumors and carcinoma in situ, which enables to reduce the risk of tumor recurrence related to undetected lesions or incomplete transurethral resection of the primary lesions. The use of 5-aminolevulinic acid is steadily expanding in diagnostics of urological malignancies. First clinical results are now reported in detection of urethral and ureteral lesions as well as in urine fluorescence cytology. Furthermore, due to the selective accumulation in transitional cell carcinoma of the bladder, 5-aminolevulinic acid may be an ideal candidate for photodynamic therapy in superficial bladder cancer. Summarizing the data of multiple clinical trials, 5-aminolevulinic acid is a promising agent in photodynamic diagnostics and treatment of superficial bladder cancer.

  18. Comparison of three diagnostic techniques for detecting occlusal dental caries in primary molars: An in vivo study

    Farhin Katge


    Conclusion: This study showed low sensitivity but substantial specificity with visual inspection. Bitewing radiography performed poorly overall when compared with the other two systems. The CarieScan PRO technique gave the highest overall combination of sensitivity and specificity for detection of occlusal caries.

  19. Diagnostic accuracy: theoretical models for preimplantation genetic testing of a single nucleus using the fluorescence in situ hybridization technique

    P.N. Scriven; P.M.M. Bossuyt


    The aim of this study was to develop and use theoretical models to investigate the accuracy of the fluorescence in situ hybridization (FISH) technique in testing a single nucleus from a preimplantation embryo without the complicating effect of mosaicism. Mathematical models were constructed for thre

  20. Image based measurement techniques for aircraft propeller flow diagnostics: Propeller slipstream investigations at high-lift conditions and thrust reverse

    Roosenboom, E.W.M.


    The aim of the thesis is to measure the propeller slipstream properties (velocity and vorticity) and to assess the unsteady and instantaneous behavior of the propeller flow field at high disk loadings, zero thrust and thrust reverse using the image based measurement techniques. Along with its implem

  1. Diagnostic significance of gas distension technique of the stomach with gas-forming agent on CT scan of stomach cancer

    Rho, Tae Jin; Song, Chang June; Choi, Joong Chan; Park, Cheong Hee; Cho, June Sik; Rhee, Byung Chull [Chungnam National University College of Medicine, Dajeon (Korea, Republic of)


    CT is a valuable method for preoperative staging of patients with stomach cancers. However, in patients with poor distension of the stomach and scanty fat between the stomach and adjacent organs, CT findings may indicate a false impression of gastric wall thickening and cannot provide the precise extent of stomach cancer. We studied the usefulness of gastric distension by gas-forming agent in 28 cases of pathologically confirmed gastric cancers on CT. Comparative analysis between CT findings and surgical pathologic findings was done in 22 cases who underwent surgery. The results were as follows; 1. Conventional CT failed to define the wall thickening or masses of the stomach, in 14 cases of 23 advanced gastric cancers, while CT with gas distension technique allowed good visualization in all advanced gastric cancers. 2. In 2 cases of 5 early gastric cancers, CT with gas distension technique could detect focal thickening of the gastric wall, even less than 1cm thickness. 3. Among 13 cases with indistinguishable border between stomach and liver on conventional CT, 7 cases were diagnosed as negative invasion on CT with gas distension technique and 5 cases of these were confirmed by surgery. 4. Among 11 cases with indistinguishable border between stomach and pancreas on conventional CT, 3 cases were diagnosed as negative invasion on CT with gas distension technique, all of which were confirmed by surgery. 5. There was no significant difference between conventional CT and CT with gas distension technique of the stomach to diagnose invasion into transverse colon, transverse colon, transverse mesocolon, lymph node metastasis, and various distant metastasis.

  2. [Psychosomatic urology. A practice-oriented presentation].

    Schwinges-Lymberopoulos, M


    Psychosomatics is a branch of medical science dealing with biopsychosocial interactions in the origin, course and treatment of human illnesses. In the biopsychosocial model the patient is considered in its entirety. In the practice of urologists the proportion of patients with psychosomatic clinical symptoms varies between 15 and 50%. The main focus is on somatoform autonomous dysfunctions. The main symptom involves the fact that often persisting complaints cannot be explained by suitable physical findings. The anatomical characteristics of the urogenital tract and the resultant three functional levels, production, reproduction and desire, explain the susceptibility to psychological participation. Besides the exclusion of inflammatory, obstructive or malignant illnesses, the diagnostics relies on an anamnesis interview in terms of the basic psychosomatic therapy. The treatment is individual and multimodal in cooperation with physiotherapists and psychotherapists.

  3. Tracking Transplanted Stem Cells Using Magnetic Resonance Imaging and the Nanoparticle Labeling Method in Urology

    Jae Heon Kim


    Full Text Available A reliable in vivo imaging method to localize transplanted cells and monitor their viability would enable a systematic investigation of cell therapy. Most stem cell transplantation studies have used immunohistological staining, which does not provide information about the migration of transplanted cells in vivo in the same host. Molecular imaging visualizes targeted cells in a living host, which enables determining the biological processes occurring in transplanted stem cells. Molecular imaging with labeled nanoparticles provides the opportunity to monitor transplanted cells noninvasively without sacrifice and to repeatedly evaluate them. Among several molecular imaging techniques, magnetic resonance imaging (MRI provides high resolution and sensitivity of transplanted cells. MRI is a powerful noninvasive imaging modality with excellent image resolution for studying cellular dynamics. Several types of nanoparticles including superparamagnetic iron oxide nanoparticles and magnetic nanoparticles have been used to magnetically label stem cells and monitor viability by MRI in the urologic field. This review focuses on the current role and limitations of MRI with labeled nanoparticles for tracking transplanted stem cells in urology.

  4. Avicenna's Canon of Medicine and modern urology: part II: bladder calculi.

    Madineh, Sayed Mohammad Ali


    In the previous issue of the Urology Journal, a comparison of Avicenna's Canon of Medicine with modern urologic findings was done in part I of this article, addressing bladder anatomy and physiology and bladder calculi. In part II of this review, the remaining chapters of the Canon of Medicine on bladder calculi are reviewed. Avicenna points to perineal urethrostomy (perineostomy), which is today performed as the last therapeutic line or as a temporary remedy before surgical treatment. He also describes surgery via transperineal route and warns the surgeon of the proximity of vasa deferentia, prostate gland, and neurovascular bundle and their exposure in this position. Usage of grasping forceps for removal of bladder calculus and emphasis on removing all calculus fragments are the interesting points of this chapter. Avicenna explains a technique similar to the use of a Babcock forceps for prevention of calculus migration. Complications of bladder calculus surgery and cystostomy are also addressed with scientific precision in the Canon. It is noteworthy that 8 centuries before Fournier described necrotizing fasciitis in male genitalia, Avicenna had described Fournier gangrene in his book.

  5. Virus integration and genome influence in approaches to stem cell based therapy for andro-urology.

    Li, Longkun; Zhang, Deying; Li, Peng; Damaser, Margot; Zhang, Yuanyuan


    Despite the potential of stem cells in cell-based therapy, major limitations such as cell retention, ingrowth, and trans-differentiation after implantation remain. One technique for genetic modification of cells for tissue repair is the introduction of specific genes using molecular biology techniques, such as virus integration, to provide a gene that adds new functions to enhance cellular function, and to secrete trophic factors for recruiting resident cells to participate in tissue repair. Stem cells can be labeled to track cell survival, migration, and lineage. Increasing evidence demonstrates that cell therapy and gene therapy in combination remarkably improve differentiation of implanted mesenchymal stromal cells (MSCs), revascularization, and innervation in genitourinary tissues, especially to treat urinary incontinence, erectile dysfunction, lower urinary tract reconstruction, and renal failure. This review discusses the benefits, safety, side effects, and alternatives for using genetically modified MSCs in tissue regeneration in andro-urology.

  6. Diffuse reflectance spectroscopy: diagnostic accuracy of a non-invasive screening technique for early detection of malignant changes in the oral cavity

    Jayanthi, J L; Nisha, G U; Manju, S; Philip, E K; Jeemon, P; Baiju, K V; Beena, V T


    Background Strong proof-of-principle for utilisation of diffuse reflectance spectroscopy, a non-invasive tool for early detection of malignant changes, has emerged recently. The potential of this technique in distinguishing normal tissue from hyperplastic and dysplastic tissues was explored. Methods Diffuse reflectance (DR) spectra in the 400–700 nm region were obtained from the buccal mucosa of 96 patients and 34 healthy volunteers. The DR spectral data were compared against the gold standard biopsy and histopathology results. A principal-component analysis was performed for dimensional reduction in the normalised spectral data with linear discriminant analysis as the classifying technique. The receiver operator characteristic curve technique was employed for evaluating the performance of the diagnostic test. Results DR spectral features for different lesions, such as normal/healthy, hyperplastic, dysplastic and squamous cell carcinoma (SCC), varied significantly according to the intensity of oxygenated haemoglobin absorption. While the classification based on discriminant scores provided an overall sensitivity of 98.5% and specificity of 96.0% for distinguishing SCC from dysplasia, they were 100.0% and 95.0%, respectively, for distinguishing dysplasia from hyperplasia. Similarly, the analysis yielded a sensitivity of 95.0% and specificity of 100.0% for distinguishing hyperplasia from healthy tissue. The areas under the receiver operator characteristic curves were 0.98 (95% CI 0.95 to 1.00) and 0.95 (95% CI 0.90 to 1.00) for distinguishing dysplasia from SCC and hyperplasia from dysplasia, respectively. Conclusion DR spectral data efficiently discriminate healthy tissue from oral malignant lesions. Diagnostic accuracies obtained in this study highlight the potential use of this method for routine clinical practice. PMID:22021749


    Tuanne Rotti ABRANTES


    Full Text Available After the report of a second case of canine visceral leishmaniasis (CVL in São Bento da Lagoa, Itaipuaçu, in the municipality of Maricá, Rio de Janeiro State, an epidemiological survey was carried out, through active search, totaling 145 dogs. Indirect immunofluorescence assay (IFA, enzyme-linked immunosorbent assay (ELISA, and rapid chromatographic immunoassay based on dual-path platform (DPP(r were used to perform the serological examinations. The parasitological diagnosis of cutaneous fragments was performed by parasitological culture, histopathology, and immunohistochemistry. In the serological assessment, 21 dogs were seropositive by IFA, 17 by ELISA, and 11 by DPP(r, with sensitivity of 66.7%, 66.7% and 50%, and specificity of 87.2%, 90.2% and 94%, respectively for each technique. The immunohistochemistry of bone marrow using the cell-block technique presented the best results, with six positive dogs found, three of which tested negative by the other parasitological techniques. Leishmania sp. was isolated by parasitological culture in three dogs. The detection of autochthonous Leishmania infantum in Itaipuaçu, and the high prevalence of seropositive dogs confirm the circulation of this parasite in the study area and alert for the risk of expansion in the State of Rio de Janeiro.


    ABRANTES, Tuanne Rotti; MADEIRA, Maria de Fátima; da SILVA, Denise Amaro; PERIÉ, Carolina dos Santos F. S.; V. MENDES, Artur Augusto; MENEZES, Rodrigo Caldas; SILVA, Valmir Laurentino; FIGUEIREDO, Fabiano Borges


    After the report of a second case of canine visceral leishmaniasis (CVL) in São Bento da Lagoa, Itaipuaçu, in the municipality of Maricá, Rio de Janeiro State, an epidemiological survey was carried out, through active search, totaling 145 dogs. Indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and rapid chromatographic immunoassay based on dual-path platform (DPP(r)) were used to perform the serological examinations. The parasitological diagnosis of cutaneous fragments was performed by parasitological culture, histopathology, and immunohistochemistry. In the serological assessment, 21 dogs were seropositive by IFA, 17 by ELISA, and 11 by DPP(r), with sensitivity of 66.7%, 66.7% and 50%, and specificity of 87.2%, 90.2% and 94%, respectively for each technique. The immunohistochemistry of bone marrow using the cell-block technique presented the best results, with six positive dogs found, three of which tested negative by the other parasitological techniques. Leishmania sp. was isolated by parasitological culture in three dogs. The detection of autochthonous Leishmania infantum in Itaipuaçu, and the high prevalence of seropositive dogs confirm the circulation of this parasite in the study area and alert for the risk of expansion in the State of Rio de Janeiro. PMID:26910449

  9. Attitude and perception of urology by medical students at the end of their medical school: An appraisal from Saudi Arabia

    Saleh Binsaleh


    Conclusions: Knowledge of medical school graduates is insufficient in many urologic subjects, and there is a need for more urology exposure. Social reasons and lack of knowledge about urology hinder the choice of urology specialty as a future career. Clearance of learning objectives, immediate and prompt feedback on performance and adequate emphasis of common problems and ambulatory care are some aspects that should be taken into account by curriculum planners as they consider improvements to urology rotation program.

  10. Diagnostic accuracies of endoscopic ultrasound-guided fine-needle aspiration with distinct negative pressure suction techniques in solid lesions: A retrospective study

    Wang, Ronghua; Wang, Jinlin; Li, Yawen; Duan, Yaqi; Wu, Xiaoli; Cheng, Bin


    Endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) is highly accurate in obtaining specific diagnoses for various diseases. The present study aimed to evaluate the diagnostic yields, accuracies and sampling adequacies, of slow-pull, 5 ml suction and 10 ml suction techniques in EUS-FNA of solid lesions. The present study was a retrospective comparative study, which was performed in tertiary academic centers, recognized for their expertise in EUS and EUS-guided FNA. The present study involved 149 patients who underwent EUS-FNA of solid masses. A total of 34 (22.8%), 37 (24.8%) and 78 (52.4%) patients underwent EUS-FNA with slow-pull, 5 ml suction and 10 ml suction techniques, respectively. The EUS-FNA cytology and histology results were compared with those from the gold standard of surgical histopathology [hematoxylin-eosin staining; immunohistochemical test of cluster of differentiation (CD) 79a, CD20 and flow cytometry test] or long-term clinical follow-up. The present retrospective comparative study demonstrated that the diagnostic yields and accuracies of EUS-FNA with slow-pull (86.1%) were significantly superior to those achieved with 5 ml suction (83.3%) or 10 ml suction (69.9%; Psuction group were adequate for histological diagnosis. By contrast, 70.6 (24/34) and 85.9% (67/78) of samples from the slow-pull and 10 ml suction groups were adequate for histological diagnosis, respectively. The samples obtained using 10 ml suction contained more blood compared with those obtained via slow-pull and 5 ml suction (P=0.0056; χ2 test). No complications were noted in any of the three groups. The samples that were obtained for histopathological diagnosis using 5 ml suction were superior to those obtained using slow-pull or 10 ml suction. Additional multi-central prospective studies in which EUS-FNA is performed with variable negative pressures are required to improve the defining of the diagnostic roles of those techniques. PMID:28521473

  11. Urology at the European university: adaptations to the Bologna Plan. The model of the Autonomous University of Madrid.

    Vela-Navarrete, R; Carballido, J; Gonzalez-Enguita, C; Olivier Gómez, C; Rodríguez de Betancourt, F


    The fundamental objective of the Convergence Plan of Bologna is to normalize, harmonize and standardize the teaching of medicine in European medical schools by implementing a similar curriculum. This objective assumes the presence of Urology as a university discipline in all European medical schools. At the same time, the teaching techniques and subject distributions have been modified, emphasizing practical teaching and active participation of the student in the acquisition of expertise and skills. This approach enhances the curricular presence of Urology and requires increased dedication from the teaching staff. These staff members, with limited face-to-face and classroom time, must inform and educate medical students on the broad healthcare commitment of urology as a surgical/medical specialty. The adaptation of the numerous European medical schools to the Bologna Plan raises a number of problems that can be easily overcome, as can be seen in the plan designed by the Faculty of Medicine at the Universidad Autonoma de Madrid. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Assessment of African Swine Fever Diagnostic Techniques as a Response to the Epidemic Outbreaks in Eastern European Union Countries: How To Improve Surveillance and Control Programs.

