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Fernandez-Fernandez, J, Moreno-Perez, V, Cools, A, Nakamura, FY, Teixeira, AS, Ellenbecker, T, Johansson, F, and Sanz-Rivas, D. The effects of a compensatory training program adding an isoinertial device in the shoulder function on young tennis players. J Strength Cond Res37(5): 1096–1103, 2023—The aim of this study was to analyze whether a compensatory training program, including isoinertial flywheel training, could reduce shoulder imbalances in a group of asymptomatic young tennis players. After an initial evaluation, 26 young tennis players were assigned to either a supervised flywheel training group (FTG, n= 13) or a control group (CG, n= 13). Shoulder passive internal (IR) and external rotation (ER) range of motion (ROM) as well as shoulder IR and ER maximal isometric strength were measured before and after a 12-week training intervention, performed 3 times per week. After the intervention, results showed significant changes for IR (p< 0.001, effect size [ES] = 1.83) and ER (p< 0.001, ES = 1.77) on the dominant (D) side, and IR on the nondominant (ND) side (p< 0.001, ES = 2.24) in the FTG compared with the CG. Regarding the ROM values, results showed that the FTG achieved significantly greater increases for the IR ROM (p< 0.001, ES = 3.32) and total ROM (TROM) (p= 0.004, ES = 1.39) on the D and ND sides (IR ROM: p= 0.002, ES = 1.53; TROM: p< 0.001, ES = 2.35) than the CG. Moreover, the CG displayed larger decrements in ER ROM (p= 0.016, ES = 1.12) on the ND side after the training period than the FTG. The conducted compensatory training program was effective to increase the ER strength and IR mobility of the FTG players, which led to a reduction in the glenohumeral imbalances.

Background: Tennis is one of the most popular sports among youths. At elite levels, a notable increase in injury incidence and a temporary decline in performance may occur when children progress through puberty. However, limited research has explored maturity-associated variations in clinical measurements suggested as predictors of injury and tennis performance in elite youth players. Therefore, the main purpose of this study was to analyze the association between chronological age and maturity status on several measures of neuromuscular capability and physical performance as well as bilateral (interlimb) asymmetries in elite youth tennis players.Hypothesis: Youth tennis players around peak height velocity (PHV) will show higher growth-related impairments or deficits in measures of neuromuscular capability and physical performance than their less (pre-PHV) and more (post-PHV) mature counterparts irrespective of sex.Level of Evidence: Level 4.Methods: A total of 68 male (age, 13.7 ± 1.1 years; height, 162.4 ± 9.4 cm; body mass, 51.4 ± 10.3 kg [Mean values ± SD]) and 60 female (age, 13.6 ± 1.1 years; height, 162.8 ± 7.2 cm; body mass, 52.7 ± 7.5 kg [Mean values ± SD]) elite youth tennis players from 2 different age groups (under 13 [U13] and under 15 [U15]) and maturity status (pre-PHV, around PHV, and post-PHV), were tested during national training camps. Tests included the Y Balance Test, isometric hip abduction and adduction strength, hip ranges of motion (ROMs), and countermovement jump (CMJ) height. Bayesian analysis was used to establish any significant between-group differences.Results: Only dynamic balance (in boys; Bayesian factor [BF10] = 88.2) and jump height (in both boys and girls; BF10>100) were significatively associated with chronological age, whereby the U15 group showed lower Y Balance Test reach distances (−6%; standardized effect size δ = 0.62) but higher CMJ height scores (+18%; δ = 0.73) than the U13 group. Although boys jump higher (+11%; δ = 0.62) and were stronger in isometric hip adduction strength (+14%; δ = 0.92) than girls, the latter had greater hip internal ROM values (+15%; δ = 0.75). Furthermore, relevant maturity-associated effects (BF10= 34.6) were solely observed for the CMJ test in boys, with the most mature players demonstrating higher jump height scores (+12%; δ = 0.93). Finally, a significant percentage (>25%) of tennis players, independent of sex, demonstrated bilateral asymmetries in hip ROM, hip strength, and jump height values.Conclusion: The findings of this study show that in U13 and U15 male and female tennis players, there were neither positive nor negative maturity-associated variations in the clinical measurements analyzed (with the exception of jump height in male players). The high proportion of tennis players showing bilateral asymmetries in dynamic balance, hip ROM, and strength and jump performance highlight the need of future studies to analyze these factors in relation to unilateral tennis-specific adaptations in the musculoskeletal and sensorimotor systems.Clinical Relevance: These results may help to better understand how different clinical measurements are associated with the process of growth and maturation in elite youth tennis players and may aid in the design of specific training interventions during these stages of development.

