Norfolk General Hospital

BACKGROUND: The Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) demonstrated that implantable cardioverter-defibrillator (ICD) therapy reduces all-cause mortality in patients with New York Heart Association class II/III heart failure and a left ventricular ejection fraction < or =35% on optimal medical therapy. Whether ICD therapy reduced sudden death caused by ventricular tachyarrhythmias without affecting heart failure deaths in this population is unknown. METHODS AND RESULTS: SCD-HeFT randomized 2521 subjects to placebo, amiodarone, or shock-only, single-lead ICD therapy. Over a median follow-up of 45.5 months, a total of 666 deaths occurred, which were reviewed by an Events Committee and initially categorized as cardiac or noncardiac. Cardiac deaths were further adjudicated as resulting from sudden death presumed to be ventricular tachyarrhythmic, bradyarrhythmia, heart failure, or other cardiac causes. ICD therapy significantly reduced cardiac mortality compared with placebo (adjusted hazard ratio, 0.76; 95% confidence interval, 0.60 to 0.95) and tachyarrhythmia mortality (adjusted hazard ratio, 0.40; 95% confidence interval, 0.27 to 0.59) and had no impact on mortality resulting from heart failure or noncardiac causes. The cardiac and tachyarrhythmia mortality reductions were evident in subjects with New York Heart Association class II but not in subjects with class III heart failure. The reduction in tachyarrhythmia mortality with ICD therapy was similar in subjects with ischemic and nonischemic disease. Compared with placebo, amiodarone had no significant effect on any mode of death. CONCLUSIONS: ICD therapy reduced cardiac mortality and sudden death presumed to be ventricular tachyarrhythmic in SCD-HeFT and had no effect on heart failure mortality. Amiodarone had no effect on all-cause mortality or its cause-specific components, except an increase in non-cardiac mortality in class III patients. [corrected] CLINICAL TRIAL REGISTRATION INFORMATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000609.

Objective.—To compare the efficacy of a single over‐the‐counter dose (7.5 mg/kg, p.o.) of children's ibuprofen suspension vs. placebo for the acute treatment of pediatric migraine. Background.—Migraine occurs in 4% of young children. There is a paucity of controlled clinical research in the treatment of childhood migraine and there are currently no approved drugs in the USA for treatment of migraine in children 12 years of age. The purpose of this study is to assess the efficacy and tolerability of a single OTC dose of ibuprofen suspension for the acute treatment of childhood migraine. Methods.—Prospective, double‐blind, placebo‐controlled, parallel group, randomized study of children 6‐12 yrs with migraine (I.H.S.‐R1997) treating 1 attack with a 7.5 mg/kg liq. ibuprofen vs matching placebo. Efficacy measures: (1) Headache severity based upon a 4 pt scale (severe, mod., mild, no headache) at 30, 60, 90, 120, 180 and 240 minutes post dose, and (2) nausea, vomiting, and photo/phonophobia at 120 min. The 1° endpoint was cumulative % of responders (severe or mod. headache reduced to mild or none) by 120 minutes. Secondary endpoints were headache recurrence within 4‐24 hours and need for rescue medicines within 4 hours. Results.—138 enrolled; 84 treated/completed diary. 45 active agent, 39 placebo. The 2 groups were comparable (active: placebo) ‐ Ages: 9: 9.1, gender boy/girl ‐ 1.25: 1.6, and diagnosis: migraine w/o aura ‐ 86%: 79%. Concomitant use of prophylactic Rx: 24%: 10% . Endpoint Ibuprofen (N=45) Placebo (N=39) P ‐value Cum. % responders, 2 hr (1° endpoint) 76% 53% 0.006 2 pt. improvement in severity, 2 hr 27 (62%) 11 (28%) 0.004 Median pain score at 2 hr 2 3 &lt;0.02 Headache recurrence (within 4‐24 hr) 8 (18%) 14 (36%) 0.06 Need for rescue medication 1 (2%) 15 (38%) &lt;0.001 Nausea was eliminated in 60% of the ibuprofen treated patients and 39% of the placebo group (p&lt;0.001). Vomiting, photophobia and phonophobia had marginal, but not statistically significant, decreases at 2 hours. A striking gender difference was noted : Endpoint Ibuprofen Placebo P ‐value Cum. % responders 76% 53% 0.006 BOYS 84% 43.4 &lt;0.0006 GIRLS 65% 66.7 0.8 Headache recurrence 5 13 &lt;0.005 BOYS 0 8 &lt;0.001 GIRLS 5 5 NS No AE's were reported. Conclusion.—Children's ibuprofen suspension at an OTC dose of 7.5 mg/kg is an effective and well‐tolerated agent for pain relief in the acute treatment of childhood migraine, particularly in boys. There is a striking difference in gender response rates and placebo responder rates between girls and boys. The boys responded at a statistically significant rate, and girls failed to do so because of a very high placebo responder rate. Multi‐center trials are recommended.

