bluuebunny/crossref_metadata_2025 huggingface dataset:
A double‐blind dose‐escalating trial comparing novel mesalazine pellets with mesalazine tablets in active ulcerative colitis
Authors: Marakhouski Y. , Fixa B. , Holomán J. , Hulek P. , Lukas M. , Bátovský M. , Rumyantsev V. G. , Grigoryeva G. , Stolte M. , Vieth M. , Greinwald R. ,   The International Salofalk Study Group
Published: January 2005

Background : Mesalazine as the treatment standard for ulcerative colitis can be applied in different galenical preparations.

Aim : A novel formulation of mesalazine pellets with delayed and prolonged release characteristics was compared with conventional Eudragit L‐coated tablets. Furthermore, the effect of mesalazine dose escalation on nonresponders was evaluated in both treatment groups.

Methods : A total of 233 patients with mild to moderately active ulcerative colitis were randomized to receive either mesalazine (1.5 g/day in three doses) as pellets (n = 115) or tablets (n = 118) for 8 weeks. At insufficient response, the dose was increased to 3.0 g.

Results : The clinical remission rate (clinical activity index ≤ 4) for pellets was 67% vs. 68% for tablets which statistically proved to be not inferior (significance level α = 2.5%). In patients without dose increase, the remission rate was 47% (pellets) vs. 42% (tablets). Endoscopic improvement was observed in 80% (pellets) vs. 83% (tablets), and histological improvement in 48% (pellets) vs. 52% (tablets) of patients.

Conclusions : Mesalazine pellets are as effective as tablets in the treatment of mild to moderately active ulcerative colitis. Dose escalation to 3.0 g/day is a valid option for nonresponders to a starting dose of 1.5 g/day.
Feasibility and tolerability of transnasal/per‐oral placement of the wireless pH capsule vs. traditional 24‐h oesophageal pH monitoring – a randomized trial
Authors: Wong W.‐M. , Bautista J. , Dekel R. , Malagon I. B. , Tuchinsky I. , Green C. , Dickman R. , Esquivel R. , Fass R.
Published: January 2005

Background : The wireless pH is a new technique to monitor oesophageal acid exposure.

Aim : To compare the feasibility and tolerability of the wireless pH capsule vs. the traditional pH probe.

Methods : Consecutive patients referred for a pH test were enrolled into the study. Patients were randomized to traditional pH probe, or wireless pH capsule. Patients recorded their activities, food consumption, symptoms, satisfaction with the test and completed a quality of life questionnaire.

Results : Of the 50 patients recruited, 25 patients underwent placement of the traditional pH probe, and 25 the wireless pH capsule. Patients with the wireless pH capsule had less nose pain, runny nose, throat pain, throat discomfort and headache as compared with those with the traditional pH probe (P = 0.047, P = 0.001, P = 0.032, P = 0.001, P = 0.009, respectively). Patients in the wireless pH capsule group had more chest discomfort during the pH test (P = 0.037). Patients in the wireless pH capsule group perceived the test as interfering less with their overall daily activities, eating and sleep (P =0.001, P = 0.003, P = 0.025, respectively), and had overall satisfaction with the test (P = 0.023).

Conclusions : Transnasal/per‐oral placement of the wireless pH capsule is significantly better tolerated then the traditional pH probe.
13C‐methacetin breath test as liver function test in patients with chronic hepatitis C virus infection
Authors: Braden B. , Faust D. , Sarrazin U. , Zeuzem S. , Dietrich C. F. , Caspary W. F. , Sarrazin C.
Published: January 2005

Background : The 13C‐methacetin breath test enables the quantitative evaluation of the cytochrome P450‐dependent liver function.

Aim : To find out whether this breath test is sensitive in noncirrhotic patients also with chronic hepatitis C in early stages of fibrosis.

Methods : Sixty‐one healthy controls and 81 patients with chronic hepatitis C underwent a 13C‐methacetin breath test. In all patients, a liver biopsy was performed. The liver histology was classified according to the histology activity index–Knodell score.

Results : Delta over baseline values of the patients at 15 min significantly differed from controls (19.2 ± 9.2‰ vs. 24.1 ± 5.7‰; P < 0.003). The cumulative recovery after 30 min in patients was 11.4 ± 4.8% and in healthy controls 13.8 ± 2.8% (P < 0.002). However, patients with early fibrosis (histology activity index IVB) did not differ in delta over baseline values of the patients at 15 min (23.2 ± 7.9‰ vs. 22.6 ± 7.2‰; P = 0.61) or cumulative recovery (13.6 ± 3.7% vs. 13.2 ± 3.8%; P = 0.45) from patients with more advanced fibrosis (histology activity index IVC). Patients with clinically nonsymptomatic cirrhosis (histology activity index IVD; Child A) metabolized 13C‐methacetin to a significantly lesser extent (delta over baseline values of the patients at 15 min: 8.3 ± 4.9‰; P < 0.005 and cumulative recovery after 30 min: 5.6 ± 3.2%; P < 0.003). The 13C‐methacetin breath test identified cirrhotic patients with 95.0% sensitivity and 96.7% specificity.

Conclusion : The non‐invasive 13C‐methacetin breath test reliably distinguishes between early cirrhotic (Child A) and noncirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C.
A comparison of liver transplantation outcomes in the pre‐ vs. post‐MELD eras
Authors: Kanwal F. , Dulai G. S. , Spiegel B. M. R. , Yee H. F. , Gralnek I. M.
Published: January 2005

Background:  The model for end stage liver disease (MELD)‐based organ allocation system is designed to prioritize orthotopic liver transplantation (OLT) for patients with the most severe liver disease. However, there are no published data to confirm whether this goal has been achieved or whether the policy has affected long‐term post‐OLT survival.

