bluuebunny/crossref_metadata_2025 huggingface dataset:
Apo B versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the thirty‐person/ten‐country panel
Authors: BARTER P. J. , BALLANTYNE C. M. , CARMENA R. , CABEZAS M. CASTRO , CHAPMAN M. JOHN , COUTURE P. , DE GRAAF J. , DURRINGTON P. N. , FAERGEMAN O. , FROHLICH J. , FURBERG C. D. , GAGNE C. , HAFFNER S. M. , HUMPHRIES S. E. , JUNGNER I. , KRAUSS R. M. , KWITEROVICH P. , MARCOVINA S. , PACKARD C. J. , PEARSON T. A. , REDDY K. SRINATH , ROSENSON R. , SARRAFZADEGAN N. , SNIDERMAN A. D. , STALENHOEF A. F. , STEIN E. , TALMUD P. J. , TONKIN A. M. , WALLDIUS G. , WILLIAMS K. M. S.
Published: February 2006

There is abundant evidence that the risk of atherosclerotic vascular disease is directly related to plasma cholesterol levels. Accordingly, all of the national and transnational screening and therapeutic guidelines are based on total or LDL cholesterol. This presumes that cholesterol is the most important lipoprotein‐related proatherogenic risk variable. On the contrary, risk appears to be more directly related to the number of circulating atherogenic particles that contact and enter the arterial wall than to the measured concentration of cholesterol in these lipoprotein fractions. Each of the atherogenic lipoprotein particles contains a single molecule of apolipoprotein (apo) B and therefore the concentration of apo B provides a direct measure of the number of circulating atherogenic lipoproteins. Evidence from fundamental, epidemiological and clinical trial studies indicates that apo B is superior to any of the cholesterol indices to recognize those at increased risk of vascular disease and to judge the adequacy of lipid‐lowering therapy. On the basis of this evidence, we believe that apo B should be included in all guidelines as an indicator of cardiovascular risk. In addition, the present target adopted by the Canadian guideline groups of an apo B <90 mg dL−1 in high‐risk patients should be reassessed in the light of the new clinical trial results and a new ultra‐low target of <80 mg dL−1 be considered. The evidence also indicates that the apo B/apo A‐I ratio is superior to any of the conventional cholesterol ratios in patients without symptomatic vascular disease or diabetes to evaluate the lipoprotein‐related risk of vascular disease.
Does cytomegalovirus play a causative role in the development of various inflammatory diseases and cancer?
Authors: SÖDERBERG‐NAUCLÉR C.
Published: February 2006

Human cytomegalovirus (HCMV) is a herpes virus that infects and is carried by 70–100% of the world's population. During its evolution, this virus has developed mechanisms that allow it to survive in an immunocompetent host. For many years, HCMV was not considered to be a major human pathogen, as it appeared to cause only rare cases of HCMV inclusion disease in neonates. However, HCMV is poorly adapted for survival in the immunosuppressed host and has emerged as an important human pathogen in AIDS patients and in patients undergoing immunosuppressive therapy following organ or bone marrow transplantation. HCMV‐mediated disease in such patients has highlighted the possible role of this virus in the development of other diseases, in particular inflammatory diseases such as vascular diseases, autoimmune diseases and, more recently, with certain forms of cancers. Current research is focused on determining whether HCMV plays a causative role in these diseases or is merely an epiphenomenon of inflammation. Inflammation plays a central role in the pathogenesis of HCMV. This virus has developed a number of mechanisms that enable it to hide from the cells of the immune system and, at the same time, reactivation of a latent infection requires immune activation. Numerous products of the HCMV genome are devoted to control central functions of the innate and adaptive immune responses. By influencing the regulation of various cellular processes including the cell cycle, apoptosis and migration as well as tumour invasiveness and angiogenesis, HCMV may participate in disease development. Thus, the various drugs now available for treatment of HCMV disease (e.g. ganciclovir, acyclovir and foscarnet), may also prove to be useful in the treatment of other, more widespread diseases.
The aftermath of the Carnian carbonate platform demise: a basinal perspective (Dolomites, Southern Alps)
Authors: KEIM LORENZ , SPÖTL CHRISTOPH , BRANDNER RAINER
Published: February 2006

In the Dolomites of northernmost Italy the carbonate‐platform growth came to a standstill late in the Early Carnian (Late Triassic). The response to this shutdown of shallow‐water carbonate production in the interplatform basins is largely unknown because erosion has removed most of the soft basinal sediments, giving rise to today's scenic landscape of the Dolomites. Mapping in the central part of the Dolomites and newly available core material has recently revealed a well‐preserved succession of basinal rocks within the Heiligkreuz Hospiz Basin (ital. Ospizio di Santa Croce Basin). In this paper, the regional depositional nature of arrested carbonate platform production is reconstructed by tracing its sedimentological record across the slope and into the basin. The uppermost St. Cassian Formation, the time‐equivalent basinal rocks to the prograding carbonate platforms, is overlain by the Heiligkreuz Formation, whose basal succession was deposited in a restricted and oxygen‐depleted environment immediately post‐dating the platform demise. The succession consists mainly of mudrocks, marlstones, and peloidal packstones, with abundant low‐diversity ostracod and pelecypod fauna and early diagenetic dolomite. C and O isotope values of the basal Heiligkreuz Formation, post‐dating platform demise, average + 2·4 and − 2·4‰, respectively, and largely overlap the isotopic composition of St. Cassian carbonates. A shift toward slightly lowerδ13C values in the Heiligkreuz Formation may reflect incorporation of isotopically depleted C released during bacterial sulphate reduction in the Heiligkreuz sediments. Sedimentological, palaeobiological and geochemical indices suggest that near‐normal marine conditions persisted long after the shutdown of shallow water carbonate‐platform growth, although there are clear indications of severely reduced oxygen levels in the restricted Heiligkreuz Hospiz interplatform basin. The Early Carnian platform demise induced a distinct switch in the locus of carbonate production from the shallow‐water platform and slope to the basin floor and a decrease in the availability of dissolved oxygen in the basinal waters. It is inferred that anoxia extended at least temporarily to the top of the carbonate slope, as indicated by the onlap of normal‐marine mounds by dark marlstones of the basal Heiligkreuz Formation.
The orientation of helical flow in curved channels
Authors: CORNEY RANSOME K. T. , PEAKALL JEFFREY , PARSONS DANIEL R. , ELLIOTT LIONEL , AMOS KATHRYN J. , BEST JAMES L. , KEEVIL GARETH M. , INGHAM DEREK B.
Published: February 2006