No AccessJournal of Urology1 Feb 1961A One Stage Hypospadias Repair Charles J. Devine, and Charles E. Horton Charles J. DevineCharles J. Devine , and Charles E. HortonCharles E. Horton View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)65301-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1961 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByJordan G (2016) Hypospadias RepairJournal of Urology, VOL. 197, NO. 2S, (S109-S110), Online publication date: 1-Feb-2017.McNamara E, Schaeffer A, Logvinenko T, Seager C, Rosoklija I, Nelson C, Retik A, Diamond D and Cendron M (2018) Management of Proximal Hypospadias with 2-Stage Repair: 20-Year ExperienceJournal of Urology, VOL. 194, NO. 4, (1080-1085), Online publication date: 1-Oct-2015.Myers J, McAninch J, Erickson B and Breyer B (2018) Treatment of Adults with Complications from Previous Hypospadias SurgeryJournal of Urology, VOL. 188, NO. 2, (459-463), Online publication date: 1-Aug-2012.Scuderi N, Chiummariello S and De Gado F (2018) Correction of Hypospadias With a Vertical Preputial Island Flap: A 23-Year ExperienceJournal of Urology, VOL. 175, NO. 3, (1083-1087), Online publication date: 1-Mar-2006.XU J, LI S, LI Y, LI Q, LIU L and WANG Y (2018) LENGTHENING URETHRAL PLATE WITH INNER PREPUTIAL SKIN GRAFTS: A MODIFICATION OF THE ONLAY TECHNIQUEJournal of Urology, VOL. 173, NO. 1, (202-203), Online publication date: 1-Jan-2005.DEWAN P, ERDENETSETSEG G and CHIANG D (2018) Ulaanbaatar Procedure for Tubularization of the Glans in Severe HypospadiasJournal of Urology, VOL. 171, NO. 3, (1263-1265), Online publication date: 1-Mar-2004.PATEL R, SHUKLA A and SNYDER H (2018) THE ISLAND TUBE AND ISLAND ONLAY HYPOSPADIAS REPAIRS OFFER EXCELLENT LONG-TERM OUTCOMES: A 14-YEAR FOLLOWUPJournal of Urology, VOL. 172, NO. 4 Part 2, (1717-1719), Online publication date: 1-Oct-2004.Duckett J (2018) Transverse preputial Island flap technique for repair of severe hypospadiasJournal of Urology, VOL. 167, NO. 2 Part 2, (1179-1182), Online publication date: 1-Feb-2002.Mitchell M (2018) Editorial commentJournal of Urology, VOL. 167, NO. 2 Part 2, (1183-1183), Online publication date: 1-Feb-2002.Ferro F, Zaccara A, Spagnoli A, Lucchetti M, Capitanucci M and Villa M (2018) Skin Graft for 2-stage Treatment of Severe Hypospadias: Back to the Future?Journal of Urology, VOL. 168, NO. 4 Part 2, (1730-1733), Online publication date: 1-Oct-2002.DUCKETT J (2018) The Island Flap Technique for Hypospadias RepairJournal of Urology, VOL. 167, NO. 5, (2148-2152), Online publication date: 1-May-2002.EL-SHERBINY M, ABOL-ENEIN H, DAWABA M and GHONEIM M (2018) Treatment of Urethral Defects: Skin, Buccal or Bladder Mucosa, Tube or Patch? An Experimental Study in DogsJournal of Urology, VOL. 167, NO. 5, (2225-2228), Online publication date: 1-May-2002.BARROSO U, JEDNAK R, SPENCER BARTHOLD J and GONZÁLEZ R (2018) FURTHER EXPERIENCE WITH THE DOUBLE ONLAY PREPUTIAL FLAP FOR HYPOSPADIAS REPAIRJournal of Urology, VOL. 164, NO. 3 Part 2, (998-1001), Online publication date: 1-Sep-2000.ATALA A, GUZMAN L and RETIK A (2018) A NOVEL INERT COLLAGEN MATRIX FOR HYPOSPADIAS REPAIRJournal of Urology, VOL. 162, NO. 3 Part 2, (1148-1150), Online publication date: 1-Sep-1999.Wiener J, Sutherland R, Roth D and Gonzales E (2018) Comparison of Onlay and Tubularized Island Flaps of Inner Preputial Skin for the Repair of Proximal HypospadiasJournal of Urology, VOL. 158, NO. 3, (1172-1174), Online publication date: 1-Sep-1997.Haberlik A, Schmidt B, Uray E and Mayr J (2018) Hypospadias Repair Using A Modification of Beck's Operation: FollowupJournal of Urology, VOL. 157, NO. 6, (2308-2311), Online publication date: 1-Jun-1997.Stock J, Cortez J, Scherz H and Kaplan G (2018) The Management of Proximal Hypospadias Using a 1-Stage Hypospadias Repair with a Preputial free Graft for Neourethral Construction and a Preputial Pedicle Flap for Ventral Skin CoverageJournal of Urology, VOL. 152, NO. 6 Part 2, (2335-2337), Online publication date: 1-Dec-1994.Hill G, Lewis A and Sheldon C (2018) A Rabbit Model of Free Bladder Mucosal Grafting in a Damaged Urethral BedJournal of Urology, VOL. 152, NO. 3, (983-986), Online publication date: 1-Sep-1994.Retik A, Bauer S, Mandell J, Peters C, Colodny A and Atala A (2018) Management of Severe Hypospadias with a 2-Stage RepairJournal of Urology, VOL. 152, NO. 2 Part 2, (749-751), Online publication date: 1-Aug-1994.Mokhless I (2018) Modified Vascularized Pedicled Scrotal Flap for Complex HypospadiasJournal of Urology, VOL. 148, NO. 1, (55-57), Online publication date: 1-Jul-1992.Fairbanks J, Sheldon C, Khoury A, Gilbert A and Bove K (2018) Free Bladder Mucosal Graft Biology: Unique Engraftment Characteristics in RabbitsJournal of Urology, VOL. 148, NO. 2 Part 2, (663-666), Online publication date: 1-Aug-1992.Burbige K (2018) Transpubic-Perineal Urethral Reconstruction in Boys Using a Substitution GraftJournal of Urology, VOL. 148, NO. 4, (1235-1238), Online publication date: 1-Oct-1992.Rober P, Perlmutter A and Reitelman C (2018) Experience with 81, 1-Stage Hypospadias/Chordee Repairs with Free Graft UrethroplastiesJournal of Urology, VOL. 144, NO. 2 Part 2, (526-529), Online publication date: 1-Aug-1990.Keating M, Cartwright P and Duckett J (2018) Bladder Mucosa in Urethral ReconstructionsJournal of Urology, VOL. 144, NO. 4, (827-834), Online publication date: 1-Oct-1990.Khoury A, Olson M, McLorie G and Churchill B (2018) Urethral Replacement with Tunica Vaginalis: A Pilot StudyJournal of Urology, VOL. 142, NO. 2 Part 2, (628-630), Online publication date: 1-Aug-1989.Decter R, Roth D and Gonzales E (2018) Hypospadias Repair By Bladder Mucosal Graft: An Initial ReportJournal of Urology, VOL. 140, NO. 5 Part 2, (1256-1258), Online publication date: 1-Nov-1988.Hendren W and Horton C (2018) Experience with 1-Stage Repair of Hypospadias and Chordee Using Free Graft of PrepuceJournal of Urology, VOL. 140, NO. 5 Part 2, (1259-1264), Online publication date: 1-Nov-1988.Koyle M and Ehrlich R (2018) The Bladder Mucosal Graft for Urethral ReconstructionJournal of Urology, VOL. 138, NO. 4 Part 2, (1093-1095), Online publication date: 1-Oct-1987.Ransley P, Duffy P, Oesch I, Van Oyen P and Hoover D (2018) The Use of Bladder Mucosa and Combined Bladder Mucosa/Preputial Skin Grafts for Urethral ReconstructionJournal of Urology, VOL. 138, NO. 4 Part 2, (1096-1098), Online publication date: 1-Oct-1987.Vyas P, Roth D and Perlmutter A (2018) Experience with Free Grafts in Urethral ReconstructionJournal of Urology, VOL. 137, NO. 3, (471-474), Online publication date: 1-Mar-1987.Barraza M, Roth D, Terry W, Livne P and Gonzales E (2018) One-Stage Reconstruction of Moderately Severe HypospadiasJournal of Urology, VOL. 137, NO. 4, (714-715), Online publication date: 1-Apr-1987.Wacksman J (2018) Use of the Hodgson XX (Modified Asopa) Procedure to Correct Hypospadias with Chordee: Surgical Technique and ResultsJournal of Urology, VOL. 136, NO. 6, (1264-1265), Online publication date: 1-Dec-1986.Palmer J and Bishai M (2018) Island Pedicle Graft in the Correction of Urethral Meatal Stenosis Following Hypospadias RepairJournal of Urology, VOL. 135, NO. 6, (1227-1228), Online publication date: 1-Jun-1986.Wacksman J (2018) Results of Early Hypospadias Surgery Using Optical MagnificationJournal of Urology, VOL. 131, NO. 3, (516-517), Online publication date: 1-Mar-1984.Hodgson N (2018) Editoral CommentJournal of Urology, VOL. 131, NO. 3, (517-517), Online publication date: 1-Mar-1984.Gonzales E, Veeraraghavan K and Delaune J (2018) The Management of Distal Hypospadias With Meatal-based, vascularized FlapsJournal of Urology, VOL. 129, NO. 1, (119-120), Online publication date: 1-Jan-1983.Lenzi R, Barbagli G, Stomaci N and di Cello V (2018) Free Full Thickness Skin Graft Urethroplasty: Indications, Technique and ResultsJournal of Urology, VOL. 128, NO. 5, (938-942), Online publication date: 1-Nov-1982.Woodard J and Cleveland R (2018) Application of Horton-Devine Principles to the Repair of HypospadiasJournal of Urology, VOL. 127, NO. 6, (1155-1158), Online publication date: 1-Jun-1982.Coleman J (2018) The Bladder Mucosal Graft Technique for Hypospadias RepairJournal of Urology, VOL. 125, NO. 5, (708-710), Online publication date: 1-May-1981.C.J.D. (2018) Editorial CommentJournal of Urology, VOL. 125, NO. 5, (710-710), Online publication date: 1-May-1981.Hendren W and Crooks K (2018) Tubed Free Skin Graft for Construction of Male UrethraJournal of Urology, VOL. 123, NO. 6, (858-861), Online publication date: 1-Jun-1980.Hodgson N (2018) Editorial CommentJournal of Urology, VOL. 123, NO. 6, (861-861), Online publication date: 1-Jun-1980. (2018) Reply by AuthorsJournal of Urology, VOL. 123, NO. 6, (861-861), Online publication date: 1-Jun-1980.Gearhart J and Witherington R (2018) The Denis-browne Hypospadias Repair RevisitedJournal of Urology, VOL. 122, NO. 1, (66-67), Online publication date: 1-Jul-1979.Mckinney D (2018) Use of Full Thickness Patch Graft in Urethrovaginal FistulaJournal of Urology, VOL. 122, NO. 3, (416-416), Online publication date: 1-Sep-1979.Devine C, Franz J and Horton C (2018) Evaluation and Treatment of Patients With Failed Hypospadias RepairJournal of Urology, VOL. 119, NO. 2, (223-226), Online publication date: 1-Feb-1978.Devine C and Horton C (2018) Hypospadias RepairJournal of Urology, VOL. 118, NO. 1 Part 2, (188-193), Online publication date: 1-Jul-1977.Kelalis P, Benson R and Culp O (2018) Complications of Single and Multistage Operations for Hypospadias: A Comparative ReviewJournal of Urology, VOL. 118, NO. 4, (657-658), Online publication date: 1-Oct-1977.Woodard J and Green B (2018) A Technique for the Correction of Bifid Scrotum in Patients with HypospadiasJournal of Urology, VOL. 117, NO. 4, (516-517), Online publication date: 1-Apr-1977.Perlmutter A and Vatz A (2018) Meatal Advancement for Distal Hypospadias without ChordeeJournal of Urology, VOL. 113, NO. 6, (850-852), Online publication date: 1-Jun-1975.Hopkins R and Campbell W (2018) A One-Stage Hypospadias Repair: Modification of the Broadbent ProcedureJournal of Urology, VOL. 112, NO. 5, (674-676), Online publication date: 1-Nov-1974.Sadlowski R, Belman A and King L (2018) Further Experience with One-Stage Hypospadias RepairJournal of Urology, VOL. 112, NO. 5, (677-680), Online publication date: 1-Nov-1974.Devine C and Horton C (2018) Chordee without HypospadiasJournal of Urology, VOL. 110, NO. 2, (264-271), Online publication date: 1-Aug-1973.King L (2018) Hypospadias—A One-Stage Repair Without Skin Graft Based on a New Principle: Chordee is Sometimes Produced by the Skin AloneJournal of Urology, VOL. 103, NO. 5, (660-662), Online publication date: 1-May-1970.King L, Mellow B and Lowry W (2018) Hypospadias: A Review of Repairs in 78 Pre-School ChildrenJournal of Urology, VOL. 103, NO. 5, (663-667), Online publication date: 1-May-1970.Gross M, Fein R and Waterhouse K (2018) Single Stage Correction of Chordee Without Hypospadias and Coronal HypospadiasJournal of Urology, VOL. 102, NO. 1, (70-74), Online publication date: 1-Jul-1969.Devine P, Sakati I, Poutasse E and Devine C (2018) One Stage Urethroplasty: Repair of Urethral Strictures with a Free Full Thickness Patch of SkinJournal of Urology, VOL. 99, NO. 2, (191-193), Online publication date: 1-Feb-1968.Smith D (2018) Repair of Hypospadias in the Preschool Child: A Report of 150 CasesJournal of Urology, VOL. 97, NO. 4, (723-730), Online publication date: 1-Apr-1967.Smith J (2018) Hypospadias Repair with Preputial Free Inlay Graft UrethroplastyJournal of Urology, VOL. 96, NO. 1, (73-79), Online publication date: 1-Jul-1966.Thompson H, George W, Kepes J and Segerson J (2018) Hypospadias: The Principle of the Third DegreeJournal of Urology, VOL. 94, NO. 5, (582-585), Online publication date: 1-Nov-1965.Grana L and King L (2018) Replacement of the Proximal Urethra with Distal UreterJournal of Urology, VOL. 92, NO. 6, (681-687), Online publication date: 1-Dec-1964.Devine P, Horton C, Devine C, Devine C, Crawford H and Adamson J (2018) Use of Full Thickness Skin Grafts in Repair of Urethral StricturesJournal of Urology, VOL. 90, NO. 1, (67-71), Online publication date: 1-Jul-1963.Persry L, Kiehn C and DesPrez J (2018) A One-Stage Hypospadias RepairJournal of Urology, VOL. 88, NO. 2, (259-261), Online publication date: 1-Aug-1962. Volume 85Issue 2February 1961Page: 166-172 Advertisement Copyright & Permissions© 1961 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Charles J. Devine More articles by this author Charles E. Horton More articles by this author Expand All Advertisement PDF DownloadLoading ...

