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Encrusted cystitis is a rare condition characterized by encrustation of the bladder mucosa with associated chronic inflammation induced by urea-splitting bacterial infection--most commonly, Corynebacterium urealyticum. Moreover, it usually occurs in immunocompromised patients, especially recipients of renal transplants or patients with a history of previous urological procedures. Due to the rarity of the entity and the slow growth of Corynebacterium species, appropriate treatment is often delayed due to difficulties in diagnosis and resistance to numerous antibiotics. We report a case of encrusted cystitis caused by Corynebacterium glucuronolyticum, another urea-splitting microbe, in a 57-year-old previously healthy Caucasian man with no known predisposing factors. The timely diagnosis and management in this otherwise healthy patient was facilitated by characteristic imaging, cystoscopy, and histologic findings confirmed by results of prolonged urine cultures and 16S ribosomal RNA (rRNA) gene sequencing of the microbe.

A diastereoselective synthesis of the nucleoside adducts corresponding to a cis ring-opening of the carcinogen (+/-)-7 beta, 8 alpha-dihydroxy-9 alpha,10 alpha-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene (BaP DE-2) by 2'-deoxyadenosine and 2'-deoxyguanosine is described. The key intermediate (+/-)-10alpha-amino-7beta,8alpha,9alpha-trihydroxy-7,8,9,10-tetrahydrobenzo[a]pyrene was synthesized by a highly diastereoselective dihydroxylation wherein phenylboronic acid was a water surrogate. The resulting boronate ester was converted to a tetraol derivative in which two of the four hydroxyl groups (trans 7, 8) were protected as benzoate esters while the remaining two (cis 9, 10) were free. The cis glycol entity was then subjected to a reaction with 1-chlorocarbonyl-1-methylethylacetate to yield an intermediate chloro monoacetoxy dibenzoate. Displacement of the halide with azide, complete cleavage of the esters, and catalytic reduction of the azide yielded the requisite amino triol. Fluoride displacement from appropriately protected nucleoside derivatives, 6-fluoropurine 2'-deoxyribonucleoside and 2-fluoro-2'-deoxyinosine, by the amino triol then yielded diastereomeric pairs of diol epoxide-adducted 2'-deoxyadenosine (dA) and 2'-deoxyguanosine (dG) nucleosides. Small aliquots of these adducts were separated for characterization purposes. The present approach provides the first diastereoselective synthesis of the cis adducts of BaP DE-2 with 2'-deoxyguanosine as well as the first synthesis of both dA and dG adducts from a common intermediate. An informative analysis of the 1H NMR spectra of the cis adducts synthesized and comparisons to the trans adducts are reported. To gain insight into the diastereoselectivity in the key dihydroxylation step, a computational analysis, including molecular mechanics (MMFF94) and semiempirical AM1 geometry optimizations, yielded results that are in fairly good agreement with the experimental observations.

Joubert syndrome (JS) is an autosomal recessive developmental brain condition characterized by hypoplasia/dysplasia of the cerebellar vermis and by ataxia, hypotonia, oculomotor apraxia, and neonatal breathing dysregulation. A form of JS that includes retinal dysplasia and cystic dysplastic kidneys has been differentiated from other forms of JS, called either “JS type B” or “cerebello-oculo-renal syndrome” (CORS), but the genetic basis of this condition is unknown. Here, we describe three consanguineous families that display CORS. Linkage analysis defines a novel locus on chromosome 11p12-q13.3, with a maximum two-point LOD score of Z=5.2 at the marker D11S1915. Therefore, the cerebello-oculo-renal form of JS is a distinct genetic entity from the Joubert syndrome 1 (JBTS1) locus described elsewhere, in which there is minimal involvement of retina or kidney. We suggest the term “CORS2” for this new locus.

