bluuebunny/crossref_metadata_2025 huggingface dataset:
Contrasting microsatellite variation between subalpine and western larch, two closely related species with different distribution patterns
Authors: KHASA DAMASE P. , JARAMILLO‐CORREA JUAN P. , JAQUISH BARRY , BOUSQUET JEAN
Published: September 2006

Subalpine larch (Larix lyallii Parl.) and western larch (Larix occidentalis Nutt.) represent two closely related species with contrasting abundance and distribution patterns in Western North America. Genetic diversity at seven informative microsatellite loci was determined for 19 populations of subalpine larch and nine populations of western larch. Contrasting genetic diversity and patterns of population differentiation were observed between the two species. The overall within‐population genetic diversity parameters were lower in subalpine larch (A = 3.2; AP = 3.6; HE = 0.418) than in western larch (AP = 5.51; HE = 0.580), a pattern that is likely related to historical or demographic factors. No evidence of interspecific hybridization was observed. Significantly more population differentiation (θ = 0.15; RST = 0.07), consistent with more restricted gene flow, was observed for subalpine larch as compared to western larch (θ = 0.05; RST = 0.04). Under the assumption of an infinite allele mutation model, 12 of the 19 subalpine larch populations showed signs of deviation from the mutation–drift equilibrium, which suggests Holocene population bottlenecks and fluctuations in effective population size for this species. None of the western larch populations deviated significantly from the mutation–drift equilibrium. For both species, Mantel's test revealed a significant positive relationship between geographical and genetic distances indicative of isolation by distance. A similar geographical structure was detected in both species, suggesting at least two genetically distinct glacial populations in each species. The various implications for gene conservation are discussed.
Functional genomics of cactus host shifts in Drosophila mojavensis
Authors: MATZKIN LUCIANO M. , WATTS THOMAS D. , BITLER BENJAMIN G. , MACHADO CARLOS A. , MARKOW THERESE A.
Published: September 2006

Understanding the genetic basis of adaptation to novel environments remains one of the major challenges confronting evolutionary biologists. While newly developed genomic approaches hold considerable promise for addressing this overall question, the relevant tools have not often been available in the most ecologically interesting organisms. Our study organism, Drosophila mojavensis, is a cactophilic Sonoran Desert endemic utilizing four different cactus hosts across its geographical range. Its well‐known ecology makes it an attractive system in which to study the evolution of gene expression during adaptation. As a cactophile, D. mojavensis oviposits in the necrotic tissues of cacti, therefore exposing larvae and even adults to the varied and toxic compounds of rotting cacti. We have developed a cDNA microarray of D. mojavensis to examine gene expression associated with cactus host use. Using a population from the Baja California population we examined gene expression differences of third instar larvae when reared in two chemically distinct cactus hosts, agria (Stenocereus gummosus, native host) vs. organpipe (Stenocereus thurberi, alternative host). We have observed differential gene expression associated with cactus host use in genes involved in metabolism and detoxification.
Red blood cells from donors with sickle cell trait: a safety issue for transfusion?
Authors: Ould amar A. K.
Published: September 2006

summarySickle cell trait (SCT) affects approximately 8% of the population in Martinique (FWI) and about the same rate is found among the African Americans. In several regions of tropical Africa, up to 40% of individuals are also affected. SCT has been characterized as a benign condition and patients are currently asymptomatic or run a benign course. However, life‐threatening complications may occur. SCT can be detected in patients hospitalized for various complaints, and SCT likely causes serious morbidity and mortality in some people. Moreover, these clinical observations have been supported by severalin vitrostudies in which haemoglobin AS red cells showed abnormalities of their filterability. These problems are revisited with the implementation of universal leucoreduction in several countries. The question of the screening of all blood donors for SCT and the use of their red blood cells (RBCs) has yet to be resolved.
Diagnostic applications of microarrays
Authors: Petrik J.
Published: September 2006

summary Microarrays were designed to monitor the expression of many genes in parallel, providing substantially more information than Northern blots or reverse transcription polymerase chain reaction analysing one or few genes at a time. The large sequencing projects provided the content for detailed expression studies under a variety of stimuli and conditions. The human genome project identified around 30 000 human genes. Estimated number of protein products is, however, 10–30 times higher, mainly due to the alternative splicing and post‐translational modifications. The identification of gene functions requires both genomic and proteomic approaches, including protein microarrays, and numerous current microarray projects focus on deciphering gene expression patterns under a variety of conditions. Establishing the key genes and gene products for particular conditions opens the way for diagnostic applications using multiparameter, high‐throughput assays. This format can also accommodate existing blood screening assays, potentially providing a single testing platform. This review considers the progress in diagnostic microarrays in a wider context of in vitro diagnostics field.
Chemokine receptors expressed on T cells in packed red blood cell units change over storage time
Authors: Illoh O. , Greb B. , Davis J. , Illoh K
Published: September 2006

