bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bladder tumour development after urothelial carcinoma of the upper urinary tract is related to primary tumour location
Authors: Zigeuner Richard E. , Hutterer Georg , Chromecki Thomas , Rehak Peter , Langner Cord 
Published: November 2006

OBJECTIVETo better define the predictors of bladder tumour development in patients operated for upper urinary tract urothelial cancer (UT‐UC).PATIENTS AND METHODSSurgical specimens from 191 consecutive patients with no history of bladder cancer and operated for UT‐UC were chosen for analysis. Bladder tumour development was assessed in relation to UT‐UC location, tumour multiplicity, stage and grade, margin status, mode of operation, age and gender.RESULTSOverall, 51 of 191 (27%) patients developed subsequent bladder tumours, including 25 of 123 (20%) with pelvic, 19 of 47 (40%) with ureteric and seven of 21 (33%) with multifocal tumours (P = 0.04 for all subgroups; P = 0.01 for pelvic vs ureteric). There was no influence of the other variables. The median (mean, range) time to recurrence was 12 (18, 3–64) months. In a multivariate analysis, ureteric tumour location was an independent predictor (P = 0.02; risk ratio, RR, 2.0, 95% confidence interval, CI, 1.1–3.7). After excluding 68 patients with systemic disease progression, bladder tumour development was noted in 39 of 123 (32%), including 18 of 76 (24%) with pelvic, 16 of 34 (47%) with ureteric and five of 13 with multifocal tumours (P = 0.06 for all subgroups; P = 0.02 for pelvic vs ureteric). In a multivariate analysis, ureteric location (P = 0.03; RR 2.1, 95% CI 1.1–4.2) and high tumour grade (P = 0.04; RR 2.2, 95% CI  1.03–4.7) were independent predictors of subsequent bladder tumour development.CONCLUSIONThe risk of developing a bladder tumour after surgery for UT‐UC is significantly related to ureteric tumour location and high tumour grade. Clinical trials to evaluate a possible reduction of bladder cancer risk by intraoperative ureteric ligation and/or peri‐operative topical intravesical chemotherapy instillation are justified.
Nephroureterectomy for treating upper urinary tract transitional cell carcinoma: time to change the treatment paradigm?
Authors: Brown Gordon A. , Busby J. Erik , Wood Christopher G. , Pisters Louis L. , Dinney Colin P.N. , Swanson David A. , Grossman H. Barton , Pettaway Curtis A. , Munsell Mark F. , Kamat Ashish M. , Matin Surena F. 
Published: November 2006

OBJECTIVETo evaluate factors associated with disease recurrence and survival in patients undergoing nephroureterectomy for upper urinary tract transitional cell carcinoma (UUT‐TCC) in one centre over an 18‐year period.PATIENTS AND METHODSThe records of patients who had a nephroureterectomy for UUT‐TCC at our institution from 1986 to 2004 were reviewed for clinical, pathological and treatment period data. Cox’s proportional hazards regression model was used to test the statistical significance of several potential prognostic factors for recurrence and survival.RESULTSThe median overall duration of follow‐up was 2.5 years for 184 patients. Significant prognosticators for disease‐specific survival (DSS) by univariate analysis were tumour stage (P < 0.01), tumour grade (P < 0.01), node‐positive disease (P < 0.01), multifocality (P = 0.03), previous cystectomy (P < 0.01) and synchronous bilateral UUT‐TCC (P = 0.02). On multivariate analysis, only tumour stage (P = 0.03) and grade (P = 0.01) correlated with DSS. The median recurrence‐free survival duration was 2.4 years. In 44 patients, the disease recurred outside the bladder; 15 (8.2%) had local recurrence, 20 (10.9%) distant metastasis, and nine (4.9%) both local and distant recurrence. Bladder tumours occurred in 40 (26.1%) patients with no previous cystectomy. The evaluation of treatment outcome during three periods of the study showed no significant effect on DSS.CONCLUSIONTumour stage and grade correlated with DSS in this cohort, with no improvement in outcome over the 18‐year period assessed. Patients with high‐stage and high‐grade disease continue to fare poorly, suggesting a need for changing the treatment protocol. Judiciously applying a multimodal approach to the management of high‐risk patients by incorporating neoadjuvant chemotherapy and surgical resection might provide, for the first time, the opportunity to improve patient outcome.
The association between local atherosclerosis and prostate cancer
Authors: Hager Martina , Mikuz Gregor , Bartsch Georg , Kolbitsch Christian , Moser Patrizia L. 
Published: November 2006

