bluuebunny/crossref_metadata_2025 huggingface dataset:
Penile Hypercoagulability During Erection: a Possible Predisposing Factor to Ageing Penile Vascular Changes
Authors: BORNMAN M. S. , du PLESSIS D. J. , COETZEE W. J. C. , FRANZ R. C.
Published: December 2008

Summary— Haemostatic changes in the penile and systemic blood during erection were studied in the Chacma baboon. Dynamic hypercoagulability developed in the penile blood and fibrin was deposited on the endothelium of the penile artery and trabeculae during erection. These suggest that penile hypercoagulability predisposes to ageing penile vascular changes.
Evaluation of Light Sources and Light Guides for Use in Transurethral Surgery
Authors: PEPPER M. G. , MOUNTFORD P. J.
Published: December 2008

Summary— An evaluation of the quality of light sources and guides was carried out in response to a demand that sufficient light intensity should always be available for transurethral procedures when bleeding occurs. A light monitor was developed for the rapid assessment of the source intensity and light guide transmission. A simple test protocol was also developed for routine assessment of the sources and guides and for evaluation of new sources and guides before purchase. The sources and guides were classified in order of merit and coded to permit the selection of those of the highest quality; this guarantees a satisfactory level of illumination during surgery.
Significance of Dipstick Haematuria. 2. Correlation with Pathology
Authors: ARM J. P. , PEILE E. B. , RAINFORD D. J.
Published: December 2008

Summary— In an evaluation of a chemical test for haematuria, all patients with positive results or a history of frank haematuria were investigated to determine the source of bleeding. In 10 of the 92 patients in whom the diagnosis was unknown at the time of admission, the presence of haematuria could not be confirmed. Of the remaining 82 patients urinary tract pathology was identified in 74. Of the other eight patients, four had exercise‐induced haematuria with no other indications of significant pathology, and in four patients investigations stopped short of renal biopsy because of the patients' age.
Ileocaecocystoplasty in Urinary Tract Reconstruction in Children
Authors: WESPES E. , STONE A. R. , KING L. R.
Published: December 2008

Summary— Ten children have undergone lower urinary tract reconstruction by ileocaecocystoplasty. Four patients had previously been diverted and the other six were reconstructed because of intractable incontinence or deteriorating renal function. Continence was primarily achieved in eight patients and renal function improved or remained stable in all 10. Reflux was prevented by a plicated ileocaecal valve in five of eight patients. Continued pharmacological manipulation, intermittent self catheterisation and secondary surgical intervention were frequently necessary in these patients who required careful counselling and follow‐up.
Hydrolytic Enzymes in Normal and Neoplastic Human Bladder Tissue
Authors: EL‐SHARABASY M. M. H. , EL‐DOSOKY I.
Published: December 2008

Summary— The value of hydrolytic enzymes in 29 specimens of human bladder cancer has been assessed. Acid and alkaline phosphatases, γ‐glutamyl transferase, arylsulphatases and lactate dehydrogenase were estimated in human bladder tumours and adjacent non‐malignant tissue. Elevated enzyme levels were observed in the tumours rather than in the non‐malignant tissue, except for adenocarcinoma. These increased levels were also noted in bilharzial bladder carcinoma but not in lymph node metastasis. Increased enzyme activity could be due to over‐production by the tumour cells. It was concluded that the increase was associated primarily with the presence of tumours and the assay of these enzymes in biopsy specimens may have significant diagnostic and therapeutic implications.
Technique and Results of Trans‐scrotal Operations for Hydrocele and Scrotal Cysts
Authors: WALDRON R. , JAMES M. , CLAIN A.
Published: December 2008

Summary— Surgical procedures for scrotal hydroceles and cysts carry a significant morbidity rate from haematoma formation. Lord's transcrotal procedure involves minimal tissue dissection. The present series of 84 cases confirms Lord's original claims of a very low risk of haematoma with no recurrence.

It is concluded that Lord's procedure is effective, simple, safe and economic.
Radiation‐induced Carcinoma of the Penis
Authors: WELLS A. D. , PRYOR J. P.
Published: December 2008

Summary— Two patients with carcinoma of the penis were treated with interstitial radiation. They were cured of their disease for 17 and 21 years respectively and then developed radiation‐induced tumours.
Does Sucrose Damage Kidneys?
Authors: LI M. K. , KAVANAGH J. P. , PRENDIVILLE V. , BUXTON A. , MOSS D. G. , BLACKLOCK N. J.
Published: December 2008

Summary— There is evidence to suggest that sucrose ingestion can cause renal pàrenchymal changes as well as increasing the urinary saturation index for calcium oxalate. Ten stone formers and 10 normal subjects received 250 gm of sucrose daily over a period of 7 days. Observations on the risk factors for calcium stone formation and urinary N‐acetyl‐B‐glucosaminidase (NAG), a marker of renal tubular cell damage, were made. Oxalate excretion increased. Urinary calcium levels were unchanged but the pattern of response was different between the two groups, as with magnesium and phosphate. NAG was spontaneously higher in the patient group and increased significantly after sucrose ingestion in both groups.
The Value of Ultrasound in the Diagnosis of Renal Failure
Authors: LISSOOS I. , THOMAS R. GLYN
Published: December 2008

