bluuebunny/crossref_metadata_2025_split huggingface dataset:
Difference in the relative contribution of lean and fat mass components to bone mineral density with generation
Authors: Mizuma Nobuhisa , Mizuma Mari , Yoshinaga Mitsuhiro , Iwamoto Ichiro , Matsuo Takashi , Douchi Tsutomu , Osame Mitsuhiro 
Published: March 2006

AbstractAim:  To investigate whether the relative contribution of body composition (lean and fat mass component) to bone mineral density (BMD) differs depending on generation or menopause.Methods:  Subjects were 302 premenopausal women aged 30–49 years old and 197 postmenopausal women aged 50–69 years old. They were classified into four subgroups with 10‐year increments. Age, height, weight and years since menopause (YSM) were recorded. Lumbar spine (L2–4), total body BMD, body fat mass, lean body mass (LBM), and the percentage of body fat (%fat) were measured using dual‐energy X‐ray absorptiometry. The correlation of body composition with BMD was investigated.Results:  The mean age at menopause was 50.2 ± 4.1 years old. On Pearson's correlation test, LBM was positively correlated with BMD of the two sites in all groups. In a group aged 60–69 years, both the %fat and body fat mass were correlated with BMD. On multiple regression analysis, LBM was the principal BMD determinant in women aged less than 60 years, while body fat mass and percentage fat were the principal BMD determinants in women aged 60–69 years. Mean %fat in the group aged 60–69 years was 35.5 ± 7.3%, which was significantly higher than that in the group aged 50–59 years (33.0 ± 6.7%, P < 0.05).Conclusion:  Although LBM still influences BMD up to 10 years after menopause, the body fat mass initially influences BMD after 60 years of age. These difference may be attributable to certain aging‐related factor(s).
Spontaneous ectopic pregnancy occurring in the isthmic portion of the remnant tube after ipsilateral adnexectomy: Report of two cases
Authors: Takeda Akihiro , Manabe Shuichi , Mitsui Takashi , Nakamura Hiromi 
Published: March 2006

AbstractTwo cases of spontaneous ectopic pregnancy occurring in the isthmic portion of the remnant tube after previous ipsilateral adnexectomy are presented. Laparoscopic observation and postoperative histopathological examination suggested intrauterine transmigration of the fertilized egg as the etiology. Laparoscopic excision of the remnant tube was performed and the postoperative course was uneventful in both cases. Attention should be paid to this unusual type of ectopic pregnancy while examining patients with previous history of adnexal surgery.
Vitamin K2 treatment for postmenopausal osteoporosis in Indonesia
Authors: Purwosunu Yuditiya ,   Muharram, Rachman Ichramsyah A. , Reksoprodjo Soelarto , Sekizawa Akihiko 
Published: March 2006

AbstractAim:  To investigate the effect of vitamin K2 (menatetrenone) treatment on bone mineral density (BMD) and a bone metabolic marker (osteocalcin) in postmenopausal women with osteoporosis living in Indonesia.Methods:  A double‐blind randomized placebo‐controlled study of 63 postmenopausal women with osteoporosis. The vitamin K2 group (n = 33) received 45 mg menatetrenone and 1500 mg calcium carbonate per day and the control group (n = 30) received placebo and 1500 mg calcium carbonate per day for 48 weeks. BMD of lumbal spine (L2–L4), osteocalcin (OC) and undercarboxylated OC were measured before, 24 and 48 weeks after initiation of the treatment.Results:  After 48 weeks of treatment, the mean percentage change of lumbar BMD in the vitamin K2 group was significantly higher (P < 0.05) than that of the control group. The undercarboxylated OC level decreased by 55.9% in the menatetrenone group and 9.3% in the control group compared with the baseline level. The difference between the two groups was significant (P < 0.01). The adverse events were three minor gastrointestinal cases, which subsided after temporary cessation of therapy.Conclusions:  Treatment with 45 mg vitamin K2 with 1500 mg calcium per day for postmenopausal women with osteoporosis for 48 weeks resulted in a significant increase in lumbar BMD and a significant decrease in undercarboxylated OC levels.
Fetal aortic distension waveforms for evaluating cardiac function and changes in blood pressure: Fetal lamb validation
Authors: Fujita Yasuyuki , Satoh Shoji , Yumoto Yasuo , Koga Tsuyoshi , Kinukawa Naoko , Nakano Hitoo 
Published: March 2006

