bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic treatment of colovesical fistulas: technique and review of the literature
Authors: TSIVIAN ALEXANDER , KYZER SHLOMO , SHTRICKER AVRAHAM , BENJAMIN SHALVA , SIDI ABRAHAM AMI
Published: June 2006

Abstract  Colovesical fistula is an uncommon complication of diverticulitis. We present our technique of a laparoscopic approach for treatment of vesicosigmoid fistulas and review the available published literature. We believe that a laparoscopic approach is a feasible and advantageous alternative for the treatment of colovesical fistulas, with low morbidity and short hospital stay.
Use of real‐time telemedicine in the detection of diabetic macular oedema: a pilot study
Authors: Peter Jayanthi , Piantadosi Julia , Piantadosi Cynthia , Cooper Peter , Gehling Neil , Kaufmann Claude , Goggin Michael
Published: June 2006

Abstract

Purpose:  The high prevalence of diabetic retinopathy (21–36%) and 2 yearly reviews recommended by the National Health and Medical Research Council for diabetics with no retinopathy creates a considerable burden for review in rural and regional Australia. Screening for diabetic retinopathy using telemedicine has significant implications. If effective, such a tool would have an impact on finance and resource allocation. The purpose of the study was to establish if telemedicine could distinguish clinically significant macular oedema (CSME) from eyes free of this form of disease.

Methods:  A study population with representative examples of normal fundi and the different grades of retinopathy was chosen from existing records. The specificity and sensitivity of telemedicine diagnosis was compared with fundus photography and examination by an experienced ophthalmologist as a ‘gold standard’, in a blinded manner. Real‐time telemedicine assessment was performed with live video and audio connections with the transmitting and receiving units set in different areas of the ophthalmology department. The transmission end consisted of a video camera mounted on a slit lamp and the receiving unit consisted of a 21″ LCD monitor. A video conference link was established using three ISDN lines capable of 128 kb per second transfer per line allowing for a total of 348 kb per second when utilizing all three lines for high resolution images. Fundus photographs were taken with a Zeiss FF 450 Plus Digital imaging system.

Results:  For telemedicine, sensitivity was 38% (95% CI, 35–40%) and specificity was 95% (95% CI, 91–99%). For photography, sensitivity was 75% (95% CI, 71–79%) and specificity was 95% (95% CI, 91–99%).

Conclusions:  In this pilot study, sensitivity of detection of CSME by photography was considerably better than for live‐link telemedicine. This study tends to confirm the continued superiority of examination of the patient by an experienced ophthalmologist as the best method of screening for CSME, a sight threatening form of diabetic retinopathy.
Delayed ocular complications of mustard gas poisoning and the relationship with respiratory and cutaneous complications
Authors: Etezad‐Razavi Mohammad , Mahmoudi Mahmoud , Hefazi Mehrdad , Balali‐Mood Mahdi
Published: June 2006

Abstract

Background: This study was aimed to determine the correlation between ocular complications and respiratory or cutaneous complications in a group of 40 Iranian veterans with late complications of sulphur mustard (SM) poisoning.

Methods: Thorough ophthalmologic examination was performed on all severely SM‐poisoned veterans in the province of Khorasan, Iran. Spirometric evaluation of pulmonary function, as well as estimation of the burned skin area, was performed for all the patients. The severities of ocular, respiratory and cutaneous complications were classified into four grades in each patient and were compared with each other, using Spearman’s rank correlation test.

Results: Forty male patients (aged 43.8 ± 9.8 years) with confirmed SM poisoning were studied 16–20 years after their initial exposure. Common symptoms were recorded as itching (42.5%), burning sensation (37.5%), photophobia (30%) and tearing (27.5%). Abnormal conjunctival and limbal findings were chronic conjunctivitis (17.5%), perilimbal hyperpigmentation (17.5%), vascular tortuosity (15%) and limbal ischaemia (12.5%). Abnormal corneal findings were subepithelial opacity (15%), corneal thinning (15%), diffuse corneal opacity (10%), neovascularization (7.5%) and epithelial defects (5%). A significant positive correlation was found between the severity of ocular and respiratory complications (r = 0.322,P = 0.043). Cutaneous complications revealed no significant correlation with either ocular or respiratory complications.

Conclusions: SM causes delayed destructive lesions in the ocular surface and cornea, leading to progressive visual deterioration and ocular irritation. Late complications of SM poisoning in the eyes, respiratory system and skin are mainly due to SM’s local irritant effects.
Complicated hyphaema: think sickle
Authors: Hooper Claire Y , Fraser‐Bell Samantha , Farinelli Adrian , Grigg John R
Published: June 2006

Abstract

Two cases of complicated hyphaema associated with sickle cell trait are presented. The pathophysiology, diagnosis and management of raised intraocular pressure in sickle cell trait are discussed.
The CAFE model of fracture—application to a TMCR steel
Authors: SHTERENLIKHT A. , HOWARD I. C.
Published: June 2006

CAFE, a combination of Cellular Automata (CA) to describe the material microstructural properties, and Finite Elements to represent the macroscopic strain, allows the evolving states of microstructural change to be analysed in a deforming body. The paper explores the potential of the technique for the assessment of the ductile‐to‐brittle transition behaviour of ferritic steels. The most important features are due to the microstructural control of cleavage. The model was applied to the Charpy test on a TMCR (Thermo‐Mechanically Controlled Rolled) steel. The results include simulations of the full Charpy energy transition curve, the varying amount of scatter in the data, and, in distinction to most other models in the literature, a full description of the state of the fracture surface on each specimen. The results agree reasonably well with the experimental data. The model follows the development of both ductile and cleavage micro‐mechanisms throughout the deformation of the structure or component. As a consequence, it allows cleavage to develop as a progressive point‐to‐point process. The model can, and does, predict the arrest of cleavage cracks by ductile processes. It can be easily generalized to include more sophisticated aspects of a material microstructure.
The F1F0‐ATPase of Bifidobacterium animalis is involved in bile tolerance
Authors: Sánchez Borja , De Los Reyes‐Gavilán Clara G. , Margolles Abelardo
Published: June 2006

