bluuebunny/crossref_metadata_2025 huggingface dataset:
An Evolutionary Perspective on Risk Taking in Tourism
Authors: Kim Jungkeun , Seo Yuri
Published: October 2018

Informed by recent developments in the field of evolutionary psychology, we elicit novel insights about the causal relationship between the activation of mating motives and gender-specific preferences for risk taking in tourism. In this endeavor, across four experimental studies, we illustrate that the effect of activating mating motives on the propensity for risk-taking tourism will be greater for men than it is for women. That is, when mating motives were salient, men consistently displayed a greater preference for the choice of high-risk travel activities (studies 1A and 1B), adventurous destination choices (study 2), and adventurous appeals in travel advertising (study 3). Our findings offer important theoretical contributions to research into the role of gender in risk-taking tourism behaviors from the perspectives both of evolution-based theorizing and managerial implications for tourism practice.
A Review on Functional Analyses of Tics
Authors: Goldman Kissel J. , DeLeon Iser G.
Published: October 2018

Tic disorders are characterized by a class of responses assumed to be neurobiological in origin. Still, several studies have shown that tic frequency can be influenced by antecedent environmental events and social consequences. Prior reviews have summarized the effects of environmental events but have not examined relations between tic diagnosis, behavioral deficits (e.g., intellectual disability), tic topography, and the consequences observed to maintain tics. These variables might be important when attempting to predict or identify relevant consequences. A more thorough understanding of the variables that maintain and give rise to tics might also be useful in predicting responsiveness to treatment and intervention refinement. We reviewed and summarized results from the 13 attempts to experimentally identify maintaining consequences for tics (i.e., functional analyses) that have been published to date. We examined patterns of functions across tic diagnoses (i.e., Tourette’s syndrome or not), communication impairments (i.e., an intellectual disability or reported language difficulty), and tic topography. Results suggested that individuals with Tourette’s syndrome and those without communication impairments are more likely to have functional analysis outcomes consistent with automatic reinforcement, but exceptions in both directions highlight the utility of functional analysis in treating tics.
Creativity and Innovation Under Constraints: A Cross-Disciplinary Integrative Review
Authors: Acar Oguz A. , Tarakci Murat , van Knippenberg Daan
Published: October 2018

Generating creative ideas and turning them into innovations is key for competitive advantage. However, endeavors toward creativity and innovation are bounded by constraints such as rules and regulations, deadlines, and scarce resources. The effect of constraints on creativity and innovation has attracted substantial interest across the fields of strategic management, entrepreneurship, industrial organization, technology and operations management, organizational behavior, and marketing. Research in these fields has focused on various constraints that trigger distinct mediating mechanisms but is fragmented and yields conflicting findings. We develop a taxonomy of constraints and mediating mechanisms and provide an integrative synthesis that explains how constraints affect creativity and innovation. Our review thus facilitates cross-disciplinary learning and sets the stage for further theoretical development.
Stepfamily Closeness and Depression Among American Indian Emerging Adults: A Structural Equation Modeling Approach
Authors: Ward Kaitlin P. , Limb Gordon E. , Higbee Sarah , Haueter Helena
Published: October 2018

Stepfamilies are one of the fastest growing family structures among all racial groups in the United States. Stepfamily research among many racial groups, specifically American Indians, is virtually nonexistent. This is unfortunate, as American Indians are more likely to divorce and remarry compared with other populations. From a family systems perspective, this study examined whether retrospectively perceived closeness in three stepfamily relationships, namely child–residential biological parent, child–residential stepparent, and child–stepsibling, were negatively associated with depression scores in 226 American Indian emerging adults. A structural equation model showed that increased child–residential biological parent and child–stepsibling closeness predicted decreased depression scores, whereas child–residential stepparent closeness did not. We also found that depression scores significantly predicted retrospective perceptions of child–residential biological parent, child–residential stepparent, and child–stepsibling closeness. Findings encourage interventions that strengthen American Indian child–residential biological parent and child–stepsibling relationships, and underscore the need for further research that explores American Indian stepfamily relationships.
Pathological Features of Corneal Phospholipidosis in Juvenile White Rabbits Induced by Ocular Instillation of Chloroquine or Amiodarone
Authors: Yamagiwa Yoshinori , Takei Yoshihiro , Koizumi Haruko , Nemoto Shingo , Kurata Masaaki , Satoh Hiroshi
Published: October 2018

Cationic amphiphilic drugs (CADs) can induce phospholipidosis (PLD) in organs/tissues. Several ophthalmic pharmaceuticals containing CADs are marketed and used in children. To investigate the effect of PLD on the developing cornea, chloroquine and amiodarone, which are representative CADs, were applied topically to the eyes of juvenile rabbits, and the effects in juvenile rabbits were compared with those in young adult rabbits. Diffuse corneal cloudiness was observed in chloroquine- and amiodarone-treated eyes. Histopathologically, vacuolation was observed in the corneal epithelium and keratocytes. On ultrastructural examination, these vacuoles contained multilamellar inclusion bodies, which are a characteristic of PLD. The size of the vacuoles in the corneal epithelium was reduced in juveniles compared with young adults. Cytoplasmic lamellar bodies and exocytosis in the corneal endothelium were observed in young adult rabbits but not in juvenile rabbits. This study revealed that topical application of chloroquine or amiodarone induces corneal PLD in juvenile and young adult rabbits. Corneal endothelial changes occurred only in young adult rabbits, but ophthalmological changes were similar between juveniles and young adults. The results of the study suggest that the effects of corneal PLD were similar among age groups based on risk assessment.
Impact of Publicly Financed Health Insurance Scheme (Rashtriya Swasthya Bima Yojana) from Equity and Efficiency Perspectives
Authors: Sinha Rajesh Kumar
Published: October 2018

