bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular side‐effects of tolterodine and oxybutynin, a single‐blind prospective randomized trial
Authors: Altan‐Yaycioglu R. , Yaycioglu O. , Aydin Akova Y. , Guvel S. , Ozkardes H.
Published: April 2005

Aim

To evaluate the effects of tolterodine and oxybutynin on visual accommodation, pupillary diameter, intraocular pressure and tear secretion in women with overactive bladder.

Methods

One hundred and four eyes from 52 consecutive female patients (age range: 22–60 years) with a urodynamic diagnosis of overactive bladder were prospectively investigated. Patients with a history of ocular disease or surgery were excluded. The subjects were randomly assigned to one of two groups: Group I received 2 mg tolterodine bid and Group II received 5 mg oxybutynin tid. All patients were evaluated at baseline (day 0) and after 1 month of treatment (day 28) by an ophthalmologist who was blinded to the medication. At each time point, a complete ophthalmic examination was performed and accommodation amplitude (AA), and pupillary diameter (PD) in dim and bright light were recorded. As well, tear secretion was assessed based on tear film break‐up time and Schirmer I‐test results. Statistical comparisons were made using the chi‐square test, Student's t‐test and Mann–Whitney U‐test, as appropriate.

Results

Twenty‐eight patients (56 eyes) received tolterodine and 24 patients (48 eyes) received oxybutynin. The mean ages of the two groups were similar (P = 0.523). After 4 weeks of treatment, AA was significantly lower in the oxybutynin treated group (P = 0.003, 95% CI 0.15, 0.62) whereas there was no significant change in AA in the tolterodine treated group (P = 0.155, 95% CI −0.042, 0.86). At day 28, PD in dim light was significantly larger in the tolterodine treated group (P = 0.031, 95% CI −0.82, −0.06), whereas no significant change in PD in dim light was noted in the oxybutynin treated group (P = 0.330, 95% CI −0.38, 0.18)). Neither group showed a significant change in PD in bright light values on day 28 (P > 0.05 for both). In each group, the differences from day 0 to day 28 for intraocular pressure, and Schirmer‐I results were insignificant (P > 0.05 for all). Both groups had significantly shorter tear film break‐up time after 1 month of therapy (P = 0.014 (95% CI 0.47, 3.81) and P = 0.02 (95% CI 1.14, 4.61) for the tolterodine and oxybutynin treated groups, respectively).

Conclusion

Four weeks of standard‐dose oxybutynin treatment in women with overactive bladder decreases AA significantly, whereas the same duration of standard‐dose tolterodine does not have this effect. However, tolterodine seemed to affect PD in dim light. One month of treatment with either of these anticholinergic drugs shortens tear film break‐up time significantly. Concerning ocular side‐effects, tolterodine seems to offer an advantage over oxybutynin because it does not affect AA, however, the shorter tear film break‐up time with both agents suggests potential problems for patients who already have dry eye.
Determination of the bioavailability of gentamicin to the lungs following inhalation from two jet nebulizers
Authors: Al‐Amoud A. I. , Clark B. J. , Assi K. A. , Chrystyn H.
Published: April 2005

Aims

To determine the bioavailability of gentamicin to the lung following inhalation from two jet nebulizers.

Methods

Serial urine samples were obtained from 10 volunteers after a 80 mg dose given orally, nebulized from a Pari LC + (PARI) and MicroNeb III (MN) devices, or after a 40 mg intravenous dose. In vitro aerodynamic characteristics of the nebulized doses were also determined.

Results

The mean (SD) absolute gentamicin lung bioavailalibility following delivery by PARI and MN devices was 1.4 (0.4) and 1.7 (0.5) %. The mass median aerodynamic diameter (MMAD) of the drug particles from the PARI and MN systems was 8.6 (0.6) and 6.7 (0.5) µm and the corresponding fine particle doses (FPD) were 10.2 (2.8) and 11.7 (1.5) mg.

Conclusions

The MMAD and FPD data reflect the poor lung deposition of gentamicin identified by urinary excretion.
Chlorpropamide 2‐hydroxylation is catalysed by CYP2C9 and CYP2C19 in vitro: chlorpropamide disposition is influenced by CYP2C9, but not by CYP2C19 genetic polymorphism
Authors: Shon Ji‐Hong , Yoon Young‐Ran , Kim Min‐Jung , Kim Kyoung‐Ah , Lim Young‐Chae , Liu Kwang‐Hyeon , Shin Dong‐Hoon , Lee Chung Han , Cha In‐June , Shin Jae‐Gook
Published: April 2005

Aims

We evaluated the involvement of cytochrome P450 (CYP) isoforms 2C9 and 2C19 in chlorpropamide 2‐hydroxylation in vitro and in chlorpropamide disposition in vivo.

Methods

To identify CYP isoforms(s) that catalyse 2‐hydroxylation of chlorpropamide, the incubation studies were conducted using human liver microsomes and recombinant CYP isoforms. To evaluate whether genetic polymorphisms of CYP2C9 and/or CYP2C19 influence the disposition of chlorpropamide, a single oral dose of 250 mg chlorpropamide was administered to 21 healthy subjects pregenotyped for CYP2C9 and CYP2C19.

