bluuebunny/crossref_metadata_2025 huggingface dataset:
Occurrence patterns of aspen‐feeding wood‐borers (Coleoptera: Cerambycidae) along the wood decay gradient: active selection for specific host types or neutral mechanisms?
Authors: SAINT‐GERMAIN MICHEL , DRAPEAU PIERRE , BUDDLE CHRISTOPHER M.
Published: October 2007

Abstract 1. Determinants of host‐use patterns in plant‐feeding insects have been extensively studied, usually within the framework of optimality theory. Comparatively, factors driving host selection in saprophagous insects have received little attention.

2. In this study, mechanisms creating occurrence peaks of saprophagous wood‐borers (Cerambycidae: Coleoptera) in standing dead aspen in the middle and late stages of decay were investigated by correlating insect occurrence with variations in substrate‐related nutritional and physical parameters. Twenty‐four snags at four decay stages were dissected from a mature stand in western Quebec, Canada. Wood samples were taken to measure levels of nitrogen, non‐structural carbohydrates, phenols, wood density, water content and snag age.

3. Several nutritional and physical parameters varied significantly along the decay gradient and were correlated with insect occurrence, but all significant parameters were also strongly correlated with snag age and wood density. Model selection using Akaike’s second order information criteria was used to rank the different models; the model including snag age only performed best, with a wi of 0.873.

4. This importance of snag age gives support to a proposed hypothesis of host selection in which temporal autocorrelation in probability of insect occurrence explains peaks observed in the middle and late stages of decay. However, further studies will be needed to confirm the prevalence of such neutral mechanisms over active selection in the determination of host‐use patterns in decaying aspen.
Distribution modelling and statistical phylogeography: an integrative framework for generating and testing alternative biogeographical hypotheses
Authors: Richards Corinne L. , Carstens Bryan C. , Lacey Knowles L.
Published: October 2007

Statistical phylogeographic studies contribute to our understanding of the factors that influence population divergence and speciation, and that ultimately generate biogeographical patterns. The use of coalescent modelling for analyses of genetic data provides a framework for statistically testing alternative hypotheses about the timing and pattern of divergence. However, the extent to which such approaches contribute to our understanding of biogeography depends on how well the alternative hypotheses chosen capture relevant aspects of species histories. New modelling techniques, which explicitly incorporate spatio‐geographic data external to the gene trees themselves, provide a means for generating realistic phylogeographic hypotheses, even for taxa without a detailed fossil record. Here we illustrate how two such techniques – species distribution modelling and its historical extension, palaeodistribution modelling – in conjunction with coalescent simulations can be used to generate and test alternative hypotheses. In doing so, we highlight a few key studies that have creatively integrated both historical geographic and genetic data and argue for the wider incorporation of such explicit integrations in biogeographical studies.
Phenoloxidase activity and pathogen resistance in yellow dung flies Scathophaga stercoraria
Authors: SCHWARZENBACH G. A. , WARD P. I.
Published: October 2007

Phenoloxidase (PO) is an important component of the insect immune system and is frequently used to measure an individual's immune defence ability. However, evidence documenting positive correlations between the immune assay and resistance against pathogens is scarce and contradictory. We used replicate lines of yellow dung flies Scathophaga stercoraria (L.) with different PO levels to investigate whether PO levels affect resistance against parasitic mites and entomopathogenic fungi. Prevalence of flies exposed to pathogens was the same in all selection regimes, although pathogens clearly negatively affected fitness. PO measurements alone therefore do not necessarily predict overall resistance against pathogens. Furthermore, under starvation lines selected for high PO levels did not survive longer than those selected for low PO levels, irrespective of exposure to pathogens. This suggests that even if elevated immune levels increase an individual's ability to combat pathogens, the benefits may not outweigh the costs of increased investment in immunity.
Lower urinary tract symptomatology: Its definition and confusion
Authors: Homma Yukio
Published: October 2007

Abstract:  Terminology for lower urinary tract symptoms has been popularized since an extensive revision by the International Continence Society (ICS) in 2002, however the revision incurred significant confusion and inconvenience among the users. For example, distinction between night time frequency and nocturia is practically infeasible; urgency must be of sudden onset (persistent urgency is an invalid usage); terms are lacking for some types of urinary leakage; bladder filling and urge to void must be differentiated; symptom syndromes are not applicable to non‐functional abnormality; a syndrome for bladder hypersensitivity is lacking; polyuria is not defined properly. This review has detailed definitions and confusions related to the latest version, and suggested possible solutions for a better vocabulary of words.
Our experience with third renal transplantation: Results, surgical techniques and complications
Authors: Nourbala Mohammad Hossein , Ghaheri Hafez , Kardavani Babak
Published: October 2007

Background: Despite the popularity of kidney transplantation in the current era, second and third kidney transplantation are not yet widely accepted and practiced. Each center has its own regulations and experiences and there is no accepted protocol for third kidney transplantation. We report here our 15 years of experience with third kidney transplantation.

Methods: This is a report of all the third kidney transplantations performed in Baqiyatallah Hospital, Tehran, Iran, between 1991 and 2006. Demographic data, surgical techniques, complications and outcomes are reported.

Results: Of the nine third kidney transplant patients, six were male. The median age was 43 years (32–52). All of the patients received kidney from living donors. All operations were performed by a midline incision and the grafts were placed at the midline, in the intraperitoneal space. For arterial anastomosis, we used internal iliac, right common iliac and both the right external iliac and inferior mesenteric artery in 4, 4 and 1 case(s), respectively. For venous anastomosis, we used vena cava, common iliac and external iliac veins in 3, 5 and 1 case(s), respectively. During the follow up period (38 months), 6 grafts (66.6%) were functioning. None of the graft rejections were due to surgical complications. Wound dehiscence occurred in two patients. No other surgical complications including infection, lymphocele or hemorrhage were observed.