Food pesticide residue data are used by the U.S. Environmental Protection Agency (EPA) to determine potential dietary risk from chronic and acute exposures. An acute dietary risk assessment determines the pesticide exposure resulting from a single-day consumption of food, and uses stepwise refinement of residue estimates to better judge actual exposures. All exposure refinements use estimates of the fraction of crops treated and food residues measured increasingly closer to the point of actual food consumption, without changes in the pesticide uses. Exposure distributions at all levels of data refinement were extremely right skewed. At the highest level evaluated, estimated exposures at the 99.9th percentile were 0.00087 mg/kgBW/day compared to 0.2648 mg/kgBW/day at the tolerance level for children 1-6 years, theoretically the highest-exposed population sub-group. The estimated exposure at the 99.9th percentile of the U.S. population was approximately twice the exposure at the 99th percentile and 33 times the exposure at the 90th percentile. This evaluation showed the calculated exposure at the highest tier of assessment was 300 times lower than the tolerance level assessment for children 1-6 years at the 99.9th percentile. Reduction in exposure estimates between these tiers was due to a combination of the following factors: food residue measurements in a specially designed market-basket study, government-sponsored monitoring data, probabilistic methodologies, market share information, and food processing data. This case study demonstrates that an improved understanding of the uncertainties of acute dietary exposure from pesticides is possible by using well-established statistical tools and applying them to comprehensive exposure information, including residue monitoring data, consumption data, and pesticide use information.

The spectral-editing method introduced by Wu, Burns and Zilm (J. Magn. Reson. A, 111 (1994) 29) based on a prescribed combination of 13C CP-MAS (cross-polarization with magic-angle spinning) experiments that include suitably chosen depolarization periods, polarization inversion periods and either short or long CP periods, has been applied to a humic acid that was isolated from the Uncompahgre National Forest. The separate spectra derived on the basis of CHn multiplicity (n=0,1,2,3) for CH groups, CH2 groups and CH3+ C (no directly attached hydrogen) groups confirm and advance previous structural interpretations based on chemical shift arguments. This work demonstrates that, while very time consuming, these spectral-editing techniques based on 13C CP-MAS techniques, are practicable for complex soil-derived samples.

We present a unique case of primary urothelial carcinoma with both histological and immunohistochemical features similar to thyroid papillary carcinoma. Following surgical resection of the primary tumor and localized metastatic lymphadenectomy, the patient was treated with a course of adjuvant chemotherapy. No evidence of primary thyroid carcinoma was noted. The patient was without recurrence after a 6 month follow-up.

Purpose: Prostate cancer progression despite organ confined pathological assessment has been reported in a variable number of men after radical retropubic prostatectomy. To study this phenomenon, we used the prostate specific antigen (PSA) reverse transcriptase-polymerase chain reaction assay.Materials and Methods: We prospectively assayed the peripheral venous blood before, during and after surgical manipulation as well as the intraoperative field blood for PSA reverse transcriptase-polymerase chain reaction-positive cells in 22 men undergoing radical retropubic prostatectomy.Results: PSA reverse transcriptase-polymerase chain reaction-positive cells were identified in 20 of the 22 operative field samples (91 percent) and 4 of 16 (25 percent) had evidence of intraoperative hematogenous dissemination (p = 0.046). No significant association was identified among Gleason score, pathological stage and the PSA reverse transcriptase-polymerase chain reaction result.Conclusions: Our results suggest that ...

Direct measurements of gaseous ammonia in the atmosphere of a dry bat cave containing several million insectivorous bats revealed a peak concentration of 1779 ppm (0.96 mg/dm3). Observations indicate that the origin of the gaseous ammonia is rapid microbial decomposition of bat urea, not chitinous guano. Modelling of ammonia distribution and diffusion indicates that ammonia production at the Cueva del Tigre is ∼257 g NH3/day, equivalent to the decomposition of ∼454 g urea/day. Ammonia production is also characterized by significant isotopic fractionation favoring isotopically light (δ15N depleted) ammonia.

