bluuebunny/crossref_metadata_2025 huggingface dataset:
3D‐Reconstructions: New Application Fields in Modern Veterinary Anatomy
Authors: Nöller C. , Henninger W. , Grönemeyer D. , Budras K. ‐D.
Published: November 2005

Introduction:  Today, the claims on the anatomical education have changed with the considerable increase of modern medical imaging. For the analysis of computed tomography (CT) images, magnetic resonance (MR) images or ultrasound, the knowledge of cross sectional anatomy is an important prerequisite for proper diagnosis. Admittedly, it is difficult for students and also for practitioners to imagine three‐dimensional objects in space. The possibilities and convenience of 3D‐reconstructions were demonstrated by generating virtual casts of frontal sinuses.

Methods:  Using a HiSpeed (DX/i Plus, General Electric) scanner transversal CT images of Persian and European Shorthair cats were acquired. The slice thickness and distance were set to 1 mm. With the software system VG Studio MAX 1.1, the obtained volumetric data was used to create volume graphics displaying object surfaces and interiors based on voxel data. Because of density value acquisition, it was possible to identify and label the objects of interest. The extension of the paranasal sinuses was analyzed and demonstrated in relation to the skull. For verification, conventional corrosion casting employing Technovit or Tensolcement, respectively, were carried out on the same specimens.

Results:  The frontal sinuses of both feline breeds showed great variations in size, shape and symmetry. With models from the skull based on 3D‐datasets including the virtual casts of the paranasal sinuses, it was easy to imagine spatial relations and localizations inside the head. The advantages of the virtually derived casting method are: creating the virtual casts in vivo; the method does not imply any health risks and is repeatedly applicable.

Conclusion:  3D‐reconstructions based on CT‐datasets are excellently suited for generating spatial sense. Additionally, a single scan series can be applied for different anatomical problems. The resulting digital 3D‐objects are readily available and can be employed for educational purposes for better comprehension of the difficult spatial relations of the head.
The Origin of Melanomacrophages Centers in Salmo Gairdneri Richardson
Authors: Passantino L. , Ribaud M. R. , Cianciotta A. , Altamura M. , Massaro M. A. , Passantino G. , Jirillo E.
Published: November 2005

By definition, melanomacrophage centres (MMC) consist of aggregates of macrophage‐like pigmented cells located in the kidney and spleen, and to a lesser extent in the liver. In 30 Salmo gairdneri Richardson trout, MMC have been identified in various organs. In the kidney, liver and spleen, respectively, macrophages (MØ) are aggregated in clusters, which are next to vessels. MMC have been cytoenzymatically identified with periodic acid Schiff (PAS), α‐naphthyl acetate esterase (ANAE), peroxidase (PEROX) reactions. Finally, in order to show pigments in the context of MMC, in particular, we used iron stain to detect iron pigments and Prussian blue reaction to detect melanin and lipofuscin. The presence of iron pigments indicates that MMC function as lymphoreticular centres where fish erythrocytes (FE) are destroyed together with other foreign material. In previous studies, we found that FE are able to bind and engulf Candida albicans (CA) without killing this fungus. FE containing engulfed CA form with MØ functional rosettes and, in reason of that MØ are solicited to phagocytose and kill CA. It is likely that rosettes and/or single FE containing engulfed foreign material migrate to distant organs, such as the kidney, the spleen and the liver. Therefore, the MMC may, in part, derive from these peripheral rosettes and pigments result from FE and foreign material digestion and destruction operated by MØ.

Reference  Passantino, L., Cianciotta, A., Jirillo, F., Carrassi, M., Jirillo, E. and Passantino, G.F. 2005: Lymphoreticular system in fish: erythrocyte‐mediated immunomodulation of macrophages contributes to the formation of melanomacrophage centers. Immunopharmacol Immunotoxicol. 27, 147–161.
Secondary or Accessory Glomerular Layer in Mice During Growth
Authors: Quinteiro P. S. , Salazar I.
Published: November 2005

Most mammals have two different structures in which we found glomerular layers at the same time: the main olfactory bulb (MOB) and the accessory olfactory bulb (AOB). Both bulbs have the same pattern of organization, but there are some differences: although the size is considerably bigger in MOB than in AOB, probably the most important difference is that the principal cells are not differentiated into mitral and tufted cells in the AOB, and are usually described as mitral/tufted cells. We have previously observed that in some mammals, like pigs and sheep, the AOB reaches maturity before birth, but this is not a rule for other species. Surprisingly, mice need several days of life to achieve full stratification of its cellular components. We have studied the chronology of this process, focusing our attention on the glomerular layer, the last to appear. We concluded that there are two critical periods, between E11.5 and E16.5 (migration phase) and between E17.5 and P3.5–7 (true morphological constitution).
Ontogenesis of the Chicken Bronchus Associated Lymphoid Tissue (BALT)
Authors: Reese S. , Dalamani G. , Kothlow S. , Kaspers B.
Published: November 2005

