bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of multiphasic helical computed tomography in planning surgical treatment for pelvi‐ureteric junction obstruction
Authors: El‐Nahas Ahmed R. , Abou‐El‐Ghar Mohamed , Shoma Ahmed M. , Eraky Ibrahim , El‐Kenawy Mahmoud R. , El‐Kappany Hamdy
Published: August 2004

OBJECTIVE

To evaluate the role of multiphasic helical computed tomography (CT) in planning surgical treatment for pelvi‐ureteric junction obstruction (PUJO).

PATIENTS AND METHODS

Multiphasic helical CT was used in 60 consecutive patients (mean age 32 years, sd 13.72) with primary PUJO. The different images were interpreted before surgery by a urologist and radiologist. The number, type and relation of the crossing vessels to the PUJ were detected. Pyeloplasty (open or laparoscopic) was used in patients where there was a significant crossing vessel (i.e. > 2 mm in diameter and passing at the PUJ) or with ballooning of the renal pelvis. Endopyelotomy (antegrade or retrograde) was used in the other patients. Subjective and objective success rates were determined 3–6 months after treatment and then every 6 months.

RESULTS

Hyperdense renal stones were detected in precontrast images in 15 patients, significant crossing vessels in 33 (55%), and anterior malrotation of the renal pelvis in 23 (38%; 19 associated with significant crossing vessels, i.e. ureterovascular hydronephrosis). A large para‐pelvic cyst compressing the PUJ and upper ureter was detected in one patient. Pyeloplasty was used in 45 patients, among whom the sensitivity of multiphasic helical CT in detecting crossing vessels was 97%, the specificity 92% and accuracy 96%. Uncomplicated endopyelotomy was used in 14 patients and percutaneous aspiration of the para‐pelvic cyst in one.

CONCLUSION

Multiphasic helical CT can accurately delineate the spatial anatomy of the renal and peri‐renal area; it may be important in planning surgical treatment for PUJO, especially when endopyelotomy is considered.
An assessment of the use of a continent catheterizable stoma in female tetraplegics
Authors: Walsh Kilian , Troxel Scott A. , Stone Anthony R.
Published: August 2004

OBJECTIVES

To evaluate the success of a continent catheterizable stoma in females with cervical spinal cord injury which resulted in neurogenic bladder dysfunction, the management of which may require clean intermittent catheterization despite altered hand function.

PATIENTS AND METHODS

Six female tetraplegic patients with a lesion at C7 or above (age range 12–22 years) had a continent catheterizable abdominal stoma formed as part of their bladder management. As an objective measure of effectiveness, the time to complete catheterization was assessed before and after surgery. A quality‐of‐life survey at a mean (range) of 44 (6–90) months was also evaluated.

RESULTS

All six patients can catheterize while in their wheelchair. The mean (range) time required for catheterization decreased from 27 (10–40) to 7.8 (1–15) min after surgery. All six reported a significant improvement in continence, body image, independence, convenience, time saving and satisfaction.

CONCLUSION

Constructing a continent catheterizable stoma is a valuable option in selected tetraplegic patients.
Parastomal hernia repair using the lateral approach
Authors: Ho Kossen M.T. , Fawcett Derek P.
Published: August 2004

OBJECTIVE

To review the results of repairing a parastomal hernia after ileal conduit formation, using the lateral approach.

PATIENTS AND METHODS

We retrospectively assessed 18 patients (9%) who developed a parastomal hernia, from 211 who had an ileal conduit created between 1982 and 2001; 15 had a surgical repair using a lateral incision.

RESULTS

All 15 patients resumed a normal diet 1 day after surgery; the median (range) hospital stay was 4 (2–14) days. In two patients with a large hernia and difficult repair the stomas became ischaemic and required refashioning. Only one of these two patients required complete conduit replacement. The median (range) follow‐up was 15 (1–72) months. A recurrence of the hernia was recorded in one grossly overweight patient.

CONCLUSION

The lateral approach obviates the need for laparotomy and stomal relocation, and enhances a quick return of bowel function and early recovery. However, extra care is needed in managing the very large and difficult hernia, to avoid compromising the ileal conduit. The success and complication rates of the current series are within acceptable limits and this technique can be included in the options for managing parastomal hernia.
The prevalence and nature of orgasmic dysfunction after radical prostatectomy
Authors: Barnas Jennifer L. , Pierpaoli Steven , Ladd Patricia , Valenzuela Rolando , Aviv Nadid , Parker Marilyn , Waters W. Bedford , Flanigan Robert C. , Mulhall John P.
Published: August 2004

Section Editor

Michael G. Wyllie

Panel of Advisors

Ian Eardley, UK

Jean Fourcroy, USA

Sidney Glina, Brazil

Julia Heiman, USA

Chris McMahon, Australia

Bob Millar, UK

Alvaro Morales, Canada

Michael Perelman, USA

OBJECTIVE

To define the type of orgasmic dysfunction in men after radical prostatectomy (RP), as absence of orgasm and orgasmic pain are recognized complaints, and changes in orgasm may lead to significant sexual dissatisfaction.

PATIENTS AND METHODS

Using an unvalidated questionnaire, demographic, erectile function and orgasmic function questions were answered by 239 patients who had previously undergone a retropubic RP.