Summary In this study, regression of the hyaloid vessels has been followed in the tunica vasculosa lentis (TVL) of the Wistar rat using light, transmission and scanning electron microscopy. The investigation extended from the 1st to the 32nd postnatal day. On day one, the posterior tunica vasculosa lentis is made up of radiating capillaries connected by side-arm branches, the vascular walls of which possess a continuous endothelium, a basement membrane and an incomplete pericyte covering. Endothelial cell specialization is apparent in the form of extreme thinning and fenestration in capillary regions lying opposite the lenticular capsule. The earliest detectable regressive changes become apparent on approximately day 3 and initially involve the short connecting capillaries surrounding the posterior pole of the lens and proceed from there. Regression takes place in the presence of rarefaction of vessel wall cells and the accumulation of endothelial cells in the adjacent capillaries. This leads to the formation of acellular channels which are made up of only basement membrane tubes. After the complete disappearance of these transitional acellular channels, the capillary meshwork coarsens. Remnants of these capillaries are detectable until the 30th postnatal day.

The 3‘,5‘-bis-O-TBDMS derivative of 2‘-deoxyguanosine can be converted to its O6-alkyl and O6-aryl ethers as well as to N6-substituted diaminopurine nucleosides in two simple steps. Also described is a novel, nonaqueous, one-step O6-desulfonylation method that leads to deprotection of the carbonyl moiety of 2‘-deoxyguanosine.

Suzuki−Miyaura cross-coupling of haloaromatic compounds with arylboronic acids provides a simple entry to biaryl systems. Despite its ease, to date, there are no detailed investigations of this pro...

Purpose: Anterior spinal fusion has become an increasingly popular technique used by orthopedic surgeons for a variety of lower spine pathology. At our institution urologists have assisted as retroperitoneal surgeons in achieving exposure of the appropriate spinal disk space. We report our experience with anterior spinal fusion in 66 patients.Materials and Methods: Since 1991 we have performed 66 exposures using the flank, modified Gibson, thoracoabdominal, paramedian and midline transperitoneal approaches. Exposure of each level has subtle technical issues which are reviewed.Results: During the study 34 men and 32 women 24 to 74 years old (mean age 43.8) underwent discectomy and anterior fusion of the spine. Access from T12 through L5-S1 interspace was required, and exposure of multiple spinal levels was necessary in 27. There was 1 death from massive pulmonary embolism in a patient with widely metastatic lung cancer. Retrograde ejaculation was reported by 2 men. There have been no episodes of deep or su...

We present a unique case of primary urothelial carcinoma with both histological and immunohistochemical features similar to thyroid papillary carcinoma. Following surgical resection of the primary tumor and localized metastatic lymphadenectomy, the patient was treated with a course of adjuvant chemotherapy. No evidence of primary thyroid carcinoma was noted. The patient was without recurrence after a 6 month follow-up.

Two winter wheat (Triticum aestivum L.) cultivars, Fredrick and Norstar, which differ in their winterhardiness potential, were compared with regard to the effects of nitrogen (N), phosphorus (P) and potassium (K) application, during acclimation, on the expression of four traits associated with winterhardiness — freezing, ice-encasement, and low temperature flooding tolerances and crown moisture content. Modified Hoagland’s nutrient solutions containing five levels of each nutrient were applied to the seedlings during a 5-wk acclimation period at 2 °C, and subsequently the crowns were tested for their ability to survive varying intensities of the stress treatments. Increasing the level of applied N from 0, caused a reduction in the level of all stress tolerances. Increased P did not significantly alter the expression of freezing tolerance, but tended to increase tolerance of the anaerobic stresses, icing and low temperature flooding, to an optimum. Increased K had minimal effects on stress tolerance at the levels tested. Increased levels of each nutrient increased crown moisture content. The cultivar Norstar was consistently more tolerant of freezing and icing stress than Fredrick and this relative ranking was not influenced by mineral nutrition. However, the relative ranking for low temperature flooding tolerance varied depending on the nutrients provided to the seedlings. The results suggest that environmental and growth regulatory factors which influence the uptake of mineral nutrients would be expected to influence crown moisture content, and the expression of stress tolerance.Key words: Freezing, ice-encasement, flooding

