bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal function up to 16 years after conduit (refluxing or anti‐reflux anastomosis) or continent urinary diversion. 1. Glomerular filtration rate and patency of uretero‐intestinal anastomosis
Authors: KRISTJÁNSSON A. , WALLIN L. , MÅNSSON W. 
Published: November 2008

Objective To evaluate the glomerular filtration rate (GFR) and incidence of anastomotic stenosis in patients with urinary diversion by ileal or colonic conduit (refluxing or anti‐reflux uretero‐intestinal anastomosis) or with a continent caecal reservoir.Patients and methods All conduit urinary diversions performed from 1977 to 1984 were randomized by type (ileal or colonic) and by the method of ureteric implantation (with or without anti‐reflux technique). In continent caecal reservoirs anti‐reflux implantation was used for both ureters. Total and separate GFR were measured pre‐operatively and after a mean follow‐up of 123 months (range 36–198) with 51Cr‐EDTA and scintillation renography.Results Of the 56 evaluable patients, 18 had an ileal and 20 a colonic conduit, and 18 had a continent reservoir. The total mean GFR fell from 88 to 71 mL/min in the ileal group, from 84 to 65 mL/min in the colonic group and from 100 to 85 mL/min in the reservoir group. Separate GFR did not differ significantly between kidneys with and without reflux protection in the patients with a conduit diversion. Strictures occurred in 15 uretero‐intestinal anastomoses and were unrelated to the mode of ureteric implantation (in the conduit groups). Renal function improved after ureteric reimplantation in six of seven kidneys, but after balloon dilatation in only one of five.Conclusion GFR fell moderately in all three groups, with no significant intergroup difference, and the continent caecal reservoir compared favourably with conduit diversion. The fall in separate GFR did not differ significantly between kidneys with and without reflux protection. Surgical exploration of uretero‐intestinal stenosis is recommended if renal function is threatened.
Renal function up to 16 years after conduit (refluxing or anti‐reflux anastomosis) or continent urinary diversion. 2. Renal scarring and location of bacteriuria
Authors: KRISTJÁNSSON A. , BATC M. , WALLIN L. , WILLNER J. , MÅNSSON W. 
Published: November 2008

Objective To evaluate the importance of refluxing versus anti‐reflux ureteric implantation for the development of renal scarring in patients with a conduit or continent urinary diversion and for the incidence of bacteriuria in the upper urinary tract of patients with a conduit.Patients and methods Renal scintigraphy using 99mTcdimercaptosuccinic acid was performed on 32 of 37 evaluable patients from a prospective, randomized study at a mean of 150 months (range 102–198) after urinary diversion. In five patients with a conduit diversion and unilateral renal scarring, urine was sampled for culture from the proximal end of the conduit and from both renal pelvices by direct percutaneous aspiration.Results Of 35 renal units (18 patients), studied after conduit diversion, scarring was found in 11 (two grade I, six grade H and three grade III) of 17 with refluxing anastomosis and in six (one grade I, four grade II and one grade III) of 18 with anti‐reflux anastomosis (P= 0.06). Of 25 renal units (14 patients) after continent diversion, 16 showed scarring (seven grade I and nine grade II). Bacteriuria was found in four of five upper urinary tracts with a refluxing anastomosis, but in only one of five with an antireflux anastomosis. In these five patients scarring was present in all kidneys with refluxing anastomosis.Conclusion Anti‐reflux ureteric anastomosis seems to be important for preventing scarring and bacteriuria in the upper urinary tract of patients with a conduit urinary diversion. Despite the anti‐reflux technique of ureteric implantation, most patients with a continent reservoir had renal scarring, though it was generally less severe than in patients with a conduit urinary diversion.
Flow‐cytometric DNA analysis of paraffin‐embedded renal cell carcinoma tissue from patients treated by parenchymal‐sparing surgery
Authors: CIANCIO G. , FERRELL S. , BLOCK N.L. 
Published: November 2008

