bluuebunny/crossref_metadata_2025_split huggingface dataset:
VS19P PATTERN OF PERIPHERAL ARTERIAL DISEASE IN CRITICAL LOWER LIMB ISCHEMIA
Authors: Han C. , Westcott M. , Morrison W. 
Published: April 2007

Purpose  This study aims to investigate the pattern of peripheral arterial disease in critical lower limb ischemia.Methodology  76 patients, without previous lower limb vascular surgery, presented to St. Vincent’s Hospital Melbourne with critical lower limb ischemia, manifesting either as rest pain, ischemic ulcers or gangrene over a 1 year period. Digital subtraction angiograms of lower limbs arteries were analyzed to understand the pattern of arterial atherosclerotic disease.Results  The superficial femoral artery was occluded in 37 of 76 patients, in this group of patients the popliteal artery was reformed from collaterals in all but 5 patients. 42 patients had a single artery run off below the knee. The peroneal artery was only remaining patent artery in 61%, the anterior tibial in 29% and the posterior tibial in 10% of patients.Conclusion  The peroneal artery is frequently the last remaining patent artery below the knee in patients with critical limb ischemia. This may have implications for surgeons in artery selection for lower limb vascular bypass surgery.
VS20P TRENDS IN EMBOLECTOMY OF THE EXTREMITIES: A POPULATION‐BASED STUDY
Authors: Norman P. , Ponosh S. , Broadhurst R. , Semmens J. 
Published: April 2007

Objective  To assess community‐wide temporal trends in the rates of embolectomy of the extremities over the period 1992–2003.Design  Population‐based study.Methods  The Western Australian Linked Data System was used to identify cases of extremity embolectomy with a combination of diagnosis (upper or lower limb embolus) and procedure (embolectomy and revascularization) codes. Trends in age‐specific and age‐standardised rates were assessed over the period 1992–2003. Data regarding warfarin prescriptions was acquired from a separate Commonwealth Government database for the period 2000–2005.Results  1005 patients aged 30 years were admitted for an embolectomy of the extremity during the study period. The age specific rate of embolectomy increased with age from 0.78 per 100,000 in the 30–49 year old group to 46.1 per 100 000 for those aged over 80 years and over. There was a significant downward trend between 1992 and 2003 (Cuzik’s trend test p = 0.015). This pattern was seen for all age groups. Prescriptions for warfarin increased by 50.4% over the period 2000–5.Conclusions  The rates of embolectomy of the extremity appear to be falling. Although the cause for this trend is not known, one possible explanation is increasing prescription of warfarin.
VS04 RISK/BENEFIT ASSESSMENT FOR ELECTIVE ABDOMINAL AORTIC ANEURYSM SURGERY
Authors: Roake J. A. 
Published: April 2007

Purpose  Prediction of individual survival benefit from elective surgery for infrarenal abdominal aortic aneurysm (AAA) is dependent upon a complex interplay between several independent but inter‐related variables. A computerised evidence‐based predictive model was developed to assist clinical decisions on indications for, and timing of, AAA surgery.Methodology  A systematic review of the literature was conducted to identify independent variables that determine survival of patients with AAA. A complex Markov‐type predictive model was developed with the following outputs: Predicted risk of rupture, operative mortality, life expectancy after AAA surgery, survival with/without surgery, survival curve crossover and breakeven points and number needed to treat.Results  Independent determinants of survival identified included predictors of a) AAA rupture (Initial diameter; Annual growth rate; Sex; Mean BP; Smoking status), b) Operative mortality (Surgical unit average mortality; Age; Sex; Cardiac, renal and pulmonary co‐morbidity), c) Life expectancy (Median life expectancy at baseline; average annual mortality secondary to co‐morbidity; adjustment for smoking, CHF or ischaemic ECG, Renal failure, COPD), and d) Post‐repair AAA‐related mortality. A sensitivity analysis demonstrated that the outputs were most sensitive to changes in AAA rupture rate and operative mortality.Conclusions  This predictive model has the potential to assist in management of patients with AAA. While the outputs require validation as objective measures of the potential to benefit from surgery, the interpretation of their relative importance will always remain a matter for subjective judgement dependent upon individual circumstances and preferences.
VS07 PRIORITY SCORING OF UNMET NEED FOR PATIENTS WITH VARICOSE VEINS
Authors: Horrocks E. , Lewis D. R. , Roake J. A. 
Published: April 2007