Fernandez-Fernandez, J, Loturco, I, Pereira, LA, Del Coso, J, Areces, F, Gallo-Salazar, C, and Sanz-Rivas, D. Change of direction performance in young tennis players: a comparative study between sexes and age-categories. J Strength Cond Res36(5): 1426–1430, 2022—The aim of this study was to examine the differences in linear sprint, change of direction (COD) performance, and COD deficit in a large sample of under-13 (U13) and under-15 (U15) male and female tennis players. One hundred and twenty-eight junior tennis players grouped into 2 age-groups (U13 years [32 boys and 28 girls] and U15 [36 boys and 32 girls]) participated in this study. Tests included anthropometric measurements, sprints (5-, 10- and 20-m), and a modified version of the 505 COD test. The differences in performance between age-categories and sex were assessed via an independent t-test. The differences in the physical tests between U13 and U15 players were tested using a univariate analysis, with age and anthropometric variables as covariates. Effect sizes (ESs) were calculated for pairwise comparisons. Results showed that boys presented lower 20-m sprint times than girls in the U13 (ES: 0.54; p< 0.05), and lower linear sprint (5–20-m) and COD times than girls in the U15 category (ES varying from 0.67 to 1.60; p< 0.05). Comparing age-groups, U15 girls demonstrated a higher COD deficit than the U13 (p< 0.05), whereas no differences were found in the other variables. In boys, no significant differences were observed in any variable when comparing both categories. These results could be of great interest for coaches and researchers involved in the development and training of elite tennis players, suggesting the need to include strategies able to improve sprint and COD performance throughout the players' specialization process.

The field of microrobotics has emerged as a promising area of research with significant applications in biomedicine, both in vitro and in vivo, such as targeted cargo delivery, microsurgery, and cellular manipulation. Microrobots actuated with multiple modalities have the potential for greater adaptability, robustness, and capability to perform various tasks. Modular units that can reconfigure into various shapes, create structures that may be difficult to fabricate as one whole unit, and be assembled on-site, could provide more versatility by assembly and disassembly of units on demand. Such multi-modal modular microrobots have the potential to address challenging applications. Here, we present a biocompatible cylindrical microrobot with a dome-shaped cavity. The microrobot is actuated by both magnetic and acoustic fields and forms modular microstructures of various shapes. We demonstrate the use of these microrobots for cellular manipulation by creating patterns on a surface.

ABSTRACTThis study analysed and compared the physical and technical demands of professional wheelchair tennis (WT) on different surfaces (clay [C], hard [H] and grass [G] courts). A total of 6,720 shots from thirteen matches played by the best ten professional WT players was analysed. Physical demands (e.g., working time, resting time, shots per point …) and technical and tactical parameters (e.g., serve, effectivity, winner stroke, shots with two bounces …) were recorded and analysed. Most physical parameters (points, shots, duration) differed according to the surface (H > C > G). Point length and shot per point were longer on H, and lower on C and G surfaces (p < 0.001). Differences in technical performance were found mainly between C and G courts, with a high use of volleys on G but fewer winners (p < 0.01). The main finding indicates that the physical and technical demands facing professional WT players differed by surface, showing that the H surface involves a higher external load than the other surfaces. Coaches can use this information to adapt their players’ style depending on the playing surface as well as to design specific training drills according to the surface of play.

Bubbles are known to influence energy and mass transfer in gas-evolving electrodes. However, we lack a detailed understanding on the intricate dependencies between bubble evolution processes and electrochemical phenomena. This review discusses our current knowledge on the effects of bubbles on electrochemical systems with the aim to identify opportunities and motivate future research in this area. We first provide a base background on the physics of bubble evolution as it relates to electrochemical processes. Then we outline how bubbles affect energy efficiency of electrode processes, detailing the bubble-induced impacts on activation, ohmic, and concentration overpotentials. Lastly, we describe different strategies to mitigate losses and how to exploit bubbles to enhance electrochemical reactions.

