bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent divergence, intercontinental dispersal and shared polymorphism are shaping the genetic structure of amphi‐Atlantic peatmoss populations
Authors: SZÖVÉNYI P. , TERRACCIANO S. , RICCA M. , GIORDANO S. , SHAW A. J.
Published: December 2008

Several lines of evidence suggest that recent long‐distance dispersal may have been important in the evolution of intercontinental distribution ranges of bryophytes. However, the absolute rate of intercontinental migration and its relative role in the development of certain distribution ranges is still poorly understood. To this end, the genetic structure of intercontinental populations of six peatmoss species showing an amphi‐Atlantic distribution was investigated using microsatellite markers. Methods relying on the coalescent were applied (im and migrate) to understand the evolution of this distribution pattern in peatmosses. Intercontinental populations of the six peatmoss species were weakly albeit significantly differentiated (average FST = 0.104). This suggests that the North Atlantic Ocean is acting as a barrier to gene flow even in bryophytes adapted to long‐range dispersal. The im analysis suggested a relatively recent split of intercontinental populations dating back to the last two glacial periods (9000–289 000 years ago). In contrast to previous hypotheses, analyses indicated that both ongoing migration and ancestral polymorphism are important in explaining the intercontinental genetic similarity of peatmoss populations, but their relative contribution varies with species. Migration rates were significantly asymmetric towards America suggesting differential extinction of genotypes on the two continents or invasion of the American continent by European lineages. These results indicate that low genetic divergence of amphi‐Atlantic populations is a general pattern across numerous flowering plants and bryophytes. However, in bryophytes, ongoing intercontinental gene flow and retained shared ancestral polymorphism must both be considered to explain the genetic similarity of intercontinental populations.
Population‐genomic approach reveals adaptive floral divergence in discrete populations of a hawk moth‐pollinated violet
Authors: HERRERA C. M. , BAZAGA P.
Published: December 2008

Local adaptation to contrasting biotic or abiotic environments is an important evolutionary step that presumably precedes floral diversification at the species level, yet few studies have demonstrated the adaptive nature of intraspecific floral divergence in wild plant populations. We combine a population‐genomic approach with phenotypic information on floral traits to examine whether the differentiation in metric floral traits exhibited by 14 populations of the southern Spanish hawk moth‐pollinated violetViola cazorlensisreflects adaptive divergence. Screening of many amplified fragment length polymorphism (AFLP) loci using a multiple‐marker‐based neutrality test identified nine outlier loci (2.6% of the total) that departed from neutral expectations and were potentially under selection. Generalized analysis of molecular variance revealed significant relationships between genetic distance and population divergence in three floral traits when genetic distance was based on outlier loci, but not when it was based on neutral ones. Population means of floral traits were closely correlated with population scores on the first principal coordinate axis of the genetic distance matrix using outlier loci, and with the allelic frequencies of four of the outlier loci. Results strongly support the adaptive nature of intraspecific floral divergence exhibited byV. cazorlensisand illustrate the potential of genome scans to identify instances of adaptive divergence when used in combination with phenotypic information.
An analysis of population genetic differentiation and genotype–phenotype association across the hybrid zone of carrion and hooded crows using microsatellites andMC1R
Authors: HAAS FREDRIK , POINTER MARIE A. , SAINO NICOLA , BRODIN ANDERS , MUNDY NICHOLAS I. , HANSSON BENGT
Published: December 2008

The all black carrion crow (Corvus corone corone) and the grey and black hooded crow (Corvus corone cornix) meet in a narrow hybrid zone across Europe. To evaluate the degree of genetic differentiation over the hybrid zone, we genotyped crows from the centre and edges of the zone, and from allopatric populations in northern (Scotland–Denmark–Sweden) and southern Europe (western–central northern Italy), at 18 microsatellites and at a plumage candidate gene, theMC1Rgene. Allopatric and edge populations were significantly differentiated on microsatellites, and populations were isolated by distance over the hybrid zone in Italy. Single‐locus analyses showed that one locus, CmeH9, differentiated populations on different sides of the zone at the same time as showing only weak separation of populations on the same side of the zone. Within the hybrid zone there was no differentiation of phenotypes at CmeH9 or at the set of microsatellites, no excess of heterozygotes among hybrids and low levels of linkage disequilibrium between markers. We did not detect any association between phenotypes and nucleotide variation atMC1R, and the two most common haplotypes occurred in very similar frequencies in carrion and hooded crows. That we found a similar degree of genetic differentiation between allopatric and edge populations irrespectively of their location in relation to the hybrid zone, no differentiation between phenotypes within the hybrid zone, and neither heterozygote excess nor consistent linkage disequilibrium in the hybrid zone, is striking considering that carrion and hooded crows are phenotypically distinct and sometimes recognised as separate species.
Effects of two levels of feed allocation on IGF‐I concentrations and metabolic parameters in GnRH‐immunized boars
Authors: Bauer A. , Lacorn M. , Claus R.
Published: December 2008