    Gallardo, C; Nieto, R; Soler, A; Pelayo, V; Fernández-Pinero, J; Markowska-Daniel, I; Pridotkas, G; Nurmoja, I; Granta, R; Simón, A; Pérez, C; Martín, E; Fernández-Pacheco, P; Arias, M


    This study represents a complete comparative analysis of the most widely used African swine fever (ASF) diagnostic techniques in the European Union (EU) using field and experimental samples from animals infected with genotype II ASF virus (ASFV) isolates circulating in Europe. To detect ASFV, three different PCRs were evaluated in parallel using 785 field and experimental samples. The results showed almost perfect agreement between the Universal ProbeLibrary (UPL-PCR) and the real-time (κ = 0.94 [95% confidence interval {CI}, 0.91 to 0.97]) and conventional (κ = 0.88 [95% CI, 0.83 to 0.92]) World Organisation for Animal Health (OIE)-prescribed PCRs. The UPL-PCR had greater diagnostic sensitivity for detecting survivors and allows earlier detection of the disease. Compared to the commercial antigen enzyme-linked immunosorbent assay (ELISA), good-to-moderate agreement (κ = 0.67 [95% CI, 0.58 to 0.76]) was obtained, with a sensitivity of 77.2% in the commercial test. For ASF antibody detection, five serological methods were tested, including three commercial ELISAs, the OIE-ELISA, and the confirmatory immunoperoxidase test (IPT). Greater sensitivity was obtained with the IPT than with the ELISAs, since the IPT was able to detect ASF antibodies at an earlier point in the serological response, when few antibodies are present. The analysis of the exudate tissues from dead wild boars showed that IPT might be a useful serological tool for determining whether or not animals had been exposed to virus infection, regardless of whether antibodies were present. In conclusion, the UPL-PCR in combination with the IPT was the most trustworthy method for detecting ASF during the epidemic outbreaks affecting EU countries in 2014. The use of the most appropriate diagnostic tools is critical when implementing effective control programs.

  13. Ergonomic status of laparoscopic urologic surgery: survey results from 241 urologic surgeons in china.

    Boluo Liang

    Full Text Available BACKGROUND: The prolonged and frequent use of laparoscopic equipment raises ergonomic risks that may cause physical distress for surgeons. We aimed to assess the prevalence of urologic surgeons' physical distress associated with ergonomic problems in the operating room (OR and their awareness of the ergonomic guidelines in China. METHODS: A sample of 300 laparoscopic urologists in China was assessed using a questionnaire on demographic information, ergonomic issues in the OR, musculoskeletal symptoms, and awareness of the ergonomic guidelines for the OR. RESULTS: There were 241 survey respondents (86.7% with valid questionnaires. Among the respondents, only 43.6% placed the operating table at pubic height during the actual operation. The majority of the respondents (63.5% used only one monitor during the procedure. Only 29.9% placed the monitor below the eye level. More than half of the respondents (50.6% preferred to use manual control instead of the foot pedal. Most of the respondents (95.0% never used the body support. The respondents experienced discomfort in the following regions, in ascending order: leg (21.6%, hand (30.3%, wrist (32.8%, shoulder (33.6%, back (53.1%, and neck (58.1%. The respondents with over 250 total operations experienced less discomfort than those with less than 250 total operations. Most of the respondents (84.6% were unaware of the ergonomic guidelines. However, almost all of the respondents (98.3% regarded the ergonomic guidelines to be important in the OR. CONCLUSIONS: Most of the laparoscopic urologists were not aware of the ergonomic guidelines for the OR; hence, they have been suffering from varying degrees of physical discomfort caused by ergonomic issues. There is an urgent need for education regarding ergonomic guidelines in the OR for laparoscopic urologists in China.

  14. Resident training in urology: Bipolar transurethral resection of the prostate - a safe method in learning endoscopic surgical procedure

    Alessandro Del Rosso


    Full Text Available Introduction: Modern medicine uses increasingly innovative techniques that require more and more capabilities for acquisition. In the urological department is increasing the presence of patients with lower urinary tract symptoms (LUTS and transurethral resection of the prostate (TURP is the standard of care in their surgical treatment. We report our surgical experience and learning curve of using bipolar plasmakinetic devices in the training of urological residents to benign prostatic hyperplasia (BPH treatment. Materials and Methods: 80 patients with benign prostatic enlargement due to BPH were enrolled in the study. TURP has been performed by three urological residents and by an expe- rienced urologist. Patients were evaluated before and 6 months after the endoscopic bipolar plasmakinetic resection using the International Prostate Symptom Score (IPSS, maximum uri- nary flow rate (Qmax, postvoid residual urine (PVR and prostate specific antigen (PSA. Results: Overall 60 procedures were performed, 18 PlasmaKinetic (PK-TURP procedures were completed by the three residents. In the other 42 cases the procedures were completed by the experienced urologist. In eight cases there was a capsular perforation and the experienced urol- ogist replaced the resident to complete the resection. No complications have been reported in the procedures completed by the senior urologist. All complications caused by the residents were man- aged intraoperatively without changing the course of the procedure. Statistical differences were observed regarding IPSS, quality of life (QoL, and PVR at 6-month follow-up when procedures completed by urological residents were compared to those completed by the senior urologist. Conclusion: Bipolar device represents appropriate tools to acquire endoscopic skills. It is safe and it can be used at the first experience of BPH treatment by a resident who has not previ- ously approached this endoscopic surgical procedure.

  15. 2D and 3D optical diagnostic techniques applied to Madonna dei Fusi by Leonardo da Vinci

    Fontana, R.; Gambino, M. C.; Greco, M.; Marras, L.; Materazzi, M.; Pampaloni, E.; Pelagotti, A.; Pezzati, L.; Poggi, P.; Sanapo, C.


    3D measurement and modelling have been traditionally applied to statues, buildings, archeological sites or similar large structures, but rarely to paintings. Recently, however, 3D measurements have been performed successfully also on easel paintings, allowing to detect and document the painting's surface. We used 3D models to integrate the results of various 2D imaging techniques on a common reference frame. These applications show how the 3D shape information, complemented with 2D colour maps as well as with other types of sensory data, provide the most interesting information. The 3D data acquisition was carried out by means of two devices: a high-resolution laser micro-profilometer, composed of a commercial distance meter mounted on a scanning device, and a laser-line scanner. The 2D data acquisitions were carried out using a scanning device for simultaneous RGB colour imaging and IR reflectography, and a UV fluorescence multispectral image acquisition system. We present here the results of the techniques described, applied to the analysis of an important painting of the Italian Reinassance: `Madonna dei Fusi', attributed to Leonardo da Vinci.

  16. [Urology and Sexology in Berlin 1880-1933: Original citations for the establishment of this frontier of urology - protagonists as reflected in their publications].

    Moll, Friedrich H; Fangerau, Heiner


    The connections between urology and sexology are often not obvious today. At the end of the 19th century both specialties developed in parallel especially in Berlin and had a fruitful relationship. Urologic journals and books were an ideal forum for publication especially for sexologists.

  17. Design and construction of translational medicine platform for urologic oncology.

    Xu, Yong; Yang, Kuo


    Translational medicine is a new medical model which focus on overcoming the serious imbalance among the basic research, its clinical and public health application. Its core is to establish effective ties among basic medical researchers, public health workers and doctors who know the needs of patients, particularly translating the molecular medical research results to suitable disease prevention, diagnosis, treatment and prevention methods effectively. This paper discusses the design and construction of the translational medicine platform for urologic system tumors. However, there is no draw on the precedent, it is a challenging project to create such a complicated platform and make it running smoothly and effectively. Based on the Tianjin Translational Medicine Platform for Urologic Oncology (TTMPUO) which had been established in support of Tianjin Science and Technology Commission, this paper will focus on describing the design ideas and the essential parts of the platform.

  18. Antibiotic resistant urinary tract infections in an urology ward

    A. Rădulescu


    Full Text Available Introduction: UTI (urinary tract infections represent a central pathology for a urological service. Antibiotic resistance is growing at a steady and alarming rate worldwide and especially in Romania. Method and materials: We have analyzed all the patients that were admitted to our clinic for continuous hospitalization between January 2015 and October 2015. All patients undergone urine culture and all cultures positive had an antibiogram worked up. We have selected all patients that had antibiotic resistance to at least an antibiotic. Results: From 1745 patients admitted for continuous hospitalization, we had 180 positive urine cultures at admission from which 125 had at least an antibiotic resistance. Conclusions: Antibiotic resistance is a serious phenomenon, with potential lethal complications, which we encounter daily in urological practice.

  19. Application of Virtual, Augmented, and Mixed Reality to Urology.

    Hamacher, Alaric; Kim, Su Jin; Cho, Sung Tae; Pardeshi, Sunil; Lee, Seung Hyun; Eun, Sung-Jong; Whangbo, Taeg Keun


    Recent developments in virtual, augmented, and mixed reality have introduced a considerable number of new devices into the consumer market. This momentum is also affecting the medical and health care sector. Although many of the theoretical and practical foundations of virtual reality (VR) were already researched and experienced in the 1980s, the vastly improved features of displays, sensors, interactivity, and computing power currently available in devices offer a new field of applications to the medical sector and also to urology in particular. The purpose of this review article is to review the extent to which VR technology has already influenced certain aspects of medicine, the applications that are currently in use in urology, and the future development trends that could be expected.

  20. Application of Virtual, Augmented, and Mixed Reality to Urology


    Recent developments in virtual, augmented, and mixed reality have introduced a considerable number of new devices into the consumer market. This momentum is also affecting the medical and health care sector. Although many of the theoretical and practical foundations of virtual reality (VR) were already researched and experienced in the 1980s, the vastly improved features of displays, sensors, interactivity, and computing power currently available in devices offer a new field of applications to the medical sector and also to urology in particular. The purpose of this review article is to review the extent to which VR technology has already influenced certain aspects of medicine, the applications that are currently in use in urology, and the future development trends that could be expected. PMID:27706017

  1. Identifying content for simulation-based curricula in urology

    Nayahangan, Leizl Joy; Bølling Hansen, Rikke; Lindorff-Larsen, Karen


    to identify technical procedures in urology that should be included in a simulation-based curriculum for residency training. MATERIALS AND METHODS: A national needs assessment was performed using the Delphi method involving 56 experts with significant roles in the education of urologists. Round 1 identified......OBJECTIVE: Simulation-based training is well recognized in the transforming field of urological surgery; however, integration into the curriculum is often unstructured. Development of simulation-based curricula should follow a stepwise approach starting with a needs assessment. This study aimed...... technical procedures that newly qualified urologists should perform. Round 2 included a survey using an established needs assessment formula to explore: the frequency of procedures; the number of physicians who should be able to perform the procedure; the risk and/or discomfort to patients when a procedure...

  2. Optimal management of urosepsis from the urological perspective.

    Wagenlehner, Florian M E; Weidner, Wolfgang; Naber, Kurt G


    Urosepsis in adults comprises approximately 25% of all sepsis cases and in most cases is due to complicated urinary tract infections (UTIs). In this paper we review the optimal management of urosepsis from the urological point of view. Urosepsis is often due to obstructed uropathy of the upper or lower urinary tract. The treatment of urosepsis comprises four major aspects: 1. Early goal-directed therapy; 2. Optimal pharmacodynamic exposure to antimicrobials both in blood and in the urinary tract; 3. Control of complicating factors in the urinary tract; 4. Specific sepsis therapy. Early tissue oxygenation, appropriate initial antibiotic therapy and rapid identification and control of the septic focus in the urinary tract are critical steps in the successful management of a patient with severe urosepsis. To achieve this goal an optimal interdisciplinary approach encompassing the emergency unit, urological specialties and intensive-care medicine is necessary.

  3. Re-exploring the high-throughput potential of microextraction techniques, SPME and MEPS, as powerful strategies for medical diagnostic purposes. Innovative approaches, recent applications and future trends.

    Pereira, Jorge; Silva, Catarina Luís; Perestrelo, Rosa; Gonçalves, João; Alves, Vera; Câmara, José S


    The human population continues to grow exponentially in the fast developing and most populated countries, whereas in Western Europe it is getting older and older each year. This inevitably raises the demand for better and more efficient medical services without increasing the economic burden in the same proportion. To meet these requirements, improvement of medical diagnosis is certainly a key aspect to consider. Therefore, we need powerful analytical methodologies able to go deeper and further in the characterization of human metabolism and identification of disease biomarkers and endogenous molecules in body fluids and tissues. The ultimate goal is to have a reliable and early medical diagnosis, mitigating the disease complications as much as possible. Microextraction techniques (METs) represent a key step in these analytical methodologies by providing samples in the suitable volumes and purification levels necessary for the characterization of the target analytes. In this aspect, solid-phase microextraction (SPME) and, more recently, microextraction by packed sorbent (MEPS), are powerful sample preparation techniques, characterized by their reduced time of analysis, low solvent consumption, and broad application. Moreover, as miniaturized techniques, they can be easily automatized to have a high-throughput performance in the clinical environment. In this review, we explore some of the most interesting MEPS and SPME applications, focusing on recent trends and applications to medical diagnostic, particularly the in vivo and near real time applications.

  4. [Cyclooxygenase 2 inhibitors and urologic and gynaecologic cancers].

    Eschwege, Pascal


    PGE2 is one of the most important prostaglandin involved in the oncogenesis. PGE2 is found at high concentration level in the most of epithelial cancer. Urologic and gynaecologic cancer express the enzyme which are at the origin of PGE2: cyclooxygenase 2. Cox2 inhibitors present anticancer properties demonstrated in wide varieties of cellular and animal models. Human applications are currently tested in many clinical trials for bladder, prostate and uterine carcinomas.

  5. Urologic robotic surgery in Korea: Past and present

    Seo, Ill Young


    Since 2005 when the da Vinci surgical system was approved as a medical device by the Korean Ministry of Health and Welfare, 51 systems have been installed in 40 institutions as of May 2015. Although robotic surgery is not covered by the national health insurance service in Korea, it has been used in several urologic fields as a less invasive surgery. Since the first robotic-assisted laparoscopic radical prostatectomy in 2005, partial nephrectomy, radical cystectomy, pyeloplasty, and other uro...

  6. The emerging use of Twitter by urological journals.

    Nason, Gregory J; O'Kelly, Fardod; Kelly, Michael E; Phelan, Nigel; Manecksha, Rustom P; Lawrentschuk, Nathan; Murphy, Declan G


    To assess the emerging use of Twitter by urological journals. A search of the Journal of Citation Reports 2012 was performed to identify urological journals. These journals were then searched on Each journal website was accessed for links to social media (SoMe). The number of 'tweets', followers and age of profile was determined. To evaluate the content, over a 6-month period (November 2013 to April 2014), all tweets were scrutinised on the journals Twitter profiles. To assess SoMe influence, the Klout score of each journal was also calculated. In all, 33 urological journals were identified. Eight (24.2%) had Twitter profiles. The mean (range) number of tweets and followers was 557 (19-1809) and 1845 (82-3692), respectively. The mean (range) age of the twitter profiles was 952 (314-1758) days with an average 0.88 tweets/day. A Twitter profile was associated with a higher mean impact factor of the journal (mean [sd] 3.588 [3.05] vs 1.78 [0.99], P = 0.013). Over a 6-month period, November 2013 to April 2014, the median (range) number of tweets per profile was 82 (2-415) and the median (range) number of articles linked to tweets was 73 (0-336). Of these 710 articles, 152 were Level 1 evidence-based articles, 101 Level 2, 278 Level 3 and 179 Level 4. The median (range) Klout score was 47 (19-58). The Klout scores of major journals did not exactly mirror their impact factors. SoMe is increasingly becoming an adjunct to traditional teaching methods, due to its convenient and user-friendly platform. Recently, many of the leading urological journals have used Twitter to highlight significant articles of interest to readers. © 2014 The Authors. BJU International © 2014 BJU International.

