bluuebunny/crossref_metadata_2025 huggingface dataset:
A Holistic Look at Minimizing Adverse Environmental Impact Under Section 316(b) of the Clean Water Act
Authors: Veil John A. , Puder Markus G. , Littleton Debra J. , Johnson Nancy
Published: March 2005

Section 316(b) of the Clean Water Act (CWA) requires that “the location, design, construction, and capacity of cooling water intake structures reflect the best technology available for minimizing adverse environmental impact.” As the U.S. Environmental Protection Agency (EPA) develops new regulations to implement Section 316(b), much of the debate has centered on adverse impingement and entrainment impacts of cooling-water intake structures. Depending on the specific location and intake layout, once-through cooling systems withdrawing many millions of gallons of water per day can, to a varying degree, harm fish and other aquatic organisms in the water bodies from which the cooling water is withdrawn. Therefore, opponents of once-through cooling systems have encouraged the EPA to require wet or dry cooling tower systems as the best technology available (BTA), without considering site-specific conditions.

However, within the context of the broader scope of the CWA mandate, this focus seems too narrow. Therefore, this article examines the phrase “minimizing adverse environmental impact” in a holistic light. Emphasis is placed on the analysis of the terms “environmental” and “minimizing.” Congress chose “environmental” in lieu of other more narrowly focused terms like “impingement and entrainment,” “water quality,” or “aquatic life.” In this light, BTA for cooling-water intake structures must minimize the entire suite of environmental impacts, as opposed to just those associated with impingement and entrainment. Wet and dry cooling tower systems work well to minimize entrainment and impingement, but they introduce other equally important impacts because they impose an energy penalty on the power output of the generating unit. The energy penalty results from a reduction in plant operating efficiency and an increase in internal power consumption. As a consequence of the energy penalty, power companies must generate additional electricity to achieve the same net output. This added production leads to additional environmental impacts associated with extraction and processing of the fuel, air emissions from burning the fuel, and additional evaporation of freshwater supplies during the cooling process. Wet towers also require the use of toxic biocides that are subsequently discharged or disposed. The other term under consideration, “minimizing,” does not equal “eliminating.” Technologies may be available to minimize but not totally eliminate adverse environmental impacts.
Analysis of Australian Legislation Dealing with Contaminated Land
Authors: Berveling Steven
Published: March 2005

An analysis of past and present Australian legislation for managing and regulating contaminated sites confirms that such legislation must deal with a number of specific matters.Australian legislation is effective in some of these areas but poor in relation to others. The analysis will assist other countries and jurisdictions to create effective legislation more speedily by avoiding identified problems.
Minimizing Adverse Environmental Impact: How Murky the Waters
Authors: Super Reed W. , Gordon David K.
Published: March 2005

The withdrawal of water from the nation’s waterways to cool industrial facilities kills billions of adult, juvenile, and larval fish each year. U.S. Environmental Protection Agency (EPA) promulgation of categorical rules defining the best technology available to minimize adverse environmental impact (AEI) could standardize and improve the control of such mortality. However, in an attempt to avoid compliance costs, industry has seized on the statutory phrase “adverse environmental impact” to propose significant procedural and substantive hurdles and layers of uncertainty in the permitting of cooling-water intakes under the Clean Water Act. These include, among other things, a requirement to prove that a particular facility threatens the sustainability of an aquatic population as a prerequisite to regulation. Such claims have no foundation in science, law, or the English language. Any nontrivial aquatic mortality constitutes AEI, as the EPA and several state and federal regulatory agencies have properly acknowledged. The focus of scientists, lawyers, regulators, permit applicants, and other interested parties should not be on defining AEI, but rather on minimizing AEI, which requires minimization of impingement and entrainment.
Determining Arsenic Distribution in Urban Soils: A Comparison with Nonurban Soils
Authors: Chirenje Tait , Ma L.Q. , Zillioux E.J.
Published: March 2005

There are many challenges in the determination of arsenic background concentrations in soils. However, these challenges are magnified when those determinations are carried out on urban soils. Irrespective of this, it is important to correctly identify and understand the extent of pollution in order to provide efficient preventative, remedial actions and cost-effective management of contaminated areas. This review paper discusses the factors that make the determination of arsenic background concentrations in urban areas different from similar determinations in nonurban areas. It also proposes solutions, where applicable, that are based on experience in determining arsenic background concentrations in both urban and nonurban areas in Florida, and from other studies in the literature. Urban soils are considerably different from nonurban areas because they have significant human disturbance, making them more difficult to study. They are characterized by high spatial and temporal variability, compaction, and modified chemical and physical characteristics. These differences have to be addressed during site selection, sample collection, and statistical analyses when determining arsenic distribution.
Modeling of Nitrate Leaching during the Fall–Winter Season in Artificially Drained Soils
Authors: El-Sadek Alaa
Published: March 2005

