bluuebunny/crossref_metadata_2025 huggingface dataset:
Discrete influx events refill depleted Ca2+ stores in a chick retinal neuron
Authors: Borges Salvador , Lindstrom Sarah , Walters Cameron , Warrier Ajithkumar , Wilson Martin
Published: November 2007

The depletion of ER Ca2+ stores, following the release of Ca2+ during intracellular signalling, triggers the Ca2+ entry across the plasma membrane known as store‐operated calcium entry (SOCE). We show here that brief, local [Ca2+]i increases (motes) in the thin dendrites of cultured retinal amacrine cells derived from chick embryos represent the Ca2+ entry events of SOCE and are initiated by sphingosine‐1‐phosphate (S1P), a sphingolipid with multiple cellular signalling roles. Externally applied S1P elicits motes but not through a G protein‐coupled membrane receptor. The endogenous precursor to S1P, sphingosine, also elicits motes but its action is suppressed by dimethylsphingosine (DMS), an inhibitor of sphingosine phosphorylation. DMS also suppresses motes induced by store depletion and retards the refilling of depleted stores. These effects are reversed by exogenously applied S1P. In these neurons formation of S1P is a step in the SOCE pathway that promotes Ca2+ entry in the form of motes.
NR2B‐ and NR2D‐containing synaptic NMDA receptors in developing rat substantia nigra pars compacta dopaminergic neurones
Authors: Brothwell S. L. C. , Barber J. L. , Monaghan D. T. , Jane D. E. , Gibb A. J. , Jones S.
Published: November 2007

NMDA receptors are present at glutamatergic synapses throughout the brain, and are important for the development and plasticity of neural circuits. Their subunit composition is developmentally regulated. We have investigated the developmental profile of functional synaptic NMDA receptor subunits in dopaminergic neurones of the substantia nigra pars compacta (SNc). In SNc dopaminergic neurones from rats aged postnatal day (P)7, ifenprodil inhibited NMDA‐EPSCs with an estimated IC50of 0.36 μmand a maximum inhibition of 73.5 ± 2.7% (10 μm), consistent with a substantial population of NR1/NR2B‐containing diheteromeric receptors. UBP141, a novel NR2D‐preferring antagonist, inhibited NMDA‐EPSCs with an estimated IC50of 6.2 μm. During postnatal development, the maximum inhibitory effect of 10 μmifenprodil significantly decreased. However, NMDA‐EPSCs were not inhibited by Zn2+(200 nm) or potentiated by the Zn2+chelator TPEN (1 μm), and the effect of UBP141 did not increase during development, indicating that NR2B subunits are not replaced with diheteromeric NR2A or NR2D subunits. The time course of the decay of NMDA‐EPSCs was not significantly changed in ifenprodil at any age tested. Together, these data suggest that diheteromeric NR1/NR2A or NR1/NR2D receptors do not account for the ifenprodil‐resistant component of the NMDA‐EPSC. We propose that NR1/NR2B/NR2D triheteromers form a significant fraction of synaptic NMDA receptors during postnatal development. This is the first report of data suggesting NR2D‐containing triheteromeric NMDA receptors at a brain synapse.
Chloride conductance in the transverse tubular system of rat skeletal muscle fibres: importance in excitation–contraction coupling and fatigue
Authors: Dutka T. L. , Murphy R. M. , Stephenson D. G. , Lamb G. D.
Published: November 2007

Contraction in skeletal muscle fibres is governed by excitation of the transverse‐tubular (t‐) system, but the properties of the t‐system and their importance in normal excitability are not well defined. Here we investigate the properties of the t‐system chloride conductance using rat skinned muscle fibres in which the sarcolemma has been mechanically removed but the normal excitation–contraction coupling mechanism kept functional. When the t‐system chloride conductance was eliminated, either by removal of all Cl− or by block of the chloride channels with 9‐anthracene carboxylic acid (9‐AC) or by treating muscles with phorbol 12,13‐dibutyrate, there was a marked reduction in the threshold electric field intensity required to elicit a t‐system action potential (AP) and twitch response. Calculations of the t‐system chloride conductance indicated that it constitutes a large proportion of the total chloride conductance observed in intact fibres. Blocking the chloride conductance increased the size of the twitch response and was indicative that Cl− normally carries part of the repolarizing current across the t‐system membrane on each AP. Block of the t‐system chloride conductance also reduced tetanic force responses at higher frequency stimulation (100 Hz) and greatly reduced twitch responses in the period shortly after a brief tetanus, owing to rapid loss of t‐system excitability during the AP train. Blocking activity of the Na+–K+ pump in the t‐system membrane caused loss of excitability owing to K+ build‐up in the sealed t‐system, and this occurred ∼3–4 times faster when the chloride conductance was blocked. These findings show that the t‐system chloride conductance plays a vital role during normal activity by countering the effects of K+ accumulation in the t‐system and maintaining muscle excitability.
Switch to Ca2+‐permeable AMPA and reduced NR2B NMDA receptor‐mediated neurotransmission at dorsal horn nociceptive synapses during inflammatory pain in the rat
Authors: Vikman Kristina S. , Rycroft Beth K. , Christie Macdonald J.
Published: November 2007

