bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tomographic assessment of therapeutic response to uveitic macular oedema
Authors: Sivaprasad Sobha , Ikeji Felicia , Xing Wen , Lightman Sue 
Published: October 2007

AbstractPurpose:  To evaluate the therapeutic effects on the different morphological patterns of uveitic macular oedema and central macular thickness using optical coherence tomography (OCT).Methods:  Retrospective observational case series. Fifty consecutive patients with a clinical diagnosis of new or recurrent macular oedema due to uveitis were examined with serial OCTs for 1 year. The correlation between different patterns of macular oedema (diffuse macular oedema, inner cystoid oedema, outer cystoid oedema, oedema involving both inner and outer layers of retina and serous retinal detachment) and change in logMAR visual acuity and the recorded variables including age, gender, systemic disease associated with uveitis, location and duration of uveitis, and duration of macular oedema were examined. Response to treatment was measured as change in logMAR visual acuity and evolution of patterns of macular oedema.Results:  Diffuse macular oedema, external cystoid and serous retinal detachment responded well to treatment. Cysts in the inner retinal layers were more resistant to treatment. The cysts in the outer layers disappeared faster than cysts in the inner layers in patients with cysts in both layers at baseline. Multivariate analysis showed that cystoid macular oedema (all types) (P = 0.03) and inner cystoid oedema (P = 0.031) were the variables significantly associated with final visual acuity.Conclusion:  Assessment of patterns of uveitic macular oedema by OCT gives useful information on the prognosis. Inner retinal cystoid oedema is more resistant to treatment than any other patterns of oedema.
Global analysis of nitrogen and phosphorus limitation of primary producers in freshwater, marine and terrestrial ecosystems
Authors: Elser James J. , Bracken Matthew E.S. , Cleland Elsa E. , Gruner Daniel S. , Harpole W. Stanley , Hillebrand Helmut , Ngai Jacqueline T. , Seabloom Eric W. , Shurin Jonathan B. , Smith Jennifer E. 
Published: October 2007

AbstractThe cycles of the key nutrient elements nitrogen (N) and phosphorus (P) have been massively altered by anthropogenic activities. Thus, it is essential to understand how photosynthetic production across diverse ecosystems is, or is not, limited by N and P. Via a large‐scale meta‐analysis of experimental enrichments, we show that P limitation is equally strong across these major habitats and that N and P limitation are equivalent within both terrestrial and freshwater systems. Furthermore, simultaneous N and P enrichment produces strongly positive synergistic responses in all three environments. Thus, contrary to some prevailing paradigms, freshwater, marine and terrestrial ecosystems are surprisingly similar in terms of N and P limitation.
Frequency‐dependence stabilizes competitive interactions among four annual plants
Authors: Harpole W. Stanley , Suding Katharine N. 
Published: October 2007

AbstractIt is the combination of large fitness differences and strong stabilizing mechanisms that often constitute niche‐based explanations for species abundance patterns. Despite the importance of this assumption to much of community ecology, empirical evidence is surprisingly limited. Empirical tests are critical because many abundance patterns are also consistent with neutral‐based alternatives (that assume no fitness differences or stabilization). We quantified interactions of four annual grassland species in two‐species mixtures at varying frequencies. We found evidence of strong negative frequency‐dependent stabilization, where scaled population growth rates increased with decreasing frequency for all four species. There was also a consistent competitive hierarchy among these species indicative of strong fitness differences that, in most cases, suggested potential competitive exclusion despite the observed strong stabilization.
Patient selection determines the prostate cancer yield of dynamic contrast‐enhanced magnetic resonance imaging‐guided transrectal biopsies in a closed 3‐Tesla scanner
Authors: Singh Anurag K. , Krieger Axel , Lattouf Jean‐Baptiste , Guion Peter , Grubb Robert L. , Albert Paul S. , Metzger Greg , Ullman Karen , Smith Sharon , Fichtinger Gabor , Ocak Iclal , Choyke Peter , Ménard Cynthia , Coleman Jonathan 
Published: October 2007