Purpose  Surgery for symptomatic varicose veins (vv’s) has been shown to be clinically and cost effective but few varicose vein operations are performed at Christchurch Hospital, New Zealand. A scoring system has been designed by NZ Vascular Surgeons and The Ministry of Health to grade priority of patients with vv’s. The aim of this study was to assess how many patients, recently removed from the hospital waiting list, score highly enough to still warrant surgery.Methods  A cohort of 77 patients, returned to GP care, was identified and scored according to their clinical records. The scoring system assessed the following six areas applying a weighted score to each domain: Extent of disease; Severity of disease; Disability; Surgery (simple or complex); Contraindications to surgery and ASA Score.Results  The median (range) age was 58 (28–81) years with a M : F ratio of 2 : 1. The mean score was 72% (range 31–96%). 66 patients (86%) achieved high enough priority scores to still need surgery.Conclusion  Of the 77 patients recently removed from the varicose vein waiting list the vast majority still need surgery in the public system. These patients should not have been removed from the waiting list, rather additional funding is needed so that vascular surgeons can address this unmet need.
VS08 3D MODELS OF BLOOD FLOW IN THE CEREBARL‐VASCULATURE
Authors: David T. , Moore S. , Fink J. 
Published: April 2007

The Circle of Willis (CoW) is a ring‐like arterial structure located in the base of the brain, responsible for the distribution of oxygenated blood throughout the cerebral mass. Among the general population, approximately 50% have a complete CoW, where among a multitude of possible anatomical variations, vessels absent from the CoW are common. Certain conditions such as a build up of atherosclerotic plaque on the arterial wall can result in ischaemic damage and stroke‐like symptoms. A 3D computer model has been developed based on the results of MRA scans of 3 patients cerebral‐vasculature including a numerical algorithm to simulate the body’s autoregulation mechanism. The intention of the present study was to investigate different anatomical states, including different vessels missing from the circle whilst occluding the main afferent arteries such as the Internal Carotid and Vertebral Arteries.Results show that variations in inflow characteristics causes peripheral resistances to change in order to maintain sufficient blood flow to the brain tissue. This indicates that ‘pressure’ is the more physiologically correct boundary condition as opposed to the specification of an inlet ‘velocity profile’.
Effects of ground cover (straw and compost) on the abundance of natural enemies and soil macro invertebrates in vineyards
Authors: Thomson Linda J. , Hoffmann Ary A. 
Published: April 2007

Abstract1 Herbicides are commonly applied under grapevines in Australia to remove weeds and thereby to avoid water loss through transpiration.2 Interest in sustainability promotes a reduction in chemical inputs, including herbicides, leading to trials with surface mulches to suppress weeds.3 Surface mulches may also influence the abundance of a range of invertebrates. Potentially, an increase in natural enemies will contribute to pest control and encourage a reduction in pesticide application.4 We used three trapping methods and direct soil sampling to assess invertebrates at ground level, in the canopy and in the soil to determine the influence of mulch on natural enemies, potential pests and soil macroinvertebrates, including earthworms.5 Collections sorted to family demonstrated that the addition of straw or compost mulches increased natural enemies collected with pitfall traps and soil organisms. However, there was no clear indication of the overall superiority of either mulch.6 Abundance of ground beetles, parasitoid Hymenoptera and spiders collected with pitfall traps were increased by the addition of mulches. In the canopy, predatory and parasitic Diptera and predatory Hemiptera increased after mulching.7 Earthworms collected by hand sorting soil increased with straw mulching.8 No influence on pests was detected. Although Lepidoptera and Sigmurethra, collected in pitfall traps, increased with straw mulching, neither included pest species.9 The results are discussed with reference to the potential economic impact of mulches.
The expression of vascular endothelial growth factor is associated with the risk of cancer progression after radical prostatectomy
Authors: Peyromaure Michaël , Camparo Philippe , Badoual Cécile , Descazeaud Aurélien , Dinh‐Xuan Anh‐Tuan 
Published: April 2007

