bluuebunny/crossref_metadata_2025 huggingface dataset:
Habitat and management affect genetic structure ofFestuca pratensisbut notLolium multiflorumecotype populations
Authors: Peter‐Schmid M. K. I. , Boller B. , Kölliker R.
Published: April 2008

Genetic diversity present in permanent grassland may be valuable for broadening gene pools in breeding programmes and for conservation of genetic resources. However, little is known about the amount of genetic diversity present at specific habitats and about site‐related factors affecting it. To identify valuable habitats, genetic diversity of 12 ecotype populations and four reference cultivars of bothFestuca pratensisHuds. andLolium multiflorumLam. was analysed using Simple sequence repeat markers (SSR). Analysis of molecular variance revealed a larger within population variation forL. multiflorum(97.1%) than forF. pratensis(92.6%).F. pratensisecotype populations were clearly separated from cultivars and formed three distinct subclusters according to the geographic regions they were sampled from. Differences betweenL. multiflorumecotype populations and cultivars were small and no grouping of populations was observed. Thus, onlyF. pratensisecotype populations were structured and habitat as well as management had a slight influence on genetic structure. This information may allow the design of individual strategies for targeted utilization of genetic resources in plant breeding programmes.
Chromosome location and microsatellite markers linked to a powdery mildew resistance gene in wheat line ‘Lankao 90(6)’
Authors: Niu J. S. , Wang B. Q. , Wang Y. H. , Cao A. Z. , Qi Z. J. , Shen T. M.
Published: April 2008

Wheat lines known as ‘Lankao 90(6)’, derived from the cross ‘Mzalenod Beer’ (hexaploid triticale)/‘Baofeng 7228’//‘90 Xuanxi’, carry a recessive powdery mildew resistance gene temporarily named PmLK906. Gene PmLK906 appears to be different from known wheat powdery mildew resistance genes. PmLK906 was tagged using microsatellite markers in a segregating population derived from the cross ‘Chinese Spring’/‘Lankao 90(6)21‐12’. The dominant microsatellite marker Xgwm265‐2AL was linked in repulsion with PmLK906 at a genetic distance of 3.72 cM, whereas the co‐dominant Xgdm93‐2AL was linked to PmLK906 at a genetic distance of 6.15 cM. Both markers were placed on chromosome arm 2AL using ‘Chinese Spring’ nulli‐tetrasomic lines. The recessive PmLK906 has a different specificity to the dominant resistance alleles located at the Pm4 locus and appeared to be located to a locus different from Pm4.
Genetic diversity in soybean genotypes from north‐eastern China and identification of candidate markers associated with maturity rating
Authors: Li W. , Han Y. , Zhang D. , Yang M. , Teng W. , Jiang Z. , Qiu L. , Sun G.
Published: April 2008

Random amplified polymorphic DNA (RAPD) and simple sequence repeat (SSR) markers were used to estimate the genetic relationships among 101 soybean cultivars developed in north‐eastern China. Fifty‐three fragments of the 100 RAPD markers and 35 SSR markers tested were polymorphic across the 101 soybean cultivars. Similarity values among these soybean cultivars ranged from 45.2% to 100% for RAPD data, and ranged from 36.1% to 100% for SSR data. The similarity matrices for SSR data and RAPD data were moderately correlated (r = 0.31, P < 0.05). Cluster analyses indicated that the cultivars released from the same seed company were mostly grouped together. A principal component analysis, based on the combined RAPD and SSR data, yielded a good separation of soybean varieties with different maturity ratings [represented by soybean Heat Unit (HU)]. The varieties with HU < 2200 were well separated from those with HU > 2200. Four RAPD markers and eight SSR markers were significantly associated with the maturity ratings of soybean.
Painful digital infarction in a male smoker treated as Buerger's disease
Authors: Foley Susan , Gibbs Harry , Muir James
Published: April 2008

A 40‐year‐old male smoker presented with a 3‐week history of painful digital infarction involving the hands. Histology was unhelpful, showing lichen simplex chronicus. A provisional diagnosis of a vasculitic disease was made. Treatment included aspirin, azathioprine, iloprost, methylprednisolone, nifedipine and prednisolone. After failure of these treatments an alternative clinical diagnosis of Buerger's disease was made. Treatment was to advise the patient of the importance of continuing to abstain from smoking, to perform bilateral video‐assisted thoracoscopic sympathectomies and to commence folate supplementation. This led to marked improvement of his symptoms and healing of the digital infarction.
Acitretin for lichen amyloidosus
Authors: Choi James YJ , Sippe John , Lee Stephen
Published: April 2008

We present two cases of lichen amyloidosus treated with retinoids. A 57‐year‐old Vietnamese woman has had extensive generalized recalcitrant lichen amyloidosus for 23 years. Treatment with oral etretinate (25 mg/day) for 3 years, and later oral acitretin (10 mg/day) for the past 10 years, has controlled the pruritus and flattened the hyperkeratotic papules. Whenever the acitretin was ceased her symptoms flared within weeks. On each occasion reintroduction of acitretin was effective within 1–2 months. The second case is that of a 51‐year‐old Australian Aboriginal woman who had a 2‐year history of lichen amyloidosus affecting her lower legs. A 2‐month course of oral acitretin (25 mg b.d.) produced a marked improvement in both the pruritus and hyperkeratotic papules. She was then lost to follow up for 2 years, during which time her symptoms recurred.
Erythroplasia of Queyrat of the glans penis on a background of Zoon's plasma cell balanitis
Authors: Starritt Emma , Lee Stephen
Published: April 2008