Objective To determine the utility of deoxyribonucleic acid (DNA) ploidy pattern, detected by flow cytometry, in predicting the outcome of renal cell carcinoma (RCC).Patients and methods DNA content was retrospectively assessed by flow cytometry in 28 primary paraffin‐embedded RCCs from 24 patients (16 men and eight women, mean age 61.9 years, range 40–89) who had undergone renal parenchymal‐sparing surgery.Results Tumour recurred locally in three patients, two with diploid tumours and one with aneuploid tumour. Two patients with diploid tumours had metastatic disease 11–58 months after surgery. Only one patient with aneuploid tumour developed metastatic disease. There was no difference in local recurrence or metastases with the type of renal parenchymal‐sparing surgery used (enucleation or partial nephrectomy) nor any significant difference in overall survival (P= 0.11).Conclusion While DNA content might be of considerable predictive value for patients with RCC, these results showed that there was no difference in mortality rate, recurrence rate, or type of renal parenchymal‐sparing surgery used between aneuploid and diploid tumours.
The use of Doppler ultrasound in the clinical management of acute testicular pain
Authors: ALMUFTI R.A. , OGEDEGBE A.K. , LAFFERTY K. 
Published: November 2008

Objective To evaluate the reliability and the clinical application of the use of a hand‐held Doppler ultrasound flowmeter probe as an aid to differential diagnosis in the assessment of cases with acute testicular pain presenting to a district general hospital.Patients and methods Over a period of 1 year, testicular Doppler ultrasonic assessment was performed on 56 patients admitted with acute scrotal pain. A handheld Doppler ultrasound probe was used, with a transducer operating at 8 MHz. All the patients were assessed pre‐operatively by a single operator in the Accident and Emergency department before transfer to theatre. The decision to explore the testis was made purely on clinical grounds by which ever emergency surgical team was on duty. The operating surgeons were not informed of the result of Doppler examinations before surgical exploration.Results Twenty‐two patients were subsequently shown to have torsion of the testis at surgical exploration, all of whom had no Doppler signal over the affected side. Of the remaining 34 patients, who were subsequently shown not to have torsion at operation, normal testicular blood flow and cord‐compression tests were demonstrated confidently in 33 patients when examined pre‐operatively. Thus the sensitivity was 100% (22/22) and the specificity 97% (33/34).Conclusion Testicular Doppler examination using an 8 MHz probe in conjunction with the cord‐compression test is a useful, simple and highly accurate clinical tool which can differentiate between testicular torsion and other conditions presenting with acute testicular pain. It is also inexpensive and readily available in the district general hospital situation.
The value of radionuclide scrotal imaging in the diagnosis of acute testicular torsion
Authors: MELLOUL M. , PAZ A. , LASK D. , MANES A. , MUKAMEL E. 
Published: November 2008

Objective To assess the accuracy of radionuclide scrotal imaging (RSI) in the diagnosis of testicular torsion and torsion of testicular appendages.Patients and methods Eighty‐seven patients (mean age 30.1 years, range 8–65) who presented with acute scrotal pain were evaluated by RSI and the results correlated with the clinical and surgical findings.Results Of the 87 patients, 44 underwent scrotal exploration and 42 patients were treated conservatively. One patient with a ‘missed torsion’ pattern on RSI refused operation and was lost to follow‐up. Of the 44 patients who underwent surgery, testicular torsion was found in 30 and torsion of testicular appendages in 14 patients. The specificity of the RSI in diagnosing testicular torsion was 100% and the sensitivity was 98%. An area of increased tracer activity in the presence of a normal radionuclide angiogram was suggestive of torsion of testicular appendages with a specificity of 93%. Of the 42 patients who were treated conservatively, 19 had epididymitis, according to clinical and RSI findings, 10 had torsion of testicular appendages, two had orchiepididymitis, two had hydrocele, two had haematocele and seven patients had normal testes. At a follow‐up examination, normal testicles were found in all 42 patients.Conclusion The RSI may assist in the evaluation of nontraumatic acute scrotum, and can clearly distinguish among testicular torsion, torsion of testicular appendages and epididymitis.
EMLA cream anaesthesia for frenuloplasty
Authors: BROUGH R.J. , BETTS CD. , PAYNE S.R. 
Published: November 2008

