bluuebunny/crossref_metadata_2025 huggingface dataset:
72  Urodynamics in the octogenarian: is it worthwhile?
Authors: DORKIN T.J. , BROMAGE S.J. , CHAN L. , TSE V.
Published: February 2006

Introduction:  Treatment of lower urinary tract (LUT) dysfunction is often based on symptoms, which may correlate poorly with definitive diagnosis and carry significant side‐effects. We analysed the utility of urodynamic assessment in an elderly population to determine how closely symptoms predict urodynamic diagnosis.

Materials and Methods:  One hundred fifty‐seven patients over the age of 80, who underwent multi‐channel fluoroscopic urodynamics for the assessment of voiding dysfunction, were included. The studies were conducted according to ICS standards. The clinical records were analysed retrospectively to collect data on patient symptoms and management. The clinical and urodynamic diagnoses were compared to assess the predictive value of symptoms in this population.

Results:  There were 122 males and 35 females. The mean age was 84 (range 80–94). Detrusor overactivity (DO) was the most common urodynamic finding in male patients, seen in 56/122 (46%), whereas decreased bladder compliance was the most common in females, seen in 11/35 (31%). 70/157 (45%) patients presented with pure storage symptoms (39 men and 31 women), and DO was found in only 30 of these (43%). 31/157 patients (20%) presented with pure voiding symptoms (29 males and 2 females), and bladder outlet obstruction was identified in only 15 of these (48%).

Conclusion:  In octogenarians, there is a poor correlation between LUT symptoms and urodynamic diagnosis. We suggest that, in suitable elderly patients, urodynamic evaluation is useful and can guide patient management. This is particularly important for patients with presumed DO, in whom empirical prescribing of antimuscarinic agents may be associated with significant side effects.
75  Long‐term follow up of tension free vaginal tape for stress urinary incontinence in females with neuropathic bladder
Authors: PATKI P. , HAMID R. , ARUMUGAM K. , WOOD S. , SHAH P.J.R.
Published: February 2006

Introduction:  We evaluated safety and long‐term efficacy of TVT in treatment of urodynamic stress incontinence (USI) in females with neuropathic bladders.

Method:  Sixteen incontinent female patients were treated. 11 women were postlumbar spinal surgery and five postspinal cord injury. Four had previously failed surgery for USI. Patient demographics, pre and postoperative clinical and videocystometrogram (VCMG) parameters were recorded. Continence assessment at 6 weeks (voiding diary and pad test), 3 months (VCMG) and yearly follow up was recorded.

Results:  Mean age was 55 years with mean follow up of 52.7 months (range 12–86). At last follow up 87.5% patients (14/16) were continent. The two failures were due to persistent USI and postoperative detrusor hyperreflexia (DH). DH was pre operatively present in 4, requiring simultaneous intra detrusor botulinum toxin injections in two and anticholinergic medications in rest. Bladder perforation was seen in one and urinary infections in three. Mean pre and postoperative detrusor pressures were 23.8 and 15 cm of water. Two patients continued to use pads (3/day) similar to pre operative cumulative average of three pads/day. Preoperatively 11 patients performed intermittent catheters (SIC), three spontaneous voids (SV) and one combination of the two with one on indwelling urethral catheter (IDUC). One patient each on SV, SIC and IDUC changed to SIC. Conversely one each on SIC and SV changed to combination.

Conclusion:  TVT is safe, effective long‐term treatment for USI in females with neuropathic bladders. DH needs adequate suppression with regular VCMG follow up. Previous incontinence surgery did not affect complications or outcome.
77  Vanilloid receptor expression in body and trigone of female urinary bladder: changes in urgency without detrusor overactivity
Authors: LIU L. , KRISTIANA I. , MANSFIELD K.J. , VAUX K. , MILLARD R.J. , BURCHER E.
Published: February 2006

Introduction:  Patients with sensory urgency (SU): the symptom complex of urgency associated with pain, burning or discomfort, often accompanied by frequency and nocturia, are difficult to treat. Vanilloid receptors on afferent neurons and on urothelium may participate in signalling from the bladder. Our aim was to examine whether changes in VR1 expression occur in bladder from SU patients compared with controls.

Patients:  Biopsies from body and trigone were obtained from patients with SU (female, aged 21–82) who had undergone videourodynamics to exclude detrusor overactivity and define first sensation. Asymptomatic age‐matched females with prior history of carcinoma acted as controls. Biopsies were collected into ‘RNALater’. Specimens were dissected into two layers, mucosa and detrusor muscle, before RNA extraction and quantitative competitive RT‐PCR (Mansfield et al 2005 Br J Pharmacol 144: 1089–99).

Results:  In control biopsies, VR1 mRNA was present in greater density in mucosa than in detrusor muscle (15.3 × 105cf. 4.6 × 105 copies/μg RNA, both n = 15, P < 0.01). In SU, VR1 mRNA expression was significantly higher in trigonal mucosa than in body mucosa (19.1 × 105 cf. 7.4 × 105 copies/μg RNA, n = 21‐‐23, P < 0.01). There was no significant change in VR1 expression in body mucosa from SU specimens compared with matched controls. In SU patients, the level of VR1 expression in trigonal mucosa (but not body mucosa) was significantly inversely correlated with the volume at first bladder sensation (r2 = 0.41, P < 0.01).

Conclusion:  We hypothesise that excessive afferent signalling via VR1 receptors in the trigone region may be related to an early first bladder sensation and sensory urgency.
79  Examination of potential sources of smooth muscle for use as a transplantable, innervated sphincter.
Authors: BRAMICH N.J. , O'CONNELL H.E. , HIRST G.D.S.
Published: February 2006

Aim:  To examine the electrical and mechanical properties of different smooth muscle tissues for their suitability to assist the malfunctioning urethral sphincter in the treatment of stress urinary incontinence.