The planform patterns of meandering submarine channels and subaerial fluvial bends show many similarities that have given rise to strong analogies concerning the fluid dynamics of these channel types. Existing models of helical motion in open‐channel bends depict flow that is characterized by surface flow towards the outer bank, and basal flow towards the inner bank. This paper investigates and compares, through an analytical model and physical experiment, flows within fluvial meanders, and submarine channel bends that contain density‐driven gravity currents. The results indicate that the sense of helical motion can be reversed in submarine bends that contain density currents when compared with fluvial bends, and that the orientation of the helical flow is dependent on the vertical distribution of downstream velocity. Specifically, the sense of helical motion is reversed in bends when the maximum downstream velocity is near the bed, resulting in near‐bed flow towards the outer bank. These findings suggest that the dynamics of sediment transport and deposition in curved channels with such velocity profiles will be fundamentally different to those currently assumed from sinuous open‐channels.
Patterns of variation in wing morphology in the cactophilic Drosophila buzzatii and its sibling D. koepferae
Authors: Carreira V. P. , Soto I. M. , Hasson E. , Fanara J. J.
Published: February 2006

Drosophila buzzatii and D. koepferae are two sibling species that breed on the necrotic tissues of several cactus species and show a certain degree of niche overlap. Also, they show differences in several life history traits, such as body size and developmental time, which probably evolved as a consequence of adaptation to different host plants. In this work we investigate the ecological and genetic factors affecting wing morphology variation both within and between species. Three wing traits were scored, distal and proximal wing length and width in isofemale lines reared in two of the most important host cacti: Opuntia sulphurea and Trichocereus terschekii. Our results revealed that differences between species and sexes in wing size and shape were significant, whereas the cactus factor was only significant for wing size. Intraspecific analyses showed that differences among isofemale lines were highly significant for both size and shape in both species, suggesting that an important fraction of variation in wing morphology has a genetic basis. Moreover, the line by cactus interaction, which can be interpreted as a genotype by environment interaction, also accounted for a significant proportion of variation. In summary, our study shows that wing size is phenotypically plastic and that populations of D. buzzatii and D. koepferae harbour substantial amounts of genetic variation for wing size and shape. Interspecific differences in wing size and shape are interpreted in terms of spatial predictability of the different host plants in nature.
The Aum Cult leader Asahara's mental deviation and its social relations
Authors: AKIMOTO HARUO
Published: February 2006

Abstract  This paper is a further discussion of the author's previous reports on the crimes committed by the Asahara‐Aum Cult. First, the motivations of Asahara‐Aum crimes, in particular those of murders, and their abnormality beyond the realm of criminology are ascertained. Second, psychopathology of the leader, Asahara, was considered, and it was assumed that Asahara was affected with the syndrome of pseudologia phantastica which was confirmed by his strange attitude during his trials. Third, the mental status of Asahara after the first trial was investigated, and some evidence was found that his mental status was so severe as to be ‘unfit to plead’ that psychiatric evaluation and treatment would be necessary. Fourth, the reasons for making people, in particular scientific elites, fascinated with Asahara and the Aum Cult were scrutinized and some clues were described. Finally, the problem that Aum has survived under the name of Aleph, how heavy capital punishment for Leader Asahara is appropriate, and that reparations for victims of Asahara‐Aum crimes are urgent from the standpoint of social psychiatry, are discussed.
Quantification analysis of 123I‐IPT single photon emission computed tomography uptake in the striatum of parkinsonism with the standard magnetic resonance template
Authors: JUH RAHYEONG , PAE CHI‐UN , LEE CHANG UK , KIM JAESUNG , MOON DAEHYUK , SUH TAESUK , CHOE BOYOUNG
Published: February 2006

