Stricture of the Afferent Isoperistaltic Tubular Segment: A Late and Rare Cause of Bilateral Dilation of the Upper Urinary Tract After Ileal Bladder Substitution

OBJECTIVE To evaluate the etiology and treatment of bilateral hydronephrosis not responding to bladder substitute drainage after ileal bladder substitution using an afferent isoperistaltic tubular segment. MATERIALS AND METHODS A retrospective analysis was performed of a consecutive series of 739 patients who had undergone bladder substitution from April 1985 to August 2012. RESULTS Of the 739 ileal bladder substitute patients, 10 (1.4%) developed bilateral hydronephrosis unresponsive to complete bladder substitute drainage. The etiology was stenosis of the afferent isoperistaltic tubular segment. The median interval to presentation was 131 months (range 45-192). The incidence of afferent tubular segment stenosis was significantly higher in the 61 ileal bladder substitute patients with recurrent urinary tract infection (9 [15%]) than in the 678 without recurrent urinary tract infection (1 [0.15%]; P <.001). Urine cultures revealed mixed infections (34%), Escherichia coli (18%), Staphylococcus aureus (13%), enterococci (11%), Candida (8%), Klebsiella (8%), and others (8%). Seven patients underwent 10 endourologic interventions, only 1 of which was successful (10%). After failed endourologic treatment, 7 open surgical revisions with resection of the stricture were performed, with all 7 (100%) successful. CONCLUSION Bilateral dilation of the upper urinary tract after ileal orthotopic bladder substitution unresponsive to complete bladder substitute drainage is likely to be caused by stenosis of the afferent isoperistaltic tubular segment. The stenosis occurs almost exclusively in patients with long-lasting, recurrent urinary tract infection and can develop many years after the ileal bladder substitution. Minimally invasive endourologic treatment is usually unsuccessful; however, open surgical revision offers excellent results.

Weathering geochemistry and Sr-Nd fingerprints of equatorial upper Nile and Congo muds

This study investigates processes of sediment generation in equatorial central Africa. An original, complete and integrated mineralogical-geochemical database on silt-sized sediments derived from different parent rocks (basalt, granite, gneiss, metapsammite, sandstone) along the East African Rift from 5°S in Tanzania to 5°N in Sudan is presented and used to assess the incidence of diverse factors controlling sediment composition (source-rock lithology, geomorphology, hydraulic sorting, grain size, recycling), with particular emphasis on chemical weathering.

(Table 1) Elemental composition, pyrite-Fe and degree of pyritisation in Upper Pliensbachian and Lower Toarcian sediments from the costal section of Yorkshire

Profiles of Mo/total organic carbon (TOC) through the Lower Toarcian black shales of the Cleveland Basin, Yorkshire, United Kingdom, and the Posidonia shale of Germany and Switzerland reveal water mass restriction during the interval from late tenuicostatum Zone times to early bifrons Zone times, times which include that of the putative Early Toarcian oceanic anoxic event. The degree of restriction is revealed by crossplots of Mo and TOC concentrations for the Cleveland Basin, which define two linear arrays with regression slopes (ppm/%) of 0.5 and 17. The slope of 0.5 applies to sediment from the upper semicelatum and exaratum Subzones. This value, which is one tenth of that for modern sediments from the Black Sea (Mo/TOC regression slope 4.5), reveals that water mass restriction during this interval was around 10 times more severe than in the modern Black Sea; the renewal frequency of the water mass was between 4 and 40 ka. The Mo/TOC regression slope of 17 applies to the overlying falciferum and commune subzones: the value shows that restriction in this interval was less severe and that the renewal frequency of the water mass was between 10 and 130 years. The more restricted of the two intervals has been termed the Early Toarcian oceanic anoxic event but is shown to be an event caused by basin restriction local to NW Europe. Crossplots of Re, Os, and Mo against TOC show similar trends of increasing element concentration with increase in TOC but with differing slopes. Together with modeling of 187Os/188Os and d98Mo, the element/TOC trends show that drawdown of Re, Os, and Mo was essentially complete during upper semicelatum and exaratum Subzone times (Mo/TOC regression slope of 0.5). Drawdown sensitized the restricted water mass to isotopic change forced by freshwater mixing so that continental inputs of Re, Os, and Mo, via a low-salinity surface layer, created isotopic excursions of up to 1.3 per mil in d98Mo and up to 0.6 per mil for 187Os/188Os. Restriction thereby compromises attempts to date Toarcian black shales, and possibly all black shales, using Re-Os chronology and introduces a confounding influence in the attempts to use d98Mo and initial 187Os/188Os for palaeo-oceanographic interpretation.