  7. Reprocessing and reuse of urological armamentarium: How correct are we!

    Krutik Vipulbhai Raval


    Full Text Available Healthcare is expensive for a large proportion of the population in spite of high per capita income and good health insurance penetration. In an effort to reduce cost of the procedure, reprocessing of devices was started in the late 1970s. Reprocessing practice includes various measures such as proper cleaning, disinfection, and sterilization procedures. As reprocessing is aimed at reducing cost, there is a potential risk of compromising patient safety due to cross contamination after inadequate sterilization. There is also risk of performance alteration of urological reprocessed devices during sterilization/disinfection processing. Therefore, there is a need for formulating proper guidelines to decide methods of reprocessing for various urological equipment. There is also need to discuss the problematic areas that urologists face and to find their solutions. A PubMed search was made in September 2016, using key words “reprocessing of medical devices,” “Single Use Devices,” “methods of reprocessing of devices in clinical practice,” “use of formalin chamber,” “urological disposable sterilization,” etc., After excluding duplicates, all English articles were reviewed by title and abstract. Full texts of selected articles were obtained, and these articles were cross-referenced to find any other related articles. All the articles were reviewed. A product can be reused if it can be economically reprocessed with validated protocols with preservation of its function. There is no reason to discard it after one use. This practice is useful for controlling economics of a urological case and to reduce the financial burden. Current Food and Drug Administration guidelines are stringent. The contamination described to test the sterilization process in the suggested guidelines actually does never exist in clinical practice. Therefore, new guidelines considering the clinical practice scenario are desirable.

  8. Surgical site infection rates following laparoscopic urological procedures.

    George, Arvin K; Srinivasan, Arun K; Cho, Jane; Sadek, Mostafa A; Kavoussi, Louis R


    Surgical site infections have been categorized by the Centers for Medicare and Medicaid Services as "never events". The incidence of surgical site infection following laparoscopic urological surgery and its risk factors are poorly defined. We evaluated surgical site infection following urological laparoscopic surgery and identified possible factors that may influence occurrence. Patients who underwent transperitoneal laparoscopic procedures during a 4-year period by a single laparoscopic surgeon were retrospectively reviewed. Surgical site infections were identified postoperatively and defined using the Centers for Disease Control criteria. Clinical parameters, comorbidities, smoking history, preoperative urinalysis and culture results as well as operative data were analyzed. Nonparametric testing using the Mann-Whitney U test, multivariable logistic regression and Spearman's rank correlation coefficient were used for data analysis. In 556 patients undergoing urological laparoscopic procedures 14 surgical site infections (2.5%) were identified at mean postoperative day 21.5. Of the 14 surgical site infections 10 (71.4%) were located at a specimen extraction site. Operative time, procedure type and increasing body mass index were significantly associated with the occurrence of surgical site infections (p = 0.007, p = 0.019, p = 0.038, respectively), whereas history of diabetes mellitus (p = 0.071) and intraoperative transfusion (p = 0.053) were found to trend toward significance. Age, gender, positive urine culture, steroid use, procedure type and smoking history were not significantly associated with surgical site infection. Body mass index and operative time remained significant predictors of surgical site infection on multivariate logistic regression analysis. Surgical site infection is an infrequent complication following laparoscopic surgery with the majority occurring at the specimen extraction site. Infection is associated with prolonged operative time and

  9. Use of a semiconductor-diode laser in urology

    Watson, Graham M.


    The gallium arsenide semiconductor laser can emit in the near infrared where the depth of penetration into tissue is great although scattering is less than with the Nd:YAG laser. The laser is highly compact. It runs off a normal electrical outlet with no cooling requirement. It is therefore quiet and convenient. The laser has been assessed in a wide variety of applications in our urological department.

  10. Early urologic considerations in patients with persistent cloaca.

    VanderBrink, Brian A; Reddy, Pramod P


    Cloacal malformations represent one of the most complex conditions among anorectal malformations. Urologic conditions occur with an increased frequency in cloaca patients compared to patients with other types of ARM. The morbidity of the upper and lower urinary tract dysfunction/malformations at times can be severe; manifested by urinary tract infection, lower urinary tract symptoms, urinary incontinence, chronic kidney disease, and even end stage renal disease. Long-term follow-up of patients with cloaca has described significant chronic kidney disease and end-stage renal disease. Whether this rate of chronic kidney disease is a function of intrinsic renal dysplasia or acquired renal injury from neurogenic bladder is currently unknown. However, it is well known that severe lower urinary tract dysfunction, no matter the etiology, poses significant risk to the upper tracts when untreated. Neonatal assessment of the urinary tract accompanied by early identification of abnormal structure and function is therefore fundamental to minimize the impact of any urologic condition on the child's overall health. Adequate management of any associated bladder dysfunction is essential to preserving renal function, minimizing risk of urinary tract infection, and potentially avoiding need for future reconstructive surgery. This article summarizes our institution's approach to the ongoing early urologic management in patients with cloaca. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Manipulating the epigenome for the treatment of urological malignancies.

    O'Rourke, Colm J


    Urological malignancies (cancers of the prostate, bladder, kidney and testes) account for 15% of all human cancers and more than 500,000 deaths worldwide each year. This group of malignancies is spread across multiple generations, affecting the young (testicular) through middle and old-age (kidney, prostate and bladder). Like most human cancers, urological cancers are characterized by widespread epigenetic insult, causing changes in DNA hypermethylation and histone modifications leading to silencing of tumor suppressor genes and genomic instability. The inherent stability yet dynamic plasticity of the epigenome lends itself well to therapeutic manipulation. Epigenetic changes are amongst the earliest lesions to occur during carcinogenesis and are essentially reversible (unlike mutations). For this reason, much attention has been placed over the past two decades on deriving pharmacological compounds that can specifically target and reverse such epi-mutations, either halting cancer on its developmental trajectory or reverting fully formed cancers to a more clinically manageable state. This review discusses DNA methyltransferase and histone deacetylase inhibitors that have been extensively studied in preclinical models and clinical trials for advanced and metastatic urological cancers.

  12. [Urologic surgery and risks of complaints in medical responsibility].

    Haillot, O; Haertig, A; Vannier, J; Janin, P; Lanson, Y


    The card-index study of specialized insurance companies allowed the analysis of 82 cases concerning urological surgical procedures. Forty-two cases went to the Civil Court, 10 to the Penal Court and 5 to the Administrative Tribunal, while 5 cases were simply declared to insurance companies without judiciary consequences. Sixty-two cases concerned private plaintiffs surgeons and 34 cases concerned non specialist urologic surgeons. Sixteen plaintiffs were compensated, 9 after a conciliatory agreement and 7 after trial. There were no penal condemnations (one case on the waiting list). Impotence was the most frequent cause for complaint which was compensated. Next, came incontinence generally secondary to endoscopic resection. Retrospectively, 19 cases seemed to be unwarranted due to the dishonesty of patients (3 patients were prosecuted for unwarranted procedures). On the other hand, 32 cases seemed to be due to a lack of information given to the patients themselves or to their families, either before of after the incriminated act. The risk of prosecution is relatively low in urology. It could be decreased by careful management of the medical chart, by rapid analysis of complications and by a constant effort to inform the patient and his family.

  13. [De novo urologic tumors in kidney transplant patients].

    Rodríguez Faba, O; Breda, A; Gausa, L; Palou, J; Villavicencio, H


    The ability of a transplant recipient to accept a graft depends on the ability of immunosuppressive drugs to regulate the immune system. Such treatments have been associated with tumor promotion and progression. A systematic literature review was carried out. Electronic searches were performed in PubMed database. The searching criterion was "urological tumors in kidney transplant recipients". The most important issues regarding incidence, urological tumor-specific features, and relevant ones about the treatment are summarized. In renal transplant, 15% of all tumors are urological neoplasias; furthermore, they are the leading neoplastic cause of death. In transplant population the incidence rate of renal cell carcinoma (RCC), transitional cell bladder carcinoma (TCBC), testicular carcinoma (TC) and prostate cancer are increased 15, 3, 3 and 2 times respectively. Treatments used in transplant patients are similar to those employed in the general population:radical nephrectomy for the native kidney and conservative surgery for the graft are indicated for RCC. Radical prostatectomy is technically feasible for localized PC.Regarding to transitional cell carcinoma BCG or MMC is not contraindicated. The incidence rate of cancer has increased among transplant population. These tumors can be managed following the same criteria than in general population. Because in this population the prognosis is worse for the immunosuppression, closer monitoring is required. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. The diagnostic yield of fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography in recurrent testicular seminoma

    Athanasios Bantis


    Full Text Available The use of positron emission tomography-computed tomography (PET-CT scan imaging is undoubtedly a significant evolution in oncological urology, although at present of limited use in every day urology practice. The aim of this study is to highlight the indication and diagnostic accuracy of fluorine-18 fluorodeoxyglucose PET/CT in the staging of a patient with metachronous bilateral testicular seminoma, elevated tumor markers, and equivocal conventional imaging findings.

  15. Contribution of Diagnostic Tests and Drug Therapy in Screening of Benign Prostatic Hyperplasia (BPH) in Western Algerian Hospital

    Abdelkrim Berroukche; Abderahmane Labani; Mohamed Terras


    The incidence of benign prostatic hyperplasia (BPH) is known through the American and European continents whereas it remains much to make to know the epidemiologic profile of this pathology in Algeria. This study aims to show a contribution of diagnostic tests and drug therapy in screening of BPH in Western Algerian hospital. Our study was carried out on 385 men recruited in the Urology department of Saida hospital during the period 2010-2013, consulting for urologic problems whose 120 patien...

  16. Novel Applications of Lanthanoides as Analytical or Diagnostic Tools in the Life Sciences by ICP-MS-based Techniques

    Müller, Larissa; Traub, Heike; Jakubowski, Norbert


    Inductively coupled plasma mass spectrometry (ICP-MS) is a well-established analytical method for multi-elemental analysis in particular for elements at trace and ultra-trace levels. It has found acceptance in various application areas during the last decade. ICP-MS is also more and more applied for detection in the life sciences. For these applications, ICP-MS excels by a high sensitivity, which is independent of the molecular structure of the analyte, a wide linear dynamic range and by excellent multi-element capabilities. Furthermore, methods based on ICP-MS offer simple quantification concepts, for which usually (liquid) standards are applied, low matrix effects compared to other conventional bioanalytical techniques, and relative limits of detection (LODs) in the low pg g-1 range and absolute LODs down to the attomol range. In this chapter, we focus on new applications where the multi-element capability of ICP-MS is used for detection of lanthanoides or rare earth elements, which are applied as elemental stains or tags of biomolecules and in particular of antibodies.

  17. Antibiotic prophylaxis for transurethral urological surgeries: Systematic review

    Basim S Alsaywid


    Full Text Available The use of antibiotic prophylaxis to prevent urinary tract infection and bacteremia (sepsis following endoscopic urologic procedures is a controversial topic. Evidence in the literature revealed that urological instrumentation is associated with increased incidence of urinary tract infection and bacteremia. The aim of this review is to evaluate the effectiveness of antibiotic prophylaxis in reducing the risk of urinary tract infection in patients who had transurethral urological surgeries. We have selected all RCTs of adult population who underwent all different types of transurethral urological surgery, including cystoscopy, transurethral resection of prostate and transurethral resection of bladder tumor, and received prophylactic antibiotics or placebo/no treatment. At first, more than 3000 references were identified and reviewed; of which 42 studies with a total of 7496 patients were included in the final analysis. All those trials were analyzing antibiotic prophylaxis versus placebo/no treatment, and they were significantly favoring antibiotic use in reducing all outcomes, including bacteriuria (RR 0.36, 95% CI 0.29 to 0.46, P < 0.0001 with moderate heterogeneity detected (I 2 48%, symptomatic UTI (RR 0.38, 95% CI 0.28 to 0.51, P < 0.0001 with no significant heterogeneity was detected (I 2 = 17%, bacteremia (RR 0.43, 95% CI 0.23 to 0.82, P < 0.0001 with no noted heterogeneity (I 2 = 0%, and fever ≥38.5 Celsius (RR 0.41, 95% CI 0.23 to 0.73, P = 0.003; also, there was no noted heterogeneity (I 2 = 0%. However, using antibiotic prophylaxis did not reduce the incidence of low grade temperature (RR 0.82, 95% CI 0.61 to 1.11, P = 0.20 or in moderate grade temperature (RR 1.03, 95% CI 0.71 to 1.48, P = 0.89. Antibiotic prophylaxis appears to be an effective intervention in preventing urinary tract infections and its sequels following transurethral urological surgeries in patients with preoperative sterile urine.

  18. Plasma diagnostics discharge parameters and chemistry

    Auciello, Orlando


    Plasma Diagnostics, Volume 1: Discharge Parameters and Chemistry covers seven chapters on the important diagnostic techniques for plasmas and details their use in particular applications. The book discusses optical diagnostic techniques for low pressure plasmas and plasma processing; plasma diagnostics for electrical discharge light sources; as well as Langmuir probes. The text also describes the mass spectroscopy of plasmas, microwave diagnostics, paramagnetic resonance diagnostics, and diagnostics in thermal plasma processing. Electrical engineers, nuclear engineers, microwave engineers, che

  19. Open versus minimally invasive surgical approaches in pediatric urology: Trends in utilization and complications.

    Tejwani, Rohit; Young, Brian J; Wang, Hsin-Hsiao S; Wolf, Steven; Purves, J Todd; Wiener, John S; Routh, Jonathan C


    Minimally invasive surgery (MIS) techniques are anecdotally reported to be increasingly used, but little objective data supports this. Our objective was to assess trends in MIS utilization across various procedures in pediatric urology and to compare postoperative complication rates between MIS and open procedures. We analyzed the 1998-2012 Nationwide Inpatient Sample. We identified children (<18 years old) undergoing open and MIS inpatient procedures and any in-hospital post-operative complications that occurred during that postoperative hospitalization. We utilized propensity score matching and multivariable logistic regression to adjust for confounding factors. We identified 163,838 weighted encounters in the "overall cohort," 70,273 of which were at centers performing more than five MIS procedures over the years studied. Use of MIS techniques increased significantly over time for several procedures, most prominently for nephrectomy (Fig.). The overall rate of complications was lower in patients undergoing MIS compared with open surgery (6% vs. 11%, p < 0.001). Specialized centers had a significantly lower overall rate of complications than unspecialized centers (9% vs. 12%, p < 0.001). Within specialized centers, MIS had lower complication rates than open procedures (7% vs. 9%, p < 0.001); this finding was consistent even after adjusting for other factors (OR 0.71, p = 0.02). Limitations include that these data may not be generalizable to encounters not in the sample pool. As a large, retrospective, administrative database, NIS may be affected by miscoding bias - rendering our analysis sensitive to the accuracy of procedure coding in NIS. Although the accuracy level of NIS is high for an administrative database, it is possible at least some portion of our cohort may be incorrectly coded. Further, the NSQIP complications we identified may represent associated comorbidities and not true postoperative complications, as NIS does not provide temporal

  20. Women in Urology Residency, 1978-2013: A Critical Look at Gender Representation in Our Specialty.

    Halpern, Joshua A; Lee, Una J; Wolff, Erika M; Mittal, Sameer; Shoag, Jonathan E; Lightner, Deborah J; Kim, Soo; Hu, Jim C; Chughtai, Bilal; Lee, Richard K


    To evaluate changes over time in female representation among urology residents compared to those within other specialties. Urology match data were obtained from the American Urological Association from 1996 to 2015. Trends in match rates of male and female urology applicants were assessed. Data for gender representation among residencies were extracted from reports in the Journal of the American Medical Association from 1978 to 2013. We compared the annual percentage of women among urology residents vs residents of other specialties over time. Mean number of male vs female urology applicants per year was 285.0 ± 27.1 vs 76.5 ± 21.8 (P women, respectively (80.7% and 13.5%). The largest growth occurred in urology among all other specialties (P women among all specialties during the study period, women have remained a minority among urology residents. Gender representation within urology is a reflection of many factors and demonstrates a need for further improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Surgical management of bone metastases from urological malignancies: an analysis of 70 cases

    Toğral, Güray; Arıkan, Murat; Aktaş, Erdem; Öztürk, Recep; Güven, Oğuz; Eksioğlu, Fatih


    ... (blastic, mixed, lytic), type of surgical reconstruction, systemic affections, and visceral organ metastasis for 70 bone metastases from deceased urological malignancies patients (55 male, 15 female...

