bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemo‐prevention in superficial bladder cancer using mitomycin C: a survey of the practice patterns of British urologists
Authors: CLARKE NICHOLAS S. , BASU SAURAJYOTI , PRESCOTT STEVEN , PURI RAJIV 
Published: March 2006

OBJECTIVETo assess the use of mitomycin C, by urologists within the UK, as a single‐dose intravesical agent. Current European recommendations are to use one dose after any new tumour resection.METHODSWe assessed the current patterns of mitomycin C usage amongst British urologists, particularly with reference to one instillation after resecting a new bladder tumour, hypothesizing that British urologists would use mitomycin C in line with current guidelines. A one‐page questionnaire was mailed to 527 consultant urologists in the UK enquiring about their use of mitomycin C in superficial bladder cancer. A second mailing was sent to encourage nonresponders.RESULTSOf the 527 consultants, 320 (61%) replied, of which 313 (59%) questionnaires were evaluable. Of these 313 respondents, 299 (95%) used mitomycin C; 244 respondents (82%) advocated the use of one dose of mitomycin C after resecting a new tumour, but only 10 (4%) would use it immediately after tumour resection and 155 (64%) use it within 24 h. Most (98%) respondents favoured the use of a mitomycin C course after resecting multiple tumours or after multiple recurrences. Interestingly, 20 respondents (7%) would use mitomycin C as a first‐line therapy for carcinoma in situ and a further 23 (8%) would use it for G3T1 tumours. A minority (14%) would use it after nephrectomy for upper tract transitional cell carcinoma. Almost all respondents indicated a dose of 40 mg in 40 mL of diluent. Maintenance treatment with mitomycin C was advocated by 44 (15%) of respondents, mainly for recurrent multifocal Ta/T1 tumours. The perception of the side‐effects of mitomycin C was favourable, with 69% of respondents judging mitomycin C to be well tolerated with mild side‐effects.CONCLUSIONUrologists adopt new ideas rapidly, as shown by the wide acceptance of the UK Medical Research Council study. The prompt use of mitomycin C needs to be reinforced, as efficacy is optimum within 6 h of resection. A few consultants persist in continuing with established practices, which have little evidence base. The publication of such survey results, with guidelines for treatment, should encourage those urologists whose practice is at variance from the norm to reflect on and change their practice.
Risk factors for urinary stone formation in men with spinal cord injury: a 17‐year follow‐up study
Authors: KU JA HYEON , JUNG TAE Y. , LEE JEONG K. , PARK WON H. , SHIM HONG B. 
Published: March 2006

OBJECTIVETo establish hazard ratios for risk of urinary stone formation in men with chronic spinal cord injury.PATIENTS AND METHODSIn all, 140 men injured before 1987 were eligible for this investigation and were followed yearly from January 1987 and December 2003.RESULTSOver the 17 years, 39 patients (28%) and 21 (15%) were diagnosed with bladder and renal stones for a total of 59 and 25 episodes, respectively. In multivariate analysis, bladder stone was more common in patients injured when aged ≥ 24 years than in those injured when aged <24 years (odds ratio 2.5; 95% confidence interval 1.1–5.7; P = 0.03). In another model, patients with complete injury had a greater risk of renal stone formation than those with incomplete injury (4.1, 1.3–12.9; P = 0.016). Renal stone was more common for patients with urethral catheterization than for those voiding spontaneously (5.7, 1.3–24.6, P = 0.021) and for patients with bladder stone than for those without (4.7, 1.5–15.1; P = 0.01).CONCLUSIONInjury characteristics are important for the development of urinary stone in chronic traumatic spinal cord injury. In addition, the present findings suggest that in men who cannot use intermittent catheterization or when the bladder cannot empty spontaneously, suprapubic cystostomy is better than urethral catheterization to avoid renal stone formation.
Ileocaecal vs ileal neobladder after radical cystectomy in patients with bladder cancer: a comparative study
Authors: KHAFAGY MEDHAT , SHAHEED FOUAD ABDEL , MONEIM TAREK ABDEL 
Published: March 2006

