Total penile reconstruction: A systematic review.

BACKGROUND: Phalloplasty poses a unique challenge to the plastic and reconstructive surgeon. The development of advanced microsurgical techniques has greatly augmented the range of surgical approaches available. METHODS: A systematic review of the MEDLINE and Cochrane databases was performed to identify clinical studies of total penile reconstruction published within the last 10 years using the search algorithm: "(phallus or penis or penile) and (reconstruction or phalloplasty or transplant)". RESULTS: The primary literature search retrieved 1400 articles. After applying inclusion and exclusion criteria, 30 studies were selected for review. The radial forearm free flap is the preferred technique for total phalloplasty; however, other techniques including the fibular osteocutaneous flap, anterolateral thigh flap, latissimus dorsi flap, scapular free flap, and abdominal flap are described. Background, indications, and preoperative and postoperative care are also discussed. CONCLUSIONS: Total penile reconstruction can provide functional, aesthetic, and psychosocial benefits to the patient. Use of the radial forearm free flap has been proposed as the gold standard; however, the wide range of potential complications associated with phalloplasty warrants an individualized approach to each patient.

Epigenetic variations in heredity and evolution.

The biological and medical importance of epigenetics is nowtaken for granted, but the significance of one aspect of it­epigenetic inheritance­is less widely recognized. New datasuggest that not only is it ubiquitous, but both the generationand the transmission of epigenetic variations may be affectedby developmental conditions. Population studies, formalmodels, and research on genomic and ecological stressesall suggest that epigenetic inheritance is important in bothmicro-and macroevolutionary change.

[Epigenetic heredity in evolution]. / Epigeneticheskaia nasledstvennost' v évoliutsii.

We discuss the role of cell memory in heredity and evolution. We describe the properties of the epigenetic inheritance systems (EISs) that underlie cell memory and enable environmentally and developmentally induced cell phenotypes to be transmitted in cell lineages, and argue that transgenerational epigenetic inheritance is an important and neglected part of heredity. By looking at the part EISs have played in the evolution of multicellularity, ontogeny, chromosome organization, and the origin of some post-mating isolating mechanisms, we show how considering the role of epigenetic inheritance can sometimes shed light on major evolutionary processes.

On the advantages of information sharing.

During the evolution of life, there have been several transitions in which individuals began to cooperate, forming higher levels of organization, and sometimes losing their independent reproductive identity For example, multicellularity and insect societies evolved independently multiple times. Several factors that confer evolutionary advantages on higher levels of organization have been proposed. In this paper we highlight one additional factor: the sharing of information between individuals. Information sharing is not subject to the intrinsic conservation laws that characterize the sharing of physical resources. A simple model will illustrate how information sharing can result in aggregates in which the individuals both receive more information about their environment and pay less for it. This may have played a role in the evolution of higher levels of organization.

Adopting adoption.

The common occurrence of adoption among birds and mammals presents evolutionary biologists with an explanatory challenge. The benefits to adoptees are self-evident, but the benefits to the adopter(s), the origin of the set of behaviours that constitute 'adoptive' behaviour, and the conditions for its spread in populations are not always clear. Explanations in terms of direct and indirect benefits to adopters and adoptees, and in terms of conflict between them have been suggested to account for the current functions and the evolutionary origin of 'adoptive' behaviour. In this paper we emphasize one aspect of the parenting behaviour associated with adoption that has been neglected: we suggest that adoption in birds and mammals is a route for the transfer of learnt information through social learning of patterns of behaviour, including styles of parenting. By using simple models we show that learning parenting from non-parents may provide additional opportunities for the spread of the 'adoptive' behaviour itself, even when it has no selective advantage. We also offer an additional explanation for the adaptive significance of adoption for both adopters and adoptees. Our 'match-making' hypothesis suggests that in some cases, by adopting foreign young, parents provide their genetic young with future ecologically compatible, but genetically unrelated, mates. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.

'Lamarckian' mechanisms in darwinian evolution.

