bluuebunny/crossref_metadata_2025 huggingface dataset:
The significance of β‐APP immunoreactivity in forensic practice
Authors: Reichard R. R. , Smith C. , Graham D. I.
Published: May 2005

The neuropathologist involved in forensic work is not uncommonly confronted with a case in which there is no or only a limited history or, if available, the information is uncertain or is often conflicting. In recent years the immunohistochemical stain β‐amyloid precursor protein (β‐APP) has been used to assess the extent of axonal injury in a variety of pathological processes but in forensic practice is of greatest utility in the assessment of traumatic brain injury. Diffuse traumatic axonal injury (TAI) in humans has been demonstrated by β‐APP immunoreactivity in patients surviving at least 2 h after head injury. However, many of these patients also have an associated ischaemic injury, either focal or diffuse, which may make the interpretation of β‐APP immunoreactivity difficult. The present study was designed to evaluate if the published descriptions of the different morphological patterns and distributions of β‐APP immunoreactive axons could be used to microscopically distinguish axonal injury attributed to trauma from other causes. To test this hypothesis a total of 73 cases were reviewed. The cases were selected from six different groups based on clinical information. Immunostained sections from each case were assessed ‘blind’ to the clinical history, and the microscopic pattern and distribution of β‐APP positive axons were recorded. Haematoxylin and eosin (H+E) stained sections were then reviewed for each case and a final pathological diagnosis was recorded and compared to the clinical history. 62/73 (85%) cases were correctly correlated with the clinical history and in particular 14/17 (82%) cases of TAI were correctly identified. These findings indicate that the published microscopic patterns of the distribution of β‐APP positive axons in TAI and in diffuse ischaemic injury can be used, in conjunction with microscopy of H+E stained sections to determine the cause of axonal pathology in most cases.
The Alzheimer disease‐related calcium‐binding protein Calmyrin is present in human forebrain with an altered distribution in Alzheimer's as compared to normal ageing brains
Authors: Bernstein H.‐G. , Blazejczyk M. , Rudka T. , Gundelfinger E. D. , Dobrowolny H. , Bogerts B. , Kreutz M. R. , Kuznicki J. , Wojda U.
Published: May 2005

The EF‐hand calcium binding protein Calmyrin (also called CIB‐1) was shown to interact with presenilin‐2 (PS‐2), suggesting that this interaction might play a role in the pathogenesis of Alzheimer's disease (AD). Here we have investigated the distribution of Calmyrin in normal human and AD brain. In normal brain Calmyrin immunoreactivity was unevenly distributed with immunostaining in pyramidal neurones and interneurones of the palaeo‐ and neocortex, cerebellar granule cells and hypothalamic neurones of the paraventricular, ventromedial and arcuate nuclei. Moderate immunoreactivity was present in hippocampal pyramidal cells and stronger in dentate gyrus neurones. Thalamic and septal neurones were devoid of immunoreactivity. No apparent differences were visible between stainings of brain sections from younger and older nondemented patients. In AD brain a substantial loss of Calmyrin‐immunopositive neurones was observed in all regions, especially in cortical areas. Still immunoreactive neurones, however, displayed stronger staining that was especially concentrated in perinuclear regions. Calmyrin immunosignals were in part associated with diffuse and senile plaques. Thus, although protein levels of Calmyrin are low in human forebrain, its cellular localization as well as its altered distribution in AD brain suggest that it may be involved in the pathogenesis of AD.
A topographically and conformationally constrained, spin‐labeled, α‐amino acid: crystallographic characterization in peptides*
Authors: Crisma M. , Deschamps J.R. , George C. , Flippen‐Anderson J.L. , Kaptein B. , Broxterman Q.B. , Moretto A. , Oancea S. , Jost M. , Formaggio F. , Toniolo C.
Published: May 2005

Abstract:  2,2,6,6‐Tetramethylpiperidine‐1‐oxyl‐4‐amino‐4‐carboxylic acid (TOAC) is a topographically and conformationally restricted, nitroxide containing, Cα‐tetrasubstituted α‐amino acid. Here, we describe the molecular and crystal structures, as determined by X‐ray diffraction analyses, of a TOAC terminally protected derivative, the cyclic dipeptide c(TOAC)2·1,1,1,3,3,3‐hexafluoropropan‐2‐ol (HFIP) solvate, and five TOAC‐containing, terminally protected, linear peptides ranging in length from tetra‐ to hepta‐peptides. Incipient and fully developed, regular or distorted 310‐helical structures are formed by the linear peptides. A detailed discussion on the average geometry and preferred conformation for the TOAC piperidine ring is also reported. The X‐ray diffraction structure of an intramolecularly cyclized side product resulting from a C‐activated TOAC residue has also been determined.
The deconstructing angel: nursing, reflection and evidence‐based practice
Authors: Rolfe Gary
Published: May 2005

The deconstructing angel: nursing, reflection and evidence‐based practice

This paper explores Jacques Derrida's strategy of deconstruction as a way of understanding and critiquing nursing theory and practice. Deconstruction has its origins in philosophy, but I argue that it is useful and relevant as a way of challenging the dominant paradigm of any discipline, including nursing. Because deconstruction is notoriously difficult to define, I offer a number of examples of deconstruction in action. In particular, I focus on three critiques of reflective practice by the meta‐narrative of evidence‐based practice (EBP) and attempt to show how those critiques can be directed back at EBP itself. I conclude with the observation that EBP is open to many of the criticisms that it directs at other discourses, including problems of a lack of empirical evidence, of distortions due to memory, and of falsification of the ‘facts’.
Men, culture and hegemonic masculinity: understanding the experience of prostate cancer
Authors: Wall David , Kristjanson Linda
Published: May 2005

