bluuebunny/crossref_metadata_2025 huggingface dataset:
Over‐expression of STP13, a hexose transporter, improves plant growth and nitrogen use in Arabidopsis thaliana seedlings
Authors: SCHOFIELD R. A. , BI Y.‐M. , KANT S. , ROTHSTEIN S. J.
Published: November 2008

In Arabidopsis thaliana, the regulation of hexose levels by the large monosaccharide transporter (MST) gene family influences many aspects of plant growth. The cloning and transgenic expression of one family member (STP13) enabled the manipulation of carbon (C) and nitrogen (N) metabolism in Arabidopsis. Transgenic seedlings constitutively over‐expressing STP13 (STP13OX) had increased rates of glucose uptake, higher endogenous sucrose levels and accumulated more total C and biomass per plant when grown on soil‐less media supplemented with 55 mm glucose and sufficient N (9 mm nitrate). Furthermore, STP13OX seedlings acquired 90% more total N than the Col‐0 seedlings, and had higher levels of expression of the nitrate transporter NRT2.2. In addition, STP13OX seedlings were larger and had higher biomass than Col‐0 seedlings when grown under a limiting N condition (3 mm nitrate). Transgene analysis of STP13 reveals that its gene product is localized to the plasma membrane (PM) in tobacco BY‐2 suspension cells, that it encodes a functional MST in planta, and that the STP13 promoter directs GUS expression to the vasculature and to leaf mesophyll cells. This work highlights the link between C and N metabolism, demonstrating that a plant's N use may be improved by increasing the availability of C.
Temperature and nitrogen effects on regulators and products of the flavonoid pathway: experimental and kinetic model studies
Authors: OLSEN KRISTINE M. , SLIMESTAD RUNE , LEA UNNI S. , BREDE CATO , LØVDAL TROND , RUOFF PETER , VERHEUL MICHEL , LILLO CATHRINE
Published: November 2008

The flavonoid pathway is known to be up‐regulated by different environmental stress factors. Down‐regulation of the pathway is much less studied and is emphasized in the present work. Flavonoid accumulation was induced by exposing plants for 1 week to nitrogen depletion at 10 °C, giving high levels of anthocyanins and 3‐glucoside‐7‐rhamnosides, 3,7‐di‐rhamnosides and 3‐rutinoside‐7‐rhamnosides of kaempferol and quercetin. Flavonol accumulation as influenced by temperatures and nitrogen supply was not related to the glycosylation patterns but to the classification as quercetin and kaempferol. When nitrogen was re‐supplied, transcripts for main regulators of the pathway, PAP1/GL3 and PAP2/MYB12, fell to less than 1 and 0.1% of initial values, respectively, during 24 h in the 15–30 °C temperature range. Anthocyanins showed a half‐life of approximately 1 d, while the degradation of flavonols was much slower. Interestingly, the initial fluxes of anthocyanin and flavonol degradations were found to be temperature‐independent. A kinetic model for the flavonoid pathway was constructed. In order to get the observed concentration‐temperature profiles as well as the temperature compensation in the flavonoid degradation flux, the model predicts that the flavonoid pathway shows an increased temperature sensitivity at the end of the pathway, where the up‐regulation by PAP/GL3 has been found to be largest.
Heat‐induced electrical signals affect cytoplasmic and apoplastic pH as well as photosynthesis during propagation through the maize leaf
Authors: GRAMS THORSTEN E. E. , LAUTNER SILKE , FELLE HUBERT H. , MATYSSEK RAINER , FROMM JÖRG
Published: November 2008

Combining measurements of electric potential and pH with such of chlorophyll fluorescence and leaf gas exchange showed heat stimulation to evoke an electrical signal (propagation speed: 3–5 mm s−1) that travelled through the leaf while reducing the net CO2 uptake rate and the photochemical quantum yield of both photosystems (PS). Two‐dimensional imaging analysis of the chlorophyll fluorescence signal of PS II revealed that the yield reduction spread basipetally via the veins through the leaf at a speed of 1.6 ± 0.3 mm s−1 while the propagation speed in the intervein region was c. 50 times slower. Propagation of the signal through the veins was confirmed because PS I, which is present in the bundle sheath cells around the leaf vessels, was affected first. Hence, spreading of the signal along the veins represents a path with higher travelling speed than within the intervein region of the leaf lamina. Upon the electrical signal, cytoplasmic pH decreased transiently from 7.0 to 6.4, while apoplastic pH increased transiently from 4.5 to 5.2. Moreover, photochemical quantum yield of isolated chloroplasts was strongly affected by pH changes in the surrounding medium, indicating a putative direct influence of electrical signalling via changes of cytosolic pH on leaf photosynthesis.
Second transplant with two unrelated cord blood units for early graft failure after cord blood transplantation for thalassemia
Authors: Jaing Tang‐Her , Hung Iou‐Jih , Yang Chao‐Ping , Tsai Ming‐Horng , Lee Wen‐I , Sun Chien‐Feng
Published: November 2008

Abstract:  Early GF is a frequent complication following hematopoietic stem cell transplantation for patients with thalassemia. We report the outcome of double‐unit CBT in three patients who developed early GF after CBT. The initial conditioning regimen consisted of i.v. Bu 14 mg/kg (day −9 to −6), i.v. Cy 200 mg/kg (day −5 to −2) and ATG at 120 mg/kg (day −4 to −1). They received GVHD prophylaxis with cyclosporine‐A from day −3 and a short course of methylprednisolone (1 mg/kg i.v., every 12 h on days 5–19 with a taper, thereafter 25% decrease every other day). The interval between two transplants was seven and 10 months. The retransplant recipients were preconditioned with i.v. Bu 14 mg/kg (day −7 to −4), i.v. Cy 120 mg/kg (day –3 to –2) and ATG at 150 mg/kg (day −5 to −1 and +1 to +5). GVHD prophylaxis regimen was the same as the first transplant. Neutrophil engraftment were observed in all patients between day +15 and +26. All are alive, between nine and 11 months after retransplant. Our group reported successful utilization of double umblical cord blood grafts in thalassemia patients with early GF.
Continued complete remission without systemic therapy for isolated testicular relapse after bone marrow transplantation in a boy with acute lymphoblastic leukemia
Authors: Kodama Yuichi , Okamoto Yasuhiro , Ijichi Osamu , Shinkoda Yuichi , Nishikawa Takuro , Tanabe Takayuki , Yoshioka Takako , Tashiro Yukie , Mougi Hiroyuki , Kawano Yoshifumi
Published: November 2008

