bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of RET polymorphisms in a six‐generation family with G533C RET mutation: specific RET variants may modulate age at onset and clinical presentation
Authors: Tamanaha Rosana , Camacho Cléber P. , Pereira Alexandre C. , Da Silva Adriana M. Álvares , Maciel Rui M. B. , Cerutti Janete M.
Published: December 2008

Context  We previously described a six‐generation family with G533C RET mutation and medullary thyroid carcinoma, in the largest family reported do date. Of particular interest, phenotype variability regarding the age of onset and clinical presentation of the disease, was observed.

Objective  We evaluate whether single SNPs within RET oncogene or haplotype comprising the RET variants (defined by Haploview) could predispose to early development of MTC in this family and influence the clinical manifestation.

Design  Eight SNPs were selected based on their previous association with the clinical course of hereditary or sporadic MTC, in particular promoting an early onset of disease. The variants were initially tested in 77 G533C‐carriers and 100 controls using either PCR‐direct sequencing or PCR–RFLP. Association between a SNP or haplotype and age at diagnosis or presence of lymph node metastasis was tested in 34 G533C‐carries with MTC. Different bioinformatic tools were used to evaluate the potential effects on RNA splicing.

Results  An association was found between IVS1–126G > T and age at diagnosis. The variant [IVS8 +82A > G; 85–86 insC] was associated with the presence of lymph node metastases at diagnosis. In silico analysis suggested that this variant may induce abnormal splicing. This in silico analysis predicted that the [IVS8 +82A > G; 85–86 insC] could alter the splicing by disrupting and/or creating exonic splicing enhancer motifs.

Conclusions  We here identified two RET variants that were associated with phenotype variability in G533C‐carriers, which highlights the fact that the modifier effect of a variant might depend on the type of mutation.
Hyperparathyroidism during pregnancy and the effect of rising calcium on pregnancy loss: a call for earlier intervention
Authors: Norman James , Politz Douglas , Politz Laura
Published: December 2008

Introduction  Hyperparathyroidism (HPT) during pregnancy is rare but poses a significant danger to mother and baby yet the incidence of pregnancy loss and its relationship to the degree of calcium elevation is not known.

Design  A retrospective patient series from a single practice examined the past and current obstetrical histories of pregnant patients with primary HPT.

Results  Over a period of 6‐years, 32 women age ranging from 19 to 40 years had a total of 77 pregnancies while having elevated serum calcium levels because of primary HPT (incidence 0·7% of all women with primary HPT). Fifteen patients underwent parathyroidectomy during the second trimester resulting in an uneventful delivery of a healthy infant between 36 and 40 weeks gestation. There were no maternal or infant complications at surgery or during the subsequent delivery. Thirty of the remaining 62 pregnancies (48%) were lost, a rate that is 3·5‐fold higher than expected (P < 0·05). In those who did not have the HPT addressed after the first miscarriage, one‐third lost one or more additional pregnancies. Pregnancy loss occurred typically in the late first or early second trimester, with second trimester losses (30%) being sixfold higher than expected (P < 0·01) and over 4 weeks later than typical (P < 0·05). Foetal loss was seen at all levels of elevated maternal calcium but most were above 11·4 mg/dl (2·85 mmol/l). The rate of foetal loss increased directly with increasing maternal serum calcium levels (R = 0·972).

Conclusions  HPT during pregnancy is under recognized and is associated with a 3·5‐fold increase in miscarriage rates. Pregnancy loss often occurs in the second trimester and is associated with multiple miscarriages when not addressed. Pregnancy loss is more common as calcium levels exceed 11·4 mg/dl (2·85 mmol/l), but can be seen at all elevated calcium levels. Emphasis is placed on earlier recognition and surgical cure before becoming pregnant, however, once pregnant, surgery should be offered early in the second trimester for those with calcium levels above 11·4 mg/dl.
Use of 6‐[18F]‐fluorodopamine positron emission tomography (PET) as first‐line investigation for the diagnosis and localization of non‐metastatic and metastatic phaeochromocytoma (PHEO)
Authors: Timmers Henri J. L. M. , Eisenhofer Graeme , Carrasquillo Jorge A. , Chen Clara C. , Whatley Millie , Ling Alexander , Adams Karen T. , Pacak Karel
Published: December 2008

Objective  Imaging modalities available for the localization of phaeochromocytoma (PHEO) include computed tomography (CT), magnetic resonance imaging (MRI), [123I]‐ or [131I]‐labelled metaiodobenzylguanidine (123/131I‐MIBG) scintigraphy and 6‐[18F]‐fluorodopamine (18F‐FDA) positron emission tomography (PET). Our aim was to investigate the yield of 18F‐FDA PET vs. biochemical testing and other imaging techniques to establish the diagnosis and location of PHEO.

Patients and measurements  The study included 99 consecutive patients (35 Males, 64 Females, mean ± SD age 46·4 ± 13·4 years), who underwent 18F‐FDA PET, biochemical testing (plasma catecholamines and free metanephrines) and CT and/or MRI. The majority (78%) also underwent 123/131I‐MIBG.

Results  In total 26 patients had non‐metastatic PHEO, 34 patients had metastatic PHEO, and PHEO was ruled out in 39 patients. Investigations to rule out or confirm PHEO yielded the following sensitivity/specificity: plasma metanephrines 97/95%, 18F‐FDA 92/90%, 123I‐MIBG 83/100%, 123/131I‐MIBG 70/100%, CT 100/41%, MRI 98/60%. Sensitivities for localizing non‐metastatic PHEO on a per‐lesion base were: CT 97%, MRI 92%, 18F‐FDA 78%, 123I‐MIBG 78% and 123/131I‐MIBG 76%. Sensitivities for detecting metastases on a per‐patient base were: CT and MRI 100%, 18F‐FDA 97%, 123I‐MIBG 85% and 123/131I‐MIBG 65%.

