bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduction Phalloplasty and Penile Prosthesis Implantation in a Case of Megalophallus as a Consequence of Neglected Priapism
Authors: Kattan S. , Seyam R.M. , Al-Ghamdi D. 
Published: September 2004

ABSTRACT

Objectives
Megalophallus is a rare complication of priapism and sickle cell disease. More commonly, priapism in those patients is recurrent, difficult to prevent and ends up in erectile dysfunction as a result of cavernous tissue fibrosis or surgical intervention. A 33 year old man presented to us with a history of neglected priapism for 12 days 2 years previously. He developed a permanent unusual enlargement of the penis and erectile dysfunction. The patient determined that his new penile size is nonfunctional and unacceptable. We evaluated the patient and set out to surgically fashion the penis into a usable size, with adequate rigidity and stable condition.

Material and Methods
For 9 years the patient had frequent episodes of priapism which resolved spontaneously. The last episode was unsuccessfully treated conservatively and eventually the patient received a Winter shunt. The penis became enlarged and erections soft. Upon examination with intracavernous injection of 60 mg papaverine, the penis became mildly engorged and it measured 21 cm in circumference and 18 cm in length from the pubic pad of fat to the tip of the glans. MRI showed that the enlargement is mainly due to massive enlargement of corpora cavernosa. We based our goals on normative data for penile length and circumference. Under general anesthesia, we degloved the penis using a circumcision incision. The tunica albuginea was exposed laterally. A 3 cm wide strip was marked on the lateral side of each corpus cavernosum and excised along the long axis of the penis from 1 cm proximal to the coronal sulcus to the pubic bone. The cavernous tissue underneath was fibrotic and was excised to fit in the cylinders of an AMS 700 Ultrex penile prothesis. The tunica albuginea was run with an absorbable suture and the pump and reservoir were placed in the scrotum and retropubic space. Inflation of the prosthesis resulted in rupture of the suture line for 5 cm on the right side just proximal to the glans. Repeated removal of underlying cavernous tissue was not enough to accommodate the cylinder and a free tunica albuginea patch graft was sewn in.

Results
At the end of surgery, the penile length was left intact, while the circumference was reduced to 15 cm.

Conclusion
Reduction phalloplasty is feasible to manage the unusual cases of megalophallus. Extensive dissection and cavernous tissue removal necessitate penile prosthesis implantation. This is particularly justified in cases associated with erectile dysfunction complicating priapism.

Disclosure
Was this work supported by industry? No.
Flap Cover is Superior to Graft Cover Everywhere, Even in Peyronie's Disease
Authors: Krishnamurti S. 
Published: September 2004

ABSTRACT

Objectives
The aim is to re-draw attention to the penile dermal flap (PDF) and present an update. A case is made for the more widespread use of this simple and effective technique. It is important to understand the difference between flaps and free grafts and recognize the clear superiority of the former over the latter.

Materials and Methods
The PDF was first applied to close tunical defects in Peyronie's disease in uncircumcised males with available foreskin, then modified for use in the circumcised, and adapted for use in congenital penile curvatures. Nearly 100 patients have undergone this operation.

Results
Exact figures are not ready at the time of submission of this abstract. However, penile straightening occurred in nearly 100 % of patients, with very low post-operative rates of contracture or ED. Details will be presented.

Discussion
It is elementary knowledge that flaps are of proven superiority to free grafts. Yet, urologists continue to be obsessed with free grafts for Peyronie's disease. All free grafts: auto-, allo-, xeno-, synthetic—may get infected, and will contract sooner or later. This was painfully clear after 30 years’ experience with free dermal (and other) grafts, yet the lesson isn’t learnt. Vein grafts are no exception. The nitric oxide advantage of the vein intima is purely theoretical. It is well-known that luminal blood cannot always nourish the media and adventitia layers in medium-sized and large veins by diffusion alone, and that vasa vasora are necessary. Vasa vasora get destroyed when the vein is cut.

Disclosure
Was this work supported by industry? No.
New Technique for Hydraulic Penile Prosthesis Insertion and Corporotomy Closure
Authors: Andrianne R.M. 
Published: September 2004

ABSTRACT
An original technique of insertion and corporotomy closure on the level proximal is described. Proximal angle of corporotomy is closed on the pipe of the hydraulic cylinder by a point of vicryl which was installed before the device implantation. This simple technique allows correct installation of proximal extremity of the prosthesis in the tail of the cavernous body and avoids damage and perforation to the prothesis.

