bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycobacterium tuberculosis in a HIV‐1‐infected population from Southeastern Brazil in the HAART era
Authors: Pedro Heloisa S. P. , Pereira Maria I. F. , Goloni Maria R. A. , Pires Fernanda C. , Oliveira Rosângela S. , da Rocha Maria A. B. , Conceição Luciana M. , Fraga Valéria D. , Fenley Juliana C. , Cordeschi Talita , Machado Ricardo L. D. , Franco Célia , Rossit Andréa R. B.
Published: December 2010

Objective  To evaluate retrospectively the microbiological profile of Mycobacterium species isolated from HIV‐infected patients attending the HIV/TB reference health care units in São José do Rio Preto, Brazil.

Method  Retrospective evaluation of all HIV‐1 positive patients whose IAL‐SJRP laboratorial analysis was positive for Mycobacterium sp. after diagnosis of HIV Infection, from January 2000 to December 2006.

Results  Of 198 patients, acid‐fast staining detected mycobacteria early in 41%. Culture revealed 52.5% to be infected with Mycobacterium tuberculosis (MT). 42.4% had non‐tuberculous mycobacteria (NTM) and 5.1% had MT/NTM positive cultures. Eleven per cent of MT strains were resistant to at least one of the antimycobacterial drugs and 3.1% were multidrug resistant. 39.4% of isolated mycobacteria were NTM species.

Conclusion  Our data may serve as a starting point for further comparisons with other Brazilian regions and other developing countries. The data may provide important clues to the future understanding, prevention and control of such co‐infections around the world.
Progressive familial intrahepatic cholestasis: a single‐center experience of living‐donor liver transplantation during two decades in Japan
Authors: Hori Tomohide , Egawa Hiroto , Takada Yasutsugu , Ueda Mikiko , Oike Fumitaka , Ogura Yasuhiro , Sakamoto Seisuke , Kasahara Mureo , Ogawa Kohei , Miyagawa‐Hayashino Aya , Yonekawa Yukihide , Yorifuji Tohru , Watanabe Ken‐Ichiro , Doi Hiraku , Nguyen Justin H. , Chen Feng , Baine Ann‐Marie T. , Gardner Lindsay B. , Uemoto Shinji
Published: December 2010

Hori T, Egawa H, Takada Y, Ueda M, Oike F, Ogura Y, Sakamoto S, Kasahara M, Ogawa K, Miyagawa‐Hayashino A, Yonekawa Y, Yorifuji T, Watanabe K‐Ichiro, Doi H, Nguyen JH, Chen F, Baine A‐MT, Gardner LB, Uemoto S. Progressive familial intrahepatic cholestasis: a single‐center experience of living‐donor liver transplantation during two decades in Japan. Clin Transplant 2011: 25: 776–785. © 2010 John Wiley & Sons A/S.

Abstract:  Background:  Progressive familial intrahepatic cholestasis (PFIC) results in liver cirrhosis. Therefore, some PFIC patients require liver transplantation (LT). Although three types of PFIC have been identified, their etiologies include unknown mechanisms.

Patients:  A total of 717 recipients who underwent living‐donor LT (LDLT) at <20 yr old were enrolled in this study. Among these recipients, 14 PFIC recipients comprising 11 PFIC type 1 (PFIC1) and three PFIC type 2 (PFIC2) were evaluated.

Results:  Three of 11 PFIC1 recipients died, while all three PFIC2 recipients survived. Eight of 11 PFIC1 recipients showed steatosis after LDLT. Among the eight steatosis‐positive PFIC1 recipients, seven showed severe steatosis and seven were complicated with steatohepatitis. Nine of 11 PFIC1 recipients showed fibrosis after LDLT, and eight of the nine fibrosis‐positive PFIC1 recipients showed severe fibrosis. In contrast to the PFIC1 recipients, the PFIC2 recipients did not show any steatosis or fibrosis after LDLT.

Conclusions:  The clinical courses and outcomes of PFIC1 recipients after LDLT are still not sufficient owing to steatosis/fibrosis, unlike the case for PFIC2 recipients. As PFIC1 patients will require LT during the long‐term progression of the disease, further strategy improvements are required for PFIC1 patients.
Voriconazole and itraconazole in lung transplant recipients receiving tacrolimus (FK 506): efficacy and drug interaction
Authors: Kramer Mordechai R. , Amital Anat , Fuks Leonardo , Shitrit David
Published: December 2010

Kramer MR, Amital A, Fuks L, Shitrit D. Voriconazole and itraconazole in lung transplant recipients receiving tacrolimus (FK 506): efficacy and drug interaction.  Clin Transplant 2011: 25: E163–E167. © 2010 John Wiley & Sons A/S.

Abstract:  Background:  The aim of this study was to compare the extent of interaction between tacrolimus and itraconazole vs. voriconazole.

Patients and methods:  This retrospective study included 60 lung transplant recipients who were treated with a tacrolimus‐based regimen; 40 received prophylactic itraconazole for the first six months following lung transplantation (LTX), and 20 were treated with voriconazole. All patients had at least 12 months of follow‐up. Tacrolimus levels and dosage requirements were compared during and after azole therapy. We assessed the rejection rate, fungal infection rate, and renal function during the study period.