Executive Summary

Catastrophic health expenses result in impoverishment of a large number of people every year in India. This often forces the resource-poor households to forego treatment due to lack of affordability. Providing quality health care to all at an affordable cost is a policy commitment for India as it is a signatory of the Alma Ata Declaration. The Government of India is working towards providing universal health coverage through its National Health Policy. As part of universalization of health care, the government had launched a publicly financed health insurance scheme, Rashtriya Swasthya Bima Yojana (RSBY), to provide affordable and quality health services. The present study dealt with understanding the impact of the scheme for improving health care-seeking and reducing burden of health expenditure among resource-poor families through a matched controlled cross-sectional study. The study tried to assess whether RSBY had improved care-seeking and reduced incidences of catastrophic health expenditure (CHE) and health expenditure-induced poverty among the insured population and also tried to explore whether the benefits were equitable. It was conducted in purposively selected two blocks of Ranchi district in Jharkhand with 1,643 households below poverty line (BPL). Both enrolled and non-enrolled households were selected randomly for the study after matching with some key matching criteria. It was found that RSBY neither increased in-facility treatment (hospitalization) nor reduced the likelihood of CHE among the enrolled households. More importantly, it significantly increased the incidence of health expenditure-induced poverty among the households who were above the poverty line before incurring any health expenditure. From equity perspective, care-seeking was much lower among the economically weaker households compared to the better-off households. Similarly, incidences of CHE and health expenditure-induced poverty were also found to be higher among the weaker sections. The study shows that RSBY did not achieve its objective of improving care-seeking and providing financial security to the enrolled households, and more importantly to the economically weaker sections of the society. Other studies have also found that one of the factors for high out-of-pocket expenditure in health is a weak public health delivery system which forces people to seek care from private providers. Hence, it is important for the policymakers to critically evaluate whether such insurance models will actually ensure better financial security for the households from excessive health expenditure and whether strengthening the existing public health delivery system would be a better option.
Review: Matthew Watson, The Market
Authors: Davies William
Published: October 2018

Matthew Watson’s The Market provides a fascinating and rigorous history of how economists have conceived of markets, gradually eliminating historical, social, political and ethical context from their analysis over more than two centuries. This review notes that the book provides a nuanced genealogy, which stresses many of the contingencies and mutations through which the vocabulary of economics has been formed. But it also notes some unanswered questions raised by the book, concerning the contribution that economic reductionism has made to the rise of the market as an ideological trope of contemporary politics.
Attuning to laboratory animals and telling stories: Learning animal geography research skills from animal technologists
Authors: Greenhough Beth , Roe Emma
Published: October 2018

Posthumanism has challenged the social sciences and humanities to rethink anthopocentricism within the cultures and societies they study and to take account of more-than-human agencies and perspectives. This poses key methodological challenges, including a tendency for animal geographies to focus very much on the human side of human–animal relations and to fail to acknowledge animals as embodied, lively, articulate political subjects. In this paper, we draw on recent ethnographic work, observing and participating in the care of research animals and interviewing the animal technologists, to contribute to the understandings of life within the animal house. In so doing, the paper makes three key arguments. Firstly, that studying how animal technologists perform everyday care and make sense of their relationships with animals offers useful insights into the specific skills, expertise and relationships required in order to study human–animal relations. Secondly, that animal technologists are keenly aware of the contested moralities which emerge in animal research environments and can offer an important position from which to understand this. Thirdly, that storytelling (exemplified by the stories told by animal technologists) is a useful resource for animal geographers to engage with complexity in human–animal relations.
Extracellular histones indicate the prognosis in patients undergoing extracorporeal membrane oxygenation therapy
Authors: Wen Zongmei , Jin Yang , Jiang Xuemei , Sun Meng , Arman Nazzarena , Wen Tao , Lv Xin
Published: October 2018

Introduction:

Extracellular histones have been recently identified as damage-associated molecular-pattern (DAMP) molecules involved with the pathogenesis of various inflammatory diseases. This study intended to investigate whether extracellular histones can indicate the prognosis in critically ill patients supported by extracorporeal membrane oxygenation (ECMO) therapy.

Methods:

A total of 56 patients undergoing ECMO were analysed retrospectively. Median concentrations of extracellular histones in patients before ECMO were assessed and used to divide the patients into two groups (Group 1 <48 µg/ml and Group 2 ⩾48 µg/ml). Mortality rate, Sequential Organ Failure Assessment (SOFA) scores and systemic inflammation were compared between the groups.

Results:

There were relatively higher concentrations of extracellular histones in Group 2 patients (57.78 µg/ml [48.4, 71.3]) than in Group 1 patients (36.76 µg/ml [28.5, 39.3], p<0.0001). The hospital mortality rate was 55.4% for the entire study subjects, with significantly worsened mortality in Group 2 in contrast to Group 1 (58.8% vs. 50%, p=0.031). Moreover, Group 2 patients had significantly higher SOFA scores and more pronounced systemic inflammation than Group 1 patients prior to ECMO initialization.