AbstractAim:  To investigate which part of the fetal aortic distension waveform is mainly influenced by changes in fetal cardiac contractility and aortic blood pressure.Methods:  In acute preparation, aortic distension waveforms were recorded using an echo‐tracking system, and aortic and left ventricular pressure waveforms were obtained from six late‐gestation catheterized fetal lambs. Dobutamine and angiotensin II were separately infused and the correlations between the maximum value in the first derivative of left ventricle pressure waveforms (Max dP/dt) and fetal blood pressure, and the parameters obtained from aortic distension waveforms were analyzed using linear regression analysis.Results:  With a change in cardiac contractility, the maximum value of first derivative of the systolic rising slope in the aortic distension waveform had a positive correlation with Max dP/dt (r = 0.93, P < 0.0001). With changes in fetal blood pressure, both the amplitude and the ratio of increase from the end diastolic diameter obtained from the aortic distension waveform had a significant positive correlation with aortic blood pressure amplitude (r = 0.60, P < 0.01; r = 0.61, P < 0.01, respectively).Conclusion:  The maximum first derivative of the systolic rising slope in the aortic distension waveform and the amplitude in the aortic distension waveform enable us to non‐invasively substitute for fetal cardiac contractility and aortic blood pressure amplitude, respectively.
Inhibition of matrix metalloproteinase‐2 secretion and invasion by human ovarian cancer cell line SK‐OV‐3 with lysine, proline, arginine, ascorbic acid and green tea extract
Authors: Roomi M. Waheed , Ivanov Vadim , Kalinovsky Tatiana , Niedzwiecki Aleksandra , Rath Matthias 
Published: March 2006

AbstractAims:  Based on the poor prognosis associated with ovarian cancer and reported anticancer properties of specific nutrients, we investigated the effect of a nutrient mixture (NM) containing lysine, proline, arginine, ascorbic acid and epigallocatechin gallate on human ovarian cancer cells SK‐OV‐3 by measuring: cell proliferation, modulation of matrix metalloproteinase (MMP)‐2 and ‐9 expression, and cancer cell invasive potential.Methods:  Cell proliferation was evaluated by MTT assay, MMP activity by gelatinase zymography, and invasion through Matrigel.Results:  Human ovarian cancer cell growth was not significantly affected by the NM. Zymography demonstrated inhibition of MMP‐2 secretion in a dose‐dependent fashion with virtual total inhibition at 50 µg/mL NM concentration. Invasion of human ovarian cancer cells through Matrigel decreased in a dose‐dependent fashion, with 90% inhibition at 500 µg/mL NM and 100% inhibition at 1000 µg/mL NM (P < 0.0001).Conclusion:  The combination of lysine, proline, arginine, ascorbic acid and green tea extract tested inhibited critical steps in cancer development and spread, such as MMP expression and invasion, indicating its potential as a treatment modality against ovarian cancer.
An evaluation of the economic costs and patient‐related consequences of treatments for benign prostatic hyperplasia
Authors: DISANTOSTEFANO RACHAEL L. , BIDDLE ANDREA K. , LAVELLE JOHN P. 
Published: March 2006