summaryThe transfusion of blood products is associated with adverse events that are related to the leukocytes in stored units of blood. These leukocytes have been shown to promote the elaboration of inflammatory cytokines. However, the status of a set of key inflammatory mediators, chemokine receptors, expressed on T lymphocytes in stored red blood cell (RBC) units is largely unknown. We investigated the expression pattern of selected chemokine receptors on T cells from non‐leukocyte‐reduced RBC units over storage time. Selecting segments from stored RBC units, we evaluated the T‐cell subsets for the chemokine receptors CXCR3 and CCR4 by flow cytometry. Statistical analysis was performed by regression analysis. We analysed 30 samples stored between 5 and 38 days. The CD4+ T cells expressing CXCR3 increased by 0·27% daily (P= 0·02), whereas the expression of CCR4 declined by 0·40% daily (P< 0·001). Though the expression of the chemokine receptors on CD8+ cells followed the same trend, the changes were statistically nonsignificant. This study suggests that a longer duration of storage is associated with a higher expression of chemokine receptor CXCR3 and a lower expression of CCR4 on T cells in RBC units, suggesting a pro‐inflammatory Th1 bias. The clinical significance of these changes in the setting of adverse transfusion events needs further evaluation.
Coagulation patterns following haemoglobin‐based oxygen carrier resuscitation in severe uncontrolled haemorrhagic shock in swine
Authors: Arnaud F. , Handrigan M. , Hammett M. , Philbin N. , Rice J. , Dong F. , Pearce L. B. , McCarron R. , Freilich D.
Published: September 2006

summary Massive blood loss due to penetrating trauma and internal organ damage can cause severe haemorrhagic shock (HS), leading to a severely compromised haemostatic balance. This study evaluated the effect of bovine polymerized haemoglobin (Hb) (Hb‐based oxygen carrier, HBOC) resuscitation on haemostasis in a swine model of uncontrolled HS. Following liver injury/HS, swine received HBOC (n= 8), Hextend (HEX) (n= 8) or no resuscitation (NON) (n= 8). Fluids were infused to increase mean arterial pressure above 60 mmHg and to reduce heart rate to baseline. At 4 h, the animals were eligible for blood transfusions. Prothrombin time (PT), activated partial thromboplastin time, fibrinogen, thromboelastography (TEG) and platelet function analyser closure time (PFA‐CT) were compared by using mixed statistical model. At 4 h, blood loss (% estimated blood volume) was comparable for HBOC (65·5 ± 18·5%) and HEX (80·8 ± 14·4%) and less for NON (58·7 ± 10·1%; P < 0·05). Resuscitation‐induced dilutional coagulopathy was observed with HBOC and HEX, as indicated by reduced haematocrit, platelets and fibrinogen (P < 0·05). At 4 h, PT was higher in HEX than in HBOC groups (P < 0·01). In the early hospital phase, a trend to increased TEG reaction time and PFA‐CT indicates that dilutional effects persist in HBOC and HEX groups. PFA‐CT returned to baseline later with HBOC than with HEX (48 vs. 24 h) following blood transfusion. At 4 h, all surviving HEX animals (n= 3) required transfusion, in contrast to no HBOC (n= 7) or NON (n= 1) animals. In this severe uncontrolled HS model, successful resuscitation with HBOC produced haemodilutional coagulopathy less than or similar to that produced by resuscitation with HEX.
The genetics of hydatidiform moles: new lights on an ancient disease
Authors: Slim R. , Mehio A.
Published: September 2006

Hydatidiform mole (HM) is a human pregnancy with no embryo but cystic degeneration of chorionic villi. The common form of this condition occurs in 1 in every 1500 pregnancies in western societies and at a higher incidence in some geographic regions and populations. Recurrent moles account for 2% of all molar cases and a few of them occur in more than one family member. By studying a familial form of recurrent moles, a recessive maternal locus responsible for this condition was mapped to 19q13.4 and causative mutations identified. The defective protein, NALP7, is part of the CATERPILLAR protein family with roles in pathogen‐induced inflammation and apoptosis. The exact role of NALP7 in the pathophysiology of molar pregnancies is unknown yet. NALP7 could have a role either in oogenesis or in the endometrium during trophoblast invasion and decidualization. In this review, we outlined recent advances in the field of HMs and reviewed the literature in the light of the new data.
HPLC analysis of the antifungal agent posaconazole in patients with haematological diseases
Authors: Müller Carsten , Arndt Margit , Queckenberg Christian , Cornely Oliver A. , Theisohn Martin
Published: September 2006

Posaconazole is a new antifungal drug used in prophylaxis and therapy of fungal infections in patients with immunodeficiency. In the clinical development, posaconazole exhibits variable oral bioavailability. Hence drug monitoring is recommended. For this purpose, a rapid and a convenient high‐performance liquid chromatography (HPLC) method has been developed. To 200 μl serum, 50 μl internal standard (itraconazole) was added. After precipitation of the proteins with acetonitrile, the clear supernatant was evaporated in a centrifugal evaporator, and the residue was dissolved in the HPLC elution. Separation was done on a chromatography performed by injecting a 50 μl aliquot of the resuspended sample onto a Multohyp C18 BDS column (250 × 4 mm). Column temperature was maintained at 50 °C. The flow rate was 1 ml min−1. Retention time of posaconazole was about 9 min and those of itraconazole was 17 min. The limit of quantification was 50 μg l−1 and the limit of detection about 10 μg l−1. Until now the concentration of posaconazole was measured in 14 patients (64 samples). After a daily dosage of 600–800 mg posaconazole the serum concentrations varied between 100 and 3000 μg l−1 (582 ± 579 μg l−1). Oral bioavailability was especially low in patients with cytostatic therapy and/or bone marrow transplantation. Further studies are needed to establish the therapeutic range of the posaconazole concentrations.
Successful treatment of disseminated mucormycosis with a combination of liposomal amphotericin B and posaconazole in a patient with acute myeloid leukaemia
Authors: Rickerts V. , Atta J. , Herrmann S. , Jacobi V. , Lambrecht E. , Bialek R. , Just‐Nübling G.
Published: September 2006