The nitrogen processes that occur within the soil play a major role in determining the nitrate leaching to shallow groundwater. In this study, the transport and fate of nitrate within the soil profile were analyzed by comparing field data with the simulation results of a mathematical model. The objective was to study the transport and fate of nitrate within the soil profile and nitrate leaching to shallow groundwater for the fall-winter season, by applying the methodology in Elverdinge experiment, situated in the sandy loam region in Belgium, from October 1, 2000 to March 31, 2001. The analysis by comparing field data with the simulation results of DRAINMOD-N model is given. The research indicated that the DRAINMOD-N model can, after calibration and validation, be used as a useful fertilizer management tool in predicting the nitrate transport and transformation in the soil profile and the nitrate leaching to shallow groundwater and surface waters. The model can also be used as an environmental control when the environmental objective has a greater importance than profits in the agriculture field.
Genotoxicity and Mutagenicity of Suspended Particulate Matter of River Water and Waste Water Samples
Authors: Reifferscheid Georg , Oepen Britta v.
Published: March 2005

Suspended particulate matter of samples of river water and waste water treatment plants was tested for genotoxicity and mutagenicity using the standardized umu assay and two versions of the Ames microsuspension assay. The study tries to determine the entire DNA-damaging potential of the water samples and the distribution of DNA-damaging substances among the liquid phase and solid phase. Responsiveness and sensitivity of the bioassays are compared.
Express Detection of Pentachlorophenol as Dioxins Precursor in Natural Water
Authors: Krikounova Vitalia S. , Abuknesha Ramadan , Eremin Sergei A.
Published: March 2005

A rapid detection method for the pesticide pentachlorophenol (PCP) — polarization fluoroimmunoassay (PFIA) — in the dynamic range of 10–9,000 ppb was developed. PCP may form polychlorinated dibenzo-p-dioxins, making environmental monitoring of this compound an issue of great importance. In order to optimize the PFIA procedure, a number of fluorescein-labeled PCP derivatives and similar compounds (tracers) were synthesized, and the influence of their structure on PFIA characteristics was studied. Also, two antisera were tested in developing PFIA for PCP. The developed method is highly specific for PCP and can be used for its determination in water samples at a level down to 10 ppb. Total time of the assay for 10 samples is about 7 min. The assay provides a useful and a highly practical screening tool for the processing of large numbers of samples and for the preliminary estimation of potential dioxins contamination in water resources.
Proposed Methods and Endpoints for Defining and Assessing Adverse Environmental Impact (AEI) on Fish Communities/Populations in Tennessee River Reservoirs
Authors: Hickman Gary D. , Brown Mary L.
Published: March 2005

Two multimetric indices have been developed to help address fish community (reservoir fish assemblage index [RFAI]) and individual population quality (sport fishing index [SFI]) in Tennessee River reservoirs. The RFAI, with characteristics similar to the index of biotic integrity (IBI) used in stream fish community determinations, was developed to monitor the existing condition of resident fish communities[1,2,3]. The index, which incorporates standardized electrofishing of littoral areas and experimental gill netting for limnetic bottom-dwelling species, has been used to determine residential fish community response to various anthropogenic impacts in southeastern reservoirs.

The SFI is a multimetric index designed to address the quality of the fishery for individual resident sport fish species in a particular lake or reservoir[4]. The SFI incorporates measures of fish population aspects and angler catch and pressure estimates. This paper proposes 70% of the maximum RFAI score and 10% above the average SFI score for individual species as “screening” endpoints for balanced indigenous populations (BIP) or adverse environmental impact (AEI). Endpoints for these indices indicate: (1) communities/populations are obviously balanced indigenous populations (BIP) indicating no adverse environmental impact (AEI), or are “screened out”; (2) communities/populations are considered to be potentially impacted; and (3) where the resident fish community/population should be considered adversely impacted. Suggestions are also made concerning how examination of individual metric scores can help determine the source or cause of the impact.
Use of Equivalent Loss Models Under Section 316(b) of the Clean Water Act
Authors: Dey William
Published: March 2005

Equivalent loss models encompass a variety of life table-based approaches that can be used to convert age- and life stage-specific estimates of entrainment and impingement loss to a common, easily understood currency. This common currency can be expressed in terms of numbers of individuals, yield to the fishery, or biomass to the ecosystem. These models have at least two key uses in the Section 316(b) assessment process: screening for adverse environmental impact (AEI) and determination of environmental benefits associated with intake alternatives. This paper reviews the various forms of equivalent loss models, their data input requirements, and their assumptions and limitations. In addition, it describes how these models can be used as a second-level screening tool as part of the assessment of the potential for AEI. Given their relative simplicity and ease of use, equivalent loss models should prove to be an important tool in the arsenal of impact assessment methods for Section 316(b).
Kinetics of Natural Attenuation: Review of the Critical Chemical Conditions and Measurements at Bore Scale
Authors: Atteia O. , Franceschi M.
Published: March 2005

This paper describes the chemical conditions that should favour the biodegradation of organic pollutants. Thermodynamic considerations help to define the reaction that can occur under defined chemical conditions. The BTEX (benzene, toluene, ethylbenzene, and xylene) degradation is focused on benzene, as it is the most toxic oil component and also because it has the slowest degradation rate under most field conditions. Several studies on benzene degradation allow the understanding of the basic degradation mechanisms and their importance in field conditions. The use of models is needed to interpret field data when transport, retardation, and degradation occur. A detailed comparison of two existing models shows that the limits imposed by oxygen transport must be simulated precisely to reach correct plumes shapes and dimensions, and that first-order kinetic approaches may be misleading. This analysis led us to develop a technique to measure directly biodegradation in the field. The technique to recirculate water at the borehole scale and the CO2analysis are depicted. First results of biodegradation show that this technique is able to easily detect the degradation of 1 mg/l of hydrocarbons and that, in oxic media, a fast degradation rate of mixed fuel is observed.
Mercury Exchange at the Air-Water-Soil Interface: An Overview of Methods
Authors: Fang Fengman , Wang Qichao , Liu Ruhai
Published: March 2005

