bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating survival and movements using both live and dead recoveries: a case study of oystercatchers confronted with habitat change
Authors: Duriez Olivier , Sæther Stein A. , Ens Bruno J. , Choquet Rémi , Pradel Roger , Lambeck Rob H. D. , Klaassen Marcel
Published: December 2008

Animals facing partial habitat loss can try to survive in the remaining habitat or emigrate. Effects on survival and movements should be studied simultaneously since survival rates may be underestimated if emigrants are not considered, and since emigrants may experience reduced survival.

We analysed movements and survival of adult wintering oystercatcherHaematopus ostralegusin response to the 1986–1987 partial closure of the Oosterschelde in the Dutch Delta. This reduced by one‐third the tidal area of this major European wintering area for waders.

We developed a novel variant of a multistate capture–recapture model allowing simultaneous estimation of survival and movement between sites using a mixture of data (live recaptures and dead recoveries). We used a two‐step process, first estimating movements between sites followed by site‐specific survival rates.

Most birds were faithful to their ringing site. Winter survival was negatively affected by winter severity and was lowest among birds changing wintering site (i.e. moving outside of the Oosterschelde).

During mild winters, survival rates were very high, and similar to before the closure in both changed and unchanged sectors of the Oosterschelde. However, the combined effect of habitat loss with severe winters decreased the survival of birds from changed sectors and induced emigration.

The coastal engineering project coincided with three severe winters and high food stock, making assessment of its effects difficult. However, the habitat loss seems to have had less impact on adult survival and movements than did winter severity.

Synthesis and applications. Human‐induced habitat change may result in population decline through costly emigration or reduced survival or reproduction of individuals that stay. Long‐term monitoring of marked individuals helps to understand how populations respond to environmental change, but site‐specific survival and movement rates should be integrated in the same model in order to maximize the information yield. Our modelling approach facilitates this because it allows the inclusion of recoveries from outside the study area.
Guild‐specific responses of bats to landscape composition and configuration in fragmented Amazonian rainforest
Authors: Klingbeil Brian T. , Willig Michael R.
Published: December 2008

Habitat loss and fragmentation are serious threats to biodiversity, especially in the Amazon Basin, where biodiversity is greatest and deforestation is continuing at an alarming rate. Nonetheless, little is known about the responses of biotas to spatially explicit aspects of landscape structure.

Bats are a promising indicator group for studying consequences of forest fragmentation in the Neotropics. Therefore, population‐ and assemblage‐level responses of bats to landscape composition and configuration were quantified at each of three focal scales (circles of 1‐, 3‐, and 5‐km radii) at 14 sites in lowland Amazonia.

Responses to landscape characteristics were scale‐dependent. Abundance and richness were higher in moderately fragmented forest than in continuous forest. Moreover, the abundance of each of nine frugivorous species decreased with increasing forest cover.

The abundance of frugivores probably responded to landscape composition (e.g. percentage forest, mean patch density) because of an increase in early successional fruits and flowers in areas with reduced canopy cover. In contrast, abundances of gleaning animalivores responded to landscape configuration (e.g. edge density), probably by exploiting low‐contrast edges (i.e. closed canopy forest patches embedded in secondary forest) while foraging and travelling between higher quality resource patches.

Synthesis and applications. Species‐ and ensemble‐specific responses to aspects of landscape structure suggest that both compositional and configurational aspects need to be managed effectively in conservation planning. However, conservation decisions based on associations of biodiversity metrics (e.g. richness, diversity and rarity) with landscape structure may be problematic as they are composite characteristics that mask individual responses and potentially reflect only patterns of the dominant species or groups.
Surrogacy and persistence in reserve selection: landscape prioritization for multiple taxa in Britain
Authors: Franco Aldina M. A. , Anderson Barbara J. , Roy David B. , Gillings Simon , Fox Richard , Moilanen Atte , Thomas Chris D.
Published: December 2008

A principal goal of protected‐area networks is to maintain viable populations of as many species as possible, particularly those that are vulnerable to environmental change outside reserves. Ideally, one wants to be able to protect all biodiversity when selecting priority areas for conservation.

Using the area‐prioritization algorithm ZONATION, we identified the locations where UK Biodiversity Action Plan (BAP) species of mammals, birds, herptiles, butterflies and plants occur in concentrated populations with high connectivity. Both these features are likely to be correlated with population persistence. The analyses were successful in maintaining a high proportion of the connectivity of narrow‐range species, and large total amounts of the connectivity of wider‐range species over 10% of the land surface of Great Britain.

Biodiversity Action Plan (BAP – high priority) species of one taxonomic group were not particularly good surrogates (indicators) for BAP species of other taxonomic groups. Hence, maintaining population concentrations of one taxonomic group did not guarantee doing likewise for other taxa.

Species with narrow geographic ranges were most effective at predicting conservation success for other species, probably because they represent the range of environmental conditions required by other species.