BACKGROUND: Rieske non-heme iron aromatic ring-hydroxylating oxygenases (RHOs) are multi-component enzyme systems that are remarkably diverse in bacteria isolated from diverse habitats. Since the first classification in 1990, there has been a need to devise a new classification scheme for these enzymes because many RHOs have been discovered, which do not belong to any group in the previous classification. Here, we present a scheme for classification of RHOs reflecting new sequence information and interactions between RHO enzyme components. RESULT: We have analyzed a total of 130 RHO enzymes in which 25 well-characterized RHO enzymes were used as standards to test our hypothesis for the proposed classification system. From the sequence analysis of electron transport chain (ETC) components of the standard RHOs, we extracted classification keys that reflect not only the phylogenetic affiliation within each component but also relationship among components. Oxygenase components of standard RHOs were phylogenetically classified into 10 groups with the classification keys derived from ETC components. This phylogenetic classification scheme was converted to a new systematic classification consisting of 5 distinct types. The new classification system was statistically examined to justify its stability. Type I represents two-component RHO systems that consist of an oxygenase and an FNRC-type reductase. Type II contains other two-component RHO systems that consist of an oxygenase and an FNRN-type reductase. Type III represents a group of three-component RHO systems that consist of an oxygenase, a [2Fe-2S]-type ferredoxin and an FNRN-type reductase. Type IV represents another three-component systems that consist of oxygenase, [2Fe-2S]-type ferredoxin and GR-type reductase. Type V represents another different three-component systems that consist of an oxygenase, a [3Fe-4S]-type ferredoxin and a GR-type reductase. CONCLUSION: The new classification system provides the following features. First, the new classification system analyzes RHO enzymes as a whole. RwithSecond, the new classification system is not static but responds dynamically to the growing pool of RHO enzymes. Third, our classification can be applied reliably to the classification of incomplete RHOs. Fourth, the classification has direct applicability to experimental work. Fifth, the system provides new insights into the evolution of RHO systems based on enzyme interaction.

