bluuebunny/crossref_metadata_2025 huggingface dataset:
Red cell freezing and its impact on the supply chain
Authors: Hess John R.
Published: March 2004

Summary.  Red blood cells (RBC) can be frozen in glycerol solutions and stored for many years. Thawed RBC must have the glycerol removed, but the recovered cells have normal survival in humans. Freezing has been used to store RBC of rare phenotypes for more than 40 years. In the 1960s and 1970s, when medical technology and blood use were expanding rapidly and liquid whole blood and RBC storage were limited to 3 weeks, many attempts were made to expand the use of frozen RBC for meeting the needs for a stable blood supply and to have RBC reserves for emergencies. These attempts have largely been abandoned because of the cost of freezing, storing and processing, better management of the larger and longer lived RBC inventory, concerns about the safety of stored RBC that have not received the most up‐to‐date testing and the losses associated with the short shelf life of thawed RBC. New automated frozen RBC processing systems will potentially allow extending the outdate of thawed RBC to 2 weeks, but will not materially effect the costs or losses associated with the use of frozen RBC. RBC freezing will have little effect on the logistics of blood supply.
Evaluation of the future supply and demand for blood products in the United Kingdom National Health Service
Authors: Currie C. J. , Patel T. C. , McEwan P. , Dixon S.
Published: March 2004

Summary.  In addition to the clinical management of blood supplies, the UK National Blood Service (NBS) examines short‐term supply and demand to predict any potential shortages in blood supplies. However, very little data are available on the medium‐ and long‐term trends. This paper describes blood product use in a United Kingdom Hospital Trust in 1999 and combines it with donor information to project the effect of demographic changes on demand and supply over the next 25 years. Overall, 2801 (4%) inpatients received transfusions of blood products. The proportion of inpatients receiving blood products increased with age. Patients aged >70 years used 46% of the total blood product supply, whereas patients aged <30 years used 10%. The estimated total cost associated with blood product use was £2 million during 1999 (2001–2002 prices). The results show that within 20 years, demand for blood products is expected to increase by 20% relative to the supply. The estimates in this study are a valuable aid to better long‐term planning of supplies. As there is a paucity of data concerning blood product use in UK hospitals and blood use varies greatly between hospitals, further studies are required to guide blood product use policy.
Serious adverse events in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD)
Authors: Digiusto E. , Shakeshaft A. , Ritter A. , O'Brien S. , Mattick R. P. ,   the NEPOD Research Group
Published: March 2004

Aims  The study estimated serious adverse event (SAE) rates among entrants to pharmacotherapies for opioid dependence, during treatment and after leaving treatment.

Design  A longitudinal study based on data from 12 trials included in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD).

Participants and settings  A total of 1244 heroin users and methadone patients treated in hospital, community and GP settings.

Intervention  Six trials included detoxification; all included treatment with methadone, buprenorphine, levo‐alpha‐acetyl‐methadol (LAAM) or naltrexone.

Findings  During 394 person‐years of observation, 79 SAEs of 28 types were recorded. Naltrexone participants experienced 39 overdoses per 100 person‐years after leaving treatment (44% occurred within 2 weeks after stopping naltrexone). This was eight times the rate recorded among participants who left agonist treatment. Rates of all other SAEs were similar during treatment versus out of treatment, for both naltrexone‐treated and agonist‐treated participants. Five deaths occurred, all among participants who had left treatment, at a rate of six per 100 person‐years. Total SAE rates during naltrexone and agonist treatments were similar (20, 14 per 100 person‐years, respectively). Total SAE and death rates observed among participants who had left treatment were three and 19 times the corresponding rates during treatment.

Conclusions  Individuals who leave pharmacotherapies for opioid dependence experience higher overdose and death rates compared with those in treatment. This may be due partly to a participant self‐selection effect rather than entirely to pharmacotherapy being protective. Clinicians should alert naltrexone treatment patients in particular about heroin overdose risks. Duty of care may extend beyond cessation of dosing.
The Japanese Society of Alcohol‐Related Problems
Authors: Maruyama Katsuya , Higuchi Susumu
Published: March 2004

This paper presents an outline of the Japanese Society of Alcohol‐Related Problems. The precursor of the Society was the Japan Alcoholism Treatment Research Group, inaugurated in 1979, by merging two local research groups in the Tokyo and Osaka areas, both of which were exclusive gatherings of psychiatrists associated with alcoholism clinics. The Research Group developed into the Society in 1992, as the number of participants including those from other medical professions increased yearly, and the subjects of the group widened to include all addictive behaviours. In reflecting the process of establishment, it is unique in many aspects as a scientific society. The Society is not a science‐orientated body for presentation of new research findings. The main programme of the annual meeting is therefore a set of symposia in which members participate and discuss clinical and/or social problems arising from dependency on alcohol or drugs. Perhaps because of its content, the annual meeting is attended each year by the largest number of participants among all the societies in Japan concerned with alcohol and drugs. For the next several years, the Society's activities will be directed at (1) establishment of guidelines for early identification of and intervention in alcohol‐related problems; (2) expansion of its membership to include those in related fields of medicine and non‐medical professions; (3) improvement of the system of journal publication; and (4) creation of a system for timely adequate response to social problems associated with drugs and alcohol.
Angular transformation – another effect of different sample sizes
Authors: KASUYA Eiiti
Published: March 2004

