bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complete robotic‐assistance during laparoscopic living donor nephrectomies: An evaluation of 38 procedures at a single site
Authors: Hubert Jacques , Renoult Edith , Mourey Eric , Frimat Luc , Cormier Luc , Kessler Michèle 
Published: September 2007

Objective:  To evaluate our initial experience with entirely robot‐assisted laparoscopic live donor (RALD) nephrectomies.Methods:  From January 2002 to April 2006, we carried out 38 RALD nephrectomies at our institution, using four ports (three for the robotic arms and one for the assistant). The collateral veins were ligated, and the renal arteries and veins clipped, after completion of ureteral and renal dissection. The kidney was removed via a suprapubic Pfannenstiel incision. A complementary running suture was carried out on the arterial stump to secure the hemostasis.Results:  Mean donor age was 43 years. All nephrectomies were carried out entirely laparoscopically, without complications and with minimal blood loss. Mean surgery time was 181 min. Average warm ischemia and cold ischemia times were 5.84 min and 180 min, respectively. Average donor hospital stay was 5.5 days. None of the transplant recipients had delayed graft function.Conclusions:  Robot‐assisted laparoscopic live donor nephrectomy can be safely carried out. Robotics enhances the laparoscopist's skills, enables the surgeon to dissect meticulously and to prevent problematic bleeding more easily. Donor morbidity and hospitalization are reduced by the laparoscopic approach and the use of robotics allows the surgeon to work under better ergonomic conditions.
Body mass index influences prostate‐specific antigen in men younger than 60 years of age
Authors: Kim Yong‐June , Han Byung Kuy , Hong Sung Kyu , Byun Seok‐Soo , Kim Wun‐Jae , Lee Sang Eun 
Published: September 2007

Objectives:  Prostate‐specific antigen (PSA) levels can be affected by many factors. Body mass index (BMI) is suspected to influence PSA levels, but the associations are controversial. The aim of this study was to examine whether PSA levels were affected by BMI and age in Koreans.Methods:  We evaluated the association between BMI and PSA in a group of 8640 Korean men (aged 40–79 years) without prostate cancer who received a general health checkup. Eligible men were classified into age groups spanning 10 years. BMI was categorized as normal (BMI <22.9), overweight (BMI 23.0–24.9), obese (BMI 25.0–29.9), and very obese (BMI ≥30) according to the re‐defined World Health Organization (WHO) criterion for the Asia Pacific Region. PSA levels were stratified by age and BMI category.Results:  Prostate‐specific antigen levels decreased with increasing BMI (P trend <0.001). However, the inverse correlations between PSA and BMI were significant only among men 40–59 years old (P trend <0.05, respectively). BMI showed no significant associations with PSA in 60–79 years old (P trend >0.05, respectively).Conclusions:  Our study demonstrates that increased BMI is associated with decreased PSA levels only in men younger than 60 years of age. When determining whether to carry out prostate biopsy as part of early prostate cancer detection, obesity should be considered as a factor associated with reduced PSA in healthy young men (<60 years old) with marginal PSA levels.
Diagnostic performance of three‐dimensional ultrasound extended imaging at scrotal mass lesions
Authors: Elwagdy Salah , Razmy Samy , Ghoneim Sayed , Elhakim Samy 
Published: September 2007

Objectives:  High resolution two‐dimensional ultrasound (2D US) difficulty in evaluation of some scrotal mass lesions is not frequent. The aim of the present study was to prospectively evaluate the diagnostic performance of three‐dimensional ultrasound extended imaging (3D XI) in characterization of those lesions.Methods:  The study protocol had the approval of the University's review board all participants' informed consents were obtained. The study included 28 selected patients (12 testicular and 16 para‐testicular mass lesions) examined by 2D US and 3D XI applications including computed multi‐slice view (MSV) and multi‐resolution enhanced images (XI MR). Results were correlated with histopathological findings.Results:  Two‐dimensional ultrasound did not adequately characterize 28 patients out of 329 (8.5%). 3D XI interrogation was an easy procedure and distinctive of the pathological findings in 27 patients out of 28 (96.4%). The performance of XI MR with respect to characterization provided additional diagnostic information over MSV.Conclusions:  The performance of 3D XI with respect to testicular mass characterization proved better than static 2D US. Subsequently, the results of this study suggest that the routine use of 2D US in diagnosis of scrotal mass lesions should preferably be upgraded to 3D XI methods.
Bladder sparing approach for initial T1G3 bladder cancer: Do multifocality, size of tumor or concomitant carcinoma in situ matter? A long‐term analysis of 132 patients
Authors: Denzinger Stefan , Otto Wolfgang , Fritsche Hans‐Martin , Roessler Wolfgang , Wieland Wolf F. , Hartmann Arndt , Burger Maximilian 
Published: September 2007