The avian lung shows fundamental differences to its mammalian counterpart and is characterized by a larger surface area and a thinner gas‐blood barrier. These features provide the morphological basis for the enhanced respiratory efficiency of the avian lung. However, they also predispose this organ to an increased risk of injury by pathogenic microorganisms. In order to investigate the host–pathogen interaction during pulmonary infection and vaccine delivery by aerosol immunization a detailed knowledge of the structure and ontogenesis of the bronchus associated lymphoid tissue (BALT) is required. For this reason the BALT of chickens aged from 1 day to 6 months was studied by immunohistochemistry (ICC), transmission (TEM) and scanning electron microscopy (SEM) as well as by FACS analysis. During the first 2 weeks after hatching no organized lymphatic structures were found. At this time, the defence system was based on the presence of cells of the unspecific innate immune system. In the third week after hatching lymphoid follicles begin to develop at the branching of primary and secondary bronchi. These develop into a highly organized bronchus associated lymphoid tissue (BALT) characterized by high endothelial venules and a follicle associated epithelium (FAE) with ‘M‐cell‐like’ cells. However, pathogens that have successfully crossed this initial barrier are additionally confronted with large numbers of lymphocytes and macrophages distributed around the parabronchi. Our results imply that the BALT is the first and most important structure encountering antigen and microbial pathogens, thus playing a central role in the initiation of a specific immune response.
A Comparison Between Thrombocytes and Monocyte‐Macrophages in Salmo gairdneri Richardson: A Cytoenzymatic Evaluation
Authors: Ribaud M. R. , Passantino L. , Perillo A. , Jirillo F. , Carrassi M. , Jirillo E. , Passantino G. F.
Published: November 2005

Fish leukocyte heterogenity with respect to morphology, morphometry and immunological function has been object of some controversy, mostly because, in lower vertebrates, there are several interspecies differences. Leukocyte enzyme cytochemistry permits cellular differentiation, which is otherwise not possible with routine stains, and may also indicate cell function. In fish, phagocytic performance is principally operated by monocyte‐macrophages (MØ) present in tissues and in circulating blood. Fish thrombocytes (FTHR), even if they are the equivalent of platelets in mammals, are complete cells with cytoplasm and nucleus. They vary in shape from round, like small lymphocytes, to spindle‐shaped or rod‐shaped cells. Several cytochemical methods, as periodic acid Schiff (PAS), naphthol chloroacetate esterase (ASD), α‐naphthyl acetate esterase (ANAE), peroxidase (PEROX), acid phosphatase (Ac. Phos.) with and without tartaric acid (ta) and alkaline phosphatase (Alk. Phos.) have been applied in Salmo gairdneri Richardson to investigate the expression of MØ and FTHR enzyme patterns. Here, we compared cytochemistry between fish MØ and FTHR, and between human MØ and platelets/megakaryocytes, respectively, as indicated in the table. It appears that positivity to some enzyme cytochemistry is phylogenetically maintained in MØ, while in FTHR the enzyme pattern has undergone modification during evolution. For instance, this is the case of ANAE, Ac. Phos. and Alk. Phos., which changed in the phylogenesis, while PAS, AS‐D, PEROX are still present in the evolution.

PAS
AS‐D
ANAE
Perox
Ac.Phos.‐ta
Ac.Phos.+ta
Alk. Phos

Trout MØ
++
+
++
++
+
−
n.d.

Human MØ
+
+
++
+
−
−
−

Trout THR
−/++
−
−
−
−/+
−
++

Human platelets/ megakaryocytes
+
−
++
−
+
+
−

+, Positive; ++, strongly positive; (, negative; n.d., not determined.
Rhizoctonia solani AG 2‐1 as a causative agent of cotyledon rot on European beech (Fagus sylvatica)
Authors: Hietala A. M. , Mehli L. , Nagy N. E. , Kvaalen H. , La Porta N.
Published: November 2005

Rhizoctonia solani was frequently isolated in the Italian Alps from nursery‐grown European beech (Fagus sylvatica) seedlings displaying symptoms of cotyledon rot. Koch's postulates were verified and mode of infection of the associated isolates was investigated with light and scanning electron microscopy. Population structure of the pathogen was investigated by scoring the anastomosis reaction type in pairings between different isolates from the same seedbed. One pathogen genotype showed a large distribution area within the seedbed, this implying that the inoculum had been building up in the seedbed over a longer time period. Hyphal anastomosis tests and sequence analysis of the internal transcribed spacer (ITS) region of ribosomal DNA indicated that the pathogen belongs to AG 2‐1 of R. solani. ITS sequence analysis indicates that the isolates from beech are closely related to R. solani isolates causing a disease on tulip. The striking similarities between the two diseases are discussed.
Late onset of familial nephrotic syndrome associated with a compound heterozygous mutation of the podocin‐encoding gene (Case Report)
Authors: ARDILES LEOPOLDO G , CARRASCO ALEJANDRA E , CARPIO JUAN D , MEZZANO SERGIO A
Published: November 2005

SUMMARY:  A case of two young adult brothers with nephrotic syndrome secondary to focal segmental glomerulosclerosis is reported. Steroid resistance prompted us to perform genetic studies. These showed a compound heterozygous mutation of NPHS2, the gene encoding podocin. It was composed of a missense mutation in exon 7 (A284V) and the non‐neutral polymorphism R229Q in exon 5. We review literature supporting the genetic basis of the disease.
Multiple myeloma‐associated cast nephropathy with crystal structure: Case report and review of the literature (Case Report)
Authors: CHEN KUO‐JUNG , JAN YEE‐JEE , CHEN CHEN‐HSU , CHENG CHI‐HUNG , WU MING‐JU , SHU KUO‐HSIUNG
Published: November 2005