Aim:  To compare pre‐OLT liver disease severity and long‐term (1 year) post‐OLT survival between the pre‐ and post‐MELD eras.

Methods:  Using the United Network of Organ Sharing database, we compared two cohorts of adult patients undergoing cadaveric liver transplant in the pre‐MELD (n = 3857) and post‐MELD (n = 4245) eras. We created multivariable models to determine differences in: (i) pre‐OLT liver disease severity as measured by MELD; and (ii) 1‐year post‐OLT outcomes.

Results:  Patients undergoing OLT in the post‐MELD era had more severe liver disease at the time of transplantation (mean MELD = 20.5) vs. those in the pre‐MELD era (mean MELD = 17.0). There were no differences in the unadjusted patient or graft survival at 1 year post‐OLT. This difference remained insignificant after adjusting for a range of prespecified recipient, donor, and transplant centre‐related factors in multivariable survival analysis.

Conclusions:  Although liver disease severity is higher in the post‐ vs. pre‐MELD era, there has been no change in long‐term post‐OLT patient or graft survival. These results indicate that the MELD era has achieved its primary goals by allocating cadaveric livers to the sickest patients without compromising post‐OLT survival.
Novel bismuth–metronidazole–tetracycline triple‐layer tablet for treatment of Helicobacter pylori
Authors: Graham D. Y. , Opekun A. R. , Belson G. , El‐Zimaity H. M. T. , Carlson M. R.
Published: January 2005

Background:  Current anti‐Helicobacter pylori treatment regimens are costly and because of the increasing antibiotic resistance, are becoming ineffective.

Aim:  To evaluate a triple‐layer tablet containing 100 mg bismuth subcitrate, 250 mg metronidazole, and 250 mg tetracycline in a single triple‐layer tablet.

Methods:  H. pylori‐infected adult patients received bismuth–metronidazole–tetracycline (two tablets, t.d.s.) and ranitidine (300 mg) once daily for 14 days. Efficacy was determined using 13C‐urea breath testing.

Results:  Thirty‐three of 35 enrolled patients were available for evaluation; using the protocol‐specified modified intention‐to‐treat analysis, five failed treatment, two were lost to follow‐up (cure rate per‐protocol = 85.7%, intention‐to‐treat = 78.7%). The cure rate among metronidazole‐susceptible strains was 100% (22 of 22) (95% confidence interval 84–100%) compared with 55% (five of nine intention‐to‐treat) (95% confidence interval 21–86%) among metronidazole‐resistant strains. In four cases, therapy was truncated at 4–7 days because of side‐effects; yet the treatment was effective in three. The three metronidazole‐susceptible but clarithromycin‐resistant infections were cured.

Conclusion:  This novel triple‐layer tablet combination therapy was effective in all patients with metronidazole‐susceptible H. pylori and many of those with resistant organisms. A greater degree of acid suppression may further improve effectiveness.
Short Communication: Detection of dengue virus antigens in desiccated mosquitoes: an improved tool for surveillance
Authors: Thenmozhi V. , Kabilan L. , Philip Samuel P. , Dash A. P.
Published: January 2005

We developed a surveillance tool to monitor dengue virus (DENV) infection in vector mosquitoes using a dengue antigen‐capture enzyme immunoassay (EIA) on desiccated specimens stored at room temperature (RT). We tested the effect of storage on the stability of DEN1, DEN2, DEN3 and DEN4 antigens. Although desiccated infected Aedes aegypti mosquitoes stored between 31 and 34 °C (RT) showed greater reactivity in the EIA than those stored at −80 °C, a significant difference between the two was observed only with DEN2. Storage between 31 and 34 °C for up to 4 weeks (the longest period tested) did not affect the reactivity in the EIA, indicating the stability of DENV antigens.
DDT indoor residual spray, still an effective tool to control Anopheles fluviatilis‐transmitted Plasmodium falciparum malaria in India
Authors: Gunasekaran K. , Sahu S. S. , Jambulingam P. , Das P. K.
Published: January 2005

This study from two districts of Orissa State which are endemic for Plasmodium falciparum transmitted by Anopheles fluviatilis and A. culicifacies investigated the impact of dichlorodiphenyl trichloroethane (DDT) indoor residual spraying, in view of the ongoing discussion on phasing out DDT in India. Based on their high annual parasite incidence and logistical considerations, 26 villages in Malkangiri and 28 in Koraput district were selected for DDT spraying. For comparison, six and four unsprayed villages were chosen from the same districts. In each district, the prevalence of malaria infection and incidence of malaria fever, indoor resting density and parous rate of the vectors, and their susceptibility to DDT were monitored in six and three villages selected randomly from the sprayed and unsprayed groups respectively. Anopheles fluviatilis was susceptible to DDT while A. culicifacies was resistant. DDT residual spraying with 1 g/m2, was carried out in October–November 2001. Spraying 74–86% of human dwellings and 100% of cattle sheds brought down the indoor resting density of A. fluviatilis by 93–95%. This was associated with a significant reduction of incidence of malaria fever as well as prevalence of malaria infection from November to February in both districts. The spraying also seemed to impact on vector longevity, and a residual effect of DDT on the sprayed walls was observed up to 10–12 weeks despite re‐plastering. Hence DDT spraying can still be an effective tool for controlling fluviatilis‐transmitted malaria. Although this species is exophilic, its nocturnal resting behaviour facilitates its contact with the sprayed surfaces. DDT is still useful for residual spraying in India, particularly in areas where the vectors are endophilic and not resistant.
Maintenance of asthma control by once‐daily inhaled ciclesonide in adults with persistent asthma
Authors: Chapman K. R. , Patel P. , D'Urzo A. D. , Alexander M. , Mehra S. , Oedekoven C. , Engelstätter R. , Boulet L.‐P.
Published: January 2005

Background:  Inhaled corticosteroids (ICS) are recommended therapy for persistent asthma, although side effects can limit appropriate use. Ciclesonide, a novel ICS, is activated in the lung, thereby reducing systemic activity and side effects. This 12‐week, double‐blind, randomized, parallel‐group, placebo‐controlled study evaluated the efficacy and safety of ciclesonide in adults with persistent asthma.