Conclusions:

Extracellular histones are known contributors to cell damage and organ injury. Our study showed that extracellular histones have a predictive value in the assessment of outcome of patients undergoing ECMO therapy and may be helpful for risk stratification in clinical settings.
The effect of theta-burst stimulation on unilateral spatial neglect following stroke: a systematic review
Authors: Cotoi Andreea , Mirkowski Magdalena , Iruthayarajah Jerome , Anderson Rachel , Teasell Robert
Published: October 2018

Objective:

To evaluate the effectiveness of theta-burst stimulation for the treatment of stroke-induced unilateral spatial neglect.

Data sources:

A systematic literature search was conducted from the inception of each database to 30 June 2018 using CINAHL, EMBASE, PubMed, PsycINFO, and Scopus.

Review methods:

Articles were included if theta-burst stimulation was used to treat neglect following a stroke. The additional a priori inclusion criteria were as follows: (1) ⩾3 adult (⩾18 years) participants, (2) ⩾50% stroke population, and (3) peer-reviewed journal articles published in English. Extracted data included study and treatment characteristics, results, and adverse events.

Results:

Nine studies met the inclusion criteria, generating a total of 148 participants. Eight studies evaluated a continuous stimulation protocol and one study investigated an intermittent stimulation protocol. Overall, both protocols significantly improved neglect severity when compared against placebo or active controls ( P < 0.05). Adding smooth pursuit training to theta-burst stimulation did not improve neglect relative to when the stimulation was delivered alone ( P > 0.05). There was inconsistent reporting of neglect terminology, outcome measures, and adverse events. The treatment characteristics were heterogeneous among the trials.

Conclusion:

This systematic review found that theta-burst stimulation seems to improve post-stroke unilateral spatial neglect, but because the evidence is limited to a few small studies with varied and inconsistent protocols and use of terminology, no firm conclusion on effectiveness can be drawn.
What factors affect clinical decision-making about access to stroke rehabilitation? A systematic review
Authors: Longley Verity , Peters Sarah , Swarbrick Caroline , Bowen Audrey
Published: October 2018

Objectives:

To determine the factors affecting clinical decision-making about which patients should receive stroke rehabilitation.

Methods:

Data sources (MEDLINE, CINAHL, AMED and PsycINFO) were searched systematically from database inception to August 2018. Full-text English-language studies of data from stroke clinicians were included. Studies of patients were excluded. The included studies were any design focussed on clinical decision-making for referral or admission into stroke rehabilitation. Summary factors were compiled from each included study. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.

Results:

After removing duplicates, 1915 papers were identified, of which 13 met the inclusion criteria. Eight included studies were qualitative and one used mixed methods. A total of 292 clinicians were included in the studies. Quality of the included studies was mixed. Patient-level and organizational factors as well as characteristics of individual clinicians contributed to decisions about rehabilitation. The most often described factors were patients’ pre- and poststroke function ( n = 6 studies), presence of dementia ( n = 6), patients’ social/family support ( n = 6), organizational service pressures ( n = 7) and the decision-making clinician’s own knowledge ( n = 5) and emotions ( n = 5).

Conclusion:

The results highlight a lack of clinical guidance to aid decision-making and reveal that a subjective approach to rehabilitation decision-making influenced by patient-level and organizational factors alongside clinicians’ characteristics occurs across services and countries.
An economic evaluation of the SUNBEAM programme: a falls-prevention randomized controlled trial in residential aged care
Authors: Hewitt Jennifer , Saing Sopany , Goodall Stephen , Henwood Timothy , Clemson Lindy , Refshauge Kathryn
Published: October 2018

Objective:

To estimate the cost-effectiveness of a strength and balance exercise programme (SUNBEAM) which has been shown to be clinically effective in reducing the rate of falls in residents of aged care facilities.

Design:

An economic evaluation was conducted alongside a pragmatic cluster randomized controlled trial that included 16 residential care facilities and 221 participants. Mean participant age was 86 years, 65% were female and 78% relied on a mobility aide. A cost-effectiveness analysis examined the costs of providing the exercise programme and costs of health service use arising from falls in each arm (intervention and usual care) over 12 months.

Main measures:

Incremental cost-effectiveness ratios were calculated for the cost per fall avoided. Costs were bootstrapped to obtain adjusted confidence intervals for the incremental cost-effectiveness ratios.

Results:

Of 63 facilities contacted, 16 met the eligibility criteria and were randomized to the intervention or usual care (1:1). There were 142 falls in the intervention group and 277 in the usual care group. 72 injurious falls occurred in the intervention group versus 157 with usual care. Delivery of the SUNBEAM programme cost $463 per participant. The mean total cost of each fall (regardless of group) was $400.09 and the mean cost of each injurious fall was $708.27. The incremental cost-effectiveness ratio was $22 per fall per person avoided with the mean bootstrapped incremental cost-effectiveness ratio $18 per fall avoided (95% CI: −$380.34 to $417.85).