Abstract  This study evaluated the striatal specific binding ratio (SBR), the anterior to posterior ratio of the striatum (APR) and its reproducibility by employing a template‐based registration (TBR) method using the coregistered to the standard T1 magnetic resonance (MR) template (SMRT) as a replacement for the MR image of each patient. The 123I‐IPT single photon emission computed tomography (SPECT) images of 30 patients with Idiopathic Parkinson's disease (IPD) and 11 normal controls were analyzed. The region of interest (ROI) was positioned manually in the same slice showing the highest striatal activity using the manual ROI method, while the ROI were positioned automatically in the mid striatal slice of the SPECT image coregistered to the SMRT. The SBR obtained using the TBR method showed a strong correlation with those using the manual method in all groups: normal controls (r = 0.851, P = 0.001), early IPD (r = 0.841, P < 0.001), and severe IPD (r = 0.702, P = 0.007). The APR obtained by the TBR correlated with those using the manual method in only the early IPD (r = 0.72, P = 0.001), while those obtained using the manual method showed no correlation in the three groups (P > 0.05). The reproducibility (rmsCV) of the TBR method was 7.2% (normal controls, 5.2%; mild IPD, 4.2%; severe IPD, 10.8%), while the reproducibility of the manual method was 31% (normal controls, 19.7%; mild IPD, 21.7%; severe IPD, 46.2%). This shows that the use of 123I‐IPT SPECT for assessing IPD is affected by the method used to position the striatal ROI. This study showed that the TBR method using the SMRT is useful in diagnosing the IPD and assessing the disease severity with a high reproducibility, indicating a possibility of using the TBR method as a good replacement for the manual method.
Characteristics of the sensory‐motor, verbal and cognitive abilities of preschool boys with attention deficit/hyperactivity disorder combined type
Authors: IWANAGA RYOICHIRO , OZAWA HIROKI , KAWASAKI CHISATO , TSUCHIDA REIKO
Published: February 2006

Abstract  The purpose of this study is to clarify the characteristics of sensory‐motor, verbal and cognitive abilities of preschool boys with attention‐deficit/hyperactivity disorder (ADHD) in order to provide information for their treatment and education at preschool age by teachers and professionals. For this purpose, 46 Japanese boys with ADHD‐combined type (ADHD‐C) whose ages ranged from 45 to 72 months were examined using the Japanese version of the Miller Assessment for Preschoolers (JMAP), and were compared with 46 Japanese boys matched for age and gender in the normative samples that served as the standardizations for the JMAP. The results showed that the ADHD‐C group was significantly lower than the normative sample group both on the Total score and on each Index score (P < 0.01) with the exception of the Non‐verbal Index. In particular, the number of boys with ADHD‐C scoring below the 5th percentile on the Foundation Index (i.e. fundamental sensory‐motor tests) was the highest among all index scores. The ADHD‐C group had significantly lower scores than the normative sample group in equilibrium, postural control, fine motor of hand and tongue, motor praxis, articulation, memory related to the comprehension of long sentences, and visual construction. Because fundamental sensory‐motor abilities were notably lower in the ADHD‐C group than in the normative sample group, it is suggested that preschool boys with ADHD‐C should be examined and treated for sensory‐motor disabilities.
Factors associated with alcohol consumption, problem drinking, and related consequences among high school students in Taiwan
Authors: YEH MEI‐YU
Published: February 2006

Abstract  This research evaluated the risk factors associated with alcohol consumption, problem drinking, and related consequences among high school students in Taiwan. A total of 779 10th grade students from four randomly selected high schools in eastern Taiwan were included in the survey. Survey data were self‐reported by students and analyzed using logistic regression methods. The results showed that alcohol consumption and problem drinking was 2.22–2.71‐fold greater in male than in female adolescents. Parents and peer groups were the determinants influencing alcohol consumption, and these influences could be enhanced particularly by the drinking behaviors of fathers and peer groups, and the relationship of students with their peer groups. The probability of developing adolescent problem drinking was fourfold greater in students whose fathers had habits of drinking. Ethnicity had a notable impact on the risk of problem drinking. The occurrence of problem drinking among indigenous adolescents was 2.98‐fold higher than among Hans, indicating a diversity of biological factors, social norms, and expectation for alcohol drinking between these two ethnic groups. This study suggests that a policy for preventing alcohol abuse among high school students should start by addressing the two major associated problems: a need to earn peer group recognition, and the lack of family support among at‐risk students.
Prepulse inhibition of acoustic startle response in mild cognitive impairment and mild dementia of Alzheimer type
Authors: UEKI AKINORI , GOTO KYOKO , SATO NORIKO , ISO HIROYUKI , MORITA YOSHIO
Published: February 2006

Abstract Amnestic mild cognitive impairment (MCI) describes the condition of memory‐impaired individuals who otherwise function well and do not meet the clinical criteria for dementia. Such individuals are considered to represent a transitional stage between normal aging and dementia of Alzheimer type (DAT). Neurobiologic changes in amnestic MCI, and their significance for psychophysiologic function, are poorly understood. In this study, the authors compared acoustic prepulse inhibition (PPI) between subjects with amnestic MCI and mild DAT to characterize sensorimotor gating. The acoustic startle reflex, which the authors measured using an accelerometer and electromyogram, involves whole‐body movement and eye blink in response to a sudden loud noise (115 dB). PPI is inhibition of this reflex by a softer noise (prepulse; 85 dB) preceding the startle stimulus by 30 ms. PPI was examined in 30 controls, 20 subjects with amnestic MCI, and 20 subjects with mild DAT. Neither amnestic MCI nor mild DAT affected startle movement amplitude. Subjects with amnestic MCI showed significantly enhanced PPI (gating facilitation), while subjects with mild DAT exhibited significantly less PPI than controls (gating deficit). This pattern of PPI changes suggests that neuropathologic changes in the limbic cortex, mainly the entorhinal cortex, at the earliest stage of DAT might be responsible for PPI abnormalities via disturbed regulation of the limbic cortico‐striato‐pallido‐pontine circuitry. Startle PPI changes could be used as a biologic marker for amnestic MCI and mild DAT.
Relation between social functioning and neurocognitive test results using the Optional Thinking Test in schizophrenia
Authors: CHINO BUN , MIZUNO MASAFUMI , NEMOTO TAKAHIRO , YAMASHITA CHIYO , KASHIMA HARUO
Published: February 2006

