bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracellular matrix metalloproteinase inducer is expressed in the proximal tubular epithelial cells of the human kidney
Authors: SHIMADA MICHIKO , YAMABE HIDEAKI , OSAWA HIROSHI , NAKAMURA NORIO , KUMASAKA RYUICHIRO , MURAKAMI REIICHI , FUJITA TAKESHI , OSANAI TOMOHIRO , OKUMURA KEN 
Published: November 2008

SUMMARYAim:  Matrix metalloproteinases (MMP) affect matrix remodelling, and extracellular matrix metalloproteinase inducer (EMMPRIN) has been reported to increase the levels of several MMP. However, the expression of EMMPRIN in the human kidney and its regulatory mechanisms are not well known. In this study, we examined EMMPRIN expression in the human kidney with the biopsied specimens, cultured proximal tubular epithelial cells (PTEC) and human mesangial cells (HMC).Methods:  EMMPRIN expression was examined by immunofluorescent (IF) study, reverse transcription polymerase chain reaction, western blotting and enzyme‐linked immunosorbent assay. We also examined soluble EMMPRIN in the conditioned medium of PTEC stimulated by various agents and its effect in the activities of MMP‐2 and MMP‐9. Also, IF study in the several kidney diseases was performed to elucidate its role in pathological condition.Results:  EMMPRIN expression was diffusely observed in the tubular epithelial cells of most patients and healthy adults, but was never observed in glomeruli. Cultured PTEC expressed EMMPRIN, while HMC did not. Soluble EMMPRIN was also detected by enzyme‐linked immunosorbent assay in the conditioned medium of PTEC. Epidermal growth factor (50 ng/mL) and phorbol 12‐myristate 13‐acetate (10−7 mol/L) stimulated the secretion of soluble EMMPRIN and increased the MMP‐2 activity, although these agents did not increase the level of EMMPRIN mRNA. From the IF study, EMMPRIN expression was shown to decrease in tubulointerstitial nephritis.Conclusion:  EMMPRIN is widely distributed in the tubular epithelial cells of the adult human kidney and may regulate MMP‐2 activity via its secretion from PTEC.
Mobilizing Foucault: history, subjectivity and autonomous learners in nurse education
Authors: Darbyshire Chris , Fleming Valerie EM 
Published: November 2008

In the past 20, years the impact of progressive educational theories have become influential in nurse education particularly in relation to partnership and empowerment between lecturers and students and the development of student autonomy. The introduction of these progressive theories was in response to the criticisms that nurse education was characterized by hierarchical and asymmetrical power relationships between lecturers and students that encouraged rote learning and stifled student autonomy. This article explores how the work of Michel Foucault can be mobilized to think about autonomy in three different yet overlapping ways: as a historical event; as a discursive practice; and as part of an overall strategy to produce a specific student subject position. The implications for educational practice are that, rather than a site where students are empowered, nurse education is both a factory and a laboratory where new subjectivities are continually being constructed. This suggests that empowering practices and disciplinary practices uneasily co‐exist. Critical reflection needs to be directed not only at structural dimensions of power but also on ourselves as students and lecturers by asking a Foucauldian question: How are you interested in autonomy?
Septic arthritis and acute hematogenous osteomyelitis in childhood at a tertiary hospital in Japan
Authors: Yamagishi Yoshiaki , Togawa Masao , Shiomi Masashi 
Published: November 2008

AbstractBackground:  The aim of the present study was to describe the clinical features of septic arthritis (SA) and acute hematogenous osteomyelitis (AHO) in children and to assess the impact of health‐care‐associated infections and antimicrobial resistance.Methods:  A retrospective review of medical records of children presenting to Osaka City General Hospital with SA and AHO was undertaken during an 85 month period. The following data were assessed: location at onset, age and gender, risk factors, involved joints and/or bones, symptoms and time of presentation, causative agents and sensitivity to antibiotics, treatments and late complications.Results:  There were four health‐care‐associated (HCAI) and 20 community‐acquired infections (CAI). The latency period from initial presentation to diagnosis was relatively longer in HCAI than CAI. The most common pathogen was methicillin‐resistant Staphylococcus aureus (MRSA). Twenty percent of CAI patients and half of the HCAI patients were treated empirically for MRSA. All patients with complications had MRSA infection.Conclusion:  Many pediatric patients with SA were not treated initially with optimal antibiotics. Although surgical intervention was almost inevitably required, selection and administration of effective antibiotics was necessary not only to cure the current infection but also to prevent metastatic infection. In Japan, empiric treatment of SA and AHO should include first‐line antibiotics against MRSA.
Short‐term efficacy of tacrolimus ointment and impact on quality of life
Authors: Kondo Yasuto , Nakajima Yoichi , Komatsubara Ryo , Kato Makiko , Hirata Noriko , Matuyama Haruko , Kakami Michiko , Tsuge Ikuya , Ohya Yukihiro , Urisu Atsuo 
Published: November 2008