Since the Modern Synthesis, evolutionary biologists have assumed that the genetic system is the sole provider of heritable variation, and that the generation of heritable variation is largely independent of environmental changes. However, adaptive mutation, epigenetic inheritance, behavioural inheritance through social learning, and language-based information transmission have properties that allow the inheritance of induced or learnt characters. The role of induced heritable variation in evolution therefore needs to be reconsidered, and the evolution of the systems that produce induced variation needs to be studied.

The inheritance of phenotypes: an adaptation to fluctuating environments.

We discuss simple models for the evolution of rates of spontaneous and induced heritable phenotypic variations in a periodically fluctuating environment with a cycle length between two and 100 generations. For the simplest case, the optimal spontaneous transition rate between two states is approximately 1/n (where n is the cycle length). It is also shown that selection for the optimal transition rate under these conditions is surprisingly strong. When n is small, this means that the heritable variations are produced by non-classical inheritance systems, including non-DNA inheritance systems. Thus, it is predicted that in genes controlling adaptation to such environments, non-classical genetic effects are likely to be observed. We argue that the evolution of spontaneous and induced heritable transitions played an important role in the evolution of ontogenies of both unicellular and multicellular organisms. The existence of a machinery for producing induced heritable phenotypic variations introduces a "Lamarckian" factor into evolution.

The adaptive advantage of phenotypic memory in changing environments.

The adaptive value of carry-over effects, the persistence of induced phenotypes for several generations despite the change in the conditions that first induced these phenotypes, is studied in the framework of a simple model. Three different organismal strategies-non-inducible (genetic), completely inducible (plastic), and intermediate (carry-over)-are compared in fitness terms within three different environments. Analytical results and numerical simulations show that carry-over effects can have an advantage in stochastic environments even over organisms with high adaptive plasticity. We argue that carry-over effects represent an adaptive mechanism on the ecological timescale that fills the gap between short-term individual adaptations and long-term evolutionary adaptations. An extension of the concept of plasticity to incorporate the time dimension and include the stability of induced phenotypes through both clonal and sexual generations, is suggested.

The evolution of information storage and heredity.

Many important transitions in evolution are associated with novel ways of storing and transmitting information. The storage of information in DNA sequence, and its transmission through DNA replication, is a fundamental hereditary system in all extant organisms, but it is not the only way of storing and transmitting information, and has itself replaced, and evolved from, other systems. A system that transmits information can have limited heredity or indefinite heredity. With limited heredity, the number of different possible types is commensurate with, or below, that of the individuals. With indefinite heredity, the number of possible types greatly exceeds the number of individuals in any realistic system. Recent findings suggest that the emergence and subsequent evolution of very different hereditary systems, from autocatalytic chemical cycles to natural language, accompanied the major evolutionary transitions in the history of life.

Inheritance systems and the evolution of new levels of individuality.

Evolutionary transitions to new levels of individuality have usually been treated as a part of the "units of selection" problem. It has previously been assumed that the unit of transmission and heritable variation at each level is the same--that it is the DNA base sequence and its variations. It is suggested here that considering the nature and the role of hereditary variations produced by non-DNA inheritance systems is essential for understanding some evolutionary transitions. The argument is illustrated by considering the role of epigenetic inheritance systems (EISs), the systems responsible for cellular memory, in the transition from unicellularity to multicellularity. It is argued that EISs played a vital role in the transition to multicellularity and the evolution of complex ontogenies, as well as having an important effect on the evolution of developmental strategies which protect the multicellular individual from disintegrating into its component parts. An analogy between the transition to multicellularity and the transition to a cultural unit integrated by language is also suggested.

Sex chromosomes and speciation.