Conclusion: Third kidney transplantation is a field that has not been fully explored. The rate of complications seems to be not much higher than the first transplantation. Defining a standard protocol seems necessary.
Migration to and dispersal from oilseed rape by the pollen beetle, Meligethes aeneus, in relation to wind direction
Authors: Williams Ingrid H. , Frearson Dave , Barari Hassan , McCartney Alastair
Published: October 2007

1 Host‐plant‐odour‐induced upwind anemotaxis is accepted as the main mechanism by which herbivorous insects find their host plant within an heterogenous environment, but field data supporting this hypothesis are scarce.

2 The flight directions of the pollen beetle Meligethes aeneus to and from a plot of winter oilseed rape and the direction of the wind were recorded concurrently. The beetles were sampled by eight double‐sided window traps encircling the plot. Distal sides of the traps, relative to the plot, sampled the beetles as they flew towards the plot, whereas the proximal sides of the traps sampled them as they flew away from the plot. Paired data on daily catch of beetles in distal or proximal traps and the volume of air impacting each trap were compared.

3 Correlations between daily catch of M. aeneus into distal traps and trap wind volume were negative, indicating that flights by both overwintered‐ and new‐generation insects towards the plot were upwind.

4 Correlations between daily catch of M. aeneus into proximal traps and trap wind volume varied with generation. Catch of overwintered‐generation M. aeneus was negatively correlated with trap wind volume, indicating that flight was upwind. Proximal trap catch of the new‐generation M. aeneus was weakly/modestly positively correlated with trap wind volume, indicating that flights were downwind or crosswind.

5 Understanding the effect of wind direction on flight of M. aeneus holds potential for improving the forecasting of their arrival and spatial distribution on the crop for integrated pest management.
Recent non‐native invertebrate plant pest establishments in Great Britain: origins, pathways, and trends
Authors: Smith Richard M. , Baker Richard H. A. , Malumphy Chris P. , Hockland Sue , Hammon Roger P. , Ostojá‐Starzewski Joe C. , Collins Dominique W.
Published: October 2007

1 An appraisal of non‐native invertebrate plant pest establishments in Great Britain, between 1970 and 2004, was carried out to improve our understanding of current invasion processes by non‐native plant pests, and to assist national strategies in managing the risks they pose.

2 A total of 164 establishments, comprising 50 natural colonists and 114 human‐assisted introductions, were recorded across 13 major taxonomic groups.

3 The mean rate of establishment was 22.1 species per 5‐year period: 19.1 and 3.0 species outside and inside protected cultivation, respectively. Despite the continuing rapid growth in international trade and a general perception that rates of pest invasions are accelerating, no significant temporal trends in the rate of establishments in Great Britain were detected, either for natural colonists or human‐assisted introductions, or for pests of plants grown indoors or outside.

4 The plant trade, particularly in ornamental plants, accounted for nearly 90% of human‐assisted introductions; apiculture, biological control, timber imports, transport stowaways and intentional releases each contributed less than 5%. Only eight (4.9%) of the establishments could be considered as having no direct potential economic impact because all other species have been recorded as feeding on cultivated plants. A greater proportion of establishments by both natural colonists and human‐assisted introductions occurred on non‐native, woody plants.

5 The present study confirms previous work in other European countries that highlight the predominant role of the ornamental plant trade in introducing new plant pests to the European continent, mainly from Asia and North America.
Long‐term follow‐up of living kidney donors: a longitudinal study
Authors: El‐Agroudy Amgad E. , Sabry Alaa A. , Wafa Ehab W. , Neamatalla Ahmed H. , Ismail Amani M. , Mohsen Tarek , Khalil Abd Allah , Shokeir Ahmed A. , Ghoneim Mohamed A.
Published: October 2007

OBJECTIVE

To analyse retrospectively the general health status and renal and cardiovascular consequences of living‐related kidney donation, as the long‐term effects of unilateral nephrectomy for kidney donation are of particular interest with the currently increasing practice of living‐donor transplantation.

PATIENTS AND METHODS

Living‐related kidney donors (1400) who had donated their kidneys between 1976 and 2002 were asked to attend a dedicated donor follow‐up clinic starting in 2004. We attempted to contact all donors to determine the long‐term outcome of their remaining kidney. All kidney donors who responded had a detailed assessment, and were questioned about rehabilitation and their feelings on donating a kidney. The data were compared to the age‐matched health tables of the Egyptian general population.

RESULTS

In all, 339 donors had a complete evaluation (mean age at the time of evaluation 47.8 years, sd 11; mean follow‐up 10.7 years, sd 4.9). The mean (sd) creatinine level after donation was 1.1 (1.2) mg/dL, and creatinine clearance 109 (33) mL/min; the clearance was <60 mL/min in 0.9% of donors and proteinuria was >300 mg/24 h in 1.5% of donors. Seventy‐five (22.1%) donors became hypertensive and the rate was higher in donors with an interval of >25 years from donation; 174 (51.3%) of patients became either overweight or obese. Diabetes mellitus developed in 23 (6.8%) and was more common in patients with significant weight gain.