Men, culture and hegemonic masculinity: understanding the experience of prostate cancer

Following a diagnosis of, and treatment for prostate cancer, there is an expectation that men will cope with, adjust to and accept the psychosocial impact on their lives and relationships. Yet, there is a limited qualitative world literature investigating the psychosocial experience of prostate cancer, and almost no literature exploring how masculinity mediates in such an experience. This paper will suggest that the experience of prostate cancer, the process by which it is investigated, and the way in which it is understood has been shaped by an essentialist interpretation of gender, exemplified by hegemonic masculinity as the archetypal mechanism of male adaptation. In response to this static and limiting view of masculinity, this paper will offer a reframe of hegemonic masculinity. This reframe, being more aligned with common experience, will portray masculinity as a dynamic and contextual construct, better understood as one of a number of cultural reference points around which each man organises and adopts behaviour. It will be suggested that the extant literature, in being organised around hegemonic masculinity, obfuscates the experience of prostate cancer and acts to render covert any collateral masculinities, public or private, that may also be operating.
Mediating the meaning of evidence through epistemological diversity
Authors: Tarlier Denise
Published: May 2005

Mediating the meaning of evidence through epistemological diversity

Nursing's disciplinary recognition of ‘multiple ways of knowing’ reflects an epistemological diversity that supports nursing praxis. Nursing as praxis offers a conceptual way to explore what it is about the interface of practice, knowledge and evidence in nursing that distinguishes us as a discipline. I suggest that the relationship between evidence and knowledge is defined and mediated by the same epistemological diversity that supports nursing as praxis. Just as the meaning and truth‐value of evidence is evaluated from within the body of existing disciplinary knowledge, new evidence may prompt an evaluation of the meaning and truth‐value of extant nursing knowledge. Nursing practice that relies on scientific evidence as a singular basis of practice knowledge is susceptible to exploitation by the diverse agendas operating within an ideology of evidence‐based practice and the healthcare system. Mediating the meaning of evidence for nursing practice through acknowledgement of the diverse epistemologies that underpin nursing knowledge will contribute to a disciplinary‐specific definition of what constitutes evidence for nursing, and will better direct how evidence is integrated into a disciplinary body of knowledge.
In the public interest: autonomy and resistance to methods of standardising nurses’ advice and practices from a health call centre in Perth, Western Australia
Authors: Larsen Ann‐Claire
Published: May 2005

In the public interest: autonomy and resistance to methods of standardising nurses’ advice and practices from a health call centre in Perth, Western Australia

The history of nursing is replete with examples of nurses battling for autonomy over their education, knowledge and work practices. The latest battleground is HealthDirect, Australia's first medial call centre, where nurses are required to meet externally imposed clinical standards while satisfying legal and financial obligations. These objectives are arguably achieved when nurses assess callers’ health problems via computerised algorithms that determine an appropriate plan of action. That way, nurses’ subjective responses to callers are ruled out. To ensure nurses comply with the standard processes, calls are monitored randomly and surreptitiously in formal and informal ways. This paper explores how nurses respond to standard procedures and surveillance, in order to argue that nurses’ input partially drives reform processes. Nurses continue to seek autonomy over the advice they give and how their work is evaluated but are constrained by structural power relations.
Evidence for the presence of a CmuA methyltransferase pathway in novel marine methyl halide‐oxidizing bacteria
Authors: Schäfer Hendrik , McDonald Ian R. , Nightingale Phil D. , Murrell J. Colin
Published: May 2005

Marine bacteria that oxidized methyl bromide and methyl chloride were enriched and isolated from seawater samples. Six methyl halide‐oxidizing enrichments were established from which 13 isolates that grew on methyl bromide and methyl chloride as sole sources of carbon and energy were isolated and maintained. All isolates belonged to three different clades in the Roseobacter group of the alpha subdivision of the Proteobacteria and were distinct from Leisingera methylohalidivorans, the only other identified marine bacterium that grows on methyl bromide  as sole source of carbon and energy. Genes  encoding the methyltransferase/corrinoid‐binding protein CmuA, which is responsible for the initial step of methyl chloride oxidation in terrestrial methyl halide‐oxidizing bacteria, were detected in enrichments and some of the novel marine strains. Gene clusters containing cmuA and other genes implicated in the metabolism of methyl halides were cloned from two of the isolates. Expression of CmuA during growth on methyl halides was demonstrated by analysis of polypeptides expressed during growth on methyl halides by SDS‐PAGE and mass spectrometry in two isolates representing two of the three clades. These findings indicate that certain marine methyl halide degrading bacteria from the Roseobacter group contain a methyltransferase pathway for oxidation of methyl bromide that may be similar to that responsible for methyl chloride oxidation in Methylobacterium chloromethanicum. This pathway therefore potentially contributes to cycling of methyl halides in both terrestrial and marine environments.
Ecotype diversity in the marine picoeukaryote Ostreococcus (Chlorophyta, Prasinophyceae)
Authors: Rodríguez Francisco , Derelle Evelyne , Guillou Laure , Le Gall Florence , Vaulot Daniel , Moreau Hervé
Published: May 2005

