Lower urinary tract symptoms due to benign prostatic hyperplasia in men increase with aging. Risks related to anesthesia and surgery have led a search for alternative treatments. Bipolar ...radiofrequency (RF) thermotherapy is one of the methods adopted in patients with high surgical risks. The aim of this study is to compare the effect of bipolar RF thermotherapy and transurethral resection of the prostate (TURP) methods on voiding symptoms and on post-operative complication rates especially in patients carrying high surgical risks.
Pre-operative, post-operative 1
and 6
month International Prostate Symptom Score (IPSS), Qmax, quality of life, prostate volumes, and postoperative complications of the patients underwent TURP and RF for benign prostatic hyperplasia (BPH) were compared.
In the RF group, the pre-operative median IPSS was 30, prostate volume 41.5 cc, post-void residual (PVR) 80 ml, and Qmax is 5.85 ml/s.; In the TURP group, these were 29, 40 cc, 85 ml, and 5.3 ml/sec, respectively. In the Bipolar RF group, post-operative 1
- and 6
-month median values were IPSS 18, 21; prostate volume 40, 40; PVR 40, 35; Qmax 10.9, 9.15 and in the TURP group IPSS 9, 8; prostate volume 20, 20; PVR 30, 10; Qmax 17.25, 19.1, respectively.
Bipolar RF thermotherapy is an applicable treatment method for BPH patients with high surgical risks.
The COVID-19-induced effects of primary bladder cancer (BC) patients have not yet been clarified. The aim of this study was to investigate the effects of the pandemic on the diagnosis, treatment, and ...follow-up of primary BC patients.
A retrospective single-center analysis was made of all patients who underwent diagnostic and surgical procedures due to primary BC between November 2018 and July 2021. A total of 275 patients were identified and allocated to one of the groups: Pre-COVIDBC (BC diagnosed before the COVID-19 pandemic) or COVIDBC (during the pandemic).
The BC patients diagnosed during the pandemic were mostly at higher stages (T2) (p = 0.04), the risk of non-muscle invasive BC (NMIBC) was higher (p = 0.02), and recurrence and progression scores were increased (p = 0.001) compared to patients diagnosed before the pandemic. The time to surgery from diagnosis (p = 0.001) and symptom duration (p = 0.04) were significantly prolonged during the pandemic and the rate of follow-up significantly decreased (p = 0.03).
The study results highlight the significant increase in muscle invasive BC and the very high risk of NMIBC in patients presenting during the COVID-19 pandemic.
Future detection of extensive air showers (EAS) produced by ultra high energy cosmic particles by means of space-based fluorescence telescopes will open a new window on the universe and allow cosmic ...ray and neutrino astronomy at a level that is virtually impossible for ground based detectors. In the context of the extreme universe space observatory (EUSO) project, an end-to-end simulation of EAS observation with a spatial detector has been designed (EUSO simulation and analysis framework, ESAF). This paper describes the detailed Monte-Carlo developed to simulate all the physical processes involved in the fluorescence detection technique, from the EAS development to the instrument response. Particular emphasis is given to modeling the light propagation in the atmosphere and the effect of clouds. The simulation is used to assess the performances of EAS spatial detection. Main results on energy threshold and resolution, direction resolution and
X
max determination are reported. Results are based on EUSO telescope design, but are also extended to larger and more sensitive detectors.
The new setup of the CODALEMA experiment installed at the Radio Observatory in Nançay, France, is described. It includes broadband active dipole antennas and an extended and upgraded particle ...detector array. The latter gives access to the air shower energy, allowing us to compute the efficiency of the radio array as a function of energy. We also observe a large asymmetry in counting rates between showers coming from the North and the South in spite of the symmetry of the detector. The observed asymmetry can be interpreted as a signature of the geomagnetic origin of the air shower radio emission. A simple linear dependence of the electric field with respect to
v
∧
B is used which reproduces the angular dependencies of the number of radio events and their electric polarity.