CONCLUSIONS

Donor nephrectomy has minimal adverse effects on overall health status. Regular donor follow‐up identifies at‐risk populations and potentially modifiable factors.
Overexpression of CDC91L1 (PIG‐U) in bladder urothelial cell carcinoma: correlation with clinical variables and prognostic significance
Authors: Shen Yi‐Jun , Ye Ding‐Wei , Yao Xu‐Dong , Trink Barry , Zhou Xiao‐Yan , Zhang Shi‐Lin , Dai Bo , Zhang Hai‐Liang , Zhu Yao , Guo Zhongmin , Wu Guojun , Nagpal Jatin
Published: October 2007

OBJECTIVE

To investigate cell division cycle 91‐like 1 (CDC91L1; also called phosphatidylinositol glycan class U, PIG‐U) expression in bladder cancer at both the mRNA and protein levels, and to study its clinical and prognostic significance, as CDC91L1 was recently identified as a new oncogene in human bladder cancer and its role in the biological behaviour of bladder cancer is largely unknown.

PATIENTS AND METHODS

In all, 73 bladder tumours and 14 samples of normal bladder urothelium were studied by reverse‐transcription polymerase chain reaction (PCR), real‐time quantitative PCR and immunohistochemistry.

RESULTS

The normalized CDC91L1 mRNA copy number in tumours was significantly greater than in normal controls (P < 0.05). There was overexpression of CDC91L1 mRNA in 30.1% (22/73) of the bladder tumours compared with the normal urothelium. At the protein level, 75.3% (55/73) of the bladder tumours and two of 14 of the normal urothelium had high expression of CDC91L1 protein, which is statistically significant (P < 0.001). The correlation between CDC91L1 protein and tumour grade, and muscle invasion of tumour was significant (both P < 0.05). In addition to tumour extent and tumour grade, CDC91L1 protein was an independent predictor of recurrence for superficial bladder cancer and had a trend to predict tumour progression.

CONCLUSIONS

CDC91L1 (PIG‐U) plays a role in the development of bladder urothelial cell carcinoma. CDC91L1 protein might be a potential biomarker for prediction of recurrence and a therapeutic target in bladder cancer.
Sexual desire and sexual activity of men and women across their lifespans: results from a representative German community survey
Authors: Beutel Manfred E. , Stöbel‐Richter Yve , Brähler Elmar
Published: October 2007

OBJECTIVES

To present data on sexual desire and sexual activity from a representative survey of men and women covering the total age range of the adult German population, as previous studies have usually been based on samples selected for gender (either men or women) and age (ageing populations).

SUBJECTS AND METHODS

A representative sample of 2341 men and women aged 18–93 years were surveyed to determine frequency and intensity of sexual desire and sexual activity, and their social, individual and interpersonal characteristics.

RESULTS

Sexual desire declined with advancing age; overall, men reported more frequent and stronger sexual desire than women. However, there were important interactions between gender and age indicating an earlier decline among women. For both men and women, sexual activity in older participants was mostly an issue of the presence of a partnership. There were additional social and personality determinants of a lack of sexual desire and sexual inactivity: in men, sexual desire was compromised by social factors (unemployment, low income), while in women these were previous sexual traumas (childhood sexual abuse, rape).

CONCLUSION

Community surveys elucidate the trajectory of sexual desire and activity across the lifespan. Further research on the determinants and risk factors for a lack of sexual desire and sexual inactivity is recommendable taking gender and age composition of the samples into account.
Assessing the vesico‐urethral anastomosis after radical retropubic prostatectomy: transrectal ultrasonography can replace cystography
Authors: Eggert Thilo , Palisaar Jüri , Metz Petra , Noldus Joachim
Published: October 2007

OBJECTIVE

To determine if transrectal ultrasonography (TRUS) is as reliable as cystography in detecting vesico‐urethral extravasation (VE) after radical retropubic prostatectomy (RRP).

PATIENTS AND METHODS

Between October 2005 and February 2006 we prospectively investigated 100 consecutive patients undergoing RRP. The vesico‐urethral anastomosis was assessed 6 days after RRP by a combined investigation with TRUS and cystography.

RESULTS

In most patients (79%), at 6 days after RRP the vesico‐urethral anastomosis was watertight or showed minimal leakage (8%), so that the urinary catheter was removed. Different degrees of VE were detected in 21 patients. Because of small, moderate or marked VE, the indwelling catheter remained until 9, 14 and 21 days after RRP in five, three and five patients, respectively. Every VE documented by cystography was detected by TRUS beforehand; therefore TRUS showed no false‐negative results in detecting a leaking anastomosis. In two patients paraurethral fluid was detected by TRUS mimicking VE, with no confirmation by cystography.

CONCLUSIONS

TRUS can safely replace cystography for detecting anastomotic leakage after RRP. The decision to remove the catheter after RRP can be made without radiation exposure and use of expensive contrast medium.
The use of an endoscopic stapler vs suture ligature for dorsal vein control in laparoscopic prostatectomy: operative outcomes
Authors: Nguyen Mike M. , Turna Burak , Santos Bruno R. , Frota Rodrigo , Aron Monish , Stein Robert J. , Hafron Jason M. , Gill Inderbir S.
Published: October 2007

OBJECTIVE

To identify differences in operative outcome between methods of controlling the dorsal vein complex during laparoscopic prostatectomy, i.e. suture ligature or stapling with an endoscopic stapler (Endopath ETS Flex 45 linear stapler; Ethicon, Cincinnati, OH, USA).

PATIENTS AND METHODS

In all, 120 patients who had a laparoscopic prostatectomy between January 2005 and October 2006 were assessed; 60 had suture ligature and 60 were treated with the stapler. In a multivariate analysis accounting for baseline patient and disease characteristics, the primary outcome variables evaluated included estimated blood loss (EBL), operative duration and positive margin rates.

