bluuebunny/crossref_metadata_2025_split huggingface dataset:
The wing vestiture of the non‐ditrysian Lepidoptera (Insecta). Comparative morphology and phylogenetic implications
Authors: Simonsen Thomas J. 
Published: March 2003

AbstractThe ultrastructure of the dorsal forewing vestiture in exemplars of all family group taxa of non‐ditrysian Lepidoptera is examined, and the evolutionary implications at family level and above are discussed. Wing‐scale terminology is reviewed. Three different types of bilayer wing‐scale covering are recognized; only a few groups have a single‐layer wing‐scale covering. The general scale arrangement is random, but a few taxa have clustered scale arrangements and scattered heteroneurans have scales arranged in transverse rows. Cross ribs are present in all taxa, but only as vestiges in eriocraniid cover scales. Ridge dimorphism is widespread in Neolepidoptera. Surprisingly, ridges and cross ribs on the adwing scale surface are of general occurrence in Neopseustidae and Hepialidae, and are even found on parts of the ground scales of many other Neolepidoptera. Morphological evidence strongly indicates that the fused wing‐scale types found in non‐Coelolepidan Lepidoptera and Neolepidoptera are independently evolved, as evidenced from the presence of vestigial perforations. Absence of perforations is not infallible evidence that a scale is solid. Microtrichia are independently reduced in a number of taxa and probably re‐evolved in at least higher nepticulids. Wing vestiture and scale characters indicate that Tischerioidea may be the sister group of Ditrysia.
Microscopic anatomy and ultrastructure of the digestive system ofNatatolana obtusata(Vanhöffen, 1914) (Crustacea, Isopoda)
Authors: Storch V , Strus J , Brandt A 
Published: March 2003

AbstractThe scavenging cirolanid isopodNatatolana obtusatawas caught using primarily meat‐baited traps at a station in the Weddell Sea at Kap Norvegica. The hindguts of most specimens were densely stuffed with meat from the traps. The anatomy and the ultrastructure of different sections of the digestive system are described. The large and extremely expandable mouth opens into a short oesophagus which extends posteriorly into a small stomach. Lateralia and primary filter can be observed directly when the mouth opening is widened to its extreme. The anterior hindgut is extremely variable in its lumen and very distensible, depending on the nutritional condition. The cuticle of the hindgut is colonized by fungi. The length of the midgut glands varies with the nutritional conditions. Morphology and anatomy of the digestive system ofNatatolana obtusataare discussed with the background of the lifestyle of the species and compared with other taxa.
Open stone surgery in children: is it justified in the era of minimally invasive therapies?
Authors: Zargooshi Javaad 
Published: March 2003

Objective To review experience with open surgery for paediatric urolithiasis during a 10‐year period. Patients and methods The hospital records of patients up to 13 years old and treated between 1990 and 2000 for stones were reviewed; there were 310 patients (98 girls and 212 boys, aged 9 months to 13 years, mean 6.8 years). Results The commonest symptoms were renal‐ureteric colic (26.7%), gross haematuria (19%), urinary retention (16.7%), and abdominal and/or flank pain (13.2%). Because of poverty and the resultant inability to pay medical fees, 19 children presented very late with pyonephrosis (resembling peritonitis in nine) and obstructive renal atrophy in 23. In 18 other patients the delay was caused by the disappearance of pain. Delayed presentation was the most important factor in developing complications from the stone. The stones were in the calyces in 15 patients, the pelvis in 113, the ureter in 56, the bladder in 71, the urethra in 17 and in a combination of sites in 38. The mean (range, median) stone size was 27 (9–75, 22) mm; 80 (25.8%) were complete staghorn stones. Indications for open surgery were a complex stone burden (62%), ESWL failure (14.5%), need for nephrectomy (1.9%), anatomical abnormalities (2.2%), and unavailability of minimally invasive alternatives (19%). All of the nephrectomized patients underwent unilateral stone removal and contralateral nephrectomy. For parents, the cost and reliability of the result were more important than other considerations, e.g. having a large or small incision. The overall stone‐free rate at discharge was 95.4% (100% for single stones). In five cases (1.6%) a repeat open procedure was needed. The mean (range, median) hospital stay was 4 (1–13, 3) days. Conclusions Arguments against open surgery for urolithiasis in adults should not be extrapolated to children, in whom open surgery is safe and effective. In Iran and many ‘developing’ countries, open surgery is less expensive, more effective, more dependable, and more easily available than minimally invasive alternatives. At least in such countries it deserves to be among the first‐line therapies for paediatric urolithiasis, and urologists in less‐developed countries should not decline to offer open surgery because it is almost obsolete in developed countries. Delayed presentation (through poverty and/or unawareness) contributes significantly to the morbidity of urolithiasis.
The rho/rho‐kinase pathway is involved in the progression of testicular germ cell tumour
Authors: Kamai T. , Arai K. , Sumi S. , Tsujii T. , Honda M. , Yamanishi T. , Yoshida K.‐I. 
Published: March 2003