Conclusion:

The SUNBEAM programme can be considered cost-effective, relative to other fall-prevention interventions in older adults.
Molecular switching from ubiquitin-proteasome to autophagy pathways in mice stroke model
Authors: Liu Xia , Yamashita Toru , Shang Jingwei , Shi Xiaowen , Morihara Ryuta , Huang Yong , Sato Kota , Takemoto Mami , Hishikawa Nozomi , Ohta Yasuyuki , Abe Koji
Published: October 2018

The ubiquitin-proteasome system (UPS) and autophagy are two major pathways to degrade misfolded proteins that accumulate under pathological conditions. When UPS is overloaded, the degeneration pathway may switch to autophagy to remove excessive misfolded proteins. However, it is still unclear whether and how this switch occurs during cerebral ischemia. In the present study, transient middle cerebral artery occlusion (tMCAO) resulted in accelerated ubiquitin-positive protein aggregation from 0.5 h of reperfusion in mice brain after 10, 30 or 60 min of tMCAO. In contrast, significant reduction of p62 and induction of LC3-II were observed, peaking at 24 h of reperfusion after 30 and 60 min tMCAO. Western blot analyses showed an increase of BAG3 and HDAC6 at 1 or 24 h of reperfusion that was dependent on the ischemic period. In contract, BAG1 decreased at 24 h of reperfusion after 10, 30 or 60 min of tMCAO after double immunofluorescent colocalization of ubiquitin, HSP70, p62 and BAG3. These data suggest that a switch from UPS to autophagy occurred between 10 and 30 min of cerebral ischemia depending on the BAG1/BAG3 ratio and level of HDAC6.
Outcome of School-Based Intervention Program in Promoting Personal Hygiene in Primary School Children of Mumbai, India
Authors: Taware Sachin , Gawai Priyanka , Chatterjee Ameeta , Thakur Harshad
Published: October 2018

Personal hygiene plays an important role in preventing communicable diseases especially in children. In developing countries like India, the burden of communicable diseases is high which makes an awareness program imperative in school children. The objective was to study the outcome of school-based intervention program in promoting personal hygiene among the primary school children of Mumbai and Thane. This is a comparative study carried out from July 2015 to March 2016 between intervention and nonintervention groups before and after intervention. Using random sampling, 119 schools in Mumbai and 24 schools in Thane were selected. Our results suggest that knowledge, attitude, and practices were significantly different in end-line than baseline in the intervention group and had better effects as reflected in scores compared with comparison group. The findings reveal that a health education program clubbed with entertainment and interaction can bring positive attitudinal shift which is otherwise difficult to change.
Transcatheter cardiac interventions in neonates with congenital heart disease: A single centre experience
Authors: Melekoglu Asli Nuriye , Baspinar Osman
Published: October 2018

Objective

Percutaneous cardiac catheterization has been used as a diagnostic tool and as a therapeutic option in neonates with congenital heart disease (CHD). This study aimed to evaluate the procedural and short-term follow-up data of newborns who underwent cardiac catheterization procedures.

Methods

This retrospective study reviewed demographic, diagnostic and clinical data from the medical records of newborns who underwent percutaneous transcatheter interventions to treat CHD.

Results

Forty-six newborns were included in the study. The median gestational week and weight were 35.0 weeks and 2723 g, respectively. The median time to the procedure was 7.6 days. Aortic and pulmonary balloon valvuloplasty, ductal stenting, atrial balloon/blade septostomy and coronary fistula embolization procedures were used. The overall success rate was 73.9% (34 of 46 patients) with a complication rate of 28.3% (13 of 46 patients). Eleven patients (23.9%) underwent reinterventions after initial catheterization. Five patients (10.9%) died in the first 48 h after their procedures.

Conclusions

Interventional cardiological procedures applied during the neonatal period provide alternative life-saving methods to surgery, especially in developing countries where surgical outcomes are poor and newborn mortality rates are high.
Evaluating the Effectiveness of Public–Private Partnerships in Highway Development: The Case of Virginia
Authors: Wang Yin , Zhao Zhirong Jerry
Published: October 2018

Given the current momentum for public–private partnerships (PPPs), it is critical to review the experiences of PPP highway projects to see whether they succeed in serving public benefits. This article applies a goal-centered approach to evaluate the effectiveness of nine PPP highway projects in the Commonwealth of Virginia, U.S.A., that were implemented and opened to traffic between 1990 and 2016. Virginia has used highway PPPs more for financing or risk reduction than for efficiency gains. The authors examine four elements of contract agreements—PPP type, private partner selection, financial arrangements, and risk allocation—in these Virginian projects, and find that these arrangements have been effective in accessing innovative finance and preventing cost overrun, while the evidence is limited regarding shifting revenue risk or achieving efficiency gains.
Metastatic primary urothelial carcinoma of the prostatic urethra: A case report
Authors: Kisa Erdem , Semiz Hüseyin Salih , Küçük Ülkü , İlbey Yusuf Özlem
Published: October 2018

Introduction:

Primary carcinomas of the urethra differ by location and histologic subtype. Primary urethral cancer of the proximal urethra is rare and aggressive tumor with a high propensity for regional and distant metastases.

Case description:

In this case report, we present primary urothelial carcinoma of the prostatic urethra, diagnosed by transrectal ultrasound-guided biopsy of the prostate and having multiple metastases at the time of diagnosis. Metastatic patients were initiated chemotherapy according to the histological type of urethral cancer.