Angular transformation has been widely used to analyze proportions or percentages in ecology. A new type of artifact can arise by applying angular transformation to proportions or percentages. Proportions with the same mean or expected value, but with different sample sizes (denominator of proportions), have different means or expected values after this transformation. Overdispersion causes a larger deviation of the expected value after the transformation. Angular transformation should be avoided unless the sample size (denominator of proportions) is the same for all the proportions analyzed.
Seasonal migration patterns of female sika deer in eastern Hokkaido, Japan
Authors: IGOTA Hiromasa , SAKURAGI Mayumi , UNO Hiroyuki , KAJI Koichi , KANEKO Masami , AKAMATSU Rika , MAEKAWA Koji
Published: March 2004

Fifty‐seven female sika deer (Cervus nippon yesoensis), captured at the wintering area in the Shiranuka Hills in eastern Hokkaido, Japan, were radio‐tracked during 1997–2001 to examine the factors affecting seasonal migration at the individual‐landscape level. Ten of the 57 deers migrated between low‐altitude summer home ranges and intermediate‐altitude winter home ranges (the upward migrants). Twenty‐nine migrated between high‐altitude summer home ranges and intermediate‐altitude winter home ranges (the downward migrants). Twelve used the intermediate‐altitude home ranges all year round (the non‐migrants). The remaining six were unknown. The summer home ranges of deer were widely scattered over an area of 5734 km2. Migration distances ranged between 7.2 and 101.7 km. Deer showed high site fidelities to their seasonal home ranges. The upward migrants wintered in areas of less snow, higher quality of bamboo grass, and more coniferous cover than their summer home ranges. The downward migrants wintered in areas of less snow, higher quality of bamboo grass, higher winter temperature, and more southern slopes, but less coniferous cover than their summer home ranges. The non‐migrants used year‐round ranges with little snow, high quality of bamboo grass, and sufficient coniferous cover. We suggest that snow cover and bamboo grass are the factors affecting seasonal migration of the population and that coniferous cover is another factor for the upward migration.
Influence of urbanization on ant distribution in parks of Tokyo and Chiba City, Japan I. Analysis of ant species richness
Authors: YAMAGUCHI Takeshi
Published: March 2004

To investigate how progressive urbanization influences the distribution of ant species in cities, I compared the ant species richness in urban parks of different areas and ages of Tokyo, the most intensively developed urban region in Japan, and its developing neighbor, Chiba City. A total of 43 ant species were found from 98 parks. Multiple regression analysis revealed that park area and age had a positive effect on the number of ant species in the parks and that the parks in Tokyo contained fewer species than did comparable parks in Chiba. Thus, the progression of urbanization reduces ant species richness in urban parks, most likely because it isolates the parks from the surrounding area. Next, in order to examine the relationships between the types of landform modification and the ant distribution in urban areas, I compared the ant species richness in urban parks of Chiba City among different landform types (upland + terraces, lowlands, cut and fill, banking, and reclamation). This study showed that the parks in the reclaimed lands and lowlands contained fewer ant species than did parks in other areas. The reason for this decline of ant fauna is discussed.
Plant reproductive interval and population density in aseasonal tropics
Authors: MOMOSE Kuniyasu
Published: March 2004

In some tropical areas, annual cycles in the environment and plant phenology are not clearly detectable. In such aseasonal tropics, it was found that plant population density is associated with flowering intervals within the same habitats and within the same pollination guilds, if some conditions are satisfied. This finding is based on observations of flowering phenology of butterfly‐pollinated understory shrubs of the genus Ixora (Rubiaceae) for 36 months in a mixed dipterocarp forest in Sarawak, northwest Borneo. Plants did not receive sufficient pollination services and fruit set was pollination‐limited. Under such conditions, it is theoretically predicted that the plant types that reproduce frequently would have higher population density than those that reproduce less frequently, because common types must avoid competition for pollinators and rare types can have a large floral display by storing resources during long reproductive intervals to attract pollinators efficiently. Observed relationships among plant reproductive intervals, pollinator attractions and population densities in Ixora are consistent with theoretical predictions. Based on the theory proposed in this paper, I discuss a factor promoting diversification of the genus Ixora and other taxa.
Cytokine gene polymorphisms in idiopathic pulmonary fibrosis
Authors: Riha R. L. , Yang I. A. , Rabnott G. C. , Tunnicliffe A. M. , Fong K. M. , Zimmerman P. V.
Published: March 2004