Objective To clarify the role of one of the downstream effectors of Rho (Rho‐kinase) in testicular germ cell tumour (GCT) by quantifying mRNA expression for Rho‐kinase in patients with this disease. Materials and methods The mRNA levels of the RhoA and Rho‐kinase genes were analysed in surgical specimens of testicular GCT tissues from 57 consecutive Japanese patients, and in the corresponding non‐tumour tissue originating from the same patient, using the polymerase chain reaction after reverse transcription. The expression levels of these genes were compared between the tissues and the relationship between their expression levels evaluated within tumours and with tumour stage. The difference in the expression levels of the mRNAs of RhoA and Rho‐kinase genes were also assessed between tumours that were seminoma only and mixed tumours of seminoma and nonseminoma. Results RhoA and Rho‐kinase mRNAs were more abundant in tumour tissue than in non‐tumour tissue (P < 0.01 and < 0.05, respectively). High RhoA and Rho‐kinase mRNA expressions were related to tumour stage (P < 0.05 and < 0.01, respectively). The mRNA levels of RhoA and Rho‐kinase in mixed tumours were higher than in tumours with seminoma only (P < 0.01 and < 0.05, respectively). There was a positive relationship between expression levels of mRNAs of RhoA and Rho‐kinase in tumour tissues (P < 0.001). Conclusions These findings suggest that the RhoA/Rho‐kinase pathway is involved in the progression of testicular GCT. This pathway might be a molecular target for new treatment strategies for this disease.
Sleep and night‐time behaviour of enuretics and non‐enuretics
Authors: Nevéus T. , Läckgren G. , Stenberg A. , Tuvemo T. , Hetta J. 
Published: March 2003

ObjectiveTo investigate connections between nocturnal enuresis and sleep factors such as the subjective depth of sleep and classical parasomnias.Patients, subjects and methodsOne hundred school children aged 6–10 years answered a questionnaire, with their parents, and the same questions were asked of a group of 29 children of the same age suffering from severe nocturnal enuresis.ResultsThere were significant differences in arousability, with the enuretic group being ‘deep sleepers’, and in the prevalence of onset insomnia, nightmares, interrupted sleep and bedtime struggles, which were all less common among the enuretics. The prevalence of classical parasomnias did not differ between the groups.ConclusionA high arousal threshold is one of the pathogenetic factors underlying nocturnal enuresis and we propose that this group of therapy‐resistant enuretic children might not only sleep more deeply than their nonenuretic peers, but perhaps have ‘better’ sleep.
An Italian epidemiological multicentre study of nocturnal enuresis
Authors: Chiozza M.L. , Bernardinelli L. , Caione P. , Del Gado R. , Ferrara P. , Giorgi P.L. , Montomoli C. , Rottoli A. , Vertucci P. 
Published: March 2003

ObjectiveTo estimate the prevalence of enuresis in schoolchildren in Italy.Subjects and methodsThe Italian Club of Nocturnal Enuresis promoted a prevalence study of nocturnal enuresis using a self‐administered questionnaire in seven cities in Northern, Central and Southern Italy. The association between enuresis and potential risk factors, e.g. a family history of enuresis, stress, socio‐economic status and abnormal diurnal voiding habits, was investigated. The perceived impact on the child and on the family was also evaluated. A random‐cluster sampling scheme was used to obtain a sample of primary and secondary schoolchildren from each city. One primary school and one secondary school for each socio‐economic level was sampled in each city, giving a total of 42 schools surveyed; 9086 children were covered by the survey. In a cluster sampling method, the variance of prevalence is divided into two components, binomial and extra‐binomial variability. Both the DSM III and DSM IV definitions of enuresis were used because at present, there is no consensus on the diagnostic criteria.ResultsCompleted questionnaires were received from 7012 children, an overall response rate of 77.2%. Those aged 6–14 years were analysed, restricting the sample to 6892 children. There were 250 enuretic children using the DSM III definition of enuresis and 112 using the DSM IV definition. The overall prevalence was 3.8% and showed a decreasing trend with increasing age. Bedwetting was more frequent in boys than in girls. The prevalence of enuresis was higher when the child was from a family of low socio‐economic status despite the child’s age group. The logistic analysis showed that familiality, stress, birthweight, age of attaining diurnal continence, soiling and, for girls, menstruation, were statistically significant variables and thus contributed to predicting the probability of bedwetting, confirming the findings of previous studies. There was a large difference in prevalence using the two DSM definitions; a high percentage of DSM III enuretic children had more than two wet nights per week.ConclusionIt is important that a consensus about the ‘working definitions’ of enuresis is reached to avoid bias in the recruitment step, to carry out comparable epidemiological studies and to obtain adequate therapeutic responses.
Immunohistochemical analysis of Ki‐67 antigen and Bcl‐2 protein expression in prostate cancer: effect of neoadjuvant hormonal therapy
Authors: Tsuji  , Murakami  , Kanayama  , Sano  , Kagawa  
Published: March 2003