The importance of the cyanobacteria Prochlorococcus and Synechococcus in marine ecosystems in terms of abundance and primary production can be partially explained by ecotypic differentiation. Despite the dominance of eukaryotes within photosynthetic picoplankton in many areas a similar differentiation has never been evidenced for these organisms. Here we report distinct genetic [rDNA 18S and internal transcribed spacer (ITS) sequencing], karyotypic (pulsed‐field gel electrophoresis), phenotypic (pigment composition) and physiological (light‐limited growth rates) traits in 12 Ostreococcus strains (Prasinophyceae) isolated from various marine environments and depths, which suggest that the concept of ecotype could also be valid for eukaryotes. Internal transcribed spacer phylogeny grouped together four deep strains isolated between 90 m and 120 m depth from different geographical origins. Three deep strains displayed larger chromosomal bands, different chromosome hybridization patterns, and an additional chlorophyll (chl) c‐like pigment. Furthermore, growth rates of deep strains show severe photo‐inhibition at high light intensities, while surface strains do not grow at the lowest light intensities. These features strongly suggest distinct adaptation to environmental conditions encountered at surface and the bottom of the oceanic euphotic zone, reminiscent of that described in prokaryotes.
Marine diatom species harbour distinct bacterial communities
Authors: Grossart Hans‐Peter , Levold Florian , Allgaier Martin , Simon Meinhard , Brinkhoff Thorsten
Published: May 2005

We examined bacterial dynamics in batch cultures of two axenic marine diatoms (Thalassiosira rotulaandSkeletonema costatum). The axenic diatoms were inoculated with natural bacterial assemblages and monitored by 4,6‐diamidino‐2‐phenolindole (DAPI) counts, denaturing gradient gel electrophoresis (DGGE) with subsequent analysis of excised, sequenced 16S rRNA gene fragments, and fluorescencein situhybridization (FISH) with group‐specific 16S rRNA oligonucleotide probes. Our results show that algal growth exhibited pronounced differences in axenic treatments and when bacteria were present. Bacterial abundance and community structure greatly depended on species, growth and physiological status of even closely related algae. Free‐living and phytoplankton‐associated bacteria were very different from each other and were dominated by distinct phylogenetic groups. The diatom‐associated bacteria mainly belonged to theFlavobacteria–Sphingobacteriagroup of the Bacteroidetes phylum whereas free‐living bacteria, which were rather similar in both cultures, comprised mainly of members of theRoseobacter group  of  α‐Proteobacteria.  Presence and disappearance of specific bacteria during algal growth indicated pronounced differences in environmental conditions over time and selection of bacteria highly adapted to the changing conditions. Tight interactions between marine bacteria and diatoms appear to be important for the decomposition of organic matter and nutrient cycling in the sea.
Modelling viral impact on bacterioplankton in the North Sea using artificial neural networks
Authors: Winter Christian , Smit Arjan , Szoeke‐Dénes Timea , Herndl Gerhard J. , Weinbauer Markus G.
Published: May 2005

The temporal variability of the viral impact on bacterioplankton during the summer–winter transition in the North Sea was determined and artificial neural networks (ANNs) were developed to predict viral production and the frequency of infected bacterial cells (FIC). Viral production and FIC were estimated using a virus‐dilution approach during four cruises in the southern North Sea between July and December 2000 and an additional cruise in June 2001. Supplementary data such as bacterial production, and bacterial and viral abundance were collected to relate changes in FIC and viral production to the dynamics of other biotic parameters. Average viral abundance varied between 4.4 × 106 ml−1 in December and 29.8 × 106 ml−1 in July. Over the seasonal cycle, viral abundance correlated best with bacterial production. Average bacterial abundance varied between 0.5 × 106 ml−1 in December and 1.3 × 106 ml−1 in July. Monthly average values  of  FIC  ranged  from  9% in  September  to  39% in June and the average viral production from 11 × 104 ml−1 h−1 in December to 35 × 104 ml−1 h−1 in July. The data set was used to develop ANN‐based models of viral production and FIC. Viral production was modelled best using sampling time, and bacterial and viral abundance as input parameters to an ANN with two hidden neurons. Modelling of FIC was performed using bacterial production as an additional input parameter for an ANN with three hidden neurons. The models can be used to simulate viral production and FIC based on regularly recorded and easily obtainable parameters such as bacterial production, bacterial and viral abundance.
Characterization of starvation‐induced dispersion in Pseudomonas putida biofilms
Authors: Gjermansen Morten , Ragas Paula , Sternberg Claus , Molin Søren , Tolker‐Nielsen Tim
Published: May 2005

