bluuebunny/crossref_metadata_2025 huggingface dataset:
Cotton Leaf Senescence can be Delayed by Nitrophenolate Spray Through Enhanced Antioxidant Defence System
Authors: Djanaguiraman M. , Annie Sheeba J. , Durga Devi D. , Bangarusamy U.
Published: February 2009

Leaf senescence is an oxidative process, and most of the catabolic processes involved in senescence are propagated irreversibly once initiated. An experiment was conducted to test the hypothesis that nitrophenolates (Atonik, a plant growth regulator) spray can delay the leaf senescence through reduced oxidative damage. Atonik 3.75 g a.i. ha−1 was sprayed during boll filling stage on cotton, and the senescence process was evaluated by quantifying total chlorophyll contents, photosynthetic rate, Fv/Fm ratio, various reactive oxygen species (ROS) content, antioxidant content and antioxidant enzyme activity from 90 days after sowing (DAS) to 130 DAS. The result indicated that nitrophenolate spray reduced the hydrogen peroxide (H2O2), superoxide anion (O2−) accumulation, lipid peroxidation (malondialdehyde), lipoxygenase activity and membrane permeability over unsprayed control. The antioxidant enzyme activity (superoxide dismutase, SOD; ascorbate peroxidase, APX; peroxidase, POX; glutathione peroxidase, GSH‐Px) were significantly increased by the nitrophenolate spray. POX (118.1 %) and GSH‐Px (143.3 %) activities were enhanced to a higher level compared to APX (8.5 %) activity at 130 DAS. Enhanced accumulation of ascorbate (144.9 %), phenol (154.7 %) and proline (50 %) was seen in nitrophenolate‐sprayed plants compared with unsprayed control plants at 130 DAS. Ascorbate content is increased by higher dehydroascorbate reductase enzyme activity. Ascorbate was thus able to replenish reducing equivalents to phenoxyl radicals resulting in an increase in phenolic compounds. The increased phenolic acid content may be involved in scavenging the ROS produced during senescence process. The higher level of reduced ascorbate and low level of endogenous H2O2 in the leaves may be the prerequisite for delayed leaf senescence in the nitrophenolate‐sprayed plants. Based on the present work, it can be concluded that nitrophenolate‐sprayed plants can postpone the leaf senescence by peroxide/phenolic/ascorbate system which is involved in scavenging the ROS produced during leaf senescence.
Pedigree analysis in the Austrian Noriker draught horse: genetic diversity and the impact of breeding for coat colour on population structure
Authors: Druml T. , Baumung R. , Sölkner J.
Published: February 2009

The pedigree of the current Austrian Noriker draught horse population comprising 2808 horses was traced back to the animals considered as founders of this breed. In total, the number of founders was 1991, the maximum pedigree length was 31 generations, with an average of 12.3 complete generations. Population structure in this autochthonous Austrian draught horse breed is defined by seven breeding regions (Carinthia, Lower Austria, Salzburg, Styria, Tyrol, Upper Austria and Vorarlberg) or through six coat colour groups (Bay, Black, Chestnut, Roan, Leopard, Tobiano). Average inbreeding coefficients within the breeding regions ranged from 4.5% to 5.5%; for the colour groups, the coefficients varied from 3.5% to 5.9%. Other measures of genetic variability like the effective number of founders, ancestors and founder genomes revealed a slightly different genetic background of the subpopulations. Average coancestries between and within breeding areas showed that the Salzburg population may be considered as the nucleus or original stock whereas all other subpopulations showed high relationship to horses from Salzburg. The target of draught horse breeding in the 21st century does not meet the breeding concept of maximizing genetic gains any more. Stabilizing selection takes place. In this study, we show that demographic factors as well as structure given by different coat colours helped to maintain genetic diversity in this endangered horse breed.
Genetic associations between age at first calving and heifer body weight and scrotal circumference in Nelore cattle
Authors: Grossi D.A. , Venturini G.C. , Paz C.C.P. , Bezerra L.A.F. , Lôbo R.B. , Oliveira J.A. , Munari D.P.
Published: February 2009

Age at first calving (AFC) measures the entry of heifers into the beef cattle production system. This trait can be used as a selection criterion for earlier reproductive performance. Using data from Nelore cattle participating in the ‘Program for Genetic Improvement of the Nelore Breed’ (PMGRN‐Nelore Brazil), bi‐trait analyses were performed using the restricted maximum likelihood method, based on an AFC animal model and the following traits: female body weight adjusted to 365 (BW365) and 450 (BW450) days of age, and male scrotal circumference adjusted to 365 (SC365), 450 (SC450), 550 (SC550) and 730 (SC730) days of age. The heritability estimates for AFC ranged from 0.02 ± 0.02 to 0.04 ± 0.02. The estimates of additive direct heritabilities (with standard error) for BW365, BW450, SC365, SC450, SC550 and SC730 were 0.36 ± 0.07, 0.38 ± 0.07, 0.48 ± 0.07, 0.65 ± 0.07, 0.64 ± 0.07 and 0.42 ± 0.07, respectively, and the genetic correlations with AFC were −0.38, −0.33, 0.10, −0.13, −0.13 and 0.06, respectively. In the herds studied, selection for SC365, SC450, SC550 or SC730 should not cause genetic changes in AFC. Selection based on BW365 or BW450 would favor smaller AFC breeding values. However, the low magnitude of direct heritability estimates for AFC in these farms indicates that changes in phenotypical expression depend mostly on non‐genetic factors.
Predictive ability of models for calving difficulty in US Holsteins
Authors: De Maturana E.L. , Gianola D. , Rosa G.J.M. , Weigel K.A.
Published: February 2009

The performance of alternative threshold models for analyzing calving difficulty (CD) in Holstein cows was evaluated in terms of predictive ability. Four models were considered, with CD classified into either three or four categories and analysed either as a single trait or jointly with gestation length (GL). The data contained GL and CD records from 90 393 primiparous cows, sired by 1122 bulls and distributed over 935 herd‐calving year classes.