RESULTS

The baseline demographics were similar between the sutured and stapled groups for age (59.6 vs 60.1 years, P = 0.674), body mass index (29.2 vs 28.5 kg/m2, P = 0.237), preoperative prostate‐specific antigen level (5.3 vs 5.7 ng/mL, P = 0.5), Gleason score (6.4 vs 6.3, P = 0.294), clinical stage (77% vs 88% T1c, P = 0.052) and preoperative Sexual Health Inventory for Men score (19.4 vs 19.6, P = 0.813). Operative measures were not significantly different between the groups for EBL (287 vs 343 mL, P = 0.156) or operative duration (234 vs 223 min, P = 0.324). Apical margin involvement was also not significantly different (12% vs 7%, P = 0.121). The overall positive margin rate (30% vs 18%, P = 0.020) and disease volume (22% vs 13%‘extensive’, P = 0.021) were higher among the sutured group, but on multivariate analysis the overall margin rate was not significantly different.

CONCLUSIONS

There was no difference between sutured and stapled control of the dorsal vein complex during laparoscopic prostatectomy in EBL, operative duration or positive margin rate.
Oncological outcomes of hand‐assisted laparoscopic radical nephrectomy for clinically localized renal cell carcinoma: a single‐institution study with ≥3 years of follow‐up
Authors: Bandi Gaurav , Christian Matthew W. , Hedican Sean P. , Moon Timothy D. , Nakada Stephen Y.
Published: October 2007

OBJECTIVE

To evaluate the intermediate‐term outcomes of hand‐assisted laparoscopic radical nephrectomy (HALRN) for clinically organ‐confined renal cell carcinoma (RCC).

PATIENTS AND METHODS

We retrospectively reviewed patients who had HALRN for clinically organ‐confined RCC at the University of Wisconsin from 1996 to 2003. All patients with pathologically confirmed RCC and with ≥3 years of follow‐up were included in a retrospective chart review of variables before, during and after HALRN, as well as the clinical outcomes.

RESULTS

In all, 75 patients had HALRN in the study period; their mean age was 59 years, body mass index 29 kg/m2, operative duration 227 min, estimated blood loss 130 mL, and none required conversion to open nephrectomy. The median time to first oral intake was 2.5 days and the median hospital stay 4 days. On pathological examination the mean tumour size was 5.8 cm; 70% were pT1, 26% pT2 and 4% pT3; 82% were clear cell, 9% papillary, 8% chromophobe and 1% collecting duct carcinoma. Of the 65 patients who had a follow‐up of ≥36 months (mean 46, range 36–117), the 3‐ and 5‐year disease‐free survival rate was 93.4% and 90.2%, respectively; the 3‐ and 5‐year cancer‐specific survival rate was 96.5% and 94.4%, respectively.

CONCLUSION

Our study suggests that HALRN is a safe and minimally invasive treatment for managing clinically organ‐confined RCC, with good intermediate‐term oncological outcomes.
Neovesical‐urethral anastomotic stricture after orthotopic urinary diversion: presentation and management
Authors: Patel Sanjay G. , Cookson Michael S. , Clark Peter E. , Smith Joseph A. , Chang Sam S.
Published: October 2007

OBJECTIVE

To assess the frequency, presentation, treatment, and outcomes of bladder neck contractures (BNCs) among patients who had an orthotopic urinary diversion after radical cystectomy.

PATIENTS AND METHODS

We retrospectively examined our single‐institution database of 788 patients who had a radical cystectomy from 1 January 1996 to 4 January 2006 for BNC; variables evaluated included presentation, degree of stricture/contracture, clinical management, and outcomes after management.

RESULTS

Of the 374 patients who had an orthotopic urinary diversion, 11 (2.9%) men developed BNC; four BNCs were between 17 F and 22 F, six were <17 F, and one was pinhole‐sized. Nine of the 11 patients presented with voiding difficulties, one in complete retention after complicated urinary tract infection, and one with new‐onset nocturnal urinary incontinence. The treatment of BNC included cystoscopic dilatation in the clinic in six and under anaesthesia in three, and transurethral incision with a Collins knife or holmium laser in seven. After treatment, all patients were instructed to use continuous intermittent catheterization (CIC). Ten patients had follow‐up data available after the intervention, with a mean (range) follow‐up of 40.6 (10.6–98.0) months. Six patients were stricture‐ free for a mean period of 35.4 (10.6–98.0) months, while four patients had a recurrence within a mean of 7.4 (1.3–17.1) months. At the last follow‐up, nine of the 10 patients were using CIC. No patient had significant daytime or night‐time incontinence after treatment.

CONCLUSION

BNC develops in a small proportion of patients undergoing orthotopic urinary diversion, with most patients presenting with voiding difficulty. Most will require transurethral incision rather than an office‐based dilatation. After endoscopic incision to correct BNC, we recommend CIC to ensure complete emptying and to maintain the patency of the anastomotic stricture.
Impact of chronic prostatitis‐like symptoms on the quality of life in a large group of men
Authors: Walz Jochen , Perrotte Paul , Hutterer Georg , Suardi Nazareno , Jeldres Claudio , Bénard Francois , Valiquette Luc , Karakiewicz Pierre I.
Published: October 2007

OBJECTIVE

To assess the prevalence of chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) symptoms in a large group of men, using the National Institute of Health‐Chronic Prostatitis Symptom Index (NIH‐CPSI), and to evaluate which of the NIH‐CPSI symptoms had the most detrimental effect on quality of life (QoL).