No AccessJournal of UrologyHypospadias1 Feb 2017A One Stage Hypospadias Repair Charles J. Devine and Charles E. Horton Charles J. DevineCharles J. Devine More articles by this author and Charles E. HortonCharles E. Horton More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.10.094AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 2002 by American Urological Association, Inc.®FiguresReferencesRelatedDetails Volume 197Issue 2SFebruary 2017Page: S103-S108 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.®MetricsAuthor Information Charles J. Devine More articles by this author Charles E. Horton More articles by this author Expand All Advertisement PDF downloadLoading ...

Freeze-dried bone allografts (FDBAs) were evaluated alone and in combination with various types of autogenous bone in the treatment of periodontal osseous defects. A total of 381 defects were evaluated by surgical reentry approximately 1 year after grafting. Reentry data were compared with similar data obtained when the grafts were placed. Osseous regeneration and pocket reduction were rated as complete, greater than 50%, less than 50%, or failed. Complete or greater than 50% regeneration was considered successful. When compared with FDBAs, composite freeze-dried bone allografts/autogenous bone grafts (FDBA/ABGs) appear to offer significantly improved results in both osseous regeneration and pocket reduction. Use of composite FDBA/ABGs resulted in significant improvement in the treatment of combination one/two-wall defects and furcation involvements. A trend of improvement was seen with two-wall defects. The surgical data indicated that complete wound closure and the use of antibiotics enhanced graft success. The results also indicated that the presence of endodontically obturated teeth may be a consideration in the success or failure of the graft.