Abstract:  ITR after BMT in cases of acute lymphoblastic leukemia is relatively rare. Treatment for ITR after BMT generally consists of a combination of local irradiation, orchiectomy, and systemic chemotherapy. However, the effectiveness of these modalities has not been established. Both irradiation and systemic chemotherapy including a second transplantation would result in additional toxicity. In this report we describe a boy with ITR 91 months after BMT who has remained in complete remission more than two yr after a unilateral orchiectomy. We did not treat this patient with systemic chemotherapy, as his ITR developed very late. Our experience suggests that orchiectomy alone is a reasonable option for very late ITR after BMT.
Unrelated hematopoietic stem cell transplantation for Cernunnos‐XLF deficiency
Authors: Faraci Maura , Lanino Edoardo , Micalizzi Concetta , Morreale Giuseppe , Di Martino Daniela , Banov Laura , Comoli Patrizia , Locatelli Franco , Soresina Annarosa , Plebani Alessandro
Published: November 2008

Abstract:  Cernunnos‐XLF deficiency is a rare CI characterized by a defective DNA DSB repair mechanism. Its clinical manifestations are growth retardation, dysmorphic features, malformations, and severe B‐ and T‐cell lymphopenia. BM failure may complicate the clinical picture. To date, there have been no described patients with CSy undergoing allogeneic HSCT. We report a case of CSy treated successfully with unrelated allogeneic HSCT after a reduced‐intensity conditioning regimen. Two yr after HSCT, the patient maintains full donor engraftment, normal hematopoiesis, and progressively improving immune competence, thus suggesting that HSCT may be the treatment of choice for CSy.
Duct‐to‐duct biliary reconstruction in selected cases in pediatric living‐donor left‐lobe liver transplantation
Authors: Liu Chinsu , Loong Che‐Chuan , Hsia Cheng‐Yuan , Peng Cheng‐Kang , Tsai Hsin‐Lin , Tsou Mei‐Yung , Wei Choufu
Published: November 2008

Abstract:  The feasibility of D‐D biliary reconstruction in pediatric LDLT using left‐lobe graft has been discussed in few reports. The use of a trans‐anastomotic biliary tube seemed to be the favorable method to avoid the complications according to these reports. We had performed left‐lobe LDLT for seven pediatric cases and D‐D was done originally. Three cases were converted to R‐Y hepaticojejunostomy due to radical resection of hepatoduodenal ligament (n = 1) and severe kinking of D‐D (n = 2). Four cases received D‐D using 6‐0 PDS interrupted sutures without external stent tube. One D‐D case died of intra‐cerebral hemorrhage 10 days after operation with a functioning graft. There was one biliary leakage in a D‐D patient who required PTCD stent for 4 months without any sequale. From our limited experience, D‐D biliary reconstruction without external stent tube in left‐lobe LDLT is feasible in certain pediatric cases having normal extra‐hepatic bile ducts. In smaller recipient with larger graft, the use of a trans‐anastomotic biliary tube can prevent anastomotic kinking although we suggest R‐Y biliary reconstruction is better for this condition.
Audit of eosinophilic oesophagitis in children post‐liver transplant
Authors: Noble C. , Francis L. , Withers G. W. , Ee L. C. , Lewindon P. J.
Published: November 2008

Abstract:  Pediatric liver transplantation has proven so successful that 10‐yr survival post‐transplantation is in excess of 70% and following transplantation, emphasis of medical care switches from life saving to promotion of good quality of life. EE is an increasingly recognised phenomenon in the general population. Eosinophilic disorders of the GI tract are increasingly recognised in patient’s post‐solid organ transplantation but the contribution of EE to morbidity in this population has not been addressed to date. The objective of this study was to identify the incidence of EE in children receiving liver transplantation by the QLTS over the last 15.5 yr. Comprehensive review of medical records of all liver transplant recipients during study period via cross‐checking procedural and electronic laboratory results was performed. All oesophageal biopsies reporting mucosal inflammation were reviewed. EE can be diagnosed when oesophageal biopsy reveals ≥5 eosinophils per HPF; however, we used a cut‐off of 20 eosinophils per HPF, which is in accordance with current opinion. In the 159 children who received DD OLT, 130 survived and four have been diagnosed with EE (3%). Only 34 are currently followed in Queensland and all four patients diagnosed are in this cohort representing 12% of our follow‐up clinic. Many patients are followed elsewhere so occurrence of EE in our total surviving population is an underestimate. EE is clinically important in the post‐liver transplant community. Children post‐OLT who have upper GI symptoms should be considered for endoscopic evaluation and biopsy to exclude EE.
BK nephropathy in pediatric hematopoietic stem cell transplant recipients
Authors: Verghese Priya S. , Finn Laura S. , Englund Janet A. , Sanders Jean E. , Hingorani Sangeeta R.
Published: November 2008

