bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of passive and active immunization of fish against streptococcosis (enterococcosis)
Authors: Akhlaghi M , Munday B L , Whittington R J
Published: April 2006

Passive immunization of rainbow trout, Oncorhynchus mykiss (Walbaum), was carried out to determine the persistence of anti‐Streptococcus sp. antibodies (ASA) raised in sheep, rabbits or rainbow trout. The protection afforded by passive immunization was compared with the protection obtained from active immunization by immersion in or intraperitoneal (i.p.) injection with formalin‐killed cells. Assessments were undertaken concurrently for up to 3 months post‐immunization (PI) to evaluate the practical potential of passive immunization. Passively administered sheep and rabbit antibodies were detected in fish sera by enzyme‐linked immunosorbcnt assay for more than 60 days after i.p. injection. Fish responded immunologically to these antibodies and the highest humoral responses to sheep and rabbit ASA occurred at 2 months PI. The relative per cent survival (RPS) of rainbow trout challenged with virulent Streptococcus sp. after an i.p. injection (0.1 ml 100 g−1 fish body weight) of sheep, rabbit or fish ASA was: 88.8, 50 and 0% after 1 month; 33.3, 6.8 and 6.8% after 2 months; and 13.3, 0 and 6.6% after 3 months PI, respectively. Fish immunized actively had an RPS of 88.8 and 11.1% after 1 month, 38.1 and 4.7% after 2 months, and 36 and 0% after 3 months PI for the i.p. injection and immersion routes, respectively.
Necrotic myositis in cage cultured rainbow trout, Oncorhynchus mykiss (Walbaum), caused by Flexibacter psychrophilus
Authors: Lumsden J S , Ostland V E , Ferguson H W
Published: April 2006

A severe necrotic myositis characterized by large intramuscular bullae was identified in 100–500 g rainbow trout, Oncorhynchus mykiss (Walbaum), maintained in freshwater netpens. Mortality increased as the temperature decreased, with mortality rates peaking at 10% per month. Flexibacter psychrophilus was recovered from the muscle lesions and kidneys of affected fish. The gross and histological description of the disease, and the phenotypic characteristics of the causative agent are described. The necrotic myositis isolate was utilized to experimentally reproduce the disease.
Biological characterization of a monoclonal antibody against a surface membrane antigen on Cryptobia salmositica Katz, 1951
Authors: Feng S , Woo P T K
Published: April 2006

A monoclonal antibody (IgG 1) (designated as MAb‐001) was produced against the pathogenic haemoflagellate Cryptobia salmontica Katz. The antibody agglutinated live parasites under in vitro conditions. Live C. salmositica, incubated with MAb‐001 at 10 °C, did not multiply and were dead within 4 weeks in culture. About 50% of juvenile rainbow trout, Oncorhynchus mykiss (Walbaum), inoculated intraperhoneally with C. salmositica, incubated in MAb‐001 prior to inoculation, did not become infected, while in adult rainbow trout, the peak parasitaemia was reduced. These results indicate that MAb‐001 is a protective monoclonal antibody and the antigen it recognizes is located on rhe surface membrane of C. salmositica. The antibody also inhibits multiplication and affects viability of the parasite under in vitro conditions.
The nucleotide sequence of the gene encoding GCAT from Aeromonas salmonicida ssp. salmonicida
Authors: Nerland A H
Published: April 2006

The nucleotide sequence of the gene encoding GCAT (glycerophospholipid: cholesterol acetyltransferase) in Aeromonas salmonicida ssp. salmonicida has been determined. The sequence revealed an open reading frame of 1005 bp encoding 335 amino acids, an 18‐amino‐acid signal peptide and a 317‐amino‐acid mature polypeptide with a deduced molecular mass of 35 380 Da and an estimated pI of 6.25. Within the encoding region, the homology with the corresponding gene fromAeromonas hydrophila was 92.9% for the nucleotide sequence and 93.7% for the deduced amino acid sequence.
Sleeping disease and pancreas disease: comparative histopathology and acquired cross‐protection
Authors: Boucher P , Laurencin F Baudin
Published: April 2006

Sleeping disease (SD), a disease of freshwater‐reared rainbow trout, Oncorhynchus mykiss (Walbaum), was histologically compared to pancreas disease (PD), a disease of sea water‐reared Atlantic salmon, Salmo salar L. Some weeks after injection of kidney homogenates from SD‐ or PD‐affected fish in rainbow trout, the fish successively developed pancreatic, heart and muscular lesions in both populations, although the SD‐injected population was the most affected. An acquired protection was observed against PD and SD after an initial injection with PD‐ or SD‐infective material. This acquired cross‐protection and the similar histopathologies in PD and SD suggest the two diseases could be caused by a similar or identical agent.
Distribution of genetic variation within and among local populations of Arabidopsis thaliana over its species range
Authors: BAKKER E. G. , STAHL E. A. , TOOMAJIAN C. , NORDBORG M. , KREITMAN M. , BERGELSON J.
Published: April 2006

