bluuebunny/crossref_metadata_2025 huggingface dataset:
Duodenal lymphangitis carcinomatosa: Endoscopic characteristics and clinical significance
Authors: NAKASONO MASAHIKO , HIROKAWA MITSUYOSHI , MUGURUMA NAOKI , OKAMURA SEISUKE , ITO SUSUMU , OKAZAKI MICHIYO , HORIE TAKAHIRO , KIMURA MASUO , TAKEUCHI MAYUKO , INOSHITA TOSHI , SANO TOSHIAKI
Published: February 2006

Background and Aim:  Duodenal lymphangitis carcinomatosa has been sporadically described, but so far little attention has been paid to duodenal lymphangitis carcinomatosa.

Methods:  Four cases with duodenal lymphangitis carcinomatosa were endoscopically and histologically examined.

Results:  The four cases exhibited multiple polypoid lesions along the Kerckring's folds and/or were covered by characteristically granular, non‐ulcerated mucosa upon thickening. The granularity seems to been caused by dilated lymph vessels containing the carcinoma cells. The lesions were microscopically characterized by: (i) involvement of lymph vessels located in the upper portion of the lamina propria; (ii) no inflammatory changes; and (iii) no desmoplastic changes. Primary sites were thought to be the stomach in case 1, the pancreas in cases 2 and 4, and unknown in case 3. All patients died within 6 months after admission or endoscopic examination.

Conclusions:  As duodenal lymphangitis carcinomatosis shows characteristic endoscopic appearance, endoscopic diagnosis is not difficult. We should realize that the lesion represents extremely poor prognosis, and it should be distinguished from ordinary metastatic duodenal carcinoma.
Expression of vascular endothelial growth factor‐C in human hepatocellular carcinoma
Authors: YAMAGUCHI RIN , YANO HIROHISA , NAKASHIMA OSAMU , AKIBA JUN , NISHIDA NAOYO , KUROGI MINA , KOJIRO MASAMICHI
Published: February 2006

Background/Aims:  Vascular endothelial growth factor‐C (VEGF‐C) is thought to be an important factor in tumor angiogenesis/lymphangiogenesis, but its role in hepatocellular carcinoma (HCC) has not yet been fully investigated.

Methods:  We immunohistochemically examined VEGF‐C expression in surgically resected tissues of 90 HCC.

Results:  In the 78 HCC with a single histological grade, VEGF‐C expression was significantly stronger in poorly differentiated HCC than in well‐ (P = 0.003) or moderately differentiated HCC (P = 0.0002). A ‘nodule‐in‐nodule’ case presented VEGF‐A expression in the well‐differentiated component and VEGF‐C expression in the moderately–poorly differentiated component. According to nodular diameter, VEGF‐C expression was significantly higher in nodules of 3.0 cm or larger (P = 0.0263). Extrahepatic metastases seen in seven cases expressed VEGF‐C. In 20 of the 28 cases who were able to be followed up, the frequency of intrahepatic recurrence tended to be higher and extrahepatic metastasis was significantly higher in the cases who had VEGF‐C expression in the tumor casts of the intrahepatic portal/hepatic vein branches than other cases without the expression (P = 0.0139). Disease‐free survival time tended to be shorter in cases with VEGF‐C expression in tumor casts of the portal/hepatic vein than in those without VEGF‐C expression (P = 0.053; log–rank test).

Conclusions:  VEGF‐C expression is related to the progression of HCC, and VEGF‐C expression in tumor casts of the intrahepatic portal/hepatic vein is considered to be a factor indicating recurrence/metastasis sites.
Significance of cagA status and vacA subtypes of Helicobacter pylori in determining gastric histopathology: Virulence markers of H. pylori and histopathology
Authors: Kaklikkaya Nese , Cubukcu Kivanc , Aydin Faruk , Bakir Tulay , Erkul Suat , Tosun Ilknur , Topbas Murat , Yazici Yelda , Buruk Celal Kurtulus , Erturk Murat
Published: February 2006

Background:  It has been suggested that Helicobacter pylori strains containing the cytotoxin‐associated gene A (cagA), and s1m1 genotype of vacuolating cytotoxin gene A (vacA) may have been associated with peptic ulcer disease. The aim of the present study was to analyze such an association of cagA presence and vacA subtypes of H. pylori with histopathological findings in patients with gastritis.

Methods:  Sixty‐five independent H. pylori strains isolated from Turkish patients with gastritis were analyzed. The antral biopsy specimens were processed for culture and histopathology. Histopathological features were recorded and graded according to updated Sydney system. The vacA subtypes and cagA gene were tested by polymerase chain reaction.

Results:  Mild degree of antral density was associated with mild degree of gastric neutrophil infiltration (P = 0.010). Positive cagA status correlated significantly with the presence of atrophy (P = 0.035) and neutrophil infiltration (P < 0.001), but not with H. pylori density (P = 0.754) nor the degree of mononuclear cell infiltration (P = 0.945). The vacA subtypes were independent of gastric histopathology. The odds ratios for atrophy and neutrophil infiltration of cagA+ versus cagA– strains were 3.62 (95% confidence interval [CI]: 1.04–12.66) and 53.18 (95%CI: 11.08–255.23), respectively.

