bluuebunny/crossref_metadata_2025 huggingface dataset:
Ecabet sodium promotes the healing of trinitrobenzene‐sulfonic‐acid‐induced ulceration by enhanced restitution of intestinal epithelial cells
Authors: Takagi Tomohisa , Naito Yuji , Okuda Toshimitsu , Uchiyama Kazuhiko , Adachi Satoko , Mizushima Katsura , Handa Osamu , Kokura Satoshi , Ichikawa Hiroshi , Yoshikawa Toshikazu
Published: January 2010

Background and Aims:  Ecabet sodium (ES) is a gastric mucosal protective and ulcer‐healing agent. Recently enema therapy with ES was found to be effective for the treatment of human ulcerative colitis as well as experimental colitis in an animal model. Whereas ES possesses potential as a novel treatment for ulcerative colitis, its precise mechanism of action remains to be elucidated. In this study, we investigated the therapeutic efficacy of ES in an experimental rat model of colitis, and evaluated the restitution of intestinal epithelial cells treated with ES in vitro.

Methods:  Acute colitis was induced with trinitrobenzene sulfonic acid (TNBS) in male Wistar rats. Rats received intrarectal treatment with ES daily starting on day 7 and were sacrificed on day 14 after the administration of TNBS. The distal colon was removed to evaluate various parameters of inflammation. Moreover, wound‐healing assays were used to determine the enhanced restitution of rat intestinal epithelial (RIE) cells treated with ES.

Results:  Intracolonic administration of ES accelerated TNBS‐induced ulcer healing. Increases in the wet weight of the colon after TNBS administration were significantly inhibited by ES treatment. The wound assay revealed ES enhancement of the migration of RIE cells migration through the phosphorylation of extracellular signal‐regulated kinase.

Conclusion:  Daily administration of an ES enema promoted the healing of intestinal mucosal injury, in part by the enhanced restitution of intestinal epithelial cells via extracellular signal‐regulated kinase activation. ES may thus represent a novel therapeutic approach for the treatment of inflammatory bowel disease.
Electromagnetic thermoablation to treat thrombocytopenia in cirrhotic and hypersplenic rats
Authors: Zuchini Roberto , Huang Chih‐Hao , Tsai Hung‐Wen , Huang Sheng‐Chieh , Lin Chuan‐Pin , Chen Chiung‐Yu , Lee Gwo‐Bin , Lin Xi‐Zhang
Published: January 2010

Background and Aim:  Thrombocytopenia due to hypersplenism is usually a serious condition in cirrhotic patients who have undergone invasive procedures. We designed a new treatment method using a high‐frequency alternating electromagnetic force to treat the disease condition in a rat model.

Methods:  Sprague–Dawley rats were given thioacetamide in drinking water and injected with methylcellulose intraperitoneally to create a cirrhotic hypersplenism model. Spleen volume was determined using the Carlson method. The Control Group consisted of 14 rats, 15 weeks old, that were used to determine the normal platelet count and normal spleen size. Experimental Group I, consisting of 15 rats, received electromagnetic thermoablation of their spleens, after which the spleen was returned to the abdomen. Group II consisted of 13 rats, receiving the same electromagnetic thermoablation as Group I, but the ablated portion was removed. Group III consisted of 14 rats receiving total splenectomies.

Results:  Cirrhotic hypersplenism was confirmed during laparotomy and pathological examination. Spleen volume enlarged from 1513 ± 375 mm3 (Control Group) to 7943 ± 2822 mm3 (experimental groups). Platelet counts increased from 0.35 ± 0.21 × 106/mm3 to 0.87 ± 0.24 × 106/mm3 for Group I, from 0.52 ± 0.23 × 106/mm3 to 1.10 ± 0.20 × 106/mm3 for Group II, and from 0.47 ± 0.23 × 106/mm3 to 1.18 ± 0.26 × 106/mm3 for Group III. No rats died due to the treatment in any of the experimental groups.

Conclusions:  Our animal model performed successfully and our proposed electromagnetic thermotherapy effectively treated thrombocytopenia due to cirrhotic hypersplenism.
Association between clinical manifestations of complicated and uncomplicated peptic ulcer and visceral sensory dysfunction
Authors: Gururatsakul Montri , Holloway Richard H , Talley Nicholas J , Holtmann Gerald J
Published: January 2010

Background and Aims:  Peptic ulcer disease (PUD) usually manifests as either dyspepsia or less commonly with complications such as bleeding. Patients with bleeding ulcers are often asymptomatic until the bleeding occurs. A lack of dyspeptic symptoms might be explained by impaired visceral sensory function. The aim of this study was to assess symptom profiles and compare visceral sensory thresholds in patients with bleeding peptic ulcer (BPU) and uncomplicated PUD.

Methods:  A total of 30 patients with BPU, 25 with uncomplicated PUD and 32 healthy controls (HC) without dyspeptic symptoms were recruited. In ulcer patients after at least 8 weeks of ulcer treatment and an 8‐hr fast, visceral sensitivity was tested using a standardized nutrient challenge with an enteral feeding solution. Five key symptoms (fullness, abdominal pain, retrosternal/abdominal burning, nausea, and regurgitation) were assessed using visual analog scales (0–100).

