bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anesthetic management of staged separation of craniopagus conjoined twins1
Authors: GIRSHIN MICHAEL , BRODERICK CARLENE , PATEL DARSHANA , CHACKO SABEENA , REDDY SHAMANTHA , STAFFENBERG DAVID , GOODRICH JAMES , WASNICK JOHN 
Published: February 2006

SummaryWe present a case of successful separation of craniopagus conjoined twins. The procedure was staged to permit each child to develop adequate independent cerebral venous drainage and to prevent deleterious, perioperative cerebral edema. Surgical hemorrhage, blood product delivery, and hemodilution were minimized.
1  A novel approach to decision support for men diagnosed with prostate cancer: the proscan study
Authors: STEGINGA S.K. , CLUTTON S. , GARDINER R.A. , NICOL D.L. , HEATHCOTE P. , JAMES T. , WOOD G. , YAXLEY J. 
Published: February 2006

Introduction:  Men diagnosed with prostate cancer experience a range of psychosocial and physical difficulties, and in particular high levels of decision‐related distress. There is a need for a robust, theory based and targeted intervention to address men's needs at diagnosis and during the acute phase of rehabilitation.Methods:  In previous research we found that cancer threat appraisal predicts decision‐related and psychological distress and further that threat appraisal also predicts the trajectory of adjustment over time. Specifically, as men's cancer threat appraisal becomes more negative, their adjustment trajectory worsens. This finding offers great hope for the malleability of outcomes and their potential for response to intervention. Accordingly, we integrated psycho‐education and decision support in a novel intervention for men newly diagnosed with prostate cancer.Results:  In a pilot study men newly diagnosed with localised prostate cancer reported clinically lower decision‐related distress (P = 0.001) after the intervention suggesting a moderate effect size. Further to this, to date 250 men have been recruited (86% participation) to a randomised control trial of the intervention. Patterns of care and baseline data for these men will also be presented.Conclusion:  Psychosocial interventions for men with prostate cancer need to be finely tuned to the treatment experience and flexible to articulate effectively with men's varied individual decision making processes and clinician practices. The need for this approach will only increase as diagnostic methods further develop and treatment options continue to be the subject of debate.
10  What factors predict biochemical recurrence after radical retropubic prostatectomy?
Authors: O'MALLEY P.J. , HAWIZY A. , HURLE R.A. , REES J. , HUGHES O. , KYNASTON H. 
Published: February 2006

Objectives:  Several factors can predict biochemical recurrence (BCR) after radical retropubic prostatectomy (RRP). Our objective was to review these factors in our practice and whether preoperative MRI stage is an additional factor.Patients and Methods:  Data was collected prospectively from over 800 patients who attended an early prostate cancer clinic between Feb 1997–Sept 2005. 279 patients underwent RRP (14 excluded). BCR was defined as any PSA level >0.2 ng/ml at any time post operatively. Probability estimates for BCR were calculated using the Kaplan–Meier method. Log Rank and Cox proportional hazard regression ratios were used to compare the results.Results:  Median follow up was 23 months (range 3–115 months) and 10% (25/265) of patients developed BCR. Margin positivity (P = 0.001) Gleason score (P = 0.008) and preoperative MRI stage (P = 0.04) were significant predictors for BCR on univariate analysis. However, clinical stage, PSA and final pathology stage were not significant predictors of BCR. On multivariate analysis only margin positivity and Gleason score remained significant.Conclusion:  Patients with Gleason ≥7, positive surgical margins at surgery and visible tumour on MRI are at a higher risk of BCR. Adjuvant treatments should be considered in such patients.
16  Kallikrein 15 (KLK15) in prostate cancer: in silico analysis and single nucleotide polymorphism verification
Authors: KEDDA M.A. , SKEIE L.M. , SMITH R.L.G. , HIGGINS M. , SPURDLE A.B. , YAXLEY J. , STEGINGA S. , CLEMENTS J.A. 
Published: February 2006