RESULTS

Of the 239 patients, 22% had no change in orgasm intensity, 37% reported a complete absence of orgasm, 37% had decreased orgasm intensity and 4% reported a more intense orgasm after RP than before. Pain during orgasm (dysorgasmia) occurred in 14% of the patients; in these respondents the pain reportedly occurred always (with every orgasm) in 33%, frequently in 13%, occasionally in 35%, and rarely in 19%. Most patients (55%) had orgasm‐associated pain for <1 min.

CONCLUSIONS

These results indicate that orgasmic functional changes are relatively common after RP and are worth considering by clinicians and researchers.
The ambitions of adolescents born with exstrophy: a structured survey
Authors: Wilson Christine , Christie Deborah , Woodhouse Christopher R.J.
Published: August 2004

A survey is reported by authors in the UK to determine factors that control the quality of life of adolescent patients with exstrophy; as expected, affected adolescents were resilient characters, and they stressed the importance of patients’ views after surgery to correct this condition.

OBJECTIVE

To determine the factors that control quality of life as perceived by adolescent patients with bladder exstrophy, and to compare their views using standard instruments.

PATIENTS AND METHODS

Sixteen patients (mean age 19 years, range 16–21, 11 male and five female) were recruited from the departmental database; they represented 46% of those available for the study. After giving informed consent, each had a semi‐structured interview, augmented by completing a self‐reported scale, with the principal investigator. They then completed the Culture‐Free Self‐Esteem Inventory‐2 (CFSEI‐2) and the Brief Symptom Inventory (BSI). The interviews were recorded on audiocassette, transcribed verbatim and evaluated using interpretative phenomenological analysis.

RESULTS

In the interviews there was a remarkable consistency in the domains identified as important to the patients. There was a wish to be normal and to be treated as such. This was defined (amongst other items) as being able to void with an appropriate noise, being treated as peers at school and at home, and having an umbilicus. All patients reported some bullying (all but one in the past), but only severely in three. Concerns about self‐image centred on scars and genital appearance. Very similar and effective coping strategies had been created, including practical (e.g. suitable clothes) and emotional (e.g. joking, control of revealed information) aspects. Special arrangements made to help (care by a special assistant or use of a disabled lavatory at school) served only to emphasize their abnormality and were resented. No overt psychiatric or psychological morbidity was detected. There was no difference in scores with the CFSEI‐2 or BSI from established age‐related norms.

CONCLUSION

This study confirms the anecdotally reported strong resilience and personality of adolescents with exstrophy. The domains that patients considered important were not those that their carers might have expected or that are used in standard quality‐of‐life instruments. No morbidity was identified by the two instruments used. In exstrophy, and perhaps in other uncommon conditions, the patients' views of relevant domains should be considered in assessing quality of life.
Outcome of valve ablation in late‐presenting posterior urethral valves
Authors: Schober Justine M. , Dulabon Lori M. , Woodhouse Christopher R.
Published: August 2004

OBJECTIVE

To explore the symptoms, radiological findings and outcome after valve ablation in patients who present late with posterior urethral valves (PUV) and who typically have mild forms of the disease with often minimal upper tract changes; these patients frequently escape detection by ultrasonography in utero and the diagnosis may be delayed to as late as adolescence.

PATIENTS AND METHODS

The charts of 70 boys (mean age 7.46 years, range 2–14) diagnosed late with PUV and treated with value ablation were retrospectively reviewed. Before ablation, history of voiding habits, voiding frequency, presence of enuresis, dysuria and the incidence of gross haematuria was recorded. Findings of a physical examination, laboratory testing (urine analysis and serum creatinine levels), ultrasonography and voiding cysto‐urethrography (VCUG) were noted. After valve ablation, a review included a detailed voiding history and re‐examination of abnormal variables including an assessment of enuresis, voiding frequency and ultrasonography. The mean (range) follow‐up was 25 (1–78) months. One patient was lost after his first follow‐up visit, but data were included to that time.

RESULTS

The most common presenting symptom was voiding dysfunction; 47 (67%) presented with nocturnal enuresis, 42 (60%) with urinary frequency and 12 (17%) with a history of urinary tract infection. On physical examination 12 (17%) had mild age‐corrected hypertension. Microhaematuria was present in 21 (30%) but all patients had normal serum creatinine levels. Ultrasonography showed hydronephrosis in 33 (47%) and a postvoid residual volume in 57 (81%). On VCUG, 52 (79%) patients had clear evidence of PUV, 22 (31%) bladder trabeculation, 11 (16%) vesico‐ureteric reflux and eight (11%) diverticula. On cystoscopy, 67 (96%) patients presented with the classic sail‐shaped PUV and three a ring‐shaped valve. After surgical ablation of the valve most patients dramatically improved; 31 of 42 (74%) had resolution of urinary frequency, 24 of 33 (73%) of diurnal enuresis and 17 of 47 (38%) nocturnal enuresis. Of 57 patients, 39 (68%) established good bladder emptying. Of 33 affected, 20 (60%) had some reduction of hydronephrosis but 63% continued to have some symptoms of voiding dysfunction.