Erythroplasia of Queyrat of the glans penis developed in a 79‐year‐old uncircumcised man on a background of biopsy proven Zoon's plasma cell balanitis affecting the same site on the glans. The Zoon's plasma cell balanitis had been treated with topical pimecrolimus for 1 month prior to the development of clinically evident erythroplasia of Queyrat. He was subsequently treated with topical 5‐fluorouracil 5% for 2 weeks, which resulted in clinical clearance. He has since been circumcised.
Effect and persistency of botulinum toxin iontophoresis in the treatment of palmar hyperhidrosis
Authors: Davarian Sanaz , Kalantari Khosro K , Rezasoltani Asghar , Rahimi Abbas
Published: April 2008

The purpose of this study was to investigate the efficacy and persistence of the hypohidrosis induced by iontophoresis of botulinum toxin type A in patients with palmar hyperhidrosis. Eight patients with severe palmar hyperhidrosis participated in this study. Iontophoresis of botulinum toxin was applied to the patients' dominant (right) hand and the other hand was the control treated with normal saline. Gravimetry and iodine–starch tests were performed to evaluate the rate of sweating. The evaluation sessions were at baseline, 2 and 4 days, 1, 2, 3, 4, 8 and 12 weeks after treatment. The patients were also asked to fill out the Dermatology Life Quality Index questionnaire at 2, 4, 8 and 12 weeks after treatment. The mean sweating rate significantly reduced at the first, second, third and fourth week and the second and third month (P < 0.05) after the treatment in the right hand, and the third and fourth week (P < 0.05) after treatment in the left hand. Iontophoresis of botulinum toxin rapidly induced a quick reduction of sweating rate for at least 3 months with no pain, muscle weakness or other side‐effects.
Perceptions of adolescents on overweight and obesity: The weight of opinion study
Authors: Booth Michael L , Wilkenfeld Rachel L , Pagnini Deanna L , Booth Susan L , King Lesley A
Published: April 2008

Aim:  The incidence and prevalence of overweight and obesity are rising around the world. Health promotion planning must be informed by the knowledge, perceptions, motivations and perceived needs of the target population, but little is known about how adolescents perceive overweight and obesity, its causes and solutions.

Methods:  A cross‐sectional, non‐representative sample of 12‐ to 17‐year‐old boys and girls (n = 58) attending schools in diverse metropolitan areas and one rural area in NSW, Australia. Focus groups were conducted in 2005 and content analysis was used to identify key themes.

Results:  The students were aware that overweight was becoming increasingly common. They perceived the negative consequences primarily in psycho‐social terms, but were also aware of the long‐term physical health consequences. Behaviours, appearance, motivation and self‐esteem were used as criteria to judge if a person was overweight and the students distinguished between ‘healthy’ and ‘ideal’ (physically attractive) weight. The major barriers to maintaining a healthy weight were home, school and community environments in which fatty/high sugar foods were too easily accessible and where opportunities for participating in physical activity were sometimes limited. Student‐identified strategies to address the issue encompassed government policy, advertising and media, schools and home.

Conclusions:  The students have a mature and complex understanding of overweight and its potential solutions, making them likely to be creative contributors and responsive to wide‐ranging, multi‐component interventions.
Long‐standing fever and Angelman syndrome: Report of two cases
Authors: Yiş Uluç , Giray Özlem , Kurul Semra H , Bora Elçin , Ulgenalp Ayfer , Erçal Derya , Dirik Eray
Published: April 2008

Abstract:  An 8‐month‐old girl and a 20‐month‐old boy who presented with motor and developmental delay and long‐standing fever are presented. The patients were diagnosed as Angelman syndrome with fluorescence in situ hybridization (FISH) analysis. Despite extensive clinical and laboratory examinations, no inflammatory or infectious origin for the fever was found. It was considered that the long‐standing fever observed in these cases was due to hypothalamic dysfunction for thermoregulation.
Procalcitonin is a valuable prognostic marker in ARDS caused by community‐acquired pneumonia
Authors: TSENG Jeng‐Sen , CHAN Ming‐Cheng , HSU Jeng‐Yuan , KUO Benjamin Ing‐Tiau , WU Chieh‐Liang
Published: April 2008

Background and objective:  ARDS is life‐threatening acute respiratory failure, and pneumonia is one of the most common causes of direct ARDS. Procalcitonin (PCT) has been evaluated for its utility in determining the aetiology of community‐acquired pneumonia (CAP), choice of antibiotics and prediction of outcome. This study evaluated the role of PCT in predicting the outcome of patients with ARDS caused by severe CAP.

Methods:  This was a prospective observational study conducted from September 2002 to December 2003. The plasma PCT was analysed at baseline, 24 and 72 h after enrolment and measured by ELISA.

Results:  Of the 22 patients with ARDS caused by CAP and enrolled in the study, 17 (77.3%) were alive 14 days after admission and five (22.7%) had died. The survivors had lower APACHE II scores (22.2 ± 4.6 vs 30.6 ± 9.6, P = 0.031), pneumonia severity index (141.9 ± 2.2 vs 195.6 ± 23.8, P = 0.005) and lower plasma PCT at baseline (9.83 ± 3.54 vs 106.70 ± 67.86, P = 0.004), at 24 h (10.51 ± 5.39 vs 81.32 ± 57.68, P = 0.014) and at 72 h (2.03 ± 0.76 vs 19.57 ± 6.67, P = 0.005).