SUBJECTS AND METHODS

The NIH‐CPSI was completed by 1273 men during a male‐health promotion event. The presence of CP/CPPS‐like symptoms was defined according to the NIH‐CPSI criteria (perineal pain or ejaculatory pain and NIH‐CPSI‐pain score ≥ 4). Finally, using linear regression analyses we evaluated the effect of each questionnaire symptom on the NIH‐CPSI‐QoL domain.

RESULTS

The mean (range) age of the men was 57.6 (40–89) years; 133 (10.5%) reported CP/CPPS‐like symptoms, with 62 (4.9%) reporting mild and 71 (5.6%) reporting moderate to severe CP/CPPS‐like symptoms. Men with CP/CPPS‐like symptoms had higher NIH‐CPSI‐QoL scores, showing a greater detriment of QoL (4.9 vs 2.5; P < 0.001). Of all NIH‐CPSI symptoms, urinary frequency was associated with the least favourable QoL, followed by incomplete bladder emptying, pain frequency and pain intensity. The individual pain location had no significant impact on the QoL.

CONCLUSION

In a large healthy population CP/CPPS‐like symptoms are common and have an important impact on QoL. Functional CP/CPPS‐like symptoms have a greater detrimental effect on QoL than pain symptoms. Therefore, these symptoms should represent the main therapeutic targets in affected patients.
The outcome of patients with pathological Gleason score ≥8 prostate cancer after radical prostatectomy
Authors: Rodriguez‐Covarrubias Francisco , Larre Stephane , De La Taille Alexandre , Abbou Claude‐Clement , Salomon Laurent
Published: October 2007

OBJECTIVE

To analyse the outcome of patients undergoing radical prostatectomy (RP) for Gleason 8–10 clinically localized prostate cancer, and to evaluate the prognostic value of well‐known predictors of progression.

PATIENTS AND METHODS

In all, 1480 patients had RP between 1988 and 2006, of whom 180 had pathological Gleason score ≥8 and negative lymph nodes. Biochemical progression‐free survival was determined using the Kaplan‐Meier method. The effect of preoperative prostate‐specific antigen (PSA) level, pathological stage and margin status was assessed with univariate and multivariate analyses.

RESULTS

Of the 180 patients, the Gleason score in the RP specimen was 8, 9 or 10 in 70%, 27% and 3%, respectively; 24% had stage pT2 disease, 30% stage pT3a, 25% stage pT3b and 20% stage pT4a. The 5‐ and 7‐year biochemical progression‐free survival was 73 and 65% for stage pT2, 40% and 27% for stage pT3a, and 30% for stage pT3b (log rank test, P < 0.001). In the univariate model, preoperative PSA level, pathological stage and surgical margins were predictors of survival. In the multivariate analysis, preoperative PSA level and extracapsular extension predicted biochemical progression‐free survival.

CONCLUSION

Gleason 8–10 tumours have a poor prognosis. Patients with a PSA level of <10 ng/mL and stage pT2 disease have the greatest likelihood of having a longer progression‐free survival after RP.
Effect of varicocelectomy on patients with unobstructive azoospermia and severe oligospermia
Authors: Ishikawa Tomomoto , Kondo Yutaka , Yamaguchi Kohei , Sakamoto Yuichi , Fujisawa Masato
Published: October 2007

OBJECTIVES

To assess the treatment outcome and benefits after varicocelectomy in men with unobstructive azoospermia (UOA) and severe oligospermia (SO).

PATIENTS AND METHODS

The records were retrospectively evaluated for six patients with UOA and 54 with SO who had microsurgical inguinal varicocele ligation (mean age 33.3 years, sd 5.3). Fifty‐one (85%) had a unilateral left‐sided procedure (five of six with UOA, 46 of 54 with SO), and nine (15%) had a bilateral procedure.

RESULTS

After ligation, spermatogenesis was induced in two of the six men with UOA; the mean (sd) sperm concentration increased from 2.3 (1.6) to 9.2 (12.6) million/mL (P < 0.001), but the sperm motility did not change significantly. Four (7%) of the 54 men with SO achieved paternity, with unassisted pregnancies.

CONCLUSIONS

Varicocelectomy resulted in the induction or enhancement of spermatogenesis for several men with UOA or SO; it seems to be a reasonable option in selected patients with UOA or SO.
Multimodal evaluation of renal perfusional changes due to extracorporeal shock wave lithotripsy
Authors: Mitterberger Michael , Pinggera Germar M. , Neururer Richard , Peschel Reinhard , Aigner Friedrich , Gradl Johann , Bartsch Georg , Kendler Dorota , Karakolcu Fatih , Frauscher Ferdinand , Pallwein Leo
Published: October 2007

OBJECTIVES

To examine the effect of extracorporeal shock wave lithotripsy (ESWL) on renal perfusion before and after treatment, by assessing renal resistive index (RI) using colour Doppler ultrasonography (CDUS), magnetic resonance perfusion imaging (MRPI), radionuclide renography and big‐endothelin‐1 values (Big‐ET‐1).

PATIENTS AND METHODS

In 69 normotensive patients the RI was measured before, 1, 3, 6 and 24 h after ESWL using CDUS. The RI values, measured in interlobar/arcuate arteries, were correlated with the findings on MRPI, done before and within 24 h after ESWL. In addition, renal plasma flow (RPF, assessed on radionuclide renography) and Big‐ET‐1 levels (a potent vasoconstrictor peptide), served as a control for evaluating renal perfusion. The patients were stratified in three age groups, i.e. ≤39, 40–59 and ≥60 years, with 23 patients in each group.