OBJECTIVETo morphometrically compare local atherosclerotic changes in cancerous prostate with those in noncancerous prostate specimens, as epidemiological studies report a positive association between the prevalence of general atherosclerosis and prostate cancer.MATERIALS AND METHODSThe intima‐to‐media‐ratio (IMR) of 538 prostate capsular tissue arteries was measured in 50 prostate cancer‐positive and 29 prostate cancer‐negative specimens (including 26 with benign prostatic hyperplasia and three with normal prostatic tissue).RESULTSAn IMR of >1 was significantly associated with prostate cancer and a greater risk of prostate cancer (odds ratio 2.28). The IMR was >1 in cancer‐positive specimens about twice as often as in cancer‐negative tissue.CONCLUSIONLocal atherosclerosis (measured by the IMR) was more pronounced in prostate cancer‐positive than in prostate cancer‐negative specimens. The results support the view that men with local atherosclerotic lesions are at higher risk of prostate cancer.
A matched‐cohort comparison of laparoscopic cryoablation and laparoscopic partial nephrectomy for treating renal masses
Authors: O’Malley Rebecca L. , Berger Aaron D. , Kanofsky Jamie A. , Phillips Courtney K. , Stifelman Michael , Taneja Samir S. 
Published: November 2006

OBJECTIVETo compare the surgical outcomes of elderly patients with renal masses treated with laparoscopic partial nephrectomy (LPN) or laparoscopic cryoablation (LCA).PATIENTS AND METHODSAll 15 patients who had LCA at the authors’ institution between May 2003 and July 2005 were included, and compared with a matched cohort of 15 patients selected by patient age and tumour size, from a pre‐existing database of 104 patients who had LPN from July 2002 to July 2005. The two groups were compared for gender, number of comorbidities, American Society of Anesthesiologists status (ASA), body mass index (BMI), baseline renal function and haematocrit, location and size of lesion, length of stay, operative time, estimated blood loss (EBL), transfusion rate, number and type of complications, conversion rate, and postoperative renal function and haematocrit.RESULTSThe two groups were similar in age, sex, BMI, ASA, baseline renal function, haematocrit, size and side of tumour, the percentage of exophytic tumours, and the likelihood of more than one comorbidity. Surgical outcomes between the groups were also relatively similar. The length of stay, creatinine and haematocrit levels after surgery did not differ between the groups. The LPN group had a significantly longer operation (248 vs 152 min, P < 0.001) and higher EBL (222 vs 59 mL, P = 0.007) than the LCA group, but only one patient required a transfusion and there was no discernible difference in discharge haematocrit values. No recurrences were detected in either group, with a similar mean follow‐up of 9.8 and 11.9 months, respectively.CONCLUSIONAlthough this matched‐cohort comparison showed that LPN had a higher mean EBL, a longer operation and higher relative risk of open conversion, the overall clinical outcome was similar in terms of complication rates, length of stay and changes in creatinine and haematocrit after surgery. In this small retrospective evaluation, there was similar morbidity, treatment outcome and short‐term efficacy with LCA and LPN. At present, although still experimental, LCA is a good choice for elderly patients with comorbidities precluding blood loss or renal ischaemia. However, in experienced hands, LPN is a preferred option for most elderly patients and should be considered when contemplating definitive treatment of renal masses.
Social Networks and Best Practices in Public Health: The Example of Regional Billing Groups
Authors: Whitmer Deborah A. , Hawley Suzanne R. , Orr Shirley A. , Romain Theresa St. , Molgaard Craig A. 
Published: November 2006

