bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional and structural response of a cellulose‐degrading methanogenic microbial community to multiple aeration stress at two different temperatures
Authors: Wu X. L. , Conrad R.
Published: March 2003

Two cellulose‐fermenting methanogenic enrichment cultures originating from rice soil, one at 15°C with Methanosaeta and the other at 30°C with Methanosarcina as the dominant acetoclastic methanogen, both degraded cellulose anaerobically via propionate, acetate and H2 to CH4. The degradation was a two‐stage process, with CH4 production mainly from H2/CO2 and accumulation of acetate and propionate during the first, and methanogenic consumption of acetate during the second stage. Aeration stress of 12, 24, 36 and 76 h duration was applied to these microbial communities during both stages of cellulose degradation. The longer the aeration stress, the stronger the inhibition of CH4 production at both 30°C and 15°C. The 72 h stressed culture at 30°C did not fully recover. Aeration stress at 30°C exerted a more pronounced effect, but lasted for a shorter time than that at 15°C. The aeration stress was especially effective during the second stage of fermentation, when consumption of acetate (and to a lesser extent propionate) was also increasingly inhibited as the duration of the stress increased. The patterns of CH4 production and metabolite accumulation were consistent with changes observed in the methanogenic archaeal community structure. Fluorescence in situ hybridization showed that the total microbial community at the beginning consisted of about 4% and 10% archaea, which increased to about 50% and 30% during the second stage of cellulose degradation at 30°C and 15°C respectively. Methanosarcina and Methanosaeta species became the dominant archaea at 30°C and 15°C respectively. The first round of aeration stress mainly reduced the non‐Methanosarcina archaea (30°C) and the non‐Methanosaeta archaea (15°C). Aeration stress also retarded the growth of Methanosarcina and Methanosaeta at 30°C and 15°C respectively. The longer the stress, the lower was the percentage of Methanosarcina cells to total microbial cells after the first stress at 30°C. A later aeration stress decreased the population of Methanosarcina (at 30°C) in relation to the duration of stress, so that non‐Methanosarcina archaea became dominant. Hence, aeration stress affected the acetotrophic methanogens more than the hydrogenotrophic ones, thus explaining the metabolism of the intermediates of cellulose degradation under the different incubation conditions.
Biodiversity of Geodermatophilaceae isolated from altered stones and monuments in the Mediterranean basin
Authors: Urzì Clara , Brusetti Lorenzo , Salamone Paola , Sorlini Claudia , Stackebrandt Erko , Daffonchio Daniele
Published: March 2003

An investigation was made into the occurrence and biodiversity of Geodermatophilaceae on 78 samples of altered stone surfaces from 24 monuments and natural stones in the Mediterranean basin; it was found that the total microbial counts ranged between 0 and 107 cfu g−1 dry weight. Members of the Geodermatophilaceae family were isolated from 22 of the 78 samples examined, with the incidence of Geodermatophilaceae colonies in the cultivable population ranging from 1% to 100%. The highest percentage was found in six samples of markedly deteriorated stone. Sixty‐five strains randomly isolated from the plates were clustered in six different groups by amplified 16S rDNA restriction analysis (ARDRA) using five different restriction enzymes. Twenty‐five strains, representing all the ARDRA haplotypes, were characterized further by partial sequencing (350–550 bp) of the 16S rDNA and by analysing 76 morphological, metabolic and physiological properties. The strains were associated with three well‐separated clusters of the genera Geodermatophilus, Blastococcus and Modestobacter. On the basis of 16S rDNA sequence and ARDRA analysis, only two strains were found to be related to the two reference strains of Geodermatophilus. All the others could be grouped with Blastococcus aggregatus (19 strains) or the Antarctic species Modestobacter multiseptatus (44 strains), suggesting that it is these two groups, rather than Geodermatophilus, that tend to colonize the stone surfaces, and that Modestobacter‐like strains are also found in temperate/Mediterranean climates. From the BOX‐polymerase chain reaction (PCR) data, it can be seen that the Modestobacter‐like strains, belonging to the most represented ARDRA haplotype (haplotype B, 34 strains), are very polymorphic and that, over a stone surface, there is a wide genetic diversity at the microsite level.
Use of stable isotopes to identify benzoate as a metabolite of benzene degradation in a sulphidogenic consortium
Authors: Phelps Craig D. , Zhang Xiaoming , Young L. Y.
Published: March 2003

An enriched sulphidogenic consortium capable of mineralizing benzene was used to study the metabolic pathway of anaerobic benzene degradation. Benzoate was detected in active cultures and benzene was confirmed to be the source of this benzoate by the addition of deuterated benzene (D6) and subsequent detection of deuterated benzoate (D5) in active cultures but not in autoclaved controls. Benzoate was utilized by this culture at 1/12 the rate of benzene, while its presence did not inhibit benzene utilization. The benzene utilization rate was reduced, however, in the presence of 2‐fluorobenzoate. When the culture was supplemented with [13C]‐bicarbonate, the carboxyl group on benzoate was not labelled with [13C]‐carbon, suggesting that this transformation relies on a more complex set of reactions than simple addition of carbonate.
Microbial reduction of Fe(III) in the presence of oxygen under low pH conditions
Authors: Küsel Kirsten , Roth Ursula , Drake Harold L.
Published: March 2003

