Age-stratified cut-off points for the nocturnal penile tumescence measurement using Nocturnal Electrobioimpedance Volumetric Assessment (NEVA(®) ) in sexually active healthy men.

The current nocturnal penile tumescence (NPT) measurement is based on standard cut-off levels defined regardless of age. This study was conducted to provide age-stratified cut-off points for NPT measurement. Forty sexually active healthy men between 20 and 60 years old were enrolled and divided equally into four groups defined by age (20-29, 30-39, 40-49 and 50-60 years.). None of the candidates had sexual dysfunction or sleep disturbance or used supportive medication to enhance sexual function. Erectile function was evaluated by using the 5-item version of the international index of erectile function (IIEF-5). NPT was observed using the nocturnal electrobioimpedance volumetric assessment (NEVA(®) ). The NPT values of healthy men aged 20-60 years varied from 268.7% to 202.3%. The NPT differed significantly between age groups (P < 0.0009); however, no significant differences between men aged 30-39 and 40-49 (P = 0.593) were observed. Age was weakly associated with IIEF-5 scores (P = 0.004), whereas a strong and negative correlation between age and NPT (P < 0.0001) was found. IEF-5 scores were not significantly associated with NPT (P = 0.95). Therefore, the standard values for NPT testing should be considered in the evaluation of the nocturnal penile activity of men of all ages.

Two thermoformable spiral metallic ureteral stents in a patient with ileal conduit and distal stenosis of the ureters.

The insertion of two thermoformable ureteral titanium spiral stents (Memokath® 051) through ileal conduit due to bilateral ureteral stenosis distally has not been described in the English literature so far. We present the case of a young female patient with a history of ileal conduit urinary diversion due to congenital urinary bladder exstrophy, who had multiple previous surgeries and the insertion of two Memokath® ureteral stents in both ureters due to distal ureteral stenosis.

Prevalence of new psychoactive substances and prescription drugs in the Belgian driving under the influence of drugs population.

Driving under the influence of drugs (DUID) is a worldwide problem. Several countries have adopted DUID legislations which prove their deterrent effect and impact on road safety. However, the use of new psychoactive substances (NPS) and prescription drugs is not known, as the applied roadside screening tests have not yet been adapted for these compounds. In this study, 558 blood samples obtained during roadside controls in Belgium (January to August 2015) after a positive Drugwipe 5S® test and 199 oral fluid (OF) samples obtained from negatively screened test pads were analyzed. The NPS positivity rate was 7% in blood, while it reached 11% in OF. NPS detected were: diphenidine, ketamine, 4-fluoroamphetamine, 2-amino-indane, methoxetamine, α-PVP, methiopropamine, a mix of 5-MAPB/5-EAPB, TH-PVP, mephedrone, methedrone, 4-methylethylcathinone, 5-MeO-DALT, 4-Acetoxy-DiPT, AB Fubinaca, FUB-JWH018, JWH020, trifluoromethylphenylpiperazine, and ethylphenidate. Moreover, 17% of blood samples (and 5% of OF) contained an analgesic drug, 10% (0.5%) a benzodiazepine/hypnotic, 5% (2%) an antidepressant, 2% (3%) an antipsychotic, 2% an antiepileptic drug, and 1% methylphenidate. The presence of NPS in the young (and predominately male) DUID population is proven. Furthermore, a high level of poly-drug use including combinations of NPS, licit, and drugs of abuse was observed. Further research concerning the development of on-site NPS detection techniques should be established. Meanwhile, the effects of combined drug use on driving ability and the physical/psychological signs after NPS use should be performed to improve the on-site DUID detection of NPS by police officers, so they can engage in blood sampling for a general unknown screening.

Roadside drug testing: comparison of two legal approaches in Belgium.