Immunocastration of boars leads to a maintenance of growth harmone (GH) and a loss of anabolic hormones [androgens, oestrogens, insulin‐like growth factor (IGF‐I)] but an increase of voluntary feed intake. The aim of the experiment was to clarify whether IGF‐I is increased by increasing feed supply in immunocastrated boars leading to improved anabolism. Two groups of six boars were given 2 or 3 kg of feed (13.5 MJ ME/kg) daily from 18–28 weeks of age. Because in boars feed intake is limited by gonadal hormones, a group with further increased feed supply could not be included. Until week 22 (second vaccination) gonadal steroids in blood were normal but dropped rapidly thereafter. Growth harmone levels did not change following vaccination. Pigs allocated 3 kg feed had 28% higher circulating IGF‐I after the second immunization compared with pigs fed 2 kg feed daily. Higher IGF‐I was associated with increased weight gain (682.4 g/day vs. 466.7 g/day; p < 0.01) and protein synthesis (13C‐leucine infusion; 405 g/day vs. 247 g/day, p < 0.01). Protein breakdown (urea) was not different. Body fat (D2O) decreased in the low feed group from 15.2% (week 19) to 6.1% (week 25). In the high feed group it remained at the level found before second vaccination (13.7% vs. 15.0%). It is concluded that in the phase of reduced testicular steroids which inhibit appetite it is possible to increase feed intake which in turn increases IGF‐I and protein deposition without accumulating excessive fat.
Effects of isovalerate on ruminal fermentation, urinary excretion of purine derivatives and digestibility in steers
Authors: Liu Q. , Wang C. , Huang Y. X. , Dong K. H. , Yang W. Z. , Zhang S. L. , Wang H.
Published: December 2008

The objective of this study was to evaluate the effects of isovalerate supplementation on rumen fermentation, urinary excretion of purine derivatives and feed digestibility in the total tract of steers. Eight ruminally cannulated Simmental steers were used in a replicated 4 × 4 Latin square experiment. The treatments were: control (without isovalerate), low isovalerate (LIV), medium isovalerate (MIV) and high isovalerate (HIV) dosage of isovalerate at 100, 200 and 300 mg isovalerate per kg dry matter (DM) intake respectively. Diets consisted of corn stover and concentrate (60/40, DM basis). Dry matter intake was approximately 9 kg per day that was 90% of ad libitum intake including 5.4 kg corn stover and 3.6 kg concentrate. Ruminal pH (6.72–6.54) was linearly (p < 0.03) reduced, whereas total volatile fatty acid concentration (64.6–74.7 mmol/l) was linearly (p < 0.01) and quadratically (p < 0.01) increased with increasing isovalerate supplementation. Ratio of acetate to propionate increased linearly (p < 0.01) from 2.78 to 3.39 as isovalerate supplementation increased because of the increase in acetate production and decrease in propionate production. In situ ruminal degradation of amylase‐treated neutral detergent fibre (aNDF) of corn stover was improved, but crude protein (CP) degradability of soybean meal decreased with increasing isovalerate supplementation. Urinary excretion of purine derivatives was quadratically (p < 0.01) changed by altering isovalerate supplementation (50.5, 54.3, 58.9 and 55.2 mmol/day for control, LIV, MIV and HIV, respectively). Similarly, digestibilities of organic matter, aNDF and CP in the total tract were linearly and quadratically increased with increasing isovalerate supplementation. The results of this study indicate that supplementation of diet with isovalerate improved ruminal fermentation and feed digestion in beef cattle. It was suggested that the isovalerate stimulated the digestive micro‐organisms or enzymes in a dose‐dependent manner.
Organ traits and histopathology of rabbits fed varied levels of dietary fumonisin B1
Authors: Ewuola E. O
Published: December 2008

In a 196‐day feeding trial, 48 male crossbred rabbits (New Zealand × Chinchilla) were randomly assigned and fed varied dietary fumonisin levels of 0.13, 5.0, 7.5 and 10.0 mg fumonisin B1/kg diet constituting treatments 1 (control), 2, 3 and 4 respectively. Five animals were randomly selected, stunned and killed per treatment. Relative weight of various visceral organs examined except heart and adrenal gland were significantly (p < 0.05) influenced by the dietary treatments. Liver and spleen weights of rabbits fed 10.0 mg fumonisin per kg were significantly (p < 0.05) lower than those fed control diet and diet 2. Kidney and testes weights were significantly (p < 0.05) lower in rabbits fed control diet and increased with increase in the dietary fumonisin levels. Histological examination of the organs revealed that rabbits fed diets 2, 3 and 4 showed increased severe lesion of approximately 20%, 40% and 60%, respectively, of the total slides examined for each treatment. Forty per cent and 80% of the rabbits fed diets containing 7.5 and 10.0 mg/kg fumonisin, respectively, showed severe necrosis whereas 40%, 60% and 20% of the rabbits fed 5.0, 7.5 and 10.0 mg/kg, respectively, showed mild–moderate liver necrosis/lesions as compared with non‐significant lesion observed in the controls. Testicles of rabbits fed diets 3 and 4 showed mild–moderate lesions and sertoli cell degeneration. Tunica mucosa erosion was observed and predominant in the stomach and small intestine of rabbits fed 7.5 and 10.0 mg fumonisin per kg diet. This suggested that fumonisin B1 above 5.0 mg/kg in rabbit diet is toxic to body organs with potential to induce their hypofunction or total damage.
Angiotensin‐converting enzyme gene polymorphism and the progression rate of focal segmental glomerulosclerosis in Iranian children
Authors: GHEISSARI ALALEH , SALEHI MANSOUR , DASTJERDI SOMAYEH BANDI , JAHANGIRI MANSOUR , HOOMAN NAKISA , OTOOKESH HASSAN , MERIKHIPOUR ALIREZA , AJIR AFSHIN , FOROUGHMAND ALIMOHAMMAD , KHATAMI SAEIDREZA , SHAHIDI SHAHRZAD , ATAPOUR ABDOLAMIR , SEIRAFIAN SHIVA , NAEINI AFSOON EMAMI
Published: December 2008

Aim:  Focal segmental glomerulosclerosis (FSGS) is one of the most common forms of glomerulonephritis leading to end‐stage renal disease (ESRD). A few clinical and paraclinical factors are considered as contributing factors in progression rate. However, there are controversial reports on the relationship between ACE gene polymorphism and rapidity of progression of FSGS to ESRD in different populations. To elucidate this issue, we investigated the relationship between the insertion (I) and deletion (D) ACE gene polymorphism and rapidity of progression of FSGS to ESRD in Iranian children.