Glutamate receptor response properties of nociceptive synapses on neurokinin 1 receptor positive (NK1R+) lamina I neurons were determined 3 days after induction of chronic peripheral inflammation with Freund's Complete Adjuvant (CFA). A significant increase in the AMPAR/NMDAR ratio was found during inflammation, which was associated with a significant reduction in the quantal amplitude of NMDAR‐mediated synaptic currents. A significant shortening of the quantal AMPA current decay, a greater inward rectification of the AMPAR‐mediated eEPSC amplitude and an increased sensitivity to the Ca2+‐permeable AMPAR channel blocker 1‐naphthylacetyl spermine (NAS) was also observed, indicating an increase in the contribution of Ca2+‐permeable AMPARs at this synapse during inflammation. Furthermore the reduced effectiveness of the NR2B‐specific antagonist CP‐101,606 on NMDAR‐mediated eEPSCs together with a decrease in Mg2+sensitivity suggests a down regulation of the highly Mg2+‐sensitive and high conductance NR2B subunit at this synapse. These changes in glutamatergic receptor function during inflammation support the selective effectiveness of Ca2+‐permeable AMPAR antagonists in inflammatory pain models and may underlie the reported ineffectiveness of NR2B antagonists in spinal antinociception.
From feeding one to feeding many: hormone‐induced changes in bodyweight homeostasis during pregnancy
Authors: Augustine Rachael A. , Ladyman Sharon R. , Grattan David R.
Published: November 2007

Pregnancy is associated with hyperphagia, increased fat mass, hyperleptinaemia and hyperprolactinaemia. The neuroendocrine control of bodyweight involves appetite‐regulating centres in the hypothalamus, containing both orexigenic and anorexigenic neurons that express leptin receptors (LepR). In the rat, central leptin resistance develops during mid pregnancy, well after hyperphagia becomes apparent, to negate the appetite suppressing effects of leptin. We have investigated the hypothalamic response to leptin during pregnancy and examined the role of pregnancy hormones in inducing these changes. We have shown that there are multiple levels of leptin resistance during pregnancy. Despite elevated serum leptin, neuropeptide Y and agouti related peptide mRNA in the arcuate nucleus are not suppressed and may even be increased during pregnancy. LepR mRNA and leptin‐induced pSTAT3 expression, however, are relatively normal in the arcuate nucleus. In contrast, both LepR and leptin‐induced pSTAT3 are reduced in the ventromedial hypothalamic nucleus. Injecting α‐melanocyte‐stimulating hormone (α‐MSH) into the brain, to bypass the first‐order leptin‐responsive neurons in the arcuate nucleus, also fails to suppress food intake during pregnancy, suggesting that pregnancy is also a melanocortin‐resistant state. Using a pseudopregnant rat model, we have demonstrated that in addition to the changes in maternal ovarian steroid secretion, placental lactogen production is essential for the induction of leptin resistance in pregnancy. Thus, hormonal changes associated with pregnancy induce adaptive changes in the maternal hypothalamus, stimulating food intake and then allowing elevated food intake to be maintained in the face of elevated leptin levels, resulting in fat deposition to provide energy stores in preparation for the high metabolic demands of late pregnancy and lactation.
Sustained granule cell activity disinhibits juvenile mouse cerebellar stellate cells through presynaptic mechanisms
Authors: Astori Simone , Köhr Georg
Published: November 2007

GABA release from cerebellar molecular layer interneurons can be modulated by presynaptic glutamate and/or GABAB receptors upon perfusing the respective agonists. However, it is unclear how release and potential spillover of endogenous transmitter lead to activation of presynaptic receptors. High frequency firing of granule cells, as observed in vivo upon sensory stimulation, could lead to glutamate and/or GABA spillover. Here, we established sustained glutamatergic activity in the granule cell layer of acute mouse cerebellar slices and performed 190 paired recordings from connected stellate cells. Train stimulation at 50 Hz reduced by about 30% the peak amplitude of IPSCs evoked by brief depolarization of the presynaptic cell in 2‐week‐old mice. A presynaptic mechanism was indicated by changes in failure rate, paired‐pulse ratio and coefficient of variation of evoked IPSCs. Furthermore, two‐photon Ca2+ imaging in identified Ca2+ hot spots of stellate cell axons confirmed reduced presynaptic Ca2+ influx after train stimulation within the granular layer. Pharmacological experiments indicated that glutamate released from parallel fibres activated AMPARs in stellate cells, evoking GABA release from surrounding cells. Consequential GABA spillover activated presynaptic GABABRs, which reduced the amplitude of eIPSCs. Two‐thirds of the total disinhibitory effect were mediated by GABABRs, one‐third being attributable to presynaptic AMPARs. This estimation was confirmed by the observation that bath applied baclofen induced a more pronounced reduction of evoked IPSCs than kainate. Granule cell‐mediated disinhibition persisted at near‐physiological temperature but was strongly diminished in 3‐week‐old mice. At this age, GABA release probability was not reduced and presynaptic GABABRs were still detectable, but GABA uptake appeared to be advanced, attenuating GABA spillover. Thus, sustained granule cell activity modulates stellate cell‐to‐stellate cell synapses, involving transmitter spillover during a developmentally restricted period.
Widespread Triggering of Nonvolcanic Tremor in California
Authors: Gomberg Joan , Rubinstein Justin L. , Peng Zhigang , Creager Kenneth C. , Vidale John E. , Bodin Paul
Published: November 2007

We identified seven locations on or near the transform plate boundary in California where nonvolcanic tremor was triggered by the 2002 Denali earthquake. This result implies that the conditions essential for nonvolcanic tremor exist in a range of tectonic environments. Models explaining tremor typically require conditions endemic to subduction zones, that is, high temperatures and fluid pressures, because previously tremor was nearly exclusively documented in subduction zones. The absence of tremor in geothermal areas is inconsistent with such models. Additionally, we found no correlation between creeping or locked faults and tremor, contrary to predictions of frictional models of tremor.
Observation of Berry's Phase in a Solid-State Qubit
Authors: Leek P. J. , Fink J. M. , Blais A. , Bianchetti R. , Göppl M. , Gambetta J. M. , Schuster D. I. , Frunzio L. , Schoelkopf R. J. , Wallraff A.
Published: November 2007