AbstractBackground:  Topical calcineurin inhibitor (TCI) was reported to be an effective therapeutic agent for patients with atopic dermatitis (AD), for not only improving clinical findings but also for reducing pruritus. Recently in Japan tacrolimus ointment (0.03%) as a TCI was approved for use in children aged ≥2 years. There have been no reports, however, on the impact of TCI on quality of life (QOL) in pediatric AD in Japan. The purpose of the present study was therefore to evaluate the efficacy of tacrolimus ointment (0.03%) in the short‐term and the impact on patient QOL.Methods:  A total of 30 pediatric patients with AD, whose skin problems were not sufficiently controlled by mid‐high potency topical glucocorticosteroids, were enrolled. Efficacy was assessed on score of cutaneous findings, pruritus, sleeping disorder, and QOL.Results:  Three patients discontinued because of skin burning (n = 1), generalized herpes infection (n = 1), and feeling of lack of efficacy (n = 1), leaving a final total of 27 patients who were evaluated. Significant improvements in clinical findings, pruritus, and sleeplessness were observed within 1 week of treatment and consequently each QOL category was also improved. These improvements continued for the duration of the study.Conclusions:  Tacrolimus ointment therapy is rapidly effective for not only clinical symptoms (cutaneous findings, pruritus and sleeplessness) but also in QOL of AD pediatric patients aged 2 years.
Nature of subretinal fluid in patients undergoing vitrectomy for macular hole: a cytopathological and optical coherence tomography study
Authors: Herbert Edward N , Sheth Hiten G , Wickremasinghe Sanjeewa , Luthert Philip J , Bainbridge James , Gregor Zdenek J 
Published: November 2008

AbstractBackground:  Outer retinal defects (ORDs) may occur after surgical closure of full thickness macular holes (FTMH) and be associated with delayed visual recovery. This may be due to the nature of the subretinal fluid (SRF) cuff and/or the loss of retinal elements.Methods:  Vitrectomy with internal limiting membrane (ILM) peel was performed for FTMH. After fluid‐air exchange, SRF was either aspirated from the hole (group 1) or left in situ (group 2). The SRF specimens obtained were examined by light microscopy and correlated with optical coherence tomography (OCT).Results:  In group 1, cellular material was found in 6 out of 12 cases. Photoreceptors were seen in 3 and macrophages in 3 cases. Nine of 12 holes closed and ORDs were seen in 3 of these. In group 2, 7 out of 8 holes closed, with 4 having ORD. There was no difference in visual acuity (LogMAR) for closed holes at 3 months between groups 1 (0.61, range 0.3–1) and 2 (0.51, range 0.3–0.78) nor between patients with ORD (0.57, range 0.3–1.0) or without ORD (0.57, range 0.3–1.0).Conclusions:  SRF from FTMH may contain macrophages and photoreceptors. Such photoreceptor loss may contribute to reduced retinal function. ORDs occur commonly in spite of fluid aspiration, but their presence is still compatible with good vision. Aspiration of SRF did not appear to confer added benefit in this series.
Primary angle closure glaucoma: a descriptive study in Scottish Caucasians
Authors: Ng Wai S , Ang Ghee S , Azuara‐Blanco Augusto 
Published: November 2008

