bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Monetary Compensation on Relapse among Addicted Participants: Empirical vs. Anecdotal Evidence
Authors: Dempsey Jared P. , Back Sudie E. , Waldrop Angela E. , Jenkins Lisa , Brady Kathleen T.
Published: November 2008

Although common, the use of cash incentives to compensate drug‐addicted participants is controversial. This is particularly true given concerns that cash incentives might precipitate relapse, as is commonly believed. The following investigation examined whether cash versus money order compensation differentially influenced drug use among 34 non‐treatment‐seeking, cocaine‐dependent individuals. Consistent with past evidence, results did not suggest that form of compensation was associated with likelihood of continued cocaine use or dollar amount of cocaine consumed after participation. Findings do not support commonly held concerns that cash incentives increase the risk of relapse following research participation.
Outcomes of DATA 2000 Certification Trainings for the Provision of Buprenorphine Treatment in the Veterans Health Administration
Authors: Gordon Adam J. , Liberto Joseph , Granda Stephanie , Salmon‐Cox Sara , Andrée Tykia , McNicholas Laura
Published: November 2008

Despite the high numbers of veterans with opioid dependence, few receive pharmacologic treatment for this disorder. The adoption of buprenorphine treatment within the Veterans Health Administration (VHA) has been slow. To expand capacity for buprenorphine treatment, the VHA sponsored two eight‐hour credentialing courses for the Drug Addiction Treatment Act of 2000. We sought to describe the outcomes of such training. Following the training sessions, 29 participants (18 physicians) were highly satisfied with course content and affirmed their intention to prescribe buprenorphine; after nine‐month follow‐up, two physicians were prescribing. We conclude that providing credentialing courses, while popular, did not markedly promote the prescription of buprenorphine.
The Role of Context in the Categorization of Hybrid Toy Stimuli by 18‐Month‐Olds
Authors: Mareschal Denis , Tan Seok Hui
Published: November 2008

Using a sequential touching procedure, we examined whether 18‐month‐olds could use different categorization strategies adaptively as a function of context. Infants were presented with test toys of land animals (quadrupeds), cars, and hybrids made by recombining car parts with animal parts. Infants who experienced a context emphasizing a taxonomic divide were subsequently more likely to form categories that reflected a taxonomic divide, whereas infants who experienced a context emphasizing a partonomic divide were subsequently more likely to form categories based on functional parts. These results suggest that 18‐month‐olds can adapt their categorization strategies flexibly in accordance with ambient contextual cues. This adds to the growing body of evidence that early categorization is flexible and not rigidly tied to characteristic features in the environment.
The Effect of Learning Experiences and Context on Infant Imitation and Generalization
Authors: Jones Emily J. H. , Herbert Jane S.
Published: November 2008

Over the first years of life, infants gradually develop the ability to retrieve their memories across cue and contextual changes. Whereas maturational factors drive some of these developments in memory ability, experiences occurring within the learning event may also impact infants' ability to retrieve memories in new situations. In 2 experiments we examined whether it was possible to facilitate 12‐month‐old infants' generalization of learning in the deferred imitation paradigm by varying experiences before or during the demonstration session, or during the retention interval. In Experiment 1, altering the length, timing, or variability of training had no impact on generalization; infants showed a low, but consistent level of memory retrieval. In Experiment 2, infants who experienced a unique context for encoding and retrieval exhibited generalization; infants who experienced the context prior to the demonstration session, or during the retention interval, did not. Specificity is a robust feature of infant memory and is not substantially altered by encoding experiences in an observational learning paradigm. Previous history with a learning environment can, however, impact the flexibility of memory retrieval.
Parafoveal processing within and between words
Authors: Juhasz Barbara J. , Pollatsek Alexander , Hyönä Jukka , Drieghe Denis , Rayner Keith
Published: November 2008

Parafoveal preview was examined within and between words in two eye movement experiments. In Experiment 1, unspaced and spaced English compound words were used (e.g., basketball, tennis ball). Prior to fixating the second lexeme, either a correct or a partial parafoveal preview (e.g., ball or badk) was provided using the boundary paradigm (Rayner, 1975). There was a larger effect of parafoveal preview on unspaced compound words than on spaced compound words. However, the parafoveal preview effect on spaced compound words was larger than would be predicted on the basis of prior research. Experiment 2 examined whether this large effect was due to spaced compounds forming a larger linguistic unit by pairing spaced compounds with nonlexicalized adjective–noun pairs. There were no significant interactions between item type and parafoveal preview, suggesting that it is the syntactic predictability of the noun that is driving the large preview effect.
Marine Protected Areas as a tool for fishery management and ecosystem conservation: an Introduction
Authors: Hoffmann Erik , Pérez-Ruzafa Angel
Published: November 2008

Hoffmann, E. and Pérez-Ruzafa, A. 2008. Marine Protected Areas as a tool for fishery management and ecosystem conservation: an Introduction. – ICES Journal of Marine Science, 66: 1–5.
Meshing molecules and management: a new era for natural resource conservation
Authors: Latch Emily K , Ivy Jamie A
Published: November 2008