OBJECTIVETo evaluate the cancer yield of transrectal prostate biopsies in a 3‐T magnetic resonance imaging (MRI) scanner in patients with elevated prostate specific antigen (PSA) levels and recent negative transrectal ultrasonography (TRUS)‐guided prostate biopsies.PATIENTS AND METHODSBetween July 2004 and November 2005, patients with at least one previous negative prostate biopsy within the previous 12 months had MRI‐guided biopsy of the prostate in a 3‐T MRI scanner. Patients with previous positive biopsies for cancer were excluded. Target selection was based on T2‐weighted imaging and dynamic contrast‐enhanced (DCE) imaging studies.RESULTSThirteen patients were eligible; their median (range) age was 61 (47–74) years and PSA value 4.90 (1.3–12.3) ng/mL. Most patients had one previous negative biopsy (range 1–4). Four patients had a family history of prostate cancer. There were 37 distinct targets based on T2‐weighted imaging. Fifteen of 16 distinct DCE abnormalities were co‐localized with a target based on T2‐weighted imaging. Despite this correlation, only one of 13 patients had a directed biopsy positive for cancer. Including systematic biopsies, two of 13 patients had a biopsy positive for prostate cancer. One patient had prostate intraepithelial neoplasia and one had atypical glands in the specimen.CONCLUSIONThe prostate‐cancer yield of transrectal biopsies in a 3‐T MRI scanner, among patients with recent negative TRUS‐guided prostate biopsies, is similar to repeat systematic TRUS‐guided biopsy. DCE correlates with T2‐imaging but does not appear to improve prostate cancer yield in this population.
A phase II trial of cisplatin, fixed dose‐rate gemcitabine and gefitinib for advanced urothelial tract carcinoma: results of the Cancer and Leukaemia Group B 90102
Authors: Philips George K. , Halabi Susan , Sanford Ben L. , Bajorin Dean , Small Eric J. ,   Cancer and Leukaemia Group B
Published: October 2007

OBJECTIVETo conduct a phase II trial to determine the efficacy of cisplatin, a fixed dose‐rate infusion of gemcitabine and gefitinib (an orally active epidermal growth factor receptor tyrosine kinase inhibitor) in patients with advanced urothelial carcinoma.PATIENTS AND METHODSEligible patients had previously untreated measurable disease, an Eastern Cooperative Oncology Group performance status of 0–2 and creatinine clearance of >50 mL/min. The treatment regimen consisted of cisplatin 70 mg/m2 on day 1, gemcitabine 1000 mg/m2 on day 1 and 8, administered at a fixed dose rate of 10 mg/m2/min, given every 3 weeks concurrent with gefitinib 500 mg/day orally for a maximum of six cycles. Maintenance gefitinib 500 mg/day was continued for responding or stable disease.RESULTSIn all, 27 patients were accrued before the study was halted because the dose‐limiting toxicity (DLT) exceeded pre‐established stopping rules. The DLT events were two grade 5 (one infection, one cardiovascular accident) and three with grade 4 non‐haematological toxicity. In 25 evaluable patients there were nine objective responses, for an overall response rate of 36% (95% confidence interval, CI, 18–57%). The median (95% CI) survival time was 11.1 (5.2–35.3) months.CONCLUSIONThe combination of cisplatin, fixed dose‐rate gemcitabine and gefitinib is active in advanced TCC, although the relative contribution of gefitinib cannot be determined. However, this regimen was associated with excessive toxicity.
Independent assessment of a wide‐focus, low‐pressure electromagnetic lithotripter: absence of renal bioeffects in the pig
Authors: Evan Andrew P. , McAteer James A. , Connors Bret A. , Pishchalnikov Yuri A. , Handa Rajash K. , Blomgren Philip , Willis Lynn R. , Williams James C. , Lingeman James E. , Gao Sujuan 
Published: October 2007