SUMMARY:  The causes of renal failure are diverse. Among them, monoclonal gammopathy is one important but easily‐missed cause in aged people. Monoclonal gammopathy may produce a large number of abnormal immunoglobulins and/or fragments and produce different kinds of deposition in tissues, including cast, crystal, fibril and granules. Cast nephropathy is considered the hallmark of the renal disease in patients with multiple myeloma. Crystaglobulinemia syndrome and crystal nephropathy, on the other hand, have been rarely reported. Herein, we report a case of multiple myeloma presented with irreversible renal failure. The biopsy showed massive crystal deposition in bone marrow and kidneys.
Spontaneous uterine rupture at 35 weeks’ gestation, 3 years after laparoscopic myomectomy, without signs of fetal distress
Authors: Banas Tomasz , Klimek Marek , Fugiel Andrzej , Skotniczny Krzysztof
Published: November 2005

Laparoscopic myomectomy (LM) is a recently developed surgical technique, and every obstetrician should be aware of its possible complications, which can occur not only during labor but also during pregnancy. We report a case of a primigravid woman who was hospitalized at 35 weeks’ gestation because of irregular abdominal pain. She conceived spontaneously 3 years after LM. After a 20‐h stay on the obstetrician ward due to increased abdominal tenderness and vaginal bleeding, the patient was qualified for an emergency cesarean section without any symptoms of fetal distress in cardiotocography. During cesarean section a newborn with 9 Apgar points was delivered and a rupture of the uterine wall was seen. Dehiscence of the pregnant uterus following LM is an incidental case, and can therefore be misdiagnosed. Close attention should be paid to every pregnancy in previously operated uteri as the dehiscence of the pregnant uterus can occur without symptoms of fetal distress.
Heterogeneity in α‐thalassemia interactions in Malays, Chinese and Indians in Malaysia
Authors: Wee Yong‐Chui , Tan Kim‐Lian , Chow Teresa Wai‐Ping , Yap Sook‐Fan , Tan Jin‐Ai Mary Anne
Published: November 2005

Aim: Interactions between different determinants of α‐thalassemia raises considerable problems, particularly during pregnancies where antenatal diagnosis is necessary. This study aims to determine the different types of deletional α‐thalassemia and Hemoglobin Constant Spring (HbCS), and their frequency in Malays, Chinese and Indians in Malaysia.

Methods: DNA from 650 pregnant women from the Antenatal Clinic of the University of Malaya Medical Center in Kuala Lumpur, Malaysia who showed mean cell volume ≤89 fL and/or mean cell hemoglobin ≤28 pg were analyzed for the double α‐globin gene South‐East Asian deletion (‐‐SEA), the ‐α3.7 and ‐α4.2 single α‐globin gene deletions and HbCS.

Results: One hundred and three (15.8%) of the pregnant women were confirmed as α‐thalassemia carriers: 25 (3.8%) were α‐thalassemia‐1 carriers with the ‐‐SEA/αα genotype, 64 (9.8%) were heterozygous for the ‐α3.7 rightward deletion (‐α3.7/αα), four (0.6%) were heterozygous for the ‐α4.2 leftward deletion (‐α4.2/αα), nine (1.4%) were heterozygous for HbCS (αCSα/αα) and one (0.2%) was compound heterozygous with the ‐α3.7/αCSα genotype. The double α‐globin gene ‐‐SEA deletion was significantly higher in the Chinese (15%) compared to the Malays (2.5%) and not detected in the Indians studied. The ‐α3.7 deletion was distributed equally in the three races. HbCS and ‐α4.2 was observed only in the Malays.

Conclusion: The data obtained gives a better understanding of the interactions of the different α‐thalassemia determinants in the different ethnic groups, thus enabling more rapid and specific confirmation of α‐thalassemia in affected pregnancies where antenatal diagnosis is necessary.
Predicting fetal anemia by using reference centile charts for liver length, spleen perimeter and umbilical vein maximum flow velocity in Thai fetuses throughout gestation
Authors: Chawanpaiboon Saifon , Titapant Vitaya , Sutantawibul Anuwat , Kanokpongsakdi Sujin , Kangkagate Charuwan
Published: November 2005

Aim: To create reference centile charts for liver length, spleen perimeter and umbilical vein maximum flow velocity (UVVmax) in Thai fetuses in order to predict fetal anemia in Thai fetuses.

Methods: The study was a prospective, cross‐sectional study, carried out at the Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University. A total of 780 pregnant women between 13 and 40 weeks’ gestation, who attended the antenatal clinic at Siriraj Hospital, Mahidol University, Bangkok, were recruited. Each fetus was measured only once for the purpose of this study. The mean and standard deviation (SD) were estimated at each week of gestation using linear regression modeling. A total of 752 fetuses were measured for fetal liver length, spleen perimeter and UVVmax. Linear regression models were fitted to estimate the mean 95% confidence interval for liver length, spleen perimeter and UVVmax at each gestational age. The centile charts of those parameters were also presented.