No AccessJournal of Urology1 Jul 1963Use of Full Thickness Skin Grafts in Repair of Urethral Strictures Patrick C. Devine, Charles E. Horton, C.J. Devine, Charles J. Devine, Hugh H. Crawford, and Jerome E. Adamson Patrick C. DevinePatrick C. Devine , Charles E. HortonCharles E. Horton , C.J. DevineC.J. Devine , Charles J. DevineCharles J. Devine , Hugh H. CrawfordHugh H. Crawford , and Jerome E. AdamsonJerome E. Adamson View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)64362-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1963 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByBarry Belman A (2018) Editorial commentJournal of Urology, VOL. 167, NO. 2 Part 2, (1175-1175), Online publication date: 1-Feb-2002.ISELIN C and WEBSTER G (2018) DORSAL ONLAY GRAFT URETHROPLASTY FOR REPAIR OF BULBAR URETHRAL STRICTUREJournal of Urology, VOL. 161, NO. 3, (815-818), Online publication date: 1-Mar-1999.LEVINE L and ELTERMAN L (2018) URETHROPLASTY FOLLOWING TOTAL PHALLIC RECONSTRUCTIONJournal of Urology, VOL. 160, NO. 2, (378-382), Online publication date: 1-Aug-1998.Wessells H, Morey A and McAninch J (2018) Single Stage Reconstruction of Complex Anterior Urethral Strictures: Combined Tissue Transfer TechniquesJournal of Urology, VOL. 157, NO. 4, (1271-1274), Online publication date: 1-Apr-1997.Wessells H and McAninch J (2018) Use of Free Grafts in Urethral Stricture ReconstructionJournal of Urology, VOL. 155, NO. 6, (1912-1915), Online publication date: 1-Jun-1996.Finkelstein L and Blatstein L (2018) Epilation of Hair-Bearing Urethral Grafts Using the Neodymium:YAG Surgical LaserJournal of Urology, VOL. 146, NO. 3, (840-842), Online publication date: 1-Sep-1991.Benet A, Abarbanel J, Lask D and Kimche D (2018) Surgical management of long urethral stricturesJournal of Urology, VOL. 143, NO. 5, (917-919), Online publication date: 1-May-1990.Schreiter F and Noll F (2018) Mesh Graft Urethroplasty Using Split Thickness Skin Graft or ForeskinJournal of Urology, VOL. 142, NO. 5, (1223-1226), Online publication date: 1-Nov-1989.Pierce J (2018) Editorial CommentsJournal of Urology, VOL. 142, NO. 5, (1226-1226), Online publication date: 1-Nov-1989.Devine C (2018) Editorial CommentsJournal of Urology, VOL. 142, NO. 5, (1226-1226), Online publication date: 1-Nov-1989.Marshall F, Chang R and Gearhart J (2018) Endoscopic Reconstruction of Traumatic Membranous Urethral TransectionJournal of Urology, VOL. 138, NO. 2, (306-309), Online publication date: 1-Aug-1987.Peterson N (2018) Perforation-Reconst1Tution of Proximal Urethral ObliterationJournal of Urology, VOL. 137, NO. 3, (507-510), Online publication date: 1-Mar-1987.Barraza M, Roth D, Terry W, Livne P and Gonzales E (2018) One-Stage Reconstruction of Moderately Severe HypospadiasJournal of Urology, VOL. 137, NO. 4, (714-715), Online publication date: 1-Apr-1987.Yachia D (2018) A New, One-Stage Pedicled Scrotal Skin Graft UrethroplastyJournal of Urology, VOL. 136, NO. 3, (589-592), Online publication date: 1-Sep-1986.Lenzi R, Barbagli G and Stomaci N (2018) One-Stage Skin Graft Urethroplasty in Anterior Middle Urethra: A New ProcedureJournal of Urology, VOL. 131, NO. 4, (660-663), Online publication date: 1-Apr-1984.Webster G, Brown M, Koefoot R and Sihelnick S (2018) Suboptimal Results in Full Thickness Skin Graft Urethroplasty Using an Extrapenile Skin Donor SiteJournal of Urology, VOL. 131, NO. 6, (1082-1083), Online publication date: 1-Jun-1984.Brannan W (2018) Editorial CommentsJournal of Urology, VOL. 131, NO. 6, (1083-1083), Online publication date: 1-Jun-1984.Devine C (2018) Editorial CommentsJournal of Urology, VOL. 131, NO. 6, (1083-1083), Online publication date: 1-Jun-1984.Lenzi R, Barbagli G, Stomaci N and di Cello V (2018) Free Full Thickness Skin Graft Urethroplasty: Indications, Technique and ResultsJournal of Urology, VOL. 128, NO. 5, (938-942), Online publication date: 1-Nov-1982.Blum J, Feeney M, Howe G and Steel J (2018) Skin Patch Urethroplasty: 5-year FollowupJournal of Urology, VOL. 127, NO. 5, (909-909), Online publication date: 1-May-1982.De Sy W, Oosterlinck W and Verbaeys A (2018) European Experience with 1-stage Urethroplasty with Free Full Thickness Skin GraftJournal of Urology, VOL. 125, NO. 4, (502-503), Online publication date: 1-Apr-1981.Hendren W and Crooks K (2018) Tubed Free Skin Graft for Construction of Male UrethraJournal of Urology, VOL. 123, NO. 6, (858-861), Online publication date: 1-Jun-1980.Mckinney D (2018) Use of Full Thickness Patch Graft in Urethrovaginal FistulaJournal of Urology, VOL. 122, NO. 3, (416-416), Online publication date: 1-Sep-1979.Gibbons M, Koontz W and Smith M (2018) Urethral Strictures in BoysJournal of Urology, VOL. 121, NO. 2, (217-220), Online publication date: 1-Feb-1979.C.J.D. (2018) Editorial CommentJournal of Urology, VOL. 121, NO. 2, (220-220), Online publication date: 1-Feb-1979.Devine P, Wendelken J and Devine C (2018) Free Full Thickness Skin Graft Urethroplasty: Current TechniqueJournal of Urology, VOL. 121, NO. 3, (282-285), Online publication date: 1-Mar-1979.Brigman J and Deture F (2018) Giant Urethral Diverticulum after Free Full Thickness Skin Graft UrethroplastyJournal of Urology, VOL. 121, NO. 4, (523-524), Online publication date: 1-Apr-1979.Betts J, Texter J and Crane D (2018) Single Stage Urethroplasty as Treatment for Stricture DiseaseJournal of Urology, VOL. 120, NO. 4, (412-413), Online publication date: 1-Oct-1978.Olsson C and Krane R (2018) The Controversy of Single Versus Multistaged UrethroplastyJournal of Urology, VOL. 120, NO. 4, (414-417), Online publication date: 1-Oct-1978.Krane R, Wysocki J and Schwartz B (2018) Dermal Patch Urethroplasty: Experimental and Clinical ExperienceJournal of Urology, VOL. 118, NO. 2, (262-265), Online publication date: 1-Aug-1977.Devine P, Fallon B and Devine C (2018) Free Full Thickness Skin Graft UrethroplastyJournal of Urology, VOL. 116, NO. 4, (444-446), Online publication date: 1-Oct-1976. (2018) CommentJournal of Urology, VOL. 116, NO. 4, (446-446), Online publication date: 1-Oct-1976.Herr H (2018) Immunobiolqgy of Human Bladder CancerJournal of Urology, VOL. 115, NO. 2, (147-147), Online publication date: 1-Feb-1976.Kibbey R (2018) Patch Graft Urethroplasty: A Review with Emphasis On Use for Strictures in the Region of the Membranous UrethraJournal of Urology, VOL. 115, NO. 2, (155-158), Online publication date: 1-Feb-1976.Brannan W, Ochsner M, Fuselier H and Goodlet J (2018) Free Full Thickness Skin Graft Urethroplasty for Urethral Stricture: Experience with 66 PatientsJournal of Urology, VOL. 115, NO. 6, (677-680), Online publication date: 1-Jun-1976.Devine C (2018) CommentJournal of Urology, VOL. 115, NO. 6, (680-680), Online publication date: 1-Jun-1976.Berger B, Sykes Z and Freedman M (2018) Patch Graft Urethroplasty for Urethral Stricture DiseaseJournal of Urology, VOL. 115, NO. 6, (681-683), Online publication date: 1-Jun-1976.Morgan C (2018) Dorsal Rectotomy and Full Thickness Skin Graft for Repair of Prostatic Urethrorectal FistulaJournal of Urology, VOL. 113, NO. 2, (207-209), Online publication date: 1-Feb-1975.Brannan W, Ochsner M and Fuselier H (2018) Anterior Urethral Strictures: Experience with Free Graft UrethroplastyJournal of Urology, VOL. 109, NO. 2, (265-267), Online publication date: 1-Feb-1973.Orandi A (2018) One-Stage Urethroplasty: 4-Year FollowupJournal of Urology, VOL. 107, NO. 6, (977-980), Online publication date: 1-Jun-1972.Bogash M and Lasky N (2018) Experience with a Two-Stage Urethroplasty for StrictureJournal of Urology, VOL. 102, NO. 4, (444-448), Online publication date: 1-Oct-1969.Devine P, Sakati I, Poutasse E and Devine C (2018) One Stage Urethroplasty: Repair of Urethral Strictures with a Free Full Thickness Patch of SkinJournal of Urology, VOL. 99, NO. 2, (191-193), Online publication date: 1-Feb-1968.Sankey N and Heller E (2018) The Results of Urethroplasty Using a Silicone Rubber PatchJournal of Urology, VOL. 97, NO. 2, (309-313), Online publication date: 1-Feb-1967.Heller E (2018) Surgical Repair of Urethral Strictures with a Silicone Rubber PatchJournal of Urology, VOL. 94, NO. 5, (576-579), Online publication date: 1-Nov-1965. Volume 90Issue 1July 1963Page: 67-71 Advertisement Copyright & Permissions© 1963 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick C. Devine More articles by this author Charles E. Horton More articles by this author C.J. Devine More articles by this author Charles J. Devine More articles by this author Hugh H. Crawford More articles by this author Jerome E. Adamson More articles by this author Expand All Advertisement Loading ...

