bluuebunny/crossref_metadata_2025 huggingface dataset:
p53 Expression and Clinical Outcome in Prostate Cancer
Authors: THOMAS D. J. , ROBINSON M. , KING P. , HASAN T. , CHARLTON R. , MARTIN J. , CARR T. W. , NEAL D.E.
Published: November 2008

Summary Abnormally high levels of expression of p53 protein are found in many human cancers. In most cases increased expression is associated with point mutations in one allele of the p53 gene and loss of the other allele. Accumulation of the protein product can be detected by immunohistochemistry.

p53 protein expression in 68 men with prostate cancer, followed up for at least 8 years or until death, was assessed by immunohistochemistry. The aim of the study was to determine the association between p53 protein expression, cell cycling and clinical outcome. Nine (13%) of 68 tumours stained positively for p53; all 9 tumours were category T3 or T4. p53 positive tumours had a significantly greater Gleason score than p53 negative tumours. Eight of the 9 p53 positive tumours had > 10% cells in G2 +mitosis, compared with 61% of p53 negative tumours. All 7 patients with p53 positive tumours available for follow‐up progressed clinically, compared with 28 of 38 patients (74%) with p53 negative tumours. The median time to progression was 12 months in p53 positive tumours and 24 months in p53 negative tumours. Median survival in p53 positive tumours was 40 months, compared with 76 months in p53 negative tumours.

This study demonstrates that overexpression of p53 in a small population of prostate cancers is associated with a poor prognosis in terms of progression and survival.
Long‐term Results of Combined Interstitial Gold Seed Implantation plus External Beam Irradiation in Localised Carcinoma of the Prostate
Authors: LANNON S. G. , EL‐ARABY A. A. , JOSEPH P. K. , EASTWOOD B. J. , AWAD S. A.
Published: November 2008

Summary Carcinoma of the prostate is one of the leading causes of death in men. Patients with localised disease can be treated with radiotherapy, but controversy still exists regarding the most effective therapeutic technique. We report 180 patients with surgical stage A2‐C prostate cancer treated between 1976 and 1986 by pelvic lymphadenectomy and radioactive gold seed implantation followed by external irradiation. Annual post‐treatment biopsies were performed up to 5 years in most patients. Regular follow‐up included a digital rectal examination, prostatic acid phosphatase and bone scan. One hundred and sixty‐four patients had complete follow‐up data at the end‐point of data collection (December 1991).

The actuarial 10‐year cancer‐free survival rates were 83.0% and 91.3% for stages A2 and B1 respectively. The incidence of positive biopsy at 2 and 5 years was 13% and 17.1% respectively for the whole series. A firm correlation was defined between biopsy result and subsequent development of local progression, distant metastases and overall survival.

Combined interstitial gold seed implantation plus external beam irradiation represent a valid option for the treatment of patients with localised prostatic cancer.
Dynamic Echography of the Penis in the Follow‐up of Impotent Patients Treated with Intracavernous Injections
Authors: VIRAG R. , NOLLET F. , GRECO E. , SHOUKRY K.
Published: November 2008

Summary Dynamic echography of the penis (DEP) after pharmacological stimulation of erection has been designed to evaluate the albugineal wall thickness (AWT), the cavernosal appearance in the normal penis and corporeal changes in patients treated with intracavernous injections presenting with haematomata, hyperechoic images, prolonged erection and Peyronie's disease. DEP was performed in 973 patients who had had an average number of 89 (+ 16) intracavernous injections for 16.7 ± 11.7 months. A total of 1424 DEP examinations were performed. Transducer positioning, erectile condition, clinical recording and computer retrieval methods were adapted to gather ultrasonography data. The standard average AWTs recorded in patients free from Peyronie's disease and who were untreated were 0.11 cm at the septum, 0.17 and 0.15 cm at the dorsal root and the tip of the albuginea respectively, 0.14 cm ventrally and the diameter of the corpus cavernosum averaged 1.61 cm. Intracavernous therapy brought an increase in AWT of 15.38% to the septum, 11.76% and 10.53% to the dorsal tip and root respectively and 12.5% ventrally. Frequent haematomata induced greater increase, while prolonged erections did not. Patients with untreated Peyronie's disease were found to have greater AWT which decreased after treatment with intracavernosal injections. Before treatment abnormal penile hyperechoic images were found in 3.18% (intracavernous images) and 3.31% (albugineal nodules) of DEP, and in 7.09% and 7.54% respectively post‐treatment.
Effects of Plasma Exchange on Sperm Antibody Levels in Males with Subfertility
Authors: ABEL P. D. , LINDSAY K. S. , LORD ROSEANNE H. H. , MacGREGOR SUE , FLOYD IVY , WILLIAMS GORDON , PUSEY C. D.
Published: November 2008

Summary Three men with subfertility secondary to sperm antibodies with measurable serum sperm antibody levels underwent a course of 3 plasma exchanges over a period of 1 week. The levels of serum anti‐sperm antibodies fell by a mean of 3.3 dilutions. This fall was maintained for approximately 4 weeks, after which there was a return to the original levels. Plasma exchange is time‐consuming and relatively expensive but it offers a possible alternative to steroid treatment (with its potential side effects) in men with sperm antibodies and warrants further investigation.
Transtrigonal Approach for Excision of MUllerian Duct Structures
Authors: LAMOIMT G. L. , GOUGH D. C. S.
Published: November 2008