The biofilm lifestyle, where microbial cells are aggregated because of expression of cell‐to‐cell interconnecting compounds, is believed to be of paramount importance to microbes in the environment. Because microbes must be able to alternate between sessile and planktonic states, it is anticipated that they must be able to regulate their ability to form biofilm and to dissolve biofilm. We present an investigation of a biofilm dissolution process occurring in flow‐chamber‐grown Pseudomonas putida biofilms. Local starvation‐induced biofilm dissolution appears to be an integrated part of P. putida biofilm development that causes characteristic structural rearrangements. Rapid global dissolution of entire P. putida biofilms was shown to occur in response to carbon starvation. Genetic analysis suggested that the adjacent P. putida genes PP0164 and PP0165 play a role in P. putida biofilm formation and dissolution. PP0164 encodes a putative periplasmic protein of previously unknown function, and PP0164 mutant bacteria are sticky, and unable to reduce their adhesiveness and dissolve their biofilm in response to carbon starvation. PP0165 encodes a putative transmembrane protein containing GGDEF and EAL domains, and PP0165 mutant bacteria are unable to increase their adhesiveness and form biofilm. We suggest that the PP0164 and PP0165 proteins are involved in the regulation of the adhesiveness of the bacteria; the PP0165 protein through c‐di‐GMP signalling, and the PP0164 protein as a transducer of the signal.
Dorsal dartos flap for preventing fistula in the Snodgrass hypospadias repair
Authors: Djordjevic Miroslav L. , Perovic Sava V. , Vukadinovic Vojkan M.
Published: May 2005

There are three different topics covered in the paediatric urology section in this issue. Authors from Belgrade describe how a dorsal dartos flap can be used to prevent fistula in the Snodgrass hypospadias repair. The use of extracorporeal pelvic floor magnetic stimulation in children with voiding dysfunction is described by authors from Seoul. And finally, authors from Antalya write about the impact of the location of the ureteric orifice on the efficacy of endoscopic injection to correct VUR.

OBJECTIVE

To evaluate the importance of urethral covering using vascularized dorsal subcutaneous tissue for preventing fistula in the Snodgrass hypospadias repair.

PATIENTS AND METHODS

The study included 67 children (aged 1–11 years) who had hypospadias repaired between April 1998 and May 2003, including 51 with distal and 16 with midshaft hypospadias. In all children, a standard tubularized incised‐plate urethroplasty was followed by reconstruction of new surrounding urethral tissue. A longitudinal dartos flap was harvested from excessive dorsal preputial and penile hypospadiac skin, and transposed to the ventral side by a buttonhole manoeuvre; it was sutured to the glans wings around the neomeatus, and to the corpora cavernosa over the neourethra. Thus the neourethra was completely covered with well‐vascularized subcutaneous tissue.

RESULTS

At a mean (range) follow‐up of 21 (6–65) months, the result was successful, with no fistula or urethral stenosis, in all 67 children.

CONCLUSION

We suggest that urethral covering should be part of the Snodgrass procedure. A dorsal well‐vascularized dartos flap, buttonholed ventrally, is a good choice for preventing fistula. Redundancy of the flap and its excellent vascularization depends on the harvesting technique.
The changing presentation of germ cell tumours of the testis between 1983 and 2002
Authors: Powles Thomas B. , Bhardwa Jateesh , Shamash Johnathan , Mandalia Sundhia , Oliver Tim
Published: May 2005

Authors from London looked at patients diagnosed with germ cell tumours of the testis who presented between 1983 and 2002. They found that there was an overall increase in the percentage of patients presenting with stage I seminoma, with a significant reduction in the size of the primary tumour. The authors do not feel that they can clarify the reason for these changes.

There is a 20‐year follow‐up of patients who had tumours of the ureter and renal pelvis treated with resection and renal autotransplantation. In this fascinating series from Gothenberg, it was found that in patients with a normal contralateral kidney, resection and autotransplantation was not indicated. It was possibly beneficial in patients with solitary kidneys, but only after other treatments have been considered.

OBJECTIVE

To prospectively investigate the presentation of germ cell tumours (GCTs) of the testis in terms of stage or histology, as the incidence of this disease in increasing.

PATIENTS AND METHODS

Patients diagnosed with GCT of the testis between 1983 and 2002 were categorised into three periods depending on the date of diagnosis of the GCT, and the presentational characteristics assessed.

RESULTS

There was a significant increase in the proportion of patients presenting with stage I disease (59% to 78%) and seminoma (43% to 58%) over this period. There was also a significant reduction in the size of the primary tumour (5 to 4 cm).

CONCLUSION

A greater proportion of patients with GCT are presenting with stage I seminoma, the reasons for which are unclear, although earlier diagnosis through improved awareness of GCT may be important.
Tumours of the ureter and renal pelvis treated with resection and renal autotransplantation: a study with up to 20 years of follow‐up
Authors: Holmäng Sten , Johansson Sonny L.
Published: May 2005

OBJECTIVE

To report long‐term follow‐up data from patients treated with resection of urothelial neoplasms of the upper urinary tract combined with autotransplantation of the kidney.

PATIENTS AND METHODS

In a clinical and histopathological review of 23 patients who had 25 autotransplantations, they were followed for 7–20 years or until death. Nine patients had either a solitary kidney or bilateral renal pelvic tumours (group A) and 14 had a normal contralateral kidney (group B).

RESULTS

Seven operations were unsuccessful, ending in nephrectomy. Of the nine patients in group A two with high‐grade renal pelvic tumours survived with no dialysis and recurrences for 127 and 238 months, respectively. Three patients required haemodialysis 0–3 times weekly for 27, 85 and 108 months, respectively. Three patients with low‐grade disease developed invasive recurrences in the autotransplanted kidney after 16, 27 and 90 months, respectively, and later died from the disease. One patient died in an accident after 14 months. Of the 14 patients in group B, one developed a deeply invasive recurrence in the autotransplanted kidney after 86 months, despite frequent controls.