Synthesis and applications. This study identifies landscape‐scale priority areas for conservation of priority species from several taxonomic groups, using the Zonation software. ‘Indicator groups’ were only partially successful as predictors of priority areas for other taxonomic groups, and therefore, the identification of priority areas for biodiversity conservation should include information from all taxonomic groups available. Larger areas should be protected to account for species not included in the analyses. Conservation solutions based on data for many different species, and particularly those species with narrowly defined ranges, appear to be most effective at protecting other rare taxa.
Demographics and landscape features determine intrariver population structure in Atlantic salmon (Salmo salar L.): the case of the River Moy in Ireland
Authors: DILLANE E. , MCGINNITY P. , COUGHLAN J. P. , CROSS M. C. , DE EYTO E. , KENCHINGTON E. , PRODÖHL P. , CROSS T. F.
Published: December 2008

Contemporary genetic structure of Atlantic salmon (Salmo salar L.) in the River Moy in Ireland is shown here to be strongly related to landscape features and population demographics, with populations being defined largely by their degree of physical isolation and their size. Samples of juvenile salmon were collected from the 17 major spawning areas on the river Moy and from one spawning area in each of five smaller nearby rivers. No temporal allele frequency differences were observed within locations for 12 microsatellite loci, whereas nearly all spatial samples differed significantly, suggesting that each was a separate population. Bayesian clustering and landscape genetic analyses suggest that these populations can be combined hierarchically into five genetically informative larger groupings. Lakes were found to be the single most important determinant of the observed population structure. Spawning area size was also an important factor. The salmon population of the closest nearby river resembled genetically the largest Moy population grouping. In addition, we showed that anthropogenic influences on spawning habitats, in this case arterial drainage, can affect relationships between populations. Our results show that Atlantic salmon biodiversity can be largely defined by geography, and thus, knowledge of landscape features (for example, as characterized within Geographical Information Systems) has the potential to predict population structure in other rivers without an intensive genetic survey, or at least to help direct sampling. This approach of combining genetics and geography, for sampling and in subsequent statistical analyses, has wider application to the investigation of population structure in other freshwater/anadromous fish species and possibly in marine fish and other organisms.
Population fragmentation and major histocompatibility complex variation in the spotted suslik, Spermophilus suslicus
Authors: BIEDRZYCKA ALEKSANDRA , RADWAN JACEK
Published: December 2008

The fragmentation of populations typically enhances depletion of genetic variation, but highly polymorphic major histocompatibility complex (MHC) genes are thought to be under balancing selection and therefore retain polymorphism despite population bottlenecks. In this study, we investigate MHC DRB (class II) exon 2 variation in 14 spotted suslik populations from two regions differing in their degree of habitat fragmentation and gene flow. We found 16 alleles that segregated in a sample of 248 individuals. The alleles were highly divergent and revealed the hallmark signs of positive selection acting on them in the past, showing a significant excess of nonsynonymous substitutions. This excess was concentrated in putative antigen‐binding sites, which suggests that past selection was driven by pathogens. MHC diversity was significantly lower in fragmented western populations than in the eastern populations, characterized by significant gene flow. In contrast to neutral variation, amova did not reveal genetic differentiation between the two regions. This may indicate similar selective pressures shaping MHC variation in both regions until the recent past. However, MHC allelic richness within a population was correlated with that for microsatellites. FST outlier analyses have shown that population differentiation at DRB was neither higher nor lower than expected under neutrality. The results suggest that selection on MHC is not strong enough to counteract drift that results from recent fragmentation of spotted suslik populations.
Significant population structure and asymmetric gene flow patterns amidst expanding populations of Clinus cottoides (Perciformes, Clinidae): application of molecular data to marine conservation planning in South Africa
Authors: VON DER HEYDEN SOPHIE , PROCHAZKA KIM , BOWIE RAURI C. K.
Published: December 2008

Clinus cottoides is a fish endemic to the coast of South Africa, predominantly inhabiting rock pools. All South African clinids are viviparous, but probably breed throughout the year; as such, their dispersal may be limited, unlike species with pelagic larval stages. We analysed 343 fish from 14 localities on the west, south and east coasts using two mitochondrial genes and the second intron of the S7 ribosomal gene. Mitochondrial DNA analyses recovered significant genetic differentiation between fish populations from the east coast and other sampling locations, with a second break found between Gansbaai and Cape Agulhas on the south coast. Nuclear DNA recovered shallower, but significant, levels of population structure. Coalescent analyses suggested remarkably asymmetrical gene flow between sampling locations, suggesting that the cold Atlantic Benguela Current and Indian Ocean Agulhas counter‐current play important roles in facilitating dispersal. There was no gene flow between the east coast and the other sites, suggesting that these populations are effectively isolated. Divergence times between them were estimated to at least 68 000 years. Neutrality tests and mismatch distributions suggest recent population expansions, with the exception of peripheral western and eastern populations (possibly a consequence of environmental extremes at the edge of the species distribution). Analyses of the current South African marine protected areas network show that it is not connected and that De Hoop, one of South Africa's largest marine reserves, appears to be an important source population of recruits to both the south and southwest coasts.
Role of male‐biased dispersal in inbreeding avoidance in the grey‐sided vole (Myodes rufocanus)
Authors: ISHIBASHI YASUYUKI , SAITOH TAKASHI
Published: December 2008

