bluuebunny/crossref_metadata_2025 huggingface dataset:
Ecological implications of the emergence of non‐toxic subcultures from toxic Microcystis strains
Authors: Schatz D. , Keren Y. , Hadas O. , Carmeli S. , Sukenik A. , Kaplan A.
Published: May 2005

Two toxic, microcystin‐producing, Microcystis sp. strains KLL MG‐K and KLL MB‐K were isolated as single colonies on agar plates from Lake Kinneret, Israel. Two non‐toxic subcultures, MG‐J and MB‐J spontaneously succeeded the toxic ones under laboratory conditions. Southern analyses showed that MG‐J and MB‐J are lacking at least 34 kb of the mcy region, encoding the microcystin synthetase. Analyses of the 16S rRNA genes, the intergenic spacer region between cpcB and cpcA and the patterns of the polymerase chain reaction products of randomly amplified polymorphic DNA and highly iterated palindrome, and presence of mobile DNA elements did not allow unequivocal distinction between toxic and non‐toxic subcultures. Laboratory and field experiments indicated an advantage of the toxic strain over its non‐toxic successor. When grown separated by a membrane, which allowed passage of the media but not the cells, MG‐K severely inhibited the growth of MG‐J. Furthermore, when MG strains were placed in dialysis bags in Lake Kinneret during the season in which Microcystis is often observed, cells of MG‐J lysed, whereas MG‐K survived. Mechanisms whereby the non‐toxic subcultures emerged and prevailed over the corresponding toxic ones under laboratory conditions, as well as a possible role of microcystin under natural conditions, are discussed.
Physiological and molecular characterization of a microbial community established in unsaturated, petroleum‐contaminated soil
Authors: Kasai Yuki , Takahata Yoh , Hoaki Toshihiro , Watanabe Kazuya
Published: May 2005

The microbial communities established in soil samples from an unsaturated, petroleum‐contaminated zone and from an adjacent uncontaminated site were characterized by physiological and molecular approaches. Possible electron acceptors such as sulfate and nitrate had been completely depleted in these soil samples. Slurries of these soil samples were incubated in bottles in the presence of hydrocarbon indicators (benzene, toluene, xylene and decane), and the degradation of these compounds was examined. Supplementation with electron acceptors stimulated hydrocarbon degradation, although the stimulatory effect was small in the contaminated soil. The initial degradation rates in the contaminated soil under fermentative/methanogenic conditions were comparable to those under aerobic conditions. The microbial populations in the original soil samples were analysed by cloning and sequencing of polymerase chain reaction (PCR)‐amplified bacterial and archaeal 16S rRNA gene fragments, showing that the sequences retrieved from these soils were substantially different. For instance, Epsilonproteobacteria, Gammaproteobacteria, Crenarchaeota and Methanosarcinales could only be detected at significant levels in the contaminated soil. Denaturing gradient gel electrophoresis (DGGE) analyses of 16S rRNA gene fragments amplified by PCR from the incubated soil‐slurry samples showed that supplementation of the electron acceptors resulted in a shift in the major populations, while the DGGE profiles after incubating the contaminated soil under the fermentative/methanogenic conditions were not substantially changed. These results suggest that petroleum contamination of the unsaturated zone resulted in the establishment of a fermentative/methanogenic community with substantial hydrocarbon‐degrading potential.
Assemblages of ericoid mycorrhizal and other root‐associated fungi from Epacris pulchella (Ericaceae) as determined by culturing and direct DNA extraction from roots
Authors: Bougoure Damian S. , Cairney John W. G.
Published: May 2005

Ericoid mycorrhizal fungal endophytes form mycorrhizal associations with Ericaceae plant taxa and are regarded as essential to the ecological fitness of the plants in extremely nutrient‐poor soils worldwide. We isolated fungi from roots of Epacris pulchella (Ericaceae) in a south‐eastern Australian sclerophyll forest and compared rDNA internal transcribed spacer (ITS) restriction fragment length polymorphisms (RFLPs) and sequences for the cultured isolate assemblage with fungi identified in DNA extracted directly from the same root systems by cloning or denaturing gradient gel electrophoresis (DGGE). The most abundant RFLP types in the cultured isolate assemblage were identified as putative ericoid mycorrhizal ascomycete endophytes, and these also represented the most abundant RFLP types in the cloned assemblage and the most intense bands in DGGE profiles. Each method identified unique taxa, notably putative basidiomycetes in the DNA extracted directly from E. pulchella roots. However, the relative abundance of these was low.
Stable isotope probing analysis of the influence of liming on root exudate utilization by soil microorganisms
Authors: Rangel‐Castro J. Ignacio , Killham Ken , Ostle Nick , Nicol Graeme W. , Anderson Ian C. , Scrimgeour Charlie M. , Ineson Phil , Meharg Andy , Prosser Jim I.
Published: May 2005