Results:  Twenty‐five of the 30 (83%, 95% confidence interval 65–94%) patients with BPU had no dyspeptic symptoms compared with none of the 25 uncomplicated PUD patients. Patients with BPU and HC had significantly lower symptom responses (BPU 127.6 ± 24.6, HC 89.8 ± 13.9) to the nutrient challenge than uncomplicated PUD patients (338.4 ± 56.2, P < 0.0001). Patients with dyspeptic symptoms (30/55) had significantly higher symptom responses (327.3 ± 47.8) than the 25/55 patients without symptoms (98.9 ± 23.4, P < 0.0001).

Conclusion:  Most patients with BPU present without dyspeptic symptoms. Even after healing of the ulcer, patients with uncomplicated PUD have a significantly augmented symptom response to a standardized nutrient challenge compared to patients with complicated ulcers and HC. Differences in the processing of upper gastrointestinal visceral afferents may play a major role in the clinical presentation (complicated vs uncomplicated) of PUD.
On‐treatment monitoring of chronic hepatitis B virus infection: An Asian–Pacific perspective
Authors: Chien Rong‐Nan
Published: January 2010

Chronic infection with hepatitis B virus (HBV) is a major global health problem and an important cause of morbidity and mortality from sequelae of liver cirrhosis and hepatocellular carcinoma. In the past decades, better understanding of the natural history and immunopathogenesis of chronic HBV infection and of the development of many powerful antiviral agents has allowed us to improve therapeutic efficacy. Among these agents, nucleos(t)ide analogs are important and potent viral suppressors. However, when administered alone, they are not able to permanently eradicate HBV, and long‐term maintenance therapy is required for therapeutic efficacy. Additionally, prolonged treatment is frequently associated with the emergence of drug‐resistant HBV mutants. Before an ‘ideal’ drug(s), or drug combination, with optimal antiviral efficacy and negligible rates of drug resistance becomes available, the on‐treatment monitoring approach using serum HBV DNA level as a predictor for therapeutic efficacy and drug resistance is useful. However, most countries in the Asia–Pacific region have low income economies, insufficient medical care systems, and low awareness of the disease among the general population and government officers. The easy approach of the road‐map concept using an affordable drug to treat chronic HBV infection is more important in this region. There is already evidence that the long‐term outcomes of chronic HBV infection can be improved under well‐managed antiviral therapy. Profound and long‐lasting suppression of HBV replication, either maintained on‐therapy or sustained after stopping therapy, has been identified as the key determinant for achieving the goals of therapy, for reducing liver damage, and for preventing development of cirrhosis and/ or hepatocellular carcinoma.
Endoscopic resection of ampullary adenoma after a new insulated plastic pancreatic stent placement: A pilot study
Authors: Hwang Jae Chul , Kim Jin Hong , Lim Sun Gyo , Yoo Byung Moo , Cho Sung Won
Published: January 2010

Background and Aim:  Although pancreatic stent insertion is recommended for the prevention of post‐procedure pancreatitis during endoscopic papillectomy, insertion of the stent after the procedure can be technically difficult. The aim of the present study was to determine the feasibility and safety of inserting a newly developed insulated pancreatic stent before endoscopic papillectomy.

Methods:  We conducted a prospective pilot study involving 11 consecutive patients with adenomas of the major duodenal papilla. After a 5F polytetrafluoroethylene‐insulated pancreatic stent was inserted through the tumor, the stent and tumor were simultaneously grasped with a snare. After resection of the tumor with the stent in place, the tumor was incised perpendicularly along the edge of the stent for retrieval of the specimen.

Results:  In all patients, the insulated pancreatic stents were successfully inserted before endoscopic papillectomy and were resistant to electrical current; retrieval of the specimen was technically feasible and successful without stent migration. There were no stent‐related complications, but five papillectomy‐related complications (including mild bleeding [n = 4] and late papillary stenosis [n = 1]) occurred without any episodes of acute pancreatitis or perforation.

Conclusions:  Pre‐resection stenting with a polytetrafluoroethylene‐insulated stent in patients with adenomas of the major duodenal papilla is a feasible and useful technique to prevent pancreatitis.
Diagnosis of depth of invasion for early colorectal cancer using magnifying colonoscopy
Authors: Ikehara Hisatomo , Saito Yutaka , Matsuda Takahisa , Uraoka Toshio , Murakami Yoshitaka
Published: January 2010

Background and Aims:  Early colorectal cancer (CRC) with submucosal deep (s.m.‐d.) invasion should not be treated with endoscopic mucosal resection due to the higher incidence of lymph‐node metastasis. It is, therefore, clinically important to accurately diagnose s.m.‐d. lesions before treatment.

Methods:  We analyzed the endoscopic features, including pit patterns, of early CRC with s.m.‐d. invasion observed using magnifying colonoscopy. We retrospectively investigated 379 cases of early CRC. Lesions were divided into three macroscopic subtypes (pedunculated type, sessile type and superficial type) based on endoscopic findings. Eight endoscopic factors were evaluated retrospectively for association with s.m. invasion and then compared to histopathological findings.

Results:  The superficial type had a significantly higher frequency of s.m.‐d. invasion (52.4% [77/147] vs 24.6% [14/57] and 39.4% [69/175], P‐value < 0.05, respectively, for pedunculated and sessile types). Based on multivariate analysis, an independent risk factor for s.m.‐d. invasion was the existence of an invasive pit pattern in sessile and superficial types (odds ratios of 52.74 and 209.67, respectively). Fullness was also an independent risk factor for s.m.‐d. invasion in the superficial type (odds ratio = 9.25). There were no independent risk factors for s.m.‐d. invasion in the pedunculated type.