Effects of male‐biased dispersal on inbreeding avoidance were investigated in a semi‐natural population ofMyodes(formerlyClethrionomys)rufocanususing a large outdoor enclosure (3 ha). Parentage of 918 voles weaned from 215 litters and relatedness of mates were analysed using microsatellite loci, and dispersal distances were obtained from mark–recapture live‐trapping data. Natal and breeding male‐biased dispersal was observed. There remained, however, chances that incestuous mating could occur, because not all males dispersed from their natal site, and 51 matings occurred between relatives (relatednessr > 0). The number of weaned juveniles from inbred litters was significantly smaller than that from non‐inbred litters. Fourteen incestuous matings occurred between close relatives (r ≥ 0.25), most of which were those between non‐littermate maternal half siblings (four cases) and those between paternal half siblings (seven cases). When comparing the observed frequencies to the expected ones generated by combining every oestrous female with a male randomly chosen from her surroundings, the observed values for inbreeding ofr ≥ 0.25 were significantly smaller than the expectations, while no difference was observed for inbreeding of 0 < r < 0.25. These results suggest that male‐biased dispersal is partly effective to avoid incestuous mating, but it does not provide complete separation of male and female close relatives. Additional mechanisms such as kin discrimination based on familiarity may work in inbreeding avoidance of the vole.
Usefulness of serum IgG4 in the diagnosis and follow up of autoimmune pancreatitis: A systematic literature review and meta‐analysis
Authors: Morselli‐Labate Antonio M , Pezzilli Raffaele
Published: December 2008

High circulating serum immunoglobulin G4 (IgG4) levels have been proposed as a marker of autoimmune pancreatitis (AIP). The aim of the present study was to review the data existing in the English literature on the usefulness of the IgG4 serum levels in the diagnosis and follow up of patients with AIP. A total of 159 patients with AIP and 1099 controls were described in seven selected papers reporting the usefulness of serum IgG4 in diagnosing AIP. In total, 304 controls had pancreatic cancer, 96 had autoimmune diseases, and the remaining 699 had other conditions. The summary receiver–operating characteristic curve analysis was carried out by means of Meta‐DiSc open‐access software. Serum IgG4 showed good accuracy in distinguishing between AIP and the overall controls, pancreatic cancer and other autoimmune diseases (area under the curve [± SE]: 0.920 ± 0.073, 0.914 ± 0.191, and 0.949 ± 0.024, respectively). The studies analyzed showed significantly heterogeneous specificity values in each of the three analyses performed. The analysis of the four studies comparing AIP and pancreatic cancers also showed significantly heterogeneous values of sensitivities and odds ratios. Regarding the usefulness of IgG4 as a marker of efficacy of steroid treatment, a decrease in the serum concentrations of IgG4 was found in the four available studies. The serum IgG4 subclass is a good marker of AIP, and its determination should be included in the diagnostic workup of this disease. However, the heterogeneity of the studies published until now means that more studies are necessary in order to better evaluate the true accuracy of IgG4 in discriminating AIP versus other autoimmune diseases.
Biopsy site for detecting Helicobacter pylori infection in patients with gastric cancer
Authors: Kim Chan Gyoo , Choi Il Ju , Lee Jong Yeul , Cho Soo‐Jeong , Nam Byung‐Ho , Kook Myeong‐Cherl , Hong Eun Kyung , Kim Young‐Woo
Published: December 2008

Background:  Helicobacter pylori eradication is recommended in post‐gastric cancer resection, but premalignant changes may prevent the detection of H. pylori. The aim of this study was to determine appropriate biopsy site for detecting H. pylori in gastric cancer patients.

Materials and Methods:  Consecutive patients (194) with gastric adenocarcinoma were prospectively enrolled. Helicobacter pylori was evaluated by serology, histology and rapid urease test. Biopsy sites included antrum lesser curvature, upper body lesser curvature (UBLC) and upper body greater curvature (UBGC). Two biopsy specimens were obtained from each site for histological examination. One additional specimen was obtained from UBGC for the rapid urease test.

Results:  The overall infection rate of H. pylori was 84.0% (95% CI 78.9–89.2). The sensitivity of histology for detecting H. pylori at various sites was: antrum (54.9%; 95% CI 45.7–63.9), UBLC (80.3%; 95% CI 72.2–87.0) and UBGC (95.1%; 95% CI 89.6–98.2). Specificities of all three biopsy sites were more than 95%. Sensitivity and specificity of the rapid urease test performed at UBGC were 96% and 100%, respectively. Sensitivities of histology decreased in correlation with increasing severity of atrophy and intestinal metaplasia (both P < 0.001 using the chi‐square test for trend). The proportions of moderate to marked atrophy/intestinal metaplasia at UBGC (12.8%/14.7%) were significantly lower than those at antrum (50.0%/57.8%, P < 0.001 respectively) or UBLC (40.0%/48.9%, P < 0.001 respectively).

