bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early efficacy of silodosin in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia
Authors: Takao Tetsuya , Tsujimura Akira , Kiuchi Hiroshi , Matsuoka Yasuhiro , Miyagawa Yasushi , Nonomura Norio , Iwasa Atsushi , Kameoka Hiroshi , Kuroda Hideya , Matsumiya Kiyomi , Uchida Kinya , Yoshimura Kazuhiro , Okuyama Akihiko 
Published: September 2008

Objectives:  To evaluate the early efficacy of the α1A‐adrenoceptor selective drug, silodosin, for the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia.Methods:  A total of 68 patients with an International Prostate Symptom Score (IPSS) of ≧8 and a Quality of Life (QOL) index of ≧2 were included. Changes in the IPSS and QOL index were evaluated before and after 1, 2, 3, 4, 5, 6, 7, 14, and 28 days of twice daily oral administration of 4 mg silodosin. Next, changes in IPSS subscores as well as voiding, storage, and post micturition symptoms were assessed. Changes in total IPSS based on symptom severity were also determined.Results:  Total IPSS and QOL index improved significantly from 19.38 ± 7.46, 4.68 ± 1.07 at baseline to 15.81 ± 7.40, 4.22 ± 1.30 at day 1. The subscores of voiding, storage, and post micturition symptoms were significantly decreased from 8.93 ± 3.95, 7.97 ± 3.88, and 2.49 ± 1.70 at baseline to 7.28 ± 4.09, 6.52 ± 3.47, and 2.02 ± 1.56 at day 1, respectively. This trend continued throughout the study. Regardless of severity, total IPSS were significantly decreased at day 1 and maintained throughout the study.Conclusions:  Silodosin may be considered a promising treatment for benign prostatic hyperplasia/lower urinary tract symptom patients.
DEXMEDETOMIDINE FOR SEDATION DURING UPPER GASTROINTESTINAL ENDOSCOPY
Authors: Hashiguchi Kazutoshi , Matsunaga Hisayuki , Higuchi Hideyuki , Miura Soichiro 
Published: September 2008

Background:  A clinical study was conducted to investigate the safety and efficacy of dexmedetomidine for sedation of patients undergoing routine upper gastrointestinal (GI) endoscopy.Methods:  Forty middle‐aged patients who were admitted for medical examination were randomized to receive an initial loading dose infusion of dexmedetomidine 6.0 µg/kg per h over 10 min followed by a maintenance infusion of 0.6 µg/kg per h (group A) or rapid infusion of midazolam 0.05 mg/kg (group B) as sedation for routine endoscopy. Sixty patients did not receive sedative agent (group C). Assessment included measurement of heart rate (HR), blood pressure (BP), oxygen saturation, and endoscopy duration.Results:  There were no statistically significant differences among the groups in baseline characteristics. The level of sedation was similar between groups A and B, and the gag response score was significantly lower in the sedated groups than in group C. Hemodynamic stability was also demonstrated in group A during and after the endoscopic procedure. Increased systolic/diastolic BP was significantly attenuated in group A compared with group C. Interestingly, HR was significantly suppressed in group A than in groups B and C. In groups A and B, SpO2 was decreased compared with group C during and after the procedures; however, there was no significant difference between the two groups. There was no significant difference among the groups with endoscopy duration.Conclusions:  For sedation during upper endoscopy, dexmedetomidine is as safe and effective as midazolam, and it significantly reduces HR and BP during and after the endoscopic procedures.
Resource shifts in Malagasy dung beetles: contrasting processes revealed by dissimilar spatial genetic patterns
Authors: Hanski Ilkka , Wirta Helena , Nyman Toshka , Rahagalala Pierre 
Published: September 2008

AbstractThe endemic dung beetle subtribe Helictopleurina has 65 species mostly in wet forests in eastern Madagascar. There are no extant native ungulates in Madagascar, but threeHelictopleurusspecies have shifted to the introduced cattle dung in open habitats in the past 1500 years.Helictopleurus neoamplicollisandHelictopleurus marsyasexhibit very limited cytochrome oxidase subunit 1 haplotype diversity and a single haplotype is present across Madagascar, suggesting that these species shifted to cattle dung in a small region followed by rapid range expansion. In contrast, patterns of molecular diversity inHelictopleurus quadripunctatusindicate a gradual diet shift across most of southern Madagascar, consistent with somewhat broader diet in this species. The three cattle dung‐usingHelictopleurusspecies have significantly greater geographical ranges than the forest‐dwelling species, apparently because the shift to the currently very abundant new resource relaxed interspecific competition that hinders range expansion in the forest species.
A comparison of white‐light cystoscopy and narrow‐band imaging cystoscopy to detect bladder tumour recurrences
Authors: Herr Harry W. , Donat S. Machele 
Published: September 2008