Summary Persistent mtillerian structures attached to the prostatic urethra in the male may cause urinary incontinence and infection. The transtrigonal technique allows complete excision with preservation of normal bladder function and control. We describe the operative technique in detail.
Immunohistochemical Detection of Tissue‐infiltrating Lymphocytes in Mild Urothelial Dysplasia
Authors: MIGLIARI R. , DEMIRY *M. I. M. EL , MUSCAS G. , MELIS M. , USAI E.
Published: November 2008

Summary The presence and distribution of immunocompetent cells in normal and dysplastic urothelium of the bladder were investigated in 3 patients. Using an indirect immunoperoxidase staining procedure, monoclonal antibodies reacting with B (Leu 12 +) and T (Leu4 +) cells, cells of the suppressor/cytotoxic (Leu2a +), helper/inducer (Leu3a +) and natural killer (Leu7 +) phenotypes, monocyte‐macrophages (LeuM3 +), and cells expressing interleukin‐2 receptor and HLA‐DR antigen (HLA‐DR+) were tested in all specimens.

The results confirmed the presence of a well ordered and compartmentalised distribution of immunocompetent cells in the normal mucosa far from dysplasia. There was an increased number of lymphocytes in the hyperplastic/dysplastic urothelium with associated Von Brunn's nests. Leu2a + cells, HLA‐DR expressing cells and monocyte‐macrophages were present inside the epithelium, particularly within dysplasia and von Brunn's nests, but the Leu3a + /Leu2a + ratio was not inverted (0.48 + 0.1 to 0.74+ 0.2).

These findings reveal that in mild urothelial dysplasia with von Brunn's nests there is a spatial modification of the immunological barrier associated with the mucosa.
Cytogenetic Analysis in Transitional Cell Carcinoma of the Bladder
Authors: SCHAPERS R. F. M. , SMEETS A. W. G. B. , PAUWELS R. P. E. , Van den BRANDT P. A. , BOSMAN F. T.
Published: November 2008

SummaryThe potential use of numerical chromosomal abnormalities as predictive factors for the clinical behaviour of transitional cell carcinoma (TCC) was investigated. The effects on survival and progression‐free survival were measured in 91 patients with TCC treated by transurethral resection. The survival rate of patients having tumours with a diploid chromosomal modal number was significantly better than that of patients having tumours with a hyperdiploid chromosomal modal number. The survival rate of patients having TCC with diploid cells only was also significantly better than that of patients having TCC with both diploid and hyperdiploid cells. Progression‐free survival was significantly higher in patients having TCC with a diploid modal number of chromosomes than in patients with a hyperdiploid modal number.

Simultaneous evaluation of the modal chromosome number or chromosomal range, histological grade, category and mitotic index of the tumour, and the patient's age and sex as prognostic factors in multivariate analyses showed that the category of bladder carcinomas was the most important factor in predicting the survival rate. In patients with superficial tumours (category Ta and T1) the modal chromosome number was the most important factor in predicting survival. For progression‐free survival, the modal chromosome number appeared to be the most important factor. It was concluded that the modal chromosome number in TCC was useful in predicting survival in patients with superficial tumours and in predicting progression‐free survival in patients with tumours of all categories.
Urethral Recurrences following Radical Cystectomy for Invasive Transitional Cell Carcinoma of the Bladder
Authors: TONGAONKAR H. B. , DALAL A. V. , KULKARNI J. N. , KAMAT M. R.
Published: November 2008

Summary A total of 177 patients with invasive transitional cell carcinoma of the bladder underwent radical cystoprostatectomy, of whom 13 underwent simultaneous urethrectomy. The remaining 164 patients were followed up regularly with urethroscopy and urethral cytology. Fifteen patients developed urethral recurrences, 4 of which were associated with relapses at other sites (recurrence rate 9%), with a mean recurrence‐free interval of 13.5 months. Nine of the 11 patients with isolated urethral rcurrences underwent total urethrectomy and all except 1 are alive and disease‐free 2 to 8 years later. One patient was salvaged by radiation therapy and refused further treatment. The 4 patients with other associated relapses died within 18 months. The urethral recurrence rate was correlated to different risk groups defined on the basis of tumour characteristics in the cystectomy specimen. This revealed a 70% urethral recurrence rate in the high risk group, 9.6% in the moderate risk group and 1.2% in the low risk group. However, no conclusion could be drawn regarding the influence of prostatic involvement on the urethral recurrence rate.
Further Study of Sushruta's Lateral Perineal Approach for Primary Repair of the Ruptured Posterior Urethra
Authors: GADHVI N. P.
Published: November 2008

Summary Using Sushruta's lateral perineal approach, 16 primary repairs for complete rupture of the posterior urethra were carried out between January 1987 and November 1991. This approach to the urethra is short, safe, simple and direct; operative and post‐operative complications are minimal and the total recovery period is short.
Morbidity following Groin Dissection for Penile Carcinoma
Authors: RAVI R.
Published: November 2008

Summary From 1962 to 1990, 231 inguinal and 174 ilio‐inguinal lymphadenectomies were performed on 234 patients with penile carcinoma. The morbidity of inguinal lymphadenectomy included wound infection in 18%, skin edge necrosis in 61%, seroma formation in 5% of dissections, and lymphoedema in 25% of limbs. The morbidity of ilio‐inguinal lymphadenectomy included wound infection in 14%, skin edge necrosis in 64%, seroma formation in 9% of dissections, and lymphoedema in 29% of limbs. Pre‐operative radiation to the groin significantly increased the healing complications. The routine use of a myocutaneous flap for primary reconstruction of the groin following ilio‐inguinal lymphadenectomy resulted in 100% primary wound healing and significantly reduced the post‐operative hospital stay to a mean of 10 days.
The effects of sodium citrate and oral potassium citrate on urease‐induced crystallization
Authors: WANG Y. H. , GRENABO L. , HEDELIN H. , PETTERSSON S.
Published: November 2008

Objectives To study the effects of citrate on urease‐induced crystallization in human urine.