Conclusion:  The presence of the cagA gene is strongly associated with atrophic and active gastritis. Distinct vacA subtypes of H. pylori appear to have no association with histopathological findings of gastritis.
Methimazole protects lungs during hepatic ischemia–reperfusion injury in rats: An effect not induced by hypothyroidism
Authors: Tütüncü Tanju , Demirci Çagatay , Gözalan Ugur , Yüksek Yunus Nadi , Bilgihan Ayse , Kama Nuri Aydin
Published: February 2006

Background:  Hepatic ischemia–reperfusion injury may lead to remote organ failure with mortal respiratory dysfunction. The aim of the present study was to analyze the possible protective effects of methimazole on lungs after hepatic ischemia–reperfusion injury.

Methods:  Forty male Wistar albino rats were randomized into five groups: a control group, in which bilateral pulmonary lobectomy was done; a hepatic ischemia–reperfusion group, in which bilateral pulmonary lobectomy was done after hepatic ischemia–reperfusion; a thyroidectomy–ischemia–reperfusion group (total thyroidectomy followed by, 7 days later, bilateral pulmonary lobectomy after hepatic ischemia–reperfusion); a methimazole–ischemia–reperfusion group (following methimazole administration for 7 days, bilateral pulmonary lobectomy was done after hepatic ischemia–reperfusion); and a methimazole +l‐thyroxine–ischemia–reperfusion group (following methimazole and l‐thyroxine administration for 7 days, bilateral pulmonary lobectomy was performed after hepatic ischemia–reperfusion). Pulmonary tissue specimens were evaluated histopathologically and for myeloperoxidase and malondialdehyde levels.

Results:  All of the ischemia–reperfusion intervention groups had higher pulmonary injury scoring indices than the control group (P < 0.001). Pulmonary injury index of the ischemia–reperfusion group was higher than that of both the methimazole‐supplemented hypothyroid and euthyroid groups (P = 0028; P = 0,038, respectively) and was similar to that of the thyroidectomized group. Pulmonary tissue myeloperoxidase and malondialdehyde levels in the ischemia–reperfusion group were similar with that in the thyroidectomized rats but were significantly higher than that in the control, and both the methimazole‐supplemented hypothyroid and euthyroid groups.

Conclusion:  Methimazole exerts a protective role on lungs during hepatic ischemia–reperfusion injury, which can be attributed to its anti‐inflammatory and anti‐oxidant effects rather than hypothyroidism alone.
ProSealTM laryngeal mask airway in 120 pediatric surgical patients: a prospective evaluation of characteristics and performance
Authors: WHEELER MELISSA
Published: February 2006

Background:  The ProSealTM LMA (PLMATM) has recently been introduced in pediatric sizes (1.5, 2, 2.5, 3). Limited pediatric data have been published.

Methods:  After Institutional Review Board (IRB) approval, the PLMATM was placed in 120 children aged 4 months to 13 years (5–50 kg). The following data were collected prospectively: induction agent, number of placement attempts (limited to three), placement success or failure, PLMATM size, leak pressure, ventilatory pattern [spontaneous (SV) or controlled positive pressure ventilation (PPV)], success or failure of gastric suction tube placement, hypoxemia, dislodgement, laryngospasm, bronchospasm, aspiration, and traumatic placement.

Results:  The PLMATM was easily placed in children with a higher first attempt success rate (94%) than reported for adults. Overall PLMATM and gastric tube placement were both 100% successful. Leak pressures were similar to those reported for the PLMATM in adults and higher than reported for the ClassicTM LMATM in children. No bronchospasm, laryngospasm, hypoxemia, dislodgement, or aspiration occurred.

Conclusions:  Although the PLMATM can be used with SV or PPV, the higher leak pressure achieved with the PLMATM, and the ability to evacuate fluid and air from the stomach suggest that it may be a useful alternative to tracheal intubation for procedures in which PPV is desired in children aged 4 months to 13 years.
13  Treatment of localised prostate cancer using a combination of high dose‐rate Ir‐192 brachytherapy (HDRB) and external beam radiation therapy (EBRT): a 7 year experience
Authors: STEVENS M. , STRICKER P. , SAALFELD J. , BRENNER P. , KOONER R.
Published: February 2006

To June 2005, over 600 patients received HDRB treatment according to the Seattle protocols. It involves interstitial prostate dose of 1650–1800 cGy in three fractions and 24 h with EBRT 4500 cGy in 5 weeks. 98% of high and intermediate‐risk patients received concomitant 6–12 months androgen suppression. 237 patients were treated between April 1998 and April 2002. 232 patients were suitable for analysis – 158 high‐risk, 56 intermediate‐risk, 18 low‐risk. Minimum follow‐up was 3 years (median 56 months). 7‐year actuarial bNED outcomes were 84%, 94%, 100% using Houston Definition for biochemical failure. Kaplan–Meier estimates for disease‐specific survival failed to discriminate between the risk groups (P = 0.15) and negated the clinical impact of adverse cancer presentation. There were four deaths due to prostate cancer in high‐risk group. Overall cause‐specific survival was 98%, overall survival 93%. HDRB/EBRT treatment toxicity was minimal. RTOG late GI toxicity was less than 1%. Overall RTOG late GU toxicity was 10%. 7/24 G3/G4 injuries occurred within 3–24 months of acute G2 toxicity suggestive of a consequential late effect. One G4 late injury, urethral necrosis, was related to early TURP; the other G4 represented focal bladder base necrosis. There were 13 G3 toxicities. One patient was G3 classified due to early TURP (3 months) with resultant incontinence and permanent IDC. Eight late G2 effects were managed with up to 12 months of alpha‐blockade. Erectile dysfunction occurred in 56% initially potent men postirradiation and testosterone recovery. HDRB/EBRT dose escalation is safe and efficacious and dedicated urology‐radiation oncology team is critical.
15  The influence of androgen deprivation therapy on cavernous nerve grafts
Authors: SYME D.B.Y. , CORCORAN N.M. , BOUCHIER‐HAYES D.M. , COSTELLO A.J.
Published: February 2006

Introduction:  Postradical prostatectomy erectile dysfunction is thought to be neurogenic in origin, and some attempts to improve potency have focussed on regenerating the cavernous nerves. Testosterone has profound positive effects on nerve regeneration. The present study aims to evaluate whether testosterone has any effect on the regeneration of cavernous nerves.