BACKGROUND: Internationally, urine on-site testing has been used for detecting drivers under the influence of drugs (DUID) but more and more countries, such as Belgium, are switching to oral fluid screening. OBJECTIVE: To compare the previous (published in 1999) and current (published 2009) enforcement procedures of DUID in Belgium. The two evaluated procedures differ in the way the drivers are screened by the police (signs of impairment versus signs of recent drug use), the matrix for screening (urine versus oral fluid) and the analytical cut-off concentrations in plasma. METHODS: Data on positive screening and confirmation results were gathered from 1st April 2008 to 30th September 2010, when urine screening (Dipro Druglab panels test) was performed; and from 1st October 2010 to 31st March 2013, when an on-site oral fluid test (Securetec Drugwipe 5(+)) was used. RESULTS: Approximately 4100 data sets related to urine screening and 3900 data sets related to oral fluid screening were studied. Eighty-eight percent of positive urine on-site tests yielded positive results in plasma for cannabis, 21% for cocaine, 20% for amphetamines and 7% for opiates. Sixty-six percent of the positive oral fluid on-site tests yielded positive results in plasma for cannabis, 30% for cocaine, 28% for amphetamines and 8% for opiates. For cannabis, opiates and amphetamines more negative results in plasma were observed in the period of urine screening. CONCLUSIONS: The percentage of plasma samples of tested drivers, in which none of the positive screened target drugs were present in a concentration above the legal cut-off value, has decreased from 17% to 8% since the introduction of the current legislation involving oral fluid screening.

N-terminal splice variants of the type I PACAP receptor: isolation, characterization and ligand binding/selectivity determinants.

Three full-length cDNAs encoding functional splice variants of the pituitary adenylate cyclase-activating polypeptide (PACAP) type 1 receptor (PAC1) were isolated from Y-79 retinoblastoma cells and human cerebellum. Although the third intracellular loops of the three splice variants were identical, their N-terminal extracellular domains differed. The first full-length PAC1 variant, PAC1normal (PAC1n), encoded the entire N-terminus, whereas the second variant named PAC1short (PAC1s) was deleted by 21 amino acids (residues 89-109). Finally, the third variant, named PAC1very short (PAC1vs), was deleted by 57 amino acids (residues 53-109). Using semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) analysis, it was established that all three variants were expressed in neuronal tissues. Binding- and cAMP studies using human embryonic kidney 293 (HEK293) cells stably transfected with PAC1n, PAC1s and PAC1vs showed significant differences in the affinities and selectivities towards PACAP38, PACAP27 and VIP. PAC1n bound PACAP38 and PACAP27 with affinities in the low nanomolar range whereas VIP was bound with up to 400-fold lower affinity. PAC1vs preferentially bound PACAP38 (Ki=121 nM) and PACAP27 (Ki=129 nM) over VIP (Ki>1000 nM) but with 100-fold lower affinity than PAC1n. Surprisingly, PAC1s unselectively bound all three ligands with high affinity. These data indicate that residues 53-88 within the N-terminal domain of the PAC1 are important for high affinity ligand binding, whereas residues 89-109 determine the receptor's ligand selectivity.

Isolation and pharmacological characterization of two functional splice variants of corticotropin-releasing factor type 2 receptor from Tupaia belangeri.

From brain, heart and muscle tissue of the tree shrew (Tupaia belangeri), a higher order mammal, cDNA clones were isolated that encoded two functional splice variants of the corticotropin-releasing factor (CRF) type 2 receptor (CRF-R2). The first, full-length splice variant, amplified from brain and heart tissue, encoded a CRF receptor protein that is 410 amino acids in length and approximately 96% homologous to human CRF-R2alpha. The second, full-length splice variant, derived from skeletal muscle tissue, encoded a 437-amino acid CRF receptor protein that is approximately 92% homologous to human CRF-R2beta. Semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) amplifications and RNase protection analyses, showed that tree shrew CRF-R2alpha (tCRF-R2alpha) and tree shrew CRF-R2beta (tCRF-R2beta) were coexpressed in brain tissue but not in heart and skeletal muscle tissue. Finally, human embryonic kidney 293 (HEK293) cells stably transfected with tCRF-R2alpha and tCRF-R2beta were used to demonstrate that the CRF analogs urocortin and sauvagine bind with significantly greater affinity (21- to 140-fold) to these two CRF-R2 splice variants than do human/rat and ovine CRF analogs. In keeping with these results of our CRF binding studies, EC50 values were substantially lower for urocortin-and sauvagine-stimulated than for h/rCRF-and oCRF-stimulated cyclic AMP accumulation in HEK293 cells stably transfected with tCRF-R2alpha or tCRF-R2beta cDNAs. The tree shrew therefore constitutes an important animal model in which to investigate the role of CRF receptor subtypes in the stress response.