Predictive ability of each model was evaluated using four criteria: mean squared error of the difference between observed and predicted CD scores; a Kullback‐Leibler divergence measure between the observed and predicted distributions of CD scores; Pearson’s correlation between observed and predicted CD scores and ability to correctly classify bulls as above or below average for incidence of CD.

In general, the four models had similar predictive abilities. The joint analysis of CD with GL produced little, if any, improvement in predictive ability over univariate models. In light of the small difference in predictive ability between models treating CD with three or four categories and considering that a greater number of categories can provide more information, analysis of CD classified into four categories seems warranted.
Six‐year prospective study of physical fitness and incidence of disability among community‐dwelling Japanese elderly women
Authors: Tainaka Koji , Takizawa Tsuyoshi , Katamoto Shizuo , Aoki Junichiro
Published: February 2009

Aim:  To identify physical fitness factors associated with occurrence of disability requiring long‐term care and reviewing physical fitness factors to identify threshold values at which future care risk is expected to rise rapidly.

Methods:  This prospective cohort study included 74–88‐year‐old women who were living at home and who reported no disability in activities of daily living. The subjects completed 16 physical fitness tests, assessing walking ability, muscular strength, flexibility, agility and balance, and participated in a follow‐up interview 6 years later.

Results:  Among the 60 subjects who were not disabled at baseline and who participated in the 6‐year follow up, 28 subjects were certified to have a disability necessitating long‐term care after 6 years. Among the 16 physical fitness tests, 13 measures showed a significant association with the necessity of care. Maximum walking time and ankle dorsiflexion range of motion (ROM) were identified as main physical fitness factors associated with later necessity of care using a multiple logistic regression model. After adjustment for age, each subject's probability of occurrence of disability necessitating care was calculated using a logistic equation. The probability rose rapidly to more than 80% when 10 m maximum walking of 74–78‐year‐old subjects was 10 s. For 80–88‐year‐old subjects, the probability rose rapidly to more than 80% when the time was at 9 s. As ankle dorsiflexion ROM narrowed, the probability rose gradually.

Conclusion:  Ability to walk rapidly is an indicative main physical fitness marker for predicting the independence of elderly women.
Case of membranoproliferative glomerulonephritis due to essential cryoglobulinemia without hepatitis C virus infection
Authors: Okura Takafumi , Jotoku Masanori , Miyoshi Ken‐ichi , Enomoto Daijiro , Kurata Mie , Irita Jun , Nagao Tomoaki , Ohtsuka Tomoaki , Higaki Jitsuo
Published: February 2009

An 81‐year‐old man was admitted to our hospital because of leg edema. Serological studies for anti‐neutrophil cytoplasmic antibody (ANCA), anti‐double stranded DNA antibodies, and antibodies to hepatitis C and B were negative. Severe hypocomplementemia was present and a cryoglobulin was detected with serum immunoelectrophoresis being positive for the immunoglobulin (Ig)M κ type. The cryoglobulin was characterized by immunoelectrophoresis which showed that the protein was composed of polyclonal IgG and κ‐type monoclonal IgM. A diagnosis of essential type II cryoglobulinemia was made and the patient underwent a renal biopsy. The renal biopsy revealed endocapillary and mesangial cell proliferation with increased matrix. The resultant lobular appearance of the glomerulus and double contours of the basement membrane were indicative of membranoproliferative glomerulonephritis (MPGN). Immunofluorescence studies demonstrated granular staining in the capillary wall for IgG, IgA, IgM and C4 with little C3 deposition but no C1q. He was finally diagnosed with MPGN due to mixed cryoglobulinemia type II. MPGN with essential cryoglobulinemia type II without evidence of hepatitis C virus infection, like that found in the present case, is very rare.
Impact of low cost strength training of dorsi‐ and plantar flexors on balance and functional mobility in institutionalized elderly people
Authors: Ribeiro Fernando , Teixeira Fantina , Brochado Gabriela , Oliveira José
Published: February 2009

Aim:  To evaluate the effects of a low cost strength training program of the dorsi‐ and ankle plantar flexors on muscle strength, balance and functional mobility, in elderly institutionalized subjects; and to determine the association between strength gain and balance and/or functional mobility gain.

Methods:  Forty‐eight volunteers were recruited and equally divided into two groups: intervention (aged 78.44 ± 3.84 years) and control (aged 79.78 ± 3.90 years). Both groups were tested at baseline and outcome for ankle dorsi‐ and plantar flexors muscle strength, balance and functional mobility. The intervention group participated in a 6‐week program, three‐sessions‐per‐week, of resisted ankle dorsi‐ and plantar flexion exercises using elastic bands.

Results:  In the intervention group, maximal isometric dorsi‐ (from 8.4 ± 0.45 to 12.6 ± 0.95 kg; P ≤ 0.001) and plantar flexors strength (from 13.0 ± 0.85 to 17.5 ± 0.93 kg; P ≤ 0.001), balance (from 14.6 ± 0.54 to 22.3 ± 1.81 cm; P ≤ 0.001) and functional mobility (from 18.4 ± 0.51 to 11.0 ± 0.66 s; P ≤ 0.001) increased significantly after the 6‐week strength training program. In the control group, no significant differences were detected. In the intervention group, a significant correlation between plantar flexor strength gain and balance gain was found (r = 0.826; P = 0.01).