Methods:  Forty‐one children aged 1–18 years admitted to St AlZahra Hospital, Isfahan, and St Ali Asghar Hospital, Tehran, Iran, with idiopathic FSGS were enrolled. Renal death was defined as a glomerular filtration rate (GFR) of less than 50 mL/min per 1.73 m2 or a decreased GFR to less than 50% compare to baseline. Reaching renal death in less or more than 2 years were labelled as rapid progressors (RP) or slow progressors (SP), respectively. Intron 16 of the ACE gene was amplified by the polymerase chain reaction technique.

Results:  Twenty‐eight patients were male and 13 were female. In 15 RP patients, the genotype distribution was 26.6% DD, 6.7% II and 66.7% ID. In 26 SP patients, the genotype was similar (38.6% DD, 7.6% II and 53.8% ID, P > 0.05). There were no statistically significant differences for ACE I/D gene polymorphism between the two groups of patients (P > 0.05).

Conclusion:  Our study revealed no correlation between ACE I/D gene polymorphism and rapidity of progression of FSGS to ESRD in Iranian children.
Laparoscopic pyelolithotomy: Is the retroperitoneal route a better approach?
Authors: Al‐Hunayan Adel , Abdulhalim Hamdy , El‐Bakry Ehab , Hassabo Majed , Kehinde Elijah O
Published: December 2008

Objectives:  To compare the outcome of laparoscopic pyelolithotomy (LP) using the transperitoneal and the retroperitoneal routes.

Methods:  Demographics, intraoperative and postoperative clinical parameters were evaluated in 48 laparoscopic pyelolithotomies performed in patients with renal pelvic calculi of diameter >30 mm. The differences between the transperitoneal and retroperitoneal routes were analyzed.

Results:  Twenty‐seven LP were performed using the transperitoneal approach (TLP), and 21 using the retroperitoneal approach (RLP). Apart from weight, the patients' demographics and stone size were similar in the two groups. Between the RLP and the TLP routes, the operative time was 112.1 versus 93.2 min (P = 0.01), mean time for oral intake was 1.9 versus 1.2 days (P < 0.01), and mean hospital stay was 5.2 versus 3.8 days (P < 0.01). The mean postoperative analgesic requirement (2.4 vs 2.2 days, P = 0.41), mean convalescence days (9.7 vs 10 days, P = 0.56), and mean estimated blood loss (57.2 vs 62.9 ml, P = 0.5) were similar between RPL and TPL respectively. The stone‐free rate at 3 months follow‐up was comparable (88.9% vs 90.5%, P = 0.86). The postoperative complications were not significantly different.

Conclusions:  Compared with the TLP approach, RLP for large renal pelvic stone resulted in a shorter operative time, a shorter resumption time for normal oral intake, and a shorter hospital stay. As the other clinical outcomes are similar, including the stone‐free rate, we recommend the RLP route for LP.
HEURISTICS IN CARDIOTHORACIC SURGERY
Authors: Tesar Peter
Published: December 2008

Cardiothoracic surgical operations are complex procedures. Involved are an enormous number of steps that need to be carried out consistently, accurately (as the margin for error in cardiothoracic surgery is small) and in a time‐efficient manner – thus the need for repetition in their performance to achieve excellence. Encompassed within the steps is a range of skills – motor and decision‐making. The motor skills span from the gross of median sternotomy and thoracotomy, to the fine of coronary anastomoses. It is the challenge of all of this that I believe entices most prospective cardiothoracic surgeons into training, having already witnessed the difference in the ability of surgeons at surgical heuristics as beautifully described by Michael Patkin. Further, the chase for the ‘perfect operation’ I believe also is what keeps cardiothoracic surgeons enthralled for a career. As a comment, what will be presented is a personal perspective and should be seen as such – to quote Patton ‘if everyone is thinking alike, then somebody isn’t thinking’. Now surgery in general is made of movement systems as already mentioned, but critically layered upon by intellect and information. This affects the decision‐making process throughout an episode of care – preoperatively, intraoperatively and postoperatively. To contemplate surgical heuristics, the two then, the movement systems and the decision‐making process, must be discussed individually and then brought together in the end, for it is the gel that determines patient outcomes and then becomes the science to our craft.
GRIPPING THE DIFFICULT GALL BLADDER DURING LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Patkin Michael , Watson David I.
Published: December 2008

Grasping a tense, inflamed gall bladder during laparoscopic cholecystectomy for acute cholecystitis is often a problem. Although many surgeons have developed techniques to deal with this, the published work lacks information about how to manage this problem. To collate experience about how to deal with this we interviewed 20 experienced Australian surgeons and compiled a repertoire of tactics that might help deal with this clinical situation. Most surgeons indicated that they deflated the gall bladder using a needle and suction as a preliminary step. Most respondents also described the use of a specific type of forceps for the task. Various manoeuvres, such as displacement of the gall bladder with forceps, dislodging an impacted stone to make it easier to grasp, the use of a retraction suture through the gall bladder were described. The various tactics are summarized in the paper. A range of strategies applied by experienced surgeons for the task of gripping a difficult gall bladder has been documented in this paper. The variety of approaches suggests that surgeons should be prepared to flexibly apply different approaches to this task.
MONOPOLAR DIATHERMY DISSECTION MADE EASY
Authors: Beasley Spencer W.
Published: December 2008