The combination of resection of infected tissue and antifungal therapy is the treatment of choice in mucormycosis. In disseminated mucormycosis, where surgery is impossible, the mortality is almost 90%. We report the first case of disseminated mucormycosis that was cured with a combination therapy of liposomal amphotericin B and posaconazole without surgical intervention.
Posaconazole for treatment of refractory invasive fungal disease
Authors: Notheis G. , Tarani L. , Costantino F. , Jansson A. , Rosenecker J. , Friederici D. , Belohradsky B. H. , Reinhardt D. , Seger R. , Schweinitz D. V. , Wintergerst Uwe
Published: September 2006

Invasive fungal infections are usually associated with immunocompromised states About 40–60% of these patients are refractory to standard antifungal therapy We describe the effect of posoconazole in the treatment of a 12 years‐old girl with uncontrolled diabetes mellitus with life‐threatening cerebral mucor mycosis and a 4 year old girl boy with chronic granulomatous disease presenting with invasive Aspergillus nidulans infection.
Relationship between depressive affect and malnutrition‐inflammation complex syndrome in haemodialysis patients
Authors: MICOZKADIOGLU HASAN , MICOZKADIOGLU IREM , ZUMRUTDAL AYSEGUL , ERDEM ABDULLAH , OZDEMIR FATMA NURHAN , SEZER SIREN , HABERAL MEHMET
Published: September 2006

Background:  Depression is associated with high mortality in haemodialysis (HD) patients, and can be associated with the poor oral intake that contributes to malnutrition. Malnutrition‐inflammation complex syndrome (MICS) causes increased morbidity and mortality in HD patients. We investigated relationships between depressive affect, social support and various components of MICS in HD patients.

Methods:  The subjects were 110 patients (65 men and 45 women, mean age 45.39 ± 14.73 years) on maintenance HD. The Beck Depression Inventory (BDI), Cognitive Depression Index (CDI), and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess aspects of depressive affect in each subject.

Results:  The mean dialysis duration was 53.04 ± 38.15 months. The mean BDI and CDI scores were 12.10 ± 7.43 and 8.40 ± 5.72, respectively. Patients were divided into two subgroups according to CDI score (depressive affect >10 (n = 71) and non‐depressive affect ≤10 (n = 39)). CDI score was correlated with malnutrition‐inflammation score (MIS) (r = 0.24; P < 0.05), haemoglobin level (r = −0.23; P < 0.05) and MSPSS score (r = −0.28; P < 0.01). The subgroup with depressive affect had higher MIS (P < 0.01) and lower social support (P = 0.001) than the non‐depressive affect group. Logistic regression analysis identified high MIS and low MSPSS score as independent risk factor for depression.

Conclusions:  The results suggest that MIS and MSPSS are the strongest predictors of depressive affect in HD patients. Further research is needed to understand the causal relationship between depressive affect and MICS in HD patients.
Angiotensin converting enzyme gene polymorphisms do not predict the course of idiopathic nephrotic syndrome in Swiss children
Authors: SASSE BERND , HAILEMARIAM SEIFE , WÜTHRICH RUDOLF P , KEMPER MARKUS J , NEUHAUS THOMAS J
Published: September 2006

Aim:  Contradictory reports exist about a correlation of angiotensin I converting enzyme (ACE) gene polymorphisms to the outcome of idiopathic nephrotic syndrome (INS) in children. We investigated the frequency of ACE polymorphisms and their impact on the clinical course of INS in children in a Swiss hospital.

Methods:  The ACE gene polymorphism (I, insertion; D, deletion) was assessed in 32 children – 22 with steroid‐sensitive INS and 10 with steroid‐resistant INS – with a median age at onset of INS of 2.9 years (range 1.1–15.0). Polymerase chain reaction amplification was performed on genomic DNA isolated from blood leucocytes. Results were correlated to clinical course and renal morphology.

Results:  The ACE genotype was I/I, I/D and D/D in two, 12 and eight patients, respectively, with steroid‐sensitive INS, and in one, eight and one patient, respectively, with steroid resistance. Renal morphology, available in 25 patients showed minimal change glomerulopathy in 17 patients (14 steroid‐sensitive; three steroid‐resistant) and focal segmental glomerulosclerosis in eight (one steroid‐sensitive; seven steroid‐resistant). There was no significant correlation between ACE genotype and steroid responsiveness, histology or outcome. ACE genotype was I/I, I/D and D/D in none, 12 and five patients, respectively, with minimal change glomerulopathy, and in one, five and two patients, respectively, with focal segmental glomerulosclerosis. Six patients with steroid‐resistant nephrotic syndrome went into end stage renal disease; ACE genotype was I/I in one and I/D in five, but none were D/D.