Methods:  After a 2‐week baseline period in which current ICS treatment was continued, 329 patients were randomized to receive ciclesonide 160 μg (n = 107) or 640 μg (n = 112) (ex‐actuator doses, equivalent to 200 and 800 μg ex‐valve, respectively), or placebo (n = 110) once daily in the morning. Efficacy was monitored by asthma symptom scores, rescue medication use, morning and evening peak expiratory flow (PEF) measurements, spirometry, and probability of study completion without experiencing lack of efficacy.

Results:  Morning PEF remained stable with either ciclesonide dose but decreased with placebo; the differences were significant (P < 0.0001) for both ciclesonide doses vs placebo. The forced expiratory volume in 1 s and forced vital capacity decreased significantly with placebo (P < 0.005), but were unchanged with ciclesonide. Lack of efficacy was significantly greater for patients switched to placebo (63%) than it was for those treated with ciclesonide 160 μg (30%) (P < 0.0001 vs placebo) or ciclesonide 640 μg (31%) (P < 0.0001 vs placebo). There were no significant differences between the two tested doses of ciclesonide with respect to efficacy and safety. Serum and 24‐h urine cortisol were unaffected by ciclesonide treatment. Both doses of ciclesonide were well tolerated with no cases of oral candidiasis.

Conclusion:  Ciclesonide (160 or 640 μg) once daily in the morning effectively maintains asthma control, does not affect cortisol levels, and has an adverse event profile comparable with placebo in adults with primarily mild to moderate asthma.
Effect of inhaled corticosteroid on an immunoreactive thymus and activation‐regulated chemokine expression in the bronchial biopsies from asthmatics
Authors: Hoshino M. , Nakagawa T. , Sano Y. , Hirai K.
Published: January 2005

Background:  Bronchial asthma is characterized by airway inflammation, notably because of eosinophils and T cells. Thymus and activation‐regulated chemokine (TARC) is known to selectively attract Th2 cells, and is increased in response to interleukin (IL)‐4 and IL‐13, which share a common receptor, IL‐4 receptor alpha (IL‐4Rα). While corticosteroids have proven, very effective in modifying airway inflammation, the effect of corticosteroids on TARC in asthmatics has been little studied.

Objective:  We examined the effects of inhaled budesonide (BUD) on the expression of TARC and the number of inflammatory cells in bronchial biopsy specimens taken from asthma patients.

Methods:  Inhaled BUD 800 μg daily, or placebo was administered for 3 months in a double‐blind, parallel‐group study, and bronchial biopsies were performed before and after treatment. Biopsy specimens were examined by immunocytochemistry.

Results:  We observed a significant decrease in the epithelial expression of TARC (P < 0.01) in the BUD group compared with the placebo group. This was accompanied by decreases in the number of eosinophils (P < 0.01), CD3+ T cells (P < 0.05), and CD4+ T cells (P < 0.01). A significant correlation was found between changes in epithelial TARC and in IL‐4Rα immunoreactivity (rs = 0.66, P < 0.01).

Conclusions:  These findings suggest that corticosteroid asthma treatment can reduce infiltration of the airway by inflammatory cells, an effect modulated by down‐regulation of bronchial epithelial TARC expression.
Biochemical interaction between effects of beclomethasone dipropionate and salbutamol or formoterol in sputum cells from mild to moderate asthmatics
Authors: Profita M. , Gagliardo R. , Di Giorgi R. , Pompeo F. , Gjomarkaj M. , Nicolini G. , Bousquet J. , Vignola A. M.
Published: January 2005

Background:  Several in vitro studies demonstrate that corticosteroids and long‐acting β2 agonists may have a complementary and synergistic mode of action on the inflammatory processes in asthma.

Methods:  Sputum was induced in 20 mild to moderate asthmatic patients and the induced sputum cells (ISC) were cultured with beclomethasone dipropionate (BDP) 10−7 M, salbutamol 10−8 M and formoterol 10−8 M either alone or in combination, BDP plus salbutamol and BDP plus formoterol, for 24 h. We measured the levels of growth macrophages‐colony stimulating factor (GM‐CSF), released on activation normal T cells expressed and activated (RANTES) and interleukin‐8 (IL‐8), in the supernatant of stimulated cells by ELISA. Furthermore, we assessed nuclear translocation of glucocorticoid receptor (GR) and the expression of β2 receptor in ISC by immunofluorescence and RT‐PCR, respectively.

Results:  The release of GM‐CSF, RANTES and IL‐8 in ISC was significantly reduced by BDP plus salbutamol or formoterol as compared with either drug alone (P < 0.0001). β2 receptor expression was increased after 30 min of incubation with BDP and continued to increase over a time period of 4 h (P < 0.0001). Furthermore after 30 min of incubation, nuclear translocation of GR was greater with BDP plus salbutamol or formoterol than with any of the drugs alone (P < 0.0001).