OBJECTIVETo analyse the prognostic value of vascular endothelial growth factor (VEGF) in men with clinically localized prostate cancer.PATIENTS AND METHODSParaffin wax‐embedded sections from the radical prostatectomy (RP) specimens of 40 men operated for clinically localized prostate cancer were used to build tissue microarrays. Of these patients, 17 had cancer progression and bone metastases after RP (group 1), and 23 remained free‐of‐tumour recurrence after RP (group 2). VEGF‐A expression was examined in the RP specimens using immunohistochemistry.RESULTSThe groups had similar tumour characteristics in terms of prostate‐specific antigen level, Gleason score, and pathological stage. VEGF‐A expression was significantly higher in group 1 than in group 2 (P = 0.046). In logistic regression analysis, VEGF‐A expression was the most significant predictive factor of cancer progression after RP.CONCLUSIONVEGF‐A expression in prostate cancer tissue is associated with the risk of cancer progression after RP. These results suggest that VEGF‐A expression has a prognostic impact in clinically localized prostate cancer.
Renal tumour size measured radiologically before surgery is an unreliable variable for predicting histopathological features: benign tumours are not necessarily small
Authors: Remzi Mesut , Katzenbeisser Daniela , Waldert Matthias , Klingler Hans‐Christoph , Susani Martin , Memarsadeghi Mazda , Heinz‐Peer Gertraud , Haitel Andrea , Herwig Ralf , Marberger Michael 
Published: April 2007

OBJECTIVETo compare histopathological findings as a function of radiological tumour size, as published data suggest that small renal tumours are often benign and large tumours are renal cell cancer (RCC).PATIENTS AND METHODSData from 543 surgically treated patients with solid renal tumours were analysed retrospectively. Tumour size measured by computed tomography (CT) before surgery was stratified into seven subgroups (cm): 0–2, 2.1–3, 3.1–4, 4.1–5, 5.1–6, 6.1–7 and >7, and correlated with final histology.RESULTSIn all, 80 lesions (14.7%) were benign on final histology; tumour size did not correlate with benign histology (P = 0.660). Histopathological tumour size was not statistically significant different (P = 0.521) from measured tumour size on CT, and there was no statistical significance between CT and histopathological tumour size (P = 0.528). Only 13 (17%) of lesions were correctly defined as benign on CT before surgery, whereas 67 (83%) were considered to be suspicious for malignant disease. Only one patient with a tumour correctly defined as benign had a radical nephrectomy; by contrast, 28 of 67 (42%) had a radical nephrectomy for benign lesions not correctly identified as benign on CT before surgery (P < 0.001).CONCLUSIONSubstantially many renal masses are benign, independent of tumour size. Radical nephrectomy could potentially have been avoided in 42% of patients with benign renal tumours. These data provide a good argument for the use of a more refined preoperative diagnostic evaluation, in particular needle biopsy.
Pre‐clinical and clinical evaluation of estramustine, docetaxel and thalidomide combination in androgen‐independent prostate cancer
Authors: Figg William D. , Li Haiqing , Sissung Tristan , Retter Avi , Wu Shenhong , Gulley James L. , Arlen Phil , Wright John J. , Parnes Howard , Fedenko Kathy , Latham Lea , Steinberg Seth M. , Jones Elizabeth , Chen Clara , Dahut William 
Published: April 2007

OBJECTIVETo evaluate the combination of docetaxel plus estramustine (which prolongs survival in patients with androgen‐independent prostate cancer, AIPC), and thalidomide (that also adds to docetaxel activity), both pre‐clinically and clinically in AIPC.PATIENTS, MATERIALS AND METHODSIn the pre‐clinical evaluation we injected PC3 cells subcutaneously into severely combined immunodeficient mice and started treatment after the tumour volume reached 50 mm3. We also evaluated the combination using luciferase‐labelled PC3M‐luc‐C6 cells in nude mice. We enrolled 20 patients with metastatic progressive AIPC into a phase II clinical trial to evaluate this combination. Docetaxel (30 mg/m2) was administered every week, for 3 of 4 weeks. The dose of thalidomide was 200 mg/day and estramustine was given three times a day at 1, 2, 3, 8, 9, 10, 15, 16 and 17 days.RESULTSIn the mice, thalidomide with docetaxel plus estramustine reduced tumour volume by 88% at 17 days vs the control treatment (p = 0.001). The combination of docetaxel, estramustine and thalidomide nearly eradicated the signal from the luciferase‐expressing PC3M cells in the metastasis model. Clinically, the progression‐free time was 7.2 months with this combination; 18 of 20 patients had a decline of half or more in prostate‐specific antigen level and two of 10 patients with soft‐tissue lesions had a partial response on computed tomography. There were 24 grade 3 and two grade 4 complications associated with this combination. There was a statistically significant association between overall survival and the CYP1B1*3 genotype (P = 0.013).CONCLUSIONDocetaxel‐based chemotherapy is now regarded as a standard regimen for metastatic AIPC. The combination of estramustine, docetaxel and thalidomide is an advantageous treatment in pre‐clinical models of prostate cancer and is a safe, tolerable and active regimen in patients with AIPC.
Differential expression of facilitative glucose transporters in normal and tumour kidney tissues
Authors: Suganuma Nobuyasu , Segade Fernando , Matsuzu Kenichi , Bowden Donald W. 
Published: April 2007