Conclusion:  In contrast to previous reports, ACE gene polymorphism is irrelevant for clinical outcome, steroid responsiveness or morphology in Swiss children with INS.
Influence of angiotensin converting enzyme inhibitor treatment on cardiac autonomic modulation in patients receiving haemodialysis
Authors: ONDOCIN PHILIP T , NARSIPUR SRIRAM S
Published: September 2006

Background:  Cardiovascular disease mortality among patients with end stage renal disease (ESRD) exceeds that which is predicted by traditional risk factors. Sudden death accounts for up to 15–38% of patients with ESRD found dead at home. Heart rate variability (HRV) is a reliable measure of autonomic modulation and has a very strong predictive value for ventricular arrhythmias and sudden death. A lower HRV is associated with increased risk. Modifying autonomic tone pharmacologically reduces death from dysrhythmia in the general population but has not been studied in ESRD.

Methods:  We examined the effect of ramipril, an angiotensin converting enzyme inhibitor (ACEI) known in the general population to increase HRV, on cardiac function and heart rate variability in patients with renal failure. Eligible subjects on haemodialysis underwent a 2‐week washout period free of ACEI or beta blockers, during which time hypertension was treated with amlodipine, which has been shown not to affect HRV. Haemodynamic and HRV measurements were obtained at baseline and after subjects were treated for 4 weeks with an ACEI.

Results:  Haemodynamics did not differ at 0 and 4 weeks. Baseline HRV values were markedly below those found in the general population, indicating pronounced predominance of sympathetic tone over vagal tone. Actual worsening of HRV with ACEI treatment was evident in several major time domains. The time domain SDNN (the standard deviation of all normal RR intervals) fell from 42.0 ± 24.8 ms to 20.1 ± 16.1 ms (P = 0.004) and the triangulation index fell from 178.0 ± 94.0 to 115 ± 59.2 (P = 0.01). A trend toward reduced HRV was seen in several other time domains.

Conclusion:  These findings suggest that, unlike the general population, treatment of ESRD patients with an angiotensin converting enzyme inhibitor may cause a deleterious shift toward increased cardiac sympathetic nervous system tone.
Gender differences in psychiatric symptoms related to suicidal ideation in Japanese patients with depression
Authors: YOSHIMASU KOUICHI , SUGAHARA HIDEYO , TOKUNAGA SHOJI , AKAMINE MARIKO , KONDO TETSUYA , FUJISAWA KANICHIRO , MIYASHITA KAZUHISA , KUBO CHIHARU
Published: September 2006

Abstract  Recent figures show that more than 30 000 people suicide each year in Japan, and that many of them are considered to suffer from depression. In addition, the suicide rate among Japanese women has been shown to be higher than in other countries. However, it is not clear whether the psychiatric symptoms leading to suicide differ by gender. The authors examined gender differences in psychiatric symptoms related to suicidal ideation (SI) in Japanese patients with depression. Study subjects were 199 new patients (66 men and 133 women) who were diagnosed with a major depressive disorder. SI and psychiatric symptoms were assessed by several psychological tests using questionnaires. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (CI) with an adjustment for all relevant factors simultaneously. The stepwise method was also used for selecting variables. In univariate analysis, several psychosocial factors such as self‐reproach, derealization, depressive moods, depersonalization, and anxiety traits were statistically significantly associated with SI in both men and women. However, multivariate analysis using the stepwise method distinguished gender differences. Low social/family support and depersonalization were statistically significantly associated with SI in men, while depressive moods and an anxiety state were significantly associated with SI in women. The relation between derealization and SI was statistically significant in women but not significant in men.
Direct effects of short‐term psychoeducational intervention for relatives of patients with schizophrenia in Japan
Authors: YAMAGUCHI HAJIME , TAKAHASHI AKIHISA , TAKANO AKIO , KOJIMA TAKUYA
Published: September 2006

Abstract  This study examined the direct effects of short‐term psychoeducation on relatives of inpatients with schizophrenia, with the goal of introducing this type of support program into standard care. The subjects were 46 relatives of inpatients with schizophrenia who attended three or four sessions of psychoeducation. Levels of anxiety and subjective burden and distress were measured before and after sessions using self‐administered rating scales. In addition, levels of expressed emotion were also measured. Results showed that both state and trait anxiety on the State‐Trait Anxiety Inventory were significantly lower after psychoeducational intervention than before intervention. In addition, subjective burden and distress reported by the family significantly decreased on the subscales for family confusion resulting from a lack of knowledge of the illness and anxiety about the future, subjective burden and depression resulting from the patient’s illness, and difficulties in the relatives’ relationships with the patient. Comparison of high and low expressed emotion families showed that the intervention was almost equally effective for the two groups. However, its effectiveness with regard to the subjective burden and depression experienced by the families was significantly greater among high expressed emotion families. The present study confirmed that family psychoeducation during hospitalization, even for a short period, is effective for all families, whether high or low expressed emotion. Moreover, the results suggested that the intervention may have a greater effect on emotional factors in high expressed emotion families than in low expressed emotion families.
Improvement of cognitive functioning in mood disorder patients with depressive symptomatic recovery during treatment: An exploratory analysis
Authors: MANDELLI LAURA , SERRETTI ALESSANDRO , COLOMBO CRISTINA , FLORITA MARCELLO , SANTORO ALESSIA , ROSSINI DAVID , ZANARDI RAFFAELLA , SMERALDI ENRICO
Published: September 2006