Abstract The current study investigated the relationship between clinical evaluations of social functioning and neurocognitive test results, including various fluency tests for assessing divergent thinking, in patients with schizophrenia. The Optional Thinking Test (OTT) was used to measure the ability of individuals to conceive of alternatives. This test assesses alternative thinking, or the capacity to generate solutions to problems. The current study examined 36 schizophrenia patients and 25 normal subjects using the Mini‐Mental State Examination (MMSE), the Rey Auditory Verbal Learning Test (RAVLT), the Letter Cancellation Test (LCT), the Letter and Category Fluency Tests, and the OTT for neurocognitive assessment, as well as the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Social Functioning Scale (SFS), and the Life Assessment Scale for the Mentally Ill – Interpersonal Relations (LASMI‐I) for clinical measures. The schizophrenia patients had significantly poorer performances on the MMSE, RAVLT, LCT (time), fluency tests, and OTT than the controls. In the OTT, the proportions of classified strategies were indistinguishable between the schizophrenia patients and the controls. Alternative thinking, as measured by the OTT, was correlated with verbal fluency and attention but was not correlated with the social functioning scores (GAF, SFS, LASMI‐I), whereas the Means‐Ends Problem‐Solving was correlated with the GAF in schizophrenia. Patients with schizophrenia could conceive of the same categories of alternatives as healthy people, but could not conceive as many alternatives.
Prefrontal cognition in schizophrenia and bipolar illness in relation to Val66Met polymorphism of the brain‐derived neurotrophic factor gene
Authors: RYBAKOWSKI JANUSZ K. , BORKOWSKA ALINA , SKIBINSKA MARIA , SZCZEPANKIEWICZ ALEKSANDRA , KAPELSKI PAWEL , LESZCZYNSKA‐RODZIEWICZ ANNA , CZERSKI PIOTR M. , HAUSER JOANNA
Published: February 2006

Abstract  The measures of prefrontal cognition have been used as endophenotype in molecular‐genetic studies. Brain‐derived neurotrophic factor (BDNF) has been implicated in cognitive functions and in the pathogenesis of major psychoses. This study investigates the relationship between Val66Met polymorphisms of the BDNF gene and prefrontal cognitive function in 129 patients with schizophrenia and 111 patients with bipolar mood disorder. Cognitive tests included the Wisconsin Card Sorting Test (WCST), with such domains as number of perseverative errors, non‐perseverative errors, completed corrected categories, conceptual level responses, and set to the first category, and the N‐back test, where mean reaction time and percent of correct reactions were measured. Genotyping for Val66Met BDNF polymorphism was done by polymerase chain reaction method. In schizophrenia, no relationship between Val66Met polymorphism of the BDNF gene and the results of the WCST was observed. Patients with Val/Val genotype had a higher percentage of correct reactions in the N‐back test than those with the remaining genotypes. Bipolar patients with Val/Val genotype obtained significantly better results on three of five domains of the WCST. No relationship between BDNF polymorphism and the results of the N‐back test was found in this group. A limitation to the results could be variable psychopathological state and medication during cognitive testing and lack of Hardy–Weinberg equilibrium in schizophrenia group. Val66Met polymorphism of the BDNF gene may be associated with cognitive performance on the WCST in bipolar mood disorder but not in schizophrenia. An association of this polymorphism with performance on the N‐back test in schizophrenia and not in bipolar illness may suggest that in schizophrenia, the BDNF system may be connected with early phases of information processing.
Lifetime posttraumatic stress disorder in Turkish alcohol‐dependent inpatients: Relationship with depression, anxiety and erectile dysfunction
Authors: EVREN CUNEYT , CAN SUAT , EVREN BILGE , SAATCIOGLU OMER , CAKMAK DURAN
Published: February 2006

Abstract  The aim of the present study was to evaluate the prevalence of lifetime posttraumatic stress disorder (PTSD) in Turkish male alcohol‐dependent inpatients, and to investigate the relationship of lifetime PTSD diagnosis with anxiety, depression, hopelessness, erectile dysfunction and psychosocial problems related with alcohol dependency. Eighty‐two male inpatients who met DSM‐IV criteria for alcohol dependence and 48 subjects without substance use disorder as a control group were included in the study. Subjects were applied the Hamilton Depression Rating Scale (HAM‐D), the Hamilton Anxiety Rating Scale (HAM‐A), the Michigan Alcoholism Screening Test (MAST), the Beck Hopelessness Scale (BHS) and the International Index of Erectile Function (IIEF). Rate of lifetime PTSD diagnosis was found to be 26.8% among alcohol‐dependent inpatients. The mean age of patients with lifetime PTSD was lower than in patients without this diagnosis, while there were no significant differences between these two groups in terms of age of first alcohol use, lifetime major depression, current depression, presence and severity of erectile dysfunction. Mean scores of HAM‐D, HAM‐A, BHS and MAST in the group with lifetime PTSD were significantly higher than the group without this diagnosis. There was a positive relationship between lifetime PTSD diagnosis and depression, anxiety, hopelessness and severity of psychosocial problems related to alcohol dependency, while there was no relationship between lifetime PTSD comorbidity and erectile dysfunction in alcohol‐dependent patients.
Suicide in Thailand during the period 1998–2003
Authors: LOTRAKUL MANOTE
Published: February 2006