Micro‐sized magnetic particles (also known as microrobots [MRs]) have recently been shown to have potential applications for numerous biomedical applications like drug delivery, microengineering, and single cell manipulation. Interdisciplinary studies have demonstrated the ability of these tiny particles to actuate under the action of a controlled magnetic field that not only drive MRs in a desired trajectory but also precisely deliver therapeutic payload to the target site. Additionally, optimal concentrations of therapeutic molecules can also be delivered to the desired site which is cost‐effective and safe especially in scenarios where drug dose‐related side effects are a concern. In this study, MRs are used to deliver anticancer drugs (doxorubicin) to cancer cells and subsequent cell death is evaluated in different cell lines (liver, prostate, and ovarian cancer cells). Cytocompatibility studies show that MRs are well‐tolerated and internalized by cancer cells. Doxorubicin (DOX) is chemically conjugated with MRs (DOX‐MRs) and magnetically steered toward cancer cells using the magnetic controller. Time‐lapsed video shows that cells shrink and eventually die when MRs are internalized by cells. Taken together, this study confirms that microrobots are promising couriers for targeted delivery of therapeutic biomolecules for cancer therapy and other non‐invasive procedures that require precise control. A simple strategy to prepare doxurubicin‐loaded microrobots (DOX‐MRs) that are self‐propelled in presence of an external magnetic field. These microrobots are carboxylic group‐functionalized paramagnetic beads that allow covalent conjugation of DOX on its outer surface. Microrobots are ingested by cancer cells after DOX‐MRs treatment, where DOX is cleaved, and released by proteolytic enzyme activity.

ABSTRACTTo analyse the influence of age and skill level on tennis serve performance, 99 male participants took part in a study of maximum effort serves to a target (50 x 50 cm) in the add service box. Participants were divided into two skill level groups (elite and recreational) and three age groups (under 12 years old [U12], under 16 years old [U16] and +18). During testing, kinematic data were recorded and serving performance (accuracy and speed) was measured. A single-way analysis of variance (ANOVA) was used to analyse the differences for kinematic and performance variables between the six groups. Correlation analysis was performed to establish the relationships between kinematics variables and serve performance. Results highlighted the influence of both age and skill level on performance (speed and accuracy), as well as on kinematics (hand, arm, hip peak velocities) of the tennis serve. The spatial position of the hand in respect to the hip in the moments previous to ball impact in the medio-lateral, and the vertical axes was significantly correlated with serving performance in all the age groups. These results suggested that an increased range of motion of shoulder external rotation and wrist flexion, as well as higher velocities of shoulder internal rotation and elbow extension should be developed to increase tennis serve speed.

A compact snapshot of the current convergence of novel developments relevant to chemical engineering is given. Process intensification concepts are analysed through the lens of microfluidics and sonochemistry. Economical drivers and their influence on scientific activities are mentioned, including innovation opportunities towards deployment into society. We focus on the control of cavitation as a means to improve the energy efficiency of sonochemical reactors, as well as in the solids handling with ultrasound; both are considered the most difficult hurdles for its adoption in a practical and industrial sense. Particular examples for microfluidic clogging prevention, numbering-up and scaling-up strategies are given. To conclude, an outlook of possible new directions of this active and promising combination of technologies is hinted.

The objective of this article is to analyse the influence of the use of the bounce on the differences between the winner and the loser of a set during a tournament in wheelchair tennis (WT). A total of 16 international matches were recorded and analysed. The type of stroke and the number of bounces before hitting the ball were also studied. The results showed that WT players usually hit the ball after the first bounce (80.95%) and 97.19% of returns are hit after the first bounce. The second bounce is significantly used by the winners of the set. Furthermore, the use of the second bounce by WT players reduces the number of errors and increases the number of winners when compared with hitting the ball off the first bounce. [ABSTRACT FROM AUTHOR]

This study attempted to measure the capacity of wheelchair tennis players to accelerate and change directions, as well as investigate the differences with regard to the level of the athlete, either using the racket or not using the racket, when moving. 9 international players participated in this study. We measured the time they took to cover 5, 10 and 20 metres and the time to make an agility test (T court test), with and without a racket. The results showed that the use of the racket negatively impacts the movement ability of the players. Higher level players seem to make specific displacement movements more efficiently with or without the racket, as compared to lower lever players. Results of our findings, apart from being reference values for trainers, inform about the use of the racket for specific mobility in the physical training of WT players. [ABSTRACT FROM AUTHOR]

