bluuebunny/crossref_metadata_2025 huggingface dataset:
A VARIATIONAL PRINCIPLE FOR PLASTIC HINGES IN A BEAM
Authors: PERCIVALE DANILO , TOMARELLI FRANCO
Published: September 2009

We focus on a variational model of an elastic–plastic beam which is clamped at both endpoints and subject to a transverse L∞ load: the mathematical formulation is a 1D free discontinuity problem with second-order energy dependent on gradient-jump integrals but not on the cardinality of gradient-discontinuity set. The related energy is not lower semicontinuous in BH; moreover the relaxed energy is finite also when second derivatives have Cantor part. Nevertheless we show that if a safe load condition is fulfilled, then minimizers exist and they actually belong to SBH, say their second derivative has no Cantor part. If in addition a stronger condition on load is fulfilled, then minimizer is unique and belongs to H2. Moreover, we can always select one minimizer whose number of plastic hinges does not exceed 2 and is the limit of minimizers of penalized problems. When the load stays in the gap between safe load and regularity condition, then minimizers with hinges are allowed; if in addition the load is symmetric and strictly positive, then there is uniqueness of minimizer, the hinges of such minimizer are exactly two and they are located at the endpoints.
Protective mechanical ventilation does not exacerbate lung function impairment or lung inflammation following influenza A infection
Authors: Zosky Graeme R. , Cannizzaro Vincenzo , Hantos Zoltan , Sly Peter D.
Published: September 2009

The degree to which mechanical ventilation induces ventilator-associated lung injury is dependent on the initial acute lung injury (ALI). Viral-induced ALI is poorly studied, and this study aimed to determine whether ALI induced by a clinically relevant infection is exacerbated by protective mechanical ventilation. Adult female BALB/c mice were inoculated with 104.5 plaque-forming units of influenza A/Mem/1/71 in 50 μl of medium or medium alone. This study used a protective ventilation strategy, whereby mice were anesthetized, tracheostomized, and mechanically ventilated for 2 h. Lung mechanics were measured periodically throughout the ventilation period using a modification of the forced oscillation technique to obtain measures of airway resistance and coefficients of tissue damping and tissue elastance. Thoracic gas volume was measured and used to obtain specific airway resistance, tissue damping, and tissue elastance. At the end of the ventilation period, a bronchoalveolar lavage sample was collected to measure inflammatory cells, macrophage inflammatory protein-2, IL-6, TNF-α, and protein leak. Influenza infection caused significant increases in inflammatory cells, protein leak, and deterioration in lung mechanics that were not exacerbated by mechanical ventilation, in contrast to previous studies using bacterial and mouse-specific viral infection. This study highlighted the importance of type and severity of lung injury in determining outcome following mechanical ventilation.
Microgravity decreases and hypergravity increases exhaled nitric oxide
Authors: Karlsson Lars L. , Kerckx Yannick , Gustafsson Lars E. , Hemmingsson Tryggve E. , Linnarsson Dag
Published: September 2009

Inhalation of toxic dust during planetary space missions may cause airway inflammation, which can be monitored with exhaled nitric oxide (NO). Gravity will differ from earth, and we hypothesized that gravity changes would influence exhaled NO by altering lung diffusing capacity and alveolar uptake of NO. Five subjects were studied during microgravity aboard the International Space Station, and 10 subjects were studied during hypergravity in a human centrifuge. Exhaled NO concentrations were measured during flows of 50 (all gravity conditions), 100, 200, and 500 ml/s (hypergravity). During microgravity, exhaled NO fell from a ground control value of 12.3 ± 4.7 parts/billion (mean ± SD) to 6.6 ± 4.4 parts/billion ( P = 0.016). In the centrifuge experiments and at the same flow, exhaled NO values were 16.0 ± 4.3, 19.5 ± 5.1, and 18.6 ± 4.7 parts/billion at one, two, and three times normal gravity, where exhaled NO in hypergravity was significantly elevated compared with normal gravity ( P ≤ 0.011 for all flows). Estimated alveolar NO was 2.3 ± 1.1 parts/billion in normal gravity and increased significantly to 3.9 ± 1.4 and 3.8 ± 0.8 parts/billion at two and three times normal gravity ( P < 0.002). The findings of decreased exhaled NO in microgravity and increased exhaled and estimated alveolar NO values in hypergravity suggest that gravity-induced changes in alveolar-to-lung capillary gas transfer modify exhaled NO.
HIV Infection as a Risk Factor for Cervical Cancer and Cervical Intraepithelial Neoplasia in Senegal
Authors: Holmes Rebecca S. , Hawes Stephen E. , Touré Papa , Dem Ahmadou , Feng Qinghua , Weiss Noel S. , Kiviat Nancy B.
Published: September 2009

Cervical cancer is the second leading cause of cancer mortality in women worldwide, and the leading cause in Africa. There is uncertainty in the role of HIV infection as a risk factor for invasive and preinvasive cervical lesions, particularly in African populations. In a case-control study in Dakar, Senegal, we studied 150 women with invasive cervical cancer (ICC), 92 with cervical intraepithelial neoplasia (CIN) 2 or 3, 70 with CIN 1, and 515 control women. We used logistic regression analysis to estimate associations between HIV-1 and HIV-2 infection and the risk of cervical neoplasia. We found large increases in the risk of ICC and CIN 2-3, but not of CIN 1, associated with the presence of either HIV-1 or HIV-2 infection (odds ratios of 6.5 and 10.4 for ICC and CIN 2-3). Our analysis thus shows increases in the risk of both advanced and early cervical pathology associated with HIV infection in an African population. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2442–6)
Are Racial Disparities in Pancreatic Cancer Explained by Smoking and Overweight/Obesity?
Authors: Arnold Lauren D. , Patel Alpa V. , Yan Yan , Jacobs Eric J. , Thun Michael J. , Calle Eugenia E. , Colditz Graham A.
Published: September 2009