Comparison of two budesonide dry powder inhalers in the treatment of asthma in children.

The aim of this study was to compare the clinical efficacy, safety, and acceptability of budesonide inhaled from Easyhaler dry powder inhaler (DPI) (Giona Easyhaler, Orion Pharma, Finland) and from Turbuhaler DPI (Pulmicort Turbuhaler, AstraZeneca, Sweden) in the treatment of asthma in children. The 6-month, randomised, double-blind, double-dummy, parallel-group study was conducted in 229 completed, asthmatic children (5-10 years), who were symptomatic at study entry. For the first 2 months, children inhaled budesonide 2 x 200 microg b.i.d. (high-dose treatment period). Thereafter, the daily dose of inhaled budesonide was 2 x 100 microg for 4 months (low-dose treatment period). The study was carried out at 32 centers in Finland, Sweden, Norway, and Denmark. During the high-dose treatment period, the initially symptomatic patients improved in both treatment groups and the achieved control was maintained during the low-dose treatment period. An improvement was seen in the efficacy outcome parameters in the initially symptomatic patients in both treatment groups. Also, there were no differences in the number of asthma exacerbations between the treatments. The urinary free cortisol/creatinine (UCC) ratios were significantly lower in the Turbuhaler group compared to the Easyhaler group after the high-dose treatment period. In addition, there was a slight but statistically significant slower growth rate in the Turbuhaler group after the 6- month treatment period compared with the Easyhaler group. Pulmicort Turbuhaler and Giona Easyhaler are equally effective in the treatment of asthma in children aged 5-10 years old. Budesonide inhaled from Turbuhaler showed slightly greater systemic effects than budesonide inhaled from Easyhaler. The majority of children and parents preferred Easyhaler to Turbuhaler.

A computer system for on-line decoding of ultrasonic Doppler signals from blood flow measurement.

This work describes a computer system which may be used for analyzing Doppler signals obtained when measuring the blood velocity. The computer operates on-line, and the velocity components in the blood vessel are obtainedin real-time. The mean velocity and the relative velocity distribution is calculated from the velocity spectrum. Measurements taken from a femoral artery are shown.

Gardens of paradise.

Two hundred and fifty years ago, the Swedish naturalist Carolus Linnaeus (1707-1778) published his Philosophia botanica. This textbook in botanical science was widely read well into the 19th century. Today it is remembered mainly for two things: the introduction of binomial nomenclature and the formulation of a fixist and creationist species concept. While the former achievement is seen as a practical tool, still applicable for purposes of identification and information retrieval, the latter is usually deemed to have been one of the main obstacles to scientific progress in biology. That both achievements were not independent of each other, but interlocked theoretically and grounded in a specific scientific practice still thriving today--the collection of plant specimens in botanical gardens--is usually overlooked. The following article tries to uncover these connections and to demonstrate the significance that Linnaeus' achievements had for modern biology.

Primary nocturnal enuresis in children. Background and treatment.