The aim of the present study was to analyse the differences in match statistics between conventional tennis (CT) and wheelchair tennis (WT) on different surfaces by gender. Data from 220 sets (127 sets of CT and 93 of WT) from three of the 2014 Grand Slams (Australian Open (AO), Roland Garros (RG), and US Open (UO)) were analysed. The variables related to match, serve, and return were studied in relation to the modality of the match (CT or WT) and type of surface (AO, RG, or UO). Data were collected from the official website of each tournament. A univariate (Mann Whitney U) analysis of data was done to analyse the differences between modalities and types of surface. The results showed that CT players had better serve performances than WT players. However, WT players had better performances in the return than CT players. The values between CT and WT for female players were more similar than male players. Regarding court surface, players of CT had more differences in game statistics than WT for both genders. These values could be used as a reference for peak performance players’ practices and competitions as well as to aid in the understanding of the differences between modalities.

Objectives:To evaluate the long–term efficacy of sacral nerve stimulation for refractory urinary urge incontinence. Study Design and Methods:Urge incontinent patients qualified for surgical implantation of a neurostimulator system after trial screening with percutaneous test stimulation. Surgical implantation of the InterStim System (Medtronic Inc., Minneapolis, Minn., USA) was performed in cases where a >50% reduction in incontinence symptoms was documented during the 3– to 7–day test stimulation period. The InterStim System consists of an implantable pulse generator, a transforamenally placed quadripolar lead, and an extension that connects these two devices for unilateral stimulation of the S3 or S4 sacral nerve. Efficacy for 96 implanted patients was based on urinary symptom changes as quantified in voiding diaries collected at baseline and annually after surgical implantation. Results:As compared to baseline, the group of 96 implanted patients demonstrated significant reductions in urge incontinent symptoms at an average of 30.8±14.8 (range 12–60) months with respect to the number of urge incontinent episodes per day, severity of leaking, and the number of absorbent pads/diapers replaced per day due to incontinence (all p<0.0001, respectively). Gender, pretreatment variables, and age were not found to be relevant factors that affected these results. 11 of the 96 patients underwent device explant due to lack of efficacy, pain or bowel dysfunction. These data were conservatively included in the efficacy results. No permanent injuries associated with the devices or therapy were reported. Conclusion:Sacral nerve stimulation is an effective treatment for refractory urge incontinence with sustained long–term benefit through an average of 30.8 months.

The aim of this study was to analyze the activity patterns of wheelchair tennis matches. 16 male singles tennis matches were played. Eight internationally ranked players were recorded and subsequently analyzed according to the following variables: total playing time, effective playing time, resting time (both in absolute values and as a percentage of total time). The average rally duration and the number of shots per rally were also recorded. The results showed a mean (SD) of match length of 61.70 (14.33) minutes, a effective playing time of 20.07 (3.67) %, a work:rest time ratio of 1:4.12 and an average duration of point of 6.93 (5.16) seconds. Most of the points end in 3 or less shots. No significant differences were found in rally duration and shots per rally with regards to non-breakpoint opportunities and breakpoint opportunities (p>0.05). Knowledge of the activity patterns within competition helps with specific training for the sport.

The purpose of this study was to determine the differences between winning and losing a wheelchair tennis match in the 2012 Paralympic Games. Data from 67 sets of 32 matches played by 32 female players in the 2012 Paralympic Games were analysed. The variables were grouped into four groups: variables related to the serve, to the return, to winners and errors, and variables related to net points. Univariate (Wilcoxon test) and multivariate (discriminant) analyses of data were carried out to discriminate the result of the set (win or loss). The variables that best predict the result of the set are break points won and points won on the first serve. The results showed that the winning player is a more aggressive server and serve returner, achieves more winning shots than her opponent, and commits fewer errors during the match. The paper discusses the differences between conventional tennis and wheelchair tennis and the application of the results.

The aim of this study was to analyse existing testing procedures and to establish initial recommendations and guidelines based on a survey which compared and analysed the testing procedures applied in the world leading tennis nations. [ABSTRACT FROM AUTHOR]

THE AIM OF THIS REVIEW IS TO PROVIDE A BRIEF INSIGHT AND UNDERSTANDING OF THE PHYSICAL AND PHYSIOLOGICAL DEMANDS OF COMPETITIVE TENNIS MATCH PLAY. IT ALSO PROVIDES USEFUL INFORMATION THAT MAY HELP STRENGTH AND CONDITIONING COACHES TO IMPLEMENT EFFECTIVE TRAINING PROTOCOLS TO IMPROVE ON-COURT TENNIS PERFORMANCE.