Conclusion  For tumour localization, 18F‐FDA PET and 123/131I‐MIBG scintigraphy perform equally well in patients with non‐metastatic PHEO, but metastases are better detected by 18F‐FDA PET than by 123/131I‐MIBG.
Distribution of serotonin receptors and interacting proteins in the human sigmoid colon
Authors: Chetty N. , Coupar I. M. , Tan Y. Y. , Desmond P. V. , Irving H. R.
Published: December 2008

Abstract This study aimed to examine the distribution of 5‐HT receptors in the human colon. 5‐HT induces desensitization of the circular muscle and as this is facilitated by G‐protein coupled receptor kinases (GRKs) and other proteins, we also examined their distribution. Human sigmoid colon samples were dissected into three separate layers (mucosa, taeniae coli and intertaenial strips) and RNA was amplified by RT‐PCR. The 5‐HT2Breceptor and all 5‐HT7receptor splice variants were expressed in all tissues. 5‐HT4a,b,c and n splice variants were also expressed in all tissues and 5‐HT4d, 5‐HT4gand 5‐HT4iwere only detected in some samples. The 5‐HT2Areceptor was seen predominantly in the intertaenial strips of the colon. Only one transcript of the serotonin transporter (SERT) was detected in the muscle layers. Variation was seen in GRK expression with GRK2 and 3 predominantly expressed in the mucosa, while GRK5 and 6 were found more commonly in the taeniae coli. PDZ (named after postsynaptic density protein, Drosophila disc large tumour suppressor and tight junction protein ZO‐1) domain containing proteins, which may be involved in 5‐HT receptor trafficking, were also detected throughout the sigmoid colon. The 5‐HT3Asubunit was expressed in all tissues, whereas the 5‐HT3Esubunit was mainly found in the mucosa layer while the 5‐HT3Bsubunit was more common in the muscle layers. Receptor interacting chaperone (RIC‐3), which is involved in transporting 5‐HT3receptor subunits, is expressed less in mucosa compared to muscle layers. In conclusion, these results show that there is variation in distribution of 5‐HT receptors and interacting proteins within the sigmoid colon that may contribute to colonic function.
Factors influencing flight potential of Choristoneura conflictana
Authors: ELLIOTT CHRISTINA G. , EVENDEN MAYA L.
Published: December 2008

Abstract Factors affecting the flight potential of Choristoneura conflictana, an insect that undergoes cyclical changes in population density, are investigated using computer‐linked flight mills. Female and male moths are flown for a 12‐h period and the longest single flight and total flight distance of each moth is recorded. After flight bioassays, moths are subjected to lipid extraction with a soxhlet apparatus to determine the effect of body lipid content on flight. Larger C. conflictana moths fly farther than smaller moths. Female C. conflictana fly farther than male moths but the effects of both mating status and moth age on the distance flown are dependent on sex. Mated females fly farther than virgins and older females fly farther than young females but these relationships do not occur in males. Body lipid content affects the distance flown by both females and males through a significant interaction with sex and age. The factors examined in this study will vary with density in natural populations and are predicted to be important indicators of flight potential and dispersal in this species.
Identification of the adipokinetic hormone of the large milkweed bug Oncopeltus fasciatus
Authors: LORENZ MATTHIAS W. , KELLNER ROLAND , TEMNOW KATJA , WOODRING JOSEPH
Published: December 2008

Abstract The adipokinetic hormone (AKH) of the large milkweed bug Oncopeltus fasciatus is isolated from an acidified methanolic extract of 200 corpora cardiaca, purified by single step reversed phase high‐performance liquid chromatography (HPLC) and N‐terminally deblocked using pyroglutamate aminopeptidase. The sequence is identified by Edman degradation and matrix assisted laser desorption/ionization‐time of flight mass spectroscopy as pGlu‐Leu‐Asn‐Phe‐Ser‐Pro‐Asn‐Trp amide. This structure is confirmed by chemical synthesis and coelution of native and synthetic peptide on HPLC. The AKH of O. fasciatus is identical to Tenmo‐HrTH, a member of the adipokinetic/red pigment‐concentrating hormone peptide family that had been isolated earlier from several tenebrionid beetles. Tenmo‐HrTH causes a significant rise in the concentration of haemolymph lipids when injected into adult male and female O. fasciatus, but displays no hyperglycaemic activity. There is no indication of the presence of other AKHs in O. fasciatus. The large milkweed bug represents the first member of the seed bugs (Lygaeidae) for which the endogenous AKH has been identified.
Alloanti‐c in a c‐positive, JAL‐positive patient
Authors: Ong J. , Walker P. S. , Schmulbach E. , Storry J. R. , Vege S. , Westhoff C. , Lomas‐Francis C. , Reid M. E.
Published: December 2008

Background and Objectives  In the Rh blood group system, partial D, C, and e antigens are well‐known, but a partial c antigen resulting in the production of alloanti‐c in a c+ individual is rare. One example of an alloanti‐c in a c+ person was an anti‐Rh26, which can appear as anti‐c, and another was an alloanti‐c in a c+ person with a presumed R1r phenotype. The finding of an apparent alloanti‐c in a transfused c+ patient initiated this investigation.

Materials and Methods  Haemagglutination tests, DNA extraction, polymerase chain reaction (PCR)‐based assays (PCR‐restriction fragment length polymorphism, allele‐specific PCR), reticulocyte mRNA extraction, reverse transcriptase (RT)‐PCR and sequencing were performed by standard procedures.