Materials and Methods:  Forty‐five male Sprague–Dawley rats underwent bilateral cavernous nerve neurotomy followed by unilateral nerve graft using genitofemoral nerve. Animals were then randomised to castrate, intact and testosterone treated arms. At 3 months electrostimulation was performed measuring intracavernosal pressure responses. Grafted nerve segments were then harvested for histological analysis.

Results:  Significant difference in maximal intracavernosal pressure (MICP) response between groups – mean MICPs were 24, 47 and 59 for castrate, intact and testosterone treated groups respectively (P = 0.003, anova). Total axon counts within grafted segments did not differ significantly between treatment groups, but concentration of nNOS‐containing axons was significantly decreased in castrate animals.

Conclusions:  Castration resulted in a significant reduction in erectile response to electrostimulation following interpositional nerve grafting. These effects appear to be due to changes in axonal regeneration in differing androgen environments, especially in the regeneration of nNOS containing axons. Clinically, this implies that nerve grafts will be of little functional use in the face of androgen ablation.
Patterns of spread in an orthotopic mouse model of bladder cancer
Authors: BRENNAN J.P. , CHAFFER C.L. , SLAVIN J. , TEMELCOS C. , GOAD J. , WILLIAMS E.D.
Published: February 2006

Purpose:  To develop an orthotopic model of muscle‐invasive transitional cell carcinoma (TCC) of the bladder which models primary tumour growth and metastasis.

Methodology:  Cell lines were derived from the TCC cell line T24 (Tsu‐Pr1) using in vivo selection for metastatic ability (Chaffer et al. Clin Exp Metastasis 2005; 22(2): 115–25). Each of these cell lines (Tsu‐Pr1 and sub‐lines, B1 and B2) was then injected intramurally into the mouse bladder wall (n = 25 × 3). The cell lines were also injected intravesically and intraperitoneally (n = 15 × 3 in each group).

Results:  There were no differences between the three sub‐lines in primary tumour formation, presence of macroscopic metastases and survival. This model produced more macroscopic and lymph node metastases in comparison with other orthotopic models reported in the literature. After intraperitoneal injection, the B2 cell line produced a higher number of discrete intra‐abdominal masses in comparison with the parental line. This is likely to be related to the phenotype of the cells with parental cells being more mesenchymal, versus the B2 sub‐line, which has more epithelial characteristics.

Conclusion:  The TSU‐Pr1 series is a useful, clinically relevant model of muscle‐invasive TCC. In addition, this model may also provide insights into the role of mesenchymal‐epithelial transition in the metastatic process.
42  Percutaneous nephrostomy insertion for patients with bilateral ureteric obstruction caused by prostate cancer
Authors: NARICULAM J.A. , MURPHY D.G. , SWINN M.J.
Published: February 2006

Introduction:  Ureteric obstruction is a severe complication of advanced prostate cancer. Percutaneous nephrostomy (PCN) can decompress the obstructed kidney(s) and treat renal failure. This study assessed whether PCN added any survival benefit and whether bilateral PCN were necessary when both ureters were obstructed.

Methods:  The notes of 20 patients, who underwent urinary diversion by PCN for ureteric obstruction, were retrospectively analysed. Data pertinent to the mode of presentation, survival times and urine output of respective nephrostomies were retrieved.

Results:  Seventeen of the 20 patients (85%) presented with acute renal failure. 18 of the 20 patients presented with bilateral hydronephrosis. Of these, 12 patients had bilateral PCN insertion and 6 patients had unilateral PCN insertion. In those 12 patients who had bilateral PCN, 8 (66%) had a greater urine output in one PCN than the other. In the six patients who had unilateral PCN insertion, five of them had their renal failure treated. The mean survival time following PCN was 6.5 months.

Conclusion:  Percutaneous nephrostomy insertion will prevent immediate death in patients. However, long term survival is limited to 6.5 months. The above results would suggest that acute renal failure requiring palliative decompression may be best treated by unilateral as opposed to bilateral nephrostomy. However, a larger randomised controlled prospective study would be helpful to further assess this observation.
50  The role of hand assisted laparoscopic nephrectomy
Authors: MARTINDALE A. , APPANNA T.C. , GOAD J. , TEMELCOS C. , CLARKE A. , ASOPA R. , CLEEVE L. , NIALL O.
Published: February 2006

Objectives:  We have been performing laparoscopic nephrectomies since 2002 and have used the hand assisted technique on a regular basis. We aim to report our results and to comment on the use of the hand port.

Patients and Methods:  A combination of retrospective and prospective data collection was used to obtain patient demographics, operative details, pathology information and outcome data for all patients who underwent laparoscopic nephrectomy between April 2002 and June 2005 at St. Vincent's Hospital and the Melbourne Urology Group in Melbourne.