CONCLUSION

PUV should be considered in boys presenting with voiding dysfunction. After valve ablation most patients improve dramatically. Despite surgery, enuresis, urinary frequency and poor bladder emptying persisted in some and required further treatment. The continued bladder dysfunction suggested that irreversible urinary tract damage may have occurred. Even in this apparently mildly affected group, long‐term follow‐up is essential.
The concentration of elastic fibres in the male urethra during human fetal development
Authors: Bastos Ana L. , Silva Eloisio A. , Silva Costa Waldemar , Sampaio Francisco J.B.
Published: August 2004

OBJECTIVE

To describe the distribution of elastic fibres in the developing male urethra and to provide stereological data of the concentration of elastic fibres in the human urethra.

MATERIALS AND METHODS

Urethras were obtained from 10 fresh normal human fetuses at 15–36 weeks of gestation. A place‐matched spongy urethra of a 27‐year‐old normal adult man was also analysed. Samples were fixed in Bouin's solution, embedded in paraffin and histologically processed. The elastic system fibres were evaluated by light microscopy using Weigert's resorcin‐fuchsin technique after oxidation. Morphometric values were assessed by the point‐counting method. The volumetric density (Vv) of elastic fibres was correlated with fetal age.

RESULTS

At 15 weeks the elastic fibres were sparse and homogeneously distributed. The size and thickness of elastic fibres increased with age, mainly in the third trimester of gestation. Elastic fibres formed a randomly orientated network in the trabeculae of the corpus spongiosum. The mean (sem) Vv of elastic fibres in the spongy urethra was 5.2 (0.4)% in the fetus at 15 weeks and 14.8 (1.0)% at 36 weeks. In the urethra of the place‐ matched young man the Vv was 19.0 (1.3)%. The concentration of elastic fibres in the spongy urethra increased significantly with age.

CONCLUSION

The high concentration of elastic fibres in the spongy urethra may partly explain its high extensibility. The progressive increase in elastic fibres during development implies functional adaptation of the fetal male urethra.
The physical characteristics of young males with varicocele
Authors: Delaney Daniel P. , Carr Michael C. , Kolon Thomas F. , Snyder Howard M. , Zderic Stephen A.
Published: August 2004

OBJECTIVE

To determine if there is an association with habitus in young males with varicocele, as adolescent boys with varicoceles appear to be mostly taller and leaner than age‐matched controls.

PATIENTS AND METHODS

Retrospectively reviewing our records we obtained the height and weight of 43 consecutive males (mean age 14.3 years, range 11–19) under long‐term follow‐up for varicocele. The body mass index (BMI), heights and weights were compared with values from the respective growth charts for boys aged 2–20 years (Center for Disease Control and Prevention), and the statistical significance of differences determined using the chi‐square test.

RESULTS

The height and weight distributions of patients with varicocele indicated a significant deviation from normal in the 25–95th percentiles for stature and in the 25–75th for weight (P < 0.05). Deviations in BMI were insignificantly different from normal at each percentile.

CONCLUSION

These results indicate that patients with varicocele are significantly taller and heavier than age‐matched controls. Future studies to address the key areas identified in this study will help to further assess the distribution of the incidence of varicocele in closely defined subsets of adolescent growth and development, which may provide some insight into the cause of varicoceles.
Effect of circumcision on urinary tract infection after successful antireflux surgery
Authors: Kwak Cheol , Oh Seung‐June , Lee Ahnkie , Choi Hwang
Published: August 2004

OBJECTIVE

To evaluate whether circumcision during antireflux surgery can reduce the incidence of urinary tract infection (UTI) after successful ureteric reimplantation in patients with primary vesico‐ureteric reflux (VUR).

PATIENTS AND METHODS

Children who had undergone antireflux surgery for primary VUR were divided into group 1 (27, circumcised at the time of antireflux surgery at the parents’ request) and group 2 (50, those not circumcised). All antireflux operations were by the Cohen method. Regular urine samples were cultured to detect UTI, which was defined as a single species with >105 colony‐forming units/mL in a midstream voided specimen. Numbers of UTI episodes before and after surgery were compared between the groups, with 99mTc‐dimercaptosuccinic acid (DMSA) renal scans also taken in all patients. Each scan was blindly reviewed in terms of the size, number and zonal location of cortical defects, based on morphology. Interval changes were categorised as improved, no change, progressed, and new scar formation, and compared between the groups. Prophylactic antibiotics were maintained until the follow‐up studies at 4–6 months after surgery.

RESULTS

There was no significant difference between the groups in age at the time of operation (mean 42.4 vs 47.4 months), the age at the first documented UTI (mean 26.5 vs 29.3 months), reflux grade, or number of UTI episodes and renal parenchymal scarring on DMSA before surgery. There was no significant difference between the groups in the number of UTI episodes at a mean (range) follow‐up of 151.3 (114–207) months after antireflux surgery. Also there was no significant morphological change on follow‐up renal scans and no difference between the groups.