Abstract

Pro‐ and anti‐fibrotic cytokine gene polymorphisms may affect expression of idiopathic pulmonary fibrosis (IPF). The aims of the present case‐control study were to examine polymorphisms in the IL‐6, transforming growth factor (TGF)‐β1, tumour necrosis factor (TNF)‐α and interleukin‐1 (IL‐1)Ra genes in patients with IPF (n = 22) ­compared to healthy controls (n = 140). Genotyping was performed on DNA extracted from peripheral blood lymphocytes, using polymerase chain reaction − restriction fragment length polymorphism with gene polymorphisms determined according to ­published techniques. The following sites were examined: (i) IL‐1Ra*1−5 (86 bp variable tandem repeat intron 2), (ii) IL‐6 (−174G > C), (iii) TNF‐α (−308G > A) and (iv) TGF‐β1 (Arg25Pro). The TNF‐α (−308 A) allele was over‐represented in the IPF (pcorr = 0.004) group compared to controls. Risk of IPF was significant for heterozygotes for: (i) the TNF‐α (−308 A) allele (A/G) (odds ratio (OR) 2.9; 95% confidence interval (CI) 1.2−7.2; P = 0.02), (ii) homozygotes (A/A) (OR 13.9; 95%CI 1.2−160; P = 0.04) and (iii) carriage of the allele (A/A + A/G) (OR 4; 95%CI 1.6−10.2; P = 0.003). The distribution of alleles and genotypes for IL‐6, TGF‐β1 and IL‐1Ra between the two groups was not significantly different. This is the third study to independently confirm that there is a significant association of the TNF‐α (−308 A) allele with IPF. Further research is needed to assess the utility of cytokine gene polymorphisms as markers of disease ­susceptibility. (Intern Med J 2004; 34: 126−129)
Recurrence of Helicobacter pylori infection in adults with intellectual disability
Authors: Wallace R. A. , Schluter P. J. , Webb P. M.
Published: March 2004

Abstract

Although Helicobacter pylori infection is very common among particular groups of adults with intellectual disability, the rate of recurrence (reinfection or recrudescence) is unknown in this population. Thirty‐six months after successful treatment of H. pylori, 28 adults with intellectual disability were retested using the faecal antigen test. Six (21%) of 28 patients tested positive, giving an approximate yearly recurrence rate of 7%, a rate considerably higher than that in the general popu­lation (<1%). It is recommended that adults with intellectual disability who have had successful treatment of H. pylori be retested for an interval of 3−5 years after treatment. (Intern Med J 2004; 34: 000−000)
Community‐acquired pneumonia: influence of management practices on length of hospital stay
Authors: Laing R. , Coles C. , Chambers S. , Frampton C. , Jennings L. , Karalus N. , Mills G. , Town G. I.
Published: March 2004

Abstract

Aims:  To identify variation in the management of ­community‐acquired pneumonia between two New Zealand hospitals and the factors that may account for any differences.

Methods:  A 12‐month, prospective two‐centre study was conducted. Between July 1999 and July 2000, 474 adult patients with community‐acquired pneumonia were enrolled: 304 in Christchurch Hospital and 170 in Waikato Hospital. The patients were similar in age, sex, prior antibiotic use and comorbidity. There was no significant difference in the clinical outcomes for the patients at the two centres.

Results:  The mean duration of i.v. antibiotic therapy was 1.7 versus 3.0 days (P < 0.001) and length of stay (LOS) was 3.0 versus 5.9 days (P < 0.001) for Waikato and Christchurch Hospitals, respectively. Using multivariate analy­sis, we could account for 61% of the observed vari­ation in LOS. Duration of i.v. antibiotic therapy independently accounted for 16% of variation in LOS compared with age (2%), chronic obstructive pulmonary disease, duration of fever, intensive care unit admission and centre of admission (all <1%). For the duration of i.v. anti­biotics, centre of admission, largely reflecting clin­ician practice at each centre, independently accounted for 13% of variation, compared with duration of fever (5%), admission to the Intensive Care Unit (4%), Pneumonia Severity Index score (3%) and bacteraemia (3%).

Conclusion:  Of the identifiable factors, variations in clin­i­cian behaviour outweighed the influence of patient factors on the duration of i.v. antibiotic therapy, which in turn was the major determinant of LOS for patients hospitalised with community‐acquired pneumonia. An early switch from i.v. to oral antibiotic therapy in conjunction with early discharge planning may significantly reduce LOS without compromising patient outcomes. (Intern Med J 2004; 34: 91−97)
Community analysis of methanogenic archaea within a riparian flooding gradient
Authors: Kemnitz Dana , Chin Kuk‐Jeong , Bodelier Paul , Conrad Ralf
Published: March 2004

Anoxic soils in river floodplains (or riparian soils) are a source of methane emission. However, little is known about the ecology and community structure of archaeal methanogenic microbes, which are a crucial component of methane flux in those habitats. We studied the archaeal community in the vertical profile of four different sites along the River Waal in the Netherlands. These sites differ in their annual flooding regime ranging from never or seldom to permanently flooded. The archaeal community structure has been characterized by terminal restriction fragment length polymorphism (T‐RFLP) and comparative sequence analysis of the archaeal SSU rRNA gene and the mcrA gene. The latter gene codes for the α‐subunit of methyl‐coenzyme M reductase. Additionally, the potential methanogenic activity was determined by incubation of soil slurries under anoxic conditions. The community composition differed only slightly with the depth of the soil (0–20 cm). However, the diversity of archaeal SSU rRNA genes increased with the frequency of flooding. Terminal restriction fragment length polymorphism analysis of mcrA gene amplicons confirmed the results concerning methanogenic archaea. In the never and rarely flooded soils, crenarchaeotal sequences were the dominant group. In the frequently and permanently flooded soils, Methanomicrobiaceae, Methanobacteriaceae, Methanosarcinaceae and the uncultured Rice Clusters IV and VI (Crenarchaeota) were detectable independently from duration of anoxic conditions. Methanosaetaceae, on the other hand, were only found in the permanently and frequently flooded soils under conditions where concentrations of acetate were < 30 µM. The results indicate that methanogens as well as other archaea occupy characteristic niches according to the flooding conditions in the field. Methanosaetaceae, in particular, seem to be adapted (or proliferate at) to low acetate concentrations.
(5Z)‐4‐bromo‐5‐(bromomethylene)‐3‐butyl‐2(5H)‐furanone reduces corrosion from Desulfotomaculum orientis
Authors: Ren Dacheng , Wood Thomas K.
Published: March 2004

