Pronounced Relationship Research Articles

PD03-06 PLAQUE, PITTING, CONTOUR LOSS - A PATHOGENETIC SEQUENCE IN RENAL PAPILLAE OF IDIOPATHIC CALCIUM STONE FORMERS

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology I1 Apr 2018PD03-06 PLAQUE, PITTING, CONTOUR LOSS - A PATHOGENETIC SEQUENCE IN RENAL PAPILLAE OF IDIOPATHIC CALCIUM STONE FORMERS Melanie Adamsky, Andrew Cohen, Christopher Riedinger, Glenn Gerber, Elaine Worcester, and Frederic Coe Melanie AdamskyMelanie Adamsky More articles by this author , Andrew CohenAndrew Cohen More articles by this author , Christopher RiedingerChristopher Riedinger More articles by this author , Glenn GerberGlenn Gerber More articles by this author , Elaine WorcesterElaine Worcester More articles by this author , and Frederic CoeFrederic Coe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.272AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal papillary abnormalities are thought to have deeper roots in renal physiology and stone pathogenesis. A unifying hypothesis is that Randall′s plaque (RP) production is continuous, plaque loss gives rise to pitting, and this loss of tissue gives rise to changes in papillary contour (Figure 1). We have tested these predictions in a cohort of idiopathic calcium stone formers (ICSF). METHODS A previously described renal papillary grading system, which quantifies the degree of RP, pitting, plugging, and contour on each papillum, was applied to ICSF during ureteroscopy. We performed 2x2 table analysis of relationships between the scores for each papillary feature at the level of the papillum and the level of the kidney. Finally, we calculated mean scores for each feature by kidney and used Pearson correlation coefficients to measure relationships between features at the kidney level. RESULTS 85 patients were included with a total of 361 papillae graded. In table analysis of pitting scores by plaque scores, values deviated powerfully from chance (X2=63.997, p<0.00001). Increasing plaque scores were associated with decreasing percentage of pitting score zero. The presence of plaque without pitting is more often seen than pitting without plaque. A similar but less pronounced relationship was seen in the analysis of contour loss by pitting scores (X2= 35.9461, p=0.0029). Furthermore, contour loss and plaque scores showed a very strong relationship (X2 = 57.2033, p<0.00001). Results of the papillum-level analysis are summarized in Figure 2. At the level of the kidney, the strongest relationship exists between mean RP and mean contour scores (rp=0.4630, p=0.0003). CONCLUSIONS These data support our critical hypothesis that RP and attached calcium stone complex are shed from the papillum leaving behind a pitting defect on the papillary surface, which can then either heal over or, with repeated insult, progress to loss of papillary contour. We believe that understanding this sequence helps link renal physiology to a urologic endpoint. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e72-e73 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Melanie Adamsky More articles by this author Andrew Cohen More articles by this author Christopher Riedinger More articles by this author Glenn Gerber More articles by this author Elaine Worcester More articles by this author Frederic Coe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Associations of psychosocial working conditions and working time characteristics with somatic complaints in German resident physicians.

Somatic complaints (SC) are highly prevalent in working populations and cause suffering and extensive health-care utilization. Adverse psychosocial working conditions as conceptualized in the Job Demand-Control-Support Model (JDC-S) and adverse working time characteristics (WTC) are potential risk factors. This combination is particularly common in hospital physicians. This study examines associations of JDC-S and WTC with SC in resident physicians from Germany. A cross-sectional study was conducted among 405 physicians at the end of residency training. SC were measured using the Giessen Subjective Complaints List (GBB-24) containing the sub-categories exhaustion, gastrointestinal, musculoskeletal, and cardiovascular complaints. Data on working conditions were collected by a self-report method for work analysis in hospitals (TAA-KH-S) and by questions on WTC (i.e., working hours). Multivariable stepwise regression analyses were applied. Workload showed the most pronounced relationship with all sub-categories of SC except gastrointestinal complaints. Job autonomy was not significantly related to any SC sub-category. Social support at work was inversely associated with all SC sub-categories except for cardiovascular complaints. Free weekends were associated with reduced SC except for exhaustion. Shift work was related to an increased SC total score and musculoskeletal complaints. Working hours showed no association with SC. In resident physicians, high workload and shift work are associated with increased SC, while social support at work and free weekends are associated with decreased SC. These insights may inform the development of preventive measures to improve the health of this professional group. Prospective studies are needed though to corroborate our findings.