A detailed description of local population structure in Arabidopsis thaliana is presented, including an assessment of the genetic relatedness of individuals collected from the same field. A hierarchical sample of four individuals from 37 local populations, including North America, England, Eastern and Western Europe, and Asia, and a selection of ecotypes, were analysed for variation in Adh, ChiA, FAH1, F3H, Rpm1, Rps5, and five microsatellite loci. Twenty‐eight of the 37 population samples contained individuals with identical multilocus haplotypes, 12 of which were fixed for a single haplotype. These monomorphic populations were evenly distributed over the species range. Only in North America did we find a single multilocus haplotype shared among different populations, perhaps indicating a continental founder event. Despite the occurrence of local inbreeding, a considerable amount of genetic variation was found segregating within and among local populations. A novel analysis of haplotype differences reveals that genetic differentiation occurs at every geographic scale in A. thaliana, where we find a surprising under‐representation of recent migrants between local populations. This leads us to hypothesize that most dispersal between A. thaliana populations is by pollen rather than seed. Based on the structure of A. thaliana populations, it appears that regional groups of local populations may provide the most appropriate genetic material for linkage disequilibrium mapping of adaptive traits.
Identification and functional analysis of a prokaryotic‐type aspartate aminotransferase: implications for plant amino acid metabolism
Authors: de la Torre Fernando , Santis Laura De , Suárez María Fernanda , Crespillo Remedios , Cánovas Francisco M.
Published: April 2006

In this paper, we report the identification of genes from pine (PpAAT), Arabidopsis (AtAAT) and rice (OsAAT) encoding a novel class of aspartate aminotransferase (AAT, EC 2.6.1.1) in plants. The enzyme is unrelated to other eukaryotic AATs from plants and animals but similar to bacterial enzymes. Phylogenetic analysis indicates that this prokaryotic‐type AAT is closely related to cyanobacterial enzymes, suggesting it might have an endosymbiotic origin. Interestingly, most of the essential residues involved in the interaction with the substrate and the attachment of pyridoxal phosphate cofactor in the active site of the enzyme were conserved in the deduced polypeptide. The polypeptide is processed in planta to a mature subunit of 45 kDa that is immunologically distinct from the cytosolic, mitochondrial and chloroplastic isoforms of AAT previously characterized in plants. Functional expression of PpAAT sequences in Escherichia coli showed that the processed precursor is assembled into a catalytically active homodimeric holoenzyme that is strictly specific for aspartate. These atypical genes are predominantly expressed in green tissues of pine, Arabidopsis and rice, suggesting a key role of this AAT in nitrogen metabolism associated with photosynthetic activity. Moreover, immunological analyses revealed that the plant prokaryotic‐type AAT is a nuclear‐encoded chloroplast protein. This implies that two plastidic AAT co‐exist in plants: a eukaryotic type previously characterized and the prokaryotic type described here. The respective roles of these two enzymes in plant amino acid metabolism are discussed.
A specific transporter for iron(III)–phytosiderophore in barley roots
Authors: Murata Yoshiko , Ma Jian Feng , Yamaji Naoki , Ueno Daisei , Nomoto Kyosuke , Iwashita Takashi
Published: April 2006

Iron acquisition of graminaceous plants is characterized by the synthesis and secretion of the iron‐chelating phytosiderophore, mugineic acid (MA), and by a specific uptake system for iron(III)–phytosiderophore complexes. We identified a gene specifically encoding an iron–phytosiderophore transporter (HvYS1) in barley, which is the most tolerant species to iron deficiency among graminaceous plants. HvYS1 was predicted to encode a polypeptide of 678 amino acids and to have 72.7% identity with ZmYS1, a first protein identified as an iron(III)–phytosiderophore transporter in maize. Real‐time RT‐PCR analysis showed that the HvYS1 gene was mainly expressed in the roots, and its expression was enhanced under iron deficiency. In situ hybridization analysis of iron‐deficient barley roots revealed that the mRNA of HvYS1 was localized in epidermal root cells. Furthermore, immunohistological staining with anti‐HvYS1 polyclonal antibody showed the same localization as the mRNA. HvYS1 functionally complemented yeast strains defective in iron uptake on media containing iron(III)–MA, but not iron–nicotianamine (NA). Expression of HvYS1 in Xenopus oocytes showed strict specificity for both metals and ligands: HvYS1 transports only iron(III) chelated with phytosiderophore. The localization and substrate specificity of HvYS1 is different from those of ZmYS1, indicating that HvYS1 is a specific transporter for iron(III)–phytosiderophore involved in primary iron acquisition from soil in barley roots.
Recent developments in the treatment of adult atopic dermatitis
Authors: Pua Vernon SC , Barnetson Ross StC
Published: April 2006

Atopic dermatitis is a common inflammatory skin condition with increasing incidence in recent decades. The mainstay of treatment has been the combination of emollients and topical corticosteroids, with the addition of systemic therapies in severe cases. New drugs such as the topical calcineurin inhibitors have shown promise in treating mild‐to‐severe atopic dermatitis. Other novel therapies that have been reported in the literature include leukotriene antagonists, monoclonal antibodies such as infliximab, leflunomide, recombinant interferon gamma and intravenous immunoglobulin. This review will focus on the treatment of adult atopic dermatitis.
Retrospective analysis of adult patients with cutaneous leukocytoclastic vasculitis
Authors: Tai Yee J , Chong Alvin H , Williams Richard A , Cumming Simon , Kelly Robert I
Published: April 2006

A retrospective analysis was conducted on 93 adult patients with cutaneous leukocytoclastic vasculitis from St. Vincent's Hospital Melbourne to determine the classification, aetiology, severity and prognosis of this population of patients. We developed a new classification system for the purposes of our study based on modifications to the Chapel Hill Consensus Conference definitions for vasculitic syndromes. The results of our study indicate that an obvious cause was not found in 44.1% of patients. Of the patients with secondary vasculitis, the commonest causes were drugs and infections, accounting for a total of 40.9% of patients. Extracutaneous involvement was found in 39.8% of patients. Patients with symptoms resolving in less than 3 months accounted for 59.1% of the population, whereas 24.8% of patients had either symptoms lasting three or more months or evidence of recurrent symptomatology. There were 6 deaths (6.91%) and the rest were lost to follow up. The majority of patients in this retrospective series were classified as having hypersensitivity vasculitis, which is a relatively benign disorder limited mostly to skin with a low incidence of extracutaneous involvement (15.8%). Nevertheless, evidence of systemic involvement or sepsis need to be excluded as this may have important implications for patient treatment and outcome.
One‐fifth of basal cell carcinomas have a morphoeic or partly morphoeic histology: Implications for treatment
Authors: Burdon‐Jones David , Thomas Peter W
Published: April 2006