Materials and methods Urine samples were collected from seven healthy volunteers with no history of urinary tract infection or stone disease. Citrate was removed from the urine samples by decomposition with citrate lyase. Citrate was then added to the urine in increasing concentrations. Oral potassium citrate was given to the volunteers and their urine was collected. The samples were incubated with urease and the crystallization induced was observed by the Coulter counter technique, by using an optical microscope and by precipitated material analysis.

Results The initiation of crystallization was markedly delayed by both the addition of citrate to the urine and after the ingestion of citrate. Crystal growth and the resulting precipitation of both calcium and magnesium showed a concentration‐dependent reduction when citrate was added up to a concentration of 4 mM. Crystal growth and precipitation of calcium and magnesium were also significantly decreased by oral citrate intake.

Conclusion Citrate added to the urine or taken orally markedly delays urease‐induced crystallization in human urine.
Partial nephrectomy for incidental renal cell carcinoma
Authors: HERR H.W.
Published: November 2008

Objective To evaluate the role of nephron‐sparing surgery in patients with incidental renal cell carcinoma and a normal contralateral kidney.

Patients and methods A total of 230 patients underwent curative surgery for unilateral renal cancer between 1979 and 1991. Of these, 41 had a partial nephrectomy. The numbers of patients who underwent partial or radical nephrectomy over the course of the study are compared.

Results The number of partial compared to total nephrectomies increased from 8% in 1979‐84, to 20% in 1984‐88 and 30% in 1989‐91. This reflected increased detection of incidental renal tumours by radiological imaging. The local recurrence rate in those patients who underwent partial nephrectomy was 2% and survival was 95%, with an average follow‐up of 3 years (range, 2–13).

Conclusion Nephron‐sparing excision of small, incidental renal tumours achieved comparable early results to radical nephrectomy.
Corpus cavernosal relaxation in impotent men
Authors: PICKARD R.S. , KING P. , ZAR M.A. , POWELL P.H.
Published: November 2008

ObjectiveTo investigate smooth muscle responsiveness in isolated preparations of corpus cavernosum from men with vasculogenic impotence.

Patients and methodsBiopsies of corpus cavernosum were obtained from 63 men undergoing penile surgery. These included a control group of eight men (mean age 59 years, range 38–82) undergoing penile amputation for carcinoma, 47 men with vasculogenic impotence (mean age 58, range 36–72) who were further sub‐divided into arterial (n = 9), venous (n = 24) or mixed arterial/venous (n = 14) impotence according to the results of pre‐operative haemo‐dynamic investigation, and eight men with non‐vasculogenic impotence (mean age 49 years, range 34–66). Smooth muscle contractile responses to a‐adrenoceptor activation and relaxant responses to stimulation of intrinsic nerves and exposure to papaverine and sodium nitroprusside were recorded in tissue strips prepared from the biopsies. Morphology was assessed histologically using haematoxylin and eosin staining of tissue sections together with immuno‐cytochemical labelling of intrinsic nerves.

ResultsNerve‐evoked relaxation was markedly impaired in tissue from men with venous or mixed arterial/ venous impotence. A lesser degree of impairment was found in tissue from men with arterial impotence alone. Tissue from men with all types of vasculogenic impotence also showed a decreased contractile response to a‐adrenoceptor stimulation. The magnitude of relaxant responses to papaverine and sodium nitroprusside in the vasculogenic group was similar to that of the control. There were no differences in smooth muscle content or nerve density between the vasculogenic group and the control. In the non‐vasculogenic group responses to relaxant nerve stimulation, a‐adrenoceptor activation and relaxant drugs were similar to those of the control. Nerve density in this group was similar to the control but smooth muscle content was reduced.

ConclusionsThe results of this study demonstrate a functional impairment of smooth muscle contractility and neurogenic relaxation in corpus cavernosum from impotent men with abnormal penile haemodynamics. Altered smooth muscle responsiveness is likely to be a factor in the aetiology of impotence in such men and may contribute to the relatively poor results of vascular surgery for impotence.
Peyronie's disease and congenital penile curvature: long‐term results of operative treatment with the plication procedure
Authors: NOOTER R.I. , BOSCH J.L.H.R. , SCHRODER F.H.
Published: November 2008

Objective To evaluate the results of plication of the tunica albuginea in patients with a curved penis.

Patients and methods Twenty‐two men with congenital penile curvatures and 33 men with acquired penile curvatures were treated by the plication technique. Their files were studied and all patients underwent a follow‐up interview and were physically examined. The mean age of the patients with congenital penile curvatures was 25.7 (range 17–58) and that of the men with acquired penile curvatures was 54.4 (range 28–67). The mean length of follow‐up was 42 months.