Rhizosphere microorganisms play an important role in soil carbon flow, through turnover of root exudates, but there is little information on which organisms are actively involved or on the influence of environmental conditions on active communities. In this study, a 13CO2 pulse labelling field experiment was performed in an upland grassland soil, followed by RNA‐stable isotope probing (SIP) analysis, to determine the effect of liming on the structure of the rhizosphere microbial community metabolizing root exudates. The lower limit of detection for SIP was determined in soil samples inoculated with a range of concentrations of 13C‐labelled Pseudomonas fluorescens and was found to lie between 105 and 106 cells per gram of soil. The technique was capable of detecting microbial communities actively assimilating root exudates derived from recent photo‐assimilate in the field. Denaturing gradient gel electrophoresis (DGGE) profiles of bacteria, archaea and fungi derived from fractions obtained from caesium trifluoroacetate (CsTFA) density gradient ultracentrifugation indicated that active communities in limed soils were more complex than those in unlimed soils and were more active in utilization of recently exuded 13C compounds. In limed soils, the majority of the community detected by standard RNA‐DGGE analysis appeared to be utilizing root exudates. In unlimed soils, DGGE profiles from 12C and 13C RNA fractions differed, suggesting that a proportion of the active community was utilizing other sources of organic carbon. These differences may reflect differences in the amount of root exudation under the different conditions.
Moderately thermophilic Myxobacteria: novel potential for the production of natural products isolation and characterization
Authors: Gerth Klaus , Müller Rolf
Published: May 2005

Novel moderately thermophilic Myxobacteria from both known suborders (Cystobacterineae and Sorangineae) were isolated from soil samples of semiarid and warm climates. The addition of the anthelmintic and amoebizidal agent levamisole was a new and crucial improvement for the fast isolation of overall 37 strains, which grew very fast at temperatures of 42–44°C. When the 16S rDNAs were compared with GenBank data of common Myxobacteria, identities were 98–99%, thus not reflecting the physiological differences. Similar to the Myxobacteria described so far, the new isolates are multiresistant against a variety of antibiotics and are producers of typical myxobacterial secondary metabolites. Analysis of our previous strain collection isolated from soil samples taken worldwide revealed a more or less uniform distribution of strains which synthesize specific metabolites. Therefore these moderately thermophilic Myxobacteria, which grow 2–3 times faster, have the potential to replace the slow‐growing isolates and provide a means for fast and cost‐saving production of myxobacterial metabolites in the future.
Persistence of vibrios in marine bivalves: the role of interactions with haemolymph components
Authors: Pruzzo Carla , Gallo Gabriella , Canesi Laura
Published: May 2005

Marine bivalves are widespread in coastal environments and, due to their filter‐feeding habit, they can accumulate large numbers of bacteria thus acting as passive carriers of human pathogens. Bivalves possess both humoral and cellular defence mechanisms that operate in a co‐ordinated way to kill and eliminate infecting bacteria. Vibrio species are very abundant in coastal waters and are commonly isolated from edible bivalves tissues where they can persist after depuration processes in controlled waters. Such observations indicate that vibrios are regular components of bivalve microflora and that the molluscs can represent an important ecological niche for these bacteria. Here we tried to summarize data on the interactions between vibrios and bivalve haemolymph; the available evidence supports the hypothesis that persistence of bacteria in bivalve tissues depends, at least in part, on their sensitivity to the bactericidal activity of the haemolymph. Results obtained with an in vitro model of Vibrio cholerae challenged against Mytilus galloprovincialis haemocytes indicate that bacterial surface components, soluble haemolymph factors and the signalling pathways of the haemocyte host are involved in determining the result of vibrio–haemolymph interactions.
Expression of the epidermal growth factor receptor family in normal and malignant urothelium
Authors: Røtterud Ranveig , Nesland Jahn Marthin , Berner Aasmund , Fosså Sophie D.
Published: May 2005

OBJECTIVE

To compare the immunohistochemically assessed expression of the epidermal growth factor receptor (EGFR) family in normal and malignant bladder urothelium, and suggest new hypotheses about their function in the development and progression of transitional cell carcinoma (TCC).

PATIENTS AND METHODS

EGFR, ERBB2, ERBB3 and ERBB4 were evaluated immunohistochemically in normal urothelium (NU, 15), primary non‐metastasized invasive TCC (NMC, 19) and in primary invasive TCCs with corresponding metastases (MC, 51, both specimens).

RESULTS

All NU samples expressed ERBB4, none expressed ERBB2 and two expressed EGFR; all staining was uniform throughout all cell layers. ERBB2 expression increased and ERBB4 decreased from normal samples to carcinomas. There was no difference between NMCs and MCs in ERBB2, ERBB3 and ERBB4, but the NMCs expressed more EGFR than both NU and MC samples. There were no associations with T category, grade or survival. All combinations of expression levels for the four receptors were detected, with no dominant profile.

CONCLUSION

We hypothesise that: (i) ERBB4 is important for differentiation in NU; (ii) ERBB2 is up‐regulated with carcinogenesis in the urinary bladder but does not discriminate between bladder cancer with or without metastases; (iii) EGFR may be a marker of indolent disease. A current hypothesis, that superficial layers of NU do not express EGFR and thus protect the basal cells from the mitogenic effect of urinary EGF, is challenged.
A novel surgical technique for implanting a new electrostimulation system for treating female overactive bladder: a preliminary report
Authors: Nissenkorn Israel , De Jong Peter R.
Published: May 2005

There are three interesting but diverse topics in this section. Authors from Tel‐Aviv and Capetown describe a novel surgical technique for implanting a new electrostimulation system for treating overactive bladder in the female. This is followed by a classification of symptomatic nocturia from Japan, which also looks at the distribution of nocturia, with special attention to duration of time in bed. Finally, there is an interesting paper on the association between congenital adrenal hyperplasia and LUTS.

