bluuebunny/crossref_metadata_2025 huggingface dataset:
The PhoP/PhoQ system controls the intramacrophage type three secretion system of Salmonella enterica
Authors: Bijlsma Jetta J. E. , Groisman Eduardo A.
Published: June 2005

Spi/Ssa is a unique type three secretion system that functions exclusively when Salmonella enterica is inside eukaryotic cells. Expression of the Spi/Ssa system and its secreted effectors is dependent on SsrB/SpiR, a two‐component regulatory system encoded in the SPI‐2 pathogenicity island that also harbours the spi/ssa genes. Here we determine that the PhoP/PhoQ two‐component system controls the intramacrophage expression of spi/ssa genes by regulating the SsrB/SpiR system. We establish that PhoP regulates transcription of the response regulator SsrB and demonstrate binding of the PhoP protein to the ssrB promoter both in vivo using chromatin immunoprecipitation in Salmonella‐infected macrophages, and in vitro using purified PhoP protein. We show that PhoP controls the SpiR sensor post‐transcriptionally and identify a region in the 5′ untranslated region of the spiR message that is required for this effect. The demonstration that the PhoP/PhoQ system is directly involved in the regulation of the SPI‐2 pathogenicity island highlights PhoP/PhoQ's central role in Salmonella virulence. We suggest that different regulatory systems convey distinct signals over time to produce the SsrB/SpiR system, which then modulates expression of the Spi/Ssa apparatus and secreted effectors.
Structural basis for segmental gene conversion in generation of Anaplasma marginale outer membrane protein variants
Authors: Futse James E. , Brayton Kelly A. , Knowles Donald P. , Palmer Guy H.
Published: June 2005

Bacterial pathogens in the genus Anaplasma generate surface coat variants by gene conversion of chromosomal pseudogenes into single‐expression sites. These pseudogenes encode unique surface‐exposed hypervariable regions flanked by conserved domains, which are identical to the expression site flanking domains. In addition, Anaplasma marginale generates variants by recombination of oligonucleotide segments derived from the pseudogenes into the existing expression site copy, resulting in a combinatorial increase in variant diversity. Using the A. marginale genome sequence to track the origin of sequences recombined into the msp2 expression site, we demonstrated that the complexity of the expressed msp2 increases during infection, reflecting a shift from recombination of the complete hypervariable region of a given pseudogene to complex mosaics with segments derived from hypervariable regions of different pseudogenes. Examination of the complete set of 1183 variants with segmental changes revealed that 99% could be explained by one of the recombination sites occurring in the conserved flanking domains and the other within the hypervariable region. Consequently, we propose an ‘anchoring’ model for segmental gene conversion whereby the conserved flanking sequences tightly align and anchor the expression site sequence to the pseudogene. Associated with the recombination sites were deletions, insertions and substitutions; however, these are a relatively minor contribution to variant generation as these occurred in less than 2% of the variants. Importantly, the anchoring model, which can account for more variants than a strict segmental sequence identity mechanism, is consistent with the number of msp2 variants predicted and empirically identified during persistent infection.
The ClpX chaperone modulates assembly of the tubulin‐like protein FtsZ
Authors: Weart Richard B. , Nakano Shunji , Lane Brooke E. , Zuber Peter , Levin Petra Anne
Published: June 2005

Assembly of the tubulin‐like cytoskeletal protein FtsZ into a ring structure establishes the location of the nascent division site in prokaryotes. Factors that modulate FtsZ assembly are essential for ensuring the precise spatial and temporal regulation of cytokinesis. We have identified ClpX, the substrate recognition subunit of the ClpXP protease, as an inhibitor of FtsZ assembly in Bacillus subtilis. Genetic data indicate that ClpX but not ClpP inhibits FtsZ‐ring formation in vivo. In vitro, ClpX inhibits FtsZ assembly in a ClpP‐independent manner through a mechanism that does not require ATP hydrolysis. Together our data support a model in which ClpX helps maintain the cytoplasmic pool of unassembled FtsZ that is required for the dynamic nature of the cytokinetic ring. ClpX is conserved throughout bacteria and has been shown to interact directly with FtsZ in Escherichia coli. Thus, we speculate that ClpX functions as a general regulator of FtsZ assembly and cell division in a wide variety of bacteria.
RecN protein and transcription factor DksA combine to promote faithful recombinational repair of DNA double‐strand breaks
Authors: Meddows Tom R. , Savory Andrew P. , Grove Jane I. , Moore Timothy , Lloyd Robert G.
Published: June 2005

In rapidly dividing bacterial cells, the machinery for repair of DNA double‐strand breaks has to contend not only with the forces driving replication and transmission of the DNA but also its transcription. By exploiting I‐SceI homing endonuclease to break the Escherichia coli chromosome at one or more defined locations, we have been able to investigate how these processes are co‐ordinated and repair is accomplished. When breaks are induced at a single site, the SOS‐inducible RecN protein and the transcription factor DksA combine to promote efficient repair. When induced at two or more, distantly located sites, RecN becomes almost indispensable. Many cells that do survive have extensive deletions of sequences flanking the break, with end points often coinciding with imperfect repeat elements. These findings herald a much greater complexity for chromosome repair than suggested by current mechanistic models and reveal a role for RecN in protecting the chromosome from break‐induced chromosome rearrangements.
Multiple Rieske genes in prokaryotes: exchangeable Rieske subunits in the cytochrome bc1‐complex of Rubrivivax gelatinosus
Authors: Ouchane Soufian , Nitschke Wolfgang , Bianco Pierre , Vermeglio André , Astier Chantal
Published: June 2005