  2. Risk Factors and Pain Characteristics Assessment in Women with Urologic Disease related Chronic Pelvic Pain



    Full Text Available Purpose: The aim of our study was to evaluate factors predisposing or related to chronic pelvic pain in women, and whether those factors allows classification using generalized cluster analysis, consistent with the presence of chronic pelvic pain. Material and method: A survey was done on 2469 women referred to Clinical Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania, between January 2006 - December 2010. Patients were stratify in regard with presence of chronic pelvic pain (GrA and assessed in regard with demographic and habitual risk factors, medical and reproductive history, lifestyle, and pain characteristics. Identified factors were used for classification using generalized cluster analysis by k-mean technique. The results were assessed in terms of correlation with the presence of chronic pelvic pain. Results: On univariate analysis, marital status and higher education were protective while complications at delivery and physical work were risk factors for chronic pelvic pain. Age at presentation and age at menarche were lower in GrA, while caffeine and alcohol consumption, number of cigarettes smoked per day, pain intensity, coexistence of pain related to periods, deep intercourse, bladder filling, and voiding have been increased in GrA. Classification of patients correlates with the presence of chronic pelvic pain (p<0.001. Conclusions: Age, marital status, level of education, type of activity, complications at delivery, caffeine and alcohol consumption are risk factors related to chronic pelvic pain in women referred for urologic conditions. Pain intensity is related to chronic pelvic pain, regardless of type and localization. Classification of patients using k-mean technique cluster analysis correlates significantly statistic with chronic pelvic pain.

  3. Magnetic resonance urography in pediatric urology.

    Cerwinka, Wolfgang H; Kirsch, Andrew J


    Magnetic resonance urography (MRU) has evolved into an effective imaging tool for the evaluation of the urinary tract in children. The goal of this article is to describe current techniques and applications of MRU and to review recent advances. MRU is most commonly applied to the evaluation of hydronephrosis and provides valuable insight into a wide range of obstructive uropathies. MRU was shown to be superior to renal scintigraphy for the diagnosis of pyelonephritis and renal scarring. The use of MRU for the assessment of urolithiasis, vesicoureteral reflux, renal trauma, and fetal urinary tract abnormalities is limited and technical refinements are required. Judicious use of gadolinium-based contrast agents in patients at risk for nephrogenic systemic fibrosis was recently shown to avoid new occurrences. Potential future applications include virtual endoscopy and MRU-guided procedures. MRU has the potential to revolutionize imaging of the urinary tract in children. It integrates exquisite anatomical information with a variety of functional data and avoids ionizing radiation. MRU is increasingly employed as a problem solver when conventional imaging studies remain inconclusive and its growing application will likely improve availability and cost in the future.

  4. Endoscopic Optical Coherence Tomography in Urology

    Pan, Yingtian; Waltzer, Wayne; Ye, Zhangqun

    Clinical statistics has shown a stable prevalence of bladder cancer in recent years, which by far remains among the most common types of malignancy in the USA. With smoking as the most well-established risk factor, bladder cancer is the fourth most common cancer occurrences in male population [1]. In the year of 2014, an estimated 74,690 new cases are expected to occur with estimated 15,580 deaths. Bladder cancer often refers to transitional cell carcinoma (TCC) as it originates primarily from the epithelial cell layer (i.e., urothelium) of the bladder. Unlike prostate-specific antigen (PSA) for prostate cancer screening, there is currently no effective screening technique approved or recommended for the population at average risk [2-5]. As a result, hematuria (i.e., blood in the urine) is often the first clinical symptom of bladder cancer. Fortunately, urinary bladder is more accessible than prostate glands endoscopically; thus cytology following white-light cystoscopy has been the gold standard for current clinical detection of bladder cancer. This is important because bladder cancer if diagnosed prior to muscle invasion (e.g., superficial or at

  5. PET in the management of urologic malignancies.

    Kumar, Rakesh; Zhuang, Hongming; Alavi, Abass


    FDG-PET has a limited role in diagnosis of prostate cancer mainly because of the low uptake of FDG in the tumor and normal excretion of FDG through urine. FDG-PET has shown some promise in the assessment of lymph nodes and bone metastases. There is a large degree of variability when FDG-PET is compared with bone scintigraphy. New C11-labeled radiotracers (acetate, choline, and methionine) have shown promising initial results but further studies are required to determine their role in such settings. These radiotracers provide a unique opportunity for dynamic, multitracer, and quantitative studies, which improve the sensitivity and specificity on PET in this population. Short half-lives and of C-11, however with the limits to their use requires an on-site cyclotron. Recent synthesis schemes with [18F]-labeling, however, may overcome this limitation. FDG-PET has a significant potential to assist with the diagnosis and management of testicular cancer. PET has been most useful in defining the presence or absence of disease in patients with residual masses. PET has shown promising results for the initial diagnosis of this cancer, but further for studies ar required to determine its role in the management of this malignancy. PET can be used in conjunction with conventional imaging techniques to diagnose retroperitoneal masses in patients with primary testicular cancer. FDG-PET has shown very encouraging results in a limited number of studies, and has also demonstrated a good sensitivity for initial staging. FDG-PET seems to be superior to conventional imaging modalities for detecting local disease and recurrence, and distant metastases.

  6. Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy.

    Moldwin, Robert M; Fariello, Jennifer Yonaitis


    Myofascial trigger points (MTrP), or muscle "contraction knots," of the pelvic floor may be identified in as many as 85 % of patients suffering from urological, colorectal and gynecological pelvic pain syndromes; and can be responsible for some, if not all, symptoms related to these syndromes. Identification and conservative treatment of MTrPs in these populations has often been associated with impressive clinical improvements. In refractory cases, more "aggressive" therapy with varied trigger point needling techniques, including dry needling, anesthetic injections, or onabotulinumtoxinA injections, may be used, in combination with conservative therapies.

  7. Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors.

    Mingyue Luo

    Full Text Available To evaluate the diagnostic value of multidetector CT (MDCT and its multiplanar reformation (MPR, volume rendering (VR and virtual bronchoscopy (VB postprocessing techniques for primary trachea and main bronchus tumors.Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology.Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6, tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16, extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1, longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1, morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1 and extents (mild, n = 5; moderate, n = 7; severe, n = 19, distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10, and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density

  8. Adverse events resulting from lasers used in urology.

    Althunayan, Abdulaziz M; Elkoushy, Mohamed A; Elhilali, Mostafa M; Andonian, Sero


    To collate world reports of adverse events (AEs) resulting from lasers used in urology. The Manufacturer and User Facility Device Experience (MAUDE) database of the United States Food and Drug Administration (FDA) was searched using the term "Laser for gastro-urology use." In addition, the Rockwell Laser Industries (RLI) Laser Accident Database was searched for the following types of lasers: neodymium-doped yttrium aluminum garnet (Nd:YAG), holmium:yttrium aluminum garnet (Ho:YAG), potassium titanyl phosphate (KTP), diode and thulium:YAG (Tm:YAG). Both databases were last accessed on October 1, 2012. Overall, there were 433 AEs; 166 in MAUDE database (1992-2012) and 267 in RLI database (1964-2005). Most of the AEs (198/433 or 46%) resulted from generator failure or fiber tip breaking. Whereas there were 20 (4.6%) AEs harming medical operators, there were 159 (37%) AEs harming nonmedical operators using Nd:YAG, KTP, and diode lasers. Eye injuries ranging from mild corneal abrasions to total vision loss were reported in 164 AEs with the use of Nd:YAG, KTP, and diode lasers. Overall, there were 36 (8.3%) AEs resulting in patient harm, including 7 (1.6%) mortalities, 3 deaths from ureteral perforation using the Ho:YAG laser, and 4 deaths from air emboli using the Nd:YAG laser. Other reported patient injuries included bladder perforation resulting in urinary diversion in a patient, in addition to minor skin burns, internal burns, and bleeding in others. There were no AEs reported with the use of Tm:YAG laser. Most of the AEs reported relate to equipment failure. There were no eye injuries reported with the use of Ho:YAG lasers. Caution must be exercised when using lasers in urology, including wearing appropriate eye protection when using Nd:YAG, KTP, and diode lasers.

  9. Augmented reality assisted surgery: a urologic training tool.

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S


    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  10. Augmented reality assisted surgery: a urologic training tool

    Ryan M Dickey


    Full Text Available Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  11. Augmented reality assisted surgery: a urologic training tool

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S


    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training. PMID:26620455

  12. Prevention of ventriculoperitoneal shunt complications after intraperitoneal urological surgeries.

    Ikeda, Takashi; Akiyama, Sayaka; Kim, Woo Jin; Ito, Susumu; Yamazaki, Yuichiro


    To evaluate perioperative management for the prevention of postoperative shunt infection and malfunction after intraperitoneal urological surgery in patients with myelodysplasia and a ventriculoperitoneal shunt. From 2005 to 2015, 20 consecutive patients with myelodysplasia and a ventriculoperitoneal shunt who underwent intraperitoneal urological surgeries were managed with the same perioperative regimen. Intraperitoneal surgeries involved opening gastrointestinal tracts, including bladder augmentation by enterocystoplasty, creating continent catheterizable channels and Malone antegrade continent enema. We compared results with those from seven previous reports regarding postoperative shunt complications, surgical histories of previous shunt revisions, management of bacteriuria before surgery preoperative bowel preparation, antibiotic regimens, and duration of indwelling drain. Of 20 patients, 18 received prior shunt revisions, and 14 had positive urine culture before surgery that was managed with oral antibiotics. Thirteen patients underwent bladder augmentation with ileum, and one underwent augmentation with sigmoid colon. Nineteen patients underwent Malone antegrade continent enema using the appendix. All parenteral antibiotics were stopped on postoperative day 2.5. Mean duration of indwelling peritoneal drain was 2.7days. Mean follow-up period was 59.8months. Neither postoperative shunt infections nor intraperitoneal shunt malfunctions were recognized during follow-up period. This is the first study to evaluate postoperative ventriculoperitoneal shunt complications in patients with myelodysplasia who underwent intraperitoneal urological surgeries with a specific perioperative regimen. Shunt complications are greatly reduced by rigorous perioperative management, including preoperative control of bacteriuria, appropriate administration of prophylactic antibiotics, and early removal of intraperitoneal drains. The type of study: Case series with no comparison group

  13. Urological surgery in elderly patients: results and complications

    Brodak M


    Full Text Available Milos Brodak, Jan Tomasek, Jaroslav Pacovsky, Lukas Holub, Petr Husek Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic Purpose: Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients.Methods: The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012. The average age of patients was 78. The results and complications were categorized based on the type of surgery performed, and the Dindo–Clavien scale.Results: The median follow-up was 18 months. All surgeries for malignant tumors were performed successfully with no residual disease. Totally, 48 (22% complications were recorded. The most serious were as follows: one patient (<0.5% died; and four (<2% patients underwent reoperation. The most common complications involved infection, mainly sepsis and surgical site infections. Other complications included mild respiratory insufficiency, delirium, bleeding, etc.Conclusion: Surgeries in elderly patients were effective and safe. The cornerstone of safety is careful preparation and treatment of comorbidities. Complications occurred mainly as a result of emergency procedures during emergency procedures and in major surgeries such as cystectomy and nephrectomy. The standard use of low molecular-weight heparin caused no incidence of thromboembolic disease. Keywords: urinary tract, aged, postoperative complications, Dindo–Clavien classification

  14. Economic impact of training and career decisions on urological surgery.

    Langston, Joshua P; Kirby, E Will; Nielsen, Matthew E; Smith, Angela B; Woods, Michael E; Wallen, Eric M; Pruthi, Raj S


    Medical students and residents make career decisions at a relatively young age that have significant implications for their future income. While most of them attempt to estimate the impact of these decisions, there has been little effort to use economic principles to illustrate the impact of certain variables. The economic concept of net present value was paired with available Medical Group Management Association and Association of American Medical Colleges income data to calculate the value of career earnings based on variations in the choice of specialty, an academic vs a private practice career path and fellowship choices for urology and other medical fields. Across all specialties academic careers were associated with lower career earnings than private practice. However, among surgical specialties the lowest difference in value between these 2 paths was for urologists at only $334,898. Fellowship analysis showed that training in pediatric urology was costly in forgone attending salary and it also showed a lower future income than nonfellowship trained counterparts. An additional year of residency training (6 vs 5 years) caused a $201,500 decrease in the value of career earnings. Choice of specialty has a dramatic impact on future earnings, as does the decision to pursue a fellowship or choose private vs academic practice. Additional years of training and forgone wages have a tremendous impact on monetary outcomes. There is also no guarantee that fellowship training will translate into a more financially valuable career. The differential in income between private practice and academics was lowest for urologists. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. mHealth in Urology: A Review of Experts' Involvement in App Development.

    Nuno Pereira-Azevedo

    Full Text Available Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP and scientific Urology associations in their development.A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app's platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development.The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7% and only a third had been developed with a scientific Urology association (34.7%. The lowest percentage of HCP (13.4% and urological association (1.9% involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed.Despite the increasing Mobile Health (mHealth market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation.

  16. mHealth in Urology: A Review of Experts’ Involvement in App Development

    Pereira-Azevedo, Nuno; Carrasquinho, Eduardo; Cardoso de Oliveira, Eduardo; Cavadas, Vitor; Osório, Luís; Fraga, Avelino; Castelo-Branco, Miguel; Roobol, Monique J.


    Introduction Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP) and scientific Urology associations in their development. Material and Methods A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app’s platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development. Results The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7%) and only a third had been developed with a scientific Urology association (34.7%). The lowest percentage of HCP (13.4%) and urological association (1.9%) involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed. Conclusions Despite the increasing Mobile Health (mHealth) market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation. PMID:25984916

  17. mHealth in Urology: A Review of Experts' Involvement in App Development.

    Pereira-Azevedo, Nuno; Carrasquinho, Eduardo; Cardoso de Oliveira, Eduardo; Cavadas, Vitor; Osório, Luís; Fraga, Avelino; Castelo-Branco, Miguel; Roobol, Monique J


    Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with the aim of assessing the level of participation of healthcare professionals (HCP) and scientific Urology associations in their development. A systematic search was performed on PubMed, Apple's App Store and Google's Play Store, for Urology apps, available in English. Apps were reviewed by three graders to determine the app's platform, target customer, developer, app type, app category, price and the participation of a HCP or a scientific Urology association in the development. The search yielded 372 apps, of which 150 were specific for Urology. A fifth of all apps had no HCP involvement (20.7%) and only a third had been developed with a scientific Urology association (34.7%). The lowest percentage of HCP (13.4%) and urological association (1.9%) involvement was in apps designed for the general population. Furthermore, there was no contribution from an Urology society in "Electronic Medical Record" nor in "Patient Information" apps. A limitation of the study is that only Android and iOS apps were reviewed. Despite the increasing Mobile Health (mHealth) market, this is the first study that demonstrates the lack of expert participation in the design of Urology apps, particularly in apps designed for the general public. Until clear regulation is enforced, the urological community should help regulate app development. Maintaining a register of certified apps or issuing an official scientific seal of approval could improve overall app quality. We propose that urologists become stakeholders in mHealth, shaping future app design and promoting peer-review app validation.

  18. Prevalence of Trichomonas vaginalis by PCR in men attending a primary care urology clinic in South Korea.

    Seo, Jun-Hyeok; Yang, Hye-Won; Joo, So-Young; Song, Su-Min; Lee, Yu-Ran; Ryu, Jae-Sook; Yoo, Eun Sang; Lee, Won Kee; Kong, Hyun-Hee; Lee, Sang-Eun; Lee, Won-Ja; Goo, Youn-Kyoung; Chung, Dong-Il; Hong, Yeonchul


    Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.

  19. Cyanoacrylic tissue glues: Biochemical properties and their usage in urology

    Ayyıldız, Sema Nur; Ayyıldız, Ali


    Tissue adhesives are being used in medical and cosmetic industries and first aid for a long time. But their everyday usage has not been widespread. Only case report information is available about their usage. Despite good and meaningful results after they were used, there is lack of standard information that gives idea of about in which cases they could be helpful. Nowadays, cyanoacrylates are used in the surgery more frequently. In this review, we wanted to oversee the biochemical properties and the urological utilisation areas of cyanoacrylates. PMID:28270946

  20. Urological outcome after myelomeningocele: 20 years of follow-up

    Thorup, Jørgen Mogens; Biering-Sorensen, Fin; Cortes, Dina


    Study Type - Therapy (case series)¿Level of Evidence 4 OBJECTIVES: To evaluate the urological outcome in a long-term follow-up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood. MATERIAL AND METHODS: Individuals with myelomeningocele born....... In childhood and at follow-up, kidney function was estimated with renography and isotope-glomerular filtration rate examinations. RESULTS: In total, 52 individuals (28 boys and 24 girls) aged 19-41 years (median, 29 years) had follow-up. Of these, 37 (71%) individuals had bilateral normal kidney function...