AbstractPurpose:  The aim of this study is to describe the ocular and demographic features of Caucasian patients newly presenting with primary angle closure glaucoma and the proportion of workload it represents at a tertiary university hospital glaucoma service.Methods:  A retrospective case notes review was conducted for all Caucasian patients newly diagnosed with narrow angles, primary angle closure, acute primary angle closure and primary angle closure glaucoma that were seen over a period of 2 years. Demographic and ocular variables were compared and statistical analysis was carried out with the paired t‐test and chi‐squared test. Number of primary open angle closure glaucoma and acute angle closure cases were compared with total number of new referrals to the department, new patients diagnosed with glaucoma and population numbers for the North East of Scotland.Results:  One hundred and four patients were analysed. Twenty‐four (23.1%) had narrow angles, 30 (28.8%) had primary angle closure and 50 (48.1%) had primary angle closure glaucoma. Twelve (11.5%) presented with acute primary angle closure. There was no significant difference for gender, age, hypermetropia or visual acuity between groups. Primary angle closure glaucoma constituted 22.9% (50/128) of newly diagnosed glaucoma cases. Based on the 2001 Scotland census, the crude annual incidence of newly diagnosed primary angle closure glaucoma was estimated at 14.8 per 100 000 and 3.6 per 100 000 for acute primary angle closure in the over‐45‐year‐old population.Conclusion:  Our study confirms that primary angle closure glaucoma is uncommon in Caucasians, but not as rare as originally perceived as it makes up a fair proportion (22.9%) of glaucoma workload.
Aetiology of non‐diagnostic renal fine‐needle aspiration cytologies in a contemporary series
Authors: Andonian Sero , Okeke Zeph , VanderBrink Brian A. , Okeke Deidre A. , Sugrue Chiara , Wasserman Patricia G. , Richstone Lee , Lee Benjamin R. 
Published: November 2008

OBJECTIVESTo determine the aetiology of non‐diagnostic renal fine‐needle aspiration cytologies (FNACs) in a contemporary series.PATIENTS AND METHODSWe retrospectively reviewed our institutional database of renal FNACs performed between 1995 and 2005. There were 118 patients with renal lesions that underwent FNAC. Indications for FNAC were indeterminate complex renal cysts, significant medical comorbidities, previous history of malignancy, multiple bilateral renal lesions, and suspected metastatic disease. A cytotechnologist was present during the FNA procedure to perform Diff‐Quik staining and ensure an adequate sample of cells were obtained. Except for seven (six open, one ultrasound‐guided), all of the FNACs were performed with CT guidance.RESULTSThe median (range) number of passes for each FNAC session was 2.7 (1–6). Of the 16 FNACs performed for indeterminate complex renal cysts, nine (56%) were adequate with the cytodiagnosis of benign cysts. Of the seven inadequate specimens, three had benign cysts and another three were non‐diagnostic due to acellularity. Therefore, the technical failure rate was 19% (3/16) for indeterminate complex renal cysts. The last patient had a cytodiagnosis of benign cyst and the final histological diagnosis of renal cell carcinoma (RCC; papilllary, grade III). Therefore, this represents a sampling error (false negative rate) of 0.8% (1/118). For the 102 solid renal masses, 22 (22%) had inadequate specimen by Diff‐Quik staining. The technical failure rate (inability to obtain sufficient epithelial cells) was 16% (16). In 18 patients, immunocytochemistry (ICC) was used to differentiate primary renal parenchymal tumours from others such as transitional cell carcinoma (TCC), lymphoproliferative, colon, and lung. There were two FNACs with misdiagnosis (2%), where ICC was not used. In both, the cytodiagnosis was TCC and the final histological diagnosis was RCC in one and atypical urothelium in another.CONCLUSIONSNon‐diagnostic renal FNACs can be attributed to misdiagnosis (2%), sampling error (0.8%) and technical failure (16%).
Rectal fistulae after salvage high‐intensity focused ultrasound for recurrent prostate cancer after combined brachytherapy and external beam radiotherapy
Authors: Ahmed Hashim U. , Ishaq Ayesha , Zacharakis Evangelos , Shaw Greg , Illing Rowland , Allen Clare , Kirkham Alex , Emberton Mark 
Published: November 2008