Bacterial cytochrome bc1‐complex encoded by the petABC operon consists of three subunits, the Rieske iron‐sulphur protein, the b‐type cytochrome, and the c1‐type cytochrome. Disruption of the petA gene of Rubrivivax gelatinosus is not lethal under photosynthetic growth conditions. However, deletion of both petA and petB results in a photosynthesis‐deficient strain, suggesting the presence of a second gene encoding a Rieske protein and rescuing a functional cytochrome bc1‐complex in the PETA1 mutant. The corresponding petA2 gene was identified and the PETA2 mutant could also grow under photosynthetic conditions. The double mutant PETA12, however, was unable to grow photosynthetically. The presence of a photo‐induced cyclic electron transfer was tested by monitoring the kinetics of cytochrome photo‐oxidation on intact cells; the data confirm the capacity of petA2 to replace petA1 in the bc1‐complex to support photosynthesis. Soluble forms of both PetA1 and PetA2 Rieske proteins were purified from Escherichia coli and found to contain correctly inserted [2Fe‐2S] clusters. Electron paramagnetic resonance (EPR) spectroscopy and midpoint potential measurements showed typical [2Fe‐2S] signals and Em values of +275 mV for both Rieske proteins. The high amino acid sequence similarity and the obtained midpoint potential values argue for a functional role of these proteins in the cytochrome bc1‐complex. The presence of duplicated Rieske genes is not restricted to R. gelatinosus. Phylogenetic trees of Rieske genes from Rubrivivax and other proteobacteria as well as from cyanobacteria were reconstructed. On the basis of the phylogenetic analyses, differing evolutionary origins of duplicated Rieske genes in proteo‐ and cyanobacteria are proposed.
Convergent evolution of hydroxylation mechanisms in the fungal kingdom: molybdenum cofactor‐independent hydroxylation of xanthine via α‐ketoglutarate‐dependent dioxygenases
Authors: Cultrone Antonietta , Scazzocchio Claudio , Rochet Michel , Montero‐Morán Gabriela , Drevet Christine , Fernández‐Martín Rafael
Published: June 2005

The xanthine oxidases and dehydrogenases are among the most conserved enzymes in all living kingdoms. They contain the molybdopterin cofactor Moco. We show here that in the fungi, in addition to xanthine dehydrogenase, a completely different enzyme is able to catalyse the oxidation of xanthine to uric acid. In Aspergillus nidulans this enzyme is coded by the xanA gene. We have cloned the xanA gene and determined its sequence. A deletion of the gene has the same phenotype as the previously known xanA1 miss‐sense mutation. Homologues of xanA exist only in the fungal kingdom. We have inactivated the cognate gene of Schizosaccharomyces pombe and this results in strongly impaired xanthine utilization as a nitrogen source. We have shown that the Neurospora crassa homologue is functionally equivalent to xanA. The enzyme coded by xanA is an α‐ketoglutarate‐ and Fe(II)‐dependent dioxygenase which shares a number of properties with other enzymes of this group. This work shows that only in the fungal kingdom, an alternative mechanism of xanthine oxidation, not involving Moco, has evolved using the dioxygenase scaffold.
Mapping of essential replication functions of the linear plasmid lp17 of B. burgdorferi by targeted deletion walking
Authors: Beaurepaire Cécile , Chaconas George
Published: June 2005

The genome of the Lyme disease pathogen Borrelia burgdorferi strain B31 MI includes one linear chromosome, 10 circular and 12 linear plasmids. Members of four paralogous gene families, revealed by genome sequencing, have been suggested as replication/partition functions for both the linear and circular plasmids. Some of these genes have been experimentally shown to be essential for the replication of the B. burgdorferi replicons that encode them. In this study, we located the region essential for replication of lp17, the second smallest linear plasmid in B. burgdorferi. We used a novel in vivo method, targeted deletion walking, to systematically delete DNA from either the left or right end of lp17. We report that the region essential for replication of lp17 is 1.8 kb (bp 7946–9766) and contains only one intact open reading frame (BBD14). Expression of BBD14 is required for the replication, suggesting that it is the replication initiator for lp17. The BBD14 protein is a member of paralogous family (PF) 62 and we present the first experimental evidence for the role of a PF 62 member. Adjacent non‐coding sequences are also required, suggesting that the origin lies at least partially outside the coding region. Surprisingly, deletion of BBD21, the ParA orthologue (PF 32), had little effect upon plasmid stability or incompatibility. Finally, data are presented suggesting that lp17 replication occurs preferentially on a linear rather than a circular DNA molecule.
Swi/SNF‐GCN5‐dependent chromatin remodelling determines induced expression of GDH3, one of the paralogous genes responsible for ammonium assimilation and glutamate biosynthesis in Saccharomyces cerevisiae
Authors: Avendaño Amaranta , Riego Lina , DeLuna Alexander , Aranda Cristina , Romero Guillermo , Ishida Cecilia , Vázquez‐Acevedo Miriam , Rodarte Beatriz , Recillas‐Targa Félix , Valenzuela Lourdes , Zonszein Sergio , González Alicia
Published: June 2005