Results  Plasma from a 64‐year‐old African American woman with a wound infection following a mastectomy contained anti‐E, anti‐S, anti‐K, anti‐Fya and anti‐Jkb, reacting by the indirect antiglobulin test. In addition, the patient's plasma gave reactions that were consistent with an anti‐c, while her pre‐transfusion red blood cells typed c+ with some anti‐c reagents. These results are consistent with a partial c antigen. The patient's red blood cells also typed V+WVS– and JAL+. Analyses of DNA and Rh‐transcripts from this patient showed the presence of the following genes: RHD*D, RHD*DAU0, RHCE*Ce and RHCE*ceS(340).

Conclusion  The nucleotide 340C>T change in RHCE exon 3 (predicted to encode 114Trp) of the RHCE*ceS(340) allele is associated with a JAL+ phenotype and the altered expression of the c, V and VS antigens. This alteration in the c antigen allowed the patient to make an alloanti‐c. This case reveals that the RHCE*ceS(340) allele encodes a partial c antigen.
Clonal integration supports the expansion from terrestrial to aquatic environments of the amphibious stoloniferous herb Alternanthera philoxeroides
Authors: Wang N. , Yu F.‐H. , Li P.‐X. , He W.‐M. , Liu J. , Yu G.‐L. , Song Y.‐B. , Dong M.
Published: December 2008

Effects of clonal integration on land plants have been extensively studied, but little is known about the role in amphibious plants that expand from terrestrial to aquatic conditions. We simulated expansion from terrestrial to aquatic habitats in the amphibious stoloniferous alien invasive alligator weed (Alternanthera philoxeroides) by growing basal ramets of clonal fragments in soils connected (allowing integration) or disconnected (preventing integration) to the apical ramets of the same fragments submerged in water to a depth of 0, 5, 10 or 15 cm. Clonal integration significantly increased growth and clonal reproduction of the apical ramets, but decreased both of these characteristics in basal ramets. Consequently, integration did not affect the performance of whole clonal fragments. We propose that alligator weed possesses a double‐edged mechanism during population expansion: apical ramets in aquatic habitats can increase growth through connected basal parts in terrestrial habitats; however, once stolon connections with apical ramets are lost by external disturbance, the basal ramets in terrestrial habitats increase stolon and ramet production for rapid spreading. This may contribute greatly to the invasiveness of alligator weed and also make it very adaptable to habitats with heavy disturbance and/or highly heterogeneous resource supply.
Phenotype and genotype of Dent's disease in three Chinese boys
Authors: LI PENG , HUANG JIAN‐PING
Published: December 2008

Aim:  Dent's disease represents a group of hereditary renal tubular disorders mainly characterized by hypercalciuria, nephrocalcinosis and low molecular weight proteinuria. The majority of patients with Dent's disease were found to carry CLCN5 gene mutations, whereas a small fraction of patients carry OCRL1 gene mutations. Up to date, over 100 patients with Dent's disease have been reported to carry CLCN5 gene mutations, but none in Chinese patients. The purpose of this study was to investigate the phenotypes and genotypes of three Chinese boys with Dent's disease.

Methods:  Three patients from three unrelated families were studied. Genomic DNA was extracted from peripheral white blood cells using a simple salting out procedure after informed consent. Thirteen pairs of primers were used to amplify all coding exons and exon–intron boundaries of the CLCN5 gene by polymerase chain reaction (PCR). All PCR products were sequenced directly on an autosequencer.

Results:  Low molecular weight proteinuria and hypercalciuria were found in all patients, nephrocalcinosis in two patients and hypophosphataemia in two patients. Three mutations of the CLCN5 gene were revealed, including R467X, L594fsX595 and R637X. Each mutation was inherited from maternal DNA, respectively. The mutation L594fsX595 was never reported before.

Conclusion:  Low molecular weight proteinuria and hypercalciuria were the main clinical features of the three Chinese boys with Dent's disease. Our study was the first to demonstrate CLCN5 gene mutations in Chinese patients with Dent's disease and we reported a novel mutation.
Effect of reactive oxygen species in semen on the pregnancy of infertile couples
Authors: Yumura Yasushi , Iwasaki Akira , Saito Kazuo , Ogawa Takehiko , Hirokawa Makoto
Published: December 2008

Objective:  We intended retrospectively to investigate whether reactive oxygen species (ROS) levels, detected in whole semen, were correlated with the actual pregnancy rate.

Methods:  A total of 89 patients with data of ROS in semen, attending our male infertility clinics from April 1994 to June 2000, were evaluated. Semen parameters were determined with computer assisted semen analyzer (CASA) and ROS production levels were measured using a computer‐driven LKB Wallac 1251 Luminometer after the addition of 40 µL of 4 mM luminol at the patients’ first visits. All of the participants were inquired about their partners’ pregnancies after the mean follow‐up of 24.0 months (range 1.4 to 74.1). They were divided into two groups (pregnant group: n = 41, non‐pregnant group: n = 48) and their characteristics, semen profiles and integrated ROS levels were analyzed.

Results:  There was no difference between the pregnancy rate of ROS detectable cases and negative cases. However, the mean integrated ROS level in detectable cases of the non‐pregnant group was significantly higher than that in detectable cases of the pregnant group (115.61 ± 74.32 mV/30 min/106 sperm versus 7.22 ± 4.69 mV/30 min/106 sperm, P = 0.0033). Then, by calculating the receiver operating characteristics curve with 95% confidence intervals, 4.35 mV/30 min/106 sperm was considered as a cut‐off value of ROS in semen for pregnancy.