In acidic, coal mining lake sediments, facultatively anaerobic Acidiphilium species are probably involved in the reduction of Fe(III). Previous results indicate that these bacteria can co‐respire O2 and Fe(III). In this study, we investigated the capacity of the sediment microbiota to reduce Fe(III) in the presence of O2 at pH 3. In sediment microcosms with 4% O2 in the headspace, the concentration of Fe(II) increased at a rate of 1.03 μmol (g wet sediment)−1 day−1 within the first 7 days of incubation which was similar to the rate obtained with controls incubated under anoxic conditions. However, in microcosms incubated under air, Fe(II) was consumed after a lag phase of 8 h with a rate of 2.66 μmol (g wet sediment)−1 day−1. Acidiphilium cryptum JF‐5, isolated from this sediment, reduced soluble Fe(III) with either 4 or 21% O2 in the headspace, and concomitantly consumed O2. However, the rate of Fe(II) formation normalized for cell density decreased under oxic conditions. Schwertmannite, the predominant Fe(III)‐mineral of this sediment, was also reduced by A. cryptum JF‐5 under oxic conditions. The rate of Fe(II) formation by A. cryptum JF‐5 decreased after transfer from preincubation under air in medium lacking Fe(III). Acidiphilium cryptum JF‐5 did not form Fe(II) when preincubated under air and transferred to anoxic medium containing Fe(III) and chloramphenicol, an inhibitor of protein synthesis. These results indicate that: (i) the reduction of Fe(III) can occur at low O2 concentrations in acidic sediments; (ii) Fe(II) can be oxidized at O2 concentrations near saturation; and (iii) the enzyme(s) responsible for the reduction of Fe(III) in A. cryptum JF‐5 are not constitutive.
In situ studies of the phylogeny and physiology of filamentous bacteria with attached growth
Authors: Thomsen Trine Rolighed , Kjellerup Birthe Venø , Nielsen Jeppe Lund , Hugenholtz Philip , Nielsen Per Halkjær
Published: March 2003

Among the filamentous bacteria occasionally causing bulking problems in activated sludge treatment plants, three morphotypes with attached microbial growth are common, Eikelboom Type 0041, Type 1851 and Type 1701. A better knowledge of the phylogeny and physiology of these filamentous bacteria is necessary in order to develop control strategies for bulking. In this study we have used a combination of fluorescence in situ hybridization (FISH) and microautoradiography (MAR) to investigate the identity and in situ physiology of the Type 0041‐morphotype and its attached bacteria in two wastewater treatment plants. Identification and enumeration of Type 0041 using group‐specific 16S rRNA‐targeted FISH probes revealed that approximately 15% of the filaments hybridized with a gene probe specific for the TM7 group, a recently recognized major lineage in the bacterial domain. All other filaments morphologically identified as Type 0041 only hybridized to the general bacterial EUB338‐probe, indicating that they probably do not belong to commonly isolated bacterial phyla such as the Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes, for which group‐specific probes were used. The phylogenetic heterogeneity of Type 0041 again highlights the inadequacy of a morphology‐based classification system. Like the filaments, most of the attached microbial cells were not identified beyond their affiliation to the Bacteria using the group‐specific FISH probes. However, several different bacterial phyla were represented in the identified fraction suggesting that the attached microorganisms are phylogenetically diverse. The study of the in situ physiology of Type 0041 using MAR‐FISH revealed that both the filaments and the attached bacteria on Type 0041 were versatile in the use of organic substrates and electron acceptors. It was observed that all Type 0041 could consume glucose, but none of the filaments were able to consume acetate under any conditions tested, in contrast to some of the attached bacteria. No significant physiological differences were found between TM7–positive and TM7–negative Type 0041 filaments, and only minor differences were observed between the two treatment plants tested. These are the first data on the physiology of the almost entirely uncharacterized TM7 phylum and show that TM7 filamentous bacteria can uptake carbon substrates under aerobic and anaerobic conditions.
Multiple influences of nitrate on uranium solubility during bioremediation of uranium‐contaminated subsurface sediments
Authors: Finneran Kevin T. , Housewright Meghan E. , Lovley Derek R.
Published: March 2003

Microbiological reduction of soluble U(VI) to insoluble U(IV) has been proposed as a remediation strategy for uranium‐contaminated groundwater. Nitrate is a common co‐contaminant with uranium. Nitrate inhibited U(VI) reduction in acetate‐amended aquifer sediments collected from a uranium‐contaminated site in New Mexico. Once nitrate was depleted, both U(VI) and Fe(III) were reduced concurrently. When nitrate was added to sediments in which U(VI) had been reduced, U(VI) reappeared in solution. Parallel studies with the dissimilatory Fe(III)‐, U(VI)‐ and nitrate‐reducing microorganism, Geobacter metallireducens, demonstrated that nitrate inhibited reduction of Fe(III) and U(VI) in cell suspensions of cells that had been grown with nitrate as the electron acceptor, but not in Fe(III)‐grown cells. Suspensions of nitrate‐grown G. metallireducens oxidized Fe(II) and U(IV) with nitrate as the electron acceptor. U(IV) oxidation was accelerated when Fe(II) was also added, presumably due to the Fe(III) being formed abiotically oxidizing U(IV). These studies demonstrate that although the presence of nitrate is not likely to be an impediment to the bioremediation of uranium contamination with microbial U(VI) reduction, it is necessary to reduce nitrate before U(VI) can be reduced. These results also suggest that anaerobic oxidation of U(IV) to U(VI) with nitrate serving as the electron acceptor may provide a novel strategy for solubilizing and extracting microbial U(IV) precipitates from the subsurface.
Quality of life of patients after surgical treatment of anal fistula; the role of anal manometry
Authors: Mylonakis E. , Katsios C. , Godevenos D. , Nousias B. , Kappas A. M.
Published: March 2003

Objective

This study was undertaken to assess the quality of life of patients after surgical treatment of anal fistula and to investigate whether anal manometry (AM) can guide the choice of the proper surgical intervention in these patients in order to protect the sphincter mechanism.