An attempt is made to assess the present knowledge about the methods of determining mercury (Hg) exchange at the air-water-soil interface during the past 20 years. Methods determining processes of wet and dry removal/deposition of atmospheric Hg to aquatic and terrestrial ecosystems, as well as methods determining Hg emission fluxes to the atmosphere from natural surfaces (soil and water) are discussed. On the basis of the impressive advances that have been made in the areas relating to Hg exchange among air-soil-water interfaces, we analyzed existing problems and shortcomings in our current knowledge. In addition, some important fields worth further research are discussed and proposed.
Adverse Environmental Impact: A Consultant’s Perspective
Authors: Wells Alan W. , Englert Thomas L.
Published: March 2005

Environmental consultants are in a unique position to address the practical aspects of a working definition of “adverse environmental impact” (AEI) within Section 316(b) of the Clean Water Act. In our work with the electric utility industry, attorneys, and regulatory agencies, we have encountered numerous and sometimes conflicting interpretations as to what constitutes AEI. In our over 30 years of experience, we have applied most of the approaches suggested for addressing this issue, including biostatistical methods, trend analysis, time series methods, conditional mortality rate models, stock-recruitment models, equivalent adult models, and ecosystem models. In our experience, the paradigm most helpful in bringing about agreement among stakeholders is to (1) create a model of operating scenarios, (2) use empirical data from on-site studies to parameterize the model, (3) convert losses by life stage to equivalent adult losses, (4) convert equivalent adult losses to economic value, and (5) compare scenarios on an economic basis.
Atmospheric Emissions, Depositions, and Transformations of Arsenic in Natural Ecosystem in Finland
Authors: Mukherjee Arun B. , Bhattacharya Prosun
Published: March 2005

For the last 2 decades, special attention has been paid to arsenic due to its high concentration in groundwater in many regions of the globe. There are not very many reports on arsenic concentration in the Finnish ecosystem, although the metal has been known to be highly toxic since ancient times. For the majority of people in Finland, the leading exposure route to arsenic is through food consumption.

In this study, it has been observed that atmospheric emissions of arsenic from anthropogenic sources have decreased by 90%, which is due to better control technology and strict regulation. Aquatic discharge also was attenuated from 7.1 metric tons (t) in 1990 to 0.7 t in 1999. The concentration of arsenic aerosols in the atmosphere in Finland varies between 0.46 to 0.75 ng m–3. Its use in pesticides and insecticides also has been phased out in Finland. There is no information available regarding arsenic species in the Finnish environment.

Elevated concentrations of arsenic in groundwater has been reported for many countries. In Finland two hot spots are reported – one in the south of Finland and the second in Lapland. In these areas, arsenic concentration in well water is greater than 10 μg l–1(WHO recommended value: <10 μg l–1). It is believed that the release of arsenic into the Finnish groundwater is geogenic.
Measurement Error Affects Risk Estimates for Recruitment to the Hudson River Stock of Striped Bass
Authors: Dunning Dennis J. , Ross Quentin E. , Munch Stephan B. , Ginzburg Lev R.
Published: March 2005

We examined the consequences of ignoring the distinction between measurement error and natural variability in an assessment of risk to the Hudson River stock of striped bass posed by entrainment at the Bowline Point, Indian Point, and Roseton power plants. Risk was defined as the probability that recruitment of age-1+ striped bass would decline by 80% or more, relative to the equilibrium value, at least once during the time periods examined (1, 5, 10, and 15 years). Measurement error, estimated using two abundance indices from independent beach seine surveys conducted on the Hudson River, accounted for 50% of the variability in one index and 56% of the variability in the other. If a measurement error of 50% was ignored and all of the variability in abundance was attributed to natural causes, the risk that recruitment of age-1+ striped bass would decline by 80% or more after 15 years was 0.308 at the current level of entrainment mortality (11%). However, the risk decreased almost tenfold (0.032) if a measurement error of 50% was considered. The change in risk attributable to decreasing the entrainment mortality rate from 11 to 0% was very small (0.009) and similar in magnitude to the change in risk associated with an action proposed in Amendment #5 to the Interstate Fishery Management Plan for Atlantic striped bass (0.006)— an increase in the instantaneous fishing mortality rate from 0.33 to 0.4. The proposed increase in fishing mortality was not considered an adverse environmental impact, which suggests that potentially costly efforts to reduce entrainment mortality on the Hudson River stock of striped bass are not warranted.
Effects of Sewage Sludges Contaminated with Chlorinated Aromatic Hydrocarbons on Sludge-Treated Areas (Soils and Sediments)
Authors: Eljarrat Ethel
Published: March 2005

The fate of PCDDs, PCDFs, and PCBs in sewage sludges after different management techniques — such as agricultural application, land restoration, and marine disposal — was studied. Changes observed in the concentrations, in the ratio between PCDD and PCDF levels, and in the isomeric distribution suggest the influence of the sewage sludge on the sludge-treated areas (soils and sediments). Whereas land application techniques seem to produce no serious environmental consequences, marine disposal practices produce considerable increases in the levels of contamination in marine sediments.
Could Lipoprotein Lipase Play a Role in Alzheimer's Disease?
Authors: Blain Jean-Francois , Poirier Judes
Published: March 2005