In quantum information science, the phase of a wave function plays an important role in encoding information. Although most experiments in this field rely on dynamic effects to manipulate this information, an alternative approach is to use geometric phase, which has been argued to have potential fault tolerance. We demonstrated the controlled accumulation of a geometric phase, Berry's phase, in a superconducting qubit; we manipulated the qubit geometrically by means of microwave radiation and observed the accumulated phase in an interference experiment. We found excellent agreement with Berry's predictions and also observed a geometry-dependent contribution to dephasing.
Tidal Modulation of Nonvolcanic Tremor
Authors: Rubinstein Justin L. , La Rocca Mario , Vidale John E. , Creager Kenneth C. , Wech Aaron G.
Published: November 2007

Episodes of nonvolcanic tremor and accompanying slow slip recently have been observed in the subduction zones of Japan and Cascadia. In Cascadia, such episodes typically last a few weeks and differ from “normal” earthquakes in their source location and moment-duration scaling. The three most recent episodes in the Puget Sound/southern Vancouver Island portion of the Cascadia subduction zone were exceptionally well recorded. In each episode, we saw clear pulsing of tremor activity with periods of 12.4 and 24 to 25 hours, the same as the principal lunar and lunisolar tides. This indicates that the small stresses associated with the solid-earth and ocean tides influence the genesis of tremor much more effectively than they do the genesis of normal earthquakes. Because the lithostatic stresses are 10
5
times larger than those associated with the tides, we argue that tremor occurs on very weak faults.
Effects of neuromuscular electrical stimulation of the knee extensor muscles on muscle soreness and different serum parameters in young male athletes: preliminary data
Authors: Zorn Carina , Szekeres Thomas , Keilani Mohammad , Fialka-Moser Veronika , Crevenna Richard
Published: November 2007

Aim:

To evaluate the effects of neuromuscular electrical stimulation (NMES) on muscle soreness and on a variety of serum parameters during and after NMES of knee extensor muscles of young, well trained subjects over a study period of 96 h.

Methods:

Five male cyclists were included in this clinical observation. NMES (biphasic, asymmetric impulses) was applied through surface electrodes to both knee extensor muscles of each subject for 30 min. To determine changes in serum concentration of muscle proteins, blood samples were drawn at defined measure points before and after NMES. Muscle soreness was evaluated using a visual analogue scale at all measure points.

Results:

There was a maximum (p<0.05) for “muscle pain” during stimulation but no significant changes could be detected after the stimulation period. Serum creatine kinase showed a peak with a significant increase (p<0.05) 24 h after NMES. Serum lactate levels only increased slightly (p = 0.08) during NMES.

Conclusions:

Although the changes of blood parameters measured in the present work correspond to those reported in the literature on eccentric strength training, no delayed onset muscle pain could be detected. Further studies should be carried out, also investigating different stimulation protocols in non-trained healthy subjects and in patients with less muscle mass.
A BERGMAN KERNEL IN ℝn, HOLOMORPHIC FUNCTIONS, AND RELATED NON-ASSOCIATIVE ALGEBRAS
Authors: BŁOCKI ZBIGNIEW
Published: November 2007

For domains in ℝn we construct the Bergman kernel on the diagonal using solutions of the Dirichlet problem. Starting from this, in a natural way we obtain an algebra 𝔸n of dimension n(n - 1)/2 + 1 over ℝ and a class of holomorphic functions valued in 𝔸n. Of course 𝔸2 is the field of complex numbers, and it turns out that 𝔸3 is the algebra of quaternions, whereas for n ≥ 4, 𝔸n is non-associative. Holomorphic functions can be written as f + ω, where f is a (real-valued) function and ω a differential 2-form such that d* ω = df and dω = 0. We investigate the main properties of the obtained objects, especially from the analytic point of view.
FIRST CLASSIFICATION OF PFAFFIAN SYSTEMS IN DIMENSION FIVE
Authors: CAÑADAS-PINEDO M. A. , RUIZ C.
Published: November 2007

We obtain in this work, in an intrinsic way, the First classification of Pfaffian systems of rank two and three in dimension five, as well as a complete classification up to dimension four. For the general case, we prove that there exists a one-to-one correspondence, which is explicitly given, between Pfaffian systems of rank two and Pfaffian systems of rank three. That is, for a Pfaffian system of rank two in dimension five, the covariant system is constructed.
A NOTE ON THE BAR-NATAN SKEIN MODULE
Authors: ASAEDA MARTA , FROHMAN CHARLES
Published: November 2007

We introduce a new skein module for three manifolds based on properly embedded surfaces and their relations introduced by Bar-Natan in [3], and modified by Khovanov [6]. We compute the structure of the modules for some manifolds, including Seifert fibered manifolds.
NEW SYMPLECTIC V-MANIFOLDS OF DIMENSION FOUR VIA THE RELATIVE COMPACTIFIED PRYMIAN
Authors: MARKUSHEVICH D. , TIKHOMIROV A. S.
Published: November 2007

Three new examples of 4-dimensional irreducible symplectic V-manifolds are constructed. Two of them are relative compactified Prymians of a family of genus-3 curves with involution, and the third one is obtained from a Prymian by Mukai's flop. They have the same singularities as two of Fujiki's examples, namely, 28 isolated singular points analytically equivalent to the Veronese cone of degree 8, but a different Euler number. The family of curves used in this construction forms a linear system on a K3 surface with involution. The structure morphism of both Prymians to the base of the family is a Lagrangian fibration in abelian surfaces with polarization of type (1,2). No example of such fibration is known on nonsingular irreducible symplectic varieties.
Soft-Material Dissipative Formation by a Kramers-Type Picture
Authors: Gadomski Adam
Published: November 2007