Conclusion:  The present ex vivo study demonstrates a complementary mode of action between BDP and salbutamol or formoterol leading to an enhanced anti‐inflammatory activity.
Effect of loteprednol etabonate nasal spray suspension on seasonal allergic rhinitis assessed by allergen challenge in an environmental exposure unit
Authors: Krug N. , Hohlfeld J. M. , Geldmacher H. , Larbig M. , Heermann R. , LaVallee N. , Nguyen D. T. , Petzold U. , Hermann R.
Published: January 2005

Background:  Loteprednol etabonate (LE) is a novel soft steroid that was designed to improve the benefit/risk ratio of topical corticosteroid therapy. This study assesses the clinical efficacy and safety of three different doses of LE nasal spray in seasonal allergic rhinitis (SAR).

Methods:  In this single‐center, double‐blind, placebo‐controlled, parallel‐group trial 165 subjects with SAR to grass pollen received daily single doses of either 100, 200, 400 μg LE nasal spray, or placebo for 14 days. The patients underwent three 4‐h allergen challenges with grass pollen in an environmental exposure unit at a screening visit (baseline) and on days 7 and 14 of treatment. Standardized nasal symptom scores were obtained every 20 min. Nasal flow, nasal secretions, and FEV1 were measured every hour during allergen challenges.

Results:  After 14 days of treatment, patients who received 400 μg LE had significantly lower total nasal symptom scores compared with those receiving placebo (P = 0.007). LE400 reduced rhinorrhea, nasal congestion, nasal itching, the amount of nasal secretions, and improved nasal flow as compared with placebo (P < 0.05). LE100 and LE200 were not significantly different from placebo. All treatments were well tolerated.

Conclusions:  Loteprednol 400 μg once daily is superior to placebo and the only effective dose tested in improving nasal symptoms and objective parameters in patients with SAR.
Association between allergic rhinitis and hospital resource use among asthmatic children in Norway
Authors: Sazonov Kocevar V. , Thomas J. , Jonsson L. , Valovirta E. , Kristensen F. , Yin D. D. , Bisgaard H.
Published: January 2005

Background:  Preliminary evidence suggests that inadequately controlled allergic rhinitis in asthmatic patients can contribute towards increased asthma exacerbations and poorer symptom control, which may increase medical resource use. The objective of this study was therefore to assess the effect of concomitant allergic rhinitis on asthma‐related hospital resource utilization among children below 15 years of age with asthma in Norway.

Methods:  A population‐based retrospective cohort study of children (aged 0–14 years) with asthma was conducted using data from a patient‐specific public national database of hospital admissions during a 2‐year period, 1998–1999. Multivariate linear regression, adjusting for risk factors including age, gender, year of admission, urban/rural residence and severity of asthma episode, estimated the association between allergic rhinitis and total hospital days. A multivariate Cox proportional‐hazards model estimated relative hazard of readmission according to concomitant allergic rhinitis status.

Results:  Among 2961 asthmatic children under 15 years of age with at least one asthma‐related hospital admission over a 2‐year period, 795 (26.8%) had a recorded history of allergic rhinitis. Asthmatic children with allergic rhinitis had a 1.72‐times greater hazard of asthma‐related readmissions than asthmatic children without allergic rhinitis. Multivariate analysis revealed that history of concomitant allergic rhinitis was a significant predictor of increased number of hospital days per year (least‐squares mean difference 0.23 days, P < 0.05).

Conclusions:  Concomitant allergic rhinitis in asthmatic children was associated with increased likelihood of asthma‐related hospital readmissions and greater total hospital days.
Prevalence of Malassezia spp. in healthy pigs
Authors: Garau M. , Palacio Amaila del , García J.
Published: January 2005

In the present study, we evaluated the occurrence of Malassezia spp. from superficial areas (ear, anus, forehead and back) in 100 healthy pigs. All cultures from anus, forehead and back were negative for Malassezia spp. A total of 73% of pigs were colonized by Malassezia yeasts in the external ear canals. We isolated only lipid‐dependent species (Malassezia sympodialis 58%, Malassezia slooffiae 30%). This study evaluates the occurrence of Malassezia spp. in pigs since the taxonomic revision in 1996.
Characteristics of dermatophytoses among children in an area south of Tehran, Iran
Authors: Rastegar Lari A. , Akhlaghi L. , Falahati M. , Alaghehbandan R.
Published: January 2005

The aim of this study was to determine the prevalence and etiological agents of dermatophytoses, and also their distribution according to age, gender, and body site among children in an area south of Tehran. A total of 382 children aged ≤16 years suspected to have dermatophytic lesions were examined over a period of 3 years (1999–2001). The incidence rate of dermatophytoses was 6.6 per 100 000 person‐years. Trichophyton violaceum was the most frequent isolate (28.3%) followed by Microsporum canis (15.1%), Epidermophyton floccosum (15.1%), T. rubrum (13.2%), T. mentagrophytes (11.3%), M. gypseum (7.5%), and T. verrucosum (5.7%). Tinea capitis (39.6%) was the most common type of infection, followed by tinea corporis (30.2%), tinea faciei (18.9%), and tinea manuum (7.5%).
Isolation of Trichosporon in a hematology ward
Authors: Pini Gabriella , Faggi Elisabetta , Donato Rosa , Fanci Rosa
Published: January 2005