UNLABELLED: The aim of the present studies was to investigate background factors and treatment in children with monosymptomatic primary nocturnal enuresis. The study material comprised enuretics, former enuretics and controls from the municipal community of Falkenberg on the west coast of Sweden. Whenever possible all investigations were made with the children staying in their own home environment. Different background factors have been suspected as being causative: sleep disturbances, behavioural or psychological disturbances, small bladder capacity, increased night diuresis and an insufficient production of the antidiuretic hormone during sleep. These factors have been investigated in these studies. The treatment of enuresis has been dominated by the alarm and antidiuretic treatment with DDAVP. Primary nocturnal monosymptomatic enuresis is a common problem in childhood. In this study the prevalence among 392 seven year old children was 7.3%. A prior history of enuresis was found in 65% of families of the enuretics compared to 25% in controls. The enuretic children showed no statistically significant differences in behavioural or psychological problems compared to non-enuretic children. Enuretic children were described as heavy sleepers by their parents and a wake-up test performed at home showed that they were statistically significantly harder to arouse than the controls. Children with nocturnal enuresis, former enuretics and controls did not differ in social or behavioural traits in an interview study. No signs of symptom substitution was found when enuresis was resolved. Enuretic children had a normal bladder capacity and no statistically significant difference was found compared to controls and former enuretics. The enuretic children showed a normal calcium-creatinine quota in the urine. Former enuretic children showed a significantly enhanced calcium/creatinine quota compared to enuretics and controls. Enuretic children had a statistically significant lower morning plasma level of the anti diuretic hormone vasopressin than non-enuretic children. Enuretic children were treated for 12 weeks with DDAVP or the alarm. DDAVP treated patients had a more rapid effect compared with alarm treated patients. Alarm treated children had a lower relapse frequency. Enuretic children were treated in a randomised, double blind, double dummy, cross over, placebo-controlled study with DDAVP 20 micrograms intranasally by a single dose pipette or 200 micrograms orally as a tablet. Both methods were equally effective in controlling enuresis, but significantly superior to placebo. CONCLUSION: Enuretic children are normal, well adjusted children with a normal bladder capacity, a high level of arousal threshold, and a low morning level of plasma vasopressin. The alarm and DDAVP are equally effective in treating enuresis.(ABSTRACT TRUNCATED AT 400 WORDS)

[Is the validated ICIQ-SF suitable for evaluation of OAB patients? A data analysis of intravesicular botulinum toxin therapy]. / Ist der validierte ICIQ-SF zur Evaluation bei OAB-Patientinnen geeignet? : Eine Datenanalyse im Rahmen der intravesikalen Botulinumtoxin-Therapie.

BACKGROUND: The following data analysis studied the aspects of patient satisfaction following onabotulinum toxin A (BTX-A) treatment including modification of certain parameters, such as frequency of micturition and the use of pads and in particular, the applicability of the international consultation on incontinence questionnaire short form (ICIQ-SF) and the urgency perception scale (UPS) in patients with an overactive bladder (OAB). PATIENTS AND METHOD: In this study 40 female patients were questioned in the form of validated questionnaires (extended ICIQ-SF and UPS) before and after being injected with 300 IU of BTX-A in each detrusor muscle. The average age of the patients was 66 years. All patients experienced anticholinergic refractory, non-neurogenic OAB. RESULTS: The recommendation rate and related patient satisfaction was 82.5 %. A significant decrease in the frequency of micturition by 50.9 % (p < 0.01) was reported as well as a significant reduction in the use of pads by 66.7 % (p < 0.01). The average number of ICIQ-SF points could be significantly (p < 0.01) reduced via BTX-A from 15.9 to 7.3. Moreover, BTX-A demonstrated a significant improvement in the urgency to urinate, which was illustrated through the UPS. CONCLUSION: Treatment with BTX-A achieves significant improvements in female patients with anticholinergic refractory OAB with regard to the individual symptoms of OAB (e.g. pollakisuria, nocturia, undesired urination and urgency). The use of the ICIQ-SF as the only questionnaire in OAB diagnostics proved to be unsuitable as it does not include female patients with dry OAB to an adequate degree. A combination of various validated questionnaires, such as ICIQ-SF and UPS, proved to be useful.