OBJECTIVETo compare the costs and effectiveness of treatments for benign prostatic hyperplasia (BPH), including watchful waiting, pharmaceuticals (α‐blockers, 5‐α‐reductase inhibitors, combined therapy), transurethral microwave thermotherapy (TUMT), and transurethral resection of the prostate (TURP).PATIENTS AND METHODSThis study used a Markov model over a 20‐year period and the societal perspective to evaluate the costs of treatment alternatives for BPH. Markov states include urinary symptom improvement, symptom improvement with adverse effects, or no urinary symptom improvement. For the analysis, patients could remain on their initial treatment, change to a different treatment, have treatment failure that required TURP, or die (all‐cause mortality). We used published data for outcomes, including systematic reviews when possible. Costs were estimated using a managed‐care claims database and Medicare fee schedules. Costs and effectiveness outcomes were discounted at 3%/year where appropriate. Men (aged ≥ 45 years) with moderate‐to‐severe lower urinary tract symptoms and uncomplicated BPH were included in the analysis, and results were stratified by age. Outcomes include costs, disease progression, surgery, hospitalization, and catheterization time.RESULTSWhat is the ‘best’ treatment depends on the value that an individual and society place on costs and consequences. α−Blockers are less expensive than the alternatives, and are effective at relieving patient‐reported symptoms. Unfortunately, they have little effect on clinical outcomes and have the highest BPH progression rate. Other treatments have lower disease progression and better clinical outcomes, but are more expensive and entail more invasive treatments, and/or more uncertainty.CONCLUSIONSTreatment decisions are made using a variety of information, including the cost and consequences of treatment. The best treatment depends on the patient's preference and the outcome considered most important. α‐Blockers are very effective at treating urinary symptoms but do not improve clinical outcomes, including disease progression, relative to other treatments. TURP remains the ‘gold standard’ for surgical procedures. The desire to avoid TURP or the 2 weeks of catheterization associated with TUMT might affect a patient's treatment decision when symptoms are severe. Therefore, more information about patient preferences and risk aversion is needed to inform treatment decision‐making for BPH.
Institutional variability in the accuracy of urinary cytology for predicting recurrence of transitional cell carcinoma of the bladder
Authors: KARAKIEWICZ PIERRE I. , BENAYOUN SERGE , ZIPPE CRAIG , LÜDECKE GERSON , BOMAN HANS , SANCHEZ‐CARBAYO MARTA , CASELLA ROBERTO , MIAN CHRISTINE , FRIEDRICH MARTIN G. , EISSA SANAA , AKAZA HIDEYUKI , HULAND HARTWIG , HEDELIN HANS , RUPESH RAINA , MIYANAGA NAOTO , SAGALOWSKY ARTHUR I. , MARBERGER MICHAEL J. , SHARIAT SHAHROKH F. 
Published: March 2006

OBJECTIVETo assess the contemporary inter‐institutional accuracy of urinary cytology in predicting the recurrence of transitional cell carcinoma (TCC) of the bladder, in a large multi‐institutional cohort from four continents, as cystoscopy and urinary cytology represent the ‘gold standards’ for surveillance of TCC recurrences, but the ability of cytology to predict recurrence varies.PATIENTS AND METHODSTen institutions contributed 2542 patients with a history of superficial TCC, of whom 898 had TCC recurrence. Age‐ and gender‐adjusted logistic regression models were used to evaluate the association between urine cytology and TCC recurrence. The predictive accuracy derived from the logistic regression model was tested using the area under the receiver operating characteristic curve. The resulting predictive accuracy estimates were internally validated with 200 bootstrap re‐samples.RESULTSThe mean (range across institutions) age of the patients was 65 (48–69) years and 75 (67–87)% were men. Cytology was positive in 19 (10–38)% of patients; recurrence was identified in 35 (27–54)% of patients. The sensitivity was 38–65% across institutions. Urinary cytology varied significantly in its ability to predict recurrence of bladder cancer. Institution‐specific predictive accuracy adjusted for gender and age was 0.627–0.893. Stratifying by grade and stage only partly attenuated the discrepancies between centres.CONCLUSIONSThe variability of urinary cytology results was very appreciable among the 10 centres and ranged from poor (63%) to excellent (89%).
Patterns of practice in the management of prostate cancer: results from multidisciplinary surveys of clinicians in Australia and New Zealand in 1995 and 2000
Authors: CHONG COLIN C.W. , AUSTEN LYNETTE , KNEEBONE ANDREW , LALAK ANDRE , JALALUDIN BIN 
Published: March 2006

OBJECTIVETo investigate and compare patterns of practice in prostate cancer management in Australia and New Zealand from 1995 to 2000, as there are insufficient randomized trials to guide clinicians in the management of prostate cancer.SUBJECTS AND METHODSThis study represents the two largest published surveys of Australian and New Zealand clinicians dealing with prostate cancer. We sent structured questionnaires on the management of prostate cancer patients to 804 urologists, radiation oncologists and medical oncologists in Australia and New Zealand in December 2000. We compared responses to a similar survey of 579 specialist clinicians in 1995.RESULTSThe response rates were 56% in 1995 and 62% in 2000. In the management of clinically localized disease, the proportion recommending surgery or radiotherapy remained relatively constant between 1995 and 2000, although there was an increase in the use of brachytherapy and adjuvant hormonal therapy, and a reduced tendency to treat pelvic nodes. In the treatment of locally advanced disease, there was an increased use of hormonal treatment and local radiotherapy, with a reduction in the use of total androgen blockade and orchidectomy. In managing positive margins after prostatectomy, there was a clear lack of consensus, with a wide variety of treatment options proposed.CONCLUSIONSPractice has changed in several areas in 2000 compared to 1995, but not all changes were influenced by the publication of randomized trials or evidence‐based guidelines.
Testosterone and erectile function recovery after radiotherapy and long‐term androgen deprivation with luteinizing hormone‐releasing hormone agonists
Authors: WILKE DEREK R. , PARKER CHRIS , ANDONOWSKI ADAM , TSUJI DEBBIE , CATTON CHARLES , GOSPODAROWICZ MARY , WARDE PADRAIG 
Published: March 2006