During mycologic monitoring of the air in a hematology ward, we found massive air contamination caused by Trichosporon asahii, both in the room where neutropenic patients were staying and the corridor immediately outside the room. This fungal species had never been isolated in previous samplings. The urine culture taken from one of the patients in this room, whose urinary catheter had been removed immediately prior to air sampling, resulted positive for T. asahii. Both macroscopic and microscopic morphologic observation was insufficient for confirming the hypothesis of a close relationship between the strains isolated from the patient, from the air in the room and corridor. Therefore, we used genomic typing with random amplified polymorphic DNA (RAPD). The five primers used, (GTG)5, (GACA)4, M13, OPE01, RC08, produced different patterns of polymerase chain reaction (PCR) products; the genomic profiles obtained with the same primer, however, resulted perfectly superimposable for all the strains. This result led us to conclude that the massive air contamination caused by T. asahii can have effectively been determined by the removal of the urinary catheter from the patient who presented an asymptomatic infection caused by this microorganism.
Cryptococcosis in cirrhotic patients
Authors: França Alex Vianey Callado , Carneiro Marcos , Sasso Karina dal , Souza Cacilda da Silva , Martinelli Ana
Published: January 2005

The objective of the present study was to report on three distinct forms of presentation of Cryptococcus neoformans infection in three cirrhotic patients. One patient had disseminated cryptococcosis with detection of the fungus in ascitic fluid, cerebrospinal fluid and blood; the second patient had pleural involvement and the third had cutaneous infection caused by C. neoformans.
Tinea capitis in Diyarbakır, Turkey
Authors: Akpolat N. Ö. , Akdenız S. , Elci S. , Atmaca S. , Özekinci T.
Published: January 2005

The incidence and types of tinea capitis in 234 children aged 1–12 referred to our laboratory with a preliminary diagnosis of tinea capitis infection in the past 5 years were investigated. Tinea capitis was determined in 149 (63.7%) of these patients, of which agents grew in culture in 124 (83.2%). The most frequently isolated agents, in order of frequency, are as follows: Trichophyton violaceum (43.6%), Microsporum canis (37.9%), T. mentagrophytes (8.1%) and T. verrucosum (4.8%).
Retrospective study of onychomycosis in Italy: 1985–2000
Authors: Romano Clara , Gianni Claudia , Difonzo Elisa M.
Published: January 2005

Cases of onychomycosis diagnosed by mycological examination in three mycology units (Florence, Siena and Milan) of central and northern Italy over the 15‐year period, 1985–2000, were studied retrospectively. The number of cases was 4046 (1952 women, 2094 men). Dermatophytes were isolated in 2859, yeasts in 655 and moulds in 532 cases. The most frequent dermatophyte was Trichophyton rubrum (87%), followed by T. mentagrophytes var. interdigitale (10%). Candida albicans (93.2%) was the prevalent yeast. Moulds were mainly Scopulariopsis brevicaulis (48.6%) and Aspergillus spp. (25.2%). Dermatophytes and moulds most commonly infected the toenails, yeasts the fingernails.
Liquid growth conditions for abundant chlamydospore formation in Candida dubliniensis
Authors: Staib Peter , Morschhäuser Joachim
Published: January 2005

Staib liquid medium (syn. Guizotia abyssinica creatinine medium) was evaluated for the induction of chlamydospores in the yeast species Candida dubliniensis. During growth in this liquid medium C. dubliniensis produced abundant chlamydospores at the tips of pseudohyphal elements, whereas C. albicans produced only round to oval blastospores. Chlamydospore formation could be induced with the same efficiency by use of a liquid growth medium in which Helianthus annuus (sunflower) seeds, another plant of the family Compositae, were substituted for Guizotia abyssinica plant seeds. Liquid growth culture conditions for rapid and abundant formation of chlamydospores in C. dubliniensis should facilitate their enrichment and their biochemical and genetic analysis.
Kit (CD117) immunoreactivity is rare in renal cell and upper urinary tract transitional cell carcinomas
Authors: Zigeuner Richard , Ratschek Manfred , Langner Cord
Published: January 2005

OBJECTIVE

To investigate the presence of Kit (CD117), a transmembrane tyrosinase‐kinase receptor, in primary and metastatic renal cell carcinomas (RCCs) and upper urinary tract transitional cell carcinomas (TCCs).

MATERIALS AND METHODS

In human neoplasia, overexpression of Kit has been related to cell proliferation, differentiation, adhesion and control of apoptosis. If present, Kit may provide a suitable target for tumour therapy. Formalin‐fixed and paraffin‐embedded specimens of 180 primary and 58 metastatic RCCs and 54 upper urinary tract TCCs were immunostained for Kit (CD117) using a tissue microarray technique.

RESULTS

In RCCs, immunoreactivity for CD117 was detected in only two of 23 (9%) chromophobe tumours, whereas all 137 conventional and 20 papillary subtypes, and metastatic RCC tissues, lacked CD117 immunoreactivity. In TCCs, CD117 expression of <10% cancer cells was found in two of 53 (4%) cases. Stromal mast cells served as a positive control and showed specific immunostaining.

CONCLUSION

Kit immunoreactivity is infrequent in both RCCs and upper urinary tract TCCs. Thus, routine screening of tumour tissues for Kit by immunohistochemistry appears to be cost‐ineffective and cannot be recommended. Moreover, the lack of substantial Kit immunoreactivity in both primary and metastatic carcinomas does not provide a rationale to investigate imatinib mesylate therapy in clinical trials including patients with advanced disease.
Neither α‐blocker therapy nor cystography is required before early catheter removal after radical prostatectomy
Authors: Nieder Alan M. , Manoharan Murugesan , Kim Sandy S. , Soloway Mark S.
Published: January 2005

OBJECTIVE

To evaluate the success of early catheter removal from men after radical retropubic prostatectomy (RRP) without using either cystography or giving an α‐blocker.

