bluuebunny/crossref_metadata_2025 huggingface dataset:
Interferon as adjunctive treatment for non‐metastatic renal cell carcinoma
Authors: TAKAHASHI S. , TANIGAWA T. , IMAGAWA M. , MIMATA H. , NOMURA Y. , OGATA J.
Published: November 2008

Objective To investigate the effect of recombinant α2binterferon therapy on natural killer (NK) activity and antibody‐dependent cell‐mediated cytotoxicity (ADCC) in the peripheral blood in patients with renal cell carcinoma who had undergone radical nephrectomy.

Patients and methods Between January 1988 and June 1989, 20 patients (14 men and six women, mean age 59 years, range 43–80) received interferon (IFN) therapy following radical nephrectomy for renal cell carcinoma. Thirteen patients had stage I disease, one had stage II and six had stage III; none had metastases.

Results There was a significant increase in NK activity at 5 and 7 months after starting IFN therapy but there was no increase in ADCC.

Conclusions Low doses of IFN administered long‐term increased NK activity in patients with renal cell carcinoma. This finding should be helpful in designating protocols for randomized studies of post‐operative IFN administration as adjuvant therapy.
The influence of banana stem extract on urinary risk factors for stones in normal and hyperoxaluric rats
Authors: POONGUZHALI P. K. , CHEGU H.
Published: November 2008

Objective To study the effect of banana stem (Family Musaceae) extract on urinary risk factors in an animal model of hyperoxaluria.

Materials and methods Thirty male rats were divided into five groups of six rats each. The rats in Group I acted as the control, in Group II rats hyperoxaluria was induced using sodium glycollate, Group III were given aqueous banana stem extract alone, Group IV were given both sodium glycollate and aqueous banana stem extract and Group V were given sodium glycollate alone followed by aqueous banana stem extract. Urine analysis (24 h) was carried out to determine the levels of calcium, phosphorous, oxalate, glycollic acid and glyoxylic acid in each of the five groups.

Results In the rats treated with aqueous banana stem extract, urinary oxalate excretion was significantly reduced when compared with the controls. The extract reduced urinary oxalate, glycollic and glyoxylic acid and phosphorus excretion in the hyperoxaluric rats. The extract appeared to have no effect on urinary calcium excretion.

Conclusion Banana stem extract from the Musaceae family may be a useful agent in the treatment of patients with hyperoxaluric urolithiasis.
Chronic hydronephrosis: renographic drainage patterns and renal morphology in an animal model
Authors: BOWEN J. , SHARMA H. , GOUGH D.C.S.
Published: November 2008

Objective To develop an animal model of chronic progressive hydronephrosis; to establish patterns of diuretic renography during development of the condition; and to relate renographic abnormality to morphological change in the renal parencyma.

Materials and methods The cellophane sclerosis technique was used to produce a hydronephrosis in the left kidney of six rabbits. Post‐operatively MAG3 diuretic renography was performed at weekly intervals. When a steady renographic trend was noted the rabbits were killed and the kikneys examined histologically.

Results Four rabbits had persistent type II renogrphic curves on the left for 12 weeks. The measured split renal function fell steadily to <20% in this time. Morphologically there was hydronephrosis with marked structural changes in the parenchyma seen on histological examination. Two rabbits had stable type IIIa renographic drainage patterns on the left with preserved renal function. Morphologically there was hydronephrosis but histologically the kidneys were normal. There were no renographic or structural changes in a control rabbit after a sham laparotomy.

Conclusions The cellophane sclerosis technique can be used to create a reproducible chronic progressive hydronephrosis. In this animal model hydronephrosis and a persistent type II curve are associated with renographic evidence of deteriorating renal function and disruption of renal architecture histologically. Hydronephrosis and a type IIIa curve are associated with preservation of normal renal function and histological structure.
The invaginated sleeve technique for a continent cystostomy — five years' clinical experience
Authors: GARDINER R.A.
Published: November 2008

Objective To evaluate the invaginated sleeve technique for continent cystostomy in humans.

Patients and methods Over the past 5 years six patients have undergone this operative procedure. An essential principle utilized in the technique is the property of partial thickness bladder grafts to stretch longitudinally, so that each tubularized pedicle graft could be directed transmurally and extended extravesically to reach the skin of the lower abdominal wall. As a consequence a urothelial‐lined tract, both extravesically and through the bladder wall, was provided for intermittent self‐catheterization.

Results A part from one woman, whose cystostomy tract was disrupted by inappropriate catheterization in the immediate post‐operative period to attempt to stop leakage through exposed fenestrations in the suprapubic stent, this procedure provided robust, continent catheterizing routes for all patients for periods of 63, 52, 12, 7 and 1.5 months respectively. Two patients developed discrete stenoses at their mucocutaneous junctions at 3 and 5 months which were corrected easily.

Conclusion This simple, minimally morbid technique, which avoids the use of non‐urinary tract epithelial structures and maintains bladder capacity, is strongly recommended for patients who need to practise clean intermittent self‐catheterization and for whom the urethral route is impracticable.
A new, large calibre, self‐expanding and self‐retaining temporary intraprostatic stent (ProstaCoil) in the treatment of prostatic obstruction
Authors: YACHIA D. , BEYAR M. , ARIDOGAN I. A.
Published: November 2008

Objective To determine the benefits of a new selfexpanding and self‐retaining large calibre temporary intraprostatic coil stent in patients with bladder outflow obstruction due to benign prostatic hypertrophy.