We consider a model soft-material formation in dimensiond(a degree of freedom) undergoing an entropic drive, deeply rooted in first law of thermodynamics as well as in entropy production, namely, dissipation rate. It turns out that for such entropy-driven (dissipative) process, two strategies of making the formation orderly can be seen. In low-temperature limit, one may promote curvature-controlled, surface-tension involving scenario, usually characteristic of polycrystals and bubbles. In high-temperature limit, there can be a chance for creating order by establishing viscoelastic phase separation, promoting some microstress field's microrheological action that somehow renormalizes the system toward ordering. The latter, in turn, is very characteristic of protein and/or colloid network formations. This altogether implies that a disordering thermodynamic factor, such as the entropy can typically be, is able to effectively promote ordering by respective energy dissipation, in particular for soft-matter rearrangements and clusterings with weak interactions among the basic material's units, namely, “soft” grains.
Tonsillectomy and Adenoidectomy Techniques: Past, Present and Future
Authors: Sargi Zoukaa , Younis Ramzi T.
Published: November 2007

Although the number of procedures has significantly decreased over the past century, tonsillectomy and adenoidectomy are commonly performed surgeries in the pediatric group, with obstructive sleep apnea being the most common indication. Despite the availability of newer technologies, tonsillectomy is still associated with a relatively high risk of postoperative morbidity. Pain and postoperative bleeding can have a significant impact on the child’s health and quality of life. This article reviews the currently available techniques for tonsillectomy and adenoidectomy, with their characteristics and potential benefits. No gold standard exists at this point, and further prospective clinical trials are needed in this perspective.
Outcomes and Quality of Life following Adenotonsillectomy for Sleep-Disordered Breathing in Children
Authors: Mitchell Ron B. , Kelly James
Published: November 2007

Purpose: To summarize current knowledge of the outcome of adenotonsillectomy (T&A) for the treatment of sleep-disordered breathing (SDB) in children. Results: The success rate of T&A for SDB as measured on the basis of objective criteria using polysomnography ranges from 79 to 92%. Dramatic improvements in quality of life after T&A for SDB have been shown in a number of studies and these improvements are maintained up to 2 years after surgery. Significant improvements that are maintained in the long term are also seen in behavioral and neurocognitive parameters following T&A for SDB. Not surprisingly, total health care costs are reduced by one third following T&A mostly because of a reduction in upper respiratory tract infections. Conclusions: T&A is associated with improvements in polysomnography, behavior and quality of life in children with SDB. Improved health in these children leads to a reduction in health care utilization.
Microdebrider Intracapsular Tonsillectomy
Authors: Vaughan Andrew H. , Derkay Craig S.
Published: November 2007

With a continued desire to reduce the morbidity of tonsil surgery, otolaryngologists have begun to use powered microdebriders to perform partial intracapsular tonsillectomies. This technique has an advantage over conventional tonsillectomy of leaving a biological dressing or residual tonsillar tissue and capsule to protect the underlying musculature with its vessels and nerves. The literature has shown that partial intracapsular tonsillectomy is equally effective at relieving patient’s symptoms of obstruction when compared to conventional tonsillectomy and that it appears to reduce the complications of postoperative pain, dehydration, and bleeding. Patients are able to return to normal activity and diet faster as the healing process is accelerated. This article reviews the published data on microdebrider-assisted partial intracapsular tonsillectomy with a discussion of its advantages, potential limitations and areas of future research.
The Müllerian Duct: Recent Insights into Its Development and Regression
Authors: Klattig J. , Englert C.
Published: November 2007

Several recent publications have contributed to our understanding of the processes involved in development of the Müllerian ducts in both sexes and regression of these structures in male embryos. Additionally, new insights in the regulation of the anti-Müllerian hormone (AMH) signaling pathway, the pathway, which mediates the male specific degeneration of Müllerian ducts, have been gained. It has become clear that the Müllerian duct is formed by invagination of the coelomic epithelium and elongates primarily by proliferation. Later on cells of the coelomic epithelium perform epithelial to mesenchymal transition and move around the epithelium of the Müllerian duct to induce degeneration of this structure in male embryos. Besides AMH and its specific type II receptor AMHR2 two different type I receptors as well as different SMAD family members have been shown to be involved in the AMH signaling cascade. Other factors including WT1, WNT7a, β-catenin and MMP2 act upstream and downstream of AMH signaling. Here we try to draw an overall picture of Müllerian duct formation and regression by integrating the recent literature in the field.
Male-Specific Function of Dmrt7 by Sexually Dimorphic Translation in Mouse Testis
Authors: Kawamata M. , Inoue H. , Nishimori K.
Published: November 2007

Dmrt7 is known to be an essential gene for spermatogenesis but not for oogenesis despite mRNA expression in both testis and ovary. In this study, we examined further expression of Dmrt7 transcript and protein. Northern blot and RT-PCR analysis revealed that there was an alternative splicing variant possessing the entire sequence of intron 1 in adult testis (intron 1 variant), in addition to the mature form of mRNA. In fetal ovary, the intron 1 variant was not expressed whereas the fully spliced form of mRNA was expressed. Immunohistochemical analyses demonstrated that DMRT7 protein was present only in spermatocytes of adult testis but not in fetal ovary. In situ hybridization analyses revealed that the fully spliced form of Dmrt7 mRNA as well as the intron 1 variant were expressed in spermatogonia, spermatids and Sertoli cells in addition to spermatocytes. We also found that poly(A) tails of Dmrt7 mRNA underwent modification of its length from 70 to 440 bp long. Unlike Arbp mRNA, the size variation of poly(A) tails was observed in immature testis in which spermatids were absent. In this study, we demonstrated that Dmrt7 had unique sexually dimorphic expression patterns in transcripts that associated with spermatocyte-specific translation, but not in ovary.
Neuroendocrine Differentiation in Prostate Cancer: From Lab to Bedside
Authors: Cindolo Luca , Cantile Monica , Vacherot Francis , Terry Stéphane , de la Taille Alexandre
Published: November 2007