Conclusion:  PCT analysed within 72 h of the onset of ARDS predicted mortality of patients with ARDS caused by severe CAP.
Risk of respiratory syncytial virus in survivors with severe congenital diaphragmatic hernia
Authors: Masumoto Kouji , Nagata Kouji , Uesugi Toru , Yamada Tomomi , Kinjo Tadamune , Hikino Shunji , Hara Toshiro , Taguchi Tomoaki
Published: April 2008

Background: During the follow‐up period in surviving patients with severe congenital diaphragmatic hernia (CDH), respiratory complications, such as recurrence of CDH or chronic lung disease, have been reported to occur as a late complication. Although some risk factors for deterioration of respiratory condition have been reported in CDH, the risk of respiratory syncytial virus (RSV) in postoperative CDH patients has not as yet been reported upon.

Methods: In 21 survivors with severe CDH, which had been detected antenatally, and whose lung:thoracic ratio was <0.2, the risk of RSV infection in those patients was investigated.

Results: Five survivors with severe CDH had RSV infection and three patients needed hospitalization due to bronchiolitis during the follow‐up period. In two patients the recurrence of CDH after the infection resulted in the need to perform a re‐operation for CDH. All patients often suffered from chronic wheezing requiring medication after the first RSV infection.

Conclusion: RSV infection is a risk for deterioration of postoperative respiratory condition in severe CDH survivors. Considering the presence of pulmonary hypoplasia in severe CDH, the routine use of monoclonal antibody for RSV (palivizumab) might be effective for patients with severe CDH in the high season of RSV, similar to the patients with chronic lung disease, although further large multicenter studies are needed to clarify this hypothesis.
Usefulness of single photon emission computed tomography imaging in the detection of lumbar vertebral metastases from prostate cancer
Authors: Nozaki Tetsuo , Yasuda Kenji , Akashi Takuya , Fuse Hideki
Published: April 2008

Objective:  To determine whether single photon emission computed tomography (SPECT) is useful in the detection of prostate cancer bone metastases in the lumbar vertebrae.

Methods:  Thirty‐nine patients (12 with benign prostatic hyperplasia, 27 with prostate cancer) were considered and submitted to bone SPECT. All of them had increased uptake in lumbar vertebrae on bone scintigraphy. In those with prostate cancer, definitive diagnosis of bone metastases was established by magnetic resonance imaging (MRI). SPECT axial images were classified into five accumulation patterns: mosaic, large hot, diffuse, peripheral, and articular (or pediculate). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of bone SPECT were calculated.

Results:  Overall, 116 vertebral lesions (49 metastatic, 67 degenerative) were studied. Mosaic, large hot and diffuse patterns were more frequently associated with metastatic lesions (84.2%, 70.3%, and 63.1% of the cases, respectively). On the other hand, peripheral and articular (or pediculate) patterns were mostly ascribed to degenerative lesions (100% and 87.5% of the cases, respectively). Sensitivity, specificity, PPV and NPV of bone SPECT were 95.9% (47/49), 73.1% (49/67), 72.3% (47/65), and 96.1% (49/51), respectively.

Conclusions:  Bone SPECT provides better accuracy than bone scintigraphy in differential diagnosis of lumbar vertebral lesions from prostate cancer.
Prediction of extraprostatic extension by prostate specific antigen velocity, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer
Authors: Nishimoto Koshiro , Nakashima Jun , Hashiguchi Akinori , Kikuchi Eiji , Miyajima Akira , Nakagawa Ken , Ohigashi Takashi , Oya Mototsugu , Murai Masaru
Published: April 2008

Objectives:  To investigate the clinical value of prostate specific antigen velocity (PSAV) in predicting the extraprostatic extension of clinically localized prostate cancer.

Methods:  One hundred and three patients who underwent radical prostatectomy for clinically localized prostate cancer were included in the analysis. The correlation between preoperative parameters, including PSA‐based parameters, clinical stage, and histological biopsy findings, and the pathological findings were analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for the local extent of the disease.

Results:  Sixty‐four (60.2%) patients had organ confined prostate cancer and 39 (39.8%) patients had extraprostatic cancer. The biopsy Gleason score, PSA, PSA density, PSA density of the transition zone, and PSAV were significantly higher in the patients with extraprostatic cancer than in those with organ confined cancer. Multivariate logistic regression analysis indicated that the biopsy Gleason score, endorectal magnetic resonance imaging findings, and PSAV were significant predictors of extraprostatic cancer (P < 0.01). Probability curves for extraprostatic cancer were generated using these three preoperative parameters.

Conclusions:  The combination of PSAV, endorectal magnetic resonance imaging findings, and biopsy Gleason score can provide additional information for selecting appropriate candidates for radical prostatectomy.
Detrusor contractility and overactive bladder in patients with cerebrovascular accident
Authors: Natsume Osamu
Published: April 2008

Objectives:  A retrospective analysis of urodynamic studies was conducted to investigate detrusor contractility following cerebrovascular accident.

Methods:  Fifty‐seven patients (34 men and 23 women) who were rehabilitated following cerebrovascular accident were included in the analysis. Subjects with maximum contractile power values less than 10 W/m2 in men and 8 W/m2 in women, in the absence of bladder outlet obstruction, were defined as having detrusor underactivity.

Results:  A significantly lower maximum value of detrusor contractile power and a larger residual urine volume, particularly more prevalent in women than in men, appeared unexpectedly after cerebrovascular accident. Patients with underactivity had significantly lower maximum and average flow rates, lower contractile power, and an increased postvoid residual relative to their normal counterparts. The prevalence of underactivity was 35% in the men and 43% in the women. Furthermore, 67% of the men and 80% of the women with underactivity had overactive bladder symptoms. On the other hand, detrusor underactivity was observed in 8 (35%) of 23 overactive bladder patients in the men and 8 (42%) of 19 in the women.