Adaptation and tolerance to bile stress are important factors for the survival of bifidobacteria in the intestinal tract. Bifidobacterium animalis is a probiotic microorganism which has been largely applied in fermented dairy foods due to its technological properties and its health‐promoting effects for humans. The effect of the presence of bile on the activity and expression of F1F0‐ATPase, the pool of ATP and the intracellular pH of B. animalis IPLA 4549 and its mutant with acquired resistance to bile B. animalis 4549dOx was determined. The bile‐resistant mutant tolerated the acid pH better than its parent strain. Bile induced the expression of the F1F0‐ATPase and increased the membrane‐bound H+‐ATPase activity, in both parent and mutant strains. In acidic conditions (pH 5.0), the expression and the activity of this enzyme were higher in the mutant than in the parent strain when cells were grown in the absence of bile. Total ATP content was higher for the mutant in the absence of bile, whereas the presence of bile induced a decrease of intracellular ATP levels, which was much more pronounced for the parent strain. At pH 4.0, and independently on the presence or absence of bile, the mutant showed a higher intracellular pH than its parent strain. These findings suggest that the bile‐adapted B. animalis strain is able to tolerate bile by increasing the intracellular ATP reserve, and by inducing proton pumping by the F1F0‐ATPase, therefore tightly regulating the internal pH, and provide a link between the physiological state of the cell and the response to bile.
Prostate specific‐antigen distribution in asymptomatic Canadian men with no clinical evidence of prostate cancer
Authors: CHUN FELIX K.‐H. , PERROTTE PAUL , BRIGANTI ALBERTO , BENAYOUN SERGE , LEBEAU THIERRY , RAMIREZ ALVARO , LEWINSHTEIN DANIEL J. , VALIQUETTE LUC , GUAY JEAN‐PIERRE , KARAKIEWICZ PIERRE I.
Published: June 2006

OBJECTIVE

To examine prostate specific‐antigen (PSA) levels and percentage free/total PSA (f/tPSA) distributions as well as digital rectal examination (DRE) profiles in asymptomatic Canadian men with no established prostate cancer diagnosis, as recent data indicate that a man’s risk of developing prostate cancer is higher if his baseline PSA level is above the median for his age group.

SUBJECTS AND METHODS

We used data obtained during an early prostate cancer‐detection event. An invitation to an onsite DRE, PSA level and f/tPSA assessment was accepted by 313 men. Serum PSA level and f/tPSA were measured before the DRE. A suspicious DRE and/or PSA level of ≥ 2.5 ng/mL or f/tPSA of ≤ 15% represented indications for a systematic 12‐core ultrasonography‐guided prostate biopsy.

RESULTS

Of all the 313 men, most (235, 75%) had PSA levels of 0.01–1.53 ng/mL and an f/tPSA of >15% (285, 91.1%). The median (range) PSA level was 0.8 (0–34.2) ng/mL and f/tPSA was 27.4 (6.7–100)%. Age‐specific median PSA levels and f/tPSA were, respectively, 0.7, 0.9, 1.0, 1.5 ng/mL and 31%, 27%, 26%, 25% for men aged 40–49, 50–59, 60–69 and 70–79 years. A suspicious DRE was recorded in 55 (17.6%) men, with eight (8.8%), 26 (20.0%), 14 (20.6%), and seven (28.9%) having suspicious DRE findings according to above age categories. Overall, seven (2.2%) prostate cancers were detected.

CONCLUSION

The median age‐specific baseline PSA levels and f/tPSA represent valuable indicators of prostate cancer risk. The population‐specific baseline median PSA level should not be >1.0 ng/mL and the baseline f/tPSA should be >30%. Men with values outside of these ranges should be considered at greater risk of prostate cancer.
Prognostic significance of the number of renal glomeruli in reflux nephropathy
Authors: MATSUOKA HIROFUMI , NAKASHIMA YUICHI , OSHIMA KAZUHIRO
Published: June 2006

OBJECTIVE

To monitor the decrease in the number of glomeruli in reflux nephropathy (RN) and to investigate its association with glomerular hypertrophy or clinical data, as some cases of RN progress to end‐stage renal failure, although the mechanism of progression remains unknown and is generally thought to depend on remnant normal renal tissue mass, i.e. the number of remnant renal glomeruli (functional nephrons).

PATIENTS AND METHODS

From 1987 onward, a renal biopsy was taken in 71 patients (mean age 8.08 years) in two institutions to estimate the prognosis of patients with RN. The number of glomeruli per unit area and glomerular size in grossly normal renal tissue specimens were determined to explore the potential association between these variables and the total renal scars, renal function (glomerular filtration rate, GFR), or daily urinary protein excretion.

RESULTS

The number of glomeruli was closely correlated with the actual size of glomeruli (y = 14.783 − 0.052x, R = 0.782). To a lesser extent, the number of glomeruli was also closely correlated with the size of glomeruli expressed in sds (y = 6.264 − 0.832x, R = 0.630). There was a good correlation between the number of glomeruli and the extent of renal scarring, renal function, or daily urinary protein excretion, although its association with renal function (GFR) was least evident.