PATIENTS AND METHODS

We retrospectively analysed 156 consecutive patients who had RRPs between June 2003 and May 2004 to determine the incidence of urinary retention after early catheter removal, with no cystogram or using an α‐blocker.

RESULTS

The mean age of the men was 60 years and 99% were clinical stage T1 or T2; 74% had their catheters removed 8 days after RRP. The incidence of urinary retention was 1.3%, and of haematuria requiring catheter replacement 2.6%. Two patients (1.3%) developed a bladder neck contracture.

CONCLUSIONS

In the present study removing an indwelling catheter 1 week after RRP was safe, with a minimal risk of urinary retention or bladder neck contracture. The addition of an α‐blocker is unlikely to reduce the already low incidence of urinary retention.
The Ibero‐American experience with a re‐adjustable minimally invasive sling
Authors: Palma Paulo C.R. , Dambros Miriam , Riccetto Cássio Z. , Thiel Marcelo , Netto Nelson R.
Published: January 2005

OBJECTIVE

To report our experience with the SafyreTM (Promedon, Córdoba, Argentina), a new re‐adjustable and minimally invasive sling for treating stress urinary incontinence (SUI), which combines the efficacy of slings with re‐adjustability.

PATIENTS AND METHODS

In all, 126 consecutive patients with a clinical and urodynamic diagnosis of SUI had a Safyre sling procedure (mean age 63 years, range 40–71). Seventy‐six patients (60%) presented after previous failed anti‐incontinence procedures; all had a physical and clinical examination, a stress test, urodynamic study and assessment of pad use before the surgery. All the patients presented with symptoms of SUI and 37 (29%) also reported mild urgency.

RESULTS

The mean (range) follow‐up was 18 (12–36) months, and the mean operative duration 25 min. Dystopia was repaired whenever necessary during the same procedure. The mean hospital stay was 24 h. In three implants (2%) the bladder was perforated. After surgery 26 patients (21%) developed urgency symptoms; during the follow‐up 116 (92%) were continent, three (2%) reported an improvement and seven (6%) were dissatisfied.

CONCLUSION

The Safyre is a safe and quick procedure that allows for postoperative readjustment; this technique may be an attractive alternative if the good results obtained so far prove to be durable.
Effects on sleep of anticholinergics used for overactive bladder treatment in healthy volunteers aged ≥ 50 years
Authors: Diefenbach Konstanze , Arold Gerhard , Wollny Agnes , Schwantes Ulrich , Haselmann Jutta , Roots Ivar
Published: January 2005

OBJECTIVE

To study the influence of oxybutynin, tolterodine or trospium chloride, anticholinergics used to treat bladder overactivity, on sleep and the cognitive skills of healthy volunteers aged ≥ 50 years.

SUBJECTS AND METHODS

In a randomized, double‐blind, placebo‐controlled study with a crossover design, 24 healthy sleepers (12 men and 12 women) aged 51–65 years underwent polysomnographic recordings and cognitive tests in a sleep laboratory. Study medications were given as a single dose containing the total recommended daily dose.

RESULTS

There was a significant reduction in rapid‐eye movement (REM) sleep of ≈ 15% and a slightly (but not significantly) greater REM latency after oxybutynin and tolterodine than with placebo. After trospium chloride, REM duration and latency were comparable with placebo. There was no effect of the tested anticholinergics on cognitive and subjective sleep variables.

CONCLUSION

Individuals aged ≥ 50 years had a more distinct impairment of REM sleep after oxybutynin and tolterodine than had young people, but the reduction in REM sleep did not reach a pathological degree in this single‐dose study. There was no apparent impairment of concentration or cognitive function, but impairment of cognitive function and neuropsychological side‐effects cannot be excluded, especially when elderly patients with impaired REM sleep from various psychiatric diseases (e.g. depression) and/or sleep disturbances are given oxybutynin or tolterodine in long‐term treatment.
Tamsulosin in the management of patients in acute urinary retention from benign prostatic hyperplasia
Authors: Lucas Malcolm G. , Stephenson Timothy P. , Nargund Vinod
Published: January 2005

OBJECTIVE

To evaluate the efficacy of tamsulosin compared to placebo for treating catheterized patients with acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH), by comparing the numbers of patients who voided successfully after removing their catheter.

PATIENTS AND METHODS

This was a randomized, double‐blind, placebo‐controlled, parallel‐group, multicentre study. Men with AUR secondary to BPH were catheterized and then, if they fulfilled the entry criteria, were randomly assigned to receive either 0.4 mg tamsulosin hydrochloride in a modified‐release capsule once daily, or a placebo. After up to eight doses the catheter was removed and the ability to void unaided assessed.

RESULTS

In all, 149 men (mean age 69.4 years) were randomly assigned to receive tamsulosin (75) or placebo (74); eight were not evaluable, so the intent‐to‐treat population was 141 men. Thirty‐four men taking tamsulosin and 18 taking placebo did not require re‐catheterization on the day of the trial without catheter (48% and 26% respectively, P = 0.011; odds ratio 2.47, 95% confidence interval, CI, 1.23–4.97). Success using free‐flow variables was also higher in the men who received tamsulosin, at 37 (52%) vs 24 (34%) on placebo (P = 0.019; odds ratio 2.34, 95% CI 1.15–4.75). Withdrawals were high (120 men, 81%), mostly because of a need for re‐catheterization (89 men, 60%). Dizziness and somnolence occurred in seven (10%) and four (6%) men who received tamsulosin, and two (3%) who received placebo, but overall the incidence of adverse events was similar in the two groups. One patient died from carcinomatosis.