A symposium entitled ‘Applied Ecological Genetics: Molecular Approaches in Natural Resource Conservation’ was held at Purdue University, West Lafayette, Indiana from 5 to 8 October 2008. The purpose of the symposium was to bring together researchers from disparate fields of molecular ecology, evolutionary biology and genomics to address ways to apply research in ecological genetics to relevant questions in conservation and management. Symposium speakers presented ongoing research in characterizing the wealth of biodiversity on the planet, understanding the fundamental evolutionary processes influencing species over time and space, and predicting responses of species and entire ecosystems to environmental change. Recent advances in these areas have had a profound impact on conservation and management, and have helped to secure the future of our natural resources.
Arbuscular Mycorrhiza–Specific Signaling in Rice Transcends the Common Symbiosis Signaling Pathway
Authors: Gutjahr Caroline , Banba Mari , Croset Vincent , An Kyungsook , Miyao Akio , An Gynheung , Hirochika Hirohiko , Imaizumi-Anraku Haruko , Paszkowski Uta
Published: November 2008

Knowledge about signaling in arbuscular mycorrhizal (AM) symbioses is currently restricted to the common symbiosis (SYM) signaling pathway discovered in legumes. This pathway includes calcium as a second messenger and regulates both AM and rhizobial symbioses. Both monocotyledons and dicotyledons form symbiotic associations with AM fungi, and although they differ markedly in the organization of their root systems, the morphology of colonization is similar. To identify and dissect AM-specific signaling in rice (Oryza sativa), we developed molecular phenotyping tools based on gene expression patterns that monitor various steps of AM colonization. These tools were used to distinguish common SYM-dependent and -independent signaling by examining rice mutants of selected putative legume signaling orthologs predicted to be perturbed both upstream (CASTOR and POLLUX) and downstream (CCAMK and CYCLOPS) of the central, calcium-spiking signal. All four mutants displayed impaired AM interactions and altered AM-specific gene expression patterns, therefore demonstrating functional conservation of SYM signaling between distant plant species. In addition, differential gene expression patterns in the mutants provided evidence for AM-specific but SYM-independent signaling in rice and furthermore for unexpected deviations from the SYM pathway downstream of calcium spiking.
Preimplantation genetic diagnosis of haemophilia
Authors: Lavery Stuart
Published: November 2008

Preimplantation genetic diagnosis (PGD) aims to increase the number of options available to couples who could have a child affected with haemophilia and reduce the anxiety these couples often associate with reproduction. The female partner must undergo an in vitro fertilization cycle, and the eggs or embryos are then biopsied. Embryos which are unaffected by haemophilia can then be transferred to the uterus. The clear advantage of this technique is that the woman knows from the very beginning that the pregnancy is unaffected by haemophilia, and she can avoid conventional invasive prenatal diagnosis and the difficult decision on whether or not to terminate an affected pregnancy. Several strategies for this single cell genetic diagnosis have been described. These include embryonic sexing using polymerase chain reaction, embryonic sexing using fluorescent in situ hybridization, specific diagnosis using restriction enzymes, sequencing and haplotype analysis. Over the years, PGD has attracted much ethical commentary, both supportive and critical, regarding the fundamental principles of embryo selection and destruction. New scientific advances and their potential applications are considered.
Chlorambucil versus observation after anti‐Helicobacter therapy in gastric MALT lymphomas: results of the international randomised LY03 trial
Authors: Hancock Barry W. , Qian Wendi , Linch David , Delchier Jean‐Charles , Smith Paul , Jakupovic Ira , Burton Cathy , Souhami Robert , Wotherspoon Andrew , Copie‐Bergman Christiane , Capella Carlo , Traulle Catherine , Levy Michael , Cortelazzo Sergio , Ferreri Andres J. M. , Ambrosetti Achille , Pinotti Graziella , Martinelli Giovanni , Vitolo Umberto , Cavalli Franco , Gisselbrecht Christian , Zucca Emanuele
Published: November 2008

Gastric mucosa‐associated lymphoid tissue (MALT) lymphomas are uncommon tumours characterised by a tendency to remain localised for long periods. The aetiological association between MALT lymphomas and Helicobacter pylori is well established. The role of additional chemotherapy after H. pylori eradication in localised MALT lymphomas is unclear. The LY03 trial was designed to establish whether chlorambucil after treatment for H. pylori would help prevent recurrence. Patients were treated with antibiotics for H. pylori infection. Those with successful eradication of H. pylori and no evidence of progression of lymphoma were eligible for randomisation to chlorambucil or observation. Two hundred and thirty‐one patients were registered. Ninety‐seven percent patients had H. pylori eradicated after antibiotics and 59% achieved macroscopically normal gastric mucosa. One hundred and ten patients were randomised. With a median follow‐up of 58 months, six patients were dead and 17 had recurrent/progressive disease. The recurrence/progression rates at 5 years were 11% for chlorambucil, and 21% for observation with a difference of 10%, 95% confidence interval (CI) = −9% to 29%, P = 0·15. No difference was detected in recurrence/progression‐free survival [Hazard Ratio (HR) = 0·96, 95% CI = 0·41–2·2, P = 0·91] or overall survival (HR = 1·93, 95% CI = 0·39–9·58, P = 0·42). This is the first randomised trial to show there is no good evidence to support that additional single agent chemotherapy to anti‐H. pylori treatment contributes to prevent recurrence in localised gastric MALT lymphomas.
Homozygous HAX1 mutations in severe congenital neutropenia patients with sporadic disease: a novel mutation in two unrelated British kindreds
Authors: Smith Bradley N. , Ancliff Phil J. , Pizzey Arnold , Khwaja Asim , Linch David C. , Gale Rosemary E.
Published: November 2008