Authors from Egypt present the results of a comparative study of bladder reconstruction after radical cystectomy for bladder cancer. They compared an ileocaecal bladder with a neo‐ileal bladder, and found no difference in continence between them, but found the ileocaecal bladder to be better for renal unit preservation, residual urine and the development of acidosis.OBJECTIVETo compare an ileocaecal orthotopic bladder, (which has been the standard procedure in Egypt for >30 years) with the ileal neobladder, as there is no ideal continent orthotopic bladder replacement for patients after cystectomy for bladder cancer.PATIENTS AND METHODSBetween June 1999 and December 2001, 60 patients with invasive bladder cancer were randomized into two groups. Group A comprised 29 patients who had radical cystectomy and reconstruction with an ileal neobladder (median age 50 years, 27 men and two women) and group B included 31 who had an ileocaecal bladder substitution after radical cystectomy (median age 51 years, 28 men and three women).RESULTSThe complication rate after surgery in group A was 17%, with two deaths, one from acute myocardial infarction and the other from haematemesis. In group B, the complication rate was 13%, with two deaths, one from a massive pulmonary embolism and the other from liver cell failure. Daytime continence was achieved in 93% of patients in group A and 90% in group B. The mean (sd) postvoid residual urine volume was larger in group A than group B, at 90 (72) vs 12 (20) mL. Acidosis and hyponatraemia were evident in the patients in group A but in none in group B (P < 0.05). The pelvicalyceal systems were preserved in 85% of patients in group A and 93% in group B during the 2‐year follow‐up. The mean (sd) renal cortical thickness was less in group A than in group B, at 1.8 (0.5) and 1.9 (0.2) cm, respectively. Although the cystometric capacity was greater and the basal pressure less in group A than B, these were not reflected in the degree of diurnal and nocturnal continence or back pressure on the renal units.CONCLUSIONContinence in both pouches was similar but the renal units were preserved better in the ileocaecal than in the ileal neobladder. Residual urine volume was greater in the ileal neobladder, with its potential complications of infection and stone formation, and acidosis was more evident.
Multiple primary malignancies in patients with renal cell carcinoma: a national population‐based cohort study
Authors: BEISLAND CHRISTIAN , TALLERAAS OLAUG , BAKKE AUGUST , NORSTEIN JARLE 
Published: March 2006

OBJECTIVETo determine the possibly greater occurrence of multiple malignancies in patients with renal cell carcinoma (RCC).PATIENTS AND METHODSIn the 7‐year period 1987–93, all 1425 patients aged 15–70 years with registered histopathologically verified RCC in Norway were included in the study. All clinical and histopathology reports were checked manually, to verify the registered diagnosis and to ensure that no tumour was a metastasis from another. After this process, 257 patients (287 tumours other than RCC) with multiple primary malignancies were identified. The primary tumours other than RCC were classified as antecedent, synchronous and subsequent. For the subsequently occurring tumours, the expected number of different tumour types was calculated according to age group, gender and observation time.RESULTSOf the 1425 patients, 228 (16%) had one, 23 (1.6%) had two, three (0.2%) had three and one (0.07%) had four other primary malignancies. In all, 100 (34.8%) of the other tumours were diagnosed as antecedent, 53 (18.7%) as synchronous and 134 (46.7%) as subsequent to the RCC. Cancer in the prostate, bladder, lung, breast, colon and rectal cancer, malignant melanomas (MM) and non‐Hodgkin's lymphomas (NHL) were the most common other malignancies. The observed overall number of subsequent other malignant tumours was 22% higher than the expected number. The observed number of subsequent tumours was significantly higher for bladder cancer, NHL and MM. The estimated 15‐year cumulative risk for patients with RCC and no previous or synchronous other malignancy for developing a later second cancer was 26.6% in men, and 15.5% in women (statistically significant, P = 0.04). Patients with antecedent or synchronous other cancer had significantly poorer overall survival than those without.CONCLUSIONSPatients with RCC seem to have a significantly higher risk of developing other subsequent primary malignancies. This should be considered during the follow‐up of patients with RCC.
Endoscopic treatment with polydimethylsiloxane in children with dilating vesico‐ureteric reflux
Authors: BARTOLI FABIO , NIGLIO FRANCESCO , GENTILE OTTAVIO , PENZA ROSA , ACETO GABRIELLA , LEGGIO SAMUELE 
Published: March 2006