Results:  We performed 78 laparoscopic nephrectomies, 47 of which were hand assisted in the specified time period on patients with a mean age of 63.4 years. 38% of the public patients were operated on by a non‐consultant as the primary surgeon and the median operating time was 180 min. No differences were observed between pure and hand assisted laparoscopy (HAL) in terms of patient recovery, morbidity, in patient stay and analgesic use.

Conclusions:  We have found the hand port to be a safe and effective tool for nephrectomy without the inherent risks of pure laparoscopy. As an incision is required to remove the kidney from the abdomen it seems illogical not to utilise that incision from the beginning of the case. The benefits are safer port placement, tactile feedback and early control of heavy bleeding. We would therefore advocate its use in all extirpative renal surgery.
53  Salvage laparoscopic pyeloplasty
Authors: CHANG C.M. , GIANDUZZO T. , EDEN C.G.
Published: February 2006

Introduction:  Greater experience with urological laparoscopy has lead to increasing interest in its use for reconstructive surgery, such as pyeloplasty. We compared the outcomes of primary versus salvage laparoscopic pyeloplasty (LP) in a single surgeon series of 124 LP.

Patients and Methods:  One hundred and twenty‐four cases of laparoscopic pyeloplasty (LP) were performed, 11 of which followed failed primary treatment at other institutions: balloon dilatation (n = 3); endopyelotomy (n = 3); open pyeloplasty (n = 3); endopyelotomy plus balloon dilatation (n = 1); and open pyeloplasty plus balloon dilatation (n = 1). Nine patients had renal calculi. A four‐port balloon‐dissecting extraperitoneal laparoscopic approach was used in all but one patient who had a horseshoe kidney, necessitating a transperitoneal approach.

Results:  The operating time was 29 min longer in the secondary pyeloplasty group compared to primary cases (173.3 vs. 144.0 min), but the conversion rate (0% vs. 1.6%) and duration of postoperative hospitalisation (2.5 vs. 2.7 nights) were no greater. The complication rates were 3.6% and 9.1%. The success rates were 98.2% and 90.9% (P = 0.63) at a mean follow‐up of 20.2 and 19.7 months.

Conclusion:  Extraperitoneal laparoscopic dismembered pyeloplasty is capable of addressing all causes of UPJ obstruction with excellent functional results and low morbidity, and in an operating time similar to that of open pyeloplasty. Secondary LP does not increase hospitalization, conversion or complication rates.
57  Preservation of the lateral prostatic fascia during extraperitoneal laparoscopic nerve‐sparing prostatectomy
Authors: MOON D. , CHANG C. , EDEN C.
Published: February 2006

Introduction:  Recent evidence suggests that cavernous nerves run within layers of the lateral prostatic fascia. It has been proposed that a nerve sparing technique should therefore include preservation of this fascial layer in addition to the main bulk of the neurovascular bundle posterolateral to the prostate.

Materials and methods:  All patients on whom laparoscopic nerve‐sparing prostatectomy was performed (potent patients <70 years of age, PSA <10, primary Gleason score ≤3), underwent a ‘curtain dissection’ with preservation of the endopelvic and lateral prostatic fasciae. To avoid injury to the cavernosal nerves, no energy source was used and the tips of the seminal vesicles were preserved. We present an operative video demonstration of this technique.

Results:  This procedure can be performed without an increase in operative time or blood loss. Finer points of technique are displayed and explained.

Conclusion:  Preservation of the lateral prostatic fascia and the nerves running within its layers is feasible during nerve‐sparing laparoscopic radical prostatectomy. We have now performed this procedure on fifty patients, and future clinical follow‐up will assess whether this technique is associated with improved functional results.
60  Robotic laparoscopic versus open radical retropubic prostatectomy: comparison of positive surgical margin rate by a single surgeon
Authors: VAN APPLEDORN S. , BOUCHIER‐HAYES D.M. , O'MALLEY P.J. , KHAIRA H. , COSTELLO A.J.
Published: February 2006

Introduction:  A non‐laparoscopically trained genitourinary surgeon began performing robotic‐assisted laparoscopic radical prostatectomies (RLRP) in December, 2003 using the da Vinci (Intuitive Surgical Sunnyvale, CA) robotic system. It remains unclear if RLRP offers a similar degree of cancer control to open radical retropubic prostatectomy (RRP). We examined the pathological outcomes of patients who underwent RLRP and compare them to a similar cohort who previously underwent RRP by the same surgeon.

Materials and Methods:  Two consecutive patients who underwent RLRP from December, 2003 to April, 2005 were analysed. Their age, PSA, pathological stage and margin status were prospectively collected. 102 consecutive patients who underwent RRP from April 1999 to November 2003 were used for comparison.

Results:  The mean age of RLRP patients was 60.7 (range 47–73) and their mean PSA was 7.78 (1.3–21.2). Thirteen patients were stage pT3a while the remaining 89 were pT2. Fourteen patients (13.7%) had foci of adenocarcinoma at the inked surgical margin. The RRP patients had a mean age of 59.3 (45–72) and a mean PSA of 9.9 (0.9–37.6). Four patients were pathologic stage T3b, 29 patients were pT3a, and the remaining 69 were pT2. 27 RRP patients (26.4%) had tumour present at the inked margin of surgical resection.