  1. Ethics and contemporary urology practice: Setting out principles

    A Mohan


    Full Text Available Several situations of great ethical implications are encountered by physicians in daily urological practice. Informed consent for interventions, selection of patients for operative demonstrations and educational workshops, enrollment of patients in clinical trials, and the use of technology are some issues that call for stringent application of ethical principles in decision making. The issues of autonomy, privacy, rights, duties, and privileges that arise have to pass the tests prescribed by contemporary social mores and regulations. Some of the issues encountered, principles applicable, and covenants and documents that guide decision making are discussed.

  2. Multimedia search system for a textbook of urology in Japanese.

    Okada, Y; Yamashita, Y; Takahashi, T


    A search system for the textbook of urology has been developed and evaluated. The textbook is written in Japanese with 1.4 megabytes of text and has about 1000 pictures. The contents of the textbook can be seen with English or Japanese medical terms. The system contains a dictionary of Japanese medical terms. The dictionary has a network structure based on Japanese ideographic characters. Such a search system is useful for physicians because of its speed and the widely spread medical knowledge of many authors of the textbook.

  3. Diagnostic Development on NSTX

    A.L. Roquemore; D. Johnson; R. Kaita; et al


    Diagnostics are described which are currently installed or under active development for the newly commissioned NSTX device. The low aspect ratio (R/a less than or equal to 1.3) and low toroidal field (0.1-0.3T) used in this device dictate adaptations in many standard diagnostic techniques. Technical summaries of each diagnostic are given, and adaptations, where significant, are highlighted.

  4. Research Progress on Diagnostic Techniques of Foot-and-Mouth Disease%蹄疫诊断技术研究进展

    武刚; 王洪梅; 刘晓; 宋玲玲; 陈莉莉; 仲跻峰; 何洪彬


    口蹄疫是偶蹄动物的一种急性、热性、高度接触性传染病,可使世界范围内的畜牧业遭受严重的经济损失,及时准确的诊断是防制口蹄疫的重要环节.诊断口蹄疫的方法可分为临床诊断、生物学实验、血清学诊断、分子生物学检测技术及环介导等五类技术,每类技术中又包括数个具体技术.论文对其优缺点进行比较,并对口蹄疫诊断技术研究进行了展望.%Foot and mouth disease is an acute, febrile, highly contagious disease of Cloven-hoofed animals. It may cause the animal husbandry to suffer the serious economic loss in the worldwide scale. The prompt accurate diagnosis is important to fight against foot-and-mouth disease. There are several diagnosis methods of foot-and-mouth disease,such as: the clinical diagnosis, the biology experiment, the serological diagnosis, molecular biology techniques and five other Central-mediated technology. Each type of technology also includes several specific technologies. The advantages and disadvantages, as well as the methods were compared, and the development of foot and mouth disease diagnostic techniques was forecasted in this paper.

  5. 奶牛隐性乳房炎诊断技术研究进展%Research Progress on Diagnostic Techniques of Recessive Mastitis in Dairy Cows

    马金梅; 迟良; 邹明; 刘焕奇


    At the present time,the recessive mastitis has become one of the common diseases with high incidence in dairy cows,resulting in serious harm and great financial loss in dairy industry. Major diagnostic techniques and methods of the disease were compared and analyzed in this article,including cell count,PH-value test of milk,conductivity detection of milk,milk bacterial culture,PCR assay and MTT test,so as to provide guidance for better selection and further study of the diagnosis method for recessive mastitis.%目前,奶牛隐性乳房炎已成为奶牛常见的多发病,给奶牛养殖业带来了严重危害和巨大经济损失。本文对当前该病的主要诊断技术与方法,包括体细胞计数法、乳汁PH检验法、乳汁电导率检测法、乳汁细菌培养、PCR检测方法、MTT检测法等,进行了对比阐述,以期为选择和研究奶牛隐性乳房炎相关诊断方法提供借鉴。

  6. Applicability of quantitative optical imaging techniques for intraoperative perfusion diagnostics: a comparison of laser speckle contrast imaging, sidestream dark-field microscopy, and optical coherence tomography

    Jansen, Sanne M.; de Bruin, Daniel M.; Faber, Dirk J.; Dobbe, Iwan J. G. G.; Heeg, Erik; Milstein, Dan M. J.; Strackee, Simon D.; van Leeuwen, Ton G.


    Patient morbidity and mortality due to hemodynamic complications are a major problem in surgery. Optical techniques can image blood flow in real-time and high-resolution, thereby enabling perfusion monitoring intraoperatively. We tested the feasibility and validity of laser speckle contrast imaging (LSCI), optical coherence tomography (OCT), and sidestream dark-field microscopy (SDF) for perfusion diagnostics in a phantom model using whole blood. Microvessels with diameters of 50, 100, and 400 μm were constructed in a scattering phantom. Perfusion was simulated by pumping heparinized human whole blood at five velocities (0 to 20 mm/s). Vessel diameter and blood flow velocity were assessed with LSCI, OCT, and SDF. Quantification of vessel diameter was feasible with OCT and SDF. LSCI could only visualize the 400-μm vessel, perfusion units scaled nonlinearly with blood velocity. OCT could assess blood flow velocity in terms of inverse OCT speckle decorrelation time. SDF was not feasible to measure blood flow; however, for diluted blood the measurements were linear with the input velocity up to 1 mm/s. LSCI, OCT, and SDF were feasible to visualize blood flow. Validated blood flow velocity measurements intraoperatively in the desired parameter (mL·g-1) remain challenging.

  7. Applicability of quantitative optical imaging techniques for intraoperative perfusion diagnostics: a comparison of laser speckle contrast imaging, sidestream dark-field microscopy, and optical coherence tomography.

    Jansen, Sanne M; de Bruin, Daniel M; Faber, Dirk J; Dobbe, Iwan J G G; Heeg, Erik; Milstein, Dan M J; Strackee, Simon D; van Leeuwen, Ton G


    Patient morbidity and mortality due to hemodynamic complications are a major problem in surgery. Optical techniques can image blood flow in real-time and high-resolution, thereby enabling perfusion monitoring intraoperatively. We tested the feasibility and validity of laser speckle contrast imaging (LSCI), optical coherence tomography (OCT), and sidestream dark-field microscopy (SDF) for perfusion diagnostics in a phantom model using whole blood. Microvessels with diameters of 50, 100, and 400  μm were constructed in a scattering phantom. Perfusion was simulated by pumping heparinized human whole blood at five velocities (0 to 20  mm/s). Vessel diameter and blood flow velocity were assessed with LSCI, OCT, and SDF. Quantification of vessel diameter was feasible with OCT and SDF. LSCI could only visualize the 400-μm vessel, perfusion units scaled nonlinearly with blood velocity. OCT could assess blood flow velocity in terms of inverse OCT speckle decorrelation time. SDF was not feasible to measure blood flow; however, for diluted blood the measurements were linear with the input velocity up to 1  mm/s. LSCI, OCT, and SDF were feasible to visualize blood flow. Validated blood flow velocity measurements intraoperatively in the desired parameter (mL·min-1·g-1) remain challenging. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

  8. mHealth in urology : A review of experts' involvement in app development

    Pereira-Azevedo, N. (Nuno); Carrasquinho, E. (Eduardo); De Oliveira, E.C. (Eduardo Cardoso); Cavadas, V. (Vitor); Osório, L. (Luís); Fraga, A. (Avelino); Castelo-Branco, M. (Miguel); Roobol, M.J. (Monique J.)


    textabstractIntroduction: Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with

  9. Program for laparoscopic urological skills assessment: setting certification standards for residents

    Tjiam, I.M.; Schout, B.M.; Hendrikx, A.J.M.; Muijtjens, A.M.M.; Scherpbier, A.J.J.A.; Witjes, J.A.; Vleuten, C.P.M. van der


    AIM: There is growing pressure from the government and the public to define proficiency standards for surgical skills. Aim of this study was to estimate the reliability of the Program for Laparoscopic Urological Skills (PLUS) assessment and to set a certification standard for second-year urological

  10. [Establishment of university departments of urology in North Rhine-Westphalia: the Aachen model].

    Moll, F H; Halling, T; Rathert, P; Krischel, M; Fangerau, H


    The foundation of university departments of urology in postwar East and West Germany faced some opposition by some university professors of surgery who wanted to preserve the unity of their discipline. In North Rhine-Westphalia, heads of municipal hospitals or senior members of university hospitals' staff often received the first chaired professorships of urology.

  11. mHealth in urology : A review of experts' involvement in app development

    Pereira-Azevedo, N. (Nuno); Carrasquinho, E. (Eduardo); De Oliveira, E.C. (Eduardo Cardoso); Cavadas, V. (Vitor); Osório, L. (Luís); Fraga, A. (Avelino); Castelo-Branco, M. (Miguel); Roobol, M.J. (Monique J.)


    textabstractIntroduction: Smartphones are increasingly playing a role in healthcare and previous studies assessing medical applications (apps) have raised concerns about lack of expert involvement and low content accuracy. However, there are no such studies in Urology. We reviewed Urology apps with

  12. A prospective audit of emergency urology activity in a university teaching hospital


    Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period.

  13. Practical X-ray diagnostics orthopedics and trauma surgery. Indication, adjustment technique and radiation protection; Praktische Roentgendiagnostik Orthopaedie und Unfallchirurgie. Indikation, Einstelltechnik, Strahlenschutz

    Flechtenmacher, Johannes [Ortho-Zentrum am Ludwigsplatz, Karlsruhe (Germany); Sabo, Desiderius [Klinik St. Elisabeth, Heidelberg (Germany). Sportopaedic Heidelberg


    The book on X-ray diagnostics in orthopedics and trauma surgery includes the following chapters: 1. Introduction: radiation protection, equipment technology radiological diagnostics of skeleton carcinomas, specific aspects of trauma surgery, special aspects of skeleton radiology for children. 2. X-ray diagnostics of different anatomical regions: ankle joint, knee, hips and pelvis, hand and wrist joint, elbow, shoulder, spinal cord. 3. Appendix: radiation protection according to the X-ray regulations.

  14. Influence of social networks on congresses of urological societies and associations: Results of the 81th National Congress of the Spanish Urological Association.

    Gómez-Rivas, J; Rodríguez-Socarrás, M E; Tortolero-Blanco, L; Garcia-Sanz, M; Alvarez-Maestro, M; Ribal, M J; Cózar-Olmo, M


    To measure social network activity during the 81th National Congress of the Spanish Urological Association (AEU) and to compare it with the activity during other congresses of national and international urological associations. We designed and registered the official hashtag #AEU16 for the 81(th) National Congress of the AEU on the Symplur website. The following measurements were recorded: number of participants, number of tweets, tweets by participant, tweets per hour and views. The number of participants in the social network activity during the congress was 207. The measurements of activity in Twitter consisted of a total of 1866 tweets, a mean rate of 16 tweets/h, 9 tweets per participant and 1,511,142 views. The activity during the international congresses is as follows: 2016 American Urological Association annual congress (views: 28,052,558), 2016 European Association of Urology annual congress (views: 13,915,994), 2016 Urological Society of Australia and New Zealand (views: 4,757,453), 2015 Société Internationale d'Urologie annual congress (views: 1,023,038). The activity during the national congresses was recorded as follows: 2016 Annual Conference of The British Association of Urological Surgeons (views: 2,518,880), 81th National Congress of the AEU (views: 1,511,142), 109th Congress of l'Association Française d'Urologie (views: 662,828), 67th German Congress of Urology (views: 167,347). We found 10 posts in Facebook and 2 communications via Periscope TV related to #AEU16. The social network activity during the 81(th) National Congress of the AEU was notable given the results of this study. The use of social networks has expanded among urological associations, congresses and meetings, giving them a global character. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Artificial neural networks for decision-making in urologic oncology.

    Anagnostou, Theodore; Remzi, Mesut; Lykourinas, Michael; Djavan, Bob


    The authors are presenting a thorough introduction in Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. The article covers a description of Artificial Neural Network methodology and points out the differences of Artificial Intelligence to traditional statistic models in terms of serving patients and clinicians, in a different way than current statistical analysis. Since Artificial Intelligence is not yet fully understood by many practicing clinicians, the authors have reviewed a careful selection of articles in order to explore the clinical benefit of Artificial Intelligence applications in modern Urology questions and decision-making. The data are from real patients and reflect attempts to achieve more accurate diagnosis and prognosis, especially in prostate cancer that stands as a good example of difficult decision-making in everyday practice. Experience from current use of Artificial Intelligence is also being discussed, and the authors address future developments as well as potential problems such as medical record quality, precautions in using ANNs or resistance to system use, in an attempt to point out future demands and the need for common standards. The authors conclude that both methods should continue to be used in a complementary manner. ANNs still do not prove always better as to replace standard statistical analysis as the method of choice in interpreting medical data.

  16. Impact of sarcopenia in the management of urological cancer patients.

    Fukushima, Hiroshi; Koga, Fumitaka


    Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, develops as a consequence of the progression of cancer cachexia. Recent studies suggest that sarcopenia may be used as a biomarker in the management of patients with several cancers. Areas covered: In this article, the authors review 1) the methods to simply and optimally evaluate and define sarcopenia using computed tomography images in daily clinical practice and 2) the impact of sarcopenia in the management of urological cancers, specifically focusing on the usefulness in predicting treatment-related complications and prognosis. The authors also discuss the prognostic importance of changes in skeletal muscle mass in the course of treatment and the potential roles of nutritional support and exercise to prevent progression of sarcopenia. Expert commentary: Sarcopenia is associated with treatment-related complications and unfavorable prognosis in urological cancer patients. Nutritional support and exercise might be helpful in improving sarcopenia. The impact of these interventions on clinical outcomes would be elucidated by ongoing or future clinical studies.

  17. [Urologic emergencies: our difficult experience with care services].

    Belvis Esclapes, V M; Merenciano Cortina, F; Torrus Tendero, P; Mira Llinares, A


    Urological emergencies, except those occurring in children, seen in a General Hospital were studied for one year. The retrospective study, both descriptive and comparative, conducted has allowed to know that there had been 3,244 emergencies (4.2% of total cases) though the urologist acted only in 1,410 (43.4%). A predominance of males (76.10%) in their sixth and seventh decade (33% of total) was seen. Presentation increased slightly (2%) above average during the summer months. 80.9% came to the Emergency Ward of their own accord and 70% were discharged soon after assistance. Nephritic colic (19.08%), haematuria (14.04%) and U.T.I. (13.83%) were the most common causes for presentation. A total of 284 patients (20.14%) required hospitalization. 96.6% were given medical and/or instrumental treatment, versus 3.4% (49) who underwent surgery basically due to testicular disease (34.69%), sepsis (24.50%), traumatic injury of male genitalia (20.3%), etc. The most frequent conditions were analyzed by age, sex, and seasonal distribution. Also, an analysis was made on the concept of "Urological Emergency" to evaluate incidence and types in our environment.

  18. Training and outcome monitoring in robotic urologic surgery.

    Liberman, Daniel; Trinh, Quoc-Dien; Jeldres, Claudio; Valiquette, Luc; Zorn, Kevin C


    The use of robot-assisted laparoscopic technology is rapidly expanding, with applicability in numerous disciplines of surgery. Training to perform robot-assisted laparoscopic urological procedures requires a motivated learner, a motivated teacher or proctor, a curriculum with stepwise learning objectives, and regular access to a training robot. In light of the many constraints that limit surgical training, animal models should be utilized to quantifiably improve the surgical skills of residents and surgical fellows, before these skills are put into practice on patients. A system based on appropriate supervision, graduated responsibility, real-time feedback, and objective measure of progress has proven to be safe and effective. Surgical team education directed towards cohesion is perhaps the most important aspect of training. At present, there are very few published guidelines for the safe introduction of robotic urologic surgery at an institution. Increasing evidence demonstrates the effects of learning curve and surgical volume on oncological and functional outcomes in robotic surgery (RS). This necessitates the introduction of mechanisms and guidelines by which trainee surgeons can attain a sufficient level of skill, without compromising the safety of patients. Guidelines for outcome monitoring following RS should be developed, to ensure patient safety and sufficient baseline surgeon skill.