Summary— Seventy‐four patients with impaired renal function were investigated by ultrasound. By assessing renal length, renal echogenicity and collecting system dilatation, one can establish whether renal function is impaired by chronic or acute renal changes or by obstructive changes.
Personality Testing in 226 Patients with Urinary Incontinence
Authors: MORRISON L. M. , EADIE A. S. , McALISTER A. , GLEN E. S. , TAYLOR J. , ROWAN D.
Published: December 2008

Summary— Two hundred and twenty‐six female patients undergoing investigation for urinary incontinence completed the Eysenck Personality Inventory questionnaire. The results of the questionnaire were correlated with the symptomatology and urodynamic findings. Incontinence and neuroticism were found to be related. No special relationship was found between neuroticism and detrusor overactivity, although this has been reported in other smaller series.
Pharmacocavernometry‐cavernography in Impotence
Authors: WESPES E. , DELCOUR C. , STRUYVEN J. , SCHULMAN C. C.
Published: December 2008

Summary— Cavernometry and cavernography before and after injection of papaverine into the corpus cavernosum were performed in five psychogenically impotent patients and in 30 patients with organic impotence demonstrated by penile plethysmography. The flow necessary to provoke an erection in the psychogenic patients and in the 20 patients without venous leakage ranged from 80 to 120 ml/min and was reduced to 20 to 65 ml/min after injection of papaverine. In the 10 patients with venous leakage the flow necessary to create an erection ranged from 160 to 250 ml/min; after injection of papaverine it decreased to 50 to 120 ml/min and remained higher than in the two former groups.

Although cavernography‐cavernometry with papaverine injection correlates better with the physiological status of the erectile mechanism it provides no more information than when used alone.
Urinary Catheter Structure and Testing Methods in Relation to Tissue Toxicity
Authors: TALJA M. , RUUTU M. , ANDERSSON L. C. , ALFTHAN O.
Published: December 2008

Summary— Eluates from 56 latex urinary catheters from seven manufacturers were divided into three categories according to covering material (siliconised, silicone elastomer coated and teflon coated) and tested for tissue toxicity by means of cell cultures based on the inhibition of DNA synthesis.

The silicone elastomer coated catheters showed the lowest toxicity. Only 4 of 13 such catheters gave unacceptable toxic values, whereas half of the siliconised catheters were abandoned as toxic. Teflon and elastomer coatings had the best protective properties against toxic substances leaching from the catheter core. The surface contour of the catheters estimated by scanning electron microscopy (SEM) did not correlate with toxicity, whereas the cracks seen on the catheters did correlate with toxicity.

The simple in vivo test methods used by the manufacturers turned out to be insensitive to tissue toxicity testing of urinary catheters. The method used in this study was the most reliable for assessing the safety of latex urinary catheters. Thus manufacturers using multiple and in vitro cell culture tests had products of better quality than those using only a single test or simple in vivo tests.
Antibiotic Prophylaxis and Secondary Haemorrhage Following Transurethral Resection of the Prostate: a Prospective Trial
Authors: HARVEY M. H. , LEESE T. , LLOYD D. , OSBORN D. E.
Published: December 2008

Summary— One hundred and sixty‐two patients were studied in a random double‐blind controlled trial of co‐trimoxazole to prevent secondary haemorrhage following transurethral resection of the prostate (TURP). There was a significant correlation between the incidence of post‐operative urinary infection and secondary haemorrhage (P<0.05) but no difference between the incidence of bleeding in the treatment and placebo groups. Although infection may play a role in the development of secondary haemorrhage, co‐trimoxazole for 10 days does not decrease the incidence of this complication.
Prevalence of Renal Stones in 60‐year‐old Men: A 10‐year Follow‐up Study of a Health Survey
Authors: LJUNGHALL S. , LITHELL H. , SKARFORS E.
Published: December 2008

Summary— Information on the occurrence of renal stones was obtained in a health survey of 50‐year‐old men and at follow‐up of the same group 10 years later. At the latter investigation, 338 of 1781 participants (19%) had a history of renal stone formation. In 47% there had been recurrences. For the individual there was a continuous risk of acquiring a first renal stone up to the age of 60. Approximately 0.5% of the entire unselected population experienced onset annually up to this age. Recurrent renal stones occurred primarily in those with a positive family history of stones or early onset of stones, as well as in those who previously had frequently formed stones. A carefully obtained clinical history should be useful in predicting recurrences in the individual stone former.
Balloon Dilatation of Bilharzial Ureteric Strictures
Authors: JACOBSSON B. , LINDSTEDT E. , NARASIMHAM D. L. , SUNDIN T. , VIJAYAN P.
Published: December 2008

Summary— Balloon dilatation was performed in nine patients with bilharzial ureteric strictures. In six patients a percutaneous, antegrade approach was used and in three a balloon catheter was introduced into the ureter via a cystoscope. In another four patients, negotiation of the strictured area with a guide wire failed. In all dilated patients, symptomatic and urographic relief of the obstruction was obtained during follow‐up periods of 3 to 38 months (mean 19). One patient was re‐dilated after 24 months and has remained symptom‐free for a further 18 months. Balloon dilatation seems to be a promising method of treating this condition.
Instillation of Mitomycin C and Doxorubicin in the Prevention of Recurrent Superficial (Ta—T1) Bladder Cancer
Authors: JAUHIAINEN K. , ALFTHAN O.
Published: December 2008

Summary— Both Mitomycin C (MMC) and doxorubicin (Adriamycin) (ADM) prevent the recurrence of superficial papillary (Ta‐T1) urinary bladder cancers and also reduce the rate of progression. MMC appears to be more effective than ADM in buffered instillations.