Patients and methods Sixty‐five patients with bladder outflow obstruction have been studied with a followup period of 3–28 months (mean 16).

Results Thirty patients became eligible for surgery and had their stent removed without difficulty 3–12 months after stent insertion. Only one stent was removed because of urgency and incontinence. Stent repositioning was required in five patients and 14 complained of temporary dysuria or perineal pain. Twenty‐seven patients continue to pass urine through their stent without difficulty.

Conclusion Because of its large diameter and its temporary nature this new stent allows endoscopic examination of the bladder and has few side effects. This stent should be considered as an alternative to a urethral catheter or other temporary stents in patients who are unfit for surgery.
A three month double‐blind study of doxazosin as treatment for benign prostatic bladder outlet obstruction
Authors: CHAPPLE C.R. , CARTER P. , CHRISTMAS T.J. , KIRBY R. S. , BRYAN J. , MILROY E. J. G. , ABRAMS P.
Published: November 2008

Objective To evaluate the efficacy and tolerability of doxazosin in the treatment of bladder outflow obstruction resulting from benign prostatic hyperplasia (BPH).

Patients and methods One‐hundred and thrity‐five patients with symptomatic urodynamicaly confirmed obstructive BPH ware treated for 12 weeks with either doxazosin (67 patients) or placebo (68 patients) after an initial 2 week baseline evaluation. The main outcome measures were urodynamic and symptomatic evaluation for efficacy. Blook pressre and adverse events were monitored.

Results Date were obtained in 122 patients (60 doxazosin, 62 placebo). Doxazosin produced increases in both mean and maximum urinary flow rates of 1.01 ml/s and 3.2 ml/s rspectively, compared with 0.21 ml/s and 2.2 ml/s on placebo. The increase in mean flow rate was statistically significant (P=0.04). While that for maximun flow rate approached significance (P= 0.09). The maximum subracted voiding pressure was substantially reduced (P=0.007) and 19 of 53 (36%) patients had an increase in maximum flow rate of 50% or more compared with 9 of 54 (17%) on placebo (P=0.024). Twelve weeks' therapy with doxaosin resulted in significant improvements (compared with placebo) in: hesitancy 9doxazosin 26 of 46. placebo 11 of 43; P=0.003), impaired urinary stream (doxazosin 31 of 55, placebo 16 of 48; P=0.019). nocturia (doxazoshin 22 of 56, placebo 10 of 54; P=0.017) and urgency (doxazosin 27 of 45, placebo 16 of 42; P=0.041). Frequency improved with doxazosin therapy (doxazosin 26 of 59, placebo 15 of 55; P=0.062). Adverse events, most frequenly dizziness and headache, were usually mild and transient and led to a discontinuation of doxazosin therapy in one patient. No clinically significant changes in sexual function or blood pressure were seen.

Conclusion Doxazosin was well‐tolerated and produced both urodynamic and symptomatic improvement in men with BPH. thereby providing a satisfactory alterntive to existing drugs with the additional benefit of one dily dosage.
The anatomy of a prostate waiting list: a prospective study of 132 consecutive patients
Authors: SCHOU J. , POULSEN A. L. , NORDLING J.
Published: November 2008

Objective To report the results of a standard evaluation programme performed prior to transurethral resection of the prostate (TURP) for benign prostatic hypertrophy (BPH).

Patients and methods all 132 patients with symptoms of prostatism on the waiting list for surgery were invited to attend the hospital to undergo a physical examination, symptom evaluation and routine blood sampling. Of these, 117 attended. If the suspicion of BPH was sustained a transrectal ultrasound examination of the prostate and a urodynamic evaluation, including a pressure‐flow study, were performed.

Results Urodynamic evaluation was carried out in 80 of the 117 patients who attended the clinic. Infravesical obstruction was present in 61 patients while in 19 (24%) there was no obstruction. An operative procedure to relieve obstruction was performed in 65 patients (49%).

Conclusions In a population of patients scheduled for TURP. 24% were found not to have an obstruction. This is in accordance with other reports. As the patients with few symptoms and those who did not have an obstruction were treated conservatively only 49% of the referred cases underwent prostatic surgery.
Early catheter removal following transurethral prostatectomy–impact on length of hospital stay
Authors: KOH K.B.H. , MacDERMOTT J.P. , SMITH P.H. , WHELAN P.
Published: November 2008

Objective To investigate whether early catheter removal following transurethral prostatectomy (TURP) is safe and whether it has any effect on the length of hospital stay.

Patients and methods Following transurethral prostatectomy 59 patients were randomized into one of two groups: those whose catheter was removed on day 1 after surgery and those whose catheter was removed on day 2. The incidence of complications and the duration of post‐operative hospital stay were assessed.

Results Catheter removal on day 1 led to a significantly shorter post‐operative hospital stay (2.3 days versus 3.3 days) and did not incur a higher incidence of complications.

Conclusion Removal of the catheter on the first day following TURP is safe in selected patients and leads to a shorter post‐operative hospital stay.
Screening for carcinoma of the prostate: a GP based study
Authors: KIRBY R.S. , KIRBY M.G. , FENELEY M.R. , McNICHOLAS T. , McLEAN A. , WEBB J.A.W.
Published: November 2008

Objective To examine the feasibility and acceptability of screening for cancer of the prostate by digital rectal examination (DRE), prostate specific antigen (PSA) determination and subsequent transrectal ultrasound (TRUS) in selected patients in a single general practice in Hertfordshire.