Abstract  Depressive symptoms have a large impact on cognitive test performance of mood disorder patients. After remission, some improvement of cognitive functioning has been observed, but also stable deficits have been reported both during depression and remission. In the present study, the authors aimed to investigate the cognitive functioning of mood disorder patients in relation to early symptomatic recovery, by comparing performances at the Wechsler Adult Intelligence Scale‐Revised (WAIS‐R) of responders and non‐responders to the antidepressant treatment. The sample was composed of 51 hospitalized patients for a major depressive episode (major depressives/bipolars = 37/14). All patients were treated with fluvoxamine and evaluated at baseline and after 4 weeks using the 21‐item Hamilton Rating Scale for Depression. All subjects were once assessed for their cognitive functioning with the WAIS‐R, at the end of the fourth week of treatment. In the current sample, patients who showed a significant symptomatic remission after 4 weeks of treatment showed higher total WAIS‐R scores and a lower incidence of cognitive impairment, compared to non‐responders to treatment. No major differences could be observed on any particular subtest, but rather a global improving of scores in responders compared to non‐responders to pharmacotherapy. Pre‐treatment illness severity, that was significantly higher among non‐responders, was significantly associated with patients’ intelligence quotient scores. Despite a number of limitations, present data support a strong effect of depressive symptoms on patients WAIS‐R performances and an early global improvement of cognitive functioning concurrent with symptomathology recovery during pharmacological treatment.
Combined cerebral blood flow effects of a cholinergic agonist (milameline) and a verbal recognition task in early Alzheimer’s disease
Authors: TROLLOR JULIAN N. , SACHDEV PERMINDER S. , HAINDL WALTER , BRODATY HENRY , WEN WEI , WALKER BRENDA M.
Published: September 2006

Abstract RU 35926/CI‐979 (milameline) is a partial muscarinic agonist with promnestic effects in animal models. Preliminary animal studies suggest that this agent has the capacity to reverse cholinergic dysfunction and that it may impact on regional cerebral blood flow (rCBF). A total of 10 subjects with Alzheimer’s disease (AD) of mild severity underwent high resolution split‐dose single photon emission computed tomography (SPECT) during performance of a verbal recognition and control task, both before and after 18 weeks treatment with melameline or placebo. SPECT images were coregistered with individual’s magnetic resonance imaging scans allowing extraction of rCBF values from multiple anatomical regions of interest (ROI). The effect of milameline was examined in eight individuals who were found after unblinding to be taking active drug. Effects of milameline were most apparent in the frontal regions, basal ganglia and thalamus. In the group as a whole, the greatest increase in rCBF due to milameline treatment was observed in the left globus pallidus. Response to milameline treatment was associated with increases in rCBF in the cingulate gyrus bilaterally, and less so for the left thalamus. Milameline‐related increases in rCBF values were exaggerated by the verbal recognition task. Milameline has a demonstrable effect on cerebral blood flow in mild AD. Consistent with emerging animal data, the effects on rCBF appear most prominent in frontal and subcortical regions in AD subjects. The effects on rCBF appear to be augmented by the performance of a cognitively demanding task, raising the possibility that such tasks could assist in building an awareness of the functional neuropsychopharmacology of drugs designed for cognitive enhancement.
Recovery of cognitive function in neuropsychiatric Langerhan’s cell histiocytosis
Authors: RYAN PHILIP , WALTERFANG MARK , SCHOLES AMELIA , O’DONOVAN JOHN , TOMLINSON BRUCE , VELAKOULIS DENNIS
Published: September 2006

Abstract  Langerhan’s cell histiocytosis (LCH) has been described as a progressive neurological disorder marked by neurological and cognitive decline. The authors here report a case of a childhood LCH sufferer who made a significant recovery of neuropsychological function in the absence of motor recovery in late adolescence. This differential recovery of motor and cognitive functioning may relate to the interaction between LCH and childhood and adolescent neurodevelopmental processes.
Detecting malingering of Ganser‐like symptoms with tests: A case study
Authors: MERCKELBACH HARALD , PETERS MAARTEN , JELICIC MARKO , BRANDS INEKE , SMEETS TOM
Published: September 2006

Abstract  A middle‐aged man presented with Ganser symptoms. He had been involved in a car crash and was seeking disability insurance benefits. Extensive testing with malinger instruments revealed that he performed below chance on simple memory tests and endorsed a variety of nonexistent symptoms. With this in mind, the authors collected collateral information which showed that the patient was involved in high level sports activities that were difficult to reconcile with the severe cognitive dysfunctions that he claimed to suffer from. The case demonstrates that Ganser‐like symptoms deserve close scrutiny, preferably with malinger tests.
Sustained beneficial effects of intraprostatic botulinum toxin type A on lower urinary tract symptoms and quality of life in men with benign prostatic hyperplasia
Authors: Chuang Yao‐Chi , Chiang Po‐Hui , Yoshimura Naoki , De Miguel Fernando , Chancellor Michael B.
Published: September 2006

OBJECTIVE

To present a comprehensive experience with intraprostatic botulinum toxin‐type A (BoNT‐A) injection in men with symptomatic benign prostatic hyperplasia (BPH) and to assess the efficacy on lower urinary tract symptoms (LUTS) and quality of life (QoL).