Conclusions:  Post‐cerebrovascular accident patients presented various patterns of detrusor contractility. Specific attention to the possible occurrence of detrusor underactivity in these patients is essential for the successful management of overactive bladder syndrome.
Genetic variants of the XRCC7 gene involved in DNA repair and risk of human bladder cancer
Authors: Wang Shou‐Yu , Peng Lei , Li Chun‐Ping , Li Ai‐Ping , Zhou Jian‐Wei , Zhang Zheng‐Dong , Liu Qi‐Zhan
Published: April 2008

Objective:  To investigate the association between the polymorphisms of the KU70 and X‐ray repair cross complementing group 7 (XRCC7) genes and the risk of bladder cancer.

Methods:  This hospital‐based case‐control study included 213 patients with newly diagnosed bladder transitional cell carcinoma and 235 cancer‐free controls frequency‐matched by age and sex. Two polymorphisms, KU70 and XRCC7, using a method involving polymerase chain reaction‐restriction fragment length polymorphism were genotyped.

Results:  The risk of bladder cancer decreased in a dose–response manner as the number of XRCC76721G alleles increased (adjusted odds ratio [OR] = 0.70, 95% confident interval [CI] = 0.47–1.03 for 6721GT and OR = 0.31, 95% CI = 0.10–0.99 for 6721GG; Ptrend = 0.013). However, when we used 6721 (GT + GG) as the reference, we found a statistically significant increased risk of bladder cancer associated with the 6721TT genotype (OR = 1.53, 95% CI = 1.04–2.25). In the stratification analysis, this increased risk was more pronounced among subgroups of patients aged >65 years (OR = 2.27; 95% CI = 1.25–4.10) and ever smokers (OR = 2.06, 95% CI = 1.15–3.68). Furthermore, we observed a 3.24‐fold increased risk (95% CI = 1.35–7.78) for smokers aged >65 years carrying 6721TT genotype compared with those carrying the 6721 (GG + GT) genotype. However, the KU70−61C > G polymorphism was not associated with a significantly increased risk of bladder cancer.

Conclusions:  The XRCC7 but not the KU70 polymorphism appears to be involved in the etiology of human bladder cancer. Larger studies with more detailed data on environmental exposure are needed to verify these initial findings.
Comparison of cell cycle regulatory gene mRNA in three different types of human trophoblasts and effect of transforming growth factor
Authors: Richard Craig A. H. , Jones Jaqueline M. , DeLoia Julie A.
Published: April 2008

Aim:  Identifying the factors responsible for reducing the proliferation, syncytialization, and invasiveness of trophoblast tissues, as seen with preeclampsia, intrauterine growth restriction, and spontaneous miscarriage, is a current challenge in reproductive biology. These factors, transforming growth factor (TGF)‐β as an example, can work by altering trophoblast differentiation or proliferation. We therefore investigated and compared specific markers of trophoblast proliferation and differentiation in three commonly used trophoblast tissue cell models, and also investigated the influence of TGF‐β on these markers.

Methods:  In this study, we isolated human trophoblasts from first trimester and term placentas, and additionally used human choriocarcinoma cells (JEG‐3). Baseline values of human chorionic gonadotropin (hCG) secretion and relative mRNA levels of cell cycle regulators (cyclin E, p21, p27, and p57) were investigated for each cell type. We also investigated the influence of TGF‐β on these parameters.

Results:  Quantitative and longitudinal production of hCG differed between the three cell types. Significantly different amounts of cyclin E, p21, p27, and p57 mRNA were demonstrated within each cell type, as well as between all the cell types, throughout the culture time period. Each trophoblast type demonstrated a reduction of hCG secretion in response to TGF‐β. TGF‐β did not show a consistent effect on the cell cycle mRNA of any of the cell types.

Conclusion:  We were able to characterize and compare the differential production of hCG, as well as the differential expression of cell cycle‐associated mRNA of early trophoblasts, term trophoblasts, and choriocarcinoma cells. The production of hCG was altered by TGF‐β, although mRNA levels were not markedly altered by TGF‐β.
Safety and usefulness of emergency maternal transport using helicopter
Authors: Ohara Mamiko , Shimizu Yukiko , Satoh Hiroyuki , Kasai Takeshi , Takano Shinobu , Fujiwara Rei , Furusawa Yoshiaki , Kameda Shogo , Matsumura Tomoko , Narimatsu Hiroto , Kusumi Eiji , Kodama Yuko , Kami Masahiro , Murashige Naoko , Suzuki Makoto
Published: April 2008

Aim:  Japan has a shortage of tertiary medical care facilities for maternal and fetal medicine. Establishment of efficient medical transport systems is needed for pregnant women and fetuses with severe complications. Maternal transport by helicopters is expected to shorten transportation time to advanced facilities, although its feasibility has not yet been evaluated. The aim of the present study was to investigate the status of maternal helicopter transport, and conditions of the pregnant patients and children transferred by helicopter to Kameda Medical Center (KMC).

Methods:  Between August 2005 and July 2006, 26 pregnant women were transported by helicopters to KMC.

Results:  The median net flight time was 24 min (range 15–29 min), and the median of estimation of ground transportation time was 125 min (range 90–180 min). The causes for transfers were preterm labor in eight, preterm premature rupture of the membrane in five, cervical incompetence in five, pre‐eclampsia in three and other medical reasons in five. Five of the 26 patients were discharged with restored stability of pregnancy. The remaining 21 patients underwent delivery at KMC. The median gestational age was 26 weeks (range 22–33 weeks) at the time of transfer and 31 weeks (range 22–37 weeks) at delivery. Four of 26 neonates who were born at KMC died after birth due to severe premature or congenital anomaly. Seventeen of the remaining 22 neonates, including 10 twins, received treatment in the neonatal intensive care unit. All of the 22 neonates and all the mothers were discharged in good condition. No patients developed any complications requiring treatment during flights.