OBJECTIVETo investigate the differences in the pattern of glucose transporter (GLUT) gene expression between normal and tumour tissues and among histological subtypes of renal cell carcinomas (RCCs), as malignant cells are characterized by increased glucose uptake and use.MATERIALS AND METHODSEnhanced glucose uptake probably depends on the overexpression of GLUT, usually GLUT1 and/or GLUT3, but there are few comprehensive studies to evaluate the relative expression pattern and level of GLUT in normal and tumour kidney tissues, especially of the recently identified GLUT genes. In all, 71 kidney surgical samples were evaluated using reverse transcriptase‐polymerase chain reaction (RT‐PCR) for GLUT1–14 in normal and tumour (clear cell, papillary and chromophobe RCC, and oncocytoma) tissues. The expression levels for GLUT1–5, 9, 10 and 12 were quantified by real‐time quantitative PCR.RESULTSThe RT‐PCR results showed that normal kidney tissue expresses all the GLUT isoforms. In clear cell RCC GLUT1 expression increased (P < 0.001) while GLUT4, 9 and 12 decreased (P < 0.001). In papillary RCC there were no significant increases in GLUT expression, with only GLUT12 significantly expressed at lower levels (P < 0.001). In chromophobe RCC the expression of GLUT4 increased (P < 0.05), and GLUT2 and 5 decreased (P < 0.01), whereas in oncocytoma tissue there were no significant changes in the expression of GLUT1 (P < 0.01), 2, 5, 9 (P < 0.001) and 10 (P < 0.05).CONCLUSIONSThese results suggest that high‐affinity GLUTs might have a major role in enhanced glucose uptake in kidney tumours, and that histopathological types are characterized by specific patterns of GLUT expression.
‘Skipping’ is still a problem with radiofrequency ablation of small renal tumours
Authors: Klingler H. Christoph , Marberger Michael , Mauermann Julian , Remzi Mesut , Susani Martin 
Published: April 2007

OBJECTIVETo evaluate the homogeneity and extent of necrosis obtained with next‐generation radiofrequency ablation (RFA) equipment and techniques, as incomplete tumour necrosis, or ‘skipping’, has been documented after RFA of renal tumours and subsequent partial nephrectomy, but this was assumed to result from insufficient energy deposition with first‐generation low‐energy generators.PATIENTS AND METHODSIn all, 17 patients with solitary renal tumours of ≤ 4 cm were treated with RFA under laparoscopic control. A state‐of‐the‐art monopolar RFA generator and 15 G multi‐tined needle probes were used. The probe tines were deployed to create an ablation zone >0.5–1.0 cm beyond the sonographically controlled tumour borders. Target temperatures of 105 °C were applied in three cycles for 10–30 min at up to 150 W. Tumours were then removed by laparoscopic partial nephrectomy and specimens evaluated by detailed histology.RESULTSThe mean (range) resected tumour size was 22 (11–40) mm, the mean RFA time was 39 (27–59) min and the mean surgical resection time was 25 (12–45) min. In 13 patients, haemostasis was sufficient to avoid the renal pedicle being clamped. Intraoperative repeated positive margins in one patient required a laparoscopic radical nephrectomy. Thirteen (76%) renal masses showed histologically complete ablation of the entire tumour. Of the four RFA failures, three tumours were >3 cm in diameter, two were highly vascularized and three had a very heterogeneous tissue texture.CONCLUSIONEven with state‐of‐the‐art technology, skipping remains a problem with RFA for small renal masses and renders the technique unreliable.
Health‐insurance status is a determinant of the stage at presentation and of cancer control in European men treated with radical prostatectomy for clinically localized prostate cancer
Authors: Gallina Andrea , Karakiewicz Pierre I. , Chun Felix K.‐H. , Briganti Alberto , Graefen Markus , Montorsi Francesco , Walz Jochen , Jeldres Claudio , Erbersdobler Andreas , Salonia Andrea , Suardi Nazareno , Dehò Federico , Schlomm Thorsten , Scattoni Vincenzo , Haese Alexander , Heinzer Hans , Valiquette Luc , Rigatti Patrizio , Huland Hartwig 
Published: April 2007