Objective To determine differences in the immunohistochemical (IHC) expression of Bcl‐2 protein and Ki‐67 antigen in patients with prostatic cancer who underwent radical prostatectomy with or without neo‐adjuvant hormonal therapy.Materials and methods Ki‐67 antigen and Bcl‐2 protein were detected by IHC using MIB‐1 and Bcl‐2 antibodies in prostatectomy specimens from 28 patients who received hormonal therapy before surgery (group 1) and 51 patients who did not (group 2).Results In group 2, the mean MIB‐1 index increased with increasing grade of tumour, from 11.6% in low‐grade to 24.7% in high‐grade tumours (P=0.002). Bcl‐2 expression did not correlate with either tumour grade or stage. In group 1, there were no correlations between Bcl‐2 expression or MIB‐1 index and tumour grade or stage. More tumours in group 1 were Bcl‐2‐positive (16 of 28, 57%) than were tumours in group 2 (11 of 51, 22%; P=0.003). The mean (sd) MIB‐1 index of tumours in group 2 [15.6 (14.4)%], was significantly greater than that of tumours in group 2 [6.8 (7.5)%; P=0.004].Conclusions These results indicate that Bcl‐2 positivity is increased by androgen ablation therapy and conversely, that the proliferative activity of cancer cells is significantly reduced. The expression of Bcl‐2 protein may play a role in the ability of prostate cancer cells to survive in an androgen‐deprived environment.
Excision of residual masses of metastatic germ cell tumours after chemotherapy: the role of extraperitoneal surgical approaches
Authors: Christmas  , Doherty  , Rustin  , Seckl  , Newlands  
Published: March 2003

Objective To evaluate the efficacy and safety of extra‐peritoneal surgical approaches for the removal of residual masses of metastatic germ cell tumours in men after chemotherapy.Patients and methods A series of 75 men (median age 32 years) with metastatic germ cell tumours of testicular (n=63) or extragonadal (n=12) origin, who had been treated with an intensive course of platinum‐based chemotherapy, were found to have residual tumour masses. Extraperitoneal surgical approaches were used on 80 occasions to excise these masses. A thoraco‐abdominal extraperitoneal approach (n=71) was used for large masses and those with intrathoracic metastases while smaller retroperitoneal masses were removed through 12th rib (n=5) or Rutherford‐Morrison (n=4) extraperitoneal approaches.Results Complete macroscopic clearance of residual masses within the thorax and retroperitoneum was achieved in all cases. The median blood loss was 0.8 L and the median in‐patient stay was 7 days. Complications included chest infection in four cases. Two patients died about 4 weeks after surgery, one from septic pericarditis and another after an epileptic fit secondary to brain metastases. Eleven patients have developed tumour recurrence, five of whom have died from disseminated disease. Hence the survival rate and disease‐free survival rate are 91% and 83%, respectively, with a median follow‐up of 22 months.Conclusions The thoraco‐abdominal extraperitoneal surgical approach for retroperitoneal lymph node dissection after chemotherapy for testicular cancer is safe and has some advantages over anterior approaches, allowing synchronous removal of intrathoracic disease, improved access to nodes above and behind the renal vessels and more rapid post‐operative recovery.
Characterization and modulation of transitional cell carcinoma cell lines with acquired multidrug resistance
Authors: Yu  , Chang  , Ma  
Published: March 2003

