bluuebunny/crossref_metadata_2025 huggingface dataset:
A protein of the basal lamina of the sea urchin embryo
Authors: Tesoro Valentina , Zito Francesca , Yokota Yukio , Nakano Eizo , Sciarrino Serafina , Matranga Valeria
Published: October 2003

The purification, biochemical characterization and functional features of a novel extracellular matrix protein are described. This protein is a component of the basal lamina found in embryos from the sea urchin species Paracentrotus lividus and Hemicentrotus pulcherrimus. The protein has been named PI‐200K or Hp‐200K, respectively, because of the species from which it was isolated and its apparent molecular weight in SDS‐PAGE under reducing conditions. It has been purified from unfertilized eggs where it is found packed within cytoplasmic granules, and has different binding affinities to type I collagen and heparin, as assessed by affinity chromatography columns. By indirect immunofluorescence experiments it was shown that, upon fertilization, the protein becomes extracellular, polarized at the basal surface of ectoderm cells, and on the surface of primary mesenchyme cells at the blastula and gastrula stages. The protein serves as an adhesive substrate, as shown by an in vitro binding assay where cells dissociated from blastula embryos were settled on 200K protein‐coated substrates. To examine the involvement of the protein in morphogenesis of sea urchin embryo, early blastula embryos were microinjected with anti‐200K Fab fragments and further development was followed. When control embryos reached the pluteus stage, microinjected embryos showed severe abnormalities in arms and skeleton elongation and patterning. On the basis of current results, it was proposed that 200K protein is involved in the regulation of sea urchin embryo skeletogenesis.
Proximal cis‐regulatory elements of sea urchin arylsulfatase gene
Authors: Koike Hiroko , Akasaka Koji , Mitsunaga‐Nakatsubo Keiko , Shimada Hiraku
Published: October 2003

Expression of the arylsulfatase (HpArs) gene in the sea urchin, Hemicentrotus pulcherrimus, is regulated in spatially, as well as temporally, during development. To address the cis‐regulatory elements involved in this regulation, we performed reporter assays using variously deleted or mutated promoter and regulatory elements of the HpArs gene, accompanied by gel mobility shift assay and foot printing. Results show that two regions, PU1 (−72b.p. to −56 b.p.), which is similar to SpZ12‐1 and/or Oct‐1 motif, and the PD1 site (+ 133 b.p. to + 142 b.p.), which is homologous to the binding sites of Rel family transcription factors and/or AGIE‐BP1, are related to the regulation of expression of the HpArs gene. Furthermore, an HpArs enhancer element called C15, which is located 3 kb.p. downstream from the transcription start site, activates the HpArs promoter. We also report that the enhancer activity of the C 15 fragment was mediated by elements, PU1 and PD1.
Unequal divisions at the third cleavage increase the number of primary mesenchyme cells in sea urchin embryos
Authors: Kominami Tetsuya , Takaichi Miho
Published: October 2003

To clarify the distribution and behavior of the maternal factors that direct the differentiation of primary mesenchyme cells (PMC) in sea urchin embryos, unequal division was induced at the third cleavage with the treatment of dinitro‐phenol (DNP), and the numbers of differentiated PMC were examined. The most surprising finding was that the number of PMC was considerably increased in some of the DNP‐treated embryos. This increase in the number of PMC was suggested to be closely related to the size of the precocious micromeres formed at the 8‐cell stage. By measuring both the size of the precocious micromeres and the number of PMC in individual embryos, it was suggested that almost all the descendants of the precocious micromeres differentiated into PMC, if the volume was less than 26 pL (about three times the volume of normal micromeres). Cell tracing experiments ascertained that precocious micromeres with small volumes behave just like micromeres formed at the fourth cleavage in normal embryos. The obtained results indicated that the maternal factors present in sea urchin embryos can direct, at least, more than three times the number of PMC, and that the number of cell divisions of the PMC lineage is not strictly regulated.
Histone deacetylase mRNA temporally and spatially regulated in its expression in sea urchin embryos
Authors: Nemer Martin
Published: October 2003

SpHDAC1, a cDNA homolog of the yeast Rpd3 and higher eukaryotic histone deacetylases (HDAC), was cloned from the sea urchin Strongylocentrotus purpuratus. Its predicted polypeptide and the Rpd3 homologs were highly identical in two‐thirds of their lengths, but diverged in their carboxyl‐terminal regions in both length and sequence. SpHDAC1 transcripts, which reached maximal concentration at the blastula stages, and diminished thereafter, were neither ubiquitously expressed nor restricted to particular cell lineages, but appeared successively in distinct embryonic regions. In the blastula, transcripts were concentrated in a ring within the vegetal plate, comprising primordial endoderm, and, at the outset of gastrulation, in primordial hindgut endoderm. However, in early to mid‐gastrula transcripts, they also appeared in oral ectoderm. In the late‐stage gastrula, expression developed in the foregut. These shifts in spatial expression, together with an observed developmental blockage prior to sea urchin gastrulation by the histone deacetylase inhibitor trichostatin A, suggest a stepwise involvement of SpHDAC1 gene expression or SpHDAC1 functionality in the events of normal gastrulation.
Role of cell adhesion in the specification of pigment cell lineage in embryos of the sea urchin, Hemicentrotus pulcherrimus
Authors: Kominami Tetsuya
Published: October 2003

