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Objectives: To evaluate morphological changes in the hyperplastic prostate tissue following transurethral microwave thermotherapy and to investigate the dependence of the treatment outcome on structural and physiological features of the prostate., Material and Methods: In this prospective study, 13 patients with chronic urinary retention due to benign prostatic hyperplasia (BPH) underwent Coretherm (ProstaLund, Lund, Sweden) microwave thermotherapy. Prior to the treatment and 1 week and 6 months after, the patients were examined with MRI using morphologic, contrast medium-enhanced perfusion and diffusion-weighted imaging. Such advanced MRI techniques permit an assessment of parameters that have a hypothetical influence on microwave thermotherapy (e.g. prostate blood perfusion, water content and prostate microstructure)., Results: Morphologic and perfusion MRI showed a clear prostatic tissue defect in all 13 patients after 1 week and in all 12 patients at 6 months' follow-up. The mean size of the defect was 22.5 cm(3) (27%) (range 3.7-47.3 cm(3)) and 4.1 cm(3) (1.1-10.1 cm(3)) at 1 week and 6 months, respectively. The cell kill volume was estimated to be 20.5+/-7.4 cm(3) and correlated significantly with the size assessed by MRI at 1 week (r=0.8; p=0.002) and 6 months (r=0.69; p=0.05). At 6 months, the mean decrease in prostate volume was 20.1 cm(3) (p<0.0001). The microstructure of the prostate expressed as the apparent diffusion coefficient was shown to have a strong influence on the treatment process. All patients (n=12) were catheter-free at 6 months. Another patient experienced persistent obstruction and underwent transurethral resection of the prostate., Conclusions: Coretherm microwave treatment leads to significant intraprostatic necrosis, which is detectable with MRI even 6 months after the treatment. Diffusion-weighted MRI is capable of identifying structural features of the prostate that can predict the length of treatment and the amount of energy needed.

The growth of transgenic canola (Brassica napus) expressing a gene for the enzyme 1-aminocyclopropane-1-carboxylate (ACC) deaminase was compared to non-transformed canola exposed to flooding and elevated soil Ni concentration, in situ. In addition, the ability of the plant growth-promoting bacterium Pseudomonas putida UW4, which also expresses ACC deaminase, to facilitate the growth of non-transformed and transgenic canola under the above mentioned conditions was examined. Transgenic canola and/or canola treated with P. putida UW4 had greater shoot biomass compared to non-transformed canola under low flood-stress conditions. Under high flood-stress conditions, shoot biomass was reduced and Ni accumulation was increased in all instances relative to low flood-stress conditions. This is the first field study to document the increase in plant tolerance utilizing transgenic plants and plant growth-promoting bacteria exposed to multiple stressors.

Aims: To evaluate the long-term outcome of transurethral resection of the prostate (TURP) and transurethral microwave thermotherapy (TUMT) in men with symptomatic benign prostatic hyperplasia (BPH), when allocation to the treatment-group was based on urodynamic diagnosis of bladder outlet obstruction (BOO)., Methods: A total of 231 elderly men with symptomatic BPH were treated either by TURP or by low-energy TUMT. A pressure-flow study was performed to detect the obstruction and to help in the selection of the two treatments. The patients were examined at baseline then checked again after 2 and 8 years., Results: At 2 years of follow-up there was a significant improvement for both IPSS and QoL (P < 0.0001) in both groups of treatment. This was accompanied by a significant improvement (P < 0.0001) in the maximum flow rate from 10.0 (5.8) to 16.4 (7.6) in the TURP group and from 12.1 (5.2) to 14.9 (5.7) in the TUMT group. These findings persisted at 8 years, they were, however, more pronounced after TURP. The overall retreatment rate reached a value of 11% in the TURP group and 27% in the TUMT group, respectively. At the follow-up, 95% of the patients who underwent TURP and 70% of the patients treated by TUMT claimed to be satisfied with that choice., Conclusions: With durable symptomatic improvement and lowest retreatment rate, TURP still presents a standard treatment option for patients with severe BOO. Low-energy TUMT has sufficiently relieved patients' symptoms and can be offered to less obstructed patients as an alternative.