Objectives:  In T1 bladder cancer (BC) multifocality, size of tumor (≥3 cm) and concomitant carcinoma in situ (CIS) are used to stratify patients' risk. We compared the long‐term results in patients with initial T1G3 bc treated with transurethral resection of the bladder (TURB), bacille Calmette‐Guérin (BCG) instillations and repeat resection with special regard to these clinical risk factors. The aim was to determine if they influence the outcome in the bladder sparing approach for initial T1G3 bc.Methods:  One hundred and thirty‐two consecutive patients with initial T1G3 and no prior history of BC were identified. All patients completed six weekly adjuvant BCG instillations followed by control TURB. Follow‐up consisted of cystoscopy with bladder wash cytology every 3 months for 2 years and every 6 months thereafter.Results:  Forty‐two percent of patients had residual disease, 65% developed recurrence of any stage and 41% had progression to muscle‐invasive disease. Cancer‐specific survival was 89% and 78% at 5 and 10 years, respectively. Only CIS was significantly correlated with all end points on multivariate analysis. While the presence of one or two risk factors was not related to recurrence, progression or cancer‐related death, the presence of all three risk factors predicted the latter.Conclusions:  While no guideline has been established for the decision between cystectomy and bladder sparing, concomitant CIS and the presence of all three risk factors together seem to predict an adverse oncological outcome in the bladder sparing approach.
GASTRIC CANCER DETECTED AFTER HELICOBACTER PYLORI ERADICATION
Authors: Tashiro Jun , Miwa Jun , Tomita Takashige , Matsubara Yasuo , Oota Yasuhiko 
Published: September 2007

Background:  Helicobacter pylori is associated with progression to gastric cancer. However, it is still unclear whether eradication therapy can prevent the development of gastric cancer.Methods:  Subjects were 242 patients in whom success in eradication of Helicobacter pylori had been continuous for more than 3 years. Clinical, endoscopic and histological findings were compared retrospectively between those who developed gastric cancer (cancer group) and those who did not (non‐cancer group). Clinical features of each cancer case were also evaluated.Results:  Gastric cancer was found in six of the 242 subjects (2.5%) during a mean follow‐up period of 4.6 years (range: 3.0–7.0). The mean age of the cancer group tended to be higher than that of the non‐cancer group. Endoscopy revealed a more severe grade of gastric corpus atrophy in the cancer group, and histological findings showed that the degree of intestinal metaplasia in the upper corpus was higher in the cancer group. Four of the six cancers were located in the gastric antrum. All were early cancers and five were of 0‐IIc type endoscopically. All were intestinal type histologically.Conclusions:  Gastric cancer was discovered at a rate of 2.5% during the mean follow‐up period of 4.6 years after H. pylori eradication. Careful endoscopic follow up is necessary even after successful eradication, especially in cases characterized by an endoscopically high grade of gastric atrophy and pathologically severe intestinal metaplasia at the upper corpus.
NODULAR GASTRITIS WITH HELICOBACTER PYLORI INFECTION IS STRONGLY ASSOCIATED WITH DIFFUSE‐TYPE GASTRIC CANCER IN YOUNG PATIENTS
Authors: Kamada Tomoari , Tanaka Aki , Yamanaka Yoshiyuki , Manabe Noriaki , Kusunoki Hiroaki , Miyamoto Masaki , Tanaka Shinji , Hata Jiro , Chayama Kazuaki , Haruma Ken 
Published: September 2007

