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Temporomandibular disorder (TMD) incidences are believed to be related to parafunctional behaviours like teeth clenching. This pilot study aimed to (i) develop an automated clench-detection algorithm, and (ii) apply the algorithm to test for differences in nocturnal clenching in women with and without TMD. Subjects gave informed consent to participate. Adult women were categorised using Diagnostic Criteria for TMD according to presence/absence (+/-) of both TM joint disc placement (DD) and chronic pain (P) into two groups (+DD+P, -DD-P) with 12 subjects each. Surface temporalis electromyography was recorded during oral tasks performed by subjects at two laboratory sessions. The data were used to characterise muscle activity per N of bite force (μV/N) for each subject, develop the clench-detection algorithm and test its accuracy. Ambulatory surface temporalis electromyography was self-recorded by each subject over three nights and analysed using the algorithm and bite force (N) versus muscle activity μV/N calibrations. Bonferroni-adjusted homoscedastic t-tests assessed for significant between-group differences in clenching (P < 0·05). Sensitivity, specificity and accuracy of algorithm-detected laboratory clenches were all ≥96%. During self-recordings 95% of clenches had durations of

To evaluate whether the presence of both prostate atrophy (PA) and chronic prostate inflammation (CPI) in the same biopsy and in the same biopsy core are associated with prostate cancer (PCa) risk and grade in repeat biopsies. Retrospective analyses of 6132 men who were 50–75 years old undergoing 2-year repeat prostate biopsy after a negative baseline biopsy for PCa in the REduction by DUtasteride of prostate Cancer Events (REDUCE) study. PA, CPI and PCa were determined by central pathology. The association of baseline PA and CPI with 2-year repeat biopsy cancer status and grade was evaluated with χ2 test and logistic regression controlling clinicopathological features. PA, CPI and both were detected in 583 (9.5%), 1063 (17.4%) and 3675 (59.9%) baseline biopsies, respectively. Compared with biopsies with neither PA nor CPI, the presence of PA (odds ratio (OR)=0.73, 95% confidence interval (CI)=0.57–0.93), CPI (OR=0.72, 95% CI=0.58–0.88) and both (OR=0.54, 95% CI=0.45–0.64) were associated with lower PCa risk in the 2-year repeat prostate biopsy. Results were similar in multivariable analysis. Among subjects with both PA and CPI, those with both findings in the same core had even lower PCa risk compared with PA and CPI in different cores (univariable OR=0.68, 95% CI=0.51–0.91; multivariable OR=0.73, 95% CI=0.54–0.99). Combination of PA and CPI was associated with lower risk of high-grade PCa. The presence of both PA and CPI in baseline biopsies, especially in the same core, was associated with lower PCa risk and grade. The presence and topographical distribution of PA and CPI may be used in PCa risk stratification.

The reproducibility of electromyographic (EMG) activity in relation to static bite-force from masticatory muscles for a given biting situation is largely unknown. Our aim was to evaluate the reliability of EMG activity in relation to static bite-force in humans. Eighty-four subjects produced five unilateral static bites of different forces at different biting positions on molars and incisors, at two separate sessions, and the surface EMG activities were recorded from temporalis, masseter, and suprahyoid muscles bilaterally. Intraclass correlation coefficients (ICCs) were determined, and an ICC of ≥ 0.60 indicated good reliability of these slopes. The ICCs for jaw-closing muscles during molar biting were: temporalis muscles, ipsilateral 0.58-0.93 and contralateral 0.88-0.91; and masseter muscles, ipsilateral 0.75-0.86 and contralateral 0.69-0.88. The ICCs for jaw-closing muscles during incisor biting were: temporalis muscles, ipsilateral 0.56-0.81 and contralateral 0.34-0.86; and masseter muscles, ipsilateral 0.65-0.78 and contralateral 0.59-0.80. For the suprahyoid muscles the 95% CIs were mostly wide and most included zero. The slopes of the EMG activity vs. bite-force for a given biting situation were reliable for temporalis and masseter muscles. These results support the use of these outcome measurements for the estimation and validation of mechanical models of the masticatory system.