Purpose: To evaluate the durability of the effect of transurethral microwave thermotherapy (TUMT) for lower urinary-tract symptoms (LUTS) suggestive of bladder outlet obstruction (BOO)., Patients and Methods: A total of 841 patients with LUTS received TUMT using the Prostatron device at Sahlgrenska University Hospital, Sweden. Two treatment programs were used: low-energy Program 2.0 and high-energy Program 3.5. A questionnaire, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, and questions about general health status, was sent to all the patients. The mean followup after TUMT was 8.8 years for Program 2.0 and 2.5 years for Program 3.5., Results: At the end of follow-up, 67% of the patients treated with Program 2.0 were satisfied with the TUMT. During the follow-up period, 37% of patients experienced worsened symptoms, 18% various complications (e.g., hematuria), and 25% transient urinary-tract infection, and 16% went into retention. Secondary treatment (repeat TUMT, transurethral resection, medical therapy) was needed in 32% of patients. The mean IPSS was 13.5, and QoL score decreased to 2.1. With Program 3.5, 82% of the patients were satisfied, with another 17% having increased symptoms, 17% various complication, 25% urinary tract infection, and 26% retention. Only 7% of patients needed secondary treatment. The IPSS and QoL score went down to 11.4 and 1.6, respectively., Conclusion: These long-term data show that TUMT produces durable improvement and, with its safety and low retreatment rate, presents an attractive alternative for patients with LUTS suggestive of BOO.

Objective: The objective of this study was to determine performance characteristics of Ferriman Gallwey self-scoring in women with the polycystic ovary syndrome., Design: A simultaneous Ferriman Gallwey map scoring design was used., Setting: The study was performed at the General Clinical Research Center in a university medical center., Patients: Twenty-one hirsute patients with the polycystic ovary syndrome were studied., Interventions: Interventions included masked patient, physician, and research nurse simultaneous and independent Ferriman Gallwey map scoring., Main Outcome Measures: The main outcome measures were modified Ferriman Gallwey map scores., Results: Agreement analysis demonstrated that patient self scores, physician scores, and research nurse scores were quite discrepant., Conclusion: The modified Ferriman Gallwey Map scoring system has too much variation to be clinically useful.

Objectives: To detect obstruction in patients with LUTS suggestive of BPH comparing the prostatic intravesical protrusion detected by abdominal ultrasounds with uroflowmetry testing results with urodynamic study to make evidence of obstruction., Material and Methods: A series of 25 patients (mean age 67.9 years) at the first visit for BPH problems, underwent to routine examination including: abdominal ultrasound examination, TRUS, uroflowmetry IPSS and QoL questionnaires and urodynamic evaluation. We evaluated the degree in mm of prostatic intravesical protrusion by ultrasounds with a bladder volume between 150-220 cc. The degree of protrusion was classified as mild (<5 mm), moderate (5-10 mm) and severe (>10 mm), Qmax was divided in obstructed (<10 ml/s), equivocal (10-15 ml/s) and unobstructed (>15 ml/s). Confirmation or not of obstruction was validated by urodynamic study., Results: mean prostate volume was 41.4cc; IPSS 22.4; Quality of Life 4.0; post voided residual urine 97.8 cc; DAMPF 62.6; Schäfer 3.4; Qmax 9.9 ml/s. Almost all the patients with severe protrusion had obstructed flow confirmed by P/F study. Patients with severe protrusion and unobstructedflow have obstruction compensated by high pressure voiding., Conclusions: These results, despite of the numbers of patients, suggest that the degree of prostatic protrusion measured by abdominal ultrasounds is a data that, if correlated to obstructed Qmax, can be used in the evaluation of BPH patients and their grade of obstruction.