Conclusion:  Helicopter transfer is feasible for pregnant patients with severe complications.
Role of human papillomavirus in the development of epithelial ovarian neoplasms in Italian women
Authors: Giordano Giovanna , D'Adda Tiziana , Gnetti Letizia , Froio Elisabetta , Merisio Carla. , Melpignano Mauro
Published: April 2008

Aim:  In this article, for the first time, we investigate the presence of human papillomavirus (HPV) DNA in ovarian epithelial neoplasms from a group of 71 Italian women. The follow ups of the patients with or without HPV DNA were also considered to evaluate whether HPV DNA in these tumors could be an indicator of prognosis.

Methods:  HPV DNA was evaluated by polymerase chain reaction (PCR). Additionally P16 immunoractivity was evaluated in all positive cases to demonstrate the presence of HPV.

Results:  Only three cases out of 71 epithelial ovarian neoplasms (4.22%) in this series were weakly HPV positive. The presence of HPV DNA in these cases did not seem to be related with the type of neoplasm, their grade of differentiation, staging of development, patient's age or survival.

Conclusion:  The presence of HPV could be an expression of a latent infection. In both positive and negative HPV ovarian neoplasms, cervix showed only chronic cervicitis and no signal for HPV DNA on PCR analysis.
Surviving 27 weeks fetus expelled out of the ruptured rudimentary horn and detected a month later as a secondary abdominal pregnancy
Authors: Rana Ashma , Gurung Geeta , Rawal Suniti , Bista Kesang D. , Adhukari Shilu , Ghimire Ram K.
Published: April 2008

Abstracts

A pregnant woman, gravida 3 with two living children, who frequently experienced syncope from 23+5 weeks of pregnancy onwards and recurring every week for a period of 3 weeks, was repeatedly treated in line for a case of acid peptic disease/appendicitis in various peripheral hospitals of Nepal, until ultrasonogram/magnetic resonance imaging diagnosis of an (undisturbed) live 27+5 weeks abdominal pregnancy was made at our hospital. On laparotomy, this materialized to be secondary to the rupture of a left rudimentary horn pregnancy (evidenced from its sealed margin) which still retained a complete placenta, from where an umbilical cord was seen, traversing across towards the right side of the abdominal cavity just below the liver, securing its attachment to the surviving fetus and enclosed in an intact amniotic sac. Excision of the rudimentary horn containing the placenta was accomplished, after the delivery of a live baby weighing 650 g who unfortunately died on the third day of life.
Mucoepidermoid carcinoma of the parotid gland with ovarian and peritoneal metastasis
Authors: Buyukkurt Selim , Altintas Aytekin , Gumurdulu Derya , Zeren Handan , Guzel Baris
Published: April 2008

Metastatic ovarian carcinoma generally arises from the gastrointestinal tract. Mucoepidermoid carcinoma is the most common malignant tumor of the salivary gland. It typically disseminates to the regional lymph nodes and surrounding soft tissues. Distant metastasis of the parotid mucoepidermoid carcinoma is very rare, and it usually occurs to the lungs, bones and liver. A 28‐year‐old woman with a history of high grade mucoepidermoid carcinoma of the parotid gland was admitted with ascites and bilateral ovarian masses. Breast examination, endoscopic evaluation of the gastrointestinal tract, total bone scintigraphy, abdominopelvic and chest tomography and cytological analysis of the ascites did not detect a primary malignancy. Nevertheless, pathological examination of the ovaries revealed a metastasis from the mucoepidermoid carcinoma. Metastatic ovarian tumors usually originate from the gastrointestinal tract. Other sources of tumor metastasis should also be considered.
Endometrioid endometrial adenocarcinoma recurring as carcinosarcoma
Authors: Shaco‐Levy Ruthy , Piura Benjamin
Published: April 2008

Müllerian carcinosarcoma is currently regarded as a metaplastic (sarcomatous) carcinoma. Only five cases of pure ovarian adenocarcinoma recurring as carcinosarcoma have been documented in the literature. There are no documented cases of endometrial adenocarcinoma recurring as metaplastic carcinoma. We report of a case of endometrial adenocarcinoma, endometrioid type, recurring as metaplastic carcinoma showing sarcomatous differentiation. The tumor evolution in this case supports the prevailing opinion that Müllerian carcinosarcomas are derived from carcinomas and represent tumor progression.
Ovarian stromal luteoma in a patient with endometrial carcinoma
Authors: Dhingra Kajal K. , Sharma Prashant , Khurana Nita , Chaturvedi K. Uma
Published: April 2008

A 65‐year‐old patient with endometrial adenocarcinoma underwent hysterectomy. Pathological examination of the right ovary revealed a coexisting stromal luteoma. The possible relationship between the two neoplasms as well as the intriguing pathogenesis and controversial nomenclature of ovarian steroid cell tumors are discussed. The incidental discovery of a stromal luteoma in a total hysterectomy specimen removed for endometrial carcinoma raises interesting questions about the perceived innocuous nature of these rare lipid cell tumors.
Antibiotic prophylaxis in cesarean section causing anaphylaxis and intrauterine fetal death
Authors: Sengupta Amit , Kohli Jasvinder K.
Published: April 2008