Conclusions:  The UBGC side is the most sensitive and specific biopsy site to detect H. pylori in gastric cancer patients due to less frequent atrophy and intestinal metaplasia than at the antrum or UBLC side.
Spreading antibiotic resistance through spread manure: characteristics of a novel plasmid type with low %G+C content
Authors: Heuer Holger , Kopmann Christoph , Binh Chu T. T. , Top Eva M. , Smalla Kornelia
Published: December 2008

Bioactive amounts of antibiotics as well as resistant bacteria reach the soil through manure fertilization. We investigated plasmids that may stimulate the environmental spread and interspecies transfer of antibiotic resistance. After treatment of two soils with manure, either with or without the sulfonamide antibiotic sulfadiazine, a significant increase in copies of the sulfonamide resistance gene sul2 was detected by qPCR. All sul2 carrying plasmids, captured in Escherichia coli from soil, belonged to a novel class of self‐transferable replicons. Manuring and sulfadiazine significantly increased the abundance of this replicon type in a chemically fertilized but not in an annually manured soil, as determined by qPCR targeting a transfer gene. Restriction patterns and antibiograms showed a considerable diversity within this novel plasmid group. Analysis of three complete plasmid sequences revealed a conserved 30 kbp backbone with only 36% G+C content, comprised of transfer and maintenance genes with moderate homology to plasmid pIPO2 and a replication module (rep and oriV) of other descent. The plasmids differed in composition of the 27.0–28.3 kbp accessory region, each of which carried ISCR2 and several resistance genes. Acinetobacter spp. was identified as a potential host of such LowGC‐type plasmids in manure and soil.
TESTICULAR TUMOURS: LATE RESULTS OF RADICAL SURGERY1
Authors: Adams A. Wilfrid
Published: December 2008

The late results i n five cases of radical orchidectomy for testicular seminoma are reported. One had radiotherapy also. Eleven or more years later all are alive and well, are clinically free from recurrence with negative Friedman tests. testicular cancer, are also described.

Two examples of differential diagnosis, one a mimic of and the other masked
Paediatric Urolithiasis in Greece
Authors: ANDROULAKAKIS P. A. , MICHAEL V. , POLYCHRONOPOULOU SOPHIA , AGHIOUTANTIS C.
Published: December 2008

Summary— A group of 44 patients, aged from 10 months to 14 years, underwent surgery for urinary calculi over a 7‐year period (1982–1989). Eleven patients had bilateral or multiple calculi (total number of stones = 55, 20 of which were staghorn). Metabolic disorders (n = 25) and Proteus urinary infection (n = 15) were the 2 factors most often associated with lithiasis. Of the 55 stones, 51 were removed by open surgery. Complete stone clearance was achieved in 29 of 36 kidneys. Follow‐up periods in the remaining 7 renal units (with small residual fragments) ranged from 3.5 to 7.5 years (mean 6.2) and revealed stone recurrence in only 2 patients. Evaluation of childhood urolithiasis should include thorough metabolic investigation and sound surgical judgment; effective management requires prolonged post‐operative follow‐up.
Conservative Treatment of Vesicovaginal Fistulas by Bladder Drainage Alone
Authors: DAVITS R. J. A. M. , MIRANDA S. I.
Published: December 2008

Summary— We describe 4 cases of conservative management of vesicovaginal fistulas occurring as a complication of abdominal and vaginal hysterectomy. In all cases treatment involved simple bladder drainage for periods ranging from 19 to 54 days. At follow‐up all patients remained dry. Such spontaneous closure of vesicovaginal fistulas following adequate bladder drainage has not been previously reported.
The Sonographic Appearance of Irradiated Prostate Cancer
Authors: Egawa S. , WHEELER T. M. , SCARDINO P. T.
Published: December 2008

Summary— Transrectal ultrasonography of the prostate was performed before radical prostatectomy in 22 patients with persistent or recurrent cancer after definitive radiotherapy. Serial transverse sonograms were compared with whole‐mount step‐sections of the prostatectomy specimens to evaluate the sonographic features of irradiated prostate cancer. To define more clearly the effects of radiation on malignant prostatic tissue, we assessed the degree of histological change induced by the irradiation (radiation effects) as none, mild, moderate or severe. A total of 121 areas of cancer >4mm in maximum diameter were identified on the histological sections. Of these, 105 (87%) showed no radiation effects or mild effects, and 72% (76/105) of these appeared hypoechoic on the corresponding sonogram. There were 16 foci with moderate or severe radiation effects and only 25% (4/16) appeared hypoechoic. The remaining 12 foci were isoechoic.

Areas of cancer which show moderate or severe radiation effects tend to become isoechoic while large (>4mm) foci of cancer in the irradiated prostate usually show little radiation effect, and these foci typically appear hypoechoic.
Early Endoscopic Realignment of Complete Traumatic Rupture of the Posterior Urethra
Authors: GUILLE F. , CIPOLLA B. , LEVEQUE J.‐M. , GUIRASSY S. , OLIVO J. F. , LOBEL B.
Published: December 2008

Summary— Early primary endoscopic realignment of complete traumatic rupture of the posterior urethra is a simple, rapid and non‐traumatic technique. We have recently treated 5 patients in this manner. All are continent and 4 are potent. Four patients were followed up for 1 year. One patient required no further management and had excellent urinary flow rates. The other 3 developed short secondary strictures which were managed successfully by 1 or 2 internal urethrotomies.
Colour Duplex Sonography in the Assessment of Impotence
Authors: CHIANG P. H. , CHIANG C. P. , WU C. C. , WANG C. J. , CHEN M. T. , HUANG C. H. , WU D. K.
Published: December 2008

Summary— We present our experience with colour duplex sonography (Acuson 128) in the assessment of 83 impotent men. Cavernosal artery measurements were taken before and after the intracorporeal injection of papaverine. The peak velocities following papaverine injection correlated well with the degree of clinical response. Percentage diameter change corresponded with some groups of clinical erection grade, although it was not as good a discriminator as peak velocity.