OBJECTIVETo study the recovery of testosterone levels and erectile function in men who received radiotherapy plus long‐term adjuvant androgen deprivation (LTAD) with luteinizing hormone‐releasing hormone (LHRH) agonists.PATIENTS AND METHODSFrom April 2000 to July 2001, men who had completed prostate radiotherapy with ≥ 2 years of LTAD, and had their last LHRH agonist injection at least 6 months before, were invited to participate. At study entry, the men completed the International Index of Erectile Function (IIEF), and their serum total testosterone (TT), prostate‐specific antigen, LH, follicle‐stimulating hormone, haemoglobin, and body mass were measured. This assessment was repeated at 1 year.RESULTSIn all, 20 men were recruited, with a mean (range) age of 70 (55–81) years. Defining a normal TT level as ≥ 8.0 nmol/L, the median time to a normal level was 2.3 years (95% confidence interval (CI), 1.9–4.2). The median duration of castrate TT levels was 8 months (95% CI, 6.2–14.9). LH recovered before TT, suggesting that the rate‐limiting step in the recovery of TT may be at the testicular level. The median time to recovery of normal LH levels was 3.8 months, compared to 8.0 months to reach supracastrate TT levels, and 2.3 years to reach normal TT levels. Age and the LH/TT ratio were associated with the time to recovery of both supracastrate and normal levels of TT. The IIEF was completed by 17 men; there were no significant changes in the scores in any domain of the IIEF during the study.CONCLUSIONSMost men recover supracastrate testosterone levels after LTAD and external beam radiotherapy, but recovery of ‘normal’ testosterone levels is slow. Few men recover potency and sexual desire. The patients age and LH/TT ratio may be predictive of the time to recovery of both supracastrate and normal testosterone levels.
Pinpoint papular variant of polymorphous light eruption: clinical and pathological correlation
Authors: Bansal I , Kerr H , Janiga JJ , Qureshi HS , Chaffins M , Lim HW , Ormsby A 
Published: March 2006

AbstractBackground  Polymorphous light eruption (PMLE) is the most common chronic idiopathic photodermatosis usually manifesting as a papular eruption along with several other morphological variants including a pinpoint papular variant.Methods and materials  Between June 1998 and August 2003, 10 PMLE patients presented to the Department of Dermatology at Henry Ford Hospital with complaints of a pruritic pinpoint papular eruption associated with sun exposure. In six patients skin biopsies were performed along with a detailed history and complete skin examination. We correlated the histology with the clinical course of disease corresponding to acute and subacute disease presentation. We also performed immunohistochemistry on three cases to study the immunophenotype in PMLE.Results  The clinical, histologic and immunostain findings are summarized. Acute: Clinically pinpoint papules and vesicles, some with erythematous base, were seen. Histology showed focal vesicle formation, spongiosis, oedema, red blood cells extravasation, and superficial and deep perivascular and interstitial lymphocytic infiltrate with occasional eosinophils. Subacute: Clinically pinpoint papules with or without erythema were seen. Histology of the pinpoint lesion showed a nodular collection of lymphocytes and histiocytes with claw‐like extension of epidermal rete ridges at the lateral boundaries of the lesion. Overlying epidermal atrophy with adjacent spongiosis, exocytosis, oedema and a superficial perivascular lymphocytic infiltrate and parakeratosis was also observed. The histologic differential diagnosis included lichen nitidus. Immunohistochemical stains revealed the following results: CD8, CD68 positive, CD4 variable (strongly positive to negative) and S‐100 negative.Conclusion  (i) Pinpoint papular variant of PMLE is a distinct entity, which shows characteristic histology corresponding to the clinical course of the disease (acute and subacute). (ii) The histologic and immunophenotypic differential diagnosis of this variant during the subacute phase includes lichen nitidus.
Necrotizing fasciitis: a deadly infection
Authors: Kihiczak GG , Schwartz RA , Kapila R 
Published: March 2006