Results:  The mean tacrolimus dose during itraconazole treatment was 3.26 ± 2.1 mg/d compared with 5.74 ± 2.9 mg/d after itraconazole was stopped, p < 0.0001. Similarly, the mean tacrolimus dose during voricnoazole treatment was 1.75 ± 0.9 mg/d compared with 4.85 ± 0.38 mg/d after voriconazole was stopped (p = 0.002). Thus, the mean increase in the total daily dose of tacrolimus after itraconazole and voriconazole withdrawal was 76% and 64%, respectively. No differences in the rejection or fungal infection rates or renal toxicity were observed during the study period, although an increase in positive fungal isolates was noted during itraconazole therapy.

Conclusion:  The tacrolimus dose was reduced more with itraconazole than with voriconazole, without an increase in the rejection rate and with renal function preservation.
Asymmetric inhibition of spicule formation in sea urchin embryos with low concentrations of gadolinium ion
Authors: Saitoh Motoshi , Kuroda Ritsu , Muranaka Yoshinori , Uto Norihiko , Murai Junko , Kuroda Hideyo
Published: December 2010

As gastrulation proceeds during sea urchin embryogenesis, primary mesenchyme cells (PMCs) fuse to form syncytial cables, within which calcium is deposited as CaCO3, and a pair of spicules is formed. Earlier studies suggested that calcium, previously sequestered by primary mesenchyme cells, is secreted and incorporated into growing spicules. We examined the effects of gadolinium ion (Gd3+), a Ca2+ channel blocker, on spicule formation. Gd3+ did not lead to a retardation of embryogenesis prior to the initiation of gastrulation and did not inhibit the ingression of PMCs from the blastula wall or their migration along the inner blastocoel surface. However, when embryos were raised in seawater containing submicromolar to a few micromolar Gd3+, of which levels are considered to be insufficient to block Ca2+ channels, a pair of triradiate spicules was formed asymmetrically. At 1–3 μmol/L Gd3+, many embryos formed only one spicule on either the left or right side, or embryos formed a very small second spicule. Induction of the spicule abnormality required the presence of Gd3+ specifically during late blastula stage prior to spicule formation. An accumulation or adsorption of Gd3+ was not detected anywhere in the embryos by X‐ray microanalysis, which suggests that Ca2+ channels were not inhibited. These results suggest that Gd3+ exerts an inhibitory effect on spicule formation through a mechanism that does not involve inhibition of Ca2+ channels.
ATAD2B is a phylogenetically conserved nuclear protein expressed during neuronal differentiation and tumorigenesis
Authors: Leachman Nathaniel T. , Brellier Florence , Ferralli Jacqueline , Chiquet‐Ehrismann Ruth , Tucker Richard P.
Published: December 2010

ATAD2 is an E2F target gene that is highly expressed in gastrointestinal and breast carcinomas. Here we characterize a related gene product, ATAD2B. Both genes are evolutionarily conserved, with orthologues present in all eukaryotic genomes examined. Human ATAD2B shows a high degree of similarity to ATAD2. Both contain an AAA domain and a bromodomain with amino acid sequences sharing 97% and 74% identity, respectively. The expression of ATAD2B was studied in the chicken embryo using a polyclonal antibody raised against a recombinant fragment of human ATAD2B. Immunohistochemistry revealed transient nuclear expression in subpopulations of developing neurons. The transient nature of the expression was confirmed by immunoblotting homogenates of the developing telencephalon. Cell fractionation was used to confirm the nuclear localization of ATAD2B in the developing nervous system: anti‐ATAD2B recognizes a smaller band (approximately 160 kDa) in the nuclear fraction and a larger band (approximately 300 kDa) in the membrane fraction, suggesting that posttranslational processing of ATAD2B may regulate its transport to the nucleus. The expression of ATAD2B was also studied in human tumors. Oncomine and immunohistochemistry reveal ATAD2B expression in glioblastoma and oligodendroglioma; ATAD2B immunostaining was also elevated in human breast carcinoma. In tumors ATAD2B appears to be cytoplasmic or membrane bound, and not nuclear. Our observations suggest that ATAD2B may play a role in neuronal differentiation and tumor progression.
Regulation of proximal‐distal intercalation during limb regeneration in the axolotl (Ambystoma mexicanum)
Authors: Satoh Akira , Cummings Gillian M. C. , Bryant Susan V. , Gardiner David M.
Published: December 2010

Intercalation is the process whereby cells located at the boundary of a wound interact to stimulate proliferation and the restoration of the structures between the boundaries that were lost during wounding. Thus, intercalation is widely considered to be the mechanism of regeneration. When a salamander limb is amputated, the entire cascade of regeneration events is activated, and the missing limb segments and their boundaries (joints) as well as the structures within each segment are regenerated. Therefore, in an amputated limb it is not possible to distinguish between intersegmental regeneration (formation of new segments/joints) and intrasegmental regeneration (formation of structures within a given segment), and it is not possible to study the differential regulation of these two processes. We have used two models for regeneration that allow us to study these two processes independently, and report that inter‐ and intrasegmental regeneration are different processes regulated by different signaling pathways. New limb segments/joints can be regenerated from cells that dedifferentiate to form blastema cells in response to signaling that is mediated in part by fibroblast growth factor.
Pleural controversy: Optimal chest tube size for drainage
Authors: LIGHT Richard W.
Published: December 2010