Patients and methods

One hundred patients with anal fistula (AF) were studied prospectively (78 men; mean age 45 years; range 11–78). Cleveland Incontinence Score (CIS) was record pre‐operatively and 1 and 3 months postoperatively for each patient in order to specify their quality of life (QOL) before and after the surgical treatment. Also, anal manometry (AM) was performed pre‐operatively and 1 month postoperatively. The pre‐operative anal pressures and the type of fistula determined the kind of the surgical treatment. 55 patients had an intersphincteric fistula, 42 trans‐sphincteric and 3 suprasphincteric. 65 patients underwent laying open of the fistulous track, 7 fistulectomy and 28 were treated by seton fistulotomy.

Results

Three patients had defective gas control and 6 reported some degree of soiling. 3 patients developed recurrent fistula. CIS was significantly impaired (P=0.02) at the first postoperative month in these patients who were treated for trans‐sphincteric fistula by fistulotomy; AM revealed significant decrease of anal pressures in these patients (resting and squeeze; P=0.007 and 0.0001 respectively); CIS and AM in the remaining cases revealed no significant deterioration of QOL and fall of anal pressures respectively. CIS was normal in the vast majority of patients at 3‐months postoperatively.

Conclusions

QOL of patients after surgical treatment of AF is unalterable on the understanding that the AF is simple and the treatment is not associated by incontinence or recurrence. Pre‐operative AM is important regarding the choice of the proper surgical procedure.
Accuracy of hydrogen peroxide‐enhanced ultrasound in the identification of internal openings of anal fistulas
Authors: Ortiz H. , Marzo J. , Jiménez G. , DeMiguel M.
Published: March 2003

Objective  This prospective study was designed to assess the accuracy of hydrogen peroxide‐enhanced ultrasound in the identification of internal openings of anal fistulas, with surgical findings as the golden standard.

Patients and methods  A total of 143 consecutive patients (102 men; mean age, 45 years) with fistula‐in‐ano were assessed by hydrogen peroxide‐enhanced ultrasound before surgery involving one radiologist. Ultrasound was performed using a B & K Diagnostic Ultrasound System™ with a 10‐MHz rotating endoprobe. Hydrogen peroxide (3%) was infused into the fistula. All operations were perfomed by the same surgeon who was unaware of results of anal endosonography.

Results  In 128 (89.5%) patients, an internal opening was identified at surgery. Correct identification of an internal opening endosonographically was recorded in 80 (62.5%) patients. The internal opening was correctly identified by ultrasound in 32% (8/25) of patients with intersphincteric fistulas, in 77% (70/91) with transsphincteric fistulas, and in 17% (2/12) with suprasphincteric fistulas.

Conclusion  The accuracy of hydrogen peroxide‐enhanced anal endosonography for the identification of internal openings was still insufficient to justify pre‐operative endosonography as a diagnostic method for routine use in patients with fistula‐in‐ano.
Early insulin release effectively improves glucose tolerance: studies in two rodent models of type 2 diabetes mellitus
Authors: De Souza C. J. , Gagen K. , Chen W. , Dragonas N.
Published: March 2003

Aim  Islet dysfunction, characterized by the loss of an acute insulin secretory response (AIR) to glucose is a well‐established pathology of type 2 diabetes mellitus. Using oral insulin secreting agents with very different pharmacodynamic profiles, the present study was undertaken to test the hypothesis that, within the setting of an underlying insulin resistance, changes in the insulin response profile can differentially affect glycaemic control.

Method  The mildly insulin resistant high‐fat fed Sprague Dawley (HF) rat and the very insulin resistant Zucker fatty (fa/fa) rat, chronically fitted with indwelling jugular cannula were subjected to an oral glucose load. Compounds were administered 5 min before the oral glucose load.0Nateglinide (Nateg) was administered to elicit only an early insulin secretory response and glipizide (Glip) to elicit a later but greater insulin secretory response. Acetaminophen was used as a marker to assess for potential effects of these compounds on gastric emptying rates.

Results  Nateg rapidly increased early insulin release (from −5 to 0) while the effects on total insulin release were similar to those in the controls and glucose excursions were eliminated in both diabetic models with no evidence of sustained hypoglycaemia. Conversely, Glip did not affect early insulin release but increased total insulin release (− 15 to 120 min), but only after the oral glucose load. Glip partially curbed glucose excursions in the mildly insulin resistant HF rodent and was totally ineffective in the very insulin resistant Zucker rat. The differential effects could not be attributed to effects on gastric emptying rates.