Sediment deposition and overland flow hydraulics in simulated vegetative filter strips under varying vegetation covers

Vegetative filter strips (VFSs) can effectively trap sediment in overland flow, but little information is available on its performance in controlling high-concentration sediment and the runoff hydraulics in VFS. Flume experiments were conducted to investigate the sediment deposition, hydraulics of overland flow and their relationships in simulating VFS under a great range of sediment concentrations with four levels of vegetation cover (bare slope and 4%, 11% and 17%) and two flow rates (15 and 30 L min−1). Sediment concentrations varied from 30 to 400 kg m−3 and slope gradient was 9°. Both the deposited sediment load and deposition efficiency in VFS increased as the vegetation cover increased. Sediment concentration had a positive effect on the deposited load but no effect on deposition efficiency. A lower flow rate corresponded to greater deposition efficiency but had little effect on deposited load. Flow velocities decreased as vegetation cover increased. Sediment concentration had a negative effect on the mean velocity but no effect on surface velocity. Hydraulic resistance increased as the vegetation cover and sediment concentration increased. Sediment deposition efficiency had a much more pronounced relationship with overland flow hydraulics compared with deposited load, especially with the mean flow velocity, and there was a power relationship between them. Flow regime also affected the sediment deposition efficiency, and the efficiency was much higher under subcritical than supercritical flow. The results will be useful for the design of VFS and the control of sediment flowing into rivers in areas with serious soil erosion. Copyright © 2015 John Wiley & Sons, Ltd.

Association of a genetic marker at the bovine Janus kinase 2 locus (JAK2/RsaI) with milk production traits of four cattle breeds.

In addition to the main components of the somatotrophic axis (GH/GHR/IGF-I/IGF-IR), great importance in the control of growth and development is also attached to the Janus kinase 2 (JAK2) pathway. Induced by the GH/GHR complex, JAK2 activates signal transducer and activator of transcription 5 (STAT5), and in consequence, may be involved in the regulation of expression of insulin-like growth factor I (IGF-I) in the mammary gland. Silent mutation (rs110298451) has been identified within exon 20 using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). A total of 904 individuals of four dairy or dual-purpose breeds (Polish Holstein-Friesian, Montbeliarde, Simmental and Jersey) were genotyped. A genotypic imbalance in the populations was observed. In the case of dual-purpose breeds (Montbeliarde and Simmental), the frequencies of both alleles were almost equal. In contrary, the JAK2G allele was predominant in the Polish Holstein-Friesian breed while JAK2A allele in Jersey. A pronounced relationship between JAK2/RsaI polymorphism and milk production traits was found where, irrespective of breed and lactation order, the GG genotype was significantly associated with higher milk, protein and fat yields, as compared to the AA genotype. Heterozygous individuals were generally characterised by intermediate values of the analysed milk traits. It can be argued that the JAK2 gene polymorphism is a potential marker for milk production traits. However, due to the fact that rs110298451 SNP does not directly affect amino acid sequence, other association studies involving missense mutation should also be performed.

Socioeconomic structures of the Austrian wealth distribution

This paper provides first–time insights into the socioeconomic specifics of the Austrian wealth distribution. Based on data from the Household Finance and Consumption Survey 2010, we explore patterns of household characteristics associated with the wealth dispersion. Due to the pronounced nonlinear relationship of wealth, we incorporate the complex survey design in quantile regressions to analyze the joint distribution of specific attributes and households net wealth position. Our findings emphasize the role of age, education, the ownership of a main residence and company stakes in order to identify generic households across the distribution. Looking at the top, the results indicate a specific role of being self-employed or having received inheritances.

Modelagem probabilística de eventos de precipitação extrema no estado do Rio Grande do Sul

A gestão de cheias em bacias hidrográficas brasileiras deve ser discutida e priorizada, porém o cenário atual indica lacunas quanto às informações hidrológicas com variabilidade espacial e temporal condizentes. A modelagem probabilística de eventos extremos de precipitação, buscando a extrapolação para uma frequência e duração, pode servir como excelente ferramenta de análise e tomada de decisões. O objetivo principal deste trabalho foi analisar o ajuste de diferentes modelos probabilísticos a séries de precipitação máxima diária anual no Rio Grande do Sul. Séries pluviométricas de 342 estações foram ajustadas às distribuições Log-Normal a 2 e 3 parâmetros e Gumbel e a adequação foi realizada pelos testes de Kolmogorov-Smirnov e Qui-Quadrado. Todas as distribuições de probabilidade consideradas foram adequadas; entretanto, a distribuição Log-Normal a 3 parâmetros apresentou os melhores ajustes segundo os resultados do teste Qui-Quadrado. Os parâmetros das distribuições de probabilidades apresentaram variabilidade ao longo do estado e forte relação com a localização, sugerindo que a regionalização de chuvas intensas pode ser empregada no Rio Grande do Sul como excelente ferramenta de gestão.