Monopolar diathermy is employed widely in surgery, but detailed examination of its use reveals that the full potential of the instrument as a dissecting tool is not always realised. Two factors compromise its use for accurate dissection: 1) the location and control of the hand control buttons; and 2) use of a needle point. This review demonstrates how the foot control (by allowing the instrument to be held closer to the tissues) and the round‐tipped spatula end (by allowing blunt dissection without having to change instruments) can markedly increase the precision and efficiency of operative dissection.
Different regulation of tissue inhibitors of metalloproteinases‐1, ‐2 and ‐3 in human endometrial stromal cells during decidualization in vitro
Authors: FLUHR HERBERT , KRENZER STEFANIE , ZYGMUNT MAREK
Published: December 2008

Aim:  Endometrial tissue inhibitors of metalloproteinases (TIMPs) appear to play an essential role during early implantation by modulating the invasiveness of the trophoblast. The expression of TIMP‐1, TIMP‐2 and TIMP‐3 in human endometrial stromal cells (ESC) was investigated during decidualization in vitro.

Methods:  Endometrial stromal cells were isolated from hysterectomy specimens from premenopausal women undergoing surgery for benign reasons. Decidualization in vitro was induced by the application of 1 µmol/L progesterone and 30 nmol/L 17β‐estradiol over 9 days. The expression of TIMP‐1, TIMP‐2 and TIMP‐3 in ESC was measured by semiquantitative real‐time reverse transcription polymerase chain reaction and enzyme‐linked immunosorbent assay over intervals of 3 days.

Results:  Decidualization in vitro was confirmed by a significant increase in prolactin expression. TIMP‐1 and TIMP‐2 mRNA and secreted protein showed no significant changes over the time‐course of decidualization. In contrast, TIMP‐3 was upregulated during the first 3 days of decidualization. An eightfold upregulation was observed until day 6, and the effect was less pronounced by day 9.

Conclusion:  These results suggest a regulatory role of the TIMP system for endometrial differentiation in the second half of the menstrual cycle and in early implantation. The expression pattern of endometrial TIMP‐3 might be important for the regulation of trophoblast invasion. (Reprod Med Biol 2008; 7: 169–175)
Culture‐independent evidence for the persistent presence and genetic diversity of microcystin‐producing Anabaena (Cyanobacteria) in the Gulf of Finland
Authors: Fewer David P. , Köykkä Miikka , Halinen Katrianna , Jokela Jouni , Lyra Christina , Sivonen Kaarina
Published: December 2008

The late summer mass occurrences of cyanobacteria in the Baltic Sea are among the largest in the world. These blooms are rarely monotypic and are often composed of a diverse assemblage of cyanobacteria. The toxicity of the blooms is attributed to Nodularia spumigena through the production of the hepatotoxic nodularin. However, the microcystin hepatotoxins have also been reported from the Baltic Sea on a number of occasions. Recent evidence links microcystin production in the Gulf of Finland directly to the genus Anabaena. Here we developed a denaturing gradient gel electrophoresis (DGGE) method based on the mcyE microcystin synthetase gene and ndaF nodularin synthetase gene that allows the culture‐independent discrimination of microcystin‐ and nodularin‐producing cyanobacteria directly from environmental samples. We PCR‐amplified microcystin and nodularin synthetase genes from environmental samples taken from the Gulf of Finland and separated them on a denaturing gradient gel using optimized conditions. Sequence analyses demonstrate that uncultured microcystin‐producing Anabaena strains are genetically more diverse than previously demonstrated from cultured strains. Furthermore, our data show that microcystin‐producing Anabaena are widespread in the open Gulf of Finland. Non‐parametric statistical analysis suggested that salinity plays an important role in defining the distribution of microcystin‐producing Anabaena. Our results indicate that microcystin‐producing blooms are a persistent phenomenon in the Gulf of Finland.
Insights into networks of functional microbes catalysing methanization of cellulose under mesophilic conditions
Authors: Li Tianlun , Mazéas Laurent , Sghir Abdelghani , Leblon Gérard , Bouchez Théodore
Published: December 2008