Conclusion:  High magnification pit pattern diagnosis proved to be useful for predicting s.m.‐d. invasion in sessile and superficial types although it was not as helpful with the pedunculated type.
Spherical implantable collamer lenses for myopia and hyperopia: 126 eyes with 1‐year follow up
Authors: Rayner Sandra A , Bhikoo Riyaz , Gray Trevor
Published: January 2010

Abstract

Background:  To report on 1‐year follow up of a series of 126 eyes implanted with a spherical implantable collamer lens (ICL).

Methods:  Retrospective case note review of 126 eyes (68 patients) undergoing ICL placement by a single surgeon (TG) to correct preoperative mean spherical equivalents between +8.88 and −20.50 D. Main outcome measures included uncorrected visual acuity (UCVA), refraction, best spectacle‐corrected VA, unaided binocular vision, adverse events, operative/postoperative complications and patient symptoms.

Results:  Complete data were available at 1 year on 121 of the 126 eyes (65 out of 68 patients). At 12 months 86% (104/121) had postoperative UCVA better than or equal to preoperative best spectacle‐corrected VA, and 98% (118/121) had UCVA within one line of preoperative best spectacle‐corrected VA. Ninety‐six per cent (116/121) had postoperative UCVA of 6/9 or better, and 100% had postoperative best‐corrected visual acuity of 6/12 or better. Ninety‐eight per cent (64/65) patients had unaided binocular vision at 1 year of 6/7.5 or better. Average myopia treated was −8.83 D (116 patients), and average hyperopia +7.14 D (10 patients). Two ICLs were replaced because of high vaulting; one eye had increased intraocular pressure that resolved with smaller ICL placement. Four patients had visually insignificant pigment deposits on the ICL at 3/12, but no pigmentary glaucoma. Five patients noticed haloes around lights at night, none preventing driving.

Conclusions:  One‐year results from this study, the largest reported clinical investigation of the use of ICLs in New Zealand, support the safety, efficacy and predictability of ICL to treat both hyperopic and myopic spherical refractive errors.
Visualization of cystoid macular oedema using a scanning laser ophthalmoscope in the retro‐mode
Authors: Yamamoto Motoshi , Mizukami Shiho , Tsujikawa Akitaka , Miyoshi Norimi , Yoshimura Nagahisa
Published: January 2010

Abstract

Purpose:  To investigate cystoid macular oedema using a scanning laser ophthalmoscope.

Methods:  We retrospectively reviewed the medical records of 101 eyes with cystoid macular oedema because of various aetiologies. All eyes were examined with a new, commercially available scanning laser ophthalmoscope in the retro‐mode with an infrared laser.

Results:  In all eyes, scanning laser ophthalmoscope in the retro‐mode showed numerous oval or polygonal cystoid spaces. Most eyes showed a large cystoid space beneath the fovea, with surrounding small cystoid spaces. The area of the foveal cystoid space showed a correlation with its height, as measured with optical coherence tomography (R = 0.60, P < 0.0001). Visual acuity, however, did not show any correlation with either the area of the foveal cystoid space or area of all of the cystoid spaces in the macular area.

Conclusion:  Scanning laser ophthalmoscope in the retro‐mode can show each cystoid space located in any layer of the retina and allows us to detect the extent of cystoid macular oedema.
Syphilitic uveitis: a review of clinical manifestations and treatment outcomes of syphilitic uveitis in human immunodeficiency virus‐positive and negative patients
Authors: Amaratunge Bhagya Chathri , Camuglia Jayne E , Hall Anthony J
Published: January 2010

Abstract

The incidence of syphilis and syphilitic uveitis in our community is increasing. The prevalence of associated neurosyphilis is unknown, and it remains unclear whether syphilitic uveitis should be treated as secondary syphilis with intramuscular penicillin or neurosyphilis with intravenous penicillin. The (English language) literature was reviewed for all unique cases of syphilitic uveitis reported from 1984 to June 2008. For each case the following data were recorded: the clinical features of the syphilis, the uveitis and any associated neurosyphilis, the human immunodeficiency virus (HIV) status, lumbar puncture findings, treatment and follow up. We identified 143 patients in 41 original reports of syphilitic uveitis (93 HIV‐positive and 50 HIV‐negative). Posterior uveitis was reported in 79 patients (55.2%); panuveitis was reported in 36 patients (25.2%); anterior/intermediate uveitis was reported in only 28 patients (19.6%). Lumbar puncture findings were abnormal in 82 patients (57%), and the majority of these patients (76%, 62 out of 82) were HIV‐positive. One hundred and ten (77%) patients were treated with intravenous therapy, usually penicillin. Most recovered from the syphilis, however, a proportion did not recover full vision. There were 13 (9%) treatment failures, which tended to occur in patients who were HIV‐positive (n = 11), had abnormal lumbar puncture findings (n = 8) and/or were treated (n = 11) intravenously. There is a high incidence of abnormal lumbar puncture findings in patients with syphilitic uveitis and a strong association with HIV infection. Most received appropriate therapy with a low relapse rate, which was not related to the type of therapy.
Mapping the surface astrocytes of the optic disc: a fluid‐conducting role of the astrocytic covering of the central vessels
Authors: Carreras Francisco J , Porcel David , Muñoz‐Avila Jose I
Published: January 2010

Abstract

Background:  The vitreous interface of the optic nerve has been studied to delimit the covering of Elschnig's astrocytes and interstitial pathways of flow through the prelaminar region.