Subjects and methods A total of 568 of 856 men aged 55 to 70 accepted an invitation for a health check which included screening for prostate cancer. Of these, 80 individuals with either a raised PSA level or an abnormal DRE underwent TRUS. In 29 individuals biopsies were taken, 11 of which confirmed the presence of adenocarcinoma of the prostate giving an overall detected prevalence of 2%. Of the 11 tumours identified by screening, two were T1Mo, four were T2Mo, two were T3Mo and three were T3M1.

Results To assess the acceptability of the screening exercise a postal questionnaire was sent to all 568 participants: 83% replied and 69% reported no concern. Of the 67 individuals who had undergone TRUS, 69% reported discomfort. A total of 448 (95%) of respondents declared that they would be prepared to undergo the screening exercise again.

Conclusion Screening for prostate cancer would seem to be technically feasible and generally acceptable. However, there is a considerable false positive rate in the PSA range 4 ng/ml to 10 ng/ml, particularly among men with clinical evidence of benign prostatic hyperplasia. To establish the true benefit of screening a large‐scale prospective controlled study will be necessary.
The nutcracker syndrome: an uncommon cause of haematuria
Authors: SHAPER K.R.L. , JACKSON J.E. , WILLIAMS G.
Published: November 2008

Objective To increase the awareness of this rare cause of haematuria and to describe the operative techniques available for its treatment.

Patients and methods The investigation and treatment of five patients with the nutcracker syndrome have been reviewed.

Results A new variant of the nutcracker syndrome is described. Using a combination of venolysis, Gortex graft renal vein interposition and an anterior nephropexy, the haematuria of four patients has ceased and improved in one.

Conclusion The nutcracker syndrome is a rare cause of haematuria which responds successfully to surgical treatment. Successful treatment does not appear to be related to lowering of the renal vein pressure.
Risk factors for calculus formation in patients with renal transplants
Authors: HARPER J. M. , SAMUELL C. T. , HALLSON P. C. , WOOD S. M. , MANSELL M. A.
Published: November 2008

Objective To investigate the risk factors for stone formation in patients with functioning renal transplants in whom renal calculi develop.

Patients and methods Renal calculi developed in six of 178 patients with functioning renal transplants under current review, an incidence of 3%. Risk factors for stone formation were investigated in five of these patients and compared with a randomly selected control group of 41 transplant patients with no stone problems.

Results Patients with transplant calculi typically passed smaller volumes of significantly more concentrated and alkaline urine with greater urinary excretion of uric acid (P <0.05). Urine calcium excretion was also increased. Crystalluria was present in three of five stone formers compared with two of 25 controls. Overall, metabolic abnormalities included hypocitraturia (75%), hyperparathyroidism (36%), hypophosphataemia (24%), and hyoercalcaemia (10%), Urinary infection was common, (50%), and urinary output of magnesium and phosphate was at the lower end of normal for all patients.

Conclusion These results suggest a multifactorial aetiology for stone formation in renal transplant recipients. Approaches to prevention and management are discussed.
A population study of renal disease in patients with tuberous sclerosis
Authors: KABALA D. W. WEBB. J. , OSBORNE J. P.
Published: November 2008

Objective To establish prevalence of renal disease, asympotoamtic renal lesions and possible renal symptoms in geographically defined population of individuals with tuberous sclerosis.

Patients and methods The study involved 131 patients (64 men, 67 women) with tuberous sclerosis who were resident in nine of the districts within the Wessex Region and three Bristol Health Districts and who had been identified by a prevalence study [1]. The patients' been identified by a prevalence study [1]. The patients' mean age was 22 years (range 6 months‐74 years). Established renal disease was identified by history. Where possible individuals were seen were examined. Specific enquiry was made for flank pain and macroscopic haematuria. Renal ultrasound, blood pressure measurement and urine analysis was offered to all individuals with tuberous sclerosis who were resident in the Bath Health District.

Results Eight patients (6%) had a history of either renal polycystic kidney disease (two patients) or haemorrhage from renal angiomyolipomas (five female patients, one male patient). A further 21% of female and 3% of male patients had a history of severe flank pain or haematuria. Renal ultrasound screening revealed abnormalities in 10 of 21 individuals; angiomyolipoma > 1 cm were found in seven and were twice as common in female patients.

Conclusions Regular clinical review of individuals with tuberous sclerosis should include enquiry for renal symptoms and abdominal examination. Lesions >4cm are most likely to be symptomatic but sound screening of adolescents or adults can be recommended.
Renal cell carcinoma: prognostic factors
Authors: ROOSEN J.U. , ENGEL U. , JENSEN R.H. , KVIST E. , SCHOU G.
Published: November 2008

Objective To establish the prognostic value of a series of pre‐operative, per‐operative and histopathological parameters in relation to renal cell carcinoma (RCC).

Patients and methods This retrospective study involved a consecutive series of 76 patients (46 men and 30 women with a mean age of 65.3 years [range 44–91]) with a histologically confirmed diagnosis of RCC. Patients who were admitted over the period 1980–1984 were included. Data such as erythrocyte sedimentation rate (ESR). alkaline phosphatase level, histological tumour grade, degree of necrosis and presence of tumour vessels were evaluated in relation to actuarial survival.