Objectives: To discuss the current knowledge on induction, production, sustenance and promotion of neuroendocrine differentiation in human prostate cancer. Methods: Review of the literature using PubMed search and scientific journal publications. Results: Morphological evidence explains some functional relationship between neuroendocrine and neoplastic surrounding cells. Transdifferentiation phenomenon and new biochemical pathways could be included in the development of androgen independence and prostate cancer progression. Conclusion: Multiple evidence seems to confirm that a synergistic functional network between epithelial PSA secretory cells and neuroendocrine intraprostatic system is the main trigger for the induction and sustenance of neuroendocrine differentiation. The development of new antineoplastic molecules should consider the multiple interference of the intercellular network.
Periprostatic Nerve Blockage Reduces Postoperative Analgesic Consumption and Pain Scores of Patients Undergoing Transurethral Prostate Resection
Authors: Gorur Sadik , Inanoglu Kerem , Akkurt B. Cagla O. , Candan Yasar , Kiper Ahmet N.
Published: November 2007

Introduction: To evaluate the effects of periprostatic bupivacaine administration on pain control and analgesic consumption after transurethral prostate resection (TURP). Materials and Methods: The study included 40 male patients with benign prostatic hyperplasia who underwent TURP, and they were divided randomly into two groups. All patients were operated under general anesthesia. The study group patients (n = 20) received periprostatic bupivacaine (0.5% 20 ml) injection (group I), and the control patients (n = 20) received only saline (NaCl 0.9% 20 ml) injection (group II). All injections were performed bilaterally into the periprostatic areas immediately after the TURP procedure via the transperineal route. In the postoperative period, all patients (groups I and II) received tramadol using a patient-controlled analgesia device. Postoperative pain was assessed and recorded using the visual analog scale (VAS) at postoperative hours 1, 2, 3, 4, 5, 6, 7, 8, 12, 16, 20, 24, and 48. Total tramadol consumptions and additional analgesic requirements were also recorded and compared between groups. Results: There was no difference in demographic data between the two groups (p > 0.05). VAS scores of the patients at hours 1, 3, 4, 5, 7, 8, and 12 were found to be significantly lower in group I than in group II (p < 0.05). Total tramadol consumption and patient-controlled analgesia demands of groups I and II were 153.5 ± 52.4 vs. 465.0 ± 55.1 mg and 17.1 ± 7.7 vs. 77.8 ± 7.5 mg, respectively (p < 0.001). No side effect was observed regarding bupivacaine injections. Conclusions: Periprostatic bupivacaine administration was a useful and safe method for postoperative pain control and reduced analgesic consumption in patients undergoing TURP.
Improved Accuracy for Predicting the Gleason Score of Prostate Cancer by Increasing the Number of Transrectal Biopsy Cores
Authors: Miyake Hideaki , Kurahashi Toshifumi , Takenaka Atsushi , Hara Isao , Fujisawa Masato
Published: November 2007

Introduction: The objective of this study was to determine whether an increased number of transrectal biopsy cores improves the accuracy of the biopsy Gleason score. Materials and Methods: This study included a total of 225 patients who were diagnosed as having prostate cancer by transrectal needle biopsy and subsequently underwent radical prostatectomy (RP) without neoadjuvant therapy. The rate of grading concordance between biopsy and RP specimens was analyzed by dividing these patients into 2 groups as follows: group A, 107 patients who underwent transrectal biopsy sampling of 9 cores or less (median 8 cores), and group B, 118 patients who underwent biopsy sampling of 10 cores or more (median 12 cores). Results: Concordance between the biopsy and RP Gleason scores in group A (53.3%) was significantly lower than that in group B (69.5%). Upgrading of the biopsy Gleason score in group A (38.3%) was significantly more frequent than that in group B (21.2%). Furthermore, these findings tended to be more prominent as the biopsy Gleason score was lower. Multivariate analysis identified the number of biopsy cores and percent of positive biopsy cores as independent predictors of accurate Gleason grading regardless of other parameters examined in this study. Conclusion: These findings suggest that obtaining a greater number of biopsy cores contributes to improving the accuracy of the biopsy Gleason score for predicting the RP Gleason score; therefore, extended sampling of biopsy cores could provide optimal guidance to determine the therapeutic options in patients with prostate cancer.
Docetaxel plus Prednisone versus Mitoxantrone plus Prednisone for Metastatic Hormone-Refractory Prostate Cancer in Chinese Patients: Experience of a Single Center
Authors: Zhang Hai Liang , Ye Ding Wei , Yao Xu Dong , Dai Bo , Zhang Shi Lin , Shen Yi Jun , Zhu Yao , Zhang Wen
Published: November 2007