Conclusion:  These results indicate that (i) highly detectable ROS in whole semen of infertile patients may have implications in their partners’ pregnancies and that (ii) detection of ROS in whole semen has a prognostic value for idiopathic male infertility.
Effects of insulin replacement on ejaculatory dysfunction in streptozotocin‐induced diabetic rats
Authors: Yonezawa Akihiko , Ebiko Manabu , Yoshizumi Masaru , Ise Shin‐nosuke , Watanabe Chizuko , Mizoguchi Hirokazu , Iwasaki Masahiro , Kimura Yukio , Sakurada Shinobu
Published: December 2008

Objectives:  To investigate the effects of insulin replacement on ejaculatory dysfunction in streptozotocin (STZ)‐induced diabetic rats.

Methods:  Rats were divided into three groups: (i) STZ‐treated group; (ii) STZ‐treated + insulin replacement (5 and 2 international units [IU]) group; and (iii) control group. The ejaculatory function in rats was evaluated using the spontaneous seminal emission (SSE) test. The amount of seminal vesicle fluid (SVF) stored in seminal vesicle was measured after the SSE test. Blood glucose was measured using a simplified blood glucose meter.

Results:  In the SSE test, the ejaculatory capacity in STZ‐induced diabetic rats deteriorated with time after the onset of diabetes, and the incidence of SSE and the amount of ejaculated seminal material (SM) were significantly decreased from 5 weeks after STZ administration. Likewise, the amount of SVF was also significantly decreased in a time‐dependent manner. One week after STZ administration when ejaculatory capacity had not yet diminished, insulin replacement (for 4 weeks) completely prevented the decrease in frequency of SSE, the amount of SM and SVF. However, insulin replacement after the dysfunction had occurred (5 or 15 weeks after STZ administration) did not allow all parameters for ejaculatory function to be restored to the levels of the control group.

Conclusion:  This study demonstrates that at an early stage following the onset of diabetes, insulin replacement can prevent ejaculatory dysfunction in STZ‐induced diabetic rats, but once the dysfunction occurs, treatment with insulin alone does not restore the ejaculatory capacity to normal levels. In addition, this study suggests that the loss of seminal emission that results from a decrease in SVF may be involved in the mechanism of ejaculatory dysfunction in diabetic rats.
HYPERPARATHYROIDISM AND RENAL CALCULI
Authors: MILLER ASHTON , MITCHELL J. P.
Published: December 2008

A case is described of bilateral renal calculi due to hyperparathyroidism in which no skeletal changes were found. A brief survey is given of all similar cases in the literature.

The incidence of renal calculi in hyperparathyroidism and, conversely, of hyperparathyroidism in all cases of renal calculi, is discussed.

Attention is drawn to the fact that unilateral renal calculi may be due to hyperparathyroidism.

In the early stages of the disease, hyperparathyroidism is more liable to produce renal lithiasis than skeletal changes.

A brief survey is given of the criteria for diagnosis of hyperparathyroidism.

It is suggested that the possibility of hyperparathyroidism should be considered in all cases of multiple renal calculi, whether unilateral or bilateral.
TERRAMYCIN IN THE TREATMENT OF INFECTIONS OF THE URINARY TRACT
Authors: GOULD J. C. , MACLEOD J. G. , O'FLYNN J. DERMOT
Published: December 2008

1. Twenty‐five cases of infection of the urinary tract were treated with terramycin; there was a marked difference between the clinical and bacteriological results.

2. Clinical cures numbered ten, whilst fourteen cases improved, and only one was regarded as a failure.

3. In only two of the cases were the infecting bacteria eliminated; in the remainder the original infecting species remained or replacement species were isolated.

4. The organisms isolated before the start of treatment were sensitive to terramycin; all the organisms present after treatment were more or less resistant to the antibiotic.

5. The urinary concentration of terramycin was always many times the in vitro concentration required to inhibit the growth of the organisms concerned.

6. The significance of these results is discussed and certain conclusions are drawn.

We are indebted to Professor T. J. Mackie, Professor L. S. P. Davidson, and Mr David Band for much helpful criticism. Messrs Chas. Pfizer and Co. kindly supplied the terramycin.
SOME PROLIFERATIVE and METAPLASTIC CHANGES IN TRANSITIONAL EPITHELIUM
Authors: Johnson F. R.
Published: December 2008

A study of the frequency of occurrence of some forms of epithelial aberrancy in the urinary tract in man has shown that subepithelial masses of epithelial cells and epithelial crypts are extremely common. The exact form of these two abnormalities is described and their manner of formation and relationship to pyelitis cystica and pyelitis glandularis are discussed. Some of the conclusions reached are supported by experimental evidence and by a study of the urinary tract in the horse.
A CASE OF SARCOMA OF THE URINARY BLADDER IN VON RECKLINGHAUSEN'S DISEASE
Authors: Ross James A.
Published: December 2008

A case of sarcoma of the urinary bladder occurring in a patient suffering from von Recklinghausen's disease is recorded, and the patient's progress is described.

The histology of the tumour and views regarding its origin are discussed.
RIGHT NEPHRECTOMY and LEFT HEMINEPHRECTOMY IN A CHILD
Authors: Talbot C. H.
Published: December 2008

A case of bilateral duplication of the renal tract in a child is described.

 Three of the four nephro‐ureteral segments were removed.

 The remaining nephro‐ureteral segment is free from infection and is an adequate excretory organ for the child.
CYSTIC DISEASE OF THE RENAL PYRAMIDS
Authors: FENNA LOIS R.
Published: December 2008

A case of cystic disease of the renal pyramids is presented. The condition did not give rise to any symptoms, and was discovered after the patient had died from an unrelated disease.