To clarify the role of cell adhesion in the specification of pigment cell lineage in sea urchin embryos, cell contacts were inhibited by Ca2+‐free artificial seawater (ASW) treatment, and the number of differentiated pigment cells was examined by the method devised for the present study. Obtained results showed that inhibition of cell contacts during mid‐to‐late blastula stage greatly affects the number of pigment cells. Treatment with Ca2+‐free ASW during 7.5–10.5h of development drastically decreased the number of pigment cells, indicating that cell adhesion during this period is indispensable for the specification of pigment cell lineage. On the other hand, the number of pigment cells were increased by the treatment during 9.5–12.5 h of development. It was suggested that this increase was caused by excess divisions of the precursor cells, that is, the division schedule of the precursor cells was altered by inhibition of cell contacts at this period. Interestingly, the number of pigment cells was a multiple of four in a majority of embryos in which pigment cells were drastically decreased in number. These findings suggest that the founder blastomeres of the pigment cell lineage are specified during 7–10 h of development, and that these blastomeres divide twice before they differentiate into pigment cells.
Primary structure of a 120 kDa protein associated with the fucose sulfate glycoconjugate constituting the acrosome reaction‐inducing substance of the sea urchin, Hemicentrotus pulcherrimus
Authors: Ohbayashi Hideyuki , Mantoku Tsuyoshi , Yamamoto Takehiro , Nomura Kohji , Suzuki Norio
Published: October 2003

A fucose sulfate glycoconjugate (FSG), a natural acrosome reaction‐inducer, was purified from the egg jelly of the sea urchin Hemicentrotus pulcherrimus. The FSG is composed primarily of four constituents: a 120kDa protein, a 237 kDa protein, a 258 kDa protein, and a polysaccharide‐containing protein. Among them, the 120 kDa protein was thought to play a critical role in the association of other FSG constituent proteins, and therefore was characterized from a structural point of view. The protein was isolated from the carboxymethylated FSG by preparative sodium dodecyl sulfate‐polyacrylamide gel electrophoresis (SDS‐PAGE) under reducing conditions, and then digested with trypsin to obtain information regarding the primary structure. Based on the partial amino acid sequences of three internal peptides (FSG120KA: LHNNEYGYGDTAAGEPELAQEEID, FSG120KG: AIDIPAETGHYGR, and FSG120KC: RPTFDLADAVDT) and the N‐terminal peptide (LHNNEYGYGDTAAGE‐PELAQQEID) of the 120 kDa protein obtained from intact FSG, degenerate oligonucleotide primers were synthesized and used to amplify a 297 bp cDNA fragment. This fragment enabled us to obtain the full‐length cDNA (3176 bp) by 5′‐ and 3′‐rapid amplification of cDNA ends. The deduced amino acid sequence revealed that the 120 kDa protein is composed of 663 amino acid residues including 72 cysteine residues, and hence, about 40% is presumed to be carbohydrate by weight. The 120 kDa protein plays an important role in the association of FSG constituent proteins (258 and 237 kDa) through disulfide bonds.
Cysteine proteinase plays a key role for the initiation of yolk digestion during development of Xenopus laevis
Authors: Yoshizaki Norio , Yonezawa Satoshi
Published: October 2003

In electrophoretic analyses, extracts of Xenopus laevis neurulae exhibited activities digesting yolk proteins maximally at pH4.8. These activities were completely inhibited by a mixture of pepstatin A and Z‐Phe‐Phe‐CHN2, thus being identifiable as cathepsin D and cysteine proteinase. The electrophoretic profiles of yolk proteins cleaved by embryonic extracts changed at gastrula stages; the profile before stage 13 was the same as that given by cathepsin D treatment and the profile at stage 13 was a combination of the profile given by cathepsin D treatment and that given by cysteine proteinase treatment. Quantitative measurement of enzyme activities showed that the cathepsin D activity that was preserved from the beginning of development increased from stages 13 to 25 and decreased thereafter, whereas the cysteine proteinase activity appeared at stage 13, gradually increased until stage 35 and strongly increased thereafter. Immunoblot analyses showed that the 43 kDa form of cathepsin D was processed to its 36 kDa form, presumably by cysteine proteinase. This change can explain the increase of cathepsin D activity at stage 13 and thereafter. Immunofluorescent staining with the antibody against cysteine proteinase occurred in mesodermal and ectodermal cells other than neural ones at stages 13–24, and in the endodermal cells at stages 24–36. Faint staining in the neural ectoderm persisted from stages 18 to 36. Immunoelectron microscope observation showed that what stained was the superficial layer of yolk platelets. All these results indicate that cysteine proteinase plays a key role in the initiation of yolk digestion during embryonic development.
Relationship between oviposition preference and offspring performance in Australian Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae)
Authors: Jallow Mustapha FA , Zalucki Myron P
Published: October 2003

Abstract We investigated the oviposition preference and larval performance of Helicoverpa armigera under laboratory conditions to determine if the oviposition preference of individual females on maize, cowpea and cotton correlates with offspring performance on the leaves of the same host plants. The host‐plant preference hierarchy of females did not correlate with their offspring performance. Female moths chose host plants that contributed less to their offspring fitness. Plant effects accounted for the largest amount of variation in offspring performance, while the effects of female (family) was low. The offspring of most females (80%, n = 10) were broadly similar, but 20% (two out of 10), showed marked difference in their offspring performance across the host‐plant species. Similarly, there was no relation between larval feeding preference and performance. However, like most laboratory experiments, our experi‐mental design does not allow the evaluation of ecological factors (for example, natural enemies, host abundance, etc.) that can play an important role in larval performance in the field. Overall, the results highlight the importance of carrying out preference performance analysis on the individual or family level, rather than pooling individuals to obtain average population data.
Diapause termination in two species of tropical butterfly, Euploea core (Cramer) and Euploea sylvester (Fabricius) (Lepidoptera: Nymphalidae)
Authors: Canzano Andrea A , Jones Rhondda E , Seymour Jamie E
Published: October 2003