Results

In human liver microsomal incubation studies, the formation of 2‐hydroxychlorpropamide (2‐OH‐chlorpropamide), a major chlorpropamide metabolite in human, has been best described by a one‐enzyme model with estimated Km and Vmax of 121.7 ± 19.9 µm and 16.1 ± 5.0 pmol min−1 mg−1 protein, respectively. In incubation studies using human recombinant CYP isoforms, however, 2‐OH‐chlorpropamide was formed by both CYP2C9 and CYP2C19 with similar intrinsic clearances (CYP2C9 vs. CYP2C19: 0.26 vs. 0.22 µl min−1 nmol−1 protein). Formation of 2‐OH‐chlorpropamide in human liver microsomes was significantly inhibited by sulfaphenazole, but not by S‐mephenytoin, ketoconazole, quinidine, or furafylline. In in vivo clinical trials, eight subjects with the CYP2C9*1/*3 genotype exhibited significantly lower nonrenal clearance [*1/*3 vs.*1/*1: 1.8 ± 0.2 vs. 2.4 ± 0.1 ml h−1 kg−1, P < 0.05; 95% confidence interval (CI) on the difference 0.2, 1.0] and higher metabolic ratios (of chlorpropamide/2‐OH‐chlorpropamide in urine: *1/*3 vs.*1/*1: 1.01 ± 0.19 vs. 0.56 ± 0.08, P < 0.05; 95% CI on the difference − 0.9, − 0.1) than did 13 subjects with CYP2C9*1/*1 genotype. In contrast, no differences in chlorpropamide pharmacokinetics were observed for subjects with the CYP2C19 extensive metabolizer vs. poor metabolizer genotypes.

Conclusions

These results suggest that chlorpropamide disposition is principally determined by CYP2C9 activity in vivo, although both CYP2C9 and CYP2C19 have a catalysing activity of chlorpropamide 2‐hydroxylation pathway.
Characterization of macrophage subpopulations in colon cancer using tissue microarrays
Authors: Sickert D , Aust D E , Langer S , Haupt I , Baretton G B , Dieter P
Published: April 2005

Aims : To determine the pattern of macrophage infiltration in colon cancers and its correlation with clinicopathological characteristics.

Methods and results : Colon cancers from 100 patients were arrayed into a tissue microarray (TMA). Four cores per tumour were taken: three from the invasion front (IF) and one from the tumour surface (TS). Macrophages were quantified by immunohistochemistry with antibodies to the PG‐M1, KP‐1, MRP8, MRP14 and MRP8/14 antigens. The number of macrophages was significantly higher in the TS cores than in the IF cores and both tumour sites showed a higher number of macrophages than the normal mucosa. The number of macrophages decreased in higher stage tumours. The different tumour‐associated macrophage (TAM) subpopulations were positively correlated with each other.

Conclusions : The increased number of macrophages in cancers compared with normal colon mucosa indicates that macrophages are attracted to the tumour site. However, decreasing macrophages in higher stage colon cancers suggest that this attraction decreases with tumour progression.
Use of carbon‐11 in Populus shows that exogenous jasmonic acid increases biosynthesis of isoprene from recently fixed carbon
Authors: FERRIERI RICHARD A. , GRAY DENNIS W. , BABST BENJAMIN A. , SCHUELLER MICHAEL J. , SCHLYER DAVID J. , THORPE MICHAEL R. , ORIANS COLIN M. , LERDAU MANUEL
Published: April 2005

A new approach for pulse labelling of plants using the short‐lived positron emitting radioisotope carbon‐11 (half‐life: 20.4 min) as 11CO2 is reported together with its application to measuring [11C]isoprene emissions from intact leaves capturing information associated with: (1) rate of emission; (2) the relative contribution of recently fixed carbon to isoprene biosynthesis; and (3) the transit time for tracer movement through the leaf and biochemical pathways associated with isoprene biosynthesis. This approach was applied to study the response of certain Populus species to exogenous treatments of jasmonic acid (JA), a plant hormone implicated in signal transduction linked to defence response against herbivory. Twelve hours after treatment of single intact leaves of aspen (Populus tremuloides) with a 1 m m JA spray, isoprene emissions from those leaves increased 1.5 times the controls from 35.4 ± 2.2 to 53.1 ± 4.8 nmol m−2 s−1. [11C]Isoprene emissions from the same leaves, reflecting the isoprene that was derived from recently fixed carbon, increased much more, to 2.2 times the controls. This increase coincided with a change in emitted [11C]isoprene from 0.31 to 0.68% of 11C fixed in the leaf tissue, while the tracer transit time remained constant at 12.5 min. These results suggest that JA had no effect on enzyme kinetics involved in isoprene biosynthesis, but did impact the source of recent carbon feeding that pathway. Studies with poplar (Populus nigra clone NC 5271) showed similar trends in systemic emissions (from an untreated leaf on the same plant).
Origins of non‐linear and dissimilar relationships between epidermal UV absorbance and UV absorbance of extracted phenolics in leaves of grapevine and barley
Authors: KOLB CHRISTIANE A. , PFÜNDEL ERHARD E.
Published: April 2005