OBJECTIVETo report on the high rectal fistula rate associated with salvage high‐intensity focused ultrasound (HIFU) after the failure of combined brachytherapy and external beam radiotherapy (EBRT) for prostate cancer; salvage ablative therapy for prostate cancer is indicated when there is local recurrence after RT, brachytherapy or their combination.PATIENTS AND METHODSWe retrospectively reviewed all men with prostate cancer treated with HIFU between 1 March 2005 and 31 May 2007, and identified five men treated after the failure of both brachytherapy and EBRT for localized prostate cancer.RESULTSThree of the five men had iodine‐seed implantation brachytherapy combined with EBRT as primary treatment, one had high‐dose rate brachytherapy combined with EBRT and one had salvage iodine‐seed brachytherapy for failed EBRT. Three of the five patients developed a recto‐urethral fistula after HIFU.CONCLUSIONSThe high rate of recto‐urethral fistula formation in this group might reflect an impaired blood supply or HIFU‐associated near‐field heating of the rectal wall. Tissue viability and healing might affect this group regardless of the salvage method. Careful patient selection and avoidance of rectal diagnostic biopsies might minimize the risk. Emerging ablative therapies regarded as less invasive than traditional therapies must be used with caution.
Contrast‐enhanced ultrasonography using cadence‐contrast pulse sequencing technology for targeted biopsy of the prostate
Authors: Aigner Friedrich , Pallwein Leo , Mitterberger Michael , Pinggera Germar M. , Mikuz Gregor , Horninger Wolfgang , Frauscher Ferdinand 
Published: November 2008

OBJECTIVETo evaluate contrast‐enhanced ultrasonography (US) using cadence‐contrast pulse sequencing (CPS) technology, compared with systematic biopsy for detecting prostate cancer, as grey‐scale US has low sensitivity and specificity for detecting prostate cancer.PATIENTS AND METHODSIn all, 44 men with suspicious prostate‐specific antigen (PSA) levels and CPS findings were assessed; all had CPS‐targeted and systematic biopsy. Transrectal CPS images were taken with a low mechanical index (0.14). A microbubble contrast agent (SonoVue, Bracco International BV, Amsterdam, the Netherlands) was administered as a bolus, with a maximum dose of 4.8 mL. CPS was used to assess prostatic vascularity. Areas with a rapid and increased contrast enhancement within the peripheral zone were defined as suspicious for prostate cancer. Up to five CPS targeted biopsies were taken and subsequently a 10‐core systematic biopsy was taken. Cancer detection rates for the two techniques were compared.RESULTSOverall, cancer was detected in 35 of 44 patients (80%), with a mean PSA level of 3.8 ng/mL. Lesions suspicious on CPS showed cancer in 35 of 44 patients (80%) and systematic biopsy detected cancer in 15 of 44 patients (34%). CPS‐targeted cores were positive in 105 of 220 cores (47.7%) and in 41 of 440 systematic biopsy cores (9.3%) (P < 0.001). Lesions suspicious on CPS were false‐positive in nine of 44 patients (20%). The mean Gleason score for systematic biopsy was 6.7 and for CPS‐targeted biopsy 6.8 (P > 0.05). The sensitivity of CPS for detecting cancer was 100% (confidence interval, 95%). However, limitations in the series included that only CPS‐positive cases were investigated, and CPS‐targeted biopsy should be evaluated in a more extended biopsy scheme.CONCLUSIONSContrast‐enhanced US using CPS enables excellent visualization of the microvasculature associated with prostate cancer, and can improve the detection of prostate cancer compared with systematic biopsy.
Changes in chromatin phenotype predict the response to hormonal deprivation therapy in patients with prostate cancer
Authors: Mohamed Mahmoud , Greif Philipp A. , Diamond James , Sharafeldin Osama , Maxwell Perry , Montironi Rodolfo , O’Brien Aidan , Young Michael , Hamilton Peter W. 
Published: November 2008

OBJECTIVETo assess the value of studying chromatin organization using high‐resolution digital image analysis to predict the response to hormonal‐deprivation therapy (HDT) in patients with prostate cancer, using pretreatment prostate tissues.MATERIALS AND METHODSA tissue microarray (TMA) was constructed using pretreatment paraffin‐embedded tissues from transurethral resection of the prostate (TURP) samples (48 patients, 96 cores). None of the patients had received any treatment for prostate cancer before TURP. The patients’ medical records for 5 years after treatment were assessed; patients were divided, based on their prostatic specific antigen (PSA) levels after treatment, into those optimally responsive to HDT (14) and those resistant to HDT (34). The latter were further subclassified based on their nadir PSA level. Imaging comprised a calibrated digital image‐analysis system with software for densitometric and texture analysis, the latter being assessed on manually segmented nuclei (≥30 nuclei/core).RESULTSMost of the measured digital texture features assessing chromatin density and distribution were significantly different between the prognostic groups (P = 0.001). In the training set, 12 of 14 HDT‐responsive and 23 (68%) of HDT‐resistant patients were accurately predicted. However, all HDT‐resistant patients with a nadir PSA level of >5 ng/mL were accurately predicted. The overall classification sensitivity was 47%, specificity 94% with a positive predictive value of 85%. However, the sensitivity was 100% between patients optimally responsive to HDT and those poorly responsive with a nadir PSA level of >5 ng/mL.CONCLUSIONQuantitative image analysis of chromatin phenotype showed promising value in predicting before treatment the response to HDT in patients diagnosed with prostatic adenocarcinoma. However, further work using larger data sets is required before adapting the technique in routine clinical practice.
Do nomograms predict aggressive recurrence after radical prostatectomy more accurately than biochemical recurrence alone?
Authors: Schroeck Florian R. , Aronson William J. , Presti Jr Joseph C. , Terris Martha K. , Kane Christopher J. , Amling Christopher L. , Freedland Stephen J. 
Published: November 2008