Copyright of Coaching & Sport Science Review (Spanish Version) is the property of International Tennis Federation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a case study pertaining to the train bombings in Madrid, Spain on March 11, 2004. The first bomb explosion occurred in a train stopped at Atocha station, a minute later, another two explosions rocked the same train. Moments after, two trains in El Pozo and Santa Eugenia also exploded. A total of 10 explosions killed 191 people and injured more than 1500. A Salafist terrorist cell is believed to be behind the bombings.

The article discusses Linux operating system-equipped cellular phones from Symbian Ltd., a group of telecommunications and consumer electronics companies. There are four user interface frameworks available for Symbian phones, which include Series 60 (S60), Series 80 (S80), User Interface Quartz (UIQ), and Multimedia Object and Application (MOAP) model. S60 is a product developed and licensed by Nokia. While S80 is an enterprise-oriented product also available on Nokia phones. UIQ is developed and licensed by UIQ Technology of Sweden. And MOAP is a framework available from NTT DoCoMo Inc. for phones connected to its network.

AbstractObjective: Resiniferatoxin (RTX) is an analogue of capsaicin with more than 1,000 times its potency in desensitizing C-fiber bladder afferent neurons. This study investigated the safety and efficacy of intravesical RTX in patients with refractory detrusor hyperreflexia (DH).Methods: Thirty-six (22 males, 14 females) neurologically impaired patients (20 spinal cord injury, 7 multiple sclerosis, 9 other neurologic diseases) with urodynamically verified DH and intractable urinary symptoms despite previous anticholinergic drug use were treated prospectively with intravesical RTX using dose escalation in a double-blind fashion at 4 centers. Patients received a single instillation of 100 ml of placebo (n = 8 patients) or 0.005, 0.025, 0.05 , 0.10 , 0.2, 0.5, or 1.0 fLM of RTX (n = 4 each group). A visual analog pain scale (VAPS) (0-10; 10 = highest level of pain) was used to quantify discomfort of application. Treatment effect was monitored using a bladder diary and cystometric bladder capacity at weeks 1, 3, 6, and 1 2 posttreatment.Results: Mean VAPS scores revealed minimal to mild discomfort with values of 2.85 and 2.28 for the 0.5-j-LM and 1.0-j-LM RTX treatment groups, respectively. Due to the small sample size, there were no statistically significant changes in mean cystometric capacity (MCC) or incontinence episodes in each treatment dose group. However, at 3 weeks, MCC increased by 53% and 48% for the 0.5-j-μM and 1.0-j-μM RTX treatment groups, respectively. Patients in the 0.5-j-μM and 1.0-j-μM groups with MCC < 300 ml at baseline showed greater improvements in MCC at 120.5% and 48%, respectively. In some patients, MCC increased up to 500% over baseline, despite a low RTX dose. Incontinence episodes decreased by 51.9% and 52.7% for the 0.5-j-LM and 1.0-j-LM RTX treatment groups, respectively. There were no long-term complications.Conclusion: Intravesical RTX administration, in general, is a well-tolerated new therapy for DH. This patient group was refractory to all previous oral pharmacologic therapy, yet some patients responded with significant improvement in bladder capacity and continence function shortly after RTX administration. Patients at risk for autonomic dysreflexia require careful monitoring during RTX therapy.

Review article.

Neuromodulation of sacral nerves has shown promising results in correcting voiding dysfunction. We report the results of a multicenter trial designed to assess the efficacy of sacral nerve neuromodulation in patients presenting with refractory urinary urgency-frequency.

We present the experience of the North American UroLume Multicenter Study Group with removal of the UroLume ‡‡American Medical Systems, Minnetonka, Minnesota.endoprosthesis.

In a prospective randomized multicenter trial we compared the treatment results of conventional external sphincterotomy with those of UroLume [section] sphincteric stent prosthesis placement in men with spinal cord injury and external detrusor-sphincter dyssynergia.

We determine the long-term efficacy and safety of the UroLume stent as minimally invasive treatment for external detrusor-sphincter dyssynergia in spinal cord injured men.