Twelve patients with 24 cavernosal arteries were also examined using pharmacological selective arteriography. Correlation between duplex sonography and arteriography showed an accuracy of 87.5%, specificity of 100.0% and sensitivity of 82.4%.

All patients with a clinically good response following papaverine injection had peak bilateral cavernosal artery velocities ≥ 25 cm/s. Amongst the remaining suboptimal responders, 18 also had this finding. Fifteen of these underwent pharmacological cavernosography and 14 exhibited venous leakage.

Duplex sonography is a valuable and non‐invasive tool in the assessment of impotence and can provide valuable information in deciding the course of further evaluation and treatment. The procedure was always completed more quickly with the guidance of colour Doppler.
Lord's Procedure—the Best Operation for Hydrocele?
Authors: ALBRECHT W. , HÖLTL W. , AHARINEJAD S.
Published: December 2008

Summary— A prospective study was carried out to compare Lord's hydrocele operation with traditional surgical procedures. The groups of patients investigated were comparable in terms of age, period of observation, number of previous aspirations and size of hydrocele.

The incidence of isolated hydrocele of the spermatic cord, as well as epididymal cysts, was lower in the patients who underwent Lord's procedure (7.2 versus 15.8%), as was the percentage of patients reporting post‐operative pain for more than 3 days (4.3 versus 15.8%, p < 0.05).
Relationship between Segmental Arteries and Pelviureteric Junction
Authors: SAMPAIO F. J. B.
Published: December 2008

Since the first description of percutaneous endopyelotomy by Wickham and Kellett (1983) and its subsequent popularisation (Badlani et al., 1986), this procedure has become an effective alternative to standard open pyeloplasty in the management of pelviureteric junction (PUJ) obstruction. More recently, a method of performing endopyelotomy through the ureteroscope has been reported (Clayman and Picus, 1988).
Experience with Sperm Counts Following Vasectomy
Authors: THOMPSON BARBARA , MACGREGOR J. ELIZABETH , MacGILLIVRAY I. , GARVIE W. H. H.
Published: December 2008

Summary The records of Aberdeen men requesting vasectomy between 1978 and 1981 were studied and a sample of men were interviewed about 3 years after the operation; 85% completed the standard requirements for seminal analysis and were given the “all clear”; two‐thirds were cleared after sending 2 samples and usually within 20 weeks after vasectomy; 10% of men sent at least 1 sample but were never cleared and the remaining 5% ignored the requirements. Information from 70 men (63 interviews, 7 questionnaires) gave some indication of reasons, often multiple, for incomplete or non‐compliance; these included embarrassment, ambiguous feelings about having more children, inadequate understanding of reproductive physiology and blind faith in the surgeon.
Screening for Prostate Cancer. Comparison of Transrectal Ultrasound, Prostate Specific Antigen and Rectal Examination
Authors: PERRIN P. , MAQUET J. H. , BRINGEON G. , DEVONEC M.
Published: December 2008

Summary In seeking to define the relative value of transrectal ultrasound (TRUS), prostate specific antigen (PSA) and digital rectal examination (DRE) in the diagnosis of prostatic cancer, 863 patients were studied and the findings compared.

DRE detected malignancy in 0.3% of the population of asymptomatic “normal” men undergoing routine health screening, and in 1.6% of patients who consulted their General Practitioner for one reason or another. In patients who attended our out‐patient department with a variety of urological symptoms (not necessarily prostatic), TRUS suggested malignancy in 2% of those glands which were pronounced normal on DRE. Significantly elevated PSA detected malignancy in 0.3% of the patients undergoing routine health screening. (Although this figure equals the pick‐up rate by DRE in this group, they were not necessarily the same patients). When these 3 investigations are summated, the pick‐up rate is twice as high as when a single parameter is used.
The Role of Delayed Primary Repair in the Acute Management of Pelvic Fracture Injuries of the Urethra
Authors: MUNDY A. R.
Published: December 2008

Summary The principal aim of management of the ruptured urethra should be to do everything possible to reduce the long‐term complication rate and this applies principally to stricture formation. By far the most difficult complication to treat is severe distraction; thus the aim of early management should be to recognise and correct severe distraction injuries. Delayed primary repair at 7 to 10 days is recommended for this problem. The aim is not to prevent a stricture occurring but to make sure that if it does occur it is easily treatable.
Histology of Testicular Biopsies taken at Operation for Bilateral Maldescended Testes in Relation to Fertility in Adulthood
Authors: CORTES DINA , THORUP J.
Published: December 2008

Summary A total of 91 boys underwent bilateral orchiopexy with testicular biopsy. The percentage of tubular transverse sections containing spermatogonia, the fertility index (FI) and the number of spermatogonia per tubular transverse section (S/T) were measured and expressed as a percentage of the minimum normal value (FI% and S/T%, respectively). The maximum and mean of the 2 FI% and S/T% values were noted for each patient.

At follow‐up, testicular volume was measured in 73 men; 71 of these gave a blood sample for FSH and 67 provided specimens of semen for analysis. The maximum and the mean FI% and S/T% values of the patients were positively correlated to maximal sperm density and to volume of pair of testes and negatively correlated to serum FSH.

It seems reasonable to use these histological parameters as prognostic indices of fertility potential. In adulthood only 11 patients had sperm density ≥20 million/ml, 37 had normal serum FSH and 29 had bilateral testicular volume ≥ 15 ml.