The neurobiologic basis for autism is not well understood. In contrast, there have been several recent discoveries into the genetics of generalized epilepsy with febrile seizures plus, a group of epilepsy syndromes characterized by multiple seizure phenotypes. Here we describe a family with generalized epilepsy with febrile seizures plus and variably expressed autism spectrum disorder that does not show linkage to any of the four known generalized epilepsy with febrile seizures plus loci. A relationship between these two disorders has not previously been described. ( J Child Neurol 2004;19:597-603).

We report a case of testicular extramedullary myeloid cell tumor in a 37-year-old man who presented with an acute testicular hemorrhage. A pathologic examination revealed no gross tumor mass. A well-differentiated extramedullary myeloid cell tumor infiltrate was seen histologically, localized largely to the seminiferous tubules. The patient had no evidence of any past or concurrent myeloid disorders. The lack of the usual clinical features of a testicular mass and the presence of an intratubular pattern of infiltration can further compound the challenges in diagnosing this entity.

Suzuki-Miyaura cross-coupling of haloaromatic compounds with arylboronic acids provides a simple entry to biaryl systems. Despite its ease, to date, there are no detailed investigations of this procedure for deoxynucleoside modification. As shown in this study, a wide variety of C-6 arylpurine 2'-deoxyriboside (C-6 aryl 2'-deoxynebularine analogues) and C-2 aryl 2'-deoxyinosine analogues can be conveniently prepared via the Pd-mediated cross-coupling of arylboronic acids with the C-6 halonucleosides, 6-bromo- or 6-chloro-9[2-deoxy-3,5-bis-O-(tert-butyldimethylsilyl)-beta-D-erythro-pentofuranosyl]purine (1 and 2), and the C-2 halonucleoside, 2-bromo-O(6)-benzyl-3',5'-bis-O-(tert-butyldimethylsilyl)-2'-deoxyinosine (3). Although bromonucleoside 1 proved to be a good substrate for the Pd-catalyzed Suzuki-Miyaura cross-couplings, we have noted that for several C-6 arylations, the chloronucleoside 2 provides superior coupling yields. Also described in this study is a detailed evaluation of catalytic systems that led to optimal product recoveries. Finally, a comparison of the C-C and C-N bond-forming reactions of deoxynucleosides is also reported. On the basis of this comparison, we provide evidence that C-N bond formation at the C-6 position, leading to N-aryl 2'-deoxyadenosine analogues, is more sensitive to the ligand used, whereas C-C bond-forming reactions at the same position are not. In contrast to the ligand dependency exhibited in C-N bond formation at the C-6 position, comparable reactions at the C-2 position of purine deoxynucleosides proceed with less sensitivity to the ligand used.

Anterior spinal fusion has become an increasingly popular technique used by orthopedic surgeons for a variety of lower spine pathology. At our institution urologists have assisted as retroperitoneal surgeons in achieving exposure of the appropriate spinal disk space. We report our experience with anterior spinal fusion in 66 patients.Since 1991 we have performed 66 exposures using the flank, modified Gibson, thoracoabdominal, paramedian and midline transperitoneal approaches. Exposure of each level has subtle technical issues which are reviewed.During the study 34 men and 32 women 24 to 74 years old (mean age 43.8) underwent discectomy and anterior fusion of the spine. Access from T12 through L5-S1 interspace was required, and exposure of multiple spinal levels was necessary in 27. There was 1 death from massive pulmonary embolism in a patient with widely metastatic lung cancer. Retrograde ejaculation was reported by 2 men. There have been no episodes of deep or superficial wound infection and no ureteral or major vascular injuries.As surgeons of the retroperitoneum urologists have an important role in providing our orthopedic colleagues with safe, adequate exposure to the anterior surface of the spine during discectomy and anterior fusion.