Patients with autosomal dominant (AD), sporadic and X‐linked severe congenital neutropenia (SCN) may have mutations in the elastase 2 (ELA2) or Wiskott‐Aldrich syndrome (WAS) genes. Homozygous mutations in the HAX1 gene have recently been reported in autosomal recessive (AR) cases of primarily Middle‐Eastern descent and the original Kostmann family. We screened 109 predominantly Caucasian SCN kindreds for mutations in these genes; 33 (30%) had 24 different ELA2 mutations, five of them novel, two kindreds (2%) had WAS mutations and four kindreds (4%) had three different HAX1 mutations, two of them novel. One HAX1 mutation (p.Ser43LeufsX11) was found in an AR Ashkenazi Jewish kindred, the other (p.Glu31LysfsX54) in two unrelated British patients with sporadic disease. Microsatellite analysis of the HAX1 locus revealed a common haplotype (maximum distance 4·1 Megabases) for the p.Glu31LysfsX54 patients, suggesting a possible ancestral founder. In functional assays, the level of spontaneous and staurosporine‐induced apoptosis was increased in neutrophils from both p.Ser43LeufsX11 patients but not a p.Glu31LysfsX54 patient, suggesting the possible presence of modifying factors. The low incidence of HAX1 mutations in our study suggests that the frequency may vary between racial groups but suggests that irrespective of inheritance or racial origin, SCN patients should be screened for HAX1 mutations.
Using sighting records to declare eradication of an invasive species
Authors: Rout Tracy M. , Salomon Yacov , McCarthy Michael A.
Published: November 2008

A major challenge for eradication managers is deciding when a programme can be deemed successful. Regan et al. (2006) were the first to pose this problem within a decision theory framework, minimizing the net expected cost of the decision. The optimal time to declare eradication was based on the number of consecutive surveys in which the species was not found (‘absent surveys’). Their formulation used estimates of detectability and persistence – parameters that are often difficult to estimate – to calculate the probability that the invasive species is still present.

Here we use a similar decision‐making framework but instead predict presence based on the pattern of sightings, using a method developed by Solow (1993a) that assumes a constant sighting rate. This method does not require estimates of detectability and persistence. We find the number of absent surveys after which eradication should be declared, using three approaches: a stochastic dynamic program, which finds the exact optimal solution, a rule of thumb, and an approximation. We then compare these results with a method assuming a declining sighting rate.

Both the rule of thumb and approximation give results that are close to the exact optimal solution. The rule of thumb with the declining sighting rate method generally gives a larger optimal number of absent surveys.

Synthesis and applications. Analysing this problem within a decision theory framework enables us to minimize the expected cost of declaring eradication. By using the more readily available sighting data, we make this framework applicable to a wider range of invasive species. Our approximation is a simple calculation, making it an accessible tool that could be applied by managers of eradication programmes for invasive species.
Quantifying the three main components of salinity tolerance in cereals
Authors: RAJENDRAN KARTHIKA , TESTER MARK , ROY STUART J.
Published: November 2008

Salinity stress is a major factor inhibiting cereal yield throughout the world. Tolerance to salinity stress can be considered to contain three main components: Na+ exclusion, tolerance to Na+ in the tissues and osmotic tolerance. To date, most experimental work on salinity tolerance in cereals has focused on Na+ exclusion due in part to its ease of measurement. It has become apparent, however, that Na+ exclusion is not the sole mechanism for salinity tolerance in cereals, and research needs to expand to study osmotic tolerance and tissue tolerance. Here, we develop assays for high throughput quantification of Na+ exclusion, Na+ tissue tolerance and osmotic tolerance in 12 Triticum monococcum accessions, mainly using commercially available image capture and analysis equipment. We show that different lines use different combinations of the three tolerance mechanisms to increase their total salinity tolerance, with a positive correlation observed between a plant's total salinity tolerance and the sum of its proficiency in Na+ exclusion, osmotic tolerance and tissue tolerance. The assays developed in this study can be easily adapted for other cereals and used in high throughput, forward genetic experiments to elucidate the molecular basis of these components of salinity tolerance.
Adjustment of growth and central metabolism to a mild but sustained nitrogen‐limitation in Arabidopsis
Authors: TSCHOEP HENDRIK , GIBON YVES , CARILLO PETRONIA , ARMENGAUD PATRICK , SZECOWKA MAREK , NUNES‐NESI ADRIANO , FERNIE ALISDAIR R. , KOEHL KARIN , STITT MARK
Published: November 2008

We have established a simple soil‐based experimental system that allows a small and sustained restriction of growth of Arabidopsis by low nitrogen (N). Plants were grown in a large volume of a peat–vermiculite mix that contained very low levels of inorganic N. As a control, inorganic N was added in solid form to the peat–vermiculite mix, or plants were grown in conventional nutrient‐rich solids. The low N growth regime led to a sustained 20% decrease of the relative growth rate over a period of 2 weeks, resulting in a two‐ to threefold decrease in biomass in 35‐ to 40‐day‐old plants. Plants in the low N regime contained lower levels of nitrate, lower nitrate reductase activity, lower levels of malate, fumarate and other organic acids and slightly higher levels of starch, as expected from published studies of N‐limited plants. However, their rosette protein content was unaltered, and total and many individual amino acid levels increased compared with N‐replete plants. This metabolic phenotype reveals that Arabidopsis responds adaptively to low N by decreasing the rate of growth, while maintaining the overall protein content, and maintaining or even increasing the levels of many amino acids.
Intracoronary administration of autologous bone marrow‐derived progenitor cells in a critically ill two‐yr‐old child with dilated cardiomyopathy
Authors: Rupp Stefan , Bauer Jürgen , Tonn Torsten , Schächinger Volker , Dimmeler Stefanie , Zeiher Andreas M. , Schranz Dietmar
Published: November 2008