Abstract:  BK nephropathy is a known cause of renal insufficiency in kidney transplant recipients. Activation of the polyoma virus may also occur in the native kidneys of non‐renal allograft recipients. BK nephropathy has only been reported in a few patients after HCT, most being adult patients, and the single reported pediatric case had evidence of hemorrhagic cystitis. The response to antiviral therapy also seems to differ widely. Here, we describe two cases of BK nephropathy in the native kidneys of HCT recipients exposed to high levels of immunosuppression because of GVHD. Neither of our patients had any evidence of hemorrhagic cystitis. We present definitive renal pathology and detailed chronological evidence of the rising serum creatinine with simultaneous serum and urine BK PCR titers. In one of our cases, antiviral therapy did not seem beneficial as documented by continued renal dysfunction and elevated serum/urine BK PCR titers. Based on our report, intense immunosuppression in pediatric HCT recipients seems to be involved in the activation of BK virus and BK nephropathy should be suspected even in the absence of hematuria in HCT recipients with unexplained renal dysfunction.
Liver transplantation for fulminant hepatic failure in infancy: A single center experience
Authors: Strauss Annette , Grabhorn Enke , Sornsakrin Marijke , Briem‐Richter Andrea , Fischer Lutz , Nashan Bjoern , Ganschow Rainer
Published: November 2008

Abstract:  FHF is characterized by a high percentage of unknown causes leading to acute liver failure and furthermore by an increased morbidity and mortality prior to and post‐Ltx. In different transplant centers, the reasons leading to FHF differ significantly as well as outcome. We report our single center experience with 30 pediatric patients receiving a liver transplant for FHF, out of a total of 83 children presenting with FHF. The time to transfer patients to the transplant center after the diagnosis of FHF was long, with a median of 14 days (Ltx group) and 12 days (controls), respectively. In nearly half of the patients (n = 14) in the Ltx group, we were not able to establish an exact diagnosis prior to Ltx: 50% suffered from encephalopathy, and 13 patients were treated in the intensive care unit prior to transplant. Because of the availability of different surgical techniques, all children received a timely transplant [split (n = 18), living donor (n = 9), whole organ (n = 2), and reduced liver (n = 1)]. Patient survival was 93.4%, and graft survival was 83.4% for at least one yr follow‐up. Severe complications following Ltx included three cases with aplastic anemia and one child suffering from systemic mitochondrial depletion syndrome. The survival of patients treated medically was 83%. We conclude that a strong focus should be made on early referral to a specialized center and on improvement of diagnostic tools to timely detect the underlying reason for FHF. Results following Ltx for FHF are good.
Outcome of kidney transplantation in Canadian Aboriginal children in the province of British Columbia
Authors: Matsuda‐Abedini Mina , Al‐AlSheikh Khalid , Hurley Robert Morrison , Matsell Douglas G. , Chow Josephine , Carter James E. , Lirenman David S.
Published: November 2008

Abstract:  Renal transplantation remains the therapy of choice for children and adolescents with ESRD. Differences in graft survival are observed in kidney transplant recipients of different race and ethnicities. Data in pediatric populations are limited and confounded by disparities in access to health care. We performed a retrospective single Canadian centre database review to determine the short‐ and long‐term outcomes of kidney transplantation in Aboriginal children compared to non‐Aboriginals. A total of 159 primary renal transplant recipients at BCCH between 1985 and 2005 were examined (15% Aboriginal). Aboriginal children had different etiologies of ESRD, and a higher percentage of females, but were similar in age at transplantation, cold ischemia time and living donation rate. Early graft outcomes such as delayed graft function, episodes of acute rejection in the first year post‐transplant and estimated glomerular function rate at one yr were similar in both groups. Long‐term graft survival, however, was significantly worse in the Aboriginal group, with a significantly increased rate of late rejections: 50% compared with 26.7% among non‐Aboriginals (p = 0.03). In a province with uniform access to health care, significant differences in long‐term graft outcome exist among Aboriginal children compared with non‐Aboriginals.
Age‐Related Pregnancy Results and Further Examination of Bitches after Aglepristone Treatment of Pyometra
Authors: Jurka P , Max A , Hawryńska K , Snochowski M
Published: November 2008

Contents

The cystic endometrial hyperplasia and pyometra complex is one of the most common uterine diseases in bitches. The appearance of pharmacological preparations containing anti‐progestagens created new possibilities for pyometra treatment. The aim of this study was to evaluate the curative effect of the anti‐progestagen aglepristone treatment of pyometra in bitches of different ages. Twenty four bitches of different breeds, aged from 0.8 to 9.5 years (21–48 kg) exhibiting clinical pyometra symptoms (two groups – I ≤ 5 years, n = 14 and II >5 years, n = 10) were evaluated. Information about the general reproductive health was collected up to 54 months after anti‐progestagen treatment. Remission of clinical symptoms and return of blood chemistry results and total leucocyte count to referential values were achieved in all cases within 14 days of treatment. Bitches were naturally mated at the first, and when unsuccessful, the second oestrus after treatment. In group I, no recurrence of pyometra symptoms was observed during following cycle(s). Eight bitches (57.1%) had a full‐term pregnancy and the number of newborn pups ranged from 1 to 12. None of the bitches from the group II became pregnant. In conclusion, the basic indication for conservative pharmacological treatment of pyometra is preserving female fertility and obtaining offspring. The important conditions for successful aglepristone treatment are: the young age (up to 5 years) and the lack of detectible ovarian cysts. It seems necessary to mate bitches in the first or second oestrus after finishing treatment. The efficacy of treatment can be measured by the after‐treatment pregnancy rate.
Brenner tumor in pregnancy: Clinical approach and pathological findings
Authors: Gedikbasi Ali , Ulker Volkan , Aydin Ovgu , Akyol Alpaslan , Numanoglu Ceyhun , Ceylan Yavuz
Published: November 2008

The Brenner tumor is an uncommon ovarian tumor in pregnancy with only three previous cases in the English published reports. A 35‐year‐old woman delivered abdominally because of distress symptoms and a Brenner tumor was resected incidentally. Histological examination revealed a tumor composed of epithelial nests and areas of stromal luteinization. The patient was treated conservatively. Brenner tumor should be considered in the differential diagnosis of adnexal masses during pregnancy. These tumors are mainly benign and show typical luteinization associated with the hormonal milieu in pregnancy.
CARCINOMA OF THE PENIS IN SIAM
Authors: Noble T. P.
Published: November 2008

(1) The estimates of the frequency of cancer in the East are open to fallacy because of the lack of an adequate system of registration of deaths, but in the case of a particular disease, fairly reliable conclusions can be reached from hospital admissions.