OBJECTIVETo assess the renal injury response in a pig model treated with a clinical dose of shock waves (SWs) delivered at a slow rate (27 SW/min) using a novel wide focal zone (18 mm), low acoustic pressure (<20 MPa) electromagnetic lithotripter (Xi Xin‐Eisenmenger, XX‐ES; Xi Xin Medical Instruments Co. Ltd., Suzhou, PRC).MATERIALS AND METHODSThe left kidneys of anaesthetized female pigs were treated with 1500 SWs from either an unmodified electrohydraulic lithotripter (HM3, Dornier MedTech America, Inc., Kennesaw, GA, USA; 18 kV, 30 SW/min) or the XX‐ES (9.3 kV, 27 SW/min). Measures of renal function (glomerular filtration rate, GFR, and renal plasma flow) were collected before and after SW lithotripsy, and kidneys were harvested for histological quantification of vascular haemorrhage, expressed as a percentage of the functional renal volume (FRV). A fibre‐optic probe hydrophone was used to characterize the acoustic field, and the breakage of gypsum model stones was used to compare the function of the two lithotripters.RESULTSKidneys treated with the XX‐ES showed no significant change in renal haemodynamic function and no detectable tissue injury. Pigs treated with the HM3 had a modest decline from baseline (≈ 20%) in both GFR (P > 0.05) and renal plasma flow (P = 0.064) in the treated kidney, but that was not significantly different from the control group. Although most HM3‐treated pigs showed no evidence of renal tissue injury, two had focal injury measuring 0.1% FRV, localized to the renal papillae. The width of the focal zone for the XX‐ES was ≈ 18 mm and that of the HM3 ≈ 8 mm. Peak positive pressures at settings used to treat pigs and break model stones were considerably lower for the XX‐ES (17 MPa at 9.3 kV) than for the HM3 (37 MPa at 18 kV). The XX‐ES required fewer SWs to break stones to completion than did the HM3, with a mean (sd) of 634 (42) and 831 (43) SWs, respectively (P < 0.01). However, conditions were different for these tests because of differences in physical configuration of the two machines.CONCLUSIONThe absence of renal injury with the wide focal zone XX‐ES lithotripter operated at low shock pressure and a slow SW rate suggests that this lithotripter would be safe when used at the settings recommended for patient treatment. That the injury was also minimal using the Dornier HM3 lithotripter at a slow SW rate implies that the reduced tissue injury seen with these two machines was because they were operated at a slow SW rate. As recent studies have shown stone breakage to be improved when the focal zone is wider than the stone, a wide focal zone lithotripter operated at low pressure and slow rate has the features necessary to provide better stone breakage with less tissue injury.
Muscarinic and purinergic receptor expression in the urothelium of rats with detrusor overactivity induced by bladder outlet obstruction
Authors: Kim Joon Chul , Yoo Jae Suk , Park Eun Young , Hong Sung Hoo , Seo Seong Il , Hwang Tae‐Kon 
Published: October 2007

OBJECTIVETo investigate the expression of muscarinic and purinergic receptors in rat urothelium, and changes in their distribution and expression following detrusor overactivity induced by bladder outlet obstruction (BOO).MATERIALS AND METHODSThirty Sprague‐Dawley rats were divided into control (10) and BOO groups (20). Partial BOO was induced for 3 weeks and the rats assessed by cystometrography. A portion of the bladder was stained using immunofluorescence for M2 and M3 muscarinic receptors, and P2X3 purinergic receptors. The remainder was dissected into bladder urothelium and the smooth muscle layer, and the expression of the receptor proteins analysed by Western blotting.RESULTSCystometrography showed a significant decrease in contraction interval and increase in contraction pressure in the BOO group. On immunofluorescence staining, muscarinic and purinergic receptors were localized in both the urothelium and the muscle layer. Immunoreactivity of M2 and M3 muscarinic receptors was greater in the urothelium of the BOO group than in the control group; there was a smaller increase in P2X3 immunoreactivity. On Western blotting, the expression of M2, M3 and P2X3 receptors was increased in the urothelium of the BOO group, and there was increased M3 receptor expression in the muscle layer of the BOO group.CONCLUSIONSThere were detectable changes in muscarinic and purinergic receptors with bladder overactivity induced by BOO. Our results suggest that changes in urothelium receptor expression could have a role in mediating the afferent sensory responses in the urinary bladder.
Blood pressure changes during sexual stimulation, ejaculation and midodrine treatment in men with spinal cord injury
Authors: Courtois Frédérique J. , Charvier Kathleen F. , Leriche Albert , Vézina Jean‐Guy , Côté Magalie , Bélanger Marc 
Published: October 2007

Associate EditorMichael G. WyllieEditorial BoardIan Eardley, UKJean Fourcroy, USASidney Glina, BrazilJulia Heiman, USAChris McMahon, AustraliaBob Millar, UKAlvaro Morales, CanadaMichael Perelman, USAMarcel Waldinger, NetherlandsOBJECTIVESTo explore the effectiveness of various sources of self‐stimulation, including oral midodrine, in triggering ejaculation in men with spinal cord injury (SCI), and to document the systematic variations in blood pressure at ejaculation and consider a revised definition of autonomic dysreflexia.PATIENTS AND METHODSThe study included 62 men with SCI lesions from C2 to L2. Ejaculation potential was assessed with various sources of stimulation, beginning with natural stimulation, followed, if the test was negative, by penile vibrator stimulation (PVS) followed, if the test was again negative, by PVS combined with oral midodrine, started at 5 mg and increased in 5 mg steps up to 25 mg. The success rate of ejaculation was recorded, as were blood pressure (BP) changes measured at baseline and at ejaculation (or on the last trial if the test was negative). Reported sensations were also recorded and compared during positive and negative tests.RESULTSOverall, 89% of the patients reached ejaculation with one mode or another of stimulation. When patients had a negative result with natural stimulation, 56% were salvaged by PVS, and when PVS was negative, another 22% were salvaged by midodrine combined with PVS. The mean systolic BP increased by 35 mmHg at ejaculation during PVS and by 11 mmHg after midodrine, and a subsequent 29 mmHg at ejaculation during PVS combined with midodrine. By contrast, negative tests showed a relatively stable BP; the difference in changes in BP during positive and negative tests was significant (P < 0.01). Increases in BP during positive tests declined significantly more often within the limits of autonomic dysreflexia than negative tests (P < 0.01).CONCLUSIONThese results support the view that most men with SCI can obtain an ejaculation when a wide spectrum of stimulation is used, including natural stimulation, PVS, and PVS combined with oral midodrine. Positive tests were associated with significant increases in BP, in contrast to negative tests, where BP was relatively stable. This suggests that significant changes in BP are required for ejaculation and that insignificant changes are predictive of future failure. As most changes in BP during positive tests also fall within the criterion of autonomic dysreflexia, a revised definition of autonomic dysreflexia should be considered to encourage safe experiences with ejaculation and safe use of midodrine.
Rationale and clinical implication of combined chemotherapy with cisplatin and oestrogen in prostate cancer: primary evidence based on methylation analysis of oestrogen receptor‐α
Authors: Moriyama‐Gonda Nobuko , Shiina Hiroaki , Terashima Masaharu , Satoh Kazumi , Igawa Mikio 
Published: October 2007