Background:  Nodular gastritis (NG), a particular type of gastritis, is now defined as antral nodularity. Recent studies have shown that NG is strongly associated with Helicobacter pylori infection, and we recently showed that it may be associated with diffuse‐type gastric cancer of the corpus. We retrospectively investigated the relation between NG and gastric cancer in patients aged 29 years or less.Patients and Methods:  The study group comprised 150 patients (48 males, 102 females; mean age, 27.7 years) who were endoscopically diagnosed with NG and were less than 29 years of age; 3939 sex‐ and age‐matched patients without NG who were H. pylori‐positive served as the control group (1184 males, 2755 females; mean age, 27.5 years). We estimated the risk of gastric cancer development in patients with NG relative to that of patients without NG.Results:  The prevalence of gastric cancer was significantly higher in patients with NG than in the control patients (7/150; 4.7% vs 3/3939; 0.08%, P < 0.001). The odds ratio for the risk of gastric cancer in patients with NG was found to be 64.2 (95% confidence interval; 16.4–250.9). The seven cases of gastric cancer with NG showed the same characteristics: all were diagnosed histologically as the diffuse type and were located in the corpus with H. pylori infection.Conclusion:  NG with H. pylori infection is strongly associated with diffuse‐type gastric cancer of the corpus in young patients.
EVALUATION OF THE RISK FACTORS OF LYMPH NODE METASTASIS IN PT1 STAGE COLORECTAL CARCINOMA: INDICATION FOR AN ENDOSCOPIC MUCOSAL RESECTION
Authors: Nakajo Kazuo , Tamura Satoru , Hiroi Makoto , Onishi Saburo , Yasuda Nobufumi 
Published: September 2007

Aim:  In the present study, we aimed to clarify the parameters that can be used for clinically relevant treatment decisions.Patients and methods:  During the period from July 1985 to April 2005, 283 pT1 cancers were selected for this study. Risk factors for lymph node (LN) metastasis were evaluated as follows: endoscopic appearance, tumor size, location, lymphatic permeation, venous invasion, patterns of cancer invasion into the submucosal layer, and depth of vertical invasion in the submucosal layer.Results:  Results of the logistic regression analysis from these significant parameters were as follows: infiltrating growth pattern (odds ratio: 12.63); lymphatic permeation positive (odds ratio: 5.726); sigmoid colon (odds ratio: 4.585); tumor size (odds ratio: 1.718). However, the leading edge of only one cancer with LN metastasis in the expanding growth group was also cribriform pattern.Conclusion:  The invasive growth patterns of infiltrating growth, lymphatic permeation, tumor location of the sigmoid colon, and maximum tumor size were independent and significant risk factors for LN metastasis in our logistic regression analysis. In particular, the former three factors (infiltrating growth, lymphatic permeation and sigmoid colon) revealed high odds ratio and covered all cases of LN metastasis. From the results of our study, the indication for operative intervention after EMR in pT1 cancer is those lesions which possess at least one factor among the three (infiltrating growth, lymphatic permeation and sigmoid colon). Also, assessment of the leading edge with a cribriform pattern should be dealt with carefully.
Weibull analysis, extrapolations and implications for condition assessment of cast iron water mains
Authors: BELMONTE H. M. S. , MULHERON M. , SMITH P. A. 
Published: September 2007

ABSTRACTThe applicability of Weibull statistics to the condition assessment of cast iron water distribution pipes has been considered. The effect of Weibull modulus, characteristic strength, sample size and mode of loading (tension or flexure) on the strength of cast iron water distribution pipes is investigated. The strength distribution of cast iron samples cut from sections of five different water distribution pipes recovered from the ground have been characterized. Strengths have been measured in flexure, at two different temperatures (ambient and 0 °C), and in tension at ambient temperature using two different sample sizes. It is shown that characteristic strength values in flexure decrease with increasing size of graphite flake and that there is no significant difference between the results at the two temperatures investigated. For samples of the same volume tested in tension and flexure, the reduced strength measured in tension is consistent with Weibull predictions. However, the strength of large samples tested in tension was not significantly different from the small samples, perhaps because the samples were of the same thickness and conventional Weibull scaling is not applicable. Finally, using a method which treats a large pipe as an assembly of small samples, the strength distributions from the small samples tested in tension are used to make a prediction of the strengths of 1 m span sections of pipe loaded in three‐point bending, which were reported in previous work. The predicted pipe strengths are close to the lower end of the measured pipe strength distribution. Overall, this work suggests that Weibull analysis is a useful tool to examine the strength distribution of removed from cast iron water pipes and so has the potential to contribute in the assessment of asset condition.
Phylogenetic concordance analysis shows an emerging pathogen is novel and endemic
Authors: Storfer Andrew , Alfaro Michael E. , Ridenhour Benjamin J. , Jancovich James K. , Mech Stephen G. , Parris Matthew J. , Collins James P. 
Published: September 2007