Conclusion  These data support the importance of early insulin release in type 2 diabetes mellitus and indicate that, independent of the level of insulin resistance, stimulating insulin release early and briefly provides for more effective and tighter glycaemic control than increasing insulin exposure to a greater magnitude later.
Brain‐derived neurotrophic factor ameliorates lipid metabolism in diabetic mice
Authors: Tsuchida A. , Nonomura T. , Nakagawa T. , Itakura Y. , Ono‐Kishino M. , Yamanaka M. , Sugaru E. , Taiji M. , Noguchi H.
Published: March 2003

Aim: It has been reported previously that brain‐derived neurotrophic factor (BDNF) regulates blood glucose metabolism in rodent obese diabetic models such as C57BL/KsJ‐leprdb/leprdb (db/db) mice. BDNF further regulates energy expenditure, possibly through the central and autonomous nervous systems. In this study, we evaluated the effect of BDNF on both lipid and glucose metabolisms to clarify its action mechanism.

Methods: To control the energy intake, we used a pellet pair‐feeding apparatus to synchronize food intake precisely between BDNF‐treated and vehicle‐treated db/db mice. BDNF (50 mg/kg/week) was subcutaneously injected to male db/db mice twice weekly for 3 weeks, and blood glucose, serum biochemical lipid parameters and tissue weights were measured. Liver triglyceride contents were measured and liver sections were histologically analysed.

Results: Twice weekly BDNF treatment for 3 weeks significantly lowered blood glucose compared with pellet pair‐fed, vehicle‐treated db/db mice (294 ± 109 vs. 529 ± 91 mg/dL). Serum non‐esterified free fatty acid (726 ± 72 vs. 999 ± 220 µEq/l), total cholesterol (125 ± 8 vs. 151 ± 23 mg/dL) and phospholipid levels (215 ± 13 vs. 257 ± 36 mg/dL) of the BDNF‐treated db/db mice decreased significantly. Liver weights (1.51 ± 0.11 vs. 2.05 ± 0.11 g), liver triglyceride contents (17.5 ± 1.4 vs. 26.1 ± 2.1 mg/g) and fatty liver in histological appearance were reduced with BDNF treatment. There were no significant differences in body weights and white adipose tissue weights between the two groups.

Conclusions: Taken together with the accelerating effect of BDNF on energy metabolism, these findings indicate that BDNF improves glucose and lipid metabolism in obese diabetic animals without enlarging liver or adipose tissues.
Socio‐demographic and psychosocial factors are associated with features of the metabolic syndrome. The Women's Health in the Lund Area (WHILA) study
Authors: Lidfeldt J. , Nyberg P. , Nerbrand C. , Samsioe G. , Scherstén B. , Agardh C. D.
Published: March 2003

Aim: The aim was to analyse any associations between socio‐demographic and psychosocial factors and different features of the metabolic syndrome in a geographically well‐defined population of middle‐aged women.

Methods: A population of 10 766 Caucasian women aged 50–59 years was investigated regarding biological and socio‐demographic conditions, physical activity, dietary habits, aspects of quality of life, and subjective physical and mental symptoms. The screening instrument was used to discriminate subjects as positive or negative on one or more of a total of eight variables considered to be linked to the metabolic syndrome. The cut‐off values for positive screening were non‐fasting capillary blood glucose ≥ 8.0 mmol/l and serum triglycerides ≥ 2.3 mmo/l, BMI ≥ 30 kg/m2, WHR ≥ 0.90, blood pressure ≥ 160 and/or 95 mmHg, a family history of diabetes, and pharmacological treatment for hypertension or hyperlipidaemia.

Results: Altogether 6805 women (63.2%) participated: 3535 with positive and 3270 with negative screening. Multiple logistic regression analyses showed that comprehensive (OR 1.62, 95% CI 1.41–1.87) and upper secondary (1.40, 1.24–1.57) school, low physical quality of life (1.41, 1.23–1.61) and high sum of subjective physical symptoms (1.06, 1.04–1.08) were positively associated with one or more features of the metabolic syndrome, while high leisure‐time exercise and healthy diet (0.84, 0.71–0.99), and low (≤ 83 g/week) (0.71, 0.63–0.81) and moderate (84–167 g/week) (0.78, 0.65–0.93) alcohol consumption were negatively associated.

Conclusions: To identify middle‐aged women with cardiovascular risk factors and high risk for diabetes, it is important to consider not only biological, but also socio‐demographic and psychosocial conditions.
A new variant of the neodermatan‐type spermiogenesis in a parasitic ‘turbellarian’, Notentera ivanovi (Platyhelminthes) and the origin of the Neodermata
Authors: Kornakova Elena E. , Joffe Boris I.
Published: March 2003

Spermiogenesis is characterized by fully incorporated (in the testes of mature worms) or partially free (submature worms) axonemes in spermatids. Formation of free flagella correlates with tight arrangement of cells in the testes and small size of the zone of differentiation and vice versa. In both cases the axonemes elongate within the growing shaft, so that the organization of the resulting spermatids is different only with regard to the distal end. In late spermatids, the nucleus occupies the proximal half, the two mitochondria and the axonemes directed distally lie in the distal half. After detachment of the spermatid, a migration of the nucleus takes place. In the resulting mature sperm, the proximal (anterior) half is occupied by the mitochondria and axonemes the basal bodies of which lie at the anterior end of the spermatozoon; the nucleus occupies the distal (posterior) half. Because of the distal orientation of the axonemes and a peculiar mode of the migration of the nucleus, the spermiogenesis of Notentera should be classified as a new variant of the type characteristic of the Neodermata (parasitic Platyhelminthes). Based on the analysis of the available morphological and other relevant data it is argued (i) that a high‐ranked taxon, the Fecampiida, should be established within the Neoophora to include Notentera and the closely related Fecampiidae and (ii) that all the Platyhelminthes with neodermatan‐type spermiogenesis form a monophyletic taxon, the Revertospermata, which includes the sister groups Fecampiida and Mediofusata.
Sex, seminal receptacles, and sperm ultrastructure in the commensal bivalve Montacuta phascolionis (Veneroida; Galeommatacea)
Authors: Jespersen Åse , Lützen Jørgen
Published: March 2003