Conclusion:  The proposed low cost strength training of dorsi‐ and plantar flexors improved strength, balance and functional mobility in institutionalized elderly people; moreover, the improvement in plantar flexor strength was associated with the improvement in balance.
Montreal Cognitive Assessment Arabic version: Reliability and validity prevalence of mild cognitive impairment among elderly attending geriatric clubs in Cairo
Authors: Rahman Tomader Taha Abdel , El Gaafary Maha Mohamed
Published: February 2009

Aim:  Mild cognitive impairment (MCI) is a clinical label which includes elderly subjects with memory impairment and with no significant daily functional disability. MCI is an important target for Alzheimer's dementia prevention studies. Data on the prevalence and incidence of MCI varies greatly according to cultural difference. The first aim of this study was to assess the reliability and validity of Montreal Cognitive Assessment (MoCA) Arabic version in MCI detection. The second was to determine the prevalence of MCI among apparently healthy elderly people attending geriatric clubs in Cairo.

Methods:  In stage I reliability & validity of MoCA Arabic version were assessed in reference to Cambridge Cognitive Examination (CAMCOG). In stage II prevalence of MCI was estimated using Arabic MoCA among apparently healthy elderly attending geriatric clubs. These geriatric clubs were randomly selected from different regions in Cairo governorate.

Results:  Test–retest reliability data of the Arabic MoCA were collected approximately 35.0 ± 17.6 days apart. The mean change in Arabic MoCA scores from the first to second evaluation was 0.9 ± 2.5 points, and correlation between the two evaluations was high (correlation coefficient = 0.92, P < 0.001). The internal consistency of the Arabic MoCA was good, yielding a Cronbach's α on the standardized items of 0.83. In diagnosing mild cognitive impairment, the Arabic MoCA showed 92.3% sensitivity and 85.7% specificity. The prevalence of MCI among elderly subjects attending geriatric clubs in Cairo is 34.2% and 44.3% of healthy men and women, respectively.

Conclusion:  Older age, female sex and less education are the independent risk factors for MCI among apparently healthy elderly subjects attending geriatric clubs in Cairo.
Nursing home care in the USA
Authors: Eskildsen Manuel , Price Thomas
Published: February 2009

Nursing home care in the USA is part of the costliest health‐care system in the world, and is a heavily regulated industry still struggling to maintain quality care across the country. The modern nursing home dates back to the 1930s and the passage of the Social Security Act, with continued growth of the industry after the 1960s, when the Medicare and Medicaid programs were created. As in other industrialized countries, the elderly population in the USA is growing, and the highest growth is occurring among those older than 85. This is the group with the highest health‐care costs and rates of nursing home utilization. There are two major types of care provided in US nursing homes: long‐term and subacute care. In the 1980s, quality of care became an important concern, which led to major reform and passage of new regulations under the law known as OBRA‐87. During this time, the Minimum Data Set (MDS), which is a comprehensive assessment tool, was introduced. It continues to be a vital tool for both payment and research. Reform also ushered in the state survey process, which scrutinizes nursing homes yearly and assesses financial penalties for substandard care. The aging of the American population will provide challenges for financing nursing home care in the future. The use of private long‐term care insurance is growing, and may be an important source of payment for this type of care in the decades to come.
Diversity of culturable marine filamentous fungi from deep‐sea hydrothermal vents
Authors: Burgaud Gaëtan , Le Calvez Thomas , Arzur Danielle , Vandenkoornhuyse Philippe , Barbier Georges
Published: February 2009

As now very few studies have been carried out on deep‐sea marine fungi, this field remains relatively unknown. However, their presence inside benthic microbial eukaryotes at deep‐sea vents was recently pointed out from molecular microbial ecology studies. We report here an attempt to describe the culturable part of mycological communities in deep‐sea vent ecosystems that is an important step in understanding their diversity, abundance and function. Physiological characterization revealed strains that are more or less adapted to deep‐sea conditions. Those results suggest the presence of true marine organisms and other more ubiquitous. Phylogenetical characterization highly correlated to physiological data revealed the presence of fungi that have been previously described and unknown ones until now, belonging to new taxonomic groups. This survey encourages for further work in order to complete descriptions and also to describe the ecological role of these organisms in such extreme environments.
Toxicity of triclosan, penconazole and metalaxyl on Caulobacter crescentus and a freshwater microbial community as assessed by flow cytometry
Authors: Johnson David R. , Czechowska Kamila , Chèvre Nathalie , Van Der Meer Jan Roelof
Published: February 2009

Biocides are widely used for domestic hygiene, agricultural and industrial applications. Their widespread use has resulted in their introduction into the environment and raised concerns about potential deleterious effects on aquatic ecosystems. In this study, the toxicity of the biocides triclosan, penconazole and metalaxyl were evaluated with the freshwater bacterium Caulobacter crescentus and with a freshwater microbial community using a combination of single‐ and double‐stain flow cytometric assays. Growth of C. crescentus and the freshwater community were repressed by triclosan but not by penconazole or metalaxyl at concentrations up to 250 μM. The repressive effect of triclosan was dependent on culture conditions. Caulobacter crescentus was more sensitive to triclosan when grown with high glucose at high cell density than when grown directly in sterilized lake water at low cell density. This suggests that the use of conventional growth conditions may overestimate biocide toxicity. Additional experiments showed that the freshwater community was more sensitive to triclosan than C. crescentus, with 10 nM of triclosan being sufficient to repress growth and change the phylogenetic composition of the community. These results demonstrate that isolate‐based assays may underestimate biocide toxicity and highlight the importance of assessing toxicity directly on natural microbial communities. Because 10 nM of triclosan is within the range of concentrations observed in freshwater systems, these results also raise concerns about the risk of introducing triclosan into the environment.
Propiverine vs oxybutynin for treating neurogenic detrusor overactivity in children and adolescents: results of a multicentre observational cohort study
Authors: Madersbacher Helmut , Mürtz Gerd , Alloussi Schahnaz , Domurath Burghard , Henne Thomas , Körner Iris , Niedeggen Andreas , Nounla Joseph , Pannek Jürgen , Schulte‐Baukloh Heinrich , Schultz‐Lampel Daniela , Bock Paul , Strugala Gerhard
Published: February 2009