Abstract:  DCM is the most common cardiomyopathy in childhood. Effectiveness of anticongestive therapy is limited in most cases and about one‐third of children diagnosed with DCM die or receive heart transplantation within the first year after diagnosis. Cardiac stem cell transplantation has become a promising therapy to treat heart failure in adult patients. Based on these promising results, the cardiac stem cell therapy might also represent a new therapeutic option particularly in young children. The present case documents for the first time intracoronary administration of autologous bone marrow‐derived progenitor cells in a critically ill two‐yr‐old child with severe heart failure caused by DCM. Because of progressive worsening of the clinical condition despite maximal anticongestive treatment, the decision to perform autologous stem cell therapy was made. Cardiac stem cell therapy proved to be technically feasible, was associated with improvement in cardiac function, and might represent an option before heart transplantation in children with severe heart failure.
Engraftment syndrome following allogeneic hematopoietic stem cell transplantation in children
Authors: Nishio Nobuhiro , Yagasaki Hiroshi , Takahashi Yoshiyuki , Hama Asahito , Muramatsu Hideki , Tanaka Makito , Yoshida Nao , Yoshimi Ayami , Kudo Kazuko , Ito Masafumi , Kojima Seiji
Published: November 2008

Abstract:  ES is a complication that occurs immediately before or at the timing of neutrophil engraftment following autologous or allogeneic SCT. It is characterized by fever, skin rash, and non‐cardiac pulmonary infiltrates. We evaluated the incidence, risk factors, and outcomes of ES following allogeneic SCT in children. Of 100 pediatric patients, 20 (20%) developed ES occurring at a median of 14 days (range 8–27 days) post‐transplant. Patients presented with fever (100%), skin rash (100%), diffuse pulmonary infiltration (25%), and body weight gain (85%). On multivariate analysis, significant risk factors for ES included younger age (<8 yr old) and human leukocyte antigen disparity between donors and recipients. Univariate analysis showed that patients with ES had a higher incidence of developing chronic graft‐versus‐host disease and ES was not associated with other complications. Event‐free survival did not significantly differ between patients with and without ES regardless of the presence of malignant or non‐malignant diseases.
Use of neurodevelopmental delay in pediatric solid organ transplant listing decisions: Inconsistencies in standards across major pediatric transplant centers
Authors: Richards Christopher T. , Crawley LaVera M. , Magnus David
Published: November 2008

Abstract:  Children with NDD present for organ transplant evaluation, but the role of NDD as a listing criterion itself is poorly described. Therefore, we sought to investigate how major pediatric solid organ transplant programs use NDD as a criterion in their listing decisions. We developed a survey that was sent via post to active pediatric solid organ transplant programs across the United States investigating transplant listing decision‐making for neurodevelopmentally delayed children. Respondents were medical/surgical directors and transplant coordinators. Descriptive statistics summarize the findings. Programs inconsistently use NDD in listing decisions. Thirty‐nine percent of programs stated that they “rarely” or “never” consider NDD in their decisions, whereas 43% of programs “always” or “usually” do. Sixty‐two percent of programs report that informal processes guide their use of NDD, and no programs describe their process as “formal, explicit, and uniform.” The degree of delay is an additional source of discordance among programs, with 14% of programs reporting mild or moderate NDD as a relative contraindication to listing and 22% reporting that NDD was “irrelevant” to the listing decision. The use of NDD in pediatric solid organ transplant listing decisions is varied and inconsistent across active programs.
Concurrent chemoradiotherapy with nedaplatin after radical hysterectomy in patients with stage IB and II cervical cancer
Authors: Kobayashi Yoichi , Ohara Tatsuru , Wada Yasuna , Okuda Yoshiko , Kondo Haruhiro , Okuma Yoshiaki , Suzuki Nao , Gomi Hiromichi , Kiguchi Kazushige , Ishizuka Bunpei
Published: November 2008

Although radical hysterectomy is the standard surgical treatment for patients with stage IB and II cervical cancer, it does not improve the prognosis of high‐risk patients even if postoperative radiotherapy is added. There is therefore a need to establish some other therapeutic regimen. In the present retrospective study, the efficacy of concurrent nedaplatin after radical hysterectomy in high‐risk stage IB to II cervical cancer was analyzed. From 1995 through 2005, patients with an International Federation of Gynecology and Obstetrics stage of IB2 and II cervical cancer who were given only radiotherapy (RT; n = 17) or postoperative concurrent chemoradiotherapy with biweekly nedaplatin at 70 mg/m2 (p‐CCRT; n = 13) were entered. All of the patients had at least one of the following risk factors: lymphovascular space infiltration, positive lymph nodes, or parametrial invasion. There was no significant difference between the RT and p‐CCRT groups with regard to mean age and risk factors, except that more patients in the p‐CCRT group had positive lymph nodes (P < 0.05). Five‐year progression‐free survival and overall survival after RT versus p‐CCRT were 76.0% versus 83.3%, and 81.9% versus 83.3%, respectively. Although many patients in the p‐CCRT group had positive lymph nodes, there was no significant difference in either PFS or OS. No grade 4 myelosuppression or other severe side effects were seen in the p‐CCRT group. As CCRT with nedaplatin might have some benefit, a randomized control trial should be conducted in the future.
THE PREVENTION AND TREATMENT OF URETHRAL STRICTURE OF INFLAMMATORY ORIGIN
Authors: Ainsworth‐Davis J. C.
Published: November 2008

(1) Stricture is due to imperfectly treated gonorrhea, and it may take years to develop. Such treatment was common during the Great War because of the urgency of getting officers and men back to the firing line, and so the ill results of this are just beginning to be seen and will continue for the next twenty or more years.

