Electrical stimulation in the treatment of bladder dysfunction: technology update.

The urinary bladder has two functions: urine storage and voiding. Clinically, two major categories of lower urinary tract symptoms can be defined: storage symptoms such as incontinence and urgency, and voiding symptoms such as feeling of incomplete bladder emptying and slow urinary stream. Urgency to void with or without incontinence is called overactive bladder (OAB). Slow urinary stream, hesitancy, and straining to void with the feeling of incomplete bladder emptying are often called underactive bladder (UAB). The underlying causes of OAB or UAB can be either non-neurogenic (also referred to as idiopathic) and neurogenic, for example due to spinal cord injury or multiple sclerosis. OAB and UAB can be treated conservatively by lifestyle intervention or medication. In the case that conservative treatment does not provide sufficient benefit, electrical stimulation can be used. Sacral neurostimulation or neuromodulation (SNM) is offered as a third-line therapy to patients with non-neurogenic OAB or UAB. In SNM, the third or fourth sacral nerve root is stimulated and after a test period, a neuromodulator is implanted in the buttock. Until recently only a non-rechargeable neuromodulator was approved for clinical use. However, nowadays, a rechargeable sacral neuromodulator is also on the market, with similar safety and effectiveness to the non-rechargeable SNM system. The rechargeable device was approved for full body 1.5T and 3T MRI in Europe in February 2019. Regarding neurogenic lower urinary tract dysfunction, electrical stimulation only seems to benefit a selected group of patients.

Cross-language word segmentation by 9-month-olds.

Dutch-learning and English-learning 9-month-olds were tested, using the Headturn Preference Procedure, for their ability to segment Dutch words with strong/weak stress patterns from fluent Dutch speech. This prosodic pattern is highly typical for words of both languages. The infants were familiarized with pairs of words and then tested on four passages, two that included the familiarized words and two that did not. Both the Dutch- and the English-learning infants gave evidence of segmenting the targets from the passages, to an equivalent degree. Thus, English-learning infants are able to extract words from fluent speech in a language that is phonetically different from English. We discuss the possibility that this cross-language segmentation ability is aided by the similarity of the typical rhythmic structure of Dutch and English words.

Healthcare in the United States and the practice of laboratory medicine.

US healthcare and the impact of the changes in the healthcare system on the current and future practice of laboratory medicine are analyzed. Factors considered include--population and government, healthcare expenditure, organization of healthcare delivery (institutions, personnel, healthcare industry, knowledge-personnel production, financing), the impact of managed care, and political and public health issues. The effect of the changing healthcare scene on laboratories and the consequent cost-containment measures for laboratory medicine are examined, including centralization, consolidation, supplier relationships, reengineering and automation (total lab automation), expert systems, CQI, and the move to point-of-care testing.

Processing discontinuous words: on the interface between lexical and syntactic processing.

How are discontinuous words processed? Are they identified in the lexicon or in the syntax? Schreuder (1990) proposes the existence of morphological integration nodes (MI nodes) to account for the representation of complex verbs with separable prefixes in Dutch. We tested the MI model during sentence processing in Dutch, using an ungrammaticality judgment task. The results supported the predictions of the Schreuder model, and also provide evidence for distinct lexical/morphological and syntactic processing subsystems, each driven by the information resources and tasks relevant to its own representational vocabulary. It is argued that no special principles are needed to govern the interaction of lexical/morphological and syntactic processing, even for the identification of discontinuous words; this follows automatically from independently required characterizations of the subsystems themselves. We also examine the principles underlying the MI model in an attempt to extend the model to a wider array of constructions and languages. It is hypothesized that frequently encountered linguistic expressions are represented in the lexicon. In the basic case, they are represented as access nodes, if they may stand alone, and as MI nodes, if their constituents are already represented by access nodes. Unlike the original MI model, no further stipulation is needed concerning the existence or inhibition properties of MI nodes, assuming that candidate lexical/morphological hypotheses are appended to whatever portion(s) of the input string they are hypotheses about.