Methods:  Changes in contractile state and membrane potential, in response to nerve stimulation, were measured from guinea‐pig mesenteric veins, detrusor smooth muscle and rat dartos.

Results:  Intracellular recordings made from mesenteric veins (diameter 100–250 ??m) displayed stable resting membrane potentials (RMPs) of –65.2 ± 2.7 mV (10 cells, five animals). Stimulation with long trains at low frequencies (80s, 0.5–2 Hz), evoked slow sustained membrane depolarizations and constrictions which reached a peak within 50s. Stimulation at 2Hz evoked a membrane depolarization of 16.3 ± 4mV and a 17 ± 7% reduction in vessel diameter. Upon cessation of stimulation, the membrane potential and blood vessel diameter rapidly returned to baseline levels. Detrusor smooth muscle cells had RMPs of –40 ± 4 mV (n = 3). Stimulation at frequencies of 1 to 5 Hz evoked muscle action potentials and contractions. Contractions evoked by long trains of nerve stimulation were not sustained for the duration of stimulus. For example, a stimulus train of 80 s at 1 Hz, evoked a contraction of 20 ± 9 mN which reduced to 3 ± 1 mN (n = 3). Hyoscine reduced the secondary phase of the contraction from 3 ± 0.4 mN to 0.7 ± 0.4 mN (P < 0.01, n = 3). Rat dartos smooth muscle had a RMP of –64 ± 1 mV (n = 38). Long trains of low frequency nerve stimulation (1 Hz for 80s), evoked a slow membrane depolarization of 15 ± 4 mV and sustained contraction of 12 ± 2 mN. Increasing the frequency of stimulation caused a graded increase in the amplitude of both the membrane depolarization and contraction. Following the cessation of stimulus, the membrane potential and force generated by the smooth muscle immediately returned to baseline. All responses were blocked by the α‐adrenoceptor antagonists phentolamine (1 μM) and prazosin (0.1 μM).

Conclusion:  Smooth muscles of the mesenteric vein and dartos display contractile properties which make them suitable for use as transplantable sphincters. In addition, dartos smooth muscle possesses similar pharmacological properties to the proximal urethral sphincter.
86  A prospective study for the treatment of stress urinary incontinence arising from intrinsic sphincter deficiency with ACT™ balloons (adjustable continence therapy)
Authors: CHARTIER KASTLER E. , CARDOT V. , MOZER P. , BASTIEN L. , RICHARD F. , DENYS P.
Published: February 2006

Introduction:  The study assessed the treatment of intrinsic sphincter deficiency with the ACT™ system in neurogenic patients.

Material and methods:  The ACT™ consists of two postoperatively adjustable silicone balloons placed paraurethrally in females and at the prostatic apex, or vesico‐urethral anastomosis in males. Balloon titration is via tubing connected to a titanium port in the labia majora or scrotum. Efficacy assessment was based on technical feasibility and patient assessment of leakage and acceptance.

Results:  Eighteen implantations including three revisions were performed on 12 females and three males. Mean age was 51.9 years, mean follow‐up was 18 (8–40) months with a mean neurogenic history of 15 years (1 to 54). Aetiology of neurogenic disease was mixed and included degenerative; spinal cord injury; oncological, vascular and congenital disorders with most patients self catheterising and using either anticholinergics and/ or Botox or had previously undergone enterocystoplasty. Procedure was performed using local (72%), general (5.5%) or no anaesthesia (22%). At follow up, seven patients were dry and pad free(46%), six improved (not requesting any further adjustment)(40%), two failed. 8/30 devices were explanted in five patients due to erosion (six), device failure (one) and treatment failure (one). 3/5 have been reimplanted, with 1/5 planned for reimplantation. Of these three patients, two were dry and one significantly improved. No major complication has been described.

Conclusion:  ACT balloons may be considered for treatment of ISD in neurogenic patients provided that patients are informed of the increased risk of erosion, and the possibility of secondary implantation.
87  French multicentric prospective study for treatment of postprostatectomy stress urinary incontinence (SUI) using adjustable continence therapy (PROACT™)
Authors: CHARTIER KASTLER E. , LEBRET T. , GRISE P. , BOTTO H. , DELAPORTE V. , COSTA P.
Published: February 2006

Introduction:  This study assessed the feasibility and efficacy of ProACT™ for treatment of postprostatectomy incontinence.

Material and methods:  Using fluoroscopic control two percutaneous balloons are placed at the vesico‐urethral anastomosis (Prostatectomy; Ablatherm) or the apex (TURP) and filled with isotonic solution. Postoperatively, 1 ml can be titrated monthly until optimum continence is achieved.

Results:  Fifty‐eight patients were implanted, 52 postcancer treatment (51 Radical Prostatectomy with 11/51 postradiotherapy and 1/52 Ablatherm) and six following benign surgery (four TURP and two other prostatectomies). Mean age was 70.8 years old (56.6–87.2) with time since initial surgery 5.3 years (6 months–20.6 years). Prior surgical incontinence treatments included artificial urinary sphincters (eight), bulking agent injections (three) and male sling (one). Mean urethral closure pressure (n = 36) was 49 cm of H2O at baseline. Average pads/day was 2.9 (1 to 10). Mean quality of life (I‐QoL) was 45 (2–85). At median follow‐up (14 months), 11 patients (19%) were dry, 21 (36%) improved, 17 (29 %) unchanged; 2 (3.4%) worse and seven (12%) had undergone explanation. Quality of Life increased to 61 (17–100). Of the 24 postradical prostatectomy patients without radiotherapy, 92 % are improved, 38 % being completely dry. However six (55%) of postradiotherapy patients failed.