The number of recurrent tumours (RI/m) and the number of recurrence times (RR) before prophylactic instillation were of significant prognostic importance but the prognostic value of the grade was questionable.

The buffer solution, together with methyl prednisolone, reduced the incidence of chemical cystitis.
The Use of Sacral Reflex Latencies in Detrusor Bladder Neck Dyssynergia
Authors: PARYS B. T. , WOOLFENDEN K. A. , PARSONS K. F.
Published: December 2008

Summary— Detrusor bladder neck dyssynergia (DBND) is a well recognised cause of bladder outflow obstruction, especially in the younger man. The cause is unknown, and the aim of this study was to determine if any neurological dysfunction is associated with this condition.

Twenty‐five males with proven DBND had sacral reflex latency studies performed. The conduction latencies indicate that the underlying cause is unrelated to any demonstrable neuropathy. Sacral reflex latencies are not helpful in the investigation of DBND.
The Value of Testing for Unmyelinated Fibre, Sensory Neuropathy in Diabetic Impotence
Authors: FOWLER CLARE J. , ALI Z. , KIRBY R. S. , PRYOR J. P.
Published: December 2008

Summary— Measurement of thermal thresholds provides a means of assessing neurological deficit and in particular of recognising a neuropathic process affecting unmyelinated and small myelinated fibres of the peripheral nerve. These groups of fibres cannot be tested by nerve conduction studies but are particularly susceptible to disease in diabetes.

Thresholds for thermal sensation on the sole of the foot were measured in 33 men presenting with erectile dysfunction. All 15 men with erectile dysfunction, which had been considered on clinical grounds to be neuropathic, had abnormal thermal thresholds. Diabetics with non‐neuropathic erectile dysfunction had normal results.

Whereas tests of unmyelinated sensory fibre function were abnormal in all those with neuropathic erectile dysfunction, electrophysiological measurement of the bulbocavernosus reflex was normal in five of nine men with diabetic neuropathic impotence.
Modulated expression of human leucocyte antigen class I and class II determinants in hyperplastics and malignant human prostatic epithelium
Authors: Sharpe J.C. , Abel P.D. , Gilbertston J.A. , Brawn P. , Foster C.S.
Published: December 2008

Objectives To determine whether human prostatic carcinoma cells express Class I and/or Class II major histocompatibility complex (MHC) determinants and whether they might thus be immune‐competent targets for cell‐mediated cytotoxicity

Materials and methods Immunohistochemistry, performed both before and after neuraminidase digestion. wass employed to compare 13 benign prostatic hyperplaisia with 42 primary and 44 metastatic prostatic carcinomas obtained from the United Kingdom and from the United States of America. Expression of β2microglopbulin was used as the marker of Class I and HLA‐DR as the marker of Class II expression.

Results Before desialylation. Class I MHC determinants were expressed in all of the benign hyperplasias in 26% of primary carcinomas and in 14% of lymoh node meatastases. Cells expressing Class I determinants were identified in 69% of benign hyperplasias and in 2% of primary carcnomas, but in none of the lymph node metastatses. After deisalylation. Class I deternants were expressed in 100% of benign hyperplasias 59% of primary carcinomas and 34% of the lymph node meatastases. Class II determinants were identified in were expressed in 100% of benign hyperplasias. but only 19% of primary carcinomas and 5% of epithelial cells in each of the benign hyperplasias expressed MHCs, <% of the tumour cell poplulations in the positive malignant tissues (primary and metastatic)expressed MHCs, even after neuraminidase digestion. No correlation was found between expression of Class I or Class II MHC and Gleason morphological grade.

Conclusions Failure to express Class I and/or Class II MHC determinants is a common feature of the majority of human prostatic carcinoma cells. Absence of these recognition moleculed may be associate with avoidance of immune‐surveillance and contribute to the metastatic dissemination of this malignancey.
Standardized in vitro mapping with multiple core biopsies of total prostatectomy specimens: localization and prediction of tumour volume and grade
Authors: HÄGGMAN M. , NYBACKA O. , NORDIN B. , BUSCH C.
Published: December 2008

Objective To analyse the ability of systematic core biopsy mapping to provide prognostic information in patients with prostatic cancer.

Materials and methods The prostates of 60 men with prostatic cancer, stages TOd‐T2, who had undergone total retropubic prostatectomy were studied. The average age of the patients was 63 years (range 49–72). Ten core biopsies (1.2 times 35 mm) were taken from the fresh specimens according to a standardized procedure. The total prostatectomy specimens were serially stepsectioned at 5 mm intervals and were assessed regarding tumour volume, grade and pT‐stage. The World Health Organization (WHO) grade obtained in the mapping biopsies was compared with that in the operative specimens. Undergrading (WHO) decreased substantially by mapping biopsies, but was still present with the Gleason system.