Introduction:  Prostate cancer is the most common cancer in Caucasian men and there is strong evidence that kallikreins are part of an enzymatic cascade pathway activated in this disease. Altered KLK15 expression has been associated with cancer progression and grade and we postulate that single nucleotide polymorphisms (SNPs) in the KLK15 gene, will alter gene expression and will be associated with prostate cancer susceptibility and prognosis.Materials and Methods:  We have used in silico prediction of function of wildtype and variant promoter sequences through assessment of hormone receptor elements and transcription factor binding sites; as well as prediction of likely splice variants through genomic, splicing and EST databases and web sites, and multiple sequence alignment packages. We have also used PCR and sequence analysis to further characterise the promoter region of the gene.Results:  In silico analysis of the KLK15 gene has identified the following: two putative promoter regions, two putative androgen response elements (AREs) and four putative estrogen response elements (EREs); two clusters of cis elements; and 109 SNPs. Forty‐seven SNPs alter transcription factor sites (22 gain sites), 20 gain/increase probability of an ERE and three alter nuclear hormone receptor binding sites. Three new EST clones have been identified by analysis of gene expression in CGAP databases and suggest a new KLK15 splice variant, with a different start site.Conclusion:  We have identified a number of new SNPs in the KLK15 gene, which may be functionally important and, in collaboration with the Queensland Cancer Fund (ProsCan Study), we will further investigate the association of these SNPs with prostate cancer risk and prognosis.
18  Prostrate cancer: molecular diagnosis from prostatic fluid
Authors: BURGER M.J. , LANDERS K.A. , ROPER K. , SAMARATUNGA M.L.T.H. , YAXLEY J. , STENING S. , LAVIN M.F. , GARDINER R.A. 
Published: February 2006

Introduction:  Deficiencies in the use of PSA in the diagnosis of prostate cancer have led to research into examining the cellular contents of the prostate more directly. To this end, Bostwick Laboratories now provide a test which assays for PCA3/DD3 RNA (http://www.bostwicklaboratories.com/) from prostatic cells in urine immediately following DRE to provide a sensitivity and specificity as high as 84% and 80%, respectively, for a PSA of 4–10 ng/ml.Methods:  In this study, we are examining four validated RNA markers, Hepsin, PSMA, AMACR as well as PCA3/DD3, in cells from prostatic fluid obtained following DRE and from ejaculate and urines immediately following ejaculation, from men undergoing ≥12 TRUS biopsies for suspected prostate cancer. The ejaculate specimens have been processed using techniques developed on our laboratory which enrich for prostatic cells.Results:  Twenty‐two men have provided specimens of urines following DRE, ejaculate and urine immediately following ejaculation and the findings are being related to those from TRUS biopsies.Conclusion:  Unlike the use of one (albeit a highly discriminating) marker, multiple widely overexpressed markers in prostate cancer promises to detect all patients with malignancy. Furthermore, the relationship of the two methods for obtaining specimens is being evaluated to determine whether one is better than the other as well as the possibility that they are complementary in providing 100% sensitivity and specificity in the detection of this disease.Acknowledgements:  We are indebted to the Australasian Urological Foundation, the Northern Section of Urological Society of Australasia, Queensland Cancer Fund, US Department of Defense and the NHMRC for their support with this project.
2  Are urological cancer patients receiving care in accordance with good practice?
Authors: BROOKS A. , SMITH D. , BERRY M. , KNEEBONE A. , TYNAN K. 
Published: February 2006

Introduction:  The NSW Urology Oncology Program is an initiative of the Cancer Institute NSW bringing together individuals and organisations with an interest in Urological Oncology. The multidisciplinary collaboration will implement the NSW Cancer Plan as it pertains to Urological Oncology. The aim is to utilise the members expertise to determine ‘good practice’ in Urological Oncology and develop practical guidelines and protocols to support service providers. In addition the program will pursue a planned approach to research, education and training.Method:  Expressions of Interest were sought from clinicians, industry representatives, consumers and researchers with an interest in Urological Oncology. Through a series of working parties the members will address the priority issues arising from ‘Patterns of Care’ studies particularly the NSW Cancer Council study for Prostate Cancer. Specific projects are:• Tumour site specific Minimum Data Set• Guidelines and protocol development• Clinical Trials• Research• Education (multidisciplinary education)Outcomes:  A planned and coordinated program underpinned by research, education and training, will progressively reduce mortality from Urological cancer and improve the quality of patient care.Conclusion:  The NSW Urology Oncology Program will provide leadership to deliver a State‐wide planned approach to Urological Oncology in accord with ‘good practice’.
22  A gene promoter hypermethylation panel to detect transitional cell carcinoma of the bladder
Authors: YATES D.R. , REHMAN I. , MEUTH M. , CROSS S.S. , HAMDY F.C. , CATTO J.W.F. 
Published: February 2006