A recent review of climate patterns in Southern Germany has suggested significant increases in ultraviolet (UV) radiation due to decreases in cloud coverage and in cloud frequency which compound the effects of stratospheric ozone depletion. Whether such UV radiation increases result in UV damage of higher plant leaves depends partly on the capacity of UV‐absorbing hydroxycinnamic acids and flavonoids located in the plant epidermis to screen out UV radiation. Epidermal UV screening is most often assessed from UV absorbance of whole‐leaf extracts but in the present work, this method is critically examined. In grapevine (Vitis vinifera L.), hydroxycinnamic acid as well as mono‐hydroxylated and ortho‐dihydroxylated flavonoid concentrations increased in parallel with fluorometrically detected adaxial epidermal UV absorbance but only the latter class of flavonoids was associated with epidermal UV absorbance in barley (Hordeum vulgare L). For both species, curvilinear relationships between epidermal and total phenolic UV absorbance were established: initial slopes of the curves differed markedly between species. Modelling suggested that curvilinearity arises from UV‐transparent epidermal areas located between vacuoles which are particularly UV‐absorbing due to high levels of phenolics. The species‐dependent differences were related to allocation of high amounts of phenolics in the mesophyll and abaxial epidermis in barley but not in grapevine. Both factors, optical heterogeneity and variable distribution of phenolics, severely restrict the use of phenolic absorbance to estimate true epidermal screening.
Other factors than apoplastic ascorbate contribute to the differential ozone tolerance of two clones of Trifolium repens L.
Authors: D’HAESE DAVID , VANDERMEIREN KARINE , ASARD HAN , HOREMANS NELE
Published: April 2005

Apoplastic reactive oxygen intermediates, which are formed during the exposure of a higher plant to ozone (O3), have been proposed to be detoxified by apoplastic ascorbate (ASC). An investigation to determine whether the differential sensitivity of two white clover clones (Trifolium repens L. cv Regal) to O3 was related with their levels of ASC, glutathione derivatives or with the total antioxidative capacity. In contrast to what might be expected, the sensitive clone of white clover (NC‐S) constitutively showed a 72% higher concentration of apoplastic ASC compared to the O3‐tolerant clone (NC‐R). Furthermore, NC‐S also showed a higher redox status of apoplastic ASC. These results indicate that higher ASC levels in the apoplast of NC‐S are not sufficient to induce a higher O3 tolerance. The redox status, but not the absolute concentration of homoglutathione in the symplast was found to be constitutively higher in NC‐R than in NC‐S. It is not clear, however, whether homoglutathione is a direct cause of the differential O3 detoxification capacity of both clones. Total antioxidative capacity measurements ruled out the contribution of other low‐molecular antioxidants to the relative tolerance of NC‐R. It was concluded that elevated apoplastic ASC levels can not always be sufficient to render a plant O3 tolerant.
Oxygen concentration affects nodule anatomy and nitrogenase activity of Alnus maritima
Authors: KRATSCH HEIDI A. , GRAVES WILLIAM R.
Published: April 2005

Alnus maritima is a shrub that associates with N2‐fixing Frankia in the wetlands in which it is native. Despite low concentrations in waterlogged soils, O2 is critical to the maintenance of this symbiosis, and Frankia‐infected nodules exist on roots of plants in native stands. The objective of the present study was to determine how root‐zone O2 concentration influences N2 fixation and the anatomy of nodules on A. maritima. Root zones of plants inoculated with soil from native stands were exposed to eight O2 concentrations. Nitrogenase activity increased with increasing O2 concentration. Photosynthetic rate, plant dry mass, leaf N content, and nodule fresh mass were maximal in plants maintained with 15–25% O2 in the root zone. Nodule counts were maximal on roots maintained at 10% and above 25% O2, and nodules that developed at ≤ 2% O2 were < 2 mm in diameter and single‐lobed. Mean total area of air spaces within nodules decreased, and mean area per space increased, with increasing O2 concentration. Seasonal and O2‐dependent nodule pigmentation was observed. Our data illustrate that O2 is critical to the development of functional symbioses, and that nodules of this species, which are submersed in nature, possess mechanisms for responding to their low‐O2 environment.
Cutaneous extraskeletal mesenchymal chondrosarcoma in a cat
Authors: ROMANUCCI MARIARITA , BONGIOVANNI LAURA , PETRIZZI LUCIO , SALDA LEONARDO DELLA
Published: April 2005

Abstract  A 4‐year‐old, male cat was presented with a fixed, subcutaneous mass in the lumbosacral region. A histopathological examination revealed a well‐defined but nonencapsulated neoplasm characterized by a proliferation of predominantly spindle cells, with high mitotic activity. Interspersed between these cells were single cellular elements with chondroid differentiation. Large areas of cartilaginous tissue with foci of endochondral ossification, necrosis and myxoid tissue were also observed within the neoplastic parenchyma. A diagnosis of extraskeletal mesenchymal chondrosarcoma was made based on the histological pattern – characterized by the coexistence of cartilaginous islands and undifferentiated mesenchymal cells, results of Alcian blue staining at various pH, immunohistochemical reactivity against vimentin and S‐100, and the absence of skeletal involvement or other primary tumour sites. Clinical history of the cat excluded traumas, vaccinations or other types of subcutaneous inoculation. Six months on from surgical treatment, neither recurrence nor metastases have been detected.
Bioassay‐led isolation of Myrothecium verrucaria and verrucarin A as germination inhibitors of Orobanche crenata
Authors: EL‐KASSAS R , KARAM EL‐DIN Z , BEALE M H , WARD J L , STRANGE R N
Published: April 2005

