bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single‐institution experience of adjuvant 5‐fluorouracil‐based chemotherapy for stage III colon cancer
Authors: Gibbs P. , Handolias D. , McLaughlin S. , Chapman M. , Johns J. , Faragher I. 
Published: February 2008

AbstractBackground:  Adjuvant 5‐flourouracil‐based chemotherapy is standard care for patients with stage III colon cancer. Limited data are available regarding use of adjuvant treatment in routine clinical practice, where patients are often frail and/or elderly.Methods:  A review of patients with stage III colon cancer over a 7‐year period at Western Hospital using a prospective, comprehensive colorectal database was carried out. Results were compared to recent clinical trial data.Results:  We identified 554 patients with colon cancer, including 165 patients (30%) with stage III disease. Median patient age was 69 years, with a median follow up of 38 months. There were nine early postoperative deaths. Thirty other patients (19%) were not offered adjuvant chemotherapy, mainly because of advanced patient age and/or comorbidity. Of 124 patients offered adjuvant therapy 12 (10%) elected not to pursue treatment. Thirty‐four of the 112 patients that commenced treatment had a dose reduction, with 30 not completing treatment because of toxicity (14) or other reasons (16). The 5‐year progression‐free survival was 50% and 5‐year overall survival 59%.Conclusion:  In routine practice many patients with stage III colon cancer do not receive adjuvant chemotherapy. For those receiving treatment the experience is not significantly different from that reported in the carefully selected clinical trial group.
Overcoming preconceptions and perceived barriers to medical communication using a ‘dual role‐play’ training course
Authors: Lim E. C. H. , Oh V. M. S. , Seet R. C. S. 
Published: February 2008

AbstractBackground:  Communication is a core component of clinical competence. We introduced a dual role‐play (DRP) course, in which participants role‐played both the doctor‐candidate and the standardized patient. The aim of the study was to assess the usefulness of a DRP communication course for physicians and to identify factors that inhibit effective medical communication.Methods:  We conducted four medical communication skills courses from 2004 to 2006. A questionnaire was administered before and after completion of each course. We assessed respondents’ confidence levels before and after the course and sought to identify perceived barriers to effective communication among medical trainees in Singapore. Finally, we asked if they found participation in the course and its DRP nature to be useful.Results:  Twenty‐six participants, 20 men, 6 women, of mean age 30.2 years (standard deviation (SD) 2.01) completed the survey. The pre‐course confidence levels (rated on a scale of 1–10) of 6.23 (SD 1.18) rose significantly to 7.58 (SD 0.95) on completion of the course (P = 0.001, Wilcoxon signed rank test). All respondents felt that they had benefited from participation in the medical communication skills course. 24 (92.3%) respondents deemed it useful to have role‐played both the doctor and standardized patient in the exercise. We identified respondents with language difficulties to have benefited the most from the course (P = 0.031, odds ratio 2.906 (95%CI 0.292–5.519), linear regression analysis).Conclusion:  DRP is an effective way to train doctors in medical communication.
Chronic disease management: a primer for physicians
Authors: Scott I. A. 
Published: February 2008

AbstractApproximately one in three Australians or 6.8 million individuals suffer from one or more chronic diseases, the most prevalent being ischaemic heart disease, congestive heart failure, chronic obstructive lung disease, diabetes and renal disease. Potentially avoidable hospitalizations related to chronic disease comprise 5.5% of all admissions nationally and cluster in older age groups and socioeconomically disadvantaged regions. In an effort to reduce mortality and morbidity, programmes of chronic disease management have evolved with the aim of achieving formalized, population‐wide implementation of elements of the chronic care model developed by Wagner et al. Results of rigorous evaluations of such programmes suggest improved survival and/or disease control with reductions in hospitalizations and adverse clinical events. This paper aims to provide an overview of available evidence for chronic disease management programmes for practising physicians who will be increasingly invited to take an active leadership role in designing and operationalizing such programmes.
Patterns of sexual and erectile dysfunction and response to treatment in patients receiving androgen deprivation therapy for prostate cancer
Authors: DiBlasio Christopher J. , Malcolm John B. , Derweesh Ithaar H. , Womack Jamie H. , Kincade Matthew C. , Mancini John G. , Ogles Mitchell L. , Lamar Kimberly D. , Patterson Anthony L. , Wake Robert W. 
Published: February 2008