Upper Cretaceous planktic foraminiferal biozonation for the Austral Realm

A new planktic foraminiferal zonal scheme is presented for subdivision of Upper Cretaceous pelagic carbonate sequences in the circum-Antarctic region. Definition of the zones and subzones is based study of foraminifera from 13 deep-sea sections that were poleward of 50 °S paleolatitude and within the Austral Biogeographic Realm during Late Cretaceous time. The proposed biostratigraphic scheme includes seven Upper Cretaceous zones, with an average stratigraphic resolution of 4.4 m.y., and six subzones, which are all within the Maastrichtian Stage, with an average stratigraphic resolution of 1.4 m.y. The considerably higher resolution in the Maastrichtian Stage is a result of good foraminiferal preservation, availability of high quality magnetostratigraphic sections, and complete composite stratigraphic recovery in the Atlantic and Indian Ocean sectors of the Antarctic Ocean. Diminished resolution in the pre-Maastrichtian sediments of southern high latitude sections results from: (1) incomplete recovery of the middle Campanian, lower Santonian and most of the Cenomanian-lower Coniacian intervals, (2) presence of local and regional hiatuses, (3) paleobathymetric shallowing with increasing age at some sites, resulting in impoverished older planktic assemblages, and (4) poorer preservation with increasing burial depth. Cross-latitude correlation of the Campanian and older austral sequences may be improved with future drilling by recovery of sections that span existing stratigraphic gaps. Correlation of high latitude bioevents with chemostratigraphic events and their intercalibration with the magnetostratigraphy and the Geomagnetic Polarity Time Scale are needed for better chronostratigraphic resolution in existing high latitude sequences.

Upper Turonian - lower Campanian planktonic foraminifera from Exmouth Plateau

A planktonic foraminiferal zonal scheme is presented for subdivision of the Upper Cretaceous pelagic carbonate sequence from southern mid-high latitudes. Definition of the zones is based on first and last occurrences of planktonic foraminifera from Ocean Drilling Program Holes 762C and 763B (Leg 122; Exmouth Plateau, south Indian Ocean). During the Late Cretaceous the studied holes were located close to 50°S and for the first time a complete sedimentary record for the mid-high latitudes was obtained. A detailed biostratigraphic analysis has allowed recognition of two new zones (Falsotruncana maslakovae Zone and Marginotruncana marianosi Zone) for the interval extending from the last occurrence of Helvetoglobotruncana helvetica to the first occurrence of Dicarinella asymetrica (upper Turonian - lower Santonian). From this study it is apparent that some low latitude (Globotruncana ventricosa, Hedbergella flandrini, Marginotruncana marianosi) and high latitude (Globigerinelloides impensus and Hedbergella sliteri) marker taxa display a vertical distribution at mid-high latitudes which is different from that known from low latitudes; moreover, one species (Heterohelix papula), overlooked at low latitudes, exhibits a restricted range that seems to be useful for chrono-biostratigraphic correlations: its appearance is suggested to coincide with the Coniacian/Santonian boundary. The proposed biozonation, which is integrated with calcareous nannofossil and magnetostratigraphic data available for the sections studied, is compared with both the low-latitude standard zonation and the planktonic foraminiferal zonal scheme for the circum-Antarctic region, in order to define a bio-chronostratigraphic scale that is useful for mid-high latitudes of the southern oceans.