CONCLUSION

These findings suggest that circumcision during antireflux surgery has no effect on the incidence of postoperative UTI.
Comparison of cryotherapy and nephrectomy in treating implanted VX‐2 carcinoma in rabbit kidneys
Authors: Nakada Stephen Y. , Jerde Travis J. , Warner Thomas , Lee Fred T.
Published: August 2004

OBJECTIVE

To compare the efficacy of cryoablation and radical nephrectomy for treating implanted VX‐2 carcinoma in rabbit kidneys.

MATERIALS AND METHODS

A pilot study was conducted using 27 New Zealand white rabbits to assess the natural history of VX‐2 carcinoma in the kidney. VX‐2 tumour segments (1 mm3) were excised from subcutaneous tumours in carrier rabbits and implanted in the left kidney of study rabbits. The tumours were allowed to grow for 6, 7, 8, 9, 10, 14, 18, 21 and 28 days after implantation. Tumour progression was analysed in the kidney and surrounding serosa, and metastatic tumour presence in the lung, liver, spleen and bladder determined. After this, 80 rabbits were implanted with VX‐2 in the lower pole and randomized into one of three groups: group 1, 35 rabbits treated 7 days after VX‐2 implantation with cryoablation using a 15‐min double‐freeze technique and a 5‐mm tumour margin target temperature of − 20 °C; group 2, 35 rabbits treated with open radical nephrectomy; or group 3, 10 untreated controls. Rabbits were maintained for 22 days and then killed; the kidneys, lungs, liver, spleen, urinary bladder and ureter were removed, and examined grossly and histologically for tumour presence.

RESULTS

In the pilot study there was a consistent 50–100 mm3 tumour after 7 days of growth, with no evidence of metastatic disease. By day 10 the mean kidney tumour was 230 mm3 and two of three rabbits had metastases in the lung. By day 18 the mean primary tumour was 5504 mm3 and all rabbits had metastatic disease. In the comparison study, cryotherapy cured 66% of implanted rabbits while nephrectomy cured 64%. All untreated controls had significant local and metastatic tumours. Findings in animals killed at 15 days after treatment showed significant differences between both treatment groups and untreated controls (P < 0.002). There was no difference in disease‐free survival between the cryotherapy and open nephrectomy groups (P = 0.78)

CONCLUSION

Both cryoablation and radical nephrectomy were effective in treating implanted VX‐2 renal tumours compared with untreated controls. There was no statistically significant difference between cryoablation and nephrectomy.
Microarray analysis of changes in renal phenotype in the ethylene glycol rat model of urolithiasis: potential and pitfalls
Authors: Chen Daniel H.‐C. , Kaung Hue‐Lee C. , Miller Casey M. , Resnick Martin I. , Marengo Susan R.
Published: August 2004

OBJECTIVES

To investigate, in an initial study, the use of microarray analysis (MA) to develop an information base for urolithiasis. MA enables the screening of thousands of genes simultaneously making it the technique of choice for situations where the results are known, but the underlying mechanisms are not. Little is known about the pathological changes occurring in the kidney during urolithiasis and this has severely hampered efforts to develop effective therapeutics.

MATERIALS AND METHODS

Male rats were treated with 0.75% ethylene glycol for 2, 4 or 8 weeks; after death the kidneys were processed for RNA isolation and MA, conducted using a rat‐based chip (one kidney/chip) and the results confirmed by reverse transcription‐polymerase chain reaction (RT‐PCR, 21 probe sets; control, four rats; treated, five rats). Targets were defined as different by the software if the fold change (FC) was ≥ 2, and sorted into functional categories using a data‐mining tool. The repeatability of MA was investigated by subjecting the 4‐week samples to MA in two independent runs.

RESULTS

The results for targets with a FC of ≥ 2 were plotted (y = 1.01x − 0.75; r2 0.84). Comparing the results obtained by RT‐PCR and MA showed a good qualitative correlation for those targets having a FC of ≥ 5 as determined by MA. Changes in the expression of genes associated with tubule function and regulation, oxidative damage, and inflammation were the most common in the functional categories. Changes in the expression of tubule‐specific markers indicated that there was damage to the proximal (γ‐adducin, organic anion and cation transporters, sodium‐hydrogen exchange protein‐isoform 3) and distal tubules (γ‐adducin, kallikrein) at 2 and 4 weeks. Increased expression of mitochondrial uncoupling protein indicated that there were changes to the mitochondria and oxidative stress at 2 and 4 weeks.

CONCLUSION

This study shows the power of MA as an exploratory technique, and changes in the expression of several physiologically important genes whose expression has not previously been reported to be affected by hyperoxaluria or calcium oxalate crystalluria.
Mechanisms of neurokinin A‐ and substance P‐induced contractions in rat detrusor smooth muscle in vitro
Authors: Quinn Teresa , Collins Colm , Baird Alan W.
Published: August 2004

OBJECTIVE

To investigate the mechanisms of neurokinin A‐ and substance P‐induced contractions of rat urinary bladder smooth muscle, and to compare them with those of the muscarinic agonist carbachol.

MATERIALS AND METHODS

Rat urinary bladder strips were suspended under 1 g of tension in a physiological buffer at 37 °C, gassed with 95% O2/5% CO2. Mechanical activity was recorded isometrically during exposure to neurokinin A and substance P.