It is accepted that Saccharomyces cerevisiae genome arose from complete duplication of eight ancestral chromosomes; functionally normal ploidy was recovered because of the massive loss of 90% of duplicated genes. There is evidence that indicates that part of this selective conservation of gene pairs is compelling to yeast facultative metabolism. As an example, the duplicated NADP‐glutamate dehydrogenase pathway has been maintained because of the differential expression of the paralogous GDH1 and GDH3 genes, and the biochemical specialization of the enzymes they encode. The present work has been aimed to the understanding of the regulatory mechanisms that modulate GDH3 transcriptional activation. Our results show that GDH3 expression is repressed in glucose‐grown cultures, as opposed to what has been observed for GDH1, and induced under respiratory conditions, or under stationary phase. Although GDH3 pertains to the nitrogen metabolic network, and its expression is Gln3p‐regulated, complete derepression is ultimately determined by the carbon source through the action of the SAGA and SWI/SNF chromatin remodelling complexes. GDH3 carbon‐mediated regulation is over‐imposed to that exerted by the nitrogen source, highlighting the fact that operation of facultative metabolism requires strict control of enzymes, like Gdh3p, involved in biosynthetic pathways that use tricarboxylic acid cycle intermediates.
An ATP‐binding cassette‐type cysteine transporter in Campylobacter jejuni inferred from the structure of an extracytoplasmic solute receptor protein
Authors: Müller Axel , Thomas Gavin H. , Horler Richard , Brannigan James A. , Blagova Elena , Levdikov Vladimir M. , Fogg Mark J. , Wilson Keith S. , Wilkinson Anthony J.
Published: June 2005

Campylobacter jejuni is a Gram‐negative food‐borne pathogen associated with gastroenteritis in humans as well as cases of the autoimmune disease Guillain–Barré syndrome. C. jejuni is asaccharolytic because it lacks an active glycolytic pathway for the use of sugars as a carbon source. This suggests an increased reliance on amino acids as nutrients and indeed the genome sequence of this organism indicates the presence of a number of amino acid uptake systems. Cj0982, also known as CjaA, is a putative extracytoplasmic solute receptor for one such uptake system as well as a major surface antigen and vaccine candidate. The crystal structure of Cj0982 reveals a two‐domain protein with density in the enclosed cavity between the domains that clearly defines the presence of a bound cysteine ligand. Fluorescence titration experiments were used to demonstrate that Cj0982 binds cysteine tightly and specifically with a Kd of ∼10−7 M consistent with a role as a receptor for a high‐affinity transporter. These data imply that Cj0982 is the binding protein component of an ABC‐type cysteine transporter system and that cysteine uptake is important in the physiology of C. jejuni.
The mood spectrum: improving the diagnosis of bipolar disorder
Authors: Angst Jules , Cassano Giovanni
Published: June 2005

Although the distinction between bipolar and unipolar disorders served our field well in the early days of psychopharmacology, in clinical practice it is apparent that their phenotypes are only partially described by current diagnostic classification systems. A substantial body of evidence has accrued suggesting that clinical variability needs to be viewed in terms of a broad conceptualization of mood disorders and their common threshold or subthreshold comorbidity. The spectrum model provides a useful dimensional approach to psychopathology and is based on the assumption that early‐onset and enduring symptoms shape the adult personality and establish a vulnerability to the subsequent development of Axis‐I disorders. To obtain a clearer understanding of the depressive phenotype, it is pivotal that we increase our detection of hypomanic symptoms so that clinicians can better distinguish bipolar II disorder from unipolar depression. Diagnostic criteria sensitive to hypomanic symptoms have been identified that suggest bipolar II disorder is at least as prevalent as major depression. Moreover, the comorbidities of these illnesses are very different and alcoholism in particular appears to be a greater problem in bipolar II disorder than in unipolar depression. Structured clinical interviews and patient self‐report questionnaires have also successfully identified the presence of hypomanic symptoms in patients with unipolar disorder and support the concept of a spectrum of bipolar illness. In conclusion, the importance of subthreshold syndromes should not be underestimated as failure to recognize bipolar spectrum disorder could delay treatment and worsen prognosis.
Atypical antipsychotics: newer options for mania and maintenance therapy
Authors: Vieta Eduard , Goikolea Jose M
Published: June 2005

Atypical antipsychotics have been used to treat patients with schizophrenia for many years, but now there is increasing evidence of their utility in the treatment of bipolar disorder. In the past few years several atypical agents have received regulatory approval for use in bipolar mania. Through a review of randomized controlled trials for five commonly used atypical drugs, olanzapine, risperidone, quetiapine, ziprasidone and aripiprazole, this article evaluates their efficacy in the acute and maintenance phases of bipolar disorder. The evidence shows that atypical antipsychotics are effective in the treatment of manic symptoms, either alone or in combination with traditional mood stabilizers such as lithium and divalproex. Although emerging data indicate that atypical antipsychotics will be a promising addition to those therapies that are currently available for managing patients during the maintenance phase of bipolar illness, their potential in the long‐term management of bipolar disorder remains to be fully explored.

Atypical antipsychotics appear to have broadly similar efficacy against manic symptoms of bipolar disorder, but there are important differences in their tolerability profiles, which are likely to be of particular relevance during long‐term treatment. A brief assessment of tolerability issues surrounding the use of atypical agents in bipolar disorder and other aspects of treatment that have impact on the clinical effectiveness of the therapy are considered.
Bipolar depression: a new role for atypical antipsychotics?
Authors: Keck Paul E
Published: June 2005