(2) Stricture should always be thought of and prevented in every case of gonorrhea by adequate instrumental treatment.

(3) Stricture and its complications are of such a serious nature that every effort should be made to ensure early diagnosis and treatment. Unfortunately, symptoms are rarely experienced before the calibre of the urethra has been reduced to about one‐third of its normal extent, Le., 15 Charrière.

(4) Stricture is curable providing treatment is carried out in the right way, which consists in making it retrace its own footsteps by regular instrumentation, which gradually brings about rupture of the inner layers of fibrous tissue, which are then absorbed during the intervals of treatment.

(5) Efficient local anaesthesia renders this treatment painless, a great factor in ensuring regular attendance.

(6) Late diagnosis and the presence of complications call for the use of a variety of peri‐urethral instruments, which are described.

(7) Neglected cases and the occurrence of certain severe complications may necessitate operations, sometimes immediate, as a life‐saving measure. The best procedure is suprapubic cystotomy, any direct operative attack on the stricture being avoided at the time, and an attempt made by instrumentation at a later date.

(8) The treatment of certain pre‐ and post‐instrumental complications of stricture is summarised.
THE CONSERVATIVE TREATMENT OF CARCINOMA OF THE PROSTATE
Authors: NITCH CYRIL A. R.
Published: November 2008

Conservative treatment comprises; (1) Radio‐therapy; (2) Surgical; and (3) Surgical with Radio‐therapy.

The immediate results of X‐ray treatment are often excellent but the ultimate results are disappointing.

In some cases X‐rays cause rapid increase of the growth and dissemination.

The best results are obtained by the five‐field maximum method of Holfelder‐Reisner, giving a total depth dose of 150 to 200 per cent. on the prostate.

The intensive split‐dose method of Levitt, now under trial, seems productive of better results. At present only 6 per cent. of cures can be claimed for modern methods of X‐ray therapy.

The effects of radium are better, especially when applied in large doses to the rectal, vesical and urethral surfaces of the prostate. Before treatment is commenced a thorough clinical, biochemical and radiological examination must be made and a portion of the prostate should be removed by electro‐resection for microscopical examination.

When renal function tests are below normal preliminary drainage of the bladder is necessary.

About 70 mgs. of radium are used thus: 14 mgs. to the posterolateral surfaces, 50 mgs. to the vesical surface and 5 mgs. to the urethral surface.

Though only a few cases have been treated in this way the cure rate has been 28 per cent. up to the present. The method is therefore worth an extended trial.

Conservative surgery consists of suprapubic drainage, transplantation of the ureters and electro‐resection. Transplantation of the ureters into the large intestine is preferable to suprapubic drainage but can only be performed in carefully selected cases.

Electro‐resection is the best palliative measure for the relief of obstruction by growth at the neck of the bladder: it is of no value when the obstruction is due to invasion of the prostatic urethra.

It is probable that in the future electro‐resection, followed by some form of radio‐therapy, will be the method of choice.
PARENCHYMAL CARCINOMA OF THE KIDNEY
Authors: Griffiths I. H. , Thackray A. C.
Published: November 2008

1. One hundred and three cases of renal parenchymal carcinoma are reviewed; nephrectomy was performed in 60 cases, 20 were found to be inoperable, and operation was not considered in the remaining cases. Post‐mortem examinations were performed on 32 cases in the series.

2. The clinical features are analysed and their influence on prognosis discussed.

3. The tuniours are classified into three grades of malignancy according to histological criteria.

4. The spread of the tumour is described, with special reference to the sinister significance of tumour thrombosis of the renal vein.

5. Radiological features are described, stressing those that assist prognosis.

6. Nephrectomy is the only rational treatment in operable cases, and it is noted that the presence of a solitary metastasis is not a contraindication to surgery. The place of radiotherapy in treatment is indicated.

7. The survival rate for operable cases in this series compares favourably with that from the Mayo Clinic.

8. The lines on which the prognosis can be assessed are considered.
A CASE OF URETEROCELE COMPLICATED BY RENAL AND URETERIC CALCULI
Authors: McCrea Andrew N.
Published: November 2008

The case of a boy of 11 years of age with unilateral ureterocele and multiple The syiiiptoniatology, radiological appearances, and calculi is presented in detail. treatment are discussed.
PRIMARY CARCINOMA OF THE MALE URETHRA1
Authors: Vernon H. K. , Wilkins R. D.
Published: November 2008

An unusual case of transitional cell carcinoma of the male urethra is presented. The commoner squamous‐cell types are discussed.

The usual zetiological factors, urethral stricture, or seedlings from papillomatous tumours higher in the urinary track are considered in relation to this case and are not found pertinent.

When the patient was seen originally there was no evidence of stricture, but as he was not submitted to urethroscopy the possibility that he may have had a patch of submucous infiltration cannot be excluded.

The symptoms and signs are discussed; the patient presented with gangrene of the penis.

Diagnosis was made by palpation of an indurated swelling which failed to resolve with penicillin. Urethroscopic confirmation was technically impossible.