OBJECTIVE

To assess the results of peripheral electrostimulation of pelvic floor muscles in patients with overactive bladder (OAB) symptoms, and to describe a novel surgical technique for inserting a specially designed implantable electrostimulator which can deliver different forms of muscle stimulation through a para‐urethral electrode.

PATIENTS AND METHODS

The study included seven women with OAB (mean age 59 years) who had frequency (including nocturia), urgency and urge incontinence for ≥ 1 year, and in whom conventional treatment failed. The antepubic technique was used to implant the electrostimulator and a para‐urethral electrode. The patients’ urinary symptoms and quality of life (King's College Hospital incontinence questionnaire) were compared before and after surgery, and possible complications monitored.

RESULTS

The mean (range) follow‐up was 14.5 (13–17) months in six and 10 months in the seventh patient (stimulator removed because of infection). The mean (range) frequency of 15 (13–23) voids/24 h before surgery decreased to 9 voids/24 h (i.e. by 40%) afterward. All patients had leakage episodes because of urgency (4–15 times/day) before surgery, which ceased in five afterward; these patients used no further pads. In the remaining two patients urgency incontinence continued after surgery, but with significantly fewer leakage episodes, from 15 and 12 per day before to 6.7 and 4 afterward, respectively. The mean degree of urgency (graded 0–3) decreased from 2 to 1.4 after surgery, and quality of life improved significantly. Urodynamic studies showed a greater mean maximum detrusor capacity, from 135 mL before to 189 mL after implanting the stimulator.

CONCLUSIONS

The good results (over a follow‐up of 1 year) in patients with OAB symptoms treated by the present electrostimulator should encourage further clinical studies in such patients. A trial to evaluate the efficacy of pelvic floor muscle electrostimulation in a broad spectrum of diseases of the lower urinary tract causing symptoms similar to OAB has been started.
In vitro viability of human cavernosal endothelial and fibroblastic cells after exposure to papaverine/phentolamine and prostaglandin E1
Authors: Pilatz Adrian , Schultheiss Dirk , Gabouev Alexander I. , Schlote Norbert , Mertsching Heike , Jonas Udo , Stief Christian G.
Published: May 2005

OBJECTIVE

To investigate the influence of commercially available vasoactive drugs on human cavernosal endothelial and fibroblastic cells in vitro, as although corporal fibrosis is a well known side‐effect of intracavernosal injection therapy for erectile dysfunction, the possible detrimental effect of these agents on the endothelium lining the cavernosal vascular spaces is uncertain.

MATERIALS AND METHODS

Cultured primary endothelial (13) and fibroblastic cells (12), obtained from potent patients undergoing penile surgery, were exposed to different physiological dilutions of prostaglandin E1 (PGE1), papaverine/phentolamine or the respective triple‐mix of these agents for 30 min. Viable cells were counted and cell metabolic activity measured in these cultures 48 h after drug exposure.

RESULTS

There was a significant dose‐dependent decrease in the viable cell count after exposure to papaverine‐containing formulations, probably because of the low pH of this substance. This cytotoxic effect was more pronounced in endothelial than in fibroblastic cells, and was not apparent in the PGE1 groups. The relative increase in cell metabolic activity in cultures affected by a moderate cytotoxic effect indicated a regenerative process.

CONCLUSION

These comparative results in endothelial and fibroblastic cell cultures suggest that the endothelium rather than the interstitium of the corpus cavernosum is more sensitive to side‐effects produced by intracavernosal injection therapy with papaverine. Thus, unfavourable consequences on the function of the endothelial layer might be as important as the risk of interstitial fibrosis. As these effects were not detected for PGE1 this drug should be preferred to papaverine in clinical practice.
Is laparoscopic unilateral sural nerve grafting during radical prostatectomy effective in retaining sexual potency?
Authors: Porpiglia Francesco , Ragni Francesca , Terrone Carlo , Renard Julien , Musso Francesca , Grande Susanna , Cracco Cecilia , Ghignone Gianpaolo , Scarpa Roberto M.
Published: May 2005

Associate Editor

Michael G. Wyllie

Editorial Board

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

Marcel Waldinger, Netherlands

OBJECTIVES

To present a pilot study of laparoscopic unilateral sural nerve grafting during radical prostatectomy, with the aim of preserving sexual potency.

PATIENTS AND METHODS

Because they had localized prostate cancer, 29 men had a laparoscopic radical prostatectomy with deliberate wide unilateral neurovascular bundle resection and preservation of the contralateral bundle. Fifteen men (group A) had an interposition sural nerve graft on the sectioned bundle, and 14 (group B) had laparoscopic radical prostatectomy with preservation of the unilateral bundle only. The men were also involved in a rehabilitation programme, and erectile function was evaluated after surgery, and at 3, 8, 12 and 18 months, using the five‐item version of the International Index of Erectile Function (IIEF‐5) questionnaire.

RESULTS

The two groups had similar clinical characteristics (age, prostate‐specific antigen level, body mass index, prostate volume, clinical stage, Gleason score before and after surgery, postoperative stage). The follow‐up was complete for 12 men in group A and 10 in group B. Group A had significantly higher erectile function scores on the IIEF‐5 at 12 and 18 months than immediately after surgery (P < 0.01), whereas in group B the improvement was not statistically significant. Overall, by 18 months after surgery five of 12 men in group A had achieved spontaneous unassisted erection or erection assisted with sildenafil, while three of 10 in group B achieved an erection assisted with sildenafil (not significant).