Results The ESR and alkaline phosphatase level at the time of diagnosis of RCC, the histological tumour grade, degree of necrosis and presence of tumour vessels on angiography were all found to affect the actuarial length of survival significantly (P < 0.05 logrank test). Macroscopic tumour demarcation estimated per‐operatively by the surgeon or after surgery by the pathologist, microscopic demarcation, vascular density on histological examination. tumour diameter and vascular density on angiography were found not to affect actuarial survival significantly.

Conclusion The value of establishing simple and reliable diagnostic indicators for patients with RCC is stressed.
The detailed neuroanatorny of the human striated urethral sphincter
Authors: ZVARA P. , CARRIER S. , KOUR N‐W. , TANAGHO E.A.
Published: November 2008

Objective To study the nerve supply of the striated urethral sphincter.

Materials and methods The pelvis from six formalin‐fixed male cadavers was dissected.

Results Cadaveric dissection revealed that both the intrinsic and extrinsic segments of the urethral rhabdosphincter receive their innervation from sacral roots S2‐S4. The nerve fibres travel to their final destination via both the pudendal nerves and the nerve branches of the sacral roots. The terminal branches of the pudendal nerve enter the sphincteric area from the perineum. They separate shortly after they cross the ischial spine and run further ventromedially. Small branches approach the sphincter after their division from the dorsal nerve of the penis. The course of the pudendal nerve and its branching on the perineum are quite consistent. The pelvic branches travel inside the pelvis above the levator ani muscle. Among the cadavers the number of branches varied markedly, as did their site of termination (2.3 to 3.9 cm from the striated urethral sphincter). A substantial nerve approaching the sphincter from inside the pelvis was found. After it divided from the S2, S3 sacral roots it ran separately, initially just lateral to the fibres of the pelvic plexus and then on the dorsolateral surface of the rectum. In its terminal segment it dived into the levator ani muscle and terminated in the striated urethral sphincter.

Conclusions We believe that the nerve supply to the striated urethral sphincter consists of branches from both the pudendal nerve and the ‘extrapudendal’ nerves that run above the levator ani muscle inside the pelvis. The variations in the course of the latter are remarkable.
Laparoscopic nephrectomy: initial experience and cost implications
Authors: Wilson B.G. , Deans G.T. , Kelly J. , McCrory D.
Published: November 2008

Objective To assess the results and cost implications of laparoscopic nephrectomy.

Patients and methods Ten patients underwent attempted laparoscopic nephrectomy and nephro‐ureterectomy. The cost of the laparoscopic procedures was estimated to allow comparison with that of open surgery.

Results Two patients required conversion to an open procedure, one for a colonic tear, the other for irretrievable loss of pneumoperitoneum. The median operating time for successful cases was 3 h (range 2.5‐4). The mean morphine equivalent of analgesia delivered per patient was 18 mg (range 10–28). There was no mortality. Post‐operative complications consisted of one case of prolonged ileus and another of chest infection. The median hospital stay of successful cases was 5 days (range 4–17), and the mean time to return to normal activity was 4 weeks (range 3–6). The cost of the procedure using re‐usable instruments was approximately £2000, comprising £100 for equipment, £900 theatre costs and £1000 for hospital stay. Using disposable equipment adds up to £900 to the cost. In comparison an open nephrectomy typically costs around £2300.

Conclusion Laparoscopic nephrectomy is associated with lower analgesia requirements, shorter hospital stay and quicker return to work than equivalent open procedures. The cost, particularly when performed with re‐usable instruments, is not prohibitive being comparable with that of open nephrectomy. With further experience it should become part of the armamentarium of urological surgeons.
Glomerular filtration rate measurement: a neglected test in urological practice
Authors: Brown S.C.W. , O'Reilly P.H.
Published: November 2008

Objectives To assess the accuracy and reproducibility of methods used to measure glomerular filtration rate (GFR) in clinical practice.

Patients and methods Simultaneous clearances of iohexol, 99mTc‐diethylene‐triamine‐penta‐acetic acid (DTPA), 24 h renal creatinine clearance and creatinine clearance estimated from a serum sample only, were obtained in 31 patients. Accuracy was calculated relative to iohexol clearance. The reproducibility of each method was determined by repeat measurements in the same individuals: three 99mTc‐DTPA clearances in 21 patients; three 24 h creatinine clearance estimations in 12 patients; and three serum creatinine clearance estimations in 21 patients.

Results The mean differences between 99mTc‐DTPA clearance, 24 h renal creatinine clearance and estimated creatinine clearance compared with the reference method were 0.2 mL/min, 21.6 mL/min and 0.6 mL/min, respectively. 99mTc‐DTPA clearance had fairly tight 95% limits of agreement (12.2 mL/min) compared with 35.4 mL/min for 24 h creatinine clearance and 25.8 mL/min for estimated creatinine clearance. The reproducibility for each method was 5.4%, 24.3% and 6.1%, respectively.