Resting heart rate influences right ventricular volume in repaired tetralogy of Fallot.

The aim of this study is to examine the impact of heart rate (HR) on right ventricular end-diastolic volume indexed to body surface area (RVEDVi) in patients with repaired tetralogy of Fallot (TOF). In this cross-sectional study, an institutional database search identified all patients with repaired TOF who underwent cardiac magnetic resonance (CMR) and had a Holter study within 3 months. The association of HR on Holter, HR at the time of CMR, and other clinical and CMR parameters on RVEDVi was explored with univariate and then multivariable models. In the study group (n = 161, median age 23 years), a lower mean Holter HR was associated with a larger RVEDVi (p = 0.004). In a model that also included pulmonary regurgitation fraction, tricuspid regurgitation grade, RV ejection fraction, age at CMR, and gender, mean Holter HR remained associated with RVEDVi (p < 0.0001); for a decrease of 1 bpm, mean RVEDVi increased by 1.09 ml/m(2). When limiting to those with a Holter within 5 days of CMR (n = 70), the impact of mean Holter HR on RVEDVi was stronger (-1.9 ml/m(2)/bpm). HR at time of CMR had a significant but less pronounced relationship to RVEDVi (-0.58 ml/m(2)/bpm, p = 0.002). In conclusion, in repaired TOF patients, a lower HR was significantly associated with a larger RVEDVi. This relationship was stronger with a shorter time interval between the Holter and CMR, and stronger for the mean HR on Holter than for the HR at CMR. Accounting for HR in the interpretation of RVEDVi may impact decisions regarding pulmonary valve replacement and the interpretation of serial CMR data.

The Intersections of Drug Use Continuity With Nonviolent Offending and Involvement in Violence Over the Life Course

While there is much research on the continuity of drug use over the life course, these studies tend not to consider the intersections of drug use continuity with offending in general and violence in particular. The current study uses data from 411 South London males who were participants in the Cambridge Study in Delinquent Development to investigate these associations from adolescence to age 50. Results suggest that the prevalence of drug use continuity (e.g., drug use in adolescence and adulthood) is rather high (45.4%) and that variability in drug use is differentially related to nonviolent offending and involvement in violence specifically. In this vein, the most pronounced relationship surrounding differential involvement in drug use is the association between drug use continuity and nonviolent offending and violence. Individual and environmental risk factors are also relevant predictors of nonviolent offending and violence. Study limitations and directions for future research are also discussed.

The Application of the Rayleigh Wave in Subgrade Layer Detection

Based on LabVIEW platform, a highway nondestructive detection system was developed to detect highway subgrade layer and strcture characteristic. The integral principle of this system is dispersion characteristics of Rayleigh wave in different medium and the pronounced relationship between propagation velocity of Rayleigh wave and physical-mechanical properties of the medium. Using this test system to conduct a field test on a highway in Henan province and comparing the results with the actual situation, the results validated the practicability and reliability of the system.

Laboratory study of small-strain behavior of a compacted silty sand

Small-strain behavior is a key indicator for assessing the performance of compacted fills. Compaction conditions, i.e., initial moisture content and applied energy, govern compaction effectiveness and thus, the structure and matric suction of compacted soil. This paper presents an experimental study of the small-strain behavior of compacted silty sand prepared with different compaction conditions. Specimens with varying initial moisture contents and compaction energies were tested with bender elements to determine the small-strain shear modulus (G0), while the post-compaction matric suction was measured using the filter paper method and tensiometer. The experimental data suggest a pronounced relationship between G0and the degree of saturation (Sr) of the as-compacted soil specimens. X-ray computed tomography (CT) scans were performed to examine structural changes of selected specimens upon compaction. The laboratory results are also examined in light of common end-product specifications, which show that it is beneficial to compact the soil slightly dry of optimum moisture content from the modulus point of view.