Patients with both testes originally placed in the superficial inguinal pouch at surgical exploration had a higher maximal sperm density than the rest of the study group.
Diagnosis and Management of Large Seminal Vesicle Stones
Authors: LI Y. K.
Published: December 2008

Seminal vesicle stones are rare and there are few reports in the literature. Only 1 patient with recurrent huge seminal vesicle stones has been seen in this hospital.
Coronal Haemostatic Suture for Partial Nephrectomy
Authors: HADDAD F. S. , FLINT PATTI A.
Published: December 2008

Despite several new methods and techniques devised to establish haemostasis following partial nephrectomy, the most recent of which is a new dissecting instrument (Goldwasswer et al., 1986), one still encounters cases where the recommended techniques fail to control the bleeding. We found the following technique to be very effective in a patient in whom conventional methods—including the standard transverse sutures which tore through the capsule and the renal parenchyma—failed to control the bleeding.
Badenoch's Pull‐through Procedure in the Management of Urethrorectal Fistulae
Authors: SINGH P. B. , SARAF S. , KUNDU A. , KESARI P. K. , TRIPATHI V. N. P.
Published: December 2008

Urethrorectal fistula resulting from iatrogenic trauma is a difficult urological problem and the many surgical procedures used in its management reveal the complexity of the disease and require extensive dissection and bowel interference.

We have used Badenoch's pull‐through procedure in the management of a patient with urethrorectal fistula and suggest that it may provide a simpler alternative to the other methods.
Neurogenic Bladder Dysfunction in Lumbar Intervertebral Disc Prolapse
Authors: O'FLYNN K. J. , MURPHY R. , THOMAS D. G.
Published: December 2008

Summary— Lumbar disc prolapse with urinary dysfunction is an uncommon condition. The clinical, pathological and follow‐up details of 30 patients are presented. Detrusor recovery is rare and most patients are left with an areflexic bladder.

Female patients with lumbar disc prolapse and an areflexic detrusor who strain to empty their bladders are likely to develop genuine stress incontinence. This may be managed by the early institution of intermittent self‐catheterisation, which may reduce the need for incontinence surgery.
Intravesical Foreign Bodies: Five‐year Review
Authors: ECKFORD S. D. , PERSAD R. A. , BREWSTER S. F. , GINGELL J. C.
Published: December 2008

Summary— All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self‐insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimise bladder and urethral trauma. Complete extraction should also be confirmed by panendoscopy at the end of the extraction procedure.

A 5‐year review of our experience in this field has been conducted and the management and complications of intravesical foreign bodies are described. Of the 15 patients presenting to this department, 11 presented acutely and 4 presented with chronic symptoms due to complications which arose later. The possibility of an intravesical foreign body should be considered in any patient with chronic unexplained lower urinary tract symptoms.
Stress Relaxation Phenomenon in the Healthy Female Urethra
Authors: THIND P.
Published: December 2008

Summary— Following dilatation, urethral pressure declines over the next few seconds to a state of equilibrium. The stress relaxation parameter, P t0.5, was defined as the relative pressure decrease 0.5 s after dilatation, where the pressures at 0.1 s and at the new equilibrium were set to 100% and 0% respectively. Pt0.5 was calculated from 171 urethral dilatations performed at each of 3 urethral sites of measurement in 10 healthy volunteers. It was found to be independent of the rate and size of urethral dilatation. It showed a fairly high reproducibility rate when repeated after 1 h and 1 week. Pt0.5 was calculated to approximately 60% with no variation along the urethra. The parameter is assumed to be useful in evaluating urethral sphincter function. Although the method can be performed without special urodynamic equipment, the frequency response of the pressure measurement system must be adequate.
Müllerian Duct (Prostatic Utricle) Cyst: Diagnosis and Treatment in Subfertile Males
Authors: HENDRY W. F. , PRYOR J. P.
Published: December 2008

Summary— Müllerian duct cysts causing ejaculatory duct obstruction were discovered in 26 subfertile males; 21 patients had either azoospermia or very severe oligozoospermia. Characteristic seminal findings were a small volume ejaculate with acid pH and little or no fructose. The lesions were demonstrated by vasography and treated by endoscopic incision.

After surgery there was a distinct improvement in volume of the ejaculate and sperm concentration in 10 patients, although another 10 patients continued to have azoospermia or severe oligozoospermia due to either persisting obstruction or secondary epididymal blocks. Eight female partners became pregnant.
PAEDIATRIC UROLOGY Gastrocystoplasty in Children
Authors: DYKES EVELYN H. , RANSLEY P. G.
Published: December 2008

Summary— We report our experience of gastrocystoplasty in 8 children (mean age 10.1 years) with compromised renal function (mean creatinine 186 mmol/l, mean glomerular filtration rate 39 ml/min/ 1.73 m2).

Current follow‐up ranges from 11 to 35 months (mean 21). The physiological outcome of the procedure has been excellent, with improved biochemical and urodynamic parameters in all cases. Six patients are off H2‐receptor blockers and are asymptomatic. In 2 children we have encountered significant symptoms related to acid secretion in the bladder.