Conclusion Single‐injection 99mTc‐DTPA clearance provides an accurate and reproducible method of GFR measurement that is suitable for objective monitoring of renal function. Twenty‐four hour creatinine clearance is neither sufficiently accurate nor reproducible for this purpose. Creatinine clearance estimation from a serum sample without urine collection may be preferable to the more traditional 24 h collection method.
Effects on the endocrine system of long‐term treatment with the non‐steroidal anti‐androgen Casodex in patients with benign prostatic hyperplasia
Authors: Eri L.M. , Haug E. , Tveter K.J.
Published: November 2008

Objective To study the hormonal changes resulting from long‐term use of the non‐steroidal anti‐androgen Casodex.

Patients and methods A randomized, placebo‐controlled study was carried out on 27 patients with benign prostatic hyperplasia (BPH). Fourteen patients received Casodex 50 mg daily for 24 weeks and 13 received a placebo. The patients were followed up for a further 24‐week period.

Results Serum concentrations of luteinizing hormone (LH) increased by an average of 40% while follicle‐stimulating hormone (FSH) remained unchanged. Testosterone increased by 35%, oestradiol by 29% and oestrone by 23%; all changes were statistically significant. Levels of androstenedione and dihydrotestoster‐one increased by 11% and 15%, respectively, but these increases did not reach statistical significance. A nonsignificant increase was also observed for sex hormone‐binding globulin. The hormonal changes were reversible upon discontinuation of therapy. Prolactin and dehydroepiandrosterone‐sulphate levels did not change.

Conclusion This study indicates that Casodex, due to competitive inhibition of central androgen receptors, increases LH secretion, thus causing increased production and increased metabolism of testosterone.
Serum prostate‐specific antigen in a community‐based population of healthy Japanese men: lower values than for similarly aged white men
Authors: Oesterling J.E. , Kumamoto Y. , Tsukamoto T. , Girman C.J. , Guess H.A. , Masumori N. , Jacobsen S.J. , Lieber M.M.
Published: November 2008

Objective To determine whether the age‐specific reference ranges for serum prostate‐specific antigen (PSA) concentration generated for white men are applicable to other races.

Patients and methods Three‐hundred and thirty‐five healthy lapanese men, aged 40–79 years, residing in the small fishing village of Shimamaki‐mura, Japan, agreed to enter this prospective, community‐based study. All underwent a detailed clinical evaluation that included a serum PSA determination, a digital rectal examination and a transrectal ultrasound. Two‐hundred and eighty‐six (85%) completed the prostatic evaluation and had no evidence of prostate cancer by any one of the three diagnostic tests; these men formed the study population on which all analyses were performed.

Results The serum PSA concentration correlated directly with patient age (r = 0.33; P<0.001) and prostatic volume (r=0.57; P<0.001). PSA density (PSAD) also was directly proportional to age (r= 0.30; P<0.001). Adjusting for age, the serum PSA concentration was lower for Japanese men than for white men (P<0.001). Thus, the recommended age‐specific reference ranges (95th percentile) for serum PSA for Japanese were lower as well: 0.0–2.0 ng/mL for 40–49 years; 0.0–3.0 ng/mL for 50–59 years; 0.0–4.0 ng/mL for 60–69 years; and 0.0–5.0 ng/mL for 70–79 years. Based on transrectal ultrasound‐volume determinations, the lower serum PSA concentrations in Japanese men are due in large part to their smaller prostate glands as compared with white men (P<0.001).

Conclusions These findings confirm the earlier observations that serum PSA, prostatic volume and PSAD are age‐dependent. However, because of physiological differences among the two races, partly due to the size of the prostate gland, the age‐specific reference ranges for serum PSA are lower for Japanese men than for white men. Because of these racial differences, it is now crucial to conduct a similar investigation among black men.
Pseudoureterocele: potential for misdiagnosis of an ectopic ureter as a ureterocele
Authors: Sumfest J.M. , Burns M.W. , Mitchell M.E.
Published: November 2008

Objective To present several case reports of children with ‘pseudoureteroceles’. Familiarization with this entity should help to avoid an error in diagnosis and possible improper therapy.

Patients and methods Three girls with ectopic ureters entering mesonephric duct cysts are presented for review.

Results Misdiagnosis of the pseudoureterocele as an ectopic ureter was made in two children. The ‘pseudoureterocele’ may lie dormant for many years and often presents with acute urinary incontinence and/or onset of urinary tract infections. Resection of the dysplastic kidney and ipsilateral ureter, marsupialization of the cyst into the vagina, and closure of the vesical fistula is the preferred treatment.

Conclusion An ectopic ureter draining into a Gartner's duct cyst can be confused with an ectopic ureterocele. Correct diagnosis is vital to ensure proper treatment.
Can circle hook use benefit billfishes?
Authors: Serafy Joseph E , Kerstetter David W , Rice Patrick H
Published: November 2008