Abstract This study examined the factors used as cues for diapause termination by two Euploea species. Euploea core and E. sylvester were collected from two overwintering sites at Chillagoe, Queensland. Under tropical wet‐season conditions, more butterflies terminated diapause (approximately 60%) than those kept under dry‐season conditions (approximately 40%). However, 100% diapause termination occurred only when butterflies were kept under wet‐season conditions and were fed with honey. For reproductive success, Euploea species need to terminate diapause rapidly to synchronise oviposition with fresh, rapid growth of their larval host plants, which often occurs after rain. The presence of rainfall, increased temperature and long days alone is not a fail‐safe set of cues for this event. Our results suggest that food (as nectar), in conjunction with these combined environmental factors, provide Euploea species with a reliable signal that larval host resources are available for oviposition.
Flight movement of Scapanes australis australis (Boisduval) (Coleoptera: Scarabaeidae: Dynastinae) in Papua New Guinea: a radiotelemetry study
Authors: Beaudoin‐Ollivier Laurence , Bonaccorso Frank , Aloysius Michael , Kasiki Mathew
Published: October 2003

Abstract We used radiotelemetry and/or chemical light‐tags to track the flight of 15 individuals of Scapanes australis in Madang Province, Papua New Guinea. This species causes severe economic impacts on coconut palms in young plantations. Flights to feeding, mating, resting, and possibly oviposition sites covered distances of 52 to 835 m in males, and from 245 m to>1000 m in females. Upon release, females flew in a tight upward spiral above canopy level (>20 m), then usually flew along a single bearing out of radio reception within 1 min of initiating flight. Dispersing females probably follow scent trails to pheromone‐releasing males that occupy feeding galleries excavated most frequently in coconut palms, or search for oviposition sites. Most tagged females were not found again, because they dispersed beyond the tracking capabilities of our radio‐receivers, but one female was followed for 245 m to a feeding gallery excavated by an adult male. Males typically flew within 5 m of the ground, took erratic flight paths with numerous turns, and frequently circled coconuts and other host plants. We followed males from the release point until they ceased flight for a night. Males passed daylight hours either in a feeding gallery within a host plant or under soil litter.
Parobia husbandi gen. n., sp. n. (Acari: Podapolipidae): subelytral parasites of paropsine beetles (Coleoptera: Chrysomelidae)
Authors: Seeman Owen D , Nahrung Helen F
Published: October 2003

Abstract Parobia husbandi gen. n., sp. n. is described from material collected from the subelytra of the southern eucalyptus leaf beetle, Chrysophtharta agricola (Chapuis), in Tasmania, Australia. Parobia gen. n. is distinguished from other podapolipid genera adult males and females with four pairs of legs and no setae on genua I−IV and femora III−IV, adult females with setae v1 and sc2 < 20 µm, and at least two pairs of coxal setae peg‐like, adult males with dorso‐terminal genitalia, dorsal shields C‐D‐E fused, and physogastric larval females with plates C and D entire. A series of morphological plesiomorphies and biological apomorphies link Parobia gen. n. with Chrysomelobia Regenfuss, the most basal genus of Podapolipidae.
Transurethral incision of ureteroneocystostomy strictures in kidney transplant recipients
Authors: Katz R. , Pode D. , Gofrit O.N. , Shenfeld O.Z. , Landau E.H. , Golijanin D. , Shapiro A.
Published: October 2003

OBJECTIVES

To report the treatment of patients who presented with vesico‐ureteric stricture after kidney transplantation, using a minimally invasive endourological approach.

PATIENTS AND METHODS

Patients (10 men and four women, mean age 34 years, range 22–55) were assessed at presentation by serum creatinine level, ultrasonography and intravenous pyelography when the serum creatinine level was < 200 µmol/L. When there was hydronephrosis of the allograft a percutaneous antegrade pyelogram was taken, followed by inserting a nephrostomy. After decompression a stent nephrostomy was passed into the bladder and the strictures at the vesico‐ureteric junction incised along the stent during cystoscopy.

RESULTS

All 14 patients were treated endourologically by an endoscopic incision through the bladder; 13 fared well and one died from sepsis and transplantation problems. The mean follow‐up was 8 months.

CONCLUSIONS

Simple incision of the stricture via cystoscopy was safe and effective, and succeeded in most patients. The endourological management of ureteric lesions is feasible and is currently our first‐line management of ureteric complications after kidney transplantation.
The association between lower urinary tract symptoms and erectile dysfunction in four centres: the UrEpik study
Authors: Boyle P. , Robertson C. , Mazzetta C. , Keech M. , Hobbs R. , Fourcade R. , Kiemeney L. , Lee C. ,   the UrEpik Study Group
Published: October 2003

OBJECTIVE

To report a large‐scale multinational investigation of lower urinary tract symptoms (LUTS) and sexual function, designed to investigate the independent association between them, as recent small‐scale epidemiological studies suggest an association between benign prostatic hyperplasia and sexual dysfunction; both conditions are strongly associated with age and no study has been able to exclude age as a confounding factor in this relationship.