Conclusion:  RLRP can be successfully performed by a laparoscopic naïve surgeon. The surgical margin status of RLRP patients is better than a cohort treated with RRP by the same surgeon. It will require further analysis to verify if this corresponds with improved recurrence‐free rates, but initial results are promising.
61  Laparoscopic radical prostatectomy: the impact of obesity
Authors: MOON D. , GIANDUZZO T. , CHANG C. , PATIL N. , SINGH R. , EDEN C.
Published: February 2006

Introduction:  The literature‐based evidence as to whether or not obesity has any impact on the outcomes of radical prostatectomy is contradictory. This study investigates the effect of obesity on the peri‐operative parameters of patients undergoing laparoscopic radical prostatectomy (LRP).

Materials and methods:  The database entries and case notes of 532 consecutive patients undergoing LRP from March 2000 to August 2005 were retrospectively examined. Complete data were available on 505 (95%) patients, 108 (21%) of whom were obese (BMI ≥ 30 kg/m2). All patients had clinical stage T ≤ 3aN0M0 prostate cancer and had their procedure performed or supervised by the same surgeon.

Results:  Patients’ PSA, Gleason score, clinical stage and prostate weight were similar. Non‐obese and obese patients mean values for operating time = 182 and 197 min (P = 0.01), blood loss = 310 and 350 ml (P = 0.66), hospital stay = 3.0 and 3.3 nights (P = 1.00) complications = 3.5% and 4.6% (P = 0.77), positive margins = 15.4% and 20.6% (P = 0.26) and biochemical recurrence = 3.8 and 3.7% (P = 1.00) at a mean follow‐up of 9.7 and 12.0 months, respectively.

Conclusion:  The operating time was significantly longer for obese patients but this was only by a mean of 15 min. All other parameters were comparable in the two groups. Obese patients can expect a similar outcome to their non‐obese counterparts following LRP when operated on be an experienced surgeon.
62  Does obesity influence operative course or complications of robot assisted laparoscopic prostatectomy
Authors: KHAIRA H.S. , O'MALLEY P. , PETERS J.S. , COSTELLO A.J.
Published: February 2006

Introduction and Objective:  To determine if obesity is associated with greater intra or peri‐operative complications in patients undergoing Robot Assisted Laparoscopic Prostatectomy (RALP).

Methods:  Between 8/2003 and 9/2005 prospective data collection was performed for all patients undergoing RALP. Obesity was defined by BMI > 30 Kg/m2. Operative times were documented to determine duration for: overall case, robotic assistance, vesico‐urethral anastomosis.

Results:  Two hundred and forty three patients underwent RALP by one of two surgeons. 202 were classified as non‐obese and 41 obese. Preoperative and postoperative characteristics were similar: mean age 61.1 vs. 59.8 years, preoperative PSA 8.1 vs. 7.4, prostate volume was 46.6 vs. 45.3 cc, length of stay 3.2 vs. 3.4 days, time of indwelling catheter 8.2 vs.7.8 days. Operative times were less for the non‐obese group compared with the obese group: total OR Time 188 vs. 206 min (P < 0.05), Robot Time 135 vs. 147 min (P < 0.10), Anastomotic Time 31 vs. 35 min (P < 0.10). In the non‐obese group there were seven (3.5%) prolonged drain tube leaks versus four (9.8%) in the obese group (P < 0.10).

Conclusions:  Obesity was associated with longer overall operative times, which reinforces the suspicion that RARP is more challenging in this population. Overall complication rates were not significantly different; however there was a trend towards longer drain tube output amongst obese patients. Ongoing follow‐up will determine if obesity predisposed to greater long‐term morbidity.
66  The advantage of finger guided prostate biopsies in addition to transrectal ultrasound guided prostate biopsies in patients with palpable disease
Authors: HUYNH C.C. , AWAD N. , FULTON M.
Published: February 2006

Introduction:  Transrectal ultrasound guided biopsies of the prostate (TRUSGB) allows direct visualisation instead of finger‐guided approximation of prostatic anatomy. However, the efficacy of the inclusion of finger guided prostate biopsy (FGPB) of suspicious, palpable prostatic areas has not been reported.

Method:  Between February 2002 and September 2005, 287 consecutive patients being investigated for prostate cancer underwent 310 prostate needle biopsies (PNB) by a single surgeon. 240 cases were judged to have palpable disease, forming our study group. We defined palpable disease as any abnormality even the subtlest. The study group underwent both TRUSGB and FGPB. The operative and pathology reports of these patients were reviewed and tabulated. The additional information garnered by FGPB was analysed.

Results:  One hundred thirty‐three of 240 (55.4%) cases were diagnosed with prostate cancer, where 18 (7.5%) would not have been detected had they not had additional FGPB. Furthermore, of the 115 positive biopsies picked up by TRUSGB, 100 (87%) were also positive with FGPB. Within this concordant set, 27 FGPB cases were positive in regions different to that found in TRUSGB. The extra data gained provides a better estimation of tumour volume, which aided in decision‐making.