Treatment was by radical amputation of the penis and the construction of a perineal urethra.

The patient is being kept under surveyance in order that block dissection of the inguinal glands may be undertaken should they become involved by metastatic spread.
UNCOMMON TYPES OF CONGENITAL RENAL ABNORMALITY: TWO CASES
Authors: Hanbury W. J.
Published: November 2008

A case of crossed renal ectopia with fusion and one of solitary pelvic kidney are reported, both these conditions being rare congenital abnormalities. References are made to previous literature and available information summarised. Embryological factors in relation to aetiology are discussed.

I wish to thank Dr G. J. Cunningham and Professor G. Hadfield for their helpful criticism and advice, and Mr N. K. Harrison for the photographs.
Tumours of the Renal Pelvis and Ureter: Observations in 170 Patients
Authors: STEFFENS J. , NAGEL R.
Published: November 2008

Summary— A study was made of 170 patients with renal pelvis or ureteric tumours, 160 of whom underwent surgery between 1948 and 1981. The most important aetiological factor was chronic phenacetin abuse: 21.7% of 83 patients with renal pelvis tumours and 11.4% of those with ureteric tumours gave a history of phenacetin abuse. The latency periods ranged from 24 to 26 years. This is the first report of a relationship between abuse of analgesics and urothelial tumours from the Federal Republic of Germany.
Pseudo‐ureter: a Complication of Percutaneous Nephrolithotripsy
Authors: Cronan J. J. , Dorfman G. S. , Esplin C. A.
Published: November 2008

Summary— In 3 previously healthy patients undergoing percutaneous nephrolithotripsy complicated by perforation of the medial wall of the renal pelvis, a false channel or “pseudo‐ureter” formed around the ureteric stent catheter, starting from the renal pelvis and re‐entering the upper ureter. Recognition occurred 2 to 3 days after lithotripsy during nephrostography and the complication was treated by re‐positioning the stent into the true ureteric lumen.

All patients are well 7 to 10 months after lithotripsy and there have been no long‐term complications.
An in vitro Pharmacological Study of the Human Trigone—a Site of Non‐adrenergic, Non‐cholinergic Neurotransmission
Authors: SPEAKMAN M. J. , WALMSLEY D. , BRADING A. F.
Published: November 2008

Summary— Muscle strips from the human detrusor and trigone were studied in vitro. The detrusor muscle contracted strongly to both cholinergic receptor stimulation with carbachol and to electrical field stimulation. There was no evidence of atropine resistance in the detrusor strips. The superficial trigone responded maximally to alpha‐adrenergic receptor stimulation but also produced a significant cholinergic response. Intramural nerve stimulation in the presence of both atropine and phentolamine produced a residual non‐adrenergic, non‐cholinergic (NANC) response of 40% of its maximum at 5 Hz. Electrical stimulation, particularly at the lower frequencies of stimulation, produced relaxation responses in 40% of the superficial trigonal muscle strips. These relaxations were not blocked by atropine, phentolamine or propranolol, but were abolished by tetrodotoxin. The possible role of the cholinergic “input” to the superficial trigone and the importance of the NANC excitatory and inhibitory innervation in preventing vesico‐ureteric reflux and in aiding bladder neck opening is discussed.
Sushruta's Lateral Perineal Approach for Prostatectomy and Repair of the Ruptured Posterior Urethra
Authors: GADHVI N.P.
Published: November 2008

Summary— Using Sushruta's lateral perineal approach, 54 prostatectomies were carried out between August 1985 and March 1986. This approach to the prostate is short, safe, simple and direct. The same approach has been used in 6 patients with ruptured posterior urethras and found to provide a simple access to the urethra.
A Computer‐based Program for the Follow‐up of Prostatic Cancer Patients
Authors: SIMON D. , LEVY E. , SERVADIO C.
Published: November 2008

Summary— A computer‐based record program for the follow‐up of prostatic cancer patients is described and its practical applications discussed. The system enables the user to record personal data, medical history follow‐up (including laboratory and imaging tests), treatment and the response to it. The program can generate reports as a summary letter to the referring physician, follow‐up notes on a specific date, laboratory test results on a chronological base, etc. It has the capability to analyse statistically the medical database accumulated with the aid of SPSS (Statistical Package for Social Sciences).

The program, which is designed for a micro‐computer, is conducted on the IBM Personal Computer. By providing instant access to all comprehensive information, the system is a valuable tool for the correct staging of disease and for systematic follow‐up; most of all, it is a “real‐time instrument” for the analysis of medical results.
Clinical versus Ultrasonographic Evaluation of Scrotal Disorders
Authors: Kromann‐Andersen B. , Hansen L. B. , Larsen P. N. , Lawetz K. , Lynge P. , Lysen D. , Nielsen S. Pors , Stokholm K. H. , Foged P.
Published: November 2008

Summary— Clinical and ultrasonographic examinations of scrotal disorders were compared in 166 patients in order to determine their ability to distinguish between those diseases requiring surgery and those requiring clinical follow‐up only.

Ultrasound examinations were efficient in discriminating between normal and pathological findings. Extra‐testicular lesions were readily differentiated from testicular ones. Although both clinical and ultrasonographic examinations had high sensitivity (90%) in detecting testicular cancer, the number of false positive findings was smaller after ultrasound examination. This gave a predictive value of a positive test of 53% after ultrasound examination but only 33% after clinical examination.