OBJECTIVETo compare the predictive accuracy (PA) of existing models in estimating risk of biochemical recurrence (BCR) vs aggressive recurrence (BCR with a prostate‐specific antigen, PSA, doubling time, DT, of <9 months).PATIENTS AND METHODSThe study included 1550 men treated with radical prostatectomy (RP) between 1988 and 2007 within the Shared Equal Access Regional Cancer Hospital database. The PA of nine different risk stratification models for estimating risk of BCR and risk of aggressive recurrence after RP was assessed using the concordance index, c.RESULTSThe 10‐year risks of BCR and aggressive recurrence were 47% and 9%, respectively. Across all nine models tested, the PA was a mean (range) of 0.054 (0.024–0.074) points higher for predicting aggressive recurrence than for predicting BCR alone (c = 0.756 vs 0.702). Similar results were obtained in four sensitivity analyses: (i) defining patients with BCR but unavailable PSADT (220) as having aggressive recurrence; (ii) defining these patients as not having aggressive recurrence; (iii) defining aggressive recurrence as a PSADT of <6 months; or (iv) defining aggressive recurrence as a PSADT of <12 months. The improvement in PA was greater for preoperative than for postoperative models (0.053 vs 0.036, P = 0.03).CONCLUSIONAcross nine different models the prediction of aggressive recurrence after RP was more accurate than the prediction of BCR alone. This is probably because current models mainly assess cancer biology, which correlates better with aggressive recurrence than with BCR alone. Overall, all models had relatively similar accuracy for predicting aggressive recurrence.
Could the National Institute for Health and Clinical Excellence guidelines on urodynamics in urinary incontinence put some women at risk of a bad outcome from stress incontinence surgery?
Authors: Agur Wael , Housami Fadi , Drake Marcus , Abrams Paul 
Published: November 2008

OBJECTIVETo evaluate the potential impact of the UK National Institute for Health and Clinical Excellence (NICE) recommendation that preoperative urodynamics are not necessary for women with ‘pure symptoms of stress urinary incontinence’ (SUI), by using data from a population of women referred with lower urinary tract symptoms.PATIENTS AND METHODSIn a retrospective study of 6276 women with UI, from an electronic database at a tertiary referral centre, information was collected and entered into a urodynamics computer database at the time of history taking and before conducting the tests. The database was used to identify women aged 18–80 years who had multichannel cystometry for UI over a 17‐year period (1 January 1990 to 31 December 2006). To apply the NICE criterion of a ‘clearly defined clinical diagnosis of pure SUI’, strict selection criteria were used to identify patients with pure SUI. The reliability of the patients’ history in predicting ‘pure’ urodynamic SUI in patients with ‘pure’ SUI was investigated. The correspondence of the symptomatic diagnosis of pure SUI with the urodynamic findings was assessed, and sensitivity, specificity, positive and negative predictive values were calculated using contingency tables.RESULTSOnly 324 (5.2%) women had pure SUI; moreover, a quarter of those with pure SUI symptoms ultimately had urodynamic diagnoses other than urodynamic SUI, that could affect the outcome of continence surgery.CONCLUSIONThese findings indicate that only a small group of women fulfil the NICE criteria of pure SUI. These strict criteria do not ensure that all women with potentially important urodynamic findings are evaluated accordingly. Therefore, we suggest that this NICE recommendation was unwise and, furthermore, was not based on properly acquired expert opinion.