PATIENTS AND METHODS

In all, 41 men (mean age 69.1 years, sd 7.1 ) with an International Prostate Symptom Score of ≥ 8, peak flow rate of <12 mL/s, and who were refractory to medical treatment were injected with BoNT‐A (Botox®, Allergan, Inc., CA, USA) at 100 U (21 men, for prostate volume <30 mL) or 200 U (20, for prostate volume >30 mL) into the prostate transperineally under transrectal ultrasonography guidance. Study exclusion criteria were confirmed or suspected malignancy, previous pelvic surgery or trauma and previous invasive treatment for BPH. The clinical effects were evaluated at baseline and at 1, 3 and 6 months after treatment.

RESULTS

There were no significant local or systemic side‐effects in any men. LUTS and QoL indices improved by >30% in 31 of the 41 men (76%), and four of five men with urinary retention for >1 month could void spontaneously at 1 week to 1 month after the BoNT‐A injection. In 12 of 41 men (29%) there was no change in prostate volume, yet seven of these men still had a >30% improvement in maximum flow rate, LUTS and QoL. The efficacy was sustained at 12 months.

CONCLUSION

BoNT‐A injected into the prostate is safe and effective for men with symptomatic BPH. The mechanisms of relief of symptoms might not depend totally on the volume shrinkage; the inhibitory effect on the smooth muscle tone and aberrant sensory function might also be important.
The use of a suprascrotal or ‘wink’ incision for placing a testicular prosthesis
Authors: Libman Jamie L. , Pippi‐Salle Joao‐luiz , Chan Peter T.K.
Published: September 2006

Associate Editor

Michael G. Wyllie

Editorial Board

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

Marcel Waldinger, Netherlands

OBJECTIVE

To describe a suprascrotal technique of testicular prosthesis insertion that obviates the difficulties and complications associated with either the inguinal or scrotal approach, as although the insertion of a testicular prosthesis is common there are few reports of the various techniques of insertion, associated complication rates, and patient satisfaction.

PATIENTS AND METHODS

Eight males (aged 14–26 years) who had had a previous orchidectomy, had a testicular prosthesis inserted using a suprascrotal incision. A 2‐cm semilunar incision is made just above the scrotum, 2–3 cm lateral to the penis (‘wink’ incision). The prosthesis is inserted after developing the intrascrotal space with blunt dissection. All patients tolerated the procedure well and all were outpatient procedures.

RESULTS

After a median follow‐up of 12 months, all patients were satisfied with the aesthetics of the prosthesis. Incisions were hidden by pubic hair. There were no wound infections at the incision site, and no reports of any pain or discomfort associated with the prosthesis.

CONCLUSION

The ‘wink’ incision is an attractive alternative for inserting a testicular prosthesis; the advantages of the suprascrotal approach include: (i) the incision is hidden by pubic hair; (ii) no difficult dissection through fibrotic tissue in patients who have had previous inguinal surgery; and (iii) avoidance of direct contact between the prosthesis and suture line, minimizing the risk of infection, erosion and postoperative pain, while maintaining a pouch of adequate size.
Outcomes in patients with urothelial carcinoma of the bladder with limited pelvic lymph node dissection
Authors: Dhar Nivedita Bhatta , Campbell Steven C. , Zippe Craig D. , Derweesh Ithaar H. , Reuther Alwyn M. , Fergany Amr , Klein Eric A.
Published: September 2006

OBJECTIVES

To evaluate the rates of local and systemic progression (LP and SP), recurrence‐free survival and overall survival for patients with urothelial carcinoma of the bladder with limited pelvic lymph node dissection (PLND) in 1987–2000.

PATIENTS AND METHODS

A consecutive series was analysed of 385 patients (median age 61.9 years, range 30.7–83.8) treated by limited bilateral PLND and radical cystectomy (RC) between 1987 and 2000, with negative surgical margins on final pathology. All patients were staged N0M0 before RC, and none received neoadjuvant radiotherapy or chemotherapy. The boundaries of the limited PLND were the pelvic side‐wall between the genitofemoral and obturator nerves, and bifurcation of iliac vessels to the circumflex iliac vein. LP was defined as a radiographic soft‐tissue density of ≥ 2 cm below the bifurcation of the aorta. Pathological characteristics, based on the 1997 Tumour‐Nodes‐Metastasis system, recurrence patterns, and recurrence‐free and overall survival, were determined.

RESULTS

The median (range) overall follow‐up was 45.1 (1.1–165.6) months; the number of lymph nodes (LNs) reported per patient was 12 (2–32). Of the 385 patients, 130 (33.8%) had evidence of LP and 60 (15.6%) of SP. The 5‐year recurrence‐free and overall survival rates were both 71% for patients with organ‐confined, N0 tumours, and 23% and 26% for unconfined, N0 tumours. Positive LNs were found in 45 (12%) patients, who had a recurrence‐free and overall survival rate of 9% at 5 years.