OBJECTIVETo determine whether narrow‐band imaging (NBI) cystoscopy enhances the detection of non‐muscle‐invasive bladder tumours over standard white‐light imaging (WLI) cystoscopy, as surveillance WLI is the standard method used to diagnose patients with recurrent bladder tumours, but they can be missed by WLI cystoscopy, possibly accounting for early recurrences.PATIENTS AND METHODSWe evaluated 427 patients for recurrent bladder tumours by WLI cystoscopy, followed by NBI cystoscopy as a further procedure, using the same video‐cystoscope. Recurrent tumours visualized by WLI or NBI cystoscopy were mapped, imaged, biopsied and subsequently treated by transurethral resection (TUR) or fulguration. Biopsies or TUR specimens obtained by WLI and NBI were examined separately for presence of tumour.RESULTSIn all, 103 patients (24%) had tumour recurrences; 90 (87%) were detected by both WLI and NBI and another 13 (100%) only by NBI cystoscopy. NBI detected extra papillary tumours or more extensive carcinoma in situ in 58 (56%) patients found to have recurrences. The mean number of recurrent tumours visualized on WLI cystoscopy was 2.3, vs to 3.4 seen on NBI cystoscopy (P = 0.01).CONCLUSIONNBI cystoscopy improved the detection of recurrent non‐muscle‐invasive bladder tumours over standard WLI cystoscopy.
Natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation in a porcine model
Authors: Crouzet Sebastien , Haber Georges‐Pascal , Kamoi Kazumi , Berger Andre , Brethauer Stacy , Gatmaitan Patrick , Gill Inderbir S. , Kaouk Jihad H. 
Published: September 2008

OBJECTIVETo present our laboratory experience with natural orifice translumenal endoscopic surgery (NOTES) renal cryoablation.MATERIALS AND METHODSIn two female farm pigs, we performed four procedures of NOTES renal cryoablation. In each pig, NOTES was performed through a transgastric approach and a transvaginal approach for each kidney, respectively. The pig was placed in the flank position and pneumoperitoneum obtained using a transabdominal Veress needle. In the first pig, we started with the left kidney with a transgastric approach: a dual‐channel video gastroscope (Olympus, Tokyo, Japan) was used, the stomach wall was punctured using a needle‐knife, a guidewire was passed into the abdominal cavity and the access dilated using a controlled radial expansion balloon. The bowel was mobilized medially and the Gerota’s fascia overlying the upper pole was dissected. Under direct endoscopic vision, a cryoablation probe was introduced percutaneously into the anterior upper pole of the kidney. The pig was then flipped to the right flank position and a transvaginal approach was used: the gastroscope was introduced through the posterior fornix of the vagina. For the second pig, we performed initially a transgastric right‐side cryoablation then a transvaginal left‐side cryoablation as described for the first pig.RESULTSAll four procedures were performed successfully, with no intraoperative complications. No additional laparoscopic ports or open conversions were necessary. The vision of the kidney and the ice‐ball was adequate for all cases. The mean operative duration was 83 min. Stomach closure was tested watertight, and there were no abdominal or pelvic injuries found at autopsy.CONCLUSIONSNOTES can provide adequate minimal surgical dissection for safe and effective percutaneous renal cryoablation under direct videoscopic monitoring at kidney locations otherwise not accessible percutaneously. Both transgastric and transvaginal approaches can be used effectively for renal cryoablation providing a minimally invasive scar‐less surgery.
Can autologous myoblasts be used as a potential bulking agent?
Authors: Mitterberger Michael , Marksteiner Rainer , Schwaiger Wolfgang , Klima Günther , Schwentner Christian , Müller Tilko , Bartsch Georg , Radmayr Christian , Strasser Hannes , Oswald Josef 
Published: September 2008