Conclusion: Reference centile charts for fetal liver length, spleen perimeter and UVVmax of Thai fetuses were created.
Fetal hydrops associated with congenital pulmonary myofibroblastic tumor
Authors: Horikoshi Tsuguhiro , Kikuchi Akihiko , Matsumoto Yasuhiro , Tatematsu Mikiko , Takae Kentaro , Ogiso Yoshifumi , Nakayama Masahiro , Unno Nobuya
Published: November 2005

We report on a fetus with a congenital pulmonary myofibroblastic tumor, the prenatal detection of which with imaging modalities has not been reported up until now. A 32‐year‐old woman was referred to our hospital at 29 weeks’ gestation because of severe fetal hydrops. Sonograms and magnetic resonance imaging showed a large solid tumor in the left thorax. The fetus died in utero the next day. Autopsy confirmed that the tumor was confined to the lower lobe of the left lung, and circulatory insufficiency from compression by the tumor was considered to be the cause of fetal hydrops and demise. Histologic examination revealed that the tumor was composed of uniform short spindle cells with no atypia and a large number of vessels. In addition, with immunohistochemical studies, the tumor cells were stained for calponin but not for cluster differentiation (CD)‐31, CD‐34, α‐smooth muscle actin or S‐100.
Occurrence of fetal choroid plexus cysts in siblings: Concerns regarding recurrence and chromosomal abnormality
Authors: Koyama Shinsuke , Kimura Tadashi , Tokugawa Yoshihiro , Koyama Masayasu , Murata Yuji , Shimizu Takashi
Published: November 2005

Choroid plexus cysts (CPC) are a well‐known ultrasound aneuploidy marker easily detectable at second‐trimester ultrasound examination. However, their genetic etiology is totally unknown. We report two cases of Japanese mothers who carried two and three siblings respectively; all the fetuses that had CPC were noticed at second trimester. Genetic amniocentesis revealed that each fetus had different karyotypes, that is, trisomy 18 and 46,XX in the case of one mother, and trisomy 18, 46,XY and trisomy 21 in the case of the other. These observations indicate that the genetic basis of the cysts is not linked to abnormal chromosomes. We propose that careful ultrasound observation and genetic counseling of the siblings should be offered to patients who have previously had a baby with CPC, despite that baby having a normal karyotype.
Discordance in the decline in regional lean and bone mass with advancing age
Authors: Kuwahata Riki , Kuwahata Tomoki , Iwamoto Ichiro , Douchi Tsutomu
Published: November 2005

Aim: To investigate whether regional mineral‐free lean mass (lean mass) and bone mineral density (BMD) decrease equally with advancing age.

Methods: Subjects were 420 premenopausal women and 239 postmenopausal women with right‐side dominance. Age, height, weight, and body mass index were recorded. Lean mass of the arms, trunk and legs were measured by dual‐energy X‐ray absorptiometry (DEXA). BMD of the same segmental regions was measured by DEXA.

Results: Trunk and bilateral leg lean mass were inversely correlated to age (r = −0.240, P < 0.0001, −0.167, P < 0.0001, and −0.183, P < 0.0001, respectively), but arm lean mass did not decrease with aging. Regional lean mass was positively correlated to regional BMD (r = 0.284–0.449, P < 0.0001). BMD was inversely correlated to age in all segmental regions (r = −0.586 to −0.449, P < 0.0001).

Conclusions: Decline in regional lean mass and decline in BMD with advancing age are discordant. Arm lean mass may not contribute to ‘age‐related decline’ in arm BMD, because arm lean mass does not decrease with advancing age in the general population of women.
Case of a giant mucinous ovarian carcinoma with bone metastasis
Authors: Nakamura Manabu , Saitoh Maki , Miyamoto Sumitaka , Kubo Yuko , Tomita Hatsuo , Andoh Akihiko
Published: November 2005

We report the case of a 51‐year‐old Japanese woman with a giant (50.75‐kg) ovarian tumor. The histopathologic diagnosis was mucinous cystadenocarcinoma. After surgery, the patient was intubated and connected to a respirator for 8 days. Thereafter, she was diagnosed with bone metastasis to the hip bone and the femur.
Metastasis of uterine leiomyosarcoma to the pancreas
Authors: Iwamoto Ichiro , Fujino Toshinori , Higashi Yohichi , Tsuji Takahiro , Nakamura Noboru , Komokata Teruo , Douchi Tsutomu
Published: November 2005

Background: Metastasis of uterine leiomyosarcoma to the pancreas is extremely rare.

Case: A 46‐year‐old woman presented with hypermenorrhea and dysmenorrhea and underwent surgery. The histologic and immunohistochemical diagnosis was uterine leiomyosarcoma stage I with no metastasis to the ovaries or the pelvic lymph nodes. The mitotic count was very high. Thereafter, recurrences in the lung and subsequently in the pancreas were detected. The lesions in the lung and pancreas were resected and diagnosed as metastases of uterine leiomyosarcoma based on histology and immunohistochemistry.

Conclusion: We report an extraordinarily rare case of uterine leiomyosarcoma with metastasis to the pancreas following initial metastasis to the lung, both of which were diagnosed using histology and immunohistochemistry of the specimens obtained at surgery.
Ecological resistance, seed density and their interactions determine patterns of invasion in a California coastal grassland
Authors: Thomsen Meredith A. , D'Antonio Carla M. , Suttle Kenwyn B. , Sousa Wayne P.
Published: November 2005