Objectives: We examined the association between adolescent alcohol and drug use and 9 youth assets in a low-income, inner-city population., Methods: An in-person survey of 1350 adolescents and parents assessed youth assets and risk behaviors. We analyzed data with chi(2) tests and logistic regression analyses., Results: When we controlled for appropriate variables, there were significant positive relationships between several youth assets and nonuse of alcohol and drugs. Furthermore, youths who possessed all of the statistically significant youth assets were 4.44 times more likely to report nonuse of alcohol and 5.41 times more likely to report nonuse of drugs compared with youths who possessed fewer youth assets., Conclusions: Our study supports the view that specific youth assets may protect youths from alcohol and drug use.

Background: Severe deficiency of ADAMTS13 activity is a biologic risk factor for thrombotic microangiopathy (TMA). It was hypothesized that severe ADAMTS13 deficiency is associated with a distinct TMA subpopulation., Study Design and Methods: ADAMTS13 activity before treatment was determined retrospectively in 107 adult TMA patients treated with plasma exchange. Patients were not clinically categorized, but divided between severely deficient (n = 50) and nonseverely deficient (n = 57) ADAMTS13 activity. Laboratory and clinical factors before treatment were compared between the groups., Results: Median PLT counts were 44,000 per micro L in nonseverely deficient ADAMTS13 patients and 13,000 per micro L in severely deficient ADAMTS13 patients (p < 0.001). Median serum creatinine levels were 2.7 mg per dL in nonseverely deficient patients and 1.2 mg per dL in severely deficient patients (p < 0.001). In surviving patients, median plasma exchange procedures were 9 in nonseverely deficient patients and 14.5 in severely deficient patients (p < 0.01). Rates of relapse following remission were 4 of 47 in nonseverely deficient patients and 16 of 46 in severely deficient patients (p < 0.01). Among analyzed factors only mortality rates were not significantly different., Conclusion: In a heterogeneous population of TMA patients treated with plasma exchange, ADAMTS13 activity defined two subpopulations with distinct clinical and laboratory features. These results suggest that TMA with severe ADAMTS13 deficiency is a distinct pathologic process.

Primary Objective: to investigate if 30-MINUTES-TUMT can be performed under topical anesthesia and analgesics., Secondary Objectives: to evaluate retrospectively analgesics and to study parameters connected with pain., Materials and Methods: Eighty-nine patients underwent TUMT. Patients were divided into four groups with different medications. Paracetamol and tolterodin-L-tartrate were administered in all groups. The first group was also given hydromorphone hydrochloride and atropine sulphate, the second group dextropropoxyphene, the third group morphine and diclofenac, and the fourth group morphine and dextropropoxyphene. Pain during TUMT was registered using the VAS scale., Results: Pain during TUMT was (VAS in mm), respectively, total-first-second-third-fourth group: at 5 min -30, 31, 12, 28, 35; at 15 min -30, 23, 16, 25, 34; at 25 min -30, 28, 18, 25, 35. All patients accepted the treatment. No significant difference between the different drug schedules was noticed., Conclusions: It is possible to treat patients with 30-MINUTES-TUMT with local anesthesia and analgesics. The pain can be accepted by all patients.

Aims: There is no generally accepted consensus how to evaluate patients with lower urinary tract symptoms (LUTS) suggestive of bladder outlet obstruction (BOO). We have tried to determine whether the most frequently used objective variables as prostate volume, IPS-score, maximum flow rate, residual urine volume, functional bladder capacity, and pressure-flow study are reliable for diagnosis of BOO and we investigated the influence of idiopathic detrusor overactivity (IDO) on this condition., Methods: A total of 153 men with LUTS and suspected BOO were systematically examined with routine investigation including digital rectal examination, transrectal ultrasound (TRUS), post-void residual urine volume measurement, uroflowmetry, and pressure-flow study. All patients completed IPS-score. Patients were divided into groups based on Schäfer's grade of obstruction and incidence of IDO and clinical and urodynamical variables were compared., Results: At baseline, 45.8% of the patients were urodynamically moderately obstructed and 37.9% were found to be severely obstructed. The grade of obstruction did not correlate with age. Prostate volume, post-void residual volume (PVR), and maximum flow rate correlated significantly with the degree of obstruction. The mean IPS-score remained almost unchanged throughout all obstruction groups. The incidence of IDO was 40.5% and increased from 16% in the minor obstruction group to 38.6% and 53.4% in the moderate and severe obstruction group, respectively. The patients with IDO were older, had larger prostates and were more obstructed. There was no impact of IDO on symptomatology of BOO., Conclusions: These data indicate that IPS-score does not achieve sufficient diagnostic accuracy and its role in the assessment of BOO is limited. The grade of obstruction is more related to prostate volume, PVR, and maximum flow rate. BOO and IDO seem to be related and have numerous mutual interactions., (Copyright 2003 Wiley-Liss, Inc.)