CONCLUSIONS

These data suggests that laparoscopic sural nerve grafting during radical prostatectomy is feasible and safe; nevertheless we cannot conclude that sural nerve grafting is more effective than preserving the neurovascular bundle alone in retaining sexual potency. More research is required to validate the effectiveness of this technique.
A phase‐1 study of sequential mitomycin C and 5–aminolaevulinic acid‐mediated photodynamic therapy in recurrent superficial bladder carcinoma
Authors: Skyrme Rob J. , French A. Jane , Datta Shibendra N. , Allman Richard , Mason Malcolm D. , Matthews Philip N.
Published: May 2005

OBJECTIVE

To report a phase‐1 study of patients with recurrent superficial bladder cancer treated with photodynamic therapy (PDT) using sequential mitomycin C and 5‐aminolaevulinic acid (ALA).

PATIENTS AND METHODS

Twenty‐four patients were treated, the primary endpoint being the safety and tolerability of combined therapy at increasing doses of ALA and light.

RESULTS

Mitomycin C instillation was followed by ALA concentrations of 6%, 8% or 10%; there was no effect on toxicity. The light dose, at a wavelength of 635 nm, was increased from zero to 25 J/cm2, with the upper fluences producing transient symptoms. There were no episodes of skin photosensitivity or systemic toxicity. A total fluence of 25 J/cm2 represented the upper light dose for the tolerability of this procedure by patients. There were no persistently high urinary symptom scores or reduction in functional bladder capacity up to ≥24 months of follow‐up. In this group, cumulative tumour recurrences were none at 4, two at 8, six at 12, nine at 18 and 11 at 24 months after PDT, respectively.

CONCLUSION

Sequential mitomycin C and ALA‐PDT is a safe and well tolerated treatment, with potential for managing difficult‐to‐control superficial transitional cell carcinoma and carcinoma in situ of the bladder.
Is photodynamic diagnosis using hypericin better than white‐light cystoscopy for detecting superficial bladder carcinoma?
Authors: Sim Hong Gee , Lau Weber K.O. , Olivo Malini , Tan Puay Hoon , Cheng Christopher W.S.
Published: May 2005

OBJECTIVE

To review the initial clinical results of photodynamic diagnosis (PDD) using hypericin (a new photosensitizer for PDD that helps to label flat urothelial tumours to facilitate biopsy) for the early detection of superficial bladder carcinoma, as flat noninvasive tumours of the bladder may be missed during conventional white‐light cystoscopy (WLC) if there is bladder overdistension or ongoing cystitis.

PATIENT AND METHODS

Between 1 January 2001 and 30 October 2004, 41 consecutive patients (mean age 66.1 years, sd 9.1, range 46–81) had transurethral resection for bladder cancer. Hypericin was introduced intravesically for 2 h before cystoscopy. Immediately after WLC, fluorescence cystoscopy (FC) was used at the same location and the same bladder site inspected using violet light. FC findings, e.g. positive or negative red fluorescence, were documented for each specific bladder site examined, and the exact location sampled for biopsy.

RESULTS

The mean (sd, range) bladder capacity of the patients was 431 (86, 300–650) mL. In all, 179 biopsies were taken from the 41 patients; urothelial cancers were found in 41% (74) and 80% (33) had macroscopically visible bladder tumours; 40% (71) of the biopsies were positive under FC and 86% (61) of the 71 FC‐positive biopsies showed cancer on histology. Twenty‐five biopsies (14%) were positive on FC but not WLC. PDD testing with hypericin had a sensitivity of 82% (61/74) and specificity of 91% (95/105), vs WLC, at 62% (46/74) and 98% (103/105), respectively. The PDD test had a positive predictive value of 86% (61/71) and a negative predictive value of 88% (95/108), vs 96% (46/48) and 79% (103/131), respectively for WLC. There were no reports of significant complications after the procedure.

CONCLUSION

PDD using hypericin shows promise, as it has a higher sensitivity but equivalent specificity than WLC. It can be used to detect flat lesions not seen on WLC. PDD testing is also well tolerated with minimal side‐effects.
Anatomical radical retropubic prostatectomy: ‘curtain dissection’ of the neurovascular bundle
Authors: Lunacek Andreas , Schwentner Christian , Fritsch Helga , Bartsch Georg , Strasser Hannes
Published: May 2005

OBJECTIVE

To investigate the topographical relationship of the cavernosal nerves (CNs) to seminal vesicles, prostate, rhabdosphincter and urethra during the development of the prostate, and to use the resulting morphological data to modify the surgical technique of nerve‐sparing radical prostatectomy.

MATERIALS AND METHODS

The study included 29 male fetuses (gestational age 9–37 weeks) and eight adult specimens assessed anatomically and histologically. Using the plastination technique and anatomical dissection, the course of the CNs was investigated in all specimens. Based on these morphological results, the technique of dissecting the CNs during nerve‐sparing radical retropubic prostatectomy was modified.

RESULTS

During early fetal development the fibres of the CNs enclose the prostatic and membranous urethra dorsally and laterally. During the growth of the prostate, the CNs running along the prostate become displaced further anteriorly and spread, thus forming a concave shape (like a ‘curtain’) of the neurovascular bundles (NVB). Therefore, dissection of the NVB has to start anteriorly to preserve all the nerve fibres that are spread along the surface of the lateral lobes of the prostate.