Objectives To evaluate the safety profile and efficacy of α1-adrenergic receptor blockers (A1Bs) currently prescribed for benign prostatic hyperplasia (BPH).

We review the current understanding of superconductivity in the quasi-one-dimensional organic conductors of the Bechgaard and Fabre salt families. We discuss the interplay between superconductivity, antiferromagnetism, and charge-density-wave fluctuations. The connection to recent experimental observations supporting unconventional pairing and the possibility of a triplet–spin order parameter for the superconducting phase is also presented.

Objectives: The NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) was developed to assess symptoms and quality of life in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). We assessed the responsiveness of the NIH-CPSI to change over time and defined thresholds for changes perceptible to patients. Methods: We studied 174 men with CP/CPPS who participated in a placebo-controlled randomized clinical trial. Changes from baseline to six weeks in the NIH-CPSI total score and pain, urinary, and quality of life subscores were compared to a global response assessment (GRA). Effect sizes and Guyatt statistics were calculated to evaluate responsiveness; 95% confidence intervals were produced using bootstrapping. Results: All scores decreased over time with the largest decrease in subjects who reported on the GRA that they were markedly improved. The NIH-CPSI total, pain, and quality of life scores were highly responsive in the improved groups; the urinary score showed minimal responsiveness. There was no evidence of responsiveness among those subjects who worsened on the trial. ROC curves identified a 6-point decline in the NIH-CPSI total score as the optimal threshold to predict treatment response. Conclusions: The NIH-CPSI total score and pain and quality of life subscores are responsive to change over␣time.

Medical therapy for relief of symptoms of benign prostatic hyperplasia (BPH) is now a clinical reality. The challenge for urologists treating BPH with medical therapy is how to rationally employ the two proven classes of medications,the alpha blockers and finasteride, in their practice. To accomplish this, we must critically examine the results of multiple important clinical BPH trials published over the last decade and examine the short and long term effect of the various available medical therapies on symptoms, objective progression and consequences of the disease process and whether evidence based indicators will allow us to choose appropriate therapies. It appears that we can rationalize our medical therapy decisions, taking into consideration severity of disease, prostate size (and perhaps PSA) and most importantly, the patients' longterm expectations for treatment outcome. But first physicians must decide for themselves whether to expand their treatment paradigm beyond short term symptom relief to encompass long term durability and even prevention of the consequences of the long term progression of BPH.

We examined the combined effect of fosfomycin and ofloxacin against Pseudomonas aeruginosa in biofilms by using an in vitro experimental system with a modified Robbins device. Sessile cells in a mature or immature biofilm, developed on a silicon disk, were used, and an ATP bioluminescence assay was employed to assess antibacterial effects. A synergistic effect of fosfomycin and ofloxacin was clearly detected when concentrations at which each drug independently produced no detectable decrease in the bioactivity of sessile cells were used. Exposure of the cells in a mature biofilm to fosfomycin at concentrations of one-eighth of the MIC to 10 times the MIC (6.25 to 500 micrograms/ml) and ofloxacin at three or 10 times the MIC (18.75 or 62.5 micrograms/ml) resulted in reduction of the bioactivity to 1.5 to 4.5% after 72 h. Young sessile cells in an immature biofilm were more susceptible to this combination therapy. With a combination of fosfomycin at three times the MIC and ofloxacin at three times the MIC, complete eradication was confirmed by both ATP assay and scanning electron microscopy.