DNA‐SIP (stable isotope probing) was conducted on anaerobic municipal solid waste samples incubated with 13C‐cellulose, 13C‐glucose and 13C‐acetate under mesophilic conditions. A total of 567 full‐length bacterial and 448 1100‐bp‐length archaeal 16S rRNA gene sequences were analysed. In the clone libraries derived from ‘heavy’ DNA fractions, the most abundant sequences were affiliated with the phyla Firmicutes, Bacteroidetes, the gamma‐subclass of Proteobacteria and methanogenic orders Methanomicrobiales and Methanosarcinales. Sequences related to the genus Acetivibrio (phylum Firmicutes) were recovered only in the ‘heavy’ DNA fraction derived from the 13C‐cellulose incubation. An oligonucleotide probe (UCL284) targeting specifically Acetivibrio was designed and used for fluorescent in situ hybridization (FISH) experiments. Interestingly, hybridization of the probe was detected in microorganisms aggregated around cellulose fibres, strengthening the conclusion that these microorganisms were major cellulose degraders. Sequences related to genus Clostridium (phylum Firmicutes) and to the family Porphyromonadaceae (phylum Bacteroidetes) were retrieved in large numbers from the ‘heavy’ DNA library of 13C‐Glucose incubation, suggesting their involvement in saccharide fermentation. Design and hybridization of specific FISH‐probes confirmed the abundant representation of Clostridium (CLO401, CLO1248) and Porphyromonadaceae (BAC1040), which were mostly observed in the planktonic phase. Surprisingly, in the 13C‐acetate experiment, the ‘heavy’ DNA archaeal library was dominated by sequences related to the strictly hydrogenotrophic methanogenic genus Methanoculleus. One single operational taxonomic unit containing 70 sequences, affiliated to the gamma‐subclass of Proteobacteria, was retrieved in the corresponding bacterial library. FISH observations with a newly designed specific probe (UGA64) confirmed the dominance of this bacterial group. Our results show that combination of DNA‐SIP and FISH applied with a series of functionally connected substrates can shed light on the networks of uncultured microbes catalysing the methanization of the most abundant chemical renewable energy source on Earth.
Diversity of hopanoids and squalene‐hopene cyclases across a tropical land‐sea gradient
Authors: Pearson Ann , Leavitt William D. , Sáenz James P. , Summons Roger E. , Tam Mandy C.‐M. , Close Hilary G.
Published: December 2008

Bacterial hopanoids are ubiquitous in Earth surface environments. They hold promise as environmental and ecological biomarkers, if the phylogeny and physiological drivers of hopanoid biosynthesis can be linked with the distribution of hopanoids observed across a breadth of samples. Here we survey the diversity of hopanoid cyclases from a land‐sea gradient across the island of San Salvador, in the easternmost part of the Bahamas. The distribution of lipids was determined for the same sites, for the first time overlaying quantification of bacteriohopanepolyols with sqhC phylogeny. The results are similar to previous reports: environmental sqhCs average < 65% translated amino acid identity to their closest named relatives, and sequences from putative Proteobacteria dominate. Additionally, a new and apparently ubiquitous group of marine hopanoid producers is identified; it has no identifiable close relatives. The greatest diversity of hopanoid lipids occurs in soil, but hopanoids represent a minor fraction of total soil‐derived lipids. Marine samples contain fewer identifiable hopanoids, but they are more abundant as a fraction of the total extractable lipids. In soil, the dominant compounds are 35‐aminobacteriohopane‐32,33,34‐triol and adenosylhopane. In an upper estuarine sample, bacteriohopanetetrol and 32,35‐anhydrobacteriohopanetetrol dominate; while in lower estuarine and open marine samples, the most abundant are bacteriohopanetetrol and bacteriohopaneribonolactone. Cyclitol ethers are trace components in the soil, absent in the estuary, and of moderate abundance in the open marine setting, suggesting a dominant marine source. Conversely, aminotriol and aminotetrol decrease in abundance or disappear completely from land to ocean, while 2‐methyldiplopterol shows the opposite trend. Small quantities of 2‐methylbacteriohopanepolyols are detectable in all samples. The overall hopanoid distributions may correlate to the major phylogenetic families of hopanoid producers or to the environments in which they are found.
SOME OBSERVATIONS ON BLADDER NECK OBSTRUCTION1
Authors: Winsbury‐White H. P.
Published: December 2008

The data presented show amongst other things that:‐Fibrous bladder neck obstruction is more common than is generally supposed. Suprapubic prostatectomy followed by suprapubic bladder drainage can be

Prostatectomy and bladder neck resection equally require the decision, one Both prostatectomy and bladder neck resection can be successfully undertaken Suprapubic cystostomy for any form of bladder neck obstruction need not

done in a surgically sound manner. or two stages. without resorting to indwelling catheter drainage pre‐operatively. have a high mortality.
Artificial Urinary Sphincters around Intestinal Segments—Are they Safe?
Authors: WESTON P. M. T. , MORGAN J. D. T. , HUSSAIN J. , STEPHENSON T. P.
Published: December 2008

Summary— Artificial urinary sphincters (AUS) were implanted around intestinal segments to achieve urinary continence in 8 patients and faecal continence in 1. In 6 patients the cuff was placed around the lower end of the cystoplasty following bladder neck (5) or urethral (1) erosion. Four are completely dry, 1 on self‐intermittent catheterisation (SIC). One has mild stress incontinence. In 1 patient the cuff eroded at 8 months.

Two patients had cuffs implanted parastomally to create continent diversion. One is satisfactory on SIC and the other had her AUS explanted because of life‐threatening metabolic acidosis. The rectal cuff was explanted because of faecal impaction above the cuff.

As an absolute last resort, placing an AUS round a cystoplasty appears little more hazardous than round bladder neck. The use of the AUS for continent diversion has not been pursued because of reliable techniques of non‐prosthetic continent diversion. The current model of the AUS is unsuitable for the treatment of faecal incontinence.
Artificial Urinary Sphincter Insertion in Congenital Neuropathic Bladder
Authors: O'FLYNN K. J. , THOMAS D. G.
Published: December 2008

Summary— A series of 44 patients with neuropathic bladder dysfunction due to congenital myelodysplasia underwent implantation of an artificial urinary sphincter (AUS); in 26 patients a reconstructive procedure was performed at the same time. Five patients who initially had AUS implantation alone developed detrusor hyper‐reflexia and required a clam cystoplasty.