ABSTRACT
Objective: Rising health care costs, increased demand for clinical services, and reimbursement difficulties created a funding shortage among local health departments in the state of Kansas. This intervention established regional billing groups to provide professional support and increase third‐party reimbursement.Design: Through feedback sessions, billing clerks provided qualitative responses about training needs. These informed the process of establishing billing groups in each state health district.Sample: All billing clerks in the state's 6 regional health districts were invited to participate, as were insurance and billing software representatives.Intervention: Between April 2002 and September 2004, 6 collaborative groups were established. Billing clerks received professional support and training from peers, insurance representatives, and software providers. An interagency billing advisory team was established to coordinate training activities between groups.Results: These groups have allowed local health departments to increase reimbursement revenue by 50%–75%, allowing for the provision of expanded health services to client populations.Conclusions: These methods can serve as a model for other states, particularly those with considerable rural populations or decentralized health care systems. Still, funding shortages persist, and public health billing clerks will continue to need ongoing training in the most current and effective billing methods.
Neuropsychological Findings: Myoclonic Astatic Epilepsy (MAE) and Lennox‐Gastaut Syndrome (LGS)
Authors: Filippini Melissa , Boni Antonella , Dazzani Gloria , Guerra Angelo , Gobbi Giuseppe 
Published: November 2006

Summary:  Purpose: To identify a specific neuropsychological profile associated with myoclonic astatic epilepsy (MAE) and Lennox‐Gastaut syndrome (LGS). Methods: Seven patients diagnosed with MAE and four patients diagnosed with LGS were selected from patients referred to our Child Neurology Unit. The patients were assessed both clinically (awake, sleep, Holter EEG, seizures frequency, and semiology) and neuropsychologically (IQ, language, attention, visuospatial and visuomotor abilities, and behavior). One representative case of each syndrome is presented here. Results: The clinical picture of the MAE patient resembled that of an MAE condition associated with transitory epileptic encephalopathy. The neuropsychological findings suggest that electroclinical anomalies can temporarily affect cognitive and behavioral functioning. Early effective antiepileptic drug (AED) treatment was found to improve cognitive outcome. In contrast, LGS was associated with mental retardation, which persisted after seizure control. Conclusions: At present, it remains difficult to delineate a precise neuropsychological profile associated with MAE and LGS. The cognitive outcome of MAE is variable and depends on the clinical pattern. With regard to LGS, the hypothesis of a genetic predisposition underlying both the epilepsy and the mental retardation is still valid. Alternatively, exposure to subclinical electrophysiological anomalies during a critical period of cerebral development may be responsible for the mental retardation. At the time the clinical manifestations appear, drug treatment, even if effective, would have only limited impact on cognitive outcome. However, early multidisciplinary intervention may help to improve behavior and communicative abilities, enhancing the quality of life of these children and their families.
Effect of Microwave Disinfection Procedures on Torsional Bond Strengths of Two Hard Chairside Denture Reline Materials
Authors: Machado Ana Lucia , Breeding Larry C. , Puckett Aaron D. 
Published: November 2006

Purpose: This study evaluated the potential effects of denture base resin water storage time and an effective denture disinfection method (microwave irradiation at 650 W for 6 minutes) on the torsional bond strength between two hard chairside reline resins (GC Reline and New Truliner) and one heat‐polymerizing denture base acrylic resin (Lucitone 199).
Materials and Methods: Cylindrical (30 × 3.9 mm) denture base specimens (n= 160) were stored in water at 37°C (2 or 30 days) before bonding. A section (3.0 mm) was removed from the center of the specimens, surfaces prepared, and the reline materials packed into the space. After polymerization, specimens were divided into four groups (n= 10): Group 1 (G1)—tests performed after bonding; Group 2 (G2)—specimens immersed in water (200 ml) and irradiated twice (650 W for 6 minutes); Group 3 (G3)—specimens irradiated daily until seven cycles of disinfection; Group 4 (G4)—specimens immersed in water (37°C) for 7 days. Specimens were submitted to a torsional test (0.1 Nm/min), and the torsional strengths (MPa) and the mode of failure were recorded. Data from each reline material were analyzed by a two‐way analysis of variance, followed by Neuman‐Keuls test (p= 0.05).
Results: For both Lucitone 199 water storage periods, before bonding to GC Reline resin, the mean torsional strengths of G2 (2 days—138 MPa; 30 days—132 MPa), G3 (2 days—126 MPa; 30 days—130 MPa), and G4 (2 days—130 MPa; 30 days—137 MPa) were significantly higher (p < 0.05) than G1 (2 days—108 MPa; 30 days—115 MPa). Similar results were found for Lucitone 199 specimens bonded to New Truliner resin, with G1 specimens (2 days—73 MPa; 30 days—71 MPa) exhibiting significantly lower mean torsional bond strength (p < 0.05) than G2 (2 day—86 MPa; 30 days—90 MPa), G3 (2 days—82 MPa; 30 days—82 MPa), and G4 specimens (2 days—78 MPa; 30 days—79 MPa). The adhesion of both materials was not affected by water storage time of Lucitone 199 (p > 0.05). GC reline showed a mixed mode of failure (adhesive/cohesive) and New Truliner failed adhesively.
Conclusions: Up to seven microwave disinfection cycles did not decrease the torsional bond strengths between the hard reline resins, GC Reline and New Truliner to the denture base resin Lucitone 199. The effect of additional disinfection cycles on reline material may be clinically significant and requires further study.
Effect of Sintering Temperature on Flexural Properties of Alumina Fiber‐Reinforced, Alumina‐Based Ceramics Prepared by Tape Casting Technique
Authors: Tanimoto Yasuhiro , Nemoto Kimiya 
Published: November 2006