A retrospective analysis of the histopathology reports for all first or single basal cell carcinomas (1567) surgically treated over a 13‐year period, was undertaken. Basal cell carcinomas classified by standard skin pathology nomenclature were divided into three groups: purely morphoeic basal cell carcinomas, partly morphoeic basal cell carcinomas and non‐morphoeic basal cell carcinomas. A morphoeic or partly morphoeic histology was reported in 21.8% of basal cell carcinomas, particularly on the head and neck and in those over the age of 64 years. This percentage may increase further as patients live longer, and has important implications for treatment selection.
Seborrhoeic keratosis and malignancy: Collision tumour or malignant transformation?
Authors: Vun Yin , De’Ambrosis Brian , Spelman Lynda , Muir James B , Yong‐Gee Simon , Wagner Godfrey , Lun Karyn
Published: April 2006

A retrospective study of 813 histological specimens reported as seborrhoeic keratoses included 43 (5.3%) associated with non‐melanoma skin cancer. Intraepidermal carcinoma (squamous cell carcinoma in situ) was the most common of these (36). There were five basal cell carcinomas (one with intraepidermal carcinoma also) and two invasive squamous cell carcinomas. No melanomas were reported. Twenty‐seven of the intraepidermal carcinomas appeared to arise within the seborrhoeic keratosis as did one of the invasive squamous cell carcinomas. Of these 28 lesions, the head was the most common site. Fourteen were clinically diagnosed as a non‐melanoma skin cancer with only nine clinically felt to be a seborrhoeic keratosis. These lesions may represent malignant transformation within the seborrhoeic keratosis. Twelve specimens reported adjacent dual pathologies, with the trunk and limbs the most common sites. Seven were diagnosed clinically as a skin malignancy, whereas three were thought to be solar keratoses. Clinically, the remaining two were seborrhoeic keratoses. The origin of the malignancy in these cases is less obvious and may represent collision tumours. Three curette specimens could not be assessed for architecture.
Severe toxic epidermal necrolysis precipitated by amphetamine use
Authors: Roberts Hugh , Chamberlain Alexander , Rennick Gordon , McLean Catriona , Gin Douglas
Published: April 2006

A 48‐year‐old man presented with a maculopapular truncal rash 9 days following intravenous amphetamine use. He subsequently developed widespread bullae over his trunk and upper limbs. Treatment was initially commenced with intravenous hydrocortisone. A diagnosis of toxic epidermal necrolysis was made and the treatment was changed to intravenous immunoglobulin at a lower dose than requested. At the height of the reaction, there was 90% body surface area involvement with tri‐mucosal involvement. His response to the intravenous immunoglobulin was poor and was complicated by infection with methicillin‐resistant Staphylococcus aureus, Candida albicans and Pseudomonas aeruginosa. Gradual re‐epithelialization took place over the next 6 weeks.
Colloid milium arising on a non‐sun‐exposed area in an adult
Authors: Lim Cathy , Li Michael
Published: April 2006

A 59‐year‐old woman presented with multiple translucent papules on the inner surface of the tragus of the right ear. Initially they were treated with cryotherapy, with a later biopsy revealing the diagnosis of colloid milium. The histology was unusual for adult colloid milium as the lesion lacked a Grenz zone and evidence of solar elastosis. This together with a lack of aetiological factors made it difficult to classify the subtype of colloid milium.
Invasive squamous cell carcinoma arising in refractory perianal Bowen's disease in a HIV‐positive individual
Authors: Herat Asoka , Shirato Kyoko , Damian Diona L , Finlayson Robert , Whitfeld Margot
Published: April 2006

A 54‐year‐old HIV‐positive homosexual man presented with erythematous and pigmented plaques on background erythema in the perianal region, histologically consistent with Bowen's disease. Perianal Bowen's disease represents high‐grade anal intraepithelial neoplasia, which is considered a precursor lesion of invasive anal squamous cell carcinoma. This patient's anal intraepithelial neoplasia was unresponsive to multiple treatment modalities including cryotherapy, serial curettage and cautery, topical 5‐fluorouracil and 5‐aminolaevulinic acid photodynamic therapy. He progressed to develop a poorly differentiated squamous cell carcinoma of the anus three and a half years after the Bowen's disease was diagnosed. The squamous cell carcinoma was treated with combined chemoradiation. A recurrence of high‐grade anal intraepithelial neoplasia was noted 6 months after completion of chemoradiation.
Pseudoporphyria secondary to narrowband UVB phototherapy for psoriasis
Authors: Oh Carol , Jones Brad , Solomon Rustum , Egan Conleth A
Published: April 2006