RESULTS

Both agents produced concentration‐dependent contractions of smooth muscle strips which were unaffected by tetrodotoxin (1 µmol/L), peptidase inhibitors (captopril, thiorphan and bestatin; 1 µmol/L each) or piroxicam (10 µmol/L). The rank order of potency of agonists was neurokinin A > substance P > carbachol. Contractile responses to neurokinin A and substance P, like the contractile responses to carbachol, were abolished in a nominally Ca2+‐free medium and significantly reduced by nifedipine (1 µmol/L). SKF‐96365 (60 µmol/L), an inhibitor of receptor‐mediated Ca2+ entry, abolished the nifedipine‐resistant response to substance P and carbachol, and significantly attenuated the response to neurokinin A. Depleting intracellular Ca2+ stores with thapsigargin (1 µmol/L) significantly attenuated neurokinin A‐induced contractions but had no effect on substance P‐ or carbachol‐ induced contractions. The Rho‐kinase inhibitor, Y‐27632 (10 µmol/L), significantly reduced both phasic and tonic components of the contractile responses to neurokinin A, substance P and carbachol.

CONCLUSION

The contractile responses induced by tachykinins in rat urinary bladder smooth muscle strips involve a direct action on smooth muscle and are not modulated by peptidases or prostanoids. Neurokinin A and substance P, like carbachol‐induced contractions, depend on extracellular Ca2+ influx largely through voltage‐operated and partly through receptor‐operated Ca2+ channels. Intracellular Ca2+ release contributes to the contractile response to neurokinin A but appears to have no involvement in substance P‐ and carbachol‐induced contractions. Rho‐kinase activation contributes to contractions induced by substance P, neurokinin A and carbachol.
Autoaugmentation gastrocystoplasty: further studies of the sheep model
Authors: Close Clare E. , Anderson Paul D. , Edwards Glenn A. , Mitchell Michael E. , Dewan Paddy A.
Published: August 2004

OBJECTIVE

To report our experience with autoaugmentation gastrocystoplasty (AAGC, reported to result in an inconsistent augmentation effect in children) in a sheep model, specifically addressing issues of surgical techniques and postoperative bladder drainage that may affect the augmentation result, as many factors have been implicated in the poor outcome.

MATERIALS AND METHODS

Ten 6‐month‐old male lambs had a suprapubic catheter placed by an open laparotomy. Intraoperative urodynamics were evaluated before and after detrusorotomy for autoaugmentation and after completing AAGC. The bladder was drained with no distension for 1 week after surgery and the urodynamic evaluation repeated on control and experimental animals 6 months after surgery. The animals were then killed and the bladders evaluated for gastric flap survival and histological changes in the native bladder and augmentation segments. The results were analysed using a one‐sided Student's t‐test.

RESULTS

The median (range) native bladder volume at leak‐point pressure was 110 (40–490) mL. Intraoperative bladder volumes after completing AAGC confirmed adequate augmentation segments in all animals. The urodynamic evaluation at 6 months after AAGC showed increases in bladder volumes in nine of 10 animals (0–1336 mL), significantly greater than the increase in volume in the control sheep (median 337.5 vs 115.3 mL; P < 0.05). The bladder compliance (volume/pressure at leak capacity) 6 months after AAGC was slightly better but not significantly higher than in controls (median 17.3 vs 10.8 mL/cmH2O; P > 0.05). The median (range) ratio of surviving gastric flap to native bladder circumferences was 34.5 (31–53)%. Histology showed scarring of the submucosal layer in one of 10 augmentation segments and normal urothelium in all bladders.

CONCLUSION

AAGC produces reliable bladder augmentation and excellent bladder compliance in a sheep model of a non‐neurogenic bladder. The gastric flap survived well and there was no bladder wall separation with simple postoperative catheter drainage.
Pharmacological therapy of benign prostatic hyperplasia/lower urinary tract symptoms: an overview for the practising clinician
Authors: Chapple Christopher R.
Published: August 2004

Less than 10 years ago surgery and watchful‐waiting were the only widely accepted management options for lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and benign prostatic obstruction (BPO). There has been an enormous decline in the popularity of surgery and it is now apparent that medication is the most frequently used treatment for BPH/LUTS; this has arguably therefore been the most major change in urological clinical practice in the last decade. Currently α1‐adrenoceptor antagonists are the commonest medical therapy, and are thought to act by relaxing prostatic smooth muscle, the neural or so‐called ‘dynamic’ component of BPO. 5α‐reductase inhibitors (finasteride, dutasteride) are another option for BPH/LUTS, which reduce prostatic mass and therefore the mechanical or ‘static’ component of BPO. In the last 10 years there have been four direct comparative studies between α1‐adrenoceptor antagonists and finasteride, including their combination, the results of which, and their implications for therapy, are discussed. Another group of agents are the phytotherapeutic extracts, which act via various mechanisms, many as yet poorly defined. This review critically assesses existing publications relating to the medical management of BPH/LUTS.
Digitising inequality: the cul‐de‐sac of women's work in European services
Authors: Webster Juliet
Published: August 2004

This paper considers the skills and development prospects of women working in European services. Skills are increasingly job‐specific, including the relational skills necessary to the delivery of customer service. Formal training is declining and being replaced by informal learning techniques. Opportunities to acquire comprehensive or transferable skills are rare, as are women's progression opportunities in the ‘knowledge society’.
Hellenic women managers in the telecommunications sector: living in transition
Authors: Kotsilieri Felia , Marshall Judi
Published: August 2004

This paper reports a research study into the career experiences and perspectives of a sample of women managers in the telecommunications industry in Greece. The study was conducted from a social constructionist perspective, seeking to explore how social and cultural factors affect the managers’ perceptions. Tensions are explored between the research participants’ relative satisfaction with their career progress and their limited representation at the senior management levels. The strength of cultural expectations on Hellenic women to marry is noted.