Bipolar depression, the most common phase of bipolar disorder, causes significant morbidity and mortality. Traditional drugs such as lithium, lamotrigine or antidepressants each offer some clinical efficacy; however, efficacy can be limited and side effects are sometimes problematic. Thus there is a major unmet need for effective, well‐tolerated agents for the treatment of bipolar depression. The atypical antipsychotics, with their proven efficacy against manic symptoms, are emerging as candidates for use against the depressive phase of bipolar disorder. Several studies have shown that some atypicals improve depressive symptoms in mixed episodes in patients with bipolar disorder; however, few studies have been performed in patients specifically with bipolar depressive episodes. In a randomized, placebo‐controlled trial in patients with acute bipolar I depression, olanzapine monotherapy and an olanzapine‐fluoxetine combination significantly improved Montgomery‐Asberg Depression Rating Scale (MADRS) total scores compared with placebo (p < 0.001) with corresponding effect sizes (improvement of active treatment over placebo divided by pooled standard deviation) of 0.32 and 0.68, respectively. Importantly, there were no significant differences in rates of switch into mania among the three groups. Recent results from an 8‐week, randomized placebo‐controlled trial in patients with bipolar I and II disorder who were experiencing a bipolar depressive episode showed that quetiapine (300 and 600 mg/day) had significantly greater efficacy compared with placebo in improving the core symptoms of depression, including suicidal thoughts. Quetiapine significantly improved MADRS total scores compared with placebo (p < 0.001); effect sizes (improvement of quetiapine over placebo divided by pooled standard deviation) of 0.66 and 0.80 for 300 and 600 mg/day quetiapine, respectively, were observed. Both doses of quetiapine significantly improved symptoms of anxiety, sleep quality and global quality of life (all, p < 0.001 versus placebo). These initial findings suggest that atypical antipsychotics may prove to be important future treatments for patients with bipolar depression.
Evaluation of the effectiveness of sildenafil using questionnaire methods versus audio‐visual sexual stimulation
Authors: SUETOMI TAKAHIRO , ENDO FUMIYASU , TAKESHIMA HITOSHI , AKAZA HIDEYUKI
Published: June 2005

Abstract  Aim:  In the present study, an audio‐visual sexual stimulation (AVSS) test was used to evaluate the effectiveness of sildenafil, and the AVSS test was coevaluated with the international index of erectile function (IIEF) questionnaire.

Methods:  Forty‐two patients with erectile dysfunction (ED) were examined (age range, 28–73 years; mean, 51.9 ± 11.4 years). Each patient answered the IIEF questionnaire and underwent laboratory tests and the AVSS test before administration of sildenafil. The IIEF questionnaire and AVSS test (1 h after administration of 25 mg or 50 mg sildenafil) were re‐evaluated in the outpatient clinic 4 weeks later. Questions 3 and 4 of the IIEF test were used to evaluate the effectiveness of sildenafil. Sildenafil was determined to be effective if each score totalled four or five after administration.

Results:  The rate of effectiveness of sildenafil was 52.4%, and the mean score of the IIEF 5 improved from 7.2 to 15.4 following treatment with sildenafil. The maximum and mean rigidity of the penile tip improved after the sildenafil treatment (36.1%vs 57.7% and 14.2%vs 35.8%, respectively). The maximum and mean rigidity of the penile base rose (42.4%vs 57.7% and 17.9%vs 36.8, respectively). Similarly, following treatment with sildenafil, the penile tumescence increased from 6.6 cm to 7.6 cm at the penile tip and from 7.5 cm to 8.5 cm at the penile base.

Conclusions:  In some ED patients the results of the IIEF questionnaire are not always consistent with those of objective evaluation, including AVSS. In these patients, combined assessment using the IIEF and AVSS might be more useful to evaluate the precise effectiveness of sildenafil, rather than relying on the IIEF results alone.
The possibility of ‘de novo’ cancer in the prostate
Authors: YAMAMOTO SHINYA , ITO TAKAAKI , AIZAWA TAKU , MIKI MAKOTO , FURUSATO MASAKUNI
Published: June 2005

Abstract  Background:  To investigate the possibility of ‘de novo’ prostate cancer by analyzing the relationship between high grade prostatic intraepithelial neoplasia (HGPIN) and latent prostate cancer.

Materials and methods:  Latent prostate cancers found at autopsy were examined and 55 cancer foci with a poorly (Gleason grade 4 and 5) or moderately (Gleason grade 3) differentiated component were selected. The 55 foci were separated into two groups: (i) foci with either a poorly or moderately differentiated component only (single differentiation group, SDG); and (ii) mixed foci with two or more types of differentiation components (mixed differentiation group, MDG). High grade intraepithelial neoplasia was defined as positive if it was observed within 2 mm from the edge of the cancer focus and the relationship between HGPIN and the two groups was investigated.

Results:  The MDG had 39 cancer foci (71.0%) and there were 16 in the SDG (29.0%). There were 31 foci that were small‐volume cancers (<0.2 mL). In the MDG, 13 small‐volume cancer foci were HGPIN positive, but in the SDG, none of the small‐volume cancers were HGPIN positive.

Conclusions:  Small‐volume cancer foci without HGPIN in the SDG may be candidates for de novo prostate cancers.
Wound approximation with tissue glue in circumcision
Authors: OZKAN KERAMETTIN UGUR , GONEN MURAT , SAHINKANAT TAYFUN , RESIM SEFA , CELIK MUSTAFA
Published: June 2005

Abstract  Background:  To assess the feasibility of using tissue glue in the approximation of circumcision wounds in children.

Patients and methods:  A prospective randomized trial was carried out on 30 boys (age, 1–10 years) admitted to the Kahramanamaras Sutcuimam University Medical Faculty, Turkey. The results of wound approximation in circumcision with cyanoacrylate tissue glue and suturing with interrupted 5/0 plain catgut were compared. The operations were carried out by the same surgeon using an identical technique. The wounds were assessed 1 day, 3 days, 1 week and 1 month postoperatively.