OBJECTIVE

To compare, in a retrospective observational cohort study, the efficacy, tolerability, safety and clinical effectiveness of propiverine and oxybutynin in children and adolescents with neurogenic detrusor overactivity (NDO).

PATIENTS AND METHODS

In all, 255 children and adolescents (aged 1–18 years) with NDO (199 myelomeningocele, 46 spinal cord injury, 10 other diagnoses) were enrolled at 14 study centres. To evaluate the efficacy of propiverine and oxybutynin, urodynamic and clinical variables were assessed before and after at least 12 month of the antimuscarinic agents administered at variable doses.

RESULTS

In all, 127 patients given propiverine and 128 given oxybutynin were enrolled. The primary efficacy outcome, i.e. reductions in urodynamically assessed individual maximum detrusor pressure (Pdetmax), was assumed to indicate success in 74.2% of those on propiverine vs 49.6% on oxybutynin. The mean Pdetmax was significantly reduced during treatment, from 59.8 to 36.7 cmH2O in the propiverine and from 65.2 to 54.9 cmH2O in the oxybutynin groups. The mean maximum cystometric bladder capacity increased from 146 to 242 mL in the propiverine and from 222 to 310 mL in the oxybutynin group. Propiverine was better tolerated than oxybutynin, having fewer adverse drug reactions (9.4% vs 17.2%, odds ratio 2.04), and for its severity grades and premature treatment termination (none vs 11 cases).

CONCLUSION

In this non‐interventional study, reflecting ‘real‐life’ clinical practice, comparing the efficacy, tolerability and safety of propiverine and oxybutynin in children and adolescents with NDO, propiverine was at least as effective as oxybutynin, but better tolerated, resulting in superior clinical effectiveness than for oxybutynin.
Reduced bladder cancer recurrence rate with cardioprotective aspirin after intravesical bacille Calmette‐Guérin
Authors: Gee Jason R. , Jarrard David F. , Bruskewitz Reginald C. , Moon Timothy D. , Hedican Sean P. , Leverson Glen E. , Nakada Stephen Y. , Messing Edward M.
Published: February 2009

OBJECTIVE

To evaluate the recurrence‐free survival (RFS) rate of patients taking cardioprotective aspirin after intravesical bacille Calmette‐Guérin (BCG) for high‐grade noninvasive urothelial carcinoma of the bladder, as preventing the recurrence of superficial bladder cancer might decrease patient morbidity and mortality from this disease, and nonsteroidal anti‐inflammatory agents (NSAIDs) have shown promise in preclinical prevention through inhibition of the prostaglandin pathway and other mechanisms.

PATIENTS AND METHODS

In all, 43 patients with carcinoma in situ (CIS) and/or high‐grade papillary bladder cancer were treated with intravesical BCG. Patients were stratified according to whether they took cardioprotective aspirin after treatment, and Kaplan‐Meier curves of RFS were compared by log‐rank analysis. Multivariable analysis was used for potentially confounding factors, including maintenance BCG, the presence of CIS, and smoking status.

RESULTS

Of patients taking cardioprotective aspirin, the 5‐year RFS rate was 64.3%, compared with 26.9% for patients not taking aspirin, with a significantly higher RFS by univariable log rank analysis (P = 0.03). Even after adjusting for the other factors by multivariable analysis, aspirin seems to affect recurrence (hazard ratio 0.179, P = 0.001). Maintenance BCG (hazard ratio 0.233, P = 0.02) and smoking history (hazard ratio 3.199, P = 0.05) also significantly affected recurrence.

CONCLUSION

There was a significantly higher RFS rate in patients taking cardioprotective aspirin after intravesical BCG therapy for bladder cancer. The results of this study support the further investigation of aspirin and other NSAIDs as preventive agents in patients being treated for superficial bladder cancer.
Management of decreased bone mineral density in men starting androgen‐deprivation therapy for prostate cancer
Authors: Panju Abbas H. , Breunis Henriette , Cheung Angela M. , Leach Marc , Fleshner Neil , Warde Padraig , Duff‐Canning Sarah , Krahn Murray , Naglie Gary , Tannock Ian , Tomlinson George , Alibhai Shabbir M.H.
Published: February 2009

OBJECTIVE

To determine whether clinicians discuss bone‐specific side‐effects with patients on androgen‐deprivation therapy (ADT) for prostate cancer, or prescribe lifestyle and pharmacological interventions for low bone mineral density (BMD), as decreased BMD is a common side‐effect of ADT, leading to increased risk of fracture.

PATIENTS AND METHODS

Sixty‐six men (mean age 70.6 years) with non‐metastatic prostate cancer and starting continuous ADT were enrolled in a prospective longitudinal study. BMD was determined by dual X‐ray absorptiometry (DXA) at baseline. Patients were interviewed to obtain their medical histories, and charts were reviewed to determine whether clinicians documented potential bone side‐effects in clinic notes, and made lifestyle and/or medication recommendations. Both were done at the start of ADT, and 3 and 6 months later. Patients were classified based on DXA T‐score as having normal BMD, as osteopenic, or osteoporotic.