CONCLUSION

There was an association between the decrease in the number of glomeruli and glomerular hypertrophy, decreased renal function, or increased proteinuria. A renal biopsy taken from radiographically and macroscopically normal regions can be useful for assessing RN, and the size and number of glomeruli in the specimens might provide an important measure for estimating the prognosis of RN.
Gene expression profiling of renal cell carcinoma: a DNA macroarray analysis
Authors: LOVISOLO JON A.J. , CASATI BARBARA , CLERICI LIBERO , MARAFANTE ERMINIO , BONO ALDO V. , CELATO NICOLA , SALVADORE MAURIZIO
Published: June 2006

OBJECTIVES

To examine differences in gene expression levels between renal cell carcinoma (RCC) tissue and ‘normal’ appearing renal tissue using a commercially available DNA macroarray.

MATERIALS AND METHODS

Tissue was obtained from 47 consecutive radical nephrectomies, 29 of which were eligible. DNA macroarrays were analysed on the tumour and normal‐appearing control tissue to measure the expression of 1185 cancer‐related genes. The group of samples was also stratified according to the presence or absence of granular cells and according to tumour grade. Quantitative real‐time polymerase‐chain reaction (PCR) was also performed on seven key genes present on the macroarray.

RESULTS

In all, 444 genes were over‐expressed and 33 genes were under‐expressed. Using selection criteria reduced the list to nine that were significantly over‐expressed and 23 that were under‐expressed. These significant genes belonged to the families of oncogenes, growth factors, interleukins, receptors, immune system components, cytoskeleton, matrix proteins and intracellular modulators, or they coded for proteins involved in DNA transcription and RNA translation, DNA repair, protein turnover, and metabolism of carbohydrates and lipids. There were differences in gene expression according to the presence or absence of granular cells and according to tumour grade. Using quantitative real‐time PCR there was over‐expression of epidermal growth factor receptor, c‐myc, transforming growth factor‐α, vascular endothelial growth factor and vimentin, and under‐expression of TYRO3 protein tyrosine kinase. The von Hippel–Lindau gene was under‐expressed but not significantly.

CONCLUSIONS

A procedure for collecting and storing fresh renal tissue and subsequent gene expression profiling of RCC and normal renal tissue was established. A commercially available DNA macroarray coupled with the significance analysis of macroarrays allowed the identification of sets of differentially expressed cancer‐related genes that were characteristic of RCC, compared with apparently normal renal tissue, and which distinguished among subgroups divided according to tumour grade and histological subtype. Quantitative PCR is important to validate the results of macroarray experiments.
Idiopathic retroperitoneal fibrosis: the case for nonsurgical treatment
Authors: ILIE CRISTIAN P. , PEMBERTON RICHARD J. , TOLLEY DAVID A.
Published: June 2006

OBJECTIVE

To review a 10‐year experience of medical treatment for idiopathic retroperitoneal fibrosis (RPF), a rare condition of unknown causes, which may obstruct the ureter and for which treatment includes ureterolysis and relief of obstruction, and medical treatment with steroids with or without immunosuppressive medication.

PATIENTS AND METHODS

Of 31 patients with RPF treated between 1996 and 2004, 28 had idiopathic disease. Ureteric stents were used to relieve the obstruction in all patients, 12 had previous nephrostomies, 16 were given steroids and only one was treated with ureterolysis.

RESULTS

In all, 28 patients were followed for a mean of 51.17 months; the symptoms were relieved in all cases. Renal function, where impaired, improved dramatically in all patients. Fifteen patients (54%) are free of stents and medication after a mean (range) follow‐up of 60.9 (24–110) months.

CONCLUSION

Idiopathic RPF responds well to conservative management consisting of relief of urinary tract obstruction and steroids.
Vascular endothelial growth factor stimulates embryonic urinary bladder development in organ culture
Authors: BURGU BERK , MCCARTHY LIAM S. , SHAH Vanita , LONG DAVID A. , WILCOX DUNCAN T. , WOOLF ADRIAN S.
Published: June 2006

OBJECTIVES

To determine whether vascular endothelial growth factor A (VEGF) and its receptors are expressed during bladder development in mice when capillaries are forming, and whether exogenous VEGF might enhance the growth of endothelia and other types of bladder cells, using an embryonic organ‐culture model.

MATERIALS AND METHODS

Whole bladders from wild‐type mice, at embryonic day (E) 14, were grown in serum‐free organ culture in an air/5% CO2 atmosphere; some cultures were supplemented with VEGF and/or with VEGF receptor 1/Fc chimera (VEGFR1/Fc), which blocks VEGF bioactivity. Organs were harvested after 6 days and the expression of VEGF and related molecules assessed using immunohistochemistry.

RESULTS

VEGF, VEGFR1 and VEGFR2 positive cells were immunodetected in E14 and E18 bladders. Exogenous VEGF increased whole‐organ growth, as assessed by explant areas, total cell numbers, DNA and protein content; proliferation was enhanced, and apoptosis decreased, in urothelium and surrounding tissues. VEGF also increased the proportions of cells expressing endothelial (CD31) and smooth muscle (α smooth muscle actin) markers. VEGFR1/Fc blocked the growth‐enhancing effects of exogenous VEGF.