CONCLUSIONS

From these anatomical findings we propose a modified ‘curtain dissection’ to improve preservation of the CNs running in the NVB, in which the incision of the periprostatic fascia and dissection of the NVB is far more anterior than previously described.
Diverse optical characteristic of the prostate and light delivery system: implications for computer modelling of prostatic photodynamic therapy
Authors: Jankun Jerzy , Keck Rick W. , Skrzypczak‐Jankun Ewa , Lilge Lothar , Selman Steven H.
Published: May 2005

OBJECTIVE

To explore the use of photodynamic therapy (PDT) as a minimally invasive form of treatment for organ‐confined prostate cancer, for although there are several therapies, ablative treatments are associated with significant morbidity.

MATERIALS AND METHODS

Using the photosensitizer tin etiopurpurin, dogs were treated with interstitially placed laser fibres in an effort to validate PDT for treating prostate cancer. Earlier models assumed a uniform distribution of light output from a cylindrical fibre and a uniform attenuation coefficient throughout the prostate. Subsequent observations show that this model was too simple and that light radiance is not linear. To overcome under‐treatment, a computer program to complement real‐time fibre placement was developed.

RESULTS

As light radiance from interstitially placed laser fibres varies significantly from the commonly assumed ideal cylindrical emission, a predictive mathematical model of prostate PDT needs to consider the real emission. Also, the optical properties of the prostate, e.g. absorption and scattering of light, are anisotropic. Differences in the attenuation coefficient (combining absorption and scattering of light) also varied among different animals. Incorporating all these variables into a computer program produced a virtual model of the photo‐ablated zone within ± 2 mm of that observed in animals.

CONCLUSION

PDT of the prostate is not trivial and should benefit from computer‐aided methods as it is developed for clinical use.
Volume‐adjusted prostate‐specific antigen (PSA) variables in detecting impalpable prostate cancer in men with PSA levels of 2–4 ng/mL: transabdominal measurement makes a significant contribution
Authors: Kobayashi Takashi , Kawahara Takashi , Nishizawa Koji , Ogura Keiji , Mitsumori Kenji , Ide Yoshihiro
Published: May 2005

OBJECTIVE

To examine whether prostate‐specific antigen (PSA) levels adjusted according to prostate volume improve prostate cancer detection using transrected biopsies in men with PSA levels of 2–4 ng/mL, and benign findings on a digital rectal examination (DRE).

PATIENTS AND METHODS

Men aged ≤ 79 years and with serum PSA levels of 2–4 ng/mL and normal DRE findings were prospectively enrolled. Eligible patients were recommended for transrectal prostate biopsies after measuring prostate volumes with transrectal (TRUS) and transabdominal (TAUS) ultrasonography, and transition zone volumes with TRUS. In addition to PSA levels and the free‐to‐total PSA ratio, volume‐adjusted PSA levels, PSA densities determined by TRUS (PSADTRUS), and TAUS (PSADTAUS), and PSA transition zone densities (PSATzD) were compared using receiver operating characteristic analysis.

RESULTS

Prostate cancer was diagnosed in 31 (22%) of the 139 men who had prostate biopsies. The area under the curve (AUC) of PSADTRUS (0.796) and PSATzD (0.792) was similar and significantly greater than that of PSA (AUC 0.588) and the free‐to‐total PSA ratio (AUC 0.658). PSADTAUS was a significantly better indicator of prostate cancer than PSA levels alone (P = 0.043).

CONCLUSION

As predictors of prostate cancer, there were no significant differences between PSADTRUS and PSATzD. Although PSADTAUS was worse than PSA variables adjusted by total and transition zone prostate volumes determined by TRUS, it was a better predictor than the PSA value alone in men with a low PSA level. These results indicate that TAUS is worthwhile where the routine use of TRUS before biopsy is difficult.
Classification and distribution of symptomatic nocturia with special attention to duration of time in bed: a patient‐based study
Authors: Yoshimura Koji , Terai Akito
Published: May 2005

OBJECTIVE

To classify the night‐time urinary frequency of patients with symptomatic nocturia by urine volume produced, nocturnal bladder capacity and time spent in bed.

PATIENTS, SUBJECTS AND METHODS

In all, 110 patients whose principal complaint was nocturia were enrolled in the study; 32 age‐ and gender‐matched subjects were recruited as controls. From studies of the controls, 190 mL and 510 min were identified as the normal limits for mean nocturnal urine voided volume and time spent in bed. The 110 patients were classified into eight categories based on urine volume, nocturnal bladder capacity and time spent in bed.

RESULTS

There were abnormalities of urine volume produced, bladder capacity and time spent in bed in 72%, 50% and 54% of the patients, respectively. Patients with severe nocturia (≥4 voids/night) tended to have more complex pathophysiology than those with mild nocturia (≤3 voids/night).

CONCLUSION

Time spent in bed, urine volume produced and bladder capacity should be used to assess patients with symptomatic nocturia.
Does thrombin sealant allow nephron‐sparing surgery with no renal artery occlusion? A description of technique and initial results
Authors: Triaca Veronica , Zagha Ralph M. , Libertino John A.
Published: May 2005

The first paper in this section from Burlington Massachusetts describes the authors’ experience with thrombin sealant, perhaps allowing nephron‐sparing surgery without renal artery occlusion. They describe their technique and initial results.

Authors from Mannheim describe how they validate computer‐based training in ureteroscopy. This is particularly important at present, where increasingly trainees are being assessed on computer models. Obviously, all of these computer‐based methods must be carefully validated before used practically.