Thanks are due to Dr A. V. Jackson for preparation of the material for this case.
BACTERIOLOGICAL STUDIES OF URINARY TRACT INFECTION
Authors: WHITBY J. L. , MUIR G. G.
Published: December 2008

A series of 330 consecutive specimens of urine is reported and the frequency of isolation of the various infecting organisms is recorded. One‐third of all infected urines received were regarded as growing contaminants rather than true pathogens.

A larger series of Gram‐negative organisms isolated from urine is also analysed. Esch. coll was found to be the most frequent urinary pathogen isolated. The incidence of organisms described as atypical coliforms is discussed and Esch. freundii was found in 12–8 per cent, of infections. The incidence of K. aerogenes infection was only 2 per cent.
FURTHER OBSERVATIONS ON THE EFFECTS OF THE ORAL ADMINISTRATION OF POLYSODIUM METAPHOSPHATE IN THE RAT
Authors: ANDERSON C. K. , CARE A. D. , NOLAN BERNARD , WILSON G.
Published: December 2008

1. The oral administration of polysodium metaphosphate in the rat causes an increase in the incidence of the scattered foci of calcification found in the kidneys of a small proportion of normal animals.

2. No abnormal calcification occurred in other tissues.

3. Mortality was not increased.

4. Growth was not affected.

5. Fertility, pregnancy, and lactation appear to be unaffected.

6. The determination of the dosage which gives the maximum suppression of urinary calculus formation for the minimum increase in renal parenchymal calcification is discussed.

We wish to thank Professor L. N. Pyrah and Professor M. F. A. Woodruff for providing facilities for these experiments in their laboratories at Leeds University and Edinburgh University respectively, the Secretary of State for Scotland for the grant of financial assistance, and Messrs Albright & Wilson Ltd. for the supplies of polysodium metaphosphate.
COLLATERAL BLOOD SUPPLY TO THE RABBIT KIDNEY AFTER LIGATION OF THE RENAL ARTERY
Authors: O'MORCHOE C. C. C.
Published: December 2008

In nineteen rabbits subjected to left renal arterial ligation it was demonstrated by neoprene injection that the collateral circulation followed three main pathways. The most important involved dilated ureteric branches of the renal artery. The second involved one or two perihilar branches of the renal artery which anastomosed with branches of the lumbar arteries. In twelve instances the kidneys possessed perforating capsular vessels which anastomosed with arteries of the perirenal region.

The number of collateral vessels after two and six weeks was no greater than after one week.

The size of the vascular tree depended upon the extent of the collateral circulation and decreased from approximately one‐third the size of the controls at one week to approximately one‐fifth the size of the controls at six weeks. The preservation of glomeruli was discussed.
A TEST TO DETERMINE TRANSURETHRAL RESECTION ABILITY
Authors: ROWAN ROBERT L.
Published: December 2008

An attempt has been made to study the depth perception abilities of ten subjects using a transurethral resectoscope and a fixed target. The results were measurable in millimetres of distance from the target at the end‐point. It is assumed that subjects with a low score in the transurethral resectoscope depth perception simulator would be better resectionists if properly trained than those with a high score. The findings coincide with the belief that depth perception is an innate capacity which when present would enhance the ability to master the skill for doing transurethral resections.
UROLOGICAL MANAGEMENT DURING THE INITIAL PHASE OF TRAUMATIC PARAPLEGIA1
Authors: BAND DAVID
Published: December 2008

The physiological and clinical basis for the use of continuous urethral catheter drainage in the initial management of traumatic paraplegia is presented, and the application of the method is described in detail.

The value of cystometry as a guide to the correct use of a catheter regime is illustrated.

The results of this method of management in a small group of patients are summarised.

I would like to acknowledge the skill and care exercised by Mr G. F. Murnaghan in the urological management of the patients in the Spinal Injuries Unit at Edenhall Hospital.
THE EFFECT OF THE INTRAVENOUS INJECTION OF SUCCINYLCHOLINE ON MICTURITION: AN ELECTROMYOGRAPHIC STUDY1
Authors: PETERSEN I. , DHUNÉR K.‐G.
Published: December 2008

We have studied the influence of intravenously administered succinylcholine on micturition in ten healthy adult subjects. The activity of the striated urethral sphincter was determined by electromyography. As a comparison, the activity of the first interosseous muscle of the hand was also recorded.

We found a decidedly increased resistance to the paralysing effect of succinylcholine on the striated urethral sphincter as compared to the muscle of the hand. Artificial respiration became necessary even when a barely noticeable reduction of the activity in the urethral sphincter had been recorded.

Eight of our subjects could not begin the act of micturition after administration of succinylcholine, despite their having been trained before the experiment to void in a recumbent position and after catheterisation.

One subject could not begin and interrupt the act of micturition until some of the striated urethral activity had been regained following administration of succinylcholine.

One subject could both start and interrupt the act of micturition after the activity of the striated muscle in the external urethra had disappeared completely following an injection of succinylcholine.

This investigation has been supported by grants from the Swedish Medical Research Council and the Medical Society of Goteborg, Sweden.
THE ROLE OF THE FEMALE URETHRA IN INFECTIONS OF THE URINARY TRACT1
Authors: Moore Thomas , Hira N. R.
Published: December 2008

The female urethra is a complicated tube into which open many ducts and glands, the homologue of the male prostate.

It is frequently the site of infection giving rise to the well‐known syndrome of recurrent cystitis of women. The writers believe the infection is in the para‐urethral glands and therefore the condition is really a female prostatitis.

A detailed analysis of 150 cases is presented.

Diagnosis can be made accurately by a differential urethrovesical urinary cell count.

The condition is not usually a serious one and rarely leads to upper urinary tract changes.

The incidence of pyelonephritis in this series was 5–6 per cent.