Intrauterine fetal death and maternal shock occurred as a result of a type‐1 hypersensitivity reaction following antibiotic prophylaxis in a cesarean section. Amniotic fluid embolism may mimic the condition. The ability to diagnose and treat such an event as early as possible is necessary in all maternity centers. The selection of antibiotic regimen and the type of anesthesia should be individualized depending upon the existing facilities and the patient's profile, especially in a resource‐scarce developing country.
Abundance and activity of Chloroflexi‐type SAR202 bacterioplankton in the meso‐ and bathypelagic waters of the (sub)tropical Atlantic
Authors: Varela Marta M. , Van Aken Hendrik M. , Herndl Gerhard J.
Published: April 2008

The contribution of Chloroflexi‐type SAR202 cells to total picoplankton and bacterial abundance and uptake of d‐ and l‐aspartic acids (Asp) was determined in the different meso‐ and bathypelagic water masses of the (sub)tropical Atlantic (from 35°N to 5°S). Fluorescence in situ hybridization (FISH) revealed that the overall abundance of SAR202 was ≤ 1 × 103 cells ml−1 in subsurface waters (100 m layer), increasing in the mesopelagic zone to 3 × 103 cells ml−1 and remaining fairly constant down to 4000 m depth. Overall, the percentage of total picoplankton identified as SAR202 increased from < 1% in subsurface waters to 10–20% in the bathypelagic waters. On average, members of the SAR202 cluster accounted for about 30% of the Bacteria in the bathypelagic waters, whereas in the mesopelagic and subsurface waters, SAR202 cells contributed < 5% to total bacterial abundance. The ratio of d‐Asp : l‐Asp uptake by the bulk picoplankton community increased from the subsurface layer (d‐Asp : l‐Asp uptake ratio ≈ 0.03) to the deeper layers reaching a ratio of ∼1 at 4000 m depth. Combining FISH with microautoradiography to determine the proportion of SAR202 cells taking up d‐Asp versus l‐Asp, we found that ≈ 30% of the SAR202 cells were taking up l‐Asp throughout the water column while d‐Asp was essentially not taken up by SAR202. This d‐Asp : l‐Asp uptake pattern of SAR202 cells is in contrast to that of the bulk bacterial and crenarchaeal community in the bathypelagic ocean, both sustaining a higher fraction of d‐Asp‐positive cells than l‐Asp‐positive cells. Thus, although the Chloroflexi‐type SAR202 constitutes a major bathypelagic bacterial cluster, it does not contribute to the large fraction of d‐Asp utilizing prokaryotic community in the meso‐ and bathypelagic waters of the North Atlantic, but rather utilizes preferentially l‐amino acids.
Long‐term outcome of forearm flee‐flap phalloplasty in the treatment of transsexualism
Authors: Leriche Albert , Timsit Marc‐Olivier , Morel‐Journel Nicolas , Bouillot André , Dembele Diala , Ruffion Alain
Published: April 2008

OBJECTIVE

To assess the long‐term outcome of forearm free‐flap phalloplasty in transsexuals, as obtaining a satisfying neophallus in female‐to‐male transsexuals is a surgical challenge.

PATIENTS AND METHODS

We analysed retrospectively 56 transsexuals who had a phalloplasty using a radial forearm free‐flap in our department from 1986 to 2002. The complication rate was assessed by regular examination. Patient satisfaction was evaluated by a questionnaire about cosmetic aspects, sexual life and overall satisfaction.

RESULTS

The mean follow up was 110 months; 53 of the 56 patients (95%) currently have a neophallus, after a mean of six surgical procedures. Satisfaction was assessed in 53 patients using a specific questionnaire: 51 (93%) of the patients reported that the phalloplasty allowed them to accord their physical appearance with their feeling of masculinity. There were flap complications in 14 patients (25%); three (5%) flaps were lost, with one each due to early haematoma, cellulitis and late arterial thrombosis. The other 11 flap complications were all transitory, e.g. infection, haematomas and vascular thrombosis. There were prosthesis complications in 11 of 38 patients (29%). Moreover, seven of 19 patients (37%) who had a urethroplasty presented with complex strictures and fistulae that led to perineal urethrostomy.

CONCLUSION

Our study shows that phalloplasty with a forearm free‐flap leads to good results in term of flap survival and patient satisfaction. However, there was a high rate of complications. Patients must be clearly informed that the procedure can seldom be achieved in one stage.
Dietary modification in patients with prostate cancer on active surveillance: a randomized, multicentre feasibility study
Authors: Parsons J. Kellogg , Newman Vicky A. , Mohler James L. , Pierce John P. , Flatt Shirley , Marshall James
Published: April 2008

OBJECTIVES

To evaluate the feasibility of implementing a diet‐based intervention in men with prostate cancer on active surveillance, as changes in diet might potentially inhibit the progression of prostate cancer.

PATIENTS AND METHODS

As part of the Men’s Eating and Living (MEAL) Study (a multicentre pilot trial of a diet‐based intervention for prostate cancer) 43 men aged 50–80 years with prostate cancer and on active surveillance were randomized to receive either telephone‐based dietary counselling or standardized, written nutritional information. Telephone counselling targets included increased intakes of vegetables (particularly cruciferous vegetables and tomato products), whole grains, and beans/legumes. Dietary intakes and plasma carotenoid levels were assessed at baseline and at after 6 months.