Relatively little experimental evidence is available regarding how ecological resistance and propagule density interact in their effects on the establishment of invasive exotic species. We examined the independent and interactive effects of neighbour cover (biotic resistance), winter vs. spring water addition (abiotic resistance) and seed density on the invasion of the European perennial grass Holcus lanatus into a California coastal grassland dominated by exotic annual grasses. We found that decreased competition from resident exotic grasses had no effect. In contrast, increased late‐season water availability eroded the abiotic resistance offered by naturally dry conditions, facilitating invasion. Finally, watering treatment and seed density interacted strongly in determining seedling survival: while seedling mortality was close to 100% in ambient and winter water addition plots, survivor numbers increased with seed density in spring‐watered plots. Thus, decreased abiotic resistance can amplify the effect of increased propagule density on seedling establishment, thereby increasing the likelihood of invasion.
Maladaptive changes in multiple traits caused by fishing: impediments to population recovery
Authors: Walsh Matthew R. , Munch Stephan B. , Chiba Susumu , Conover David O.
Published: November 2005

Some overharvested fish populations fail to recover even after considerable reductions in fishing pressure. The reasons are unclear but may involve genetic changes in life history traits that are detrimental to population growth when natural environmental factors prevail. We empirically modelled this process by subjecting populations of a harvested marine fish, the Atlantic silverside, to experimental size‐biased fishing regimes over five generations and then measured correlated responses across multiple traits. Populations where large fish were selectively harvested (as in most fisheries) displayed substantial declines in fecundity, egg volume, larval size at hatch, larval viability, larval growth rates, food consumption rate and conversion efficiency, vertebral number, and willingness to forage. These genetically based changes in numerous traits generally reduce the capacity for population recovery.
Treatment of localized prostate cancer using high‐intensity focused ultrasound
Authors: UCHIDA TOYOAKI , OHKUSA HIROSHI , NAGATA YASUNORI , HYODO TORU , SATOH TAKEFUMI , IRIE AKIRA
Published: November 2005

OBJECTIVE

To evaluate the biochemical disease‐free survival (DFS), predictors of clinical outcome and morbidity of patients with localized prostate cancer treated with high‐intensity focused ultrasound (HIFU), a noninvasive treatment that induces complete coagulative necrosis of a tumour at depth through the intact skin.

PATIENTS AND METHODS

In all, 63 patients with stage T1c‐2bN0M0 localized prostate cancer underwent HIFU using the SonablateTM system (Focus Surgery, Inc., Indianapolis, IN, USA). None of the patients received neoadjuvant and/or adjuvant therapy. Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology consensus definition, i.e. three consecutive increases in prostate‐specific antigen (PSA) level after the nadir. The median (range) age, PSA level and follow‐up were 71 (45–87)  years, 8.5 (3.39–57.0) ng/mL and 22.0 (3–63)  months, respectively.

RESULTS

The overall biochemical disease‐free rate was 75% (47 patients). The 3‐year biochemical DFS rates for patients with a PSA level before HIFU of <10, 10.01–20 and >20 ng/mL were 82%, 62% and 20% (P < 0.001), respectively. The 3‐year biochemical DFS rates for patients with a PSA nadir of <0.2, 0.21–1 and >1 ng/mL were 100%, 74% and 21% (P < 0.001), respectively. Final follow‐up sextant biopsies showed that 55 (87%) of the patients were cancer‐free. Multivariate analysis showed that the PSA nadir (P < 0.001) was a significant independent predictor of relapse.

CONCLUSION

HIFU therapy appears to be a safe, effective and minimally invasive therapy for patients with localized prostate cancer, and the PSA nadir is a useful predictor of clinical outcome.
Frequency and nocturia after successful renal transplantation: a normal situation?
Authors: ZERMANN DIRK‐HENRIK , JANITZKY ANDREAS , HÖHNE MATTHIAS , SCHUBERT JÖRG
Published: November 2005

OBJECTIVE

To analyse lower urinary tract function before and after successful renal transplantation and compare the data with those from a healthy control group.

PATIENTS AND METHODS

Data were gathered by retrospective analysis of 331 charts of patients transplanted between March 1998 and May 2003, using written questionnaires and personal interview, and investigation of 150 patients. The control group consisted of 150 urologically healthy volunteers.

RESULTS

Frequency and nocturia were the main lower urinary tract symptoms. Frequency of more than six voids/day was reported by 87% and nocturia of more then one void/night by 93% of all patients after successful renal transplantation. There was no significant correlation with fluid intake, diuretic medication, gender or age. Over the years the number of voids tended to decrease but remained higher than in the control group. However, 94% of all patients were happy with the quality of life after renal transplantation.

CONCLUSION

Frequency and nocturia are the two main characteristics of lower urinary tract function after renal transplantation, probably through a combination of high fluid intake, a long‐term defunctionalized urinary bladder during renal replacement therapy, a denervated donor kidney, concomitant diseases and psychosocial distress. Quality of and satisfaction with life were not compromised.
Functional outcomes and oncological efficacy of Vattikuti Institute prostatectomy with Veil of Aphrodite nerve‐sparing: an analysis of 154 consecutive patients
Authors: KAUL SANJEEV , SAVERA ADNAN , BADANI KETAN , FUMO MICHAEL , BHANDARI AKSHAY , MENON MANI
Published: November 2005

OBJECTIVES

To report updated results, at 1 year of follow‐up, of a modified nerve‐sparing robotic radical prostatectomy that preserves the lateral prostatic fascia (Veil of Aphrodite).

PATIENTS AND METHODS

From January to December 2003, 154 consecutive men had a Vattikuti Institute prostatectomy with Veil of Aphrodite nerve‐sparing by one surgeon. A prospective database recorded patient demographics, intraoperative, peri‐operative, and pathological variables. Peri‐operative complications were recorded using the Clavien classification. Patients had serum prostate‐specific antigen (PSA) levels measured every 3 months and self‐administered the International Prostate Symptom Score and Sexual Health Inventory for Male questionnaires before and at 1 year after surgery.