Studies of reproductive isolation between animal species have shown (i) that if one sex of the hybrids between two species is sterile or inviable, it is usually the heterogametic sex (Haldane's rule), and (ii) the genes on the sex chromosomes play a particularly large role in hybrid sterility and inviability. We propose an explanation for these two observations which is based on the changes in chromosome conformation which take place during gametogenesis. These changes are far greater in sex chromosomes than in autosomes. They are also greater in the heterogametic than in the homogametic sex. We suggest that the sensitivity of hybrids of the heterogametic sex to the genetic divergence that occurs during periods of population isolation is partly the result of the failure of their sex chromosomes to undergo appropriate conformational changes. This hypothesis explains why the sex chromosomes play a disproportionate role in post-zygotic, but not in pre-zygotic, isolation, and why often only the germ line is sensitive to hybridization.

The evolution of heteromorphic sex chromosomes.

The facts and ideas which have been discussed lead to the following synthesis and model. 1. Heteromorphic sex chromosomes evolved from a pair of homomorphic chromosomes which had an allelic difference at the sex-determining locus. 2. The first step in the evolution of sex-chromosome heteromorphism involved either a conformational or a structural difference between the homologues. A structural difference could have arisen through a rearrangement such as an inversion or a translocation. A conformational difference could have occurred if the sex-determining locus was located in a chromosomal domain which behaved as a single control unit and involved a substantial segment of the chromosome. It is assumed that any conformational difference present in somatic cells would have been maintained in meiotic prophase. 3. Lack of conformational or structural homology between the sex chromosomes led to meiotic pairing failure. Since pairing failure reduced fertility, mechanisms preventing it had a selective advantage. Meiotic inactivation (heterochromatinization) of the differential region of the X chromosome in species with heterogametic males and euchromatinization of the W in species with heterogametic females are such mechanisms, and through them the pairing problems are avoided. 4. Structural and conformational differences between the sex chromosomes in the heterogametic sex reduced recombination. In heterogametic males recombination was reduced still further by the heterochromatinization of the X chromosome, which evolved in response to selection against meiotic pairing failure. 5. Suppression of recombination resulted in an increase in the mutation rate and an increased rate of fixation of deleterious mutations in the recombination-free chromosome regions. Functional degeneration of the genetically isolated regions of the Y and W was the result. In XY males this often led to further meiotic inactivation of the differential region of the X chromosome, and in this way an evolutionary positive-feedback loop may have been established. 6. Structural degeneration (loss of material) followed functional degeneration of Y or W chromosomes either because the functionally degenerate genes had deleterious effects which made their loss a selective advantage, or because shorter chromosomes were selectively neutral and became fixed by chance. 7. The evolutionary routes to sex-chromosome heteromorphism in groups with female heterogamety are more limited than in those with male heterogamety. Oocytes are usually large and long-lived, and are likely to need the products of X- or Z-linked genes. Meiotic inactivation of these chromosomes is therefore unlikely. In the oocytes of ZW females, meiotic pairing failure is avoided through euchromatinization of the W rather than heterochromatinization of the Z chromosome.(ABSTRACT TRUNCATED AT 400 WORDS)

Lamarckism and ageing.

Although it is usually assumed that Lamarckian inheritance does not and cannot occur, molecular mechanisms by which non-mutational changes acquired in one generation can be transmitted to the next are now known. These mechanisms involve changes in chromatin structure, rather than changes in DNA base sequence. It is argued that some parentalage effects and Lansing effects may be due to inherited changes in chromatin structure. Methods of testing this idea are suggested.

The inheritance of acquired epigenetic variations.

There is evidence that the functional history of a gene in one generation can influence its expression in the next. In somatic cells, changes in gene activity are frequently associated with changes in the pattern of methylation of the cytosines in DNA; these methylation patterns are stably inherited. Recent work suggests that information about patterns of methylation and other epigenetic states can also be transmitted from parents to offspring. This evidence is the basis of a model for the inheritance of acquired epigenetic variations. According to the model, an environmental stimulus can induce heritable chromatin modifications which are very specific and predictable, and might result in an adaptive response to the stimulus. This type of response probably has most significance for adaptive evolution in organisms such as fungi and plants, which lack distinct segregation of the soma and germ line. However, in all organisms, the accumulation of specific and random chromatin modifications in the germ line may be important in speciation, because these modifications could lead to reproductive isolation between populations. Heritable chromatin variations may also alter the frequency and distribution of classical mutations and meiotic recombination. Therefore, inherited epigenetic changes in the structure of chromatin can influence neo-Darwinian evolution as well as cause a type of "Lamarckian" inheritance.