Abstract  The aim of this study was to examine the characteristic features of suicides in Thailand between 1998 and 2003. Collected data during 1998–2003 from the Bureau of Policy and Strategy, Ministry of Public Health were analyzed to reveal the mortality from suicide according to age, gender, rate and methods of suicides. Suicide rates were found to have increased to a peak of 8.6 per 100 000 (5290 suicides) in 1999 and then to have decreased to 7.1 per 100 000 in 2003. The average suicide rate during 1998–2003 was 7.9 per 100 000 with a male to female ratio of 3.4:1. Male suicide reached a peak for those aged 25–29 years (21.9 per 100 000) while female suicide showed less variation with age. Hanging was the most common method used, followed by ingestion of agricultural toxic substances. Suicide was most prevalent in upper northern region where HIV infection might be related to the high prevalence. Suicide prevention program should focus on males in early adulthood, and particular measures should be conducted to reduce risk factors related to HIV infection among people in northern Thailand.
Beneficial effects of perospirone on aggressive behavior associated with dementia
Authors: SATO SHINJI , MIZUKAMI KATSUYOSHI , MORO KAZUO , TANAKA YOSHIRO , ASADA TAKASHI
Published: February 2006

Abstract  The aim of this study was to assess the efficacy of the serotonin‐dopamine antagonist perospirone in treating aggressive and agitated behavior in patients with dementia. Six patients were referred to the outpatient clinic of Ishizaki Hospital and were followed for 6 weeks. Their psychiatric diagnoses were made using the DSM‐IV. Their behavioral symptoms and degrees of cognitive impairment were measured using the Behavioral Pathology in Alzheimer's Disease (BEHAVE‐AD) and the Mini‐Mental Examination State. The changes in BEHAVE‐AD scores were investigated. Maximum benefit was achieved at a mean perospirone dose of 9.0 mg/day. No patient experienced severe adverse effects. Post‐hoc analysis showed significant improvement in the total BEHAVE‐AD and aggressiveness subscale scores within 2 weeks. This study suggests that perospirone is effective in improving aggressive and agitated behavioral symptoms in demented patients and is safe to use in elderly patients.
Local community intervention through depression screening and group activity for elderly suicide prevention
Authors: OYAMA HIROFUMI , ONO YUTAKA , WATANABE NAOKI , TANAKA ERIKO , KUDOH SEIJIRO , SAKASHITA TOMOE , SAKAMOTO SHINJI , NEICHI KEIKO , SATOH KYOKO , NAKAMURA KENJI , YOSHIMURA KIMIO
Published: February 2006

Abstract  This study aims to evaluate outcomes of a community‐based program to prevent suicide among the elderly (≥65 years old) using a quasi‐experimental design with two neighboring references. During 1999–2004, the program including depression screening and group activity was conducted by the public health nurses in the Minami district (population 1685) of Nagawa town, rural Japan. Pre‐post changes in the risk of completing suicide were estimated by the incidence rate ratios (IRR). The risk for Minami's elderly females was reduced by 74% (age‐adjusted IRR, 0.26; 90% CI, 0.07–0.98) more than the historical trend, while there was no change in the risk of Minami's males and nor in the male or female references. The local intervention using public health nursing would be effective against suicide for elderly females without diffusing to the surroundings.
Group A beta hemolytic streptococcal infections and obsessive‐compulsive symptoms in a Turkish pediatric population
Authors: ABALI OSMAN , NAZIK HASAN , GURKAN KAGAN , UNUVAR EMIN , SIDAL MUJGAN , ONGEN BETIGUL , OGUZ FATMA , TUZUN UMRAN
Published: February 2006

Abstract  The purpose of the present study was to evaluate obsessive‐compulsive disease (OCD) in Turkish Children who had group A beta hemolytic streptococcal (GABHS) infections and those who had not. Thirty‐one children and adolescents (the study group) were compared with 28 children and adolescents. The Children's Yale‐Brown Obsessive‐Compulsive Scale (CY‐BOCS) scores were rated between study group and control group. The mean score, obsession and compulsion scores of CY‐BOCS in the study group were significantly higher than they were in the control group (P < 0.05). The GABHS infections should be assessed in the etiology of OCD in children. Considering GABHS infections may help the treatment of OCD.
Cardiac resynchronisation therapy for heart failure
Authors: Mariani J. A. , Gould P. A. , Broughton A. , Kaye D. M.
Published: February 2006

Heart failure (HF) is increasingly common and, despite advances in pharmacotherapeutic management, often progresses. Progression is marked by structural and electrical changes–remodelling. In approximately one‐third of patients, ventricular dilatation is accompanied by intraventricular conduction delays, most commonly the left bundle branch block (LBBB). The presence of LBBB is associated with mechanical dyssynchrony of the heart. Cardiac resynchronisation therapy (CRT), the use of special pacemakers with or without implantable cardioverter defibrillators, aims to resynchronise the failing heart, improving myocardial contraction without increased energetics. Several, large, randomised clinical trials have now established the benefit of CRT in a select group of HF patients, providing functional and, recently shown, mortality benefits. However, a substantial proportion of patients are considered non‐responders to CRT, and studies are now underway to identify the patients most likely to respond to CRT.
Consent in crisis: the need to reconceptualize consent to tissue banking research
Authors: Lipworth W. , Ankeny R. , Kerridge I.
Published: February 2006