In recent years, a higher and higher percentage of patients with pleural effusions or pneumothorax are being treated with small‐bore (10–14 F) chest tubes rather than large‐bore (>20 F). However, there are very few randomized controlled studies comparing the efficacy and complication rates with the small‐ and large‐bore catheters. Moreover, the randomized trials that are available have flaws in their design. The advantages of the small‐bore catheters are that they are easier to insert and there is less pain with their insertion while they are in place. The placement of the small‐bore catheters is probably more optimal when placement is done with ultrasound guidance. Small‐bore chest tubes are recommended when pleurodesis is performed. The success of the small‐bore indwelling tunnelled catheters that are left in place for weeks documents that the small‐bore tubes do not commonly become obstructed with fibrin. Patients with complicated parapneumonic effusions are probably best managed with small‐bore catheters even when the pleural fluid is purulent. Patients with haemothorax are best managed with large‐bore catheters because of blood clots and the high volume of pleural fluid. Most patients with pneumothorax can be managed with aspiration or small‐bore chest tubes. If these fail, a large‐bore chest tube may be necessary. Patients on mechanical ventilation with barotrauma induced pneumothoraces are best managed with large‐bore chest tubes.
Small‐scale heterogeneity in the soil environment influences the distribution of lawn grass and weeds
Authors: TANAKA SATORU , MIURA REIICHI , TOMINAGA TOHRU
Published: December 2010

The association of the micro‐scale distribution of six plant species in a lawn, including the lawn grass, Zoysia japonica, with the soil's environmental factors was studied in an urban park in Kyoto, Japan. The cover of each plant species was scored in July and August. The relative elevation, depth of waterlogging after a shower, soil water content, and soil hardness were measured in 144 quadrats in a 12 m × 12 m plot. The subsurface soil was sampled at every fourth quadrat and was analyzed for the percentage of fine earth and the levels of total carbon, total nitrogen, and available phosphate. Three correlation criteria, namely the Pearson's, Mantel, and partial Mantel correlations, showed considerable disagreement in indicating whether or not there was a significant correlation between each plant species and environmental variable. Although the reason for the disagreement was not always clear, some unimodal or inverted unimodal responses of a plant species against an environmental factor, which was not detectable by the Pearson's correlation coefficient, were indicated to be significant by the Mantel or partial Mantel tests. There were four plant–environment pairs that had a significant correlation in all three criteria: Juncus tenuis in August had a positive correlation with the soil water content in July and August and a negative correlation with soil hardness and Z. japonica showed a negative correlation with the water content in August. The results suggest that the small patches of lawn with poor drainage are the sites of invasion by J. tenuis.
Phenotypic selection for seed dormancy in white snakeroot (Eupatorium rugosum)
Authors: LAU JOANN M. , ROBINSON DAVID LOWELL
Published: December 2010

Eupatorium rugosum (Ageratina altissima), commonly known as white snakeroot, is a weedy plant that invades woodland areas in North America, Korea, and Japan. In order to examine the inheritance of seed dormancy in this species, seeds from a single population were screened for their differential germination response to stratification. After two cycles of recurrent selection, the seed from the shallow–dormant lines had 4.4 times greater germination prior to stratification than did the seed from the deep–dormant lines. The seed from the deep–dormant lines showed 3.4 times greater germination after stratification, compared to the seed from the shallow–dormant selections. This suggests that primary dormancy in the seed of white snakeroot is under some degree of genetic control. This perennial species produces overwintering rhizomes that give rise to adventitious, vegetative buds each spring. The plants selected for the production of seeds with lower levels of dormancy in the fall were observed to generate rhizomatous buds that were released from dormancy earlier in spring, compared to the plants that produced seeds with higher levels of dormancy. A statistically significant positive correlation also was observed between seed and bud dormancy in a naturally occurring population of white snakeroot. Common regulatory elements might be influencing dormancy in both the seeds and vegetative buds of this species.
Preliminary findings of potentially resistant goosegrass (Eleusine indica) to glufosinate‐ammonium in Malaysia
Authors: JALALUDIN ADAM , NGIM JEREMY , BAKAR BAKI H.J. , ALIAS ZAZALI
Published: December 2010

Goosegrass (Eleusine indica), regarded as one of the world's worst weeds, is highly pernicious to cash crop‐growers in Malaysia. Following reports in 2009 that glufosinate‐ammonium failed to adequately control goosegrass populations in Kesang, Malacca, and Jerantut, Pahang, Malaysia, on‐site field trials were conducted to assess the efficacy of glufosinate‐ammonium towards goosegrass in both places. Preliminary screenings with glufosinate‐ammonium at the recommended rate of 495 g ai ha−1 provided 82% control of the weed at a vegetable farm in Kesang, while the same rate failed to control goosegrass at an oil palm nursery in Jerantut. The ensuing greenhouse evaluations indicated that the “Kesang” biotype exhibited twofold resistance, while the “Jerantut” biotype exhibited eightfold resistance towards glufosinate‐ammonium, compared to susceptible goosegrass populations. The occurrence of glufosinate resistance in goosegrass calls for more integrated management of the weed to prevent escalating resistance and further proliferation of the weed in Malaysia.
Ecophysiological study on weed seed banks and weeds in Cambodian paddy fields with contrasting water availability
Authors: KAMOSHITA AKIHIKO , IKEDA HIROYUKI , YAMAGISHI JUNKO , OUK MAKARA
Published: December 2010