Objectives To characterize in vitro drug‐induced multidrug resistance (MDR) in transitional cell carcinoma (TCC) cell lines, and to elucidate the possible mechanisms of acquired MDR and their modulation.Materials and methodsTwo drug‐resistant cell lines, TCC8702/A1000 (adriamycin 1000 ng/mL) and TCC8803/A200 (adriamycin 200 ng/mL), were established after long‐term adriamycin treatment for at least 16 months. Their biological characteristics, including growth morphology, doubling time and cell cycle, were analysed. The drug‐resistance pattern to various anticancer drugs was measured using a microplate cytotoxicity assay. The modulation of drug sensitivity by calcium‐channel blockers and protein kinase C inhibitor was assessed among the different cancer cell lines.ResultsBoth MDR sublines had lower growth rates, lower saturation densities and higher nuclear/cytoplasmic ratios than the parent cell lines. DNA staining and cell cycle analysis revealed that both TCC8702/A1000 and TCC8803/A200 cells had a decreased S‐phase fraction and the TCC8803/A200 cells a changed stem line; both sublines showed increased expression of membranous glycoprotein gp‐170. The cytoplasmic content of glutathione and glucose‐6‐phosphate dehydrogenase were not related to the MDR development in the sublines. The drug‐resistance index of TCC8702/A1000 to adriamycin was 121‐fold higher than the native cell line and TCC8803/A200 was 189‐fold higher. TCC8803/A200 also had a broader MDR to cisplatin, vinblastine and vincristine. Calcium‐channel blockers (verapamil, quinidine) and protein kinase C inhibitors (tamoxifen) inhibited gp‐170 activity and slowed the drug‐efflux pump, with the acquired‐MDR cells subsequently accumulating anticancer drugs. A calcium antagonist‐based combination of modulators all presented synergistic cytotoxic enhancement of the anticancer drugs. Parent TCC cell lines had a poorer response to modulator treatment than their MDR sublines.ConclusionDifferent MDR mechanisms and subsequent modulator responses exist between native and acquired drug resistance in TCC cells. Acquired MDR seems strongly related to increased gp‐170 expression and responds well to calcium antagonists. This phenomenon may be applicable in clinical conditions.
Prostate specific antigen velocity as a measure of the natural history of prostate cancer: defining a ‘rapid riser’ subset
Authors: Nam  , Klotz  , Jewett  , Danjoux  , Trachtenberg  
Published: March 2003

Objective To study the rate of change in prostate specific antigen (PSA velocity) in patients with prostate cancer initially managed by ‘watchful waiting’.Patients and methods Serial PSA levels were determined in 141 patients with prostate cancer confirmed by biopsy, who were initially managed expectantly and enrolled between May 1990 and December 1995. Sixty‐seven patients eventually underwent surgery (mean age 59 years) because they chose it (the decision for surgery was not based on PSA velocity). A cohort of 74 patients remained on ‘watchful waiting’ (mean age 69 years). Linear regression and logarithmic transformations were used to segregate those patients who showed a rapid rise, defined as a>50% rise in PSA per year (or a doubling time of <2 years) and designated ‘rapid risers’.Results An initial analysis based on a minimum of two PSA values showed that 31% were rapid risers. Only 15% of patients with more than three serial PSA determinations over ≥6 months showed a rapid rise in PSA level. There was no advantage of log‐linear analysis over linear regression models.Conclusion Three serial PSA determinations over ≥6 months in patients with clinically localized prostate cancer identifies a subset (15%) of patients with a rapidly rising PSA level. Shorter PSA surveillance with fewer PSA values may falsely identify patients with rapid rises in PSA level. However, further follow‐up is required to determine if a rapid rise in PSA level identifies a subset of patients with an aggressive biological phenotype who are either still curable or who have already progressed to incurability through metastatic disease.
Expression of E‐cadherin in primary prostate cancer: correlation with clinical features
Authors: Kuczyk  , Serth  , Machtens  , Bokemeyer  , Bathke  , Stief  , Jonas  
Published: March 2003