Conclusion:

Urothelial carcinomas of the urethra are rarely seen, and therefore there is no standard treatment regimen for early-stage or metastatic disease. Gemcitabine-, platinum-, and taxane-based treatments are used in the metastatic stage.
Massive Hematuria Caused by a Bleeding Intrarenal Varix Diagnosed by Selective Renal Angiography
Authors: Garti Izchak , Meiraz David
Published: October 2018

A case of massive painless hematuria caused by a bleeding intraparenchymal renal varix, as demonstrated by selective renal angiography, is presented. The literature is briefly discussed. It is the first case described in the literature.
Bladder Wall Histology and Duration of Obstruction
Authors: Simeone C. , Guerini A. , Zambolin T. , De Luca V. , Frego E. , Da Pozzo G.P. , Magri V. , Cunico S. Cosciani
Published: October 2018

In BPH patients, obstruction leads to a progressive modification in the structure of the bladder wall, with histo-pathological changes which are often irreversible. In order to detect these changes and their possible correlation with function, muscle biopsies of the bladder were taken from 28 patients during endoscopic resection for benign prostatic hyperplasia. The samples were examined by means of electron microscope to show ultrastructural charges. The magnitude of the lesions can be correlated to function, seriousness and duration of the obstruction. Detecting histo-pathological damage can justify earlier treatment in obstructed BPH patients, in order to avoid those bladder lesions, which are the probable cause of clinical disorders which may persist even after therapy of the adenoma.
Urethral Stenosis following Transurethral Resection
Authors: Graziotti P.P. , Piccinelli A. , Faggiano L , Scanzi M. , Calabrò A.
Published: October 2018

The authors report the results of a multicentric prospective study on risk factors related to post-TURP stenosis. 47 different parameters were considered and 21 urethral stenoses (9% of 234 patients) are reported. Meatal stenoses are included, but were not considered for statistical correlation with other sites. Final data, statistically examined, show that electrotomes (Martin/Danieli), urethral lubricant and rubber catheters, singly or jointly, are possibly related to post-TURP urethral stenosis.
Comparison of Patients with Symptomatic and Occasional Renal Neoplasms: Review of Case Histories
Authors: Invernizzi S. , Pozza D. , Cappoli S. , Locatelli G. , Baradel G. , Longo G.
Published: October 2018

A review of case histories from 1988 to 1990 shows an increase in the incidence of renal neoplasms compared to previous years. Analysing the symptomatology and signs that led to diagnosis of a renal tumor in 105 patients, the classical triad (hematuria, pain, swelling) was less evident while “accidental” discovery was clearly more frequent. Taking the paraneoplastic, clinical and laboratory signs into consideration, a significant incidence of anemia, high sedimentation rate and a change in the immunoglobulin (in 30% of cases) emerged, without specificity of monoclonal peaks.
Primary Classic Kaposi's Sarcoma Limited to the Glans Penis (Not Associated with Acquired Immunodeficiency Syndrome)
Authors: Guy M. , Singer D. , Arieli Y. , Eisenkfraft S.
Published: October 2018

We report two cases of primary Kaposi's sarcoma limited to the glans penis. In circumcised men the basic lesion appears as a reddish-violet nodule. The patients denied homosexuality, drug abuse or blood transfusion. Excision of the lesion with wide margins and radiotherapy was adequate therapy. Serological investigations for HIV were all negative. At two years and one year after operation the patients are well with normal serology.
Effect of Percutaneous Transluminal Renal Angioplasty on Absolute Split Renal Function in Patients with Renovascular Hypertension. Influence of Age and Other Parameters
Authors: Takeda M. , Katayama Y. , Saito K. , Tsutsui T. , Komeyama T. , Mizusawa T. , Sato S. , Kimura M. , Odano I.
Published: October 2018

Tc99m-dimercaptosuccinic acid renal uptake (DMSA uptake) was examined to assess the changes in split renal function following percutaneous transluminal renal angioplasty (PTRA) in 9 patients with a total of 12 renal artery stenoses and renovascular hypertension (RVH). The results were studied with respect to age, degree of renal artery stenosis, and renal vein renin ratio (RVRR) before PTRA. Although the degree of renal artery stenosis, systolic blood pressure, and peripheral blood plasma renin activity were improved 3 months after PTRA, neither the DMSA uptake of the affected kidneys nor that of the contralateral kidneys improved. Although restenosis occurred during the long follow-up period in one patient, DMSA uptake did not change in parallel with the degree of stenosis or RVRR. The degree of improvement in DMSA uptake, blood pressure, and plasma renin activity after PTRA in patients aged under 70 years was significantly higher than that in patients 70 years or older. Good improvement of renal function was attained in a 4-year-old boy, despite the fact that split renal function prior to PTRA was so poor that nephrectomy had been considered instead of PTRA. These results suggest that several factors before PTRA, such as DMSA uptake, degree of renal artery stenosis, and RVRR, are not absolutely predictive of results after PTRA, and that the effect of PTRA on blood pressure and renal function is greater in younger patients.
Vesico-Urethral Electrical Stimulation with Surgically Implanted Devices
Authors: Simeone C. , Zanotelli T. , Cosciani-Cunico S.
Published: October 2018