Results The volume of extracapsular tumours with extensively positive margins was significantly larger than that of intracapsular tumours (P<0.01). In addition, the fraction of cancer obtained in the biopsies from tumours with grossly positive margins was significantly smaller than that observed in biopsies from pT2 tumours (P<0.01). The cancer volume calculated from the result of the mapping correlated positively with the tumour volume determined by planimetry (R=0.83). A weaker correlation was found when only the six dorsal mapping biopsies were taken into consideration (R=0.68), but the correlation increased to R=0.75 when the six most significant biopsies were selected with the help of a correlation matrix. Biopsies from the ventral part of the prostate were also important, to obtain an accurate assessment of the tumour fraction within the whole gland.

Conclusion Mapping of the prostate gland with multiple (six or more) core biopsies is necessary for preoperative assessment of tumour volume, grade and pT stage; these are all of importance when assigning patients with clinically localized prostatic cancer to prognostic classes.
CULTURAL CIRCUMCISION IN EU PUBLIC HOSPITALS – AN ETHICAL DISCUSSION
Authors: BRUSA MARGHERITA , BARILAN Y. MICHAEL
Published: December 2008

The paper explores the ethical aspects of introducing cultural circumcision of children into the EU public health system.

We reject commonplace arguments against circumcision: considerations of good medical practice, justice, bodily integrity, autonomy and the analogy from female genital mutilation.

From the unique structure of patient‐medicine interaction, we argue that the incorporation of cultural circumcision into EU public health services is a kind of medicalization, which does not fit the ethos of universal healthcare. However, we support a utilitarian argument that finds hospital‐based circumcision safer than non‐medicalized alternatives.

The argument concerning medicalization and the utilitarian argument both rely on preliminary empirical data, which depend on future validation.
HUMAN REPRODUCTIVE CLONING: A CONFLICT OF LIBERTIES
Authors: HAVSTAD JOYCE C.
Published: December 2008

Proponents of human reproductive cloning do not dispute that cloning may lead to violations of clones' right to self‐determination, or that these violations could cause psychological harms. But they proceed with their endorsement of human reproductive cloning by dismissing these psychological harms, mainly in two ways. The first tactic is to point out that to commit the genetic fallacy is indeed a mistake; the second is to invoke Parfit's non‐identity problem. The argument of this paper is that neither approach succeeds in removing our moral responsibility to consider and to prevent psychological harms to cloned individuals. In fact, the same commitment to personal liberty that generates the right to reproduce by means of cloning also creates the need to limit that right appropriately. Discussion of human reproductive cloning ought to involve a careful and balanced consideration of both the relevant aspects of personal liberty – the parents' right to reproductive freedom and the cloned child's right to self‐determination.
Effects of UCH‐L1 on α‐synuclein over‐expression mouse model of Parkinson’s disease
Authors: Yasuda Toru , Nihira Tomoko , Ren Yong‐Ri , Cao Xu‐Qing , Wada Keiichiro , Setsuie Rieko , Kabuta Tomohiro , Wada Keiji , Hattori Nobutaka , Mizuno Yoshikuni , Mochizuki Hideki
Published: December 2008

The rare inherited form of Parkinson’s disease (PD), PARK5, is caused by a missense mutation in ubiquitin carboxy‐terminal hydrolase‐L1 (UCH‐L1) gene, resulting in Ile93Met substitution in its gene product (UCH‐L1Ile93Met). PARK5 is inherited in an autosomal‐dominant mode, but whether the Ile93Met mutation gives rise to a gain‐of‐toxic‐function or loss‐of‐function of UCH‐L1 protein remains controversial. Here, we investigated the selective vulnerabilities of dopaminergic (DA) neurons in UCH‐L1‐transgenic (Tg) and spontaneous UCH‐L1‐null gracile axonal dystrophy mice to an important PD‐causing insult, abnormal accumulation of α‐synuclein (αSyn). Immunohistochemistry of midbrain sections of a patient with sporadic PD showed αSyn‐ and UCH‐L1‐double‐positive Lewy bodies in nigral DA neurons, suggesting physical and/or functional interaction between the two proteins in human PD brain. Recombinant adeno‐associated viral vector‐mediated over‐expression of αSyn for 4 weeks significantly enhanced the loss of nigral DA cell bodies in UCH‐L1Ile93Met‐Tg mice, but had weak effects in age‐matched UCH‐L1wild‐type‐Tg mice and non‐Tg littermates. In contrast, the extent of αSyn‐induced DA cell loss in gracile axonal dystrophy mice was not significantly different from wild‐type littermates at 13‐weeks post‐injection. Our results support the hypothesis that PARK5 is caused by a gain‐of‐toxic‐function of UCH‐L1Ile93Met mutant, and suggest that regulation of UCH‐L1 in nigral DA cells could be a future target for treatment of PD.
CREB activation in the rapid, intermediate, and delayed ischemic preconditioning against hypoxic–ischemia in neonatal rat
Authors: Lin Wan‐Ying , Chang Ying‐Chao , Lee Hsueh‐Te , Huang Chao‐Ching
Published: December 2008