RESULTS

The men had a mean age of 57.4 years, a mean body mass index of 27.2 kg/m2, and a mean PSA level before surgery of 5.11 ng/mL. The mean operative duration was 122 min. At 1 year, 96% of the men reported having had intercourse and 71% had recovered normal erectile function. One man had a Clavien grade II complication, 4.6% of men with organ‐confined disease had positive surgical margins, and no patient had a PSA recurrence at 12 months; 97% of the men were continent at 1 year, and the median time to continence was 14 days.

CONCLUSION

Veil of Aphrodite nerve‐sparing surgery provides better recovery of sexual function at 1 year than in contemporary series from centres of excellence, without compromising cancer control and urinary function.
Alterations in purinergic and cholinergic components of contractile responses of isolated detrusor contraction in a rat model of partial bladder outlet obstruction
Authors: BANKS FREDERICK C.L. , KNIGHT GILLIAN E. , CALVERT ROBERT C. , MORGAN ROBERT J. , BURNSTOCK GEOFFREY
Published: November 2005

OBJECTIVE

To study the effect of 3 weeks of partial bladder outlet obstruction (BOO), compared to a sham operation, on the cholinergic and purinergic components of detrusor contractile responses to agonists and to electrical field stimulation (EFS); the expression of P2X receptor subtypes was also examined.

MATERIALS AND METHODS

Partial BOO was induced in female Sprague–Dawley rats by surgically applying a jeweller's silver ‘jump’ ring around the urethra, such that the urethra was constricted but not closed. Sham‐operated female rats underwent an identical procedure without placement of a ring.

RESULTS

After 3 weeks of partial BOO the rat bladders became significantly hypertrophied, doubling in weight. Spontaneous activity was markedly increased, but the contractile response to a single bolus of KCl (120 m m) was unaltered. The neurogenic‐induced contractile responses of strips of detrusor from obstructed bladders were significantly greater than those from sham‐operated bladders, and the responses of strips of detrusor from obstructed bladders to EFS showed a significantly greater atropine‐sensitive component than sham‐operated detrusor. However, the response of detrusor strips to EFS that was susceptible to desensitization by α,β‐methylene ATP was not significantly changed in obstructed bladders. The sensitivity of the strips from obstructed bladders to carbachol, ATP and β,γ‐methylene ATP was less than in sham‐operated detrusor. Immunohistochemical studies showed no difference in the P2X receptor subtypes expressed on detrusor smooth muscle from obstructed and sham‐operated rats.

CONCLUSION

In the rat, after moderate bladder hypertrophy, the atropine‐sensitive component was significantly up‐regulated, but the ATP‐sensitive component was marginally reduced, although not significantly. These results suggest that up‐regulation of the P2X component of bladder contraction seen in humans with bladder instability, and in other species models of BOO, is not mirrored in the rat, or occurs later in the pathological process of bladder hypertrophy.
A bipartite system for the constitutive and inducible expression of high levels of foreign proteins in plants
Authors: Cañizares M. Carmen , Liu Li , Perrin Yolande , Tsakiris Estratios , Lomonossoff George P.
Published: November 2005

We have developed combined transgene/virus vector systems for the expression of heterologous proteins in plants. The systems are based on the bipartite RNA plant virus, cowpea mosaic virus (CPMV), and involve the amplification of integrated copies of either full‐length or deleted versions of RNA‐2 carrying a foreign gene. In the case of plants transgenic for full‐length versions of RNA‐2 carrying the green fluorescent protein (GFP), amplification can be achieved by supplying RNA‐1 either exogenously or by crossing. This allows either inducible or constitutive expression of the foreign gene and results in an infection that can be passaged to further plants. Replication of deleted versions of RNA‐2 harbouring GFP requires the presence of both RNA‐1 and a suppressor of gene silencing, a function which we show can be supplied by HcPro from potato virus Y. Replication of the deleted versions of RNA‐2 can be achieved by supplying the suppressor and RNA‐1 either exogenously or by crossing, showing that this system can also be used in an inducible and constitutive format. The use of deleted forms of RNA‐2 has the advantage that no infectious virus is produced, providing an effective method of biocontainment. The CPMV‐based systems have advantages over existing plant expression systems in terms of the expression levels obtainable and the simplicity and flexibility of use, and should be of great practical benefit in the development of plants as bioreactors.
Evidence‐based review of hair removal using lasers and light sources
Authors: Haedersdal M , Wulf HC
Published: November 2005

Background  Unwanted hair growth remains a therapeutic challenge and there is a considerable need for an effective and safe treatment modality.

Objective  From an evidence‐based view to summarize efficacy and adverse effects from hair removal with ruby, alexandrite, diode, and Nd:YAG lasers and intense pulsed light (IPL).

Methods  Original publications of controlled clinical trials were identified in Medline and the Cochrane Library.