Sixteen patients required explanation due to infection (two); urinary retention (one); urethral erosion (one); pain (one), defective balloons (two); other (one) non‐response (eight). Four patients were successfully re‐implanted.

Conclusion:  ProACT is an effective treatment option as an alternative to the artificial urinary sphincter.
89  Twenty years of artificial urinary sphincters in the treatment of female urinary incontinence.
Authors: CARTMILL R.A.
Published: February 2006

Aim:  To review the use of the artificial urinary sphincter (AUS) in female urinary incontinence.

Methods:  Review of a single surgeon experience with use of the AMS 800 (American Medical Systems) in the period Aug 1983–July 2005. Data was collected prospectively on all patients. Follow‐up information was complete on all cases to Oct 2005.

Results:  A total of 48 patients had an AUS with an average follow‐up of 12.5 years (0.3–22 years). Indications for placement were urethral incompetence following failed previous anti‐stress surgery (36), pelvic trauma (seven), previous urethral surgery (two), myelomeningocele (one) and other (two). A total of 19 revision procedures were required in 15 patients (31%). With the exception of one case with infection, revisions related to mechanical failure. Fluid loss occurred in 16 cases with either splits or small holes in the tubing being the most commonly identified cause. Non‐leak device malfunction occurred in only two patients (5%).

Summary:  The AUS is a highly successful intervention for incontinence related to intrinsic sphincter deficiency in female patients. It avoids the potential problem of bladder outflow obstruction associated with slings. Up to a third of patients will require revision surgery with long term follow‐up. However this is largely related to fluid leakage and readily addressed. The AUS may be an underutilised treatment modality for female urinary incontinence and should be considered in selected patients with intrinsic sphincter deficiency in preference to other procedures.
90  Transurethral resection of prostate for locally advanced prostate cancer with bladder outlet obstruction
Authors: BERJIDIS N. , BOUCHIER‐HAYES D.M. , THOMAS B.C. , COSTELLO A.J.
Published: February 2006

Introduction:  Bladder outlet obstruction is a common complication of locally advanced carcinoma of the prostate. The aim of this study was to evaluate the operative morbidity and outcome after TURP for locally advanced prostate cancer and to compare it with the results from patients who had a TURP for benign prostate hyperplasia.

Methods:  Between January 1998 and December 2003 422 consecutive patients had a TURP for BPH and 53 consecutive patients underwent a TURP for LUTS with a diagnosis of locally advanced prostate cancer.

Results:  Mean age at time of surgery was 76.6 years (range 63–95) and mean PSA was 100.2 (range 0.3–2630) for those with cancer. Before the TURP 24.5% of the patients had hormonal treatment alone, 11.3% had radiotherapy and 64.2% had not treatment for their prostate cancer. At TURP histopathology revealed high grade cancer (Gleason score 8–10) in 75% and moderate grade (Gleason score 6 or 7) in 25%. Mean resection weight was 12.6 gram (range 2–65). There was no difference in the overall mortality, failure to void or complication rates between the established prostate cancer and the BPH group (Chi‐squared, P < 0.05).

Conclusion:  TURP can be performed with little fear of excess complications in patients with established cancer of the prostate gland.
91  Initial experience with greenlight photoselective vaporisation of the prostate
Authors: WOO H.
Published: February 2006

Introduction:  Greenlight Photoselective Vaporisation of the Prostate (GLPVP) has been the subject of much interest and associated with many positive claims about outcomes and patient satisfaction. This objective of this study was to assess the early experience of this modality in an Australian centre and whether this mirrors international experience to date.

Patients and Methods:  Patients undergoing GLPVP from the commencement of offering this modality in March 2005 have been followed prospectively. TRUS prostate volume, laser energy and operating times were recorded at baseline. The IPSS, IIEF and flow study parameters have been recorded at baseline and on follow up.

Results:  Fifty‐one patients with a mean age of 64 ± 8 years and mean prostate size of 40 ± 17 cc have been treated with GLPVP. Average operating time was 70 ± 26 min. Mean energy requirements was 217 ± 85 kJ. Mean period of catheterisation and length of stay was 8.9 h and 0.9 days respectively. Laser efficiency of kJ/min improved with experience. Baseline IPSS, QL, Qmax and PVR results were 20.6, 4.3, 8.0 ml/s and 162 ml. Of eight evaluable men who had reached 3‐months follow up, IPSS, QL, Qmax and PVR results were 5, 1.6, 25.6 ml/s and 52 ml respectively. No cases of incontinence or impotence or transfusion.

Conclusion:  Early experience with GLPVP finds outcomes as would be expected following TURP at 3 months. Clear benefits in morbidity, legth of stay and catherisation times appear evident. Early results indicate that there should be any easy transition to performing the majority of cases as day procedures.
92  Photoselective vaporisation of the prostate randomised against turp‐preliminary results
Authors: BOUCHIER‐HAYES D.M. , ANDERSON P.A. , VAN APPLEDORN S. , BUGEJA P. , COSTELLO. A.J.
Published: February 2006

Introduction:  Many technologies have attempted to supplant TURP as the surgical treatment of choice in the treatment of lower urinary tract symptoms, but have not undergone randomised trials. Photoselective vaporization of the prostate (PVP) using the Greenlight® laser system (Laserscope, San Jose, Ca.) gives an 80‐watt laser ablation system and here is compared to TURP in the world's first randomised trial.