Results:  There was no difference between the two groups in the rates of wound inflammation, infection, bleeding and dehiscence, although cosmetic appearance was better in the tissue glue group. The operation time was also shorter in this group.

Conclusion:  Using tissue glue for wound approximation in circumcision is a feasible alternative.
Loss of testicular volume associated with intratesticular varicocele
Authors: HO KUO‐JONG , MCATEER EAMON , YOUNG MICHAEL
Published: June 2005

Abstract  Intratesticular varicocele is a rare entity and its clinical significance is not well established. We report a case of left‐sided intratesticular varicocele associated with a significant reduction in left testicular volume at follow up. This association has not been previously reported. Incidentally, our patient is also the youngest case reported in the literature to date.
Apoptosis in prostate cancer: Bax correlation with stage
Authors: AMIRGHOFRAN ZAHRA , MONABATI AHMAD , GHOLIJANI NASSER
Published: June 2005

Abstract  Background:  Dysregulation of apoptosis may contribute to the process of prostate tumorigenesis by reducing the rate of cell death. Bcl‐2 and bax are important molecules involved in the regulation of apoptosis. The aim of the present study is to examine apoptosis and related regulatory molecular markers in a group of Iranian patients with prostate cancer.

Methods:  Paraffin‐embedded tissues from 50 patients of prostate carcinoma were examined for the expression of bcl‐2 antiapoptotic and bax proapoptotic markers and also proliferation marker, Ki‐67, by immunohistochemistry. Detection of apoptotic cells was performed using TUNEL method. Correlation between apoptotic index, proliferation index and bcl‐2 and bax expression with stage, pathological grade and Gleason score was determined.

Results:  Apoptosis was detected in 12% of prostate cancers. No correlation was observed between apoptosis and differentiation status of carcinoma. Bcl‐2 expression was detected in 21 of samples. A significant correlation between bcl‐2 expression and Ki‐67 staining index (r = 0.349, P = 0.012) was observed. High bax protein expression was shown in our study. We found a significant correlation between bax expression and stage of carcinoma (r = 0.388, P = 0.031), but not with the apoptosis index, suggesting the presence of a non‐functional bax protein or the role of other proapoptotic molecules.

Conclusion:  The patients in the present study showed a different pattern of apoptosis positivity compared to other reports. Bax expression may be a useful marker for prognosis of prostate cancer.
Synergistic effect between catechin and ciprofloxacin on chronic bacterial prostatitis rat model
Authors: LEE YONG SEOK , HAN CHANG HEE , KANG SUNG HAK , LEE SEUNG‐JU , KIM SAE WOONG , SHIN OK RAN , SIM YOUNG‐CHUL , LEE SANG‐JUN , CHO YONG‐HYUN
Published: June 2005

Abstract  Background:  Chronic bacterial prostatitis (CBP) is the most common urological disease in adult men. Antibiotic therapy is the gold standard of treatment. However, long‐term therapy resulted in many side‐effects and bacterial resistance. Because of these reasons, we need new treatment modality that could replace traditional antibiotic therapy. Catechin, an extract of green tea, has antimicrobial effect against various bacteria and synergy effect to antibiotics. We evaluate the synergistic effects of catechin on the treatment of CBP in an animal model.

Methods:  An experimental CBP model was induced in 70 male Wistar rats by instillation of 0.2 mL bacterial suspension (E‐coli Z17, O2:K1:H‐) containing 1 × 108 CFU/mL into the prostatic urethra. Microbiologically and histologically proven CBP model was demonstrated in 58.6% (41 of 70) of the rats after 4 weeks of bacterial instillation. The 41 rats demonstrating CBP were randomly divided into four groups; the control, catechin, ciprofloxacin and catechin with ciprofloxacin groups. All drug treatments were conducted over a period of 2 weeks. After treatment, the results were analyzed with microbiological cultures and histological findings of the prostate and urine samples to compare each group.

Results:  Microbiological cultures and histological findings of the prostate and urine samples demonstrated reduced bacterial growth and improved inflammatory responses in all three experimental groups compared with the control group. The catechin group showed coherent trends of decrease in bacterial growth and improvements in prostatic inflammation compared with the control group, but not to a statistically significant degree (P > 0.05). However, the ciprofloxacin and catechin with ciprofloxacin groups showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (P < 0.05). The catechin with ciprofloxacin group showed a statistically significant decrease in bacterial growth and improvements in prostatic inflammation compared with the ciprofloxacin group (P < 0.05).

Conclusions:  These results suggest that catechin may be an effective material in CBP treatment. Particularly, combination treatment of catechin and ciprofloxacin has synergistic effect. Therefore, we suggest that the combination of catechin and ciprofloxacin may be effective in treating CBP with a higher success rate.
Successful treatment of recurrent vesicourethral stricture after radical prostatectomy with holmium laser: Report of three cases
Authors: HAYASHI TETSUO , YOSHINAGA ATSUSHI , OHNO RENA , ISHII NOBUYUKI , WATANABE TORU , YAMADA TAKUMI , KIHARA KAZUNORI
Published: June 2005

Abstract  We report three cases with severe anastomotic strictures, which recurred several times after radical prostatectomy despite repeated treatments of urethral dilation, internal urethrotomy and/or transurethral resection. All three cases were finally treated with holmium laser successfully without any intraoperative or postoperative complications after repeated failures of each treatment. There were two specific characteristics in these three cases: the early onset of the stricture and the pinhole opening located on the top (12‐o’clock) of the stricture wall.
Arteriovenous malformation of the urinary bladder: Treated by transurethral resection
Authors: PARK JONG‐MIN , PARK YONG‐KOO , CHANG SUNG‐GOO
Published: June 2005