Results  A total of 9 randomized controlled (RCTs) and 21 controlled trials (CTs) were identified. The best available evidence was found for the alexandrite (three RCTs, eight CTs) and diode (three RCTs, four CTs) lasers, followed by the ruby (two RCTs, six CTs) and Nd:YAG (two RCTs, four CTs) lasers, whereas limited evidence was available for IPL sources (one RCT, one CT). Based on the present best available evidence we conclude that (i) epilation with lasers and light sources induces a partial short‐term hair reduction up to 6 months postoperatively, (ii) efficacy is improved when repeated treatments are given, (iii) efficacy is superior to conventional treatments (shaving, wax epilation, electrolysis), (iv) evidence exists for a partial long‐term hair removal efficacy beyond 6 months postoperatively after repetitive treatments with alexandrite and diode lasers and probably after treatment with ruby and Nd:YAG lasers, whereas evidence is lacking for long‐term hair removal after IPL treatment, (v) today there is no evidence for a complete and persistent hair removal efficacy, (vi) the occurrence of postoperative side‐effects is reported low for all the laser systems.

Conclusion  The evidence from controlled clinical trials favours the use of lasers and light sources for removal of unwanted hair. We recommend that patients are pre‐operatively informed of the expected treatment outcome.
Correlation between Bcl‐2 and Bax in atrophic and hypertrophic type of actinic keratosis
Authors: Tomas D , Krušlin B , Čupič H , Stanimirovič A , Bošnjak B , Lovričevič I , Belicza M
Published: November 2005

Background  Recent investigations consider actinic keratosis (AK) as an earliest visible pattern of squamous cell carcinoma (SCC). We have analysed the expression of apoptosis‐related proteins TP53, Bcl‐2 and Bax in 30 atrophic and 30 hypertrophic AK cases.

Material and methods  Immunohistochemical analysis was performed following microwave streptavidin immunoperoxidase protocol on DAKO TechMateTM Horizon automated immunostainer (DAKO, Copenhagen, Denmark). Monoclonal antibody for TP53 and Bcl‐2 and polyclonal antibody for Bax (DAKO, Copenhagen, Denmark) were used.

Results  Expression of TP53 showed no significant differences between two analysed groups (χ2‐test, P = 0.35636) whereas expression of Bcl‐2 and Bax protein was significantly higher in atrophic compared to hypertrophic AK (χ2‐test, P = 0.01458 and P = 0.00358, respectively). Comparison of Bcl‐2 : Bax ratio in two analysed AK showed significantly higher value in hypertrophic compared to atrophic AK (Mann–Whitney U test, P = 0.02272). Statistical analysis did not show any correlation between patient's sex and age, localization and size of the lesion with expression of investigated oncoproteins (anova, P > 0.05).

Conclusions  Our results may indicate higher resistance of keratinocytes on apoptotic stimuli in hypertrophic compared to atrophic AK. Thus, we suppose that keratinocytes in hypertrophic AK live longer and probably have higher propensity for additional mutations and conversion to overt SCC.
Pneumococcal cellulitis in an immunocompetent adult
Authors: Bachmeyer C , Martres P , Blum L
Published: November 2005

Streptococcus pneumoniae is a rare cause of cellulitis that develops mainly in patients with underlying chronic disease or those immunocompromised by drug or alcohol abuse. We report here a case of pneumococcal cellulitis in an immunocompetent patient.
Phoneme manipulation not onset‐rime manipulation ability is a unique predictor of early reading
Authors: Savage Robert , Carless Sue
Published: November 2005

Background:  Phonological awareness is known to be an excellent predictor of later reading acquisition. It remains unclear, however, whether phoneme manipulation alone best explains this association or whether an additional direct contribution of onset‐rime awareness is predictive. This issue is explored here.

Method:  A longitudinal study is reported predicting national test and teacher‐assessed performance of 351 children aged 7 from phonological awareness measures, pupil baseline attainment and background measures at age 5.

Results:  Explicit phoneme manipulation skills at age 5 correlated most strongly with literacy skills at age 5. Phoneme manipulation at age 5 predicted all four reading measures taken at age 7 after pupil background, baseline data and onset‐rime awareness were controlled in regression analyses. Onset‐rime manipulation did not predict reading at 7 in parallel analyses. After controlling for initial reading at age 5, phoneme manipulation still predicted reading comprehension, and teacher‐assessed reading and writing at age 7.

Conclusions:  Results support the existence of a route from phoneme manipulation, but not an additional direct route from explicit onset‐rime manipulation at 5, to reading at 7. Practically, findings show that professionals can augment baseline and pupil background data with phoneme manipulation screening in the early identification of learning needs.
Headache and coping in a female working population
Authors: Raak Ragnhild , Wahren Lis Karin
Published: November 2005

Tension‐type headache is a common disorder amongst working people and, because of its very high prevalence, represents one of the most costly ailments in modern society. To study the frequency of tension‐type headache in a working female population and to investigate how females who have experienced tension‐type headache cope with pain compared with the way healthy pain‐free subjects cope with stress. A total of 400 females working at a university hospital in Sweden were asked about their experience of headache in the previous 3 months. Instruments used were a specific Headache Questionnaire, the Jalowiec Stress‐coping Questionnaire and Coping Strategy Questionnaire. Before the study, approval from the board of directors and the employees’ council was obtained. About 257 females (64.3%) answered the questionnaire and 78% of them (n = 199) reported that they had experienced headache in the previous 3 months. About 90% of the participants had never had an appointment with a doctor concerning headache and 57% reported a relationship between stress and headache. Regarding pain‐coping strategy, increased pain behaviour was the most frequent strategy used. With regard to stress‐coping style, a significant difference in the use of emotive style was found between females reporting headache and females not reporting headache. The results indicate that prevention programmes emphasizing stress management and coping may influence the experience of tension‐type headache.
Women's experiences with short admission in abdominal hysterectomy and their patterns of behaviour
Authors: Wagner Lis , Carlslund Anne Mette , Sørensen Mette , Ottesen Bent
Published: November 2005