This paper reviews recent literature on the role of lipoprotein lipase in the central nervous system with a focus on its recently described role in synaptic remodeling. This novel role could have implication for Alzheimer's disease treatment.
Electromagnetic Fields and Human Endocrine System
Authors: Karasek Michal , Woldanska-Okonska Marta
Published: March 2005

Extremely low frequency electromagnetic fields (ELF EMF) are commonly present in daily life all over the world. Moreover, EMF are used in the physiotherapy of many diseases because of their beneficial effects. There is widespread public concern that EMF may have potential consequences for human health. Although experimental animal studies indicate that EMF may influence secretion of some hormones, the data on the effects of EMF on human endocrine system are scarce. Most of the results concentrate on influence of EMF on secretion of melatonin. In this review, the data on the influence of EMF on human endocrine system are briefly presented and discussed.
The Biological Effect of Extremely Low Frequency Electromagnetic Fields and Vibrations on Barley Seed Hydration and Germination
Authors: Amyan Armine , Ayrapetyan Sinerik
Published: March 2005

The changes of wet and dry weights and germination of barley seed in different periods of its swelling in nontreated (control), extremely low frequency electromagnetic fields (ELF EMF) )treated, and extremely low frequency vibrations (ELFV)treated cold (4°C) and warm (20°C) distilled water (DW) were studied. The metabolic-dependent seed hydration, dry weight dissolving, germination, and water binding in seed were modulated by preliminary EMF- and ELFV-treated DW. Frequency “windows” for the effect of EMF and ELFV on seed hydration, solubility, water binding in seed, and germination were discovered. These “windows” were different for EMF and ELFV, as well as in various phases of seed swelling. It is suggested that EMF-induced water structure modification has a different biological effect on the process of seed hydration, solubility, water binding in seed, and germination compared to ELFV.
The Effect on Rat Thymocytes of the Simultaneous In Vivo Exposure to 50-Hz Electric and Magnetic Field and to Continuous Light
Authors: Quaglino Daniela , Capri Miriam , Zecca Luigi , Franceschi Claudio , Ronchetti Ivonne P.
Published: March 2005

Thymus plays an important role in the immune system and can be modulated by numerous environmental factors, including electromagnetic fields (EMF). The present study has been undertaken with the aim to investigate the role of long-term exposure to extremely low frequency electric and magnetic fields (ELF-EMF) on thymocytes of rats housed in a regular dark/light cycle or under continuous light. Male Sprague-Dawley rats, 2 months old, were exposed or sham exposed for 8 months to 50-Hz sinusoidal EMF at two levels of field strength (1 kV/m, 5 μT and 5 kV/m, 100 μT, respectively). Thymus from adult animals exhibits signs of gradual atrophy mainly due to collagen deposition and fat substitution. This physiological involution may be accelerated by continuous light exposure that induces a massive death of thymocytes. The concurrent exposure to continuous light and to ELF-EMF did not change significantly the rate of mitoses compared to sham-exposed rats, whereas the amount of cell death was significantly increased, also in comparison with animals exposed to EMF in a 12-h dark-light cycle. In conclusion, long-term exposure to ELF-EMF, in animals housed under continuous light, may reinforce the alterations due to a photic stress, suggesting that,in vivo, stress and ELF-EMF exposure can act in synergy determining a more rapid involution of the thymus and might be responsible for an increased susceptibility to the potentially hazardous effects of ELF-EMF.
Coexisting Angiomyolipoma and Renal Cell Carcinoma in a Kidney of an Elderly Woman: Case Report and Review of the Literature
Authors: Billings Barry , Hamrick Leon C. , Bueschen Anton J. , Kenney Philip J.
Published: March 2005

Angiomyolipoma is a well described but relatively uncommon benign renal neoplasm composed of varying admixtures of mature adipose tissue, smooth muscle, and thick-walled blood vessels.[1] The incidence of angiomyolipoma is about 0.3% overall.[2] It frequently occurs in patients with tuberous sclerosis. Even more uncommon is the simultaneous occurrence of angiomyolipoma and renal cell cancer in the same kidney in a patient without tuberous sclerosis.
GU Evaluation and Management of Renal Transplant Candidates and Recipients
Authors: Bretan Peter N.
Published: March 2005

There are more than 200,000 end stage renal disease (ESRD) patients who are potential transplant candidates and more than 100,000 previously transplanted renal recipients with functioning allografts in the United States1. Fifty-seven percent of these patients are male and forty percent are greater than 50 years of age2, 3. Diabetes is the most common cause of kidney failure. It is evident that many patients are at high risk for development of urologic problems and thus it is estimated that the average urologist will care for up to ten of these patients yearly4. Thus a review of the genitourinary (GU) evaluation and management of these patients is timely.
Use of the Silastic Sheath in Bladder Neck Reconstruction
Authors: Diamond D.A. , Quimby G.F. , Rink R.C. , Ransley P.G.
Published: March 2005