Abstract  A localized arteriovenous malformation of the bladder is extremely rare. To our knowledge, arteriovenous malformation of the bladder has been reported in limited number of cases in the published literature. When arteriovenous malformation is suspected, an angiogram and pelvic computed tomography or magnetic resonance imaging is essential to delineate the extent of the disease and to plan appropriate therapy. Common symptoms include pain, gross hematuria and acute urinary retention. No well‐established guidelines exist concerning their management. We report a case of an arteriovenous malformation of the urinary bladder that was successfully treated by transurethral resection.
Congenital scaphoid megalourethra: Report of two cases
Authors: ÖZOKUTAN BÜLENT HAYRI , KÜÇÜKAYDIN MUSTAFA , CEYLAN HALUK , GÖZÜKÜÇÜK ALI , KARACA FAHRI
Published: June 2005

Abstract  Congenital megalourethra is a rare congenital malformation of the penile urethra. It is defined as the diffuse dilatation of the anterior urethra due to the absence of development of the erectile tissue of the penis. Since the initial description, nearly 80 cases with megalourethra have been reported in English literature. Congenital megalourethra has been classified into scaphoid and fusiform types and is usually associated with additional urinary tract and other system anomalies, irrespective of its type and severity. We report two rare cases of scaphoid megalourethra without any associated anomaly.

A 13‐year‐old boy and an 8‐month‐old boy were admitted to the Department of Pediatric Surgery with complaints of penile swelling and dysuria since birth. Physical examination and retrograde cystourethrogram confirmed the diagnosis of congenital scaphoid megalourethra. Both patients underwent a reduction urethroplasty. They did well postoperatively and voided with a normal stream without any abnormality of the penile shaft.
Determination of the relative probability for prostate cancer to avoid unnecessary biopsy
Authors: OKAMURA KIKUO , TAKABA HIDENORI , KAMIHIRA OSAMU , KINUKAWA TSUNEO , ONO YOSHINARI , OHSHIMA SHINICHI , NAGASAKA TETSURO
Published: June 2005

Abstract  Background:  To investigate whether using a new concept of relative probability for prostate cancer (RPpca) can increase sensitivity and specificity in detecting prostate cancer.

Methods:  For 217 patients with total prostate‐specific antigen (PSA) level of 4–20 ng/mL, prostate volume and free to total PSA (F/T) ratio were measured. From the fitted curves between positive predictive values for prostate cancer and age, prostate volume, total PSA or the F/T ratio, each function predicting prostate cancer was determined. RPpca defined by the combined functions of age, prostate volume, total PSA and F/T ratio was calculated for each individual patient. The probability of prostate cancer was also calculated, using logistic regression analysis (LRPpca). Receiver‐operating characteristic analysis was performed to elucidate the areas under the curve (AUC), sensitivities and specificities and cutoff values of the conventional and new parameters. Finally, we investigated the applicability of the above parameters in the other patient group using a different PSA assay kit (AxSYM).

Results:  Although RPpca had the largest AUC in the total PSA range of 4–20 ng/mL, it did not reach statistical significance between RPpca and F/T ratio or LRPpca. The cutoff values of F/T ratio, LRPpca and RPpca were determined as 0.15, 0.12 and 0.20, respectively. Using these cutoff values in AxSYM data, RPpca had the highest sensitivity (91%) and specificity (57%).

Conclusions:  RPpca can provide more precise information to avoid unnecessary biopsy than LRPpca or F/T ratio. RPpca could be valuable to decide whether to perform prostate biopsy when using various PSA kits.
Efficacy and morbidity of transrectal ultrasound‐guided 12‐core biopsy for detection of prostate cancer in Japanese men
Authors: MATSUMOTO KAZUMASA , SATOH TAKEFUMI , EGAWA SHIN , SHIMURA SATORU , KUWAO SADAHITO , BABA SHIRO
Published: June 2005

Abstract  Background:  The objectives of the present study were to determine whether an extensive biopsy scheme contributes to enhanced detection of prostate cancer in Japanese men and to assess the associated pain and morbidity.

Methods:  A total of 147 patients were included in this analysis, with 12 biopsy cores being obtained from each patient. Standard systematic sextant biopsy at the apex, mid‐prostate and base of the prostate gland was carried out under local anesthesia and this was followed by the acquisition of additional sextant cores at the same levels from the far lateral peripheral zone. Each patient answered a self‐administered questionnaire on pain and morbidity during the 5 days following biopsy.

Results:  Overall, 39 patients (26.5%) received a diagnosis of prostate cancer. Nine patients (23.1%) were positive only at the standard sextant sites, three patients (7.7%) were positive exclusively at the far lateral sites and the remaining 27 patients (69.2%) were positive at both sites. Cancer was found most frequently in cores obtained from the apex (P = 0.009), with this trend being more evident in patients with abnormal rectal findings, positive sonographic findings, gland volume < 40 cm3 and prostate‐specific antigen density > 0.15 ng/mL/cm3 (P < 0.03). These findings were also true for those with a prostate‐specific antigen range from 4.1 to 20.0 ng/mL. A gradual decrease in incidence and grade of pain, hematuria and rectal bleeding was observed during the first 5 days after biopsy (P < 0.0001).