A 59‐year‐old woman undergoing narrowband UVB phototherapy for treatment of psoriasis presented suddenly with tense blisters on both hips. The blisters were asymptomatic and disappeared within 24 hours. Histopathology together with a negative porphyrin screen made the diagnosis of pseudoporphyria. Blood tests including a full blood count, urea and electrolytes, liver function tests and antinuclear autoantibodies were normal. The patient was otherwise healthy; there was no history of extensive sun exposure, sunbeds or medication with non‐steroidal anti‐inflammatory drugs. This presentation of pseudoporphyria secondary to narrowband UVB radiation is unusual, as UVB radiation is not known to be associated with pseudoporphyria.
Useful subcutaneous suture technique to optimize wound edge apposition and avoid ‘dog ears’
Authors: Vinciullo Carl
Published: April 2006

The key to obtaining excellent scars is perfect wound edge apposition with little or no tension across the sutured wound. Unsightly ‘dog ear’ protrusions at the ends of the wound should be avoided as they can detract from the cosmetic result. A simple, practical and efficient surgical technique is described, which can provide the optimal conditions for a perfect scar.
Occupational allergic contact dermatitis to cobalt octoate included as an accelerator in a polyester resin
Authors: Anavekar Namrata S , Nixon Rosemary
Published: April 2006

A 46‐year‐old woman, who worked as a laminator of spa baths, presented with hand dermatitis, which was suspected to be related to her occupation. Patch testing revealed strong reactions to both cobalt chloride and a polyester resin that the patient had been using at her workplace. She also reacted to latex and had been wearing cotton gloves underneath rubber gloves at work. It was later discovered that cobalt octoate (synonym: cobalt‐2‐ethylhexanoate), a compound not listed on the manufacturer's material safety data sheet, was included as an accelerator in the polyester resin. She was then tested to cobalt octoate, which was also strongly positive. Her successful treatment included protection of her hands at work with cotton lined PVC gloves. This case highlights the role of cobalt salts as sensitizers and their presence as accelerators used in polyester resins, and the importance of recognizing concomitant latex allergy that may complicate occupational dermatitis. It also illustrates the difficulties in relying on material safety data sheets to identify all possible allergens.
Seborrhoeic keratoses with associated lesions: A retrospective analysis of 85 lesions
Authors: Lim Cathy
Published: April 2006

Seborrhoeic keratoses are benign epidermal neoplasms that are rarely associated with other skin lesions especially malignancies. In this study, the aim was to assess the incidence of associated lesions occurring either adjacent to or contiguous with a seborrhoeic keratosis. A retrospective case series over a 12‐month period was carried out. In total, 639 consecutive histologically diagnosed seborrhoeic keratoses were identified, of which 85 (9%) were found to be associated with other lesions. Of these associated lesions, 44 (7%) were malignant, with four of these found to be arising within the seborrhoeic keratosis. These associated lesions included premalignant lesions, malignancies, melanocytic lesions and miscellaneous lesions. Men (59%) were affected more commonly than women. The average age was 74 years (range 33–98 years). Seborrhoeic keratoses associated with other lesions were found most commonly on the head and neck. The incidence of associated lesions, in particular malignancy arising within seborrhoeic keratoses may be higher than previously thought. This may be an incidental phenomenon, or seborrhoeic keratosis could represent a precursor lesion. Therefore, seborrhoeic keratoses that have undergone recent clinical change should be considered for biopsy and histological examination.
Rapid detection of the fluoroquinolone resistance‐associated ParC mutation in Neisseria gonorrhoeae using TaqMan probes
Authors: SHIGEMURA KATSUMI , SHIRAKAWA TOSHIRO , TANAKA KAZUSHI , ARAKAWA SOICHI , GOTOH AKINOBU , FUJISAWA MASATO
Published: April 2006

Backgrounds:  In fluoroquinolone‐resistant Neisseria gonorrhoeae, the amino acid mutations in the fluoroquinolone‐resistant determining region (QRDR) of the parC gene are an important factor. The aim of the present study was to develop a rapid detection method of a serine 88 to proline substitution in parC which we previously showed as having significantly higher fluoroquinolone minimal inhibitory concentrations (MIC) using the TaqMan discrimination system.

Methods:  We extracted DNA from 90 urine or urethral swab samples obtained from male patients with urethritis caused by N. gonorrhoeae. After DNA extraction, they were subjected to real‐time polymerase chain reaction (PCR) using a TaqMan discrimination system and compared with the results of conventional DNA sequencing.

Results:  Of the 90 samples, the TaqMan technique result showed 13 samples that were classified as having a serine 88 to proline mutation in parC, and 77 samples that did not have a serine 88 to proline mutation in parC. The classifications of all samples completely corresponded to those determined by conventional DNA sequencing. We also found that N. gonorrhoeae with a serine 88 to proline mutation in parC have a significantly higher MIC to ciprofloxacin than that without a serine 88 to proline mutant in parC.

Conclusions:  The present genotyping method of real‐time PCR using a TaqMan discrimination system could be applied to the rapid detection of a serine 88 to proline amino acid mutation in parC of N. gonorrhoeae. This point mutation is significant for the determination of fluoruquinolone resistance. This rapid detection system may lead to the prevention of use of noneffective antimicrobial agents and a decrease of resistant strains.
Significance of Fas expression alteration during tumor progression of renal cell carcinoma
Authors: SEJIMA TAKEHIRO , MIYAGAWA IKUO
Published: April 2006

Background:  In order to characterize the alteration of apoptotic regulatory molecule expression during tumor progression of renal cell carcinoma (RCC), we compared the expression between tumor and normal tissues, and evaluated the relationship of the expression in tumors with pathological and clinical characteristics.

Methods:  Competitive reverse transcription–polymerase chain reaction (RT–PCR) and immunohistochemistry (IHC) allowed the determination of Fas and bcl‐2 mRNA and protein expression in surgically resected tumor and normal tissue of 50 RCC.