Methods:  Perfusion of the prelaminar tissue under controlled pressure with a fluorescent marker injected into the vitreous cavity in pig eyes. The prelaminar region of the optic nerve and adjacent retina was fixed and flatmounted or frozen and cryosectioned and examined with the confocal laser microscope. Samples were also prepared for conventional transmission electron microscopy.

Results:  The surface of the vitreous surface of the optic nerve is covered by a cobblestone‐like pavement made of astrocytic projections. Intensely stained passages of different thickness indicate the presence of wide interconnected intercellular spaces in the covering of Elschnig's astrocytes. Those passages are absent in the intervascular areas occupied by axons and axon‐linked astrocytes.

Conclusions:  Delineation of the astrocytic pavement and the preferred flow routes formed by wide extracellular spaces are conspicuous features of the prelaminar region when examined with the confocal laser microscope and the help of sticky fluorescent tracer. This suggests that excess extracellular fluid can be interchanged with the vitreous by a network of interconnected extracellular spaces or preferred flow routes. Some pathogenic mechanisms can be related to fluid interchange in the optic nerve head.
Effects of riboflavin/UVA corneal cross‐linking on keratocytes and collagen fibres in human cornea
Authors: Mencucci Rita , Marini Mirca , Paladini Iacopo , Sarchielli Erica , Sgambati Eleonora , Menchini Ugo , Vannelli Gabriella B
Published: January 2010

Abstract

Purpose:  To evaluate the effects of corneal cross‐linking on keratocytes and collagen fibres in human corneas.

Methods:  Fifteen corneal buttons were examined. Ten were from patients with keratoconus submitted to penetrating keratoplasty and five of them were treated with cross‐linking 6 months before penetrating keratoplasty. Five normal corneal buttons from healthy donors were used as controls. All samples were prepared for TUNEL assay and Western blot analysis for the detection of keratocyte apoptosis and immunohistochemical analysis for the morphological evaluation of keratocytes and collagen fibre diameter.

Results:  Normal corneas exhibited no TUNEL‐positive keratocytes and keratoconic and cross‐linked corneas showed moderate apoptotic cells mainly in the anterior part of the stroma. This apoptotic trend was confirmed by the cleavage of poly (ADP‐ribose) polymerase assessed using Western blot. The Ki‐67 staining showed a significant increase in the keratocyte proliferation in cross‐linked corneas compared with normal and keratoconus. In cross‐linked corneas CD34‐positive keratocytes were regularly distributed throughout the whole corneal stroma as in the control, and keratoconus was associated with patchy loss of immunoreactivity. The immunohistochemical analysis of collagen type I showed a significant increase in fibre diameter of cross‐linked corneas compared with control and keratoconus.

Conclusion:  Corneal cross‐linking leads to keratocyte damage; after 6 months a repopulation by proliferating cells, a distribution of CD34‐positive keratocytes as in control and an increase in collagen fibre diameter were observed. These modifications are the morphological correlate of the process leading to an increase in biomechanical stability.
Size effects in the transition region and the beginning of the upper shelf for ferritic steels
Authors: IPIÑA J. E. PEREZ , BEREJNOI C.
Published: January 2010

The determination of a characteristic fracture toughness value for ferritic steels in the ductile‐to‐brittle transition regime becomes difficult due to the scatter observed in the results. As the temperature increases, ductile mechanisms become more active and sometimes no brittle fracture occurs. Close to the upper shelf, and contrary to what happens when only cleavage occurs, the scatter diminishes as the temperature increases, and it is also size‐dependent: more scatter is found for larger sizes than for smaller specimens. An interpretation of the phenomena that takes place from the transition region up to the beginning of the upper shelf is presented in this work. This interpretation explains the difference in scatter and toughness among different sample sizes, and it also validates that the beginning of the upper shelf is dependent on the size of the sample or structure. Results from the Euro Dataset Round Robin were used to validate this interpretation.
Regression analysis of spatial data
Authors: Beale Colin M. , Lennon Jack J. , Yearsley Jon M. , Brewer Mark J. , Elston David A.
Published: January 2010

Ecology Letters (2010) 13: 246–264

Many of the most interesting questions ecologists ask lead to analyses of spatial data. Yet, perhaps confused by the large number of statistical models and fitting methods available, many ecologists seem to believe this is best left to specialists. Here, we describe the issues that need consideration when analysing spatial data and illustrate these using simulation studies. Our comparative analysis involves using methods including generalized least squares, spatial filters, wavelet revised models, conditional autoregressive models and generalized additive mixed models to estimate regression coefficients from synthetic but realistic data sets, including some which violate standard regression assumptions. We assess the performance of each method using two measures and using statistical error rates for model selection. Methods that performed well included generalized least squares family of models and a Bayesian implementation of the conditional auto‐regressive model. Ordinary least squares also performed adequately in the absence of model selection, but had poorly controlled Type I error rates and so did not show the improvements in performance under model selection when using the above methods. Removing large‐scale spatial trends in the response led to poor performance. These are empirical results; hence extrapolation of these findings to other situations should be performed cautiously. Nevertheless, our simulation‐based approach provides much stronger evidence for comparative analysis than assessments based on single or small numbers of data sets, and should be considered a necessary foundation for statements of this type in future.
Cultivation of a Synergistetes strain representing a previously uncultivated lineage
Authors: Vartoukian S. R. , Palmer R. M. , Wade W. G.
Published: January 2010