Purpose: To preliminarily investigate the efficacy of docetaxel plus prednisone and mitoxantrone plus prednisone for treating metastatic hormone-refractory prostate cancer and to further evaluate its adverse events in Chinese patients. Materials and Methods: 83 patients with metastatic hormone-refractory prostate cancer were enrolled in the trial and given a combination of docetaxel 75 mg/m2 intravenously on day 2 or mitoxantrone 12 mg/m2 on day 1 plus prednisone 5 mg twice daily on days 1–21, 21 days a cycle. Serum PSA level, relief of bone pain, myelosuppression, and vomiting were recorded and calculated. Results: Docetaxel plus prednisone was administered to 44 patients: 13.6% (6/44) of them achieved complete response, 29.5% (13/44) partial response, 29.5% (13/44) had stable disease, and 27.3% (12/44) had disease progression. The average time to PSA progression was 37.8 weeks (12–101 weeks) in the response and stable disease patients. The 12 patients with disease progression were given MP as salvage therapy, and 16.7% (2/12) achieved a partial response, 25.0% (3/12) had stable disease and formed the new baseline. Only 2 patients died of disease aggravation. Mitoxantrone plus prednisone were given to 39 patients, and 7.7% (3/39) of them achieved complete response, 25.6% (10/39) partial response, 25.6% (10/39) had a stable disease, and 41.0% (16/39) of patients had disease progression. The mean time to PSA progression was 25.3 weeks (8–61 weeks) in the response and stable disease patients. The 14 patients with disease progression were administered DP as a salvage therapy and 7.1% (1/14) achieved complete response, 35.7% (5/14) partial response, and 21.4% (3/14) had stable disease and formed the new baseline. Four patients had died at the last follow-up. Conclusions: In Chinese patients, docetaxel plus prednisone is better than mitoxantrone plus prednisone in PSA response rate and PSA control, but has a bit more toxicity. When the tumor is resistant to one regimen, the other might still be effective in controlling disease progression.
Role of MMP-1 1G/2G Promoter Gene Polymorphism on the Development of Prostate Cancer in the Turkish Population
Authors: Albayrak Selami , Cangüven Önder , Göktaş Cemal , Aydemir Hüseyin , Köksal Vedat
Published: November 2007

Introduction: To investigate the association of 1G/2G polymorphism in matrix metalloproteinase-1 (MMP-1) promoter with susceptibility to prostate carcinoma in the Turkish population. Materials and Methods: MMP-1 promoter polymorphism was genotyped by PCR-RFLP analysis in 55 prostate cancer patients and 43 healthy controls. Results: The frequency of 1G/2G genotypes in prostate cancer patients was similar to that of the controls (all p values were >0.05). Compared with the 1G/1G genotype, neither the 2G/2G nor a combination with the 1G/2G genotype significantly modified the risk of developing prostate cancer and metastasis status. In addition, the frequencies of genotypes were not significantly different among patients stratified by smoking status and family history of prostate cancer. Conclusions: The 2G allele of the MMP-1 promoter polymorphism might not modify the risk of prostate cancer development and might not be used as a putative marker to predict the potential of metastasis in this cancer type, at least in the Turkish population.
Outcomes of 80 W KTP Laser Vaporization of the Large Prostate
Authors: Tugcu Volkan , Tasci Ali I. , Sahin Selcuk , Ordekci Yılmaz , Karakas Omer F. , Zorluoglu Fatih
Published: November 2007

Purpose: We evaluated the safety and efficacy of 80 W potassium-titanyl-phosphate (KTP) laser vaporization of the prostate in men with prostate volumes >70 ml. Materials and Methods: Laser vaporization of the prostate with an 80 W KTP laser was applied between September 2003 and April 2005. Preoperative evaluation of 100 patients included the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), prostate volume, serum sodium, creatinine, hemoglobin, prostate-specific antigen and urinalysis. Results: The mean age of the patients, mean volume of the prostates, mean operative time and mean energy delivery were 67.0 ± 7.9 (53–90) years, 98.2 ± 18.9 (74–170) ml, 150.1 ± 22.7 (100–240) min and 246.1 ± 77.8 (100–500) kJ, respectively. The serum sodium, creatinine and hemoglobin levels did not change significantly. Urinary retention requiring recatheterization was detected in 10 patients. There was moderate dysuria in 22 patients with a mean duration of 2 months and mild hematuria in 16 patients with a mean duration of 1 month postoperatively. Urinary tract infection occurred in 5 patients. We observed clot retention in 2 patients. The IPSS, Qmax and PVR values had significantly improved by postoperative months 1, 3, 6 and 12. Reoperation was performed in 5 patients. Internal urethrotomy was performed in 1 patient with bladder neck contracture. Conclusions: 80 W KTP laser vaporization is a virtually bloodless, safe and effective procedure for surgical treatment of large volume prostates.
Sensitivity and Specificity of P53 Protein Detection by Immunohistochemistry in Patients with Urothelial Bladder Carcinoma
Authors: Salinas-Sánchez Antonio S. , Atienzar-Tobarra Manuel , Lorenzo-Romero Juan G. , Sánchez-Sánchez Francisco , Giménez-Bachs José M. , Donate-Moreno María J. , Pastor-Navarro Héctor , Hernández-Millán Ibrahim , Segura-Martín Miguel , Escribano-Martínez Julio
Published: November 2007