OBJECTIVE: The study compared two populations of patients undergoing bladder neck reconstruction using the silastic sheath in two major pediatric centers. The success with this technique was markedly different in the two centers. The purpose of the study was to determine factors that might explain the divergent results.PATIENTS AND METHODS: Fifteen patients treated in Indianapolis were compared with 94 patients treated in London with the silastic sheath technique of bladder neck reconstruction. Eighty-seven percent of the Indianapolis patients had myelomeningocele whereas 86% of the London group had exstrophy/epispadias. Median age of the Indianapolis patients was 11 years whereas it was 8.4 years in London. Seventy-three percent of patients in Indianapolis were female and 79% in London were male. Patients were followed for a minimum of eight years in Indianapolis and a mean of seven years in London. Similar surgical technique was employed in the two centers but, over time, the London approach included use of a non-reinforced silastic wrapped loosely around the bladder neck with the interposition of omentum. RESULTS: Both groups achieved continence rates exceeding 90%. Of the Indianapolis patients, two-thirds experienced erosion of the silastic at a mean of 48 months. With modifications in the London technique, the erosion rate of silastic was lowered from 100% to 7%. CONCLUSION: Direct, snug wrap of silastic without omentum around the Young-Dees tube as well as simultaneous bladder augmentation placed patients at increased risk for erosion. The silastic sheath technique may be less applicable to myelomeningocele patients. It seems most applicable to older male patients with exstrophy or epispadias undergoing Young-Dees bladder neck reconstruction who have the ability to void.
Renal Urologic Anomalies Presenting In Adult Identical Twins
Authors: Edelstein Robert A. , Altman Richard E. , Koch-Weser Peter
Published: March 2005

Two sets of identical adult twins recently presented to our hospital. In one case, the patients demonstrated (ipsilateral) renal agenesis. In the other, the patients presented approximately one year apart with symptomatic (ipsilateral) ureteropelvic junction obstructions. Although the literature suggests a few reports of this type in the pediatric and newborn population, the authors are unaware of similar reports in adults.
Comparison of Three Types of Continent Urinary Diversions in a Single Center
Authors: Girgin Cengiz , Sezer Akif , Ozer Kutan , Tarhan Huseyin , Bolukbasi Ahmet , Gurel Gozen
Published: March 2005

The results including the complication and continence rates for 3 types of continent urinary diversion were evaluated. From 1992 to 1998 we performed 58 continent urinary diversions after radical cystectomy for invasive transitional cell carcinoma (TCC) of the urinary bladder. All three types of continent diversions and ileal loop procedures were discussed and patient preferences were determined. The patient preference rate for continent urinary diversion was 96.6%, and half of these patients wanted to be completely dry. Mean age of the patients was 58.2 years. Of the 58 patients, 9 (15.5%) had a Kock pouch, 15 (25.8%) had a Kock neobladder and 34 (58.6%) had sigmoidorectal pouch (Mainz-II pouch). Early and late complication rates of the three different continent diversions were evaluated. The number of complications, such as urine leakage, pyelonephritis, hydronephrosis, reflux and stone formation, were similar in all three types of diversions. Two (5.9%) Mainz pouch II patients who had stopped oral alkalinization demonstrated severe hyperchloremic acidosis. Spontaneous pouch rupture occurred in 1 of the Kock pouches. Reoperation rates were higher with the Kock pouch and Kock neobladder cases. Daytime continence rates for the Kock pouch, Kock neobladder and Mainz II pouch were 77.7%, 86.7% and 100% respectively. Even though complete dryness may not be achieved in every patient, orthotopic bladder substitution appears to be the best choice after radical cystectomy. Although it carries the risk of life-long oral alkalinization therapy, the Mainz pouch II is associated with an excellent continence rate and may be a good alternative for patients who desire to be dry.
Epididymal Metastasis from Carcinoma of the Prostate
Authors: Heman-Ackah C. , Urol Dip , Fox A. T. , El-Jabbour J.
Published: March 2005

Epididymal Metastasis from a primary carcinoma of the prostate gland is a rare but recognised phenomena. We describe a case of such metastasis which, unlike previous reports, presents as a painful epididymal mass. Therefore it is important for urologists to consider epididymal metastasis as part of the differential diagnosis in a patient with known carcinoma of the prostate and a tender epididymal mass.
Release of Obstructive Prostatic Disease and Improvement of Erectile Dysfunction by Repetitive Prostatic Massage and Antimicrobial Therapy
Authors: Hennenfent Bradley R. , Feliciano Antonio Novak
Published: March 2005

We report on a 69-year-old male who presented with an indwelling urinary catheter due to obstructive prostatic disease. The patient also complained of impotence. With repetitive prostatic massage combined with antimicrobial therapy the urinary obstruction was released, the patient's urinary symptoms resolved, and sexual function improved.
Pilonidal Sinus of the Penis
Authors: O'Kane Hugh F. , Duggan B. , Mulholland C. , Crosbie J.
Published: March 2005

A pilonidal sinus is a subcutaneous sinus containing hair. It is most commonly found in the natal cleft of hirsute men. Here we describe the unusual finding of a pilonidal sinus arising on the male foreskin.
VURD Syndrome Managed by Pyelostomy
Authors: Rosser Charles J. , Auringer Sam , Kroovand R. L.
Published: March 2005