The reproducibility of electromyographic (EMG) activity in relation to static bite-force from masticatory muscles for a given biting situation is largely unknown. Our aim was to evaluate the reliability of EMG activity in relation to static bite-force in humans. Eighty-four subjects produced five unilateral static bites of different forces at different biting positions on molars and incisors, at two separate sessions, and the surface EMG activities were recorded from temporalis, masseter, and suprahyoid muscles bilaterally. Intraclass correlation coefficients (ICCs) were determined, and an ICC of ≥ 0.60 indicated good reliability of these slopes. The ICCs for jaw-closing muscles during molar biting were: temporalis muscles, ipsilateral 0.58-0.93 and contralateral 0.88-0.91; and masseter muscles, ipsilateral 0.75-0.86 and contralateral 0.69-0.88. The ICCs for jaw-closing muscles during incisor biting were: temporalis muscles, ipsilateral 0.56-0.81 and contralateral 0.34-0.86; and masseter muscles, ipsilateral 0.65-0.78 and contralateral 0.59-0.80. For the suprahyoid muscles the 95% CIs were mostly wide and most included zero. The slopes of the EMG activity vs. bite-force for a given biting situation were reliable for temporalis and masseter muscles. These results support the use of these outcome measurements for the estimation and validation of mechanical models of the masticatory system.

Despite major technological improvements in catheter drainage systems, the indwelling Foley catheter remains the most common cause of nosocomial infection in medical practice. By approaching this common complicated urinary tract infection from the perspective of the biofilm strategy bacteria appear to use to overcome obstacles to produce bacteriuria, one appreciates a new understanding of these infections. An adherent biofilm of bacteria in their secretory products ascends the luminal and external surface of the catheter and drainage system from a contaminated drainage spigot or urethral meatus into the bladder. If the intraluminal route of bacterial ascent is delayed by strict sterile closed drainage or addition of internal modifications to the system, the extraluminal or urethral route assumes greater importance in the development of bacteriuria, but takes significantly longer. Bacterial growth within these thick coherent biofilms confers a large measure of relative resistance to antibiotics even though the individual bacterium remains sensitive, thus accounting for the failure of antibiotic therapy. With disruption of the protective mucous layer of the bladder by mechanical irritation, the bacteria colonizing the catheter can adhere to the bladder’s mucosal surface and cause infection. An appreciation of the role of bacterial biofilms in these infections should suggest future directions for research that may ultimately reduce the risk of catheter-associated infection.

Objectives To evaluate the safety profile and efficacy of α1-adrenergic receptor blockers (A1Bs) currently prescribed for benign prostatic hyperplasia (BPH). Data sources A systematic literature search of MEDLINE, the Cochrane Database and the Food and Drug Administration Web site through December 2006 identified double-blinded, prospective, placebo-controlled trials, evaluating agents commercially available by prescription for the symptomatic treatment of BPH. Review methods Data were reviewed by two investigators with the use of a standardised data abstraction form. Studies were evaluated for methodological quality using the Jadad scale. Studies with a score of < 3 were considered of weaker methodology. Results Of 2389 potential citations, 25 were usable for evaluation of safety data, 26 for efficacy. A1B use was associated with a statistically significant increase in the odds of developing a vascular-related event [odds ratio (OR) 2.54; 95% confidence interval (CI): 2.00–3.24; p < 0.0001]. The odds of developing a vascular-related adverse event were: alfuzosin, OR 1.66, 95% CI: 1.17–2.36; terazosin, OR 3.71, 95% CI: 2.48–5.53; doxazosin, OR 3.32, 95% CI: 2.10–5.23 and tamsulosin, OR 1.42, 95% CI: 0.99–2.05. A1Bs increased Qmax by 1.32 ml/min (95% CI: 1.07–1.57) compared with placebo. Difference from placebo in American Urological Association symptom index/International Prostate Symptom Score was −1.92 points (95% CI: −2.71 to −1.14). Conclusions Alfuzosin, terazosin and doxazosin showed a statistically significant increased risk of developing vascular-related events compared with placebo. Tamsulosin showed a numerical increase that was not statistically significant. All agents significantly improved Qmax and symptom signs compared with placebo.