Good clinical results may be achieved with electrical stimulation in many fields of medicine. After a long period of experimental research, electrical stimulation has gained an important role in Urology too. Surgically implanted devices have been utilized only in recent years to cure neurogenic bladder, while external electrical stimulation with portable devices for female incontinence is well-defined in literature. Direct stimulation of detrusor muscle and sphincter was abandoned but, nowadays, selective neurostimulation seems to be very effective. In this paper, the most important surgical techniques are reviewed. Even if some of them are no longer used, knowledge of them is probably important to a better understanding of present results and future possibilities.
A Case of Primary Malignant Lymphoma of the Urinary Bladder: Clinico-Pathological and Immunohistochemical Study
Authors: Bianchini E. , Rimondi A.P. , Ferro G. , Pegoraro V.
Published: October 2018

The clinical and histopathological findings in a case of primary malignant lymphoma of the urinary bladder and morphologic and immunophenotypic characterization are reported with a review of the literature.
Flow-Cytometry Dna Analysis in Prostatic Hyperplasia and Prostatic Cancer
Authors: Schiavone D. , Curti P. , Tontodonati M. , Lazzarotto M. , Novella G. , Azzolina L.S. , Lestani M. , Mobilio G.
Published: October 2018

We submitted 229 tissue samples of 90 patients with prostatic hyperplasia and 51 patients with prostatic cancer to flow-cytometry DNA analysis. Samples were obtained with different modalities. Needle biopsy proves an effective method to provide adequate tissue samples. Results show that more than one sample is necessary in order to establish the cytometric pattern of hyperplastic and neoplastic prostate glands. Both aneuploidy and high S-phase can be found in BPH. Prostatic cancer is often heterogeneous at DNA analysis; aneuploidy can be found more frequently than in hyperplastic tissue and can be of different type.
Subcutaneous Interleukin-2 in the Treatment of Renal Cell Carcinoma. Preliminary Report
Authors: Benvenuti S. , Gastaldi E. , Mennini B. , Iacoviello M. , Caviguone M. , Traverso G.B.
Published: October 2018

10 patients with locally advanced renal cell carcinoma and 5 patients with metastatic renal cell carcinoma were treated with IL-2 subcutaneously. Adverse effects were not important. This study shows that IL-2 alone given subcutaneously is an effective and well-tolerated treatment for renal cell carcinoma.
Urinary Endothelin-1 Activity at the Relief of Urinary Tract Obstruction in Congenital Hydronephrotic Patients
Authors: Katayama Y. , Takeda M. , Tsutsui T. , Komeyama T. , Saito K. , Sato S.
Published: October 2018

To indicate renal disorders and to predict the prognosis of renal function, we investigated the significance of endothelin-I (ET-1) in retained urine, which was collected at the relief of urinary tract obstruction in 20 congenital hydronephrotic patients. Urinary ET-1 level ranged from 15 to 1411 pg/mg creatinine (Cr), and was higher than in normal Subjects in many cases. The value showed a positive correlation with the N-acetyl-β-Dglucosaminidase level (U/gCr) (r=0.663, p < 0.01) and β-2-microglobulin level (μg/mgCr) (r=0.486, p < 0.05). There was no significant correlation between ET-1 and albumin level. Immunohistochemical staining of renal tissue specimens showed ET-1 positivity in part of the medullary tubular epithelia of both normal and hydronephrotic kidneys, but no difference was seen between normal and hydronephrotic kidneys. These data suggest that urinary ET-1 level is a potential indicator of renal tubular disorders in hydronephrotic patients.
Epidemiological Findings on the Prevalence of Dysuria and Benign Prostatic Hypertrophy in 7303 Patients over 50 Years Old
Authors: Fini M. , Vagliani G.F. , Perrone A. , Salvi G. , Misuriello G. , Di Silverio A. , Batoumeni G. , Creti S. , Mauceri G. , Bicocchi M. , Tartoni P.
Published: October 2018

From April 1989 to April 1994 we performed a mass-screening for early diagnosis of prostatic carcinoma (by D.R.E.) on 7303 men aged 50-79 years. Moreover we evaluated the prevalence of obstructive urinary symptoms and clinically significant B.P.H. We found a prevalence rate of benign prostatic hyperplasia of 17.3% (1259/7303). The most commonly found were incomplete bladder emptying, dribbling and weak stream force. The prevalence of urinary symptoms rose significantly with increasing age and prostate size (evaluated also by T.R.U.S. on 480 men). We haven't found clear correlations between BPH and occupational or environmental risk factors. Despite the good knowledge about the development of pathological B.P.H., there is little agreement about the definition of the clinical patterns of the disease. For Garraway, B.P.H. is an enlargement of the prostate gland for an equivalent weight >20 g. in the presence of symptoms of urinary dysfunction and/or a urinary peak flow rate < 15 ml/s. Our study presents some correlations with Garraway's experience, making use of clinical and morphological evaluations. A correct clinical and social interpretation of the disease will be feasible only by comparing populations with similar diagnostic and therapeutical patterns.
Benign Prostatic Hyperplasia: Instrumental Diagnostics
Authors: Catalano G. , Di Meglio G.
Published: October 2018