A total of 188 fungal isolates was obtained from the rhizosphere of Vicia faba grown in an Egyptian soil heavily infested with Orobanche species. Agar cultures of 58 isolates inhibited the germination of conditioned seed of Orobanche crenata exposed to the germination stimulant, GR24. Filtrates of inhibitory fungi grown in liquid medium for 9–15 days were also assayed and those of five isolates, which were morphologically similar, inhibited germination even when diluted 16‐fold. The fungus was identified as Myrothecium verrucaria (Alb. & Schwein.) Ditmar by its morphology and the nucleotide sequence of the ITS1 and ITS2 regions of the ribosomal repeat unit. Purification of the inhibitor to homogeneity was accomplished by solvent partitioning, flash chromatography on silica gel, semi‐preparative HPLC on a reversed phase C18 column, solid phase extraction and tlc on silica gel. The inhibitor was identified as verrucarin A by nuclear magnetic resonance spectroscopy and comparison of the spectra with those of an authentic sample of the compound. A preliminary experiment demonstrated that infection of V. faba by O. crenata could be prevented by addition of spores of the fungus to soil infested by the parasite.
Soil steaming to reduce intrarow weed seedling emergence
Authors: MELANDER B , JØRGENSEN M H
Published: April 2005

Steaming the soil prior to crop establishment can be a very effective method of preventing weed seedling emergence on raised beds of vegetable crops. However, current mobile steaming technology for outdoor vegetables is characterized by an extremely high energy consumption and a low work rate. This has led to the concept of band‐steaming, where only a limited soil volume is steamed corresponding to the intrarow area of a row‐grown vegetable crop. Weeds growing in the intrarow area are difficult to remove by traditional non‐chemical means, usually involving substantial input of manual labour in organic cropping. This paper presents the initial results from laboratory studies with steaming a limited soil volume simulating a band. The investigations describe the relationship between maximum soil temperature achieved from soil steaming for different periods and effects seen on subsequent weed seedling emergence. The relationships obtained were generally sigmoid and could appropriately be described by a common dose–response function. Seedling emergence from natural weed species was reduced by 90% when the maximum soil temperature reached 61°C, and a further 10°C rise in temperature gave 99% reduction. Added and non‐imbibed seeds of Lolium perenne and Brassica napus generally required higher temperatures to achieve the same control level as the natural weeds in the soil samples.
Management of the invasive species Opuntia stricta in a Botanical Reserve in Portugal
Authors: MONTEIRO A , CHEIA V M , VASCONCELOS T , MOREIRA I
Published: April 2005

Opuntia stricta is an invasive species in the Dom António Xavier Pereira Coutinho Nature Reserve (Portugal). Different chemical approaches were assessed to simultaneously manage it and preserve the natural flora of the Botanical Reserve. Glyphosate was applied at different concentrations (2.8–180 g a.e. L−1) and times of application (April, July and October) by injection into cladophyll and direct application onto areas in which the cladophyll had been cut (90 and 180 g a.e. L−1). The efficacy of the herbicide applied on the cut areas was good, but the pieces of the cladophyll that had been cut were difficult to remove and destroy. Herbicide injection of a 2 mL of solution containing 45 g a.e. L−1 glyphosate in the summer proved to be the easiest and most effective way of controlling the weed. Germination studies were carried out in order to understand the importance of seeds in the dissemination of O. stricta. The optimum constant temperature for germination was generally 20–25°C, there was a tendency towards increased germination following leaching in water for 24 h (7% germination at 20°C 12‐h light) and 60‐min scarification in sulphuric acid (15% at 20°C 12‐h light). Although germination rates may be considered low, they do indicate that the emergence of O. stricta seedlings is possible.
Effect of preoperative Cox‐II‐selective NSAIDs (coxibs) on postoperative outcomes: A systematic review of randomized studies
Authors: Straube S. , Derry S. , McQuay H. J. , Moore R. A.
Published: April 2005

Background:  Preoperative use of coxibs has been claimed to reduce postoperative pain and analgesic consumption, and to affect other postoperative outcomes.

Methods:  Systematic review of randomized trials comparing preoperative coxib with preoperative placebo, or active comparator. Searching of PubMed and Cochrane Library to August 2004. A qualitative and a quantitative analysis.

Results:  Twenty‐two included trials with 2246 patients had high reporting quality and validity scores, though treatment group sizes were small, with a median size of 30 patients. Most trials used oral preoperative rofecoxib (mainly 50 mg) or celecoxib (mainly 200 mg).

Preoperative coxibs significantly reduced both postoperative pain and analgesic consumption compared with preoperative placebo in 15/20 trials. In one further trial postoperative pain was reduced and in one analgesic consumption. There was no significant difference in the incidence of postoperative nausea and vomiting in 13/17 studies or when data were pooled. Postoperative antiemetic use was significantly reduced in all five trials reporting it; the NNT to prevent one patient using postoperative antiemetic was 10 (5.5 to 66). No trial reported any significant difference in intraoperative blood loss or recovery from anaesthesia. Patient satisfaction was significantly increased with preoperative coxib use. No conclusions could be drawn from the three trials comparing preoperative coxib with preoperative NSAID. One study reported significantly improved cost‐efficacy with rofecoxib.