(5Z)‐4‐bromo‐5‐(bromomethylene)‐3‐butyl‐2(5H)‐furanone (furanone) from the red marine alga Delisea pulchra was found previously to inhibit the growth, swarming and biofilm formation of Gram‐positive bacteria (Ren et al., 2002, Lett Appl Microbiol 34: 293–299). In the present study, the Gram‐positive sulphate‐reducing bacterium (SRB), Desulfotomaculum orientis, was used to study the inhibition of mild steel corrosion due to the addition of furanone. The weight loss from batch coupon experiments incubated with 40 µg ml−1 furanone was reduced fivefold compared with samples that lacked furanone. Analysis of the metal surface with environmental scanning electron microscopy further confirmed the protection afforded by the addition of furanone. In agreement with the corrosion inhibition, most probable number (MPN) analysis showed that 20 and 40 µg ml−1 furanone inhibited 58% and 96% of the D. orientis growth respectively. Hence, furanone has the potential to inhibit microbial‐induced corrosion related to Gram‐positive bacteria.
The use of DGGE analyses to explore eastern Mediterranean and Red Sea marine picophytoplankton assemblages
Authors: Zeidner Gil , Béjà Oded
Published: March 2004

In vast areas of the oceans, most marine photosynthetic production is performed by cells smaller than 2–3 µm (picoplankton). Here, we report on denaturing gradient gel electrophoresis (DGGE) analyses of naturally occurring marine oxygenic picophytoplankton using the conserved photosynthetic psbA gene. The psbA gene proved to be a good indicator for picophytoplankton presence and was shown to work with DGGE. The DGGE results show the distribution of photosynthetic marine groups belonging to cyanobacteria and the eukaryotic prasinophytes (green algae) in the Red and eastern Mediterranean Seas in the seasons examined. The present study demonstrates the value of DGGE as a tool for rapid analyses of natural marine communities of picophytoplankton.
Storage symptoms of the bladder: prevalence, incidence and need for services in the UK
Authors: McGrother C.W. , Donaldson M.M.K. , Shaw C. , Matthews R.J. , Hayward T.A. , Dallosso H.M. , Jagger C. , Clarke M. , Castleden C.M. ,   the MRC Incontinence Study Team
Published: March 2004

OBJECTIVE

To establish valid and reliable prevalence and incidence rates for urinary incontinence and storage disorder, and estimate the extent of healthcare need and requirement for the UK.

SUBJECTS AND METHODS

This was a cross‐sectional and longitudinal population‐based study involving registrants with 108 general practices in Leicestershire and Rutland counties (UK). In all, 162 533 (prevalence study) and 39 602 (incidence study) people aged ≥ 40 years were approached by postal questionnaire, with response rates of 60% and 63%, respectively; 1050 non‐responders were followed up. The main measures were incontinence (involuntary leakage) storage disorder (including incontinence or urgency or frequency or nocturia above clinically defined thresholds), storage symptoms (as for storage disorder, above epidemiologically defined thresholds), professionally defined healthcare need (storage disorder, or storage symptoms with an impact on quality of life, QoL), and healthcare requirement (using services or wanting help among those with a healthcare need), all within the last year.

RESULTS

The period prevalence was: moderate or greater incontinence, 16.1%; storage disorder, 28.5%; storage symptoms with impact on QoL, 30.4%; healthcare need, 37.1% and requirement 20.4%. Among those with storage disorders 81% reported effects on QoL. Annual incidence rates were: incontinence, 6.3%; storage disorder, 14.1%; healthcare need, 15.6% and requirement 8.4%. The remission rates were substantially greater in men than women. The problem becomes increasingly established and less likely to remit with age.

CONCLUSIONS

In the UK over a 1‐year period, over a third of people aged ≥ 40 years are estimated to have a healthcare need for urinary storage symptoms (i.e. 9 million) and a fifth (i.e. 5 million) are estimated to require healthcare, with unmet requirement affecting 3 million. This represents a major public health problem. Apparent inconsistencies between prevalence, impact and uptake of services are explained.
Parallel changes in bladder suburothelial vanilloid receptor TRPV1 and pan‐neuronal marker PGP9.5 immunoreactivity in patients with neurogenic detrusor overactivity after intravesical resiniferatoxin treatment
Authors: Brady C.M. , Apostolidis A.N. , Harper M. , Yiangou Y. , Beckett A. , Jacques T.S. , Freeman A. , Scaravilli F. , Fowler C.J. , Anand P.
Published: March 2004

OBJECTIVE

To compare PGP9.5 and transient receptor potential vanilloid receptor (TRPV1) suburothelial immunoreactivity between controls and patients with spinal neurogenic detrusor overactivity (NDO) before and after treatment with intravesical resiniferatoxin, as suburothelial PGP9.5‐staining nerve fibres decrease in patients with spinal NDO who respond to intravesical capsaicin, and TRPV1 is present on these suburothelial nerve fibres in normal and overactive human urinary bladder.