Disclosure
Was this work supported by industry? No.
Riboflavin Production in
Lactococcus lactis
: Potential for In Situ Production of Vitamin-Enriched Foods
Authors: Burgess Catherine , O'Connell-Motherway Mary , Sybesma Wilbert , Hugenholtz Jeroen , van Sinderen Douwe 
Published: October 2004

ABSTRACT

This study describes the genetic analysis of the riboflavin (vitamin B
2
) biosynthetic (
rib
) operon in the lactic acid bacterium
Lactococcus lactis
subsp.
cremoris
strain NZ9000. Functional analysis of the genes of the
L. lactis rib
operon was performed by using complementation studies, as well as by deletion analysis. In addition, gene-specific genetic engineering was used to examine which genes of the
rib
operon need to be overexpressed in order to effect riboflavin overproduction. Transcriptional regulation of the
L. lactis
riboflavin biosynthetic process was investigated by using Northern hybridization and primer extension, as well as the analysis of roseoflavin-induced riboflavin-overproducing
L. lactis
isolates. The latter analysis revealed the presence of both nucleotide replacements and deletions in the regulatory region of the
rib
operon. The results presented here are an important step toward the development of fermented foods containing increased levels of riboflavin, produced in situ, thus negating the need for vitamin fortification.
Bacterial Community Structure and Diversity in a Century-Old Manure-Treated Agroecosystem
Authors: Sun H. Y. , Deng S. P. , Raun W. R. 
Published: October 2004

ABSTRACT

Changes in soil microbial community structure and diversity may reflect environmental impact. We examined 16S rRNA gene fingerprints of bacterial communities in six agroecosystems by PCR amplification and denaturing gradient gel electrophoresis (PCR-DGGE) separation. These soils were treated with manure for over a century or different fertilizers for over 70 years. Bacterial community structure and diversity were affected by soil management practices, as evidenced by changes in the PCR-DGGE banding patterns. Bacterial community structure in the manure-treated soil was more closely related to the structure in the untreated soil than that in soils treated with inorganic fertilizers. Lime treatment had little effect on bacterial community structure. Soils treated with P and N-P had bacterial community structures more closely related to each other than to those of soils given other treatments. Among the soils tested, a significantly higher number of bacterial ribotypes and a more even distribution of the bacterial community existed in the manure-treated soil. Of the 99 clones obtained from the soil treated with manure for over a century, two (both
Pseudomonas
spp.) exhibited 100% similarity to sequences in the GenBank database. Two of the clones were possible chimeras. Based on similarity matching, the remaining 97 clones formed six major clusters. Fifty-six out of 97 were assigned taxonomic units which grouped into five major taxa: α-, β-, and γ-
Proteobacteria
(36 clones),
Acidobacteria
(16 clones),
Bacteroidetes
(2 clones),
Nitrospirae
(1 clone), and
Firmicutes
(1 clone). Forty-one clones remained unclassified. Results from this study suggested that bacterial community structure was closely related to agroecosystem management practices conducted for over 70 years.
Composition and Diversity of Microbial Communities Recovered from Surrogate Minerals Incubated in an Acidic Uranium-Contaminated Aquifer
Authors: Reardon Catherine L. , Cummings David E. , Petzke Lynn M. , Kinsall Barry L. , Watson David B. , Peyton Brent M. , Geesey Gill G. 
Published: October 2004

ABSTRACT

Our understanding of subsurface microbiology is hindered by the inaccessibility of this environment, particularly when the hydrogeologic medium is contaminated with toxic substances. In this study, surrogate geological media contained in a porous receptacle were incubated in a well within the saturated zone of a pristine region of an aquifer to capture populations from the extant communities. After an 8-week incubation, the media were recovered, and the microbial community that developed on each medium was compared to the community recovered from groundwater and native sediments from the same region of the aquifer, using 16S DNA coding for rRNA (rDNA)-based terminal restriction fragment length polymorphism (T-RFLP). The groundwater and sediment communities were highly distinct from one another, and the communities that developed on the various media were more similar to groundwater communities than to sediment communities. 16S rDNA clone libraries of communities that developed on particles of a specular hematite medium incubated in the same well as the media used for T-RFLP analysis were compared with those obtained from an acidic, uranium-contaminated region of the same aquifer. The hematite-associated community formed in the pristine area was highly diverse at the species level, with 25 distinct phylotypes identified, the majority of which (73%) were affiliated with the β-
Proteobacteria
. Similarly, the hematite-associated community formed in the contaminated area was populated in large part by β-
Proteobacteria
(62%); however, only 13 distinct phylotypes were apparent. The three numerically dominant clones from the hematite-associated community from the contaminated site were affiliated with metal- and radionuclide-tolerant or acidophilic taxa, consistent with the environmental conditions. Only two populations were common to both sites.
Comparison of Different Primer Sets for Use in Automated Ribosomal Intergenic Spacer Analysis of Complex Bacterial Communities
Authors: Cardinale Massimiliano , Brusetti Lorenzo , Quatrini Paola , Borin Sara , Puglia Anna Maria , Rizzi Aurora , Zanardini Elisabetta , Sorlini Claudia , Corselli Cesare , Daffonchio Daniele 
Published: October 2004