(2) Cancer of the penis formed 9.6 per cent. of the total admissions for cancer to the Siriraj Hospital during the four years under review.

(3) Phimosis appears to play the chief rôle in the etiology of this disease. Siam, being a Buddhist country, circumcision is not performed as a rite in early life.

(4) Syphilis comes second in importance as a causative factor.

(5) The inguinal glands, although usually enlarged, are rarely the site of a secondary cancer.
OBSERVATIONS ON THE FORMATION AND THE PREVENTION OF CALCULI*
Authors: SNAPPER I. , BENDIEN W. M. , POLAK A.
Published: November 2008

Urine is a supersaturated solution of many substances. Large quantities of different substances, practically insoluble, are present in solution in the urine. This may partly be explained by the simultaneous presence of other so‐called hydrotropic substances which further the solubility of the insoluble salts. The hydrotropic action of urea, hippuric, salicylic and mandelic acid is discussed.

Beside this hydrotropic action of the substances just mentioned, the presence of different colloids may also collaborate to the solution of the insoluble salts. Chondroitic sulphuric acid and nucleic acid may help specially to keep the insoluble salts in solution.

However, for the calculogenesis the precipitation of colloids is more important than the precipitation of salts. In the formation and the growth of kidney stones flocculation of colloids is the primary process–which is only followed by secundary incrustation with salts.

Therefore it must be possible to prevent calculogenesis by preventing precipitation of colloids. Different organic salts can be used for stabilising solutions of colloids. In vitro experiments show that the hippuric acid of the urine must belong to these colloid stabilising substances.

Thus the hippuric acid of the urine might (a) Prevent formation of stone nuclei by stabilisation of the colloids; (b) Prevent secundary incrustation by its hydrotropic action. As a matter of fact, administration of sodium benzoate by mouth did (a) Prevent stone formation in rats on CaCO3 rich diet. (b) Stop phosphaturia in man. (c) Diminish renal colic in patients. Other more powerful stabilisers of the colloids of the urine (salicylates, mandelates) might be used for this purpose.
EARLY DIAGNOSIS AND RADICAL TREATMENT OF CARCINOMA OF THE PROSTATE*
Authors: KEYES EDWARD L. , FERGUSON RUSSELL S.
Published: November 2008

(1) Carcinoma of the prostate should be attacked as a curable disease.

(2) No large proportion of cases will be controlled unless diagnosed by (aspiration) biopsy before diagnosis is possible by rectal touch, even with a sound in the urethra.

(3) An operation is proposed which, with low operative mortality, promises to compare favourably with the total prostatectomy of Young.

(4) Grave post‐operative radium burn is preventable by proper technic and such prevention is especially easy to assure in the early and curable cases.
A METHOD OF DEMONSTRATING THE POSTERIOR ABDOMINAL WALL LYMPHATICS AND DYE ABSORPTION THEREBY
Authors: Wallace A. B.
Published: November 2008

(a)A method of denionstrating the lynipliatics of the posterior abdominal wall by dissection, maintaining the anatomical relationship has heen described.

(b)A method of demonstrataing dye absorption from small areas without causing trauma has been described. The specimen was finally prepared as in (a).

(c)These methods might be useful in genito‐urinary studies.
TOTAL CYSTECTOMY
Authors: Millin Terence , Masina F.
Published: November 2008

A technique of descending abdominal cystectomy, based on our conception of the anatomico‐pathological principles involved, is presented. We do not claim that any technical finality has been achieved, but suggest that it represents an advance on any method we have yet seen described or practised.
Diagnosis and Management of Lymphoceles after Renal Transplantation
Authors: BURGOS F. J. , TERUEL J. L. , MAYAYO T. , LOVACO F. , BERENGUER A. , ORTE L. , TALLADA M. , ORTUÑO J.
Published: November 2008

Summary— Eighteen lymphoceles developed after 199 renal transplantations, 11 being asymptomatic. Ultrasound was the most sensitive method of detection. Seven lymphoceles were symptomatic, pelvic mass and decreased renal function being the most frequent signs. Five lymphoceles were successfully treated by instillation of iodate povidone into the lymphatic cavity; there were no complications or recurrences. This is a simple, safe and inexpensive method for the treatment of lymphoceles after renal transplantation.
The Prevalence of Variation of Resting Urethral Pressure in Women and its Association with Lower Urinary Tract Function
Authors: TAPP A. J. S. , CARDOZO LINDA D. , VERSI E. , STUDD J. W. W.
Published: November 2008

Summary— Variation of resting urethral pressure has been reported and it has been postulated that this is important in the genesis of lower urinary tract symptomatology in women. In order to differentiate between normal and abnormal urethral pressure variations several arbitrary values have been chosen and the prevalence of abnormality in symptomatic women reported. However, large variations in urethral pressure may be seen in healthy, asymptomatic volunteers. We have identified the prevalence of urethral pressure variation in a large group of female volunteers and have shown that “abnormal” urethral pressure variation is not associated with lower urinary tract symptomatology.
Chemotherapy for Carcinoma in situ of the Bladder
Authors: JENKINS B. J. , ENGLAND H. R. , FOWLER C. G. , TIPTAFT R. C. , BADENOCH D. F. , PARIS A. M. I. , OLIVER R. T. D. , BLANDY J. P.
Published: November 2008