Between 2001 and 2005, Blacks from the United States experienced a 32% higher pancreatic cancer death rate than Whites. Smoking, diabetes, and family history might explain some of this disparity, but prospective analyses are warranted. From 1984 to 2004, there were 6,243 pancreatic cancer deaths among Blacks (n = 48,525) and Whites (n = 1,011,864) in the Cancer Prevention Study II cohort. Multivariate Cox proportional hazards models yielded hazards ratios (HR) for known and suspected risk factors. Population attributable risks were computed and their effect on age-standardized mortality rates were evaluated. Blacks in this cohort had a 42% increased risk of pancreatic cancer mortality compared with Whites (HR, 1.42; 95% confidence intervals (CI), 1.28-1.58). Current smoking increased risk by >60% in both races; although Blacks smoked less intensely, risks were similar to Whites (HRBlack, 1.67; 95% CI, 1.28-2.18; HRWhite, 1.82; 95% CI, 1.7-1.95). Obesity was significantly associated with pancreatic cancer mortality in Black men (HR, 1.66; 95% CI, 1.05-2.63), White men (HR, 1.42; 95% CI, 1.25-1.60), and White women (HR, 1.37; 95% CI, 1.22-1.54); results were null in Black women. The population attributable risk due to smoking, family history, diabetes, cholecystectomy, and overweight/obesity was 24.3% in Whites and 21.8% in Blacks. Smoking and overweight/obesity play a substantial a role in pancreatic cancer. Variation in the effect of these factors underscores the need to evaluate disease on the race-sex level. The inability to attribute excess disease in Blacks to currently known risk factors, even when combined with suspected risks, points to yet undetermined factors that play a role in the disease process. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2397–405)
Vitamin D Related Genes,CYP24A1andCYP27B1,and Colon Cancer Risk
Authors: Dong Linda M. , Ulrich Cornelia M. , Hsu Li , Duggan David J. , Benitez Debbie S. , White Emily , Slattery Martha L. , Farin Fred M. , Makar Karen W. , Carlson Christopher S. , Caan Bette J. , Potter John D. , Peters Ulrike
Published: September 2009

Genetic association studies investigating the role of vitamin D in colon cancer have primarily focused on the vitamin D receptor (VDR), with limited data available for other genes in the vitamin D pathway, including vitamin D activating enzyme 1-α hydroxylase (CYP27B1) and vitamin D deactivating enzyme 24-α hydroxylase (CYP24A1). We evaluated whether 12 tagging single nucleotide polymorphisms (SNP) in CYP24A1, identified by resequencing the gene in 32 Caucasian samples, and 1 SNP in CYP27B1 were associated with colon cancer risk. In addition, we evaluated whether these two genes modify associations between colon cancer on the one hand and total vitamin D intake and UV-weighted sun exposure on the other, as well as other variants in VDR. Unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for the association between polymorphisms and haplotypes in CYP27B1 and CYP24A1 in a multicenter population-based case-control study of 1,600 cases and 1,949 controls. The CYP24A1 polymorphism IVS4-66T > G showed a statistically significant association with risk of colon cancer overall, particularly for proximal colon cancer. When stratified by anatomic site, we also found statistically significant associations for three CYP24A1 polymorphisms with risk of distal colon cancer (IVS4 + 1653C > T: OR for CT/TT versus CC, 0.81; 95% CI, 0.68-0.96; IVS9 + 198T > C: OR for CC versus TT, 1.33; 95% CI, 1.03-1.73; and within whites only: +4125bp 3′ of STPC > G: OR for GG versus CC, 1.44; 95% CI, 1-2.05). In addition, a possible interaction between CYP27B1 and UV-weighted sun exposure with proximal colon cancer was observed. As this is the first study to evaluate these genes in relation to colon cancer, additional studies are needed to confirm these results. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2540–8)
Relationship of Body Mass, Height, and Weight Gain to Prostate Cancer Risk in the Multiethnic Cohort
Authors: Hernandez Brenda Y. , Park Song-Yi , Wilkens Lynne R. , Henderson Brian E. , Kolonel Laurence N.
Published: September 2009

We investigated the relationship of body size and prostate cancer risk in the Multiethnic Cohort, a longitudinal study of individuals ages 45 to 75 in Hawaii and in California. Self-reported measures of height and weight were obtained at baseline. Of 83,879 men enrolled from 1993 to 1996, a total of 5,554 were diagnosed with prostate cancer during an average of 9.6 years of follow-up. The influence of baseline weight and weight change since age 21 varied by ethnic group. Whites gaining more than 10 lbs had a nonlinear, increased risk of advanced and high-grade prostate cancer [relative risks (RR), 2.12; 95% confidence intervals (CI), 1.19-3.78 for 25-39.9 lbs; P trend 0.43; and RR, 1.49; 95% CI, 1.04-2.14, for ≥40 lbs; P trend 0.20, respectively]. African American men gaining 40 lbs or more (relative to <10 lbs) had a nonmonotonic, increased risk of localized prostate cancers (RR, 1.26; 95% CI, 1.02-1.54; P trend 0.09) and those who gained 25 lbs or more were at increased risk of low-grade disease (RR, 1.28; 95% CI, 1.03-1.58, for ≥40 versus 10 lbs, respectively; P trend 0.07). Japanese men had a statistically significant, inverse association of weight gain and localized disease (RR, 0.80; 95% CI, 0.65-0.99 for ≥40 versus 10 lbs; P trend 0.05). Our findings provide evidence that adiposity and changes in adiposity between younger and older adulthood influence the development of prostate cancer. Ethnic differences in risk may be explained by variation in the distribution of accumulated body fat that could differentially affect prostate carcinogenesis.(Cancer Epidemiol Biomarkers Prev 2009;18(9):2413–21)
Birth Characteristics and Risk of Prostate Cancer: the Contribution of Genetic Factors
Authors: Cnattingius Sven , Lundberg Frida , Sandin Sven , Grönberg Henrik , Iliadou Anastasia
Published: September 2009

Background: Prostate cancer has a strong hereditary component, but it has been proposed that hormonal influences in utero may contribute to offspring risk. We investigated the associations between birth characteristics and the risk of prostate cancer in twins, and whether possible associations could be confounded by familial factors, such as shared environment and common genes.