ABSTRACT

ITSF and ITSReub, constituting a new primer set designed for the amplification of the 16S-23S rRNA intergenic transcribed spacers, have been compared with primer sets consisting of 1406F and 23Sr (M. M. Fisher and E. W. Triplett, Appl. Environ. Microbiol. 65:4630-4636, 1999) and S-D-Bact-1522-b-S-20 and L-D-Bact-132-a-A-18 (L. Ranjard et al., Appl. Environ. Microbiol. 67:4479-4487, 2001), previously proposed for automated ribosomal intergenic spacer analysis (ARISA) of complex bacterial communities. An agricultural soil and a polluted soil, maize silage, goat milk, a small marble sample from the façade of the Certosa of Pavia (Pavia, Italy), and brine from a deep hypersaline anoxic basin in the Mediterranean Sea were analyzed with the three primer sets. The number of peaks in the ARISA profiles, the range of peak size (width of the profile), and the reproducibility of results were used as indices to evaluate the efficiency of the three primer sets. The overall data showed that ITSF and ITSReub generated the most informative (in term of peak number) and reproducible profiles and yielded a wider range of spacer sizes (134 to 1,387) than the other primer sets, which were limited in detecting long fragments. The minimum amount of DNA template and sensitivity in detection of minor DNA populations were evaluated with artificial mixtures of defined bacterial species. ITSF and ITSReub amplified all the bacteria at DNA template concentrations from 280 to 0.14 ng μl
−1
, while the other primer sets failed to detect the spacers of one or more bacterial strains. Although the primer set consisting of ITSF and ITSReub and that of S-D-Bact-1522-b-S-20 and L-D-Bact-132-a-A-18 showed similar sensitivities for the DNA of
Allorhizobium undicula
mixed with the DNA of other species, the S-D-Bact-1522-b-S-20 and L-D-Bact-132-a-A-18 primer set failed to detect the DNA of
Pseudomonas stutzeri
.
Setting of noninvasive pressure support in young patients with cystic fibrosis
Authors: Fauroux B. , Nicot F. , Essouri S. , Hart N. , Clément A. , Polkey M.I. , Lofaso F. 
Published: September 2004

The aim of the current study was to compare a clinical noninvasive method of setting up noninvasive pressure support ventilation (PS-NI) in young patients with cystic fibrosis (CF), based on parameters such as breathing frequency, arterial oxygen saturation and comfort rating, with a more invasive method (PS-I) targeted at optimising unloading of the inspiratory muscles and enhancing patient-ventilator synchronisation.PS-NI and PS-I were compared in random order in 10 children with CF.PS-NI differed from PS-I with regard to the level of inspiratory pressure (n=5), rate of inspiratory pressurisation (n=1), inspiratory trigger sensitivity (n=2) and expiratory trigger sensitivity (n=5). Although both methods modified breathing pattern, improved oxygen saturation and reduced diaphragmatic pressure time product (450±91 cmH2O·s−1·min−1during spontaneous breathing, and 129±125 and 104±75 cmH2O·s−1·min−1during PS-NI and PS-I, respectively), patient-ventilator synchrony and patient comfort were enhanced more during PS-I.In young patients with cystic fibrosis, setting up pressure support using a clinical noninvasive approach based on easily measurable parameters, such as respiratory rate and comfort rating, is as effective as a more invasive technique based on unloading of the inspiratory muscles and optimising patient-ventilator synchronisation. However, whilst the standard clinical method is satisfactory in the majority of patients, more invasive measurements should be considered in patients who have difficulty synchronising with the ventilator to enhance patient tolerance and compliance.
Expansion of CCR5+ CD4+ T-lymphocytes in the course of active pulmonary tuberculosis
Authors: Santucci M.B. , Bocchino M. , Garg S.K. , Marruchella A. , Colizzi V. , Saltini C. , Fraziano M. 
Published: September 2004