Weed infestations are a major cause of yield reduction in rice (Oryza sativa) cultivation, particularly with direct‐seeding methods, but the relationship between weed dynamics and water availability in Cambodian paddy fields has not been documented previously. We surveyed the weed abundance and weed seed banks in the soil of paddy fields with inferred differences in their water regime in 22 farm fields in three provinces of Cambodia in the 2005 and 2006 rainy seasons. We studied rain‐fed lowland fields in upslope and downslope topographic positions and fields at different distances from the irrigation water source inside an irrigation rehabilitation area. The weed seed banks were estimated by seedling emergence in small containers and weed abundance and vigor were estimated by a simple scoring system. The estimated weed seed bank in the top 5 cm of soil ranged from 52.1 to 167 × 103 seeds m−2 (overall mean of 8.5 × 103 seeds m−2) and contained a high proportion (86%) of sedge species, such as Fimbristylis miliacea L. and Cyperus difformis. Several fields had particularly large seed banks, including one near the reservoir. No clear difference was found in the weed seed banks between the irrigated fields that were located close to (upstream) and distant from (downstream) the water source or between the irrigated and rain‐fed lowland fields, but the weed scores were larger in the rain‐fed fields and the downstream fields within the irrigated area. A water shortage during the late growing season in 2005 led to a proliferation of weeds in some fields and an associated increase in weed seedbank size in 2006. However, the weed scores in 2006 were more strongly associated with that year's water conditions than with the weed seedbank size.
Proapoptotic effect of metalloproteinase 9 secreted by trophoblasts on endothelial cells
Authors: Xu Jingjing , Liu Haiyi , Wu Yuanyuan , Gong Xun , Zhou Qiong , Qiao Fuyuan
Published: December 2010

Aim:  During normal placentation, the uterine spiral arteries are remodeled to form high‐flow, low‐resistance vessels, which is necessary to meet the increasing demands of the fetus for blood and oxygen. Remodeling of uterine arteries is mediated by extravillous trophoblasts, which penetrate the arterial walls and induce the endothelial apoptosis. But the mechanism of endothelial apoptosis is not yet fully understood. In this study, we investigate the involvement of matrix metalloproteinase 9 (MMP‐9) in trophoblast‐induced endothelial apoptosis.

Methods:  MMP‐9 small interfering RNA (siRNA) was transfected into extravillous trophoblasts (TEV‐1) by lipofectamine. After transfection, the levels of MMP‐9 and Fas Ligand (FasL) mRNA were assessed using real‐time polymerase chain reaction (PCR), and the intracellular or extracellular levels of these proteins were measured using enzyme‐linked immunosorbent assay. Then, trophoblasts transfected with MMP‐9 siRNA or control siRNA were co‐cultured with endothelial cells, respectively, in a transwell system. The apoptosis of endothelial cells was detected with flow cytometry.

Results:  MMP‐9 mRNA was significantly decreased in MMP‐9 siRNA‐treated cells as compared with the control. However, FasL mRNA appeared unaffected. After transfection with MMP‐9 siRNA, the intracellular and extracellular MMP‐9 proteins were both efficiently decreased, as the soluble FasL protein, while the intracellular FasL protein was increased. Trophoblasts transfected with MMP‐9 siRNA led to significant inhibition of endothelial apoptosis as compared with the control.

Conclusions:  Our results suggest that MMP‐9 secreted by trophoblasts contributes to endothelial apoptosis via extracellular release of soluble FasL.
Neurological complications without eclampsia during pregnancy in Turkey
Authors: Yerdelen Deniz , Karataş Mehmet
Published: December 2010

Aim:  Some neurological diseases associated with pregnancy may develop initially during gestation, pregnancy may predispose the patient to some of these diseases or some may occur only with pregnancy. The aim of this study is to draw attention to the rare neurological diseases – other than eclampsia – that develop during pregnancy or the diseases initially described as associated with pregnancy.

Methods:  Our sample comprised of 16 pregnant women who developed neurological disorders that are rarely encountered or initially reported during this phase, eclampsia excluded.

Results:  The proportion of cerebrovascular diseases was 56%. The others included intracranial hypotension accompanied by seizures, cerebral primitive neuroectodermal tumor, ophthalmoplegic migraine, hemiplegic migraine, spinal segmental myoclonus, acute motor axonal neuropathy and acute motor axonal neuropathy associated with ophthalmoplegia.

Conclusion:  Our results suggest that by adopting a careful and correct approach and accurate neurological diagnosis, most of these patients could be treated successfully with good prognosis of the newborns.
Late bacille Calmette–Guérin infection with a large focal urinary bladder ulceration as a complication of bladder cancer treatment
Authors: Ströck Viveka , Dotevall Leif , Sandberg Torsten , Gustafsson Christina Kåbjörn , Holmäng Sten
Published: December 2010

Study Type – Therapy (case series)  Level of Evidence 4

What's known on the subject? and What does the study add?