Conclusion:  In patients with palpable disease, the addition of finger guided prostate biopsy of these areas, increased the positive predictive value over transrectal ultrasound prostate biopsies alone. Additional information obtained in terms of tumour volume and tumour positive areas helps in tailoring a management plan for the patient. This technique should be considered in all patients with palpable disease.
8  Australian prostate cancer collaboration (APCC) bioresource
Authors: HORSFALL D.J , CLEMENTS J.A.
Published: February 2006

The Mission Statement of the APCC is ‘To reduce mortality and morbidity and improve the quality of life of men with prostate cancer by facilitating translational research that will lead to improved prostate cancer management’. National enhancement of translational research endeavours requires establishment of an Australian Prostate Cancer BioResource and associated clinical database. Establishment funds were provided by Prostate Cancer Foundation of Australia (PCFA), Commonwealth Bank and Andrology Australia. Funding for the prospective tissue collection is from NHMRC via an Enabling Grant (July 2004 to June 2009). Tissue collections centre on four nodes, each with a network of affiliated public and private hospitals. The nodes are at Hanson Institute (Adelaide), QUT (Brisbane), Monash Institute (Melbourne), and Garvan Institute (Sydney). The nodes will be linked via a web‐based database, which can be interrogated for assembly of specific research tissue cohorts. Access to the tissue and data collections will be equitably available to Australian prostate cancer researchers. An Access Policy has been developed. A business plan and a partial cost recovery program are under development to supplement funding. Fresh tissue procurement began October 2005. Expected annual accrual rate is 800–1000 patients. Between 2–6 × 5 mm punch biopsy cores per patient will be stored at –80°C. Current access to archived tissues for tissue microarray (TMA) construction is approximately 3000 patients. A TMA of 150 patients has been produced. Australian researchers will be able to access the collection in 2006. Tissue will be supplied to ethically approved, high quality research programs after peer review.
85  Evaluation of the adjustable continence therapy for male and female stress urinary incontinence
Authors: CHIN P. , WATT H. , KOVAC P. , SKYRING T.
Published: February 2006

Introduction:  The treatment for stress urinary incontinence is varied and depends on the aetiology and the varying continence state of the patient. We report the results of implanting the postoperatively adjustable balloon devices (ACT and ProACT) in a group of patients.

Material and Methods:  Male and Female patients with Intrinsic Sphincter Deficiency were offered this treatment consisting of an initial surgical placement of two paraurethral silicone balloons with postoperative adjustments as required after a six week period.

Results:  To date 24 patients have been treated since April 2003 (10 males in 11 procedures and 13 females) with an average age of 64 years (range 36–81). Disease aetiology was mixed but included eight postradical prostatectomy; two neurogenic, eight posthysterectomy and four vaginal repairs. One patient had failed an Artificial Urinary Sphincter and another a prior fascial sling. Quality of Life improved from 46.1 at baseline to at 87 at 6 months and at 79.6 at 12 months. Pad Usage decreased from 4.3 to 1.2 at 6 and 1 at 12 months. Average initial balloon volume was 1.2 ml increasing to 3 ml at 6 months with an average of 1.7 adjustments required. Complications included erosion / infection (two), migration (one), labial discomfort (one); non‐response (one). Two patients required repositioning of their devices.

Conclusions:  The capacity to postoperatively titrate to an individuals’ continence requirements coupled to the ability to remove and adjust the position of the device is of great benefit in patients with ISD. Optimal initial placement is important in determining outcomes.
93  Radiofrequency ablation of prostate using bipolar technology
Authors: WOO H.
Published: February 2006

Introduction:  Monopolar radiofrequency ablation has become an accepted modality within minimally invasive treatments for benign prostatic obstruction (BPO). Lesions created by bipolar technology are greater in size than those produced by monopolar devices. Recently, a bipolar system has been developed. This pilot study aims to determine if there is sufficient efficacy of this bipolar system to justify further clinical studies.

Patients and Methods:  Fourteen patients with BPO were identified for this pilot study of radiofrequency interstitial thermotherapy (RFITT) using the CelonUroTM bipolar probe and generator (OLYMPUS Winter and Ibe GmbH). Inclusion criteria included IPSS>12, QL>2 and Qmax<12 ml/s. The mean age was 62 years (range 53–77) and the mean TRUS prostate size was 33.7 cc(range 15–66). The majority treated on a day case basis.

Results:  The mean number of radiofrequency lesions per prostate was 6.2 (range 3–12). The mean operating time was 19.8 min (12–34). Baseline IPSS, QL, Qmax and PVR were respectively 23, 4.8, 7.1 ml/s and 168 ml. Ten patients have 6–12 data and nine patients have 12‐month follow up data. At 6–12 weeks and at one year followup, there are highly statistically significant (P < 0.01) and clinical significant improvements in IPPS, QL, Qmax and PVR. These were respectively, 12.8, 2.1, 14 ml/s, 75 ml and 10.3, 1.7, 12.5 ml/s and 77 ml. Two patients developed urinary retention; both were catheter free by 4 weeks but one was salvaged with TURP by request of the patient. No retrograde ejaculation was reported amongst those who were sexually active. No other complications were reported.

Conclusions:  RFITT represents a further development in radiofrequency technology for the minimally invasive treatment of BPO. These early results indicate potential efficacy of bipolar radiofrequency ablation to treat BPO. Randomised studies using bipolar RFITT are necessary to determine its positioning between drug therapy and cavitating surgical procedures in terms of efficacy and morbidity profile.
96  Buccal mucosa substitution urethroplasty experience
Authors: MARK S.D.
Published: February 2006

Introduction:  Buccal Mucosa is the free graft of choice in substitution urethroplasty. I have reviewed a consecutive series of patients undergoing a buccal mucosa urethroplasty to determine outcomes and complications.

Method:  A retrospective review of all patients who underwent a buccal mucosa graft for their substitution urethroplasty was undertaken. Follow‐up was for a minimum of 6 months and included symptom review and a urethrogram at 3 months with a further review at 6 months and urethrogram as required.