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of laparoscopic-assisted sigmoid colectomy for the treatment of diverticulitis. METHODS: The Norfolk Surgical Group Laparoscopic Surgery Registry identified all patients undergoing laparoscopic colon and rectal surgery. Retrospective chart review was performed for all patients undergoing elective sigmoid resection for a final diagnosis of diverticulitis and minimum follow-up of 12 months. Demographic data, indications for surgery, operative data, conversion rate, reason for conversion, complications, postoperative course (days to flatus and regular diet), and length of stay were identified. A telephone survey determined the incidence of recurrent diverticulitis. Statistical analysis was performed to evaluate the frequency of conversion over time, to determine risk factors for conversion, and to compare the laparoscopic-assisted and conversion groups with regard to postoperative days to flatus, regular diet, and discharge. RESULTS: From June 1992 to September 1997, elective laparoscopic-assisted sigmoid colectomy was attempted in 69 patients. Uncomplicated recurrent diverticulitis was the most common indication for surgery, occurring in 51 of 69 patients (75 percent). No deaths occurred. Complications were identified in seven patients (10.1 percent) including one wound infection and one incarcerated port-site hernia with small bowel obstruction. There were no anastomotic leaks or major septic complications. Conversion to laparotomy occurred in 18 of 69 patients (26 percent). Uncomplicated, recurrent diverticulitis was associated with conversion in 7 of 51 patients (14 percent), whereas complicated diverticulitis required conversion in 11 of 18 patients (61 percent). Logistic regression identified fistula and abscess as predictors of conversion (P = 0.0009). Comparison of the laparoscopic-assisted sigmoid colectomy group with the conversion group revealed that postoperative days to regular diet were 3.5 and 5.2 (P = 0.0004), respectively, and lengths of stay were 4.2 and 6.4 days (P < 0.0001), respectively. No difference was noted with regard to operative time or postoperative complications. Median follow-up was 48 (range, 13-76) months, and a single recurrence of diverticulitis has been identified. CONCLUSIONS: Laparoscopic-assisted sigmoid colectomy for diverticulitis can be safely performed. Conversion appears to be associated with complicated diverticulitis (fistula or abscess), which may be better approached by laparotomy. Short-term follow-up indicates that recurrence is rare and suggests that laparoscopic-assisted sigmoid colectomy achieves adequate resection. Laparoscopic-assisted sigmoid colectomy offers benefits of decreased ileus and length of stay and may represent the procedure of choice for elective resection for uncomplicated sigmoid diverticulitis.