OBJECTIVETo investigate the incidence of patient‐reported erectile (ED) and sexual dysfunction and response to treatment in men after the induction of androgen deprivation therapy (ADT) for prostate cancer, as ADT‐induced changes in serum testosterone can result in changes in libido and sexual function.PATIENTS AND METHODSWe retrospectively reviewed patients receiving ADT for prostate cancer at our institution between January 1989 and July 2005; those receiving only neoadjuvant ADT were excluded. Variables included age, race, body mass index, prostate‐specific antigen level before ADT, Gleason sum, clinical stage, ADT type (medical vs surgical) and schedule (continuous vs intermittent), previous treatment for prostate cancer, presence of pre‐existing or new‐onset diabetes mellitus (DM), and presence of ED before ADT. After ADT induction, charts were reviewed for reporting of ED, changes in libido, and initiation of ED therapy (medical or surgical).RESULTSIn all, 395 patients (mean age of 71.7 years; 59.0% African‐American, 41.0% Caucasian/other, at initiation ADT) were analysed. At mean follow‐up of 87.4 months, 57 (14.4%) patients reported ED; 40 of these (70%) reported new‐onset ED, while 17 (30%) reported ED before ADT. Response rates were 33–80% with medical therapy, including 44% receiving phosphodiesterase‐5 inhibitor monotherapy. On multivariate analysis, age <70 years (P < 0.001) and the absence of DM (P = 0.024) were associated with reporting ED after ADT.CONCLUSIONSPatients receiving ADT for prostate cancer have variable degrees of ED. Successful outcomes are possible, particularly when implementing multimodal therapy. Younger patients and those with no DM are more likely to report ED after ADT induction.
Co‐assessment of cytoplasmic and nuclear androgen receptor location in prostate specimens: potential implications for prostate cancer development and prognosis
Authors: Diallo Jean‐Simon , Aldejmah Abdulhadi , Mouhim Abdelali Filali , Fahmy Mona Alam , Koumakpayi Ismaël Hervé , Sircar Kanishka , Bégin Louis R. , Mes‐Masson Anne‐Marie , Saad Fred 
Published: February 2008

OBJECTIVETo address, by co‐assessing cytoplasmic and nuclear androgen receptor (AR) expression in prostate tissues, the contribution of the AR throughout the stages of prostate cancer (PC) and its value as a marker for predicting biochemical recurrence (BCR) after radical prostatectomy (RP).PATIENTS AND METHODSArchival prostate specimens from patients who were cancer‐free (43), with hormone‐sensitive prostate cancer (HSPC, 62), and with androgen‐independent prostate cancer (AIPC, 30) were used to construct tissue microarrays (total 135). Prostatic intraepithelial neoplasia (PIN) and non‐neoplastic tissues (NA) found adjacent to HSPC were also included. Nuclear and cytoplasmic AR expression was scored by two observers using a composite scale, after immunohistochemical detection of the AR. The nuclear/cytoplasmic AR expression ratio was also calculated. Univariate Kaplan‐Meier plots, and multivariate Cox and survival‐tree analyses, were then used to assess the ability of the AR to predict BCR in the patients with HSPC.RESULTSThere was markedly greater nuclear AR staining intensity in NA than in normal prostate tissues from cancer‐free patients. Cytoplasmic AR expression was highest in AIPC and markedly more than in HSPC. The nuclear/cytoplasmic AR expression ratio was highest in NA and PIN. In univariate analyses, a low nuclear AR, low cytoplasmic AR, and a high nuclear/cytoplasmic AR expression ratio were associated with BCR. Although cytoplasmic AR was an independent predictor of BCR in a Cox multivariate model (hazard ratio 2.736, 95% confidence interval 1.228–6.091, P = 0.014), survival‐tree analyses suggested a complex relationship between AR expression and clinicopathological features.CONCLUSIONWe propose that increased nuclear AR expression might be a precursor to PC and that cytoplasmic AR could contribute to the AIPC phenotype. The predictive ability of the AR might be closely linked to clinicopathological features.
Altered expression of calcium‐activated K and Cl channels in detrusor overactivity of rats with partial bladder outlet obstruction
Authors: Li Longkun , Jiang Chonghe , Song Bo , Yan Junan , Pan Jinhong 
Published: February 2008