CONCLUSIONS

In patients with a normal contralateral kidney resection and renal autotransplantation is not indicated and might even be harmful, compared to standard nephroureterectomy. The operation might be beneficial in patients with solitary kidneys but other treatments should first be considered, including open or endoscopic resection, and nephroureterectomy and haemodialysis.
Radical cystectomy in patients aged ≥ 75 years: an updated review of patients treated with curative and palliative intent
Authors: Zebic Nikola , Weinknecht Stephan , Kroepfl Darko
Published: May 2005

OBJECTIVE

To evaluate the morbidity and mortality of radical cystectomy in a group of unselected patients aged ≥ 75 years who were treated with curative and palliative intent.

PATIENTS AND METHODS

We retrospectively analysed 53 patients aged 75–90 years (median 78.8 years) who had radical cystectomies between May 1994 and July 2002. The patients were divided into two groups: 46 were treated with curative intent (group A) and seven with palliative intent (group B). The indications for cystectomy in group A were recurrent and otherwise therapy‐resistant bladder cancer, severe irritative voiding symptoms, and recurrent macrohaematuria. The indications in group B were advanced pelvic malignancy with severe irritative voiding symptoms, severe pain, and recurrent macrohaematuria requiring blood transfusions. Patients were categorized according to the American Society of Anesthesiologists classification, with a score of II in 28 patients, III in 21 and IV in four. Complications and mortality before, during and after surgery, and the duration of hospital stay and clinical outcome, were assessed.

RESULTS

The early mortality rate in group A was 4% (2/46); in group B two patients died after prolonged complications. The median (range) hospital stay was 28 (6–56) days, and was significantly longer in patients with complications, at a median (range) of 36 (6–70) days. The complication rates early and late after surgery in group A were 22% and 11%, respectively, and in group B, five of seven (early). The total median survival was 2 (0.33–7) years.

CONCLUSIONS

Elderly people undergoing radical cystectomy have a greater risk of perioperative morbidity and mortality, especially those with very advanced pelvic malignancies who have had cystectomy with palliative intent. The incidence of early and late complications in patients treated with curative intent is acceptable, but the hospital stay is prolonged.
Quantitative molecular urinary cytology by fluorescence in situ hybridization: a tool for tailoring surveillance of patients with superficial bladder cancer?
Authors: Bollmann Magdolna , Heller Hildegard , Bánkfalvi Agnes , Griefingholt Harald , Bollmann Reinhard
Published: May 2005

OBJECTIVE

To determine whether it is possible to stratify patients with superficial bladder cancer into low‐ and high‐risk groups for tumour recurrence/progression based on the chromosomal pattern detected by fluorescence in situ hybridization (FISH) in one urine cytology specimen used for follow‐up testing.

PATIENTS AND METHODS

Voided urine samples from 47 consecutive patients with urinary tract neoplasms (13 with no history of urothelial malignancy and 34 under follow‐up after complete transurethral resection of superficial urothelial carcinoma of the bladder) were evaluated by liquid‐based cytology (ThinPrep®, CYTYC Corp., Boxborough, MA, USA) and UroVysion FISH (Vysis‐Abbott, Downers Grove, IL).

RESULTS

Of the 34 patients under surveillance, the UroVysion test was negative in four, 17 had loss of 9p21 sequences either alone or combined with low‐frequency trisomy/ies or tetrasomy/ies of chromosomes 3, 7 and 17 in single cells (low‐risk FISH), and 13 also had complex aneusomies of the remaining chromosomes (high‐risk FISH). One of the four FISH‐negative neoplasms, four of the 17 low‐risk FISH cases and five of the 11 informative high‐risk FISH‐positive patients developed recurrence. Progression occurred only in patients with high‐risk FISH results, showing high‐frequency complex chromosomal polysomies (four of 11).

CONCLUSION

The results from this pilot study indicate that the UroVysion FISH test may help to individually assess the clinical behaviour of superficial bladder cancer, based on the chromosomal pattern of exfoliated tumour cells in follow‐up urinary cytology. It might be of use to identify those patients likely to progress at earlier and curable stages of disease, and lengthen the surveillance period in those with persistent or recurrent low‐risk disease.
Imaging with radiolabelled monoclonal antibody (MUJ591) to prostate‐specific membrane antigen in staging of clinically localized prostatic carcinoma: comparison with clinical, surgical and histological staging
Authors: Nargund Vinod , Al Hashmi Dona , Kumar Priya , Gordon Stephen , Otitie Ugo , Ellison David , Carroll Melvyn , Baithun Sohail , Britton Keith E.
Published: May 2005

OBJECTIVE

To evaluate the reliability of prostate scintigraphy using a radiolabelled antibody (MUJ591) raised against the external domain of prostate‐specific membrane antigen (PSMA) in the staging of early prostate cancer.

PATIENTS AND METHODS

This was a prospective study of 16 patients who had radical retropubic prostatectomies (median PSA 9.75 ng/mL). All patients underwent PSMA imaging using MUJ591 radiolabelled with 99mTc using a photo‐reduction technique.

RESULTS

The findings of prostate imaging and histology were identical in seven patients. Scans showed understaging and overstaging in six and three patients, respectively.