The purpose of these experiments was to determine whether experimental spinal trauma would result in urological dysfunction similar to that seen clinically and whether recovery of normal micturition can be correlated with motor functional recovery. A standard rat model of spinal impact trauma was employed. Neurologic evaluation included a modified 7 point hindlimb Tarlov scale applied weekly for 4 weeks after injury. Micturition measurement was accomplished by placing the animal in a metabolic cage for 24-hour periods and collecting urine on an electronic scale connected to Lotus Measure data acquisition software. All assessments were performed in a blinded fashion. Animals were categorized as normal control (N = 10), sham injured (N = 11), spinal cord injury (SCI) without (N = 11) and with locomotor recovery (N = 11).

Our purpose was to determine if intact perianal (S4–5) pin sensation (PPS) and bulbocavernosus (S2–4) reflex (BCR) shortly after spinal cord injury (SCI) are predictive of bladder function recovery. Twenty-eight SCI patients (aged 18–68 years, Frankel Classification A–D, spinal injury level C4–T12), admitted within 72 hours of injury, underwent evaluation of initial PPS and BCR. The presence of intact PPS and BCR were correlated with the patient's voiding function and urodynamic evaluation results 1 year postinjury. Of the 28 patients within 72 hours of SCI, PPS was intact in 17 (60%) and absent in 11 (40%), while 15 patients (54%) demonstrated a positive BCR and 13 (46%) did not. One year after SCI, no patient with absent PPS voided unassisted, while of the 17 patients with preserved PPS, 11 (65%) were voiding spontaneously. Of these 11 patients, urodynamic evaluation revealed detrusor areflexia in 1 (9%), normal detrusor function in 2 (18%), and detrusor hyperreflexia in 8 (73%), with 3 of these 8 patients (38%) also demonstrating detrusor-sphincter dyssynergia. At 1 year postinjury, only 2 of 13 patients (15%) with an absent BCR voided spontaneously, while 9 of 15 patients (60%) with an intact BCR were able to void. Although PPS and BCR are moderately sensitive in predicting the return of spontaneous voiding, they cannot predict detrusor hyperreflexia and sphincter dyssynergia. Therefore, urodynamic study remains an essential component of initial urologic evaluation after SCI. Neurourol. Urodynam. 17:25–29, 1998. © 1998 Wiley-Liss, Inc.

To investigate the effect of rectus urethromyoplasty on vesicourethral anastomosis healing during radical retropubic prostatectomy (RRP) and in an animal model.

We investigated the effectiveness and associated complications of treatment with an endoluminal urethral sphincter prosthesis in 153 spinal cord injury men (mean age 36 years, range 16 to 74 years) with urodynamically diagnosed detrusor-external sphincter dyssynergia. These patients were prospectively treated with a urethral sphincter stent at 15 centers in North America. Followup ranged from 2 to 33 months. Voiding pressures averaged 76 ± 28, 42 ± 21, 44 ± 38, 35 ± 18 and 32 ± 20cm. water, respectively, before prosthesis insertion in 153 patients, and at 3 months in 123, 6 months in 114, 12 months in 98 and 24 months in 22. A significant decrease in voiding pressure was noted in the 22 patients at 24 months compared with matched preoperative data (80 ± 25cm. water, p = 0.03). The residual urine decreased from 181 ± 154ml. before insertion to 82 ± 93ml. at 24 months (p = 0.01). Maximum cystometric capacity remained constant, with a mean of 195 ± 158ml. before insertion to 248 ± 122ml. at 24 months (p = 0.17). No significant differences were apparent after 24 months of followup in any of the urodynamic parameters between 44 patients with and 109 without previous external sphincterotomy.