OBJECTIVETo evaluate the activity of large‐ and small‐conductance calcium‐activated potassium channels (BKCa, SKCa) and calcium‐activated chloride channels (ClCa) in detrusor overactivity (DO) cells after partial bladder outlet obstruction (PBOO) in rats.MATERIALS AND METHODSThirteen female Wistar rats with DO caused by PBOO were studied simultaneously with eight sham‐operated rats. The expression of KCa and ClCa channels was assessed by reverse transcription‐polymerase chain reaction, and the function of the two groups compared.RESULTSIn the DO cells the expression of BKCa, SKCa2 and SKCa3 was lower, and that of ClCa channels higher, than in the control group cells. Using confocal laser scanning microscopic analysis, the function of BKCa and SKCa channels was suppressed, and that of ClCa channels was enhanced in DO group cells. KCa and ClCa effectors altered the cell membrane potentials more significantly in the DO cells than in the control cells, indicating a decrease in KCa and an increase in ClCa in DO group in either iso‐ or hypo‐osmolar medium. Moreover, the change in BKCa, SKCa and ClCa channel activators in DO cells showed a more excitable state in hypo‐osmolar medium than in iso‐osmolar medium.CONCLUSIONIn DO myocytes after PBOO, the expression and function of KCa channels were decreased, and those of ClCa channels increased. These changes all provoke greater cell excitability, and could partly account for the DO.
Retroperitoneal lymph node dissection after chemotherapy in patients with elevated tumour markers: indications, histopathology and outcome
Authors: Ong Teng A. , Winkler Mathias H. , Savage Philip M. , Seckl Michael J. , Christmas Timothy J. 
Published: February 2008

OBJECTIVETo evaluate the factors affecting outcome and the pathological findings in patients who had retroperitoneal lymph node dissection (pcRPLND) after chemotherapy with elevated tumour markers, as such patients have an unfavourable prognosis, with further salvage chemotherapy being the usual treatment of choice.PATIENTS AND METHODSInformation on the preoperative treatment, tumour markers, histopathology and outcome data of the patients who had pcRPLND were extracted from the hospital databases. Survival was analysed using the Kaplan‐Meier method and multivariate analysis with Cox regression model.RESULTSIn all, 358 patients had pcRPLND between September 1992 and April 2006, by one surgeon. In 48 patients the tumour markers were elevated at the time of surgery, they were on a ‘rising trend’ in 26 (54%) and ‘downward or stable’ trend in 22 (46%). The overall incidence of active germ cell tumour, differentiated teratoma and necrosis in the resected specimens was 58%, 25% and 17%, respectively. The median follow‐up was 51.5 months and the overall 5‐year survival was 69%. The favourable prognostic factors assessed by univariate analysis were elevation of α‐fetoprotein alone, complete resection of residual disease, histological finding of differentiated teratoma in the resected tissues and normalization of tumour markers after pcRPLND. By multivariate analysis the only statistically significant independent survival factor was the normalization of the tumour markers after pcRPLND.CONCLUSIONFor selected patients with elevated tumour markers after chemotherapy, RPLND can offer a significant chance of cure with no need for further chemotherapy. The patients most likely to benefit are those with elevations of α‐fetoprotein alone. In this group, pcRPLND can offer the prospect of long‐term survival and should be considered in the management of selected patients.
Effect of aldosterone on isolated human penile corpus cavernosum tissue
Authors: Muguruma Hiroshi , Kawanishi Yasuo , Sugiyama Hiroaki , Kagawa Jun‐ichiro , Tanimoto Syuuji , Yamanaka Masahito , Kojima Keiji , Anzai Hideaki , Numata Akira , Kishimoto Tomoteru , Kanayama Hiro‐omi 
Published: February 2008

OBJECTIVETo clarify the physiological effects of aldosterone on human penile corpus cavernosum (hPCC) tissue, as aldosterone has a wider physiological action than just the maintenance of electrolyte balance, and there are mineralocorticoid receptors, i.e. aldosterone receptors, in hPCC tissue.MATERIALS AND METHODSSpecimens of hPCC were obtained from 10 patients (mean age 38 years, range 21–75), with informed consent and approval by the local ethics committee. One patient had a penectomy because of penile cancer, and nine had a penile biopsy because of erectile dysfunction. Patients with diabetes mellitus, hypertension or ischaemic heart disease were excluded. In a pharmacological study we evaluated the effect of aldosterone on the isolated hPCC tissues.RESULTSAldosterone caused no significant change in resting tension and did not affect the nitric oxide‐dependent relaxation reaction. However, the dose–response curve of noradrenaline was shifted to the left when the strip preparation was treated with aldosterone (1 × 10−5m) for 20 min before administering noradrenaline. Moreover, the shift to the left was completely blocked when spironolactone (anti‐aldosterone agent) was added as a pre‐treatment. Pre‐treatment with aldosterone also significantly extended the mean (sem) time required to reach 50% relaxation of a noradrenaline‐induced contraction, of 9.3 (1.5) min, vs the control, of 5.2 (1.0) min (P = 0.002).CONCLUSIONAldosterone has no direct contractile action or a relaxant action on human penile cavernous tissue, but acts to significantly enhance the noradrenaline‐induced contraction. The effect on the noradrenaline‐induced contraction is probably caused by aldosterone enhancing the affinity of the α‐receptors for noradrenaline in hPCC. We suggest that aldosterone acts to enhance contraction of hPCC tissue, and is one of the restraining factors for human penile erection.
THE ROLE AND INTERNALIZATION OF HOMOGENEOUS AND NON‐HOMOGENEOUS DESIGN EFFECTS IN RECYCLING SYSTEMS
Authors: Nishimura Kazuhiko 
Published: February 2008