Being able to ignite or reignite a gas turbine engine in a cold and rarefied atmosphere is a critical issue for many manufacturers. From a fundamental point of view, the ignition of the first burner ...and the flame propagation from one burner to another are phenomena that are usually not studied. The present work is a large eddy simulation (LES) of these phenomena. To simulate a complete ignition sequence in an annular chamber, LES has been applied to the full 360° geometry, including 18 burners. This geometry corresponds to a real gas turbine chamber. Massively parallel computing (700 processors on a Cray XT3 machine) was essential to perform such a large calculation. Results show that liquid fuel injection has a strong influence on the ignition times. Moreover, the rate of flame progress from burner to burner is much higher than the turbulent flame speed due to a major effect of thermal expansion. This flame speed is also strongly modified by the main burner aerodynamics due to the swirled injection. Finally, the variability of the combustor sectors and quadrant ignition times is highlighted.
Male anterior urethral strictures can be treated successfully with the help of optical internal urethrotomy (OIU) and is usually performed under general or regional anesthesia. In this study, we ...determined the efficacy of intraurethral lidocaine in OIU for anterior urethral stricture in an outpatient setting.
A total 157 patients with anterior urethral strictures underwent OIU under local urethral anesthesia with lidocaine. Optical urethrotomy was performed with a cold-cutting knife. Visual analogue scale (VAS) was used to evaluate patient discomfort and pain levels.
Using local anesthesia with lidocaine 2%, internal urethrotomy under vision was successfully completed in 151 of 157 patients. The overall success rate 96.1%. A total of 125 patients experienced mild, 26 patients moderate and 6 patients severe pain. The procedure was not completed in six patients because of severe pain. These patients went on OIU under general anesthesia. 18 (11.4%) recurrent strictures were seen during at least 6 months of follow-up.
Topical intraurethral lidocaine is a simple and efficacious anesthesia technique for surgical procedures on the anterior urethra. It is a safe, cost-effective and a well tolerated procedure. OIU under topical anesthesia can be easily performed and satisfactorily completed in an outpatient setting. It is anesthetic efficacy and reasonable success rate when compared with the other anesthetic techniques may provide an alternative approach in the management of urethral strictures.
In this paper, a pressure-based semi-implicit algorithm for compressible flows is described. This type of solver is of great interest in combustion devices where the flow speed is small but where the ...unsteady heat release can be coupled to the acoustic modes and lead to instabilities. The fractional-step method used in this algorithm is based on a characteristic splitting, which clearly separates the acoustics from the advection. This splitting allows to use adapted numerics for these different time-scales. The algorithm is second-order in space and time for linear acoustics and for low-Mach advection without iterating the time-step. Moreover, when kinetic-energy conserving schemes are used for the predictor step, the algorithm discretely conserves the kinetic energy in the low-Mach limit. All these properties are illustrated on simple test cases and the algorithm is finally validated by performing the LES of the cold flow of an industrial burner.
The turbulent flow within a complex swirled combustor is studied with compressible large eddy simulation (LES), acoustic analysis, and experiments for both cold and reacting flows. Detailed fields of ...axial, tangential, and radial velocities (average and RMS) given by LES are compared with experimental values measured by LDV. The unsteady activity is identified using LES and acoustic tools for the whole geometry from inlet (far upstream of the swirler) to the atmosphere (far downstream of the chamber exhaust). Concerning comparisons between experiments and LES, this nose-to-tail procedure removes all ambiguities related to the effects of boundary conditions. Results for the cold flow show that the second acoustic mode at 360 Hz dominates in the plenum while a hydrodynamic mode at 540 Hz due to a precessing vortex core (PVC) is found in the combustion chamber. With combustion, the PVC mode is damped and the main mode frequency dominating all unsteady activity is 500 Hz. Acoustic analysis shows that this mode is still the second acoustic mode observed in the cold flow: its frequency shifts from 360 to 500 Hz when combustion is activated. More generally, these results illustrate the power of combined numerical tools (LES and acoustic analysis) to predict mean flow as well as instabilities in combustors.
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