Introduction:  Promoter methylation has been established as a mechanism for silencing of tumour suppressor genes (TSGs) in TCC. Detection of aberrant methylation has been proposed as a novel diagnostic test, but the desired sensitivity and specificity has not been proven. The gene specific nature of methylation necessitates investigators to identify a panel of TSG's, that when analysed for aberrant methylation in tumour DNA, demonstrate a high sensitivity, specificity and diagnostic accuracy for clinical use. Here, we analyse a panel of 16 genes in the DNA of 96 TCCs and 30 samples of normal urothelium.Methods:  DNA was obtained from 96 TCCs and 30 normal bladders. The DNA was bisulphite modified and quantitative methylation specific PCR (QMSP) was performed for 16 gene promoters.Results:  Methylation was detected for all 16 genes in the 96 TCCs. This ranged from 3% to 75%. The genes with the highest frequency of methylation were RASSF1a (54%), E‐cadherin (41%), BCL2 (45%), TNFRS25 (75%), EDNRB (66%), IGFBP3 (43%) and WIF1 (56%). High levels of methylation were detected in the normal controls for RASSF1a (50%) and E‐cadherin (20%), with 11 other genes having low levels of methylation. Using a panel of 5 heavily methylated genes, a sensitivity of 57%, specificity of 89% and a diagnostic accuracy of 80% resulted.Conclusion:  The frequency of methylation varied widely for different genes, confirming the gene specific nature of aberrant methylation in TCC. Using our panel of gene loci, the sensitivity and specificity of methylation DNA analysis was not adequate. However, our study does demonstrate the feasibility of TCC DNA methylation analysis and with the identification of further cancer specific gene loci, it may prove a useful early detection strategy.
25  Interobserver agreement in the evaluation of urine cytology for the detection of urothelial malignancy
Authors: BUCHAN N.C. , CAMPBELL P.A. , SHIELD P. , COSIER J. , COMINOS D. , KERR K. , MACTAGGART P. , NICOL D.L. 
Published: February 2006

Introduction:  Urine cytology is a test used to diagnose and monitor for urothelial malignancy. It is a biological test for which there is no gold standard. The diagnosis offered is based on the subjective interpretation by the cytopathologist viewing the slide. As in all biological systems for which there is no gold standard, the interpretation is subject to clinical disagreement and interobserver variation. The aim of this study is to evaluate the agreement between cytopathologists in the interpretation of urine cytology.Materials and Methods:  Two hundred urine cytology slides were collected over a six month period, from a busy metropolitan pathology firm. The series was made up of four categories, normal, atypical, suspicious for malignancy, and malignant. Each category contained fifty representative slides. The slides were reviewed by two independent reviewers as quality control and masked prior to been given randomly to four raters for assessment. The raters consisted of two screening scientists and two cytopathologists. Each rater received each slide in a random fashion and was asked to independently categorise the slide into one of the above categories. The level of agreement was analysed using Cohen weighted Kappa statistics.Results:  The interobserver agreement in the assessment of urine cytology by cytopathologits in the detection of urothelial malignancy is moderate using Cohen's kappa weighted statistics.Conclusions:  The interobserver agreement in the assessment of urine cytology by cytopathologists is moderate and as such should be born in mind when investigating patients for urothelial malignancy.
28  Bladder dome air bubbles in TURBT: is there any benefit from removing the air bubble at TURBT?
Authors: DELANEY D.P. , OPESKIN K. , WILLIAMS E. , TEMELCOS C. , ASOPA R. , CLARKE A. , NIALL O. , BRENNAN J. , GOAD J. 
Published: February 2006