ABSTRACTThis paper considers recycling systems in which producers and a monopolistic recycler are independent agents, while the design of products determined by the producer affects the recycler's productivity. It is found that such design effects could be internalized within the economy, if the monopolistic recycler pays the normative values of the wasted products according to their designs, while the producers formulate design so as to minimize the product's net price. However, if unfortunate, the equilibrium may fall into a local optimum and may not be stable. We also investigate how such property of the equilibrium could be changed if the recycler's productivity is influenced by the diversity in recycle design.
Long‐term changes in neurotrophic factor expression in distal nerve stump following denervation and reinnervation with motor or sensory nerve
Authors: Michalski B. , Bain J. R. , Fahnestock M. 
Published: February 2008

AbstractSeveral factors have been proposed to account for poor motor recovery after prolonged denervation, including motor neuron cell death and incomplete or poor regeneration of motor fibers into the muscle. Both may result from failure of the muscle and the distal motor nerve stump to continue expression of neurotrophic factors following delayed muscle reinnervation. This study investigated whether regenerating motor or sensory axons modulate distal nerve neurotrophic factor expression. We found that transected distal tibial nerve up‐regulated brain‐derived neurotrophic factor (BDNF) and glial cell line‐derived neurotrophic factor (GDNF) mRNA, down‐regulated neurotrophin‐3 and ciliary neurotrophic factor mRNA, and that although these levels returned to normal with regeneration, the chronically denervated distal nerve stump continued to express these neurotrophic factors for at least 6 months following injury. A sensory nerve (the cutaneous saphenous nerve) sutured to distal tibial nerve lowered injury‐induced BDNF and GDNF mRNA levels in distal stump, but repair with a mixed nerve (peroneal, containing muscle and cutaneous axons) was more effective. Repair with sensory or mixed nerves did not affect nerve growth factor or neurotrophin‐3 expression. Thus, distal nerve contributed to a neurotrophic environment for nerve regeneration for at least 6 months, and sensory nerve repair helped normalize distal nerve neurotrophic factor mRNA expression following denervation. Furthermore, as BDNF and GDNF levels in distal stump increased following denervation and returned to control levels following reinnervation, their levels serve as markers for the status of regeneration by either motor or sensory nerve.
Dissolved organic carbon in soil solutions: a comparison of collection methods
Authors: Buckingham S. , Tipping E. , Hamilton‐Taylor J. 
Published: February 2008

AbstractA field study was undertaken to compare dissolved organic carbon (DOC) concentrations in soil solutions obtained with three different sampling methods over a range of soil types. The sampling devices used were a tension‐free collector, a tension Prenart collector and a tension Rhizon collector. Samples were collected fortnightly for a year at seven sites in northern England, each collection being replicated three times. The soil solution DOC ranged from 1.3 g m−3 in an acid ranker to 34.7 g m−3 in a peat. The DOC concentrations obtained with the three methods correlated reasonably well (r2 = 0.6–0.8) but with an indication of bias, as the best fit line differed from the 1:1 line. The tension‐free collector gave generally higher DOC concentrations except at very low concentrations (in the acid ranker soil). The DOC concentrations measured with the tension‐free collectors were significantly (P < 0.05) higher than those obtained with Prenart and Rhizon collectors at four and six sites, out of seven, respectively. Subsequent laboratory tests on tension‐free collected samples showed no DOC loss on filtration through 0.1 and 0.22‐μm membranes, whereas a significant loss of DOC occurred when tension‐free collected samples were subsequently passed through Prenart and Rhizon collectors, indicating a probable sampling artefact with the tension devices. The difficulties of acquiring representative soil solution samples are discussed, together with the advantages and disadvantages of tension and tension‐free methods.
The influence of afforestation and tree species on soil methane fluxes from shallow organic soils at the UK Gisburn Forest Experiment
Authors: McNamara N. P. , Black H. I. J. , Piearce T. G. , Reay D. S. , Ineson P. 
Published: February 2008