We report a case of VURD syndrome in a three day old neonate who was diagnosed with hydronephrosis on a prenatal ultrasound. Severe tortuosity and dilation of the upper urinary tracts in the presence of progression of hydronephrosis or a persistently elevated creatinine may favor a proximal urinary diversion rather than primary valve ablation or cutaneous vesicostomy. Because of a persistently elevated serum creatinine, a nonfunctioning kidney with grade 4/5 vesicoureteral reflux and worsening contralateral hydronephrosis despite lower tract drainage, a left cutaneous pyelostomy was performed, contralateral to the kidney involved with VURD. Postoperatively the serum creatinine stabilized at 1.0 mg/dl and decreased to 0.3 mg/dl at one month of age.
Renal Artery Stenosis and Ipsilateral Renal Cell Carcinoma: Description of an In Situ Partial Nephrectomy and Splenorenal Arterial Bypass
Authors: Slavis Scott A. , Ganesan George S. , Swift Claudia , Ruppert Ronald C.
Published: March 2005

A case of a renal artery stenosis and ipsilateral renal cell carcinoma with long term results is reported. A 65-year-old man with renovascular hypertension, renal insufficiency, and nephrotic range proteinuria presented with an incidental renal cell carcinoma. Concomitant in situ left partial nephrectomy and splenorenal arterial bypass was achieved. The patient is doing well without evidence of malignancy, stable renal function, markedly improved proteinuria and stable blood pressure more than three years later. The techniques of this procedure are detailed and underscore the possibility of successful removal of a renal cell carcinoma with preservation of renal function despite renal artery stenosis.
Spontaneous Renal Artery Dissection in a Normotensive Young Male
Authors: Taylor John A. , Martin Eric C. , Sawczuk Ihor S.
Published: March 2005

We report a case of spontaneous superior pole renal artery dissection in a healthy forty-one year old man. Spontaneous renal artery dissection is a rare event occurring in patients with hypertension or renovascular disease such as fibromuscular dysplasia. This case demonstrates the importance of maintaining renovascular accidents as part of the differential diagnosis of abdominal pain.
Incisionless Pubovaginal Fascial Sling Using Transvaginal Bone Anchors for the Treatment of Stress Urinary Incontinence
Authors: Vasavada Sandip P. , Comiter Craig V. , Raz Shlomo
Published: March 2005

Introduction: Bladder neck suspension (BNS) for stress urinary incontinence (SUI) can have significant morbidity, including bleeding, infection and pain. In an effort to reduce this potential morbidity, we have devised a technique which provides the same suburethral support as a standard anterior vaginal wall sling (AVWS), but without a vaginal or suprapubic incision. We describe this minimally invasive technique. Methods: From April 1998 to February 1999, 85 women underwent an incisionless suburethral fascial sling procedure. A transvaginal bone drill was used to place a bone anchor loaded with #1 prolene suture into the inferior aspect of the pubic bone on either side of the urethra. A subepithelial tunnel was created at the level of the bladder neck. A 2 x 7 cm segment of cadaveric fascia lata was placed through the subepithelial tunnel. The sutures were passed through the fascia 5mm from either edge, effectively creating a 6.0 cm sling. Finally, the sutures are tied up to the pubic symphysis.Results: Follow-up was via a self-administered questionnaire and patient interview. Recurrent SUI was noted in 2/85 (3%). New onset urge incontinence was present in 4/85 (5%). Permanent urinary retention has not occurred in either group. All procedures were performed on an outpatient basis and no operative complications occurred.Conclusions: Early results for the incisionless sling compare favorably with the long term results for the AVWS. This minimally invasive approach has thus far not been associated with any significant complications. Elimination of the vaginal and suprapubic incisions has not compromised efficacy, and appears to reduce the incidence of urge incontinence. Long term follow-up will establish the lasting efficacy of this novel surgical technique.
Urologic Issues During Pregnancy
Authors: Weiss Jeffrey P.
Published: March 2005

Pregnancy induces a variety of physiologic changes in the urinary tract. When such changes become accentuated the physiologic becomes the pathologic and symptoms arise, at times of significance enough to threaten the well being of mother and/or fetus. This article intends to describe the basis for urinary physiology and its pathologic counterparts during pregnancy. Such a background may then facilitate a rational management protocol for various urologic problems in the gravid state.
The regulation and activation of lupus‐associated B cells
Authors: Fields Michele L. , Hondowicz Brian D. , Wharton Gina N. , Adair Brigette S. , Metzgar Michele H. , Alexander Shawn T. , Caton Andrew J. , Erikson Jan
Published: March 2005