Introduction:  The recurrent nature of superficial bladder cancer is currently explained by two theories – field change and implantation, with good evidence supporting each theory. Many recurrent tumours occur at the dome of the bladder. It is postulated at transurethral resection of superficial bladder cancer (TURBT) tumour fragments are held within the air bubble that forms at the dome and lead to recurrent tumours. In a pilot study we have shown there are viable tumour cells at the air‐bubble fluid interface. In this study we examine the effects of removing the air‐bubble on reducing tumour fragments in voided urine following TURBT and its effect on tumour recurrence. We have used urine cytology as a surrogate marker of the likelihood of tumour recurrence. Positive urine cytology at day 3 following TURBT has been associated with increased incidence of recurrent tumours.Method:  All patients having a TURBT for primary or recurrent superficial bladder cancer (Ta, T1 and CIS) were entered prospectively. Two groups were examined – group one had a standard TURBT and group two had removal of the air bubble and macroscopic tumour fragments at the end of standard TURBT. All patients then had a voided urine specimen on day 1 postTURBT. The voided urine had quantitative analysis performed. Patients were then followed for tumour recurrence with cystoscopy surveillance.Results:  Formal results to be tabulated.Conclusion:  Removal of the air bubble at the time of TURBT does reduce the incidence of tumour cells in voided urine at day 1 postTURBT.
30  Radical cystectomy for primary bladder malignancy: a 10‐year review
Authors: LOUIE‐JOHNSUN M. , HENRY M. , BRASLIS K. , MURPHY D. , NEERHUT G. , GRILLS R. 
Published: February 2006

Purpose:  Radical cystectomy has long been the gold standard in the definitive management of muscle invasive bladder cancer and preventing stage progression in high risk groups. There are few recent reviews outside of major international centres. We compared our institution's results to published literature.Methodology:  Records of 50 consecutive patients treated with radical cystectomy for biopsy proven bladder carcinoma between 1995 and 2005 were reviewed.Results:  The mean age was 70 years and 76% were male. Median follow up was 37 (1–111) months. 23 patients (46%) had known history of superficial TCC and 12 patients (24%) had previous intravesical therapy. Transitional cell tumours accounted for 94% of cases and most (76%) were poorly differentiated. 24 (48%) had ≥pT3 disease. Regional lymph nodes were involved in 35%. 23 patients (46%) developed recurrence and over half (12 patients) recurred within 12 months. Both lymph node involvement and recurrence were associated with higher pT stage (P < 0.001). All patients with recurrent disease were dead within a year (median 103 days). Median hospital stay was 19 days and there was 1 postoperative death (2%). 5‐year disease free and overall survival were 42% and 34% respectively.Conclusion:  Survival following curative resection for primary bladder malignancy is at best modest. Our overall proportion of higher staged disease contributed to poorer survival rates. An earlier more aggressive approach to definitive treatment may be warranted.
34  In vivo tumour hypoxia and carbonic anhydrase IX expression in xenografted human renal cell carcinoma animal models using probes, 124I‐G250 pet, biodistribution and immunohistochemistry immunobiodistribution, and oxygen studies
Authors: LAWRENTSCHUK N. , MURONE C. , RIGOPOLOUS A. , MOUNTAIN A. , O'KEEFE G. , JONES G. , LEE F.T. , DAVIS I.D. , SCOTT A.M. , BOLTON D.M. 
Published: February 2006

Introduction:  Hypoxia stimulates angiogenesis and has been demonstrated in tumours where it correlates with resistance to treatment and poor prognosis. We have previously demonstrated hypoxia in human Renal Cell Carcinoma (RCC). The purpose of animal models was to further evaluate oxygen levels within RCC whilst also focusing on expression of the protein carbonic anhydrase IX (CA IX). This protein is stimulated by hypoxia and involved in angiogenesis and may be a potential tumour target for imaging and future therapies.Methods:  Balb/c nude mice had human RCC (SK‐RC‐52) xenografted subcutaneously. Tumours were grown to different volumes with oxygen levels measured. Further groups then had the radiolabelled monoclonal antibody 124I‐G250 (that binds to CA IX) injected intravenously and had Positron Emission Tomography (PET), gamma counting and oxygen studies performed on days 0,1,2,3,5,7,10 and 14 post injection. Immunohistochemistry and autoradiography was also performed.Results:  An inverse relationship between tumour volume and hypoxia within the model was established (P < 0.001). Furthermore, CA IX was expressed by tumours with maximal uptake of 124I‐G250 on days 2/3 by distribution with gamma counting that could be correlated with uptake on PET imaging.Conclusions:  The xenograft model confirms human RCC are hypoxic. Also, that the level of hypoxia is inversely proportional to tumour sise. A correlation was made between PET scanning with 124I‐G250 and biodistribution within tumours by gamma counting confirming CAIX as an imaging and potential therapeutic target in RCC.
35  A novel method for transplanting a reproducible volume of xenograft tumour beneath the renal capsule using automated biopsy equipment and an epidural needle
Authors: LAWRENTSCHUK N. , RIGOPOLOUS A. , MURONE C. , LEE F.T. , DAVIS I.D. , SCOTT A.M , BOLTON D.M. 
Published: February 2006