Exploring ΔR2* and ΔR1 as imaging biomarkers of tumor oxygenation

To investigate the combined use of hyperoxia-inducedΔR(2) * and ΔR(1) as a noninvasive imaging biomarker of tumor hypoxia. MRI was performed on rat GH3 prolactinomas (n = 6) and human PC3 prostate xenografts (n = 6) propagated in nude mice. multiple gradient echo and inversion recovery truefisp images were acquired from identical transverse slices to quantify tumor R(2) * and R(1)before and during carbogen (95% O2 /5% CO2 ) challenge, and correlates of ΔR(2) * and ΔR(1) assessed. Mean baseline R(2) * and R(1) were 119 ± 7 s(-1) and 0.6 ± 0.03 s(-1) for GH3 prolactinomas and 77 ± 12 s(-1) and 0.7 ± 0.02 s(-1) for PC3 xenografts, respectively. During carbogen breathing, mean ΔR(2) * and ΔR(1) were -20 ± 8 s(-1) and 0.08 ± 0.03 s(-1) for GH3 and -0.5 ± 1 s(-1) and 0.2 ± 0.08 s(-1) for the PC3 tumors, respectively. A pronounced relationship betweenΔR(2) * and ΔR(1) was revealed. Considering the blood oxygen-hemoglobin dissociation curve, fast R2 * suggested that GH3 prolactinomas were more hypoxic at baseline, and their carbogen response dominated by increased hemoglobin oxygenation, evidenced by highly negative ΔR(2) *. PC3 tumors were less hypoxic at baseline, and their response to carbogen dominated by increased dissolved oxygen, evidenced by highly positive ΔR(1) . Because the two biomarkers are sensitive to different oxygenation ranges, the combination of ΔR(2) * and ΔR(1) may better characterize tumor hypoxia than each alone.

Trace elements and Pb isotope records in Dome C (East Antarctica) ice over the past 800,000 years

Trace elements (V, Cr, Mn, Fe, Co, Cu, Zn, As, Rb, Sr, Mo, Cd, Sb, Ba, Tl, Pb, Bi, Th and U) and Pb isotopic compositions from the EPICA (European Project for Ice Coring in Antarctica) Dome C ice core have been determined using inductively coupled plasma sector field mass spectrometry (ICP-SFMS) and thermal ionization mass spectrometry (TIMS), covering the period from ~533 kyr BP to ~800 kyr BP, respectively. Our data have enabled us to extend the previous EDC records of trace elements and Pb isotopes from the Holocene back to the Marine Isotopic Stage 20.2, ~800 kyr BP. We here discuss the EDC records of Ba, Rb, Mo, Sb, Cd, Tl, Bi and Pb isotopes. Crustal elements such as Ba and Rb show well defined variations in concentrations in relation to climatic conditions with lower values during the interglacial periods and much higher values during the coldest periods of the last eight climatic cycles. Volcanogenic Cd, Tl and Bi show a less pronounced relationship between concentrations and climatic conditions. The isotopic signatures of Pb suggest that changes in the provenance of dust reaching the East Antarctic Plateau from Potential Source Areas occurred during the interglacial periods before the MBE. Our data suggest that the main factors affecting deposition fluxes and sources of natural trace elements over Antarctica are most likely linked to a progressive coupling of the climates of Antarctica and lower latitudes over the past 800 kyr.

Nurse migration in Europe—Can expectations really be met? Combining qualitative and quantitative data from Germany and eight of its destination and source countries

BackgroundWhile nurse migration has received considerable political attention since the EU enlargements in 2004 and 2007, most research concentrated on the specific migration motives and the impact on health care systems, while little research focused on the experiences of nurses abroad or combined these experiences with research on working conditions in hospitals. ObjectivesTo test whether the combination of qualitative and quantitative data on motives to migrate and to leave the current hospital, respectively, provides sufficient information (1) to analyse working conditions in Germany compared to five destination and three source countries, (2) to verify or falsify the assumption that working conditions in destination countries are better than in source countries, and (3) to identify sound strategies for workforce planning. Design and data sources(a) Relevant push factors for migrating from Germany were identified via an online survey, focus groups, and telephone interviews. (b) Eight factors were operationalised using items selected from the revised Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Maslach Burnout Inventory (MBI). (c) The impact of these push factors on the stated “intention-to-leave” of 1508 hospital nurses in Germany was assessed using multivariate data analysis. (d) Descriptive statistics were used to illustrate comparisons across all countries using a total sample of 27,451 nurses from 328 hospitals. Results(1) All push factors show a positive association with the risk for nurses to leave their current jobs, with “poor working environment” having the most pronounced relationship (OR 3.235, 95% CI 2.434–4.301). (2) On average, four out of five destination countries receive better ratings than Germany (with 5/5 for “sufficient nursing staff”, “recognition”, “decision-making power”, and “collaboration between nurses and physicians” but only 1/5 for “advanced training prospects”), while two out of three source countries receive worse ratings than Germany. (3) Results suggest that the way to retain and attract nurses on the short-term is to invest in better working environments. ConclusionsBy successfully linking qualitative and quantitative research, new insights about factors for the movement of nurses can be gained. German nurses would indeed find more satisfying conditions abroad in most cases–findings which encourages a revision of work-related aspects in German hospitals.