(The authors are the primary researcher and her research supervisor, respectively.)
Stories about men implementing and resisting new technologies
Authors: Eriksson‐Zetterquist Ulla , Knights David
Published: August 2004

In this article the literature on masculinity, gender and technology or science provides the context for discussing two case studies where new information technology has recently been introduced. The empirical material is counter‐intuitive to the general understanding that technology reflects and reinforces men's masculinity and the article provides a variety of theoretical interpretations for these findings.
Analysis of nubbin expression patterns in insects
Authors: Li Hua , Popadić Aleksandar
Published: August 2004

Summary
Previous studies have shown that the gene nubbin (nub) exhibits large differences in expression patterns between major groups of arthropods. This led us to hypothesize that nub may have evolved roles that are unique to particular arthropod lineages. However, in insects, nub has been studied only in Drosophila. To further explore its role in insects in general, we analyzed nub expression patterns in three hemimetabolous insect groups: zygentomans (Thermobia domestica, firebrat), dyctiopterans (Periplaneta americana, cockroach), and hemipterans (Oncopeltus fasciatus, milkweed bug). We discovered three major findings. First, observed nub patterns in the ventral central nervous system ectoderm represent a synapomorphy (shared derived feature) that is not present in other arthropods. Furthermore, each of the analyzed insects exhibits a species‐specific nub expression in the central nervous system. Second, recruitment of nub for a role in leg segmentation occurred early during insect evolution. Subsequently, in some insect lineages (cockroaches and flies), this original role was expanded to include joints between all the leg segments. Third, the nub expression in the head region shows a coordinated change in association with particular mouthpart morphology. This suggests that nub has also gained an important role in the morphological diversification of insect mouthparts. Overall, the obtained data reveal an extraordinary dynamic and diverse pattern of nub evolution that has not been observed previously for other developmental genes.
Wing disc development during caste differentiation in the ant Pheidole megacephala (Hymenoptera: Formicidae)
Authors: Sameshima Shin‐ya , Miura Toru , Matsumoto Tadao
Published: August 2004

Summary
The genus Pheidole has three distinct castes in females: queen, major, and minor workers. It has been believed that the larvae of major workers have prominent mesothoracic wing discs, although the minor worker larvae lack them. Here we conducted histological examinations of wing discs during larval development in P. megacephala. We show that all three castes have mesothoracic wing discs, at least in their early stage of the final larval instar, and that the wings degenerate differently in the dimorphic worker castes. The minute wing discs of minor workers neither grow nor metamorphose but disappear during the prepupal stage. On the contrary, the wing discs of major workers evaginate at the onset of the prepupal stage but subsequently degenerate by apoptotic cell death. This apoptotic wing degeneration in the prepupal stage was contradistinguished from wing degeneration in some lepidopteran insects, in which apoptosis occurs in the pupal wing buds. Our results suggest that each worker caste shows a different degeneration process to express the wingless character and that apoptotic degeneration has been adopted in association with the evolution of worker dimorphism.
Influence of environmental conditions on the expression of the sexual dispersal phenotype in a lower termite: implications for the evolution of workers in termites
Authors: Korb Judith , Katrantzis Stephania
Published: August 2004

Summary
Phenotypic plasticity is thought to be of prime importance for the evolution of castes in social insects. However, conclusions are generally drawn from holometabolous social Hymenoptera, whereas little is known about the hemimetabolous termites. We investigated the influence of environmental conditions on the expression of the alternative phenotypes, worker versus dispersing sexual, in the drywood termite Cryptotermes secundus. Season played a fundamental role in this regulatory process by setting developmental deadlines. Individuals failing to reach these deadlines developed back to workers, whereas those in time progressed to dispersing sexuals. This seasonal regulation was superposed by the influence of food availability in the nest that adjusted the number of remaining workers versus dispersing sexuals. In line with declining benefits at the natal nest, there were more dispersing sexuals when the food was reduced. Provided that the life type of C. secundus reflects the ancestral state in termite evolution, as is often assumed, our results support the hypothesis that termite workers originated from individuals failing in sexual development. Furthermore, a taxonomical comparison between termite species with different life‐styles stresses the importance of a predictable variation in food availability for the existence of a plastic development and the occurrence of conditionally expressed phenotypes in termites. Compared with social Hymenoptera, the mechanisms involved in caste polyphenism in termites differed considerably, which demands more differentiated discussions about social insects caste polyphenism.
When molecules and morphology clash: reconciling conflicting phylogenies of the Metazoa by considering secondary character loss
Authors: Jenner Ronald A.
Published: August 2004