OBJECTIVETo determine whether oestrogen enhances platinum sensitivity, and if promoter CpG methylation of the oestrogen receptor‐α (ER‐α) gene determines the potential of cisplatin‐induced apoptosis in prostate cancer, as the high‐mobility group 1 (HMG1) preferentially binds to cisplatin‐modified DNA and is up‐regulated after oestrogen treatment in breast cancer cell line MCF‐7.MATERIALS AND METHODSThe study comprised prostate cancer cell lines (LNCaP and PC‐3), 156 pathologically confirmed 156 radical prostatectomy samples and eight hormone‐refractory prostate cancer (HRPC) samples (from needle biopsy). Expression of HMG1 in cell lines was analysed by Western blotting or differential reverse‐transcription‐polymerase chain reaction (PCR). The methylation status of ER‐α was analysed by methylation‐specific PCR using bisulphite DNA as a template or bisulphite DNA sequencing.RESULTSIn LNCaP cells, treatment with oestrogen increased HMG1 expression and co‐treatment with cisplatin and oestrogen reduced cell viability by accelerating apoptosis, compared with cisplatin alone. However, in PC‐3, oestrogen did not up‐regulate HMG1 or accelerate the cisplatin‐induced apoptosis. Although ER‐β was expressed in both LNCaP and PC‐3, ER‐α was expressed only in LNCaP. Bisulphite DNA sequencing of the ER‐α promoter showed partial methylation in LNCaP but complete methylation in PC‐3. ER‐α AS transfection diminished the cisplatin‐induced apoptosis in oestrogen‐treated LNCaP cells. In clinical samples there was ER‐α hypermethylation in 40% of prostate cancers this correlated with Gleason score (GS, 31% for GS < 7, 50% for GS = 7 and 56% for GS > 7). In addition, five of eight HRPC samples showed ER‐α hypermethylation.CONCLUSIONThese findings suggest that HMG1 induction as an enhancer of platinum sensitivity is mediated through interaction between oestrogen and ER‐α. As CpG hypermethylation of the ER‐α promoter is a frequent event in aggressive prostate cancer, negative conversion of ER‐α methylation is essential to achieve the most beneficial effect when combined chemotherapy of cisplatin with oestrogen is used in patients with prostate cancer.
Comparison of the precision of transurethral endoscopic versus ultrasound‐guided application of injectables
Authors: Mitterberger Michael , Pinggera Germar M. , Pelzer Alexandre , Bartsch Georg , Colleselli Daniela , Neuwirt Hannes , Gradl Johann , Pallwein Leo , Aigner Friedrich , Frauscher Ferdinand , Strasser Hannes 
Published: October 2007