Detailed investigations suggest that the excess aciduria is related to the size of the gastric patch in 1 patient. The second child underwent renal transplantation 5 months after gastrocystoplasty and it is postulated that his immunosuppressive regimen (which includes prednisolone) may be responsible for the increased acid secretion.

It is concluded that gastrocystoplasty is a very satisfactory alternative to intestinal segment bladder enhancement in children with compromised renal function, but the size of the gastric patch is critical in determining the resultant acid secretion. Post‐transplantation immunosuppressive therapy may increase acid production from the gastric patch; since the children most suitable for gastrocystoplasty are also those likely to require transplantation, this aspect requires further study.
Role of the Artificial Urinary Sphincter in the Treatment of Stress Incontinence in Women
Authors: DUNCAN H. J. , NURSE DIANE E. , MUNDY A. R.
Published: December 2008

The artificial urinary sphincter (AUS) is rarely indicated in the treatment of women with stress incontinence because most of these women have deficient urethral support rather than pure sphincter weakness and the AUS is a treatment specifically for pure sphincter weakness. The procedure is contraindicated after pelvic radiotherapy and after previous sling surgery because of the high incidence of cuff erosion. Otherwise the artificial sphincter gives excellent results comparable to those seen in men with post‐protatectomy incontinence and much better than in neuropathic bladder dysfunction.
Analysis of Continent Versus Standard Urinary Diversion
Authors: BENSON M. C. , SLAWIN K. M. , WECHSLER M. H. , OLSSON C. A.
Published: December 2008

The seemingly high complication and re‐operation rates associated with continent urinary diversion have led some to criticise its morbidity and question its role in reconstructive urological surgery. We therefore reviewed our experience with all patients undergoing either continent or standard urinary diversion performed by 3 urological surgeons during a specified 3‐year period. In 73 consecutive patients (22 continent urinary diversion, 51 standard urinary diversion), no significant difference was demonstrated with respect to the number of post‐operative in‐hospital days, complication rate, re‐operation rate and operative mortality rate between the 2 groups. While those undergoing continent diversion were on average younger and healthier than their counterparts receiving standard diversion, stratification of patients in each group according to age and a pre‐operative “fitness” score showed no significant difference in operative mortality or major morbidity between comparable patients in each group. The mean post‐operative length of hospital stay was, however, 3 days shorter for the youngest and fittest patients receiving standard versus continent urinary diversion.
A Prostatectomy Audit: Phase I–Insights and Questions
Authors: McKELVIE G. B. , MORISON M. , HEHIR M. , ROGERS A. C. N.
Published: December 2008

A local prostatectomy audit is being undertaken to gain some insight into the pre‐and peri‐operative factors that inffuence post‐operative outcome and length of post‐operative stay. The aims of the first phase of the audit, involving 150 prostatectomy patients, have been to attempt to define the minimum data set required to meet the study's objectives, and to devise a data‐collecting tool that can be completed by the medical and nursing staff as part of the routine work. A tentative model has been devised to forecast post‐operative stay. The audit has raised a number of questions which will form the basis of further studies.
Detection of Lymph Node Invasion in Prostatic Carcinoma with Iliopelvic Lymphoscintigraphy
Authors: HORENBLAS S. , NUYTEN M. J. C. , HOEFNAGEL C. A. , MOONEN L. M. F. , DELEMARRE J. F. M.
Published: December 2008

Eleven patients, ranging in age from 58 to 79 years and referred for 125I implantation because of localised prostatic carcinoma, were subjected to iliopelvic lymphoscintigraphy (IPL) prior to lymph node dissection. Scintigraphy was performed by perianal injection into the ischiorectal fossa of 0.2 ml 99mTc radio‐labelled antimony sulphide colloid. The sensitivity of IPL was 100% and the specificity 13%, with a prevalence of positive nodes of 27%. It was concluded that IPL is not useful as a non‐surgical method of detecting lymph node invasion in localised prostatic carcinoma because of the low specificity.
Ureteric Stone Management Using a Second Generation Lithotriptor
Authors: MISHRIKI S. F. , WILLS M. I. , MUKHERJEE A. , FENELEY R. C. L. , GINGELL J. C.
Published: December 2008

A series of 209 consecutive patients with ureteric calculi underwent 296 extracorporeal shock wave lithotripsy treatments on the Siemens Lithostar over a 25‐month period; 123 stones were upper ureteric, 30 mid‐ureteric and 56 lower ureteric; 46.9% were right‐sided stones, 53.6% were left‐sided and 0.5% (1 patient) were bilateral. On referral, 60 patients had stents and 15 had nephrostomies for obstruction. All treatments were performed without anaesthesia except for 9 patients in whom stent insertion or ureteroscopic manipulations were attempted concomitant to ESWL.

The average number of treatments was 1.42, with 27.5% of patients requiring more than 1 treatment. The average number of shocks per treatment was 3995 and the average hospital stay was 1.79 days. Complete clearance of the stone was achieved in 82% of upper ureteric stones, 89% of mid‐ureteric and 80% of lower ureteric stones.