RESULTS

The mean (sd) RI increased significantly in the treated kidneys, from 0.64 (0.05) before to 0.72 (0.08) after ESWL (P = 0.001). Only in patients aged ≥60 years did the RI continue to increase over the 24 h. MRPI showed a decrease of renal blood flow (RBF) in all age groups, but most significantly in those aged ≥60 years. The radionuclide renography and big‐ET‐1 levels changed significantly only in the oldest group. The best correlation was between RI and RBF changes detected by MRPI.

CONCLUSIONS

ESWL obviously causes disturbances of renal perfusion, particularly in elderly patients (≥60 years). Measurement of RI with Doppler techniques might provide useful information for the clinical diagnosis of renal damage.
New blood‐based biomarkers for the diagnosis, staging and prognosis of prostate cancer
Authors: Shariat Shahrokh F. , Karam Jose A. , Margulis Vitaly , Karakiewicz Pierre I.
Published: October 2007

The introduction of prostate‐specific antigen (PSA) has revolutionized the detection and management of patients with prostate cancer. Despite this there has always been a concern among clinicians about the usefulness of total PSA levels as a marker for prostate cancer. We discuss the use of calculated variables and molecular forms of PSA. The precursor forms of PSA have been associated with the presence and biological behaviour of prostate cancer. With recent advances in biotechnology, e.g. high‐throughput molecular analyses, many potential blood biomarkers have been identified and are currently under investigation. Given the plethora of candidate biomarkers we discuss a selected group of novel blood‐based biomarkers, e.g. human glandular kallikrein, early prostate cancer antigen, insulin‐like growth factors, urokinase plasminogen activators, transforming growth factor‐β, interleukin‐6, chromogranin A, and prostate secretory protein. While these and other markers have shown promise in early‐phase studies, no single biomarker is likely to have the appropriate degree of certainty to dictate treatment decisions. Consequently, the future of cancer prognosis might rely on small panels of markers that can accurately predict cancer presence, stage and metastasis, and serve as prognosticators, targets, and/or surrogate endpoints of disease progression and response to therapy.
Purinergic receptor‐mediated effects of ATP in high‐grade bladder cancer
Authors: Shabbir Majid , Ryten Mina , Thompson Cecil , Mikhailidis Dimitri , Burnstock Geoffrey
Published: October 2007

OBJECTIVE

To assess whether the antineoplastic action of extracellular ATP seen in hormone‐refractory prostate cancer extends to other aggressive urological malignancies by investigating its effect in high‐grade bladder cancer cells in vitro and in vivo.

MATERIALS AND METHODS

HT‐1376 cells (human grade 3 transitional cell carcinoma) were incubated with various purinergic receptor agonists and antagonists and their effects on cell growth was examined in vitro. The presence of different P2 receptor mRNAs was determined using reverse transcriptase‐polymerase chain reaction. The effect of combining ATP with the cytotoxic agent mitomycin C (MMC) was also investigated. Models of tumour outgrowth in athymic mice were used to examine the effect of ATP on tumour growth in vivo.

RESULTS

HT‐1376 cells expressed P2X4,5,7 and P2Y1,2,4,6,11 receptor mRNA. ATP significantly reduced cell growth in a concentration‐dependent manner via the induction of P2 receptor‐mediated apoptosis. Pharmacological profiling implicated P2X5 and/or P2Y11 receptors in this antineoplastic response, the same receptor subtypes shown to be active in prostate adenocarcinoma, despite the differing cellular origin. ATP and MMC combined in an additive manner. Intraperitoneal injections of ATP significantly reduced the growth of implanted tumour cells by a combination of apoptosis and necrosis.

CONCLUSIONS

ATP effectively reduces the growth of high‐grade bladder cancer cells in vitro and in vivo. This highlights the potential use of ATP in the treatment of advanced urological malignancies irrespective of the cellular origin.
Subclinical hypothyroidism is a risk factor for nephropathy and cardiovascular diseases in Type 2 diabetic patients
Authors: Chen H.‐S. , Wu T.‐E. J. , Jap T.‐S. , Lu R.‐A. , Wang M.‐L. , Chen R.‐L. , Lin H.‐D.
Published: October 2007

Aims  The purpose of this study was to determine the relationship between subclinical hypothyroidism and prevalence of retinopathy and nephropathy, incident cardiovascular disease, and mortality in Type 2 diabetic patients without taking thyroid medication.

Methods  Serum thyrotropin and free thyroxine concentrations were measured in 588 Type 2 diabetic subjects in Taipei Veterans General Hospital, Taiwan. In a cross‐sectional study, we examined the prevalence of retinopathy and nephropathy. In a longitudinal study, we examined the risk of cardiovascular disease events, cardiovascular mortality and total mortality in the 4‐year follow‐up.

Results  In the cross‐sectional analysis, subclinical hypothyroidism was associated with a greater prevalence of diabetic nephropathy (odds ratio, 3.15 [95% CI, 1.48–6.69]) and did not show a high prevalence of diabetic retinopathy (odds ratio, 1.15 [95% CI, 0.59–2.26]) compare to euthyroid diabetics. During the 44.0 ± 7.4 months of follow‐up, 51 participants had cardiovascular events. The risk of cardiovascular events was significantly increased in Type 2 diabetics with subclinical hypothyroidism after adjustment for age, sex, A1C, other standard cardiovascular risk factors and medication (hazard ratio, 2.93; 95% CI, 1.15–7.48; P = 0.024), but it became nonsignificant after additional adjustment for urinary albumin‐to‐creatinine ratio (hazard ratio, 2.06; 95% CI, 0.67–6.36; P = 0.211). The rates of cardiovascular‐related and total mortality did not significantly differ by thyroid status.