Study Design:  One hundred and twenty patients are to be randomised to undergo TURP or PVP after evaluation which is repeated at 1, 3, 6 and 12 months. Irrigation use, length of catherisation time (LOC), length of hospital stay (LOS), blood loss and operative time are also assessed. All procedures were performed by fellows/registrars.

Results:  To date 90 patients are randomised and 68 are evaluable and were similar at baseline. Both techniques produced equivalent significant improvement in flow rates and IPSSs, and significantly shorter length of time of catherisation (LOC) and length of stay (LOS) in the PVP group. Adverse events were less frequent in the PVP group, and the procedure was 22% cheaper than TURP.

Conclusions:  This trial demonstrates with preliminary data that PVP may be an effective technique when compared to TURP, producing equivalent improvements in flow rates and IPSS scores with markedly reduced LOS, LOC and adverse events.
The medicalisation of shyness: from social misfits to social fitness
Authors: Scott Susie
Published: February 2006

Shyness has become an ‘unhealthy’ state of mind for individuals living in contemporary Western societies. Insofar as its behavioural ‘symptoms’ imply a failure to achieve certain cultural values, such as assertiveness, self‐expression and loquacious vocality, shyness is increasingly defined as a problem for which people can, and should, be treated. This paper first critically discusses the idea that we are witnessing a new ‘cultural epidemic’ of shyness, as evidenced by increasing rates of diagnosis for Social Phobia, Social Anxiety Disorder and Avoidant Personality Disorder. It then examines three main dimensions of the medicalisation of shyness: biomedical and genetic approaches, the therapeutic interventions of cognitive‐behaviour therapy and ‘shyness clinics’, and the disciplinary regimes imposed by self‐help books and websites. Within a cultural climate of pervasive anxiety and privatised risk, the medicalisation of shyness suggests a powerful new way of defining and managing certain kinds of deviant identities, but we can also find some evidence of resistance to this approach.
Boundaries obscured and boundaries reinforced: incorporation as a strategy of occupational enhancement for intensive care
Authors: Carmel Simon
Published: February 2006

Medical dominance is a recurring theme in sociological analyses of healthcare work. One example of a theoretical framework by which the medical profession is said to dominate other healthcare occupations is Turner's (1995: 138) enumeration of the modes of subordination, limitation and exclusion. As Elston (1991) has noted, however, such frameworks tend to be rather speculative and there is not a great deal of evidence on how these strategies are exercised, for example, at a micro‐level. There is also a tendency to portray healthcare occupations as monolithic entities, without acknowledging differences within healthcare occupations, and the relationships between them, which can arise in different clinical locales. Through a micro‐level analysis of the practice of intensive care, using ethnographic data collected on three intensive care units (ICUs) in England, this paper proposes a hitherto unidentified strategy –incorporation– for medical dominance at a micro‐level. Paradoxically, an enhanced position for both intensive care medicine and intensive care nursing arises, relative to proximal healthcare groups. The argument of this paper is that within the ICU an occupational boundary (doctor‐nurse) is obscured, while an organisational boundary which differentiates the ICU from the wider hospital is reinforced. Overall, the power relationship between medicine and nursing in intensive care is not ‘zero‐sum’: the influence of both groups in the wider hospital is increased by this strategy of incorporation.
Late Pleistocene and Holocene development of the felid fauna (Felidae) of Europe: a review
Authors: Sommer R. S. , Benecke N.
Published: February 2006

In the fossil deposits of the Late Pleistocene (c. 115 000–11 500 years ago), five felid species are recorded in Europe: the wildcat Felis silvestris, Eurasian lynx Lynx lynx, Iberian lynx Lynx pardinus, leopard Panthera pardus and cave lion Panthera leo spelaea. In the Holocene, Europe was colonized by F. silvestris, L. lynx and L. pardinus as well as the lion Panthera leo. The status of P. pardus in post‐glacial Europe is unknown. So far, only sparse records indicate that P. pardus survived into the early Holocene. During the Late Glacial, both L. lynx and L. pardinus occurred on the Iberian Peninsula. However, from the Holocene, only the Iberian lynx is recorded in this region. There are subfossil records that indicate that L. pardinus also occurred in central and western France until c. 3000 years ago. Surprisingly, with reservations on the determination of the bones (by J. Altuna), both lions and cave lions seem to be recorded in the Iberian Peninsula in the Late Glacial. There are published records of the lion P. leo in the northern Iberian Peninsula from the early Holocene. However, its presence in Europe on the basis of subfossil records was proven initially from the Atlantic period. In Ponto‐Mediterranean regions of Europe, the lion is recorded from the Atlantic to the younger sub‐Atlantic.
Isolation and characterization of polymorphic microsatellite markers in Pagellus bogaraveo, and cross‐species amplification in Sparus aurata and Dicentrarchus labrax
Authors: PIÑERA J. A. , BERNARDO D. , BLANCO G. , VÁZQUEZ E. , SÁNCHEZ J. A.
Published: February 2006

Several new fish species are currently being included in breeding programmes. However, as specific molecular markers have not yet been developed, this represents a commercial handicap with respect to traditional aquaculture species such as gilthead sea bream or Atlantic salmon. In the present study, 12 new microsatellite loci were developed for blackspot sea bream (Pagellus bogaraveo) that show high levels of polymorphism, especially useful in parentage assignment and individual identification. In addition, cross‐amplification was obtained for two important species for Spanish aquaculture, gilthead sea bream and sea bass.
Genic microsatellite markers derived from EST sequences of switchgrass (Panicum virgatum L.)
Authors: TOBIAS CHRISTIAN M. , HAYDEN DANIEL M. , TWIGG PAUL , SARATH GAUTAM
Published: February 2006