BACKGROUND: Halitosis is an unpleasant odour emanating from the oral cavity. Mouthwashes, which are commonly used for dealing with oral malodour, can be generally divided into those that neutralize and those that mask the odour. OBJECTIVES: To investigate the effects of mouthrinses in controlling halitosis. SEARCH STRATEGY: We searched the following databases: Cochrane Oral Health Group Trials Register (to August 2008); the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 3); MEDLINE (1950 to August 2008); EMBASE (1980 to August 2008); and CINAHL (1982 to August 2008). There were no language restrictions. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing mouthrinses to placebo in adults over the age of 18 with halitosis and without significant other comorbidities or health conditions.The primary outcomes considered were self expressed and organoleptic (human nose) assessments of halitosis, and the secondary outcomes included assessment of halitosis as measured by a halimeter, portable sulphide monitor or by gas chromatography coupled with flame-photometric detection. DATA COLLECTION AND ANALYSIS: Two independent review authors screened and extracted information from, and independently assessed the risk of bias in the included trials. MAIN RESULTS: Five RCTs, involving 293 participants who were randomised to mouthrinses or placebo, were included in this review.In view of the clinical heterogeneity between the trials, pooling of the results and meta-analysis of the extracted data was not feasible and therefore only a descriptive summary of the results of the included trials is provided.0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse significantly reduced the mean change (standard deviation (SD)) of organoleptic scores from baseline compared to placebo (-1.13 (1.1) P < 0.005 versus -0.2 (0.7)) and also caused a more significant reduction in the mean change (SD) in peak level of volatile sulphur compounds (VSC) (-120 (92) parts per billion (ppb) versus 8 (145) ppb in placebo). The chlorhexidine cetylpyridinium chloride zinc lactate mouthrinse showed significantly more tongue (P < 0.001) and tooth (P < 0.002) staining compared to placebo.However, in view of the incomplete reporting of results in three of the trials and the sole use of the halimeter for assessment of VSC levels as outcomes in two further trials, caution should be exercised in interpreting these results. AUTHORS' CONCLUSIONS: Mouthrinses containing antibacterial agents such as chlorhexidine and cetylpyridinium chloride may play an important role in reducing the levels of halitosis-producing bacteria on the tongue, and chlorine dioxide and zinc containing mouthrinses can be effective in neutralisation of odouriferous sulphur compounds.Well designed randomised controlled trials with a larger sample size, a longer intervention and follow-up period are still needed.

OBJECTIVE: To determine prognostic indicators for the surgical treatment of brachycephalic obstructive airway syndrome (BOAS) and to compare the prognosis of 2 multilevel surgical procedures. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Client-owned pugs, French bulldogs, and bulldogs (n = 50). METHODS: Noninvasive whole-body barometric plethysmography (WBBP) was used to assess respiratory function before, 1 month and 6 months after upper airway corrective surgery. Postoperatively, BOAS indices (ie, ascending severity score generated from WBBP data, 0%-100%) that equaled to or exceeded the cut-off values of BOAS in the diagnostic models were considered to have a "poor prognosis." A multivariate logistic regression was used to assess predictors for prognosis. RESULTS: The median BOAS indices decreased after surgery (from 76% to 63%, P < .0001), although dogs with indices in this range would still be considered clinically affected. Age (odds ratios [OR] = 0.96, 95% confidence interval [CI]: 0.93-0.99, P < .05), body condition (OR = 0.06, 95% CI: 0.01-0.39, P < .01), laryngeal collapse (OR = 6.1, 95% CI: 1-37.22, P < .05), and surgical techniques (OR = 7.94, 95% CI: 1.17-54.01, P < .05) were associated with postoperative prognosis. The multivariate model suggests modified multilevel surgery (MMS) may have a better outcome than traditional multilevel surgery (TMS) (P = .034). The positive predictive value of the logistic model was 84% (95% CI: 68-94%) and the area under the receiver operating characteristic (ROC) curve was 89% (95% CI: 78-99%, P <.0001). CONCLUSIONS: Younger age, normal body condition, presence of laryngeal collapse, and treatment with TMS were negative prognostic factors after surgical treatment of BOAS. MMS is recommended, particularly in dogs with a higher probability of poor prognosis.

MLADICK, RICHARD A. M.D.; HORTON, CHARLES E. M.D.; ADAMSON, JEROME E. M.D.; COHEN, BERNARD I. M.D. Author Information

Eleven cases of tracheobronchial rupture are described. Nine were the result of external non-penetrating trauma and all but three had other serious injuries. The remaining two were caused by endobronchial intubation. Of the cases caused by external injury, respiratory tract injury was confined to the cervical trachea in three. Two required tracheostomy and repair and the third was managed conservatively; all made satisfactory recoveries. Intrathoracic rupture was recognised on or soon after admission in three cases. One patient died of uncontrollable pulmonary haemorrhage before he could be operated on; immediate repair gave good long term results in the other two. In three cases rupture of the main bronchus was not recognised until complete obstruction developed three, five, and 12 weeks after the accidents. The strictures were resected and the lung re-expanded. Robertshaw endobronchial tubes ruptured the left main bronchus in two patients undergoing oesophageal surgery. Uneventful recovery followed immediate repair. The difficulty of confirming rupture of a major airway is discussed and the importance of conserving the lung when the diagnosis has been missed is emphasised.

OBJECTIVE: To gather data on cats living in US households, document their neuter status, and identify demographic characteristics associated with neuter status. DESIGN: Cross-sectional, random-digit-dial telephone survey. SAMPLE POPULATION: 1,205 adults in the continental United States contacted between April 24, 2007, and May 14, 2007. PROCEDURES: Information was gathered by means of computer-assisted telephone interviews. Multivariate logit analysis was used to identify demographic characteristics significantly associated with neuter status. RESULTS: 383 of 1,205 (31.8%) respondents reported having at least 1 cat at the time of the survey, yielding an estimated population of 82.4 million cats living in 36.8 million US households. Overall, 680 of 850 (80.0%) cats were reportedly neutered. Of the 371 neutered female cats, 303 (81.7%) had reportedly been neutered before having any litters. Proportion of cats that were neutered differed significantly across annual family income groups, with 96.2% (231/240) of cats in households with annual family incomes >or= $75,000 being neutered, 90.7% (231/254) of cats in households with annual family incomes between $35,000 and $74,999 being neutered, and only 51.4% (123/239) of cats in households with annual family incomes < $35,000 being neutered. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that a high percentage (80.0%) of cats living in households in the United States were neutered and that annual family income was the strongest predictor of whether cats in the household were neutered. The present study did not attempt to address stray and feral cats, which represent a substantial but unknown percentage of the total US cat population.