Summary:  Anti‐double‐stranded DNA (anti‐dsDNA) B cells are regulated in non‐autoimmune mice. While some are deleted or undergo receptor editing, a population of anti‐dsDNA (VH3H9/Vλ1) B cells that emigrate into the periphery has also been identified. These cells have an altered phenotype relative to normal B cells in that they have a reduced lifespan, appear developmentally arrested, and localize primarily to the T/B‐cell interface in the spleen. This phenotype may be the consequence of immature B cells encountering antigen in the absence of T‐cell help. When provided with T‐cell help, the anti‐dsDNA B cells differentiate into antibody‐forming cells. In the context of the autoimmune‐prone lpr/lpr or gld/gld mutations, the VH3H9/Vλ1 anti‐dsDNA B cells populate the B‐cell follicle and by 12 weeks of age produce serum autoantibodies. The early event of anti‐dsDNA B‐cell follicular entry, in the absence of autoantibody production, is dependent upon CD4+ T cells. We hypothesize that control of autoantibody production in young autoimmune‐prone mice may be regulated by the counterbalancing effect of T‐regulatory (Treg) cells. Consistent with this model, we have demonstrated that Treg cells are able to prevent autoantibody production induced by T‐cell help. Additional studies are aimed at investigating the mechanisms of this suppression as well as probing the impact of distinct forms of T‐cell‐dependent and ‐independent activation on anti‐dsDNA B cells.
Rheumatoid arthritis
Authors: Goronzy Jörg J , Weyand Cornelia M
Published: March 2005

Summary:  Therapeutic efficacy of depleting B cells or blocking T‐cell costimulation in rheumatoid arthritis (RA) has confirmed the critical pathogenic role of adaptive immune responses. Yet, RA preferentially affects elderly individuals, in whom adaptive immunity to exogenous antigens begins to fail. Here, we propose that senescence of the immune system is a risk factor for RA, with chronic inflammation resulting from the accumulation of degenerate T cells that have a low threshold for activation and utilize a spectrum of novel receptors to respond to microenvironmental cues. The process of immunosenescence is accelerated in RA and precedes the onset of disease, the acceleration, in part, being conferred by the HLA‐DR4 haplotype. Naive CD4+ T cells in RA are contracted in diversity and restricted in clonal burst. Senescence of effector CD4+ T cells is associated with the loss of CD28 and the de novo expression of KIR2DS2, NKG2D, and CX3CR1, all of which function as costimulatory molecules and reduce the threshold for T‐cell activation. The synovial microenvironment promotes chronic persistent immune responses by facilitating ectopic lymphoid neogenesis, such as the formation of aberrant germinal centers. With the propensity to develop complex lymphoid architectures and to provide optimal activation conditions for senescent CD4+ T cells, the synovium becomes a natural target for pathogenic immune responses in prematurely aged individuals.
Genetic lesions in T‐cell tolerance and thresholds for autoimmunity
Authors: Liston Adrian , Lesage Sylvie , Gray Daniel H. D. , Boyd Richard L. , Goodnow Christopher C.
Published: March 2005

Summary:  The cause of common organ‐specific autoimmune diseases is poorly understood because of genetic and cellular complexity in humans and animals. Recent advances in the understanding of the mechanisms of the defects underlying autoimmune disease in autoimmune polyendocrinopathy syndrome type 1 and non‐obese diabetic mice suggest that failures in central tolerance play a key role in predisposition towards organ‐specific autoimmunity. The lessons from such rare monogenic autoimmune disorders and well‐characterized polygenic traits demonstrate how subtle quantitative trait loci can result in large changes in the susceptibility to autoimmunity. These data allow us to propose a model relating efficiency of thymic deletion to T‐cell tolerance and susceptibility to autoimmunity.
The RET proto‐oncogene: A molecular therapeutic target in thyroid cancer
Authors: Kodama Yoshinori , Asai Naoya , Kawai Kumi , Jijiwa Mayumi , Murakumo Yoshiki , Ichihara Masatoshi , Takahashi Masahide
Published: March 2005

The RET proto‐oncogene is responsible for the development of several human inherited and non‐inherited diseases. Germline point mutations were identified in multiple endocrine neoplasia types 2A and 2B, and familial medullary thyroid carcinoma. More than 10 rearranged forms of RET, referred to as RET/PTC 1–9, ELKS/RET and RFP/RET, have been cloned from sporadic and radiation‐associated papillary thyroid carcinomas. These mutations induced oncogenic activation of RET tyrosine kinase by different mechanisms. To date, various kinds of therapeutic approaches have been developed for the treatment of RET‐associated cancers, including tyrosine kinase inhibitors, gene therapy with dominant negative RET mutants, and RNA interference to abrogate oncogenic mutant RET expression. RET and some signaling molecules that function downstream of RET could be potential targets for the development of selective cancer therapeutics. (Cancer Sci 2005; 96: 143–148)
Expression of hypoxia‐inducible factor‐1α in esophageal squamous cell carcinoma
Authors: Matsuyama Tomokazu , Nakanishi Kuniaki , Hayashi Takuya , Yoshizumi Yutaka , Aiko Satoshi , Sugiura Yoshiaki , Tanimoto Takao , Uenoyama Maki , Ozeki Yuichi , Maehara Tadaaki
Published: March 2005