Results The mean angle of deviation in relation to the longitudinal axis was 48.2d̀ in the congenital curvatures and 63.3d̀ in the acquired curvatures. AU congenital curvatures were corrected successfully, i.e. the penis was straight and satisfactory intercourse was possible. Slight shortening of the penile shaft was noticed by eight patients, but none was concerned about this finding. Pre‐operatively, 12 of 33 patients with acquired curvature were unable to have intercourse because of the combination of decreased rigidity and abnormal curvature. Of these patients, three were able to have satisfactory intercourse post‐operatively. Most of the nine patients with a poor result were known pre‐operatively to have adverse factors affecting erectile function. Of the 21 patients who were only able to have intercourse with difficulty pre‐operatively, intercourse was easier and more satisfactory in 18 and more difficult in three post‐operatively. Pre‐operative pain with erection improved in all patients. Complications were mild. Shortening concerned only two patients with recurrent Peyronie's disease after re‐operation.

Conclusion Plication of the curved penis is a relatively simple, save and effective procedure.
Adenylate and guanylate cyclase activity in the penis and aorta of the diabetic rat: an in vitro study
Authors: MILLER M.A.W. , MORGAN R.J. , THOMPSON C.S. , MIKHAILIDIS D.P. , JEREMY J.Y.
Published: November 2008

Objective To investigate the role of adenylate and guanylate cyclases in the mediation of erection in diabetic rats.

Materials and methods Hyperglycaemic diabetes mellitus was induced in 3 5 rats using streptozotocin. Two months later the penises and aortae of these rats were excised and cut into rings or segments before being treated with varying concentrations of acetylcholine (Ach). sodium nitroprusside (NaNP), prostaglandin E1 (PGE1) and adrenaline (AD). The levels of adenosine 3'5′‐cyclic monophosphate (cAMP) and guanosine 3'5′‐cyclic monophosphate (cGMP) so generated were measured by radioimmunoassay and the results com‐ pared with those from seven age‐matched control rats that had not been given streptozotocin.

Results Ach‐stimulated cGMP synthesis was impaired in the aortae in diabetic rats. Ach‐stimulated cGMP synthesis was undetectable in the penis. NaNP‐stimulated cGMP and PGE,‐stimulated cAMP synthesis was enhanced in both the penises and aortae in diabetic rats compared with controls. AD‐stimulated cAMP synthesis was enhanced in the aorta in diabetic rats compared with controls, but AD had no effect on CAMP synthesis in the penis.

Conclusion Ach‐stimulated nitric oxide (NO) synthesis is impaired in the vasculature of diabetic rats and an Ach‐NO axis may not be present in the penis of the rat. The enhanced capacity of the penis and vasculat‐ ure to generate cAMP and cGMP may constitute an adaptive response to counteract the reduction in recep‐ tor‐linked NO release. Impaired adenylate or guanylate cyclase activity does not contribute to erectile dysfunc‐ tion in diabetic rats.
Laparoscopic procedure for varicocelectomy
Authors: MISCHINGER H.J. , COLOMBO T. , RAUCHENWALD M. , ALTZIEBLER S. , STEINER H. , VILITS P. , HUBMER G.
Published: November 2008

Objective To report the results of laparoscopic varicocelectomy, a new surgical technique which presents minimal risks and provides an effective management of clinical varicoceles.

Patients and methods Between July 199 1 and November 1992, 45 laparoscopic varicocelectomies were performed in 44 patients whose ages ranged from 11 to 41 years. Endoscopic ligation, carried out according to the technique described by Palomo [1], was performed in 14 patients. In the remaining 30 patients ligation of 31 spermatic veins was performed according to Bernardi's procedure [2].

Results On post‐operative follow‐up symptoms disappeared in all the patients treated. Two of the patients showed persistent venous reflux on colour Doppler ultrasound examination.

Conclusions The excellent identification of the anatomical structures, the minimal surgical trauma, the decrease in post‐operative morbidity and the quick convalescence of the patients have made this new technique a viable alternative to routine open high ligation.
The nutcracker syndrome: new methods of diagnosis and treatment
Authors: SHOKEIR A. A. , EL‐DIASTY T. A. , GHONEIM M. A.
Published: November 2008

Objective To study the pathophysiology of the nutcracker syndrome and to describe a new method of treatment.

Subjects and methods Computerized tomography (CT) was used to compare the anatomical relations of the left renal vein with the aorta and the superior mesenteric artery in three patients with the nutcracker syndrome and in a control group of 12 healthy kidney donors.

Results Abnormal branching of the superior mesenteric artery from the arota was identified as the cause of the nutcraker syndrome. Two patients were treated by autotransplantation of the left kidney, while the third refused surgery. In the treated patients haematuria ceased 4 and 6 weeks after surgery. Postoperative excretory urography and repeated isotopic studies revealed perfect configuration and function of the autotransplanted kidneys. The patients remain asymptomatic 6 and 12 months after surgery.

Conclusion In patients with haematuria from the left kidney, angiographic CT must be considered before phlebography and pressure measurement of the left renal vein. If the diagnosis of the nutcracker syndrome is established, autotransplantation of the left kidney is a treatment alternative.
A comparison between digitally‐guided fine needle aspiration and ultrasound‐guided transperineal core needle biopsy of the prostate for the detection of prostate cancer
Authors: ENGELSTEIN D. , MUKAMEL E. , CYTRON S. , KONICHEZKY M. , SUTZKI S. , VADIO C. SER
Published: November 2008

Objective To prospectively examine the accuracy of fine needle aspiration (FNA) for the detection of prostate cancer. Ultrasound‐guided core needle biopsy of the prostate was used as the standard to which the FNA results were compared.