We performed a quantitative review to evaluate circle hook use in recreational and commercial hook‐and‐line fisheries that interact with billfishes (Family: Istiophoridae). Specifically, we scrutinized the findings of 11 recent empirical studies that reported, on a species‐specific basis, side‐by‐side measures of circle vs. J‐hook fishing performance: catch, mortality, deep‐hooking and bleeding rates. Of the 30 total comparisons extracted from the literature that satisfied our inclusion criteria, 13 indicated significant differences between hook types for the specific metric compared. No study reported significant billfish catch rate differences between hook types. However, when significant differences between hook types were found, higher mortality rates and higher rates of deep‐hooking and bleeding were associated with J‐hooks relative to circle hooks. We conclude that empirical evidence is sufficient to promote circle hook use in almost all hook‐and‐line fishery sectors that typically interact with istiophorids. However, billfish conservation benefits will only be realized if fishers use unmodified circle hooks, commit to releasing live fish and take other appropriate measures which maximize post‐release survival. While there may be fishing modes where circle hook effects are negative, for billfish conservation, we recommend managers grant exceptions to circle hook use only when experimental results support such a practice.
Hospital‐Physician Collaboration: Landscape of Economic Integration and Impact on Clinical Integration
Authors: BURNS LAWTON ROBERT , MULLER RALPH W.
Published: November 2008

Context: Hospital‐physician relationships (HPRs) are an important area of academic research, given their impact on hospitals' financial success. HPRs also are at the center of several federal policy proposals such as gain sharing, bundled payments, and pay‐for‐performance (P4P).

Methods: This article analyzes the HPRs that focus on the economic integration of hospitals and physicians and the goals that HPRs are designed to achieve. It then reviews the literature on the impact of HPRs on cost, quality, and clinical integration.

Findings: The goals of the two parties in HPRs overlap only partly, and their primary aim is not reducing cost or improving quality. The evidence base for the impact of many models of economic integration is either weak or nonexistent, with only a few models of economic integration having robust effects. The relationship between economic and clinical integration also is weak and inconsistent. There are several possible reasons for this weak linkage and many barriers to further integration between hospitals and physicians.

Conclusions: Successful HPRs may require better financial conditions for physicians, internal changes to clinical operations, application of behavioral skills to the management of HPRs, changes in how providers are paid, and systemic changes encompassing several types of integration simultaneously.
Revisiting Rose: Comparing the Benefits and Costs of Population‐Wide and Targeted Interventions
Authors: AHERN JENNIFER , JONES MATTHEW R. , BAKSHIS ERIN , GALEA SANDRO
Published: November 2008

Context: Geoffrey Rose's two principal approaches to public health intervention are (1) targeted strategies focusing on individuals at a personal increased risk of disease and (2) population‐wide approaches focusing on the whole population. Beyond his discussion of the strengths and weaknesses of these approaches, there is no empiric work examining the conditions under which one of these approaches may be better than the other.

Methods: This article uses mathematical simulations to model the benefits and costs of the two approaches, varying the cut points for treatment, effect magnitudes, and costs of the interventions. These techniques then were applied to the specific example of an intervention on blood pressure to reduce cardiovascular disease.

Findings: In the general simulation (using an inverse logit risk curve), lower costs of intervention, treating people with risk factor values at or above where the slope on the risk curve is at its steepest (for targeted interventions), and interventions with larger effects on reducing the risk factor (for population‐wide interventions) provided benefit/cost advantages. In the specific blood pressure intervention example, lower‐cost population‐wide interventions had better benefit/cost ratios, but some targeted treatments with lower cutoffs prevented more absolute cases of disease.

Conclusions: These simulations empirically evaluate some of Rose's original arguments. They can be replicated for particular interventions being considered and may be useful in helping public health decision makers assess potential intervention strategies.
Do Hypothetical Imperatives Require Categorical Imperatives?
Authors: Schwartz Jeremy
Published: November 2008

Abstract:Recently, the idea that every hypothetical imperative must somehow be ‘backed up’ by a prior categorical imperative has gained a certain influence among Kant interpreters and ethicists influenced by Kant. Since instrumentalism is the position that holds that hypothetical imperatives can by themselves and without the aid of categorical imperatives explain all valid forms of practical reasoning, the influential idea amounts to a rejection of instrumentalism as internally incoherent. This paper argues against this prevailing view both as an interpretation of Kant and as philosophical understanding of practical reason. In particular, it will be argued that many of the arguments that claim to show that hypothetical imperatives must be backed up by categorical imperatives mistakenly assume that the form of practical reasoning must itself occur as a premise within the reasoning. An alternative to this assumption will be offered. I will conclude that while instrumentalism may well be false, there is no reason to believe it is incoherent.
Direction of perceptual displacement of a moving target's starting and vanishing points: The key role of velocity
Authors: ACTIS‐GROSSO ROSSANA , BASTIANELLI ALESSIA , STUCCHI NATALE
Published: November 2008

Abstract:  Individuals make localization errors when asked to localize the perceived onset (starting point; SP) and offset (vanishing point; VP) of a moving target. For VP, a position shifted forward is usually indicated, whereas for SP two conflicting spatial mislocations are reported (i.e., one in the direction of motion and the other in the direction opposite to motion). Three experiments are presented, aimed at testing the influence on SP and VP errors of the modulation of target's velocity in the first, central, and last part of a horizontal or vertical motion path. A forward VP displacement was obtained, whereas for SP a backward displacement proved significant only for horizontal motions. Velocity modulation had an effect only on VP mislocation (Experiment 1), and this effect was due to instantaneous velocity at VP (Experiment 2). These results are discussed in light of the hypothesis that a low‐level mechanism is responsible for both SP and VP mislocations.
Noble gas and boron isotopic signatures of the Bacon‐Manito geothermal fluid, Philippines
Authors: BAYON F. E. B. , SEE F. S. , MAGRO G. , PENNISI M.
Published: November 2008

