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The aim of this manuscript was to provide a systematic literature review of clinical trial evidence for a range of electrical stimulation therapies in the treatment of lower urinary tract symptoms (LUTS). The databases MEDLINE, BIOSIS Previews, Inside Conferences, and EMBASE were searched. Original clinical studies with greater than 15 subjects were included. Seventy-three studies were included, representing implanted sacral nerve stimulation (SNS), percutaneous posterior tibial nerve stimulation (PTNS), and transcutaneous electrical stimulation (TENS) therapy modalities. Median mean reductions in incontinence episodes and voiding frequency were similar for implanted SNS and PTNS. However, long-term follow-up data to validate the sustained benefit of PTNS are lacking. Despite a substantial body of research devoted to SNS validation, it is not possible to definitively define the appropriate role of this therapy owing largely to study design flaws that inhibited rigorous intention to treat analyses for the majority of these studies.

A highly stereoselective Saucy–Marbet rearrangement using chiral ynamides and propargyl alcohols is described here. This rearrangement can be catalyzed by para-nitrobenzenesulfonic acid and leads to high diastereoselectivities for a range of different chiral propargyl alcohols and ynamides in a stereochemically intriguing matched, mismatched or indifferent manner. The stereoselective Saucy–Marbet rearrangement of ynamides provides an excellent entry to highly substituted chiral homo allenyl alcohols.

Aims: The urethral retro-resistance pressure (URP) is a retrograde urethral pressure pro¢le measured by a new urodynamic measurement system. 1 URP is the pressure required to achieve and maintain an open sphincter. This clinical investigation focused on a comparison of URP to standard urodynamic measurements and an examination of their relationship to incontinence severity. Methods: Twenty-two centers enrolled 258 stress incontinent women in a randomized, crossover study of two groups: (1) test procedure followed by multichannel urodynamics, (2) multichannel urodynamics followed by test procedure. We de¢ned incontinence severity categories using 24 hr urine loss and assessed these categories using incontinence quality of life (I-QOL), urinary incontinence severity score (UISS), incontinence visual analogue score (VAS), URP, maximum urethral closure pressure (MUCP), and leak point pressure (LPP). Results: The mean age was 56.2 (� 12) years. No order eiect was present. The correlation coe⁄cient between URP and MUCP was 0.31 (95% CI 0.19 ^1, P < 0.0001); between URP and LPP was 0.28 (95% CI 0.12^1, P ¼ 0.003); and between MUCP and LPP was 0.14 (95% CI � 0.04 ^1, P ¼ 0.101). The mean values for URP across symptom severity categories were signi¢cantly diierent (P ¼ 0.028) and decreased with increasing severity. The mean values for MUCP and LPP did not decrease with increasing severity. Conclusions: The study demonstrated that URP had a consistent relationship with incontinence severity. The data suggested that URP is a physiological measure of urethral function and may have clinical utility as a diagnostic tool. Future outcomes-based research is necessary to establish the predictive value of URP, MUCP, and LPP measurements in terms of incontinence cure rates and diagnosis of sphincter dysfunction. Neurourol.Urodynam.23:109 ^114,2004. 2004 Wiley-Liss, Inc.

Teleoperation requires a complex combination of the operator's cognitive, perceptual, and motor skills. Our experiment tested the ability of subjects to teleoperate a remote robot under different conditions of increasing sensory feedback. We also evaluated each operator's spatial perception skills using a battery of tests to understand the effect of spatial perception on the operator's ability to perform the teleoperation task. The experiment showed that the spatial ability of an operator—as reflected by a test battery of two spatial recognition and two spatial manipulation tests—was significantly correlated with the ability to teleoperate the robot through a maze. Surprisingly, providing different combinations of visual, auditory, and vibrotactile feedback to the operator did not significantly change performance. However, there was an interaction between spatial ability and feedback condition that affected teleoperation performance.

Two epoxidations of chiral allenamides are described here. While treatment with m-CPBA led to highly stereoselective formation of an alpha-keto aminal that can be useful synthetically, DMDO oxidation led to conclusive evidence for both nitrogen-substituted allene oxide (via mono-epoxidation) and spiro-epoxide (via bis-epoxidation) using intramolecular nucleophilic trapping experiments. NMR studies provide reliable evidence for a 3-oxetanone that can be derived from the spiro-epoxide and also suggest the presence of an allene oxide. Despite a facile second epoxidation as evidenced by the predominant formation of the 3-oxetanone, in the presence of furan, [4 + 3] cycloaddition of the nitrogen-substituted allene oxide or oxyallyl cation with furan occurs faster than the second epoxidation efficiently leading to cycloadducts. This rate difference plays an invaluable role for the success of a stereoselective sequential epoxidation-[4 + 3] cycloaddition reaction via DMDO epoxidations of chiral allenamides.