  19. The value of a core clinical rotation in urology for medical students.

    Patel, Premal; Nayak, Jasmir G; McGregor, Thomas B


    In 2013, our institution underwent a change to the undergraduate medical curriculum whereby a clinical urology rotation became mandatory. In this paper, we evaluated the perceived utility and value of this change in the core curriculum. Third year medical students, required to complete a mandatory 1-week clinical urology rotation, were asked to complete a survey before and after their rotation. Fourth year medical students, not required to complete this rotation, were also asked to complete a questionnaire. Chi-squared and Fisher's exact test were used for data analysis. In total, 108 third year students rotated through urology during the study period. Of these, 66 (61%) completed the pre-rotation survey and 54 (50%) completed the post-rotation survey. In total, there were 110 fourth year students. Of these, 44 (40%) completed the questionnaire. After completing their mandatory rotations, students felt more comfortable managing and investigating common urological problems, such as hematuria and renal colic. Students felt they had a better understanding of how to insert a Foley catheter and felt comfortable independently inserting a Foley catheter. Importantly, students felt they knew when to consult urology and were also more likely to consider a career in urology. Compared to fourth year students, third year students felt urology was an important component to a family medicine practice and felt they had a better understanding of when to consult urology. The introduction of a mandatory urology rotation for undergraduate medical students leads to a perceived improvement in fundamental urological knowledge and skill set of rotating students. This mandatory rotation provides a valuable experience that validates its inclusion.

  20. Survey on the perception of urology as a specialty by medical students

    Kim, Soojin; Farrokhyar, Forough; Braga, Luis H.


    Introduction: Upon inquiring with medical students and urologists across Canada, it is evident that urology is perceived as a male-dominant specialty, among other stereotypes. These misperceptions may hamper the recruitment of the best and brightest trainees. With that in mind, we surveyed medical students at our institution to obtain an objective assessment of their perception of urology and to determine the cause for misperceptions. Methods: A 25-factor, validated, anonymous, cross-sectional, self-reported, electronic survey was sent to all medical students at McMaster University to assess their perception of urology. The survey was piloted among students and educational leaders to optimize face and content validity, and minimize measurement bias. Six variables (years in training, role model, a family member or friend in urology, gender, and exposure) were selected a priori and entered into a logistic regression model to determine factors associated with a positive impression of the specialty. Results: The overall response rate was 70%. Of the respondents, 66% had no exposure to urology and 61% found the amount of exposure to be inadequate. Urology staff and resident involvement in education was considered to be poor by over 30% of medical students. Over 70% perceived urology to be a specialty with a great gender imbalance. On multivariate analysis, exposure to urology was the most important factor (purology exposure and poor staff and resident involvement in undergraduate education were seen as potential causes for misperceptions of the specialty. Increasing exposure to urology, encouraging female students, constant effort to approach senior students, and providing mentorship are found to be important factors in establishing a positive perception of urology PMID:27800058

  1. Validation of multiple diagnostic techniques to detect Cryptosporidium sp. and Giardia sp. in free-ranging western lowland gorillas (Gorilla gorilla gorilla) and observations on the prevalence of these protozoan infections in two populations in Gabon.

    van Zijll Langhout, Martine; Reed, Patricia; Fox, Mark


    Anthropozoonotic diseases threaten the survival of western lowland gorillas (Gorilla gorilla gorilla). Use of accurate diagnostic techniques in gorilla health monitoring contributes to the conservation of gorillas by providing robust information for appropriate management decisions. To identify suitable protozoa diagnostic techniques for wild gorillas, 95 fecal specimens were collected in Lopé National Park and east of Moukalaba-Doudou National Park in Gabon, areas with high and low levels of human activity, respectively. The samples were examined for Cryptosporidium sp. and Giardia sp. by using the following diagnostic techniques: a commercially available immunofluorescent antibody test kit, Merifluor, and a rapid immune-assay, ImmunoCard STAT!, to detect Cryptosporidium sp. and Giardia sp., and a modified Ziehl-Neelsen stain to detect Cryptosporidium sp. oocysts. The results obtained from the Merifluor test, considered the "gold standard" in human studies, were used to estimate the prevalence of Cryptosporidium sp. and Giardia sp. infections in Lopé National Park (19.0% and 22.6%, respectively) and east of Moukalaba-Doudou National Park (0% and 9.1%, respectively). The difference in prevalence in both areas may be associated with differing levels of anthropogenic disturbance. The sensitivity and specificity of the latter two diagnostic techniques were calculated by using the Merifluor test as a control. The ImmunoCard STAT! was found suitable for Giardia sp. antigen detection (specific but not sensitive) and inappropriate for Cryptosporidium sp. antigen detection (not specific or sensitive). The modified Ziehl-Neelsen stain was found to be highly specific but not sensitive in the detection of Cryptosporidium sp. oocysts. These results underline the necessity of using ancillary tests and concentration methods to correctly identify positive samples. This is the first report of Cryptosporidium sp. and Giardia sp. infections in free-ranging western lowland gorillas

  2. Plasma diagnostics for tokamaks and stellarators

    Stott, P. E.; Sanchez, J.


    A collection of papers on plasma diagnostics is presented. The papers show the state of the art developments in a series of techniques: Magnetic diagnostics, Edge diagnostics, Langmuir probes, Spectroscopy, Microwave and FIR diagnostics as well as Thomson Scattering. Special interest was focused on those diagnostics oriented to fluctuations measurements in the plasma. (Author) 451 refs.

  3. Taenia solium porcine cysticercosis in Madagascar: Comparison of immuno-diagnostic techniques and estimation of the prevalence in pork carcasses traded in Antananarivo city.

    Porphyre, V; Betson, M; Rabezanahary, H; Mboussou, Y; Zafindraibe, N J; Rasamoelina-Andriamanivo, H; Costard, S; Pfeiffer, D U; Michault, A


    Taenia solium cysticercosis was reported in official veterinary and medical statistics to be highly prevalent in pigs and humans in Madagascar, but few estimates are available for pigs. This study aimed to estimate the seroprevalence of porcine cysticercosis among pigs slaughtered in Antananarivo abattoirs. Firstly, the diagnostic performance of two antigen-ELISA techniques (B158B60 Ag-ELISA and HP10 Ag-ELISA) and an immunoblotting method were compared with meat inspection procedures on a sample of pigs suspected to be infected with (group 1; n=250) or free of (group 2; n=250) T. solium based on direct veterinary inspection in Madagascar. Sensitivity and specificity of the antigen ELISAs were then estimated using a Bayesian approach for detection of porcine cysticercosis in the absence of a gold standard. Then, a third set of pig sera (group 3, n=250) was randomly collected in Antananarivo slaughterhouses and tested to estimate the overall prevalence of T. solium contamination in pork meat traded in Antananarivo. The antigen ELISAs showed a high sensitivity (>84%), but the B158B60 Ag-ELISA appeared to be more specific than the HP10 Ag-ELISA (model 1: 95% vs 74%; model 2: 87% vs 71%). The overall prevalence of porcine cysticercosis in Antananarivo slaughterhouses was estimated at 2.3% (95% credibility interval [95%CrI]: 0.09-9.1%) to 2.6% (95%CrI: 0.1-10.3%) depending on the model and priors used. Since the sample used in this study is not representative of the national pig population, village-based surveys and longitudinal monitoring at slaughter are needed to better estimate the overall prevalence, geographical patterns and main risk factors for T. solium contamination, in order to improve control policies.

  4. Use of sting-response techniques for simulate diagnostics in human esophagus; Uso de tecnicas estimulo-respuesta para simular diagnosticos en esofago humano

    Rodriguez, I.; Gonzalez, Y.; Valdes, L.; Alfonso, J.A.; Estevez, E. [Facultad de Quimica Farmacia, Universidad Central de Las Villas (Cuba)


    In this work a study of simulation of the gamma graphic studies that are carried out in human esophagus in the Dept. of Nuclear Medicine of the 'Celestino Hernandez Robau Hospital of Santa Clara is presented. For the investigation tubular reactors were used and sting-response techniques with radioactive tracer of Technetium 99 metastable to a concentration of 1 mCi and several flows were applied. The distribution curves of residences times were obtained, those that respond to an equation of the type: Y = A + B exp (- exp((x-C)/D)) - ((x-C/D)+1). They were also carried out, optimizations studies of the doses of the radioactive to give to the patients from 1 mCi (that is the one used in studies) up to 0,5 mCi, and the influences on the obtained distributions of residence time were analyzed. It was confirmed the possibility to lower the doses with clear information of the signal. It was also carried out a simulation of the attenuation of the radiations that takes place in the patients by the interposition of tissues among the analyzed organ, and the detection equipment. It was used paraffin for tissue simulation. It was found the almost independence of the intensity of the radiations with the thickness, for the assayed doses. Lastly it was found a complex mathematical model that responds to the diagnostic curves obtained in these studies, being correlated the coefficients of the pattern with the most important physical parameters of the system, giving it a practical and useful value, all time that the error among the values that this it predicts and the experimental ones do not surpass of 5%. (Author)

  5. Rotorcraft Diagnostics

    Haste, Deepak; Azam, Mohammad; Ghoshal, Sudipto; Monte, James


    Health management (HM) in any engineering systems requires adequate understanding about the system s functioning; a sufficient amount of monitored data; the capability to extract, analyze, and collate information; and the capability to combine understanding and information for HM-related estimation and decision-making. Rotorcraft systems are, in general, highly complex. Obtaining adequate understanding about functioning of such systems is quite difficult, because of the proprietary (restricted access) nature of their designs and dynamic models. Development of an EIM (exact inverse map) solution for rotorcraft requires a process that can overcome the abovementioned difficulties and maximally utilize monitored information for HM facilitation via employing advanced analytic techniques. The goal was to develop a versatile HM solution for rotorcraft for facilitation of the Condition Based Maintenance Plus (CBM+) capabilities. The effort was geared towards developing analytic and reasoning techniques, and proving the ability to embed the required capabilities on a rotorcraft platform, paving the way for implementing the solution on an aircraft-level system for consolidation and reporting. The solution for rotorcraft can he used offboard or embedded directly onto a rotorcraft system. The envisioned solution utilizes available monitored and archived data for real-time fault detection and identification, failure precursor identification, and offline fault detection and diagnostics, health condition forecasting, optimal guided troubleshooting, and maintenance decision support. A variant of the onboard version is a self-contained hardware and software (HW+SW) package that can be embedded on rotorcraft systems. The HM solution comprises components that gather/ingest data and information, perform information/feature extraction, analyze information in conjunction with the dependency/diagnostic model of the target system, facilitate optimal guided troubleshooting, and offer

  6. Training for MIS in pediatric urology: proposition of a structured training curriculum.

    Escolino, Maria; Turrà, Francesco; Settimi, Alessandro; Esposito, Ciro


    In Europe there are a lot of training centers for minimally invasive surgery (MIS) but a standardized MIS training program in pediatric urology doesn't exist at the moment. We performed a literature review with the last goals to propose a structured training curriculum in MIS urology for pediatric surgeons. Pediatric urologists have to obtain a valid MIS training curriculum completing the following 4 steps: (I) Theoretical part (theoretical courses, masterclass) to acquire theoretical knowledge; (II) experimental training (simulation on pelvic trainer, virtual reality simulators, animal models, 3-D ex-vivo models) to acquire basic laparoscopic skills; (III) stages in European centers of reference for pediatric MIS urology to learn all surgery aspects; (IV) personal operative experience. At the end of the training period, the trainee would be expected to perform several MIS urological procedures independently, under supervision of an expert tutor. At the end of the training program, each center will analyze the candidate training booklet and release for each applicant a certification after an exam. We think that this MIS training program in pediatric urology may assure an integrated acquisition of basic and advanced laparoscopic skills during residency training in pediatric urology. Each European country should adopt this program so as to secure a standardized technical qualification in MIS urology for all future pediatric urologists.

  7. Laparoscopic skill laboratory in urological surgery: tools and methods for resident training

    Fabio C. M. Torricelli


    Full Text Available PURPOSE: Laparoscopy has certainly brought considerable benefits to patients, but laparoscopic surgery requires a set of skills different from open surgery, and learning in the operating room may increase surgical time, and even may be harmful to patients. Several training programs have been developed to decrease these potential prejudices. PURPOSES: to describe the laparoscopic training program for urological residents of the "Hospital das Clinicas" of the Sao Paulo Medical School, to report urological procedures that are feasible in dry and wet labs, and to perform a critical analysis of the cost-benefit relation of advanced laparoscopic skills laboratory. MATERIALS AND METHODS: The laparoscopic skill lab has two virtual simulators, three manual simulators, and four laparoscopic sets for study with a porcine model. The urology residents during their first year attend classes in the virtual and manual simulator and helps the senior urological resident in activities carried out with the laparoscopic sets. During the second year, the urological resident has six periods per week, each period lasting four hours, to perform laparoscopic procedures with a porcine model. Results: In a training program of ten weeks, one urological resident performs an average of 120 urological procedures. The most common procedures are total nephrectomy (30%, bladder suture (30%, partial nephrectomy (10%, pyeloplasty (10%, ureteral replacement or transuretero anastomosis (10%, and others like adrenalectomy, prostatectomy, and retroperitoneoscopy. These procedures are much quicker and caused less morbidity. CONCLUSION: Laparoscopic skills laboratory is a good method for achieving technical ability.

  8. Twitter Activity Associated With US News and World Report Reputation Scores for Urology Departments.

    Ciprut, Shannon; Curnyn, Caitlin; Davuluri, Meena; Sternberg, Kevan; Loeb, Stacy


    To analyze the association between US urology department Twitter presence and U.S. News and World Report (USNWR) reputation scores, to examine the content, informational value, and intended audience of these platforms, and to identify objectives for Twitter use. We identified Twitter accounts for urology departments scored in the 2016-2017 USNWR. Correlation coefficients were calculated between Twitter metrics (number of followers, following, tweets, and Klout influence scores) with USNWR reputation scores. We also performed a detailed content analysis of urology department tweets during a 6-month period to characterize the content. Finally, we distributed a survey to the urology department accounts via Twitter, inquiring who administers the content, and their objectives for Twitter use. Among 42 scored urology departments with Twitter accounts, the median number of followers, following, and tweets were 337, 193, and 115, respectively. All of these Twitter metrics had a statistically significant positive correlation with reputation scores (P reputation, and urologists are considered the most important target audience. There is statistically significant correlation between Twitter activity and USNWR reputation scores for urology departments. Our results suggest that Twitter provides a novel mechanism for urology departments to communicate about academic and educational topics, and social media engagement can enhance reputation. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Maintenance antimicrobials in high risk urologic pediatric patients.

    McCann, T M; Churchill, B M; Hardy, B E; Arbus, G S


    As an alternative to the practice of obtaining repeated laboratory cultures for patients at high risk of renal impairment from recurrent UTI, a program of bone monitoring using a mail-in culture dipspoon was started. A study involving 454 children with neurogenic bladder or other urologic abnormalities showed (1) that the incidence of UTI infection in patients for whom long term antimicrobial therapy had been prescribed was not significantly lower than that in patients who were not on antimicrobials and (2) that at least 50% of dipspoons inoculated due to presentation of UTI symptoms showed no or insignificant growth. These findings suggest that need for further assessment of the efficacy of long term prophylactic antimicrobials in preventing recurrent UTI and the advisability of obtaining a urine culture result before initiating treatment when symptoms are not severe.

  10. The economics of urologic practice in the twenty-first century.

    Holtgrewe, H L


    Our nation's health care has been undergoing an economic revolution. The practice of urology has not escaped. Speculation regarding the economics of urologic practice in the twenty-first century must be based on the continuation of policy trends begun over the last decade by government and managed care coupled with the impact of changes in the science of urology, shifting population demographics, and changing social factors. The hallmarks of the years ahead include increased physician accountability, expanded use of clinical care guidelines, continued relentless penetration of managed care, and reduced reimbursement for surgical services.

  11. A Study of Occupational Radiation Dosimetry During Fluoroscopically Guided Simulated Urological Surgery in the Lithotomy Position.