Conclusions  Type 2 diabetic patients with subclinical hypothyroidism are associated with an increased risk of nephropathy and cardiovascular events, but not with retinopathy. Our data suggest that the higher cardiovascular events in subclinical hypothyroidism with Type 2 diabetes may be mediated with nephropathy.
Efficacy of continuous subcutaneous insulin infusion in Type 1 diabetes: a 2‐year perspective using the established criteria for funding from a National Health Service
Authors: Giménez M. , Conget I. , Jansà M. , Vidal M. , Chiganer G. , Levy I.
Published: October 2007

Aim  To determine the 2‐year efficacy of continuous subcutaneous insulin infusion (CSII) following the current established criteria for funding of a National Health Service.

Methods  Longitudinal, prospective, observational unicentre study. Included in the study were 153 Type 1 diabetes (T1D) subjects, previously treated with multiple daily injections (MDI) of insulin, in whom CSII was started in accordance with the criteria for reimbursement of the Catalan National Health Service. At baseline, we recorded data on age, gender, duration of the disease, body mass index (BMI), insulin dose and indications for CSII. Glycated haemoglobin (HbA1c) and the frequency of hypoglycaemic events were used to assess glycaemic control. Quality of life was assessed using three different self‐report questionnaires. After 24 months, these same items were remeasured in all subjects. Serious adverse events and injection‐site complications were also recorded.

Results  In 96% of subjects, CSII indication included less than optimal glycaemic control using MDI. HbA1c fell from 7.9 ± 1.3 to 7.3 ± 1.1% (P ≤ 0.001) after 24 months of CSII. Insulin requirements were significantly lower at the end of follow‐up (0.55 ± 0.21 U/kg body weight) in comparison with before use of CSII (0.70 ± 0.20, P ≤ 0.001). BMI increased from 24.0 ± 3.1 to 24.4 ± 3.2 kg/m2 after 24 months (P ≤ 0.025). The rate of episodes of diabetic ketoacidosis per year remained unchanged. Mild and severe hypoglycaemic episodes were significantly reduced. The scores in all subsets of the Diabetes Quality‐of‐Life (DQoL) questionnaire significantly improved after 24 months of CSII.

Conclusions  CSII, commenced according to the criteria for a nationally funded clinical programme, improves glycaemic control and quality‐of‐life outcomes with fewer hypoglycaemic episodes in T1D subjects previously conventionally treated with MDI.
Significant bacteriuria in outpatient diabetic and non‐diabetic persons
Authors: Matteucci E. , Troilo A. , Leonetti P. , Giampietro O.
Published: October 2007

Aims  The prevalence of significant bacteriuria (SB) in diabetes mellitus has not been clearly established. Having previously investigated SB frequency in inpatient diabetic women, we now screened for SB (both asymptomatic and symptomatic forms) in outpatients.

Methods  We examined 511 consecutive outpatients with Type 1 (T1D) or Type 2 diabetes (T2D), and 98 non‐diabetic subjects. At least one uncontaminated midstream urine sample was available from 602 subjects: 64 T1D (37 female, age 49 ± 13 years, diabetes duration 23 ± 15 years), 441 T2D (212 female, 66 ± 10 years, 12 ± 10 years), and 97 healthy control subjects (39 female, 57 ± 12 years). On the same day, we determined: blood cell count, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), plasma creatinine, urinary creatinine, and urinary albumin excretion (UAE; µg/mg urinary creatinine).

Results  The rate of SB was 14.1% in T1D, 9.3% in T2D and 6.2% in control subjects (P = NS). The 50 diabetic patients with SB differed from the 455 diabetic patients without SB in gender (43 male vs. 206 female, P < 0.001), FPG (10.2 ± 3.6 vs. 9.2 ± 2.9 mmol/l, P < 0.05), HbA1c (7.8 ± 1.1 vs. 7.5 ± 1.3%, P < 0.05), and UAE (median 15.6 vs. 7.6 µg/mg, P < 0.01). Eleven diabetic patients with SB had symptoms (vs. 48 without SB, P < 0.05); UAE levels were higher in the 39 asymptomatic diabetic patients with SB than in the 11 symptomatic patients.

Conclusions  The prevalence of SB is similar in outpatient diabetic individuals and in non‐diabetic subjects. The main risk factors for SB in diabetic patients were female gender and UAE. The likelihood of asymptomatic SB increased with UAE levels, i.e. with the presence of established microangiopathy. Poor glycaemic control is associated with bacteriuria, either as a cause or consequence of bacteriuria.
Anatomy and cytology of the thymus in juvenile Australian lungfish, Neoceratodus forsteri
Authors: Mohammad M. G. , Chilmonczyk S. , Birch D. , Aladaileh S. , Raftos D. , Joss J.
Published: October 2007

The anatomy, histology and ultrastructure of the thymus of a dipnoan, the Australian lungfish, Neoceratodus forsteri, was studied by light and transmission electron microscopy. The thymic tissue showed clear demarcation into a cortex and medulla with ample vascularization. Large cells including foamy and giant multinucleated cells with periodic acid Schiff/Alcian blue positive staining properties were localized mainly in the medulla. The major cellular components were epithelial cells and lymphoid cells. The epithelial cells were classified by location and ultrastructure into six sub‐populations: capsular cells, cortical and medullary reticular cells, perivascular endothelial cells, intermediate cells, nurse‐like cells and Hassall‐like corpuscles. Myoid cells were found mainly in the cortico‐medullary boundary and medulla. Macrophages and secretory‐like cells were also present. These findings will provide a base of knowledge about the cellular immune system of lungfish.
Skeletal histology of the dermal armor of Placodontia: the occurrence of ‘postcranial fibro‐cartilaginous bone’ and its developmental implications
Authors: Scheyer Torsten M.
Published: October 2007