Conclusions:  Preoperative coxibs had clear benefits in terms of reduced postoperative pain, analgesic consumption and patient satisfaction compared with placebo. Effects on postoperative nausea and vomiting remain uncertain, as do those on recovery from surgery or economic benefit. Future trials should be larger and more pragmatic in nature.
Acute myocardial infarction and thyrotoxic storm – a difficult and dangerous combination
Authors: Opdahl H. , Eritsland J. , Søvik E.
Published: April 2005

We describe an unusual case of acute myocardial infarction (AMI) and cardiogenic shock in a 25‐year‐old woman. After coronary revascularization, a thyrotoxic storm developed and the patient's cardiac failure changed into a hyperdynamic circulation without obvious changes in the patient's vital signs. This report will focus on three issues: (1) the benefit of advanced hemodynamic monitoring in circulatory unstable patients, (2) the confounding effects of untreated hyperthyroidism on the circulation, and (3) previous cancer treatment as a cause of AMI in young persons.
Web‐based research of lower urinary tract symptoms that affect quality of life in elderly Japanese men: analysis using a structural equation model
Authors: Masumori Naoya , Homma Daiichi , Tsukamoto Taiji
Published: April 2005

OBJECTIVE

To investigate the distribution of lower urinary tract symptoms (LUTS) in elderly Japanese men, to clarify which variables contributed to medical care‐seeking behaviour, and to construct a structural‐equation model (SEM) to explain overall quality of life (QoL).

SUBJECTS AND METHODS

A dataset was obtained from 662 Japanese men aged 50–79 years who participated in the programme by accessing a website via the Internet between 10.30 hours on 19 February 2003 and 10.30 hours on 24 February 2003. The participants were queried about their International Prostate Symptom Score (IPSS), bother, QoL index and medical care‐seeking behaviour.

RESULTS

Of the 662 participants, 314 reported intending to seek medical care for LUTS (intention group); the remaining 348 answered that they did not intend to see a doctor (no‐intention group). The characteristic of weak stream had the strongest correlation with the QoL index, not only in the intention (r = 0.58) but also in the no‐intention group (r = 0.48). Among several SEMs proposed, one that included a latent variable termed ‘QoL sensitivity’ was the most appropriate to explain overall QoL. In this model it was assumed that ‘QoL sensitivity’ was affected by other latent variables, termed the ‘voiding symptom factors’ and ‘storage symptom factors’, and affected the degree of bother related to each symptom.

CONCLUSION

In Japanese men, voiding symptoms, especially weak stream, contributed to overall QoL for medical care‐seeking behaviour. Differences in ‘QoL sensitivity’ among men may be one of the reasons why symptomatic severity is not always correlated with symptom‐related bother.
Retrograde ureteroscopy for distal ureteric stone removal in children
Authors: De Dominicis Mauro , Matarazzo Ennio , Capozza Nicola , Collura Giuseppe , Caione Paolo
Published: April 2005

A wide range of topics is covered in the Paediatric Urology section in this month's issue: retrograde ureteroscopy for distal ureteric stones, outcomes of continent catheterizable stomas for urinary and faecal incontinence, an exploration of a possible common cause between enuresis in childhood and urinary and faecal incontinence in adult life, and a description of a new surgical procedure, the colpo‐wrap.

OBJECTIVE

To compare the efficacy and safety of ureteroscopy plus intracorporeal lithotripsy (ULT) with extracorporeal shock wave lithotripsy (ESWL) for treating distal ureteric calculi in childhood, as such stones are commonly treated by ESWL as the first option in adults but there is no agreement on the method of treating them in children.

PATIENTS AND METHODS

From July 2002 to July 2003, children presenting with ureteric stones were consecutively randomized for treatment using ULT or ESWL. The two groups were matched for age, sex and stone position in the distal ureter. A 7.5 F ureteroscope combined with a ballistic lithotripter or holmium‐YAG laser was used for ULT. ESWL was administered using a second‐generation lithotripter. The success rate, effectiveness quotient, complication rate and hospitalization were evaluated and compared using Student's t‐test (chi‐square) and Fisher's exact test as appropriate. In all, 31 patients (21 girls and 10 boys, mean age 7.2 years, range 2–17) were treated, by ULT in 17 (12 girls and five boys) and ESWL as a primary procedure in 14 (five boys and nine girls).

RESULTS

After one ULT, all the girls and four boys, and after ESWL, four girls and two boys, were rendered stone‐free at the first treatment. The total stone‐free rate was 16 of 17 for ULT and six of 14 for ESWL (P = 0.004). Eight patients had a second ESWL and three then became stone‐free. The five patients in whom both ESWL treatments failed had a successful ULT. There was no significant difference between the groups in complication rate and hospitalization. General anaesthesia was required in all patients <12 years old treated by ULT or ESWL. The calculated efficiency quotient for treating distal ureteric calculi was significantly lower for ESWL than ULT (P < 0.05).

CONCLUSIONS

ULT should be recommended as the treatment of choice for distal ureteric calculi in children; using small ureteroscopes the target stone was treated safely and effectively.
The additive erectile recovery effect of brain‐derived neurotrophic factor combined with vascular endothelial growth factor in a rat model of neurogenic impotence
Authors: Chen Kuo‐Chiang , Minor Thomas X. , Rahman Nadeem U. , Ho Hao‐Chung , Nunes Lora , Lue Tom F.
Published: April 2005

OBJECTIVE

To test the hypothesis that combined intracavernosal injection with vascular endothelial growth factor (VEGF) with adeno‐associated virus‐mediated brain‐derived neurotrophic factor (AAV‐BDNF) synergistically facilitates the neural regeneration and erectile function after cavernosal nerve injury.