RESULTS

In the intervention arm the mean daily intakes of total vegetables, crucifers and tomato products increased by 71%, 180% and 265%, respectively (P < 0.05); in the control arm there were no significant changes in mean intakes of these components. Similarly, in the intervention arm, mean plasma levels of α‐carotene, β‐carotene, lutein, lycopene and total carotenoids increased by 37%, 32%, 23%, 30% and 25%, respectively (P < 0.05); in the control arm there were no significant changes in plasma levels of these components. There were no significant changes in either group in whole grain, beans/legumes, or fat intake.

CONCLUSIONS

Telephone‐based dietary counselling increases vegetable intake and plasma concentrations of potentially anticarcinogenic carotenoids in men with prostate cancer on active surveillance. These data support the feasibility of implementing clinical trials of diet‐based interventions in this population.
Cluster analysis and lower urinary tract symptoms in men: findings from the Boston Area Community Health Survey
Authors: Çinar Amy , Hall Susan A. , Link Carol L. , Kaplan Steven A. , Kopp Zoe S. , Roehrborn Claus G. , Rosen Raymond C.
Published: April 2008

OBJECTIVES

To classify lower urinary tract symptoms (LUTS) in a large, representative sample of men in the USA by means of cluster analysis and to investigate risk factors and comorbidities associated with the resulting cluster patterns.

SUBJECTS AND METHODS

A combination of hierarchical and non‐hierarchical cluster methods was used to assign men with LUTS in the Boston Area Community Health (BACH) study to symptom‐based categories or clusters. Of the 2301 men in the BACH study, those reporting one or more of 14 common LUTS (1592 men) were included in the analysis. The prevalence and frequency of symptoms in each cluster was assessed, in addition to the demographic, lifestyle risk factors, comorbidities, quality of life, and interference with activities of daily living associated with each cluster. We used anova methods for assessing cluster effects on continuous variables, and cross‐classification and chi‐square tests for categorical measures. Internal validity of the cluster solution was tested by means of a split‐half replication, and external validity by comparison with previously published data.

RESULTS

Five clusters were identified among symptomatic men. About half of the symptomatic men were assigned to Cluster 1, which included individuals with a low prevalence and frequency of urological symptoms and a correspondingly low level of interference with activities of daily living. There were intermediate levels of symptom frequency and prevalence in Clusters 2–4, which were characterized by mixed patterns of voiding, storage and postvoiding symptoms. Cluster 5 consisted of predominantly older men (mean age 58.9 years), with a high prevalence and frequency of urological symptoms with a mean (sd) number of symptoms of 9.9 (2.1), and with elevated levels of comorbid cardiovascular disease (P < 0.001). These men also had higher rates of kidney and bladder infections and previous urological surgery. Men with increased waist circumference and more sedentary lifestyles were over‐represented in the more symptomatic clusters.

CONCLUSION

Cluster analysis provides an empirically based method for categorizing men with LUTS. These findings provide a new framework for examining aetiological pathways and mechanisms, the potential impact of and consequences for comorbid conditions, and for assessing prognosis and outcomes associated with common urological disorders.
Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL
Authors: Pfitzenmaier Jesco , Gilfrich Christian , Pritsch Maria , Herrmann Daniela , Buse Stephan , Haferkamp Axel , Djakovic Nenad , Pahernik Sascha , Hohenfellner Markus
Published: April 2008

OBJECTIVE

To compare the safety and outcome of potassium‐titanyl‐phosphate (KTP) GreenlightTM (Laserscope, AMS, Minnetonka, MN, USA) vaporization for treating benign prostatic hyperplasia (BPH) in prostates of ≥80 vs <80 mL.

PATIENTS AND METHODS

In all, 204 consecutive patients were enrolled into this prospective study; 31 were excluded from analysis for various reasons, thus 173 (median age 66.8 years; 39 with prostates of ≥80 mL) were evaluated for maximum urinary flow rate (Qmax), postvoid residual urine (PVR), the International Prostate Symptom Score (IPSS), and quality‐of‐life (QoL) score. The median follow‐up was 11.7 months. Of the 173 men, 26.6% were anaesthesiological high‐risk patients and 32.4% took anticoagulants.

RESULTS

The Qmax improved in prostates of ≥80 mL from 6.9 mL/s before to 15.3 mL/s immediately after catheter removal, and 23.4 mL/s after 3 months (P < 0.001). The improvement was similar to that in smaller prostates. There were equally effective changes in PVR (P < 0.001). The IPSS decreased from 19.0 before to 7.0, 4.0 and 5.5 at 3, 6 and 12 months after surgery (P < 0.001). Changes did not differ from those in smaller glands. The results were similar for QoL (P < 0.001). During surgery there was no major bleeding and no transurethral resection syndrome. There was acute urinary retention after catheter removal in 10.4% of men; 4.6% developed urinary tract infections, whereas the rate was higher in men with larger prostates (10.3%). The re‐operation rate was higher in men with larger prostates, at 23.1% vs 10.4% (P = 0.09).

CONCLUSION

KTP laser vaporization is a safe and effective procedure for surgically treating BPH. The functional outcome in larger prostates is similar to that in smaller glands, but there was a serious trend to a higher re‐operation rate in men with larger prostates.
Curtain dissection of the lateral prostatic fascia and potency after laparoscopic radical prostatectomy: a veil of mystery
Authors: Chabert Charles C. , Merrilees David A. , Neill Mischel G. , Eden Christopher G.
Published: April 2008

OBJECTIVE

To assess the effect on potency recovery of incorporating a high incision of the lateral prostatic fascia (LPF) or curtain dissection (CD) into our technique of laparoscopic nerve‐sparing radical prostatectomy (LNSRP).

PATIENTS AND METHODS

In all, 137 bilateral neurovascular bundle (NVB) preserving LNSRPs were performed, incorporating curtain dissection (CD) of the LPF. Potency was assessed at 1, 3, 6 and 12 months using validated questionnaires and compared with a control group (CG) of standard NVB preservation.