Introduction:  The growth of human tumours under the renal capsule in animal models has been performed successfully for many years. However, the use of modern surgical equipment has not always been translated into the animal laboratory. We report on a novel method for human renal tumour transplants using an automated biopsy gun to obtain tumour tissue and an epidural needle with introducer to easily deploy the grafts under the renal capsule.Methods:  Nude mice had human xenografted tumours grown subcutaneously after implantation of cells from culture. Tumours were then biopsied using a 16 gauge automated biopsy gun. Digital callipers were used to measure a 2 mm segment of the biopsy core that was cut and placed inside a hollow needle (epidural needle). The needle was placed under the renal capsule and the trochar introduced to deploy the graft beneath the capsule with minimal trauma.Results:  Tumour grafts were be established in ninety percent of grafted kidneys in this renal subcapsular model. Grafts were confirmed by direct observation and histology.Conclusion:  Modern surgical equipment may be utilised to allow tumour transplantation to be undertaken in a more precise fashion than has previously been possible, with the volume of deployed tumour able to be identified and reliably reproduced. Surgical researchers and laboratory‐based scientists need to embrace new techniques and utilise them where appropriate in order to allow for a more objective comparison of results of xenograft transplantation.
36  Clinical disagreement in histological diagnosis and pathological stage in a series of nephrectomy specimens: the impact of recent changes to the WHO and TNM systems
Authors: CAMPBELL P.A. , PERRY‐KEENE J. , WILSON I. , MACTAGGART P. , NICOL D.L. , CAMPBELL C.M. 
Published: February 2006

Introduction:  The prognosis and treatment of carcinoma of the kidney is predicted by the histological subtype and the pathological stage of the tumour. These are determined by pathological examination of the surgical specimen and the application of accepted classification and staging systems. We aimed to document how frequently disagreement in diagnosis and staging occurred in a retrospective review of a series of nephrectomy specimens.Materials and methods:  All nephrectomies performed for tumour (all originally diagnosed as ‘renal cell carcinoma’) in the years 1990–1995 were identified. The original pathology report and the archived histological material were re‐examined. Cases were re‐classified using the 2004 WHO histological classification and clear cell renal cell carcinomas (RCC) were re‐staged using the 2002 TNM staging system. The revised and original classifications were compared for disagreement.Results:  One hundred and twenty four (124) nephrectomy specimens were reviewed and a discrepant diagnosis was recorded in 24 (19%). Re‐classification of 123 primary tumours identified 100 clear cell RCC, 1 multilocular cystic clear cell RCC, 9 papillary RCC, 4 chromophobe RCC and 9 oncocytomas. When the 2002 and 1997 TNM stages were compared there was agreement for all cases of pT1a, pT3b, pT3c and pT4 tumours. Four pT1b and 2 pT2 cases were originally staged as pT3a. In 19 cases of pT3a tumours, 2 were originally staged as pT1, 6 as pT2 and 2 as pT3b. This represents a disagreement in 16% of cases (16/97). In 24/60 (40%) cases of organ confined disease, renal sinus fat had not been sampled and a pT3a stage could not be excluded.Conclusion:  A retrospective review of nephrectomy specimens performed for tumour re‐assessed using the 2004 WHO classification and the 2002 TNM staging systems, demonstrated clinical disagreement in 19% and 16% of cases respectively. In 40% of cases of presumed organ confined disease the specimen had not been adequately sampled to exclude pT3a stage disease.