Summary
Molecular and morphological data sets have yielded conflicting phylogenies for the Metazoa. So far, no general explanation for the existence of this conflict has been suggested. However, I believe that a neglected aspect of metazoan cladistics has introduced a systematic and substantial bias into morphological phylogenetic analyses. Most characters used for metazoan cladistics are coded as binary absence/presence characters. For most of these characters, the absence states are assumed to be uninformative default plesiomorphies, if they are defined at all. This character coding strategy could seriously underestimate the number of informative apomorphic absences or secondary character losses. Because nodes in morphological metazoan phylogenies are typically supported by relatively small numbers of characters each with a potentially strong impact on tree topology, failure to distinguish between primary absence and secondary loss of characters before a cladistic analysis may mislead morphological cladistics. This may falsely suggest conflict with molecular phylogenies, which are not sensitive to this bias. To test the existence of this bias, I compare the phylogenetic placement of a variety of metazoan taxa in molecular and morphological trees. In all instances investigated here, phylogenetic conflict can be resolved by allowing for secondary loss of morphological characters, which were assumed to be primitively absent in cladistic analyses. These findings suggest that we should be cautious in interpreting the results of morphological metazoan cladistic analyses and additionally illustrate the value of a more functional approach to comparative morphology in certain circumstances.
Acute renal failure associated with raisin or grape ingestion in 4 dogs
Authors: Mazzaferro E. M. , Eubig P. A. , Hackett T. B. , Legare M. , Miller C. , Wingfield W.E. , Wise L.
Published: August 2004

Objective: Description of a case series of 4 dogs with acute renal failure after ingestion of raisins or grapes.

Case summary: Four dogs were presented with acute oliguric or anuric renal failure after a known ingestion of varying quantities of raisins or grapes. Prior to the onset of vomiting, all dogs were healthy, had no previous history of renal insufficiency, and had no exposure to other potentially nephrotoxic agents. This case series describes the clinical course and various treatment modalities used in the 4 dogs.

New or unique information provided: This is the first report of clinical signs, treatment, and clinical outcome in dogs that developed renal failure after ingestion of raisins or grapes. The pathogenesis of nephrotoxicity associated with raisins and grapes remains unknown. Outcome was favorable in 2 out of the 4 cases of acute renal failure associated with raisin or grape ingestion in these dogs.
Relative adrenal insufficiency in critical illness
Authors: Martin Linda G. , Groman Reid P.
Published: August 2004

Objective: To review the effects of critical illness on hypothalamic–pituitary–adrenal (HPA) function in human and veterinary medicine.

Data sources: Data from human and veterinary literature was reviewed.

Human data synthesis: Relative adrenal insufficiency (RAI) appears to be common in critically ill human patients with sepsis or septic shock. Hypotension that is refractory to fluid therapy and requires vasopressors is the most common presentation of RAI in the human intensive care unit (ICU). Many investigators now advocate the use of a low‐dose adrenocorticotropin hormone stimulation test to diagnose RAI. It is important to evaluate for the presence of adrenal dysfunction, because current data suggest that treatment with ‘stress’ or low doses of glucocorticoids (200–300 mg hydrocortisone daily) may improve patient outcome in humans.

Veterinary data synthesis: There is a paucity of controlled studies in the veterinary literature regarding the effects of critical illness on HPA function. The results of these studies are varied. However, research models of sepsis and hemorrhagic shock suggest the existence of RAI in animals. Prospective clinical studies are needed to further examine pituitary–adrenal response to severe illness in veterinary patients, and to determine if there are therapeutic options, including glucocorticoid administration, which will improve patient outcome in animals.

Conclusions: RAI is well documented in critically ill human patients, yet little is known about adrenal dysfunction in veterinary critically ill patients. A small number of studies suggest that RAI may exist in certain subpopulations of veterinary patients. The syndrome of RAI could be considered as a differential diagnosis in seriously ill veterinary patients that fail to respond to appropriate therapy, especially when hypotension refractory to fluid and vasopressor therapy is encountered. This disorder may represent a previously unidentified syndrome in critically ill veterinary patients with important therapeutic implications.
Comparison of non‐invasive cardiac output measurement by partial carbon dioxide rebreathing with the lithium dilution method in anesthetized dogs
Authors: Gunkel Cornelia I. , Valverde Alexander , Morey Timothy E. , Hernández Jorge , Robertson Sheilah A.
Published: August 2004

Objective:To compare the partial CO2rebreathing method (non‐invasive cardiac output [NICO]) and the lithium dilution method (lithium dilution cardiac output [LiDCO]) for cardiac output (CO) measurement in anesthetized dogs.

Design:Prospective study.

Setting:College of Veterinary Medicine, University of Florida.

Animals:Six adult dogs (weight range 22–25.4 kg).

Interventions:All animals were instrumented for CO determinations using the LiDCO and NICO methods. Direct blood pressure, heart rate, arterial blood gases, end‐tidal isoflurane (ETI), and CO2concentrations were monitored throughout the study. CO was manipulated with dobutamine and isoflurane to allow for intermediate, low, and high CO determinations in that order using LiDCO and NICO.