Finally, there are two papers which describe how CT can aid in the management of urinary calculi either by PCNL or by ESWL.
Validation of computer‐based training in ureterorenoscopy
Authors: Knoll Thomas , Trojan Lutz , Haecker Axel , Alken Peter , Michel Maurice Stephan
Published: May 2005

OBJECTIVES

To evaluate the outcome of training both urological novices and experts, using the recently developed UroMentor (Simbionix Ltd, Israel) trainer, that provides a realistic simulation of rigid and flexible ureterorenoscopy (URS).

SUBJECTS AND METHODS

Twenty experienced urologists (total number of previous flexible URSs 21–153) were monitored during simulated flexible URS for treating a lower calyceal stone, and the outcome was correlated with individual experience. A score was compiled based on the variables recorded, including total operation time, stone contact time, complications such as bleeding or perforation, and treatment success. A further five urological residents with no endourological experience were trained on the UroMentor in rigid URS for ureteric stone treatment. Their acquired clinical skills were subsequently compared to those of five urological residents who received no simulator training.

RESULTS

All 20 experienced urologists disintegrated the stone on the simulator, and the score achieved was related to their personal experience; there was a significant difference in performance in those with < 40 and > 80 previous flexible URSs. For the five urological residents with no endourological experience, simulator training improved their skills, and comparison with urological residents who had received no simulator training showed advantages for the trained residents. After being trained on the simulator, the group performed better in the first four URSs on patients.

CONCLUSIONS

Individual experience correlates with individual performance on the simulator. Simulator training was helpful in improving clinical skills. Although the distribution of computer‐based simulators is limited by high prices, virtual reality‐based training has the potential to become an important tool for clinical education.
Planning percutaneous nephrolithotomy using multidetector computed tomography urography, multiplanar reconstruction and three‐dimensional reformatting
Authors: Thiruchelvam Nikesh , Mostafid Hugh , Ubhayakar Gaurang
Published: May 2005

OBJECTIVE

To assess a modified technique of multidetector computed tomographic urography (CTU) which can reproducibly and accurately map the pelvicalyceal system (PCS) and complex renal calculi, as such information is essential in choosing the optimal percutaneous approach into the PCS for safe and successful percutaneous nephrolithotomy (PCNL).

PATIENTS AND METHODS

Ten consecutive patients with renal calculi underwent a modified four‐detector multislice CTU with frusemide, abdominal compression and subsequent injection with contrast medium. After unenhanced CT of the abdomen, a high‐resolution contrast‐enhanced scan was taken through the kidneys in the pyelographic phase. Data were analysed using multiplanar reconstruction and three‐dimensional (3D) reformatting.

RESULTS

In 10 CTUs there were three staghorn, two diverticular, 25 calyceal, two infundibular and two renal pelvic calculi; nine showed posterior calyces and good infundibular anatomy, and provided a good map of the PCS. Seven patients had PCNL, with the remaining three having either primary extracorporeal shock wave lithotripsy or conservative management. CTU detected stones in all patients and accurately located their relation to the PCS. With reconstructed images, subjectively the 3D imaging provided an advantage over conventional imaging in optimizing nephrostomy placement.

CONCLUSION

CTU with this protocol and post‐processing techniques enables an accurate and confident, reproducible prediction of the site, number and size of stones in complex pelvicalyceal anatomy, optimal site(s) for placing the percutaneous track, and potential hazards when placing the track, with no significant increase in the patient's radiation burden. 3D CTU should become the standard imaging method for planning PCNL in selected patients.
Postoperative resorptive and excretory capacity of the ileal neobladder
Authors: Rinnab Ludwig , Straub Michael , Hautmann Richard E. , Braendle Edgar
Published: May 2005

Authors from Ulm have a further look at their model of orthotopic bladder replacement and particularly at the problem of mild metabolic acidosis due to proton reabsorption, which they describe as a common problem after ileal neobladder. They ascribe it to the mucus production of the neobladder, and its internal surface or diuresis, but suggest further investigation to characterize the different influences further.

OBJECTIVE

To assess the extent and mechanism of renal reabsorption and excretion in patients with an ileal neobladder, as mild metabolic acidosis cause by proton reabsorption is common after such surgery, and long‐term pharmacological correction is often necessary.

PATIENTS AND METHODS

The study comprised 30 patients (29 men and one woman) with ileal neobladders after oncological surgery; before surgery all had normal retention values. Before and after withdrawing the transurethral catheter, serum creatinine and urea were analysed and used to assess the effect of the neobladder on retention values, expressed as the percentage change from baseline (Δ creatinine and urea).

RESULTS

There was a significant correlation between the Δ−creatinine and Δ−urea values (P < 0.001; r = 0.66); 15 patients (50%) showed resorption of creatinine and urea, eight (27%) excreted creatinine into the neobladder and resorbed urea from it at the same time, and three (10%) showed the reverse response, i.e. creatinine resorption and urea excretion. Interestingly, four patients (13%) excreted both creatinine and urea into the neobladder.

CONCLUSIONS

We assume that there was both a resorptive and excretory function. Probably the metabolic state (resorption or secretion) of the neobladder depends on its mucus production and on the internal surface, or on diuresis. Further investigation is required to characterize these different influences.
A comparison of one‐stage procedures for post‐traumatic urethral stricture repair
Authors: Berger Andreas P. , Deibl Martina , Bartsch Georg , Steiner Hannes , Varkarakis John , Gozzi Christian
Published: May 2005

OBJECTIVE

To compare the results and complication rates of various one‐stage treatments for repairing a post‐traumatic urethral stricture.