Switchgrass is a large, North American, perennial grass that is being evaluated as a potential energy crop. There is a need to assess genetic diversity in stored accessions and in remaining native stands to assist breeding and conservation efforts. Marker development will also be necessary for genetic linkage mapping. Toward this end, 32 switchgrass genic di‐, tri‐ and tetranucleotide repeat microsatellites were identified from expressed sequence tags (ESTs). These microsatellites were used to screen individuals from two different named cultivars. The markers displayed a high level of polymorphism consistent with the tetraploid, allogamous behaviour of the cultivars tested.
Microsatellite markers in Carica papaya L.: isolation, characterization and transferability to Vasconcellea species
Authors: PÉREZ JOHN OCAMPO , DAMBIER DOMINIQUE , OLLITRAULT PATRICK , D’EECKENBRUGGE GEO COPPENS , BROTTIER PHILIPPE , FROELICHER YANN , RISTERUCCI ANGE‐MARIE
Published: February 2006

A dinucleotide microsatellite‐enriched genomic library was obtained from Carica papaya L. Sixty‐nine microsatellites were evaluated on three genotypes of C. papaya and seven species of the neighbour genus Vasconcellea. Among them, 45 markers were characterized on a sample of 29 accessions of C. papaya from the Caribbean region and 11 accessions of Vasconcellea from the Andes of Colombia and Ecuador. Twenty‐four gave polymorphism in C. papaya and only four among the seven species of Vasconcellea, confirming the divergence between both genera.
Cloning and characterization of 29 tetranucleotide and two dinucleotide polymorphic microsatellite loci from the endangered marbled murrelet (Brachyramphus marmoratus)
Authors: REW MARY BETH , PEERY M. ZACHARIAH , BEISSINGER STEVEN R. , BÉRUBÉ MARTINE , LOZIER JEFFREY D. , RUBIDGE EMILY M. , PALSBØLL PER J.
Published: February 2006

We developed 31 novel, polymorphic microsatellite loci in the marbled murrelet (Brachyramphus marmoratus), a critically endangered seabird. Variability was tested on 15 individuals from the Santa Cruz, California population, with each locus characterized by two to 12 alleles. Observed levels of heterozygosity ranged from 0.13 to 0.93. These loci provide a valuable means of assessing the population structure and demographic parameters of this species, which may be critical to its conservation across a fragmented habitat.
Characterization of polymorphic microsatellite loci in the terrestrial isopod Armadillidium vulgare
Authors: VERNE SÉBASTIEN , PUILLANDRE NICOLAS , BRUNET GÉRALDINE , GOUIN NICOLAS , SAMOLLOW PAUL B. , ANDERSON JOEL D. , GRANDJEAN FRÉDÉRIC
Published: February 2006

The common pill bug, Armadillidium vulgare, is known to harbour two distinct strains of the feminizing proteobacteria Wolbachia. In order to study the effect of the presence of Wolbachia on the evolution of A. vulgare populations, we developed and characterized a set of nine polymorphic microsatellite loci from two microsatellite‐enriched genomic libraries. We screened 48 individuals from three French populations and found high genetic variation. Locus‐specific allelic diversity ranged from four to 28 and observed heterozygosity from 0.40 to 1.00, which indicates that these markers can be used to conduct population genetic studies in A. vulgare.
Analysis of multilocus fingerprinting data sets containing missing data
Authors: SCHLÜTER PHILIPP M. , HARRIS STEPHEN A.
Published: February 2006

Missing data are commonly encountered using multilocus, fragment‐based (dominant) fingerprinting methods, such as random amplified polymorphic DNA (RAPD) or amplified fragment length polymorphism (AFLP). Data sets containing missing data have been analysed by eliminating those bands or samples with missing data, assigning values to missing data or ignoring the problem. Here, we present a method that uses random assignments of band presence–absence to the missing data, implemented by the computer program famd (available from http://homepage.univie.ac.at/philipp.maria.schlueter/famd.html), for analyses based on pairwise similarity and Shannon's index. When missing values group in a data set, sample or band elimination is likely to be the most appropriate action. However, when missing values are scattered across the data set, minimum, maximum and average similarity coefficients are a simple means of visualizing the effects of missing data on tree structure. Our approach indicates the range of values that a data set containing missing data points might generate, and forces the investigator to consider the effects of missing values on data interpretation.
Development of microsatellite markers in polyploid persimmon (Diospyros kaki Lf) from an enriched genomic library
Authors: SORIANO J. M. , PECCHIOLI S. , ROMERO C. , VILANOVA S. , LLÁCER G. , GIORDANI E. , BADENES M. L.
Published: February 2006

The oriental persimmon (Diospyros kaki Lf) is believed to have originated in China with subsequent introduction into Japan and Korea in ancient times. The species was then brought to Europe, Brazil and the USA from Japan in the 19th century. Recent studies highlighted the poor state of identification of cultivars in these countries due to incorrect labelling and presence of synonyms among local varieties. Thus, molecular marker characterization of germplasm resources is of great value for genetic resource preservation and plant breeding of persimmon. Therefore, to identify accessions for further plant breeding and germplasm management, 37 microsatellite loci were developed from a CT/AG‐enriched persimmon genomic library.
Isolation and characterization of microsatellite loci in Lesquerella fendleri (Brassicaceae) and cross‐species amplification
Authors: SALYWON ANDREW , DIERIG DAVID A.
Published: February 2006