AbstractThere is growing evidence that land use is an important factor in influencing soil methane (CH4) fluxes, and afforestation is viewed as a potential tool for mitigating CH4 releases from soils. However, the influence of different tree species on soil CH4 fluxes is not well understood. We measured soil CH4 fluxes under four tree species and grassland on similar soils at the Gisburn Experimental Forest (NW England) at 2 weekly intervals over 12 months using a static chamber technique. The treatments were Norway spruce (Picea abies), Scots pine (Pinus sylvestris), oak (Quercus petraea), alder (Alnus glutinosa) and grassland. Positive soil CH4 fluxes were observed from grassland plots (average 4.6 kg/ha/year) and negative fluxes from all four tree species (average of all tree species −0.5 kg/ha/year). There were, however, no statistically significant differences between individual treatments. Soil water table depth and moisture content had the greatest influence on soil CH4 fluxes. It is possible that the afforestation of shallow organic and/or poorly drained soils such as these may have a relatively low capacity for mitigating CH4 fluxes. Although methanotrophic bacteria may exist (i.e. there is the potential for oxidation), they may not be able to dominate due to their requirements for specific environmental conditions.
Cuckoo in the Nest? Australian Military Historiography: The State of the Field
Authors: Grey Jeffrey 
Published: February 2008

AbstractMilitary history in Australia presents a paradox: a field with a healthy popular profile and high‐level political endorsement but which attracts decidedly mixed interest amongst university‐based historians. This article surveys the current state of the field and examines the legacy of the official history tradition, the recent re‐emergence of populist ‘blockbusters’, the academic historians’ emphasis upon memory, commemoration and the history of emotions, and military biography. The article concludes by noting the divide between historians whose work concentrates on operations, technology, logistics and doctrine and those, mostly academic, historians whose chief influence is social history.
Elimination of Migraine‐Associated Nausea in Patients Treated with Rizatriptan Orally Disintegrating Tablet (ODT): A Randomized, Double‐Blind, Placebo‐Controlled Study
Authors: Freitag Fred , Taylor Frederick R. , Hamid Mohammed A. , Rodgers Anthony , Hustad Carolyn M. , Ramsey Karen E. , Skobieranda Franck 
Published: February 2008

Objective.— To confirm the efficacy of rizatriptan 10 mg orally disintegrating tablet (ODT) for the elimination of migraine‐associated nausea.Background.— Pooled studies of rizatriptan analyzing elimination of nausea as a secondary endpoint showed that 65% of rizatriptan patients reported elimination of nausea at 2 hours compared with 41% of patients taking placebo.Methods.— This was a multicenter, randomized, double‐blind, placebo‐controlled single‐attack trial enrolling adult patients with at least a 6‐month history of migraine who typically experience migraine‐associated nausea. Patients treated a moderate or severe migraine headache at the earliest sign of nausea with either rizatriptan 10 mg ODT or placebo (2 : 1). The primary endpoint was elimination of nausea at 2 hours postdose, and the secondary endpoint was pain relief at 2 hours postdose.Results.— Although not statistically significant, a greater percentage of patients had elimination of nausea at 2 hours with rizatriptan compared with placebo (70.3% vs 62.0%, P = .165, odds ratio [95% CI] = 1.45 [0.86, 2.46]). When patients were grouped by baseline headache severity, rizatriptan showed a greater advantage than placebo for patients with moderate pain (rizatriptan 72.8% vs placebo 57.4%), but no difference for patients with severe pain (rizatriptan 67.7% vs placebo 66.7%). There were significantly more patients who achieved 2‐hour pain relief with rizatriptan (69.7% vs 54.3%, P = .012, odds ratio [95% CI] = 1.94 [1.16, 3.25]).Conclusion.— Although the efficacy of rizatriptan 10 mg ODT for the elimination of migraine‐associated nausea was comparable to that seen in previous rizatriptan trials, the higher‐than‐usual placebo response prevented a finding of a statistically significant difference. There was a sizable difference in placebo response between patients who treated moderate vs severe migraine. Rizatriptan was effective for 2‐hour pain relief.