PATIENTS AND METHODS

The medical records of 153 patients who had a post‐traumatic urethral stricture repaired between 1977 and 2003 were evaluated retrospectively, and analysed for the different types of urethral reconstruction.

RESULTS

The procedures included direct end‐to‐end anastomosis in 86 (56%) patients, free dorsal onlay graft urethroplasty using preputial or inguinal skin in 40 (26%), ventral onlay urethroplasty using buccal mucosa in seven (5%) and ventral fasciocutaneous flaps on a vascular pedicle in 20 (13%). At a mean (median, range) follow‐up of 75.2 (38, 12–322) months, 121 (79%) patients had no evidence of recurrent stricture, while in 32 men (21%) they were detected at a mean follow‐up of 30.47 (1–96) months. Patients having a dorsal onlay urethroplasty had the longest strictures. The re‐stricture rate was lowest after a dorsal onlay urethroplasty (5% vs 27% when treated with end‐to‐end anastomosis, 15% after fasciocutaneous flaps and 57% after a ventral buccal mucosal graft). The surgical technique used had no effect on postoperative incontinence or erectile dysfunction rates.

CONCLUSION

In patients with strictures which are too long to be excised and re‐anastomosed, tension‐free dorsal onlay urethroplasty is better than ventral graft or flap techniques. In patients with short urethral strictures direct end‐to‐end anastomosis remains an option for the one‐stage repair of urethral stricture.
Extracorporeal pelvic floor magnetic stimulation in children with voiding dysfunction
Authors: Kim Jae Wook , Kim Myoung Jin , Noh Ji Yeun , Lee Hye Young , Han Sang Won
Published: May 2005

OBJECTIVE

To determine the effect of extracorporeal pelvic floor magnetic stimulation in children with an overactive bladder, as although such stimulation is an effective treatment for voiding dysfunction such as urge incontinence (UI) and urgency‐frequency syndrome, experience in children is scarce.

PATIENTS AND METHODS

This prospective study included 42 children diagnosed with an overactive bladder, based on urodynamic or video‐urodynamic study; a complete follow‐up was available in 34. The children were grouped into those with UI only, not monosymptomatic nocturnal enuresis (nMNE), or MNE, according to their symptoms. Clinical variables were assessed by recording a voiding and nocturnal enuresis diary before and after magnetic stimulation, the latter being administered twice a week for 4 weeks using a size‐adjusted magnetic chair (each session took 20 min).

RESULTS

The UI only and nMNE group had a significant decrease in voiding frequency and frequency of UI (P < 0.05); the MNE group also had a significant decrease in voiding frequency (P < 0.05). There was a significant increase in functional bladder capacity in all groups (P < 0.05) but no significant decrease in the mean volume and frequency of NE in the nMNE and MNE groups (P > 0.05).

CONCLUSIONS

Extracorporeal pelvic floor magnetic stimulation has an acute effect on voiding dysfunction such as urge syndrome in children. However, controlled studies with a sham‐stimulation group and various durations of stimulation are necessary for its application as a primary treatment for voiding dysfunction in children.
Immunotherapy of murine prostate cancer using whole tumour cells killed ex vivo by cytosine deaminase/5‐fluorocytosine suicide‐gene therapy
Authors: Pandha Hardev S. , Cook Dorthe , Greenhalgh Rebecca , Dalgleish Angus
Published: May 2005

OBJECTIVE

To evaluate the efficacy of antitumour vaccines comprising irradiated allogeneic or autologous whole cells expressing cytosine deaminase (CD) which are first killed ex vivo by prodrug activation using 5‐fluorocytosine (5‐FC), as the immunogenicity of tumour cells used as irradiated vaccines depends both on antigen expression and on the mode of their death.

MATERIALS AND METHODS

The PA3 rat prostate cell line and MATLyLu, an androgen‐insensitive subline, were grown and transfected with CD (designated PCD and MCD). In vitro drug‐sensitivity was assessed in the cell lines using a viability assay, and the mode of cell death quantified by assessing apoptosis. Bax and bcl‐2 expression were assessed by Western blot analysis. For in vivo experiments, male 8–10‐week‐old Lobund‐Wistar rats were vaccinated (using vehicle in control groups) with 5 × 106 cells, all cells being irradiated before injection, to give groups with PA3, PCD, PCD killed with 5‐FC, MatLyLu, MCD, and MCD killed with 5‐FC. After 7 days all animals were given a subcutaneous tumour challenge of PA3 cells, and tumour volume measured subsequently. Immune responses were assessed in splenocytes.

RESULTS

The efficiency of cell kill varied between the cell lines assessed, but cell death was by induced apoptosis. Single doses of vaccine were most effective in the allogeneic setting, causing significantly slower growth of syngeneic tumour challenge (P < 0.01), and 25% better survival at 50 days (P < 0.02) than irradiated untransfected cells. This was consistent with the greater proliferative response after allogeneic than autologous vaccination.