Patients and methods One‐hundred patients who had been referred for urological evaluation were suspected of having prostate cancer on the basis of digital rectal examination (DRE) and/or transrectal ultrasound (TRUS). All were further evaluated by digitally guided transrectal FNA and by TRUS‐guided transperineal core needle biopsy.

Results Prostate cancer was identified in 54 patients by core needle biopsy and in 45 by FNA. The sensitivity of FNA was 81% and both specificity and positive predictive value were 98%.

Conclusion FNA is easily performed, has negligible morbidity and offers prompt results. These data suggest that FNA is a reasonable initial diagnostic procedure for the detection of prostate cancer. Core needle biopsy may be reserved for patients with negative cytology who are clinically suspected of having prostate cancer. In selected patients, FNA may be used as an alternative to core needle biopsy for diagnosis, treatment planning and follow‐up.
Laparoscopy in 100 consecutive patients with 128 impalpable testes
Authors: Cortes D. , Thorup J.M. , Lenz K. , Beck B.L. , Nielsen O.H.
Published: November 2008

Objective To investigate the value of laparoscopy in boys with impalpable testes, to carry out a histological examination of testicular biopsies or orchidectomy specimens, and to present a clinical description of boys with impalpable testes.

Patients and methods One hundred consecutive patients underwent laparoscopy for 128 impalpable testes. They ranged in age from 2.7 to 19.3 years (median 10.8). Histological examination was performed on 39 testicular biopsies, nine primarily orchidectomized testes and 13 tissue samples from the end of blind‐ending vessels and vasa deferentia. Any additional diagnoses to that of impalpable testes were recorded.

Results There were no complications associated with laparoscopy and the procedure clarified the situation in all patients. In 50% of patients either blind‐ending cord structures above the internal inguinal ring or intra‐abdominal testes were identified; in the remainder, cord structures could be seen passing through the ring, indicating an intracanalicular testis. The impalpable testis was absent in 77% of patients with a contralateral scrotal testis. A seminoma was found in one 18.6‐year‐old patient with bilateral cryptorchid‐ism. No intratubular germ cell neoplasia (carcinoma in situ) was found. Germ cell hypoplasia or aplasia was demonstrated in 95% of patients with testicular parenchyma. Additional diagnoses were made in 49% of patients with bilaterally undescended testes (one or both of which were impalpable).

Conclusion We recommend laparoscopy as a safe procedure which leads to a diagnosis in patients with impalpable testes; the advent of laparoscopic procedures makes definitive treatment possible in about 50% of such patients. Open procedures will be indicated only to ascertain the quality and treatment of intracanalicular testes.
A comparative optical analysis of laser side‐firing devices: a guide to treatment
Authors: Anson K. , Buonaccorsi G. , Eddowes M. , MaCrobert A. , Mills T. , Watson G.
Published: November 2008

Objective To compare the optical characteristics of five different laser side‐firing fibres used to perform deep laser coagulation of the prostate.

Materials and methods The intensity profile, angle of exit and beam divergence from the launch fibre were measured underwater (to simulate endoscopic conditions) for each fibre using both the Helium Neon(633 nm) and Nd:YAG(1064 nm) lasers.

Results The intensity profiles and spot sizes varied among fibres but broadly fell within two groups characterized by large and small footprints (low and high power density). There was a maximum 5.5 fold difference in average power densities between the fibres.

Conclusions Not all side‐firing devices are the same. Variations in the power density profiles among the fibres suggest that the choice of fibre is of critical importance in determining the type of laser tissue interaction (i.e. coagulation or vaporization) that will follow the use of that fibre.
Post‐operative risk factors associated with artificial urinary sphincter infection‐erosion
Authors: Martins F.E. , Boyd S.D.
Published: November 2008

Objective To determine the incidence of infection‐erosion associated with the implantation of artificial urinary sphincters (AMS 800) in a high‐risk group of patients (post‐major pelvic surgery/radio therapy), and to emphasize the commonly neglected risk factors associated with this complication.

Patients and methods One‐hundred‐and forty‐five male patients aged 55–79 years (mean 71) who had had an AMS 800 artificial sphincter implanted between January 1987 and November 1993 were reviewed. All patients had undergone meticulous surgical technique, intra‐operative shave and rigorous scrub, and were given peri‐operative antibiotics. The mean follow‐up was 34.3 months (range 1–83).

Results Infection‐erosion occurred in 13 patients (9%), of whom 10 are currently available for follow‐up. One atient died of his underlying disease (bladder cancer) and two were lost to follow‐up. AH 13 patients had undergone radical pelvic surgery (radical retropubic prostatectomy, radical cystectomy and abdomino‐perineal resection); seven patients had also received radiation therapy. Cultures of the infected AMS 800 devices revealed a pleomorphic group of organisms, specifically enteric, Gram‐positive and anaerobic organisms. The risk of infection‐erosion was found to be increased in the presence of two main factors, improper urethral catheterization and urethral endo‐scopic manipulation with an activated AMS 800 artificial sphincter in place and exposure to radiation. At the time of revision, nine of the 13 patients were found to have positive urine cultures.