Methods: All like-sexed male twins in the Swedish Twin Registry, born from 1926 to 1958 and alive in 1973, were eligible. Data were obtained from birth records, and 11,420 male twins with reliable birth weight data were included in the final study population. Hazard ratios with 95% confidence intervals (CI) from Cox regression models were used to estimate associations between birth characteristics and risk of prostate cancer. Paired analysis was done to account for potential confounding by familial factors.

Results: Compared with twins with a birth weight of 2,500 to 2,999 g, the hazard ratio (95% CI) for twins with a higher birth weight (≥3,000 g) corresponded to 1.22 (0.94-1.57). In analyses within twin pairs, in which both twins had a birth weight of ≥2,500 g, a 500 g increase in birth weight was associated with an increased risk of prostate cancer within dizygotic twin pairs (odds ratio, 1.41; 95% CI, 1.02-1.57), but not within monozygotic twin pairs (odds ratio, 1.06; 95% CI, 0.61-1.84).

Conclusions: High birth weight is associated with an increased risk of prostate cancer. The difference in risk within dizygotic and monozygotic twin pairs may be due to genetic factors playing an important role in this association. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2422–6)
A Novel Polymorphism rs1329149 of CYP2E1 and a Known Polymorphism rs671 of ALDH2 of Alcohol Metabolizing Enzymes Are Associated with Colorectal Cancer in a Southwestern Chinese Population
Authors: Yang Huan , Zhou Yanhong , Zhou Ziyuan , Liu Jinyi , Yuan Xiaoyan , Matsuo Ketaro , Takezaki Toshiro , Tajima Kazuo , Cao Jia
Published: September 2009

Background: To screen for tagging single nucleotide polymorphisms (tagSNP) in the major alcohol metabolizing enzymes: ADH1B, ALDH2, and CYP2E1, and to evaluate the association between these tagSNPs and colorectal cancer (CRC) in a southwestern Chinese population.

Methods: A hospital-based case-control study of 440 CRC patients and 800 cancer-free controls was conducted. Personal information was collected by a Semi-Quantitative Food Frequency Questionnaire. The tagSNPs were screened in the HapMap with Haploview by setting the minor allele frequency at 0.03 with the highest score of r2 form each block. Genotypes were identified by using the SNPLex System. Both crude and adjusted odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the risk of each SNP.

Results: Sixteen tagSNPs were selected, and 13 were successfully genotyped. A novel CYP2E1 locus rs1329149 and a known ALDH2 locus rs671 were found to be significantly associated with CRC risk. The adjusted OR was 1.86 (95% CI, 1.12-3.09) for the rs671 A/A genotype and 4.04 for the rs1329149 T/T genotype (95% CI, 2.44-6.70), compared with their common homozygous genotypes. Interaction was found between alcohol consumption and gene polymorphisms on CRC, the adjusted OR was 7.17 (95% CI, 2.01-25.53) for drinking habits combined with rs671 A/A or rs1329149 T/T genotype.

Conclusion: The results of this study suggest that rs671 A/A and the first reported locus rs1329149 T/T genotypes increase the susceptibility to CRC, and gene-environmental interaction between the two loci and alcohol use existed for CRC in Southwestern Chinese. Larger studies are warranted to verify our findings. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2522–7)
Saturation Density of Skin Fibroblasts as a Quantitative Screen for Human Cancer Susceptibility
Authors: Rubin Harry
Published: September 2009

Genomic analysis of human cancers reveals a large number of genetic changes per cell that presumably underlie development of the disease. The complexity of these changes that differ from one type of cancer to the other and from patient to patient with the same type of cancer raises questions about the feasibility of genomic analysis as an indicator of susceptibility to cancer. However, skin fibroblasts (SF) from individuals in families with heritable forms of cancer, and from cancer-bearing individuals, show correlation with a significant increase in saturation density (SD), as well as other neoplasia-related properties. Procedures are described for amplifying and quantifying differences in SD on the basis of studies of spontaneous transformation in the NIH 3T3 line of mouse fibroblasts. It is proposed that such procedures be evaluated as quantitative screens for susceptibility to cancer in the general population. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2366–72)
p21 Expression in Colon Cancer and Modifying Effects of Patient Age and Body Mass Index on Prognosis
Authors: Ogino Shuji , Nosho Katsuhiko , Shima Kaori , Baba Yoshifumi , Irahara Natsumi , Kirkner Gregory J. , Hazra Aditi , De Vivo Immaculata , Giovannucci Edward L. , Meyerhardt Jeffrey A. , Fuchs Charles S.
Published: September 2009