MATERIALS AND METHODS

Forty Sprague‐Dawley male rats were randomly divided into five equal groups: eight had a sham operation while 32 had bilateral cavernosal nerve freezing followed by an immediate intracavernosal injection with either phosphate‐buffered saline (PBS), VEGF, AAV‐BDNF, or AAV‐BDNF + VEGF. Erectile function was assessed by cavernosal nerve electrostimulation at 3 months, and samples of the major pelvic ganglia and penile tissue were evaluated histologically.

RESULTS

In this animal model of impotence from nerve injury, the recovery of erectile function was greatest in those receiving AAV‐BDNF + VEGF; the mean (sd) maximal intracavernosal pressure in this group was 87.2 (20.78) cmH2O, compared with 37.3 (11.39) for VEGF alone and 49.8 (29.58) for AAV‐BDNF alone. No erectile dysfunction was identified in the sham group, with a pressure of 100.7 (22.70) cmH2O, while all treatment groups significantly outperformed the PBS (control) group, at 29.3 (13.52) cmH2O. Furthermore, all animals receiving monotherapy or combined treatment had more NADPH‐diaphorase‐positive nerve fibres than controls but less than in the sham group.

CONCLUSION

Bilateral cavernosal nerve freezing causes erectile dysfunction with accompanying neurological changes. Intracavernosal injection with either VEGF or AAV‐BDNF alone enhances nerve regeneration, with combined therapy (VEGF and AAV‐BDNF) promoting neural and erectile recovery additively.
Analysing Macro‐Poverty Linkages of External Liberalisation: Gaps, Achievements and Alternatives
Authors: Gunter Bernhard G. , Taylor Lance , Yeldan Erinç
Published: April 2005

CGE modelling has dominated analysis of the impact of external liberalisation on poverty. This article provides a structuralist critique of standard neo‐classical CGE models. It highlights five sets of gaps and partial achievements in the modelling of issues affecting the poverty impact of macroeconomic policies: duality and structural rigidities; efficiency gains and quota rents; the investment and savings specification; the nature of public expenditures; and the modelling of financial fragility, risk premia and issues of credibility. It outlines a model that makes it possible to analyse more plausible stories about the impact of both current and capital account liberalisation and questions the realism of existing approaches to ex‐ante poverty impact assessment.
Power Structures and Capacity Aspects of Macro‐Poverty Analyses
Authors: Spence W. Randy
Published: April 2005

This article discusses the role of domestic and international power structures in macro‐poverty impact analyses. It reviews current approaches to poverty measurement, to the analysis of linkages between macro policies and poverty, and to ex‐ante and ex‐post impact assessment. It then draws attention to the influence of country‐specific governance realities and international power structures on the role and influence of PSIAs. The importance of domestic policy priorities, processes and institutions points to the necessity of overcoming domestic capacity constraints on the use of PSIA tools. PSIAs could be improved by being performed in the country of analysis, by domestic individuals and institutions, with all the long‐term external suppport they need.
Chronic Migraine and Medication-Overuse Headache Through the Ages
Authors: Boes CJ , Capobianco DJ
Published: April 2005

We set out to review early descriptions of chronic migraine and medication-overuse headache. The International Headache Society (IHS) recently gave criteria for chronic migraine and medication-overuse headache. Chronic migraine was absent from the 1988 IHS criteria. Peters and Horton described ergotamine-overuse headache in 1951. In the 1980s it was more fully appreciated that overuse of other acute headache medications could increase headache frequency. We reviewed published English-language papers and book chapters. Willis (1672), Oppenheim (1900), Collier (1922), Balyeat (1933), and von Storch (1937) all described chronic migraine. Lennox (1934), O'Sullivan (1936), Silfverskiöld (1947), Graham (1955), Friedman (1955), and Lippman (1955) wrote about ergotamine-overuse headache. Graham (1955), Friedman (1955), Lippman (1955), and Horton and Peters (1963) outlined withdrawal protocols. Chronic migraine has been mentioned in the literature for centuries, while medication-overuse headache has been written about for decades. Graham, Friedman, and Lippman deserve credit for separately reporting the first ergotamine withdrawal programmes.
PRICE HETEROGENEITY AND “REAL” INEQUALITY: A CASE STUDY OF PRICES AND POVERTY IN RURAL SOUTH INDIA
Authors: Rao Vijayendra
Published: April 2005

This paper, based upon a case‐study of three Indian villages, studies whether households within the same market pay different prices for identical goods. It is found that not only are unit prices for food heterogeneous, but that the poor pay more for the same goods than the rich. This is because liquidity constraints force poorer households to purchase goods in small quantities and consequently subject them to quantity premiums. Household specific index numbers are used to adjust nominal incomes to real values and it is found that Gini coefficients of real incomes are between 12 percent to 23 percent greater than the Gim for nominal incomes. An econometric analysis of the determinants of prices shows that incomes are negatively correlated with prices, as is family size, but that the amount of land owned shows a positive relationship.
The Future Is Upon Us
Authors: GARDELS NATHAN
Published: April 2005

The race is on between environmental destruction on a global scale and sustainable solutions. The finish line, in Jared Diamond's alarmed estimation, is only 50 years away. For Bruce Mau, sustainable solutions, already at hand, will win out. Diamond, too, hopes our civilization will learn from those in history who rose to their challenges and prospered, not suffer the fate of others who dithered and collapsed.
Strengthening the Role of Public Health in Environmental Policy
Authors: Burke Thomas A. , Shalauta Nadia M. , Tran Nga L.
Published: April 2005