It is argued that the paired structures in adult Montacuta phascolionis previously claimed to be testes are seminal receptacles. The receptacles in 3.0mm long females are filled with sperm cells or spermatids. A 2.0‐mm long specimen had a well‐developed testes exhibiting ripe sperm. It is concluded that the species is a protandrous hermaphrodite and that the previously described dwarf males are rather complemental males. The ultrastructure of the sperm cells is described and compared with that of the sperm of related species.
Relationship between serum ferritin levels and tumour status in patients with renal cell carcinoma
Authors: Miyata Y. , Koga S. , Nishikido M. , Hayashi T. , Kanetake H.
Published: March 2003

Objective To assess the relationship between serum ferritin levels (a useful marker for diagnosing and staging renal cell carcinoma, RCC) and tumour status in RCC of  7 cm diameter.

Patients and methods Serum ferritin levels were measured using an enzyme immunoassay in 101 patients before treatment for RCC. The largest diameter of the primary tumour was measured in the pathological specimens. The correlation between serum ferritin levels and histopathological status was assessed retrospectively in all patients, and separately in the 67 patients with tumours of  7 cm diameter.

Results For the whole group, lymph node metastasis, distant metastasis, extracapsular invasion, vascular invasion and nuclear grade were significantly different (P < 0.001) between patients with normal and those with elevated ferritin levels. However, in patients with tumours of  7 cm, only the presence of distant metastasis was significantly different (P < 0.001) between the groups.

Conclusions Elevated serum ferritin levels in patients with RCC of  7 cm may suggest the presence of distant metastasis.
Urological complications of coitus
Authors: Eke N.
Published: March 2003

Objective To ascertain the urological complications of coitus, as the proximity of the lower urinary tract to the organs of coitus exposes the tract to coital trauma.

Materials and methods Medline was searched from 1966 to 2000 to identify reports on coital injuries. Publications and relevant references were retrieved. Those reporting urological complications were selected for analysis.

Results In all, 1454 cases of reported coital injuries were reviewed; 790 occurred in men while 664 occurred in women, mainly in the genital area. Physical urological complications were more common in men than in women. The injuries were often sustained during voluntary coitus, but one penile fracture was sustained during an attempted rape. The presentations included penile swellings and deviations, haemorrhage, erectile dysfunction and urinary incontinence. Complications included vesicovaginal fistulae, bladder and cavernosal ruptures, and urinary tract infections. Rare complications included isolated rupture of the penile vasculature. Major risk factors included penovaginal disproportion, excessive force at coitus, urethral coitus, fellatio and anal intercourse. Urethral injuries were the commonest complications; in men these were associated with 10–38% of penile fractures. The treatments included cold compress and anti‐inflammatory agents in contusions, repairs of lacerations, closure of fistulae and urethral and vaginal reconstruction. The results of treatment were essentially good. Recurrent penile fractures were reported.

Conclusion Coitus, although pleasurable, may be risky. The complications have been termed ‘faux pas’ implying that they are preventable. While the ultimate prevention is abstinence, this is an unrealistic prescription. Therefore, efforts are necessary to identify risk factors to enable preventive strategies.
Clinicopathological features of prostate cancer in Jamaican men
Authors: Shirley S.E. , Escoffery C.T. , Sargeant L.A. , Tulloch T.
Published: March 2003

Objective To document the clinicopathological features of prostate cancer in a cohort of Jamaican men, and to determine which of these features are of prognostic significance in this population.

Patients and methods The clinical and pathological findings in 99 patients with prostate cancer (diagnosed consecutively after biopsy, in the Department of Pathology at the University of the West Indies) between 1993 and 1997 were reviewed retrospectively. Biopsy specimens included 74 needle biopsies and 25 transurethral resection (TUR) specimens.

Results The mean age at diagnosis was 72.3 years and 79 patients (80%) were symptomatic. The median (range, interquartile range) serum prostate‐specific antigen (PSA) value at diagnosis was 37 (1–2100, 2–750) ng/mL; 63% of the patients had clinical stage T1 or T2 disease. Most (60%) of the cancers had a Gleason score of 8–10. Perineural invasion was present in a third of cases overall; high‐grade prostatic intraepithelial neoplasia and periprostatic involvement were present in 18% and 8% of biopsies, respectively. The median percentage involvement of all biopsy samples was 37%, that for needle biopsies 47% and for TUR specimens 14%. Of the 90 patients with complete follow‐up data, 37 (41%) died; the cause was progressive disease in 19 (51%). The mean (sd, range) survival was 41.3 (19.7, 1–73) months. On univariate analysis, age, PSA level, tumour stage, Gleason score, perineural involvement and periprostatic involvement were significantly associated with an increased risk of dying from prostatic cancer; in a multivariate model, PSA and tumour stage (4 vs 1) were the only independent factors.