p21 (Cyclin-dependent kinase inhibitor-1A, CDKN1A or CIP1) plays a role in regulating cell cycle, and its expression is lost in most colorectal cancers. p21 Is related with energy balance status, cellular senescence, and stem cell aging. Thus, the influence of p21 loss on tumor behavior and clinical outcome may be modified by patient age and body mass index (BMI). Using 647 colon cancers in two independent prospective cohorts, p21 loss was observed in 509 (79%) tumors by immunohistochemistry. Cox proportional hazard models computed hazard ratio (HR) for death, adjusted for potential confounders, including p53, cyclin D1, KRAS, BRAF, PIK3CA, LINE-1 hypomethylation, CpG island methylator phenotype (CIMP), and microsatellite instability (MSI). p21 Loss was independently associated with low colon cancer–specific mortality [HR, 0.58; 95% confidence interval (95% CI), 0.38-0.89; adjusted for the covariates including MSI, CIMP, and LINE-1 methylation]. The prognostic effect of p21 loss differed significantly by age at diagnosis (Pinteraction < 0.0001) and BMI (Pinteraction = 0.002). The adjusted HR for cancer-specific mortality (p21 loss versus p21 expression) was 4.09 (95% CI, 1.13-14.9) among patients <60 year old and 0.37 (95% CI, 0.24-0.59) among patients ≥60 year old. The adverse prognostic effect of obesity was limited to p21-expressing cases (adjusted HR, 5.85; 95% CI, 2.28-15.0; BMI, ≥30 versus <30 kg/m2), but no such effect was observed among p21-lost cases. In conclusion, p21 loss in colon cancer is associated with longer survival among patients ≥60 year old, whereas it is associated with shorter survival among patients <60 year old. Patient BMI also differentially influences prognosis according to p21 CDKN1A status. Our data suggest host-tumor interactions influencing tumor aggressiveness. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2513–21)
No Association between Polymorphisms in LEP, LEPR, ADIPOQ, ADIPOR1, or ADIPOR2 and Postmenopausal Breast Cancer Risk
Authors: Teras Lauren R. , Goodman Michael , Patel Alpa V. , Bouzyk Mark , Tang Weining , Diver W. Ryan , Feigelson Heather Spencer
Published: September 2009

There is evidence that adipokines such as leptin and adiponectin may influence breast tumor development. We conducted a nested case-control study using women in the American Cancer Society Cancer Prevention Study II to examine the association between postmenopausal breast cancer and variability in the genes encoding leptin, the leptin receptor, adiponectin, adiponectin receptor 1, and adiponectin receptor 2. Using 648 cases and 659 controls, we found no statistically significant (P < 0.05) associations between breast cancer risk and any of the single nucleotide polymorphisms. Individual odds ratios ranged from 0.93 to 1.06. We found no evidence of effect modification by body mass index, adult weight gain, location of weight gain, or physical activity. Although we cannot rule out that these genes are involved in gene-gene or gene-environment interactions, our results suggest that individual single nucleotide polymorphisms in these genes do not substantially affect postmenopausal breast cancer risk. (Cancer Epidemiol Biomarkers Prev 2009;18(9):2553–7)
Identification of Novel Genes Associated with Molecular Sex Differentiation in the Embryonic Gonads of Rainbow Trout (Oncorhynchus mykiss)
Authors: Cavileer T. , Hunter S. , Okutsu T. , Yoshizaki G. , Nagler J.J.
Published: September 2009

The molecular pathways in embryonic vertebrates leading to gonad formation in each sex are incompletely understood. The purpose of this study was to identify novel genes that could be associated with sex-specific gonadal differentiation in a fish, the rainbow trout (Oncorhynchus mykiss). This study was facilitated by a custom microarray based on 7,671 genes derived from embryonic rainbow trout gonad cDNA libraries and public databases. Gonad samples for total RNA isolation were obtained from pvasa-green fluorescent protein (pvasa-GFP) transgenic rainbow between 300 and 700 degree-days of development post-fertilization. The transgenic fish permitted the collection of gonads from embryonic rainbow trout during the period of molecular sex differentiation in advance of any morphologically distinguishable characteristics of sex. A bioinformatic method was used with the microarray data that looked for strong associations in gene expression patterns between known sex differentiation genes (the target genes) and novel genes (the target-associated genes) previously not allied with sex differentiation in fishes. The expression patterns of representative target genes from both sexes and their target-associated genes were independently confirmed by real-time reverse transcription polymerase chain reaction to support the validity of the bioinformatic method employed. Numerous novel genes were identified in the gonads of embryonic female and male rainbow trout that could be involved in sex-specific differentiation pathways in this fish.
Germ Cell Degeneration in High-Temperature Treated Pufferfish, Takifugu rubripes
Authors: Lee K.H. , Yamaguchi A. , Rashid H. , Kadomura K. , Yasumoto S. , Matsuyama M.
Published: September 2009

Exogenous factors such as temperature, social behavior, and salinity play a crucial role during the critical sensitive period of sex differentiation in many vertebrates. In fishes, amphibians, and reptiles temperature treatment is known to induce all-male (or female) individuals, and genes related to sex differentiation have been studied. The Japanese pufferfish, Takifugu rubripes, possesses the most compact genome among vertebrates and has immense potential for studies focusing on comparative genome analysis. In this study, we describe gonadal morphology and vasa (germ cell marker) and dmrt1 (Sertoli cell marker) expression on a molecular level in relation to the development of temperature-treated pufferfish. To investigate the relationship between temperature and gonadal development, pufferfish were exposed to high-temperature conditions (32°C) during early gonadal development. Morphological observations showed that this high-temperature treatment did not influence sexual differentiation as determined by ovarian cavity characteristics; however, high-temperature treatment induces gonadal degeneration that is devoid of germ cells. RT-PCR results revealed no vasa expression within germ cell-degenerated gonads. In situ hybridization results showed that dmrt1 was expressed in somatic cells of germ cell-degenerated ovaries. These results suggest that high-temperature treatment during early gonadal development induces germ cell degeneration and masculinization of ovarian somatic cells in pufferfish.
Correlation between Upgrading of Prostate Biopsy and Biochemical Failure and Unfavorable Pathology after Radical Prostatectomy
Authors: Ozden Cuneyt , Oztekin Cetin Volkan , Ugurlu Ozgur , Gokkaya Serkan , Yaris Mehmet , Memis Ali
Published: September 2009