Purpose: The purpose of this study was to investigate the effect of sintering temperature on flexural properties of an alumina fiber‐reinforced, alumina‐based ceramic (alumina‐fiber/alumina composite) prepared by a tape casting technique.
Materials and Methods: The alumina‐based ceramic used a matrix consisting of 60 wt% Al2O3 powder and 40 wt% SiO2‐B2O3 glass powder with the following composition in terms of wt%: 33 SiO2, 32 B2O3, 20 CaO, and 15 MgO. Prepreg sheets of alumina‐fiber/alumina composite in which uniaxial aligned alumina fibers were infiltrated with the alumina‐based matrix were fabricated continuously using a tape casting technique employing a doctor blade system. Four sintering temperatures were investigated: 900°C, 1000°C, 1100°C, and 1200°C, all for 4 hours under atmospheric pressure in a furnace. The surface of the alumina‐fiber/alumina composite after sintering was observed with a field‐emission scanning electron microscope (FE‐SEM). A three‐point bending test was carried out to measure the flexural strength and modulus of alumina‐fiber/alumina composite specimens. In addition, sintered alumina fiber was characterized by X‐ray diffraction (XRD).
Results: FE‐SEM observation showed that alumina‐fiber/alumina composite was confirmed to be densely sintered for all sintering temperatures. Three‐point bending measurement revealed that alumina‐fiber/alumina composite produced at sintering temperatures of 1100°C and 1200°C exhibit flexural strengths lower than those of alumina‐fiber/alumina composite produced at sintering temperatures of 900°C and 1000°C; alumina‐fiber/alumina composite produced at sintering temperatures of 1100°C and 1200°C exhibit flexural moduli lower than that of alumina‐fiber/alumina composite produced at a sintering temperature of 1000°C. Additional XRD pattern of alumina fiber indicated that with increasing sintering temperature, the crystallographic structure of γ‐alumina transformed to mullite.
Conclusions: There were significant differences in the flexural properties between the alumina‐fiber/alumina composite sintered at the four temperatures. This indicates that the choice of optimum sintering temperature is an important factor for successful dental applications of alumina‐fiber/alumina composite developed by the tape casting system.
Transesophageal Echocardiography in the Diagnosis of Thrombosis Associated with Permanent Transvenous Pacemaker Electrodes
Authors: KORKEILA PETRI J. , SARASTE MARKKU K. , NYMAN KAI M. , KOISTINEN JUHANI , LUND JUHA , JUHANI AIRAKSINEN KARL EINO 
Published: November 2006