Conclusions The mean PSA values at the time of diagnosis, the median percentage of biopsy involvement by cancer and the number of patients with tumours of high histological grade were comparatively high, probably reflecting the patients' relatively late clinical presentation. Established prognostic markers were predictive of the risk of death from prostate cancer.
Behavioural problems in children with urge incontinence and voiding postponement: a comparison of a paediatric and child psychiatric sample
Authors: Von Gontard A. , Lettgen B. , Olbing H. , Heiken‐Löwenau C. , Gaebel E. , Schmitz I.
Published: March 2003

Objective

To analyse prospectively the incidence of behavioural disorders and the subjective views of children with urge incontinence (defined by detrusor instability, sudden urge symptoms and frequent micturitions) and voiding postponement (characterized by delayed micturition in typical situations and a low voiding frequency) according to an identical protocol in a paediatric and a child psychiatric unit.

Patients and method

Ninety‐four consecutive or randomly selected children aged 5.0–10.9 years with either voiding postponement (52) or urge incontinence (42) were examined prospectively using an intelligence test (CFT1 or CFT20), the Child Behaviour Checklist (CBCL 4/18), the ICD‐10 child psychiatric diagnoses and a structured interview.

Results

In the groups from both centres combined, those postponing voiding had a significantly higher incidence of externalizing behavioural symptoms (31% vs. 8%; P<0.01) and total problems (37% vs. 13%; P<0.05) in the clinical range (CBCL), and a higher rate of at least one ICD‐10 child psychiatric diagnosis (54% vs. 29%P<0.05) and of expansive disorders (31% vs. 5%; P<0.01). The incidence of children with behavioural symptoms was lower in the paediatric centre, being exceptionally low among urge incontinent children (only 6%, CBCL). In contrast, from the children’s subjective appraisal, there were no significant differences in concepts, explanations and implications of wetting; 79% of urge incontinent children and 64% of those postponing voiding suffered emotionally from the adverse effects of wetting. Only a minority (3% vs. 6%) saw any advantages at all.

Conclusion

Children with voiding postponement had a significantly higher incidence of behavioural problems, especially expansive/externalizing behaviour, 3–4 times higher than in the normal population. Children with urge incontinence had a significantly lower incidence of behavioural problems, mainly emotional/internalizing behaviour, that was only slightly higher (1–2 times) than that in the normal population. Because of selection, similar trends but lower incidences were found in the paediatric setting, with very few problems among urge incontinent children. In contrast, the children’s subjective views did not differ; disadvantages associated with emotional suffering were reported by all children.
Increased expression of substance P receptor‐encoding mRNA in bladder biopsies from patients with interstitial cystitis
Authors: Marchand  , Sant  , Kream
Published: March 2003

Objectives

 To determine whether substance P (SP, also known as neurokinin 1, NK1) receptors are differentially expressed in bladder biopsies from patients with interstitial cystitis (IC) compared with matched controls.

Materials and methods

Cold‐cup biopsies were taken during routine diagnostic cystoscopy. NK1‐receptor expression was assessed using a quantitative analysis of NK1‐receptor‐encoding mRNA in bladder biopsies from patients and controls using in situ hybridization histochemistry (ISHH) combined with autoradiographic image analysis.

Results

Autoradiographic signal indicating the presence of NK1‐encoding mRNA was localized to detrusor muscle, urothelium and vascular structures. In the bladder vasculature, the signal was predominantly associated with endothelial cells. NK1 receptor‐encoding mRNA within the vascular endothelium was increased in the biopsies obtained from patients with IC.

Conclusion

Increased levels of NK1 receptor‐encoding mRNA within the bladder vascular endothelium suggests the up‐regulation of NK1 receptor as a putative factor in the pathogenesis of pain related to IC. Increased responsiveness to SP released from the perivascular sensory terminals may result in a local cascade of neurogenic inflammatory responses which trigger the pathophysiological changes, including pain, characteristic of IC.
Reducing artefacts in ambulatory urodynamics
Authors: Salvatore  , Khullar  , Anders  , Cardozo
Published: March 2003

Objective

 To compare the diagnoses derived from a retrospective analysis of 50 ambulatory urodynamic recordings, unaware of the final diagnosis, and to evaluate the importance of the symptom diary and the presence of two transducers in the bladder rather than one.

Patients and methods

 Fifty women underwent ambulatory urodynamics (duration 4 h) after video cysto‐urethrography. A single solid‐state microtip pressure catheter was inserted with both transducers inside the bladder, and another was inserted in the rectum. The women were asked to complete a symptom diary and the results were analysed with the active participation of the patient. Detrusor ‘instability’ was diagnosed on ambulatory urodynamics if there was a simultaneous increase in detrusor pressure and in the ‘urethral’ line in the presence of symptoms (urgency or leakage). All 50 recordings were analysed retrospectively in four combinations, i.e. with and without the additional ‘urethral’ line displayed on the screen and with and without the diary information. The total number of detrusor contractions was then calculated for each reading and ‘abnormal detrusor activity’ diagnosed when a contraction occurred with or without symptoms as recorded in the diary. The final diagnosis for each reading was then compared with that made at the time of the test with the patient present.

Results

 Using the information from the diary reduced the number of pressure rises classified as ‘abnormal detrusor activity’ by 58%; using a second bladder pressure transducer further reduced the number of pressure rises classified as ‘abnormal’ by 19%. Overall, using both techniques together reduced the number of spurious pressure rises misclassified as ‘abnormal detrusor activity’ by 64%.