PATIENTS AND METHODS

Patients with refractory NDO were enrolled in a prospective, randomized, parallel‐group, double‐blind, placebo‐controlled trial using escalating doses of resiniferatoxin to a maximum of 1 µmol/L. Flexible cystoscopic bladder biopsies obtained at baseline, 4 weeks after each instillation and at the time of maximum clinical response were compared with biopsies taken from control subjects. Frozen sections were incubated with rabbit antibodies to TRPV1 and PGP9.5, and assessed using standard immunohistochemical methods. PGP9.5 nerve density was analysed using a nerve‐counting graticule by an observer unaware of sample origin. Another two independent observers unaware of each other's results used a random grading scale to evaluate TRPV1 nerve fibre density and intensity. The immunohistochemistry results were compared with histology findings (haematoxylin‐eosin), and the Mann–Whitney test used to assess any differences (P < 0.05 significant) and the Pearson test for correlation.

RESULTS

There were eight controls and 20 patients with spinal NDO, 14 (five clinical responders and nine not) who received the maximum dose of resiniferatoxin. There were more PGP9.5 and TRPV1 nerve fibres in patients with NDO than in controls (P = 0.007 and 0.002, respectively). Immunoreactivity before resiniferatoxin was similar in both groups for both PGP9.5 and TRPV1. In responders there were fewer PGP9.5 and TRPV1‐positive fibres after treatment (P = 0.008 for each) but no change in those not responding. Changes after treatment for TRPV1 correlated well with those for PGP9.5 (r = 0.88, P < 0.001).

CONCLUSIONS

The decrease of PGP9.5 and TRPV1 immunoreactive nerve fibres in responders to resiniferatoxin (to levels in control tissues) suggests that the increased numbers of nerve fibres in patients with NDO are mainly of sensory origin and express TRPV1. As baseline nerve fibre values were similar in responders and nonresponders, an additional factor may account for the difference in treatment outcome.
Tissue‐engineered buccal mucosa for substitution urethroplasty
Authors: Bhargava S. , Chapple C.R. , Bullock A.J. , Layton C. , MacNeil S.
Published: March 2004

OBJECTIVE

To develop tissue‐engineered buccal mucosa (TEBM) for use in substitution urethroplasty, as urethral reconstruction is limited by the amount and type of tissue that is available for grafting, and BM has become the favoured tissue for use as a urethral substitute in the last decade.

MATERIALS AND METHODS

After enzymatic treatment of a small (0.5 cm) BM biopsy the epidermis and dermis were mechanically separated. Oral keratinocytes were isolated from the epidermis and oral fibroblasts from the dermis. These cells were expanded and applied to sterilized de‐epidermized dermis (DED) to obtain a full‐thickness TE oral mucosa. Horizontal migration of keratinocytes on the DED was assessed using a tetrazolium‐blue (MTT) assay. The TEBM was assessed histologically after mechanical stressing in vitro using catheterization and meshing.

RESULTS

Histologically the TEBM closely resembled the native oral mucosa after culturing at an air–liquid interface for 2 weeks. The MTT assay showed good horizontal migration of keratinocytes on the DED. Serial histology revealed a gradually increasing thickness of the epidermis and remodelling of the dermis by the fibroblasts from day 1 to day 14. Despite subjecting the TEBM to mechanical stress the integrity of the epidermal‐dermal junction was maintained.

CONCLUSIONS

We report the successful culture of full‐thickness TEBM for substitution urethroplasty, which is robust and suitable for clinical use.
Effect of time of castration and tumour volume on time to androgen‐independent recurrence in Shionogi tumours
Authors: So A.I. , Bowden M. , Gleave M.
Published: March 2004

The understanding of the timing and development of the recurrence of androgen‐independent prostate cancer is limited and has significant clinical implications. The paper by So et al. addresses, for the first time, the concept of recurrence after androgen ablation in an animal model. They show clearly in this well designed and conducted study that the recurrence of an androgen‐independent cancer depends on both the initial size of the tumour and the delay leading to castration. These results have significant clinical importance in the understanding and treatment of prostate cancer.

OBJECTIVE

To use the androgen‐dependent Shionogi tumour model in mice to help define the effects of the timing of androgen ablation on the development of androgen resistance in prostate cancer, as the timing of androgen ablation remains controversial.

MATERIALS AND METHODS

Groups of nine mice were castrated at 1, 3, 6, 10 and 14 days after tumour inoculation, with a similar‐sized group of mice castrated before tumour inoculation serving as a control. The time of first palpable tumour recurrence and tumour volume was monitored after castration.

RESULTS

All mice were observed for ≥ 80 days after castration. Only mice castrated at 10 and 14 days had palpable tumour at the time of castration. Mice castrated at 14 days had the highest rate of early tumour recurrence (all nine) while mice castrated before inoculation or at 1 and 3 days afterward had a significantly lower rate of tumour recurrence (four of nine; P < 0.01). Mice castrated at 14 and 10 days had tumour recurrence significantly earlier than mice in the other groups. When calcium‐channel blockers were administered to inhibit apoptosis, all mice had a similar time to recurrence and time to death regardless of the time of castration.