Objectives: To estimate the relationship between age and the values of different diagnostic tests in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic enlargement (BPE) and to compare prostate growth curves between the normal population sample, healthy men and men with LUTS., Material and Methods: A series of 354 men (mean age 70.2 years; range 45-91 years) with LUTS due to BPE were stratified into seven age groups and reviewed retrospectively. All patients underwent a standard evaluation, involving determination of the International Prostate Symptom Score (IPSS), digital rectal examination, uroflowmetry, determination of the prostate-specific antigen (PSA) level and transrectal ultrasonography. Descriptive statistics were used to describe all the variables and Spearman's correlation test was used to evaluate the relationships between them., Results: The mean prostate volume was 40.1 (+/-23.9) cm(3) and mean PSA concentration 3.9 (+/-4.2) ng/ml. Both values increased progressively from 27.5 ml and 1.5 ng/ml, respectively in the <54 years age group to 48.2 ml and 5.4 ng/ml, respectively in the <80 years age group. However, in the 75-79 years age group there was a decrease in both prostate volume and symptom score; PSA concentration remained unchanged and maximal flow rate increased slightly. A statistically significant but weak correlation was found between prostate volume and age (r = 0.25, p < 0.0001) and between PSA and age (r = 0.28, p < 0.0001). Prostate volume correlated positively with serum PSA (r = 0.54, p < 0.0001). The correlations between maximum flow rate and age, prostate volume, PSA and IPSS were r = -0.21, p < 0.0001; r = -0.18, p < 0.0006; r = -0.29, p < 0.0001; and r = 0.14, p < 0.0098, respectively., Conclusions: These data confirm that prostate volume and serum PSA concentration are significantly correlated and increase with advanced age. The correlations between uroflowmetry (Qmax) and age, prostate volume, serum PSA and IPSS were also significant. However, there was no relationship between symptoms and objective measures of BPE. The increase in different parameters of the severity of benign prostatic hyperplasia with advanced age is not continuous. The prostate volume alone is not useful in the estimation of disease severity.

The adaptor protein Lnk, and the closely related proteins APS and SH2B, form a subfamily of SH2 domain-containing proteins implicated in growth factor, cytokine, and immunoreceptor signaling. To elucidate the physiological function of Lnk, we derived Lnk-deficient mice. Lnk(-/-) mice are viable, but display marked changes in the hematopoietic compartment, including splenomegaly and abnormal lymphoid and myeloid homeostasis. The in vitro proliferative capacity and absolute numbers of hematopoietic progenitors from Lnk(-/-) mice are greatly increased, in part due to hypersensitivity to several cytokines. Moreover, an increased synergy between stem cell factor and either interleukin (IL)-3 or IL-7 was observed in Lnk(-/-) cells. Furthermore, Lnk inactivation causes abnormal modulation of IL-3 and stem cell factor-mediated signaling pathways. Consistent with these results, we also show that Lnk is highly expressed in multipotent cells and committed precursors in the erythroid, megakaryocyte, and myeloid lineages. These data implicate Lnk as playing an important role in hematopoiesis and in the regulation of growth factor and cytokine receptor-mediated signaling.