Differences in the Biologic Activity of 2 Novel MEK Inhibitors Revealed by 18F-FDG PET: Analysis of Imaging Data from 2 Phase I Trials

Two mitogen-activated protein kinase kinase (MAPK2, also known as MEK) inhibitors were assessed with (18)F-FDG PET in separate phase I clinical studies, clearly illustrating the potential of metabolic imaging for dose, dosing regimen, and compound selection in early-phase trials and utility for predicting nonresponding patients. (18)F-FDG PET data were collected during 2 independent, phase I, dose-escalation trials of 2 novel MEK inhibitors (RO5126766 and RO4987655). PET acquisition procedures were standardized between the 2 trials, and PET images were analyzed centrally. Imaging was performed at baseline; at cycle 1, day 15; and at cycle 3, day 1. A 10-mm-diameter region of interest was defined for up to 5 lesions, and peak standardized uptake values were determined for each lesion. The relationship between PET response and pharmacokinetic factors (dose and exposure), inhibition of extracellular-signal-regulated kinase (ERK) phosphorylation in peripheral blood mononuclear cells, and anatomic tumor response as measured by Response Evaluation Criteria in Solid Tumors was investigated for both compounds. Seventy-six patients underwent PET, and 205 individual PET scans were analyzed. Strong evidence of biologic activity was seen as early as cycle 1, day 15, for both compounds. (18)F-FDG PET revealed striking differences between the 2 MEK inhibitors at their recommended dose for phase II investigation. The mean amplitude of the decrease in (18)F-FDG from baseline to cycle 1, day 15, was greater for patients receiving RO4987655 than for those receiving RO5126766 (47% vs. 16%, respectively; P = 0.052). Furthermore, a more pronounced relationship was seen between the change in (18)F-FDG uptake and dose or exposure and phosphorylated ERK inhibition in peripheral blood mononuclear cells in patients receiving RO4987655. For both investigational drugs, PET responses tended to be greatest in patients with melanoma tumors. (18)F-FDG was able to identify early nonresponding patients with a 97% negative predictive value. These data exemplify the role of (18)F-FDG PET for guiding the selection of novel investigational drugs, choosing dose in early-phase clinical development, and predicting nonresponding patients early in treatment.

Natural Gas Prices on Three Continents

We investigate the pricing formation of natural gas markets on three different continents (Europe, Asia and North America). We find that natural gas markets showed a strong relationship with the crude oil market between 1992 and 2001 and natural gas prices tended to thermal parity with crude oil prices. From 2002 natural gas markets exhibited a less pronounced relationship with the crude oil market and major natural gas markets were severely underpriced compared to crude oil. A globally integrated natural gas market, comparable to the global oil market, has not evolved. The main natural gas markets, however, exhibit some level of integration, especially over a longer time. The European market exhibits the strongest levels of integration, while the North American market exhibits the weakest.

The Relationship Between Episodic and Dispositional Forgiveness, Psychosocial Development, and Counseling

The relationship between episodic and dispositional forgiveness and the resolution of Erikson's (1963) psychosocial crises were explored in this study. Participants (N = 66) completed the Enright Forgiveness Inventory (Enright & Rique, 2004), Tendency to Forgive Scale (Brown, 2003), and Measures of Psychosocial Development (Hawley, 1988). Results are consistent with forgiveness and Eriksonian theories. Episodic forgiveness and dispositional forgiveness accounted for 8% and 10%, respectively, of the variance in global resolution of psychosocial crises. The most pronounced relationship was between both forgiveness types and Erikson's crises related to basic trust and ego integrity. Implications for counseling research, practice, and training are discussed.