Results:  Thirty‐three patients were followed with a mean follow‐up of 36 months (range 6 – 72 months). Age range 6 to 79 years. 19 patients underwent a bulbar urethroplasty (10 ventral patch) with 1 stricture recurrence. 13 patients underwent a 2 stage repair with 3 requiring revisions before their 2nd stage due to graft shrinkage. 11 of 13 have had a successful 2nd stage, 2 awaiting repair. One complete tube graft failed. Of the 33 donor sites, 19 were primarily closed and three developed contractures requiring operative correction. Primary closures were more painful.

Conclusion:  This retrospective review confirms the success of buccal mucosal graft as successful for substitution urethroplasty. Significant graft shrinkage occurs in staged repairs, dissection and graft size needs to accommodate this. Donor graft sites should be left open.
Gaze following: why (not) learn it?
Authors: Triesch Jochen , Teuscher Christof , Deák Gedeon O. , Carlson Eric
Published: February 2006

We propose a computational model of the emergence of gaze following skills in infant–caregiver interactions. The model is based on the idea that infants learn that monitoring their caregiver's direction of gaze allows them to predict the locations of interesting objects or events in their environment (Moore & Corkum, 1994). Elaborating on this theory, we demonstrate that a specificBasic Setof structures and mechanisms is sufficient for gaze following to emerge. This Basic Set includes the infant's perceptual skills and preferences, habituation and reward‐driven learning, and a structured social environment featuring a caregiver who tends to look at things the infant will find interesting. We review evidence that all elements of the Basic Set are established well before the relevant gaze following skills emerge. We evaluate the model in a series of simulations and show that it can account for typical development. We also demonstrate that plausible alterations of model parameters, motivated by findings on two different developmental disorders – autism and Williams syndrome – produce delays or deficits in the emergence of gaze following. The model makes a number of testable predictions. In addition, it opens a new perspective for theorizing about cross‐species differences in gaze following.
Infants' physical knowledge affects their change detection
Authors: Wang Su‐hua , Baillargeon Renée
Published: February 2006

Prior research suggests that infants attend to a variable in an event category when they have identified it as relevant for predicting outcomes in the category, and that the age at which infants identify a variable depends largely on the age at which they are exposed to appropriate observations. Thus, depending on age of exposure, infants may identify the same variable at different ages in different event categories. A good case in point is the variable height, which is identified at about 3.5 months in occlusion events, but only at about 12 months in covering events and 14 months in tube events. In the present experiments, 11‐month‐olds detected a change to an object's height in an occlusion but not a covering event, and 12.5‐month‐olds detected a similar change in a covering but not a tube event. Thus, infants succeeded in detecting a change to an object's height in an event where height had been identified as a relevant variable, but failed to detect the exact same change in another event where height had not yet been identified as a relevant variable. These findings provide evidence that infants’ physical knowledge affects which changes they detect in physical events. Possible mechanisms underlying these findings are also discussed, in light of recent accounts of change detection in adults.
The eyes have it: visual pop‐out in infants and adults
Authors: Adler Scott A. , Orprecio Jazmine
Published: February 2006

Visual search studies with adults have shown that stimuli that contain a unique perceptual feature pop out from dissimilar distractors and are unaffected by the number of distractors. Studies with very young infants have suggested that they too might exhibit pop‐out. However, infant studies have used paradigms in which pop‐out is measured in seconds or minutes, whereas in adults pop‐out occurs in milliseconds. In addition, with the previous infant paradigms the effects from higher cognitive processes such as memory cannot be separated from pop‐out and selective attention. Consequently, whether infants exhibit the phenomenon of pop‐out and have selective attention mechanisms as found in adults is not clear. This study was an initial attempt to design a paradigm that would provide a comparable measure between infants and adults, thereby allowing a more accurate determination of the developmental course of pop‐out and selective attention mechanisms. To this end, we measured 3‐month‐olds’ and adults’ saccade latencies to visual arrays that contained either a + among Ls (target‐present) or all Ls (target‐absent) with set sizes of 1, 3, 5 or 8 items. In Experiment 1, infants’ saccade latencies remained unchanged in the target‐present conditions as set size increased, whereas their saccade latencies increased linearly in the target‐absent conditions as set size increased. In Experiment 2, adults’ saccade latencies in the target‐present and target‐absent conditions showed the same pattern as the infants. The only difference between the infants and adults was that the infants’ saccade latencies were slower in every condition. These results indicate that infants do exhibit pop‐out on a millisecond scale, that it is unaffected by the number of distractors, and likely have similar functioning selective attention mechanisms. Moreover, the results indicate that eye movement latencies are a more comparable and accurate measure for assessing the phenomenon of pop‐out and underlying attentional mechanisms in infants.
Words and maps: developmental changes in mental models of spatial information acquired from descriptions and depictions
Authors: Uttal David H. , Fisher Joan A. , Taylor Holly A.
Published: February 2006

People acquire spatial information from many sources, including maps, verbal descriptions, and navigating in the environment. The different sources present spatial information in different ways. For example, maps can show many spatial relations simultaneously, but in a description, each spatial relation must be presented sequentially. The present research investigated how these source differences influence the mental models that children and adults form of the presented information. In Experiment 1, 8‐year‐olds, 10‐year‐olds and adults learned the layout of a six‐room space either from verbal descriptions or from a map. They then constructed the configuration and pointed to target locations. Participants who learned from the map performed significantly better than those who learned from the description. Ten‐year‐olds performed nearly as well as adults did. The 8‐year‐olds’ mental models differed substantially from the older children's and adults’ mental models. The younger children retained the sequential information but did not integrate the relations into a survey‐like cognitive map. Experiment 2 demonstrated that viewing the shape of the configuration, without seeing the map in full, could facilitate 8‐year‐olds’ use of the verbal information and their ability to integrate the locations. The results demonstrate developmental differences in the mental representation of spatial information from descriptions. In addition, the results reveal that maps and other graphic representations can facilitate children's spatial thinking by helping them to transcend the sequential nature of language and direct experience.
Squamous cell carcinoma arising in CHILD syndrome
Authors: Jacyk WK , La Cock A
Published: February 2006