The issues surrounding consent to tissue banking research in Australia are complex and have created a forum of intense debate, thus providing a window of opportunity to critically appraise and challenge standard models of consent for research in general and for tissue banking research in particular. The usual practical difficulties associated with meeting the criteria for valid consent to research (including adequate information provision and voluntariness) are amplified in the case of tissue banking research. A number of models, based on widely accepted ethical principles, have been proposed to improve the process of obtaining consent to tissue banking research, all of which assume that the consent ofindividualtissue donors is needed to meet the criteria for valid consent. Feminist and communitarian theories use many of the same criteria for valid consent but interpret these criteria differently and de‐emphasize the importance of individual autonomy as the central criterion for valid consent. An enriched model of consent incorporating feminist and communitarian ideas could satisfy the currently accepted criteria for valid consent while also furthering a broader range of community values.
An apparently sporadic paraganglioma with an SDHB gene germline mutation presenting at age 68 years
Authors: Elston M. S. , Benn D. , Robinson B. G. , Conaglen J. V.
Published: February 2006

Paragangliomas (PGLs) are rare tumours arising from parasympathetic‐associated paraganglia (particularly of the head and neck) or from sympathetic‐associated paraganglia such as in the adrenal medulla when they are termed phaeochromocytomas and at extra‐adrenal sites in the abdomen and thorax. Recent reports have found frequent germline mutations of VHL, RET, SDHB or SDHD not only in familial cases but also in apparently sporadic cases of phaeochromocytoma. These germline mutations are particularly likely to be found if multifocal disease is present or if the phaeochromocytoma or PGL occurs at a young age. We report a germline splice site mutation in SDHB in a patient presenting with an incidental, apparently sporadic, abdominal sympathetic PGL at 68 years of age.
Early patency rates after the two‐suture invagination technique of vaso‐epididymal anastomosis for idiopathic obstruction
Authors: KUMAR RAJEEV , GAUTAM GAGAN , GUPTA NARMADA P.
Published: February 2006

OBJECTIVES

To prospectively evaluate the results of vaso‐epididymostomy, using a two‐suture microsurgical invagination technique, when used for men with azoospermia due to an obstruction at the vaso‐epididymal junction.

PATIENTS AND METHODS

Between December 2002 and November 2004, 29 men with idiopathic obstructive azoospermia underwent vaso‐epididymostomy with the two‐suture invagination technique. The patency rate was assessed by return of sperm in the semen after surgery.

RESULTS

In all, 23 men provided at least one postoperative semen sample. The mean (range) follow‐up was 7.6 (1.5–30) months. In 11 of these men (48%), patency was shown at a mean of 3.2 (1.5–7) months after surgery. The median sperm density was 17 (10–65)  million/mL. Four men had normal sperm density and motility (>20 million/mL; >50% total motility).

CONCLUSIONS

Men with idiopathic vaso‐epididymal junction obstruction can have significant sperm positivity after vaso‐epididymostomy. With a patency rate of nearly half within a year of surgery, vaso‐epididymostomy should be the first line of therapy for these men.
Effects of long‐term vardenafil treatment on the development of fibrotic plaques in a rat model of Peyronie's disease
Authors: FERRINI MONICA G. , KOVANECZ ISTVAN , NOLAZCO GABY , RAJFER JACOB , GONZALEZ‐CADAVID NESTOR. F.
Published: February 2006

OBJECTIVES

To determine whether the phosphodiesterase‐5 (PDE5) inhibitor, vardenafil, given orally and in different regimens, has a similar effect to that of the PDE5 inhibitor sildenafil, which prevented the development of a Peyronie's disease (PD)‐like plaque formation induced by injecting transforming growth factor β1 (TGF‐β1) into the tunica albuginea of the rat.

MATERIALS AND METHODS

Vardenafil was given to male rats (eight per group) either in the drinking water or as an oral instillation once daily, at ≈ 1 and ≈ 3 mg/kg/day for 45 days after one injection with TGF‐β1 into the tunica albuginea, as an ‘early preventive’ treatment for TGF‐β1‐induced formation of a PD‐like plaque. Other groups received the two doses of vardenafil only in the drinking water, starting with a well‐formed plaque, for 42 days (‘late, therapeutic’ administration). Sections of penile tissue were stained histochemically or immunohistochemically, followed by quantitative image analysis for collagen/smooth muscle and collagen III/I ratios, myofibroblast content (α‐smooth muscle actin), TGF‐β1 expression, and apoptotic index.

RESULTS

Preventative treatment with vardenafil at the higher dose (both continuous and once‐daily treatments) reduced the collagen/smooth muscle and collagen III/I ratios, and the numbers of myofibroblasts and TGF‐β1‐positive cells, and selectively increased the apoptotic index in the PD‐like plaque. The lower dose was less effective, When vardenafil was given continuously in the drinking water for 41 days after the PD‐like plaque was formed, there was only a partial reduction of the plaque.

CONCLUSIONS

Long‐term oral treatment with vardenafil slows and reverses the early stages of an experimental PD‐like plaque in the rat, and might ameliorate a more advanced plaque.
Immediate administration of intravesical mitomycin C after tumour resection for superficial bladder cancer
Authors: MOSTAFID A. HUGH , RAJKUMAR RAJ G.N. , STEWART ALISTAIR B. , SINGH RAJ
Published: February 2006

OBJECTIVE

To assess the feasibility and safety of administering intravesical mitomycin C in theatre immediately after transurethral resection of bladder tumour (TURBT).

PATIENTS AND METHODS

A protocol was developed to allow the safe administration of mitomycin C in theatre immediately after TURBT. Over a 32‐month period all patients not excluded by the protocol were given mitomycin C in theatre after TURBT, and any adverse events reported.

RESULTS

In all, 177 instillations were carried out; there were two minor patient‐related complications, and no staff‐related adverse events.