The much‐visited topic of endoscopic treatment of VUR in children with an injectable agent is assessed by authors from Italy. However, in this study using Macroplastique, they had a 72% success rate after the first injection, 97% after the second, and 100% after the third. What is interesting is that 68% of the cases had grade IV–V VUR.OBJECTIVETo report our experience of treating dilating vesico‐ureteric reflux (VUR) in children, using an injectable form of polydimethylsiloxane (MacroplastiqueTM, MPQ; Uroplasty BV, Geleen, The Netherlands), as medical treatment for moderate or severe VUR is associated with a high proportion of persistence or development of new scars.PATIENTS AND METHODSThe study included 32 children (40 ureters) with VUR; 13 (32%) were grade III, 20 (50%) grade IV and seven (18%) grade V. They were treated over a period of 42 months, 66% for some form of bladder dysfunction and 38% had associated diseases. The main indications were VUR grade, recurrent urinary tract infection and progression of reflux nephropathy. MPQ was injected under general anaesthesia via an 11 F cystoscope, × 30 objective, with a 5 F working channel.RESULTSThe mean (sd) follow‐up was 28.5 (10.2) months; VUR resolved in 80% of patients and improved to minimal VUR in the remaining 20%. The resolution/improvement rate was 72% after the first injection, 97% after the second and 100% after the third. There were no significant complications.CONCLUSIONThe endoscopic implantation of MPQ always corrected VUR even though 68% of the cases were grade IV–V. It should become the treatment of choice for severe VUR.
Uroepithelial cells can directly respond to Mycobacterium bovis bacillus Calmette‐Guérin through Toll‐like receptor signalling
Authors: MIYAZAKI JUN , KAWAI KOJI , OIKAWA TAKEHIRO , JOHRAKU AKIRA , HATTORI KAZUNORI , SHIMAZUI TORU , AKAZA HIDEYUKI 
Published: March 2006

OBJECTIVETo investigate, in a human urinary tract cell line, the interaction of Toll‐like receptor (TLR) signals with cytoplasmic adapter proteins MyD88 and bacillus Calmette‐Guérin (BCG), and evaluate the epithelial cytokine response to BCG infection. Intravesical BCG therapy is effective against carcinoma in situ and as prophylaxis for recurrence, but although immunological mechanisms have been assumed, the mechanisms of the antitumour effects of BCG have not been completely elucidated.MATERIALS AND METHODSThe cell line was first screened for TLR expression by reverse transcription‐polymerase chain reaction (RT‐PCR). Total RNA was isolated from a human urinary cell line, Hu35E6E7, and cDNA synthesised. PCR was used to measure the gene expression of TLR‐2, ‐3, ‐4, ‐5, ‐9, MyD88, MD‐2, CD14 and interleukin‐8 and ‐6. The Hu35E6E7 cell line was cultured in keratinocyte serum‐free medium, and BCG was added to the cell culture. After Hu35E6E7 cells were stimulated by BCG for various periods, the total RNA of the cells was extracted. Quantitative real‐time PCR was conducted for MyD88 using appropriate probes, and the expression of MyD88 analysed. The cell supernatant was collected, and the levels of interferon‐γ, tumour necrosis factor‐α, interleukin‐2, ‐12, ‐4, ‐6, ‐10, ‐8 and ‐1β were assayed using an enzyme‐linked immunosorbent assay.RESULTSUroepithelial cells expressed TLR‐2, ‐3, ‐4 and ‐9, and MyD88, MD2, CD14, interleukin‐6 and ‐8 were also detected. At 3, 6, 9 and 12 h after adding BCG, quantitative PCR assay showed that the expression of MyD88 was maximal at 6 h. The presence of BCG stimulated the release only of interleukin‐6 and ‐8 from Hu35E6E7 cells after 6 h. By contrast, interferon‐γ, tumour necrosis factor‐α, interleukin‐2, ‐12, ‐4, ‐10 and ‐1β were not detected in the culture supernatant.CONCLUSIONThese results show that uroepithelial cells, but not immune cells, responded directly to BCG through TLR signalling. Further investigation is needed to determine the role of cytokines released from uroepithelial cells after BCG infection.
Limited significance of routine excretory urography in the follow‐up of patients with superficial bladder cancer after transurethral resection
Authors: MIYAKE HIDEAKI , HARA ISAO , YAMANAKA KAZUKI , INOUE TAKA‐AKI , FUJISAWA MASATO 
Published: March 2006