PurposeTo determine the acute effect of intravesical capsaicin on bladder mucosal integrity in normal and spinal cord injured (SCI) rats.Materials and MethodsIntravesical reagents were instilled in 5 groups of age and weight matched female rats: 1) control+normal saline solution (NSS), 2) control+ethanol (EtOH), 3) control+capsaicin/EtOH, 4) SCI+NSS, 5) SCI+capsaicin/EtOH. Intravesical instillations were performed 4 weeks after a standard T10 SCI. Intravesical capsaicin (1 mM.) was dissolved in 30% EtOH/NSS. The animals (n = 3 each group) were sacrificed at 30 minutes, 24 hours, 72 hours, and 7 days after intravesical instillation. Whole bladders were harvested, fixed in 10% buffered formalin, and paraffin embedded. Tissue blocks were blind coded and sectioned (5 micro m. thickness) for histopathological analysis. All sections were initially stained with hematoxylin and eosin (H & E). Specific staining for mucin carbohydrate moieties included periodic acid-Schiff (PAS) and alcian blue. Also, immunohistochemical staining for GP51 (a urinary glycoprotein) was performed.ResultsControl and SCI rats exhibited similar bladder mucosal histology by H & E and mucin specific stains. Instillation of saline demonstrated no effect on bladder histology, whereas instillation of intravesical capsaicin induced a profound acute effect of thinning of the epithelium, submucosal edema, and diminished presence of GP51. EtOH produced similar pathological findings, but to a lesser degree than capsaicin. Intravesical capsaicin demonstrated a similar effect in both control and SCI animals. The peak effect was seen after 30 minutes and continued for 24 hours. Partial recovery was noted after 72 hours and complete recovery was evident by 1 week.ConclusionsThe control and SCI rats demonstrated a histologically similar mucosa and glycosaminoglycan layer. The effect of saline instillation on the mucosa was negligible. Intravesical capsaicin dissolved in 30% ethanol/NSS had a profound effect on the bladder urothelium submucosa that was more pronounced than that seen with the ethanol vehicle alone in normal animals.

PurposeWe determine the relationship between lower urinary function and somatic neurological status after thoracolumbar fracture.Materials and MethodsWithin 72 hours of thoracolumbar vertebral fracture we evaluated 44 consecutive patients, including 30 men and 14 women 17 to 84 years old (mean age 38.7), with occult neurogenic bladder dysfunction following incomplete thoracolumbar spinal injuries (American Spinal Injury Association impairment classifications C to E). The neurological level and degree of injury were established, and testing for perianal pinprick sensation and bulbocavernosus reflex was done. Video urodynamic evaluation was then performed between 3 and 14 days after injury but before spinal surgery.ResultsUrodynamics revealed neurogenic lower urinary tract dysfunction in all 10 patients with classification C, 82% with D and 41% with E (otherwise completely intact neurologically) impairment. Although pinprick sensation deficiency and decreased bulbocavernous reflex correlated with injury classification, lower urinary tract dysfunction was present in 62% of the patients with intact pinprick sensation and in 59% with intact bulbocavernous reflex.ConclusionsNeurologically intact patients with thoracolumbar spinal injuries may have neurogenic lower urinary tract dysfunction on urodynamics. Pinprick sensation and bulbocavernosus reflex are specific but not sensitive indicators of lower urinary tract dysfunction after spinal cord injury. Although these indicators, which demonstrate somatic nerve function, were absent in all patients with detrusor areflexia, intact pinprick sensation and bulbocavernosus reflex are not sensitive for predicting lower urinary tract function, which depends on autonomic nerve function. Urodynamic evaluation is mandatory for the complete evaluation of patients with incomplete lumbosacral spinal injuries.

PurposeWe determine whether inguinal cystoceles, a type of extraperitoneal herniation of the bladder, are responsible for symptoms consistent with prostatism in men without bladder outlet obstruction.Materials and MethodsFrom January 1996 to February 1997 inguinal cystoceles were treated with surgical repair of the floor of the inguinal canal in 8 men with a relatively long history of symptoms consistent with prostatism. The diagnosis of inguinal cystoceles was based on the filling phase of video urodynamic studies done with the patient standing. The clinical outcome of surgery was assessed using the International Prostate Symptom Score and urodynamic findings.ResultsAll inguinal cystoceles studied were physically occult but clearly detected as wide-mouthed, mild protrusions of the bladder wall in the inguinal region on cystograms obtained with the patient standing. Although clear cystoceles were present on radiography on the right side in 1 case, the left side in 2 and bilaterally in 5, apparent bilateral weakness in Hesselbach's triangle was noted in all at surgery. High detrusor opening pressure and a relatively long opening time were regarded as urodynamic parameters characteristics of this condition. These parameters and subjective symptoms dramatically improved after bilateral surgical repair of the floor of the inguinal canal.ConclusionsInguinal cystoceles negatively affect voiding dynamics by increasing opening pressure and opening time, indicating that they should be considered in the differential diagnosis of men with symptoms consistent with prostatism. Video urodynamics is mandatory to detect this condition, which to our knowledge has been previously overlooked on radiography and urodynamics.