CONCLUSIONS

Large tumour volume and corresponding delay in castration reduced the time to androgen‐independent tumour recurrence and survival. Earlier androgen ablation, at the time of subclinical (impalpable) disease, significantly delayed the rate and time to androgen‐independent recurrence compared with delayed therapy when the tumour burden was high.
The value of (−7, −5)pro‐prostate‐specific antigen and human kallikrein‐2 as serum markers for grading prostate cancer
Authors: Bangma C.H. , Wildhagen M.F. , Yurdakul G. , Schröder F.H. , Blijenberg B.G.
Published: March 2004

OBJECTIVE

To assess the value of the precursor form (−7,5pro) of prostate‐specific antigen (PSA) and human kallikrein‐2 (hK2) for detecting and grading prostate cancer, as better serum markers with improved specificity are needed in men with lower ranges of total (t)PSA.

PATIENTS AND METHODS

tPSA, free PSA (fPSA), the precursor (−7,5)proPSA and hK2 were measured in a subset of participants of the European Randomised Study of Screening of Prostate Cancer. In a pilot study, sera from 143 men biopsied but with no prostate cancer, 142 with BPH, and 146 with prostate cancer were analysed to determine the relative value of serum markers for differentiating between the groups. Then , in 141 men with prostate cancer who had a radical prostatectomy, these serum markers were related to the pathological grading to analyse their value as prognostic variables.

RESULTS

Levels of (−7,5)proPSA, hK2 and fPSA could be used to distinguish between BPH and cancer, but proPSA and hK2, alone or combined, did not improve the specificity of fPSA for discriminating BPH and cancer. There was also no correlation between these serum markers and pathological tumour grade.

CONCLUSION

The clinical effect of using (−7,5)proPSA or hK2 for detecting and grading prostate cancer remains limited.
The use of a fibrin tissue sealant during laparoscopic partial nephrectomy
Authors: Pruthi R.S. , Chun J. , Richman M.
Published: March 2004

The use of a fibrin tissue sealant in laparoscopic partial nephrectomy is described by authors from Chapel Hill. They used it in 15 patients after electrocauterization and argon‐beam coagulation; it was helpful in haemotasis and in preventing urinary leak.

OBJECTIVE

To assess the feasibility and efficacy of commercially available fibrin tissue sealant as a haemostatic agent and collecting‐system sealant during hand‐assisted laparoscopic partial nephrectomy (LPN).

PATIENTS AND METHODS

Fifteen consecutive patients underwent LPN for enhancing renal masses suspicious for renal cell carcinoma via a transperitoneal approach and with the use of a hand‐assistance device. Monopolar electrocauterization and argon‐beam coagulation were initially used to slow bleeding from the resection site. Through a laparoscopic applicator, TisseelTM fibrin sealant (Baxter Inc., Deerfield, IL) was applied to the transected partial nephrectomy bed while the surgeon's hand maintained adequate compression and partial haemostasis. No further haemostatic measures were required in any patient; the patients were evaluated for acute and delayed bleeding or urinary extravasation.

RESULTS

In all cases electrocauterization and argon‐beam coagulation followed by the application of Tisseel was successful in obtaining strict haemostasis of the surgical bed, with no evidence of bleeding during or after surgery on immediate and extended follow‐up. In addition, there was no evidence during or after surgery of any urinary leak. There were no immediate or delayed complications in any of the patients; a short‐term outpatient follow‐up (12–60 weeks) revealed no additional problems.

CONCLUSIONS

Conventional haemostatic measures of electrocauteriztion and argon‐beam coagulation combined with commercial fibrin sealant allows successful haemostasis during LPN. In addition to haemostatic properties, fibrin sealants appear to have sealing properties that may help to prevent complications of urinary leakage by helping to seal or close the small defects in the urinary collecting system. The use of this compound may facilitate the ability of the urological laparoscopist during LPN.
Evaluation of the safety of sildenafil for male erectile dysfunction: experience gained in general practice use in England in 1999
Authors: Boshier A. , Wilton L.V. , Shakir S.A.W.
Published: March 2004

OBJECTIVE

To examine the safety of sildenafil, the first of the phosphodiesterase type 5 inhibitors licensed for the treatment of male erectile dysfunction (ED), as used in general medical practice in England, quantifying the incidence of a range of events in patients treated with sildenafil, and identifying any previously unrecognized adverse drug reactions.

METHODS

In a postmarketing observational cohort study using prescription‐event monitoring (PEM), exposure data were derived from dispensed prescription details for patients who started treatment between April and August 1999. Outcome data were derived from ‘green form’ questionnaires (GFs) returned by general practitioners (GPs).

RESULTS

In all, 24 835 (54.7%) of GFs posted to GPs were returned, of which 22 473 contained useful data for 22 471 male and two female patients. The major primary indications/clinical context of prescribing were impotence (16 583, 73.8%) and diabetes mellitus (183, 0.8%); 145 events were reported as adverse drug reactions to sildenafil. GPs recorded 3951 reasons for stopping sildenafil, and ischaemic heart disease (IHD) in 135 patients was the commonest clinical reason reported. The clinical condition reported most frequently in the first month of observation was diabetes mellitus and/or hyperglycaemia (in 99 events). A standardized mortality ratio (SMR) for deaths caused by IHD in the first 8893 of 22 473 patients was 31.41 (95% confidence interval 18.29–50.29), using the comparator population of males in England in 1998.

CONCLUSION

This study identified the safety profile of sildenafil as used in the community, showing no unexpected events. The SMR analysis of deaths from IHD provided no evidence to suggest a higher incidence of deaths in the study cohort than in the male population in England.
Sacral neuromodulation decreases narcotic requirements in refractory interstitial cystitis
Authors: Peters K.M. , Konstandt D.
Published: March 2004

OBJECTIVE

To assess the efficacy of long‐term sacral neuromodulation (InterStim®, Medtronic Inc., Minneapolis, MN) in treating chronic pelvic pain associated with interstitial cystitis (IC, a symptom complex of urinary urgency, frequency and pelvic pain, often necessitating narcotics) refractory to standard therapy.