Intravesical BCG treatment has been used worldwide for many decades but there are only a few published reports on persisting BCG infection of the urinary bladder.

This is the first report on large tuberculosis‐like ulcers of the urinary bladder after intravesical BCG treatment. The finding results in a recommendation to take urine cultures for mycobacteriae in patients with unclear inflammatory lesions in the bladder after instillation of BCG.

OBJECTIVE

To report a late bacille Calmette–Guérin (BCG) complication previously not described in the literature.

PATIENTS AND METHODS

We reviewed our database with 858 patients treated with BCG from 1986 to 2008 and identified 13 male patients (1.8% of all male patients) who had a large tuberculous‐like bladder ulcer.

RESULTS

All patients had high‐grade tumours and seven had tumours invading lamina propria before BCG treatment. A solitary ulceration or inflammatory lesion, 10–50 mm in diameter, was seen at routine follow‐up cystoscopy 2–34 months (median 8 months) after the first instillation. Significantly more patients had been treated with BCG‐RIVM than with BCG‐Tice (10/320 vs. three of 454, P < 0.01). BCG was cultured from urine 3–34 months (median 14 months) after the last instillation.

So far, eight patients have been successfully treated with rifampicin and isoniazid. Nine patients are still tumour‐free 15–66 months (median 44 months) after the last transurethral resection before BCG treatment.

Another three patients had one to two non‐invasive recurrences. One patient had an invasive recurrence and underwent cystectomy. The present study is limited by biases associated with its retrospective design.

CONCLUSIONS

This is the first report on persisting BCG infections with large inflammatory lesions in the bladder. Treatment is effective and the oncological outcome is good.

Mycobacterial cultures of the urine should be performed in BCG‐patients with unclear inflammatory lesions in the bladder since a delayed diagnosis of a persistent BCG infection could result in a permanently reduced bladder capacity.

Large studies are warranted to study differences in efficacy and side‐effects between different BCG strains.
Effects of potassium channel modulators on myogenic spontaneous phasic contractile activity in human detrusor from neurogenic patients
Authors: Oger Stephanie , Behr‐Roussel Delphine , Gorny Diane , Bernabé Jacques , Comperat Eva , Chartier‐Kastler Emmanuel , Denys Pierre , Giuliano Francois
Published: December 2010

OBJECTIVE

To characterize the spontaneous contractile activity (SCA) developed by detrusor from patients with neurogenic detrusor overactivity (NDO) because the alteration of detrusor properties plays a critical role in the pathogenesis of detrusor overactivity, as well as to evaluate the role of KATP and KCa channels on this SCA because these channels regulate detrusor SCA in many species, including humans without overactive bladder (OAB).

PATIENTS AND METHODS

Human bladder samples were obtained from 44 patients undergoing cystectomy for bladder cancer with no known OAB symptoms and from 38 patients suffering from urodynamically diagnosed NDO. Detrusor strips with or without urothelium/suburothelium were mounted isometrically in organ baths filled with Krebs‐HEPES (37 °C; 95% O2/5% CO2). Strips were incubated with 10 µm pinacidil (KATP opener) followed by 10 µm glibenclamide (KATP blocker). In another set of experiments, strips were incubated with 30 µm NS‐1619 (BKCa opener) followed by 100 nm iberiotoxin (BKCa blocker) or with 100 nm apamin (SKCa blocker).

RESULTS

SCA occurred more frequently with larger amplitude and area under the curve in detrusor strips from NDO patients compared to control patients. The presence of urothelium/suburothelium did not significantly modify SCA in either patient population. Pinacidil markedly inhibited SCA of detrusor strips from control and NDO patients. This effect was reversed by glibenclamide. By contrast, NS‐1619 followed by iberiotoxin did not elicit any significant changes in SCA from NDO patients, contrary to control patients.

CONCLUSIONS

KATP and SKCa channels regulate SCA of NDO patients’ detrusor strips. By contrast, BKCa channels are not involved in the regulation of detrusor SCA in NDO patients, whereas they regulate SCA in control patients. These results should be considered in the development of K+ channels openers for the treatment of NDO. Moreover, SCA observed in vitro should be regarded as an in vitro modelling of human NDO.
First 500 cases of robotic‐assisted laparoscopic radical prostatectomy from a single UK centre: learning curves of two surgeons
Authors: Sharma Naomi Laura , Papadopoulos Alexandros , Lee Dominic , McLoughlin John , Vowler Sarah L. , Baumert Herve , Warren Anne Y. , Patil Vishal , Shah Nimish , Neal David E.
Published: December 2010

Study Type – Therapy (case series)

Level of Evidence 4

What’s known on the subject? and What does the study add?

The recent uptake of robotic‐assisted laparoscopic radical prostatectomy by urologists has led to questions about its implementation and results, particularly with reference to the learning curve. There have been several large studies, including from the USA, but as yet, no published data from a large series in the UK.

This is the first published series of robotic‐assisted laparoscopic radical prostatectomy from the UK, and provides detailed outcomes from a single centre treating patients from an unscreened population. These outcomes suggest the learning curve for robotic prostatectomy is longer than has previously been suggested and highlights the importance of a structured mentoring program.