    Horsburgh, Ben A; Higgins, Mike


    To quantify through environmental audit the radiation dose that urologists receive during surgery in the lithotomy position, and to quantify the dose reduction achieved by altering exposure techniques and personal protective equipment use. Simulated surgery in the lithotomy position using an anthropomorphic phantom as a patient and a SimMan(®) mannequin as the surgeon. Pulsed fluoroscopy, focus-to-skin distance (FSD), collimation, and addition of a lead shield at the table end were individually and collectively introduced after a control study. Scattered X-ray dose rates to the simulated surgeon's eye, thyroid, trunk, external genitalia, and leg were measured with each of the technique adjustments. The absorbed dose in air at the phantom skin was measured throughout. Results were compared to discover surgeon dose rates with technique alteration. Increasing FSD leads to a rise in surgeon eye dose, and table end lead protection increases the patient skin dose. Use of all the dose-reduction techniques together reduces the dose to the patient, and a surgeon's trunk dose is decreased by 95%, external genitalia dose by 99%, and leg dose by 97%. Sitting to perform fluoroscopically guided surgery in the lithotomy position increases surgeon dose by a median value of 17%, with the external genitalia dose increased by 78% compared with the standing position. This study describes effective methods of dose reduction that are easy to instigate. The resulting reduction in radiation dose during urology procedures meets the requirements of international guidelines and legislation. This change in practice improves patient care and reduces risk to urologists from occupational exposure to radiation. By combining all of the dose-reduction techniques, urologists should never reach the threshold for deterministic radiation effects to their eyes during their career, and they will have a significantly lower chance of stochastic risks such as cancer.

  12. Laparoendoscopic single-site surgery (LESS) for major urological procedures in the pediatric population: A systematic review.

    Symeonidis, Evangelos N; Nasioudis, Dimitrios; Economopoulos, Konstantinos P


    Improvements in laparoscopic surgery have led to the introduction of laparoendoscopic single-site surgery (LESS) as an alternative to conventional laparoscopy conferring a number of possible advantages. In this review, we aim to elucidate the aspects of LESS for major urological procedures in the pediatric population. An in-depth search of the literature was performed in the databases of PubMed and Scopus, for studies investigating the technical aspects and clinical outcomes of partial nephrectomies, nephrectomies, nephroureterectomies, varicocelectomies and pyeloplasties in children. Data on parameters such as operation time, instrumentation, perioperative complications, hospital stay and follow up period were collected and further analyzed cumulatively. Twenty nine studies met the inclusion criteria incorporating 386 patients who underwent 401 procedures. There were no major intraoperative complications, with only 19 patients (4.73%) facing postoperative complications. No perioperative deaths were reported. In the hands of experienced surgeons LESS seems a feasible, efficient and less invasive alternative to standard laparoscopy in the field of pediatric urology. There is an eminent need of well-designed randomized controlled trials comparing the two techniques. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  13. Consultation on urological specimens from referred cancer patients using real-time digital microscopy: Optimizing the workflow

    Henrik Holten-Rossing


    Full Text Available Introduction: Centralization of cancer treatment entails a reassessment of the diagnostic tissue specimens. Packaging and shipment of glass slides from the local to the central pathology unit means that the standard procedure is time-consuming and that it is difficult to comply with governmental requirements. The aim was to evaluate whether real-time digital microscopy for urological cancer specimens during the primary diagnostic process can replace subsequent physical slide referral and reassessment without compromising diagnostic safety. Methods: From May to October 2014, tissue specimens from 130 patients with urological cancer received at Næstved Hospital′s Pathology Department, and expected to be referred for further treatment at cancer unit of a university hospital, were diagnosed using standard light microscopy. In the event of diagnostic uncertainty, the VisionTek digital microscope (Sakura Finetek was employed. The Pathology Department at Næstved Hospital was equipped with a digital microscope and three consultant pathologists were stationed at Rigshospitalet with workstations optimized for digital microscopy. Representative slides for each case were selected for consultation and live digital consultation took place over the telephone using remote access software. Time of start and finish for each case was logged. For the physically referred cases, time from arrival to sign-out was logged in the national pathology information system, and time spent on microscopy and reporting was noted manually. Diagnosis, number of involved biopsies, grade, and stage were compared between digital microscopy and conventional microscopy. Results: Complete data were available for all 130 cases. Standard procedure with referral of urological cancer specimens took a mean of 8 min 56 s for microscopy, reporting and sign-out per case. For live digital consultations, a mean of 18 min 37 s was spent on each consultation with 4 min 43 s for each case

  14. Diagnostics of Nanodusty Plasma

    Greiner, Franko; Groth, Sebastian; Tadsen, Bejamin; Piel, Alexander


    The diagnostic of nanodusty plasmas, i.e. plasmas including nano-sized dust particles, is a challenging task. For both, the diagnostic of the nanodusty plasma itself, and the in-situ diagnostic of the nanoparticles, no standard diagnostic exist. Nanodust particle size and density can be estimated using light scattering techniques, namely kinetic Mie ellipsometry and extinction measurements. The charge of the nanoparticles can be estimated from the analysis of dust density waves (DDW). Parameters like the electron density, which give information about the plasma itself, may be deduced from the DDW analysis. We present detailed investigations on nanodust in a reactive Argon-Acetylene plasma created in an rf-driven parallel plate reactor at low pressure using the above mentioned portfolio of diagnostic. Funded by DFG under contract SFB TR-24/A2.

  15. [Urology and National Socialism: the fate of Alexander von Lichtenberg 1880-1949].

    Moll, F H; Krischel, M; Rathert, P; Fangerau, H


    Alexander von Lichtenberg (1880-1949) was one of the famous members of the German Urological Society (DGU) in pre-war Germany. He introduced excretion urography and a special TURP Instrument. In 1928 he was president of the 8th meeting held in the German capital Berlin. His Handbook of Urology, released by Ferdinand Springer publishing house, was a trendsetter in establishing urology as a specialty in Germany and bringing together the whole wisdom of all aspects of urology. He was the founder of the famous Maximilian Nitze Award of the DGU. As a Jew he-like many others-was forced to leave Nazi Germany after 1933. Even in Hungary, his native country, he again had to resist anti-Semitic hostility. Later on he lived in Mexico. Alexander von Lichtenberg has to be remembered with special focus on the exodus of German Jewish scientists during the Nazi time.


    S. K. Yarovoy


    Full Text Available The article presents the results of a retrospective analysis of the provision of urological care 352 HIV-infected patients in the Urological City Clinical Hospital №47 of Moscow Health Department for the period 1996–2012. We estimated of income dynamics of HIV-infected patients in urological hospital, studied the distribution of these patients for urological nosology and stage of HIV infection. We noted the predominance of acute infectious and inflammatory diseases of the genitourinary system, that require immediate initiation of antibiotic therapy in the empirical mode, and in some cases, emergency surgery. We detected the predisposition to acute infectious and inflammatory diseases of the scrotum is a feature of HIV-infected patients.Article is supplemented with analysis of the effectiveness of the main pharmacological groups of antibacterial drugs for the treatment of nonspecific infectious and inflammatory diseases of the urogenital system in patients with HIV infection.

  17. International Society of Urological Pathology grading and other prognostic factors for renal neoplasia.

    Delahunt, Brett; Srigley, John R; Egevad, Lars; Montironi, Rodolfo


    The International Society of Urological Pathology convened an international consensus conference in 2012 to review aspects relating to the prognostic assessment, classification, and diagnosis of adult renal malignancy. The detailed recommendations of the conference are reported.

  18. [Dr. Puigvert and Archivos Españoles de Urología].

    Pérez Albacete, Mariano


    For the celebration of the first Century of Dr. Antonio Puigvert Gorro's birth we want to know his contribution to and relationship with Archivos Españoles de Urología. We review all articles published by Dr. Puigvert, and additionally all articles with reference to his person and his work; we also review his written works and biography. He was one of the founders of the journal and always maintained a great cooperation until the '70s; he published important works in it, which are analyzed. We also emphasize his contribution to Urology in addition to his dedication to the history of the speciality. Dr. Puigvert is one of the most distinguished figures in the Spanish Urology, with an immense working capacity and written works. In his works published in Archivos he presents the results of his observations and his studies, as well as part of his innovations, ideas, and discoveries, that he later left in his urology books.

  19. Knowledge about urology in the general population of Jeddah, Saudi Arabia

    Ghassan A Barayan


    Conclusion : Although significant proportion of our population know little about the field of urology, the overall result is better when compared to North American population. The clarity of Arabic terminology related to the field may explain the difference.

  20. The Role of Scarless Procedures in Urology: A Review of Literature

    urological literature, as a new surgical intervention to access ... to the retraction of organs, bleeding control, and handling of ... surgical trauma and to enhance cosmesis, a scarless ... reduced wound infection and postoperative pain. (6).

  1. [Development of the Stettin municipal hospital. The beginnings of urology in Stettin (1.)].

    Zajaczkowski, T; Wojewski-Zajaczkowski, E M


    The growth of the city's population, rapid advances in medical science, the increasing understanding of the importance of hygiene and, finally, the demand for health care led to the erection of a modern 353-bed municipal hospital complex at Pommerensdorf, Apfelallee, which was officially opened in 1879. From the very beginning of its existence, the municipal hospital was constantly in the process of extension and rebuilding. A hospital base was set up and new departments and clinics were opened. In 1937, the number of the hospital beds had increased to 1,004. The official existence of an independent urology department with 30 beds, first headed by Dr. Felix Hagen (1880-1962), dates back to March 1919. The aim of this new department was to carry out examinations and differential diagnoses, together with the department of internal medicine, for those patients from the urological surgery sector including evaluation for surgery. Surgical urology was the responsibility of the surgery department. The remaining cases requiring urological experience, such as those involving transurethral intervention, diseases of the bladder and urinary tract infection, were treated in the new urology department. As an auxiliary department, de facto dependent on the departments of surgery and internal medicine, urology could not develop properly and survive. In October 1935, the position of the head of the urological department was terminated, and urology was incorporated into the department of surgery. During the Second World War, between 1939 and 1945, as during the World War 1, a field hospital was set up in the municipal hospital at Pommerensdorf in Stettin.

  2. Prevalence and management status of urologic diseases in geriatric hospitals in South Korea: A field research

    Lee, Sang Heon; Suh, Jungyo; Kim, Hyung Suk; Lee, Young Ju; Lee, Sang Rim; Kim, Khae Hawn


    Purpose We aimed to investigate the current management status of urologic diseases in geriatric hospitals in South Korea. Materials and Methods Questionnaire surveys and in-depth person-to-person interviews were conducted at 13 hospitals within the Seoul and Incheon areas. Results The study was carried out from July to December 2014; 75.6% of patients (1,858/2,458) and 77.5% (779/1,031) of medical personnel responded to our survey. All surveys and interviews were performed by urology specialists, fellows, residents, or nurses. The hospitals included in the study had an average of 215.2 beds (range, 110–367), 189.1 patients (range, 90–345), and 40.2 nurses (range, 10–83). The average number of physicians was 6.2 (range, 3–11), but none of these were certified urologists. Only 4 hospitals provided consultation services for urological disorders. In total, 64% of patients had urological disorders, although only 20.7% of patients were receiving medication. Most patients were being treated using urological interventions; diapers (49.7%), indwelling catheters (19.5%), clean intermittent catheters (12.2%), and external collection urinary drainage (7.9%). However, most interventions were inadequately implemented, and only 17% of the patients had been examined by a certified urologist. Urological complications were found in 20.2% of patients, and secondary complications occurred in 18.8%. Excluding redundant cases, the total prevalence of urological complications was 39.0%. Conclusions Urologic diseases are poorly managed, and no certified urologists work in geriatric hospitals. Therefore, more designated urologists are needed in geriatric hospitals. PMID:28097271

  3. Long-term follow-up and late complications following treatment of pediatric urologic disorders.

    Akhavan, Ardavan; Stock, Jeffrey A


    Many pediatric urologic disorders have sequelae that may affect patients well into adulthood. Despite adequate treatment, many patients are at risk for progressive urologic deterioration years after surgical reconstruction. While many pediatric urologists follow their patients years after surgery, screening for late complications is a shared responsibility with primary care providers. This article discusses potential late complications and appropriate follow-up for patients who have a history of ureteral reimplantation, pyeloplasty, hypospadias repair, posterior urethral valve ablation, and intestinal interposition.

  4. Globalization in Urology: A Bibliographical Analysis of Cross-Continent Publication between 2002 and 2012.

    Mani, Jens; Juengel, Eva; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A


    Asian scientists have now increasingly begun to contribute to globalization; yet it is not clear whether publishing in the field of urology is paralleled by elevated cross-continental scientific publishing. An exemplary bibliometric analysis of urologic journals from 3 different continents was conducted between 2002 and 2012. Based on the ISI Web of Knowledge Journal Citation Reports, 2 urologic journals with similar impact factors (IFs) in 2013 were selected from Europe ('British Journal of Urology International', 'World Journal of Urology'), Asia ('International Journal of Urology', 'Asian Journal of Andrology') and North America ('Urologic Oncology-Seminars and Original Investigations', 'Urology'). The home continent of the journal, the workplace continental affiliation of the last author, article type (clinical, experimental or review) as well as the IF were documented. Most authors published their manuscripts in journals from the same continent in which they worked. However, a significant increase in cross-continental publishing was apparent from 2002 to 2012. Asians publishing in North America increased from 17% in 2002 to 35% in 2012. Europeans also increased the number of articles they published in North American journals, while publications from North American authors were shifted towards both European and Asian journals. Experimental and clinical articles showed significant increases in cross-continental publishing, while review publishing showed no significant change. The average IF for authors from all 3 continents increased from 2002 to 2012 (p < 0.001). The largest increase in the IF was found for Asian authors (0.11 per year). Cross-continental publication significantly increased during the period from 2002 to 2012. The impact that the Asian authors have experienced was found to be gradually impacting the North American and European colleagues. © 2015 S. Karger AG, Basel.

  5. [Referral criteria for benign prostatic hyperplasia in primary care.Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina General, Sociedad Española de Medicina de Familia y Comunitaria, Asociación Española de Urología].

    Castiñeiras Fernández, J; Cozar Olmo, J M; Fernández-Pro, A; Martín, J A; Brenes Bermúdez, F J; Naval Pulido, E; Molero, J M; Pérez Morales, D


    Benign prostatic hyperplasia (BPH) is a high prevalence condition in men over 50 years that requires continued assistance between primary care and urology. Therefore, consensus around common referral criteria was needed to guide and support both levels. Medical history, symptom assessment with International Prostate Symptom Score (IPSS) questionnaire, digital rectal examination and prostate-specific antigen (PSA) measurement are diagnostic tests available for general practitioners that allow setting a correct BPH diagnose. Patients with an IPSS1.5 ng/ ml combined treatment and evaluation at the first and sixth month is recommended. Some clear criteria for referral to urology are established in this document, which help in the management of these patients. Those patients with BPH who do not show any improvement at the third month of treatment with alpha-blockers, or the sixth month with 5alpha-reductase inhibitors, will be referred to urology. Patients will also be referred to urology if they have lower urinary tract symptoms, a pathological finding during rectal examination, IPSS>20, PSA>10 ng/ml or PSA>4 ng/ml and free PSA<20% or if they are <50 years with suspected BHP, or if they have any urological complication.

  6. A review of routinely collected data studies in urology: Methodological considerations, reporting quality, and future directions.

    Welk, Blayne; Kwong, Justin


    Studies using routinely collected data (RCD) are common in the urological literature; however, there are important considerations in the creation and review of RCD discoveries. A recent reporting guideline (REporting of studies Conducted using Observational Routinely-collected health Data, RECORD) was developed to improve the reporting of these studies. This narrative review examines important considerations for RCD studies. To assess the current level of reporting in the urological literature, we reviewed all the original research articles published in Journal of Urology and European Urology in 2014, and determined the proportion of the RECORD checklist items that were reported for RCD studies. There were 56 RCD studies identified among the 608 articles. When the RECORD items were considered applicable to the specific study, they were reported in 52.5% of cases. Studies most consistently (>80% of them) reported the names of the data sources, the study time frame, the extent to which the authors could access the database source, the patient selection, and discussed missing data. Few studies (RCD studies may serve to increase the quality of these studies in the urological literature. With increased technological integration in healthcare and the proliferation of electronic medical records, RCD will continue to be an important source for urological research.