The reliability, advantages and limits of instrumental methods, such as uroflowmetry, urinary residue determination, urodynamic examination and urethrocystoscopy, are discussed with regard to patients with benign prostatic hypertrophy. The authors concentrate on the usefulness of urodynamics (cystomanometry and pressure/flow study) in objectively detecting obstructions in the lower urinary tract and the concomitant presence of primitive or secondary detrusorial instability, which is often associated with a higher rate of therapeutic failure.
Morpho-structural Alterations of the Bladder Wall by Obstruction due to Benign Prostatic Hyperplasia
Authors: Sacchi G. , Forgiarini O. , Zucconelli R.
Published: October 2018

This study evaluated the classical primary lesions found in the bladder wall in 35 patients with cervico-prostatic obstruction and in 8 controls. The preliminary elements have been obtained for a subsequent precise evaluation of the possible morpho-functional correlations in this type of patient.
Controversy regarding Diagnosis and Staging of Prostatic Carcinoma: The Role of Rectal Exploration and Imaging Methods
Authors: Tallarigo C. , D'Amico A. , Curti P. , Beltrami P. , Bianchi G.
Published: October 2018

Although rectal examination (RE) represents the most utilized diagnostic tool, its reliability is limited by the large number of false positive results (low sensitivity) which” limit its use as a screening method. Transrectal ultrasound (TRUS) is very useful in the diagnosis of prostatic neoplasms, as the hypoechoic lesions are very likely to be cancerous and should be biopsied. Nevertheless tumoral hypoechogenicity is not specific and at most only 1 of 3 hypoechoic areas in the peripheral and central zones will prove to be cancer. Of palpable stage B cancers in the peripheral and central zones, 21% are reported to be isoechoic. Moreover cancers that arise in the transitional zone cannot ever be detected as hypoechoic tumors because of the heterogenic echo texture of this zone filled with diffuse hypoechoic nodules of BPH. The integration between RE, TRUS and PSA improves diagnostic accuracy. As far as neoplasm staging is concerned the proper evaluation of the Gleason score and spatial distribution of the tumor are referred by some authors to be assured only by means of “systematic” biopsies of the two prostatic lobes, independently of the echographic support. RNM and CT do not assure a better diagnostic or staging reliability, while endorectal RM is considered to afford, in comparison with TRUS, a better visualization of periprostatic structures and therefore a more reliable evaluation of neoplastic extracapsular extension.
Solid Tumour-like Form of Bladder Schistosomiasis: Diagnostic and Clinical Considerations
Authors: Singer D. , Eisenkraft S.
Published: October 2018

A case of bladder schistosomiasis is reported where the lesion had a solid tumour-like appearance. This presentation is rare, especially outside endemic areas. Without specific travel history, the aspect of these lesions may induce a diagnosis of space-occupying lesions of the bladder. Their clinical behavior is relatively mild but their aspect usually leads to surgical decisions. Surgery is sometimes the only and final diagnostic tool.
Leiomyosarcoma of the Scrotum
Authors: Becchetti A. , Monaldi M. , Panighi F.M. , Iuliani M. , Costa L. , Guerini A. , Petrelli G.
Published: October 2018

Scrotal leiomyosarcoma is a rare tumour which occurs in the muscular structures of the scrotum. Based on a recently observed case and on literature, the Authors discuss diagnostic and therapeutic problems of this tumour. The few cases observed do not allow definitive conclusions.
Prostatic Intraepithelial Neoplasm: Anatomo-Clinical and Follow-Up Trends
Authors: Vagliani G. , Nannini R. , Bondi A. , Di Silverio A. , Fini M.
Published: October 2018

Cellular proliferation in the prostatic ducts and acini presents a morphological continuum from benign proliferation without cytological atypia (hyperplasia) to proliferations with different degrees of dysplasia. The term prostatic intraepithelial neoplasm (P.I.N.) indicates the theoretical morphological extremity of that continuum. The criteria for differentiating P.I.N. into three grades are to be found in the cytological and architectural aspect as well as the integrity of the basal cell layer and the basal membrane. Clinically P.I.N. is strongly associated with prostatic carcinoma and diagnosis should be followed by further investigations for a co-existing carcinoma. All the elements (age, severity of P.I.N., P.S.A., D.R.E. and T.R.U.S. characteristics) which may be used for correct follow-up are discussed, as well as possible therapeutic options.
Incidental Prostatic Carcinoma
Authors: Mandressi A. , Mangiarotti B. , Chisena S. , Antonelli D.
Published: October 2018

Incidental carcinoma of the prostate is defined as an incidentally detected cancer without any clinical manifestation, i.e. latent. Clinically, it is diagnosed mostly by TUR and is staged as T1a and T1b according to the TNM classification. There is clinical understaging, however, of up to 27% for T1a and 68% for T1b. Although the subdivision seems justifiable on the basis of the progression rates (8% and 63% respectively), it is not a useful indicator of the natural history of the incidental carcinoma. Pathological staging of TUR specimens is far from standardized, with regard to both the different sampling methods and the commonly-used classifications. Since the T1 staging system is based more on how the cancer is identified than on classifying its pathology, different methods should be used for a full clinical understanding of an incidental carcinoma. Distinguishing cancers as clinically important or not allows a better prognostic indication compared to the staging systems, which can still not be considered as precise indicators of whether to treat the cancer or wait and see. Unfortunately the true prognostic factors cannot be directly deduced from the currently used sampling methods of TUR specimens. A complete diagnostic assessment should be carried out after initial diagnosis of incidental prostatic cancer in order to appreciate its clinical importance. Basically both revision of the material by the pathologist and further clinical investigation are useful. Lastly, the need for close co-operation between urologists and pathologists should be stressed.
Anatomo-Pathological Problems in Radical Surgery of Prostatic Carcinoma: Lymph Nodes
Authors: Severini G. , Morisi C. , Frigola M. , Arnone S. , Voce S.
Published: October 2018