Results:  The mRNA expression of Fas and bcl‐2 in RCC was significantly reduced compared to that in normal tissues. An IHC analysis was supportive of the RT–PCR results. In terms of relationships with pathological and clinical characteristics, the mRNA and protein expression of Fas in high‐stage or high‐grade tumors was significantly higher than that in low‐stage or low‐grade tumors. Moreover, a statistically poor prognosis was observed in tumor cases expressing a high amount of mRNA. In bcl‐2 analysis, the mRNA and protein expression was significantly reduced in clear cell tumors compared to chromophobe cell tumors.

Conclusion:  It is suggested that the reduced expression of Fas and bcl‐2 in RCC compared with the expression in normal kidney is a prominent alteration of apoptotic regulatory molecules. The alteration of the up‐regulated Fas expression might be characterized during the tumor progression stage. It is also suggested that the effect of alteration of bcl‐2 expression might be minimal during the tumor progression stage because of the reduced expression in tumors of the clear cell type, which is the most dominant cell type in RCC.
Three‐year results of treatment for prostate cancer with low‐dose rate temporary iridium‐192 brachytherapy
Authors: MOMMA TETSUO , SAITO SHIRO , TOYA KAZUHITO , YOROZU ATSUNORI , DOKIYA TAKUSHI , MURAI MASARU
Published: April 2006

Aim:  To report the 3‐year treatment results of definitive irradiation by using a temporary interstitial implant with low‐dose rate iridium‐192 with or without external beam radiotherapy in the treatment of localized prostate cancer.

Methods:  One‐hundred and forty‐three patients with pathologically defined prostate carcinoma were treated from December 1997 to April 2003. The patients were classified into a low‐risk group (T2, PSA ≤ 20 ng/mL and Gleason score ≤ 6) or a high‐risk group (T3, PSA > 20 ng/mL or Gleason score ≥ 7). Low‐risk patients were treated with low‐dose‐rate iridium brachytherapy as monotherapy delivering 70 Gy. High‐risk patients were treated with the combination of brachytherapy and external beam radiotherapy delivering 40 Gy and 36 Gy, respectively. Kaplan–Meier estimates of prostate‐specific antigen (PSA) progression‐free survival rate were analysed. To assess the treatment quality in different periods, PSA progression‐free survival rates in late era (year of 2000 and after) and in early era (before 2000) were compared. Morbidity was graded according to the Radiation Therapy Oncology Group grading scale.

Results:  One hundred and nineteen patients were analysed, of which 86 patients underwent monotherapy with an iridium implant, and 33 were treated with the combination of external beam radiotherapy. Twenty‐four patients were excluded from the analysis because the classification of risk group did not suit the criteria. The total (n = 119) PSA progression‐free survival rate at 3 years was 80.3%. The PSA progression‐free survival rate at 3 years for the monotherapy group (n = 86) and the combination therapy group (n = 33) were 78.2% and 86.9%, respectively. There were 23 patients who were followed for more than 36 to 63 months, and, during this period, only 1 patient who received the monotherapy was diagnosed as PSA failure at 50 months. The 3‐year PSA progression‐free survival rate of monotherapy in late era was significantly higher than that in early era; however, no significant difference was seen in the combination treatment. Morbidity for the combination treatment was low; however, for the monotherapy, three patients developed severe rectal ulcers, and colostomies were made.

Conclusions:  The PSA progression‐free survival rate after low‐dose rate iridium‐192 brachytherapy with or without external beam radiotherapy can be satisfactory and longer follow up is necessary to compare the efficacy of other treatments.
Is interval from an initial biopsy a significant predictor of prostate cancer at repeat biopsies?
Authors: SATOH AKINORI , MATSUMOTO KAZUHIRO , NAKAMURA SO
Published: April 2006

Background:  Currently, there are no clear criteria for indicating repeat biopsies in patients with negative results at an initial biopsy of the prostate. The aim of the present study is to determine the clinical and pathological parameters which predict prostate cancer at repeat biopsies with special attention to the interval between biopsies in addition to prostate specific antigen (PSA) and its derivatives.

Methods:  We reviewed 100 patients who underwent an initial biopsy that proved negative for prostate cancer and required repeat biopsies between November 1996 and November 2003. Clinical parameters such as age, PSA and its derivatives, interval between biopsies, number of cores taken and initial biopsy histology were analyzed.

Results:  In total, 31 patients (31.0%) were found to have prostate cancer, 18 (25.7%) of 70 patients by the second biopsy and 13 (46.4%) of 28 patients by the third biopsy. Two patients underwent the fourth biopsy, which revealed no prostate cancer. The patients with a positive biopsy had a significantly longer interval between the biopsies than the patients with a negative biopsy (P = 0.0036). Furthermore, in both univariate and multivariate logistic regression analysis, only the interval between the biopsies proved to be an independent predictor of positive results at repeat biopsies (P = 0.0094 and 0.0019).

Conclusions:  Only the biopsy interval was a significant predictor of prostate cancer at repeat biopsies in both univariate and multivariate analysis.
Application of cardiopulmonary bypass for resection of renal cell carcinoma and adrenocortical carcinoma extending into the right atrium
Authors: OCHI TATSUMASA , TANJI NOZOMU , SHIMAMOTO KENJI , IKEDA TETSUHIRO , TOSHINO AKIHIKO , YOKOYAMA MASAYOSHI
Published: April 2006

Aim:  The application of cardiopulmonary bypass to atrial involvement represents an important advance that has improved the safety and technical efficacy of a difficult surgical undertaking. Our experiences of the management of extended thrombi into the right atrium in patients with retroperitoneal malignancy using a cardiopulmonary bypass were discussed.