Conclusions:  Using this 12‐core biopsy scheme, we found cancer most frequently in cores taken at the level of the apex. While the extensive procedure only marginally enhanced overall detection of prostate cancer, it was well tolerated with gradually decreasing pain and morbidity over a brief postbiopsy period. Further efforts to optimize biopsy schemes are warranted.
Antiplatelet therapy and spontaneous perirenal hematoma
Authors: YAMAMOTO KEISUKE , YASUNAGA YUTAKA
Published: June 2005

Abstract  This case report clarifies an adverse reaction of antiplatelet therapy which has been a standard prophylactic method for patients harboring significant risks of thromboembolic events. A 71‐year‐old Japanese man who had been taking aspirin tablets (81 mg) for a year presented with sudden colic pain in the left flank region. An abdominal computed tomography scan revealed a significant perirenal hematoma of the left kidney. There were no pathological kidney conditions, such as renal tumors, calculi or vascular diseases, found by magnetic resonance imaging examination. After cessation of aspirin administration followed by conservative management, the hematoma completely disappeared 6 months later. This is the first documented case of spontaneous perirenal hematoma secondary to low‐dose aspirin treatment. While such unpleasant events occur extraordinarily, this should be noted as a severe risk of antiplatelet therapy.
Renal cell carcinoma with solitary toe metastasis
Authors: PERDONÀ SISTO , AUTORINO RICCARDO , GALLO LUIGI , DE SIO MARCO , MARRA LUIGI , CLAUDIO LUIGI , CARACÒ CORRADO , FRANCO RENATO , FAZZIOLI FLAVIO , GALLO ANTONIO
Published: June 2005

Abstract  Solitary metastases to the small bones and/or to the soft tissue of the hands and feet (acrometastases) are rare. We report a case of renal cell carcinoma (RCC) with big toe metastasis revealed before the primary tumor became apparent. The best treatment for a single metastasis is always surgical excision, regardless of the lesion being synchronous or metachronous. The biological behavior of metastatic RCC is unpredictable and only early diagnosis and treatment may favorably affect patient survival. Thus, metastatic RCC should be included in the differential diagnosis of all enlarging cutaneous nodules, wherever they develop.
Colonic adenocarcinoma and stones in an Indiana pouch
Authors: KOMAI YOSHIHIRO , KAWAKITA MUTSUSHI , SHIMADA OSAMU , MUGURUMA KOUEI , SAKAIDA NORIKO , MATSUDA TADASHI
Published: June 2005

Abstract  We report on a 63‐year‐old woman with adenocarcinoma and stones in an Indiana pouch. Adenocarcinoma of an Indiana pouch is extremely rare. To our knowledge, only four cases with adenocarcinoma in an Indiana pouch have been reported.
Spontaneous recovery from renal infarction resulting from renal artery dissection
Authors: ANDO TADASUKE , OHNO HITOSHI , HIRATA YUJI , EMOTO AKIO , OGATA SYUNICHI , MIMATA HIROMITSU
Published: June 2005

Abstract  A 31‐year‐old, previously normotensive healthy man developed right flank pain and was admitted to a medical service. Right renal infarction was suspected by enhanced abdominal computed tomography (CT) and arteriography. Fourteen days after the onset, he was transferred to the Oita University Hospital, Oita, Japan. Renal angiography revealed an isolated renal artery dissection causing renal atrophy due to main stem narrowing of the right renal artery. Renogram and renal scintigram with 99mTc‐diethylene triamine pentaacetic acid revealed a remarkable decline in the glomerular filtration rate and almost no uptake in the right kidney. Four months later, in spite of our belief that functional recovery could not be expected, intravenous pyelography and enhanced abdominal CT scans revealed a functioning right kidney that had spontaneously recovered from the renal artery dissection through conservative management.
Evaluation of the role of varicocelectomy including external spermatic vein ligation in patients with scrotal pain
Authors: KARADEMIR KENAN , ŞENKUL TEMUÇIN , BAYKAL KADIR , ATEŞ FERHAT , IŞERI CÜNEYD , ERDEN DOĞAN
Published: June 2005

Abstract  Objectives: The aim of the present study was to assess and compare pre‐ and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches.

Methods: The study included 144 consecutive patients with left‐sided varicocele who had left scrotal pain for more than 3 months. All patients underwent varicocele ligation using either a subinguinal or inguinal approach with or without external spermatic vein ligation. We asked the patients to complete an ‘Assesment Questionnaire for Scrotal Pain’ both before and after the surgery.

Results: The surgery was successful in 101 (83.4%) of the 121 patients available for follow up. Seventy‐four (61.1%) patients reported the complete resolution of pain while 27 patients (22.3%) reported partial resolution. Symptoms worsened in a single case and pain persisted postoperatively in 19 cases (15.7%). There were no statistically significant differences in the characteristics of the pain and grade of varicocele between postoperative groups. A significant difference was observed in postoperative success between patients who had external spermatic vein ligation and those who did not, regardless of the surgical approach (inguinal or subinguinal). All patients who reported complete or partial resolution of pain stated that they would recommend surgery to relatives with the same problem.

Conclusions: Varicocelectomy using either inguinal or subinguinal approaches is an effective and reasonable treatment option in this patient group and should include external spermatic vein ligation for a satisfactory outcome.
Long‐term safety, tolerability and efficacy of extended‐release tolterodine in the treatment of overactive bladder in Japanese patients
Authors: TAKEI MINEO , HOMMA YUKIO ,   THE JAPANESE TOLTERODINE STUDY GROUP
Published: June 2005

Abstract  Aim: To evaluate the long‐term safety, tolerability and efficacy of extended‐release (ER) tolterodine in Japanese patients completing 12‐week treatment in a randomized, double‐blind trial comparing tolterodine ER 4 mg once daily, oxybutynin 3 mg three times daily or placebo in patients with overactive bladder.