Subgingival plaque samples obtained from human subjects with periodontitis, shown to include previously uncultivable members of the phylum Synergistetes, were used to inoculate Cooked Meat Medium (CMM). The presence of Cluster A (uncultivable) Synergistetes was monitored by fluorescent in situ hybridization (FISH) and quantitative PCR (Q‐PCR). Cluster A Synergistetes were found to grow in CMM in co‐culture with other plaque bacteria and growth was stimulated by the addition of mucin and serum. Plaque samples were also used to inoculate Blood Agar (BA) plates and growth of Cluster A Synergistetes was revealed after anaerobic incubation, by colony hybridization with specific probes. Surface growth on the plates in regions identified by colony hybridization was harvested and used to inoculate fresh plates, thus enriching for Cluster A Synergistetes. Cross‐streaks of other plaque bacteria were also used to stimulate Synergistetes growth. In the early passages, no discrete Synergistetes colonies were seen, but after eight passages and the use of cross‐streaks of other bacteria present in the enriched community, colonies arose, which consisted solely of Cluster A Synergistetes cells, as determined by 16S rRNA gene PCR and cloning. This is the first report of the successful culture of a member of the uncultivable branch of this phylum.
The major outer membrane protein OmpU of Vibrio splendidus contributes to host antimicrobial peptide resistance and is required for virulence in the oyster Crassostrea gigas
Authors: Duperthuy Marylise , Binesse Johan , Le Roux Frédérique , Romestand Bernard , Caro Audrey , Got Patrice , Givaudan Alain , Mazel Didier , Bachère Evelyne , Destoumieux‐Garzón Delphine
Published: January 2010

Vibrio splendidus, strain LGP32, is an oyster pathogen associated with the summer mortalities affecting the production of Crassostrea gigas oysters worldwide. Vibrio splendidus LGP32 was shown to resist to up to 10 µM Cg‐Def defensin and Cg‐BPI bactericidal permeability increasing protein, two antimicrobial peptides/proteins (AMPs) involved in C. gigas immunity. The resistance to both oyster Cg‐Def and Cg‐BPI and standard AMPs (polymyxin B, protegrin, human BPI) was dependent on the ompU gene. Indeed, upon ompU inactivation, minimal bactericidal concentrations decreased by up to fourfold. AMP resistance was restored upon ectopic expression of ompU. The susceptibility of bacterial membranes to AMP‐induced damages was independent of the ompU‐mediated AMP resistance. Besides its role in AMP resistance, ompU proved to be essential for the adherence of V. splendidus LGP32 to fibronectin. Interestingly, in vivo, ompU was identified as a major determinant of V. splendidus pathogenicity in oyster experimental infections. Indeed, the V. splendidus‐induced oyster mortalities dropped from 56% to 11% upon ompU mutation (Kaplan–Meier survival curves, P < 0.01). Moreover, in co‐infection assays, the ompU mutant was out competed by the wild‐type strain with competitive indexes in the range of 0.1–0.2. From this study, ompU is required for virulence of V. splendidus. Contributing to AMP resistance, conferring adhesive properties to V. splendidus, and being essential for in vivo fitness, the OmpU porin appears as an essential effector of the C. gigas/V. splendidus interaction.
The management of cyclophosphamide‐induced haematuria
Authors: Mukhtar Saheel , Woodhouse Christopher
Published: January 2010

Haemorrhagic cystitis is a frequent complication of treatment with cyclophosphamide. It remains a difficult clinical problem to treat, compounded by the frailty of patient. Furthermore, the preventative measures and treatments available for CP‐induced haematuria have their own benefits and disadvantages.
Factors influencing the choice of urinary diversion in patients undergoing radical cystectomy
Authors: Ashley Matt S. , Daneshmand Siamak
Published: January 2010

Study Type – Preference (case studies) Level of Evidence 4

OBJECTIVE

To examine the rate at which patients undergo various types of urinary diversion (UD) and the reasons why they had the given reconstruction, analysed in the context of a standardized preoperative protocol for patients undergoing radical cystectomy (RC) at our institution, as there is wide variation in the distribution of patients undergoing continent (CUD) vs incontinent (ICUD) after RC.

PATIENTS AND METHODS

Between September 2004 and December 2008, 200 patients had RC with UD by one surgeon. Each patient was given standardized preoperative counselling; the charts were reviewed retrospectively to determine the relative frequencies of the various types of UD, and the reasons why patients had an ICUD assessed, including medical contraindications and personal choice.

RESULTS

During preoperative counselling, 149 patients (75%) were assessed as being eligible for a CUD, while 51 (25%) had one or more contraindication; 140 (70%) ultimately had a CUD, and the remaining 60 (30%) a ICUD. Of the 149 patients eligible for a CUD, only nine (6%) chose to undergo ICUD for personal reasons.

CONCLUSION

Few patients choose to have an ICUD in the absence of an absolute medical contraindication. Proper patient selection and thorough, standardized preoperative counselling result in a higher rate of CUD than ICUD after RC.
Robot‐assisted radical prostatectomy: learning rate analysis as an objective measure of the acquisition of surgical skill
Authors: Sammon Jesse , Perry Andrew , Beaule Lisa , Kinkead Thomas , Clark David , Hansen Moritz
Published: January 2010

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE

To adapt an industrial definition of learning‐curve analysis to surgical learning, and elucidate the rate at which experienced open surgeons acquire skills specific to robot‐assisted radical prostatectomy (RARP) at a community‐based medical centre.