Ischemic preconditioning (IP) is a defense program in which exposure to sublethal ischemia followed by a period of reperfusion results in subsequent resistance to severe ischemic insults. Very few in vivo IP models have been established for neonatal brain. We examined whether rapid, intermediate, and delayed IP against hypoxic–ischemia (HI) could be induced in neonatal brain, and if so, whether the IP involved phosphorylation of cAMP response element‐binding protein (pCREB) after HI. Postnatal day 7 rat pups were subjected to HI at 2 h (2‐h IP), 6 h (6‐h IP), or 22 h (22‐h IP) after IP. We found all three IP groups had significantly reduced neuronal damage and TUNEL‐(+) cells 24 h post‐HI than no‐IP group. Compared with control, the no‐IP group had significant decreases of pCREB and mitochondria Bcl‐2 levels in the ipsilateral cortex 24 h post‐HI. In contrast, the three IP groups had increased pCREB and mitochondria Bcl‐2 levels, and significant differences were found between three IP and no‐IP groups. The increases of cleavage of caspase‐3 and poly (ADP‐ribose) polymerase and of cells with nuclear apoptosis inducing factor post‐HI in no‐IP group were all significantly reduced in three IP groups. The increases of caspase‐3 and calpain‐mediated proteolysis of α‐spectrin post‐HI were significantly reduced only in 22‐h IP group. Furthermore, all three IP groups had long‐term neuroprotection at behavioral and pathological levels compared with no‐IP group. In conclusion, IP, rapid, intermediate, or delayed, in neonatal rat brain activates CREB, up‐regulates Bcl‐2, induces extensive brakes on caspase‐dependent and ‐independent apoptosis after HI, and provides long‐term neuroprotection.
When to start antiepileptic drug treatment and with what evidence?
Authors: Marson Anthony G.
Published: December 2008

Where possible, the decision as to when to start antiepileptic drug treatment should be informed by the results of randomized controlled trials. For patients presenting with their first seizure, randomized controlled trials have demonstrated that compared to no or delayed treatment, antiepileptic drugs reduce the risk of a second seizure, but do not alter longer term seizure outcomes. A prognostic model has been developed to identify patients at low, medium and high risk of recurrence, to further inform treatment decisions. For patients presenting with two or more seizures, consensus holds that treatment should be initiated if the seizures were of significant symptomatology such that the patient would wish treatment, and they occurred over a period of less than 6–12 months. However, randomized controlled trials recruiting an unselected population of patients following two or more seizures have not been undertaken and the magnitude of any treatment effect is therefore unknown. This consensus is based upon data from observational studies that show a high rate of a 3rd or 4th seizures even with antiepileptic drug treatment. Recurrence risks for patients with two or more seizures of minor symptomatology (e.g., simple partial seizures) or seizures separated by long time periods of time have been investigated in a randomized control trial. They may wish to start antiepileptic drug treatment if they are in a medium or high recurrence risk group as defined by a prognostic model.
Debate: Should antiepileptic drugs be stopped after successful epilepsy surgery?
Authors: Cole Andrew J. , Wiebe Samuel
Published: December 2008

There is no consensus on whether or when to stop anticonvulsant drug treatment in patients after apparently successful epilepsy surgery. Although there are compelling reasons to consider antiepileptic drug (AED) discontinuation, there are relatively few data, and no class 1 data, to guide patient and physician decision‐making on this topic. This debate lays out a conceptual framework for considering the issue of AED discontinuation, and reviews and critiques the avaialble data. The goal is to provide physicians with the best available data, a context in which to consider it, and a full understanding of its limitations. This article also highlights an area that is ripe for further prospective study.
What is known about the mechanisms underlying SUDEP?
Authors: So Elson L.
Published: December 2008

This article highlights studies in three major domains of potential mechanisms of sudden unexplained death in epilepsy (SUDEP): cardiac, respiratory, and autonomic. Ictal cardiac arrest is a clinically rare but well‐recognized potential mechanism of SUDEP. Studies have failed to identify preexisting cardiac electrophysiologic or structural abnormalities that distinguish SUDEP persons. Some degree of pulmonary congestion is a common autopsy finding, but severe pulmonary edema occurs very rarely with seizures. In contrast, periictal apnea and hypoxia occur commonly with generalized tonic–clonic seizures and, to a lesser degree, with complex partial seizures. There are several animal models of postictal respiratory arrest. Postictal respiratory arrest in audiogenic seizure mice can be induced by serotonin receptor inhibition or prevented by selective serotonin reuptake inhibitor (SSRI) drugs. Reduced heart rate variability occurs in patients with refractory epilepsy and can be induced in animal seizure models, but its precise role in predisposing persons to sudden death requires further investigation.
Cutaneous metastasis from a parotid myoepithelial carcinoma: a case report and review of the literature
Authors: He Deng‐qi , Hua Cheng‐ge , Tang Xiu‐fa , Feng Yang
Published: December 2008

Myoepithelial carcinoma of the parotid gland is a rare salivary gland tumour, and its distant cutaneous metastasis has not been reported to date. Here, we report a case of myoepithelial carcinoma of the left parotid gland, which had metastasised to the skin of the right thorax after parotidectomy and radiotherapy. Diagnosis of the primary and metastatic tumour was based on the clinical findings and was confirmed by immunohistochemistry. A literature review of the clinical features of the skin metastases of parotid malignancies and their related pathological mechanisms is included in this case study. It was noted that myoepithelial carcinoma of the parotid gland has the potential to develop distant skin metastasis, which may be indicative of widespread dissemination and poor prognosis. Attention should be paid to initial treatment of the primary tumour and to emerging cutaneous masses whose location is distant from the primary tumour during follow up.
Pemphigoid vegetans: a case report and review of the literature
Authors: Kim Jinah , Chavel Severine , Girardi Michael , McNiff Jennifer M.
Published: December 2008