Objective To correlate the immunohistochemically detected loss of E‐cadherin expression with patient age, clinical and biological variables, and to investigate the prognostic value of these variables for the relapse‐free and overall survival of patients with different stages of newly diagnosed prostate cancer.Patients and methods Sixty‐seven patients (median age 63 years, range 48–78) undergoing radical prostatectomy for the treatment of primary prostate cancer were assessed to determine whether age, tumour stage, histological grading, serum levels of prostate specific antigen and prostatic acid phosphatase, regional lymph node status and E‐cadherin expression were prognostic factors for relapse‐free and overall survival.Results With a median (range) follow‐up of 54 (3–193) months, there was no independent prognostic value of decreased E‐cadherin expression for the long‐term or recurrence‐free survival of patients, using a threshold value of 40% for the relative amount of positively stained tumour cells, or for any other threshold value calculated (25%, 60% or 75%). However, comparing a follow‐up of 16 months in patients with <40% positivity and 46 months in patients with ≥40% positivity, those patients retaining E‐cadherin expression had a significantly longer recurrence‐free interval after radical prostatectomy (P<0.01).Conclusion The value of E‐cadherin expression as an additional independent prognostic variable for patients with primary prostate cancer is questionable.
Free‐to‐total prostate‐specific antigen (PSA) ratio improves the specificity for detecting prostate cancer in patients with prostatism and intermediate PSA levels
Authors: Recker  , Kwiatkowski  , Piironen  , Pettersson  , Goepel  , Tscholl  
Published: March 2003

Objective To investigate the clinical significance of the free‐to‐total prostate‐specific antigen (PSA) ratio in improving the specificity of PSA measurement for detecting prostate cancer within the diagnostic intermediate range (4–10 ng/mL total PSA) in patients referred for the treatment of urinary symptoms.Patients and methods Serum samples were obtained from 333 consecutive patients with obstructive and irritative urinary symptoms. Of these men, 114 had total PSA levels of 4–10 ng/mL; 22 had prostate cancer (group 1) and 71 had benign prostatic hyperplasia (BPH, group 2). Group 3 consisted of 21 patients with BPH and a chronic indwelling catheter. The concentrations of free and total PSA (ProStatusTM, Wallac Oy, Turku, Finland) and PSA complexed to α‐1‐antichymotrypsin were measured and the free‐to‐total PSA ratio calculated. All patients under 70 years of age or with suspicious findings on digital rectal examination or transrectal ultrasonography underwent ultrasound‐guided sextant prostate biopsies. Of the 114 patients, 105 (92%) underwent transurethral resection of the prostate and six (5%) radical retropubic prostatectomy.Results Patients in group 1 had significantly lower median free PSA concentrations (0.78 ng/mL vs 1.13 ng/mL, P<0.001) and a lower free‐to‐total PSA ratio (12.1% vs 19.9%, P<0.001) than those in group 2. The differences were similar between group 1 and group 3 (median free PSA in group 3, 1.06 ng/mL, P=0.03, and free‐to‐total PSA ratio 18.7%, P=0.007). There were no significant differences between patients in groups 2 and 3. The free‐to‐total PSA ratio had a higher specificity than total PSA at all sensitivity levels, e.g. a threshold free‐to‐total PSA ratio of 0.20 detected 91% of cancers and spared 48% (group 2) or 46% (group 3) from unnecessary biopsies. The area under the receiver operating characteristic curve for group 1 vs group 2 was 0.56 (total PSA) and 0.78 (free‐to‐total PSA ratio) and for group 1 vs group 3 was 0.56 (total PSA) and 0.81 (free‐to‐total PSA ratio).Conclusion In those patients with extensive symptoms from BPH and requiring surgical treatment, the free‐to‐total PSA ratio improves the specificity for detecting prostate cancer in the diagnostic ‘grey zone’ of 4–10 ng/mL total PSA. This improvement occurred in patients with or without a chronic indwelling catheter for urinary retention.
Penile perfusion and functional scintigraphy:
Authors: Drawz  , Drawz  , Kittner  , Seiter  , Schuemichen  
Published: March 2003

Objective To determine the effect on penile haemodynamics of vascularization using the Hauri method for the treatment of erectile dysfunction of vascular aetiology, as assessed by penile perfusion and functional scintigraphy.Patients and methods Penile perfusion and functional scintigraphy were performed before and after penile revascularization by the Hauri method in 13 patients. The established method of scintigraphy was carried out using 10 MBq/kg body weight of 99mtechnetium pertechnetate for in vivo labelling of erythrocytes, modified by including an estimate of mean virtual blood inflow rate.Results In 10 of the 13 patients there was a significant increase in the mean virtual blood inflow rate after surgery (P<0.01, Wilcoxon test). In three patients, the inflow rate was lower after surgery than before; Doppler ultrasonography showed an occluded anastomosis in these patients.Conclusions Penile vascularization using the Hauri method provides an objectively demonstrable improvement in penile haemodynamics in man. It is thus a sufficiently therapeutic procedure for treating erectile dysfunction of vascular aetiology and its effect greatly exceeds any ‘psychological influence’.