CONCLUSIONS

In organ culture, exogenous VEGF not only stimulated embryonic bladder endothelial cells but also strikingly enhanced the growth of the whole organ. Whether the effects of VEGF on diverse bladder cell populations are direct or indirect requires further investigation. The finding that VEGF protein is present in embryonic bladders in vivo raises the possibility that it has similar actions during normal development. The results also illuminate the pathobiology of certain bladder diseases in which VEGF levels have been shown to be increased.
High‐grade and hormone‐treated prostate cancer express high levels of thymidylate synthase
Authors: INOUE TAKAHIRO , SEGAWA TAKEHIKO , SHIRAISHI TAIZO , YAMADA TOMOMI , KINUKAWA NAOKO , YOSHIDA TORU , TODA YOSHINOBU , SHIMIZU YOSUKE , NAKAMURA EIJIRO , KINOSHITA HIDEFUMI , KAMOTO TOSHIYUKI , OGAWA OSAMU
Published: June 2006

OBJECTIVE

To evaluate the expression of thymidylate synthase and dihydropyrimidine dehydrogenase in prostate tissue.

MATERIALS AND METHODS

Tissue from 79 patients with localized prostate cancer was used. Thymidylate synthase and dihydropyrimidine dehydrogenase expression were determined semiquantitatively by immunohistochemistry.

RESULTS

Thymidylate synthase and dihydropyrimidine dehydrogenase immunostaining grades of benign tissue were significantly higher than those of cancer tissue (both P < 0.01). Cancer tissue with a primary Gleason grade of ≥ 4 expressed a higher thymidylate synthase staining grade than those with a primary Gleason grade of <4 (P < 0.01). Cancer tissue spots from patients treated with neoadjuvant therapy revealed significantly higher thymidylate synthase and dihydropyrimidine dehydrogenase grades than those with no neoadjuvant therapy (P < 0.01).

CONCLUSIONS

High thymidylate synthase expression in localized prostate cancer might reflect an aggressive status. High expression in high‐grade prostate cancers and prostate cancers after hormonal therapy suggest that thymidylate synthase could be a new therapeutic target for advanced prostate cancer.
Effect of dutasteride on the symptoms of benign prostatic hyperplasia, and patient quality of life and discomfort, in clinical practice
Authors: DESGRANDCHAMPS FRANÇOIS , DROUPY STEPHANE , IRANI JACQUES , SAUSSINE CHRISTIAN , COMENDUCCI ANDREA
Published: June 2006

OBJECTIVE

To assess the improvements in symptoms, quality of life (QoL), discomfort and satisfaction in patients with symptomatic benign prostatic hyperplasia (BPH) treated with dutasteride in clinical practice.

PATIENTS AND METHODS

In a prospective, multicentre open‐label study, we evaluated the efficacy and safety in clinical practice of dutasteride, 0.5 mg/day for 24 weeks, in patients with symptomatic BPH. The primary endpoint was the proportion of patients achieving at least a 3‐point decrease from baseline in the International Prostate Symptom Score (IPSS) after 24 weeks of treatment. The secondary endpoints included changes from baseline in measures of QoL (IPSS item 8 and BPH Impact Index score, BII), and patient discomfort and satisfaction (visual analogue scales, VAS) at 12 and 24 weeks.

RESULTS

Of the 366 patients assessed, 72.5% achieved at least a 3‐point reduction in IPSS at 24 weeks; the IPSS decreased from 15.3 at baseline to 10.2 at 12 weeks, and to 9.1 at 24 weeks. There were significant (P < 0.001) decreases in all the individual IPSS items at 12 and 24 weeks, with more marked improvements in voiding symptoms than storage symptoms. There were also significant (P < 0.001) improvements in the BII and VAS scores for patient discomfort and satisfaction at both times.

CONCLUSIONS

Dutasteride treatment for 24 weeks significantly improved BPH symptoms, QoL and patient discomfort and satisfaction, and was well tolerated in clinical practice.
Plaque incision and fascia lata grafting in the surgical management of Peyronie’s disease
Authors: KALSI JAS S. , CHRISTOPHER NIM , RALPH DAVID J. , MINHAS SUKS
Published: June 2006

OBJECTIVE

To assess the outcome of using modified human fascia lata (TutoplastTM, Mentor Corp, Santa Barbara, CA, USA) in the surgical management of Peyronie’s disease (PD), as the penile deformity associated with PD can be corrected by plaque incision and saphenous vein grafting (Lue procedure).

PATIENTS AND METHODS

In all, 14 patients (mean age 51 years, range 34–59) with PD had their penile deformity corrected by plaque incision and Tutoplast grafting. Three patients had a previous unsuccessful Nesbit operation. The mean (range) penile deformity before surgery was 67.2 (20–90)° and the mean follow‐up was 31 (17–37) months.

RESULTS

Using set criteria, 13 patients were satisfied (excellent or satisfactory) with the results of surgery. The penis was completely straight in 11 of 14 patients. One patient developedde novoerectile dysfunction after surgery. In 10 patients there was no penile shortening, whereas four reported penile shortening of >1 cm.