Chronic prostatitis has been a perplexing problem for urologists for decades. This review explores the perils and pitfalls urologists encounter with epidemiology, etiology, classification, diagnosis, and treatment of this syndrome. The major question involves the problem of developing rational treatment plans for patients with a medical condition associated with genitourinary pain, variable voiding, and sexual dysfunction but no obvious and accepted etiology. Exciting, innovative, ongoing research does offer some solutions and management strategies that urologists can even now incorporate into their practice while waiting for the fundamental questions to be answered.

Using a renormalization group approach, we determine the phase diagram of an extended quasi-one-dimensional electron gas model that includes interchain hopping, nesting deviations and both intrachain and interchain repulsive interactions. d-wave superconductivity, which dominates over the spin-density-wave (SDW) phase at large nesting deviations, becomes unstable to the benefit of a triplet $f$-wave phase for a weak repulsive interchain backscattering term $g_1^\perp>0$, despite the persistence of dominant SDW correlations in the normal state. Antiferromagnetism becomes unstable against the formation of a charge-density-wave state when $g_1^\perp$ exceeds some critical value. While these features persist when both Umklapp processes and interchain forward scattering ($g_2^\perp$) are taken into account, the effect of $g_2^\perp$ alone is found to frustrate nearest-neighbor interchain $d$- and $f$-wave pairing and instead favor next-nearest-neighbor interchain singlet or triplet pairing. We argue that the close proximity of SDW and charge-density-wave phases, singlet d-wave and triplet $f$-wave superconducting phases in the theoretical phase diagram provides a possible explanation for recent puzzling experimental findings in the Bechgaard salts, including the coexistence of SDW and charge-density-wave phases and the possibility of a triplet pairing in the superconducting phase., 19 pages, 13 figures

Using a renormalization group approach, we determine the phase diagram of an extended quasi-one-dimensional electron gas model that includes interchain hopping, nesting deviations and both intrachain and interchain repulsive interactions. We find a close proximity of spin-density- and charge-density-wave phases, singlet d-wave and triplet f-wave superconducting phases. There is a striking correspondence between our results and recent puzzling experimental findings in the Bechgaard salts, including the coexistence of spin-density-wave and charge-density-wave phases and the possibility of a triplet pairing in the superconducting phase., 4 pages, 5 eps figures

We calculate the phase diagram of a ladder system, with a Hubbard interaction and an interchain coupling $t_\perp$. We use a Renormalization Group method, in a one loop expansion, introducing an original method to include $k_{||}$ dependence of couplings. We also classify the order parameters corresponding to ladder instabilities. We obtain different results, depending on whether we include $k_{||}$ dependence or not. When we do so, we observe a region with large antiferromagnetic fluctuations, in the vicinity of small $t_\perp$, followed by a superconducting region with a simultaneous divergence of the Spin Density Waves channel. We also investigate the effect of a non local backward interchain scattering : we observe, on one hand, the suppression of singlet superconductivity and of Spin Density Waves, and, on the other hand, the increase of Charge Density Waves and, for some values of $t_\perp$, of triplet superconductivity. Our results eventually show that $k_{||}$ is an influential variable in the Renormalization Group flow, for this kind of systems., Comment: 20 pages, 19 figures, accepted in Phys. Rev. B 71 v. 24

A ureolytic strain of Proteus mirabilis, isolated from a patient with infectious kidney stones, produced struvite (MgNH4PO4 X 6 H2O) and apatite [Ca10(PO4)6CO3] crystals in vitro when grown in artificial urine. Surface-attached crystals were encased in a slime-like layer. Scanning electron microscopy revealed that surfaces submerged in the artificial urine were colonized by P. mirabilis. Bacteria-associated crystals appeared soon after colonization and eventually became coated with an amorphous substance. Energy-dispersive X-ray analysis of these crystals revealed the presence of Mg, Ca, and P which are major components of struvite and apatite. Transmission electron microscopy of surface scrapings revealed that the glycocalyx of P. mirabilis contained a large number of crystals. Based on these observations and previous work, a theory for infectious renal calculogenesis is proposed. The kidney is initially colonized by invading ureolytic pathogens. These pathogens secrete copious amounts of glycocalyx which facilitates adhesion of the organisms to the kidney, provides protection for these bacteria, and serves to bind struvite and apatite crystals that result from bacterial urease activity. Growth of these calcified microcolonies into mature stones is characterized by continued bacterial growth, incorporation of urinary mucoproteins into the matrix along with bacterial glycocalyx, and a continued deposition of struvite and apatite crystals due to the high pH. The mature stone, in effect, represents an enlarged "fossilized" bacterial microcolony.