AbstractThe purpose of this study was to compare the effect on urodynamic parameters of anticholinergic and musculotropic agents in sham injured and spinal cord injured (SC I) rats. A standard rat SCI model induced by impact trauma was employed. Cystometrograms were performed under urethane anesthesia four weeks after SCI. Bladder capacity and voiding pressure were determined at the point of micturition monitored urodynamically and visually. The effect of oxybutynin chloride (0.01 - 0.1 mg/kg), propantheline bromide (0.05 - 0.5 mg/kg) and flavoxate hydrochloride (0.1 - 1.0 mg/kg) were assessed independently in sham injured and SCI rats (n = 1 0 in each group). Bladder capacities were 0.6± 0.2 and 7.1± 1.6 ml in sham and SCI rats (p <0.01 ), respectively. Maximal filling pressure was 17.5±5 mmHg in sham and 25±5 mmHg in SCI rats (p <0.05). Bladder capacity increased with all three medications. Administration of oxybutynin, propantheline and flavoxate in sham rats resulted in bladder capacities of 0.88±0.3, 0.71±0.3 and 0.8± 0.2 ml, respectively (p <0.01 ). In SCI rats, these drugs resulted in bladder capacities of 9.8± 1.1, 7.9± 1.3 and 8.8±2.0 ml , respectively (p <0.01 ). No significant change in maximum filling pressure occurred. We conclude that anticholinergic and musculotropic agents caused a similar increase in bladder capacity in both sham and SCI rats. Oxybutynin enhanced bladder capacity more than propantheline or flavoxate. (J Spinal Cord Med1997; 20:31-35)

There were 62 patients referred to our institution for evaluation of upper urinary tract filling defects. These patients had undergone any of several diagnostic evaluations, including computerized tomography, B-mode ultrasound scanning and urinary cytology studies with or without upper tract brush biopsy. In all cases a conclusive diagnosis could not be formulated.

The imaging accuracy of a catheter-based endo-luminal ultrasound system was compared to traditional imaging techniques for surgical treatment of urethral diverticula in 7 women and 1 man. At surgical repair the urethra was catheterized directly with a 6.2F or 9F (12.5 or 20 MHz.) catheter-based ultrasound transducer, generating a 360-degree transaxial real-time image. The endo-luminal ultrasound images were compared with preoperative voiding cystourethrography (7 patients), transvaginal ultrasound examinations (3) and double balloon urethrograms (2). Surgical diverticulectomy was then done with endo-luminal ultrasound monitoring.

To determine whether the differential expression of bladder smooth muscle isoactin can be used as a molecular marker for the development of interstitial cystitis (IC).

It's the pits: Increased efficiency and controllability of sonochemical reactions was achieved with silicon surfaces on which pits were micromachined to entrap gas, which, upon ultrasonic excitation, emits a stream of microbubbles (see picture). The microbubbles are chemically active at ultrasonic amplitudes well below those necessary for sonochemical activity in conventional reactors.

Chemaly: Gilead: Research Funding; Gilead: Other: Personal fees; Chimerix: Research Funding; ReViral: Other: Personal fees; Oxford Immunotec: Other: Personal fees; Ansun: Other: Personal fees; Chimerix: Other: Personal fees; Oxford Immunotec: Research Funding; Merck: Research Funding; Ansun Pharmaceuticals: Research Funding; Janssen: Other: Personal fees; ADMA Biologics: Other: Personal fees; Merck: Other: Personal fees; Clinigen: Other: Personal fees; Ablynx: Other: Personal fees. Boeckh:Chimerix: Research Funding; GSK: Other: Personal fees; Merck: Research Funding; GSK: Research Funding; Clinigen: Other: Personal fees; Merck: Other: Personal fees. Weber:Janssen Pharmaceuticals: Employment; Johnson & Johnson: Equity Ownership. Fleischhackl:Johnson & Johnson: Equity Ownership; Janssen Pharmaceuticals: Employment. Stevens:Johnson & Johnson: Equity Ownership; Janssen Pharmaceuticals: Employment. Michiels:Johnson & Johnson: Equity Ownership; Janssen Pharmaceuticals: Employment. Rivas:Janssen Pharmaceuticals: Employment; Johnson & Johnson: Equity Ownership. Chien:Johnson & Johnson: Equity Ownership; Janssen Pharmaceuticals: Employment. Witek:Johnson & Johnson: Equity Ownership; Janssen Pharmaceuticals: Employment.