Methods:  Data were reviewed for five patients (two men and three women; mean age, 60.4 years; range, 49–79 years) with retroperitoneal tumors displaying intracardiac tumor extension. Tumors originated in the right kidney in four patients, and in left adrenal gland in one patient. Cardiopulmonary bypass was used in all cases.

Results:  Mean total blood loss was 6059 mL. Mean operative time was 14.7 h. No intra‐ or postoperative complications due to surgical technique were encountered, and no significant bleeding occurred during incision of the inferior vena cava or after removal of tumor thrombus. The follow‐up period ranged from 3 to 20 months with a mean of 12.6 months. Of the five patients, three died of metastatic diseases, one died of liver dysfunction and one remains disease free as of 18 months postoperatively.

Conclusions:  Our experience indicates that this procedure can be safely used for atrial involvement. Although superior long‐term survival cannot be shown yet, favorable early results and a lack of perioperative complications were identified.
Outcome analysis for conservative management of Peyronie's disease
Authors: HASHIMOTO KOHEI , HISASUE SHIN‐ICHI , KATO RYUICHI , KOBAYASHI KO , SHIMIZU TAKASHI , TSUKAMOTO TAIJI
Published: April 2006

Background:  We retrospectively analysed the outcomes of conservative management of Peyronie's disease and determined the factors predicting successful outcome.

Methods:  The study involved 31 patients with Peyronie's disease who were treated at our institute between 1985 and 2003. We assessed the efficacy of vitamin E for the improvement of the symptoms, and the factors which contributed to successful outcome with conservative management using multivariate analysis.

Results:  There was no statistically significant difference in the relief rate between the vitamin E and no‐medication groups. The overall estimated relief rate was 67.5% at 2 years from presentation. The multivariate analysis revealed plaque size to be the only significant factor predicting the relief from all symptoms in patients with conservative management. The rate was 100% in patients having a plaque size of 20 mm or smaller and 20.0% in those having a size of larger than 20 mm (P = 0.005).

Conclusions:  We could not confirm the benefit of vitamin E for Peyronie's disease. Plaque size was the only significant factor predicting the relief from all symptoms. Patients with larger plaque might fail to respond to the conservative management.
Urinary macromolecules and renal tubular cell protection from oxalate injury: Comparison of normal subjects and recurrent stone formers
Authors: TSUJIHATA MASAO , TSUJIKAWA KOZO , TEI NORIHIDE , YOSHIMURA KAZUHIRO , OKUYAMA AKIHIKO
Published: April 2006

Aim:  To determine whether urinary macromolecules (UMM), which are the high molecular weight substances in urine, can provide protection against the oxalate‐associated injury to the renal tubular cells.

Methods:  UMM were extracted from 24‐h urine of 12 healthy adult male volunteers and 13 recurrent‐stone‐former male patients. Urine parameters in relation to urolithiasis were measured, including the level of glycosaminoglycans (GAG) in the UMM. Madin‐Darby canine kidney (MDCK) cells were used to evaluate the protective activity of UMM from oxalate‐induced cytotoxicity by LDH release measurement and methyl‐thiazolyl tertrazolium (MTT) assay.

Results:  Considering urinary parameters, citrate was significantly higher in urine from normal subjects than stone‐former subjects; the other parameters show no differences between the groups. Total UMM and the level of GAG in the UMM were also significantly higher in the normal subject group. Compared with normal subject and stone‐former subject UMM, after cells were treated with the UMM and then exposed to oxalate solution, LDH release was significantly higher in stone‐former group. In the MTT assay, we found that more viable cells were observed after treatment with UMM compared to control in both groups. Moreover, UMM from the normal subjects showed higher protective activity against oxalate‐related cytotoxicity than UMM from the stone‐former subjects.

Conclusion:  UMM protected renal epithelial cells from oxalate‐related injury. This protective activity was found to be higher in normal subject UMM than stone‐former UMM. Among other factors, a higher concentration of GAG and citrate in normal subject UMM might affect some parts in this finding.
Five years experience of transrectal high‐intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer
Authors: UCHIDA TOYOAKI , OHKUSA HIROSHI , YAMASHITA HIDEYUKI , SHOJI SUNAO , NAGATA YOSHIHIRO , HYODO TORU , SATOH TAKEFUMI
Published: April 2006

Background:  High‐intensity focused ultrasound (HIFU) is a minimally invasive technique used in achieve coagulation necrosis. We evaluated biochemical disease‐free survival rates, predictors of clinical outcome and morbidity in patients with localized prostate cancer treated with HIFU.

Methods:  A total of 181 consecutive patients underwent HIFU with the use of Sonablate (Focus Surgery, Indianapolis, IN, USA). Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The median age and pretreatment prostate‐specific antigen (PSA) level were 70 years (range 44–88) and 9.76 ng/mL (range 3.39–89.60). A total of 95 patients (52%) were treated with neoadjuvant hormones. The median follow‐up period for all patients was 18.0 months (range 4–68).

Results:  The biochemical disease‐free survival rates at 1, 3 and 5 years in all patients were 84%, 80% and 78%, respectively. The biochemical disease‐free survival rates at 3 years for patients with pretreatment PSA less than 10 ng/mL, 10.01–20.0 ng/mL and more than 20.0 ng/mL were 94%, 75% and 35%, respectively (P < 0.0001). Multivariate analysis identified pretreatment PSA (P < 0.0001) as a independent predictor of relapse.