Fifteen novel microsatellite primer pairs are presented for Lesquerella fendleri, which were developed from seven dinucleotide, five trinucleotide and three tetranucleotide microsatellite DNA loci. These loci were characterized for 40 individuals from 24 localities throughout the species range. The number of alleles observed per locus ranged from three to 16, the observed heterozygosity ranged from 0.175 to 0.750, and the polymorphic information content ranged from 0.218 to 0.889. Cross‐species transferability tested on nine species of Lesquerella and one species of the related genus Physaria indicates that these primer pairs may be useful for population genetic studies of other species in Lesquerella and possibly other closely related genera.
Isolation of six microsatellite loci in the pollinating fig wasp, Platyscapa awekei
Authors: VAN VUUREN GERT J. JANSEN , KRYGER PER , GREEFF JACO M.
Published: February 2006

Platyscapa awekei DNA was enriched for several repeat motifs. Sequencing of 48 transformed colonies showed that 22 contained microsatellite loci. Eleven of these loci were tested and six of them proved to be reliable and variable. As expected from these wasps’ biology, FIS was high (= 0.423), indicating frequent sibmating. Notwithstanding, we estimate that dispersing males may secure as much as 8% of all matings.
Characterization of polymorphic microsatellite loci for the polychaete tubeworm Hobsonia florida
Authors: OLSON MARY ANN , ZAJAC ROMAN , CACCONE ADALGISA , RUSSELLO MICHAEL A.
Published: February 2006

Eight dinucleotide microsatellite loci were isolated and characterized from Hobsonia florida, a tube‐dwelling ampharetid polychaete. The identified loci were highly polymorphic, with allelic diversity ranging from six to 11 alleles. Levels of expected heterozygosity were 0.52 or greater in all cases, averaging 0.78 across the complete set of loci. Cross‐species amplification was successful in three of the eight loci for one or both of the other species (Melinna cristata and Ampharete acutifrons) tested. Although these novel loci were designed for immediate utility in H. florida population‐level research, these results indicate they may prove useful in studies of other related taxa.
Development of sequence tagged microsatellites (STMs) for the barley scald pathogen Rhynchosporium secalis
Authors: KEIPER FELICITY J. , HAYDEN MATTHEW J. , WALLWORK HUGH
Published: February 2006

A rapid and cost efficient technique was developed and used to generate 168 sequence tagged microsatellites (STMs) in the barley scald pathogen Rhynchosporium secalis. Sixty‐two STMs, amplifying 66 loci, revealed a high level of polymorphism among a diverse set of 16 Australian isolates. Each locus revealed two to nine alleles (average 4 ± 1.82), and a gene diversity measure of 0.54 was obtained. This technique not only halved the cost of marker development compared to traditional methods, but substantially reduced the cost of performing fluorescence‐based microsatellite assays. These STMs provide a powerful tool for genetic studies in R. secalis.
ml‐relate: a computer program for maximum likelihood estimation of relatedness and relationship
Authors: KALINOWSKI STEVEN T. , WAGNER AARON P. , TAPER MARK L.
Published: February 2006

Genetic data are useful for estimating the genealogical relationship or relatedness between individuals of unknown ancestry. We present a computer program, ml‐relate that calculates maximum likelihood estimates of relatedness and relationship. ml‐relate is designed for microsatellite data and can accommodate null alleles. It uses simulation to determine which relationships are consistent with genotype data and to compare putative relationships with alternatives. ml‐relate runs on the Microsoft Windows operating system and is available from http://www.montana.edu/kalinowski.
Development of Local Government Debt Financing Markets: Application of a Market‐Based Framework
Authors: MARTELL CHRISTINE R. , GUESS GEORGE M.
Published: February 2006

Needed is clear guidance on how to develop market‐based debt financing systems in transitional and developing countries. We propose an analytical framework useful for identifying constraints to financial development and providing recommendations to overcome constraints to develop municipal financing capacity. The proposed framework is applied to five country case studies: Indonesia, Mexico, Philippines, Poland, and South Africa. The thesis of this paper is that municipal credit market development is related to improvements in the legal/regulatory framework governing local borrowing, the capacity of financial institutions to assess risk, and borrower capacity to support and manage debt.
Do Legislatures Matter in Budgetary Reform?
Authors: BOURDEAUX CAROLYN
Published: February 2006

A recurring problem in the implementation of budgetary reforms at the state level is whether and how to engage legislatures in the effort. This paper posits that legislatures are critical for effective implementation and that different legislative institutional arrangements may have differential effects on both legislative and agency implementation. Drawing on a multistate survey, the analysis shows that higher levels of legislative responsibility for budgeting as well as legislative engagement in oversight of performance information are significantly associated with increased use of performance measures in making budgetary decisions both at the legislative and agency levels.
Organization of Frequency Spectra of Atrial Fibrillation: Relevance to Radiofrequency Catheter Ablation
Authors: TAKAHASHI YOSHIHIDE , SANDERS PRASHANTHAN , JAÏS PIERRE , HOCINI MÉLÈZE , DUBOIS RÉMI , ROTTER MARTIN , ROSTOCK THOMAS , NALLIAH CHRISHAN J. , SACHER FRÉDÉRIC , CLÉMENTY JACQUES , HAÏSSAGUERRE MICHEL
Published: February 2006

Introduction: We hypothesized that the frequency spectra of fibrillatory electrograms may reflect the complexity of activities perpetuating atrial fibrillation (AF). To test this hypothesis, we evaluated the frequency spectra in patients with paroxysmal AF in relation to catheter ablation.