AbstractDistinguishing whether pathogens are novel or endemic is critical for controlling emerging infectious diseases, an increasing threat to wildlife and human health. To test the endemic vs. novel pathogen hypothesis, we present a unique analysis of intraspecific host‐pathogen phylogenetic concordance of tiger salamanders and an emergingRanavirusthroughout Western North America. There is significant non‐concordance of host and virus gene trees, suggesting pathogen novelty. However, non‐concordance has likely resulted from virus introductions by human movement of infected salamanders. When human‐associated viral introductions are excluded, host and virus gene trees are identical, strongly supporting coevolution and endemism. A laboratory experiment showed an introduced virus strain is significantly more virulent than endemic strains, likely due to artificial selection for high virulence. Thus, our analysis of intraspecific phylogenetic concordance revealed that human introduction of viruses is the mechanism underlying tree non‐concordance and possibly disease emergence via artificial selection.
Sanio’s laws revisited. Size‐dependent changes in the xylem architecture of trees
Authors: Mencuccini Maurizio , Hölttä Teemu , Petit Giai , Magnani Federico 
Published: September 2007

AbstractEarly observations led Sanio [Wissen. Bot.,8, (1872) 401] to state that xylem conduit diameters and lengths in a coniferous tree increase from the apex down to a height below which they begin to decrease towards the tree base. Sanio’s law of vertical tapering has been repeatedly tested with contradictory results and the debate over the scaling of conduit diameters with distance from the apex has not been settled. The debate has recently acquired new vigour, as an accurate knowledge of the vertical changes in wood anatomy has been shown to be crucial to scaling metabolic properties to plant and ecosystem levels. Contrary to Sanio’s hypothesis, a well known model (MST, metabolic scaling theory) assumes that xylem conduits monotonically increase in diameter with distance from the apex following a power law. This has been proposed to explain the three‐fourth power scaling between size and metabolism seen across plants. Here, we (i) summarized available data on conduit tapering in trees and (ii) propose a new numerical model that could explain the observed patterns. Data from 101 datasets grouped into 48 independent profiles supported the notions that phylogenetic group (angiosperms versus gymnosperms) and tree size strongly affected the vertical tapering of conduit diameter. For both angiosperms and gymnosperms, within‐tree tapering also varied with distance from the apex. The model (based on the concept that optimal conduit tapering occurs when the difference between photosynthetic gains and wall construction costs is maximal) successfully predicted all three major empirical patterns. Our results are consistent with Sanio’s law only for large trees and reject the MST assumptions that vertical tapering in conduit diameter is universal and independent of rank number.
Grinnellian and Eltonian niches and geographic distributions of species
Authors: Soberón Jorge 
Published: September 2007

AbstractIn the recent past, availability of large data sets of species presences has increased by orders of magnitude. This, together with developments in geographical information systems and statistical methods, has enabled scientists to calculate, for thousands of species, the environmental conditions of their distributional areas. The profiles thus obtained are obviously related to niche concepts in the Grinnell tradition, and separated from those in Elton’s tradition. I argue that it is useful to define Grinnellian and Eltonian niches on the basis of the types of variables used to calculate them, the natural spatial scale at which they can be measured, and the dispersal of the individuals over the environment. I use set theory notation and analogies derived from population ecology theory to obtain formal definitions of areas of distribution and several types of niches. This brings clarity to several practical and fundamental questions in macroecology and biogeography.
Variation in gene content among geographically diverse Sulfolobus isolates
Authors: Grogan Dennis W. , Ozarzak Melissa A. , Bernander Rolf 
Published: September 2007