Purpose: To investigate relationships among youth risk behaviors and demographic factors using an adolescent age group approach., Design: Cross-sectional data from a randomly selected population. Risk behaviors were compared within specific demographic factors and by adolescent age groups., Setting: Racially diverse, inner-city neighborhoods in two midwestern cities., Subjects: Teenagers (n = 1350) and parents (n = 1350) of the teenagers., Measures: Truancy; arrested/picked up by police; weapon carrying; fighting; sexual intercourse; tobacco, alcohol, and other drug use; demographic factors; and family structure., Results: Youth mean age was 15.4 (+/- 1.7) years and 52% were female; racial/ethnic characteristics were 47% White, 22% Black, 19% Hispanic, and 10% Native American. Parents' mean age was 42.2 (+/- 8.4) years and 81% were female. chi 2 analyses indicated numerous significant (p < .05) youth risk behavior differences within the demographic factors and that many of the differences varied by adolescent age group. For example, risk behavior differences within racial/ethnic groups were most profound in the middle and older age groups, whereas risk behavior differences within parent income, education levels, and family structure were most apparent in the younger age groups. Of the demographic factors, family structure was most frequently associated with the risk behaviors., Conclusions: The results generally suggest that the relationships among risk behaviors and demographic factors vary within the adolescent age groups included in this study. The results will be useful for developing age-appropriate prevention programs for youth who fit the profile for these risk behaviors. The study protocol also includes specific sampling methods that may be useful for future studies that intend to collect data from difficult-to-reach populations.

Objective: To examine associations between health behaviors and lifetime sexual partners among college students., Methods: Data from the 1995 National College Health Risk Behavior Survey were analyzed., Results: After adjusting for age, sex, and race, having 2 or more lifetime sexual partners was associated with infrequently using seat belts, driving after drinking, having a physical fight, considering suicide, and using chewing tobacco and marijuana. Significant sex interactions occurred with cigarette smoking and fruit and vegetable consumption, and significant age interactions occurred with binge drinking., Conclusions: Having multiple lifetime sexual partners (> or = 2) was associated with several negative health behaviors.

Purpose: To assess current physician self-reported practices regarding initial management of childhood idiopathic thrombocytopenic purpura (ITP) and to determine physician self-reported willingness to participate in randomized clinical trials comparing different initial management strategies., Patients and Methods: A questionnaire was mailed in November 1997 to all 720 members of the American Society of Pediatric Hematology/Oncology asking how they would diagnose and manage ITP in children 18 months, 5 years, and 15 years of age who were experiencing either dry purpura (cutaneous hemorrhage only) or wet purpura (active mucous membrane hemorrhage). Specific questions dealt with bone marrow aspiration, hospital admittance, treatment strategy, and specific doses of corticosteroids and intravenous immunoglobulin., Results: The response rate to the questionnaire was 57%. Most respondents indicated they usually perform a bone marrow aspirate when corticosteroids are to be prescribed and administer drug therapy to patients with newly diagnosed ITP with wet or dry purpura. Only 16% of respondents would administer no drug therapy to a child with dry purpura. Intravenous immunoglobulin (IVIG) was preferred to steroids, with anti-D immunoglobulin prescribed less frequently. Hospital admittance often was used for patients with dry purpura and usually recommended for patients with wet purpura. Most respondents expressed willingness to randomize patients with dry purpura to IVIG versus no therapy and those with wet purpura to IVIG versus prednisone as part of a randomized controlled clinical trial., Conclusions: The self-reported care of the patient with ITP was influenced by the severity of presentation (dry versus wet purpura). Most physicians reported they would administer specific drug treatment in both scenarios. This survey illustrates the diverse diagnostic and management strategies currently used in childhood ITP. Because no one therapeutic approach is predominant and a scientific basis for decision making in childhood ITP has not been developed, future randomized trials are warranted. On the basis of these survey results, such trials are desired by most pediatric hematology/oncology specialists.

Protein tyrosine phosphorylation plays a key role in regulating eukaryotic cell proliferation and differentiation. Genetic analysis in invertebrates has been invaluable for dissecting the signalling events downstream of receptor tyrosine kinases (RTKs). We have used this approach in mammals to analyse the interactions between the Kit RTK encoded by the murine Dominant white spotting (W) locus and the Shp1 protein tyrosine phosphatase, the product of the murine motheaten (me) gene. Homozygosity for mutations in both W and me ameliorates aspects of both the me and W phenotypes, including the lethal lung disease associated with me and the embryonic lethality and mast cell deficiency associated with W, demonstrating that the Kit receptor plays a role in the pathology of the me phenotype and conversely that Shp1 negatively regulates Kit signalling in vivo.