Over the past 25 years there has been a steady decline in the role of public health agencies in environmental protection. This paper examines the major factors that have contributed to that decline, including the impact of federal environmental laws, the disparity in funding between regulatory and public health activities in environmental protection, and the emergence of risk assessment as a basis for environmental decisions. The methods of risk assessment and traditional public health approaches are contrasted, and the advantages of the involvement of public health agencies are discussed. Recommendations are presented for strengthening the role of public health in environmental decisionmaking to address more effectively public concerns about environmental risks.
Procedural and Substantive Fairness in Risk Decisions: Comparative Risk Assessment Procedures1
Authors: Paterson Christopher J. , Andrews Richard N. L.
Published: April 2005

The issue of fairness often is central within environmental policy debates. The recent proliferation of state and local comparative risk projects for informing the selection of environmental policy priorities offers an appropriate setting to explore the issue of procedural fairness in risk‐based decisionmaking. This paper describes and evaluates the process by which one of the initial state comparative risk projects, Washington's “Environment 2010,” attempted to include a broader range of participants in identifying, assessing, and generating preferred management strategies for a wide range of environmental hazards. The Washington case study suggests that comparative risk projects can be fairer procedurally, but that significant barriers remain. Noting that greater procedural fairness does not necessarily produce greater substantive fairness, the paper concludes that more attention needs to be directed at the process by which comparative risk projects translate their consensus upon risk priorities into subsequent actions.
Environmental Justice and the Allocation Of Risk: The Case of Lead and Public Health
Authors: Kraft Michael E. , Scheberle Denise
Published: April 2005

This paper examines conceptual and methodological issues in the analysis of environmental justice through use of the case of lead‐exposure health risks. Researchers face important obstacles in measuring variable risks among population subgroups. The case of lead exposure, however, illustrates the dramatic potential where adequate data exist for identifying and correcting significant inequities in risk exposure. Despite sharp reductions in the general population's exposure to lead since the 1970s, substantial numbers of minority and low‐income children continue to exhibit unacceptably high blood‐lead levels due primarily to exposure to lead‐based paint. Resolving environmental inequities in this and similar instances requires solid documentation of the risk and better integration of equity issues with other policy demands such as the call for cost‐effective environmental policy.
When Studies Collide*
Authors: Zimmerman Rae
Published: April 2005

Environmental epidemiology increasingly is being used as a foundation for environmental health policy. Since environmental epidemiologic studies have increased dramatically in number, approaches are needed to interpret them. Two approaches used in epidemiology are rules of evidence and meta‐analysis. Rules of evidence pertain to the consistency, strength, uniqueness, and medical basis of the relationship between disease and risk factors such as chemicals. Meta‐analysis is a systematic and rigorous approach to comparing studies and understanding their heterogeneity. Dioxins, benzene, and formaldehyde are three chemicals that are at the forefront of health policy debates. These chemicals illustrate some of the conditions under which researchers are drawn or are not drawn to approaches to compare studies. A meta‐analysis was not conducted for dioxins or benzene, but was conducted for formaldehyde. Rather than addressing study comparisons, epidemiologic studies of dioxins are focusing on expanding the number of health effects studied and obtaining greater specificity for exposures, whereas studies of benzene are focusing on effects at low dose exposures. In the case of formaldehyde, meta‐analysis has strengthened the evidence for some health effects beyond what individual studies could provide. Thus, whether rules of evidence and meta‐analysis approaches to synthesizing information are used can depend upon where the debates are focused.
The Democratic Deficit, the European Union, and the European Future
Authors: Talbot Ross B.
Published: April 2005

Martin Westlake, A Modern Guide to the European Parliament.
Perceptions of Discrimination
Authors: Naff Katherine C.
Published: April 2005

Despite legal efforts to eliminate employment discrimination, lawsuits and demonstrations suggest that many federal employees believe they are subject to discriminatory practices. This article analyzes responses to a governmentwide survey of federal employees in order to understand such perceptions more fully. Propositions examined, and at least partially supported, include that minority groups hold identifiable, but structurally different, belief systems with regard to discrimination, and that there are identifiable factors correlated with these perceptions.
Gun Control as Security Dilemma
Authors: Matthes Mike
Published: April 2005

Robert J. Spitzer, The Politics of Gun Control.
Preferences for Water Policy in the Ogallala Region of New Mexico
Authors: Avalos Manuel , De Young Timothy
Published: April 2005

In the late‐1970s, Congress formed the High Plains Study Project to assess and study various management and water supply strategies for the Ogallala basin. In the early‐1980s, the High Plains Study Council released its findings and recommendations, which in turn stimulated numerous interpretive critiques. A decade has passed since the High Plains Study Council report, yet water management problems persist. Using data from a survey of water experts in New Mexico, we identify the determinants of support and opposition to three water management options: voluntary conservation, mandatory regulation, and water importation.