Conclusion:  High‐intensity focused ultrasound therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/mL.
Prostaglandin E2 release from isolated bladder strips in rats with spinal cord injury
Authors: MASUNAGA KOICHI , YOSHIDA MASAKI , INADOME AKITO , IWASHITA HITOSHI , MIYAMAE KOICHI , UEDA SHOICHI
Published: April 2006

Aim:  Recent studies have shown that various factors contribute to the increased excitability into the bladder afferent nerves in spinal cord injury (SCI) rats. It has been reported that prostaglandins (PG) act as local modulators of reflex micturition in pathological conditions. In the present study, we measured the amount of PGE2 release from the bladder of chronic SCI rats.

Methods:  Spinal cord was transected at the level of T8–9 in adult female Sprague‐Dawley rats. After 10 weeks, specimens of the urinary bladder were obtained from SCI rats and sham‐injured control rats, and bladder strips were dissected from the bladder. Using an muscle‐bath technique and a microdialysis procedure, the dialysate, containing substance released from bladder strips, was collected. Then the amount of PGE2 in the dialysate was measured by radioimmunoassay.

Results:  Excretion of urinary PGE2 was significantly higher in SCI rats than in control rats. PGE2 release from bladder strips was significantly higher in SCI rats than in control rats. Removal of urothelium caused significant decreases in PGE2 release in both control and SCI rats. Stretches of the bladder strips caused significant resting tension‐dependent increases in PGE2 release from the strips with urothelium.

Conclusions:  The present data suggest that bladder urothelium partly contributes to the increase in PGE2 release from the bladder, and that bladder distension may cause increases in PGE2 release in SCI rats.
Discovery of a pituitary adenoma following a gonadotropin‐releasing hormone agonist in a patient with prostate cancer
Authors: MASSOUD WALID , PAPAREL PHILIPPE , LOPEZ JEAN‐GABRIEL , PERRIN PAUL , DAUMONT MICHELE , RUFFION ALAIN
Published: April 2006

Abstract  Gonadotropin‐releasing hormone (GnRH) agonists have become the treatment of choice for locally advanced and metastatic prostate cancer. We report a case of prostate cancer in which this treatment led to severe symptoms of intracranial hypertension due to the concomitant presence of an asymptomatic functional pituitary adenoma. A 70‐year‐old white man was initially evaluated for a multifocal adenocarcinoma, Gleason score 6 (3 + 3) with perineural invasion suggesting an extracapsular extension. A conformational external beam radiation (74 Gy) with a concomitant GnRH agonist (leuprolide) was initiated. Almost 10 days after the administration of leuprolide the patient complained of visual disturbance, diplopia and other symptoms of intracranial hypertension. Magnetic resonance imaging (MRI) of the brain demonstrated a large sella mass lesion. To relieve the patient's symptoms, a transsphenoidal subtotal tumorectomy was necessary. The histopathological examination revealed an invasive gonadotroph pituitary adenoma. Two years later, there is no sign of progression either on his prostatic disease (prostate‐specific antigen of 0.21 ng/mL) or on his pituitary disease (FSH, 4.7 UI/L, LH, 3.1 UI/L and total testosterone, 627 ng/dL) with values of the hypothalamic–pituitary axis in the normal range. We advocate that a high index of suspicion of pituitary tumor must be considered in any case of intracranial hypertension following the administration of GnRH agonist. Abarelix could have a place in such cases.
Ureteral obstruction associated with pelvic inflammatory disease in a long‐term intrauterine contraceptive device user
Authors: YONEMURA SHIGENORI , MORIYA MITSUHIKO , HORI YASUHIDE , ARIMA KIMINOBU , TOYODA NAGAYASU , SUGIMURA YOSHIKI
Published: April 2006

Abstract  We report herein a case of ureteral obstruction associated with pelvic inflammatory disease in a long‐term intrauterine contraceptive device (IUD) user. A 62‐year‐old woman presented with a 2‐week history of left flank pain and high fever, but no abdominal pain. She had forgotten the use of an IUD. Retrograde pyelography showed a stricture in the lower third of the left ureter. Magnetic resonance showed swelling of the uterus wall and left parametria, but did not reveal the presence of an IUD. Subtotal hysterectomy, bilateral salpingo‐oophorectomy and left nephronureterectomy was performed. The IUD was then found in the uterine cavity. The results of pathological and bacteriological findings for Actinomyces infection were negative. Therefore we diagnosed this case as ureteral obstruction associated with pelvic inflammatory disease. Ureteral obstruction associated with pelvic inflammatory disease in a long‐term IUD user is extremely rare.
Combined surgical intervention and medical management in a case of atypical idiopathic retroperitoneal fibrosis
Authors: SAHEED MOHAMMED CS , GINILKUMAR POOLERI , SANJEEVAN KALAVAMPARA V , BHAT SANJAY H
Published: April 2006

Abstract  Idiopathic retroperitoneal fibrosis (RPF) is one of the causes of obstructive uropathy. This disease, ever since its original description in 1948, has undergone much trial and error in its management. We present a case of a rare type of idiopathic RPF causing obstructive uropathy, which is perirenal and different from the classical RPF seen around the great vessels. To our knowledge, such a type of RPF has not been described. We treated the patient by a combined surgical approach in the form of ureterolysis and omentoplasty, followed by medical management with steroids and tamoxifen. The combined regimen yielded excellent results, and the patient is doing well at 9 months of follow up. The rarity of the presentation, with predominant bilateral perirenal fibrosis, and response of perirenal RPF to steroids and tamoxifen, is highlighted in this case presentation.
Transient anuria requiring nephrostomy after intravesical bacillus Calmette‐Guérin instillations for superficial bladder cancer
Authors: KANEKO TOMOYUKI , FUJITA KIICHIRO , HOMMA YUKIO
Published: April 2006