Methods and Results: This study comprised two protocols: 25 patients undergoing pulmonary vein (PV) isolation in protocol I, and 20 patients undergoing mitral isthmus linear ablation after PV isolation in protocol II. The mean of dominant frequency (DF) and organization index (the ratio of the area under the DF and its harmonics to the total power) were determined from 32‐second recordings in the coronary sinus. In protocol I, a PV was considered “driver” of AF if isolation of the PV resulted in termination or slowing of AF (decrease in DF by ≥0.25 Hz). Twenty‐one patients had AF termination during four PV isolation. Among these 21 patients, 13 patients with single driving PV showed significantly higher baseline organization index than eight patients with multiple driving PVs (0.45 ± 0.08 vs 0.35 ± 0.07, P = 0.009). Patients with multiple driving PVs showed a significant increase in the organization index to 0.45 ± 0.11 (P < 0.05) after isolation of the initial driving PVs. In protocol II, the baseline organization index was significantly higher in seven patients who had termination of AF during mitral isthmus ablation than 13 patients who did not (0.50 ± 0.10 vs 0.38 ± 0.07, P < 0.008). The baseline DF was not associated with outcomes of ablation in both protocols.

Conclusions: A higher organization index of atrial electrograms is associated with termination of AF during limited ablation. This parameter may be useful to anticipate the extent of ablation.
Reentrant and Nonreentrant Forms of Atrio‐Ventricular Nodal Tachycardia Mimicking Atrial Fibrillation
Authors: DIXIT SANJAY , CALLANS DAVID J. , GERSTENFELD EDWARD P. , MARCHLINSKI FRANCIS E.
Published: February 2006

Background: Atrial fibrillation (AF) manifests disorganized atrial activity and irregular R‐R intervals on electrocardiogram (ECG). Variation in R‐R intervals can also be seen with other supraventricular tacyhcardias that may mimic AF.

Objective: We report our observations on three patients who were referred to our center to undergo pulmonary vein (PV) isolation for erroneously diagnosed AF in the setting of dual atrio‐ventricular (AV) nodal pathways manifesting as AV nodal reentrant tachycardia (AVNRT) and/or double response during sinus rhythm.

Methods and Results: These three subjects (two females) were derived from a group of 456 consecutive patients undergoing AF ablation at our center over a 3‐year period. All three patients had been symptomatic for over 2 years, having failed two or more antiarrhythmic medications. In each case AF was initially diagnosed on ECG and/or recordings from ambulatory monitoring. However, in all three cases the correct diagnosis was established during the invasive electrophysiologic study. In one patient during the stimulation protocol, two narrow complex tachycardias were serially induced (cycle lengths: 305 and 360 msecs; VA time: 60 and 240 msecs). The latter was confirmed to be atypical AVNRT and during this tachycardia, block in upper pathway was observed. In the other two patients, sinus rhythm with repetitive runs of double response and isolated junctional beats were observed in the absence of retrograde conduction. Successful slow pathway modification was performed in each subject and all three patients have remained arrhythmia free over a mean follow‐up of 31 ± 16 months off antiarrhythmic medications.

Conclusions: AF can be erroneously diagnosed in patients with dual AV nodal pathways manifesting double response and/or AVNRT. Incorporating a stimulation protocol as a part of the AF ablation procedure may help in diagnosing these rare clinical presentations that can be cured by slow pathway modification alone.
Narrow, Slow‐Conducting Isthmus Dependent Left Atrial Reentry Developing After Ablation for Atrial Fibrillation: ECG Characterization and Elimination by Focal RF Ablation
Authors: SHAH DIPEN , SUNTHORN HENRI , BURRI HARAN , GENTIL‐BARON PASCALE , PRUVOT ETIENNE , SCHLAEPFER JURG , FROMER MARTIN
Published: February 2006

Introduction: The complete circuit of reentrant left atrial tachycardias (LATs) occurring after ablation for atrial fibrillation (AF) has not been well described. Identifying discrete isthmuses critical to these LATs may simplify their elimination by catheter ablation.

Methods and Results: Fifteen patients (all male, 56 ± 8 years) with 15 reentrant LATs following AF ablation underwent activation and entrainment mapping. Eleven patients (11 LATs) had a single localized site with low amplitude (0.16 ± 0.05 mV), fractionated long duration (131 ± 23 msec) electrograms coinciding with an isoelectric interval of 106 ± 24 msec between flutter waves on all 12 ECG leads. Three‐dimensional mapping and entrainment revealed this site to be a narrow markedly slowly conducting isthmus adjacent to ablated left (n = 8) or right (n = 3) pulmonary vein (PV) ostia, and critical to nine small diameter (15 ± 3 mm) and two large diameter (49 ± 2 mm) circuits. One radiofrequency (RF) application on this isthmus eliminated LAT in all 11 patients. Four patients (four LATs) with large circuits around the mitral annulus and/or PV ostia lacked isoelectric ECG intervals and slow‐conducting isthmuses and required multiple RF applications across anatomically wide, rapidly conducting isthmuses.

Conclusion: Focally ablatable narrow isthmuses of slow conduction are critical for the majority of reentrant LAT occurring after ablation for AF. The role and presence of these isthmuses can be anticipated by observing significant isoelectric intervals between flutter waves on all 12‐surface ECG leads. Their distinctive electrophysiological characteristics allow their identification and elimination by simple RF ablation.
Sirolimus‐ versus Paclitaxel‐Eluting Stents: A Comparison of Two Consecutive Series in Routine Clinical Practice
Authors: KATRITSIS DEMOSTHENES G. , KOROVESIS SOCRATES , KARABINOS ILIAS , GIAZITZOGLOU ELEFTHERIOS , THEODOROU SPYRIDOULA , KARVOUNI EVANGELIA , VORIDIS EUTYCHIOS
Published: February 2006

Background: We compared two consecutive series of patients treated with sirolimus‐eluting stents (SES) or paclitaxel‐eluting stents (PES).