Measurements and main results:A 1.5% ETI produced the intermediate rate of CO, a constant‐rate infusion of dobutamine (1–4 μg/kg/min) and 1.1% ETI, the highest rate, and 2.5–3% ETI, the lowest rate. Measurements were obtained in duplicate or triplicate for the LiDCO and continuously for the NICO method after achieving a stable hemodynamic plane for at least 15 minutes at each level of CO, allowing 5 minutes between measurements. Forty‐seven comparisons were determined. The correlation coefficient (r) between the 2 methods was 0.888 for all determinations. The mean LiDCO and NICO from 47 measurements were 155.9±78.7 mL/kg/min (range, 49.6–303.2) and 146.6±62.9 mL/kg/min (50–290.3), respectively. The bias between LiDCO and NICO estimations was 9.3 (−60.7 to +79.4) mL/kg/min (mean and 95% confidence interval). The mean (mL/kg/min) of the differences of LiDCO–NICO was 1.11 × NICO. The relative error was 2.4±24.7%. As CO increased, the relative difference between the methods also increased.

Conclusions:The NICO is a viable non‐invasive method for CO determination in the dog and compares well with the LiDCO.
Canine parvoviral enteritis: a review of diagnosis, management, and prevention
Authors: Prittie Jennifer
Published: August 2004

Objective:To review and summarize current information regarding epidemiology, risk factors, and pathophysiology associated with canine parvoviral infection, and to outline diagnostic and treatment modalities for this disease. Preventative and vaccination strategies will also be discussed, as serologic documentation of immunocompetence and adoption of safe and effective vaccination protocols are crucial in limiting infection and spread of canine parvoviral enteritis.

Etiology:Parvoviruses (Parvoviridae) are small, nonenveloped, single‐stranded DNA viruses that replicate in rapidly dividing cells. Canine parvovirus 2 (CPV‐2) remains a significant worldwide canine pathogen and the most common cause of viral enteritis in this species.

Diagnosis:Classic presentation of CPV infection includes acute‐onset enteritis, fever, and leukopenia. Definitive diagnostic tests include detection of CPV in the feces of affected dogs, serology, and necropsy with histopathology.

Therapy:Standard therapeutic practices for both mildly and severely affected puppies will be discussed. The ability of this virus to incite not only local gastrointestinal injury, but also a significant systemic inflammatory response has recently been reviewed in the literature, and novel innovative experimental and clinical therapeutic strategies, such as antagonism of proinflammatory cytokines and immunostimulation, are introduced in this article.

Prognosis:CPV remains a significant worldwide canine pathogen. In experimentally affected dogs, mortality without treatment has been reported as high as 91%. However, with prompt recognition of dogs infected with CPV‐2, and aggressive in‐hospital supportive therapy of severely affected puppies, survival rates may approach 80–95%.
Hypernatremia secondary to homemade play dough ingestion in dogs: a review of 14 cases from 1998 to 2001
Authors: Barr Julie M. , Khan Safdar A. , McCullough Sheila M. , Volmer Petra A.
Published: August 2004

Objective:To correlate the sodium chloride dosage and the serum sodium concentration to clinical signs, to determine if the dosage of homemade play dough (and, therefore, sodium chloride) is the most reliable way to predict clinical signs and prognosis, and to review previously reported treatment options.

Design:Retrospective case series.

Animals:Fourteen dogs with a history of homemade play dough ingestion.

Procedure:Cases were examined for each animal's signalment including body weight, age, approximate amount of play dough ingested, the estimated sodium chloride dosage, clinical signs, serum sodium concentration, and outcome when available. The literature was reviewed to determine pathophysiology and treatment regimens.

Results:Twelve of 14 dogs (86%) that ingested homemade play dough showed clinical signs. Vomiting (9 of 14, 64%), polydipsia, and seizures (4 of 14 each, 29%) were the most common signs followed by polyuria, tremors (3 of 14 each, 21%), and hyperthermia (2 of 14, 14%). The lowest calculated dosage associated with objective clinical signs was 1.9 g/kg. Seizures were reported in all animals with serum sodium levels greater than 180 mEq/L.

Conclusions and clinical relevance:Homemade play dough ingestion can be a serious and life‐threatening problem. Many factors can contribute to the toxicity of homemade play dough. This study indicates that the serum sodium concentration is a more reliable indicator of the clinical course of the toxicity rather than the amount of play dough and, therefore, the dosage of sodium chloride ingested. Treatment should be based on a clinical evaluation of the patient and laboratory results, and consists of controlling seizures, reducing serum sodium concentrations slowly, and supportive care.
Tissue regeneration based on tissue engineering technology
Authors: Tabata Yasuhiko
Published: August 2004

ABSTRACT  Recent development of biomedical engineering as well as basic biology and medicine has enabled us to induce cell‐based regeneration of body tissue to self‐repair defective tissue or substitute biological functions of damaged organs. For successful tissue regeneration, it is indispensable to give cells an environment suitable for regeneration induction. Tissue engineering is a newly emerging biomedical technology for creating an environment for tissue regeneration with various biomaterials. The paper presented here overviews recent research data on tissue regeneration based on tissue engineering, and briefly explains the key technology of tissue engineering.