CONCLUSION

The immediate administration of mitomycin C in theatre after TURBT is feasible and safe for patients and staff. It provides the earliest and surest prophylaxis against tumour cell re‐implantation at TURBT.
Laparoscopic robotic‐assisted management of pelvi‐ureteric junction obstruction in patients with horseshoe kidneys: technique and 1‐year follow‐up
Authors: CHAMMAS MARIO , FEUILLU BENOIT , COISSARD ALAIN , HUBERT JACQUES
Published: February 2006

Authors from France describe their experience, in a small series of patients with pelvi‐ureteric junction obstruction, of laparoscopic robotic‐assisted pyeloplasty, and present their operative results with a 1‐year follow‐up.

The accuracy of MRI renal angiography and venography in predicting vascular anatomy before donor nephrectomy is presented by authors from the UK. They present evidence suggesting that this technique has the advantage over CT of having virtually no side‐effects, and felt it was a good investigation.

OBJECTIVE

To report our experience with laparoscopic robotic‐assisted management of pelvi‐ureteric junction obstruction (PUJO) in patients with horseshoe kidneys.

PATIENTS AND METHODS

Between January 2002 and May 2003, two men and a woman with horseshoe kidneys (mean age 44.6 years) had laparoscopic dismembered pyeloplasty with robotic assistance for PUJO with no division of the isthmus. Two patients had renal stones which were extracted during surgery. None of the patients had had previous abdominal surgery.

RESULTS

The mean operative duration was 148.3 min, the mean estimated blood loss was <100 mL and the mean hospital stay was 7.6 days. Renal function was preserved in all three patients during the immediate and long‐term follow‐up as measured by intravenous urography. The three patients had durable clinical and radiographic success during a mean follow‐up of 21 months. One patient needed complementary extracorporeal shockwave lithotripsy, and one had an episode of pyelonephritis, which was treated successfully. There were no other significant complications before or after surgery.

CONCLUSION

Laparoscopic robotic‐assisted pyeloplasty for horseshoe kidney is safe and feasible, offering the advantages of minimally invasive surgical procedures with enhanced laparoscopic skills related to the use of the robot.
Risk factors for Peyronie's disease: a case‐control study
Authors: BJEKIC MILAN D. , VLAJINAC HRISTINA D. , SIPETIC SANDRA B. , MARINKOVIC JELENA M.
Published: February 2006

OBJECTIVE

To test some hypotheses about risk factors for Peyronie's disease (PD).

PATIENTS AND METHODS

In a case‐control study, 82 patients with PD, consecutively diagnosed at the first author's institution, were compared with 246 men visiting the same institution for dermatological diseases. Univariate and multivariate logistic regression analyses were used to assess the data.

RESULTS

From the multivariate logistic regression analysis the risk factors for PD were: a history of genital and/or perineal injuries, transurethral prostatectomy, cystoscopy, diabetes mellitus, hypertension, lipoma, propranolol in therapy, Dupuytren's contracture in the medical history, ever having smoked, alcohol consumption, fibromatous lesions of the genital tract of the partner, and surgical intervention on the genital tract of the partner.

CONCLUSION

The results of the present study are in line with the hypothesis that, in addition to genetic predisposition, trauma of the penis and systemic vascular diseases are risk factors for PD. Smoking and alcohol consumption also seem to have some role in the development of the disease.
A new fast‐melting oral formulation of desmopressin: a pharmacodynamic study in children with primary nocturnal enuresis
Authors: VANDE WALLE JOHAN G.J. , BOGAERT GUY A. , MATTSSON SVEN , SCHURMANS THIERRY , HOEBEKE PIET , DEBOE VEERLE , NORGAARD JENS PETER ,   the ‘Desmopressin oral lyophilisate PD/PK study group’
Published: February 2006

OBJECTIVE

To determine the pharmacodynamic properties of a new oral lyophilisate formulation of desmopressin (in single doses of 30, 60, 120, 240, 360 or 480 µg) in children with known primary nocturnal enuresis (PNE) and thus identify those dosages that could provide a duration of action corresponding to a typical length of night‐time sleep in children with PNE; additional objectives were to determine the safety and tolerability of desmopressin in this population.

PATIENTS AND METHODS

Children with PNE (mean three or more wet nights/week), aged 6–12 years, were randomized into a double‐blind, placebo‐controlled study. An overhydration technique was used before dosing to suppress endogenous vasopressin production and thereby ensure that any antidiuresis could be attributed to treatment. Dosing with desmopressin or placebo occurred when urinary production was >0.13 mL/min/kg. Urinary volume, osmolality and duration of urinary‐concentrating action (above three threshold levels: 125, 200 and 400 mOsm/kg) were determined as endpoints.

RESULTS

All 72 participants receiving desmopressin had a pharmacodynamic response to the drug, while there was no change in urinary output in the 12 placebo‐treated patients. There was a clear relationship between desmopressin dose and duration of action and osmolality during action, although the three highest‐dose groups had similar results. The mean duration of action of desmopressin at the lowest osmolality threshold level was 3.6–10.6 h, according to dose; for the highest threshold, the values were 1.3–8.6 h.

CONCLUSION

Desmopressin, as the oral lyophilisate, causes a marked decrease in urinary output in hydrated children with PNE. A small dose range (120–240 µg) is likely to control diuresis for a period corresponding to a night's sleep (7–11 h) in most children with PNE. However, some patients might require a higher dose to obtain antidiuresis for the complete night.
The ‘learning curve’ in hypospadias surgery
Authors: HOROWITZ MARK , SALZHAUER ELAN
Published: February 2006

For urologists who do not perform hypospadias surgery, the number of techniques which has been described may seem astonishing, but each one seems to have added something new to the art of penile and urethral reconstruction in these children. The authors from the USA describe the learning curve in this complicated technique.