OBJECTIVETo determine whether health‐insurance status might result in more localized stage at presentation, more favourable stage at surgery and in a lower rate of biochemical recurrence (BCR), in patients diagnosed with prostate cancer and treated with radical prostatectomy (RP), as despite uninhibited access to healthcare, private and public health insurance are available in most European countries.PATIENTS AND METHODSIn all, 4442 consecutive men had RP in two large European centres, of whom 2372 had public and 2070 had private health insurance. The groups were compared for several variables according to insurance status (private vs public). Means and proportions tests were complemented with logistic regression or Kaplan–Meier analyses.RESULTSSerum prostate‐specific antigen level (P < 0.001), clinical stage (P < 0.001), pathological Gleason sum (P = 0.02), positive surgical margin rate (18.4% vs 25.4%, P < 0.001), extracapsular extension rate (17.7% vs 20.0%, P = 0.047) and seminal vesicle invasion rate (9.6% vs 11.6%, P = 0.04) were more favourable in privately insured patients. Conversely, the rate of lymph‐node involvement was higher in those with private than public insurance (4.4% vs 3.3%, P = 0.045). In univariate analyses addressing pathological variables, private insurance was invariably protective (all P < 0.05). The Kaplan–Meier analyses showed that privately insured patients had a lower rate of BCR after RP (log‐rank P = 0.017).CONCLUSIONDespite uninhibited access to healthcare, insurance status represents a rate‐limiting variable, which affects stage at presentation and the outcome of cancer control.
18F‐choline and/or 11C‐acetate positron emission tomography: detection of residual or progressive subclinical disease at very low prostate‐specific antigen values (<1 ng/mL) after radical prostatectomy
Authors: Vees Hansjörg , Buchegger Franz , Albrecht Susanne , Khan Haleem , Husarik Daniela , Zaidi Habib , Soloviev Dmitri , Hany Thomas F. , Miralbell Raymond 
Published: April 2007

OBJECTIVESTo assess the value of positron emission tomography (PET)/computed tomography (CT) with either 18F‐choline and/or 11C‐acetate, of residual or recurrent tumour after radical prostatectomy (RP) in patients with a prostate‐specific antigen (PSA) level of <1 ng/mL and referred for adjuvant or salvage radiotherapy.PATIENTS AND METHODSIn all, 22 PET/CT studies were performed, 11 with 18F‐choline (group A) and 11 with 11C‐acetate (group B), in 20 consecutive patients (two undergoing PET/CT scans with both tracers). The median (range) PSA level before PET/CT was 0.33 (0.08–0.76) ng/mL. Endorectal‐coil magnetic resonance imaging (MRI) was used in 18 patients. Nineteen patients were eligible for evaluation of biochemical response after salvage radiotherapy.RESULTSThere was abnormal local tracer uptake in five and six patients in group A and B, respectively. Except for a single positive obturator lymph node, there was no other site of metastasis. In the two patients evaluated with both tracers there was no pathological uptake. Endorectal MRI was locally positive in 15 of 18 patients; 12 of 19 responded with a marked decrease in PSA level (half or more from baseline) 6 months after salvage radiotherapy.CONCLUSIONSAlthough 18F‐choline and 11C‐acetate PET/CT studies succeeded in detecting local residual or recurrent disease in about half the patients with PSA levels of <1 ng/mL after RP, these studies cannot yet be recommended as a standard diagnostic tool for early relapse or suspicion of subclinical minimally persistent disease after surgery. Endorectal MRI might be more helpful, especially in patients with a low likelihood of distant metastases. Nevertheless, further research with 18F‐choline and/or 11C‐acetate PET with optimal spatial resolution might be needed for patients with a high risk of distant relapse after RP even at low PSA values.