Pemphigoid vegetans is an exceptionally rare intertriginous variant of bullous pemphigoid characterized by vegetative and purulent lesions present in the groin, axillae, thighs, hands, eyelids and perioral regions. The clinical, histopathological and immunofluorescent profile of a new case of pemphigoid vegetans in a 79‐year‐old man is reported. Our patient had papillomatous plaques with pustules in the bilateral inguinal folds, which clinically resembled pemphigus vegetans. Also suggesting pemphigus vegetans, an initial skin biopsy showed eosinophilic spongiosis, while a second biopsy showed histological and immunological features diagnostic of pemphigoid. Because only a few cases of pemphigoid vegetans have been reported in the literature, clinical and morphological data are scant. Most reported cases were successfully treated with topical antibiotics or steroids; therefore, appropriate diagnosis of this rare lesion will assist management.
THIS ARTICLE HAS BEEN RETRACTED  CD34‐reactive tumors of the skin. An updated review of an ever‐growing list of lesions
Authors: Tardío Juan C.
Published: December 2008

Over the past few years, a growing number of cutaneous tumors expressing CD34 is being reported. The list contains benign and malignant neoplasms as well as reactive and hamartomatous lesions of diverse lineages of differentiation, including fibroblastic, myofibroblastic, fibrohistiocytic, vascular, neural, adipocytic, smooth muscle, hematopoietic, melanocytic and epithelial. The more frequent diagnostic difficulties are found in spindle cell proliferations, mainly in those of the fibrocytic lineage. In part, this is because of the fact that in this area are, aside to well‐defined entities, histologically and clinically diverse, recently reported cutaneous CD34‐reactive lesions, whose definitions, limits and relationships are not completely established. The CD34 expression plays a key role in the differential diagnosis of some tumors, such as dermatofibrosarcoma protuberans, epithelioid sarcoma (ES) or pleomorphic hyalinizing angiectatic tumor of soft parts, with important therapeutic consequences. In others, as in desmoplastic trichilemmoma, it can help to resolve diagnostic problems in concrete cases. Finally, in many of the CD34‐positive lesions, the diagnosis with the hematoxylin and eosin stain is straightforward. However, in all of them, the knowledge of the immunohistochemical profile contributes to our understanding of the cutaneous pathology.
Biofilm formation of Candida albicans on the surface of a soft denture‐lining material
Authors: Boscato Noéli , Radavelli Alessandra , Faccio Daniela , Loguercio Alessandro Dourado
Published: December 2008

Background:  Soft denture lining‐materials are more susceptible to microbial adhesion than hard denture base acrylic resin. Poor oral hygiene and Candida albicans infection are common among elderly denture wearers as these patients usually have difficulty in keeping them clean.

Purpose:  To evaluate the influence of the oral hygiene methods on the formation of a biofilm over a soft denture‐lining material.

Material and methods:  Twenty volunteers were randomly separated into two groups: G1 and G2. Ten volunteers performed daily hygiene of the prostheses with a soft toothbrush and toothpaste. The G2 performed a treatment identical to G1 but also immersed the prostheses in sodium hypochlorite 0.5% for 20 min, once a week. Quantification of the mean score values of biofilm formation at different times were statistically analysed using analysis of variance and Tukey’s test (α = 0.05).

Results:  G1 (0.65 ± 0.52) showed the lowest mean score values of biofilm formation. There was statistical difference between G1 and G2. The highest mean score values were found at 6 weeks (1.3 ± 1.08) and were statistically different from other times.

Conclusion:  The oral hygiene methods had a significant effect in the formation of the biofilm over a soft denture‐lining material.
GOVERNMENT OFFICES FOR AUSTRALLA'S AGED THE COMMONWEALTH OFFICE FOR THE AGED: A BRIEF DESCRIPTION
Authors: Keys Alan
Published: December 2008

The Bureau for the Aged was created by the W. A. State Government in order to meet effectively the challenges of demographic trends in an ageing Australia. Through consultation with service consumers and providers the Bureau will be a focus for aged concerns. An essential link between aged people and Government will be established.

The Main functions of the bureau are centred in the areas of policy development and advice on policy priorities; co‐ordination of Government activities directed to the aged and liaison with non‐government organisations; research and planning to make effective use of available resources and to identify priority areas of need, and encouragement of education programs in the community.
EATING — A LIFETIME OF PLEASURE
Authors: Prinsley Derek M.
Published: December 2008

Eating is an essential physiological activity which is a source of pleasure throughout life. Older people face risks of malnutrition through poor mobility and catering skills. Some food ingredients should be taken in only moderate amounts and the meal as a social occasion is important. Even in old age enjoyment of food and good digestion are to be expected, and being a little overweight is probably a good thing.
REVIEW OF NURSING HOMES AND HOSTELS
Authors: Rees Glenn
Published: December 2008

Reports on care of aged people are no novelty. Nor are the criticisms which have been directed at aged care services. The Review of Nursing Homes and Hostels and the 1986–87 Commonwealth Budget have at last provided the capacity to plan the provision of services over the next few years and to begin the process of redistributing resources away from nursing homes to a higher quality of care in less institutionalised hostel settings and community services.