Placodontia (Reptilia: Sauropterygia) is a group of enigmatic armored marine reptiles restricted to the Triassic time period. Only a single row of osteoderms dorsal to the spine is present in the basal placodontoid Placodus gigas, whereas derived cyamodontoids superficially resemble turtles in enclosing their body in an armor shell. Despite the extensive occurrence of the dermal armor in the derived cyamodontoid group, little research has focused on its bone histology and development. Here, I present an overview of the bone microstructures that reveals the unique presence of cartilaginous tissue in the postcranial armor plates. Placodont armor plates stand in contrast to osteoderms of other tetrapods that develop intramembraneously or through metaplastic ossification without cartilaginous preformation. The different developmental pathways leading to this ‘postcranial fibro‐cartilaginous bone’ tissue found in placodont plates compared to the dermal bone tissues of most other tetrapod osteoderms indicate the non‐homology of these structures. A resulting morphogenetic model of histogenesis is given to exemplify how the derived armor morphologies (i.e. spiked, flat polygonal and hexagonal, and rhomboidal shapes) together with the peculiar bone histologies could have developed through differential growth. In accordance with the pachyostotic limb bones of placodonts, the presence of the compact ‘postcranial fibro‐cartilaginous bone’ is interpreted as an osteosclerotic trend in the armor plates which aids in buoyancy control and affects maneuverability and swimming speed.
Local inflammatory response in choriodecidua induced by Ureaplasma urealyticum
Authors: Aaltonen R , Heikkinen J , Vahlberg T , Jensen JS , Alanen A
Published: October 2007

Ureaplasma urealyticum is the bacterial species most often connected with preterm birth, although it often colonises the amniotic fluid without any adverse effects. The induction of preterm labour seems to depend on whether the bacteria produce an inflammatory reaction. In vitro stimulation of choriodecidual tissue with high amounts of U.urealyticum or with lipopolysaccharide induced a qualitatively similar inflammatory response detected by the production of tumour necrosis factor alpha, followed by secretion of anti‐inflammatory cytokine interleukin‐10 and of prostaglandin E2. Lower quantities of bacteria failed to induce any response.
The impact of surgical treatment on the mental health of women with obstetric fistula
Authors: Browning A , Fentahun W , Goh JTW
Published: October 2007

Obstetric fistula is estimated to affect 2 million women worldwide and has considerable social and psychological effects on affected individuals. In this prospective study, 51 consecutive women with obstetric fistula admitted to the Barhirdar Hamlin Fistula Centre in the north of Ethiopia were screened using the General Health Questionnaire (GHQ‐28) for potential mental health disorder before and 2 weeks after fistula surgery. Prior to surgery, all women screened positive. By 2 weeks after, this had dropped to 36% (P = 0.005). 27% of the 45 women who were cured of their incontinence screened positive, while all 6 of those with severe residual incontinence continued to screen positive. We conclude that surgical treatment of obstetric fistula results in marked improvements in mental heath.
The treatment of 65 women with imperforate hymen by a central incision and application of Foley catheter
Authors: Acar A , Balci O , Karatayli R , Capar M , Colakoglu MC
Published: October 2007

Objective  To determine the surgical outcome of 65 women with imperforate hymen treated with a central surgical incision and insertion of a Foley catheter.

Design  A prospective study.

Setting  The study was carried out at Department of Obstetrics and Gynecology, Faculty of Meram Medicine, Selcuk University, between 1 January 1996 and 30 June 2006.

Population  A total of 65 women diagnosed as imperforate hymen.

Methods  A central oval incision was performed to imperforate hymenal membrane, then 16F Foley catheter was protruded and the balloon was insufflated. Catheter was removed after 2 weeks duration. Estrogen cream was prescribed to all women for application onto hymenal structure for 2 weeks.

Main outcome measures  Efficacy of procedure in treatment of imperforate hymen, preserving hymenal structural integrity that is accepted as important for virginity in some societies.

Results  After the procedure, hymenal orifice created remained open and intact in all women except two women. Closure of artificially created hymenal orifice in these two women was believed to be related to inappropriate administration of estrogen cream. Subsequent treatment with local estrogen treatment results in the hymenal orifice remaining opened in these two women.

Conclusions  We have previously reported the technique in 2002, but now we are able to demonstrate results of our technique in an expanded number of women. This technique is less invasive than other methods and prevents many social problems related to virginity by preventing destruction of the integrity of the hymenal structure and providing an annular‐intact hymenal ring.
Persistence of fetal cells in the mother: friend or foe?
Authors: Lissauer D , Piper KP , Moss PAH , Kilby MD
Published: October 2007

There is increasing evidence that both circulating cells and free fetal DNA persist in the maternal circulation after delivery of the fetus. In some cases, this has been described many years after the end of the pregnancy. This article reviews the evidence for these cells being present, the potential methodologies used to identify such cells and the potential effects on maternal immunomodulation. Data relating to the potential beneficial and potentially harmful effects are discussed.
An introduction to Toll‐like receptors and their possible role in the initiation of labour
Authors: Patni S , Flynn P , Wynen LP , Seager AL , Morgan G , White JO , Thornton CA
Published: October 2007

Toll‐like receptors (TLR) have emerged as key upstream mediators of inflammation at many tissue sites in humans. Inflammatory processes are involved in the process of parturition suggesting that TLR activity within gestation‐associated tissues might have an important role in the initiation and/or maintenance of normal term labour and in various pathological states of pregnancy such as infection‐associated preterm labour. Either TLRs or their signalling molecules might be excellent therapeutic targets for prevention of preterm labour.