One of biggest problems when assessing radical surgery of prostatic cancer is progression of the locally advanced disease when lymph nodes are positive. The following questions should be asked: 1) if there are patterns of lymph node involvement 2) if retroperitoneal lymphadenectomy is indispensable in pre-operative clinical removal 3) if the prognosis, in relation to lymph node invasion, worsens with the increase in number of positive lymph nodes or if the lesion becomes bilateral. The authors’ experience is reported.
Report On: “Latest Developments in Cryptorchidism”. Introduction
Authors: Bargelloni U. , Ferrarese P. , Santacatterina U. , Bragato F. , Serra F.
Published: October 2018

There are still many unresolved problems regarding cryptorchidism, so a review of recent diagnostic and therapeutic methods is of interest. The authors analyse the results of a retrospective survey of 180 cryptorchid patients operated about 25 years ago. A systematic approach at birth and periodic controls would help early diagnosis as well as making it easier to distinguish between true cryptorchidism and retractile testis.
Current Diagnostic Possibilities in Cryptorchidism
Authors: Bragato F. , Ferrarese P. , Serra F. , Santacatterina U. , Bargelloni U.
Published: October 2018

From a review of Literature on the subject, the Authors have followed developments in diagnosing cryptorchidism. The objective examination is still fundamental, but nowadays ultrasound, NMR, CT, phlebography and laparoscopy can be used. Surgical exploration remains a valid method for completing the above examinations.
Laparoscopy of Non-Palpable Testes
Authors: Trombetta C. , Belgrano E.
Published: October 2018

The Authors report on their case histories of impalpable testes using laparoscopy for diagnosis. They also report their first experience of therapeutic laparoscopy in adults and children, as a natural development of adequate training.
Latest Developments in Cryptorchidism: Conclusions
Authors: Bargelloni U. , Ferrarese P. , Santacatterina U. , Bragato F. , Serra F.
Published: October 2018

Infertility and cancer in cryptorchids are real possibilities, even if the latter has been greatly reappraised. The risk from intrinsic causes can benefit greatly from early hormonal therapy with HCG and LH-RH, while extrinsic ones can be treated by early orchiopexy. A randomised study would be useful to establish if the best age is before the 7th or the 18th month of life.
Validity of Ice Water Test in Diagnosis and Treatment of Neurogenic Bladders
Authors: Ronzoni G. , Menchinelli P. , Manca A. , De Giovanni L.
Published: October 2018

After having illustrated the physiopathological basis of the micturition reflex to cold water (a reflex tied to specific receptors and carried by type C unmyelinated fibres) the Authors report the results in the diagnosis and treatment of neurological bladder. The Ice Water Test (IWT) was carried out on 148 patients with neurological bladder resulting from traumatic lesion for diagnostic and treatment purposes and in 130 patients with neurological bladder and multiple pathogenic disorders for diagnosis and treatment and to classify hyperactive bladders. The IWT served as an aid in performing cystographic exams in 24 patients with neurological bladder. In normal control subjects the test results are always negative. Because it is simple to perform, it is considered to be a useful complement to every urodynamic examination in patients with neurological bladder or when there is difficulty in interpreting micturitional disorders.
The Mini-Invasive Treatment of Reno-Ureteral Lithiasis: Economic Evaluation
Authors: Malossini G. , Ficarra V. , Giusti G. , Mofferdin A. , Beltrami P.
Published: October 2018

Present therapeutic options for the treatment of urinary stones consist of extracorporeal sound wave lithotripsy (SWL), percutaneous lithotripsy (PCNL) and ureterorenoscopy (URS). The aim of this work is to compare the cost and the financing related to the above treatments.
Infiltrating Bladder Cancer: Surgery and Chemotherapy
Authors: Ronconi C.
Published: October 2018

Various surgical options, both partial and radical, are considered as well as chemotherapeutic protocols and a brief literature review is presented. Radical cystectomy associated with various urinary diversions remains the choice therapy for infiltrating bladder cancer whenever feasible.
Bladder Leiomyoma: Case Report
Authors: Badiali G.
Published: October 2018

The author describes a case of bladder leiomyoma that is particularly interesting for the rarity of the tumour and especially for its dimensions which required a subtotal cystectomy with enlargement ileocystoplasty.
Adrenal Myelolipoma
Authors: Constantinides C. , Mitsogiannis I. , Kyroudi A. , Manousakas Th. , Pantazopoulos D. , Dimopoulos C.
Published: October 2018

Myelolipoma of the adrenal gland is an unusual, benign tumour which is composed of mature adipose tissue and hematopoietic elements, similar to those of bone marrow. The tumour is hormonally inactive and unilateral although four cases in which the tumour has been found bilaterally have been reported. Extra adrenal myelolipoma has also been reported in the kidney, the liver and the presacral area. We present the case of an asymptomatic adrenal myelolipoma in a 68-year-old man, which was surgically removed.