Meiotic pairing constraints and the activity of sex chromosomes.

The state of activity and condensation of the sex chromosomes in gametocytes is frequently different from that found in somatic cells. For example, whereas the X chromosomes of XY males are euchromatic and active in somatic cells, they are usually condensed and inactive at the onset of meiosis; in the somatic cells of female mammals, one X chromosome is heterochromatic and inactive, but both X chromosomes are euchromatic and active early in meiosis. In species in which the female is the heterogametic sex (ZZ males and ZW females), the W chromosome, which is often seen as a condensed chromatin body in somatic cells, becomes euchromatic in early oocytes. We describe an hypothesis which can explain these changes in the activity and condensation of sex chromosomes in gametocytes. It is based on the fact that normal chromosome pairing seems to be essential for the survival of sex cells; chromosomal anomalies resulting in incomplete pairing during meiosis usually result in gametogenic loss. We argue that the changes seen in the sex chromosomes reflect the need to avoid pairing failure during meiosis. Pairing normally requires structural and conformational homology of the two chromosomes, but when the regions is avoided when these regions become heterochromatinized. This hypothesis provides an explanation for the changes found in gametocytes both in species with male heterogamety and those with female heterogamety. It also suggests possible reasons for the frequent origin of large supernumerary chromosomes from sex chromosomes, and for the reported lack of dosage compensation in species with female heterogamety.

5-aza-C-induced changes in the time of replication of the X chromosomes of Microtus agrestis are followed by non-random reversion to a late pattern of replication.

Treatment with 5-azacytidine (5-aza-C) causes an advance in the time of replication and enhances the DNase-I sensitivity of the inactive X chromosome in Gerbillus gerbilllus fibroblasts. We found that these changes were not stably inherited and upon removal of the drug the cells reverted to the original state of one active and one inactive X chromosome. In order to determine whether this reversion was random, we used a cell line of female Microtus agrestis fibroblasts in which the two X chromosomes are morphologically distinguishable. In this work we show that the reversion to a late pattern of replication is not random, and the originally late replicating X chromosome is preferentially "reinactivated", suggesting an imprinting-like marking of one or both X chromosomes. The changes in the replication pattern of the X chromosome were associated with changes in total DNA methylation. Double treatment of cells with 5-aza-C did not alter this pattern of euchromatin activation and reinactivation. A dramatic advance in the time of replication of the entire X linked constitutive heterochromatin (XCH) region was however, observed in the doubly treated cells. This change in the replication timing of the XCH occurred in both X chromosomes and was independent of the changes observed in the euchromatic region. These observations suggest the existence of at least two independent regulatory sites which control the timing of replication of two large chromosomal regions.

DNA hypomethylation causes an increase in DNase-I sensitivity and an advance in the time of replication of the entire inactive X chromosome.

We have examined the effect of 5-azacytidine (5-aza-C) induced hypomethylation of DNA on the time of replication and DNase I sensitivity of the X chromosomes of female Gerbillus gerbillus (rodent) lung fibroblast cells. Using in situ nick translation to visualise the potential state of activity of large regions of metaphase chromosomes we show that 5-aza-C causes a dramatic increase in the DNase-I sensitivity of the entire inactive X chromosome of female G. gerbillus cells and this increase in nuclease sensitivity correlates with a large shift in the time of replication of the inactive X chromosome from late S phase to early S phase. These effects of 5-aza-C on the inactive X chromosome are associated with a 15% decrease in DNA methylation. Our results indicate that DNA methylation concomitantly affects both the time of replication and the chromatin conformation of the inactive X chromosome.