We are particularly indebted to Professor P. J. Collard, Dr R. M. Stirland and Dr T. Beswick of the Department of Bacteriology, and Professor A. C. P. Campbell, Professor of Pathology, University of Manchester, for all their interest and help. We are also very indebted to Dr H. W. Ashworth of the Department of General Practice of the University of Manchester for allowing us access to some of his records; to Dr W. M. C. Allen of the Altrincham General Hospital for the cysto‐urethrographic studies; and, as ever, to Dr R. G. W. Ollerenshaw and members of the staff of the Department of Medical Illustration of the Manchester Royal Infirmary for their help with the illustrations. We are also extremely grateful to the members of the nursing staff of the Manchester Royal Infirmary who so willingly acted as controls in the urinary cell count studies and to the Matron, Miss W. F. Morgan, for allowing the investigations to be carried out on members of her staff.
UROLOGICAL SURVEY OF CHRONIC PYELONEPHRITIS AND RECURRENT URINARY INFECTION WITHOUTOBSTRUCTION1
Authors: Murnaghan By G. F. , Williams H. B L. , Jeremy D.
Published: December 2008

Symptoms.‐Sixteen patients (8 per cent.) presented without symptoms referable to the urinary tract whilst sixty‐eight patients (33 per cent.) presented with hæmaturia alone or with other urinary

A urological survey of a consecutive series of 207 patients with urinary tract infection or chronic pyelonephritis without obstruction is presented.

The incidence of vesico‐ureteric reflux, urethritis, trigonitis, cervicitis, renal papillary necrosis, renal ptosis and congenital abnormalities of the upper urinary tract is reported.

The urological findings are discussed in relation to age, duration of symptoms, excessive phenacetin intake and with reference to their possible significance in the aetiology of chronic pyelonephritis.
INVESTIGATION AND TREATMENT OF INCONTINENCE OF URINE IN WOMEN WHO HAVE HAD A PROLAPSE REPAIR OPERATION1
Authors: Warrell David W.
Published: December 2008

Eighty‐one patients who continued to be incontinent of urine after repair of prolapse have been investigated, treated and followed up from one to six years.

Cases have been classified by investigation as having mechanical faults of the urethral sphincter mechanism or faults of bladder action.

Fifty‐two patients were considered to have anatomical abnormalities of the urethral sphincter mechanism usually due to fixity by scar tissue. Forty‐two patients have been cured by freeing the urethra and bringing in fresh tissue. Twenty‐nine cases were found to have abnormal bladder action usually due to chronic cystitis or urethro‐trigonitis and only one‐half have been cured.
A MODIFIED TECHNIQUE FOR INTRAVENOUS PYELOGRAPHY1
Authors: Servadio C.
Published: December 2008

A method is described which results in better and clearer pictures on intravenous pyelography by applying abdominal compression prior to the injection of the contrast medium. Its use has been demonstrated and the probable physiological explanation of the findings discussed. It is felt that the safety, the simplicity and the minimal discomfort to the patient make such an investigation well justified, particularly before resort is made to retrograde pyelography or other more complicated procedures.
MULTILOCULAR CYST OF THE SEMINAL VESICLE
Authors: Lawson L. J. , Macdougall J. A.
Published: December 2008

The pathology, symptoms, diagnosis and treatment of a case of cystic malformation of the seminal vesicle has been described. A further case report is added to the previous literature of the condition.
HUNNER'S ULCER (Chronic Interstitial Cystitis): A Manifestation of Collagen Disease
Authors: Shipton Eva A.
Published: December 2008

Four patients with interstitial cystitis (thinner's ulcer) are reported. The similarity of this condition to chronic lupus erythematosus and scleroderma is noted and the literature is reviewed.

A method of treatment using high vitamin dosage is suggested.
A CLINICAL TRIAL OF SULPHAMETHOXAZOLE IN PYELONEPHRITIS WITH SIMPLIFIED METHODS OF ASSESSMENT
Authors: Linton A. L. , Chatfield W. R.
Published: December 2008

A trial of the effect of sulphamethoxazole in pyelonephritis is described. Strict criteria of success were observed, and a follow‐up conducted after cessation of treatment. Simplified methods of assessment of pyuria and bacteruria were used and proved easy and accurate. Fifty‐eight per cent, of the cases treated remained free of evidence of infection three months after treatment.
PREPUBERTAL GYNÆCOMASTIA IN ASSOCIATION WITH AN INTERSTITIAL–CELL TUMOUR OF THE TESTIS
Authors: JOHNSTONE GEORGE
Published: December 2008

A case of interstitial–cell tumour of the testis with pre–pubertal gynecomastia is described. The literature is reviewed and it is noted that only five of the 39 reported cases showed evidence of gynecomastia, although every case had features of precocious virilism. The danger of confusing bilateral testicular adrenal rests with interstitial–cell tumours of the testis and the diagnostic safeguards are mentioned. Malignancy has not been reported in any of these prepubertal tumours but can be excluded only by prolonged observation. The 17–ketosteroid and oestrogen excretions in this case are given, with reservations. It has been assumed that an excess of oestrogen is the cause of gynecomastia. The mechanisms of this excess production are mentioned. It is suggested that excess oestrogen might modify the psycho–sexual effects but not the physical effects of this virilising tumour.