Summary— In an 8‐year period, 71 patients were diagnosed as having carcinoma in situ of the bladder. Twenty patients with primary carcinoma in situ were treated with systemic cyclophosphamide or intravesical mitomycin C and 19 of them survived 3 years. Three patients required cystectomy: 1 for invasive cancer and 2 for intractable symptoms in the absence of tumour. Fifty‐one patients had either secondary or concomitant carcinoma in situ. Systemic or intravesical chemotherapy was given to 28 patients in whom carcinoma in situ was associated with G1 or G2 exophytic superficial tumour: there was only one cancer death in 3 years. Fifteen patients with G3 carcinoma in situ associated with a G3 or invasive exophytic tumour were treated with radiotherapy: 9 responded but 4 of the 6 with radio‐insensitive tumours died of cancer within 3 years. Eight patients with secondary carcinoma in situ were managed by transurethral resection alone: in 6 there was spontaneous regression and 2 developed muscle invasion within 1 year.

These results compare well with those of immunotherapy or early radical surgery and suggest that chemotherpy should be given a trial in patients with carcinoma in situ.
Primary Malignant Melanomas of the Urinary Bladder
Authors: GOLDSCHMIDT P. , PY J. M. , KOSTAKOPOULOS A. , JACQMIN D. , GROSSHANS E. , BOLLACK C.
Published: November 2008

Primary melanoma of the bladder is rare and only six cases have been reported (Willis et al., 1980; Anichkov and Nikonov, 1982). We present two further cases and discuss the diagnosis and clinical problems.
Chyluria and the Yellow Nail Syndrome
Authors: TOAL B. J. , DOHERN C. C. , JOHNSTON S. R.
Published: November 2008

The yellow nail syndrome is a triad consisting of yellow discolouration, primary lymphoedema and respiratory complications (Nakielna and Wilson, 1976). Since the original description by Sammon and White (1964), many non‐respiratory manifestations of the syndrome have been reported, but not involvement of the renal lymphatics.
Bullous Pemphigoid Associated with Renal Carcinoma
Authors: Van POPPEL H. , ASWARIE H. , BAERT L.
Published: November 2008

The correlation between bullous pemphigoid and malignant tumours is still controversial. Our experience of the dermatological disorder after radical nephrectomy for renal carcinoma indicates the need for thorough diagnostic exploration in patients with bullous pemphigoid.
Inverted Papilloma of the Ureter with Malignant Change
Authors: STOWER M. J. , MacIVER A. G. , GINGELL J. C. , CLARKE E.
Published: November 2008

Summary— Three patients with inverted papilloma of the ureter are described. A range of histological features was seen, including one showing malignant change. This condition, which is probably more common than previously thought, can be successfully treated by conservative surgery and close follow‐up.
Clean Intermittent Self‐catheterisation in 172 Adults
Authors: WEBB R. J. , LAWSON AURIOL L. , NEAL D. E.
Published: November 2008

Summary— We report the results of clean intermittent self‐catheterisation (CISC) in 172 adults (68 male, 104 female). Seven patients were unable or unwilling to master the technique and 145 still remain on CISC, representing a total experience of 6981 patient‐months. Ten patients required readmission: 5 for retraining and 5 for complications (average hospital stay 2.4 days); 123/163 patients catheterised themselves every 3 to 4 h and 92 were continent on CISC; of the 107 patients incontinent prior to starting CISC, 101 were improved; 70 patients had no infections whilst on CISC, the mean infection rate being 1 per 14 patient‐months; 29% of patients experienced persistent urethral bleeding; 156/163 patients were satisfied or very satisfied with CISC and 140 found the technique easy or very easy; 76 patients had never visited their GP for a urinary problem whilst using ClSC and the mean rate was 1 visit per 8 patient‐months. ClSC is an easily learnt technique that is safe and acceptable to patients, and one which places few extra burdens on hospital or community resources.
Estimation of Growth Fraction in situ in Human Bladder Cancer with Bromodeoxyuridine Labelling
Authors: NEMOTO R. , HAITORI K. , UCHIDA K. , SHIMAZUI T. , KOISO K. , HARADA M.
Published: November 2008

Summary— A group of 8 patients with invasive bladder cancer received fractionated intra‐arterial infusions of the thymidine analogue bromodeoxyuridine (BrdU), 150 mg, every 6 to 10 h for 3 days before endoscopic cold cup biopsy to label tumour cells in the proliferative pool (growth fraction). The tumour specimens were fixed and stained by an indirect immunoperoxidase method using anti‐BrdU monoclonal antibody. There was an area which could not be stained with anti‐BrdU monoclonal antibody surrounding the stained area where diffusion effects could be excluded. This indicates a growth fraction < 1 and implies that a proportion of the tumour cells in bladder tumours are cycling and contributing to growth. The BrdU labelling index (growth fraction) was determined by counting the number of BrdU labelled cells in the well labelled tissue sections. The average growth fraction of invasive bladder cancer was 38.4 ± 7.7% (range 26.9–48.1%). Grade 3 tumours averaged 42.8 ± 5.4% labelling versus 31.0 ± 4.4% in grade 2. The higher growth fraction may indicate greater biological malignancy. These results indicate that immunohistochemical studies of cell kinetics using BrdU monoclonal antibodies may provide information about the biological characteristics of bladder tumours in situ.
Natural History of Pelviureteric Obstruction Detected by Prenatal Sonography
Authors: ARNOLD A. J. , RICKWOOD A. M. K.
Published: November 2008

Summary— Fifty‐six infants with prenatally diagnosed hydronephrosis are reported. In all instances the diagnosis was confirmed postnatal and at renography 45 were obstructed; 38 obstructed kidneys (84%) and all of the non‐obstructed kidneys had a differential function exceeding 40% of total function.