The facility for X‐ray localisation of stones allows a high proportion of ureteric calculi to be treated successfully by ESWL, including the more taxing middle and lower ureteric calculi.
Age‐related Variation in Urinary Flow Variables and Flow Curve Patterns in Elderly Males
Authors: JØRGENSEN J. BALSLEV , JENSEN K. M. ‐E. , MOGENSEN P.
Published: December 2008

A group of randomly selected males, over 50 years of age, was examined with regard to history and urinary flow rate. Originally, the group had comprised 93 men without voiding problems, 15 who, although suffering from voiding problems, had not yet contacted their doctor, and 4 who had contacted their doctor because of voiding problems. Five years later the data were re‐examined and 61 men were fully investigated again; in the remaining 51 patients only the history was updated. The 2 sets of data were evaluated separately as 2 cross‐sectional investigations and as paired data sets by means of non‐parametric statistical analysis.

All uroflow variables were considered, i. e. Qmax, Qave, Qmax‐time, Q “corrected”, volume and the ratio Qmax/Qmax‐time. In addition, the flow curve configuration was classified as normal or abnormal.

When compared as 2 cross‐sectional investigations, the latter confirmed the results of the first. Qmax, Qave, Q“corrected” and volume decreased with advancing age, but no correlation could be demonstrated between Qmax‐time and age. The flow curve pattern altered, so that a normal flow curve was seldom seem at an advanced age. Uroflow variables tended towards the abnormal with advancing years and symptoms increased concurrently. These changes were largely accepted by the elderly males. Thus the decision to operate for benign prostatic hyperplasia should be based on both history and urinary flow.
Identification of Metastatic Disease by T Category, Gleason Score and Serum PSA Level in Patients with Carcinoma of the Prostate
Authors: RANA A. , KARAMANIS K. , LUCAS M. G. , CHISHOLM G. D.
Published: December 2008

Pre‐operative serum prostate specific antigen (Tandem‐R assay), T category, Gleason score and the metastatic (M 1) status of a consecutive series of 60 patients with newly diagnosed carcinoma of the prostate were studied prospectively. The results revealed that, of these variables, pre‐operative serum PSA (> 100 ng/ml) was the single most important indicator of metastatic disease, with 100% predictive value. With this alone, 83.3% of M1 disease could be correctly identified. For the remaining 17%, however, we advocate a high index of suspicion if the tumour is T3‐T4 category on digital rectal examination (predictive value = 71.4%) and has a high grade with a Gleason score 8–10 (predictive value = 81%).
Value of Testicular Ultrasound in the Evaluation of Blunt Scrotal Trauma without Haematocele
Authors: MARTINEZ‐PIÑEIRO L. , CEREZO E. , COZAR J. M. , AVELLANA J. A. , MORENO J. A. , MARTINEZ‐PIÑEIRO J. A.
Published: December 2008

The value of ultrasound in testicular trauma with haematocele has been questioned inasmuch as the injured testis should always be explored surgically. Ultrasonography, however, plays an important role in the diagnosis and follow‐up of patients with blunt scrotal trauma without haematocele.

We have evaluated 17 such patients with real‐time ultrasound. In 9 cases the testis and epididymis were normal to palpation, although in 6 of them parenchymal lesions, mainly subcapsular haematomas and parenchymal contusions not amenable to surgical intervention, were detected with ultrasonography. Seven patients presented with changes in the testicular or epididymal morphology at palpation and in 1 case the testes were not palpable.

Ultrasonography was of great value, indicating surgery in 6 of these patients where physical examination alone was not sufficient to establish the need for surgical exploration.
Routine Radio‐imaging in Filarial Chyluria–Is it Necessary in Developing Countries?
Authors: DALELA D. , KUMAR A. , AHLAWAT R. , GOEL T. C. , MISHRA V. K. , CHANDRA H.
Published: December 2008

Chyluria is a common presentation of filariasis in developing countries and mostly affects economically poor classes. The judicious use of investigations is mandatory to keep the cost of treatment acceptable. A modified plan is suggested for managing such patients without using retrograde pyelography or lymphangiography.

A total of 54 patients were studied at 2 separate institutions, with retrograde pyelography being carried out at one institution but not at the other. All patients were treated primarily by the instillation of 1% silver nitrate, with an initial success rate of 70%. Eight patients who failed to respond underwent pyelolymphatic disconnection, the success rate being 88%. The omission of retrograde pyelography and lymphangiography had no effect on either treatment or outcome. The value of these radio‐imaging techniques is discussed.
Fixation of a Single Testis: Always, Sometimes or Never
Authors: MISHRIKI S. F. , WINKLE D. C. , FRANK J. D.
Published: December 2008

If it is necessary to perform an orchiectomy for an intravaginal testicular torsion it is the usual practice of surgeons to fix the contralateral testis. When faced with a child with only one testis for another reason it is our practice to fix this single testis to eliminate the small but disastrous risk of a torsion. We were interested to see whether this practice was usual and therefore sent out a questionnaire to the 67 consultant paediatric surgeons and urologists in Great Britain. Sixty‐six surgeons replied. Seven surgeons (11%) always fix the single testis, 28 (42%) sometimes and 31 (47%) never fix a single testis. Five surgeons had looked after 6 patients who had a torsion of a second unfixed testis after losing the first for a reason other than intravaginal torsion. Four of these patients had initially had a neonatal supravaginal torsion, 1 had a torsion of an undescended testis and the sixth had severe testicular atrophy following an inguinal herniotomy.

In our opinion the devastating loss of these solitary testes makes contralateral testicular fixation after an orchiectomy for whatever reason mandatory.