An electronic specimen collection protocol schema (eSCPS). Document architecture for specimen management and the exchange of specimen collection protocols between biobanking information systems.

BACKGROUND: The integrity of collection protocols in biobanking is essential for a high-quality sample preparation process. However, there is not currently a well-defined universal method for integrating collection protocols in the biobanking information system (BIMS). Therefore, an electronic schema of the collection protocol that is based on Extensible Markup Language (XML) is required to maintain the integrity and enable the exchange of collection protocols. MATERIALS AND METHODS: The development and implementation of an electronic specimen collection protocol schema (eSCPS) was performed at two institutions (Muenster and Cologne) in three stages. First, we analyzed the infrastructure that was already established at both the biorepository and the hospital information systems of these institutions and determined the requirements for the sufficient preparation of specimens and documentation. Second, we designed an eSCPS according to these requirements. Finally, a prospective study was conducted to implement and evaluate the novel schema in the current BIMS. RESULTS: We designed an eSCPS that provides all of the relevant information about collection protocols. Ten electronic collection protocols were generated using the supplementary Protocol Editor tool, and these protocols were successfully implemented in the existing BIMS. Moreover, an electronic list of collection protocols for the current studies being performed at each institution was included, new collection protocols were added, and the existing protocols were redesigned to be modifiable. The documentation time was significantly reduced after implementing the eSCPS (5 ± 2 min vs. 7 ± 3 min; p = 0.0002). CONCLUSION: The eSCPS improves the integrity and facilitates the exchange of specimen collection protocols in the existing open-source BIMS.

[Prediction of overactive bladder treatment outcome by using long-term urodynamics]. / Prädiktion der Therapie der überaktiven Blase mittels katheterloser Langzeiturodynamik.

In Germany, overactive bladder (OAB) syndrome affects around 6.5 million people over the age of 40. The primary treatment consists of anticholinergics or beta-3-receptor agonists. After an anticholinergic treatment period of around 4 months, compliance is around 40%, which is probably due a larger proportion of nonresponders. One condition of an efficient medication treatment is the presence of detrusor overactivity (DO). However, the detection rate of DO during standard urodynamics is very low. The primary goal in the future is to target OAB treatment by detection of DO. Using the Wille Capsule (WiCa) in an in vitro model, DO could be detected over a time period of 72 h, which would ensure a higher compliance to the OAB treatment in a positive way.

Generalized subcutaneous emphysema caused by injection of air into the penis for autoerotic purposes.

The injection of air or water into the scrotum has been described only a few times so far in the literature. Injection of air into the penis and its consequences has not been described at all. Here, we present the case of a young man who, acting on his previously suppressed sexual fantasies, injected air into his penis and caused generalized subcutaneous emphysema.

[Impact of preoperative pain on postoperative pain chronification. Six-month follow-up after urologic surgery]. / Einfluss präoperativer Schmerzen auf die postoperative Schmerzchronifizierung. Sechs Monate Nachbeobachtung nach urologischen Operationen.

BACKGROUND: We examined the influence of preoperative pain on postoperative pain chronification in urological patients. METHODS: Pain was determined before operation, immediately afterwards and 3 or 6 months post-surgically. Acute and chronic pain was analysed in detail with regard to severity, grade of chronification and pain intensity. We also assessed patients with the Hospital Anxiety and Depression Scale. RESULTS: Patients with preoperative pain reported postoperatively higher pain scores compared to patients without preoperative pain. Patients with higher Hospital Anxiety and Depression Scale scores reported higher pain scores for the first 7 days after the operation. Three months after surgery 51.2% of all patients and 6 months after surgery 1.2% of all patients reported about pain. CONCLUSION: Our results give evidence to the fact that preexisting pain prior to surgery has an influence on the postoperative pain course. To avoid chronification adequate therapy of the preexisting pain should be carried out.