Noble gas isotopic composition and abundances were determined on dry gas sampled in geothermal wells from the Bacon‐Manito (BGPF) geothermal field in the Philippines. The most significant findings come from the 3He/4He ratio; a mantle‐He source is evidenced by ratio close to 7 Ra. Peripheral fluid from the west and south of the geothermal system is relatively enriched in 4He (R/Ra slightly > 2), most probably sourced from U and Th decay in old igneous or crustal rocks. The two end‐members mix, producing the range of R/Ra ratios observed in the other wells included in this study. Preliminary data on the δ11B signature of the Bacon Manito fluid separated from vapour range from 7‰ to 9‰. These values suggest that the local magmatic rocks could represent the main boron source, in agreement with the boron isotopic signature of Pacific arc lavas.
Recent progress in the application of gas geochemistry: examples from Taiwan and the 9th International Gas Geochemistry Conference
Authors: YANG T. F.
Published: November 2008

Gas geochemistry in the last two decades has emerged as an important scientific tool in geosciences due to the significant improvement of instrumentation. A review of recent progress in this field, based on the examples in Taiwan, shows that gas geochemistry is applicable to a wide range of problems in Earth sciences. The International Conferences on Gas Geochemistry (ICGG), held since 1982, are the only international venues exclusively dedicated to studies of gas geochemistry. This thematic edition, which includes 11 case studies presented during the 9th ICGG held in Taipei, 2007, covers a wide range of topics from both on‐land and submarine geothermal, seepage/venting studies to gas flux estimation from mangroves and optimum sequestration depth for CO2 geological storage.
Music‐syntactic processing and auditory memory: Similarities and differences between ERAN and MMN
Authors: Koelsch Stefan
Published: November 2008

The early right anterior negativity (ERAN) is an event‐related potential (ERP) reflecting processing of music‐syntactic information, that is, of acoustic information structured according to abstract and complex regularities. The ERAN is usually maximal between 150 and 250 ms, has anterior scalp distribution (and often right‐hemispheric weighting), can be modified by short‐ and long‐term musical experience, can be elicited under ignore conditions, and emerges in early childhood. Main generators of the ERAN appear to be located in inferior fronto‐lateral cortex. The ERAN resembles both the physical MMN and the abstract feature MMN in a number of properties, but the cognitive mechanisms underlying ERAN and MMN partly differ: Whereas the generation of the MMN is based on representations of regularities of intersound relationships that are extracted online from the acoustic environment, the generation of the ERAN relies on representations of music‐syntactic regularities that already exist in a long‐term memory format. Other processes, such as predicting subsequent acoustic events and comparing new acoustic information with the predicted sound, presumably overlap strongly for MMN and ERAN.
Extinction chronology and palaeobiology of the cave bear (Ursus spelaeus)
Authors: PACHER MARTINA , STUART ANTHONY J.
Published: November 2008

The cave bear (Ursus spelaeus) was one of several spectacular megafaunal species that became extinct in northern Eurasia during the late Quaternary. Vast numbers of their remains have been recovered from many cave sites, almost certainly representing animals that died during winter hibernation. On the evidence of skull anatomy and low δ15N values of bone collagen, cave bears appear to have been predominantly vegetarian. The diet probably included substantial high quality herbaceous vegetation. In order to address the reasons for the extinction of the cave bear, we have constructed a chronology using only radiocarbon dates produced directly on cave bear material. The date list is largely drawn from the literature, and as far as possible the dates have been audited (screened) for reliability. We also present new dates from our own research, including results from the Urals.U. spelaeusprobably disappeared from the Alps and adjacent areas – currently the only region for which there is fairly good evidence –c. 24 000 radiocarbon years BP (c. 27 800 cal. yr BP), approximately coincident with the start of Greenland Stadial 3 (c. 27 500 cal. yr BP). Climatic cooling and inferred decreased vegetational productivity were probably responsible for its disappearance from this region. We are investigating the possibility that cave bear survived significantly later elsewhere, for example in southern or eastern Europe.
Factors Affecting the Restoration of Heathland and Acid Grassland onPteridium aquilinum–Infested Land across the United Kingdom: A Multisite Study
Authors: Cox Emma S. , Marrs Robert H. , Pakeman Robin J. , Le Duc Michael G.
Published: November 2008

The variability in the success ofPteridium aquilinum(bracken) control and vegetation restoration has been highlighted as a major issue in the United Kingdom. Experiments were set up at four different regional locations to assess bracken control at the national scale and the impact of restoration practices at the local scale. Bracken control treatments (cutting once or twice per year, a combination of cutting and asulam spraying, and asulam in year 1) were combined with site‐specific treatments designed to restore appropriate heathland or acid grassland vegetation. This article considers the effects on the developing understorey vegetation, testing the following hypotheses: (1) local differences between sites would affect community change; (2) treatments applied to controlPt. aquilinum(same at all sites) influences community change; and (3) treatments applied at the individual site level to restore vegetation influences community change toward the target vegetation. There were a considerable number of spatial effects. It is, therefore, difficult to develop a one‐size‐fits‐all policy for vegetation restoration within a nationalPt. aquilinumcontrol strategy. Few bracken control treatment effects were found, and, where they were detected, it was only at single sites. Thus, the development of target vegetation requires a combination of control and restoration treatments that take into consideration the aspects of that site. Only three species,Deschampsia flexuosa,Galium saxatile, andCampylopus introflexus, increased as a direct effect of the control treatments. Vegetation restoration was most successful in the cutting‐twice‐per‐year plots, the treatment with the greatest reduction inPt. aquilinumcover.
The Importance of Soil Characteristics in Determining Survival of First‐Year Cottonwood Seedlings in Altered Riparian Habitats
Authors: Bhattacharjee Joydeep , Taylor John P. , Smith Loren M. , Spence Liter E.
Published: November 2008