Forty patients (90%) are continent, 2 are occasionally damp and 2 are wet and awaiting further surgery; 66% of patients who underwent AUS insertion and reconstruction were found to have significant residual urine and they perform intermittent self‐catheterisation (ISC).

In patients with a good bladder capacity and normal compliance and detrusor hyper‐reflexia controlled by anticholinergic drugs, cystoplasty is not necessary at the time of AUS insertion.
Experience with Childhood Urolithiasis
Authors: BASAKLAR A. C. , KALE N.
Published: December 2008

Summary— A total of 196 children with urinary calculi were treated surgically. Their ages ranged from 1 to 14 years. The male:female ratio was 3:1. Stones were located in the kidney in 96 patients, in the bladder in 52 and in the ureters in 32. Multiple organ involvement was present in 16 patients and associated urinary tract anomalies were found in 11. Stone analysis revealed calcium oxalate and phosphate stones in 121 patients, struvite stones in 60 and uric acid stones in 15.
A Consumer's Guide to Commercially Available Urodynamic Equipment
Authors: BARNES D. G. , RALPH D. , Hill P. D. , LEWIS C. A. , SHAW P. J. R. , WORTH P. H. L.
Published: December 2008

Summary— Eight commercially available urodynamic machines from 6 major manufacturers (Aspen Medical, Dantec, Electro‐Medical Supplies (EMS), Uro‐gyn, Ormed and Wiest) were assessed for accuracy, construction and user‐friendliness. There was < 10% inaccuracy with regard to fill volume, void rate and pressure measurements. The Wiest 6000 plus system was between 11 and 14% inaccurate during voided volume measurement and other systems were < 10% inaccurate. User‐friendliness was assessed during routine cystometry and is mainly dependent on the software supplied with the equipment. The merits and faults of each urodynamic system with regard to performing a urodynamic investigation, running a urodynamic service and data management are compared with an “ideal” urodynamic system.
Cystoscopic Suction Diathermy for the Treatment of Superficial Bladder Tumours
Authors: BUNCE C. J. , SARMAH B. DEV , CONSIDINE J.
Published: December 2008

Summary— The treatment of superficial bladder tumours (Ta, T1) is a time‐consuming exercise for urological surgeons and patients. A method of treating the tumours, whether primary or recurrent, by endoscopic suction diathermy has been developed. The technique significantly reduces the amount of tumour debris within the bladder during treatment as well as the amount of diathermy employed. By removing the free tumour cells in the irrigation fluid the risk of tumour cell implantation may be kept to a minimum.
Neuro‐endocrine Cells—A New Prognostic Parameter in Prostate Cancer
Authors: COHEN R. J. , GLEZERSON G. , HAFFEJEE Z.
Published: December 2008

Summary Neuro‐endocrine cells are a recognised component of prostatic ducts and acini. Half of all clinically manifest cancers show neuro‐endocrine differentiation. Occult carcinomas have a lower incidence of such differentiation. Neuro‐endocrine cells are of major prognostic importance and appear more reliable in predicting patients' survival than do conventional histological grading systems.
Presentation and Management of Urethral Calculi
Authors: SHARFI A. R.
Published: December 2008

Summary A total of 36 patients with urethral calculi are presented; 34 were males, aged 2 to 65 years (mean 43). Eight patients were under the age of 6 years and presented with retention of urine. Calculi were in the posterior urethra in 56% of the patients, 33% had associated urinary tract calculi, and 47% had other diseases of the lower urinary tract, the commonest being posterior urethral stricture (42%). Of these calculi, 58% could be manipulated endoscopically into the urinary bladder, then crushed. Associated urethral strictures were dealt with by visual internal urethrotomy before manipulating the calculi. Other methods of treatment and their complications are discussed.
Blood and Urine Analysis in Patients with Intestinal Bladders
Authors: WAGSTAFF K. E. , WOODHOUSE C. R. J. , ROSE G. A. , DUFFY P. G. , RANSLEY P. G.
Published: December 2008

Summary A group of 183 patients whose urine was stored in pouches formed either wholly or partly from bowel was reviewed to establish abnormal biochemical and haematological factors and to assess the risk of infection. Minimum follow‐up was 1 year (range 1–28.5, mean 3 years 8 months) and the mean age of the patients at follow‐up was 16.5 years (range 4–43). Pouches were augmentation and substitution cystoplasties and complete reconstructions with bowel. Bowel segments were ileum (55 patients), colon (100) and mixed (28). Anaemia was found in 15 patients, folate deficiency in 2 and folate excess in 2. Definite hyperchloraemic acidosis was found in 25 patients and borderline results in 40. Most of these patients had colon in the pouch but 5 definite and 13 borderline cases had ileum only. Troublesome urinary infections occurred in 27.9% of patients; 3 developed renal stones and 22 developed pouch/bladder stones. Stones were usually associated with infection and/or staples. Delayed linear growth occurred in 20% of children in spite of a normal increase in weight; there was no difference in any of the measurements between those who grew and those who did not.
Koilocytosis in Neoplasia of the Urinary Bladder
Authors: HARTVEIT FLORA , MÆHLE B. O. , THUNOLD S.
Published: December 2008

Summary— Koilocytosis is commonly regarded as indicative of human papilloma virus infection in the uterine cervix. In 1987 morphologically similar changes were reported in bladder tumours. This is confirmed in the present study, the incidence here being 65%. In addition the incidence of koilocytic change was shown here to increase from non‐infiltrative WHO grade I to infiltrative WHO II lesions, and to be more common in bladder lesions in women with cervical koilocytosis. The latter is in keeping with our previous report that the incidence of koilocytosis in the cervix of patients with bladder neoplasia is higher than expected in the general population, adding support to the hypothesis that both lesions may be virus‐related.
Disodium Pamidronate Identifies Differential Osteoclastic Bone Resorption in Metastatic Prostate Cancer
Authors: CLARKE N. W. , McCLURE J. , GEORGE N. J. R.
Published: December 2008

Summary— In a controlled trial the effects of the osteoclast inhibitor disodium pamidronate were studied over a 6‐month period in men with metastatic bone disease from prostate cancer. Using serial biochemical measurement of metabolic bone activity, and complementary subjective and quantitative bone histology, the effects of pamidronate were evaluated in tumour‐free and metastatic regions of the skeleton, enabling analysis of the differential mechanisms of bone destruction in this disease.