CONCLUSION

The immunogenicity of irradiated tumour cells is enhanced when they are killed ex‐vivo using suicide‐gene therapy. This approach would be clinically applicable in terms of ease of vaccine production, safety, storage and avoidance of potential toxicities of in vivo gene transfer.
What's new in the treatment of metastatic kidney cancer?
Authors: Mancuso Andrea , Sternberg Cora N.
Published: May 2005

It is important for us as urologists to keep up to date with new drugs being introduced for treating metastatic renal cancer, particularly in the era of the multidisciplinary team approach to cancer therapy. Authors from Rome cover this topic in this month's issue.

In other mini reviews in this section, the topics of ejaculatory disorders and cryosurgery are described. Both are relevant to modern management of common urological disorders.

Finally there is an historical contribution. There is no such section for these manuscripts, but occasionally subjects of interest are presented which are intended to be of general educational value to the reader. I believe that the paper on prisons presented in this issue to be such a case.
Free and Cheap Riding in Strict, Conservative Churches
Authors: OLSON DANIEL V. A. , PERL PAUL
Published: May 2005

Iannaccone (1994)uses rational choice theory to argue that strict rules (e.g., no smoking or drinking) raise average commitment levels in conservative churches because strictness discourages free riding. Tests of this assertion have been hampered, in part, by uncertainties concerning how free riding should be measured. We introduce a new, indirect measure of free (and cheap) riding, the level of positive skewness of a congregation's money contributions—that is, the extent to which a few members give much more than the mean amount while the majority gives much less. Using a study of giving in five denominations, we find that strict, conservative congregations have both higher mean giving and less skewness in the pattern of their giving. The higher mean‐contribution levels at strict, conservative congregations are not simply due to each member giving more or a few members giving a lot more. Instead, as Iannaccone's model predicts, some combination of strict rules and/or conservative theology appears to systematically limit the proportion of free‐ and cheap‐riding members giving far less than the mean and thus increase the proportion giving at or above the mean.
Spiritual Seeking, Narcissism, and Psychotherapy: How Are They Related?
Authors: WINK PAUL , DILLON MICHELE , FAY KRISTEN
Published: May 2005

This study used data from a long‐term longitudinal study of men and women to examine the relations among spirituality, narcissism, and psychotherapy. The findings indicated that in late adulthood (age late 60s/mid 70s) spirituality was related to autonomous or healthy narcissism but was unrelated to willful (overt) or hypersensitive (covert) narcissism, two pathological forms of the construct. Autonomy in early adulthood (age 30s) was a significant predictor of spirituality in late adulthood (a time interval of close to 40 years) and this relation was mediated by involvement in psychotherapy in midlife. Autonomy was related positively, and hypersensitivity was related negatively, to concern for the welfare of future generations. These findings are discussed in light of current concerns about the social implications of the therapeutic culture.
Individual, Congregational, and Denominational Effects on Church Members’ Civic Participation
Authors: SCHWADEL PHILIP
Published: May 2005

Previous research demonstrates two aspects of religion that affect civic activity—church participation and religious conservatism. Conservative religious beliefs and membership in conservative denominations are often associated with low levels of civic activity while church participation is said to increase civic activity. This article advances the discussion of the relationship between religion and civic participation by introducing the congregational context. Data from the 1987 Church and Community Planning Inventory show that congregations vary in their members’ civic activity—congregational factors associated with conservative Christianity (high levels of biblical literalism and within‐church friendships) are strongly and negatively associated with church members’ activity in nonchurch organizations. At the individual level, the data show that education and participation in church activities other than religious services have particularly strong, positive effects on church members’ activity in nonchurch organizations. The findings demonstrate that a conservative congregational context limits church members’ activity in nonchurch organizations, potentially limiting their opportunities to build heterogeneous social networks and social capital that bridges church members to other people in their communities.
Entrepreneurial Logics and the Evolution of Falun Gong
Authors: LU YUNFENG
Published: May 2005

This article documents the shift of Falun Gong from a primarily secular healing system to a new religion centering on salvation. Emerging as a qigong organization in China in the early 1990s that provided immediate healing treatments to practitioners, Falun Gong eventually developed into a salvation‐oriented religious firm. Mr. Li Hongzhi, the founder of Falun Gong, played a vital role in promoting the movement's transition. Facing the competitive qigong market, Mr. Li decided to differentiate Falun Gong from other competing qigong movements by offering a theory about salvation. He also adopted other organizational and doctrinal mechanisms that are useful in sustaining practitioners and preventing potential schisms. These strategies partly accounted for the growth of Falun Gong in the 1990s. This case study indicates that the religious economy model is helpful in understanding the evolution of Falun Gong, a new religion in contemporary China.
Subjective Religiosity and Depression in the Transition to Adulthood
Authors: ELIASSEN A. HENRY , TAYLOR JOHN , LLOYD DONALD A.
Published: May 2005

Does being more religious make one less susceptible to depression? We consider the association between subjective religiosity (religious self‐perception and coping) and depression in the context of social support (from family and friends) and stress exposure (recent negative life events, chronic stress, lifetime trauma, and discrimination). Data come from a sample of 1,803 Miami‐Dade County young adults interviewed between 1997 and 2000. We find higher levels of depression among the moderately religious than among either very religious or nonreligious respondents. Interestingly, when observations are made within gender, this relationship applies only to females. Controlling for socioeconomic status and social support largely accounts for the link between religiosity and depression. However, controlling for stress exposure reveals a suppressor effect wherein religiosity once again emerges as significant. Our interpretation is that, while established patterns of religious coping can routinely mitigate distress, heightened stress exposure may elicit increased prayer among the less religious.