OBJECTIVESTo evaluate the utility of routine excretory intravenous urography (IVU) for detecting subsequent upper urinary tract cancer (UUTC) during the follow‐up of patients with superficial bladder cancer.PATIENTS AND METHODSThe study included 413 patients who had transurethral resection (TUR) of superficial bladder cancer between January 1986 and December 2003, and were followed for at least 1 year. After TUR, patients were followed by periodic cystoscopy, urinary cytology and IVU. The risk factors for UUT recurrence after TUR were analysed, and based on this outcome, we then determined whether routine IVU should be used for patients with superficial bladder cancer.RESULTSDuring the observation period, UUTCs developed in 20 of the 413 patients (4.8%) within a median of 33 months from the initial TUR to the detection of UUTCs. Among several factors examined, only multiplicity was significantly associated with UUT recurrence after TUR. Of the 20 patients with secondary UUTCs, only two, who had multiple superficial bladder cancers at initial presentation, were diagnosed as having UUTCs by routine IVU, while the remaining 18 presented with symptoms suggesting possible UUT recurrence before IVU, including macrohaematuria (10 patients), intravesical recurrence (five), positive urinary cytology (five), abdominal pain (three) and high fever (two).CONCLUSIONSMost patients with recurrent UUTCs presented with some subjective and/or objective symptoms, and routine IVU failed to detect recurrent diseases in such patients. Therefore, routine IVU may not be required for all patients who have TUR of superficial bladder cancer.
Surgery for giant high‐flow renal arteriovenous fistula: experience in one institution
Authors: OSAWA TAKAHIRO , WATARAI YOSHIHIKO , MORITA KEN , KAKIZAKI HIDEHIRO , NONOMURA KATSUYA 
Published: March 2006

OBJECTIVETo present five cases of renal arteriovenous fistula (RAVF) seen at our institution, with an emphasis on surgical treatment.PATIENTS AND METHODSWe assessed five patients with giant high‐flow RAVF. The affected kidney was evaluated functionally using 99mTc‐diethylenetriamine pentaacetic acid renal scintigraphy. The size, location, involvement of branched arteries, and renal function dictated the choice of operative method. Four patients were treated with in situ ligation of the feeding artery for extrarenal RAVF, and the remaining patient had a nephrectomy of the nonfunctioning kidney. The clinical outcome was analysed by renal function, blood pressure control, radiographic cardiothoracic ratio (CTR), occlusion of RAVF, and renal artery patency.RESULTSOf two patients with hypertension, the blood pressure was normalized in one. The renal function of the affected side was preserved in four patients. CTR was normalized or improved in all four patients with preoperative cardiomegaly. There was no recurrence of RAVF in any of the five patients and there was no major morbidity after surgery.CONCLUSIONSSurgery for giant high‐flow RAVF is safe and feasible from the perspective of complications and recurrence, even though transarterial embolization has become the first line of therapy for RAVF.
Alfuzosin 10 mg once daily prevents overall clinical progression of benign prostatic hyperplasia but not acute urinary retention: results of a 2‐year placebo‐controlled study
Authors: ROEHRBORN CLAUS G. ,   ALTESS Study Group
Published: March 2006

OBJECTIVESTo evaluate the effect of alfuzosin 10 mg once daily administered for 2 years on progression events in men with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH).PATIENTS AND METHODSIn all, 1522 men at risk of having progression events from LUTS/BPH were randomized to receive alfuzosin 10 mg once daily (759) or placebo (763) for 2 years. Endpoints assessed were the occurrence of a first episode of acute urinary retention (AUR; primary) and the need for BPH‐related surgery. Post hoc analyses included a deterioration in the International Prostate Symptom Score (IPSS) of ≥ 4 points and overall clinical progression of BPH (occurrence of AUR and/or surgery and/or symptom deterioration).RESULTSOver 2 years, symptom deterioration was the most common progression event (14.3%), followed by BPH‐related surgery (5.8%) and AUR (2.0%). Alfuzosin did not reduce the risk of AUR (alfuzosin 2.1% vs placebo 1.8%, P = 0.82) but tended to reduce the risk of surgery (5.1% vs 6.5%, P = 0.18); the reduction in risk (RR) and 95% confidence interval with alfuzosin was 22 (−18 to 48)%; and significantly reduced the risk of symptom deterioration (11.7% vs 16.8%; P = 0.0013); the RR was 30 (10–46)%. The overall clinical progression of BPH was significantly lower with alfuzosin than with placebo (16.3% vs 22.1%, P < 0.001); RR 26 (9–40)%. Alfuzosin also significantly improved the IPSS (P = 0.017), quality of life (P < 0.001) and peak flow rate (P = 0.001) compared with placebo. Baseline levels of prostate‐specific antigen (PSA) predicted both AUR and BPH‐related surgery events, while the baseline postvoid residual urine volume predicted symptom deterioration. The incidence of adverse events with alfuzosin was comparable to that with placebo.CONCLUSIONSAlfuzosin 10 mg once daily prevents the overall clinical progression of BPH, defined by the occurrence of a deterioration in IPSS of ≥ 4 points and/or AUR and/or BPH‐related surgery, but does not reduce the primary occurrence of AUR. Alfuzosin significantly improves LUTS and quality of life over 2 years, and is well tolerated.
PLUG‐IN ESTIMATION OF GENERAL LEVEL SETS
Authors: Cuevas Antonio , González‐Manteiga Wenceslao , Rodríguez‐Casal Alberto 
Published: March 2006