Objective To evaluate the use of a eutectic mixture of local anaesthetics (EMLA) cream as the sole anaesthetic for frenuloplasty.Patients and methods Fifteen patients (mean age 25.6 years, range 19–41) were given topical EMLA cream 30 min before frenuloplasty: a Tegaderm® dressing was applied to keep the anaesthetic in place. The level of anaesthesia was assessed on arrival in theatre using pin‐prick testing and the patients were asked to grade their level of pain during the procedure using a visual analogue scale. If the level of anaesthesia was inadequate for the operation to be performed, then supplementary infiltrative anaesthesia was administered.Results Fourteen patients had pain scores of zero and were fully anaesthetized during the procedure. One patient's Tegaderm® dressing was displaced soon after application and he was inadequately anaesthetized on testing, had a pain score of 4 and required infiltrative lignocaine before proceeding with frenuloplasty.Conclusions EMLA cream is a well‐tolerated and reliable anaesthetic for frenuloplasty. Using a condom to keep the cream in place would reduce the small failure rate associated with the displacement of the Tegaderm® dressing.
Clinical outcomes associated with the implementation of a cost‐efficient programme for radical retropubic prostatectomy
Authors: KOCH M.O. , JR J.A. SMITH 
Published: November 2008

Objective To develop and analyse a cost‐containment programme for radical retropubic prostatectomy.Patients and methods An in‐depth analysis of the hospital charges associated with radical retropubic prostatectomy was conducted and a standard programme developed to control patient costs using a collaborative pathway method. The development of this programme and the outcomes of the first 50 patients who underwent radical retropubic prostatectomy while on the collaborative care pathway system are summarized.Results The programme reduced both overall hospital charges per patient and the duration of hospital stay by 44%. In addition, there was a significant reduction in the duration of surgery, intra‐operative blood loss and the need for transfusion. Implementation of this programme had no apparent adverse effects on the rates of major or minor complications or hospital re‐admissions, and was accepted well by the patients.Conclusion The collaborative care pathway developed for radical prostatectomy provides a system to deliver high quality, cost‐efficient care in an environment which is highly acceptable to patients and which allows continued refinements in the care delivered.
Prostate‐specific antigen density: correlation with histological diagnosis of prostate cancer, benign prostatic hyperplasia and prostatitis
Authors: IERSEL M.P. VAN , WITJES W.P.J. , ROSETTE J.J.M.C.H. DELA , OOSTERHOF G.O.N. 
Published: November 2008

Objective To assess the additional value of prostate‐specific antigen density in the diagnosis of prostate cancer in patients who undergo prostate biopsies.Patients and methods The study comprised 376 patients with symptoms of prostatism who were undergoing prostate biopsy. Digital rectal examination (DRE) and transrectal ultrasonography (TRUS) were performed and the prostate specific antigen level (PSA) and density (PSAD) were determined for each patient.Results Both PSA and PSAD significantly differentiated (P < 0.001) between benign and malignant histology. Of the 376 patients, 91 (24%) had a PSA level in the intermediate range (4.0–10.0 ng/mL). In these patients PSAD was significantly better than PSA in differentiating between benign and malignant histology (P= 0.027 vs 0.316). With a PSAD limit of 0.15 ng/mL/cm3 in these patients, the sensitivity was 92% and the specificity was 54% for the diagnosis of prostate cancer. No patient with a positive biopsy had a PSAD < 0.11 ng/mL/cm3. No limiting value could be found for PSAD that combined both an acceptable sensitivity and specificity. Of the patients with a malignancy detected by the biopsy, 92% also had a suspect DRE.Conclusion In patients with intermediate PSA levels, PSAD is of limited additional value when compared to DRE in correctly diagnosing prostate cancer. Acute prostatitis is also a possible cause of elevated PSA. Both PSA and PSAD had no additional value in differentiating between benign prostatic hyperplasia (BPH) and histologically proven extensive prostatitis.
Ex vivo activated memory T‐Iymphocytes as adoptive cellular therapy of human renal cell tumour targets with potentiation by cis‐diamminedichloroplatinum(II)
Authors: GOLD J.E. , MASTERS T.R. , BABBIT B. , FINE E.M. , WEBER H.N. , UNGER P.D. , LEVENTHAL I. , ZIPPE C.D. , OSBAND M.E. 
Published: November 2008