I wish to thank Dr W. J. Maelor Evans, Chief Medical Officer, Ministry of Health, Tanzania, for having given permission to publish this paper. I am greatly obliged to Drs P. Grech and P. J. Philip for their very considerable help and I wish to express my sincere thanks to them. My thanks also go to Drs J. Hamerton and M. T. Maletnlema for the photographs and to my House Surgeon, Dr G. A. S. Kombe for his assistance. 1 also wish to thank the laboratory staff of the Muhimbili Hospital who undertook the urinary steroid estimations whilst coping with a welter of routine work.
URINARY ENZYMES IN BENIGN AND MALIGNANT URINARY TRACT DISORDERS:ALKALINE PHOSPHATASE AND LACTIC ACID DEHYDROGENASE1
Authors: GAULT M. HENRY , OLIVER JOHN A. , LANG CELLA , ASGHAR M. I. , LEVY S. W.
Published: December 2008

The normal range of values for urinary alkaline phosphatase by a partially automated method and for urine lactic–acid dehydrogenase activity by a colorimetric method was established and was compared with values obtained in association with neoplasms of the urinary tract, extra–urinary neoplasms, and with other disorders of the genito–urinary tract. The findings do not indicate that such assays constitute an important addition to conventional methods for the diagnosis of kidney or bladder neoplasms, although urinary enzyme activity was increased in the presence of normal urine analysis in some patients. Urinary alkaline phosphatase activity may be increased in cases of malignant disease not involving the urinary tract and also in association with a major elevation of activity in the serum. Problems associated with the assay of urinary enzymes and the interpretation of the values obtained are discussed.

We are indebted to Miss A. Illing for technical assistance.
THE PRIMARY VESICAL SPHINCTER
Authors: ARDRAN G. M. , COPE V. , ESSENHIGH D. M. , TUCKEY M.
Published: December 2008

Evidence has been put forward in recent years that urinary continence depends on urethral length. There are theoretical objections to this hypothesis which are discussed.

Nine dogs were investigated under anaesthesia. Six dogs were found to be continent when the urethra was divided at the bladder neck. Three dogs were incontinent and these were found to be suffering from marked prostatic hyperplasia. In four dogs it was possible to remove the full bladder completely after dividing the urethra at the bladder neck and it was shown that the primary sphincter could withstand a pressure of up to 15 cm. of water. It is concluded that the primary sphincter of the bladder is at the internal meatus. We have been unable to show that the posterior urethra is necessary to maintain continence in the normal dog and it is likely that the broad aspects of function at the bladder neck are similar in man.
A METHOD OF PRODUCING EXPERIMENTAL URæMIA IN THE RABBIT WITH SOME OBSERVATIONS ON THE INFLUENCE OF URæMIA ON PERITONEAL HEALING
Authors: MOTT T. J. , ELLIS Professor HAROLD
Published: December 2008

A one–stage retroperitoneal method of producing acute transient experimental uræia is described. After defects in the peritoneum have been fashioned, the uræmic state delays the formation of new peritoneum and depresses the production of collagen. It would be advisable to include uræmia amongst other general factors when future studies of wound disruption are contemplated.

The majority of this work was performed in the Surgical Unit Laboratories, Westminster Hospital. We would like to thank Professor D. Slome for providing additional facilities at the Department of Physiology, Royal College of Surgeons. We are grateful to Dr Klaus Lewin for assistance with the histology and photographs.
MANAGEMENT OF THE URETHRA FOLLOWING TOTAL AMPUTATION OF THE PENIS
Authors: SAWHNEY C. P.
Published: December 2008

A procedure has been described to prevent the development of meatal stenosis following total amputation of the penis for carcinoma of penis, and to reconstruct a stump of penis.
ELECTRON MICROSCOPY AND X–RAY DIFFRACTION OF PRECIPITATED URINARY CALCIUM PHOSPHATES
Authors: CIFUENTES L. , CATALINA F. , GARCIA–VICENTE J. , ESTEBAN B.
Published: December 2008

Spontaneous urinary sediments in cases of so–called phosphaturia have been observed with the electron microscope and X–ray diffractometer. Spherulite–like elements and clusters were seen and they showed a poor crystalline structure, almost completely amorphous, as judged by their X–ray diffraction patterns. Extremely minute, but well–formed, crystals were found in other cases, which, under the optical microscope, appeared to be amorphous calcium phosphates; these gave a typical apatite–like diffraction pattern. The occasional presence of calcium phosphate (apatite–like) true crystalluria could be demonstrated.
SUPPURATION OF SOLITARY CYST OF THE KIDNEY
Authors: DELIVELIOTIS A. , ZORZOS S. , VARKARAKIS M.
Published: December 2008

Two cases of spontaneous suppuration of congenital solitary cyst of the kidney are presented. The second case, in which chronic pyelonephritis and hypertension co–existed, has additional interest because of the probable relationship between the chronic pyelonephritis and suppuration of the cyst of the kidney.
BLOOD STREAM INFECTION FOLLOWING RETROPUBIC PROSTATECTOMY
Authors: MARSHALL A.
Published: December 2008

Pre– and post–operative blood culture studies were made in 196 patients having retropubic prostatectomy.

In all patients having urethral catheter drainage before operation the incidence of bacteremia was reduced when a Gibbon or Franklin catheter was used and the drainage system was of the closed type.

Bacteremia, when protracted, may be a predisposing factor in post–operative mortality from pyelonephritis.

In patients whose urine was sterile at operation the incidence of bacteremia was low.

In patients whose urine was infected at operation the incidence of bacteræmia could be very high.

In infected patients bacteræmia was significantly reduced when appropriate broad–spectrum antimicrobials were given over the period of operation.

Infected patients with bacteremia had a significantly higher incidence of severe upper urinary tract infective complications following operation.
BILATERAL PRIMARY HYPERNEPHROMATA
Authors: EDWARDSON K. F.
Published: December 2008

Two patients with bilateral hypernephromata are described. From a consideration of the probable mechanisms of spread of metastases it was deduced that these were cases of bilateral primary hypernephroma.