Ultrasound examination may, therefore, reduce the number of surgical explorations in the scrotum and should be performed in patients with suspected testicular pathology based on history and palpatory findings.
The Clinical Varicocele in Infertility
Authors: Talati J. J. , Islahuddin M.
Published: November 2008

Summary— Of 238 infertile males seen over a 47‐month period, 47 (20%) had a varicocele. Of these 51% had an abnormal sperm count (21% were azoospermic and 30%oligozoospermic) and 60% had less than a third of sperms motile; 23 patients were subjected to gonadotrophin assays. Serum follicle stimulating hormone and leutinising hormone levels were elevated in 48% and 70% of patients respectively. Serum prolactin assayed in 19 patients was raised in 10% and serum testosterone estimated in 16 patients was low in 6%. Twenty‐five patients (53%) were advised to undergo surgery but only 10 agreed. Of these, 1 showed a dramatic improvement in his spermiogram and a pregnancy ensued. The sperm count and motility of 2 others improved after treatment with prostaglandin synthetase inhibitors, and 1 after testosterone. Medical treatment improved the count and motility in 7 of 8 patients in whom surgery was not suggested as primary treatment because of abnormal hormonal results.

This study has shown that infertile patients with varicocele are a heterogeneous group and that improvement in spermiograms can best be achieved by selective treatment; this may be surgery, surgery followed by medical treatment, or medical treatment alone.
Neodymium‐YAG Laser Irradiation of Stage T2 Muscle‐invasive Bladder Cancer. Long‐term Results
Authors: BEISLAND H. O. , SANDER S.
Published: November 2008

Summary— The study group consisted of 15 patients with solitary stage T2 bladder tumours treated with transurethral resection (TUR) and subsequent neodymium‐YAG laser irradiation.

Ten patients are alive without evidence of cancer 56 to 78 months (mean 67) after treatment; 1 died of cardiovascular disease 2 years after treatment and autopsy revealed no cancer. In 4 patients the treatment failed and cystectomy or external beam radiation was carried out.

The long‐term results indicate the combination of TUR and laser irradiation to be beneficial in the management of T2 tumours in selected cases.
Significance of Histological Prognostic Indicators in Patients with Carcinoma of the Prostate
Authors: MUKAMEL E. , DeKERNION J. B. , DOREY F. , HANNAH J.
Published: November 2008

Summary— The relationships between histological prognostic indicators and their relative significance in prognosis were studied in 139 patients who underwent radical prostatectomy. The estimated progression rates at 5 and 8 years were 14 and 52% respectively for patients with high grade tumours, 25 and 50% for those with capsular penetration, 31 and 58% for patients with seminal vesicle invasion and 23 and 55% for those with lymph node metastases. Each of the 4 parameters yielded an approximately equal increased risk of disease progression at 5 and 8 years. The occurrence of 2 or more risk factors in the same patient did not result in a statistically increased risk of progression at 5 and 8 years. The effect of capsular involvement on progression was directly related to the extent of invasion. The progression rate at 8 years was 3% for patients with mild involvement, 19% for those with extensive invasion and 50% for those with capsular penetration.
Prostaglandin E, in Erectile Dysfunction. Efficiency and Incidence of Priapism
Authors: SCHRAMEK P. , DORNINGER R. , WALDHAUSER M. , KONECNY P. , PORPACZY P.
Published: November 2008

Summary— Prostaglandin E1 (PG E1) was used for diagnostic and therapeutic purposes in 149 men with erectile dysfunction over a period of 20 months (February 1987‐October 1988). The intracavernous application of PG E1 in varying doses resulted in an erection sufficient for sexual intercourse in 79% of cases. In order to differentiate between vascular and non‐vascular impotence, 5 pg PG El were found to be a sufficiently high and safe dose for the first intracavernous injection. Local discomfort, ranging from mild to severe pain after injection, was recorded in 40% of patients. A significant difference in severe side effects was found between arterial, venous and non‐vasculogenic impotence, the highest incidence of local pain occurring in non‐vasculogenic patients. The most striking result was the occurrence of 4 cases of priapism, all in the non‐vascular group, 1 of these occurring after the injection of only 5 μg PG El.
Acquired Venous Disease of the Lower Urinary Tract
Authors: PLEASS H. , CARLSON G. , LOOSE H. W. , NEAL D. E.
Published: November 2008

Summary— Thrombosis of the vena cava, femoral veins or iliac veins can result in the formation of large collateral veins in the pelvis and retroperitoneum which are often asymptomatic but which may cause severe bleeding and produce major difficulties in urological management. Such abnormalities are a rare cause of urological symptoms but may be difficult to diagnose unless a high index of suspicion is maintained. Three patients are reported who developed significant urological problems as a consequence of acquired venous disease; the use of ultrasound, venography and CT in the diagnosis of this condition is described.
Measurement of Voiding Pressures on Ambulatory Monitoring: Comparison with Conventional Cystometry
Authors: WEBB R. J. , GRIFFITHS C. J. , RAMSDEN P. D. , NEAL D. E.
Published: November 2008

Summary— A series of 20 patients underwent conventional medium fill cystometry (CMG) and ambulatory monitoring during natural bladder filling (AM). The measurement of voiding pressures by the 2 techniques was compared.