Conclusion Despite all the precautions taken, there remains a group of patients who are still at a higher risk of infection‐erosion due to adverse circumstances that distort the anatomy of the perineal area, impair the host defence mechanisms, and ultimately enable the establishment of the infection‐erosion complex. Radiotherapy is known to increase the likelihood of non‐mechanical complications, specifically infection‐erosion. Extreme care must be taken so that avoidable iatrogenic factors such as improper urethral catheterization and endoscopic manipulation with an activated AMS 800 device in situ are not the cause of ‘failure’.
Periurethral implantation of glutaraldehyde cross‐linked collagen (contigen®) in women with type I or III stress incontinence: quantitative outcome measures
Authors: Moore K.N. , Chetner‐ M.P. , Metcalfe J.B. , Griffiths D.J.
Published: November 2008

Objective To evaluate the effectiveness of periurethral collagen (Contigen®) implantation as a treatment for stress incontinence, using quantitative measures of urine loss and the patients' subjective response.

Patients and methods Twelve women, age range 46–87 years, had video urodynamic testing—confirming Type I or m stress urinary incontinence and were eligible for periurethral collagen implant. Eleven had had at least one anti‐incontinence operation. One woman was withdrawn from the study because of a severe subcutaneous skin reaction 21 days after the skin‐test and one patient declined follow‐up. Ten patients had up to two implants each, introduced 3–5 months apart under local anaesthetic (5 mL collagen per implant). All patients underwent 10 h pad tests (with 2‐hourly pad changes) at baseline and 8 weeks after collagen implant. The following quantitative measures of incontinence severity and voiding function were studied: urine loss during the 10 h test, number of wet pads, weight of urine in the wettest pad, maximum voided volume, residual volume on ultrasound, maximum flow rate and urinary flow curve pattern. Blind to the quantitative results, patients were asked to categorize their outcome as cured, improved and failed.

Results There was a significant decrease in urine loss (P= 0.007), number of wet pads (P= 0.05) and weight of the wettest pad (g) (P= 0.03) from baseline to 8 weeks after the second collagen implant. There was no significant difference at any point in maximum voided volume, maximum urinary flow rate and residual volume after voiding measured on ultrasound. Objectively, two women appeared cured (< 5 g urine loss on 10 h pad test); subjectively, both reported themselves as improved (not cured); one subject stated she was cured and on pad test had 11 g urine loss; two women stated there was no change yet urine loss decreased markedly by > 60% from 434 g to 123 g and 533 g to 199 g. The remaining six stated they were improved although, objectively, their urine loss after the collagen implant remained high (mean 132 g, range 87–185).

Conclusion These Results show a significant reduction in urine loss at 8 weeks after the second collagen implant and an Objective cure rate of 18%. There was little relationship between the Objective measure of success and the self‐report. Of interest is the fact that no obstructive changes occurred in the voided amount, the flow curve and the residual volume after voiding.
Experience with ureteroscopy in children
Authors: Shroff S. , Watson G.M.
Published: November 2008

Objective To present our experience of ureteroscopic procedures in children using miniaturized instrumentation.

Patients and methods Fourteen children aged between 13 months and 14 years underwent 20 ureteroscopic procedures. Semi‐rigid 7.2 F and flexible 9.5 F uretero‐scopes were used in a retrograde and an antegrade fashion. Eighteen ureteroscopies were performed retro‐gradely and two antegradely. Of the 20 ureteroscopic procedures, 18 were for stone disease, one for haema‐turia of unknown origin and one for removal of a migrated stent. The average size of the stone was 12.9 × 6.6 mm.

Results Access using miniaturized ureteroscopes was successful in all patients. Dilatation was required only in 1 of 20 procedures. The management of stone disease in 10 of 13 children was straightforward and a single ureteroscopy was required to clear the ureters. In three of 13 children with stone disease the problems were more complex and nine ureteroscopies were undertaken to render the ureters stone free. Complications were stricture at the site of stone impac‐tion (one patient), retention of urine due to a stone fragment in the urethra (one patient), haematuria (one patient) and migrated stent requiring ureteroscopy (one patient).

Conclusion In the hands of an experienced surgeon ureteroscopy can be used with equal success in children as in adults to treat calculus disease.
Does Public Broadcasting Make a Difference? Political Knowledge and Electoral Campaigns on Television
Authors: Jenssen Anders Todal
Published: November 2008

The political role of the modern media and the impact on public opinion has come under intense scrutiny. The arguments in the scientific dispute have been structured under the optimistic ‘cognitive mobilisation’ and pessimistic ‘media malaise’ banners. For obvious reasons the role of television has been most intensely discussed. TV has the widest reach and is believed to have to the strongest impact. So far, much of the exchange of arguments has been based on data from the United States. In many European countries, public broadcasting is far more prominent than in the United States, and one can argue that the ideals underlying public broadcasting have put their mark on the TV industry in many European countries. Norway is such a case. The interesting question is, of course, whether this matters. Does public broadcasting foster a ‘virtuous circle’ of increased political competence, whereas commercial TV creates ‘media malaise’? Data from the Norwegian 1997–2001 election survey panel is used in this study to overcome the main methodological problem in the many studies based on cross‐sectional data: the question of causality. Too often researchers have based their inferences about the link between media exposure and political knowledge on cross‐sectional correlations. The empirical results do little to support the optimistic view of TV as the great political educator. On the contrary, neither exposure to the state‐owned public broadcasting NRK nor the commercial TV2 help to increase the general level of political knowledge. However, NRK seems to be the preferred channel among the politically well‐informed.
Helping Smokers Quit: Understanding the Barriers to Utilization of Smoking Cessation Services
Authors: GOLLUST SARAH E. , SCHROEDER STEVEN A. , WARNER KENNETH E.
Published: November 2008

Context:Counseling smokers to quit smoking and providing them with pharmaceutical cessation aides are among the most beneficial and cost‐effective interventions that clinicians can offer patients. Yet assistance with quitting is not universally covered by health plans or offered by all clinicians. Analysis of stakeholders' perspectives and interests can identify the barriers to more widespread provision of cessation services and suggest strategies for the public policy agenda to advance smoking cessation.