Conclusions

 Both the symptom diary and the placement of two transducers in the bladder can decrease, by almost two‐thirds, the diagnosis of pathological detrusor activity on ambulatory urodynamics.
Immunotherapy of advanced prostate cancer: a phase I/II trial using Mycobacterium vaccae (SRL172)
Authors: Hrouda  , Baban  , Dunsmuir  , Kirby  , Dalgleish
Published: March 2003

Objective

 To assess whether a new heat‐killed Mycobacterium vaccae preparation (SRL172), which enhances cell‐mediated immunity and has been proposed for use as an immunotherapeutic agent against cancer, is safe in patients with advanced hormone‐refractory prostate cancer, can stimulate desirable cytokine changes in these patients and modulate the progression of the disease.

Patients and methods

 Ten patients were given SRL172 intradermally at regular intervals. The serum prostate specific antigen (PSA) level was used as a surrogate marker of response. The proportion of peripheral blood mononuclear cells (PBMC) secreting interleukin 2 (IL2), interferon gamma (IFNγ) and interleukin 4 (IL4) was measured by flow cytometry (FACS) before and after vaccination to assess whether the treatment induced a Th2 (predominantly humoral) to Th1 (predominantly cell‐mediated) switch.

Results

 There were no significant adverse events. In five patients the serum PSA declined during the trial and in two of these there was no concomitant change of therapy apart from vaccination with SRL172. Before vaccination with SRL172 patients had a low proportion of PBMC producing IFNγ and IL2 (all 10) and a higher proportion secreting IL4 (all three tested), suggesting a predominantly Th2 cytokine profile. After vaccination the proportion of IL4 secreting PBMC fell in all three patients tested. The proportion of IL2 secreting PBMC increased in three patients whose PSA fell. The proportion of IFNγ‐secreting cells remained depressed in nine of 10 patients.

Conclusion

 Two patients with advanced hormone‐refractory prostate cancer had a PSA response to the vaccination with SRL172. The proportion of PBMC secreting IL2 is a potential marker of response to immunotherapy.
The management of vesical calculi with combined optical mechanical cystolithotripsy and transurethral prostatectomy: is it safe and effective?
Authors: Asci  , Aybek  , Sarikaya  , Büyükalpelli  , Yilmaz
Published: March 2003

Objectives

To investigate the effectiveness and reliability of the combination of optical mechanical cystolithotripsy (OMC) and transurethral prostatectomy (TURP) for the treatment of bladder calculi and obstructive benign prostatic enlargement (BPE).

Patients and methods

From December 1990 to December 1996, 61 patients who had bladder stones and BPE or bladder neck contracture were treated with combined OMC and TURP; 32 patients who had bladder stones with no infravesical obstruction were treated with OMC alone. The records of a random selection of 97 patients with obstructive BPE who were treated with TURP only in the same period were used as the control. The operative duration time, the length of hospital stay, the duration of urethral catheterization, outcome and complications of the procedures for each patients were reviewed. The Mann–Whitney U‐test and chi‐square tests were used for statistical analysis.

Results

The mean duration of surgery, hospital stay and urethral catheterization were significantly longer with combined OMC and TURP than with OMC alone (P<0.05). Stone‐free rates were 94% after OMC alone and 93% after combined OMC and TURP. The postoperative mean peak flow rates were 14.3 mL/s after the combined procedure and 15.2 mL/s after TURP alone. The complication rates were 21% for the combined procedure and 13% for OMC alone. The complication rate of TURP was 5%, significantly lower than that for the combined procedure (P<0.05).

Conclusion

Bladder stones were associated with infravesical obstruction in two‐thirds of patients. Simultaneous treatment with OMC and TURP did not change the effectiveness of these procedures, but caused additional morbidity.
Thrombotic risk factors associated with transurethral prostatectomy
Authors: Bell  , Murdock  , Pasi  , Morgan
Published: March 2003

Objective

To ascertain the potential thrombotic risk associated with transurethral prostatectomy (TURP).

Patients and methods

The changes in coagulation variables were assessed in a prospective study of 40 patients undergoing TURP.

Results

There was a significant increase in thrombin‐antithrombin complexes 6 h after TURP (anova, P=0.01) combined with a significant decrease in activated partial thromboplastin time (anova, P=0.006), suggesting a postoperative hypercoagulable state. The significant increase in d‐dimer 24 h after TURP (anova, P=0.015) in the absence of any significant rise in tissue plasminogen activator antigen levels perioperatively (anova, P=0.737) suggests a physiological fibrinolytic response to the developing procoagulant state. The absence of any significant increase in plasminogen activator inhibitor‐1 antigen perioperatively (anova, P=0.348) suggests the observed hypercoagulability is not due to a ‘fibrinolytic shutdown’ reported in other forms of surgery.

Conclusion

TURP is associated with a hypercoagulable prothrombotic state; aspirin withdrawal perioperatively may be hazardous, and low‐dose heparin prophylaxis for venous thrombosis should be considered.
The growth of the testes during the fetal period
Authors: Malas  , Sulak  , Öztürk
Published: March 2003

Objective

 To determine the size and position of the fetal testes during gestation.

Materials and methods

The study comprised 48 testes obtained from 24 human fetuses with no congenital abnormalities, aged 14–40 weeks. The development of the fetuses was evaluated by measuring the crown‐rump length. Testicular size was assessed as the height, width, thickness and weight, and the position of testes determined during fetal development.