Objective: To evaluate whether upgrading of the biopsy after radical prostatectomy (RP) affects disease outcome in terms of unfavorable pathology and biochemical failure. Patients and Methods: We retrospectively evaluated the records of 174 patients who underwent RP. Prostate biopsy and RP specimen Gleason scores (GSs) and correlative clinical data were recorded, and a multivariate analysis was applied. Results: Overall (138 patients), the disease of 69 men (50.0%) was upgraded, in 19 (13.8%) it was downgraded, and in 50 (36.2%) it had an identical biopsy and pathological GS. Accuracy rates were significantly higher for GS 8–10 compared to low GSs, with a concordance of 50.0 and 12.2%, respectively (p < 0.01). Multivariate analysis revealed the single independent prognostic factor for a non-organ-confined disease as a RP GS 8–10 (p = 0.035). The factors associated with a positive surgical margin were a biopsy GS 8–10 (p < 0.001) and the presence of biopsy score upgrading (p = 0.02). Biopsy GS ≥8 (p < 0.001) and presence of biopsy score upgrading (p = 0.009) were the two independent predictors of relapse after RP. Conclusion: This study demonstrated that biopsy upgrading was present in almost half of the patients who underwent RP and it was significantly related to positive surgical margins and biochemical relapse after RP.
Topical and Long-Acting Local Anesthetic for Prostate Biopsy: A Prospective Randomized Placebo-Controlled Study
Authors: Yurdakul Talat , Taspinar Bulent , Kilic Ozcan , Kilinc Mehmet , Serarslan Alparslan
Published: September 2009

Objective: To determine the efficacy of intrarectal lidocaine gel alone and a combination of lidocaine gel with 2 different longer-acting local anesthetic (LA) agents that were injected into the periprostatic area before transrectal ultrasound-guided prostate biopsy. Patients and Methods: One hundred patients undergoing transrectal prostate biopsy were randomized into 4 groups of 25 patients each. Before the biopsy, group 1 received no local anesthesia, group 2 received 2% lidocaine gel intrarectally, group 3 received intrarectal lidocaine gel and 5 ml bupivacaine (0.25%) injected into periprostatic area, and group 4 received lidocaine gel intrarectally and a 5-ml ropivacaine injection (0.25%) in the same location as group 3. Pain levels during and after the biopsy were assessed by using a 10-point linear visual analog scale (VAS). Results: Patients in groups 3 and 4 had significantly lower VAS scores than those in groups 1 and 2, both during and 1 h after biopsy. There were no differences in the pain scores between groups 1 and 2. Conclusion: The combination of intrarectal lidocaine gel and periprostatic longer-acting LA agents significantly reduces the pain related to prostate biopsy, whereas intrarectal lidocaine gel administration alone does not reduce pain. Thus, administration of the periprostatic longer-acting LA agents alone is adequate.
Percentage of Positive Biopsy Cores at the Onset of Hormone Therapy for Prostate Cancer: Prognostic Significance
Authors: Normand Guillaume , Celhay Olivier , Briffaux Raphaël , Pirès Christophe , Doré Bertrand , Fromont Gaëlle , Irani Jacques
Published: September 2009

Introduction: The percentage of positive prostate biopsy cores (%PBC) has been shown to be a prognostic factor in localized prostate cancer. We hypothesized that it would predict time to hormonal independence and survival in prostate cancer patients treated with androgen deprivation therapy (ADT). Patients and Methods: We used clinical data from 403 men treated with ADT between 1980 and 1999 and focused on a subgroup of 220 patients treated with GnRH analogue. %PBC was defined as the number of positive biopsy cores multiplied by 100 and divided by the total number of biopsy cores. Results: Median %PBC was 83.3% (16.7–100%). Mean follow-up was 57.4 months. Survival at 5 years in men with 83.3% PBC or less was 62.3, 89.1 and 82.6% for recurrence-free, specific and overall survival, respectively, significantly better than that of men with a %PBC of more than 83.3% (32.2, 74.7 and 67.7%, respectively; p < 0.004). Among the factors available in the pretreatment setting, namely age, clinical stage, PSA, Gleason score, bone scan and %PBC, the latter was independently associated with survival in multivariate analysis. Conclusions: %PBC may improve the ability to predict time to hormonal resistance and survival in patients treated with ADT for prostate cancer. This finding warrants further investigation.
Health-Related Quality of Life of Prostate Cancer Patients Compared to the General German Population: Age-Specific Results
Authors: Zenger Markus , Hinz Andreas , Stolzenburg Jens-Uwe , Rabenalt Robert , Schwalenberg Thilo , Schwarz Reinhold
Published: September 2009

Objective: The objective of this study was to examine the age-specific health-related quality of life (HRQOL) of prostate cancer patients (PCPs). Patients and Methods: 387 PCPs were asked to self-assess their HRQOL with the EORTC QLQ-C30 questionnaire. Patients’ data were compared with those of the general German population. Results: The reported global health/QOL scores of the study group and the general German population are nearly equal. However, most of the subdomains of HRQOL are negatively affected in PCPs, especially in younger patients (≤59 years). Conclusion: Medical professionals should pay more attention to the emotional burden of PCPs, because their stress and strains during the time before treatment have a rather more emotional than physical character.
Hounsfield Units on Computed Tomography Predict Calcium Stone Subtype Composition
Authors: Patel Sutchin R. , Haleblian George , Zabbo August , Pareek Gyan
Published: September 2009