RESULTS

At baseline, 53% of patients had osteopenia and 5% had osteoporosis. Within 6 months of starting ADT, general side‐effects and bone‐specific side‐effects of ADT were documented as being discussed with 26% and 15%, respectively. Clinicians recommended lifestyle interventions to 11% of patients. Pharmacological interventions (calcium, vitamin D, and/or bisphosphonates) were recommended to 18% of all patients within 6 months of starting ADT, and to 26% and 67% of osteopenic and osteoporotic patients, respectively.

CONCLUSIONS

A minority of patients is being informed of bone‐specific side‐effects of ADT. Lifestyle and drug interventions to prevent declines in BMD were recommended uncommonly. Practices around bone health for men starting ADT are suboptimal.
Evaluation of different techniques to create chronic urinary incontinence in the rat
Authors: Pauwels Elisabeth , De Wachter Stefan , Wyndaele Jean‐Jacques
Published: February 2009

OBJECTIVE

To evaluate models for chronic urinary incontinence (UI) in the rat.

MATERIALS AND METHODS

Two models were fully evaluated: one of repeated dilatation of the vagina, simulating birth trauma, the vaginal dilatation (VD) group; the other, with surgical transposition of the urethra to a vertical position, the urethral transposition (UT) group. The VD rats were evaluated by the sneeze test. When negative, vaginal dilatation was repeated in a similar way. The UT group was evaluated by observation of continuous urine leakage. The leak‐point pressure (LPP) was measured at study end in all the rats.

RESULTS

All the VD rats had occasional negative sneeze tests and all had to be dilated again. This resulted in persistent UI on sneeze testing for the entire period. In the UT group, 12 rats leaked continuously during the whole study period; in the other four UI became less at 4, 5, 6, and 7 weeks, respectively. The LPP in the rats with UI was significantly lower than in the respective control groups.

CONCLUSIONS

These models permit study of chronic stress UI and continuous UI in the rat. Spontaneous recovery of continence was seen mostly in the VD group.
Effect of dutasteride, tamsulosin and the combination on patient‐reported quality of life and treatment satisfaction in men with moderate‐to‐severe benign prostatic hyperplasia: 2‐year data from the CombAT trial
Authors: Barkin Jack , Roehrborn Claus G. , Siami Paul , Haillot Olivier , Morrill Betsy , Black Libby , Montorsi Francesco
Published: February 2009

OBJECTIVE

To investigate the effect of dutasteride and tamsulosin as combined therapy compared with each monotherapy for improving patient‐reported health outcomes in men with moderate‐to‐severe urinary symptoms and prostate enlargement, reporting the pre‐planned 2‐year analyses from the CombAT trial.

PATIENTS AND METHODS

The CombAT study is an ongoing, international, double‐blind, randomized, parallel‐group trial. Men aged ≥50 years with a clinical diagnosis of benign prostatic hyperplasia (BPH), an International Prostate Symptom Score (IPSS) of ≥12 units, a prostate volume of ≥30 mL, a total serum prostate‐specific antigen level of 1.5–10 ng/mL and a peak urinary flow of >5 and ≤15 mL/s, with a minimum voided volume of ≥125 mL, were randomized to receive 0.5 mg dutasteride, 0.4 mg tamsulosin or the combination once daily for 4 years. Symptoms were assessed every 3 months. The primary endpoint at 2 years was the change in IPSS from baseline. Secondary endpoints included various measures of health outcomes, which included the BPH Impact Index (BII), IPSS Question 8 (Q8), and the Patient Perception of Study Medication (PPSM) questionnaire.

RESULTS

Combined therapy resulted in significantly greater improvements in BII and IPSS Q8 from baseline than did dutasteride from 3 months and compared with tamsulosin from 9 months (BII) or 12 months (IPSS Q8). Assessments using the PPSM questionnaire showed that a significantly higher proportion of patients were satisfied with and would request dutasteride and tamsulosin combined therapy than with each monotherapy at 24 months.

CONCLUSIONS

Dutasteride and tamsulosin combined therapy provides significantly greater improvements in patient‐reported quality of life and treatment satisfaction than both monotherapies at 2 years, following the trends for clinical improvements in symptom scores and peak urinary flow rates, in men with moderate‐to‐severe BPH symptoms.
p53 immunochemistry is an independent prognostic marker for outcome in conservatively treated prostate cancer
Authors: Kudahetti Sak , Fisher Gabrielle , Ambroisine Laurence , Foster Christopher , Reuter Victor , Eastham James , Møller Henrik , Kattan Michael W. , Cooper Colin S. , Scardino Peter , Cuzick Jack , Berney Daniel M.
Published: February 2009

OBJECTIVE

To determine whether p53 is an independent biomarker of prostate cancer outcome against currently used biomarkers in a cohort of conservatively treated prostate cancers with long‐term follow‐up available.

PATIENTS AND METHODS

We examined p53 expression by immunohistochemistry in a cohort of 705 patients with clinically localized prostate cancer, who were treated conservatively. Patients were selected through UK Cancer Registries. End‐points included prostate cancer death and overall death rates. Standard biological variables, including diagnostic serum PSA, contemporary Gleason scoring, clinical staging and cancer extent were available. p53 expression was measured semi‐quantitatively on microscopic examination and compared with current clinical biomarkers.