CONCLUSION

Fascia lata Tutoplast grafts provide a reliable and well tolerated biomaterial for penile reconstruction in PD. The outcome of using Tutoplast is similar to that from saphenous vein but without the morbidity associated with the donor site. However, there remains a significant risk of penile shortening and development of erectile dysfunction.
Antimuscarinic drugs in detrusor overactivity and the overactive bladder syndrome: motor or sensory actions?
Authors: FINNEY STEVEN M. , ANDERSSON KARL‐ERIK , GILLESPIE JAMES I. , STEWART LAURENCE H.
Published: June 2006

Antimuscarinic drugs are generally thought to exert their therapeutic action on detrusor overactivity by reducing the ability of the detrusor muscle to contract. We review currently available published data to establish whether there is any evidence to support this contention. Using a PubMed data search, only 14 original articles (including two abstracts) were found that contained cystometric data for both filling and voiding phases and where the actions of antimuscarinic drugs have been reported in detail. These articles were separated into three groups dealing with neuropathic patients (three papers), patients with idiopathic overactive bladder (four papers) and a group whose aetiology was unclear (seven papers). Variables relating to bladder function during the filling phase (time of first desire to void, time to first unstable contraction, and bladder capacity) were identified. Similarly, variables relating to voiding were identified and compared (e.g. maximum detrusor pressure and detrusor pressure at maximum flow rate). The antimuscarinic drugs have a clearly significant effect on sensations of urge, time to first sensation to void, maximum bladder capacity, decrease in voiding frequency and reduction in incontinence episodes. However, only one article (studying neuropaths) reported a significant reduction of the variables associated with detrusor contraction. The remaining four studies (idiopaths/not stated), reported no change in bladder contractility with antimuscarinic drugs. Thus the available data do not support the conclusion that antimuscarinic drugs at doses used in current clinical practice exert their therapeutic action by inhibiting detrusor contractility, but they suggest effects on variables associated with sensation.
Nonpharmacological treatment of lower urinary tract dysfunction using biofeedback and transcutaneous electrical stimulation: a pilot study
Authors: BARROSO UBIRAJARA , LORDÊLO PATRÍCIA , LOPES ANTÔNIO A. , ANDRADE JUAREZ , MACEDO ANTONIO , ORTIZ VALDEMAR
Published: June 2006

OBJECTIVE

To report a series of children with lower urinary tract dysfunction (LUTD) whose urge syndrome was treated by electrical stimulation, and their voiding dysfunction by biofeedback; none of the children were using anticholinergic drugs during treatment.

PATIENTS AND METHODS

In all, 36 children who presented with symptoms of urinary urgency and/or daily incontinence completed the treatment and were prospectively evaluated. The mean (range) follow‐up was 13.8 (4–24) months, and their mean age 7 (3–14) years, 17 children were aged <5 years. The children were divided into two groups: group 1, with urge syndrome treated with superficial parasacral electrical stimulation, and group 2, with voiding dysfunction, treated with biofeedback.

RESULTS

In group 1, the mean (range) number of electrical stimulation sessions was 13.1  (4–20). Of the 19 children treated, 12 had a complete clinical improvement, six a significant improvement, and one a mild improvement. In group 2, the mean (range) number of biofeedback sessions was 6 (4–14). Of the 17 children treated, there was complete improvement of symptoms in 10, significant improvement in two and mild improvement in five. Six children who had no resolution of symptoms after biofeedback had salvage therapy with electrical stimulation, after which four had complete improvement of symptoms, and two a 90% and 40% improvement, respectively. Taking the two groups together, after treatment, four children developed isolated episodes of urinary tract infection. Of 21 children with nocturnal enuresis, bed‐wetting continued in 13 (62%) after treatment.

CONCLUSION

In this short‐term follow‐up, the nonpharmacological treatment of voiding dysfunction using biofeedback, and of urge syndrome by electrical stimulation, was effective for treating LUTD in children.
Pioglitazone prevents corporal veno‐occlusive dysfunction in a rat model of type 2 diabetes mellitus
Authors: KOVANECZ ISTVAN , FERRINI MONICA G. , VERNET DOLORES , NOLAZCO GABY , RAJFER JACOB , GONZALEZ‐CADAVID NESTOR F.
Published: June 2006

OBJECTIVES

To determine whether corporal veno‐occlusive dysfunction (CVOD), corporal smooth muscle (SM) loss, fibrosis and oxidative stress occur in a rat model of type 2 diabetes, and whether these are counteracted by pioglitazone, as pioglitazone is vasculoprotective, and corporal SM is an extension of arterial SM.

MATERIALS AND METHODS

Male obese Zucker fa/fa rats were fed chow containing 0%, 0.001% or 0.02% pioglitazone for 2 or 5 months, using untreated lean Zucker and Fischer 344 rats as controls. Functional changes were determined by dynamic‐infusion cavernosometry. Histological changes were assessed by histochemistry and immunohistochemistry followed by quantitative image analysis and/or quantitative Western blot.

RESULTS

CVOD was detected at 4.5 months of diabetes, accompanied by a lower corporal SM/collagen ratio, and increases in collagen, collagen III/I ratio, apoptotic index, and systemic and tissue oxidative stress. In the short‐term treatment, high‐dose pioglitazone normalized glycaemia and ameliorated fibrosis and oxidative stress, but induced CVOD, whereas the effects with the low dose were not significant. However, low‐dose pioglitazone for 5 months corrected all alterations.

CONCLUSION

Type 2 diabetes in Zucker fa/fa rats was associated with penile corporal fibrosis, oxidative stress, and CVOD, which were ameliorated by long‐term low‐dose pioglitazone, suggesting that this drug might protect the SM, independently from its antidiabetic effect.
Radical prostatectomy in patients infected with human immunodeficiency virus
Authors: HUANG WILLIAM C. , KWON ERIC O. , SCARDINO PETER T. , EASTHAM JAMES A.
Published: June 2006

OBJECTIVE

To present the complications and early outcomes in a small series of men infected with human immunodeficiency virus (HIV) and treated with radical prostatectomy (RP) for prostate cancer, and to review reports on surgery in HIV‐positive patients.