CONCLUSIONS

PSMA scintigraphy using 99mTc‐labelled MUJ591 identifies the presence of prostate cancer, but is not sensitive in delineating micro‐invasion of the capsule, seminal vesicles or bladder neck. As in other studies it seems to be useful in detecting prostate bed recurrence and distant micrometastasis.
Prostate cancer detection in men with a ‘normal’ total prostate‐specific antigen (PSA) level using percentage free PSA: a prospective screening study
Authors: Rowe Edward W.J. , Laniado Mark E. , Walker Marjorie M. , Patel Anup
Published: May 2005

OBJECTIVE

To assess the utility of percentage free/total prostate‐specific antigen (f/tPSA) levels for detecting prostate cancer in a prospectively screened population of men with a ‘normal’ total PSA level.

PATIENTS AND METHODS

Men aged 50–65 years were contacted via their general practitioner and invited for prostate cancer screening. All had their total and f/tPSA levels measured; those meeting the biopsy criteria (PSA 1.1–3.99 ng/mL and f/tPSA ≤ 20%) were offered a biopsy. The cancer detection rate was then evaluated and compared with other methods of detection. In all, 773 men were screened, of whom 115 met the criteria and agreed to undergo a prostate biopsy.

RESULTS

Cancer was detected in 13 of the 115 men (11.3%) of whom most would have been missed by lowering the age‐adjusted threshold for total PSA to 2.5 ng/mL. There was no significant difference in total and f/tPSA values in men with and without prostate cancer. Those cancers that could be evaluated were found to be clinically significant.

CONCLUSION

In this study prostate cancer was detected solely on the basis of a low f/tPSA value. Most men with cancer would have been missed by simply lowering the age‐adjusted threshold for total PSA. Using the f/tPSA level may allow the detection of clinically significant cancer in men at a time when they are most likely to benefit from treatment.
Congenital adrenal hyperplasia and lower urinary tract symptoms
Authors: Davies Melissa C. , Crouch Naomi S. , Woodhouse Christopher R.J. , Creighton Sarah M.
Published: May 2005

OBJECTIVES

To assess urinary symptoms in adult women with congenital adrenal hyperplasia (CAH), as feminizing surgery in infancy is current standard practice for CAH and one of the indications for surgery is to reduce urinary symptoms.

PATIENTS, SUBJECTS AND METHODS

In a case‐control study, 19 women with CAH, of whom 16 had had childhood feminizing genital surgery, and age‐matched women with no CAH, were evaluated. Subjects and controls completed the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire.

RESULTS

Urge incontinence was reported in 13 (68%) patients and three (16%) controls (P = 0.003); stress incontinence was present in 47% and 26%, respectively (P = 0.31). Results from the controls were comparable with those documented in larger studies on normal populations. Nine of the patients felt that their urinary symptoms had an adverse effect on their lives, compared with only one of the controls (P = 0.008).

CONCLUSION

Patients with a diagnosis of CAH are more likely to have significant urinary symptoms than normal controls. At present it is not clear whether this is a result of surgery or an effect of CAH. In at least two‐thirds of patients surgery did not achieve the objective of reducing urinary symptoms.
Role of computed tomography with no contrast medium enhancement in predicting the outcome of extracorporeal shock wave lithotripsy for urinary calculi
Authors: Gupta Narmada P. , Ansari Mohd S. , Kesarvani Pawan , Kapoor Annu , Mukhopadhyay Seema
Published: May 2005

OBJECTIVE

To evaluate the usefulness of urinary calculi attenuation values from non‐contrast computed tomography (NCCT) in predicting the outcome of treatment by extracorporeal shock wave lithotripsy (ESWL).

PATIENTS AND METHODS

We evaluated 112 patients with solitary renal and upper ureteric calculi of 0.5–2 cm undergoing ESWL. All patients had NCCT at 120 kV and 240 mA on a spiral CT scanner. During each ESWL session 3000 shock waves were given to a maximum of 3.0 kV. A final X‐ray of the kidney, ureters and bladder was taken 12 weeks after the last ESWL session. Fragments of ≤ 5 mm were regarded as clinically insignificant residual fragments (CIRF). The calculi retrieved were analysed by X‐ray diffraction and the results assessed by comparing the mean density (as measured in Hounsfield units, HU) with the number of ESWL sessions and clearance.

RESULTS

In all, 82 (76%) patients had complete clearance of stones and 26 (24%) had CIRF. There was a linear relationship between the calculus density and number of ESWL sessions required. Of patients with calculi of ≤ 750 HU, 41 (80%) needed three or fewer ESWL sessions and 45 (88%) had complete clearance. Of patients with calculi of > 750 HU, 41 (72%) required three or more ESWL sessions, and 37 (65%) had complete clearance. The best outcome was in patients with calculus diameters of < 1.1 cm and mean densities of ≤ 750 HU; 34 (83%) needed three or fewer ESWL sessions, and the clearance rate was 90%. The worst outcome was in patients with calculus densities of > 750 HU and diameters of > 1.1 cm; 23 (77%) needed three or more ESWL sessions and the clearance rate was only 60%. The calculus density was a stronger predictor of outcome than size alone.