Latterly we have come to recommend early pyeloplasty only if differential function of a renographically obstructed kidney is less than 40%; 6 early pyeloplasties were performed for this reason; 28 infants (30 renal units) were managed non‐operatively and 18 of these (19 renal units) were reassessed renographically. In 11 the obstruction persists. Sonography demonstrated improving hydronephrosis in 8 kidneys with resolution in 5 and no change in 6. Of the other 10 infants (11 renal units), the hydronephrosis has improved in 4, resolved in 1 and remains unchanged in 6.

Our experience suggests that neonatal and early pyeloplasty can be restricted to a modest number of infants in whom there is impaired renal function. In cases with normal function the natural history appears essentially benign and does not justify routine pyeloplasty.
Parameatal Urethral Cysts of the Glans Penis
Authors: KOGA S. , ARAKAKI Y. , MATSUOKA M. , OHYAMA C.
Published: November 2008

Summary— Parameatal urethral cysts are uncommon in the male. We have seen 9 cases and have reviewed these and the 35 cases reported in Japan between 1919 and 1984.

The cysts recurred after rupture or aspiration in 3 cases and complete excision is recommended.
Antegrade Ureterolitholapaxy in the Treatment of Obstructing or Incarcerated Proximal Ureteric Stones
Authors: ANSELMO G. , BASSI E. , FANDELLA A. , MERLO F. , FELICI E. , MACCATROZZO L.
Published: November 2008

Summary— Extracorporeal shockwave lithotripsy (ESWL) and retrograde ureterorenoscopy (RU) have transformed the management of ureteric calculi. Nevertheless, patients with obstructing proximal ureteric calculi are not suitable for ESWL or RU.

From January 1986 to September 1988, 17 patients with fixed upper ureteric stones underwent antegrade renoureteroscopy and percutaneous surgery. The technique was effective in removing incarcerated proximal ureteric calculi: all patients were stone‐free at follow‐up 3 months later.
Vesicoureteric Reflux in the Adult Male
Authors: CHAPPLE C. R. , CHRISTMAS T. J. , TURNER‐WARWICK R. T.
Published: November 2008

Summary— The main prevalence of vesicoureteric reflux (VUR) is in the adult female population. Although recognised as a clinical entity in adult males, little detailed information is available on this subject. A retrospective analysis was carried out on the results of 1519 consecutive videocystometrograms performed on male patients. VUR had an overall incidence of 8.6% within this population, with a range of 5.1% in patients with normal urodynamics to 15.6% in those with detrusor‐sphincter dyssynergia. The common denominator between VU R and urodynamic measurement appears to be the generation of high intravesical pressures. These findings suggest that VU R is not uncommon in the male population, is usually asymptomatic and should respond to the treatment of any underlying bladder abnormality.
Defective Interleukin‐1 Production of Monocytes in Patients with Bladder Cancer
Authors: IKEMOTO S. , KISHIMOTO T. , IIMORI H. , MORIKAWA Y. , HAYAHARA N. , MAEKAWA M.
Published: November 2008

Summary— Patients with advanced malignant neoplasms have a variety of abnormal lymphocyte and monocyte functions. We examined the PHA (phytohaemagglutinin) blastogenic response of lymphocytes and interleukin‐1 (IL‐1) production of monocytes in 40 bladder cancer patients and 16 control subjects. The correlation between the 2 parameters was also studied. The PHA blastogenic response was measured by the incorporation of 3H‐thymidine into lymphocytes. IL‐1 production was assayed by the murine thymocyte 3H‐thymidine incorporation assay. As a result, the PHA blastogenic response and IL‐1 production were significantly lower in the high stage bladder cancer patients compared to the control subjects and low stage patients. However, there was no significant correlation between the 2 parameters.

Furthermore, with the addition of indomethacin, IL‐1 production in the control subjects and low stage patients improved to the same degree, but it did not reach the control level in the high stage patients.
Ultrasound Cystography in the Diagnosis of Vesicoureteric Reflux
Authors: HANBURY D. C. , COULDEN R. A. , FARMAN P. , SHERWOOD T.
Published: November 2008

Summary— Vesicoureteric reflux is common in children with urinary tract infection and may cause end‐stage renal failure. The diagnosis is usually based on micturating cystourethrography (MCU). We describe an alternative technique using ultrasound during bladder infusion with agitated saline. Comparison of the 2 methods shows ultrasound to be 100% sensitive in the detection of grades 3 and 4 reflux. Conclusive evidence of reflux was seen in 2 cases where MCU was subsequently normal, questioning the role of MCU as the gold standard.
Microwave Warming of 1.5% Glycine Solution
Authors: STAPLETON A. M. F. , WOOLLARD G. A. , CADWALLADER J. A.
Published: November 2008

Summary— The urological irrigating fluid 1.5% glycine is routinely warmed in specifically designed warming drawers prior to use. This study shows that the use of microwave energy to achieve body temperature in 2‐litre bags of glycine solution is biochemically safe and that the sterility of the solution is maintained. There is a linear relationship between the temperature of the solution and time in the microwave oven, so allowing a simple formula to predict the correct heating time given variable ambient starting temperatures.
Urethral Calculi
Authors: KOGA S. , ARAKAKI Y. , MATSUOKA M. , OHYAMA C.
Published: November 2008