This paper assesses the significance of the 1986–87 Budget and identifies the areas for priority attention in achieving the proposed new directions:

*the more effective planning of services;

*the flexible development of the hostel concept;

*the establishment of new and expanded assessment teams;

*the resolution of issues relating to standards and user rights; and

*the development of priorities and directions for the expansion and delivery of community services.
NEW CONCEPTS OF CAUSE AND MANAGEMENT OF PAIN IN THE ELDERLY
Authors: Helme Robert D.
Published: December 2008

Pain is a sensory and emotional experience and, as such, is always subjective. However, for many patients pain results from stimulation of nociceptors in the somatic structures. This nociceptive information is conveyed to the central nervous system by thinly myelinated and unmyelinated nerve fibres. Many unmyelinated fibres have polymodal nociceptors responsive to chemical as well as mechanical and thermal stimuli. These receptors also mediate neurogenic inflammation through the release of neuropeptides from the nerve terminals.

The study of nociceptor and afferent nerve function in man, although in its infancy, suggests that it may be possible to assess the contribution of the peripheral nervous system to the total pain experience. One method Is to analyse the neurogenic inflammatory response of polymodal nociceptors in patients with different pain states. One hypothesis is that some treatment modalities may act to desensitize polymodal nociceptors. Some recent evidence for this view obtained in a sample of elderly patients with low back pain is presented.
THE INTRODUCTION OF A BEHAVIOURAL APPROACH INTO THE MANAGEMENT OF THE CONFUSED AND DISTURBED ELDERLY IN A NURSING HOME
Authors: Bowles John R.
Published: December 2008

A ‘Behavioural Approach’ was introduced into the care and management of four elderly nursing home residents as a pilot project to investigate the problems and effects of implementing such a system. Base line observations were followed by recommendations for intervention based on ‘Rules of Thumb’ guidelines. Although data was not considered reliable, conclusions were that the techniques were of value, should be practiced by all nurses and that more training was needed. Recommendations included simpler recording of behavioural events and the establishment of special areas for the care of wandering, severely demented patients.
AGEISM: PUBLIC PREJUDICE AND PRIVATE PRECONCEPTIONS*
Authors: Radford Anthony J.
Published: December 2008

The concept of “ageism” or automatic prejudice towards elderly people solely on the basis of their age, is not new. Recently, however, comment has been developed, especially in relation as to how ageism may be decreasing the quality of life and appropriate care of our senior citizens. Professor Robert Butler, to whom authorship of the term is ascribed identified five myths on which he believed ageism is built. This paper greatly expands the number of these myths and discusses some ways in which they may be addressed to reduce the level of ageism in society.
GREY WHAT?: PENSIONER PERCEPTIONS OF GREY POWER
Authors: Wiles David
Published: December 2008

This article explores aspects of ageing and politics including pensioners' perceptions of the ‘Grey Power’ concept. First, the reasons behind the voting behaviour of some pensioners are examined, in order to illuminate the political ‘world view’ of older Australians. Then, the issue of changes in voting is investigated, with the finding that these pensioners were quite stable in their voting choices. While the majority of pensioners were unaware of ‘Grey Power’, they provided a diverse range of reactions to this political idea. Finally, strategies are suggested towards the development of Grey Power and the empowerment of the elderly.
USER CHARGES FOR COMMUNITY SERVICES
Authors: Howe Anna , Hayman Annette
Published: December 2008

User charges have been suggested as a means of limiting demand for subsidised community services, yet the practicalities and effectiveness of this strategy remain largely unknown. Discussion of user charges has also been stimulated recently with the development of Regional Geriatric Assessment Teams and the restructuring of community services under the Home and Community Care Program.

The first part of this paper presents an empirical analysis of user charges practices and policies in twelve Local Government Areas in metropolitan Melbourne that are served by the same Regional Geriatric Assessment Team. The significance of user charges in the financing of community services relative to subsidies from Commonwealth and State Governments and contributions from Local Government are also examined, and relationships between levels of funding and provision are analysed.

The second part of the paper discusses a number of implications of the findings from the perspectives of users, providers and Commonwealth and State Governments.

User charges appear to have limited effectiveness in containing demand for services, and the considerable variation found in all aspects of user charges creates both vertical and horizontal inequities. These problems compound the uneven access to services arising from variability in levels of central government subsidies, with resultant constraints on the operation of Regional Geriatric Assessment Teams.
BOOKSHELF
Authors: Last P.M.
Published: December 2008

The Elderly and Residential Care: Australian Lessons for Britain. R.A. Parker. (Pp 128; S65) Aldershot: Cower Publishing Company Limited, 1987. ISBN 0 566 05 367 8
PILLS, PERCEPTION AND PARTICIPATION ‐ HEALTH IN OLDER AGE A survey of the views of older people in NSW
Authors: Jones S.
Published: December 2008