Results

The testes in 11 fetuses (22 testes) aged 14–37 weeks were in the abdominal cavity; no testis had descended to the scrotum in any fetus until 27 weeks of gestation. Both testes had descended to the scrotum only in fetuses aged 33–40 weeks. There was no significant difference between right and left testicular size in 13 fetuses (26 testes) aged 27–40 weeks, but size correlated with gestational age (P<0.001).

Conclusion

All testes had descended to the scrotum by 33 weeks of gestation, but there was considerable variation in position from 27 weeks.
The prognostic value of peripheral blood lymphocyte subsets in patients with bladder carcinoma treated using neoadjuvant M‐VEC chemotherapy
Authors: Soygür  , Bedük  , Baltaci  , Yaman Ö. , Tokgöz
Published: March 2003

Objectives

To assess the prognostic value of peripheral blood lymphocyte subsets in patients with bladder cancer who were treated with neoadjuvant chemotherapy.

Patients, subjects and methods

Thirty patients with a histological diagnosis of invasive bladder transitional cell carcinoma and 30 age‐matched controls with no evidence of cancer and immunological disorders were evaluated. Peripheral blood samples were assessed in both groups using monoclonal antibodies. Patients with bladder cancer who achieved complete or partial responses and those who had progression of the disease after systemic chemotherapy with methotrexate, vinblastine, epirubicin and cisplatin were compared according to the pretreatment values of the peripheral blood lymphocyte subsets.

Results

There were no significant differences in B lymphocyte levels between the groups. In patients with bladder cancer, the percentages of T lymphocytes (P<0.01), natural killer (NK) cells (P<0.05) and the CD4+/CD8+ ratio (P<0.05) were significantly lower than in the control group. In patients who responded to the chemotherapy regimen, the pretreatment values of T lymphocytes (P<0.001), the CD4+/CD8+ ratio (P<0.01) and NK cell levels (P<0.01) were significantly higher than in the patients who did not.

Conclusion

In patients with invasive bladder carcinoma, cell‐mediated immunity may have a role in the resistance to this malignancy and in these patients the pretreatment levels of T lymphocyte subsets may be an indicator of the potential response to chemotherapy.
Latex allergy in subjects who had undergone multiple surgical procedures for bladder exstrophy: relationship with clinical intervention and atopic diseases
Authors: Ricci  , Gentili  , Di Lorenzo  , Righetti  , Pigna  , Masi  , De Castro
Published: March 2003

Objective

To evaluate the prevalence of latex sensitization in a group of patients with bladder exstrophy, and to determine the role of associated risk factors, e.g. atopy, and the number and duration of surgical and anaesthetic procedures.

Patients and methods

The study comprised 17 patients (15 children and two young adults) affected by bladder exstrophy who had undergone multiple surgical procedures. Skin‐prick tests and specific immunoglobulin‐E (IgE) assays against latex, food allergens cross‐reacting with latex and inhalant allergens were carried out.

Results

Twelve patients showed latex sensitization and five showed symptoms related to latex exposure, the most common of which was contact urticaria (four of the symptomatic patients). Intraoperative anaphylactic reaction had led to life‐threatening events in only one child. Latex‐specific IgE determined both by the prick test and assay was positive in all those with symptoms. Specific IgEs against inhalant allergens and foods were present in four of five symptomatic patients. In the seven sensitized patients with no clinical symptoms, the assay was positive in all, while the skin‐prick test was positive only in four; specific IgEs against inhalant allergens were present in three of the seven. In the five patients not allergic and not latex‐sensitized, only one showed allergic sensitization against grass pollen and mite allergen. None of the children without latex antibodies had symptoms of latex allergy. Symptomatic patients had a undergone significantly more hours of surgery, more cystography and had used intermittent catheterization for longer than those with no symptoms.

Conclusion

A third of patients with bladder exstrophy showed latex symptoms and another third had latex sensitization. Multiple surgical procedures and atopy play a major role in the development of latex hypersensitivity
Histopathological changes and nitric oxide synthase activity in corpus cavernosum from rats with neurogenic erectile dysfunction
Authors: Basar M.M. , Yildiz M. , Söylemezoglu F. , Sürücü H.S. , Basar H. , Akan H. , Basar R.
Published: March 2003

Objective

To investigate changes in histology and nitric oxide synthase (NOS) activity in cavernosal tissues from rats with neurogenic erectile dysfunction induced experimentally.

Materials and methods

Twenty‐four adult male Sprague‐Dawley rats were divided equally into three groups and underwent a sham operation (control, group 1), unilateral (group 2) or bilateral (group 3) cavernosal nerve resection. Three months later they were killed and the cavernosal tissues analysed histologically by light and transmission electron microscopy, with NOS activity detected using an NADPH‐diaphorase staining technique.

Results

On light and electron microscopy, while penile nerves and cavernosal smooth muscle cells had a normal morphological appearance in the eight control rats, there were degenerative changes of the myelinated penile nerves and axonal fibrosis in groups 2 and 3. However, these changes were not significant. Using NADPH‐diaphorase staining, NOS activity was detected in all three groups in endothelial cells and cavernosal structures. However, the staining was more intense in endothelial cells and cavernosal muscles of rats in group 2 than in the other groups.

Conclusion

NOS activity was increased in the cavernosal tissue after cavernosal denervation, but the pharmacological action of nitric oxide may be impaired.