RESULTS

p53 over expression was a significant predictor of cause‐specific survival (hazard ratio [HR] 2.95, 95% CI 2.05–4.25, P < 0.001) and overall survival (HR 2.37, 95% CI 1.84–3.05, P < 0.001). In multivariate analysis including competing biological variables p53 expression was still significantly linked to prostate cancer survival (HR 1.51, 95% CI 1.04–2.19, P = 0.03) and overall survival (HR 1.57, 95% CI 1.21–2.05, P = 0.001).

CONCLUSIONS

We conclude that p53 may have a role in the future assessment of newly diagnosed prostate cancer, as it significantly adds to the current prognostic model.
Fulguration of the lumen does not improve vasectomy sterilization rates
Authors: Munro Nicholas P. , Kotwal Sanjeev , Gogoi Ng K. , Weston Philip M.T. , Browning Anthony J. , Harrison Simon C.W. , Biyani Shekhar , Chahal Rohit , Sundaram Subramanian K.
Published: February 2009

OBJECTIVES

To assess the effect of adding lumen diathermy fulguration to our standard technique of vas ligation with polyglactin 910 (VicrylTM, Ethicon, Sommerville, NJ, USA) excision and fascial interposition, in an attempt to improve our sterilization rates. We previously reported the effect of changing suture material on vasectomy success rates; 3005 post‐vasectomy semen analyses (PVSA) revealed a decrease in sterilization rates after surgery on changing from chromic catgut to polyglactin 910.

PATIENTS AND METHODS

We retrospectively reviewed PVSA undertaken for vasectomies performed by urological surgeons at the Mid‐Yorkshire NHS Trust for 18 months from September 2005 to February 2007.

RESULTS

There were 592 vasectomies in all; the age distribution of patients between the groups treated with the standard and new method was similar. Overall, 166 patients (28%) failed to provide two semen samples as instructed, and so were excluded from further analyses. Sterility was achieved in 367 patients (86%); a further 28 (7%) have indeterminate analyses to date, with one of the last two PVSAs showing sperm, with the PVSA of 32 (7%) patients showing persisting sperm. For the eight surgeons reviewed the sterility rates were broadly similar.

CONCLUSIONS

The introduction of diathermy fulguration of the lumen has not improved vasectomy sterilization rates, with up to 14% having sperm on PVSA.
Outcomes after radical prostatectomy in men receiving previous pelvic radiation for non‐prostate malignancies
Authors: Masterson Timothy A. , Wedmid Alexei , Sandhu Jaspreet S. , Eastham James A.
Published: February 2009

OBJECTIVE

To report the perioperative and functional outcomes of nine patients treated at our institution who had radical prostatectomy (RP) after previous pelvic radiotherapy (RT) for non‐prostate malignancies.

PATIENTS AND METHODS

From 1993 to 2007, nine patients had RP after external beam RT for testicular seminoma (six), anorectal cancer (two) and colon cancer (one). Clinical information was obtained from a prospective prostate cancer database.

RESULTS

RP was completed with no identifiable injury to adjacent structures in all nine patients. Four patients had significant pelvic fibrosis, and three required bilateral neurovascular bundle (NVB) resection. The NVB was preserved in the remaining six patients, four with good preoperative erectile function. However, no patient recovered erectile function after RP at a median (range) follow‐up of 75 (12–172) months. Of seven men continent before RP, four required one or fewer pads daily and three were completely dry, achieving complete urinary control at a median (range) time of 7.5 (2–20) months. Two patients developed an anastomotic stricture, one being associated with concomitant ureteric stricture.

CONCLUSIONS

RP after pelvic RT for non‐prostate malignancies was not associated with increased intraoperative morbidity. However, rates of anastomotic stricture, erectile dysfunction and urinary incontinence appeared to be higher than those reported after RP in men with no previous RT, and comparable with those seen in the salvage RP setting.
Quality of life and perioperative outcomes after retroperitoneoscopic radical nephrectomy (RN), open RN and nephron‐sparing surgery in patients with renal cell carcinoma
Authors: Gratzke Christian , Seitz Michael , Bayrle Florian , Schlenker Boris , Bastian Patrick J. , Haseke Niko , Bader Markus , Tilki Derya , Roosen Alexander , Karl Alexander , Reich Oliver , Khoder Wael Y. , Wyler Stephen , Stief Christian G. , Staehler Michael , Bachmann Alexander
Published: February 2009

OBJECTIVE

To prospectively evaluate health‐related quality of life (HRQoL) and perioperative outcomes in patients with T1 and T2 renal cell carcinoma (RCC) after retroperitoneoscopic radical nephrectomy (RRN), open RN (ORN) or open nephron‐sparing surgery (NSS).

PATIENTS AND METHODS

The data of 117 patients who had undergone RRN (36), ORN (37) or NSS (44) were evaluated. RRN data were obtained at Basel University Hospital, Switzerland, while the ORN and NSS data were collected at the University of Munich, Germany. Perioperative outcomes were analysed and compared. HRQoL was prospectively evaluated based on the Short Form 36 questionnaire with a mean follow‐up of 22 months.

RESULTS

Operative duration was significantly longer in the RRN group compared with the ORN and NSS groups, at a mean (sem) of 146 (42) min vs 113 (48) min and 114 (42) min (P < 0.001). In the RRN group intraoperative blood loss was lower than in the ORN and NSS groups, at a mean (sem) of 231 (153) mL vs 424 (361) mL and 494 (360) mL (P < 0.001). Morbidity rates were 13.9% for RRN, 16.2% for ORN and 20.5% for NSS, the most relevant complications being bleeding requiring transfusions in RRN and NSS patients and haemorrhage (5% of patients in each group). Creatinine values at 6 months after surgery only recovered completely in the NSS group. Patients in the ORN group had a trend towards higher mental well‐being scores than patients in the RRN and NSS groups, with a mean Mental Component Summary Score of 48.3 vs 48.0 and 44.5, respectively (not statistically significant), while all patients were in similar physical condition after surgery, with a mean Physical Component Summary Scores of 48.0 (ORN), 47.4 (RRN) and 47.2 (NSS). The physical condition scores of patients in all groups were higher than scores reached by an age and sex‐matched population (45.8).