Introduction: Hounsfield unit (HU) determination of urinary stones on noncontrast computed tomography (NCCT) has been shown to predict stone composition. However, no in vivo studies have attempted to radiographically separate the various calcium stone compositions. We investigate the efficacy of HU measurement on NCCT to determine if it can differentiate the various calcium stone subtypes. Patients and Methods: Of the 684 patients who had undergone ureteroscopy at our institution from 1/2003 to 10/2007, 100 were identified with a documented NCCT, a chemical stone analysis and a stone size >5 mm but <2 cm. Results: Stone compositions were categorized as 100–80% calcium oxalate monohydrate (CaOMH) (n = 24), <80–60% CaOMH (n = 21), <60–50% CaOMH (n = 11) calcium oxalate dihydrate (CaODH) (n = 16), apatite (n = 9), brushite (n = 4), cystine (n = 2) and uric acid (n = 13). Mean HU were 879 ± 230, 769 ± 295, 717 ± 304, and 517 ± 203 for the 100–80% CaOMH, <80–60% CaOMH, <60–50% CaOMH and CaODH groups, respectively. The average HU for the apatite, brushite, cystine and uric acid groups were 844 ± 346, 1,123 ± 254, 550 ± 74 and 338 ± 145, respectively. The CaOMH groups together had a significantly higher HU than the CaODH group (p < 0.05) and a significantly lower HU than the brushite group (p < 0.05). Conclusions: HU measurement of urinary stones on NCCT may be used to separate some calcium stone subtypes, specifically CaOMH and CaODH. This information may be useful in counseling patients on treatment options for patients requiring intervention.
Prospective Questionnaire-Based Evaluation of the Prevalence of Urinary Incontinence in Women with Chronic Cough
Authors: Shariat Shahrokh F. , Zimmern Philippe E. , Hilton Kathleen , Gruchalla Rebecca S.
Published: September 2009

Purpose: Because chronic cough leads to repeated increases in intra-abdominal pressure, it might cause or unmask stress urinary incontinence (SUI). To test this hypothesis, we performed a cross-sectional prospective survey of women with chronic cough and female subjects without cough symptoms. Methods: A group of women with chronic cough (n = 297) presenting at a specialty asthma/allergy clinic over an 18-month period and a control group (n = 106) completed a self-administered survey that included the Urogenital Distress Inventory (UDI)-6 questionnaire and a global quality of life (QOL) question. Subjects on medication for bladder symptoms (n = 14) or who had undergone prior anti-incontinence surgery (n = 29) were excluded. Results: 263 patients and 97 control subjects met criteria for analysis. Chronic cough patients were older than control subjects (median 41 versus 35 years; p < 0.001). There was no difference in weight between groups (p = 0.544). The UDI-6 question responses correlated with each other and with the responses to the QOL questions (p values ≤0.002). Chronic cough patients were more bothered by urinary frequency (UDI question 1, 33 vs. 20%, p = 0.018), sense of incomplete emptying (UDI question 5, 10 vs. 3%, p = 0.047). There was no statistical difference in SUI between chronic cough patients and controls (UDI question 3, 24 vs. 15%, p = 0.059). Conclusions: Based on this exploratory study, we found no statistically significant difference in the prevalence of SUI between patients with or without chronic cough. However, increased urinary frequency may have had a protective effect on SUI, thereby masking a larger difference in SUI.
The Incontinence Impact Questionnaire: Results in an Italian Female Population Stratified by Educational Status
Authors: Costantini Elisabetta , Lazzeri Massimo , Bini Vittorio , Del Zingaro Michele , Kocjiancic Ervin , Porena Massimo
Published: September 2009

Objective: To determine the response rate to the self-administered Incontinence Impact Questionnaire (IIQ) in an Italian female population. Patients and Methods: 172 consecutive patients referred to the urogynecological department of an urban university teaching hospital were invited to answer the self-administered IIQ. Correlations were investigated between answer rate, age, educational status and urogenital pathology. Results: Only 41.6% of patients with low educational status answered all questions compared with 47.6 and 58% of medium and high educational status (p = 0.038 and p = 0.011 respectively). Mean patient age correlated inversely with educational status (ρ = –0.443; p < 0.0001) and directly with non-response rate (ρ = 0.207; p = 0.007). The non-response rate was correlated significantly and inversely with educational status only in continent patients (ρ = –0.254; p = 0.037) and in patients with pelvic organ prolapse (ρ = –0.256; p = 0.017). Conclusions: The IIQ answer rate correlated directly with educational status in an Italian female population.
Clinical and Demographic Characteristics of Children with Urolithiasis: Single-Center Experience from Eastern Turkey
Authors: Tabel Yilmaz , Akin Ilke Mungan , Tekin Serap
Published: September 2009

Objective: To evaluate the clinical and demographic findings of children with urolithiasis in eastern Turkey. Methods: We retrospectively reviewed the medical records of 67 children with urolithiasis for clinical and laboratory data. Results: Mean age at the time of diagnosis was 39.1 ± 41.2 months. Complaints at admission were: urinary tract infection (29.9%), macroscopic hematuria (26.9%), abdominal or flank pain (19.4%), spontaneous passing of the stone (8.9%), growth and developmental delay (7.5%), and non-specific findings (8.9%). A family history of urolithiasis was positive in 50.7% of patients. Metabolic screening could be performed in 47 (70.1%) of patients due to socioeconomic problems and revealed hypercalciuria in 59.6%, infectious stone in 17%, cystinuria in 6.4%, hyperuricosuria in 10.6%, hyperoxaluria 4.3%, and hypocitruria in 2.1%. Stone analysis of patients (26.9%) revealed calcium oxalate in 38.9%, calcium phosphate in 22.2%, uric acid in 16.7%, cystine in 11.2%, struvite in 5.6% and mixed content in 5.6%. Conclusion: We believe early diagnosis with detailed metabolic screening and appropriate treatment and follow-up procedures and the contribution of urolithiasis to end-stage renal disease can be avoided.
Does Ureteral Stenting prior to Shock Wave Lithotripsy Influence the Need for Intervention in Steinstrasse and Related Complications?
Authors: Ather M.H. , Shrestha B. , Mehmood A.
Published: September 2009