Authors from the UK present a large series of Y‐type urethral duplication in the male and describe the surgical procedures required to correct this rare congenital anomaly.

OBJECTIVE

To provide an insight into the ‘learning curve’ of fellowship‐trained paediatric urologists associated with hypospadias repair, as hypospadias surgery is one of the most common yet difficult procedures used by the paediatric urologist.

PATIENTS AND METHODS

Prospective data were collected on 231 consecutive hypospadias operations performed by one paediatric urologist (M.H.) over a 5‐year period, beginning with his first year after completing his fellowship. All patients were having their first surgery and none had a staged repair. Fistula formation was used as a surrogate for the complication rate, as it is an objective measurable outcome that is easily identified with little interobserver or parental/physician variability. The follow‐up included several visits in the 15 months after repair, during which virtually all complications could be identified and addressed.

RESULTS

The operative results improved throughout the 5 years of observation; there was a statistically significant decline in the fistula rate in each year of observation (P < 0.001; Kruskal–Wallis exact test for ranked groups). The absolute reduction in fistula rates between the first 2 and the last 2 years was 12.7% (P < 0.02; chi squared).

CONCLUSIONS

The science and surgery of hypospadiology is mostly and correctly delegated to the paediatric urologist. Even in the hands of a fellowship‐trained paediatric urologist, a successful repair, as measured by complication rate, statistically improves with time and experience.
Recovery of serum testosterone after neoadjuvant androgen deprivation therapy and radical radiotherapy in localized prostate cancer
Authors: MURTHY VEDANG , NORMAN ANDREW R. , SHAHIDI MEHDI , PARKER CHRISTOPHER C. , HORWICH ALAN , HUDDART ROBERT A. , BANGE ARSHA , DEARNALEY DAVID P.
Published: February 2006

OBJECTIVE

To prospectively evaluate the time‐course of recovery of serum testosterone levels after a short course of luteinizing hormone‐releasing hormone analogue (LHRHa) and radical radiotherapy to the prostate.

PATIENTS AND METHODS

Testosterone, luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) were sequentially measured prospectively in 59 men who received short‐course LHRHa treatment and radiotherapy for localized prostate cancer. Measurements were made before treatment (baseline), during LHRHa treatment, and at 6, 12, 18, 24 and >40 weeks after the last LHRHa injection.

RESULTS

The median (range) time from the first to last LHRHa injection was 116 (54–194) days. The mean (95% confidence interval) testosterone levels (in nmol/L) at baseline, during treatment and at 6, 12, 18, 24 and >40 weeks afterward were 12.0 (10.8–13.1), 0.6 (0.5–0.7), 1.4 (0.6–2.2), 11.4 (9.7–13), 12.2 (10.5–14), 10.4 (8.9–12) and 11.7 (10.5–13). Four men had low baseline testosterone levels (<6.1 nmol/L). At 6 weeks after the last LHRHa injection, no men had testosterone levels in the ‘normal’ range; 35% were in the normal range at 12 weeks, 85% at 18 weeks, 89% at 24 weeks, and 96% at 1 year.

CONCLUSION

After LHRHa treatment and radiotherapy, the testosterone levels of most men had recovered to normal by 18–24 weeks after the last LHRHa injection.
Predictive factors for nocturia in elderly men: a cross‐sectional study in 21 general practices
Authors: GOUROVA LUBA W. , VAN DE BEEK CEES , SPIGT MARK G. , NIEMAN FRED H.M. , VAN KERREBROECK PHILIP E.V.A.
Published: February 2006

OBJECTIVE

To measure the prevalence of nocturia in general practice and to determine which factors are associated with nocturia.

SUBJECTS AND METHODS

Data were collected from 3048 elderly men, who completed a questionnaire that was sent to every man aged 55–75 years in 21 general practices in Maastricht (the Netherlands). The symptom of nocturia was defined as two or more nocturnal voids. We investigated the prevalence of nocturia and the predictive relationships with the following factors: cerebrovascular disease, diabetes mellitus/insipidus (DMI), Parkinson's diseases, cardiovascular disease, hypertension, bladder/prostate cancer, kidney diseases, urinary bladder inflammation, congenital diseases (kidneys or prostate), using medical treatment for lower urinary tract symptoms, other treatment, psychological depression, symptoms suggestive of benign prostatic hyperplasia (BPH), and alcohol intake.

RESULTS

Data from 2934 respondents were analysed; the prevalence of nocturia (two or more nocturnal voids) was 32.9% (965 men). The frequency of the number of nocturnal voids was: zero in 588 (20.0%), one in 1344 (45.8%), two in 611 (20.8%), three in 208 (7.1%), four in 70 (2.4%), and five or more in 76 (2.6%), with 37 values missing. A multivariate logistic regression analysis showed that nocturia in elderly men was significantly related to bladder/prostate cancer, cerebrovascular disease, treatment of voiding disorders, and moderate alcohol consumption. Next to these, BPH had a significant relationship with nocturia, especially in respondents with DMI and hypertension. Cardiovascular disease or hypertension was significantly related to nocturia, mutually replacing each other as a risk factor.

CONCLUSION

Nocturia in elderly men is be related to many sources of potential risk factors: earlier urological diseases, cardiovascular and cerebrovascular diseases, BPH, DMI and behavioural habits. Some of these sources may interact and generate especially high risk in some groups for nocturia.