Methods:Review of literature and discussions with representatives of stakeholders.

Findings:All stakeholders—health plans, employers, clinicians, smokers, and the government—face barriers to broader smoking cessation activities. These range from health plans' perceiving that covering counseling and pharmacotherapy will increase costs without producing commensurate health care savings, to clinicians' feeling unprepared and uncompensated for counseling. Like other preventive measures aimed at behavior, efforts directed at smoking cessation have marginal status among health care interventions. State governments can help correct this status by increasing Medicaid coverage of treatment and expanding coverage for state employees. The federal government can promote the adoption of six initiatives recommended by a government subcommittee on cessation: set up a national quit line, develop a media campaign to encourage cessation, include cessation benefits in all federally funded insurance plans, create a research infrastructure to improve cessation rates, develop a clinician training agenda, and create a fund to increase cessation activities through a new $2 per pack cigarette excise tax. Both the federal and state governments can increase cessation by adopting policies such as the higher cigarette tax and laws prohibiting smoking in workplaces and public places.

Conclusions:Public policy efforts should assume greater social responsibility for smoking cessation, including more aggressive leadership at the state and federal levels, as well as through advocacy, public health, and clinician organizations.
Judgment of perceptual synchrony between two pulses and verification of its relation to cochlear delay by an auditory model1
Authors: AIBA ERIKO , TSUZAKI MINORU , TANAKA SATOMI , UNOKI MASASHI
Published: November 2008

Abstract:  This study investigates whether the delay caused in the course of wave propagation along the basilar membrane (BM) of the cochlea (i.e., the cochlear delay) affects the perceptual judgment of the synchronization of two sounds. An experiment was conducted to examine the detection of asynchrony using two types of chirps (compensatory and enhanced chirps) and a pulse. A compensatory delay chirp was designed to align the peaks of the BM velocity. An enhanced delay chirp had a delay pattern that “enhances” the assumed cochlear delay. The pulse had a cosine phase relation and, as a result, an intrinsic cochlear delay at the auditory peripheral. The results suggest that it was difficult for the auditory system to distinguish sounds when the lower‐frequency components arrived after the higher‐frequency components, as happens with a pulse. An auditory model could closely simulate the BM velocity for all stimuli. From both experimental and simulation results, we concluded that the BM velocity corresponding to the higher‐frequency components was one of the cues used in the perceptual judgment of synchronization.
Characterization of natural gases in Japan based on molecular and carbon isotope compositions
Authors: WASEDA A. , IWANO H.
Published: November 2008

In this paper, the origin, maturity, migration, biodegradation and mixing of natural hydrocarbon gases in Japan have been interpreted using molecular and carbon isotope compositions. No indications of abiogenic gases have been found, the gases being classified as microbial, thermogenic or mixed microbial/thermogenic. However, secondary alteration (mixing, biodegradation, fractionation in migration processes) has had a major but variable impact on the composition of natural gases. Biodegradation, especially, has altered both molecular and isotopic signatures. Thus, the prime control of isotopic and molecular characteristics in gases is due to genetic phenomena, but secondary effects must be taken into account when attempting to understand the origin and distribution of gas. Where the extent of secondary alteration is small, carbon isotope compositions of thermogenic hydrocarbons are controlled largely by maturity. An isotope model developed by Berner and Faber was applied successfully to natural gases in northeast Japan. Besides maturity estimation, the application of the model enables detection of biodegradation, mixing between microbial and thermogenic gases, and mixing among gases with different maturities. The carbon isotope compositions of carbon dioxide also provide information for their genetic origins.
Methane seepage in an urban development area (Bacau, Romania): origin, extent, and hazard
Authors: BACIU C. , ETIOPE G. , CUNA S. , SPULBER L.
Published: November 2008

The paper describes a case of a natural emission of methane from soil in an urban development area, generating a significant risk for the local population and buildings, due to gas explosiveness and asphyxiation potential. The site is located on the south‐western margin of the East‐European Platform in eastern Romania, in a hydrocarbon‐prone area crossed by the Pericarpathian lineament and regional faults. Molecular composition of gas and stable isotopic analyses of methane (CH4>90%, δ13C1: −49.4‰, δD1: −173.4‰) indicate a dominant thermogenic origin, with significant amounts of C2‐C5 alkanes (∼5%), likely migrating through faults from a deep reservoir. Possible candidates are the Saucesti and Secuieni gas fields, located in the same petroleum system. Two surface geochemical surveys, based on closed‐chamber flux measurements, were performed to assess the degassing intensity and the extent of the affected area. Methane fluxes from soil reach orders of 104 mg m−2 day−1. Gas seepage mainly occurs in one zone 30 000 m2 wide, and it is likely controlled by channeling along a fault and gas accumulation in permeable sediments and shallow subsoil. The estimated total CH4 emission is about 40 t year−1 CH4, of which 8–9 t year−1 are naturally released from soil and 30–35 t year−1 are emitted from shallow boreholes. These wells have likely channeled the gas accumulated in shallow alluvial sediment but gas flux from soil is still high and mitigation measures are needed to reduce the risk for humans and buildings.
The gas flow at mineral springs and mofettes in the Vogtland/NW Bohemia: an enduring long‐term increase
Authors: KOCH U. , BRÄUER K. , HEINICKE J. , KÄMPF H.
Published: November 2008