Objective: To analyze factors affecting steinstrasse (SS) and study the impact of pre-shock wave lithotripsy (SWL) stenting in the prevention of SS and related complications. Patients and Methods: The cohort included 4,644 patients with renal stones treated by SWL. Three hundred and twenty-six (7%) developed SS. Initially, all patients were managed conservatively (group 1); interventions were reserved for those in whom conservative treatment failed (group 2). The 2 groups were further analyzed to identify factors influencing the need for intervention. The impact of pre-SWL stenting on the development of SS and the need for intervention was also assessed. Results: Expectant management was successful in 176 (54%) patients, while 150 (46%) required intervention for SS. The size of the stones had a significant association with the number of sessions required (p < 0.01) and the development of SS. The placement of a stent prior to SWL decreased neither the sessions of SWL (p < 0.01) nor the interventions required for SS and related complications. Conclusions: SWL for larger stones is a potentially significant complication of SWL and is associated with significant morbidity. Ureteral stents decrease the acute presentations of patients with SS; however, it does not decrease the ultimate need for intervention in the management of SS.
Alendronate Reduces the Excretion of Risk Factors for Calcium Phosphate Stone Formation in Postmenopausal Women with Osteoporosis
Authors: Yasui Takahiro , Itoh Yasunori , Okada Atsushi , Hamamoto Shuzo , Hirose Masahito , Kobayashi Takahiro , Tozawa Keiichi , Kohri Kenjiro
Published: September 2009

Objective: Osteoporosis is associated with the pathogenesis and risk of urolithiasis, which is higher among postmenopausal women (as opposed to premenopausal). Bisphosphonates potently inhibit bone resorption, and are used in the management of bone disease. We investigated the ability of a bisphosphonate to prevent calcium stone formation. Methods: We studied 12 postmenopausal women (63.8 ± 7.3 years) who were not receiving osteoporosis therapy, and had stones comprised of calcium phosphate (CaP; n = 3), calcium oxalate (CaOx; n = 3) and CaP + CaOx (n = 6). We measured bone mineral density (BMD), serum and urinary values in 24-hour urine specimens before and 3 months after the oral administration of 5 mg/day of alendronate (ALN). The indexes of the ionic activity product of calcium oxalate, AP(CaOx), and of calcium phosphate, AP(CaP), were estimated using the Tiselius method. Results: ALN significantly reduced the AP(CaP) index (1.53 ± 1.37 to 0.89 ± 0.81, p <0.05). Urinary calcium, oxalate, phosphate and the AP(CaOx) index did not significantly change. BMD improved in 11 of the 12 patients. Urinary stones did not develop in any of the patients during the course of the study. Conclusion: The results suggested that ALN not only improves BMD and osteoporosis, but also reduces the risk of calcium phosphate stone formation in postmenopausal women.
Sympathetic Nervous System Overactivity in the Wistar Rat with Proliferative Lesions of Ventral Prostate Induced by Chronic Stress
Authors: Huang Shengliang , Fang Xiaolei , Meng Yan , Chen Yougen , Zhang Xufeng , Zhao Shengtian
Published: September 2009

Objectives: The sympathetic nervous system and hypothalamic-pituitary-adrenal axis have been known to be reactive to psychological factors such as stress in which several humoral factors are released. Growing data suggest that stress conditions could be associated with the development or aggravation of prostatic disease. The present study aims to investigate the influence of chronic stress and blockade of the sympathetic nerve on rat prostate. Methods: We used 2 weeks of restraint water-immersion stress to induce a chronic psychological stress model of Wistar rats. Denervation of the peripheral sympathetic nerve was done by 6-hydroxydopamine (6-OHDA). Blood flow of ventral prostate, plasma catecholamine and cortisol were measured at the end of the experiment. The weight and secretions of dissected prostate lobes were measured and histology was performed by hematoxylin and eosin stain. Results: After 14 days of stress, the blood flow of ventral prostate decreased and plasma cortisol increased. The apparent proliferation of epithelium of ventral lobes were observed and dorsolateral ones were almost unaffected. On the other hand, the hyperplasia changes were not seen after the chemical sympathectomy had been done during stress. Conclusions: Chronic stress may lead to hyperplasia of ventral prostate, the overactivity of sympathetic nervous system is involved in the pathogenesis of prostatic disease.
Subthalamic Nucleus Location: Relationships between Stereotactic AC-PC-Based Diagrams and MRI Anatomy-Based Contours
Authors: Caire François , Ouchchane Lemlih , Coste Jérôme , Gabrillargues Jean , Derost Philippe , Ulla Miguel , Durif Franck , Lemaire Jean-Jacques
Published: September 2009

Subthalamic nucleus (STN) targeting is classically performed based on AC-PC probabilistic position. Nevertheless, MRI allows direct visualization and targeting. We aimed to compare the position localized on MR images with standard stereotactic diagrams. The STN was manually contoured on MR images (22 Parkinson’s disease patients); boundaries were simplified in a schematic polygonal form. Front and lateral stereotactic diagrams were constructed according to Talairach and Benabid. We compared x, y and z coordinates of the geometrical center of MRI-based polygons and stereotactic diagrams (Wilcoxon matched-pairs tests). There was significant discordance between MRI-based polygons and AC-PC-based images. MRI shows the STN as more posterior, medial and slightly inferior.
Fatigue Is Not Associated with Impaired Function of Regulatory T Cells in Untreated Patients with Multiple Sclerosis
Authors: Yaldizli Özguer , Kumar Manoj , Vago Susanne , Kreuzfelder Erich , Limmroth Volker , Putzki Norman
Published: September 2009