OBJECTIVE

• To study the outcomes and learning curve of robotic‐assisted laparoscopic radical prostatectomy (RALP) in a single centre by two surgeons.

PATIENTS AND METHODS

• In total, 500 consecutive patients underwent RALP between 2005 and 2009 carried out by two surgeons. Using an ethically‐approved database, prospective data collection of demographic, surgical, oncological and functional outcomes (patient reported) was performed, with up to 4 years of follow‐up.

• The learning curves of both surgeons were analyzed and, in addition, the first 100 and last 100 patients were compared to determine the effect of surgeon experience.

RESULTS

• The mean age of the patients was 61.5 years and mean preoperative prostate‐specific antigen was 7.0 µg/L. Clinical stages were T1 in 63.2%, T2 in 33.8% and T3 in 3.0% of patients. Median (range) operating time was 170 (63–420) min and median (range) blood loss was 200 (20–3000) mL, with significant improvements for both surgeons with increasing experience (P < 0.001 and P= 0.029, respectively).

• Pathological stages were pT2 in 53.4%, pT3a in 41.6%, pT3b in 4.0% and pT4 in 0.6% of patients. Overall, the positive margin rate (PMR) was 24.0% and stage‐specific rates were 16.1%, 30.4%, 55.0% and 100.0% for pT2, pT3a, pT3b and pT4 disease, respectively. In the last 50 cases performed by each surgeon, the PMRs for pT2 and pT3a disease were 8.0% and 19.1% (surgeon 1) and 12.9% and 23.5% (surgeon 2).

• At 12 months of follow‐up, 91.3% of patients were continent and, by 48 months of follow‐up, 75% of men with preoperative potency who underwent bilateral nerve‐sparing RALP were potent.

CONCLUSION

• This is the first report of two surgeons’ learning curves in a single centre and shows that key learning curve outcomes continued to improve during the series, suggesting that the learning curve for RALP may be longer than has been previously suggested.
The penis in diabetes: structural analysis of connective tissue and smooth muscle alterations in a rabbit model
Authors: Abidu‐Figueiredo Marcelo , Ribeiro Ilma C. , Chagas Mauricio A. , Cardoso Luiz E. M. , Costa Waldemar S. , Sampaio Francisco J. B.
Published: December 2010

Study Type – Aetiology (case control)

Level of Evidence 3b

OBJECTIVE

To assess the volumetric density of collagen, elastic system fibres and smooth muscle cells in the corpus cavernosum (CC), corpus spongiosum (CS) and tunica albuginea (TA) in the penis of diabetic rabbits.

MATERIALS AND METHODS

Twenty‐six New Zealand white rabbits were used. Diabetes was induced at 8 weeks of age in 13 rabbits by i.v. injection of 100 mg/kg of alloxan. The remaining 13 rabbits served as a control group. After 10 weeks, the rabbits were killed using sodium thiopenthal.

Midshaft penile fragments were obtained and processed by routine histological techniques. Stereological analysis of collagen, elastic system fibres and smooth muscle was performed in 5‐µm sections by using a M42 test grid system.

Data were expressed as volumetric density (Vv; %). Collagen organization was evaluated by Picrosirius red staining under polarization.

RESULTS

In the TA of diabetic rabbits, thickness increased by 88% (P < 0.001) with an enhanced collagen turnover. Moreover, the elastic fibre content was 34% higher (P < 0.001). In the CC of diabetics, collagen was diminished by 45% (P < 0.001) with a more organized collagen.

The elastic fibres were decreased by 46% (P < 0.001). Diabetes induced a 11% increase in CS collagen (P < 0.024) with an enhanced collagen turnover.

Smooth muscle in the CC of diabetic rabbits was increased by 40% (P < 0.001), whereas, in the CS, it was decreased by a similar amount (P < 0.001).

CONCLUSIONS

Penile tissues were affected differently by diabetes, possibly as a result of cellular heterogeneity.

These changes could have an impact on blood flow and tissue resistance, and therefore might adversely affect erection.
ACCOUNTING FOR THE GENDER GAP IN COLLEGE ATTAINMENT
Authors: GE SUQIN , YANG FANG
Published: December 2010

One striking phenomenon in the U.S. labor market is the reversal of the gender gap in college attainment. Females have outnumbered males in college attainment since 1987. We develop a discrete choice model of college entry decisions to study the driving forces of changes in college attainment by gender. We find that the increase in relative earnings between college‐educated and high‐school‐educated individuals and the increasing parental education have important effects on the increase in college attainment for both genders, but cannot explain the reversal of the gender gap. Rising divorce probabilities increase returns to college for females and decrease those for males, and thus are crucial in explaining the reversal of the gender gap in college attainment. (JEL J24, J16, I20)
Diet and gender influences on processing and discrimination of speech sounds in 3‐ and 6‐month‐old infants: a developmental ERP study
Authors: Pivik R.T. , Andres Aline , Badger Thomas M.
Published: December 2010