PATIENTS AND METHODS

During 2002–2005, seven men infected with HIV underwent RP at our institution. For the five patients whose HIV status was known before surgery, we retrospectively examined preoperative variables, including HIV‐specific data (clinical category, CD4+ lymphocyte count, viral load, duration of HIV diagnosis, and opportunistic infections), and the complications and early outcomes after RP.

RESULTS

Before RP all the patients were in the Center for Disease Control clinical category A (asymptomatic HIV infection). The CD4+ counts before RP ranged from 269–870 cells/µL and viral loads ranged from <50–18 700 copies/mL. Three patients were on highly active anti‐retroviral therapy (HAART) at the time of surgery. After RP, two patients had incisional wound infections, including one requiring re‐hospitalization for intravenous antibiotics. During the follow‐up (median 26 months) none of the patients progressed to acquired immunodeficiency syndrome or developed biochemical recurrence of prostate cancer. One healthcare worker was exposed to contaminated urine and placed on prophylactic therapy, but has not sero‐converted.

CONCLUSION

The risk of peri‐operative complications in HIV‐positive patients can be minimized by carefully selecting the patient and procedure, and by measuring routine and HIV‐specific preoperative variables. The two infectious complications in this series were in patients with less favourable preoperative factors, i.e. the lowest CD4+ count and the highest viral load. Further experience is needed to determine whether the risk of surgical infections is higher in this cohort. However, our results are consistent with reports from other surgical specialities that surgery in asymptomatic HIV‐positive patients is safe and effective.
Tolerability, efficacy and pharmacokinetics of bicalutamide 300 mg, 450 mg or 600 mg as monotherapy for patients with locally advanced or metastatic prostate cancer, compared with castration
Authors: TYRRElL CHRIS J. , IVERSEN PETER , TAMMELA TEUVO , ANDERSON JOHN , BJÖRK THOMAS , KAISARY AMIR V. , MORRIS THOMAS
Published: June 2006

OBJECTIVE

To evaluate the pharmacokinetics, tolerability and effect on endocrinology of bicalutamide given as once‐daily monotherapy at doses of >150 mg to patients with locally advanced (M0) or metastatic (M1) prostate cancer, with efficacy as a secondary endpoint.

PATIENTS AND METHODS

Patients were initially enrolled to receive bicalutamide 300 mg in a non‐randomized phase, after which further patients were randomized to higher bicalutamide doses (in 150 mg increments) or castration. Overall, 248 patients received bicalutamide at 300 mg (21), 450 mg (95) or 600 mg (42), or castration (90).

RESULTS

Systemic exposure to bicalutamide stabilised at a dose of ≈ 300 mg, as determined by pharmacokinetic analysis. The tolerability of high doses of bicalutamide was similar to that of the 150 mg dose, with no increase in the incidence of adverse events. Patients receiving bicalutamide had early increases in the mean levels of oestradiol, testosterone and luteinizing hormone, which were maintained throughout the study. Levels of these hormones rapidly decreased in the castration group and remained low. From baseline (first day of treatment) to 12 weeks there was an equivalent reduction in prostate‐specific antigen (PSA) levels across all four groups. At a median follow‐up of 5 years, there was no significant survival difference between patients who received bicalutamide and those who received castration, either in M0 or M1 disease.

CONCLUSION

The low median PSA level (180 ng/mL) of patients with M1 disease might account for the lack of survival difference between the treatment groups. Further studies are needed to assess whether high‐dose bicalutamide monotherapy can provide equivalent efficacy to castration in patients with M1 prostate cancer.
Functional erythropoietin deficiency in patients with Type 2 diabetes and anaemia
Authors: Thomas M. C. , Tsalamandris C. , MacIsaac R. , Jerums G.
Published: June 2006

Aims  Anaemia is a common finding in patients with diabetic nephropathy. Impaired production of erythropoietin is thought to be the predominant cause, as a result of renal microvascular disease. This study aims to determine the prevalence of functional erythropoietin deficiency in a cross‐sectional survey of patients with Type 2 diabetes.

Methods  Clinical data on 604 patients with Type 2 diabetes were obtained, including a full blood count, iron indices and detailed history of diabetic complications. Erythropoietin levels were correlated with the presence of anaemia, iron deficiency and renal dysfunction. Functional erythropoietin deficiency was defined by erythropoietin levels in the normal range despite the presence of anaemia.

Results  Nineteen per cent of patients (n = 112) were anaemic, among whom erythropoietin deficiency (76%) and reduced iron availability (58%) were common findings. Over 90% of patients had erythropoietin deficiency, once those with reduced iron stores or availability were excluded. Most of these patients had moderate renal impairment (60%, n = 67). However, even in the absence of renal impairment, 71% of anaemic patients (n = 32/45) had functional erythropoietin deficiency, although most had other evidence of nephropathy. In addition, two‐thirds of patients with reduced iron availability were unable to increase erythropoietin above the normal range.

Conclusions  These findings confirm the failure of the kidney to produce erythropoietin in response to a falling haemoglobin is a key component to anaemia in diabetes. The likelihood of functional erythropoietin deficiency as a cause of anaemia is not dependent on the severity of renal impairment or excluded in diabetic patients with reduced iron stores or availability.
Smoking enhances absorption of insulin but reduces glucodynamic effects in individuals using the Lilly‐Dura inhaled insulin system
Authors: Wise S. , Chien J. , Yeo K. , Richardson C.
Published: June 2006

Aim  To quantify the pharmacokinetic (PK) and glucodynamic (GD) impact of smoking on inhaled and subcutaneous (SC) insulin administration in healthy subjects.