Peritonitis in peritoneal dialysis: Bacterial colonization by biofilm spread along the catheter surface. We have used modern techniques of direct microscopic examination and quantitative bacterial recovery to show the existence of a route of bacterial colonization along the external and internal surfaces of Tenckhoff catheters implanted in experimental animals. The external route of progressive bacterial colonization extends from the cutaneous exit site through the dacron cuff and into the peritoneum. Bacterial growth along this route consists primarily of glycocalyx enclosed bacterial biofilms adherent to catheter and tissue surfaces, and this surface colonization may or may not give rise to peritoneal infection in which free-living bacteria are found in the peritoneal fluid. The rate of this progressive bacterial colonization depends on the degree of bacterial contamination of the exit site at the time of implantation. Exit site sterilization (hibitane) delays the process while inoculation with rabbit skin strains of Staphylococcus epidermidis accelerates it. Even with optimal implantation techniques, bacterial colonization proceeds via this subcutaneous route so that most Tenckhoff catheter surfaces are covered with a bacterial biofilm, consisting predominantly of gram positive cocci, within three weeks after the implantation of these devices, the rate of bacterial biofilm development on both surfaces of these Tenckhoff catheters, the bacterial colonization of peritoneal tissues, and the dissemination of bacteria into the peritoneal fluid are all significantly accelerated by dialysis in this experimental animal model of continuous ambulatory peritoneal dialysis (CAPD).

This Letter reports new observations of resonances in a low-density plasma column and a quantitative theory of the frequency spectrum which is in excellent agreement with these measurements. Other measurements have recently been reported by Dattner. (1)

Cutaneous diversion of the urine through intestinal conduits results in bacteriuria with uropathogenic organisms in up to 80% of patients, many of whom suffer pyelonephritis. Analysis of the bacteriologic data from daily sampling at multiple sites and scanning and transmission electron microscopic studies of sequential loop and autopsy specimens in rabbits with functioning colonic conduits indicate that the pyelonephritis evolves in sequential stages of microbial colonization. Using these data on the natural progression of bacterial infection, we can rationally test the ability of strains of bacteria indigenous to the conduit of this animal model to prevent uropathogenic colonization of the conduit.

Primary carcinoids of the kidney are very rare, only 10 cases having been reported in the literature. The authors report a case of primary renal carcinoid in a 50-year-old woman. A radical nephrectomy with lymphadenectomy was successfully performed and there was no residual or recurrent tumour at 2-year follow-up. A review of the reported cases revealed a variable, nonspecific presentation. Most laboratory tests were non-contributory except for urinalysis. When a renal carcinoid is diagnosed, a search should be made for a possible primary elsewhere. Primary renal carcinoid does exhibit malignant behaviour. It should be managed by radical nephrectomy with retroperitoneal lymphadenectomy.

Percutaneous renal surgery was developed initially to remove renal calculi safely without the attendant morbidity of standard open pyelolithotomy. As familiarity with techniques has been obtained, other intrarenal diseases have been treated using this approach. This report reviews the current applications of percutaneous renal surgery and discusses its relation to extracorporeal shock-wave lithotripsy in the management of renal calculi.