Objective: To analyze the correlation between the genotypic and phenotypic patterns of p53 in patients with transitional cell carcinoma (TCC) of the urinary bladder. Materials and Methods: Cross-sectional study of 73 patients diagnosed with TCC. DNA was obtained from the tumor tissue to perform polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) of exons 5–9 of the p53 gene, with automatic sequencing done on any mutated samples. Immunohistochemistry (IHC) was also performed using anti-human P53 monoclonal antibody, and the diagnostic performance of this test was analyzed by a ROC curve, using the presence of p53 mutations found by PCR-SSCP as ‘gold standard’. Results: The cutoff point for defining immunopositivity was 20%. IHC had a specificity of 62.9%, and a sensitivity of 65.8%. The highest sensitivity values appeared in G3 tumors (75%) and infiltrating tumors (71.4%), and the highest specificity values were observed in G1 (77.7%) and G2 tumors (90%) and superficial tumors (66.6%). Mutations in exon 8 gave a positive result most frequently (73.7%) and were considered most relevant in terms of altering P53 function (60.9%). False negatives were documented in 28.5% of infiltrating tumors, and false positives in 33.4% of superficial tumors. Conclusions: There is a moderate correlation between p53 mutations and P53 protein overexpression, with this stronger in high-grade, infiltrating tumors, in exon 8 mutations, and when the mutation induces relevant changes in the protein structure. Although IHC is useful in routine clinical practice, the classic prognostic factors should still be considered the most important in the follow-up of these patients.
Control of Pain during Transrectal Ultrasound-Guided Prostate Biopsy: A Prospective Study Comparing Two Methods
Authors: Bhomi K.K. , Lim H.H. , Consigliere D.T. , Tiong H.Y.
Published: November 2007

Aim: To evaluate the efficacy of intramuscular injection of 75 mg diclofenac sodium and periprostatic nerve block (PPNB) with 1% lignocaine in controlling pain during transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and Methods: A total of 120 patients undergoing TRUS-guided prostate biopsies were prospectively enrolled in the study. First, 20 patients did not get any form of analgesia/anesthesia and served as control; next, 20 patients received an intramuscular injection of diclofenac sodium. PPNB with 1% lignocaine was performed in the remaining 80 patients. Pain was assessed using Wong-Baker Faces Pain-Rating Scale (0–10). Results: All three groups of patients were comparable at baseline in terms of age, prostate-specific antigen and final histological diagnosis. The mean pain scores (±SD) for control, diclofenac and PPNB groups were 5.10 ± 3.14, 3.70 ± 2.36 and 2.24 ± 1.63, respectively. The difference was statistically significant between control and PPNB (p = 0.001), and diclofenac and PPNB (p = 0.002), but not between the control and diclofenac group (p = 0.120). In addition, the proportion of patients having mild or no pain (defined as pain score ≤3) during the biopsy was greater in the PPNB group (71%) compared with the diclofenac group (45%) and the control group (30%) (p = 0.001). The total duration for TRUS biopsy was not significantly different between the three groups (p = 0.114). Conclusion: PPNB with 1% lignocaine significantly decreases pain associated with prostate biopsy when compared with control and intramuscular diclofenac.
Cost-Effectiveness of Percent Free PSA for Prostate Cancer Detection in Men with a Total PSA of 4–10 ng/ml
Authors: Bermúdez-Tamayo Clara , Martín Martín Jose Jesús , del Puerto López del Amo González Maria , Pérez Romero Carmen
Published: November 2007

Objective: To assess the cost-effectiveness of two diagnostic strategies for prostate cancer in men with prostate-specific antigen (PSA) levels of 4–10 ng/ml and normal digital rectal examination (DRE). Design: Cost-effectiveness analysis was performed using a decision tree model. Data collection and a systematic review of patients at the Urology Department (Carlos Haya Hospital) were made. 101 patients over the age of 40 with PSA levels of 4–10 ng/ml and normal DRE were selected. Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and percent free PSA testing prior to TRUS-Bx were performed. The outcome measures used were the incremental cost-effectiveness ratio, and costs were calculated through activity-based costing. The effectiveness was measured by means of the number of detected cases, test utility and actual cases (detected cases minus lost cases). Results: Using base-case analysis, the strategy of percent free PSA + TRUS-Bx was found to be the most cost-effective. The incremental cost-effectiveness ratio for free PSA + TRUS-Bx compared with TRUS-Bx was EUR 2,277.40. Strategy 2 (TRUS-Bx) would be more cost-effective if the cost of percent free PSA increased to EUR 21.64 or if prostate cancer prevalence increased to 26%. Conclusions: The use of percent free PSA prior to TRUS-Bx is the most cost-effective diagnostic strategy. However, this result is very sensitive and strategy 2 (TRUS-Bx) would be more cost-effective if the cost of the percent free PSA increased to EUR 21.64 or if the prevalence of prostate cancer increased to above 26%.
Long-Term Follow-Up after Retroperitoneal Laparoscopic Decortication of Symptomatic Renal Cysts
Authors: Thwaini Ali , Shergill Iqbal S. , Arya Manit , Budair Zahran
Published: November 2007

Introduction: The purpose of this study was to present our long-term experience of retroperitoneal laparoscopic decortication (RLD) for patients with severely symptomatic simple renal cysts. The feasibility, safety and efficacy of this technique is reported, along with immediate and long-term clinical outcomes. Materials and Methods: Over a 6-year period, 22 consecutive patients with symptomatic simple renal cysts underwent RLD by a single surgeon. Demographic data, perioperative blood loss, length of operative procedure, length of hospital stay and complications were analyzed. Follow-up included clinical review and renal ultrasonography, at 6-monthly intervals for 1 year, and then annually. Results: The mean patient age was 45 (range 31–63) years. RLD was successfully performed in all 22 patients – no open conversions were required. There was no mortality and there were no perioperative complications. Mean duration of surgery was 101.9 min (59–117 min) and operative blood loss was <150 ml in all cases (10–150 ml). Mean length of hospital stay was 3.2 (2–6) days and return to normal activities was achieved after a mean of 15 (10–30) days. At a mean follow-up of 60 (22–93) months, 17 patients (77%) were completely relieved of symptoms, while 5 (23%) patients complained of some pain not requiring any analgesia. Renal ultrasonography showed an absence of radiological recurrence of the symptomatic renal cyst in all cases. Conclusion: RLD is a safe and effective method to treat symptomatic renal cysts, with an immediate postoperative symptomatic relief, a short convalescence period and effective 5-year clinical and radiological outcome.
Pain Scores and Early Complications of Transrectal Ultrasonography-Guided Prostate Biopsy: Effect of Patient Position
Authors: Kilciler Mete , Demir Erkan , Bedir Selahattin , Erten Koray , Kilic Cenk , Peker Ahmet Fuat
Published: November 2007