Methods  This study employed the euglycemic clamp procedure in a four‐period, four‐way randomized crossover design. Eight smoking and eight non‐smoking healthy males were given SC insulin on two occasions and human insulin inhalation powder (HIIP) on two other occasions.

Results  Smokers exhibited greater insulin exposure (AUC0‐t′) than non‐smokers, following both routes of insulin administration (HIIP, P = 0.003, 58% increase; SC, P = 0.006, 24% increase). The maximum insulin concentration (Cmax) following HIIP was greater in smokers by 172% (P = 0.001) compared with non‐smokers. The glucodynamic effects were greater in smokers following HIIP, consistent with the insulin concentration difference observed. However, maximum glucose response (Rmax) following SC was decreased by 36% (P = 0.001) and obtained later [time of maximum glucose response (TRmax); P < 0.001] in smokers than in non‐smokers. Smokers appeared less sensitive to insulin [total glucose infused during the clamp procedure normalised by total insulin exposure (Gtot)/AUC0‐t′] than non‐smokers following both SC (P = 0.001) and inhaled (P = 0.011) routes of administration.

Conclusion  Smokers had substantially increased peak HIIP insulin concentration, but the glucodynamic effect was partially offset, most likely because of increased insulin resistance.
Comparison of international and New Zealand guidelines for the care of pregnant women with diabetes
Authors: Cutchie W. A. , Cheung N. W. , Simmons D.
Published: June 2006

Objective  To compare international guidelines for the care of women with diabetes and pregnancy with reported current practice among New Zealand tertiary centres.

Research design and methods  A literature review of national and international guidelines for the care of women with diabetes in pregnancy was undertaken. Guideline activities were placed within nine facets of care, from preconception advice, through pregnancy from screening to follow‐up. New Zealand tertiary centres guidelines were obtained and placed in the same framework.

Results  International guideline consensus was inconsistent across most facets of care. Those for the detection and diagnosis of gestational diabetes mellitus (GDM) were particularly discordant internationally, although intranational agreement has occurred.

Conclusions  International guidelines for the care of women with diabetes in pregnancy remain fragmented. The development of one set of guidelines based on the consensus of international best practice could overcome many of the misconceptions associated with diabetes in pregnancy.
Predictive Gaze Cues and Personality Judgments
Authors: Bayliss Andrew P. , Tipper Steven P.
Published: June 2006

Although following another person's gaze is essential in fluent social interactions, the reflexive nature of this gaze-cuing effect means that gaze can be used to deceive. In a gaze-cuing procedure, participants were presented with several faces that looked to the left or right. Some faces always looked to the target (predictive-valid), some never looked to the target (predictive-invalid), and others looked toward and away from the target in equal proportions (nonpredictive). The standard gaze-cuing effects appeared to be unaffected by these contingencies. Nevertheless, participants tended to choose the predictive-valid faces as appearing more trustworthy than the predictive-invalid faces. This effect was negatively related to scores on a scale assessing autistic-like traits. Further, we present tentative evidence that the “deceptive” faces were encoded more strongly in memory than the “cooperative” faces. These data demonstrate the important interactions among attention, gaze perception, facial identity recognition, and personality judgments.
Bayesian Palaeoclimate Reconstruction
Authors: Haslett J. , Whiley M. , Bhattacharya S. , Salter-Townshend M. , Wilson Simon P. , Allen J. R. M. , Huntley B. , Mitchell F. J. G.
Published: June 2006

We consider the problem of reconstructing prehistoric climates by using fossil data that have been extracted from lake sediment cores. Such reconstructions promise to provide one of the few ways to validate modern models of climate change. A hierarchical Bayesian modelling approach is presented and its use, inversely, is demonstrated in a relatively small but statistically challenging exercise: the reconstruction of prehistoric climate at Glendalough in Ireland from fossil pollen. This computationally intensive method extends current approaches by explicitly modelling uncertainty and reconstructing entire climate histories. The statistical issues that are raised relate to the use of compositional data (pollen) with covariates (climate) which are available at many modern sites but are missing for the fossil data. The compositional data arise as mixtures and the missing covariates have a temporal structure. Novel aspects of the analysis include a spatial process model for compositional data, local modelling of lattice data, the use, as a prior, of a random walk with long-tailed increments, a two-stage implementation of the Markov chain Monte Carlo approach and a fast approximate procedure for cross-validation in inverse problems. We present some details, contrasting its reconstructions with those which have been generated by a method in use in the palaeoclimatology literature. We suggest that the method provides a basis for resolving important challenging issues in palaeoclimate research. We draw attention to several challenging statistical issues that need to be overcome.
Sex and population variation in ultraviolet reflectance of colour patches in Gallotia galloti (Fam. Lacertidae) from Tenerife (Canary Islands)
Authors: Molina‐Borja M. , Font E. , Mesa Avila G.
Published: June 2006