RESULTS

There were no conversions to open surgery in either group. The median operative duration in the CD group and the CG was 178 min and 174 min (P = 0.04), blood loss was 300 mL and 200 mL (P = 0.01), and the positive margin rate was 16.1% and 24.1% (P = 0.04), respectively. At a mean follow‐up of 5.8 months in the CD group and 28.2 months in the CG, potency rates were 21.1% and 8.8% at 1 month (P = 0.01), and 68.4% and 67.2% at 12 months (P = 1.00), respectively.

CONCLUSION

The potency rate was significantly higher in the CD group at 1 month than in the CG, thereafter the rates were similar between the groups. We think that the merit of this technique is in improved visualization of the basal prostatic contour during antegrade NVB dissection, rather than preserving important nerve fibres. This may explain the lower basal positive margin rate in the CD group of 0% vs 5.8% in the CG (P = 0.007).
Differential expression of prognostic markers in histological subtypes of papillary renal cell carcinoma
Authors: Perret Anne Gentil , Clemencon Alix , Li Guorong , Tostain Jacques , Peoc’h Michel
Published: April 2008

OBJECTIVE

To assess the expression of the tumour markers stromelysin 3, MUC1, p53 and cytokeratin‐7 in papillary renal cell carcinoma (pRCC, for which two histological subtypes are distinguished, i.e. type 1 and type 2, the latter appearing to be associated with a poorer prognosis) and to determine whether any of these markers might be of prognostic value.

PATIENTS AND METHODS

In a retrospective study of 50 patients, the type and nuclear grade of tumours was determined by histological analyses, the presence of microvascular emboli detected, and the markers assessed by immunohistochemical analysis using anti‐stromelysin 3, anti‐MUC1, anti‐p53 and anti‐cytokeratin‐7 antibodies.

RESULTS

Twenty‐five patients each had a type 1 or type 2 tumour. MUC1 and cytokeratin‐7 were principally expressed in type 1 tumours, being detected in 76% and 84%, respectively. By contrast, p53 accumulated principally in type 2 tumours (36%); the accumulation of p53 was also associated with poorer survival. In patients with type 2 tumours with a more unfavourable development, stromelysin‐3 expression was associated with a more advanced stage and a higher risk of metastases.

CONCLUSION

Subtyping pRCC according to the recommended morphological criteria appears to be worthwhile, and can be reinforced by immunohistochemical tests capable of detecting cytokeratin‐7 and MUC1 expression. Immunohistochemical detection of p53 is of prognostic value, as accumulation of this factor is associated with poorer survival.
‘Crushing the stone’: a brief history of lithotripsy, the first minimally invasive surgery
Authors: Herr Harry W.
Published: April 2008

OBJECTIVE

To trace the history of lithotripsy, marking the start of minimally invasive surgery.

METHODS

Primary and secondary sources describing the development of lithotripsy as a method to treat common bladder stones were reviewed.

RESULTS

Lithotripsy emerged in the early 19th century as an alternative to the morbid and frequently fatal perineal lithotomy practised for thousands of years to relieve sufferers of bladder stones. Lithotripsy developed in stages, first by learning how to pass a straight hollow sound, then drilling stones to break them up, later by crushing them, followed by means to evacuate the fragments, finally by integrating the lithotrite with the cystoscope, permitting surgery under direct vision.

CONCLUSIONS

Lithotripsy evolved as the first minimally invasive surgical procedure owing to the ingenuity and skill of our urological forebears.
Performance and functional outcome of endoscopic extraperitoneal radical prostatectomy in relation to obesity: an assessment of 500 patients
Authors: Liatsikos Evangelos , Mühlstädt Sandra , Kallidonis Panagiotis , Rabenalt Robert , Do Minh , Burchardt Martin , Herrmann Thomas R. , Stolzenburg Jens‐Uwe
Published: April 2008

OBJECTIVE

To investigate the impact of obesity on the performance and functional outcome of endoscopic extraperitoneal radical prostatectomy (EERPE).

PATIENTS AND METHODS

We retrospectively examined 500 patients treated with EERPE; they were categorized into three groups according to the World Health Organization classification of obesity: normal weight (body mass index, BMI, <25.0 kg/m2), overweight (25.0–29.9 kg/m2) and obese (30.0 kg/m2). The database of our institution was reviewed and perioperative data evaluated. The functional data were collected through questionnaires before and after EERPE and analysed statistically.

RESULTS

The age, prostate size and preoperative PSA level were similar in all three groups. The mean (sd) BMI was 27 (3.3) kg/m2, with 26.8%, 56.6% and 16.6% of the patients classed as normal, overweight and obese, respectively. A pelvic lymph node dissection and nerve‐sparing was done in 218 and 123 patients, respectively. There was no statistically significance difference in the number of patients in each group who had previous procedures. Obese patients had a significantly higher American Society of Anesthesiologists score. The mean operative duration for all patients was 149 min; there was a statistically significant difference in duration among the three groups, with EERPE or nerve‐sparing EERPE requiring a mean of 20 min more in obese patients. There was no conversion to open surgery. The estimated mean blood loss was 200 mL; four patients, none of them in the obese group, received a blood transfusion. At 3 months after EERPE there was a trend to worse continence in obese patients, but it was not statistically significant, and was not apparent at 6 months. There was no difference in transfusion rate and duration of catheterization.

CONCLUSION

EERPE seems to be a feasible and reproducible surgical technique in obese patients, although the operation takes longer.