OBJECTIVETo compare the precision of transurethral endoscopic‐ vs ultrasound (US)‐guided injections, as transurethral application of various injectables under endoscopic view are widely used to treat urinary incontinence.MATERIAL AND METHODSBovine collagen was injected into the lower urinary tract in 20 dead female pigs. In each pig five depots of collagen were injected and there were five pigs in each group. In group I collagen was injected into the urethral wall under endoscopic control. In group II collagen depots were injected periurethrally under endosocopic guidance. In group III collagen was injected into the urethral wall under US control. In group IV collagen depots were injected periurethrally under US guidance. A transurethral US probe (6 F, 15 MHz) and injection device were used for transurethral US‐guided injections. In all pigs the urethra and the periurethral tissue were removed after injection and investigated using anatomical preparations and histological sections.RESULTSIn group I only two collagen depots were actually located in the urethral wall in two pigs (two of 25 depots, 8%). In group II five depots in two pigs were located in the urethral wall (five of 25 depots, 20%). The periurethral collagen depots were found to spread out in the loose connective and fat tissue around the urethra. In group III all US‐guided injections of collagen were situated in the urethral wall and in group IV they were all located periurethrally.CONCLUSIONSThe present study shows that endoscopic application of injectables is an inaccurate technique, while US‐guided injections are precise. US‐guided injection enables excellent control of the therapeutic procedure.
The effect of prostate weight on the outcomes of laparoscopic radical prostatectomy
Authors: Frota Rodrigo , Turna Burak , Santos Bruno Mello R. , Lin Yi‐Chia , Gill Inderbir S. , Aron Monish 
Published: October 2007

Associate EditorAsh TewariEditorial BoardRalph Clayman, USAInderbir Gill, USARoger Kirby, UKMani Menon, USAOBJECTIVETo evaluate the effect of prostate weight on perioperative, functional and oncological outcomes after laparoscopic radical prostatectomy (LRP).PATIENTS AND METHODSBetween January 2003 and January 2006, 327 patients had LRP by one surgeon, 193 of whom were available for analysis. Patients were stratified into three groups on the basis of pathological prostate weight, i.e. ≤30, 30–75 and ≥75 g. Perioperative, oncological and functional (continence and potency at 1 year) outcomes were compared among the three groups.RESULTSOf the 193 patients the prostate was ≤30 g in 18 (9%), 30–75 g in 131 (68%) and ≥75 g in 44 (23%); the mean prostate weight was 27, 49 and 98 g in the three subgroups, respectively. At presentation, 144 patients (75%) had T1c disease, 159 (82%) were potent and 187 (97%) were continent. Unilateral nerve‐sparing was done in 37 (19%) and bilateral in 114 (59%) patients. The three subgroups were comparable in age, body mass index, preoperative prostate‐specific antigen level, preoperative Gleason score, clinical stage, operative duration, length of hospital stay, duration of catheterization, biochemical recurrence and continence after LRP. In the patients with a prostate of ≤30 g there was a higher incidence of positive margins (39% vs 16% vs 27%; P = 0.03) and inferior 1‐year potency (47% vs 75% vs 79%; P =0.04), respectively. Estimated blood loss increased with increasing prostate size (204 vs 256 vs 340 mL; P = 0.01).CONCLUSIONSProstate size has no effect on continence or biochemical recurrence at 1 year after LRP, but affects intraoperative blood loss, potency and surgical margins. More patients with a longer follow‐up are needed to confirm these findings.
Evaluation of costs and morbidity associated with laparoscopic radiofrequency ablation and laparoscopic partial nephrectomy for treating small renal tumours
Authors: Bensalah Karim , Zeltser Ilia , Tuncel Altug , Cadeddu Jeffrey , Lotan Yair 
Published: October 2007

OBJECTIVETo compare the costs and morbidity of laparoscopic radiofrequency ablation (LRFA) and laparoscopic partial nephrectomy (LPN) for treating small localized renal tumours.PATIENTS AND METHODSWe retrospectively analysed the outcomes of 88 patients treated at our institution for a renal tumour either by LPN (50) or LRFA (38) between March 2000 and May 2006. Patients with multiple tumours, combined LRFA and LPN, and those who had other simultaneous surgical procedures were excluded. Clinical variables and outcomes were analysed for each patient. Direct cost data were available for 40 patients treated with LPN and 14 with LRFA. Continuous and categorical variables were compared using an independent t‐test and chi‐square test, respectively.RESULTSThe tumour size was comparable in each group; patients in the LRFA group had more comorbidities (P = 0.01) and a higher overall mortality rate (P = 0.01) but no patient died from cancer. Operative duration, estimated blood loss and length of stay were significantly shorter in the LRFA group but there was no difference in complication rate. LRFA was less costly than LPN ($6103 vs $6808, P = 0.3) but not statistically significantly. The cost savings from the shorter operative duration and length of stay were reduced by the cost of probe. With a median follow‐up of 20 months there was no difference in oncological outcome.CONCLUSIONPatients undergoing LRFA tend to be older and have more comorbidities than those treated with LPN. The cost is minimally lower for LRFA, secondary to the added cost of the probe. LRFA might be a good alternative treatment in patients at higher risk of surgical complications, but LPN provides good results when done by an experienced surgeon.