Background: The pathophysiology of multiple sclerosis (MS)-associated fatigue is poorly understood. Immunological mechanisms may play a role. Alterations in immunological profile indicate a chronic immune activation in MS patients with fatigue. T-regulatory (Treg) cells seem to play a key role in coordinating autoimmune mechanisms in MS. This is the first study investigating the relationship between Treg cell function and fatigue in MS patients. Methods: In this cross-sectional in vitro, ex vivo study, we isolated peripheral blood mononuclear cells (PBMCs) from 20 MS patients with fatigue, determined lymphocyte subsets by flow cytometry and suppressive function of Treg cells in PBMC cultures with antigen stimulation. Forkhead box protein 3 expression was evaluated by PCR. Results were compared with 20 MS patients without fatigue and with 19 healthy controls. Results: Leukocytes and lymphocyte subsets including Treg cell frequency did not differ in patients with and without fatigue. Co-culturing of Treg cells with CD4+CD25– cells did not lead to a significant suppression of myelin basic protein- and pokeweed mitogen-induced proliferation in MS patients in contrast to healthy controls. There were no statistical differences between MS patients with and without fatigue regarding this suppression activity. Conclusions: Fatigue seems not to be associated with impaired function of Treg cells in untreated MS patients.
Correlation of Brain White Matter Diffusion Anisotropy and Mean Diffusivity with Reaction Time in an Oddball Task
Authors: Konrad Andreas , Vucurevic Goran , Musso Francesco , Stoeter Peter , Winterer Georg
Published: September 2009

Background: Reaction time (RT) is a frequently used measure of information processing speed, but the underlying physiological and anatomical conditions are not yet fully understood. A correlation between measures of white matter (WM) ultrastructural properties and RT is expected – particularly for those WM tracts that are involved in the attentional system of the brain. Methods: Diffusion tensor imaging data were acquired in 43 unrelated healthy subjects (age: 22.7 ± 1.8 years), and RT was measured during an attention-requiring visual oddball task in the same scanning session. Voxel-by-voxel and region of interest analyses were performed for the large association tracts. A linear regression model was used to correlate fractional anisotropy (FA) and mean diffusivity (MD) values with mean RT. Results: Our analyses revealed significant positive correlations between RT and MD in several WM association tracts, predominantly in the right hemisphere. To a lesser extent, significant negative correlations were found between RT and FA in right temporal WM. Conclusion: These findings suggest that subcortical ultrastructural properties of the dorsal and ventral visual stream are relevant with regard to information processing speed. Furthermore, MD appears to be more sensitive than FA in detecting functionally relevant ultrastructural variations in WM tracts.
Arachidonic Acid Supplementation Decreases P300 Latency and Increases P300 Amplitude of Event-Related Potentials in Healthy Elderly Men
Authors: Ishikura Yoshiyuki , Ikeda Gakuro , Akimoto Kengo , Hata Mie , Kusumoto Aki , Kidokoro Ayako , Kontani Masanori , Kawashima Hiroshi , Kiso Yoshinobu , Koga Yoshihiko
Published: September 2009

In the present study, we examined the effects of arachidonic acid (ARA) on age-related event-related potential (ERP) changes in 25 healthy elderly men. This study was performed using a double-blind crossover design. The subjects were administered 600 mg/day of ARA-enriched triglyceride (SUNTGA40S; containing 240 mg ARA) in capsules or the same amount of olive oil in capsules as an inactive placebo for 1 month. ERPs were measured before capsule administration and after 1 month of administration, and P300 latency and amplitude were also measured. In subjects administered 240 mg/day ARA, P300 latency was significantly shorter, and P300 amplitude was significantly higher than in those administered olive oil capsules, and they exhibited a significant increase in ARA content in serum phospholipids. These findings suggest that supplementation of ARA can improve cognitive function in healthy elderly men.
Impaired Function of Innate T Lymphocytes and NK Cells in the Acute Phase of Ischemic Stroke
Authors: Peterfalvi Agnes , Molnar Tihamer , Banati Miklos , Pusch Gabriella , Miko Eva , Bogar Lajos , Pal Jozsef , Szereday Laszlo , Illes Zsolt
Published: September 2009

Background: Functional alterations of innate lymphocytes, which can mount rapid immune responses and shape subsequent T cell reactions, were examined in the acute phase of ischemic stroke. Methods: Frequencies, intracellular perforin and interferon-γ (IFN-γ) expression of Vδ2 T cells, CD3+ CD56+ natural killer T (NKT)-like and NK cells were examined in the peripheral blood of 20 healthy controls and 28 patients within 6 h of the onset of acute ischemic stroke and after 72 h by flow cytometry. Cytokine production of isolated NKT-like and NK cells following in vitro activation was measured by cytometric bead array. NK cytotoxicity was examined in the peripheral blood mononuclear cells. Results: Percentages of Vδ2, NKT-like and NK cells were constant, and similar to percentages in healthy subjects. In contrast, proinflammatory intracellularIFN-γ expression by Vδ2 T cells, NKT-like cells and NK cells and IFN-γ production by isolated NK cells in culture was low at 6 h and reached the level of healthy subjects by 72 h after stroke. Production of anti-inflammatory cytokines was unaltered. Intracellular perforin expression by Vδ2 T cells, NKT-like cells and NK cells, and NK cytotoxicity was low at 6 h, and reached the level of healthy subjects by 72 h. Increases in IFN-γ and perforin expression by Vδ2 T cells correlated with clinical improvement indicated by decreases in NIHSS scores. Conclusions: Pro-inflammatory and cytotoxic responses of NK, NKT-like and Vδ2 T cells become acutely deficient in ischemic stroke, which may contribute to an increased susceptibility to infections.