CONCLUSION

These real‐world data show that each of the surgical techniques can be considered safe. Importantly, after surgery patients reported high QoL scores independent of the technique used.
Changes in the androgen levels in the ventral prostate of spontaneously hypertensive rats after castration
Authors: Hu Mingqiu , Xin Dianqi , Chen Jun , Sun Guofeng , Wang Yiming , Na Yanqun
Published: February 2009

OBJECTIVE

To characterize the changes in androgen levels in the prostate after castration, as androgens are critical in the progression of prostate cancer after castration, but the time at which the androgen remaining in the prostatic cancer tissue after castration exerts its effects is poorly understood.

MATERIALS AND METHODS

The ventral prostate (VP) in adult male spontaneously hypertensive rats was excised at 2, 4 and 8 h, 1, 2, 4 and 7 days, and 2, 4 and 8 weeks after castration. The dihydrotestosterone (DHT), testosterone, dehydroepiandrosterone (DHEA) and androstenedione (4‐dione) levels in the VP were measured simultaneously using gas chromatography/tandem mass spectrometry.

RESULTS

Within 2 days of castration, the DHT and testosterone levels in the VP decreased sharply, while there were no significant changes in the DHEA or 4‐dione levels. From 2 days to 2 weeks after castration (2–7 days for 4‐dione), there was a sharp peak in tissue androgen levels in the VP (P < 0.05 for all androgens); during the subsequent 6 weeks after castration, all of the tissue DHT, testosterone, DHEA and 4‐dione levels gradually increased with time.

CONCLUSIONS

These data show the changes which occur in androgen levels in rat VP after castration and support the concept that the adrenal glands compensate for the loss of testicular androgen.
Prospective single‐centre comparison of 120‐W diode‐pumped solid‐state high‐intensity system laser vaporization of the prostate and 200‐W high‐intensive diode‐laser ablation of the prostate for treating benign prostatic hyperplasia
Authors: Ruszat Robin , Seitz Michael , Wyler Stephen F. , Müller Georg , Rieken Malte , Bonkat Gernot , Gasser Thomas C. , Reich Oliver , Bachmann Alexander
Published: February 2009

OBJECTIVE

To evaluate the safety, efficacy and short‐term outcome of a new 980 nm high‐intensity diode (HiDi) laser (Limmer Laser, Berlin, Germany) system in comparison to the diode‐pumped solid‐state laser high‐performance system (HPS; GreenLightTM, AMS, Minnetonka, MI, USA) for treating benign prostatic hyperplasia (BPH) in a prospective non‐randomized single‐centre study.

PATIENTS AND METHODS

From February to September 2007, 117 consecutive patients with lower urinary tract symptoms secondary to BPH were included; 62 patients were treated with 120‐W HPS laser vaporization and 55 with 980‐nm HiDi laser ablation of the prostate. We evaluated perioperative variables, and complications during and after surgery. Patients presenting for follow‐up completed the International Prostate Symptom Score, and had their maximum urinary flow rate and postvoid residual urine volume measured.

RESULTS

The mean (sd) age of the patients was 72.3 (8.8) years (HiDi) and 73.1 (10.8) years (HPS), with a mean preoperative prostate volume of 64.7 (29.7) and 67.4 (46.9) mL, respectively. The mean operative duration was comparable, at 56.4 (20.2) and 62.7 (36.3) min, respectively, whereas the mean energy delivery was significantly higher with the diode laser, at 313 (132) vs 187 (129) kJ (P < 0.001). For patients treated with the HPS the rate of visual impairment from bleeding was higher (0% vs 12.9%, P < 0.01), as was prostate capsule perforation (0% vs 4.8%, P > 0.05). Soon after surgery the rate of dysuria (23.6% vs 17.7%, P > 0.05) and transient urge incontinence (7.3% vs 0%; P < 0.05) was higher for the HiDi laser. During the follow‐up there were higher rates of bladder neck stricture (14.5% vs 1.6%, P < 0.01), re‐treatment (18.2% vs 1.6%, P < 0.01) and stress urinary incontinence (9.1% vs 0%; P < 0.05) for the HiDi laser group.

CONCLUSION

Both systems investigated provide good tissue ablative properties. The HiDi laser at 980 nm is more favourable in terms of haemostasis. The penetration depths, resulting in coagulation necrosis and leading to increased re‐treatment, bladder neck stricture and incontinence rates, were higher with the HiDi laser.
Long‐term results of a combination of paclitaxel, cisplatin and gemcitabine for salvage therapy in male germ‐cell tumours
Authors: Nicolai Nicola , Necchi Andrea , Gianni Luca , Piva Luigi , Biasoni Davide , Torelli Tullio , Stagni Silvia , Milani Angelo , Pizzocaro Giorgio , Salvioni Roberto
Published: February 2009

OBJECTIVE

To retrospectively review the long‐term activity, efficacy and toxicity of the combination of paclitaxel, cisplatin and gemcitabine (TPG) as third‐ or further‐line chemotherapy in patients with germ‐cell tumours (GCTs) who are not cured after at least two courses of standard‐dose chemotherapy, high‐dose chemotherapy or both.