SUBJECTS AND METHODS

Culturally and linguistically validated versions of standard questionnaires were used to estimate the prevalence of LUTS (using the International Prostate Symptom Score, IPSS) and erectile dysfunction (ED) score (using O’Leary's Sexual Function Inventory) in regions of the UK (Birmingham), the Netherlands (Boxmeer), France (Auxerre) and Korea (Seoul). In each centre, stratified random samples were selected from population registers to provide representative samples of the population of men aged 40–79 years (and their partners) in each community. Direct interviews were held in Seoul and postal questionnaires used in the three European centres. The samples were selected randomly, providing representative samples in each community.

RESULTS

In all, 4800 men and 3674 women responded; the response rates among men were 77% in Boxmeer, 21% in Auxerre, 42% in Birmingham and 65% in Seoul. The overall prevalence of ED for men aged 40–79, estimated as an ED score of 0–4, was 21.1%. There was evidence of a linear increase with age (P < 0.001) and the pattern was very similar in the four centres. From the weighted logistic model, there was evidence of an association between sexual dysfunction, other self‐reported diseases and lifestyle. From the ED score, after adjusting for age and country, men with diabetes were more likely to score of 0–4 (odds ratio 1.57, 95% confidence interval 1.09–2.25), as were those with high blood pressure (1.38, 1.09–1.75) and with an IPSS of 8–35 (1.39, 1.10–1.74). For lifestyle, smokers were more likely to score 0–4 (1.54, 1.23–1.92), while physical activity during leisure time was slightly associated with a reduction in the chance of scoring 0–4 (0.87, 0.77–0.99). The analysis gave the same results when repeated using self‐reported ED instead of the dichotomised score.

CONCLUSIONS

ED is clearly age‐related and a problem for a large proportion of men in the community. It can have a profound impact on the quality of life of the man and on his partner. Were all men with this problem to seek medical help there would be a large burden on healthcare systems. There are cultural and age effects on the assessment of this problem.
Expression and cellular localization of Na,K‐ATPase isoforms in the rat ventral prostate
Authors: Mobasheri A. , Pestov N.B. , Papanicolaou S. , Kajee R. , Cózar‐Castellano I. , Avila J. , Martín‐Vasallo P. , Foster C.S. , Modyanov N.N. , Djamgoz M.B.A.
Published: October 2003

OBJECTIVE

To determine the expression and plasma membrane domain location of isoforms of Na,K‐ATPase in the rat ventral prostate.

MATERIALS AND METHODS

Ventral prostate glands from adult male rats were dissected, cryosectioned (7 µm) and attached to poly‐l‐lysine coated glass slides. The sections were then fixed in methanol and subjected to indirect immunofluorescence and immunoperoxidase procedures using a panel of well‐characterized monoclonal and polyclonal antibodies raised against known Na,K‐ATPase subunit isoforms. Immunofluorescence micrographs were digitally captured and analysed by image analysis software.

RESULTS

There was expression of Na,K‐ATPase α1, β1, β2 and β3 subunit isoforms in the lateral and basolateral plasma membrane domains of prostatic epithelial cells. The α1 isoform was abundant but there was no evidence of α2, α3 or γ isoform expression in epithelial cells. The α3 isoform was not detected, but there was a relatively low level of α2 isoform expression in the smooth muscle and stroma.

CONCLUSION

Rat prostate Na,K‐ATPase consists of α1/β1, α1/β2 and α1/β3 isoenzymes. These isoform proteins were located in the lateral and basolateral plasma membrane domains of ventral prostatic epithelial cells. The distribution and subcellular localization of Na,K‐ATPase is different in rodent and human prostate. Basolateral Na,K‐ATPase probably contributes to the establishment of transepithelial ionic gradients that are a prerequisite for the uptake of metabolites by secondary active transport mechanisms and active citrate secretion.
Prospective vs retrospective assessment of lower urinary tract symptoms in patients with advanced prostate cancer: the effect of ‘response shift’
Authors: Rees J. , Waldron D. , O'Boyle C. , Ewings P. , MacDonagh R.
Published: October 2003

OBJECTIVE

To compare prospectively obtained symptom scores (pre‐tests) with retrospective assessment (then‐tests) in patients with newly diagnosed advanced prostate cancer.

PATIENTS AND METHODS

Patients with newly diagnosed locally advanced or metastatic prostate cancer were recruited. They completed the International Prostate Symptom Score (IPSS) and Symptom Problem Index (SPI) before starting treatment. At 3 and 6 months after diagnosis they again completed these questionnaires, but also retrospectively reassessed their initial symptom level. Healthy age‐matched controls were recruited from primary care and completed the same questionnaires; in all, 76 patients and 17 controls participated.

RESULTS

The IPSS and SPI scores decreased significantly over the 6 months of the study. Patients retrospectively rated their level of symptoms and symptom bother as higher than their contemporaneous assessments. This was not the case in the control group.

CONCLUSION

These results question the assumption that contemporaneously collected pre‐test scores are interchangeable with retrospectively assessed then‐tests. This suggests that caution is required when comparing the results of studies that use these two alternative techniques of data collection. The difference between then‐test and pre‐test scores may represent an example of a phenomenon termed ‘response shift’, in which, by adapting to their disease, patients changed the internal standards by which they assessed their symptoms.
Wogonin suppresses cellular proliferation and expression of monocyte chemoattractant protein 1 in Peyronie's plaque‐derived cells
Authors: Wang Z. , Lin G. , Lue T.F. , Lin C.S.
Published: October 2003

The group of authors from San Francisco and Shanghai describe their investigation of wogonin, a flavonoid extracted from a naturally occurring root, which has been used in traditional Chinese medicine to treat inflammatory diseases. Here they study the mechanisms for its anti‐inflammatory properties.