PATIENTS, SUBJECTS AND METHODS

The total procedure time (TPT) of the first 75 RARPs, performed by three surgeons experienced with retropubic RP, was analysed to determine the point at which their learning rate stabilised. Operative characteristics were compared before and after this point to isolate the plateau of learning rate as a mark of acquiring surgical skill. The operative characteristics examined were TPT, estimated blood loss (EBL), bladder neck contractures (BNC), positive margins (PM) and length of hospital stay (LOS).

RESULTS

The mean rate of TPT decrease, for procedures 1–75, was 13.4% per doubling of RARPs performed. After the first 25 procedures the TPT decreased at a rate of 1.8% per doubling, not significantly different from 0 (P > 0.05). There was no significant difference between procedures 1–25 and 26–75 in rates of EBL, BNC and PM. There was a significant change for all surgeons in TPT, with a mean of 303.1 min (RARPs 1–25) vs 213.6 min (26–75) (P < 0.001), and LOS, of 2.1 days (1–25) vs 1.4 days (26–75) (P < 0.001).

CONCLUSIONS

An industrial definition of learning‐curve analysis can be adapted to provide an objective measure of learning RARP. The average learning rate for RARP was found to plateau by the 25th procedure. Also, the learning rate plateau can serve as an objective measure of the acquisition of surgical skill.
THE IMPACT OF REGULATION ON PHARMACEUTICAL RESEARCH EXPENDITURES: A DYNAMIC APPROACH
Authors: WIGGINS STEVEN N.
Published: January 2010

This Paper estimates the impact of federal regulation of drug quality on research spending by the pharmaceutical industry. The theoretical approach recognizes that the effects of these regulations on reseach spending depend upon the reactions of R&D decision makers and the information available during project selection. The information available to R&D decision makers inthe 1960s suggests that it would have been diffcult for them to forecast accurately regulatory effects on research profitability. As better information developed in the late 1960s and early 1970s, however, regulation had a significant effect on research spending. These differences in response are tested econometrically and prove to be empirically significant. The estimates of current regulatory effects on pharmaceutical R&D are quite large.
CHERRIES, LEMONS, AND THE FTC: MINIMUM QUALITY STANDARDS IN THE RETAIL USED AUTOMOBILE INDUSTRY
Authors: METZGER MICHAEL R.
Published: January 2010

The FTC initially considered two forms of regulation in the used automobile market, requiring dealers to either certify or warrant the mechanical condition of each automobile sold. Since the regulation would have been imposed only on dealers and not on private sellers, its effectiveness was dependent on the magnitude of the induced shift of sales into the private market. Accordingly, this paper employs a gametheoretic model to examine the theoretical conditions under which society could be expected to benefit from either regulatory alternative. Among other things, it is concluded that a socially beneficial minimum quality standard may not exist in some situations.
THE SUPPLY OF OCCUPATIONAL REGULATION
Authors: FAITH ROGER L. , TOLLISON ROBERT D.
Published: January 2010

This paper examines the state's decision to supply monopoly rights to occupations. The two key aspects of the analysis are the degree of political competition and the proportion of market demand of the regulated service accounted for by government officials. An application of the analysis is developed to explain an episode of comparative occupational regulation in mercantile England and France. Other applications of the analysis are suggested.
THE INCENTIVES FOR RESALE PRICE MAINTENANCE UNDER IMPERFECT INFORMATION
Authors: MATHEWSON G. F. , WINTER R. A.
Published: January 2010

This paper considers both the incentives for and the welfare effects of resale price maintenance (RPM) in retail markets characterized by imperfect consumer information. In markets where point‐of‐sale information on the product is essential for sales and information on prices is costly, RPM permits manufacturers with some monopoly power to resolve two incentive conflicts with retailers. First, because retailers with price‐setting powers do not appropriate the gains in profit to an upstream manufacturer from actions taken to increase demand, their incentives to inform consumers of the product and to set low prices are inadequate. This purely vertical externality results in the classic “double mark‐up” of final prices. Second, when consumers' costs of price search vary, stores offering low prices and no information can exist in the market equilibrium. These discount houses free‐ride on the informational services of high‐price informing retail outlets — a horizontal externality. In the imperfect information setting of this paper, (1) administered pricing improves monopolists' profits by resolving the incentive conflict; (2) the profitable use of a price floor reduces the maximum retail price charged and may reduce the average retail price; (3) price floors or administered prices can be Pareto‐improving and more likely welfare (surplus)‐improving; (4) price floors are welfare‐improving.
AN ANALYSIS OF INFORMATIONAL RESTRICTIONS ON THE LENDING DECISIONS OF FINANCIAL INSTITUTIONS
Authors: BARTH JAMES R. , CORDES JOSEPH J. , YEZER ANTHONY M. J.
Published: January 2010

Lenders are assumed to use formal credit scoring schemes in order to evaluate borrower credit worthiness. Variables used in these schemes may be measured with error resulting in credit scores which include the effects of biased parameter estimates, and in lending decisions that appear to be discriminatory although lenders are not prejudiced. Regulations which restrict the information used in credit scoring schemes may produce undesirable credit supply results. Theoretical models are supplemented with illustrative empirical analysis of mortgage lending in which use of information on property location is prohibited. The empirical results indicate that the quantitative impact of such regulations is modest.
HOUSING MARKET CAPITALIZATION OF ENERGY‐SAVING DURABLE GOOD INVESTMENTS
Authors: JOHNSON RUTH C. , KASERMAN DAVID L.
Published: January 2010