Processing novel compounds: evidence for interactive meaning activation of ambiguous nouns.

In three experiments, the meaning activation of ambiguous nouns in novel nominal compounds was investigated. Ambiguous nouns were unbalanced homographs occurring as the second members of the compound. Meaningful interpretations of the compounds were based on either the dominant or the subordinate meaning of the ambiguous noun. In Experiment 1, visually presented novel compounds serving as primes were followed at varying intervals by targets associatively related to distinct meanings of the ambiguous noun. In a lexical decision task, facilitation effects were found only for targets related to the meaning that was relevant for the interpretation of the compound. Experiment 2 showed that interactive activation could not be attributed to differences in semantic relatedness between the first members of compounds and targets. Experiment 3 demonstrated equal intralexical relatedness between members for both types of compounds. It is proposed that interactive activation may facilitate the interpretation of the novel compound. Compatible meaning aspects of the nouns may become more strongly activated, and incompatible meaning aspects may not become activated. The selection of meaning aspects relevant for interpretation would thereby be simplified.

The interpretation of isolated novel nominal compounds.

The lexical decision task was used to investigate interpretative processing of isolated novel compounds (noun-noun nominals). On the basis of interpretability ratings, novel compounds were classified as being of either high or low interpretability. In a lexical decision task in which novel compounds functioned as nonwords, a significant interference effect was found for compounds of high interpretability. In a naming task, no differences were found between the two types of novel compounds, but lexicalized compounds resulted in shorter latencies than did novel compounds. Novel compounds were also shown to be interpreted under conditions unfavorable to morphological decomposition, suggesting that the interpretation process is beyond strategic control by the subject. Equal semantic priming effects were obtained for members of established semantic categories and nouns of highly interpretable compounds. Interpretative processes dealing with a limited set of basic semantic relations and analogy with lexicalized compounds are discussed.

Elevation of brain-type creatine kinase in serum from patients with carcinoma.

The brain isoenzyme of creatine kinase (CK BB) occurs in trace amounts in normal serum and is moderately increased in only a small number of non-oncological conditions. Although many tissues and tumors contain CK BB, we observed serum elevations only in certain carcinomas. Eleven patients with tissue-proven small cell anaplastic carcinoma (SCAC) of the lung had striking elevations of serum CK BB and no evidence of central nervous system (CNS) metastases. Significant increases were also observed in three cases of prostatic carcinoma with no apparent CNS involvement, and in one case each of adenocarcinoma and SCAC of the lung with proven CNS metastases. Three patients with SCAC of lung without distant metastases, three with SCAC of the esophagus with distant metastases but no known CNS involvement, and 17 patients with oncological conditions other than SCAC of the lung or adenocarcinoma of the prostate have failed to show elevation in serum CK BB activity. Serum CK BB may be useful as a diagnostic marker or indicator of metastases for some carcinomas.

Spurious brain creatine kinase in serum from patients with renal disease.

Creatine kinase isoenzyme I(BB) is generally not detectable in normal serum, and its occurrence in serum has been documented in only a few disease states. In particular, increased activity of this isoenzyme has been reported in association with chronic renal failure, hemodialysis, and renal transplantation. The present study demonstrates that the apparent creatine kinase observed in the serum of such renal patients is an artifact, observed as a result of measuring creatine kinase isoenzymes by fluorescence. Our observations resemble those of McKenzie et al. [Clin. Chim. Acta 70, 333(1976)] concerning an artifact in the fluorometric determination of lactate dehydrogenase isoenzymes in the sera of patients with end-stage renal failure. The artifact binds to albumin, is not a protein, and occurs in some normal sera at very low concentrations. This artifact can be mistakenly identified as isoenzyme I in renal-disease patients if CK isoenzymes are determined fluorometrically.