The Extended Water Footprint and illegal groundwater use in the Upper Guadiana Basin (Spain)

Tablas de Daimiel National Park is located in the Upper Guadiana Basin and represents one of the largest and most important wetlands in Europe. The long term ecological integrity of this wetland is inherently associated with the maintenance of a shallow groundwater table, namely the Western Mancha aquifer (WMA) or Aquifer 23. The intensive use of groundwater, mainly for irrigation, has led over the last decades to deep socio‐economic changes. Such intensive use has also lowered the water table of Aquifer 23, drastically reducing the flooded area of the wetland and threatening its ecological integrity. A number of plans and measures have been developed and implemented since the declaration of overexploitation of Aquifer 23 in the year 1987. The most recent one is the Special Plan for the Upper Guadiana (SPUG), approved in 2008. This Plan is the main measure to comply with achieving the objective of good quantitative and qualitative status required under the Water Framework Directive (2000). This paper offers a new type of integrated analysis which allows assessing under a common lens the physical, economic and social dimensions of groundwater use in the area. The first objective is to calculate the groundwater footprint of agricultural production in the Upper Guadiana basin and its evolution during 2000‐2008. For this purpose, we have applied the Extended Water Footprint (EWF) methodology ‐a novel approach based on the classical Water Footprint (WF) approach‐ that includes an assessment of the water productivity from an economic and social perspective. Compared to the classical WF, the EWF allows for a more complete overview of the sector, providing new insights for policy decisions (e.g. to define options and possibilities on water re‐allocation in order to achieve both better ecosystem conservation and social equity). The second objective is to use the EWF to compare the existing authorized and non‐authorized or illegal use of water. This allows us to discuss current initiatives by public authorities in relation to the existing frame of water rights

Paleoecology, Diagenesis and Biological Affinity of Tetradiids in the Upper Ordovician (Sandbian) Black River Group of the Kingston Area, Ontario, Canada

Tetradiids are a group of colonial, tubular fossils that occur globally in Middle to Upper Ordovician strata. Tetradiids were first described as a type of tabulate coral; however, based on their four-fold symmetry, division, and presence of a central-sparry canal, they were recently reinterpreted as a florideophyte rhodophyte algae, a reinterpretation that is tested in this thesis. This study focused on understanding the affinity and taphonomy of this order of fossil. Research was conducted by stratigraphic and petrographic analyses of the Black River Group in the Kingston, Ontario region. Tetradiid occurrences were divided into fragment or colonial, with three morphologies of tetradiids described (Tetradium, Phytopsis and Paratetradium). Morphology is specific to depositional environment, with compact Tetradium consistently within ooid grainstones and open branching Phytopsis and chained Paratetradium consistently within mudstones. Two types of patch reefs were recognized: a Paratetradium bioherm, and a Paratetradium, Phytopsis, stromatolite bioherm. The presence of bioherms implies that tetradiids were capable of hypercalcifying. Preservation styles of tetradiids were investigated, and were compared to brachiopods, echinoderms, mollusks, and ooids. Tetradiids were preferentially preserved as molds and demonstrated complete dissolution of skeletal material. Rare specimens, however, demonstrated preserved horizontal partitions, central plates, and a double wall. Skeletal molds were filled with either calcite spar, mud or encrusted by a cryptomicrobial colony. Both calcitic and aragonitic ooids were discovered. The co-occurrence of aragonitic ooids, aragonitic crytodontids, and the evolution of aragonitic, hypercalcifying tetradiids is interpreted as representing the geochemical favoring of aragonite and HMC in a time of global calcite seas. The geochemical favoring of aragonite is interpreted to be independent to global Mg: Ca ratios, but was the result of increased saturation levels and temperature driven by high atmospheric pCO2. Based on the presence of epitheca, tabulae, septa, and the commonality of growth forms, tetradiids are interpreted as an order of Cnidaria. The evolution of an aragonitic skeleton in tetradiids is interpreted to be the result of de novo acquisition of a skeleton from an unmineralized clade.