Most major rivers in the southwestern United States have been hydrologically altered to meet human needs. Altered hydrological regimes have been associated with declines in native riparian forests. Today, many riparian areas have little or no regeneration of native riparian species and are now dominated by exotic Saltcedar (Tamarix chinensis Lour.). Success of riparian restoration efforts at least partially depends on the number of seedlings surviving the first growing season. Seedling survival is influenced by many abiotic and biotic factors including competition from other plants and available soil moisture, which is partially dependent on soil texture. In this study, we evaluated the relative importance of four soil categories (sandy loam, loam, silt, and clay), rate of soil moisture decline, salinity, beginning‐ and end‐season Saltcedar density, initial Cottonwood (Populus deltoides Marshall subsp. wislizenii (Wats.) Eckenw.) seedling density, percent vegetation cover by potential dominant competitors Pigweed (Amaranthus L.) and Barnyard grass (Echinochloa crusgalli L., Beauv.), and average total vegetation height to Cottonwood seedling survival. Factors influencing seedling survival differed among the four soil types. Rate of moisture decline was important in sandy soils, whereas vegetation height influenced seedling survival in loamy soils. Overall, models of seedling survival in all the four soil types indicated rate of moisture decline as the single most important variable influencing Cottonwood survival. High initial densities of Saltcedar were correlated to higher survival in Cottonwood seedlings. Therefore, it is important to identify soil texture and understand soil moisture decline rates when proposing riparian Cottonwood restoration.
Soil Magnetic Susceptibility: A Quantitative Proxy of Soil Drainage for Use in Ecological Restoration
Authors: Grimley David A. , Wang Jing‐Shu , Liebert Derek A. , Dawson Jeffrey O.
Published: November 2008

Flooded, saturated, or poorly drained soils are commonly anaerobic, leading to microbially induced magnetite/maghemite dissolution and decreased soil magnetic susceptibility (MS). Thus, MS is considerably higher in well‐drained soils (MS typically 40–80 × 10−5 standard international [SI]) compared to poorly drained soils (MS typically 10–25 × 10−5 SI) in Illinois, other soil‐forming factors being equal. Following calibration to standard soil probings, MS values can be used to rapidly and precisely delineate hydric from nonhydric soils in areas with relatively uniform parent material. Furthermore, soil MS has a moderate to strong association with individual tree species’ distribution across soil moisture regimes, correlating inversely with independently reported rankings of a tree species’ flood tolerance. Soil MS mapping can thus provide a simple, rapid, and quantitative means for precisely guiding reforestation with respect to plant species’ adaptations to soil drainage classes. For instance, in native woodlands of east‐central Illinois, Quercus alba, Prunus serotina, and Liriodendron tulipifera predominantly occur in moderately well‐drained soils (MS 40–60 × 10−5 SI), whereas Acer saccharinum, Carya laciniosa, and Fraxinus pennsylvanica predominantly occur in poorly drained soils (MS <20 × 10−5 SI). Using a similar method, an MS contour map was used to guide restoration of mesic, wet mesic, and wet prairie species to pre‐settlement distributions at Meadowbrook Park (Urbana, IL, U.S.A.). Through use of soil MS maps calibrated to soil drainage class and native vegetation occurrence, restoration efforts can be conducted more successfully and species distributions more accurately reconstructed at the microecosystem level.
Evaluating Hydroperiod Response in Restored Carolina Bay Wetlands Using Soil Physicochemical Properties
Authors: Barton Christopher D. , Andrews Danielle M. , Kolka Randall K.
Published: November 2008

Carolina bays are shallow depression wetlands found in the southeastern United States that have been severely altered by human activity. The need to restore these complex and diverse systems is well established, but our limited understanding of wetland hydrologic processes in these systems hinders our ability to assess the effectiveness of bay restoration efforts. Carolina bays exhibit a wide range of moisture regimes from seasonally saturated to semipermanently inundated. Differing physicochemical properties of soils within bay interiors may control bay hydrology. However, previous efforts to establish relationships between soil characteristics and bay hydrology have been inconclusive. An assessment of soil and hydroperiod was initiated in 16 bays designated to be restored and 6 bays that were not restored (reference). Soil morphology was described, and permanent monitoring wells were installed at each site. Multiple regression analysis was used to determine relationships between the soil physicochemical characteristics and the bay hydroperiod for restored and reference bays in both pre‐ and postrestoration periods. A significant relationship (r2= 0.75,p= 0.02) between prerestoration hydroperiod and clay content in the argillic horizon (Bt) of the reference bays was observed. This relationship was then used to evaluate hydroperiod change in the restored bays from the postrestoration period. The relationship accurately identified sites that exhibited high prerestoration hydroperiods and did not need hydrologic restoration (n= 4) and effectively showed sites that exhibited substantial increases in hydroperiod due to the restoration activities (n= 7).