Energy conservation in the residential sector depends, in large measure, upon the willingness of builders and homeowners to invest in the durable goods which result in an energy efficient house. Since these durable goods generally become attached permanently to the dwelling unit and since ownership of the unit is likely to change within the expected lifetime of the installed equipment, the incentive to invest in conservation measures depends upon the efficiency of the housing market in capitalizing the financial benefits of future fuel savings. This paper examines housing market efficiency in this regard by first estimating an hedonic price index with the annual fuel bill included as an explicit attribute of the structure. Then, from the estimated hedonic price of a one‐dollar reduction in annual fuel costs and assumed fuel price escalation rates and remaining lifetimes of the equipment, implicit housing market discount rates are calculated. The relatively low estimated discount rates indicate that the housing market performs efficiently in capitalizing future fuel savings.
THE STATE OF THE FEDERAL BUDGET AND THE STATE OF THE ECONOMY
Authors: ABRAMS RICHARD K. , FROYEN RICHARD , WAUD ROGER N.
Published: January 2010

This paper tests systematic responses of the Federal budget to forecasts of inflation and unemployment. Estimated coefficients from fiscal policy reaction functions are examined to determine whether there are such systematic responses. Additionally, the coefficients of these estimated fiscal policy reaction functions are used to test several hypotheses concerning fiscal policy which have been advanced in the political business cycle and public choice literatures.
MIGRATION TRENDS AND EARNINGS OF FREE AGENTS IN MAJOR LEAGUE BASEBALL, 1976–1979
Authors: CYMROT DONALD J.
Published: January 2010

This paper is an empirical investigation of the effect of team characteristics on the migration pattern of free agents in Major League Baseball during the period 1976–1979. The results indicate that high‐quality free agents tend to leave winning teams and move to teams in cities with large or rapidly growing populations. The compensation paid to free agents is shown to depend on these team characteristics as well as the players' personal characteristics and market conditions.
EMPLOYEE EVALUATION OF PENSION CLAIMS AND THE IMPACT OF INDEXING INITIATIVES
Authors: PESANDO JAMES E.
Published: January 2010

There is discussion in both Canada and the United States of proposals which require private pension plans to provide indexed pension benefits. This paper employs both an auction and an implicit contract model to identify the compensating wage differentials required of possible policy initiatives. The contract model, motivated by the prevalence (especially in Canada) of ad hoc cost‐of‐living adjustments to pensions in pay, presumes that workers have a call option on the investment earnings in excess of the interest rate assumption used to value the plan. The analysis indicates that wage offsets are potentially quite large, may be difficult to predict, and may vary substantially across firms. In addition, the case for policy action would appear to rest largely on the implicit assumption that workers misperceive the value of their pension benefits.
INFORMATION ASYMMETRIES IN BASEBALL'S FREE AGENT MARKET
Authors: LEHN KENNETH
Published: January 2010

This study examines whether baseball's free agent market has been characterized by an asymmetric distribution of information among clubs. It is argued that the clubs for which players have performed have more information with which to estimate the players' future performance than do clubs that have not employed the player. Evidence is presented which shows that free agents spend more time on the disabled list than non‐free agents. Over time it appears that club owners have adjusted their expectations of free agent performance.
SPECULATIVE STORAGE, FUTURES MARKETS, AND THE STABILITY OF COMMODITY PRICES
Authors: SARRIS ALEXANDER H.
Published: January 2010

A theoretical dynamic model is developed that integrates the micro‐behavior of commodity and futures speculators into the simultaneous determination of cash and futures prices in a storable commodity market. The model is used to demonstrate the way in which the introduction of a futures market, by affecting the decisions of speculative inventory holders, alters the distribution of spot prices and to elucidate the conditions that render futures trading stabilizing for cash prices.
STOCHASTIC INFLATION AND THE OPTIMAL POLICY OF PRICE ADJUSTMENT
Authors: DANZIGER LEIF
Published: January 2010

This paper analyzes the optimal policy of price adjustment for a monopolistic firm in the presence of stochastic inflation. It shows that an increase in the expected rate of inflation or in the cost of price adjustment leads to an increase in the initial real price and a decrease in the terminal real price in each period with a fixed nominal price. It also shows that the effects of increased riskiness of inflation are ambiguous.
THE ECONOMICS OF CARPOOLS
Authors: LEE LI WAY
Published: January 2010

The paper shows how separate parts of a work trip enter the decision to carpool, and examines how the size of a carpool is related to the gasoline price, the wage rate, speed limits, and other factors. The paper also suggests that policies designed to promote carpooling may produce perverse effects on gasoline consumption.
THE ALLOCATIVE EFFECT OF NON‐BINDING PRICE CONTROLS*
Authors: ZORN THOMAS S.
Published: January 2010

This paper shows that the imposition of non‐binding price controls affects the allocation of resources. Given uncertainty the imposition of such controls will affect expectations of future prices and therefore current investment and output decisions. Non‐binding ceilings (floors) will cause future market clearing prices to be higher (lower). More surprisingly they may cause a current period shortage (surplus). The effects of threatened (stochastic) price and profit controls are also examined.
FURTHER RESULTS ON EQUILIBRIUM PATTERNS OF COMPETITION IN OCS LEASE SALES
Authors: SMITH JAMES L.
Published: January 2010