SummaryThe ability of competitive (i.e., comparative) genomic hybridization (CGH) to assess similarity across entire microbial genomes suggests that it should reveal diversification within and between natural populations of free‐living prokaryotes. We used CGH to measure relatedness of genomes drawn from Sulfolobus populations that had been shown in a previous study to be diversified along geographical lines. Eight isolates representing a wide range of spatial separation were compared with respect to gene‐specific tags based on a closely related reference strain (Sulfolobus solfataricus P2). For the purpose of assessing genetic divergence, 232 loci identified as polymorphic were assigned one of two alleles based on the corresponding fluorescence intensities from the arrays. Clustering of these binary genotypes was stable with respect to changes in the threshold and similarity criteria, and most of the groupings were consistent with an isolation‐by‐distance model of diversification. These results indicate that increasing spatial separation of geothermal sites correlates not only with minor sequence polymorphisms in conserved genes of Sulfolobus (demonstrated in the previous study), but also with the regions of difference (RDs) that occur between genomes of conspecifics. In view of the abundance of RDs in prokaryotic genomes and the relevance that some RDs may have for ecological adaptation, the results further suggest that CGH on microarrays may have advantages for investigating patterns of diversification in other free‐living archaea and bacteria.
Surgery for fistula‐in‐ano: an audit of practise of colorectal and general surgeons1
Authors: Nwaejike N. , Gilliland R. 
Published: September 2007

AbstractObjective  Some conditions, previously managed by general surgeons, may be treated more successfully by colorectal specialists. This argument is well established for rectal cancer but does it also apply to benign conditions? This study compares the treatment strategies and outcomes for fistulae‐in‐ano by general and colorectal surgeons in a district general hospital.Method  Patients who had surgery for fistula‐in‐ano from January 1992–October 2003 were identified from theatre records. Case notes were reviewed for data on type of fistula, aetiology, surgery performed and recurrence. All patients were sent a questionnaire requesting details of recurrence and incontinence. The severity of incontinence was assessed using the Faecal Incontinence Quality of Life Scale (FIQOLS) and the Faecal Incontinence Severity Index (FISI).Results  Eighty four patients (male = 53) were identified. Colorectal surgeons performed surgery in 34 and general surgeons in 50 patients. These groups were comparable with terms of age, gender, aetiology (colorectal: IBD = 5, cryptoglandular = 21: general IBD = 14, cryptoglandular = 24; P = 0.28; Chi‐squared test), and type of fistulae (colorectal: inter‐sphincteric = 20, trans‐sphincteric = 13: general inter‐sphincteric = 30, trans‐sphincteric = 18: P = 1.0; Fisher's exact test). Colorectal surgeons carried out fewer fistulotomies (47.1%vs 84.0%; P < 0.001; Fisher's exact test), more staged fistulotomies with Setons (44.1%vs 10.0%: P < 0.001; Fisher's exact test), and had fewer recurrences (9.7%vs 30.0%: P < 0.05; Fisher's exact test) when compared with general surgeons. Five patients with recurrence from the general surgery group were subsequently referred to the colorectal surgeons; four patients had further surgery (fistulotomy = 2; staged fistulotomy = 2) with no recurrence to date; one patient required proctectomy. Forty seven (64.4%) patients answered the questionnaire. There was no difference between patients operated on by colorectal or general surgeons with regards the frequency (43.5%vs 62.5%: P = 0.25; Fisher's exact test) or severity [FISI 26 (21–38); median (inter‐quartile range) vs 26 (17–38); median (inter‐quartile range: P = 0.85; Mann–Whitney test) of faecal incontinence. There was no difference between the groups with regards any of the four scales that comprised the FIQOLS.Conclusions  The number of included patients is far too low to draw any conclusions but there were some interesting trends. For similar patient samples, colorectal surgeons seem to adopt a more conservative approach and have fewer recurrences than general surgeons. These differences are not reflected in the frequency or severity of postoperative incontinence.