Objective To determine if cis‐diamminedichloroplat‐inum(II) (CDDP) enhances, by immune‐modulation, ex vivo anti‐tumour cytotoxicity of autolymphocyte therapy (ALT) against a chemotherapy‐resistant tumour, and if lysis is mediated through T‐cells, NK‐cells, or both.Materials and methods Human renal cell carcinoma (RCC) target cells were derived from surgical specimens and incubated in complete medium (CM) with CDDP, or in CM alone (control group). ALT‐cells were prepared from autologous whole peripheral blood mononuclear cells (PBMC) or NK‐cell (CD56)‐depleted PBMC obtained before surgery. Tumour cells from each group were labelled with chromium‐51(51Cr) and used as targets for ALT‐cells and PBMC in a standard (4h) and delayed (18 h) 51Cr‐release assay at varying effector/target ratios (E:T).Results Tumour cells incubated in CDDP showed enhanced lysis, as measured by the 51Cr‐release assay, at all E:T tested. This lysis was significantly greater during the 18 h assay and when ALT‐cells were used as the effector cells rather than PBMC. Depletion of CD45RO+ (memory) T‐cells from the ALT cell population precluded both the 4 and 18 h tumour cell lysis. Depletion of NK‐cells (CD56+) diminished the ex vivo lysis of autologous targets during the 4 but not the 18 h assay. ALT‐cells derived from two patients demonstrated ex vivo tumour‐specificity against autologous and allogeneic RCC.Conclusions These data suggest that: (i) ex vivo activated memory T‐cells are the principal component demonstrating significant tumour‐specific cytotoxicity of ALT‐cells against RCC tumour targets; (ii) CDDP may alter the physical properties of tumour cells rendering them susceptible to immune‐mediated attack; (iii) the combination of ALT and CDDP may lead to increased therapeutic efficacy in patients with metastatic RCC.
Mapping Highly Detailed Colour Information on Extremely Dense 3D Models: The Case of David's Restoration
Authors: Dellepiane M. , Callieri M. , Ponchio F. , Scopigno R. 
Published: November 2008

Abstract The support of advanced information technology (IT) to preservation, restoration and documentation of Cultural Heritage (CH) is becoming a very important goal for the research community. Michelangelo's David was one of the first applications of 3D scanning technology on a highly popular work of art. The subsequent restoration campaign, started in 2002 and concluded in 2004, was also a milestone for the adoption of modern scientific analysis procedures and IT tools in the framework of a restoration process. One of the focuses in this restoration was also methodological, i.e. to plan and adopt innovative ways to document the restoration process. In this paper, we present the results of an integration of different restoration data (2D and 3D datasets) which has been concluded recently. The recent evolution of HW and SW graphics technologies gave us the possibility to interactively visualize an extremely dense 3D model which incorporates the colour information provided by two professional photographic campaigns, made before and after the restoration. Moreover, we present the results concerning the mapping, in this case on the 2D media, of the reliefs produced by restorers to assess and document the status of the marble surface before the restoration took place. This result could lead to new and fascinating applications of computer graphics for preservation, restoration and documentation of CH.
The effect of tillage intensity on soil structure and winter wheat root/shoot growth
Authors: Munkholm Lars J. , Hansen Elly M. , Olesen Jørgen E. 
Published: November 2008

AbstractDespite a vast amount of data on the effect of tillage on crop productivity, surprisingly there is little detailed information available on the influence on below and aboveground crop growth dynamics. Such information is essential for developing sustainable cropping systems. The objective of this study was to investigate the effect of tillage intensity on crop growth dynamics and soil structure. A tillage experiment was established in autumn 2002 on two Danish sandy loams (Foulum and Flakkebjerg) in a cereal‐based crop rotation. The tillage systems included in this study were direct drilling (D), harrowing 8–10 cm (H8‐10), and ploughing (P). A single‐disc drill was used in the H8‐10 and D treatments and a traditional seed drill in the P treatment. Measurements were carried out in 2004–05 and 2005–06 and winter wheat was grown in both years (first and second year winter wheat). Shoot and root growth was followed during the growing seasons using spectral reflectance and mini‐rhizotron measurements, respectively. A range of soil physical properties were measured. We found decreased early season shoot and root growth with decreasing tillage intensity. Differences diminished later in the growing season, although significant treatment effects were observed throughout the growing season for the second year winter wheat. The formerly ploughed layer in the D and H8‐10 treatments was noticeably compacted as indicated by increases in both penetration resistance and bulk density. Nitrate leaching increased with decreasing tillage intensity for the first year winter wheat at Foulum. In general ploughing resulted in the highest grain yields. This study highlights the important interaction between soil structure and crop growth dynamics.
Fiscal Forecasting: Lessons from the Literature and Challenges*
Authors: Leal Teresa , Pérez Javier J. , Tujula Mika , Vidal Jean‐Pierre 
Published: November 2008