(Figure 2) Distribution of planktonic foraminifera in the upper Paleocene of DSDP Hole 93-605

Good faunal preservation in the upper part of the Planorotatites pseudomenardii Zone at Deep Sea Drilling Project Site 605, northwestern Atlantic, allows a biometric analysis of the upper Paleocene planktonic foraminiferal species Planorotatites pseudomenardii (Belli), a keeled species that probably developed from a middle Paleocene unkeeled Planorotalites form. Multivariate analysis shows a consistent separation of all Planorotatites specimens into two groups, which are differentiated by the presence or absence of a complete keel; other variables are only of minor importance. The keeled group coincides with P. pseudomenardii. We recognize only one unkeeled species, Planorotalites chapmani (Parr), with Planorotalites ehrenbergi (Bolli), Planorotalites imitata (Subbotina), Planorotalites planoconica (Subbotina), Planorotalites troelseni (Loeblich and Tappan), and Planorotalites hausbergensis (Gohrbrandt) as junior synonyms. P. chapmani ranges from the middle Paleocene to at least the top of the upper Paleocene. The morphology of P. pseudomenardii does not change significantly, and although the frequency of Planorotalites is variable, the proportion of P. pseudomenardii to all Planorotalites varies only slightly around 65% in the upper two-thirds of its range at Site 605. However, in the top 1.5 m of its range the proportion of P. pseudomenardii decreases; in the same section, all Planorotalites specimens show a reduction in the size of their tests, suggesting that a temporary change in environmental conditions led to the exit of P. pseudomenardii\ in Magnetozone C24R at Site 605-apparently higher than expected from current standard zonations. Unkeeled Planorotalites, in contrast to R. pseudomenardii, persisted and regained normal size. The entry of P. pseudomenardii at Site 605 cannot be described in the same detail because of low frequencies of Planorotalites specimens and an erratic distribution of P. pseudomenardii in the lower part of its range. Many of the washed residues of the samples from these sediments are dominated by radiolarians, and the poorly preserved foraminiferal faunas may have abundant benthics, indicating carbonate dissolution. The initially low frequencies of P pseudomenardii relative to the unkeeled Planorotalites show a strong negative correlation with the total amount of radiolarians per sample and could be the result of preferential preservation, as well as of the same environmental conditions that caused the abundance of radiolarians.

Medial upper eyelid shortening to correct medial eyelid laxity in floppy eyelid syndrome: A new surgical approach

Purpose: To describe and present the results of a new surgical technique for patients with floppy eyelid syndrome, based on the medial upper eyelid stretching encountered in this condition. Methods: A case series of 24 patients with floppy eyelid syndrome who where found to have symptomatic predominately medial upper eyelid laxity was analyzed. The history, clinical features, histopathology, and outcome were reviewed after patients underwent medial upper eyelid shortening with or without upper eyelid skin reduction as the first surgical procedure. Results: Of the 24 patients, 18 were men (75%) with a mean age at referral of 56 years, having ocular discomfort and conjunctival irritation/papillary conjunctivitis as the main complaints at presentation. Obesity was present in 96% of cases, with lower eyelid laxityl/ectropion (50%) and upper eyelid eyelash ptosis (29%) in conjunction with the upper eyelid laxity. The affected side was related to sleeping habits or recurrent mechanical eyelid trauma. Histologic studies showed a nonspecific inflammatory cell infiltrate and loss of elastin with loose dermal connective tissue. After surgery, complete relief of ocular symptoms and good functional and cosmetic results were present in all cases after 18 months of follow-up. Conclusions: This new surgical approach is based on the presence of predominately medial upper laxity in patients with floppy eyelid syndrome. The excision of this stretched area stabilized the upper eyelid in an anatomic fashion, providing a good and stable long-term result. The possible mechanisms involved in the medial upper eyelid stretching are discussed.

Mastigatory efficiency in denture wears with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

Mastigatory efficiency in denture wears with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

(Table 1) Distribution of upper Campanian-lower Maestrichtian calcareous nannofossils at DSDP Hole 71-511

Calcareous nannofossils from upper Campanian-lower Maestrichtian Deep Sea Drilling Project Leg 71 Cores 511-23 and 511-24 are described and correlated with assemblages of similar age from piston and drill cores on the Falkland Plateau, South Atlantic Ocean. The Leg 71 cores partially fill a drilling gap of at least 20 meters left within a thick (50 m) carbonate section first drilled by DSDP Leg 36 at Site 327. Cores 511-23 and 511-24 both fall within the upper portion of the Biscutum coronum Zone of Wind and demonstrate an overlap in the range of Monomarginatus quaternarius with the ranges of M. pectinatus, Misceomarginatus pleniporus, and Biscutum coronum across the Campanian/ Maestrichtian boundary. Resolution of the sequence of highest occurrence datums for the latter species must await the recovery of a more complete section. Comparison of the Site 511 assemblages with those from Mas Orcadas Core 07-75-44 to the north confirms earlier speculation that the Falkland Plateau served as an important boundary between major water masses during the Late Cretaceous.