Following treatment, abnormally high markers of bone breakdown fell significantly (fasting urine hydroxyproline/creatinine (OHP): P< 0.05; fasting urine calcium excretion (CaE): P<0.0001), confirming that activated osteoclasts play an integral role in the osteolytic process. Serial histomorphometry of bone from tumour‐free areas showed that pamidronate restored abnormal levels of bone erosion to normal in 93% of cases. Suppression of bone destruction was also evident within metastases, although this was incomplete.

The results confirm that osteoclast overactivity is responsible for a significant proportion of the accelerated osteolysis seen in both tumour‐free and infiltrated bone in patients with prostate cancer. The differential effects in tumour‐free and infiltrated bone suggest that the mechanisms of osteoclast activation may differ in metastatic and non‐metastatic regions of the skeleton.
Urethral Stress Relaxation Phenomenon in Healthy and Stress Incontinent Women
Authors: THIND P. , LOSE G.
Published: December 2008

Summary— Urethral stress relaxation was induced by sudden forced dilatation. The stress relaxation parameter, P t0.5, was defined as the relative pressure decrease 0.5 s after dilatation, where the pressures at 0.1 s and at the new equilibrium were set to 100% and 0% respectively. P t0.5 was calculated in 28 healthy and 30 women with genuine stress incontinence. Measurements were performed at the bladder neck, in the high pressure zone and in the distal urethra. The measurements showed that all along the urethra, P t0.5 was statistically significantly greater in the healthy women than in the incontinent women, the greatest difference being found at the bladder neck. Although there was a slight overlap in values between the 2 groups, this parameter seems useful in differentiating between competent and incompetent urethral sphincters.
Renal Cortical Scarring in Acute Pyelonephritis
Authors: TSUGAYA M. , HIRAO N. , SAKAGAMI H. , OHTAGURO K. , WASHIDA H.
Published: December 2008

A series of 14 patients with acute pyelonephritis was evaluated for the formation of renal scarring by serial computed tomography (CT) and intravenous urography. Although the urography results were normal, CT showed renal parenchymal atrophy (cortical scarring) in 6 patients. Cortical scarring was observed to occur after 61 to 187 days, and it was slower to develop in the patients with recurrent fever lasting for 2 weeks or more in total than in those with fever for less than 2 weeks. Scarring was significantly more frequent in patients with severe renal involvement than in those with mild involvement, and scars developed at the sites of the most extensive lesions seen on the initial CT scans. Cortical scars were detected in 6 of the 7 patients in whom the lesions occupied 30% or more of the renal parenchyma. We conclude that the extent of the initial renal parenchymal involvement was the most important determinant of eventual scar formation.
Cystectomy and Substitution Enterocystoplasty: Alternative Primary Treatment for T2/3 Bladder Cancer
Authors: HOLMES S. A. V. , CHRISTMAS T. J. , KIRBY R. S. , HENDRY W. F.
Published: December 2008

The optimal treatment for invasive bladder cancer remains controversial. Although external beam radiotherapy is able to eradicate the disease in a number of patients, the difficulty is selecting those who will respond. Those who do develop a local recurrence will require a salvage cystectomy combined with urinary diversion. The results of performing cystectomy and bladder reconstruction as a primary procedure are presented and the concept of combining this with chemotherapy as an alternative strategy for the management of bladder cancer is discussed.
Selective Surgical Management of Renal Stab Wounds
Authors: HEYNS C. F. , Van VOLLENHOVEN P.
Published: December 2008

Summary— Patients with stab wounds and haematuria were selected for surgical exploration if they had signs of severe blood loss, an associated intra‐abdominal laceration or major abnormality on the intravenous urogram (IVU). Patients without these signs were selected for non‐operative management, consisting of bed rest, an intravenous antibiotic for 24 h and regular observation. Of 95 patients, 60 (63%) were selected for non‐operative management (Group 1) and 35 (37%) were selected for primary surgical exploration (Group 2).

At surgery in Group 2, a major renal injury and/or associated intra‐abdominal laceration was found in 31 patients. Thus a probably unnecessary operation was performed in only 4 patients (4% of the whole group of 95 patients). Renal complications occurred in 12 of the 60 patients (20%) in Group 1 and consisted mainly of secondary haemorrhage caused by an arteriovenous fistula (AVF) or pseudo‐aneurysm. Management of the renal complications included segmental artery embolisation in 6, nephrectomy in 2, heminephrectomy in 1, open surgical ligation of an AVF in 1 and spontaneous resolution in 2 patients. The mean period of hospitalisation was significantly shorter in Group 1 (6.1 days) than in Group 2 patients (9.9 days).