PATIENTS AND METHODS

Twenty‐one patients (17 female, four male, mean age 45.5 years, range 17–68) with refractory IC with chronic pelvic pain were reviewed retrospectively. In these patients a mean of six previous treatments for IC had failed. All patients had had cystoscopy and hydrodistension to confirm their diagnoses. All had a permanent InterStim device implanted by one surgeon (K.M.P.) between 2000 and 2002, after responding to a temporary test. Data were collected from chart reviews and patient questionnaires. Intramuscular morphine dose equivalents (MDEs) were calculated before and after implantation.

RESULTS

All 21 patients responded to the questionnaire; the mean (range) follow‐up after implantation was 15.4 (7.4–23.1) months. Eighteen patients used chronic narcotics before the InterStim and 20 reported moderate or marked improvement in pain afterward. The mean MDE decreased from 81.6 to 52.0 mg/day (36%) after implantation (P = 0.015). Four of 18 patients stopped all narcotics after InterStim implantation.

CONCLUSIONS

Sacral neuromodulation decreases narcotic requirements and subjective pelvic pain in patients with refractory IC. Further decreases in MDE are anticipated as dose reductions continue in patients who improved.
Transdermal testosterone gel: pharmacokinetics, efficacy of dosing and application site in hypogonadal men
Authors: Meikle A.W. , Matthias D. , Hoffman A.R.
Published: March 2004

Testosterone gels are being increasingly used throughout the world. There is still some controversy associated with their use, but many of the uncertainties are gradually being overcome and explained. The authors from the USA evaluated the pharmacokinetics and the efficacy of dosing and application sites of another such transdermal gel.

The arrival of oral agents for treating male erectile dysfunction has made it easier for GPs to treat this condition. The authors from Southampton have examined the safety of sildenafil used in general medical practice in England, finding that it was used safely at this level, with no unexpected events.

OBJECTIVE

To determine the regimen that would most effectively maintain serum testosterone concentrations in treated hypogonadal men within the normal reference range of 3–11.4 µg/L.

PATIENTS AND METHODS

Eighteen men aged 24–69 years with either primary or secondary hypogonadism participated in and 16 completed a randomized, six‐treatment regimen, three‐period (phase), three‐way matrix‐type crossover study. A 1% and 2% testosterone gel (CP601, Cellegy Pharmaceuticals, Inc., San Francisco, USA) was administered either once or twice daily transdermally at different body sites to determine optimal dosing, application sites, and its pharmacokinetics and tolerability in hypogonadal men. Treatments A–F included 1 g of 1% and 2% gel that was equivalent to 10 or 20 mg of testosterone, applied once or twice daily to the skin of either the thigh or the upper arm. Six men also participated in a study of 3 g of 2% gel that was equivalent to 60 mg of testosterone applied once daily, half on each thigh. Pharmacokinetic variables were calculated for testosterone for each man in each treatment period and the results analysed by anova.

RESULTS

In general the higher dose regimens produced higher serum concentrations of testosterone; the 3 g/2% dose was most successful in maintaining serum testosterone within the normal reference range. The average testosterone concentration (Cavg) was 6.52 µg/L and all men had a Cavg of > 3.0 µg/L. The prediction of all men achieving a Cavg of > 3.0 µg/L was 96%. The mean minimum concentration (Cmin) was 3.83 µg/L and half the patients had a Cmin of > 3.0 µg/L. Most men had serum testosterone levels within the normal reference range throughout the 24 h, and the treatment was well tolerated.

CONCLUSIONS

The 3 g/2% dose applied to the skin daily resulted in serum testosterone in the normal reference range in most hypogonadal men. Dose adjustments to either a lower or higher dose should shift serum testosterone concentration to the desired range in those who do not achieve this range with this dose.
Early structural effects of oestrogen on pudendal nerve regeneration in the rat
Authors: Kane D.D. , Kerns J.M. , Lin D.L. , Damaser M.S.
Published: March 2004

OBJECTIVE

To determine the early effects of oestrogen on the ultrastructure of the pudendal nerve and distal nerve fascicles near the external urethra sphincter (EUS) after a pudendal nerve crush injury. The pudendal nerve is one of the pelvic floor tissues injured during vaginal delivery, possibly contributing to the development of stress urinary incontinence (SUI) in women, the symptoms of which often do not appear until menopause, implicating hormonal factors.

MATERIALS AND METHODS

Twenty‐seven virgin female Sprague‐Dawley rats were anaesthetized and underwent ovariectomy. Three days later, they had one of four procedures: bilateral pudendal nerve crush plus implant of a subcutaneous oestrogen‐containing capsule (NC+E); nerve crush plus implant of a sham saline‐containing capsule (NC+S); no nerve crush with an oestrogen capsule; or no nerve crush with a sham capsule. After 2 weeks the pudendal nerves and urethral tissues were prepared for light and electron microscopy. The number of axons, myelin figures and endoneurial nuclei in the pudendal nerve segment distal to the lesion were counted. Nerve fascicles near the EUS were also counted and categorized as normal or showing signs of degeneration and/or regeneration. The location of each nerve fascicle was specified as either ventral or dorsal.