SummaryGiven an unknown function (e.g. a probability density, a regression function, …) f and a constant c, the problem of estimating the level set L(c) ={f≥c} is considered. This problem is tackled in a very general framework, which allows f to be defined on a metric space different from . Such a degree of generality is motivated by practical considerations and, in fact, an example with astronomical data is analyzed where the domain of f is the unit sphere. A plug‐in approach is followed; that is, L(c) is estimated by Ln(c) ={fn≥c}, where fn is an estimator of f. Two results are obtained concerning consistency and convergence rates, with respect to the Hausdorff metric, of the boundaries ∂Ln(c) towards ∂L(c). Also, the consistency of Ln(c) to L(c) is shown, under mild conditions, with respect to the L1 distance. Special attention is paid to the particular case of spherical data.
ALL‐BIAS DESIGNS FOR POLYNOMIAL SPLINE REGRESSION MODELS
Authors: Woods David , Lewis Susan 
Published: March 2006

SummaryPolynomial spline regression models of low degree have proved useful in modeling responses from designed experiments in science and engineering when simple polynomial models are inadequate. Where there is uncertainty in the number and location of the knots, or breakpoints, of the spline, then designs that minimize the systematic errors resulting from model misspecification may be appropriate. This paper gives a method for constructing such all‐bias designs for a single variable spline when the distinct knots in the assumed and true models come from some specified set. A class of designs is defined in terms of the inter‐knot intervals and sufficient conditions are obtained for a design within this class to be all‐bias under linear, quadratic and cubic spline models. An example of the construction of all‐bias designs is given.
ROBUST INFERENCE IN PARAMETRIC MODELS USING THE FAMILY OF GENERALIZED NEGATIVE EXPONENTIAL DISPARITIES
Authors: Bhandari Subir K. , Basu Ayanendranath , Sarkar Sahadeb 
Published: March 2006

SummaryWe examine robust estimators and tests using the family of generalized negative exponential disparities, which contains the Pearson's chi‐square and the ordinary negative exponential disparity as special cases. The influence function and α‐influence function of the proposed estimators are discussed and their breakdown points derived. Under the model, the estimators are asymptotically efficient, and are shown to have an asymptotic breakdown point of 50%. The proposed tests are shown to be equivalent to the likelihood ratio test under the null hypothesis, and their breakdown points are obtained. The competitive performance of the proposed estimators and tests relative to those based on the Hellinger distance is illustrated through examples and simulation results. Unlike the Hellinger distance, several members of this family of generalized negative exponential disparities generate estimators which also possess excellent inlier‐controlling capability. The corresponding tests of hypothesis are shown to have better power breakdown than the Hellinger deviance test in the cases examined.
Phonics self‐teaching materials for foundation literacy
Authors: Spencer Ken 
Published: March 2006

AbstractThe effect of irregular English orthography (spelling) on foundation literacy, and in particular on alphabetic decoding, is discussed within the context of the orthographic depth hypothesis. A method for circumventing the retarding effects of traditional English orthography, based on the support provided for Chinese pupils learning their character‐based system of writing, is described. Evidence for the beneficial effects of a regularised form of English to support conventional orthography is presented in the form of a case study and a small group experiment, both carried out in a primary school in the North of England.
Putting literature at the heart of the literacy curriculum
Authors: Nicholson Deborah 
Published: March 2006

AbstractThis paper documents an initiative in Continuing Professional Development, conceived and carried out by London's Centre for Literacy in Primary Education (CLPE). The intention was to improve the teaching and learning of writing in Years 5 and 6 of the primary school (9–11‐year‐olds), through working with challenging literature. This teacher education project drew on CLPE's earlier research project, published as The Reader in the Writer (Barrs and Cork, 2001). Classroom approaches developed through the initiative are described, and qualitative and quantitative changes in children's writing are discussed. Patterns of teaching in the classrooms that appear to have made a particular difference to the children's achievement are explored.