The aim of this study was to describe how women experienced short admission in abdominal hysterectomy and to describe patterns of behaviours in short admission. A Short admission is now widely used in Denmark in relation to hysterectomy and involves one to two postoperative days. The diagnostic, prognostic and clinical indicators are well described in the literature. Documentation however, is sparse regarding the experiences of the women involved. This article presents and discusses the women's own experiences and the impact of the short admission. The results are part of a lager evaluation of women and staff experiences overall. The design is exploratory and descriptive. Ten women who underwent a hysterectomy were selected consecutively from August 2001 and were followed from their initial examination to 1 month following hospital discharge. Data were collected by individual interviews. To grasp a complex reality and patterns of behaviour a typical‐type methodology were used. As a result three types of women were identified: (i) The intervening type, (ii) the cooperative type and (iii) the unsure type. The women considered dialogue with the staff to be essential in short admissions. Women in this study who described emotional reactions considered it important that staff do not refrain from speaking about sensitive subjects. In conclusion the importance of dialogue creates new demands for the staff, as somatic care in this context has changed to be more oriented towards information and follow‐up. The women in this study did not have any physical side effects but reported some psychological areas of importance. An outpatient clinic staffed by nurses could cover the needs of the woman.
Daily living with hyperacusis due to head injury 1 year after a treatment programme at the hearing clinic
Authors: Hallberg Lillemor R‐M , Hallberg Ulrika , Johansson Mattias , Jansson Gunilla , Wiberg Agne
Published: November 2005

The aim of this study was to gain a deeper understanding of the quality of daily living of persons with hyperacusis after a traumatic head injury 1 year after these persons had participated in a treatment programme at a Swedish hearing clinic. The study group consisted of 21 patients with a mean age of 36 years. In‐depth interviews, conducted 1 year after the treatment programme, were analysed using the grounded theory method. Five emergent categories were labelled moderating vulnerability, awareness of restrictions, conditioned participation, structuring daily life and controlling mood changes. The core category, moderating vulnerability, describes the necessary balancing act between activity and recovery. The informants were aware of their new restrictions and managed daily life by structuring and planning each day in detail to minimize exposure to sensory stimuli. They had learned to prioritize their activities and, thereby, rationed their time. The evaluated programme appears to have positive effects and facilitates patients’ adjustment process to hyperacusis with relatively restricted costs for the society.
The SEIQoL and functional status: how do they relate?
Authors: Lhussier Monique , Watson Bill , Reed Jan , Clarke Charlotte Laura
Published: November 2005

Over recent years, an emphasis has emerged in the UK and international policy documents, over the involvement of people in the delivery of health care. However, evaluations of health services still largely rest on outcome measures that reflect professional concerns. As new health services are being developed, new patient‐centred outcome measures are needed to evaluate them. This paper aims at exploring the possibility of individual quality of life as an outcome measure for health services. As a first step, it aims to elucidate the relationship of functional outcome measures to the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) in groups of people whose age or medical diagnosis serve as the basis for health service design. Its objectives are to study the relation of SEIQoL scores and life areas to functional status in an older population and in a group of people with chronic obstructive pulmonary disease (COPD). Older people selected their health most frequently as one of the most important areas in their life (9.9%, vs. 8.6% for people with COPD) and were more satisfied with it (U = 2512, p = 0.007). People's health status did not impact on the way they defined their quality of life, but on their level of satisfaction with discrete life areas. The weights attributed to health were significantly negatively correlated to people's overall quality of life score in the overall sample (ρ = −0.34, p < 0.001). In the light of recent national and international policy documents advocating for the development of new, more person‐centred health services, our results support the proposition of the authors of SEIQoL, that individual quality of life measures have the potential to bring a significant contribution to the evaluation of health services.
Care of elderly lower limb amputees, as described in medical and nursing records
Authors: Bäck‐Pettersson Siv , Björkelund Cecilia
Published: November 2005

The aim of this study was to characterize elderly lower limb amputees and explore problems/requirements inherent in their care. A retrospective study of medical and nursing records of patients who had undergone lower limb amputation (LLA) at Uddevalla General Hospital in 1997 was conducted. Demographic data were compared with those from a comparable regional health care district. Hospitalization, rehabilitation and nursing‐related data related to subjects alive after 6 months were compared with data concerning those deceased during hospital stay and within 6 months after amputation. During the defined period, the study population consisted of 45 patients aged 60 and above. Fifty‐six percent were men, with a mean age of 81.6. Eight patients died in the hospital post‐amputation and five died within 6 months of surgery. The aetiology of the diagnosis leading to the LLA was cardiovascular disease in the majority of cases. The most common amputation level was below the knee. LLA patients were reported to have major problems maintaining physical and mental functions, markedly deteriorated general health status and severe pain problems.

LLA patients require well functioning and qualified care and rehabilitation. The patients surviving after 6 months had permanent problems in the area of nutrition, elimination, skin ulceration, sleep, pain and pain alleviation. The patients who died during the hospital stay had problems in all these areas. With increasing shorter stays in hospital and decreasing resources in primary and municipal care, there is a risk that these patients’ needs and requirements for professional care might be underestimated and thus remain unfulfilled.