PATIENTS AND METHODS

We evaluated 22 consecutive men treated between April 1999 and December 2000. Half of them were classified as absolutely refractory to cisplatin and a further two as refractory. The median (range) number of previous courses of chemotherapy was 8  (5–11). Treatment consisted of paclitaxel 80 mg/m2, cisplatin 50 mg/m2 and gemcitabine 800 mg/m2 on days 1 and 8, every 3 weeks for four courses, followed by surgery of actual residual resectable masses.

RESULTS

The follow‐up was updated at August 2007. There were no deaths from toxicity and only one patient needed suspension of therapy for toxicity. There was both grade 3–4 thrombocytopenia and neutropenia in 15 patients (68%), and anaemia in nine (41%). There were partial remissions in eight (36%) patients. Six (27%) patients were rendered disease‐free with surgical removal of a residual mass after chemotherapy (two still containing viable cancer). Four (18%) patients are long‐term survivors at more than 80, 81, 94 and 99 months. The median (range) overall survival of the whole series was 13.5 (1–>99) months.

CONCLUSION

This combination had a toxicity profile that was acceptable and comparable with other third‐line regimens. There were eight (36%) major responses. After a 6‐year minimum follow‐up, four (18%) patients were long‐term disease‐free survivors.
Recent advances in adaptive thermogenesis: potential implications for the treatment of obesity
Authors: Wijers S. L. J. , Saris W. H. M. , Van Marken Lichtenbelt W. D.
Published: February 2009

Large inter‐individual differences in cold‐induced (non‐shivering) and diet‐induced adaptive thermogenesis exist in animals and humans. These differences in energy expenditure can have a large impact on long‐term energy balance and thus body weight (when other factors remain stable). Therefore, the level of adaptive thermogenesis might relate to the susceptibility to obesity; efforts to increase adaptive thermogenesis might be used to treat obesity. In small mammals, the main process involved is mitochondrial uncoupling in brown adipose tissue (BAT), which is regulated by the sympathetic nervous system. For a long time, it was assumed that mitochondrial uncoupling is not a major physiological contributor to adaptive thermogenesis in adult humans. However, several studies conducted in recent years suggest that mitochondrial uncoupling in BAT and skeletal muscle tissue in adult humans can be physiologically significant. Other mechanisms besides mitochondrial uncoupling that might be involved are futile calcium cycling, protein turnover and substrate cycling. In conjunction with recent advances on signal transduction studies, this knowledge makes manipulation of adaptive thermogenesis a more realistic option and thus a pharmacologically interesting target to treat obesity.
Does oestrogen allow women to store fat more efficiently? A biological advantage for fertility and gestation
Authors: O'Sullivan A. J.
Published: February 2009

In normal healthy‐weight humans, women have a higher percentage body fat than men, a difference that commences at puberty and continues throughout adult life, suggesting that the mechanism is related to sex steroids. The first half of pregnancy is also a stage of body fat gain in women. From an energy balance point, there is no explanation why women should be fatter than men, as the latter consume more calories proportionately. Moreover, women store fat in early pregnancy when caloric intake does not significantly change. The aim of this review is to focus on evidence supporting one mechanism that may account for these findings. That is, oestrogen reduces postprandial fatty acid oxidation leading to an increase in body fat which may account for the greater fat mass observed in women compared with men and the fat gain in early pregnancy. Therefore, female puberty and early pregnancy could be seen as states of efficient fat storage of energy in preparation for fertility, foetal development and lactation providing an obvious biological advantage. Further research into this mechanism of fat storage may provide further insights into the regulation of body fat.
Employee Participation in Employee Share Ownership: an Evaluation of the Factors Associated with Participation and Contributions in Save As You Earn Plans
Authors: Pendleton Andrew
Published: February 2009

The factors associated with participation in and contributions to UK Save As You Earn (SAYE) share option plans are examined. In the absence of a UK literature, the American literature on subscriptions to 401(k) pension plans is drawn upon to develop hypotheses. In addition to the demographic factors (income, age, sex etc.) identified in that literature, the role of attitudinal factors in influencing employee participation and contributions is also investigated. The data source is over 2600 employees in three large UK companies with well‐established SAYE plans. In common with the 401(k) literature, income and age are found to be strong determinants of both participation and contribution levels. Views about the plan are more important than attitudes to the firm in influencing contributions, whilst participation rates are negatively related to commitment (contrary to predictions). These findings are shown to have implications for companies, policy‐makers and researchers.
Resolution Independent NPR‐Style 3D Line Textures
Authors: Potter Kristin , Gooch Amy , Gooch Bruce , Willemsen Peter , Kniss Joe , Riesenfeld Richard , Shirley Peter
Published: February 2009

This work introduces a technique for interactive walk‐throughs of non‐photorealistically rendered (NPR) scenes using three‐dimensional (3D) line primitives to define architectural features of the model, as well as indicate textural qualities. Line primitives are not typically used in this manner in favour of texture mapping techniques which can encapsulate a great deal of information in a single texture map, and take advantage of GPU optimizations for accelerated rendering. However, texture mapped images may not maintain the visual quality or aesthetic appeal that is possible when using 3D lines to simulate NPR scenes such as hand‐drawn illustrations or architectural renderings. In addition, line textures can be modified interactively, for instance changing the sketchy quality of the lines. The technique introduced here extracts feature edges from a model, and using these edges, generates a reduced set of line textures which indicate material properties while maintaining interactive frame rates. A clipping algorithm is presented to enable 3D lines to reside only in the interior of the 3D model without exposing the underlying triangulated mesh. The resulting system produces interactive illustrations with high visual quality that are free from animation artifacts.