The previous paper published in the BJU International on genital piercing proved to be of great interest to urologists in general. We do not have a history section in the Journal, but it is worth knowing more about the use of this ‘body decoration’ in historic times and up to the present. The Historical Committee of the European Association of Urology has produced much interesting material over the years and here some of that group have written another very interesting paper.

OBJECTIVE

To test the effect of wogonin on cellular proliferation and expression of monocyte chemoattractant protein 1 (MCP‐1) in cells derived from normal and diseased tunica albuginea (TA), as related to Peyronie's disease (PD).

MATERIALS AND METHODS

Cells with characteristics of fibroblasts were isolated from three tissue sources. Those from the plaque of patients with PD were designated as P cells, those from the adjacent, normal‐appearing tissue as C cells, and those from the TA of patients without PD as N cells. These cells were treated with wogonin at doses of 0, 10, 20 and 40 µmol/L for 24 h or treated at a fixed dose of 40 µmol/L for 1, 8 and 24 h. Cell proliferation was assayed with a commercial kit, MCP‐1 mRNA expression by reverse transcription‐polymerase chain reaction, and secreted MCP‐1 by enzyme‐linked immunosorbent assay.

RESULTS

Wogonin suppressed cell proliferation in a dose‐dependent manner; the effect was more pronounced against P cells at 8 and 24 h. Wogonin down‐regulated MCP‐1 mRNA expression, especially in P cells. Wogonin suppressed the level of secreted MCP‐1 by 59–88%. P cells, which secreted far more MCP‐1 than N and C cells at 1 h, were suppressed by 88%. C cells were the least suppressed at all three times.

CONCLUSIONS

Wogonin suppressed the proliferation, the expression of MCP‐1 mRNA, and the expression of secreted MCP‐1 in TA‐derived cells. In most cases, the effect of wogonin was greatest against cells derived from the plaque. Wogonin appears to be a worthy candidate for preclinical trials in men with PD.
Nocturia and associated morbidity in a community‐dwelling elderly population
Authors: Rembratt A. , Norgaard J.P. , Andersson K.‐E.
Published: October 2003

OBJECTIVE

To investigate the association between nocturia and selected concomitant diseases and medications in a community‐dwelling elderly population.

SUBJECTS AND METHODS

Data were obtained with a validated questionnaire mailed to all inhabitants aged ≥ 65 years in Tierp, Sweden. Descriptive statistics on age, gender, concomitant diseases and medications were calculated for non‐nocturics (subjects reporting a mean of < 1 void/night), intermediate (reporting a mean of 1–2 voids/night) and nocturics (reporting a mean of ≥ 2 voids/night). Correlations between the number of nocturnal voids/week and concomitant diseases/medications were investigated with logistic regression, controlling for age and gender.

RESULTS

Of the 4264 questionnaires sent, 67% (2866) were returned, of which 73% (2081) were fully evaluable on nocturia and incorporated in the analysis. Of these, 62% reported ≥ 1 void/night and 29%≥ 2 voids/night. The median (range) age of the respondents was 74 (65–99) years. The prevalence of nocturia increased with age and men reported more nocturia than women. The nocturic group had the highest percentage of reported disease and medication on each question. In the logistic regression, controlling for age and gender, there was no significant correlation between the number of nocturnal voids and hypertension, angina pectoris or diabetes mellitus, nor with treatment of these diseases. Neither was there any correlation for congestive heart failure, snoring, use of diuretics or hypnotics. There were highly statistically significant correlations (P < 0.001) between the increase in number of nocturnal voids and incontinence, daytime urge and nocturnal thirst. The increase in number of nocturnal voids was negatively correlated with good sleep and with feeling in good health (P < 0.001).

CONCLUSION

There was no correlation between the number of nocturnal voids and a known and treated hypertension, angina pectoris, congestive heart failure or diabetes mellitus. The number of nocturnal voids was highly correlated with urge and incontinence.
Clinical efficacy and tolerability of extended‐release tolterodine and immediate‐release oxybutynin in Japanese and Korean patients with an overactive bladder: a randomized, placebo‐controlled trial
Authors: Homma Y. , Paick J.S. , Lee J.G. , Kawabe K. ,   the Japanese and Korean Tolterodine Study Group
Published: October 2003

OBJECTIVE

To compare extended‐release (ER) tolterodine and immediate‐release (IR) oxybutynin with placebo in Japanese and Korean patients with an overactive bladder (OAB).

PATIENTS AND METHODS

Men and women aged ≥ 20 years with symptoms of urinary urgency, urinary frequency (≥ 8 micturitions/24 h), urge incontinence (≥ 5 episodes/week) and symptoms of OAB for ≥ 6 months were randomized to double‐blind treatment with tolterodine ER 4 mg once daily, oxybutynin IR 3 mg three times daily or placebo for 12 weeks. Efficacy assessments included changes from baseline in numbers of incontinence episodes per week, voids/24 h and mean volume voided/void. Patient perceptions of bladder condition, urgency and treatment benefit were also assessed.