A key challenge in managing innovation is to explicitly identify ways to improve an organization's performance with regard to discontinuous innovation. However, discontinuous innovation does not fit the existing ‘frame of reference’ and hence requires a reframing of the traditional ways of innovating within the organization. More specifically, previous research shows that practices that work well in the context of incremental innovation do not work in the context of discontinuous innovation. Thus, the aim of this paper is to explore innovation practices that enable organizations to select innovation projects, which are ‘outside the box’ of its prior experience, i.e. are discontinuous in nature. Building on the experience of more than 150 firms across 12 countries, we have identified nine innovation practices for the selection of discontinuous innovation; these can be grouped into three clusters: enable, engage and experience. In sum, we identify that an organization needs to acknowledge that its choice to engage in discontinuous innovation will have consequences for the innovation practices chosen to select which discontinuous projects to carry forward.

This report details the experience with nine patients over a 3-year period who had partial or total nasal reconstruction using an expanded forehead flap. The history of nasal reconstruction is reviewed, emphasizing the evolution of the forehead flap as the ideal donor site. The author's experience with skin expansion of the forehead to produce a thin ideal flap is presented in detail. Complications of the procedure are reviewed. Technical considerations to achieve a good result are emphasized. The forehead donor site is minimal and well accepted. This procedure provides a solution to a major problem with partial and total nasal reconstruction.

OBJECTIVE: To evaluate the risk of hemolysis in subjects with glucose-6-phosphate dehydrogenase (G6PD) deficiency who were treated for acne vulgaris with either dapsone gel, 5% (dapsone gel), or vehicle gel. DESIGN: Double-blind, randomized, vehicle-controlled, crossover study. SETTING: Referral centers and private practice. PARTICIPANTS: Sixty-four subjects 12 years or older with G6PD deficiency and acne vulgaris. Intervention Subjects were equally randomized to 1 of 2 sequences of 12-week treatment periods (vehicle followed by dapsone gel or dapsone gel followed by vehicle). The washout period was 2 weeks. Treatments were applied twice daily to the face and to other acne-affected areas of the neck, upper chest, upper back, and shoulders as required. MAIN OUTCOME MEASURES: Results of clinical chemical analysis and hematology values; plasma dapsone and N-acetyl dapsone concentrations; spontaneous reports of adverse events. RESULTS: A 0.32-g/dL decrease in hemoglobin concentration occurred from baseline to 2 weeks during dapsone gel treatment. This was not accompanied by changes in other laboratory parameters, including reticulocytes, haptoglobin, bilirubin, and lactate dehydrogenase levels, and was not apparent at 12 weeks as treatment continued. The number of subjects with a 1-g/dL drop in hemoglobin concentration was similar between treatment groups at both week 2 and week 12. The largest drops in hemoglobin concentration were 1.7 g/dL in the vehicle gel treatment group and 1.5 g/dL in the dapsone gel treatment group. No clinical signs or symptoms of hemolytic anemia were noted. CONCLUSIONS: After treatment with dapsone gel, 5%, no clinical or laboratory evidence of drug-induced hemolytic anemia was noted in G6PD-deficient subjects with acne vulgaris. Trial Registration clinicaltrials.gov Identifier: NCT00243542.

The purpose of this study was to determine the quantity of new bone formation in critical sized calvaria defects in rats treated with two composite graft systems. The systems consisted of either a combination of the bone inductive protein (osteogenin) plus type I collagen (Os + C) or the combination of osteogenin with coralline hydroxyapatite (Os + HA). Additional treatments consisted of coralline hydroxyapatite (HA) or untreated control defects. After 28 days the calvaria were recovered and processed for quantitative radiography (radiomorphometry) and histomorphometry. Histomorphometric results were based on quantitation of regenerated trabecular bone. Results indicated that the Os + C combination produced substantially more bone than the Os + HA, HA, or control groups (P less than 0.05). Radiomorphometric assessment was based on the detection of radiopacity in the calvarial wounds. Due to the radiopaque property of HA, it was not possible to accurately quantitate the radiopacity of the regenerating bone from HA and host bone. Therefore, conclusions about the efficacy of the treatments must be derived from histomorphometric data. Results from histometric measurements of healing indicate that the Os + C combination has the greatest potential for regenerating calvarial bone defects. The potential for osteogenin in regenerating alveolar bone lost due to periodontal disease is suggested by these studies.

We report the prolonged survival of a harlequin fetus who was treated with intensive supportive measures, emollients, and oral etretinate.

BACKGROUND: Buttressing bone formation has been described as the development of thickened or exostotic buccal alveolar bone in response to heavy occlusal forces. Little supporting evidence for this model has been found in previous literature, however, and there is little seen on the prevalence or characteristics of buccal alveolar exostoses. METHODS: A sample of 416 selected teeth and investing bone in 52 modern skeletal specimens at the National Museum of Natural History were examined. Two measures of heavy occlusal function--periodontal ligament (PDL) width and occlusal attrition--were analyzed for their relationship to three parameters of buccal alveolar bone (exostoses, lipping, and overall thickness). RESULTS: Buccal alveolar bone enlargements were found in 25% of all teeth examined: 18% were expressed as marginal bony lippings and 7% as buccal exostoses. Exostoses were mainly seen around maxillary molars and bicuspids, especially in males, while lippings were seen in molars, bicuspids, and mandibular incisors, with even gender distribution. When findings were controlled for arch and tooth type, no significant correlations were found between wider PDL spaces or occlusal attrition and exostotic, lipped, or thicker alveolar bone. CONCLUSIONS: These results indicate a lack of anatomic evidence for the theory of buttressing bone formation and suggest that other factors may be of greater importance in the etiology of buccal bone enlargements. Incidentally, no correlation was found between widened PDL spaces or severe occlusal attrition and the presence of cervical loss of tooth structure, which casts doubt on the currently popular concept of abfraction.

This report describes a life-cycle assessment conducted by the National Renewable Energy Laboratory (NREL) of 10 hydrogen production, delivery, dispensing, and use pathways that were evaluated for cost, energy use, and greenhouse gas (GHG) emissions. This evaluation updates and expands on a previous assessment of seven pathways conducted in 2009. This study summarizes key results, parameters, and sensitivities to those parameters for the 10 hydrogen pathways, reporting on the levelized cost of hydrogen in 2007 U.S. dollars as well as life-cycle well-to-wheels energy use and GHG emissions associated with the pathways.