Paleoecology, Diagenesis and Biological Affinity of Tetradiids in the Upper Ordovician (Sandbian) Black River Group of the Kingston Area, Ontario, Canada

Tetradiids are a group of colonial, tubular fossils that occur globally in Middle to Upper Ordovician strata. Tetradiids were first described as a type of tabulate coral; however, based on their four-fold symmetry, division, and presence of a central-sparry canal, they were recently reinterpreted as a florideophyte rhodophyte algae, a reinterpretation that is tested in this thesis. This study focused on understanding the affinity and taphonomy of this order of fossil. Research was conducted by stratigraphic and petrographic analyses of the Black River Group in the Kingston, Ontario region. Tetradiid occurrences were divided into fragment or colonial, with three morphologies of tetradiids described (Tetradium, Phytopsis and Paratetradium). Morphology is specific to depositional environment, with compact Tetradium consistently within ooid grainstones and open branching Phytopsis and chained Paratetradium consistently within mudstones. Two types of patch reefs were recognized: a Paratetradium bioherm, and a Paratetradium, Phytopsis, stromatolite bioherm. The presence of bioherms implies that tetradiids were capable of hypercalcifying. Preservation styles of tetradiids were investigated, and were compared to brachiopods, echinoderms, mollusks, and ooids. Tetradiids were preferentially preserved as molds and demonstrated complete dissolution of skeletal material. Rare specimens, however, demonstrated preserved horizontal partitions, central plates, and a double wall. Skeletal molds were filled with either calcite spar, mud or encrusted by a cryptomicrobial colony. Both calcitic and aragonitic ooids were discovered. The co-occurrence of aragonitic ooids, aragonitic crytodontids, and the evolution of aragonitic, hypercalcifying tetradiids is interpreted as representing the geochemical favoring of aragonite and HMC in a time of global calcite seas. The geochemical favoring of aragonite is interpreted to be independent to global Mg: Ca ratios, but was the result of increased saturation levels and temperature driven by high atmospheric pCO2. Based on the presence of epitheca, tabulae, septa, and the commonality of growth forms, tetradiids are interpreted as an order of Cnidaria. The evolution of an aragonitic skeleton in tetradiids is interpreted to be the result of de novo acquisition of a skeleton from an unmineralized clade.

Fossil associations from the middle and upper Eocene strata of the Pamplona Basin and surrounding areas (Navarre, western Pyrenees)

Fossil associations from the middle and upper Eocene (Bartonian and Priabonian) sedimentary succession of the Pamplona Basin are described. This succession was accumulated in the western part of the South Pyrenean peripheral foreland basin and extends from deep-marine turbiditic (Ezkaba Sandstone Formation) to deltaic (Pamplona Marl, Ardanatz Sandstone and Ilundain Marl formations) and marginal marine deposits (Gendulain Formation). The micropalaeontological content is high. It is dominated by foraminifera, and common ostracods and other microfossils are also present. The fossil ichnoasssemblages include at least 23 ichnogenera and 28 ichnospecies indicative of Nereites, Cruziana, Glossifungites and ?Scoyenia-Mermia ichnofacies. Body macrofossils of 78 taxa corresponding to macroforaminifera, sponges, corals, bryozoans, brachiopods, annelids, molluscs, arthropods, echinoderms and vertebrates have been identified. Both the number of ichnotaxa and of species (e. g. bryozoans, molluscs and condrichthyans) may be considerably higher. Body fossil assemblages are comparable to those from the Eocene of the Nord Pyrenean area (Basque Coast), and also to those from the Eocene of the west-central and eastern part of South Pyrenean area (Aragon and Catalonia). At the European scale, the molluscs assemblages seem endemic from the Pyrenean area, although several Tethyan (Italy and Alps) and Northern elements (Paris basin and Normandy) have been recorded. Palaeontological data of studied sedimentary units fit well with the shallowing process that throughout the middle and late Eocene occurs in the area, according to the sedimentological and stratigraphical data.