RESULTS

In all, 608 patients were randomized to treatment with tolterodine (240), oxybutynin (246) or placebo (122). More patients prematurely withdrew on oxybutynin (23%) than with tolterodine (10.4%) or placebo (16.4%). After 12 weeks of treatment, the median number of incontinence episodes/week was reduced significantly more in the tolterodine (79%; P= 0.0027) and oxybutynin groups (76.5%; P= 0.0168) than on placebo (46.4%). There were also significantly greater improvements in the number of voids/24 h and volume voided/void with tolterodine and oxybutynin than with placebo. More patients in the tolterodine and oxybutynin than in the placebo groups reported improvements in perceived bladder condition, ability to hold urine and treatment benefit. Patients treated with oxybutynin reported more adverse events than those treated with tolterodine or placebo. Dry mouth was significantly more common with oxybutynin than with tolterodine (53.7% vs. 33.5%; P < 0.001), and occurred in 9.8% of placebo patients.

CONCLUSION

Tolterodine ER has similar efficacy but is better tolerated than oxybutynin IR in Japanese and Korean patients with OAB.
Transurethral resection vs microwave thermotherapy of the prostate: a cost‐consequences analysis
Authors: De La Rosette J.J.M.C.H. , Floratos D.L. , Severens J.L. , Kiemeney L.A.L.M. , Debruyne F.M.J. , Pilar Laguna M.
Published: October 2003

OBJECTIVE

To compare the costs and outcome of high‐energy transurethral microwave thermotherapy of the prostate (HE‐TUMT) with transurethral resection of the prostate (TURP), as the former is considered to be the best minimally invasive method for managing lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS

Between January 1996 and March 1997, 144 patients were randomized to treatment with HE‐TUMT (78) using the Prostatron device and Prostasoft 2.5 software (EDAP Technomed, Lyon, France), or TURP (66). At baseline and during the annual follow‐up, patients were evaluated by the International Prostate Symptom Score and uroflowmetry (maximum flow rate and postvoid residual volume). Kaplan‐Meier survival analyses were used to calculate the cumulative risk of re‐treatment. A cost‐consequences analysis was performed based on the prospective measurement of healthcare use, with costs expressed as Netherland guilders (NLG).

RESULTS

During a 3‐year follow‐up period, the mean (95% confidence interval) risk of re‐treatment was 22.9 (12.5–33.2)% and 13.2 (4.5–21.9)% for HE‐TUMT and TURP, respectively (P = 0.215). The mean direct cost of treatment was 3450 (3444–3456) and 6560 (5992–7128) NLG for HE‐TUMT and TURP, respectively. The mean total (including re‐treatments), discounted (4%) 3‐year cost for the HE‐TUMT and TURP group was 5300 (4692–5908) and 7800 (7118–8482) NLG, respectively.

CONCLUSIONS

In this prospective randomized trial, HE‐TUMT and TURP had a comparable 3‐year risk of re‐treatment. Healthcare expenditure on HE‐TUMT, mainly because it is an outpatient treatment, was significantly lower than for TURP.
Short‐term results of rotoresection for benign prostatic hyperplasia: a prospective study of safety and efficacy
Authors: Wadie B.S. , Shehab El‐Dein A.B. , Mohamed A.M. , Elhalwagy S.M. , Ghoneim M.A.
Published: October 2003

OBJECTIVE

To assess the safety and efficacy of rotoresection as a method for treating benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS

Thirty patients were prospectively enrolled between September 2000 and May 2001 (mean age 61 years, sd 6, range 52–78). All patients had a symptom score (AUA) of > 12, a maximum urinary flow rate (Qmax) of < 12 mL/s, a prostate of 20–80 mL and a prostate‐specific antigen (PSA) level of 0–4 ng/mL. Patients with prostate or bladder cancer, a PSA level of > 10 ng/mL, previous prostate surgery, previous pelvic surgery, urethral stricture, active urinary tract infection (UTI), acute urine retention, neuropathic bladder and a serum creatinine of > 1.8 mg/mL were excluded. The adenoma was resected using the Rotoresect® system (Karl Storz, Tuttlingen, Germany); the mean (sd) operative duration was 45.2 (9.9) min. The catheter was removed after 1.97 (0.3) days and patients assessed at 1, 3 and 6 months after surgery by an AUA score, Qmax, blood haemoglobin level, urine analysis and transrectal ultrasonography; all patients but two completed the follow‐up.

RESULTS

At 6 months the mean (sd) AUA score decreased from 20.5 (3.8) to 1.6 (1.3), the Qmax increased from 8.7 (2) to 25.3 (12.6) mL/s, and the total prostate volume decreased from 36.5 (13) to 20.5 (7.8) mL. The mean initial haemoglobin level was 138 (10) g/L and at 1 month was 135 (12) g/L. No patient required a blood transfusion or had signs of transurethral resection syndrome. Early complications included UTI and mild stress incontinence in 10 and 11 patients, respectively. At 6 months these patients had sterile urine and were continent. Two patients had a urethral stricture and posterior urethral stone at 6 months and were treated successfully.

CONCLUSION

In the short‐term, rotoresection is a safe and effective method for treating BPH; there was no significant blood loss or resection syndrome. The hospital stay was short, with excellent functional results.
Long‐term results of high‐power holmium laser vaporization (ablation) of the prostate
Authors: Tan A.H.H. , Gilling P.J. , Kennett K.M. , Fletcher H. , Fraundorfer M.R.
Published: October 2003

Many technological treatments for BPH have been introduced in recent years, some with successful and others with poor results. Most authors have an initial enthusiasm for their novel technique but in some cases later evaluation of long‐term results is somewhat disappointing. The holmium laser has been used in a wide variety of cases of BPH, particularly by the authors from New Zealand, who present their long‐term (7‐year) results in this section. They are happy to recommend the holmium laser on the basis of their results.

Another technique for treating BPH is rotoresection. Authors from Mansoura present their short‐term results, but seem to support the previous impression that this is a potentially useful method for treating BPH.