Early post‐natal nutrition influences later development, but there are no studies comparing brain function in healthy infants as a function of dietary intake even though the major infant diets differ significantly in nutrient composition. We studied brain responses (event‐related potentials; ERPs) to speech sounds for infants who were fed either breast milk (BF), milk‐based formula (MF), or soy formula (SF) during the first 6 months of life. Two syllables presented in an oddball paradigm elicited a late positive wave (P350) from temporal and frontal brain regions involved in language processes. All groups showed significantly greater response amplitudes to the infrequent syllable across sites at 3 months and frontally at 6 months, but significant discrimination at temporal sites was only observed at 6 months in BF infants. Decreases in response amplitudes from 3 to 6 months were greater for the frequently presented syllable, most prominent in BF infants, and greater in females than males. The results indicate greater syllable discrimination in BF than formula‐fed infants, but whether this can be attributed to dietary influences alone remains unclear. Feeding method and background factor differences between breastfed and formula‐fed infants may also contribute to the observed differences. The general absence of differences between formula‐fed groups is notable and suggests that milk‐based formula and soy formula equally support brain development and function during the first post‐natal 6 months. Finally, the results indicate gender differences in the development of neural and temporal processes involved in sensory discrimination, and suggest that at 6 months these processes are better developed in females.
A statistical estimate of infant and toddler vocabulary size from CDI analysis
Authors: Mayor Julien , Plunkett Kim
Published: December 2010

For the last 20 years, developmental psychologists have measured the variability in lexical development of infants and toddlers using the MacArthur‐Bates Communicative Development Inventories (CDIs) – the most widely used parental report forms for assessing language and communication skills in infants and toddlers. We show that CDI reports can serve as a basis for estimating infants’ and toddlers’total vocabulary sizes, beyond serving as a tool for assessing their language development relative to other infants and toddlers. We investigate the link between estimated total vocabulary size and raw CDI scores from a mathematical perspective, using both single developmental trajectories and population data. The method capitalizes on robust regularities, such as the overlap of individual vocabularies observed across infants and toddlers, and takes into account both shared knowledge and idiosyncratic knowledge. This statistical approach enables researchers to approximate the total vocabulary size of an infant or a toddler, based on her raw MacArthur‐Bates CDI score. Using the model, we propose new normative data for productive and receptive vocabulary in early childhood, as well as a tabulation that relates individual CDI measures to realistic lexical estimates. The correction required to estimate total vocabulary is non‐linear, with a far greater impact at older ages and higher CDI scores. Therefore, we suggest that correlations of developmental indices to language skills should be made to vocabulary size as estimated by the model rather than to raw CDI scores.
Intonational phrase structure processing at different stages of syntax acquisition: ERP studies in 2‐, 3‐, and 6‐year‐old children
Authors: Männel Claudia , Friederici Angela D.
Published: December 2010

This study explored the electrophysiology underlying intonational phrase processing at different stages of syntax acquisition. Developmental studies suggest that children’s syntactic skills advance significantly between 2 and 3 years of age. Here, children of three age groups were tested on phrase‐level prosodic processing before and after this developmental phase, while their brain activity was recorded. The Closure Positive Shift (CPS), which indexes the perception of intonational phrasing in adults, served as dependent variable. The event‐related brain potentials of 3‐ and 6‐year‐olds, but not of 21‐month‐olds, showed a CPS. These results suggest that prosodic phrase processing, as indicated by the CPS, is established only later during children’s development, pointing to a close interaction of prosody and syntax acquisition.
NONPARAMETRIC META‐ANALYSIS FOR MINIMAL‐REPAIR SYSTEMS
Authors: Beutner E. , Cramer E.
Published: December 2010

We consider the situation that repair times of several identically structured technical systems are observed. As an example of such data we discuss the Boeing air conditioner data, consisting of successive failures of the air conditioning system of each member of a fleet of Boeing jet airplanes. The repairing process is assumed to be performed according to a minimal‐repair strategy. This reflects the idea that only those operations are accomplished that are absolutely necessary to restart the system after a failure. The ‘after‐repair‐state’ of the system is the same as it was shortly before the failure. Clearly, the observed repair times contain valuable information about the repair times of an identically structured system put into operation in the future. Thus, for statistical analysis and prediction, it is certainly favourable to take into account all repair times from each system. The resulting pooled sample is used to construct nonparametric prediction intervals for repair times of a future minimal‐repair system. To illustrate our results we apply them to the above‐mentioned data set. As expected, the maximum coverage probabilities of prediction intervals based on two samples exceed those based on one sample. We show that the relative gain for a two‐sample prediction over a one‐sample prediction can be substantial. One of the advantages of the present approach is that it allows nonparametric prediction intervals to be constructed directly. This provides a beneficial alternative to existing nonparametric methods for minimal‐repair systems that construct prediction intervals via the asymptotic distribution of quantile estimators. Moreover, the prediction intervals presented here are exact regardless of the sample size.
INCENTIVES TO INNOVATE IN OLIGOPOLIES
Authors: BELLEFLAMME PAUL , VERGARI CECILIA
Published: December 2010

In the spirit of Arrow (The Rate and Direction of Inventive Activity, Princeton, NJ, Princeton University Press, 1962), we examine, in an oligopoly model with horizontally differentiated products, how much a firm is willing to pay for a process innovation that it would be the only one to use. We show that different measures of competition (number of firms, degree of product differentiation, Cournot vs. Bertrand) affect incentives to innovate in non‐monotonic, different and potentially opposite ways.
Cognitive ability and simple reaction time predict cardiac reactivity in the West of Scotland Twenty‐07 Study
Authors: Ginty Annie T. , Phillips Anna C. , Der Geoff , Deary Ian J. , Carroll Douglas
Published: December 2010