Methods: Two hundred and ninety‐five patients with 590 coronary lesions were treated with 274 SES and 379 PES. Patients with symptoms or positive dobutamine stress echocardiography were subjected to repeat coronary angiography.

Results: During a follow‐up of 13.3 ± 5.7 months, the incidence rate of major adverse cardiac events (MACE) was 4.1%, including, 1 death, 4 Q‐wave myocardial infarctions, 2 late angiographic stent thromboses, 3 subacute stent thromboses, and 11 target vessel revascularizations (TVR), and was not significantly different between SES (n = 5) and PES (n = 7).
Stent overlapping was found to be an independent predictor of both MACE (odds ratio = 0.078, P = 0.02) and TVR (odds ratio = 0.077, P = 0.02). Follow‐up symptoms‐ or ischemia‐driven angiography was performed in 45 patients. Only vessel size was a predictor of stent restenosis (P = 0.02), independent of stent type. Late loss was independently predicted by postdilatation of stent (beta =−0.24, P = 0.03), but not by type of stent (P = 0.14) or other parameters. Edge restenosis was seen in 8 patients subjected to lesion predilatation. The restenosis pattern after SES implantation was focal, but diffuse (n = 1) or proliferative (n = 1) restenosis, and in‐stent aneurysm formation (n = 1) was also seen with PES.

Conclusions: Despite a trend for a higher incidence of MACE with PES, no significant differences between the two stent types were detected. Diffuse restenosis was seen only with PES, and edge restenosis only in lesions with balloon predilatation before stent implantation. Stent overlapping was an independent predictor of both TVR and MACE.
Percutaneous Retrieval of a Broken Catheter from the Pulmonary Artery
Authors: MAUTONE ALESSANDRO , PITSCHEIDER WALTER , DESIATO ROBERTO
Published: February 2006

We describe a case regarding the percutaneous retrieval of a broken catheter from the pulmonary artery of a 54‐year‐old female patient in which we successfully used a “Goose Neck” snare. The analysis of relevant literature and the successful outcome of the case confirm that the percutaneous retrieval of a foreign body is a feasible, sure, and effective procedure.
Low Power Ultrasound Delivered Through a PTCA‐Like Guidewire: Preclinical Feasibility and Safety of a Novel Technology for Intracoronary Thrombolysis
Authors: CHOI SUNG W. , SALTZMAN ADAM J. , DABREO ALEXANDRA , SALOMON ROBERT N. , GRAY JONATHAN G. , SENSENEY‐MELLOR HEATHER , GOSNELL MARK R. , WAXMAN SERGIO
Published: February 2006

Background: Low power ultrasound delivered through an angioplasty‐like guidewire may be effective for intracoronary thrombolysis. We evaluated the preclinical feasibility and safety of such wire.

Methods and Results: In 15 anesthetized Yucatan minipigs, the ultrasonic wire was advanced percutaneously into all three coronaries. Each coronary was randomized to long activation (6 minutes), short activation (3 minutes), or control (3 minutes indwelling, no activation). The energy delivered was 0.14 ± 0.01 W/cm of active length (20 kHz). No changes in heart rate, rhythm, or arterial pressure occurred during wire positioning or activation. Mean lumen diameter (MLD) by quantitative angiography was not significantly different pre‐ and postintervention (2.36 ± 0.12 mm vs 2.36 ± 0.11 mm for long activation, P = 0.96; 2.33 ± 0.15 mm vs 2.34 ± 0.14 mm for short activation, P = 0.54; 2.30 ± 0.12 mm vs 2.33 ± 0.12 mm for control, P = 0.21). There were no angiographic stenoses at 60 or 90 days follow‐up. Compared with baseline, MLD at follow‐up increased in all the three groups (2.40 ± 0.13 mm vs 2.53 ± 0.11 mm, P = 0.004 for long activation; 2.37 ± 0.17 mm vs 2.52 ± 0.14 mm, P = 0.023 for short activation; 2.20 ± 0.12 mm vs 2.33 ± 0.11 mm, P = 0.001 for the control group). By histology, there were no clinically significant pathologic changes in coronary morphology.

Conclusion: Use of a transverse cavitation therapeutic wire is feasible and well tolerated acutely in the normal porcine coronary. At 60 and 90 days, no angiographically apparent damage, no clinically significant pathologic changes, and no adverse events were seen. This technology may be safely used during percutaneous coronary intervention. Further studies are justified to evaluate its efficacy for intracoronary thrombus ablation.
An unholy alliance: substance abuse and social exclusion among assertive outreach patients
Authors: Fakhoury W. K. H. , Priebe S. ,   PLAO Study Group
Published: February 2006

Objective:  To investigate the relationship between social exclusion and outcomes of mentally ill patients with substance abuse problems receiving assertive outreach treatment in London.

Method:  Analysis was conducted on data on 580 patients from the ‘Pan‐London Assertive Outreach Study (PLAO)’. Data were collected using clinician‐rated scales of alcohol and drug abuse in the last 6 months before baseline. Outcomes – hospitalization and compulsory hospitalization– were assessed over a 9‐month follow‐up period.

Results:  The analysis identified a group of patients with substance abuse who suffer from social exclusion and forensic problems (n = 77, 15.8%), and had poorer outcomes than the rest of the patients in terms of hospitalization (52% vs. 36% respectively) and compulsory (39% vs. 22% respectively) hospitalization.

Conclusion:  There is a distinct group of patients whose treatment requires social inclusion and forensic expertise. Future research into which model of service is suitable for these patients and in what setting is recommended.