OBJECTIVETo investigate the behaviour of donor myoblasts at the vesico‐ureteric junction (VUJ) and to evaluate their potential as an autologous bulking agent, as myoblast transplantation has been shown to regenerate damaged or degenerated tissue, and it was postulated that they could be used to treat vesico‐ureteric reflux.MATERIALS AND METHODSMuscle biopsies were obtained from the lower limb muscles of 10 pigs. The quality of the cells was evaluated by electrophysiological and immunohistochemical tests. The cell membranes of myoblasts were labelled with PKH26, a fluorescent dye. Six weeks after taking of the muscle biopsies all pigs underwent cell transplantation; 30 × 106 cells suspended in transplantation medium (in 1‐mL syringes) were injected at the VUJ, into the proximal urethra and the rhabdosphincter. At the VUJ volumes of 1 mL were injected, whereas in the urethra and rhabdosphincter small cell depots (0.1 mL) were injected. All the pigs were killed 8 weeks later, and the myoblasts and newly formed myofibres were identified using fluorescence microscopy, with a histological evaluation and investigation of potential local inflammatory reaction.RESULTSTwo to three intact layers of autologous myoblasts were found in the outer aspects of the large cell depots in the VUJ. Immunohistochemistry further showed that the myoblasts were only viable at these outermost borders of the large bulking areas, whereas necrosis with red fluorescent cell detritus was visible in the remaining central aspects of the large bulk of cells. By contrast, cells survived and formed myotubes in the wall of the proximal urethra and the rhabdosphincter where the small cell depots had been injected.CONCLUSIONSIn small depots, transplanted autologous myoblasts can survive and differentiate into myofibres, while in a large bulk of cells the vast majority of cells become necrotic. The present results show that myoblasts cannot be used for augmentation of large volumes of tissue or as a bulking agent.
The administration of folic acid improves erectile function and reduces intracavernosal oxidative stress in the diabetic rabbit
Authors: Shukla Nilima , Hotston Matthew , Persad Raj , Angelini Gianni D. , Jeremy Jamie Y. 
Published: September 2008

OBJECTIVETo test the possibility that folic acid (FA) may be a means of treating erectile dysfunction (ED) in diabetes mellitus (DM), by studying the effect of FA administration to DM rabbits on cavernosal function and intrapenile oxidative stress.MATERIALS AND METHODSTo investigate the effect of administering FA to DM rabbits on erectile function and oxidative stress the formation of superoxide (O2‐), 8‐isoprostane F2α(8‐IPF2α) and prostacyclin (as 6‐keto‐PGF1α) were assessed, as well as carbachol‐ and electrical field stimulated (EFS) relaxation and p47phoxcontent (active component of NADPH oxidase complex). Non‐ketotic DM was induced in New Zealand rabbits with alloxan and FA administered orally daily for 1 month. Rabbits were killed, penises excised and segments prepared. These were mounted in an organ bath and relaxation elicited with carbachol or EFS. O2‐release was measured spectrophotometrically, p47phoxexpression by Western blotting and 8‐IPF2αand 6‐keto‐PGF1αformation by enzyme‐linked immunosorbant assay. Blood was collected for measurement of homocysteine, red blood cell (RBC) folate and glucose.RESULTSIn cavernosal tissue from DM rabbits, carbachol‐and EFS‐induced relaxation was significantly impaired compared with the untreated controls. O2‐release, p47phoxexpression and 8‐IPF2αformation were all enhanced and 6‐keto‐PGF1αformation reduced compared with the controls. All these effects were reversed by FA. Plasma total homocysteine was reduced and RBC folate elevated.CONCLUSIONSThe administration of FA may constitute a strategy for reducing ED in patients with DM.
Robotic single‐port transumbilical surgery in humans: initial report
Authors: Kaouk Jihad H. , Goel Raj K. , Haber Georges‐Pascal , Crouzet Sebastien , Stein Robert J. 
Published: September 2008