A human hemoglobin solution partially saturated with carbon monoxide was rapidly quenched at -25 degrees C into a hydro-organic buffer containing ferricyanide. Under the experimental conditions of pH, ionic strength, and buffer composition used in this work, it was found that the deoxy hemes were rapidly transformed into their met form, whereas practically no carbon monoxide-bound hemes were oxidized before the separation of the mixture from the oxidizing agent. As a preliminary step to the analysis of the resulting solution, carbonylhemoglobin solutions partially oxidized with ferricyanide were studied by isoelectric focusing at -25 degrees C under identical conditions. The relative position in the gel of all nine possible valence hybrids was established as follows (going from the anodic to the cathodic side of the gel) alpha CO2 beta CO2, (alpha CO beta +)(alpha CO beta CO) (alpha CO beta CO), (alpha CO2 beta +2), (alpha + beta CO), (alpha + beta +)-(alpha CO beta CO), (alpha + beta +)(alpha CO beta +), (alpha +2 beta CO2), (alpha + beta +)(alpha + beta CO), alpha +2 beta +2. When carbonylhemoglobin and methemoglobin were mixed in equal proportion at -25 degrees C and then analyzed by isoelectric focusing at the same temperature, it was found that the contribution of valence hybrids other than alpha CO2 beta CO2 and alpha +2 beta +2 to the total amount of hemoglobin in the gel was no more than 6%. When carbonylhemoglobin and deoxyhemoglobin were mixed in the same proportion and incubated at 20 degrees C so to allow the redistribution of the carbon monoxide molecules between all possible binding sites to occur, a substantially higher amount of valence hybrids, derived from the oxidation of intermediate compounds of hemoglobin with carbon monoxide, was found. The isoelectric focusing separation indicated the presence in the original solution of intermediate species other than carbonylhemoglobin and deoxyhemoglobin at a concentration of about 10% of the total.

Sulfatides are membrane-bound glycosphingolipids which tend to associate in micellar forms in water. In this study, combining the data obtained by several techniques, including 31P-NMR, DTA calorimetry, freeze-fracture electron microscopy, trapped volume and turbidity measurements plus enzymatic determination of outer-side "marker ganglioside", have enabled us to establish that bilayered liposomes of phosphatidylcholine formed in the presence of increasing amounts of sulfatide are stable up to 30 mol % glycolipid. Above thus, bilayered lipids progressively start to break up into micellar forms with bilayer-micelle transition complete at sulfatide concentrations above 80 mol %. The gel-to-liquid-crystalline phase transition of a dipalmitoylphosphatidylcholine-sulfatide dispersion is shown to strongly influence the equilibrium between micellar and bilayered forms, the micelles being present at higher concentrations as the fluidity of the system decreases. The possibility that such structural transitions may occur in vivo and effectively contribute to the modulation of some biological properties of the membranes is discussed.

A quenching technique for the study of rapid protein reactions is described which consists of injecting a small volume of aqueous solution of reactants into a large volume (X10) of hydro-organic solvent cooled at subzero temperature and mechanically shaken. The protein reaction intermediates, stabilized at subzero temperature and brought into a hydro-organic solution, can then be separated by subzero temperature electrophoretic methods, such as isoelectric focusing, in the same solvent. The alkaline hydrolysis of 2,4-dinitrophenylacetate was studied by the use of this quenching technique in order to compare the quenching time and the rate constants of the reaction with those obtained by normal rapid quenching methods. It was found that first-order reactions having rate constants up to about 5 s-1 can be satisfactorily studied by this technique. The technique is not suitable for the study of faster reactions because of the high value of the quenching time (40-100 ms). The hybridization reaction of carboxyhemoglobins A and C in aqueous solution at 22 degrees C was studied as an example of the application of this quenching technique and of the isoelectric focusing method at subzero temperature to the isolation of unstable intermediates in a protein reaction.