Comparing the Group 1 patients who developed renal complications with those who did not, we would recommend more aggressive selection for surgery of those patients exhibiting clinical signs of shock, a fall in haemoglobin during observation, a palpable abdominal mass, a haemothorax and/or pneumothorax ipsilateral to the renal injury, and IVU signs of extravasation, non‐function, delayed excretion or hydroureteronephrosis due to blood clots. An alternative management strategy would be to perform renal angiography before surgical exploration, with segmental artery embolisation as definitive treatment of the renal injury.
Dynamic Clearance: Mathematical Assessment of Flow Mechanics in Prostatic Resection
Authors: BRIGGS T. P. , PARKER C. , MILLER R. A. , SCHROTER R. C. , RICHARDSON S. M.
Published: December 2008

Summary— The understanding of flow mechanics in endoscopy is poor. In prostatic surgery, emphasis has been placed on limiting the rise of intravesical pressure with little regard to the effect on flow mechanics and visibility. A model has been developed using dynamic clearance to compare different methods of prostatic resection. The results show that in a 0.95‐cm glass urethra, continuous flow irrigation has slower clearance at all flow rates when compared with intermittent irrigation and suprapubic suction. Although intravesical pressure is important, attention should also be paid to flow dynamics and more emphasis should be placed on this when new instruments and fluid delivery systems are developed.
Long‐term Results of Surgical Treatment of Renal Carcinoma in Solitary Kidneys by Extracorporeal Resection and Autotransplantation
Authors: van der VELDEN J. J. I. M. , van BOCKEL J. H. , ZWARTENDIJK J. , van KRIEKEN J. H. J. M. , TERPSTRA J. L.
Published: December 2008

Summary— We describe the technique and present the long‐term results of extracorporeal partial nephrectomy and autotransplantation in 6 patients with renal carcinoma. During a follow‐up period exceeding 5 years, dialysis was not required and the patients' blood pressure improved or remained within normal limits. One patient died post‐operatively from gastrointestinal bleeding. The mean duration of follow‐up was 54 months (range 14–97). The alternatives to extracorporeal resection and autotransplantation (such as complete nephrectomy and in situ resection of the tumour) are discussed.
Endometriosis of the Ureter
Authors: PATEL A. , THORPE P. , RAMSAY J. W. A. , SHEPHERD J. H. , KIRBY R. S. , HENDRY W. F.
Published: December 2008

Summary— Five patients with ureteric endometriosis are described. Extensive pre‐operative investigation failed to reveal the aetiology of the unilateral upper urinary tract obstruction seen in all of these patients. Due to the dense fibrosis that invariably accompanies ureteric endometriosis, early surgical excision of the ureteric stricture permits effective resolution of upper tract dilatation and improved renal salvage.
Vesicoureteric Reflux in Sibships
Authors: UEHLING D. T. , VLACH R. E. , PAULI R. M. , FRIEDMAN A. L.
Published: December 2008

Summary— A family with 4 of 6 siblings manifesting vesicoureteric reflux is presented. Reflux could not be demonstrated in preceding and succeeding generations in this family.

Genetic analysis suggests that most instances of familial vesicoureteric reflux arise secondary to expression of autosomal dominant single genes with incomplete penetrance.

Screening of sibships for reflux might be most appropriately carried out by urine analysis, culture and ultrasound imaging.
P53 and Ki‐67 Immunoreactivity in Human Prostate Cancer and Benign Hyperplasia
Authors: THOMPSON S. J. , MELLON K. , CHARLTON R. G. , MARSH C. , ROBINSON MARY , NEAL D. E.
Published: December 2008

Summary— Mutation of the p53 gene is one of the commonest genetic abnormalities found in solid human tumours. This gene is probably concerned with the control of cellular proliferation and in view of this we carried out a study of human prostate cancer and benign prostatic hyperplasia, comparing the expression of mutated p53 with measurement of growth fractions as assessed by staining with Ki‐67.

A series of 29 patients with prostate cancer (CaP) were compared with 34 men with benign hyperplasia (BPH); 22 of 29 prostate cancers (76%) contained Ki‐67 immunoreactivity compared with 10 of 34 (29%) BPH. With respect to p53 staining, significantly more prostate cancers (17%) were stained than BPH (0%). The mean Ki‐67 score in cancers positive for p53 (4.3%) was greater than that found in cancers negative for p53 (1.2%), but no statistically significant relationship was found between tumour grade and Ki‐67 staining. The use of Ki‐67 and p53 staining may allow identification of tumours with a higher rate of cell growth and may permit development of prognostic factors.
Is Pre‐operative Imaging of the Urinary Tract Worthwhile in the Assessment of Prostatism?
Authors: WILKINSON A. G. , WILD S. R.
Published: December 2008

Summary— The reports of routine pre‐operative imaging investigations performed on patients presenting with symptoms of uncomplicated benign prostatic hypertrophy were compared with management decisions and clinical outcome. In 175 patients with prostatism no urological abnormality which altered management was discovered on plain films of the abdomen and pelvis and ultrasound of the urinary tract which were performed routinely.

Post‐micturition residual volume (PMRV), estimated by ultrasound, was compared with the maximum urine flow rate (Q max) in 57 patients. PMRV showed negative correlation with Q max. Both high PMRV and low Q max were associated with the urologist's decision to operate, but multiple logistic regression revealed that ultrasound residual volume was not a significant predictor of operation when adjusted for Q max. Urologists in this hospital therefore use flow rates as the primary indication of the need to operate.

We suggest that no routine pre‐operative imaging need be performed in patients presenting with prostatism.