Summary— We present 56 patients with urethral calculi. In males the commonest location was the posterior urethra; 46 patients complained of dysuria but urinary retention was present in only 7. In 9 patients with penile urethral calculi, 6 had associated urethral disease (urethral stricture in 5 and urethral diverticula in 1). Transurethral litholapaxy or lithotripsy after retrograde manipulation was performed in 33 patients. Endoscopic manipulation was found to be the safest procedure.
Ureterocalicostomy for Reconstruction of Complicated Pelviureteric Junction Obstruction
Authors: ROSS J. H. , STREEM S. B. , NOVICK A. C. , KAY R. , MONTIE J.
Published: November 2008

Summary— Seven patients with complicated pelviureteric junction (PUJ) obstruction underwent reconstruction by means of Ureterocalicostomy; 5 had undergone previous surgery and 2 had primary obstruction. Radiographic studies showed resolution or improvement of the obstruction in 5 patients, who remain asymptomatic 15 to 47 months (mean 30) post‐operatively. Obstruction persists in 1 patient and the other developed renal artery thrombosis with subsequent loss of the kidney. It was concluded that Ureterocalicostomy can provide long‐term, successful reconstruction of a complicated PUJ obstruction, but significant complications may be associated with the procedure.
Testicular Histology after Treatment with LH‐RH Analogue for Carcinoma of the Prostate
Authors: JOHANSEN T. E. B. , ØGREID P. , KJELLEVOLD K. , BLOM P.
Published: November 2008

Summary— Orchiectomy was performed in 16 patients because of progression of prostatic cancer despite adequate medical castration with goserelin (Zoladex, ICI) over a mean period of 17.6 months. Severe tubular atrophy was seen in the testes. The Leydig cells also showed signs of atrophy, a fact that may indicate a direct effect of goserelin on these cells. In 1 patient, however, orchiectomy was postponed for 3 months after cessation of medical castration. The serum testosterone had resumed almost normal values and testicular histology revealed intact spermatogenesis and apparently normal Leydig cells.
Comparative Trial of Sclerotherapy for Hydroceles
Authors: RENCKEN R. K. , BORNMAN M. S. , REIF S. , OLIVIER I.
Published: November 2008

Summary— We present a prospective single‐blind trial of sclerotherapy for hydroceles with tetradecyl sulphate and rolitetracycline as sclerosants. Twenty‐seven hydroceles were treated with tetradecyl sulphate and 28 with rolitetracycline. The median follow‐up was 13 months. There were no statistically significant differences between the 2 drugs in respect of cure rate and complications. The overall cure rate for both drugs was 96%. Complications were rare and common to both drugs. Tetradecyl sulphate and rolitetracycline were found to be equally effective as sclerosants.
Long‐term Follow‐up of Children with Renal Carcinoma
Authors: BRUCE J. , GOUGH D. C. S.
Published: November 2008

Summary— Renal carcinoma is a rare tumour in children. The clinical, histological and follow‐up details of 6 patients are presented. Haematuria is confirmed as an important indicator of renal pathology. Long‐term follow‐up suggests that chemotherapy and radiotherapy have little effect on the prognosis in advanced disease.
Application of the Invaginated Sleeve Technique to Form a Continent Ileal Urostomy
Authors: GARDINER R. A. , SAMARATUNGA M. L. T. H.
Published: November 2008

Summary— The invaginated sleeve technique has been adapted to produce a continent urostomy, able to be catheterised, from a length of canine ileum measuring less than 10 cm. Of the 4 dogs catheterised twice daily up to 13 weeks, narrowing was present in the extra‐ileal segment in 2, but all intra‐ileal double‐barrelled lumina remained healthy with preservation of bowel mucosa.
Effect of Urine pH on the Stability of Doxorubicin and its Recovery from Bladder Instillations
Authors: ILETT K. F. , ONG R. T. T. , BATTY K. T. , TAYLOR J. D.
Published: November 2008

Summary— Doxorubicin (1 mg/ml) was shown to be stable when added to urine samples with a mean natural pH of 5.4 and in urine buffered to a mean pH of 4.6. However, at alkaline pH (mean = 8.1) there was a biphasic degradation of doxorubicin (mean t1/2 = 3.24 and 89 h respectively). The data indicate that buffering intravesical doxorubicin to pH 4.6 (acetate buffer) or pre‐dosing of patients with ammonium chloride may minimise loss of active drug during the time for which the drug is retained in the bladder. Recovery of doxorubicin following 1 hour's retention in the bladder was similar (77%) for doses of 38/48 or 78 mg. It is suggested that a dose of 50 mg (1 mg/ml) is sufficient to ensure an adequate delivery of active drug to the bladder wall.
The “Clam”: Indications and Complications
Authors: LEWIS D. K. , MORGAN J. R. , WESTON P. M. T. , STEPHENSON T. P.
Published: November 2008

Summary— We have reviewed 78 patients who underwent “clam” enterocystoplasty as part or all of their lower urinary tract reconstruction. Nearly half (32) were non‐neuropathic; the remainder were either overtly neuropathic (mainly spina bifida) or suspected neuropathic (mainly the older primary enuretics). Only 5 were non‐walkers—all neuropathic. Most patients were operated on for incontinence but 12 had upper tract damage related either to urinary diversion or to poor bladder compliance in the early phase of filling; 69 patients became dry, voiding spontaneously (30), by activation of an artificial urinary sphincter (17) or by self intermittent catheterisation (22). Four patients still have noctural enuresis, 3 diurnal enuresis and 2 have stress incontinence. One patient has had a continent diversion. The “clam” procedure has revolutionised bladder reconstruction. Careful review has failed to predict the small number who do not achieve a perfect result.
Effect of Bladder Filling on Upper Tract Urodynamics in Man
Authors: JONES D. A. , LUPTON E. W. , GEORGE N. J. R.
Published: November 2008