When we read about LUTS in men or women the importance of epidemiological and quality‐of‐life studies is clear, because these studies improve knowledge and act as a help in their treatment. In this section there are four such studies and it is to be expected that they will fulfil the aims stated here and be helpful to the reader.

OBJECTIVE

To present the 7‐year follow‐up data from the initial series of patients treated by holmium laser ablation of the prostate (HoLAP) for symptoms of benign prostatic hyperplasia at our institution.

PATIENTS AND METHODS

In all, 79 patients underwent HoLAP in the initial series between September 1994 and May 1995. All patients were contacted by telephone and mail; those available for follow‐up had their peak urinary flow rate, American Urological Association (AUA) symptom score, single‐question quality‐of‐life (QoL) score and adverse events assessed. Patients were also assessed using the International Continence Society ‘male short‐form’ (ICSmaleSF) questionnaire on lower urinary tract symptoms (LUTS).

RESULTS

At a median follow‐up of 89 months (7.4 years), 17 patients had died (21%), 28 could not be contacted or refused follow‐up (35%), leaving 34 patients (43%) available for assessment. The mean (range) AUA score of the remainder was 10.0 (0–26), the maximum urinary flow rate 16.8 (5–35) mL/s and QoL score 2.1 (0–5). The mean ICSmaleSF voiding score was 5.8 and the mean incontinence score 3.2. The impact score of their current LUTS (QoL) was 0.68, implying a minimal effect. No patient required pads for incontinence. The reoperation rate was 15%, with one patient each undergoing transurethral resection or bladder neck incision, two undergoing holmium laser enucleation of the prostate and one having a bladder stone removed endoscopically.

CONCLUSIONS

The long‐term results of HoLAP were satisfactory in those patients who were available for the follow‐up.
Renal function may not be restored when using decreasing differential function as the criterion for surgery in unilateral hydronephrosis
Authors: Eskild‐Jensen A. , Munch Jørgensen T. , Olsen L.H. , Djurhuus J.C. , Frøkiær J.
Published: October 2003

The authors from Denmark evaluated the use of decreasing differential renal function as an indication for surgery in children with congenital hydronephrosis. In this study they were able to indicate several problems associated with the type of follow‐up, both on the side of the medical staff and that of the patient. They make some recommendations which they suggest should be closely followed.

OBJECTIVE

To evaluate the use of decreasing differential function (DF) as an indication for surgery in children with congenital hydronephrosis followed according to a flow chart with repeated renography and ultrasonography.

PATIENTS AND METHODS

The hospital records of consecutive children (0–12 years old) who underwent an Anderson‐Hynes pyeloplasty between 1993 and 2000 were reviewed. Follow‐up was recommended according to a flow chart, with isotope renography and ultrasonography at 1, 3 and 6 months, and at 1 (2), 3 and 5 years of age. The diagnosis and follow‐up were often at the referring hospital. The criteria for surgery included a decrease in renographic DF of > 10% of DF, and a DF of < 42%, breakthrough pyelonephritis despite antibiotic prophylaxis, pain or an anterior‐posterior pelvic diameter of > 50 mm.

RESULTS

Fifty‐two children with unilateral hydronephrosis were included; eight had surgery because of decreasing DF of the hydronephrotic kidney. Seven children had a prenatal diagnosis. Only one of these eight children was managed according to the recommended procedures for follow‐up. In two and possibly three children there was significant irreversible kidney damage since the initial renography before surgery. In one child the initial renography was at 15 months and the DF was < 10%. There was a functional improvement after surgery in three children.

CONCLUSION

Few children undergo surgery for decreasing DF of the hydronephrotic kidney in this study. Failure to adhere to the follow‐up schedule was common; this may jeopardize kidney function when using decreasing DF as a criterion for surgery. Therefore, not complying (by medical staff or the patient) with the follow‐up should be considered when using expectant management for asymptomatic hydronephrosis. The serious consequences for renal function of not complying with follow‐up can be avoided by surgery if the patient risks renal functional deterioration, by close cooperation with medical staff at referring hospitals, and by close follow‐up at an early age with renography and ultrasonography.
The use of flutamide as a single antiandrogen treatment for hormone‐refractory prostate cancer
Authors: Barqawi A. , Akduman B. , Abouelfadel Z. , Robischon M. , Crawford E.D.
Published: October 2003

OBJECTIVE

To investigate the efficacy of low‐dose flutamide (125 mg twice daily) in the treatment of prostate‐specific antigen (PSA) recurrence after definitive treatment with radical retropubic prostatectomy (RRP), external‐beam radiation therapy (RT), or cryotherapy.

PATIENTS AND METHODS

In this phase II prospective trial, patients who had a PSA recurrence after definitive treatment for prostate cancer were treated with flutamide. Endpoints for assessing treatment efficacy were PSA progression, treatment toxicity and clinical symptoms. Results were stratified into complete response (PSA < 0.2 ng/mL on two consecutive assessments), partial response (PSA decrease of half that at baseline on two consecutive assessments) and progressive disease. Seventeen patients were enrolled in who definitive treatment for primary prostate cancer had failed.

RESULTS

Low‐dose flutamide was clinically effective (i.e. complete or partial response) in 13 patients. Four had a complete response (mean duration 28 months), nine a partial response (mean duration 19 months), and two progressive disease, but were in the study for a mean of 1 year before progression. Two patients discontinued the study at 3 months, secondary to drug‐related toxicity; one had grade 3 toxicity and five grade 1 toxicity.