Abstract.While fiscal forecasting and monitoring has its roots in the accountability of governments for the use of public funds in democracies, the Stability and Growth Pact has significantly increased interest in budgetary forecasts in Europe, where they play a key role in EU multilateral budgetary surveillance. In view of the increased prominence and sensitivity of budgetary forecasts, which may lead to them being influenced by strategic and political factors, this paper discusses the main issues and challenges in the field of fiscal forecasting from a practitioner's perspective and places them in the context of the related literature.
A Twin Study of Metabolic Syndrome and Autonomic Tone
Authors: GEHI ANIL K. , LAMPERT RACHEL , VELEDAR EMIR , LEE FORRESTER , GOLDBERG JACK , JONES LINDA , MURRAH NANCY , ASHRAF ALI , VACCARINO VIOLA 
Published: November 2008

Introduction:
One possible mechanism of higher cardiovascular mortality associated with the metabolic syndrome (MetS) may be through abnormal modulation in autonomic tone.
Methods and Results:
We examined the association between the MetS and autonomic tone as measured by heart rate variability (HRV) among 288 twins from the Twins Heart Study (THS). Of the 288 participants, 151 (52%) had the MetS. The MetS was associated with decreased HRV across all frequency ranges, and each additional MetS risk factor was associated with lower HRV. After adjustment for several potential confounders, very‐low frequency (P < 0.001), low frequency (P < 0.001), and total power (P = 0.02) spectra of HRV remained significantly lower in twins with a progressively higher number of MetS components (18–50% decrease comparing twins with 5 risk factors to those with no risk factors). Among 87 twin pairs who were discordant for the number of MetS components, a one‐unit increment in MetS components was associated with an 8% smaller very‐low frequency (p = 0.03) and a 15% smaller low frequency spectrum (P = 0.002) comparing each twin with his brother.
Conclusion:
MetS was associated with lower HRV in a well‐characterized sample of middle‐aged male twins. This association persisted even after controlling for genetic and shared environmental factors accounted for by comparison within twin pairs. Abnormalities of autonomic tone, as evidenced by lower HRV, may be partly responsible for the higher rate of atrial fibrillation, coronary heart disease, cardiac death, and overall mortality seen in patients with the MetS.
Electroanatomic Mapping of the Right Coronary Artery: A Novel Approach to Ablation of Right Free‐Wall Accessory Pathways
Authors: FISHBERGER STEVEN B. , HERNANDEZ ANTERO , ZAHN EVAN M. 
Published: November 2008

Background:
Catheter ablation of right free‐wall (RFW) accessory pathways continues to be associated with lower success and higher recurrence rates compared with other pathway locations. Reliably identifying the precise location of RFW accessory pathways often contributes to the difficulty in ablating these pathways. Improved localization of RFW accessory pathways has been described utilizing multielectrode right coronary artery (RCA) catheterization. This approach has not been widely adopted, in part due to concerns of prolonged catheter placement within the RCA. We describe the technique of creating a 3‐D electroanatomic map of the right atrioventricular groove, limiting the duration of a microcatheter within the RCA, to facilitate ablation of RFW accessory pathways.
Methods and Results:
Following intracardiac identification of a RFW accessory pathway, an octapolar microcatheter was placed in the RCA. A 3‐D electroanatomic map of the RCA was created during retrograde accessory pathway conduction using ventricular pacing. Immediately following creation of the map, the RCA catheter was removed. Endocardial mapping and ablation of the RFW accessory pathway was performed using the RCA electroanatomic map as a guide. This technique was used in four pediatric patients. The microcatheter was within the RCA for less than 1 min in all patients. Radiofrequency catheter ablation of the RFW accessory pathways were successfully performed with two lesions. There were no complications or recurrences at follow‐up.
Conclusions:
The creation of a 3‐D electroanantomic map of the RCA effectively localizes RFW accessory pathways and facilitates successful ablation. This technique minimizes the duration of RCA instrumentation.