Abstract  A 76‐year‐old man received intravesical bacillus Calmette‐Guérin (BCG) instillations for recurrent superficial bladder cancer. He had undergone right nephroureterectomy for right renal pelvic cancer 9 months previously. He presented with anuria and left hydronephrosis after the fourth instillation, with serum creatinine increasing up to 15.7 mg/dL. Percutaneous nephrostomy was indwelled, and antegrade pyelography showed left vesicoureteral obstruction. There was no sign of recurrent bladder cancer or ureteral cancer. He started spontaneous voiding on day 4 and the nephrostomy was removed on day 8. Most of the side‐effects of intravesical BCG therapy are minor, and major adverse reactions are rare. Life‐threatening ureteral obstruction would be a rare complication of BCG immunotherapy. Although BCG intravesical instillation after nephroureterectomy is a common practice, special care should be taken of renal function in patients with unilateral kidney during BCG therapy.
Osteosarcoma of the testis
Authors: TAZI HICHAM , KARMOUNI TARIQ , OUALI MOHAMMED , KOUTANI ABDELATIF , HACHIMI MOHAMMED , LAKRISSA AHMED
Published: April 2006

Abstract  This report describes a case of primary osteosarcoma of the testis in a 60‐year‐old man. Treatment consisted of an inguinal orchiectomy with no adjuvant therapy. The patient is alive and doing well without recurrent disease at 18 months after diagnosis. Only three reports have been published on primary osteosarcoma of the testis. The origin of this tumor from undifferentiated mesenchymal cells or from a malignant transformation of pre‐existing teratomatous elements is still unclear. Management guidelines are difficult to establish due to the rarity of such tumors, but inguinal orchiectomy with careful follow up appears to be sufficient treatment.
Primary immature teratoma of the prostate with angiosarcoma component: Its unusual response to chemotherapy
Authors: LEE HYUN MOO , SONG SANG YONG , PARK JOON OH , KIM BO‐HYUN
Published: April 2006

Abstract  Here, we present a case of immature teratoma of prostatic origin, which included an angiosarcoma component. This mass proved unresponsive against preoperative chemotherapy for immature teratoma. Angiosarcoma, although quite rare, should be included in the differential diagnosis as a component of prostatic teratoma, especially in cases in which the tumor proves unresponsive to well‐known chemotherapeutic protocols. This is, to our knowledge, the first reported case of primary prostatic immature teratoma containing an angiosarcoma component.
Hydatid cyst of the seminal vesicle
Authors: PAPATHANASIOU ATHANASIOS , VOULGARIS STELIOS , SALPIGGIDIS GEORGE , CHARALABOUS STAVROS , FATLES GEORGE , ROMBIS VASILEIOS
Published: April 2006

Abstract  We present a rare case of a hydatid cyst involving the seminal vesicle of a 48‐year‐old man. Urinary retention was the initial symptom. Both imaging and clinical evaluation revealed a substantial retrovesical cystic mass. The histopathological report was ‘hydatid cyst of the seminal vesicle’.
Paraffinoma of the urinary bladder
Authors: MADEB RALPH , DOCKERY KEITH F , WHALEY KEVIN , O'BRIEN JEANNE , ERTURK ERDAL
Published: April 2006

Abstract  We present a rare case of paraffinoma of the urinary bladder. Paraffinomas involving the urinary tract are rare and not well described. They are usually associated with insertion of materials into the lower urinary tract by patients with psychiatric disorders. Not only can the diagnosis be delayed, but they are also easily misdiagnosed. They are usually discovered during work up for recurrent urinary tract infections. Therefore, a high index of suspicion is needed in patients with recurrent urinary tract infections, psychiatric histories, and past history of foreign object insertion. Treatment options for paraffinoma includes open surgical excision, possibly transurethral excision or dissolution, and is usually dictated by the size of the mass..
Intravesical migration of intrauterine device resulting in pregnancy
Authors: HOŞSCAN MUSTAFA B , KOŞAR ALIM , GÜMÜŞTAŞ ÜMİT , GÜNEY MEHMET
Published: April 2006

Abstract  Spontaneous migration of an intrauterine device into the bladder is very rare. A 29‐year‐old woman in whom an intrauterine device had been placed 6 years previously, presented complaining of chronic pelvic pain and recurrent irritative urinary tract symptoms. One year after insertion she had became pregnant and given birth without complications. Intravesical migration of the intrauterine device was confirmed by sonography and cystoscopy. The intrauterine device was removed by suprapubic cystostomy.
Treatment of adult female epispadias without exstrophy in the presence of rhabdosphincter function
Authors: PELZER ALEXANDRE E. , AKKAD THOMAS , SCHWENTNER CHRISTIAN , STRASSER HANNES , BARTSCH GEORG , REHDER PETER
Published: April 2006

Abstract  Female epispadias without exstrophy is a very rare entity. Symptoms of female epispadias are primary urinary incontinence and anatomical abnormal features. A 24‐year‐old married women with two children presented with primary urinary incontinence. Due to previous failure of correct diagnosis and ineffective medical treatment, the patient developed psychological problems (anxiety and depression). In the presence of minimal rhabdosphincter function we could achieve socially acceptable urinary continence by bladder neck plication and a Burch colposuspension. The patient did not consent to a major reconstruction.