Sex and population differences in the ultraviolet (UV) reflectance patterns of two phenotypically divergent lacertids from Tenerife, Gallotia galloti eisentrauti and G. g. galloti, are described. Adults in both populations have rows of lateral and ventro‐lateral blue patches on either side of the trunk that show a single peak of reflectance in the near UV. The lateral patches of males are more intensely reflective than those of females, but females have more chromatic and UV‐shifted lateral patches than males. Most G. g. eisentrauti and some G. g. galloti also have blue cheek patches on either side of the gular area. Male cheek patches have reflectance peaks in the near UV, whereas those of females peak in the visible part of the spectrum. The lateral patches of males from the two populations differ in hue but not in intensity, those of G. g. galloti being more UV‐shifted than those of G. g. eisentrauti. Female G. g. galloti have more intensely reflective lateral patches than female G. g. eisentrauti. Interindividual variation in peak wavelength and/or UV chroma is present in both sexes and populations. This is the first demonstration of sexual dichromatism in the UV reflectance of colour patches in a lacertid.
Natal dispersal and breeding dispersal of a subsocial spitting spider (Scytodes pallida) (Araneae: Scytodidae), from Singapore
Authors: Li D. , Kuan J. Y. X.
Published: June 2006

Social spiders are thought to have evolved from subsocial ancestors, species in which siblings have an extended association with their parent, but disperse from the natal nests before reaching reproductive maturity. Therefore, natal dispersal is a factor that may constrain permanent socialization. Understanding the natal dispersal behaviour of subsocial species may provide insights into the sociality of spiders. In this study, we investigated the natal dispersal and breeding dispersal patterns in a subsocial spitting spider Scytodes pallida in Singapore. Spiderlings stayed in their natal nest for 2–3 weeks and then dispersed more or less in clusters, with a short mean travel distance of 218.9 cm. Those from natal nests that contained more spiderlings dispersed earlier and at a smaller body size. The mean distance dispersed significantly increased with the clutch size (the number of spiderlings in a nest). This suggests that competition for nest sites in the vicinity of the natal nest may affect dispersal distance. The results from observations of the breeding dispersal (nest relocation) show that significantly more juveniles than adults, more males than females and more non‐brooding (egg free) than brooding (egg carrying) females were likely to relocate their nests. Based on the results of the breeding dispersal, mate competition and inbreeding avoidance do influence the natal dispersal of spitting spiders.
The effect of hedgerows on soil organic carbon storage in hillslopes
Authors: Walter C. , Merot P. , Layer B. , Dutin G.
Published: June 2006

Abstract. The Bocage in the western part of Europe is an ancient rural landscape characterized by a network of hedgerows. The system studied here consists of hedges growing on earth and stone banks, which are found in the Armorican Massif (western France). Seven sites were analysed, which represented a large, but not complete, set of situations. We investigated the influence of hedges parallel to contour lines on soil characteristics, soil profile morphology and carbon storage at the hillslope scale. The analysis is based on a morphological description of the soil catena from the top of the hill to downslope of the hedge, and on measurements of bulk density and organic carbon in different soil profiles on the slopes. The results show that thickness of the organic horizon increases slowly from the top of the hill as far as the hedge, whereas under the hedge the bulk density is low and the soil organic carbon (SOC) storage large. Two effects of the hedges on SOC storage are apparent, namely, a local effect under the hedge, due to tree activity, and an anti‐erosive effect at the hillslope scale. A rough approximation based on these data assessed the fraction of SOC storage attributed to the hedge network of between 13 and 38% of the total carbon stock.
Effect of no‐tillage on turnover of organic matter in a Rhodic Ferralsol
Authors: Machado P.L.O.A. , Sohi S.P. , Gaunt J.L.
Published: June 2006

Abstract. Soil organic matter (SOM) is considered to be key to sustainability of agriculture in the tropics. In southern Brazil, no‐tillage has been adopted widely to control soil erosion, but its impact on the dynamics of SOM is not well established. We measured soil carbon (C) and δ13C in two crop rotations, one of which contained C4 maize (Zea mays L.), after 21 years of contrasting tillage (conventional tillage versus no‐tillage). Adjacent sites that reflected historic land‐uses were also sampled. In the tillage experiment there was no effect of tillage on the total amount of C in the 0–40 cm profile (even when contrasting bulk density was accounted for), and the concentration of C differed only in the 0–5 cm and 5–10 cm layers. However, the occasional input of C4 material in the maize rotation resulted in a significant effect of rotation on δ13C (P <0.001). Using 13C as a tracer for the SOM formed since the start of the experiment, we estimated the abundance of ‘recent’ and ‘old’ C within each depth interval. We found the main effect of tillage was to increase the medium‐term turnover of SOM, particularly in the subsoil (i.e. below 20 cm depth). Compared with no‐tillage, there was almost five times more recent C in the subsoil, and 20% more recent C in the 0–40 cm profile as a whole.
Accounting for changes in soil carbon under the Kyoto Protocol: need for improved long‐term data sets to reduce uncertainty in model projections
Authors: Falloon P. , Smith P.
Published: June 2006

Abstract. Soils can be used as a biospheric sink for carbon under Article 3.4 of the Kyoto Protocol and parties are able to use agricultural soil carbon sinks to contribute towards carbon emission reduction targets. This should be done ‘taking into account uncertainties, transparency in reporting, and verifiability’. Models are often tested against data sets of long‐term changes in soil organic carbon (SOC), but most data sets have only mean SOC values available at each sample date, with no estimates of error about the mean. We show that when using data sets that do not include estimates of error about the mean, it is not possible to reduce the error (root mean squared error) between modelled and measured values below 6.8–8.5%, even with site‐specific model calibration. Equivalent errors for model runs using regional default input values are 12–34%. Using error as an indicator of the certainty that can be attached to model projections, we show that a significant reduction in uncertainty is needed for Kyoto accounting. Uncertainties for modelling during the first Kyoto Commitment Period could be reduced by better replication of soil measurements at benchmark sites. This would allow model error to be separated from measurement error, which would allow more comprehensive model testing and, ultimately, more certainty to be attached to model predictions.