Over the last 15 years, there has been an increase in the 3He/4He ratios (Ra) at gas emission sites including springs (liquid‐dominated) and mofettes (gas‐dominated) in the Vogtland (Germany) and NW Bohemia (Czech Republic), indicating an active magmatic process. The highest Ra value (6.2) was measured at the mofette Bublák. Continuous CO2 flow records at Bad Brambach mineral springs (Vogtland) and Cheb Basin mofettes show a significant and enduring increase in gas flow. This increase ranges from 1.6% at Schillerquelle spring, Bad Brambach, and 61% per year at mofette Bublák. Calculated gas flow ratios between the individual emission sites not only emphasize the greater increase in gas flow over time at the Cheb Basin mofettes compared with the Bad Brambach springs (factor 2.1 to 2.6) but also show a uniform gas flow behaviour within both emission areas. Using simplified models, it is demonstrated that long‐term gas flow measurements reveal a gas‐hydraulic parameter, the effective cross‐sectional ratio, to compare the near‐surface gas‐bearing fissures and cracks between the emission sites. Thus, the overall cross‐sectional area of gas pathways at the mofette Soos is 13.2 times higher than at the Wettinquelle spring, indicating greater overall fissure widths for gas transport at the Cheb Basin mofettes than at the mineral springs. Comparison between the monthly fluctuations of free gas flow and dissolved CO2 at the Wettinquelle spring shows an inverse dependence of both parameters but without a temporal trend of dissolved CO2. This indicates that the mineral water body acts as a kind of buffer saturated by CO2 and being degassed more or less strongly, depending on the flow rate of the ascending free gas. The results suggest increased activity of the magmatic reservoir below the Cheb Basin, not only from the qualitative (3He/4He) but also from the quantitative (amount of magmatic CO2) perspective.
Large Allele Frequency Differences between Human Continental Groups are more Likely to have Occurred by Drift During range Expansions than by Selection
Authors: Hofer T. , Ray N. , Wegmann D. , Excoffier L.
Published: November 2008

Several studies have found strikingly different allele frequencies between continents. This has been mainly interpreted as being due to local adaptation. However, demographic factors can generate similar patterns. Namely, allelic surfing during a population range expansion may increase the frequency of alleles in newly colonised areas. In this study, we examined 772 STRs, 210 diallelic indels, and 2834 SNPs typed in 53 human populations worldwide under the HGDP‐CEPH Diversity Panel to determine to which extent allele frequency differs among four regions (Africa, Eurasia, East Asia, and America). We find that large allele frequency differences between continents are surprisingly common, and that Africa and America show the largest number of loci with extreme frequency differences. Moreover, more STR alleles have increased rather than decreased in frequency outside Africa, as expected under allelic surfing. Finally, there is no relationship between the extent of allele frequency differences and proximity to genes, as would be expected under selection. We therefore conclude that most of the observed large allele frequency differences between continents result from demography rather than from positive selection.
Grazing Gradient versus Restoration Succession of Leymus chinensis (Trin.) Tzvel. Grassland in Inner Mongolia
Authors: Li Yonghong , Wang Wei , Liu Zhongling , Jiang Shu
Published: November 2008

Grazing‐induced degradation of grasslands is the primary impediment to the socioeconomic development of Inner Mongolia. It affects the entire environment of northern China. Understanding grassland dynamics is necessary for restoration and sustainable management of these degraded ecosystems. The recovery dynamics of a degraded Leymus chinensis (Trin.) Tzvel. grassland after removal of grazing was studied in comparison with its spatial variation along a grazing gradient, using its climax community as a benchmark. The species composition, diversity, and biomass of the grassland vegetation, as well as the attributes (height, density, and individual mass) of major species, were examined on the eight sites along the grazing gradient and in the recovering grassland over 11 years. The spatial pattern of grassland vegetation along the grazing gradient closely reflected its recovery trajectory over time. Both the spatial and the temporal processes exhibited the same shift in species dominance in association with grazing removal or less grazing intensity. Grassland degradation was accompanied by an increase in species density and a decrease in species size; this trend was reversed during recovery. This result suggested that the degraded grassland is highly resilient and that restoration could occur naturally by reducing or excluding grazing animals. However, some differences existed between the spatial and the temporal processes. Species richness was high on the light‐ or no‐grazing sites along the gradient, but varied little during the recovery of the degraded grassland. Species evenness was high under moderate to light grazing along the gradient and was high at the beginning of the recovery period but not at the end. Although standing biomass improved significantly during the recovery period, it did not change significantly along the grazing gradient. These observed discrepancies were related to the intrinsic difference in the spatial versus temporal processes and are discussed together with the advantage/disadvantage of the grazing gradient versus dynamic monitoring methods in grassland dynamics studies.