I would like to express my appreciation to Mr D. P. B. Turner for his enthusiastic help and encouragement in presenting this paper and also for allowing me to present the first case. My thanks are also due to Dr J. McConnell for allowing me to publish the second case and to Dr J. H. E. Carmichael for permission to reproduce the radiographs.
Nephrogenic Adenoma of the Bladder
Authors: KALLOOR GEORGE J. , SHAW RICHARD E.
Published: December 2008

We report an additional case of “nephrogenic adenoma” of the urinary bladder.

“Nephrogenic adenoma” is not a neoplastic condition but an unusual form of metaplasia of the vesical mucosa in response to infection.

The lesions respond well to treatment by diathermy.
Genetic Aspects of Hydronephrosis Associated with Renal Agenesis
Authors: FINN RONALD , CARRUTHERS J. A.
Published: December 2008

Two families with hereditary hydronephrosis are reported and a further 4 families form the literature reviewed. In these families the condition may be unilateral or bilateral, and if unilateral, is more common on the left side.

Hereditary pelvi‐ureteric obstruction is due to an autosomal dominant gene with variable penetrance. Evidence from animal studies relating to the pathogenesis of pelvi‐ureteric obstruction is discussed.

It is suggested that the mild form of the condition may have more clinical significance than has been previously realised. The association of renal agenesis and hereditary hydronephrosis is also noted.
The Effect of Cellulose Phosphate on Intestinal Absorption and Urinary Excretion of Calcium: Some Experience in its use in the Treatment of Calcium Stone Formation
Authors: BLACKLOCK N. J. , MACLEOD M. A.
Published: December 2008

Sodium cellulose phosphate can significantly diminish the absorption of calcium from the intestine; there is concomitant diminution of urinary calcium excretion. The plasma levels of the divalent cations do not appear to be influenced by this therapy.
A Geographical and Historical Survey of the Composition of Urinary Stones
Authors: SUTOR D. JUNE , WOOLEY SUSAN E. , ILLINGWORTH J. J.
Published: December 2008

The composition of urinary stones in different countries can be related to the extent of economic development present and the major types of stones in the world, namely children's and adult lower urinary tract calculi in technically developing countries and adult upper urinary tract ones in industrialised areas, are of very different composition.

Approximately 89 % of children's stones consist of or contain ammonium acid urate + calcium oxalate and the composition of the nucleus suggests the former compound is more important in the nucleation of such calculi. Of similar composition are children's bladder stones from old museum collections in England.

Large amounts of uric acid and calcium oxalate are present in adult lower urinary tract stones from technically developing countries and museum collections, and many stones contain these 2 compounds frequently with ammonium acid urate.

Adult upper urinary tract calculi from industrialised countries and from “Westernised” areas of technically developing ones, consist predominantly of calcium oxalate + calcium phosphate or pure calcium oxalate. Stones of such composition are not often found in collections of children's bladder calculi, whether from technically developing countries or museum collections, and stones with ammonium acid urate + calcium oxalate do not occur in industrialised countries like Great Britain and America. However, uric acid + calcium oxalate stones, but without ammonium acid urate, are found in some countries in Europe where they are the most frequently occurring type after the pure calcium oxalate and calcium oxalate + calcium phosphate varieties.

Children's stones and adult lower urinary tract ones in industrialised countries and children's upper tract stones in technically developing countries, though of less importance, nevertheless have their own particular composition which again is different for regions of different economic development.

The most frequent combinations of individual constituents in the different composition types are discussed, as well as the sex and average age of the patients and the number and weight of the stones.
Incomplete Urethral Duplication and Urinary Retention
Authors: FELLOWS G. J. , JOHNSTON J. H.
Published: December 2008

Three boys with incomplete urethral duplication and urinary retention are reported.

The mechanism of retention is discussed and operative correction by marsupialisation of both channels and subsequent urethroplasty described.
Liposarcoma of Paratesticular Origin: A Case Report
Authors: MACKENZIE I. , ROBERTS G. HEFIN
Published: December 2008

A liposarcoma of paratesticular origin is reported; this is the 12th recorded case. A survey of previously published cases suggests that there is a considerable variation in behaviour, but that they are probably less malignant than the commoner testicular neoplasms, and that orchidectomy with high ligation and excision of the spermatic cord is adequate.
Hydronephrosis and Polycythaemia
Authors: NARAYANA A. SRIMAN , GALLAGHER F. , KELLY D. G. , DUFF F. A.
Published: December 2008

2 cases of secondary polycythaemia apparently caused by hydronephrosis are described. The polycythaemia resolved following nephrectomy in each case.
Circumcaval Ureter: A Report of Four Cases in Children with a Review of the Literature and a New Classification
Authors: KENAWI M. M. , WILLIAMS D. INNES
Published: December 2008

4 cases of circumcaval ureter presenting in childhood are reported.

A review of the literature reveals that most cases receive attention only later in life at a time when ureteric changes are not so readily reversible.
The Use of Alpha‐adrenergic Blockers in Benign Prostatic Obstruction
Authors: CAINE MARCO , PFAU ALPHONSE , PERLBERG SHAUL
Published: December 2008

As a result of previous in‐vitro studies on the a‐adrenergic receptor activity of the human prostate and prostatic capsule a trial was made of a‐adrenergic blockers for the relief of obstructive prostatic symptoms.

Considerable benefit was obtained in several groups of patients, as demonstrated either by the relief or prevention of complete retention, or by diminution in residual urine or improvement in urinary flow‐rate recordings. A number of illustrative cases are described, and the indications for the use of this treatment are suggested.

It is emphasised that this treatment provides symptomatic relief only, and in no sense purports to be a treatment of the enlarged prostate itself.