AbstractNecrotizing fasciitis (NF) is a life‐threatening condition, consisting of a soft‐tissue infection with rapidly progressive, widespread fascial necrosis. NF may be caused by a wide variety of microbes. Indeed, NF may be an infection of one species of bacteria or may be polymicrobial. Prompt diagnosis and treatment are essential. Surgical debridement and antibiotic therapy are the primary treatment options.
Rocky Mountain spotted fever
Authors: Lacz NL , Schwartz RA , Kapila R 
Published: March 2006

AbstractRocky Mountain spotted fever (RMSF) is an unusual but important dermatological condition to identify without hesitation. The classic triad of headache, fever, and a rash that begins on the extremities and travels proximally to involve the trunk is found in a majority of patients. The cutaneous centripetal pattern is a result of cell to cell migration by the causative organism Rickettsia rickettsii. Such individuals should receive prompt antimicrobial therapy and supportive care to avoid serious and potentially fatal complications.
Exercise‐induced vasculitis
Authors: Ramelet A‐A 
Published: March 2006

AbstractBackground  Usually misdiagnosed and ignored in the literature, exercise‐induced vasculitis (EIV) is not uncommon, occurring mostly in long‐distance runners and in females after long walks, especially in hot weather.Observations  I report 23 otherwise healthy patients (22 females, 1 male) who developed EIV after walking or hiking in hot weather. Erythematous, urticarial or purpuric plaques arose on the lower legs, not involving skin compressed by socks. Symptoms included itch, pain, and burning sensation. Lesions resolved after some days. Relapses were frequent at further muscular exercise, and could be prevented in some cases by compression hosiery, manual lymphatic drainage, intake of oedema protective agents, or steroids (local or systemic).Investigations  Histopathology demonstrated leucocytoclastic vasculitis in five biopsies, and urticarial vasculitis in one. Extensive blood investigations have been performed in six patients and were negative. No clear relation with chronic venous disease (duplex or Doppler) had been established in 12 patients.Conclusions  I suggest denominating this condition exercise‐induced vasculitis. This clinical entity is well defined, but poorly recognized. The presentation of 23 original cases demonstrates its reality.
The Tulip classification of perinatal mortality: introduction and multidisciplinary inter‐rater agreement
Authors: Korteweg FJ , Gordijn SJ , Timmer A , Erwich JJHM , Bergman KA , Bouman K , Ravise JM , Heringa MP , Holm JP 
Published: March 2006

Objective  To introduce the pathophysiological Tulip classification system for underlying cause and mechanism of perinatal mortality based on clinical and pathological findings for the purpose of counselling and prevention.Design  Descriptive.Setting  Tertiary referral teaching hospital.Population  Perinatally related deaths.Methods  A classification consisting of groups of cause and mechanism of death was drawn up by a panel through the causal analysis of the events related to death. Individual classification of cause and mechanism was performed by assessors. Panel discussions were held for cases without consensus.Main outcome measures  Inter‐rater agreement for cause and mechanism of death.Results  The classification consists of six main causes with subclassifications: (1) congenital anomaly (chromosomal, syndrome and single‐ or multiple‐organ system), (2) placenta (placental bed, placental pathology, umbilical cord complication and not otherwise specified [NOS]), (3) prematurity (preterm prelabour rupture of membranes, preterm labour, cervical dysfunction, iatrogenous and NOS), (4) infection (transplacental, ascending, neonatal and NOS), (5) other (fetal hydrops of unknown origin, maternal disease, trauma and out of the ordinary) and (6) unknown. Overall kappa coefficient for agreement for cause was 0.81 (95% CI 0.80–0.83). Six mechanisms were drawn up: cardio/circulatory insufficiency, multi‐organ failure, respiratory insufficiency, cerebral insufficiency, placental insufficiency and unknown. Overall kappa for mechanism was 0.72 (95% CI 0.70–0.74).Conclusions  Classifying perinatal mortality to compare performance over time and between centres is useful and necessary. Interpretation of classifications demands consistency. The Tulip classification allows unambiguous classification of underlying cause and mechanism of perinatal mortality, gives a good inter‐rater agreement, with a low percentage of unknown causes, and is easily applicable in a team of clinicians when guidelines are followed.