CONCLUSIONS

The use of NCCT for determining the attenuation values of urinary calculi before ESWL might help to predict the treatment outcome, and so might help in planning alternative treatment in patients with a likelihood of a poor outcome from ESWL.
The pitfalls of vaginal construction
Authors: Davies Melissa C. , Creighton Sarah M. , Woodhouse Christopher R.J.
Published: May 2005

OBJECTIVE

To evaluate a group of young women undergoing complex vaginoplasty, which may be defined as where there has already been previous complex pelvic surgery and the patient is unsuitable for conservative treatment or minor surgical revision.

PATIENTS AND METHODS

All patients who had undergone a complex vaginoplasty between 1997 and 2004 were reviewed retrospectively. Information was recorded on the underlying condition, previous surgery and preoperative assessment. The operative technique and complications were noted, and the outcome in terms of menstruation and sexual activity. In all, 15 patients fulfilled the criteria (mean age 22.2 years, range 17–36) and the mean follow‐up was 4.75 (0.75–7) years.

RESULTS

Fourteen patients had complex congenital anomalies of the lower genital tract and 11 of these had associated anomalies of the urinary and gastrointestinal system; four were XY females. The 15 patients had had 31 vaginal procedures, including ileal vaginoplasty, mobilization of perineal skin flaps and split‐skin grafting. Three patients required osteotomies to increase pelvic outlet diameter. The commonest complications were stenosis (six patients) and fistula formation (four). Eight patients are now sexually active; the remaining seven have not attempted sexual intercourse.

CONCLUSIONS

Complications are common and can be major; most patients require many repeat operations to achieve a patent vagina. Unfortunately at present, this is the only option for this group of young women to achieve a functional vagina. Patients with complex congenital anomalies of the reproductive and genital tracts are increasingly surviving into adulthood, and the numbers of these patients is likely to increase in the future.
The effect of location of the ureteric orifice on the efficacy of endoscopic injection to correct vesico‐ureteric reflux
Authors: Yucel Selcuk , Ucar Murat , Guntekin Erol , Kukul Erdal , Melikoglu Mustafa , Baykara Mehmet
Published: May 2005

OBJECTIVE

To review our 11‐year experience and identify the mechanisms responsible for the failure of endoscopic injection for vesico‐ureteric reflux (VUR) with three different injectable agents, based on the location of the ureteric orifice on endoscopy.

PATIENTS AND METHODS

We retrospectively reviewed the charts and endoscopic video‐photographs of 46 patients (26 girls, 20 boys, median age 6 years, range 2–16) with VUR treated once or twice by subureteric injection with PTFE, or polydimethylsiloxane or dextranomer/hyaluronic acid copolymer, from 1992 to 2003. Five patients were lost to follow‐up and six ectopic and/or duplicated ureters were excluded from the analysis; in all, 52 ureters were analysed. According to the international classification, the VUR was grades I to V in four (8%), 12 (23%), 16 (31%), 13 (25%) and seven (13%) ureters, respectively.

RESULTS

After 3 months, voiding cysto‐urethrography showed that VUR continued in six of 19, seven of 12 and eight of 21 ureters (38%), respectively, after subureteric PTFE, polydimethylsiloxane and dextranomer/hyaluronic acid copolymer injection; after the second injection, reflux continued in two of six, four of seven and three of eight ureters, respectively. Mound displacement and/or volume loss was the most common failure with all three bulking agents after both the first (62%) and second injections (44%) (P < 0.05). The first injection failed in 32% (11 of 35) normally located ureters and 10 of 17 lateral ureters (P < 0.05). The second injection failed in 11% (four of 35) normal and five of 17 lateral ureters (P < 0.05).

CONCLUSIONS

A lateral ureteric orifice may decrease the efficacy of endoscopic injection, as the likelihood of a faulty injection is greater. However, a more careful second injection decreases the failure rate, particularly in those with low‐ to medium‐grade refluxing ureters.
Indices of bird‐habitat preference from field surveys of birds and remote sensing of land cover: a study of south‐eastern England with wider implications for conservation and biodiversity assessment
Authors: Fuller Robin M. , Devereux Bernard J. , Gillings Simon , Amable Gabriel S. , Ross A. Hill
Published: May 2005

Aim  This paper describes the development of novel indices of bird‐habitat preference to examine bird species’ use of habitats and their distributions relative to habitats. It assesses the implications for bird conservation regionally and the scope for biodiversity assessments generally.

Location  A 200 km by 400 km area of farmland with seminatural and urban areas, covering south‐eastern England.

Methods  Cluster analysis was used to link birds to landscapes. Cluster centroid coordinate values were processed to derive indices of bird‐habitat preference. Further developments assessed the relative values of individual habitats for birds.

Results  Clustering objectively linked birds to landscapes. Maps of the clusters showed strong regional patterns associated with distinctive habitat assemblages. Derived indices related bird species directly to individual habitats and habitats to birds. Even rare species and scarce habitats showed successful linkages, often to each other. Objective corroboration strongly supported the associations of coastal, wetland, urban and woodland birds and habitats; but, it suggested that farmland birds, whose numbers have nearly halved since 1977, may prefer alternative habitats.