RESULTS

As there were no significant differences between the two control groups they were combined to form a single control group. In the distal pudendal nerve there were significantly fewer myelinated axons and large myelinated axons in the NC+E and NC+S groups than in the control group. There were three times as many large unmyelinated axons in the NC+E group than in either the NC+S or control groups (P < 0.05). There were only half as many nerve fascicles near the ventral side of the EUS in the NC+S group than in both the control and NC+E groups (P < 0.05).

CONCLUSION

Oestrogen appears to affect large unmyelinated axons in both the injured pudendal nerve and at the denervated EUS target. After pudendal nerve crush, nerve fascicles with evidence of degeneration or regeneration near the EUS appear to be spared with oestrogen treatment, particularly in the ventral region. These observations may reflect the early stages of a neuroregenerative effect of oestrogen. Additional studies are needed to confirm these results at later periods and with functional methods.
Activity and energetics of free‐swimming fish: insights from electromyogram telemetry
Authors: Cooke Steven J , Thorstad Eva B , Hinch Scott G
Published: March 2004

Electromyogram (EMG) telemetry studies that involve remotely monitoring the locomotory activity and energetics of fish are contributing important information to the conservation and management of fisheries resources. Here, we outline the development of this rapidly evolving field and formulate the studies conducted that utilize this technology. To date, more than 60 studies have been conducted using EMG telemetry that spans 18 species. Several general trends were observed in the methodology of the studies that we have highlighted as standards that should be adopted associated with transmitter customization, electrode placement and surgical technique. Although numerous studies have been methodological, there are still some deficiencies in our basic understanding of issues such as the need for individual calibration and the method of reporting or transforming data. Increasingly, this technology is being applied to address issues in conservation, management and aquaculture production. At present, the technology has been most frequently applied to the study of animal activity or energetics and to migration. Several recent studies have also focused on addressing more basic questions in ecological and evolutionary biology (e.g. parental care dynamics) similar to the large body of literature that has been collected for other taxa (e.g. marine mammals, birds), using activity telemetry. Collectively, studies conducted using EMG telemetry have contributed important information on free‐swimming fish that was previously difficult to obtain. EMG telemetry is particularly effective for examining behaviour at temporal and spatial scales that are difficult using other techniques. The development of an ultrasonic transmitter based on the same proven principles as those used in the current radio transmitter technology will permit studies in other environments (i.e. marine, brackish, deep water) and on different species of fish. We encourage the continued development and refinement of devices for monitoring the activity and energetics of free‐swimming fish, and also encourage researchers to consider EMG telemetry as a tool for addressing questions that are not effectively answered with other techniques.
Computerized digital dermoscopy
Authors: Gewirtzman A J , Braun R P
Published: March 2004

Within the past 15 years, dermoscopy has become a widely used non‐invasive technique for physicians to better visualize pigmented lesions. Dermoscopy has helped trained physicians to better diagnose pigmented lesions. Now, the digital revolution is beginning to enhance standard dermoscopic procedures.

 Using digital dermoscopy, physicians are better able to document pigmented lesions for patient follow‐up and to get second opinions, either through teledermoscopy with an expert colleague or by using computer‐assisted diagnosis. As the market for digital dermoscopy products begins to grow, so do the number of decisions physicians need to make when choosing a system to fit their needs. The current market for digital dermoscopy includes two varieties of relatively simple and cheap attachments which can convert a consumer digital camera into a digital dermoscope. A coupling adapter acts as a fastener between the camera and an ordinary dermoscope, whereas a dermoscopy attachment includes the dermoscope optics and light source and can be attached directly to the camera. Other options for digital dermoscopy include complete dermoscopy systems that use a hand‐held video camera linked directly to a computer. These systems differ from each other in whether or not they are calibrated as well as the quality of the camera and software interface. Another option in digital skin imaging involves spectral analysis rather than dermoscopy.

 This article serves as a guide to the current systems available and their capabilities.
Offspring production and development in the parasitoid wasp Melittobia clavicornis (Cameron) (Hymenoptera: Eulophidae) from Japan
Authors: GONZÁLEZ Jorge M. , ABE Jun , MATTHEWS Robert W.
Published: March 2004

The development time, sex ratio and offspring production of Melittobia clavicornis reared with wild, facultative and factitious hosts are presented. Known hosts and different biological aspects presented in previously published reports are summarized and clarified. Immature development time was equivalent or slightly longer than that of other Melittobia species, and the sex ratio was approximately 97% female. Total offspring numbers were considerably lower than that of other Melittobia species using the same hosts. We report female dimorphism in this species for the first time. The number and relative proportion of brachypterous morph females produced was higher than that in other species of the genus.
Revision of the genus Stichillus Enderlein of Japan (Diptera: Phoridae)
Authors: NAKAYAMA Hiroto , SHIMA Hiroshi
Published: March 2004

The genus Stichillus in Japan is revised. Three species are recognized: S. japonicus (Matsumura), S. spinosus Liu and Chou and S. cylindratus sp. nov. Stichillus brunneicornis Beyer is excluded from the Japanese fauna. These Japanese species are described and keyed. The male genitalia and the female terminalia are illustrated. Some unique characters of the male genitalia in the genus are reported, and morphology of the male genitalia and the female terminalia is discussed.