CONCLUSION

Compared with published reports of similar cohorts of patients managed with RC and extended PLND, the present study suggests that limited PLND is associated with suboptimal staging, greater rates of LP, and lower rates of recurrence‐free survival, particularly for patients with unconfined or LN‐positive disease.
Erythropoietin administration protects against functional impairment and cell death after ischaemic renal injury in pigs
Authors: FORMAN COLIN J. , JOHNSON DAVID W. , NICOL DAVID L.
Published: September 2006

OBJECTIVE

To determine whether the administration of erythropoietin at the time of ischaemic renal injury (IRI) inhibits apoptosis, enhances tubular epithelial regeneration and promotes renal functional recovery, as it does in rodent models, in a higher mammalian model.

MATERIALS AND METHODS

The model of IRI involved unilateral nephrectomy in pigs, followed a week later by renal artery occlusion for 1 h, followed by reperfusion for 5 days. Pigs were randomized to receive erythropoietin 5000 units/kg intravenously at the time of ischaemia, followed by 1000 units/kg subcutaneously daily, or no treatment (six pigs each). Renal function and structure were analysed; blood and urine were collected daily to determine serum creatinine level, blood urea nitrogen, and creatinine clearance. Animals were killed after 5 days to obtain the injured kidneys. The kidneys were examined histologically for evidence of cellular mitosis, apoptosis and necrosis.

RESULTS

Erythropoietin significantly abrogated renal dysfunction after IRI compared with controls at 12 h after injury; the mean (sem) creatinine clearance (as a percentage of baseline) for IRI was 68.2 (6)% vs erythropoietin‐IRI 94.9 (8.9)% (P = 0.027), although by 36 h this was no longer significant, with values of 73.8 (12.7)% vs 95.9 (12)%, respectively (P = 0.23). Erythropoietin also significantly reduced the amount of cell death on histological analysis after 5 days of reperfusion, with a median (range) for IRI of 5.5 (1–45) vs erythropoietin‐IRI of 1.5 (0–4) (P = 0.043).

CONCLUSION

This study confirms the potential clinical applications of erythropoietin as a novel therapeutic agent in patients at risk of IRI.
Regulation versus pricing in urban water policy: the case of the Australian National Water Initiative
Authors: Byrnes Joel , Crase Lin , Dollery Brian
Published: September 2006

The Australian National Water Initiative (NWI) builds on the foundations of earlier water reforms, attempts to correct earlier errors in both policy and its implementation, and seeks to better define some of the policy aims with the benefit of hindsight. However, despite the deliberate effort to improve on earlier reforms, the NWI still embodies a significant economic paradox. Although policymakers have shown their faith in the market insofar as allocating water between competing agricultural interests is concerned, they have not shown the same degree of faith in the ability of urban users to respond to price signals. This paper attempts to shed at least some light on this question by examining the responses of a number of State governments across Australia to the NWI. The paper specifically explores the rationale for non‐price regulation in the urban context but challenges the long‐term viability of this approach.
New Zealand freshwater management and agricultural impacts
Authors: Cullen Ross , Hughey Kenneth , Kerr Geoffrey
Published: September 2006

In New Zealand, it is increasingly recognised, including by government, that water resource allocation and water quality are issues of national importance. Agriculture is frequently portrayed by public media as a major user of water and a major contributor to worsening water quality. We outline the water management systems in New Zealand, and the use of water by agriculture. Official reports on agriculture's impact on New Zealand water availability and quality are summarised. We report how the New Zealand public perceive water, its management, and the roles of agriculture in water issues. Data from a nationwide mail survey were analysed to determine how New Zealanders assess the state of New Zealand lakes, rivers and streams, and aquifers, the performance of three agencies responsible for management of freshwater resources, and willingness to fund stream enhancement. We provide brief explanations for the failures of water resource management in New Zealand and report on options, including community‐based responses that might address some of the mounting public, scientific, and government concerns about trends in water quantity and quality. A willingness to pay proposition, concerning riparian areas, included in the nationwide survey provides some evidence that the public are willing to pay for improved waterway management. Relevant non‐market valuation studies also indicate that the public places considerable value on preservation values of water in New Zealand.
Urban water demand with fixed volumetric charging in a large municipality: the case of Brisbane, Australia*
Authors: Hoffmann Mark , Worthington Andrew , Higgs Helen
Published: September 2006

This paper uses suburb‐level quarterly data to model residential water demand in Brisbane, Australia, from 1998 to 2003. In this system, residential consumption is charged using a fixed annual service fee with no water entitlement followed by a fixed volumetric charge per kilolitre. Water demand is specified as average quarterly household water consumption and the demand characteristics include the marginal price of water, household income and size, and the number of rainy and warm days. The findings not only confirm residential water as price and income inelastic, but also that the price and income elasticity of demand in owner‐occupied households is higher than in rented households. The results also show that weather, particularly summer months and the number of rainy days, exerts a strong influence on residential water consumption.
The optimal allocation of water along a system of rivers: a continuous model with sequential bidding*
Authors: Coram Alex
Published: September 2006

This paper uses a control theory approach to analyse the collectively optimal rate of extraction along a river system and constructs a bidding mechanism that would produce the required prices at each point. It also analyses some characteristics of this mechanism. This approach brings some new perspective to existing work on externalities. It also helps bring to light some aspects of the system as a whole that may be less obvious in a more piecemeal analysis, including the fact that there may not be an optimal solution to the allocation problem. Although the bidding mechanism may be difficult to implement, it may be possible to design various forms of hybrid schemes that have practical value.
QUANTUM AND CONSCIOUSNESS: IN SEARCH OF A NEW PARADIGM
Authors: Laszlo Ervin
Published: September 2006