Congenital hemidysplasia with ichthyosiform naevus and limb defects (CHILD) syndrome is a rare X‐linked dominant disorder. The first case of squamous cell carcinoma arising within the affected ichthyosiform skin in a 33‐year‐old woman is reported.
Linear atrophoderma of Moulin together with leuconychia: a case report
Authors: Atasoy M , Aliagaoglu C , Sahin O , Ikbal M , Gursan N
Published: February 2006

Linear atrophoderma of Moulin has a distinctive disease pattern characterized by hyperpigmented atrophoderma and was described originally in 1992. It follows the line of Blaschko, and occurs without preceding inflammation, subsequent induration or scleroderma. The lesions usually develop during childhood or adolescence, and the prognosis is good. The diagnosis is made clinically and histopathologically. In our 18‐year‐old male patient, there were atrophic plaques unilaterally located on the trunk and arm, and white discoloration on all finger nails. Histopathological examination revealed epidermal atrophy together with disruption of collagen fibres.
Minocycline‐induced cutaneous hyperpigmentation: confocal laser scanning microscope analysis
Authors: Dodiuk‐Gad RP , de Morentin HM , Schafer J , Harel A , Neudorfer M , Misonzhnik F , Gitstein G , Rozenman D , Tur E , Brenner S
Published: February 2006

Background  Minocycline has a characteristic yellow‐green fluorescent emission. This fluorescence has been previously demonstrated only in type 1 minocycline‐induced skin hyperpigmentation.

Objective  To investigate whether the fluorescence can be detected in other types of minocycline‐induced cutaneous hyperpigmentation, and to study the possible mechanisms.

Methods  Biopsies of pigmented and nonpigmented skin from 3 patients with different types of skin hyperpigmentation induced by minocycline were analysed by light microscopy and Confocal Laser Scanning Microscope (CLSM).

Results  A yellow‐green fluorescence was observed in the hyperpigmented skin of two patients with type 2, and one patient with type 4 minocycline–induced cutaneous hyperpigmentation. No fluorescence was detected in the non‐pigmented skin.

Conclusion  Minocycline can possibly serve as a fluorescent probe in the diagnosis of all types of minocycline‐induced cutaneous hyperpigmentation.
Primary Gougerot–Sjögren syndrome: a dermatological approach
Authors: Roguedas A‐M , Youinou P , Lemasson G , Pennec Y‐L , Misery L
Published: February 2006

Gougerot–Sjögren syndrome (GSS) is a chronic heterogeneous non‐organ‐specific autoimmune disease, encompassing a wide spectrum of clinical manifestations. It is characterized by a lymphocytic infiltration of the exocrine glands, also called epitheliitis, resulting in xerostomia and keratoconjunctivitis sicca. The skin can also be involved; for example, xerosis is a consequence of epitheliitis. Dermatological consequences of polyclonal reactivity are vasculitis and manifestations of B‐cell proliferation vary from plasma cell infiltrates to B‐cell lymphoma.
Ascription, Choice, and the Construction of Religious Identities in the Contemporary United States
Authors: CADGE WENDY , DAVIDMAN LYNN
Published: February 2006

Within the past 15 years, sociological studies of religion have emphasized the chosen, achieved nature of religious identities and have deemphasized ascription or tribalism as the basis of Americans' construction of religious selves. The accounts many people develop in narrating their religious life experiences, however, often combine notions of ascription and achievement in ways scholars have not clearly conceptualized. This article develops an approach to religious identity that shows how, rather than being treated as a dichotomy, the concepts of ascription and achievement are integrated in nuanced ways in the narratives of religious identity told by first‐generation immigrant Thai Buddhists and third‐generation Jews, two groups with strong inherited religious identities. The comparison between Jews and Buddhists shows how members of both groups blend the concepts of ascription and achievement in similar and different ways, particularly around practice, regardless of their participation in religious organizations.
Religio‐Biography, Coping, and Meaning‐Making Among Persons with HIV/AIDS
Authors: JACOBSON C. JEFF , LUCKHAUPT SARA E. , DeLANEY SHELI , TSEVAT JOEL
Published: February 2006

Recently, quality of life studies among patients with HIV/AIDS have shown high levels of life satisfaction. Spiritual and religious factors may contribute to these positive outcomes. We interviewed 19 patients with HIV/AIDS in order to understand better the role of religious‐spiritual biographies and orientations in quality of life, and found four patterns to describe the ways in which past experiences with religion/spirituality and religious/spiritual meaning‐making help to explain how patients are currently coping with HIV/AIDS. We illustrate each of these patterns with a prototypic patient: (1) the Deferring Believer (“God allows things to happen for a reason.”); (2) the Collaborating Believer (“This is where I'm supposed to be.”); (3) the Religious/Spiritual Seeker (“I'm trying to get my life together.”); and (4) the Self‐Directing Believer (“What else is new?”). The findings support a previously described theoretical model of meaning‐making in response to adversity, and they suggest the value of life course and narrative approaches to understanding religious coping.