Background: The aim of the study was to evaluate the pain scores and complications of transrectal ultrasonography (TRUS)-guided prostate biopsy and to compare lithotomy position (LP) versus left lateral decubitis position (LLDP). Methods: A total of 340 patients were referred for TRUS-guided biopsy. In group 1 (n = 170), biopsies were performed in LP (n = 170), and in group 2 (n = 170) biopsies were performed in LLDP (n = 170). In 68 patients, biopsies were repeated. We constituted two additional groups: in group 3 (n = 33) patients underwent biopsies in LP and LLDP, respectively, and in group 4 (n = 35) patients underwent biopsies in LLDP and LP, respectively. Pain score, infection rates, hematospermia, hematuria, rectal bleeding, and serious complications were compared between group 1 and group 2. Pain scores were compared between the four groups. Results: There were no differences between group 1 and group 2 for age, prostate volume, prostate-specific antigen level, biopsy time, hematuria, infection, hematospermia, and rectal bleeding. Pain scores were lower in group 2 than in group 1. Also, for LLDP, pain scores were lower in group 3 and group 4. Conclusion: The effect of position on pain scores in TRUS biopsy patients has not been previously described. Our study indicates that pain scale values are lower in LLDP than in LP.
A Rare Case of Lethal Retroperitoneal Abscess Caused by Citrobacter koseri
Authors: Cai Tommaso , Giubilei Gianluca , Vichi Francesca , Farina Umberto , Costanzi Antonio , Bartoletti Riccardo
Published: November 2007

Retroperitoneal abscesses are very uncommon clinical conditions. The characteristically vague symptomatology of retroperitoneal abscess and the inherent difficulty of identifying retroperitoneal disease by physical examination contributed to these dismal therapeutic outcomes. We present an unusual case of lethal retroperitoneal abscess, caused by Citrobacter diversus(koseri), treated with surgical drainage. Citrobacter species have rarely been involved in deep tissue infection and there is no reported case of lethal retroperitoneal abscess caused by C. koseri. This case is the only reported case of C. koseri as the sole pathogen associated with a lethal retroperitoneal abscess in immunocompetent patient. The case is also notable because it confirms the recent bacterial resistance to β-lactam antibiotics and to other antimicrobical agents, like chloramphenicol or cotrimoxazol.
Proptosis – An Uncommon Presentation of Orbital Metastases Secondary to Prostate Cancer
Authors: Vissamsetti B. , McArdle P.A. , Adams C.J. , Hotiana Z. , Morton A.L. , Alexander R.J.T.
Published: November 2007

We report the case of a man with advanced prostate cancer who presented as an emergency with proptosis of his right eye. Cross-sectional imaging of his head confirmed the cause to be orbital metastases secondary to his prostate cancer. The patient responded well to treatment with dexamethasone and palliative orbital radiotherapy.
Genetic Predisposition to Respiratory Diseases: Infiltrative Lung Diseases
Authors: Steele Mark P. , Brown Kevin K.
Published: November 2007

The availability of high-throughput genotyping and large collaborative clinical networks creating well-characterized patient populations with DNA repositories has facilitated genome-wide scans and candidate gene studies to identify susceptibility alleles for the development of interstitial lung disease. The association of pulmonary fibrosis with rare inherited disorders, and the variable susceptibility of inbred mouse strains to this disease indicate that pulmonary fibrosis is determined by genetic factors. Sarcoidosis represents a complex disease with racial and ethnic differences in disease prevalence, and evidence of familial clustering. Familial aggregation of sarcoidosis from ‘A Case-Control Etiologic Study of Sarcoidosis’ (ACCESS) reveals a familial odds ratio (OR) of sarcoidosis of 5.8 (95% CI 2.1–15.9) for sibs and 3.8 (95% CI 1.2–11.3) for parents. Several HLA class II alleles have been associated with either increased or decreased risk of sarcoidosis, and results vary depending on study populations of different ethnicity. Genome-wide screening has conclusively identified linkage to chromosome 5q11and the development of sarcoidosis, and HLA genes and BTNL2 are susceptibility genes located in this region. Familial aggregation of idiopathic interstitial pneumonia (IIP) has been established by several groups, and a large US-based study suggests autosomal dominant inheritance with reduced penetrance; furthermore, cigarette smoking was associated with affection status among siblings (OR = 3.6, 95% CI 1.3–9.8, p = 0.01). Families demonstrate more than one type of IIP, suggesting various subtypes of IIP may share a common pathogenesis. Genome-wide linkage scans in familial interstitial pneumonia demonstrate linkage to chromosomes 4, 5 and 11. Candidate gene studies indicate that surfactant protein C and telomerase are susceptibility genes for the development of pulmonary fibrosis. Future challenges include determining how multiple susceptibility alleles interact with each other and environmental factors resulting in disease risk and multiple phenotypes, and determining the mechanism of action and cellular pathways involving susceptibility alleles. Further insight into these areas may lead to new therapeutic interventions.