Declining Genetic Diversity and Increasing Genetic Isolation toward the Range Periphery ofStipa pennata, a Eurasian Feather Grass

A common assumption in ecology and evolutionary biology is that genetic diversity declines and differentiation increases toward the edge of a species’ geographic range, where populations tend to be smaller and more isolated. We tested these predictions in a characteristic Eurasian steppe plant, Stipa pennata, by inspecting 230 AFLP bands in 26 populations (345 individuals) along a 3300-km longitudinal gradient from the range core, in Russia, to the range periphery, in central Europe. Overall, our study species showed low genetic diversity within populations (mean proportion of polymorphic ) and moderately high genetic differentiation among them (mean ). As predicted, genetic diversity declined significantly from the range core to the periphery but was not correlated with population size. Pairwise genetic differentiation was significantly higher among peripheral populations than central populations but did not show a pronounced relationship with geographic distance. Our results indicate that peripheral populations may experience higher genetic drift and lower gene flow than their central counterparts, possibly because of smaller population sizes, spatial isolation, and a more complex landscape structure. In addition, historic range fluctuations and the mixed breeding system could have enhanced the observed patterns in our study species.

Length of the Spacer Rather than its Plasticity Relates to Species Distribution in Various Natural Habitats

Much evidence from laboratory experiments and theoretical studies show that plasticity of clonal growth traits like lateral spread provides advantage in heterogeneous conditions. However, few tests of whether species with plastic clonal growth have an advantage over non-plastic species in natural conditions exist. I analyzed whether spacer length (i.e., length of a stolon or a rhizome branch between two ramets) and the variation of it (as a surrogate to its plasticity) relate to species presence and abundance in open meadow, wooded meadow and forest habitats with varying environmental conditions at Laelatu wooded meadow, Estonia. In fertilized, compared to unfertilized conditions, a weak and non-conclusive advantage of both long spacers and high variability of spacer length was detected. Abandonment in open meadows lead to a prevalence of species with shorter spacers, while on abandoned wooded meadows the species with longer spacers dominated. There was no difference in variability of spacer length between managed and abandoned meadows. In more heterogeneous forest habitats high variability of spacer length was more common, but the effect of lengthy spacers was more pronounced. The results suggest that while the variability of spacer length indeed corresponds with larger abundance in some conditions, the actual length of spacers has a more pronounced relationship with abundance of plants in natural vegetation.

Serum MMP 2 and TIMP 2 in patients with inguinal hernias

More than sixty thousand inguinal hernia operations are performed every year in Poland. Despite many years of related research, the exact pathologic mechanism of this condition is still not fully understood. Recent studies suggested a pronounced relationship between the molecular structure of collagen fibers and the activity of metalloproteinases, the enzymes taking part in the degradation of collagen, as well as their tissue inhibitors. A prospective study has been established to measure serum levels of the matrix metalloproteinase 2 (MMP-2) and Matrix metalloproteinase tissue inhibitor 2 (TIMP-2) in 150 males between the ages of 26 and 70. The control group (CG) consisted of thirty healthy male volunteers of a similar age distribution. Our results indicate that MMP-2 was highest in the direct hernia group, a statistically very significant elevation (P<0(.) 05) of 1562ng mL(-1) against the CG 684ng mL(-1) . The highest level of TIMP, 78ng mL(-1) , was found in the group with recurrent hernia, against 49(.) 5ng mL(-1) of the CG (statistical significance of P<0(.) 05). The MMP-2 and TIMP-2 levels were concurrently elevated only in the recurrent hernia group. The patients with inguinal hernia have a statistically significant increase in serum levels of MMP-2. Our finding of the MMP-2 and TIMP-2 distinctly higher in the patients suffering from recurrence of direct inguinal hernia (reflecting a previous surgical failure) may suggest the theory that the extracellular matrix defect lies at the basis of this disorder.

The evolution of island gigantism and body size variation in tortoises and turtles

Extant chelonians (turtles and tortoises) span almost four orders of magnitude of body size, including the startling examples of gigantism seen in the tortoises of the Galapagos and Seychelles islands. However, the evolutionary determinants of size diversity in chelonians are poorly understood. We present a comparative analysis of body size evolution in turtles and tortoises within a phylogenetic framework. Our results reveal a pronounced relationship between habitat and optimal body size in chelonians. We found strong evidence for separate, larger optimal body sizes for sea turtles and island tortoises, the latter showing support for the rule of island gigantism in non-mammalian amniotes. Optimal sizes for freshwater and mainland terrestrial turtles are similar and smaller, although the range of body size variation in these forms is qualitatively greater. The greater number of potential niches in freshwater and terrestrial environments may mean that body size relationships are more complicated in these habitats.