Nonsyncytium inducing, macrophage tropic HIV strains predominate in the course of active tuberculosis (TB). The present study assesses the expression of CCR5 in CD4+ T-lymphocytes from blood and bronchoalveolar lavage (BAL) of TB patients, non-TB lung disease controls and healthy controls.Memory (CD45RO+), recently activated (CD69+), proliferating (Ki67+) CCR5+ or CCR3+ CD4+ T-lymphocytes were determined by multiparametric flow cytometry analysis.Results show that BAL CD4+ T-lymphocytes expressing CCR5 or CCR3 were significantly increased when compared to peripheral blood both in patients and in healthy controls. However, the data show that the proportions of peripheral blood CCR5+ CD4+ and CCR3+ CD4+ T-lymphocytes and BAL CCR5+ CD4+ T-lymphocytes, but not BAL CCR3+ CD4+ T-lymphocytes, were significantly increased in TB patients. Furthermore, the observation that BAL CCR5+ CD4+ T-lymphocytes from TB patients expressed early activation markers, were not proliferating and showed down-regulation of CCR5 expression suggests recruitment and trapping at the site of disease.Altogether, these results suggest that the lower respiratory tract mucosa may provide cellular targets accessible for efficient transmission of macrophage tropic HIV-1 variants and that tuberculosis may enhance this phenomenon.
Brief adrenomedullin inhalation leads to sustained reduction of pulmonary artery pressure
Authors: von der Hardt K. , Kandler M.A. , Chada M. , Cubra A. , Schoof E. , Amann K. , Rascher W. , Dötsch J. 
Published: September 2004

The effect of aerosolised adrenomedullin (ADM), a potent vasodilator peptide, on pulmonary artery pressure was studied for 24 h in a surfactant-depleted piglet model.Animals received either aerosolised ADM (50 ng·kg−1·min−1, ADM, n=6), or aerosolised normal saline solution (control, n=6). Aerosol therapy was performed for a 2 h treatment period followed by a 22 h observation period. Ventilator settings were adapted to keep arterial oxygen tension and carbon dioxide arterial tension between 13.3–14.6 kPa and 4.9–5.7 kPa, respectively.Aerosolised ADM reduced mean pulmonary artery pressure (MPAP) compared with the control group (end-point median 24 h after therapy start: ΔMPAP −14.0versus−8.0 mmHg; 23.5 h after therapy start). After therapy start, mean systemic arterial pressure (MAP) was not significantly different between the groups (end-point median: MAP ADM 70 (61/74)versuscontrol 72 (54/81) mmHg). Endothelin-1, a potent pulmonary vasoconstrictor, is regulated by ADMviacAMP. Twenty two hours after inhalation of aerosolised ADM, endothelin-1 mRNA in lung tissue and endothelin-1 protein expression in pulmonary arteries was reduced compared with controls (median semi-quantitative immunhistochemical score: ADM 0.21, control 0.76).Aerosolised adrenomedullin significantly reduced mean pulmonary artery pressure independently of arterial oxygen tension.
The effect of fluticasone on the airway inflammatory response to organic dust
Authors: Ek A. , Palmberg L. , Larsson K. 
Published: September 2004

Exposure to organic dust in a swine house causes acute airway inflammation and increased bronchial responsiveness to methacholine in healthy subjects. The aim of this study was to investigate whether an inhaled glucocorticoid, fluticasone propionate, alters the acute airway responses induced by exposure in a swine barn.In 15 healthy subjects, analysis of nasal lavage fluids, serum samples and bronchial methacholine responsiveness were performed before and after exposure to organic dust in a swine house for 3 h. Seven subjects received fluticasone propionate (500 µgb.i.d.by inhalation and 100 µg intranasally once daily) and eight subjects received placebo during the 2 weeks prior to exposure.Post-exposure plasma interleukin (IL)-6 levels and body temperature were significantly lower in the fluticasone group than in the placebo group. Intranasally administered fluticasone propionate significantly attenuated the plasma protein (assessed as albumin concentrations) leakage and IL-8 and tumour necrosis factor-α response induced by exposure. Fluticasone propionate inhalation exerted no influence on the increased bronchial responsiveness to methacholine induced by exposure.In conclusion, glucocorticoid treatment attenuated the inflammatory response to inhaled organic dust without influencing the increased bronchial responsiveness to methacholine.
Sputumversusbronchoscopy for diagnosis ofPseudomonas aeruginosabiofilms in cystic fibrosis
Authors: Aaron S.D. , Kottachchi D. , Ferris W.J. , Vandemheen K.L. , St. Denis M.L. , Plouffe A. , Doucette S.P. , Saginur R. , Chan F.T. , Ramotar K. 
Published: September 2004