Methods: Of 293 Japanese patients completing the 12‐week study, 188 continued in the open‐label trial and received tolterodine ER 4 mg once daily for 12 months, irrespective of previous treatment. The primary objective was to assess the safety of tolterodine ER for up to 52 weeks of treatment and at post‐treatment follow‐up. Secondary endpoints included changes in micturition diary variables, patient perception of bladder condition and urgency and treatment benefit.

Results: Overall, 77% of patients completed 12 months of open‐label treatment. Tolterodine ER was well tolerated and the most common adverse event was dry mouth (33.5%). In general, there was no increase in adverse event frequency with long‐term treatment compared with short‐term treatment. The efficacy of tolterodine ER was maintained over the 12‐month period. The complete analysis showed a median reduction in incontinence  episodes/week (−92.9%; mean  reduction, −77.2%), a mean reduction in micturitions/24 h (−21.3%) and a mean increase in volume voided per micturition (19.6%). Of patients completing the 12‐month study, 78.6% reported improvement in patient perception of bladder condition, 52.4% reported improvement in perception of urgency and 89.7% reported treatment benefit.

Conclusions: Favorable safety, tolerability and efficacy of once‐daily tolterodine ER was maintained over 12 months in a Japanese overactive bladder patient population.
Granulomatous prostatitis – an infrequent diagnosis
Authors: MOHAN HARSH , BAL AMANJIT , PUNIA RAJ PAL SINGH , BAWA AMARPREET SINGH
Published: June 2005

Abstract  Background: Granulomatous prostatitis is an unusual benign inflammatory process of the prostate. Clinically, it mimics prostatic carcinoma, thus requiring pathological examination for diagnosis.

Materials and methods: Histopathological records of 1353 prostate specimens received in the Department of Pathology, Government Medical College, Chandigarh, India, over a period of 8 years (1995–2002) were reviewed and 20 cases of granulomatous prostatitis were retrieved.

Results: Out of 20 cases of granulomatous prostatitis, we encountered 12 cases of non‐specific granulomatous prostatitis, two cases of xanthogranulomatous prostatitis, two cases of tuberculous prostatitis, two cases of malakoplakia prostate and one case each of granulomatous prostatitis associated with adenocarcinoma prostate and post‐surgical palisading granuloma. The diagnosis was made by histopathological examination of Trucut biopsy, transuretheral resection of prostate chips or retropubic prostatectomy specimen. In all the cases, granulomatous prostatitis was an incidental finding.

Conclusions: Non‐specific granulomatous prostatitis is the most common type of granulomatous prostatitis. Despite tuberculosis being very common in India, granulomatous prostatitis associated with tuberculosis is not common. Distinction between non‐specific and infectious granulomatous prostatitis is important for therapeutic reasons.
The prevalence of penoscrotal abnormalities and inguinal hernia in elementary‐school boys in the west of Iran
Authors: YEGANE ROOH‐ALLAH , KHEIROLLAHI ABDOL‐REZA , BASHASHATI MOHAMMAD , REZAEI NIMA , TARRAHI MOHAMMAD‐JAVAD , KHOSHDEL JAMAL‐ALDIN
Published: June 2005

Abstract  Aim: We designed a cross‐sectional study in order to determine the prevalence of inguinal hernia and penoscrotal abnormalities in the Lorestan province, situated in the west of Iran.

Methods: We studied 3205 elementary‐school boys, aged 6–12 years, who underwent clinical examinations of the groin and genitalia in 2002.

Results: Abnormalities were detected in 213 children (6.64%). The most frequent anomaly was indirect inguinal hernia, seen in 78 children (2.4%). The other abnormalities were retractile testes in 39 boys (1.22%), undescended testes in 36 boys (1.12%), hydrocele in 28 boys (0.87%) and hypospadiasis in 25 boys (0.78%). Also, three children had micropenises, two had epispadiasis and another two boys had varicoceles. Ambiguous genitalia and apenia were not seen in the present series. Most of the parents were not aware of their children's anomalies (60.1%).

Conclusions: Education of the public and medical staff about these abnormalities and screening system are needed to improve the outcome.
Intestinal‐type mucinous adenocarcinoma arising from the prostatic duct
Authors: SAKAMOTO NAOTAKA , OHTSUBO SATOSHI , IGUCHI ATSUSHI , TAKESHITA MORISHIGE , KUROZUMI TAKESHI
Published: June 2005

Abstract  We present a case of mucinous adenocarcinoma of intestinal type arising from the prostatic duct in a 72‐year‐old Japanese man. The patient presented with macroscopic hematuria. Cystourethroscopy exibited a mucus deposit at the 5 o’clock position of the verumontanum portion. A transurethral biopsy specimen revealed mucinous adenocarcinoma. A radical retropubic prostatectomy was performed. In the prostatectomy specimen, the cancer lesion mainly showed intraductal growth in the prostatic ducts with scattered mucin lakes in the prostatic stroma. There were no abnormalities in the urethral epithelium. The cancer cells resembled the intestinal epithelium rather than either the prostatic duct or the acinar epithelium, which showed diffusely positive immunohistochemical staining for carcinoembryonic antigen, but showed negative staining for prostate‐specific antigen. Therefore, these findings suggest mucinous adenocarcinoma of intestinal type arising from the prostatic duct. A number of cases with mucinous adenocarcinoma arising from the prostatic urethra resembling the present case have been reported, but this is the first known case of carcinoma arising from the prostatic duct.