OBJECTIVETo describe our initial clinical experience of robotic single‐port (RSP) surgery.PATIENTS AND METHODSThe da Vinci® S robot (Intuitive, Sunnyvale, CA, USA) was used to perform radical prostatectomy (RP), dismembered pyeloplasty, and radical nephrectomy. A robot 12‐mm scope and 5‐mm robotic grasper were introduced through a multichannel single port (R‐port, Advanced Surgical Concepts, Dublin, Ireland). An additional 5‐mm or 8‐mm robotic port was introduced through the same umbilical incision (2 cm) alongside the multichannel port and used to introduce robotic instruments. Vesico‐urethral anastomosis and pelvi‐ureteric anastomosis were successfully performed robotically using running intracorporeal suturing.RESULTSAll three RSP surgeries were performed through the single incision without adding extra umbilical ports or 2‐mm instruments. For RP, the operative duration was 5 h and the estimated blood loss was 250 mL. The hospital stay was 36 h and the margins of resection were negative. For pyeloplasty, the operative duration was 4.5 h, and the hospital stay was 50 h. Right radical nephrectomy for a 5.5‐cm renal cell carcinoma was performed in 2.5 h and the hospital stay was 48 h. The specimen was extracted intact within an entrapment bag through the umbilical incision. There were no intraoperative or postoperative complications. At 1 week after surgery, all patients had minimal pain with a visual analogue score of 0/10.CONCLUSIONSTechnical challenges of single‐port surgery that may limit its widespread acceptance can be addressed by using robotic technology. Articulation of robotic instruments may render obsolete the long‐held laparoscopic principles of triangulation especially for intracorporeal suturing. We report the initial series of robotic surgery through a single transumbilical incision.
Transumbilical single‐port laparoscopic partial nephrectomy
Authors: Aron Monish , Canes David , Desai Mihir M. , Haber Georges‐Pascal , Kaouk Jihad H. , Gill Inderbir S. 
Published: September 2008

OBJECTIVETo present the initial experience with laparoscopic partial nephrectomy (LPN) performed through a transumbilical single port.PATIENTS AND METHODSBetween November 2007 and April 2008, five selected patients underwent single‐port LPN (SPLPN) for renal tumours. All procedures were performed through a single intraumbilical multichannel laparoscopic port. A 2‐mm grasper was inserted through a 2‐mm Veres needle‐port in the anterior axillary line to aid in tissue retraction and sutured renal reconstruction. The technique of standard multiport LPN was replicated, with the renal hilum clamped.RESULTSSPLPN was successfully completed in four patients, while an additional 5‐mm port was required in one patient. The median (range) tumour size was 3 (1–5.9) cm. The median (range) operating time was 270 (240–345) min and the estimated blood loss was 150 (100–600) mL. The median (range) warm ischaemia time was 20 (11–29) min. The median (range) length of the umbilical incision was 2.5 (2.5–4) cm. The median (range) hospital stay was 3(3–22) days. There were no intraoperative complications. All surgical margins were negative for tumour. There were no postoperative complications in four patients. One patient had postoperative bleeding and pulmonary embolism.CONCLUSIONSSPLPN is technically feasible, albeit more challenging than conventional LPN. Proper case selection is essential. Advances in single‐port specific instrumentation are needed before these procedures can become a part of mainstream urological laparoscopy.
The association between prostate size and Gleason score upgrading depends on the number of biopsy cores obtained: results from the Shared Equal Access Regional Cancer Hospital Database
Authors: Turley Ryan S. , Terris Martha K. , Kane Christopher J. , Aronson William J. , Presti Joseph C. , Amling Christopher L. , Freedland Stephen J. 
Published: September 2008

OBJECTIVETo test the hypothesis that the association between prostate size and risk of Gleason grade upgrading varies as a function of sampling.PATIENTS AND METHODSWe examined the association between pathological prostate weight, prostate biopsy scheme and Gleason upgrading (Gleason ≥7 at radical prostatectomy, RP) among 646 men with biopsy Gleason 2–6 disease treated with RP between 1995 and 2007 within the Shared Equal Access Regional Cancer Hospital Database using logistic regression. In all, 204 and 442 men had a sextant (six or seven cores) or extended‐core biopsy (eight or more cores), respectively. Analyses were adjusted for centre, age, surgery, preoperative prostate‐specific antigen level, clinical stage, body mass index, race, and percentage of cores positive for cancer.RESULTSIn all, 281 men (44%) were upgraded; a smaller prostate was positively associated with the risk of upgrading in men who had an extended‐core biopsy (P < 0.001), but not among men who had a sextant biopsy (P = 0.22). The interaction between biopsy scheme and prostate size was significant (P interaction = 0.01).CONCLUSIONSThese data support the hypothesis that the risk of upgrading is a function of two opposing contributions: (i) a more aggressive phenotype in smaller prostates and thus increased risk of upgrading; and (ii) more thorough sampling in smaller prostates and thus decreased risk of upgrading. When sampled more thoroughly, the phenotype association dominates and smaller prostates are linked with an increased risk of upgrading. In less thoroughly sampled prostates, these opposing factors nullify, resulting in no association between prostate size and risk of upgrading. These findings help to explain previously published disparate results of the importance of prostate size as a predictor of Gleason upgrading.
Seminal vesicle amyloidosis does not provide any protection from invasion by prostate cancer
Authors: Erbersdobler Andreas , Kollermann Jens , Graefen Markus , Röcken Christoph , Schlomm Thorsten 
Published: September 2008