Abstract. Two fundamental issues raised by Lothar Schäfer are considered: (1) the question of a suitable paradigm within which the findings of quantum physics can be optimally interpreted and (2) the question of the assessment of the presence and importance of mind and consciousness in the universe. In regard to the former, I contend that the ideal of science is to interpret its findings in an optimally consistent and minimally speculative framework. In this context Schäfer's assertion that certain findings in quantum physics (those that relate to virtual states) indicate the presence of mind at the quantum level implies a dualistic and hence unnecessarily speculative assumption. In regard to the assessment of mind and consciousness, a consistent and parsimonious paradigm suggests that mind and consciousness are not part of a chain of events consisting of an admixture of physical and mental events but that physical events form a single, coherent set of events, and mental events another set, with the two sets related, as Teilhard (and a number of other philosophers, including White head) affirmed, as the “within” and the “without” (or the “mental pole” and the “physical pole”) of one and the same fundamental reality. This panpsychist as contrasted with Schäfer's dualist paradigm provides a single self‐consistent framework for the interpretation of quantum (and all natural) events while recognizing the presence of mind in the universe as the least speculative realist implication of our immediate experience of consciousness.
ON THE LIMITATIONS AND PROMISE OF QUANTUM THEORY FOR COMPREHENSION OF HUMAN KNOWLEDGE AND CONSCIOUSNESS
Authors: Helrich Carl S.
Published: September 2006

Abstract. I present a partially historical discussion of the basis of the quantum theory in nonmathematical terms using human knowledge and consciousness as an underlying theme. I show that the philosophical position in both classical and quantum theory is the experimental and mathematical philosophy of Isaac Newton. Because almost all the systems we deal with are multicomponent, we must consider the limitations and openness imposed by thermodynamics on our claims in both classical and quantum treatments. Here the reality of measurement stands in the way of any simple picture but also provides the basis for considerations of free will. Particular care is taken with the concepts of quantum measurement, entanglement, and decoherence because of their importance in the discussion.
A RESPONSE TO STANLEY KLEIN: A DIALOGUE ON THE RELEVANCE OF QUANTUM THEORY TO RELIGION
Authors: Schäfer Lothar
Published: September 2006

Abstract. I respond to Stanley Klein's critique of my essay “Quantum Reality, the Emergence of Complex Order from Virtual States, and the Importance of Consciousness in the Universe,” arguing in support of the necessity to derive a quantum perspective of evolution rather than adhering to an essentially classical view. In response to Klein's criticism of my concept of a cosmic morality, the origins of that concept are traced back to Zeno of Citium. I wholeheartedly embrace Klein's suggestion that the new science inspires views of the human condition that can help us make the world a better place.
EMERGENCE EVERYWHERE?! REFLECTIONS ON PHILIP CLAYTON'S MIND AND EMERGENCE
Authors: Jackelén Antje
Published: September 2006

Abstract. Emergence is a powerful concept marked by great emotional, aesthetic, and intellectual appeal. It makes inroads into the understanding of the most diverse phenomena. Emergence appears to have the potential of explaining anything from the behavior of atoms, ant colonies, and traffic jams to insurance risks, human consciousness, and divine action. Philip Clayton's book Mind and Emergence (2004) offers much‐needed clarification of the philosophical grounding of emergence theory. To a large extent, emergence hinges on the concept of levels and hierarchies in nature. The preferred metaphor is that of a ladder. Given the tendency of concepts like emergence to build ideology, a careful analysis of language and metaphor is called for, however. I argue that the preference for the ladder metaphor does not do justice to the differentiated relationality that is a distinct mark of emergence. This oversight may have detrimental consequences when emergence theory is transferred from natural to social and cultural processes. A hermeneutical analysis suggests that better metaphors and visualizations need to be found. As an invitation to consider alternatives, some examples of complex regular poly topes are offered.
SPECIES OF EMERGENCE
Authors: Peterson Gregory R.
Published: September 2006

Abstract.The category of emergence has come to be of considerable importance to the science‐and‐religion dialogue. It has become clear that the term is used in different ways by different authors, with important implications. In this article I examine the criteria used to state that something is emergent and the different interpretations of those criteria. In particular, I argue similarly to Philip Clayton that there are three broad ranges of interpretation of emergence: reductive, nonreductive, and radical. Although all three criteria have their place, I suggest that the category of radical emergence is important both for science and theology.
Fiscal Policy Coordination and International Trade
Authors: ANDERSEN TORBEN M.
Published: September 2006

While assertions are often made that non‐cooperative fiscal policies suffer a contractionary bias, general equilibrium models have shown that the bias is unambiguously expansionary. This paper argues that the latter result relies on a particular and critical way of modelling international trade, and that under a more plausible trade structure, it is possible that fiscal policy is insufficiently expansionary in the non‐cooperative case. Non‐cooperative policy‐making thus implies that fiscal policies are used too little if they expand private employment, and too much if they contract private employment. Inefficiencies in non‐cooperative fiscal policies worsen when product markets become more integrated.