CONCLUSIONS

The administration of low‐dose flutamide (125 mg) was clinically effective in treating PSA recurrence after definitive treatments for prostate cancer, and was well tolerated. Further investigation in a phase III trial is warranted.
Broadening the criteria for avoiding staging bone scans in prostate cancer: a retrospective study of patients at the Royal Marsden Hospital
Authors: O'Sullivan J.M. , Norman A.R. , Cook G.J. , Fisher C. , Dearnaley D.P.
Published: October 2003

OBJECTIVE

To determine if it is possible to exclude staging bone scans in a greater proportion of patients if more consideration is given to T stage and Gleason score, as recent guidelines from the National Institute of Clinical Excellence state that routine staging bone scans for prostate cancer are unnecessary in patients with a prostate specific antigen level (PSA) of < 10 ng/mL and Gleason scores of < 8.

PATIENTS AND METHODS

We identified a cohort of consecutive patients with untreated prostate cancer who had a staging isotope bone scan between 1 January 1995 and 31 December 2000, who were not on hormone therapy, who had their PSA estimated within 30 days of the scan, and who had histologically confirmed prostate cancer on biopsy reviewed at the Royal Marsden. Data were analysed according to Gleason score, major Gleason grade, clinical T‐stage and PSA level.

RESULTS

In all, 420 patients were identified who fulfilled the criteria for inclusion; 67 scans (16%, 95% confidence interval, CI, 13–20%) were positive. Of the 187 scans taken in patients with a PSA level of ≤ 20 ng/mL, stage < T4 and Gleason < 8 (with major Gleason grade < 4), two (1%, 0.3–4%) were reported as positive, giving a negative predictive value of 99% (95% CI 98.5–99.5%) for these criteria for avoiding the need for staging bone scans. In 116 patients (28%) with Gleason score 7, of whom 28 (24%) had positive scans, there was a statistically significant association between positive scans and a major Gleason pattern of 4 compared with 3.

CONCLUSIONS

Isotope bone scans are an unnecessary part of staging of prostate cancer if the PSA level is ≤ 20 ng/mL, stage < T4 and Gleason score < 8, and should be omitted unless the major Gleason pattern is 4. The present results suggest that by considering the Gleason score and T stage, a larger proportion of patients with prostate cancer than previously thought could avoid a staging bone scan.
Surgical anatomy of the puboprostatic complex with special reference to radical perineal prostatectomy
Authors: Wimpissinger T.F. , Tschabitscher M. , Feichtinger H. , Stackl W.
Published: October 2003

We are always interested in developing an understanding of anatomical relationships, particularly as this can often make surgery more reliable for patients; the classic anatomical studies of Walsh and Donker are remembered by everyone. Here, the authors from Vienna investigate the retropubic space and the attachments of the prostate and urethra to aid the performance of radical perineal prostatectomy.

Authors from London describe their criteria based on clinical experience, for performing bone scans in patients with prostate cancer. Their proposals are somewhat more exclusive than some of the suggestions made previously but it is worth considering the authors’ views and seeing whether they might be valid and important guidelines for the future.

On the subject of bone metabolism in prostate cancer, authors from the UK suggest that there is a high incidence of osteoporosis in patients with advanced prostate cancer before hormonal manipulation, and that patients requiring such treatment should have densitometry before starting treatment.

OBJECTIVE

To investigate the retropubic space and attachments of the prostate and urethra, with special reference to radical perineal prostatectomy.

MATERIALS AND METHODS

Anatomical relationships were assessed intraoperatively in 60 patients, and in five cadavers after preparing the dorsal vein complex with coloured latex. Cross‐sections of the area of interest were evaluated by microscopy.

RESULTS

The puboprostatic (pubovesical) ligaments could be clearly distinguished from the median part of the puboprostatic complex continuous with the urethral suspensory mechanism. The dorsal vein complex is integrated into this fibromuscular attachment of the prostate and male urethra. During the perineal approach, dissection in this region follows the so‐called avascular plane.

CONCLUSION

With this new insight into the anatomical relationships the nomenclature derived from radical retropubic prostatectomy could be mirrored. In radical perineal prostatectomy, both the urethral suspensory mechanism and the dorsal vein complex can be preserved.
Folic acid fortified fat‐free plain set yoghurt
Authors: Aryana Kayanush J
Published: October 2003

The objective was to elucidate the effect of folic acid incorporation on the physico‐chemical and sensory characteristics of yoghurt. Folic acid was added during mix preparation (before pasteurization) or immediately after culture addition (after pasteurization) at 25 and 50% of the recommended dietary allowance (RDA) of 300 µg. Folic acid fortified yoghurts were significantly different from the control and were yellowish. The pH and titratable acidity (TA) values of folic acid fortified yoghurts remained unchanged compared to the control. Folic acid fortified yoghurts had significantly lower flavour, body and texture scores and better water‐holding capacity compared to the control.
The potential therapeutic benefits of consuming ‘health‐promoting’ fermented dairy products: a brief update
Authors: Itsaranuwat Pariyaporn , Al‐Haddad Khawla S H , Robinson R K
Published: October 2003

Despite the publication of a few contrary indications, the general consensus seems to be that the regular consumption of probiotic cultures, perhaps accompanied by ‘prebiotic’ compounds, improves the healthy operation of the digestive system of a typical consumer. Whether other benefits follow is a more contentious issue, especially for a given individual. Nevertheless, the dairy industry needs to be aware of the various ideas that are currently being explored, and this brief review seeks to summarize some recent findings.