Hypoxia‐inducible factor‐1 (HIF‐1) is a transcription factor that plays an important role in tumor growth and metastasis by regulating energy metabolism and inducing angiogenesis. Elevated levels of HIF‐1α, a subunit of HIF‐1, are noted in various malignant tumors, but it is unclear whether this is so in esophageal carcinoma. The purpose of this study was to evaluate the implications of HIF‐1α expression in esophageal squamous cell carcinoma. In 215 patients with esophageal carcinoma, we examined immunoreactivity for HIF‐1α protein, vascular endothelial growth factor (VEGF) protein and p53 protein. In 38 patients, we examined the expression of HIF‐1α messenger ribonucleic acid (mRNA) (using the semiquantitative reverse transcriptase‐polymerase chain reaction [RT‐PCR]). A positive HIF‐1α protein expression was recognized in 95% of the patients, and was strongly apparent within both the nuclei and/or cytoplasm of tumor cells. The proportion of patients in the ‘high score’ group for HIF‐1α protein expression increased significantly with increasing VEGF protein expression. Immunoreactivity for HIF‐1α protein was found to have a significant effect on disease‐free survival rate in our univariate analysis, but no effect on overall survival rate. In RT‐PCR, HIF‐1α mRNA scores correlated significantly with scores for HIF‐1α protein expression, but not with any clinicopathologic factor or either of the survival rates. The detection of HIF‐1α protein and mRNA would appear to offer limited information as to progression and prognosis in esophageal carcinoma. (Cancer Sci 2005; 96: 176–182)
Identification of hemoglobin‐α and ‐β subunits as potential serum biomarkers for the diagnosis and prognosis of ovarian cancer
Authors: Woong‐Shick Ahn , Sung‐Pil Park , Su‐Mi Bae , Joon‐Mo Lee , Sung‐Eun Namkoong , Gye‐Hyun Nam , Young‐Lae Cho , Ho‐Sun Choi , Heung‐Jae Jun , Chong‐Kook Kim , Young‐Wan Kim , Byoung‐Don Han , Hyun‐Sun Jin
Published: March 2005

The development of new biomarkers for ovarian cancer is clearly necessary for the improved detection and monitoring of the disease. Surface enhanced laser desorption and ionization time‐of‐flight mass spectrometry (SELDI‐TOF‐MS) can be employed in the identification of differentially expressed proteins in cancer cells. The objective of this study was, then, to identify potential diagnostic serological biomarkers for ovarian cancer. We performed protein expression difference analyses of 45 serum samples using SELDI protein chip array. Forty‐five sera obtained from ovarian cancer patients (n = 35) and normal healthy females (n = 10), were profiled on the surface of SELDI protein chip. The candidate biomarkers were purified by CM‐Sepharose, and their N‐terminal amino sequence was determined. The amounts of hemoglobin (Hb) in cancer patient's sera versus that of normal sera were measured by ELISA. Nine sera proteins that were found to be significantly differentially expressed (P < 0.05) between the sera of ovarian cancer patients and that of normal healthy females were selected using the WCX2 array. The most distinctive polypeptide peaks detected in the ovarian cancer samples were at 15.1 and 15.8 kDa and these two peaks were identified as the hemoglobin‐alpha (Hb‐α) and ‐beta (Hb‐β) chain, respectively. ELISA indicated that the sensitivity for intact Hb level was 77% in sera obtained from ovarian cancer patients, as compared with normal healthy female sera. In conclusion, two ovarian cancer biomarker proteins were discovered and identified as Hb‐α and Hb‐β. Hb levels were significantly different in ovarian cancer serum samples and those obtained from normal healthy females, as determined by ELISA. Additional studies are required to further validate Hb‐α and Hb‐β biomarkers. (Cancer Sci 2005; 96: 197–201)
Cognitive, emotional, physical and social effects of growth hormone treatment in adults with Prader–Willi syndrome
Authors: . Höybye C , Thorén M. , Böhm B.
Published: March 2005

Background  Prader–Willi syndrome (PWS) is a multisystem genetic disorder characterized by short stature, muscular hypotonia, hyperphagia, obesity, maladaptive behaviour, hypogonadism and partial growth hormone (GH) deficiency (GHD). Severe GHD of other aetiologies has been shown to affect mood and quality of life negatively, and there are reports of improvements with GH replacement. We have studied cognitive, emotional, physical and social parameters in PWS adults at baseline, during and after GH treatment.

Patients and methods  Nineteen patients, 9 females and 10 males, median age 25 years, mean BMI 35 kg/m2 participated in this study. Approximately half of the group had GHD. All patients fulfilled the clinical criteria for PWS and 13 had a positive genotype. The patients were randomized to 6 months of treatment with either GH [1.6 IU/day (0.53 mg/day)] or placebo, followed by 12 months of active GH treatment. Treatment was then stopped, and the patients were followed for an additional period of 6 months. A test battery for general cognitive evaluation and a computer‐based measurement of reaction time, motor speed and fluency were employed at baseline, after 6 months and at the end of GH treatment. At the same time intervals, a self‐evaluation questionnaire was answered at the end of each test session. Other questionnaires reflecting the patients’ cognitive, emotional, physical and social status were answered by relatives/caretakers at baseline and at 3 and 6 months following cessation of GH treatment.

Results  Baseline cognitive level was estimated to be moderately to mildly impaired; IQ range was 40–90. The results from some of the cognitive and the motor performance tests improved significantly after 6 and 18 months of GH treatment. According to the questionnaires, both the patients and the relatives/caretakers evaluated physical status rather negatively at baseline, but still, impairments in both physical and social status and overall functioning were observed when GH treatment was discontinued. The self‐evaluation did not change in any aspect during GH treatment.

Conclusions  In this pilot study of an adult PWS cohort, we were able to document beneficial effects in mental speed and flexibility and in motor performance during GH treatment. Impairment was seen in physical and social status as well as overall functioning, when GH treatment stopped. Studies of larger cohorts are needed to further elucidate the role of GH treatment in this group of patients.