The results reported in this paper are from a survey of 1329 New South Wales older people conducted by the NSW Council on the Ageing (NSW COTA) as a resource for policy development. The paper will report health‐related data from the survey, focusing on perceived health, medication, and well‐being and life style variables.
CARS AND THE SOCIAL NETWORKS OF THE ELDERLY: THE CREATION OF DISADVANTAGE
Authors: Cant R.
Published: December 2008

The eminent economist Galbraith once argued that if you are poor, it is better to be poor in a poor society. His argument was that in a poor society, systems such as the transport system were based on the needs of the poor; in a rich society, where car ownership rates are high, the poor find their needs are not met. By extending this argument, it is possible to hypothesize that the elderly who are a minority in our society, albeit an increasing one, have their transport needs often overlooked, and their rights in this area denied. The focus of this paper is an examination of transport patterns with reference to the lives of the elderly. It is argued that the elderly in our society are one group with reduced access to the motor car. In a society based on the motor car, this results in an induced dependency. Further their social networks are weakened and their social power correspondingly reduced. This paper uses survey data and secondary data sources to examine the limited access of the elderly to motor cars and ways in which this affects their social networks.
AN AGEING POPULATION: BURDEN OR BLESSING?
Authors: Horn R.
Published: December 2008

The net cost to the community of an ageing population is usually overstated for two main reasons: national expenditure reflects costs only within the static framework of national accounts that do not show up separately the demand created by re‐spending: and the bogey of unproductive labour misrepresents the role played by such activities in the economic and social life of the community.
MANAGING URINARY INCONTINENCE IN NURSING HOMES BY NURSING ASSISTANTS: A SURVEY
Authors: Fleming A. , Welsh G.
Published: December 2008

A questionnaire was administered to assistants in nursing identifying their current practices in managing urinary incontinence. The questionnaire also explored how and through whom assistants in nursing acquired knowledge regarding management of urinary incontinence. It was found that toileting regimes were carried out by 76% of the respondents with second hourly toileting being the most common practice. Significantly 24% of the respondents did not routinely practice some form of toileting. A little over half of the respondents mentioned changing and washing the incontinent resident and just 16% included psychological support in their current practices. While teaching took place primarily on the job, significantly it was found that 30% were required to provide care to incontinent residents without receiving any prior instruction. These results highlight the need for a review of current nursing practices along with further investigation into educational programs for assistants in nursing with the view to increasing the assessment and psychological support elements of such programs.
SKILL ACQUISITION FOR PRODUCTIVE OLD AGE
Authors: Seedsman T.A.
Published: December 2008

Confound not the distinctions of thy life which nature has divided; that is, youth, adolescence, manhood, and old age; nor in these divided periods, wherein thou are in manner four, conceive thyself but one. Let each distinction have its salutary transition, and critically deliver thee from the imperfections of the former; so ordering the whole, that prudence and virtue may have the largest selection (Sir Thomas Browne. 1605–1682).
IS DISTANCE EDUCATION IN GERONTOLOGY PRACTICAL?
Authors: Helme RD , Scherer S. , Andrews PV
Published: December 2008

The purpose of education is to increase the knowledge of those being instructed, to promote ongoing self instruction and to facilitate critical analysis and application of the acquired information. Problems associated with reaching a distant audience are maintaining relevance and interest. The methods used to educate at a distance are written, auditory, visual and mixed; and these methods may be used in either a passive or active manner. Interactive computer learning (ICL) has advantages in that it requires active involvement in visual (text and diagram) instruction and potentially auditory and written modalities. It is flexible and capable of continuous updating. Disadvantages include a lack of interpersonal communication and delayed feedback for judgement of relevance. However, ICL is practical and relatively inexpensive. An example of ICL application in gerontology is presented.

This brief outline illustrates the potential of this form of education. The material presented extends from clinical contact through to the details of social, psychological and medical aspects of dementia research. It gives the student the opportunity to explore a variety of issues surrounding the diagnosis of dementia, but only in a framework which represents the true world of clinical experience. Again, it should be emphasised that one of the most important aspects of this form of teaching program is that it is flexible. It is able to be changed easily if peer review by an expert panel suggests there is ambiguity in its construct, if feedback from students suggest there is some confusion in application, or if concepts regarding the area of study change. In this particular example. a video and text program is being prepared that will substitute for some of the clinical components which are now represented by text only.

Interactive computer learning will become the mainstay of distance education in Australia over the next several years. It is particularly applicable to the field of gerontology, the only limitations being the time and imagination required for production as well as the moderate costs involved in reception and use of the product. If any reader envisages the possibility of providing their labour and expertise for the production of a learning package related to a topic of their interest, they should contact the authors.
THE EFFECT OF AGEING ON REMEMBERING TO REMEMBER: AN INVESTIGATION OF SIMULATED MEDICATION REGIMENS
Authors: Rendell P.G. , Thomson D.M.
Published: December 2008

Remembering to remember, prospective memory, was investigated by simulation of medication regimen. Subjects were 80 adult volunteers in five age groups: 20s, 40s, 60s, 70s and 80 plus years. Subjects were asked to push a button at prescribed times on a small box containing an electronic device that recorded the date and time of each push. They were required to push the button at the same times over two periods of seven days; once‐a‐day for one week and four‐times‐a‐day for the other week. There was a significant effect for age, with the older adults more often on time and when late they were closer to the set times than the younger adults. However, the typical age‐related decline was found on a retrospective task.