When disks of urinary catheter material were exposed to the flow of artificial urine containing cells of Pseudomonas aeruginosa, a thick adherent biofilm, composed of these bacteria and of their exopolysaccharide products, developed on the latex surface within 8 h. After this colonization, sterile artificial urine containing 1,000 micrograms of tobramycin per ml was flowed past this established biofilm, and a significant proportion of the bacterial cells within the biofilm were found to be still viable after 12 h of exposure to this very high concentration of aminoglycoside antibiotic. Planktonic (floating) cells taken from the test system just before the exposure of the biofilm to the antibiotic were completely killed by 50 micrograms of tobramycin per ml. The MIC of tobramycin for cells taken from the seeding cultures before colonization of the catheter material, and for surviving cells recovered directly from the tobramycin-treated biofilm, was found to be 0.4 micrograms/ml when dispersed cells were assayed by standard methods. These data indicate that growth within thick adherent biofilms confers a measure of tobramycin resistance on cells of P. aeruginosa.

Struvite stones are formed as the result of urinary tract infection by urease-producing bacteria. Ultrastructural examination of calculi removed from a patient revealed bacteria incorporated throughout the stone matrix. Exopolysaccharide stained by ruthenium red was associated with most of the bacteria, but it represented only a small portion of the organic matrix in the stone. Localised deposits of calcium and phosphorus, components of carbonate-apatite, and magnesium, a struvite component, were detected in close proximity to the cells. Histochemical examinations revealed that several of the gram-negative bacteria within the stone matrix possessed high levels of urease activity. We propose that bacterial slime production, intimately involved in the initiation of stone matrix deposition, is less prominent in mature stones because of the increased incorporation of host-derived mucoproteins and mucopolysaccharides.

Necrotizing fasciitis of the male genitalia was first described 100 years ago. Although the mortality of this condition has generally been high, the last few years have seen dramatic therapeutic improvements. This paper details the treatment of necrotizing fasciitis in two patients and describes a plan of management, which includes early diagnosis, vigorous antibiotic treatment and radical débridement of the necrotic tissues, that should improve the prognosis of the condition.

An accurate, rapid, and inexpensive method was developed for detecting and enumerating bacteria adherent to Foley urinary catheters based on malachite green staining of acridine orange-prestained specimens. This method has proven to be quick and reliable and will find application in quantitative studies of biomaterial-related sepsis.

The frequency and importance of bacteriuria in patients requiring short-term postoperative catheterization (24 to 48 hours) is unknown. From a prospective, controlled study of 100 patients requiring catheterization postoperatively, the authors determined that there was a definite risk (6%) of bacteriuria; however, a symptomatic urinary tract infection developed in only 1% of the patients. There was no advantage to using either a latex or silicone catheter. It appears that the risk of symptomatic bacteriuria in this group of patients is very low when a closed urinary drainage system is used under strict, sterile conditions of catheter insertion and with meticulous ongoing catheter care.

A scanning and transmission electron microscopic study was made of material from the surface of a Foley catheter removed from an 87-year-old woman with antibiotic-resistant bacteriuria. A thick, adherent bacterial biofilm was found. The sessile adherent bacteria were surrounded by an extensive exopolysaccharide glycocalyx that appears to be fundamental in the pathogenesis of catheter-associated urinary tract infections and their resistance to systemic antibiotic therapy.

A quantitative theory of resonance oscillations, such as observed by Dattner and others, is given. The first two moments of the collisionless Boltzmann equation assuming a scalar pressure are used in conjunction with a physically reasonable radial electron density profile to describe the oscillations of a hot nonuniform plasma cylinder. These equations coupled with Maxwell's equations assuming a scalar potential are solved numerically to yield the frequency spectrum of the plasma wave resonances. It is found that the frequency spectrum depends on the parameter r/w2/ where rw is the radius of the plasma column and is the mean square Debye length of the electron plasma. New experimental observations of dipole and quadrupole spectra for two plasma columns of differing radii are reported and the results of these observations are in good agreement with the theory. The physical mechanism of the resonances is described.