In this stuy, we compared chicken gene transcriptional profiles following primary and secondary infections with Eimeria acervulina using a 9.6K avian intestinal intraepithelial lymphocyte cDNA microarray (AVIELA). Gene Ontology analysis showed that primary infection significantly modulated the levels of mRNAs for genes involved in the metabolism of lipids and carbohydrates as well as those for innate immune-related genes. By contrast, secondary infection increased the levels of transcripts encoded by genes related to humoral immunity and reduced the levels of transcripts for the innate immune-related genes. Because the observed modulation in transcript levels for gene related to energy metabolism and immunity occurred concurrent with the clinical signs of coccidiosis, these results suggest that altered expression of a specific set of host genes induced by Eimeria infection may be responsible, in part, for the observed reduction in body weight gain and inflammatory gut damage that characterizes avian coccidiosis.

A selective review of the literature regarding hormonal therapy for patients with carcinoma of the prostate is presented to assess the current status of the following: (1) therapeutic advantages, disadvantages and risks of alternate approaches to hormonal therapy; (2) observations to predict the magnitude and duration of response to therapy; (3) indications for initiating hormone therapy; (4) the short-term and long-term effects of therapy; and (5) role of hormone therapy in patients with recurrent tumor activity after initial hormonal measures.

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Several studies have observed that patients who complain of chronic pain have significantly elevated scores on the first 3 clinical scales of the Minnesota Multiphasic Personality Inventory (MMPI). Some studies imply that this profile allows one to conclude that such patients exaggerate their symptoms, have strong feelings of inadequacy, have emotional problems which are neurotic, with implications that this is functional pain. The present study and its results challenges the use of the MMPI in attempting to distinguish psychogenic from organic pain. The MMPI was administered to 62 patients on their admission to the hospital. All 62 patients had a diagnosis of some organic findings consistent with their pain symptomatology. The average MMPI scores resulted in an elevated "Conversion-V" profile. It was also noted that as characteristics such as age of the subject, number of surgeries, and number of physicians seen increased, there was a corresponding increase in the neurotic scales. It was concluded that utmost caution should be used in interpreting individual pain patients' MMPI scores. It is especially important to avoid dismissing the pain symptomatology as functional by simply giving the patient a psychiatric diagnosis consistent with the profile. The potential of the MMPI as an aid in developing the treatment plan and as a possible predictive tool for certain treatment procedures is discussed. It is suggested that MMPI data be collected on a comparison group of patients, who have had successful relief of pain through surgical intervention.

A selective review of the literature regarding hormonal therapy for patients with carcinoma of the prostate is presented to assess the current status of the following: therapeutic advantages, disadvantages and risks of alternate approaches to hormonal therapy; observations to predict the magnitude and duration of response to therapy; indications for initiating hormone therapy; the short-term and long-term effects of therapy; and role of hormone therapy in patients with recurrent tumor activity after initial hormonal measures.

• The mechanical properties of nerve fibers and the changes they undergo during and after mechanical strains are well understood. This knowledge affords a factual basis for the diagnosis and treatment of peripheral nerve dysfunction, as is illustrated by a detailed description of the physical therapy applied in a case of neuropathy of the facial nerve. The aim is to stimulate the contractile elements of muscle temporarily denervated, retain extensibility of fibrous tissues in and about the muscle, maintain elasticity of the capsule about affected joints, promote increased blood supply, and insure good position and motion of the affected part during the recovery period. Electrical stimulation, passive motion, assistive exercises, and dynamic bracing are important. Electromyography gives valuable information and can be used to motivate the patient. Exercise, to be effective, should be against sufficient resistance and should continue until the parts involved have regained strength in proportion to the demands of the patient's occupation.