CONCLUSION

Men catheterized for AUR can void more successfully after catheter removal if treated with tamsulosin, and are less likely to need re‐catheterization. The side‐effect profile was similar for tamsulosin and placebo, and consistent with known pharmacology. From these results tamsulosin can be recommended for treating men after catheterization for AUR, and can reduce the likelihood of the need for re‐catheterization.
Uretero‐ureterocutaneostomy (wrapped by omentum)
Authors: Lodde Michele , Pycha Armin , Palermo Salvatore , Comploj Evi , Hohenfellner Rudolph
Published: January 2005

The tubularized‐incised plate urethroplasty has traditionally been used in children for repairing hypospadias. As shown here, it can also be used successfully in adults, with very good results. The rate of wound healing, infection and complications is the same as in children, as are the cosmetic and functional outcomes.

OBJECTIVES

To evaluate the outcome of uretero‐ureterocutaneostomy (UUC) wrapped by omentum for palliative cystectomy in symptomatic elderly high‐risk patients with high‐stage bladder cancer.

PATIENTS AND METHODS

The study included 15 patients (14 men and one woman, aged 72–87 years, American Society of Anesthesiology score 3) with symptomatic recurrent bleeding bladder cancer (T2/T3) who were treated with palliative cystectomy. UUC was performed by mobilizing the right pre‐vesical divided ureter up to the pelvi‐ureteric junction and a high retroperitoneal crossover to the divided left ureter. A stoma was created with a circular 2‐cm skin excision and resecting the fatty subcutaneous tissue. Wrapped by the omentum, both well‐vascularized ureteric stumps were pulled through a cross‐like fascia incision up to skin level. Spatulated and everted, the ‘butterfly’ flaps were fixed to the skin and underlying omentum. Soft splints were inserted for 21 days and a Karaya ring placed.

RESULTS

The postoperative course and stoma healing was normal in 14 of the 15 patients; the sigmoid was resected because of sigmoid diverticulitis in one. The median (range) follow‐up was 15 (6–24) months. There was pyelonephritis in one patient, and the dilatation of the upper tract (grade 3) in two returned to grade 2, with new asymptomatic grade 1 dilatation in one other. All patients were without stents and stoma care was provided at home.

CONCLUSIONS

This modified UUC by omental wrapping in 15 high‐risk patients after palliative cystectomy was simple and safe, and their recovery was uneventful. To date the few patients with stomal obstruction were managed by J catheters, changed every 4–6 months.
Alteration of body configuration after retroperitoneoscopic nephrectomy and nephroureterectomy
Authors: Yoshimura Koji , Ichioka Kentaro , Matsui Yoshiyuki , Terai Akito , Arai Yoicih
Published: January 2005

OBJECTIVE

To evaluate objective alterations of body configuration in patients who treated with retroperitoneoscopic nephrectomy (RN) and retroperitoneoscopy‐assisted nephroureterectomy (RAN).

PATIENTS AND METHODS

Twenty‐six patients who had RN and 23 RAN were eligible for the study. Abdominal computed tomography films before and after surgery were evaluated. The intra‐abdominal content surrounded by the vertebral bones and the muscles forming the trunk of the body were divided into four subspaces. The areas of these four portions were measured, and the ratio of occupation of each portion calculated before compared with that obtained after surgery.

RESULTS

While RAN had little impact on body configuration, RN significantly affected it; after RN the total area and area of ventral subspaces decreased homogeneously throughout the L2–L4 levels. The ipsilatero‐dorsal subspace had a marked cranial decrease in area and no caudal alteration.

CONCLUSIONS

While RAN has little effect on body configuration, RN has a significant effect, as measured objectively. Continuing the skin incision between ports and muscle splitting to extract the specimen is probably responsible for the difference between the findings of RAN and RN.
Stone‐bearing live‐donor kidneys for transplantation
Authors: Devasia Anthony , Chacko Ninan , Gnanaraj Lionel , Cherian Rekha , Gopalakrishnan Ganesh
Published: January 2005

OBJECTIVE

To evaluate potential donor kidneys with asymptomatic calculi detected during screening, and the management of the calculus before, during and after transplantation, as with fewer live donors, marginal kidneys and donors are a significant subgroup in renal transplantation.

PATIENTS AND METHODS

Five live‐related donors, with one incidentally detected calculus during their routine evaluation, were accepted for transplantation. Of these, three were detected only on spiral computed angiography. There was no biochemical evidence of a metabolic abnormality or history of stone disease. One donor had elective lithotripsy and another nephrolithotomy under ultrasonographic control immediately after perfusion. The others were transplanted with the calculus in situ. Ureteric reimplantation was by the Leadbetter‐Politano technique over a JJ stent.

RESULTS

One recipient patient passed the calculus within 4 h of stent removal. The follow‐up ultrasonogram at 3 months showed a stone in only one recipient. In the others, the calculus could not be seen after stent removal. The maximum follow‐up was 2 years and graft function has remained normal in all.

CONCLUSIONS

Voluntary kidney donors with one calculus incidentally detected on routine evaluation form a unique group and can be accepted for transplantation in selected cases. Careful follow‐up of the donor and recipient is essential, with early intervention if necessary.
Perineal anastomotic urethroplasty for managing post‐traumatic urethral strictures in children: the long‐term outcome
Authors: Hafez Ashraf T. , El‐Assmy Ahmed , Sarhan Osama , El‐Hefnawy Ahmed S. , Ghoneim Mohamed A.
Published: January 2005

OBJECTIVE

To evaluate the long‐term results of one‐stage perineal anastomotic urethroplasty for post‐traumatic paediatric urethral strictures.