Preference for water management strategies is a function of how policy is perceived (regulatory vs. distributive). Water users in the Ogallala East region of New Mexico tended to oppose mandatory regulatory policies that provide the best option for conserving ground water resources for future generations; voluntary conservation‐the least effective option—enjoyed the strongest support from respondents. The findings of this research should be of interest to persons concerned with the future of the Ogallala aquifer and to students of public policy.
Privileged Ideas and State Interests
Authors: Klyza Christopher McGrory , Mlyn Eric
Published: April 2005

The puzzle that intrigues us is the source of interests that guide the state in instances of state autonomy. We argue that one important source of these interests is ideas: When relative state autonomy exists over long periods of time, there is a strong likelihood of a privileged idea that informs state interests. State actors direct state policy during autonomous periods by adopting and privileging particular ideas (institutionalization), resulting in policy outcomes reflecting these now privileged ideas. This argument is examined in two case studies: nuclear weapons targeting since World War II, guided by counterforce, and federal public lands forestry policy since 1900, guided by technocratic utilitarianism.
Universal Values and Win‐Win Policy
Authors: Nagel Stuart S.
Published: April 2005

This is a follow‐up to the previous note in the spring 1995 issue of the Policy Studies Journal entitled “Win‐Win Policy.” Its purpose is to provide further examples regarding the question, “What policy issues are worth providing examples for?”1
Rethinking State Rail Policy
Authors: Feser Edward J. , Cassidy Glenn D.
Published: April 2005

In the last two decades, many states established rail promotion programs in an effort to limit the contraction of their railroad networks. Now federal funds for rail projects are nearly exhausted, and states must decide whether to expand considerably their levels of internal funding for short line investments. Such a decision requires a careful articulation of policy goals, combined with sound cost‐benefit techniques. Research shows, however, that states often fail to evaluate the full range of costs and benefits when considering rail investments. Instead, the economic development benefits of local rail service frequently are overstated, while the potential for rail investments to meet broader transportation planning needs is neglected. This paper evaluates the rationale behind state intervention in the rail industry, discusses the tendency of states to focus on economic development to the exclusion of other benefit categories, and presents summary results from an analysis of an investment project in North Carolina. The paper suggests that state funding for rail projects is more likely to be justified based on intermodal substitution benefits generated by local rail service, rather than the railroads' potential to increase jobs.
Airport Privatization
Authors: Truitt Lawrence J. , Esler Michael
Published: April 2005

In today's economic and political climate, there is a growing trend toward less governmental intervention in the economy and more reliance on the private sector for the delivery of a variety of services. Deficit politics, airline deregulation, and the prospect of a windfall of cash has prompted many local units of government that own and operate airports to consider selling or leasing these facilities to private investors. Airport privatization has emerged as a contentious issue, with weighty arguments on both sides of the debate. This article examines these arguments and presents several models of airport privatization. The authors suggest that the most aggressive form of privatization–full divestiture–is unlikely to produce the benefits advertised by its proponents. However, less radical forms of privatization serve as useful models for future airport ownership and operation. The authors conclude that, given the great variation in the types of airports in the United States system, no single model is sufficient.
Cities and Privatization
Authors: Greene Jeffrey D.
Published: April 2005

Cities across America look for management strategies useful for accomplishing their responsibilities and programs. While some cities include privatization strategies in their management portfolios, others do not, and the underlying reasons are not readily apparent. This study seeks to gain some insight into this disparity through several questions: Why do some cities use more privatization than others? Are privatization levels higher in fiscally healthy or fiscally stressed cities? Where are the cities that use privatization located? This study attributes municipal privatization levels in medium‐sized cities, in part, to degree of wealth, fiscal stress, and location. The findings suggest that privatization levels are higher in wealthy, fiscally healthy, suburban cities.
The Spending‐Service Connection
Authors: Morgan David R. , LaPlant James T.
Published: April 2005

This research tests the relationship between state and local spending for health and hospitals, a set of health service measures, and three final policy outcomes—low birthweight infants, infant mortality, and child deaths. The analysis includes several proxies for service demand—state resources, percentage of single‐teen births, and percentage of the population without health insurance. The multiple regression equations also incorporate a measure of federal spending on health and an indicator of state spending for Medicaid. This first stage of the analysis can account for only a limited amount of variation in per capita state and local health and hospital spending. Health expenditures, however, are prominently related to health workers per 10,000 population, while hospital spending buys hospital beds. The final step in the analysis uses path models. The results show that neither spending nor the intermediate‐level health outputs (including a measure of prenatal care) are significantly related to the final three outcome variables. Single‐teen births is the dominant influence in the final equations.
Revisiting the Urban Classics
Authors: Grimshaw William J.
Published: April 2005

The classic urban pluralist studies are reconceptualized as providing alternative theoretical perspectives. These political order and economic development perspectives exert an enduring influence, as seen in urban regime theory and in Paul Peterson's economistic conception of politics in City Limits. A supplementary theoretical perspective is proposed that addresses the problem of inequality and takes the promotion of social justice as the principal task of urban governance. Reconciling the three perspectives provides a more comprehensive framework for conducting research.
Sexual Harassment Policy
Authors: Lindenberg Karen E. , Reese Laura A.
Published: April 2005

This research explores hew public‐sector employees feel about sexual harassment policies in their workplace, identifies policy attributes that appear to lead to dissatisfaction, and examines employee suggestions for policy improvement. Based on a survey of employees in two public‐sector organizations, it concludes that satisfaction with policies is mixed and uncertainty is high, while reporting rates are low relative to harassment experiences. And, while employees are better able to identify problems than propose solutions, recommendations for policy improvements include training on the nature of sexual harassment, use of an ombudsperson, and increased accountability of supervisors.