Objectives: We sought to assess the value of transesophageal echocardiography (TEE) in the diagnosis of PM‐lead‐associated central venous thrombi.
Background: Venous thrombosis is not infrequent after pacemaker (PM) or implantable cardioverter‐defibrillator (ICD) implantation. Previous incidence studies of thrombosis have been based on venography or Doppler ultrasound, but the role of TEE has not been systematically evaluated in this setting.
Methods: Study group comprised 66 consecutive patients (mean age 64 years, 67 % male) referred for implantation of their first PM or ICD and with a successful TEE, transthoracic echocardiography (TTE) and venography at 6 months after implantation. The total number of implanted leads was 110. During the 6 months of clinical follow‐up, nuclear ventilation‐perfusion scan or spiral computed tomography was performed when symptoms aroused a clinical suspicion of PE.
Results: TEE revealed a right atrium (RA) or lower superior vena cava (SVC) thrombus in 6 (9%) patients. These thrombi were not visualized by TTE or venography. Additionally, 12 (20%) patients were found to have venographic subclavian or innominate vein thrombi, but none of those could be diagnosed with TEE. Symptomatic pulmonary embolism (PE) was diagnosed in two and an asymptomatic PE in one individual and two of these occurred among the six patients with a thrombus in TEE. No clinical predictors for thrombosis were found.
Conclusions: TEE is an excellent method to visualize electrodes within the RA and proximal SVC. Electrode‐associated RA thrombi appear to be relatively common after PM implantation, and they may remain undetectable by venography or TTE. Although these thrombi are mostly asymptomatic, they can give rise to pulmonary embolism and should also be kept in mind in the differential diagnosis of endocarditis. TEE is the method of choice for the diagnosis of these lesions.
Wavelet‐Based Tachycardia Discrimination in ICDs: Impact of Posture and Electrogram Configuration
Authors: WOLBER THOMAS , BINGGELI CHRISTIAN , HOLZMEISTER JOHANNES , BRUNCKHORST CORINNA , STROBEL ULLA , BOES CLAUDIA , MOSER RAY , BECKER DANIEL , DURU FIRAT 
Published: November 2006

Background: Inappropriate therapy delivery is an important concern in the management of patients with implantable cardioverter defibrillators (ICDs). Recently, a morphology‐based algorithm (wavelet feature) has been introduced for differentiation of ventricular and supraventricular tachycardia. In this study, we evaluated the performance of the wavelet algorithm using various electrogram (EGM) configurations during different body positions.
Methods: Patients with a single‐chamber Medtronic model 7230 ICD (Minneapolis, MN, USA) and a double‐coil lead were included. EGM templates were collected during baseline rhythm in supine position for different EGM sources (right ventricular [RV] coil‐can, RV coil‐superior vena cava [SVC] coil, tip‐ring, SVC coil‐can). For each EGM configuration, morphologic similarity (match percentage) of EGMs obtained during different body positions (supine, left and right lateral, sitting, standing, walking) were compared with the templates.
Results: Twenty‐eight patients (24 males; age 58 ± 17 years) were studied. A total of 9,775 intracardiac EGMs were analyzed. Median match percentage (interquartile range) was 88% (85–94), 88% (82–94), 82% (76–88), and 73 (58–85) for the RV coil‐can, RV coil‐SVC coil, tip‐ring, and SVC coil‐can configurations, respectively. Correct classification rates, as defined by match percentage of 70% or higher, were significantly higher with the RV coil‐can, RV coil‐SVC coil, and tip‐ring EGM configurations, as compared to the SVC coil‐can configuration (95, 91, and 91 vs 58%≥70% match percent, P < 0.001).
Conclusion: Wavelet‐based morphology scores in ICDs may change with various body positions. These variations are relatively minor using the nominal configuration (RV coil‐can), as well as by using RV coil‐SVC coil and tip‐ring. However, morphology scores can vary considerably when SVC coil‐can is used; therefore, this configuration should be avoided while using the wavelet algorithm.
Use of platelet‐rich plasma under autogenous onlay bone grafts
Authors: Miranda Sandra Regina , Filho Hugo Nary , Marques Padovan Luís Eduardo , Ribeiro Daniel Araki , Nicolielo Daniela , Matsumoto Mariza Akemi 
Published: November 2006

AbstractObjectives: To analyze the healing of autogenous onlay bone grafts in three different situations, focusing on the interface area.Material and methods: Sixteen rabbits underwent autogenous bone graft surgeries in the calvaria. The block bone grafts were positioned in three different situations: direct contact between bone graft and receptor bed, graft interposed by particulate bone, and graft interposed by platelet‐rich plasma (PRP). After 7, 15, 30, and 60 days, the specimens were retrieved for histological and morphometric evaluation.Results: All groups healed uneventfully and presented incorporation of the grafts after 30 days. A slightly more evident new bone formation could be observed in the PRP group in the first analyzed period, and an earlier maturation of bone in the last period, although no statistically significant differences were achieved.Conclusion: The use of additional material between the bone graft and the receptor bed when using the onlay technique must be carefully considered, taking into account the size of the reconstruction and the cost/benefit relation. The addition of PRP in between autogenous bone blocks and the receptor bed did not confer significant benefit for the new bone formation and healing on the calvaria of bone of rabbits.