The present authors hypothesised that bronchoscopy with protected specimen brush may sample biofilm-forming bacteria adherent to the airway wall, whereas traditional sputum collection may not.Pseudomonas aeruginosaobtained from sputum, bronchoalveolar lavage and protected brush, taken from the right upper lung bronchus of 12 adult patients with cystic fibrosis, were compared. Retrieved bacteria were genotyped, and grown in planktonic cultures and as biofilms, and susceptibilities to individual antibiotics and to antibiotic combinations were determined.Bacterial cultures obtained using bronchoscopy did not yield any new strains of bacteria that were not also found in sputum. A total of 10 patients (83%) had a single strain ofP. aeruginosafound using sputum, bronchoalveolar lavage and protected brush techniques, and two patients (17%) had two strains recovered in sputum, but only one strain was recovered using bronchoscopic techniques. Susceptibility to single antibiotics and to antibiotic combinations were not different between planktonically or biofilm-grown bacteria derived from sputum, as compared to those obtained by bronchoalveolar lavage and protected brush.In conclusion, sputum collection provides as much information as bronchoscopy for characterising the genotype and antibiotic susceptibility of chronicPseudomonas aeruginosainfection in patients with stable cystic fibrosis.
Radiofrequency ablation of airway smooth muscle for sustained treatment of asthma: preliminary investigations
Authors: Cox P.G. , Miller J. , Mitzner W. , Leff A.R. 
Published: September 2004

Bronchial thermoplasty is a procedure now being tested in humans for the treatment of asthma. Current studies focusing on safety are encouraging. The procedure, which causes extensive ablation of airway smooth muscle (ASM), is well tolerated, and there is a sustained reduction in airway responsiveness to methacholine. Two assumptions underlie the development of this procedure: 1) ASM is a vestigial tissue; and 2) that treatment directed at ASM alone will provide sustained symptomatic and physiological improvement in asthmatic humans. Even if this procedure is efficacious, it must be safe in the long-term. Current studies in animals and humans suggest that this is very likely to be the case.While bronchial thermoplasty may have a broad application, especially for patients who wish for a permanent amelioration of their symptoms or have difficulty adhering to medical regimens, the compelling use of this procedure is for patients who are inadequately controlled on current drug therapy or who cannot adhere to therapeutic regimens. The application of this procedure for the treatment of asthma is currently being considered by regulatory agencies, and study centres are currently disseminated throughout North America and Europe. Within the next 1–2 yrs, a profile of the potential role of this therapy in human asthma should be developed fully.
Sarcoidosis: social predictors of severity at presentation
Authors: Rabin D.L. , Thompson B. , Brown K.M. , Judson M.A. , Huang X. , Lackland D.T. , Knatterud G.L. , Yeager H. , Rose C. , Steimel J. 
Published: September 2004

To determine relationships among social predictors and sarcoidosis severity at presentation, demographic characteristics, socioeconomic status, and barriers to care, A Case-Control Etiologic Study of Sarcoidosis (ACCESS) was set up.Patients self-reported themselves to be Black or White and were tissue-confirmed incident cases aged ≥l8-yrs-old (n=696) who had received uniform assessment procedures within one of 10 medical centres and were studied using standardised questionnaires and physical, radiographical, and pulmonary function tests. Severity was measured by objective disease indicators, subjective measures of dyspnoea and short form-36 subindices.The results of the study showed that lower income, the absence of private or Medicare health insurance, and other barriers to care were associated with sarcoidosis severity at presentation, as were race, sex, and age. Blacks were more likely to have severe disease by objective measures, while women were more likely than males to report subjective measures of severity. Older individuals were more likely to have severe disease by both measures.In conclusion, it was found that low income and other financial barriers to care are significantly associated with sarcoidosis severity at presentation even after adjusting for demographic characteristics of race, sex, and age.