OBJECTIVETo determine whether seminal vesicle amyloidosis (SVA, an unusual finding in prostatectomy specimens, with deposits usually localized and asymptomatic) affects the extension of prostate cancer into the SVs.PATIENTS AND METHODSWe identified 73 cases of localized SVA from 6575 prostatectomy specimens, that were removed because of clinically localized prostate cancer. All cases were confirmed by Congo red staining and polarization microscopy. The mean thickness of the amyloid band was measured in each case and correlated with clinicopathological characteristics. The frequency of SV involvement by prostate cancer in the presence of amyloid was compared with the percentage of pT3b classifications in the absence of amyloid.RESULTSThe mean (range) age of the patients with localized SVAs was 64.4 (52–73) years. The mean thickness of the amyloid band did not correlate with patient age, preoperative prostate‐specific antigen levels, the weight of the prostates, or the Gleason score and T category of the prostate cancers. In the SVA group, seven cancers invaded the SVs (9.6%), which was not significantly different from the percentage of SV involvement by cancer in total sample (9.2%, P = 0.932).CONCLUSIONSThe pathogenesis of localized SVA remains poorly understood, but SVA does not seem to provide an absolute or relative protection from SV involvement by prostate cancer.
A real‐life multicentre clinical practice study to evaluate the efficacy and safety of intravesical chondroitin sulphate for the treatment of interstitial cystitis
Authors: Nickel J. Curtis , Egerdie Blair , Downey Joe , Singh Rajiva , Skehan Anthony , Carr Leslie , Irvine‐Bird Karen 
Published: September 2008

OBJECTIVETo report a multicentre, community based open‐label study designed to assess the efficacy and safety of intravesical sodium chondroitin sulphate in the treatment of patients with the clinical diagnosis of interstitial cystitis (IC). Chondroitin sulphate is a naturally occurring glycosaminoglycan (GAG) in the bladder mucus layer and changes in this GAG have been implicated in the pathogenesis of IC, and small single‐centre studies have suggested that intravesical chondroitin sulphate may have efficacy in IC.PATIENTS AND METHODSPatients with IC were treated with sodium chondroitin sulphate (Uracyst®, Stellar Pharmaceuticals Inc., London ON, Canada) solution 2.0% via urinary catheter weekly for 6 weeks and then monthly for 16 weeks for a total of 10 treatments. The primary efficacy endpoint was the percentage of responders to treatment as indicated by a marked or moderate improvement on a seven‐point patient Global Response Assessment (GRA) scale at week 10 (4 weeks after the initial six treatments) compared with baseline. A major secondary efficacy endpoint (durability) was the percentage of responders on the GRA scale after 10 treatments. Additional secondary efficacy objectives were differences from baseline in Patient Symptom/Problem Index scores over the course of the treatment compared with baseline.RESULTSIn all, 47% of the 53 enrolled patients with long standing moderately severe IC (mean [sd, range] diagnosis of IC 3.0 [3.4, 0.1–16] years; duration of symptoms 9.2 [9.2, 1–39] years; baseline symptom score 14.2 [3.2]) were responders at week 10. At 24 weeks, 60% were responders. There was a statistically and clinically significant decrease in the mean (sd) symptom and bother scores from baseline at 10 weeks and 24 weeks, at 9.0 (4.3) and 8.1 (5.0), respectively (P < 0.001). There were no significant safety issues during the study.CONCLUSIONSThis multicentre community based real‐life clinical practice study suggests that intravesical chondroitin sulphate may have an important role in the treatment of IC and validates the rationale for a randomized placebo‐controlled trial.