Summary— A group of 21 patients with hydronephrosis but normal bladders had their upper urinary tract pressures monitored while perfusing the affected kidneys through a fine bore nephrostomy tube, initially with the bladder on free drainage and subsequently during bladder filling. In 7 patients the renal pelvic pressures were altered by bladder filling and loin pain was reproduced in 4. It was concluded that with high upper tract flow rates, vesical filling can affect upper tract dynamics and this should be considered when evaluating patients with loin pain or potential obstructive uropathy.
Comparison of Morphometry and DNA Flow Cytometry with Standard Prognostic Factors in Bladder Cancer
Authors: LIPPONEN P. K. , COLLAN Y. , ESKELINEN M. J. , PESONEN E. , SOTARAUTA M. , NORDLING S.
Published: November 2008

Summary— In 83 bladder cancer patients with adequate follow‐up (mean 13 years, range 9–22) the prognostic value of morphometric, DNA flow cytometric and clinical parameters was assessed. Paraffin embedded material was used in flow cytometry. Univariate life‐table analysis showed the statistically significant relation of clinical stage, histological grade, mean nuclear area, the Standard Deviation (SD) of nuclear area, mean maximal nuclear diameter, mean nuclear perimeter and the volume corrected mitotic index (M/V index) to survival when bladder cancer deaths alone were used in the analysis. The recurrence of bladder cancer could be predicted with the M/V index. Survival analysis with Cox's regression model pointed to primary tumour clinical stage as the most important prognostic factor of crude survival. Histologically, grade and the SD of nuclear area were the best prognostic factors. Primary tumour stage and histological grade were the best predictors of death from bladder cancer. In Cox's model, histoquantitative methods are almost as good as clinical staging in predicting prognosis. DNA flow cytometry of paraffin embedded material offered no advantage over clinical stage, histological grade or morphology in assessing prognosis.
Long‐term Results of Carbon Dioxide Laser Treatment of Meatal Condylomata Acuminata
Authors: KROGH J. , BEUKE H.‐P. , MISKOWIAK J. , DE LICHTENBERG M. HONNENS , NIELSEN O. S.
Published: November 2008

Summary— A group of 74 men who underwent carbon dioxide laser treatment of meatal condylomata were observed for an average of 18 months. The cure rate after 1 treatment of isolated meatal lesions was 78%; the presence of external lesions lowered the rate to 32% and additional external and urethral warts to 25%. Following multiple treatments all but 6 patients were cured; 83% of the recurrences developed within 3 months. One urethral and 6 meatal strictures occurred more than 3 months after treatment; 9 patients had a spraying stream many years after treatment and 2 complained of frequency.
Prompt Orchiectomy Reduces Morbidty and Mortal from Testicular Carcinoma
Authors: WISHNOW K. I. , JOHNSON D. E. , PRESTON W. L. , TENNEY D. M. , BROWN B. W.
Published: November 2008

Summary— The records of 154 patients with non‐seminomatous germ cell testicular tumours were reviewed to determine the potential effect of prompt diagnosis and orchiectomy on morbidity and mortality from this disease. Orchiectomy was performed 30 days or less after the onset of testicular symptoms on 65 patients (Group 1) and more than 30 days after the onset of symptoms on 89 patients (Group 2). The initial clinical stages of Group 1 patients were: I, 40 (62%); II, 14 (22%); III, 5 (8%); marker only, 6 (9%). The initial clinical stages for Group 2 patients were: I, 25 (28%); II, 15 (17%); III, 35 (39%); market only, 14 (16%). The difference between the percentages of Group 1 and Group 2 patients with stage I disease was statistically significant, as was the difference between the percentages of Group 1 and Group 2 patients with stage III disease. One of the Group 1 patients died, whereas 11 of the Group 2 patients died. In 5 of the Group 2 patients who died, orchiectomy had been performed more than 120 days after the onset of testicular symptoms.

This study suggests that orchiectomy performed promptly after the onset of testicular symptoms not only helps to reduce mortality from testicular cancer but also has a major effect on its morbidity by reducing the need for systemic chemotherapy or major surgery.
Urodynamic Studies in Children who Wet
Authors: MAYO M. E. , BURNS M. W.
Published: November 2008

Summary— The value of urodynamic evaluation was assessed in children with diurnal and/or nocturnal enuresis without overt obstruction or neuropathy. The hypothesis that children with bladder instability and dysfunctional voiding represent 2 separate populations was also examined. A simplified urodynamic method was used to evaluate 191 children and they were divided into 3 groups: 64 had normal bladders which were stable during filling and voiding was co‐ordinated and complete; 97 had unstable bladders but voiding was normal and co‐ordinated; 30 had dyssynergic voiding and an increased volume of residual urine. The urodynamic evaluations were helpful in distinguishing the large number of children with normal findings in whom the problem was motivational. The children with unstable bladders had a physiological abnormality due to delayed maturation and in these cases anticholinergic and musculotrophic agents were usually helpful. The dysfunctional voiders had serious behavioural problems, were difficult to treat, and often required a multidisciplinary approach.

These data indicate that there are indeed 2 distinct groups: 1 with instability alone and 1 with dysfunctional voiding with or without instability. Although infection and/or reflux are common in the former, the more devastating urinary tract changes, particularly heavy trabeculation and elongation of the bladder, occur in the latter group.
Endoscopic Correction of Vesicoureteric Reflux in Children with Spina Bifida
Authors: DEWAN P. A. , GUINEY E. J.
Published: November 2008

Summary— Twenty patients with vesicoureteric reflux (VUR) secondary to a neuropathic bladder and associated spina bifida were treated with the endoscopic injection of subureteric polytetrafluoroethylene (Teflon)paste. Of the 19 patients (29 ureters) followed up, 13 have persistent reflux, although only 3 of these ureters have needed a second injection. Twelve of the 16, where reflux resolved, required only 1 injection.