A prior model of competitive bidding for offshore petroleum leases is subjected to more extensive empirical testing based on underlying geological data prepared by the U.S. Geological Survey. The current results strongly reinforce the tentative conclusions advanced in the previous paper, and demonstrate the robustness of the model. In light of the current results, it seems very likely that participants in offshore lease sales behave as if their operations were constrained physically such that only a limited volume of petroleum reserves are pursued in any one sale.
ON SOME RECENT EXPLANATIONS OF WHY CAPITAL HIRES LABOR
Authors: PUTTERMAN LOUIS
Published: January 2010

Conventional microeconomics contains no explanation of why capital hires labor (and not the reverse). In view of some surprisingly positive results in the theoretical analysis of worker‐run enterprise systems, recent contributions to the theory of the firm have attempted to explain the dominance of capitalist production relations in efficiency terms. The present paper critically reviews works in this area by Alchian and Demsetz (1972), Williamson (1975, 1980), and Jensen and Meckling (1979), and contends that a convincing efficiency argument for the general superiority of capital owners' over workers' control of enterprises still is lacking.
ARM‐BREAKING, CONSUMER CREDIT AND PERSONAL BANKRUPTCY
Authors: REA SAMUEL A.
Published: January 2010

The consumer credit transaction is analyzed as a contract which provides insurance as well as present consumption for the borrower. Creditors' remedies such as “arm‐breaking” are shown to facilitate provision of insurance (forgiveness of debts) when lenders cannot monitor outcomes. Alternatively, if outcomes are observable but lenders do not ex ante know the risk associated with each borrower, the market may generate an excessive amount of arm‐breaking and agreements to forgo discharge following bankruptcy as low risk borrowers signal their characteristics, suggesting that government limitations on such provisions might be efficient. The secured credit transaction is shown to be a complex contract which attempts to provide efficient repayment, seller incentives for performance and mitigation following default, and insurance for the borrower. Garnishment and discharge of debts following bankruptcy are also considered.
AUTOMOBILE FUEL EFFICIENCY: MEASUREMENT AND EXPLANATION
Authors: WILCOX JAMES A.
Published: January 2010

This paper extends the hedonic technique of adjusting for quality change to a new area: the construction of a quality‐adjusted automobile fuel efficiency index. This index, which holds constant a wide range of characteristics that affect observed fuel economy, rises by over 20 percent from 1949 until the late 1960s. The advent of increasingly stringent antipollution regulations coincides with its decline through the mid‐1970s. Thereafter, the constant‐quality index rises sharply. This paper will demonstrate that the fall and rise over the last decade coincide with the reductions in allowable automobile exhaust emissions and the rising relative price of petroleum, respectively.
IS LAND LEASING A SOLUTION TO UNAFFORDABLE HOUSING?
Authors: FRY MAXWELL J. , MAK JAMES
Published: January 2010

The increase in U.S. mortgage rates from nine per cent in 1976 to fifteen per cent in 1982 raised monthly mortgage payments by about sixty per cent, even before rising house prices in the United States over this period are taken into account. Not surprisingly, attention has been focused on ways and means of counteracting spiralling housing costs. One proposed solution is land leasing. Under such an arrangement, the homebuyer purchases the house but leases the land. (There may be an option to buy the land at some time in the future.) Land leasing reduces the overall purchase price, and hence lowers the minimum down‐payment and the initial monthly mortgage payment. In Hawaii, land leasing has been a readily available alternative to land owning throughout the postwar period. The analysis of residential housing prices in Hawaii provides some quantitative estimates of the relative prices of leasehold versus fee simple properties. The average price differential is surprisingly small. One explanation of these small price differentials, for which a model is developed and tested here, is that borrowing‐constrained households use high discount rates to calculate the present value of the future land price that they will, in effect, have to pay at the expiration of the lease. These discount rates are estimated in a nonlinear hedonic property price equation. The results are then employed to answer the question: Under what conditions would a leaseholder buy the land outright before the expiration of the lease?
ECONOMIC RESPONSE TO A CRIME DETERRENCE PROGRAM: MANDATORY SENTENCING FOR ROBBERY WITH A FIREARM
Authors: McPHETERS LEE R. , MANN ROBERT , SCHLAGENHAUF DON
Published: January 2010

This paper reports the results of the application of intervention analysis, an interrupted times series methodology, to test the deterrent response of criminal offenders faced with changes in the penalty structure for the crime of robbery with a firearm. The results are consistent with the hypothesis of general deterrence as set out by Becker and extended theoretically and tested empirically by others. Offenders in Arizona metropolitan areas rapidly reduced the number of robberies with a firearm supplied as penalties for firearm use became more severe. This finding suggests legislation which punishes those who choose to use such weapons in illegal activities may be effective while leaving intact the rights of private citizens to own firearms. One disturbing finding was that a Portion of the deterrent effect of harsher mandatory sentencing for firearm use in robbery may have been offset by substitution of other types of robbery not covered by the new legislation.
MACROECONOMIC STABILITY AND THE SHORT RUN FEDERAL RESERVE REACTION FUNCTION, 1969–1979
Authors: WITTE WILLARD E.
Published: January 2010

This paper examines the dynamic stability of a situation in which monetary policy is implemented by means of short‐run control of interest rates. Using a simple dynamic model it is shown that such procedures may lead to instability unless the central bank allows the controlled interest rate to adjust sufficiently to economic developments. The theoretical model is then used to guide an empirical examination and evaluation of Federal Reserve behavior for the period 1969–1979. Evidence is presented that on average over this period the Federal Reserve's control of the Federal funds rate could have been a destabilizing factor.