Few studies have examined the association between cognitive ability and cardiovascular reactivity, although both have been implicated in later cardiovascular disease. We studied the relationship between cognitive ability, assessed using the Alice Heim‐4 test of general intelligence, simple reaction time, and subsequent cardiovascular reactivity in 409 55‐year‐olds. Blood pressure and heart rate reactions to an acute mental arithmetic task were measured 7 years after cognitive assessment. In regression models that adjusted for baseline cardiovascular activity, socio‐demographics, body mass index, medication status, and stress task performance, cognitive ability and reaction time were associated with future cardiac reactivity. Low reactivity was characteristic of those with relatively low cognitive ability. The results are consistent with the notion that high reactivity may not always be a maladaptive response.
Hybrid networks and the global politics of the digital revolution – a practice‐oriented, relational and agnostic approach
Authors: FLYVERBOM MIKKEL
Published: December 2010

The rapid growth of internet users and the importance of networked technologies for most spheres of life raise questions about how to foster and govern the digital revolution on a global scale. Focusing on internet governance and the use of ICTs for development purposes, I provide a multi‐sited, ethnographic exploration of two UN‐based multi‐stakeholder arrangements – comprising governments, business and civil society groups – that have contributed to the construction of the digital revolution as an object of global governance. In this article I show how analytical insights from governmentality studies and actor‐network theory can be used to capture how objects of governance and organizational arrangements are constructed and consolidated. Conventional approaches to networks and governance tend to treat organizational arrangements and issue areas as bounded, separate and fixed. By contrast, I demonstrate the merits of a practice‐oriented, relational and agnostic research strategy, which foregrounds the governmental techniques and moments of translation involved when new objects and modes of governance are assembled and negotiated.
Group I mGluR‐dependent epileptogenesis
Authors: Merlin Lisa R. , Bianchi Riccardo , Wong Robert K.S.
Published: December 2010

Group I metabotopic glutamate receptors (mGluRs) can initiate protein synthesis‐dependent intracellular signaling processes that can result in enhanced expression of ictal‐length discharges. Studies reveal that the fragile X syndrome phenotype is mediated by excessive mGluR‐driven protein synthesis. Defective endogenous regulation of mGluR effects may thus enhance patient susceptibility to epileptogenesis. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).
Plasticity of glutamate synaptic mechanisms
Authors: Victor Nadler J.
Published: December 2010

Enhanced glutamate synaptic transmission may be expected to alter the balance of excitation and inhibition in brain, leading to seizures. Several differences between epileptic and nonepileptic brains in presynaptic and postsynaptic glutamate mechanisms have been reported. These findings suggest that altered glutamate mechanisms contribute to the hyperexcitability of epileptic brain. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).
Normal and pathologic high‐frequency oscillations
Authors: Staba Richard J.
Published: December 2010

Pathologic high‐frequency oscillations, believed to reflect basic neuronal disturbances responsible for epilepsy, are promising biologic markers that may be used in clinical studies to optimize surgical treatment of medically refractory epilepsy, and studies that seek to develop new therapies for treatment, and possible prevention, of epilepsy. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).
GABAergic gain‐of‐function in absence seizures
Authors: Crunelli Vincenzo , Leresche Nathalie , Cope David W.
Published: December 2010

New evidence indicates that increased, rather than decreased, γ‐aminobutyric acid (GABA)ergic inhibition characterizes typical absence seizures. In particular, enhanced tonic GABAA inhibition, resulting from a malfunction of the astrocytic GABA transporter GAT‐1, occurs in thalamocortical neurons of all well‐established pharmacologic and genetic models. Interestingly, GABAB receptors positively modulate this tonic current. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).
Histopathology of human epilepsy
Authors: de Lanerolle Nihal C. , Lee Tih‐shih , Spencer Dennis D.
Published: December 2010

The histopathology of the hippocampus of patients with temporal lobe epilepsy shows two major processes. One involves reorganization of neural circuits in the dentate gyrus and the other a proliferation of reactive astrocytes that have many unusual properties. These modified astrocytes may play a major role in creating an epileptic focus. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).
Mossy fiber sprouting in the dentate gyrus
Authors: Buckmaster Paul S.
Published: December 2010

Aberrant sprouting of granule cell axons is a common feature in temporal lobe epilepsy. An increasingly detailed picture of granule cell circuit changes has emerged, but the cause–effect relationship between mossy fiber sprouting and epileptogenesis remains unclear. Recent progress in suppressing mossy fiber sprouting might help address its functional consequences. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).
Alterations in the distribution of GABAA receptorsin epilepsy
Authors: Houser Carolyn R. , Zhang Nianhui , Peng Zechun
Published: December 2010

Alterations in the distribution of GABAA receptors are likely to play pivotal roles in epilepsy. Current findings indicate that such changes are more complex than general increases or decreases in specific subunits and can involve differential changes in principal cells and interneurons, altered localization at synapses, and altered subunit partnerships. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).