The maximum subtracted detrusor contraction pressure recorded during CMG (50 ± 30 cm H2O) was significantly less than that recorded during AM (86 ± 35 cm H2O). Voiding pressures during natural filling are greater than those observed during conventional urodynamic studies: this finding may have important implications in the definition of bladder outflow obstruction.
Surgical Management of the Congenital Neuropathic Bladder
Authors: PARRY J. R. W. , NURSE D. E. , BOUCAUT H. A. P. , MURRAY K. H. A. , MUNDY A. R.
Published: November 2008

Summary— We have previously described 3 types of lower urinary tract dysfunction in the congenital neuropathic bladder—contractile, intermediate and acontractile—accounting for 35,40 and 25% of patients respectively. Subsequent urodynamic and surgical experience has shown that the intermediate type is commoner and the acontractile type less common than was thought. The contractile group accounts for 31% of patients and rarely requires surgery (a “clam” ileocystoplasty). The acontractile group accounts for only 9% but more commonly requires surgical treatment, usually the implantation of an artificial urinary sphincter (AUS). The intermediate group accounts for 60% of patients and usually requires surgery. If there is no significant sphincter weakness incontinence, a “clam” ileocystoplasty alone is performed; if there is sphincter weakness, a “clam and a cuff” procedure is performed with implantation of the remainder of the AUS at a later date, if required.
Immunohistochemical Staining with Monoclonal Antibody 32–2B to Desmosomal Glycoprotein 1: Its Role in the Histological Assessment of Urothelial Carcinomas
Authors: CONN I. G. , VILELA M. J. , GARROD D. R. , CROCKER J. , WALLACE D. M. A.
Published: November 2008

Summary— A series of transitional cell carcinomas of bladder were stained immunohistochemically with the monoclonal antibody, 32–2B, to desmosomal glycoprotein 1. All of the sections showed positive staining with the antibody. Assessment of staining intensity, by 3 independent examiners, revealed a strong negative correlation between density of desmosomal staining and degree of invasion (P=0.012). Nests of strongly staining cells were identified in several invasive tumours, possibly indicating early squamous differentiation. Invasive tumour cells in the subepithelial stroma also stained strongly with the antibody. Correlation with clinical course, however, revealed no significant association between desmosomal staining and the incidence of recurrence or progression.

It is suggested that staining with this antibody may be of value in detecting both stromal invasion and early squamous differentiation of transitional cell carcinomas. Both this and previous studies emphasise the value of this antibody as an epithelial marker in neoplasia.
Epidemiological Study of Urinary Tract Stones in a Northern Italian City
Authors: BORGHI L. , FERRETTI P. P. , ELIA G. F. , AMATO F. , MELLONI E. , TRAPASSI MARIA RITA , NOVARINI A.
Published: November 2008

Summary— An epidemiological study of stone disease in a Northern Italian city was carried out by means of a postal questionnaire mailed to 6000 individuals (2.5% of the entire population).

It was found that the incidence of stone disease was comparable to that of industrialised Western Europe. There was a relationship between stone disease and gout and stone disease and a positive family history. The frequency of uric acid stones was high (26.5%). Stone‐formers showed no alimentary differences from non‐stone formers apart from the use of spices and herbs.

Stone‐formers used less water from public aqueducts and more uncarbonated mineral water, but only 19% of these drank at least 2 litres a day.
Minimally Invasive Treatment of Ureteric Calculi Using Modern Techniques
Authors: SCHMIDT A. , RASSWEILER J. , GUMPINGER R. , MAYER R. , EISENBERGER F.
Published: November 2008

Summary— Between July 1985 and July 1986, 226 upper and 62 distal ureteric calculi were treated. In situ extracorporeal Shockwave lithotripsy (ESWL) is the treatment of choice for upper and distal ureteric calculi, with success rates of 81 and 76% respectively. Retrograde manipulation of the calculus was undertaken only when in situ ESWL was impossible because of difficulty in localisation. Although ESWL after successful mobilisation was successful in 95% of patients, retrograde mobilisation was possible in only 80%. Antegrade ureterorenoscopy via a percutaneous nephrostomy was performed to avoid open surgery if retrograde mobilisation was not feasible, and was successful in 90%. Two second generation lithotripters, the modified Dornier H M3 + and the Wolf Piezolith 2200, both suitable for treatment without anaesthesia, were compared in terms of efficacy. In situ ESWL of upper ureteric calculi was successful in 70.6% with the HM3+ and 37.2% with the Piezolith 2200. In situ ESWL of middle ureteric calculi was successful in 81.8% with the modified H M3 +, while in situ treatment of middle ureteric calculi was impossible with the Piezolith 2200 because of inadequate ultrasound localisation. Distal ureteric calculi were treated successfully in 71.4% with the modified Dornier HM3+ and in 64% with the Piezolith 2200. We report our experience of ESWL using the prone position for iliac ureteric calculi; 8 of 10 patients were treated successfully in situ.
Megestrol Acetate in Relapsed Carcinoma of Prostate
Authors: DANIEL F. , MacLEOD P. M. , TYRRELL C. J.
Published: November 2008

Summary— A series of 22 patients with advanced carcinoma of the prostate who had failed first‐line hormonal therapy (orchiectomy, stilboestrol, luteinising hormone‐releasing hormone agonist) were treated with 160 mg megestrol acetate daily. Treatment was well tolerated, side effects were minimal and 21 patients were evaluable. There were no complete or partial responses, although 8 patients had a good subjective response. In 6 patients the disease was stabilised for 6 to 12 months and there was a 40 to 50% reduction in their prostatic acid phosphatase (PAP) levels. It was concluded that megestrol acetate has a role as second‐line hormonal therapy in the management of prostatic carcinoma.