Main conclusions  Land cover maps from remote sensing provide an effective way to link birds to habitats and vice versa. Thus, generalized habitat maps might be used to extrapolate localized or sample‐based bird observations or the results of autecological studies, helping to predict and understand bird distributions in the wider countryside. The weak links between farmland birds and farmland habitats in a region dominated by farming, suggests that reasons for the decline in farmland birds may be deep seated and thus hard to reverse. The procedures described are repeatable elsewhere and applicable more generally to evaluate landscapes and biodiversity. It is suggested that remote sensing could rarely be bettered as a means of assessing habitats, comprehensively, over wide areas, in most parts of the world.
Local vs. landscape controls on diversity: a test using surface‐dwelling soil macroinvertebrates of differing mobility
Authors: Dauber Jens , Purtauf Tobias , Allspach Andreas , Frisch Johannes , Voigtländer Karin , Wolters Volkmar
Published: May 2005

Aim A better understanding of the processes driving local species richness and of the scales at which they operate is crucial for conserving biodiversity in cultivated landscapes. Local species richness may be controlled by ecological processes acting at larger spatial scales. Very little is known about the effect of landscape variables on soil biota. The aim of our study was to partly fill this gap by relating the local variation of surface‐dwelling macroarthropod species richness to factors operating at the habitat scale (i.e. land use and habitat characteristics) and the landscape scale (i.e. composition of the surrounding matrix).

Location An agricultural landscape with a low‐input farming system in Central Hesse, Germany.

Methods We focused on five taxa significantly differing in mobility and ecological requirements: ants, ground beetles, rove beetles, woodlice, and millipedes. Animals were caught with pitfall traps in fields of different land use (arable land, grassland, fallow land) and different habitat conditions (insolation, soil humidity). Composition of the surrounding landscape was analysed within a radius of 250 m around the fields.

Results Factors from both scales together explained a large amount of the local variation in species richness, but the explanatory strength of the factors differed significantly among taxa. Land use particularly affected ground beetles and woodlice, whereas ants and rove beetles were more strongly affected by habitat characteristics, namely by insolation and soil characteristics. Local species richness of diplopods depended almost entirely on the surrounding landscape. In general, the composition of the neighbouring landscape had a lower impact on the species richness of most soil macroarthropod taxa than did land use and habitat characteristics.

Main conclusions We conclude that agri‐environment schemes for the conservation of biodiversity in cultivated landscapes have to secure management for both habitat quality and heterogeneous landscape mosaics.
Microbial macroecology: highly structured prokaryotic soil assemblages in a tropical deciduous forest
Authors: Noguez Ana M. , Arita Héctor T. , Escalante Ana E. , Forney Larry J. , García‐Oliva Felipe , Souza Valeria
Published: May 2005

Aim To assess the hypothesis that free‐living prokaryotes show a pattern of ‘no biogeography’ by examining the scaling of soil prokaryotic diversity and by comparing it with other groups’ biogeographical patterns.

Location Two sites in the tropical deciduous forest of Chamela, Jalisco, on the western coast of Mexico.

Methods We examined the diversity and distribution of soil prokaryotes in two 8 × 8 m quadrats divided in such manner that we could sample at four spatial scales. Restriction fragment length polymorphisms of16S rRNAgenes were used to define operational taxonomic units (OTUs) that we used in lieu of species to assess diversity.

Results We found highly structured species assemblages that allowed us to reject multiple predictions of the hypothesis that soil bacteria show ‘no biogeography’. The frequency distribution of range size (measured as the occupancy of quadrats) of OTUs followed a hollow curve similar to that of vertebrates on continents. Assemblages showed high levels of beta diversity and a non‐random nested pattern of diversity. OTU diversity scaled with area followed a power function with slopesz = 0.42 and 0.47.

Main conclusions We demonstrate a non‐ubiquitous dispersal for soil prokaryotes, which suggests a complex biogeography similar to that found for terrestrial vertebrates.
WITCHES AND ZOMBIES OF THE SOUTH AFRICAN LOWVELD: DISCOURSE, ACCUSATIONS AND SUBJECTIVE REALITY
Authors: Niehaus Isak
Published: May 2005

Anthropological studies generally interpret discourses about witches and zombies in sub‐Saharan Africa as critical commentary on the emergence of new forms of wealth, the commodification of labour, and the crisis of reproduction. Drawing on data collected in the Bushbuckridge area of the South African lowveld, I point to the limitations of these arguments and suggest that we can more fully capture the diverse and contradictory meanings of witches and zombies by separating discourses from actual accusations and from subjective realities. Whilst generic discourses highlight the use of zombies as a means of accumulating wealth, those accused of witchcraft are nearly always subordinate and impoverished persons who allegedly keep zombies as a means of survival. At the same time, these beliefs are connected to powerful psychological motivations, such as emotionally overwhelming experiences of bereavement, loss, and mourning. I suggest that witches and zombies derive their broad appeal from indeterminacy that defies interpretive control and constantly allows for alternative interpretations.
BURSTING THE BUBBLE: THE SOCIO‐CULTURAL CONTEXT OF ECOTOURISM
Authors: Carrier James G. , Macleod Donald V.L.
Published: May 2005

Ecotourism is a form of tourism that is highly visible and growing rapidly. It is commonly presented and understood as very different from conventional mass tourism because it is especially responsible, and even beneficial, environmentally and socio‐culturally. However, such a view may be inaccurate. The favourable image of ecotourism is a consequence of viewing it in an ecotourist bubble, analogous to the idea of the tourist bubble. Within this ecotourist bubble, the destinations and experiences sold to tourists are abstracted from their contexts, thus inducing a distorted image of them and of ecotourism itself. Aspects of what the bubble excludes are illustrated through a consideration of two destinations in the Caribbean.