PATIENTS AND METHODS

Thirty‐five boys who had a perineal anastomotic urethroplasty for post‐traumatic bulbous or posterior urethral strictures between 1991 and 2003 were analysed retrospectively. Patients were followed up for a mean (range) of 46 (6–132) months by a history, urinary flow rate estimate, retrograde urethrography and voiding cysto‐urethrography.

RESULTS

The mean (range) age of the patients was 11.9 (6–18) years. The estimated radiographic stricture length before surgery was 2.6  (1–5) cm. The perineal anastomotic repair was successful in 31 of 35 (89%) patients. All treatment failures were at the anastomosis and were within the first year. Failed repairs were successfully managed endoscopically in two patients and by repeat perineal anastomotic repair in the remaining two, giving a final success rate of 100%. All boys are continent except two who had early stress incontinence, and that resolved with time. There was no chordee, penile shortening or urethral diverticula during the follow‐up.

CONCLUSIONS

The overall success of a one‐stage perineal anastomotic repair of post‐traumatic urethral strictures in boys is excellent, with minimal morbidity. Substitution urethroplasty or abdomino‐perineal repair should be reserved for the occasional patients with concomitant anterior urethral stricture disease or a complex posterior urethral stricture, respectively.
An evaluation of laparoscopic tissue harvesting for human adult urological smooth muscle physiological experimentation
Authors: Bolton John F. , Whittlestone Timothy H. , Sibley Gary N.A.
Published: January 2005

OBJECTIVE

To evaluate the properties of laparoscopically harvested bladder neck and ureteric smooth muscle, compared with tissue obtained at open surgery.

MATERIALS AND METHODS

Bladder neck was harvested from patients undergoing open (eight) or laparoscopic radical prostatectomy (11). Ureter was obtained from patients undergoing nephrectomy (laparoscopic or open) and cystectomy (open only); obtained openly from 16 and laparoscopically from seven. Muscle strips dissected from these samples were perfused in a Brading‐Sibley organ bath, and stimulated using standard agonists (100 µmol/L carbachol for bladder neck, 100 mmol/L KCl‐enriched Krebs’ solution for ureteric muscle). Tensions produced were recorded using strain gauges and analysed using data‐acquisition software. Results were compared by a two‐tailed Fisher's exact test to determine significance.

RESULTS

Openly harvested bladder neck muscle strips from six patients showed a measurable response to the standard agonist. Laparoscopically harvested bladder neck strips from only two patients showed any measurable response. Openly harvested ureteric muscle strips from 12 patients responded to K‐enriched solution, while one patient's laparoscopically harvested strips responded to stimulation. This difference was significant in both tissue groups separately (P < 0.025). Histological evaluation identified no specific differences between openly and laparoscopically harvested tissue.

CONCLUSION

The yield of smooth muscle available for research is significantly less when the resection is laparoscopic; this might be a result of diathermy damage at a subcellular level. With the increasing use of the laparoscopic approach in urological surgery, the effect on tissue availability for human smooth muscle physiological study is important to researchers in this field.
Clinical and molecular genetic evaluation of patients with primary dystonia
Authors: Shang H. , Clerc N. , Lang D. , Kaelin‐Lang A. , Burgunder J.‐M.
Published: January 2005

Primary dystonia is a movement disorder characterized by involuntary and sustained muscle contractions causing twisting or abnormal postures and mutations in several genes have been identified. Our goal was to investigate, whether the clinical presentation would differ between patients with a positive family history, and patients without. Furthermore, we have performed mutation analysis in the subgroup of patients with a positive family history. A total of 175 patients with primary dystonia were evaluated. Data on gender, presence and frequency of pain and tremor, age of onset, and the distribution of affected body parts were compared between patients with positive and negative family history. All exons of the torsion dystonia 1, GTP cyclohydrolase 1 and ɛ‐sarcoglycan genes were examined in 40 patients by SSCP analysis of PCR products followed by sequencing of variant conformers. Dystonia patients with a positive family history of dystonia had an earlier age of onset and those with a positive family history of tremor more often associated tremor than those with a negative family history. Four new polymorphisms in the ɛ‐sarcoglycan gene were found and others confirmed, but no known or new mutations could be detected. Our study supports the notion that primary dystonia is a genetically heterogeneous disease.
Health promotion by means of health sport – a framework and a controlled intervention study with sedentary adults
Authors: Brehm Walter , Wagner Petra , Sygusch Ralf , Schönung Anke , Hahn Ursula
Published: January 2005

Only 10–20% of adults in industrialized countries reach the health‐related minimum level of a consumption of energy of more than 800 kcal week−1, additional to activities of daily living. The objective of this longitudinal study was to evaluate the impact of a health‐promoting exercise program for sedentary adults on medical and subjective health status and on behavioral changes. The first 12 months of the study (t1–t2) consisted of a structured intervention exercise program. After this period, participants had the opportunity to stay in a follow‐up‐program or to change to other programs of the same club for further 12 months (t2–t3). Within these 2 years data have been collected from the intervention group (117 subjects) and control group (40 subjects). It can be shown that on the basis of a structured intervention (one session per week, 90 min, for 1 year), a stable behavioral change is reached with positive effects on fitness status, risk factors and mental health. Contrary to findings in other studies, the average health effects are at least stable in the second year in this study.