  7. The Publication Ranking Score for pediatric urology: quantifying thought leadership within the subspecialty.

    Lloyd, Jessica C; Madden-Fuentes, Ramiro J; Nelson, Caleb P; Kokorowski, Paul J; Wiener, John S; Ross, Sherry S; Kutikov, Alexander; Routh, Jonathan C


    Clinical care parameters are frequently assessed by national ranking systems. However, these rankings do little to comment on institutions' academic contributions. The Publication Ranking Score (PRS) was developed to allow for objective comparisons of scientific thought-leadership at various pediatric urology institutions. Faculty lists were compiled for each of the US News & World Report (USNWR) top-50 pediatric urology hospitals. A list of all faculty publications (2006-2011) was then compiled, after adjusting for journal impact factor, and summed to derive a Publication Ranking Score (PRS). PRS rankings were then compared to the USNWR pediatric urology top-50 hospital list. A total of 1811 publications were indexed. PRS rankings resulted in a mean change in rank of 12 positions, compared to USNWR ranks. Of the top-10 USNWR hospitals, only 4 were ranked in the top-10 by the PRS. There was little correlation between the USNWR and PRS ranks for either top-10 (r = 0.42, p = 0.23) or top-50 (r = 0.48, p = 0.0004) hospitals. PRS institutional ranking differs significantly from the USNWR top-50 hospital list in pediatric urology. While not a replacement, we believe the PRS to be a useful adjunct to the USNWR rankings of pediatric urology hospitals. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. Urologic complication in laparoscopic radical hysterectomy: meta-analysis of 20 studies.

    Hwang, Jong Ha


    A meta-analysis was done to assess the risk of intraoperative and postoperative urologic complications, and laparoscopic radical hysterectomy (LRH) and lymph node dissection. Pubmed, EMBASE and Cochrane library were searched for studies published to December, 2011, supplemented by manual searches of relevant bibliographies from the retrieved articles. Two researchers independently extracted the data. Eligible studies had reported perioperative complications and a sample size of at least 10 patients. The search yielded 19 retrospective studies and one prospective cohort study (intraoperative urologic complication, 18 studies; postoperative urologic complication, 16 studies). When all studies were pooled, the odds ratio (OR) of LRH for the risk of intraoperative urologic complications compared to abdominal radical hysterectomy (ARH) was 1.97 [95% confidence interval (CI) 1.23-3.13] and the OR of LRH for postoperative complication risk compared to ARH was 1.35 [95% CI 0.84-2.16]. In subgroup analysis, obesity and laparoscopic type (laparoscopic assisted vaginal radical hysterectomy) were associated with intraoperative urologic complications. Laparoscopic radical hysterectomy is associated with a significant increased risk of intraoperative urologic complications. Copyright © 2012. Published by Elsevier Ltd.

  9. Sexual Activity and Urological Morbidities Among Nigerian Menopausal Women: Findings from a Community Based Survey

    Adedokun, BO; Morhason-Bello, IO; Okonkwo, SN; Ojengbede, OA


    Background: Menopause represents the end of women reproductive career and it is at this time they begin to manifest morbidities such as urinary incontinence. Aim: To document proximate determinants of sexual activity and urological morbidities of menopausal women. Subjects and Methods: This was a community survey conducted among 254 menopausal women Mokola in Ibadan, Nigeria in 2008. Respondents were selected using cluster sampling technique. Interviewer administered questionnaires were used to obtain information on their characteristics, pattern of urological and sexual activities. Descriptive, bivariate and multivariable tests were performed with Statistical Package for the Social Sciences 15.0 (Chicago, IL USA) and statistical significance was set at P value less than 0.05. Results: The mean age of subjects was 60.3 (standard deviation = 10.2 years). About 33.5% (85/254) was still sexually active. About 68% (173/254) reported a reduction in sexual frequency since menopause while 31.5% (80/254) reported no change. The mean self-rated sexual performance score was 4.3 based on a numerical scale where 10 is the maximum obtainable. Significant predictors of reduction in sexual activity were age at menopause and education. Those between 45 and 49 years were less likely than those at 55 years or more (odds ratio [OR] = 0.21; 95% confidence interval OR = 0.05-0.87) while women with at least secondary education were thrice less likely than those with none to report a reduction in sexual activity after menopause. Less than a tenth reported urinary incontinence as a complaint. Urge incontinence was the most commonly reported followed by dysuria and stress incontinence. Less than a quarter of them had requested for a form of treatment. Conclusion: Sexual performance of Nigerian menopausal women is associated with age at menopause and education. Non-fistulous urinary incontinence is now being mentioned as a complaint contrary to the widely held view that it is part of the

  10. Summary receiver operating characteristic curves as a technique for meta-analysis of the diagnostic performance of duplex ultrasonography in peripheral arterial disease

    deVries, SO; Hunink, MGM; Polak, JF


    Rationale and Objectives. We summarized and compared the diagnostic performance of duplex and color-guided duplex ultrasonography in the evaluation of peripheral arterial disease. We present our research as an example of the use of summary receiver operating characteristic (ROC) curves in a meta-ana

  11. [Robot-assisted surgery in visceral and thoracic surgery gynaecology, urology--importantanaesthetic considerations].

    Schütt, Torben; Carstens, Arne; Egberts, Jan-Hendrik; Naumann, Carsten Maik; Höcker, Jan


    Robot-assisted surgery, as a development of laparoscopic surgery, has an increasing field of application. Beside urology, this technique has also been implemented in visceral and thoracic surgery and gynaecology. For the surgeon an enhanced view of the surgical field and a better mobility of the instruments are the most important advantages. Thus, it is possible to work more accurate and prevent inadvertent tissue damage. For the anaesthesiologist several characteristics are of importance. Limited access to the patient as a result of a special positioning requires adequate anaesthetic preparation. For many visceral and thoracic surgical interventions the head and airway of the patient is bedded remote from the anaesthesiologist. Therefore, a standardised order and protection of all i. v.-lines, cables and the ventilation-hose of the (double-lumen) tube is essential. After the roboter is connected to the patient, it is nearly impossible to change or extend patient monitoring. Especially in case of emergency, e. g. respiratory complications or heart failure, a close communication with the surgeon and a team approach are indispensable.

  12. Advances in renal neoplasia: recommendations from the 2012 International Society of Urological Pathology Consensus Conference.

    Delahunt, Brett; Srigley, John R; Montironi, Rodolfo; Egevad, Lars


    The International Society of Urological Pathology (ISUP) 2012 Consensus Conference made recommendations regarding the classification, prognostic factors, staging, and immunohistochemical and molecular assessment of adult renal tumors. There was consensus that 5 entities should be recognized as novel tumors: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell papillary RCC, microphthalmia transcription factor-family translocation RCC [in particular t(6; 11) RCC], and hereditary leiomyomatosis RCC syndrome-associated RCC. In addition, 3 rare epithelial carcinomas were considered emerging or provisional entities: thyroid-like follicular RCC, succinate dehydrogenase B deficiency-associated RCC, and anaplastic lymphoma kinase translocation RCC. There were also a number of suggested modifications to existing World Health Organization 2004 categories, with the new classification to be known as the ISUP Vancouver Classification. Tumor morphotype, sarcomatoid/rhabdoid differentiation, and tumor necrosis were identified as significant prognostic parameters for RCC. The ISUP Grading System was accepted with grades 1-3 of clear cell and papillary RCC being based on nucleolar prominence, whereas extreme nuclear pleomorphism or sarcomatoid and/or rhabdoid differentiation defined grade 4 tumors. It was agreed that chromophobe RCC should not be graded. Consensus guidelines were formulated for specimen handling, and it was agreed that renal sinus invasion is present when tumor is in direct contact with fat or loose connective tissue of the sinus or if there is involvement of endothelial-lined spaces within the renal sinus, regardless of the size. The role of biomarkers in the diagnosis and assessment of prognosis of renal tumors was considered, and panels of immunohistochemical markers were identified for use in specific differential diagnostic scenarios.

  13. Research progress of laboratory diagnostic techniques for Brucella%布鲁杆菌实验室诊断技术研究进展



    tests play a major role in diagnosis when the bacteria cannot be detected by culture. The routine identification and differentiation of Brucellaspecies is a time-consuming and labor-intensive process which frequently places personnel at risk of laboratory-acquired infection and the bacteria from laboratory diffusion. In recent years the appeared new immunological methods and polymerase chain reaction has high sensitivity and specificity. The article reviews the laboratory diagnostic techniques and research progress of Brucella.

  14. Molecular diagnostic technique in the diagnosis of cardiovascular disease:application and challenge%分子诊断技术在心血管疾病诊疗中的应用与挑战

    黄山; 张春阳


    Application ofmolecular diagnostic technique has shown greatpotential and technical advantages in the diagnosis and treatment of cardiovascular disease ( CVD ) .It can be used toscreening , diagnosis , treatment and prognostic evaluation of CVD disease .Early screening helps to notice the risk of the disease, make us take appropriate measures to reduce the health care costs and improve outcomes .To achieve the highest diagnostic efficiency by applying different molecular diagnostic strategies in different diseases.In term of treatment, molecular diagnostic technologies are mainly used in the drug discovery , personalized drug therapy and treatment options; In addition, prognostic assessment of CVD is also an important development direction of molecular diagnostic technique .However, there are severe challenges remained in applying molecular diagnostic techniques in CVD disease , such as the basic andclinicalapplication research and the quality control , etc.%分子诊断技术在心血管疾病诊疗上的应用,已经显示了巨大的潜力和技术优势,可用于心血管疾病的筛查、诊断、治疗和预后评价。筛查有助于预告疾病风险、提早采取相应措施降低医疗成本和改善预后;对不同的疾病采用不同的分子诊断策略,可以达到最佳的诊断效能;分子诊断技术在治疗方面主要应用于新药研发、个性化药物治疗和治疗方案选择;对心血管疾病进行预后评估也是分子诊断技术的重要发展方向。分子诊断技术在心血管疾病的基础和临床应用研究、质量管理等方面,也存在着严峻的挑战。(中华检验医学杂志,2015,38:433-435)

  15. Critical appraisal of technical problems with robotic urological surgery.

    Nayyar, Rishi; Gupta, Narmada P


    To record the technical problems and complications associated with the use of da Vinci S robotic system (Intuitive Surgical, Sunnyvale, CA, USA) and to review previous reports. We analysed our records for all machine- or instrument-related errors during the course of 340 consecutive robot-assisted urological operations at our centre from July 2006 to March 2009, using one robotic machine. The cause of the error (machine or human), troubleshooting methods and consequences of the errors were evaluated. The overall device failure rate was 10.9% (37/340). The most frequent technical problems were related to robotic instruments (23/37). Other failures included colour/hue changes in the console image, intermittent double vision, fused illuminator bulb and problems with the master tool-manipulator device (hand-piece unit), patient cart circuitry, patient-side manipulator arm, closed-circuit camera unit or camera cable. Of 37 problems, 28 (76%) were surmountable during the course of surgery. The overall conversions to standard open/laparoscopic procedure attributable to mechanical failures of the robot were 0.6% (2/340). There were no complications or direct harm to the patient in any case. Most faults could be corrected or bypassed with some addition to operating room time. Despite an association of various types of new technical problems with robotic surgery, it provides a safe mode of minimally invasive surgery with very low conversion rates attributable to it, and no direct patient injury.

  16. [Oswald Schwarz: a pioneer in psychosomatic urology and sexual medicine].

    Berberich, H J; Schultheiss, D; Kieser, B


    Oswald Schwarz, a urologist from Vienna, was a scholar of Anton Ritter von Frisch and Hans Rubritius. As a physician during World War I, he was confronted with numerous bullet wounds to the spinal cord. In 1919, he completed his professorial thesis"Bladder dysfunction as a result of bullet wounds to the spinal cord". Oswald Schwarz was known as a committed surgeon. As an urologist he also treated patients with sexual dysfunction. Besides his practical and scientific urology-related work, he was also interested in psychology and philosophy. He held lectures on both subjects earning himself the nickname, the Urosoph. In the 1920s, Oswald Schwarz belonged to the inner circle of Alfred Adler, the founder of Individual Psychology, and was editor of the first psychosomatic textbook published in German, "Psychological origin and psychotherapy of physical symptoms" (1925). In addition, Schwarz wrote numerous articles and several books on sexual medicine. He also made many valuable contributions to the development of medical anthropology. Altogether, his work includes over 130 publications. Faced with the rise of fascism and National Socialism in Europe, Oswald Schwarz, who was of Jewish origin, emigrated to England in 1934. There he died in 1949. Unfortunately his scientific work has largely been forgotten. The aim of the following article is to remind us of his important contributions to the field.

  17. Digital engagement in nursing: a urology nurse's journey.

    Brocksom, Jane E

    The use of technology is transforming society-underpinning communication, information gathering and collaboration. Indeed, 2013 may prove to be the tipping point for healthcare delivery. No longer are policies and guidance documents being produced solely on the basis of cautions and negatives. We are entering a new era. Documents are now being produced that are constructive, focusing equally on positives and collaboration. Digital engagement within nursing and healthcare communities can be a tremendously positive experience; with the help of online resources, we can be part of the tipping point. From micro blogging to content communities, from collaborative projects to social networking, Web2.0 technology is providing 21st-century practitioners with opportunities we have not yet fully realised the potential of-for ourselves, our patients or our institutions. In this article, I share my personal journey, aiming to show my fellow healthcare practitioners how these technologies might be used to inform and improve nursing practice, within urology and beyond.

  18. [Molecular diagnostics and imaging].

    Fink, Christian; Fisseler-Eckhoff, Annette; Huss, Ralf; Nestle, Ursula


    Molecular diagnostic methods and biological imaging techniques can make a major contribution to tailoring patients' treatment needs with regard to medical, ethical and pharmaco-economic aspects. Modern diagnostic methods are already being used to help identify different sub-groups of patients with thoracic tumours who are most likely to benefit significantly from a particular type of treatment. This contribution looks at the most recent developments that have been made in the field of thoracic tumour diagnosis and analyses the pros and cons of new molecular and other imaging techniques in day-to-day clinical practice.

  19. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.

    Barry, M J; Fowler, F J; O'Leary, M P; Bruskewitz, R C; Holtgrewe, H L; Mebust, W K; Cockett, A T


    A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach's alpha = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects' global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p < 0.001). The AUA symptom index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols.

  20. The Timed Up and Go Test as a Measure of Frailty in Urologic Practice.

    Pangilinan, Jayce; Quanstrom, Kathryn; Bridge, Mark; Walter, Louise C; Finlayson, Emily; Suskind, Anne M


    To evaluate the prevalence of frailty, a known predictor of poor outcomes, among patients presenting to an academic nononcologic urology practice and to examine whether frailty differs among patients who did and did not undergo urologic surgery. The Timed Up and Go Test (TUGT), a parsimonious measure of frailty, was administered to patients ages ≥65. The TUGT, demographic data, urologic diagnoses, and procedural history were abstracted from the medical record into a prospective database. TUGT times were categorized as nonfrail (≤10 seconds), prefrail (11-14 seconds), and frail (≥15 seconds). These times were evaluated across age and urologic diagnoses and compared between patients who did and did not undergo urologic surgery using chi-square and t tests. The TUGT was recorded for 78.9% of patient visits from December 2015 to May 2016. For 1089 patients, average age was 73.3 ± 6.3 years; average TUGT time was 11.6 ± 6.0 seconds; 30.0% were categorized as prefrail and 15.2% as frail. TUGT times increased with age, with 56.9% of patients age 86 and over categorized as frail. Times varied across diagnoses (highest average TUGT was 14.3 ± 11.9 seconds for patients with urinary tract infections); however, no difference existed between patients who did and did not undergo surgery (P = .94). Among our population, prefrailty and frailty were common, TUGT times increased with age and varied by urologic diagnosis, but did not differ between patients who did and did not undergo urologic surgery, presenting an opportunity to consider frailty in preoperative surgical decision making. Copyright © 2017 Elsevier Inc. All rights reserved.